# Hair Transplants > Hair Transplant: Start Your Own Topic >  Procedure Booked w/ Dr. Rahal (2nd transplant)

## win200

Hey all,

Excited that I've booked my second transplant for this June.  I received 1,450 on 6/20/12 from Dr. Niedbalski in Seattle, and almost two years to the day later I'll be doing 1,500 with Dr. Rahal to increase density at the front, soften the hairline, and lower the temples.  I'm happy with my result, but I don't believe I've lost any ground behind the grafts, and I'm treating aggressively with finasteride, dutasteride (.5mg daily, plus a once-a-week blast of 2.5mg), minoxidil, RU, and the usual vitamins.  I'm 31, FYI.  Some pre-op pics, when I was 29, are included as well as some I took today.

The thread about my first surgery is here:  http://www.baldtruthtalk.com/showthread.php?t=9370

I realize this is a relatively aggressive transplant strategy, but it's what I want.  I haven't much cared for the strong widow's peak and would like it minimized, and I can't wait for Dr. Rahal to do his hairline magic.

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## Jazz1

Wow nice, don't me me asking which country you from, before choosing Rahsl did you fly out for a consultation?

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## win200

> Wow nice, don't me me asking which country you from, before choosing Rahsl did you fly out for a consultation?


 I'm from Seattle.  I didn't fly out to Rahal for the consult; obviously that's ideal, but I wasn't going to go through that hassle just to do it again.  I'm very familiar with his work and approach, so I just wanted to confirm that he thought my preferred approach was reasonable, which he did. 3,000 cumulative grafts in the hairline is a lot, and some docs would probably balk at that.

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## Jazz1

> I'm from Seattle.  I didn't fly out to Rahal for the consult; obviously that's ideal, but I wasn't going to go through that hassle just to do it again.  I'm very familiar with his work and approach, so I just wanted to confirm that he thought my preferred approach was reasonable, which he did. 3,000 cumulative grafts in the hairline is a lot, and some docs would probably balk at that.


 Nice, how did he figure your graft count? Pictures? Online consultation? Don't mind me asking the cost?

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## yeahyeahyeah

> I'm from Seattle.  I didn't fly out to Rahal for the consult; obviously that's ideal, but I wasn't going to go through that hassle just to do it again.  I'm very familiar with his work and approach, so I just wanted to confirm that he thought my preferred approach was reasonable, which he did. 3,000 cumulative grafts in the hairline is a lot, and some docs would probably balk at that.


 Your hairstyle reminds me of Chris Issak.

Actually suits you really well. But I can understand why you want to lower your hairline.

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## Notcoolanymore

Damn yeahyeahyeah, you are hitting these transplant threads hard.  We gotta get you in to that chair.

win200, your hair looks great.  Good luck with your latest and future procedures.

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## win200

> Nice, how did he figure your graft count? Pictures? Online consultation? Don't mind me asking the cost?


 I sent in pictures plus an explanation of what I was looking for.  I said I wanted to keep the graft count 1,500 or under, because I think using more than 3k on the hairline starts to get reckless.  He thought 1,500 more grafts would lower the corners and be sufficient to do a very dense pack.  That's a lot of grafts to go into a hairline, so it should look very close to full density.

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## win200

> Damn yeahyeahyeah, you are hitting these transplant threads hard.  We gotta get you in to that chair.
> 
> win200, your hair looks great.  Good luck with your latest and future procedures.


 Thanks!  I'm pleased with what I've got, but of course that's not stopping me from going back under the knife.

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## win200

> Your hairstyle reminds me of Chris Issak.
> 
> Actually suits you really well. But I can understand why you want to lower your hairline.


 Yeah--I'm pretty graft-greedy.  I do like the style I've got, and was a bit on the fence about whether to bother changing it.  I mean, I'm probably in NW 1 territory at this point.  But I'd like to whittle away at the tops of the temples and create a straighter hairline.  I may live to regret this, but whatever.

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## Jazz1

Thanks man, last question how much RU are you using? What vehicle?

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## win200

> Thanks man, last question how much RU are you using? What vehicle?


 100mg/daily for now with a 70% everclear/30% PG vehicle.  Probably gonna reduce the dosage.  Only been using for a few weeks, haven't noticed much of a difference yet.  The problem is that my original hairline is buried within my transplanted one, so it's really difficult to detect regrowth or thickening.  That's one of the downsides of a transplant--it becomes much harder to keep an eye on your loss.

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## Jazz1

> 100mg/daily for now with a 70&#37; everclear/30% PG vehicle.  Probably gonna reduce the dosage.  Only been using for a few weeks, haven't noticed much of a difference yet.  The problem is that my original hairline is buried within my transplanted one, so it's really difficult to detect regrowth or thickening.  That's one of the downsides of a transplant--it becomes much harder to keep an eye on your loss.


 Nice, is that from Kane? I have RU as back up in my fridge with kb solution and also dut as back. Looking Close up you have some fine hairs at the temples etc. Im going use Dr feriduni or Rahal for tansplant. My hairline was so perfect until recently I decided to added saw palmetto, it ruined my hairline and made me horny. I'm starting promox spray next month I'm going to give it few months if I don't see my hairs come back I'm getting transplant, I love Rahal work, amazing.

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## win200

> Nice, is that from Kane? Close up you have some fine hairs at the temples etc. Im going use Dr feriduni or Rahal for tansplant.


 Yup, from Kane.  The fine hairs at the hairline started when I got on minoxidil, but they've become more numerous and a bit thicker lately.  The picture doesn't really capture them well.

I agree that Feriduni and Rahal are among the best for hairlines.  Feller should be on that list, too.

