This is my first visit to this site and hoping that someone can ease my frustrations a little. I had my 3rd major(2000 graph) HT last Summer, and have not realy noticed much new growth this time.

I've been pleased with the previous two procedures, but a little frustrated with this last one. I've only noticed a couple new graphs coming through. I noticed them a couple months into the procedure, but they are only about 1 to 2 cms off my scalp and haven't grown much at all in the last 5 to 6 months and I have not seen any additional graphs coming through.

Is it possible for some patients to not experience much growth well into 9 or 10 months after the procedure? I'm sure there are other graphs farther back into my scalp that may be coming through that I can't see, but it is minimal if it exists at all.

Also, I'm wandering if I'm getting the best bang for my buck. I've been happy with the look/feel of the new growth, but since my hair loss was relatively minimal to begin with I don't understand why it has taken so many procedures and I'm still not happy. I can't imagine how many it would take for someone with significant hair loss.

Can anyone comment on how a patient could try to get a honest opinion as to how many graphs/procedures it should honestly take to get to their desired results? I guess I just want to know how many times it should take so I'm not disappointed each time...

Perhaps that is too much to ask, but thought I would see who else may have experienced the same frustrations....

Looking forward to your responses!

Ask your doc. Same as first two?

C78, is this your 3rd HT all in the same place, or is this in the crown, etc... Also, who is your doc? In addition, why have you had 3 surgeries and it still sounds as if you are planning on having more?????

My first procedure was a minor one of about 200 graphs performed by Robert Thomas Medical in KC. They are no longer in business in this area.

The last three procedures were done by Dr. Ken Buchwach. All of the procedures were done at the front of my head. The first major procedure was to bring my hairline down, and the second two were to fill it in. The doctor thought that I should be happy after the third procedure and not need anything additional.

So far I have not noticed much additional growth from my third procedure. Unless that changes significantly, then I will plan on have another procedure until I'm completely happy.

Do you have any photos you can post up, It would really help alot of people if we could see pictures of how you are now and what you looked like before your 3 HT's. I just had my second HT, but with my first HT, I had not noticed any growth up to 3 to 4 months, and around 9 to 10 months it really started to kick in for me.

I don't have any pictures currently, but could work on that if needed.

I went ahead and scheduled an appointment with Dr. Buchwach on Wed. so I can post his comments later this week.

There can be times when growth is delayed growth in subsequent sessions.This may be due to various factors such as changes in vascular supply or the effects of localized scarring/ The issue of localized scarring is probably more relevant when larger (non follicular unit grafts) are utilized.
I would suggest speaking with your doctor and voicing your concerns. It may be helpful to review photos and discern your starting point.

In terms of grafts required for a particular area I have found that patients are often very pleased with an ultimate density of 30-40 FUs per sq cm behind the frontal hairline area. In the frontal hairline zone I often utilize densities of 50+ FUs per sq cm. The result will of course depend on hair characterisitics such as caliber and curl and color etc. A great deal also depends on the amount of donor available and the area to be covered. In some instances the density can be increased further. The surgeon must remain aware of the possible progression of hairloss in the future and plan accordingly.

Paul T Rose, MD, JD
President ISHRS
thehairlosscure.com
612 965 4247
2919 West Swann Ave
Tampa, Fl 33609

Thanks to everyone that responded to my questions. I had my visit with Dr. Buchwach earlier today. He definately eased my concerns.

First, I must correct myself. I've had 3 (what I would call) major HT procedures, but I only received between 800 and 1200 graphs each time. The Dr. stated that due to the density of my hair, that he is unable to do more graphs than that.

We did look at pictures together and I could see where it was possible that some graphs did grow that I didn't notice. However, we both agreed that the last procedure didn't provide the results we were both expecting. He stated that it could be due to receiving mostly 1 hair graphs than 2/3 hair graphs.

He offered a discounted session for me next month in which he would do as many graphs as possible given my density,etc.

As stated before, I would certainly recommend Dr. Buchwach to anyone.

I'm still curious to know if I might experience additional growth from my last procedure as Dr. Rose suggested was possible. Dr. Buchwach didn't seem to think it was likely.

Thanks again!

I would like to know what your donor density is, and why it is limiting your session size to 800-1200 grafts a session? Hell, a donor density of 80 fu's per cm/2 and a 20 cm strip (mine was 28cm long) will yield 1600 grafts!!!! I am just a little concerned with the 3 and 4 sessions that are not having a major impact. I also dislike the fact that you were not aware of your session sizes, etc.... I think that is the Dr's responsibility and his or her consultant's JOB to impress upon you EXACTLY what type of results and why the doctor is operating in this manner. I am not casting stones, because I believe Dr. Buchwach does solid work.

I'm not sure how to answer your question regarding my donor density. Is that something the doctor should be telling me precisely? All I've heard is that I'm not a good candidate for a larger amount of graphs. He also mentioned that the larger number of graphs doesn't necessarily mean more hair if you are only getting one hair per graph instead of two or three. I understand that, but don't know that someone getting 3000 graphs isn't also getting 2 to 3 hairs per graph.

They actually did tell me the number of graphs for each procedure, but for some reason I doubled that in my head so I do think they did their job in that respect.

Overall - I just want this to be done and I feel like I'm almost there, but want to know if this will be my last procedure. The Dr. thought I would be happy after the last procedure and potentially not need another one.

So far that is not the case.

Cory, your doctor should be able to measure your donor density (roughly)in order to estimate your session size and what size strip to excise.
Call your doctor and find out the size of the donor strip he took and let us know, along with the amount of grafts per session, that will allow us to approximate your density.
Just a thought.