I started losing my hair, in the typical male pattern baldness around 40. It was very gradual, just in front at first, but then over the years the full receding hairline in the front as well as losing hair at the crown.
I wouldn't say it bugged me a lot - but it bugged me a little. Especially the crown as I had to always remember to wear hats, sunscreen or sunburned the top of my head all the time.
So it's been on the list to look into doing something about it for... 14 years now.
A decade ago I tried Rogaine for a few months - but the daily application didn't really stick, and also left with a bit of a burning sensation/sensitivity.
This year, I turned 54, on a bit of a work hiatus, so had a good window of time to look into it more seriously.
Researched various options on my own, and scheduled consults with 4 providers in the Seattle area. Landed on Advanced Hair Restoration in Bellevue. All recommended starting something to protect the "adjacent hair" which was all still good. So started in on Propecia/Finesteride through my GP - which I should have started 14 years ago to protect hair I had. I kinda thought maybe it would stop falling out... wishful thinking. :)
Everything about the experience with AHR was great. Starting with the easy initial consult with Steven - which I scheduled for the next day online. He took time to explain the whole procedure carefully, took nice pics in their studio, and curated some good before/after shots to give me a good sense of how it would go. Answered many of my questions about success rate or transplanted hair (95%+), anesthesia (local lidocaine), what to expect post surgery, side effects they see.
Then he brought in Dr. Allan Parungao so I could meet with him also. Immediately felt at ease with Dr. Parungao - and felt like I was in the hands of both a great doctor, but also artist who was thinking about hairline, how the crown should be shaped, and other aspects to make sure I was happy with the result.
After having 4 consults with other providers, thought about now or later in 2024... and decided, now was the time I have for a pretty easy 7-10 day recovery. So let steve know, paid the deposit, and scheduled for the 25th of October.
The professionalism of the team at AHR was amazing from start to finish. They called a week prior to go over pre-op steps (which were minor, don't drink the night before mainly). And then also all the post-op steps. That call was comforting, answered all remaining questions.
There were literally 12 people assigned to work with me during the day in various roles. All were super kind, professional, and were very experienced and well trained.
So this was a fairly long day - I think was 9h end-to-end - but it went by in several stages:
-- 7:30 arrival, completed paperwork (which they had provided ahead of time to read) and paid. Did a debrief of the day with Dr. Parungao, and he drew in the hairline, donor areas, and went over the game plan.
-- Went back to the barber... got a full head shave, which I had never done before. He was funny, and said "everyone should see themselves fully bald sometime" which was true. Didn't look as bad as I had imagined.
-- 8:30 Moved into main surgery room where I spent the day. First nurse did the lidocane to numb my scalp (about 15 shots of it). So like the dentist when getting a filing - This was probably the worst bit - wasn't bad at all, just a couple spots that stung. And after that... felt like I had a helmet on, scalp was totally numb. She said that was the worst part, and it was.
-- Dr. Parungao then came in and made the 3,000 transplant holes in my scalp. The transplanted hair slides into these spots at whatever angles he sets. Seems to be the artistry part. Took maybe 15m to do them all.
-- Then the donor extraction team came in, the FUE machine was fired up, and they removed 3000 hairs from the donor area. This took a couple hours. There was a team of 4 folks who received the extracted hairs looked at them under microscopes to make sure they were good to implant, and seemed to put them into trays for the next part. This all took about 2.5 hours of little drill/extract. It didn't hurt at all - but I probably would have worn earbuds (which was an option) so not listening to the little buzz. I got up a couple times to go to the bathroom, was always a natural pause point to take a break.
--- then then brought me a nice lunch of #4 with Cheese from Jimmy Johns, which is exactly what I wanted!
-- Then in the afternoon a team of 4 took over the implants with lead nurse directing, and carefully placed the hair to its new home. I was sitting up for all this part, so just watched a couple netflix shows.
-- Dr. checked on me at the end, and made sure all looked good. Got a cool surgical hat for the drive home, and went for a coffee!
