Colorado42's - Profile page My hair transplant with Dr H Rahal

Posted :8/10/2010

I am
a forty year old male with progressive onset of thinning
hair. Last week (August 2010), I underwent a hair transplant operation of
approximately 4000 grafts with the goal of restoring some former glory to my
head and hair.
While
I have not yet come to the end of my transplant journey (only having undergone this week), I feel there is merit in documenting my progress moving forward
– both in writing and through images.
I hope
this text may assist other people seeking information about hair transplants in
the future. For me, it was invaluable to be able to educate myself by
conducting research on a number of hair loss websites. I am very grateful to
the people that took the time to write their thoughts and insights down, as
these helped me make an informed decision about whether or not to proceed. I
would like to contribute to the topic as a gesture of thanks.
My
history of hair loss:
I
first began noticing that my hair was thinning at around the age of 34. I’m
sure it was thinning out before then but this was perhaps the tipping point. I
have always had fine hair, but in enough quantity to not have a problem. At
first I noticed that I could see my scalp when my hair got wet after a shower
or swimming in a pool. Around a year later, I obtained a hair thickening gel
from my hairdresser that delivered excellent results (now discontinued) – the
product used beeswax to give the hairs more bulk.
At
thirty five, the situation had deteriorated to the point where I sought advice
from a large corporate hairloss company. This company used very hard sell
tactics to get me onboard and, in my humble opinion did not deliver
substantially more than I could have found by surfing the web and ordering
products online. Ultimately, they charged me over $4500 to provide a quantity
of Saw Palemetto extract, shampoo, conditioner, a topical liquid vitamin hair
bath, their topical solution (a 7% Minoxidil compound with Retin A added), a
prescription for Proscar and some laser treatments.
I
used everything the company supplied except the Proscar. I didn’t want to use
that product (for no specific reason except that I didn’t particularly want
to).  It felt a bit heavy duty to
go from doing very little with regard to my hair care to suddenly, taking
tablets, applying solutions morning and night, washing my hair with custom
products, having laser treatments etc…  All in an effort to hold this genetic predisposition to
baldness at bay. Regardless, I carried on and to the hair loss company’s
credit, within a few months, these products not only stalled the deterioration
of hair loss, my hair grew back thicker and stronger like before.
This
went on for around a year and when I went to reorder the Minoxidil solution,
their price was $1500 for a years worth of product. I thought that was a bit
steep so I decided to purchase the 5% Rogaine solution and used that for the
next few years.
By
age 38, the Rogaine was starting to have less and less effect. Standing under
bright lights would make be feel uncomfortable and I took to wearing hats more
and more often.
Finally,
last year (39), I decided to throw in the towel, I cut my hair short and stopped
applying the Rogaine as its effectiveness had become quite marginal.
I
had never really considered hair transplants seriously as I had seen examples
of this procedure in the 1990’s and for whatever reason mentally associated
HT’s with things like “plugs” and nasty artificial looking hairlines.
I
came across a website quite by accident one day that showed some modern
examples of hair transplants and was highly impressed. What appealed to me was
the concept that a hair transplant could offer a much lower maintenance
solution to this problem as the transplanted hairs from the back of ones head
are not as susceptible to the balding condition as the ones on top.
I
found a few websites that contained really helpful and informative info on hair
loss and transplants and from there decided to contact a few firms and see if I
was a potential candidate for this procedure.
One
of the significant things I learned from my research was that one shouldn’t
choose a hair transplant firm based on price, marketing or distance. Initially,
I had contacted a local company to talk about the viability of a hair
transplant as all the photos on their website looked very good. I read from a
post on an independent hairloss website that the photos from this firm hadn’t
changed in over seven years! If their results were so amazing, why weren’t they
posting images of their success stories more frequently? This fact made me
question how successful the firm was and I decided to look further afield for
my solution as I wanted the best result possible with the least chance of
problems in the future.
I took
a number of photographs of my head and sent them off to a few hairloss sites overseas
and received similar assessments: that I was in need of a transplant in the
range of approximately 4000 grafts, with possible additional smaller surgeries
in the future.
My
search narrowed to a couple of firms in Canada. Both companies had a great
reputation and handled my enquiries in a most professional manner. Their
pricing model was similar (one was more competitive quoting in Canadian
currency while the other was quoting in US currency).  Both firms were very highly regarded on multiple hairloss
websites so for me, it came down to the individual surgeons and their artistic
talent regarding density and hairlines.
Repeatedly,
I came across people expressing high regard for Dr Rahal’s work in Ottawa.
Multiple testimonials praising the hairlines and teamwork at the Rahal Hair
Institute and my own personal long distance interaction with their team
convinced me to book a surgery and at least go to the facility and meet the
team face to face to then make a decision to proceed if a personal consultation
proved fruitful.
I
was advised to do a series of scalp laxity exercises to attain the 4000 graft
level and I began these around four months prior to the surgery. I did thirty
minutes of these exercises each evening and as often as I could in the mornings
when possible.


Hair graft mapping


Pre-op on day of surgery


In early August 2010, my fiancé and I decided to go together and departed for Canada. We arrived in Ottawa a few days before the scheduled consultation and surgery.

My partner and I went to my consultation with Dr Rahal a day before the scheduled surgery with a list of questions for him. It was very important that Dr Rahal instil me with confidence that my individual case was a good candidate for hair transplant surgery and that I understood what the realistic outcome would be for me in addition to a detailed discussion about the possible negative consequences associated with the procedure.  I found it helpful that my fiancé attended as well so that both of us could ask questions to make an educated decision about whether to proceed. Dr Rahal spoke to us at length and with a friendly attitude that was very much appreciated. We spoke about what my expectations for the surgery were and outlined what he felt the outcome would be. I showed Dr Rahal two drivers license photos of myself: one from 2007 and one from 2010. These two images showed quite clearly that there had been a significant change in the time between them.  Dr Rahal explained what he considered the realistic outcome would be and we were both satisfied. After this worthwhile discussion, my partner and I both felt much more comfortable and decided to proceed with the surgery.

I arrived at the facility at 9:30am the next day and again met with Dr Rahal. During this consultation we discussed where the hairline would start and I let Dr Rahal make the decision based on his experience where this should be. Dr Rahal then drew out a map of the placement of the donor grafts on my head and from there we went to a small room to take a series of pre surgery photos. I was then asked to exchange my shirt for a gown while keeping my jeans and shoes on.

I was led into an operating room to be given an injection and a few pills to take for pain and nausea. I was connected to a blood pressure monitor and the donor and recipient areas were then shaved.

The areas on my head were then prepped for the procedure and Dr Rahal began injecting a freezing agent at various points over my head. This part of the process for me was probably the only part that I felt a bit of pain. After the freezing agent took hold, the donor hair was removed and the dissection team (around eight people) began removing the hair follicles from the pieces taken from my donor area. The doctor put in some sutures to fuse the donor area together. Dr Rahal then began creating lots of little slits in my head to insert the grafts into. During this phase we had a nice conversation about a range of topics and this took my mind off the procedure entirely. Both Dr Rahal and his medical team went to great lengths to ensure I was comfortable and feeling well during the procedure. This care and attention was greatly appreciated.

From here, the medical team began the transplantation process with grafts being relocated into their new home on top of my head. As I was having a 4000 graft transplant, this process took some time to complete. A few times during the procedure, additional freezing agent was administered and I would say that the hardest part of the procedure for me was trying to sit as still as possible while the transplant was taking place. I was provided a tasty sandwich for lunch and I watched a few movies in the afternoon. I did sleep a little in the afternoon but not much.

In total, Dr Rahal was able to transplant 3918 grafts out of an anticipated 4000 and apparently I am fortunate in that 803 of those grafts contained three hairs, 2460 had two hairs and 655 of the grafts contained single hairs.

At around 7pm, the procedure was completed and my head was bandaged. My fiancé then arrived to pick me up and both Dr Rahal and his head nurse went through the medication they supplied (pain killers, anti inflammatory and antibiotics) and explained what to do. They also provided us with a detailed instruction guide for both the medication and postoperative requirements. Although there was a range of pain medications available to me, I was only feeling a little nausea and a slight headache so I opted to take two Tylenol 3 tablets and a nausea tablet. A packaged hot dinner was provided for us to take with us and I thought it was a really nice touch that Dr Rahal’s team included two dinners for both my partner and me instead of just one.

I traveled to where we were staying and ate dinner and then went to bed. All things considered, I felt pretty good and had to remind myself that it was over! I slept on a 45 degree angle (and continued to do so for five nights) and also used a travel pillow. I’m still using this pillow each night when I sleep and recommend it highly as it lifts the head up high enough to not lay on the sutures (which causes me a bit of