PostOp
- First 3 nights were fine, very little pain - main hard thing was trying to not sleep on the transplanted hair - so sleeping on an angle, and had a airplane pillow so could sort of sleep on one cheek and keep weight off. So not perfect sleep, but also got some rest.
- Went back next day to remove the bandage and do a first wash with the team there.
... and now just waiting for it to all grow back. Will post a few progress photos.
Updated on 3 Nov 2023:
Surprised by how fast this all healed up, and also how fast hair grows in a week!
Took a week to get full sensation back in scalp (just a bit numb feeling in spots), and the transplant area had a bit of tightness to it - just the those 3000 little scabs felt tight like a road rash on my head.
But took a few ibuprofen for the first 4 days, nothing after that.
Updated on 9 Nov 2023:
Two weeks since procedure today.
All of the scabs at transplant areas are gone, slight redness, but not really noticeable. Transplants all seem very solid now, able to wash hair like normal, back to working out, etc. The donor area in the back has all grown over. The hair in back/sides grows faster than on top - so doubt it'll come back evenly, but a haircut will fix that in a couple months.
But been venturing out in public without a hat, just a nice crewcut. Will post another update at 1 month.
Updated on 26 Nov 2023:
4 weeks since procedure was completed. The back and sides have fully grown in. Many of the transplanted hairs have now fallen out, which was expected shock loss. But they should grow new hair now in a couple months.
Went to Thanksgiving, and no one in the family really even noticed/commented since I usually wore my hair pretty short anyway. Which is impressive from where it was just a month ago. I think it looks a bit worse than before the procedure - because I have the full stripe down the middle on my crown (where it was grown over better before). Especially from a distance and with overhead lights - as the new/existing hair is still very thin. But it's there, and growing... slowly.
Updated on 8 Dec 2023:
Most of the transplanted hairs have fallen out, though can still see where there are hair follicles and the scalp area is a little more red. Donor areas and sides are all growing back in. Comparing the pre-op back photo to today - they are pretty similar, just a little bit more gray I think coming in.
Most noticeable to me from the straight on front view - look more bald than before, as that top area is growing slow. Excited for it to fill in a bit more.
Updated on 18 Jan 2024:
Today is 3 months since the FUE transplant surgery. Parting words from my Dr. were to be patient - will be 6 months before really noticing a difference. Today, pretty much back to where I started. I did get my first hair cut about 4 weeks ago, and likely will continue to keep it kinda short, to let the growth at different rates catch up.
I have had a few ingrown hairs along the way (showing as red bumps). And noticing crown area now feels "fuzzy" which I hope are new baby hairs.
Updated on 25 Feb 2024:
Hair is all starting to fill back in - I had to buy a comb - which was an exciting moment. All looking natural, and blending in as it grows. Facing front view, I had forgotten what I looked like without a receding hairline. And the crown which was fully bald at the beginning, starting to really fill in.
Updated on 27 Mar 2024:
Hair is starting to fill in nicely. The front is a slightly different texture - sort of more curly as well - than the rest, but was told that is to be expected and it will become more straight/normalized as it grows further. The crown area is starting to really look great - added two pictures, as in more natural light barely look bald anymore. The bright LED lights from the bathroom mirror reflect more scalp through but even in that photo hair is filling in.
I was told that 6 months would be a real turning point, and that seems to be the case. And after 12 months is when it will actually all be back. I was a bit of a skeptic - fascinating that it is actually working! :)
Updated on 25 Apr 2024:
This is right after a haircut, so very short. Can see how well hair has come back on top, in front and back of crown is almost all filled back in. The texture of the new hair is still a little different than the rest, but that's supposed to normalize over time.
Updated on 27 Aug 2024:
Pretty much all filled in at this point, and noticed the texture of the hair changing slightly (less curly than it was at first). Some slightly thin areas in the middle top - those were were not transplanted areas. Minor.
Updated on 28 Oct 2024:
This is the results after one year. Some before/after photos done by AHR. Turned out great, I keep it pretty short, but would cover even more if longer. A little spot in the crown - but seems very natural whorl and normal 55 year old look. Happy I did it, and was a great experience - probably last post on this one.