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## yeahyeahyeah

> Damn yeahyeahyeah, you are hitting these transplant threads hard.  We gotta get you in to that chair.
> 
> win200, your hair looks great.  Good luck with your latest and future procedures.


 Thinking of getting my hairline fixed.

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## yeahyeahyeah

> Yeah--I'm pretty graft-greedy.  I do like the style I've got, and was a bit on the fence about whether to bother changing it.  I mean, I'm probably in NW 1 territory at this point.  But I'd like to whittle away at the tops of the temples and create a straighter hairline.  I may live to regret this, but whatever.


 Why are using dut if fin is working?

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## win200

> Why are using dut if fin is working?


 Well, couple reasons.  First, there's still some shedding.  I get roughly 8-15 hairs on my hands when I shower, and about the same amount when I do my minoxidil application at night.  This could all be just normal shedding--I have no idea.  Most of the hairs don't seem to be miniaturized.  Also, as I mentioned earlier on here, I can't tell if my hairline has continued to recede because my hairline is now transplanted, which hides any recession.  It doesn't _look_ like there's been any change, but I'm a slow receder, so I could be losing ground just at a gradual rate.

I also don't think there's much--if any--downside to going onto dut.  I tolerated fin extremely well, so I think my side effect potential is pretty minimal.  And as we all know, it's exponentially easier to keep hair on your head in the first place rather than try to get it back after it's been lost.  I don't want to get five years down the line and wonder if I'd be in a better position if I'd opted for the more potent drug from the outset.  Maybe my hair will look like shit in eight, ten years, but at least I'll know that I did everything I could.

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## win200

> Thinking of getting my hairline fixed.


 Is there a link to your pics somewhere on here?

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## mkamph

I gotta say that Dr. Niedbalski did some excellent work on the original transplant.  I know pics don't always tell the whole story, but it looks undetectable.

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## win200

> I gotta say that Dr. Niedbalski did some excellent work on the original transplant.  I know pics don't always tell the whole story, but it looks undetectable.


 Thanks!  No, I'd say the pics do it justice here.  My desire for a second transplant is in no way a reflection on Dr. Niedbalski's work, which was excellent.  No one--not even my parents or best friends--realized I had a transplant.  (Both my parents did ask if I'd dyed my hair, as the transplanted hair grew in much darker than the native hair behind it--like black as compared to medium brown.)

This is actually the only factor that's caused me a little pause about getting a second transplant--whether it's stupid to mess with a great result.  There's always the risk that Dr. Rahal could transplant the hairline lower and and more to my liking in that respect, but I get a less natural result or something else goes wrong in the process, and I end up worse off when all is said and done.  I figured that the odds of that happening in Dr. Rahal's hands are pretty slim.  But willing to hear thoughts on that front.

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## Dan26

My honest opinion man....

Wait a full year and if you still feel/want to have it done then go for it.

You obviously dont 'need' it, but at the same time going for it just because you want it is no big deal as your loss is stabilized.

Good luck bro.

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## topcat

What you plan on doing is extremely foolish. If you do not lose another head on your head it might workout for you otherwise you will absolutely be screwed in a few years. The hair behind the hairline should be thicker then the hair in front of it as that is the natural balding process and what looks normal. If you do not have the donor to continue this pattern it will look completely abnormal and its not a matter of if only a matter of when.

You are using a high percentage of donor on a small percentage of hair loss area, in the end the math usually does not add up. Hope you know what you are doing. You will not be the first nor the last who has been given poor advice, so you will not be alone.

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## win200

> What you plan on doing is extremely foolish. If you do not lose another head on your head it might workout for you otherwise you will absolutely be screwed in a few years. The hair behind the hairline should be thicker then the hair in front of it as that is the natural balding process and what looks normal. If you do not have the donor to continue this pattern it will look completely abnormal and its not a matter of if only a matter of when.
> 
> You are using a high percentage of donor on a small percentage of hair loss area, in the end the math usually does not add up. Hope you know what you are doing. You will not be the first nor the last who has been given poor advice, so you will not be alone.


 I definitely appreciate the thought, and it's something I've considered.  One thing I took into account is my age and rate of recession.  While 31 isn't "old," it's not "young, necessarily, in terms of hairloss.  I'm not one of the 24 year olds on these boards.  I've always receded very slowly, and I can't find any evidence that that recession has continued since my surgery in 2012.  I'm treating as aggressively as possible, so I'm not jumping off without a net.  For example, there have been numerous 20-somethings on this forum that have used ~2,200 grafts for a NW2-3 *without* being on a DHT inhibitor.  To me, at least, that's far riskier than what I'm doing.

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## Jazz1

I say go for it, hopefully future technology might get better or just shave it, at least by doing this your moving on in life, it's too short just get it done and move on be happy. I would have done the same going for perfection, will make me more happy, at least what your doing is what you feel right.

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## yeahyeahyeah

> I say go for it, hopefully future technology might get better or just shave it, at least by doing this your moving on in life, it's too short just get it done and move on be happy. I would have done the same going for perfection, will make me more happy, at least what your doing is what you feel right.


 He looks great already to be honest.

My hairstyle/hairline is like his, but the difference is, mine doesnt suit my face, his does.

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## rev3

wow!

great result

once the corners are in it will be complete

good luck!

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## win200

> wow!
> 
> great result
> 
> once the corners are in it will be complete
> 
> good luck!


 Thanks--I agree!  Just makes me with that I'd gone a little lower in the original, but oh well.  I think it looks like a knockout head-on, but the higher corners show a little more when viewed from the side, and the right temple is a bit higher than the left--that'll even out.  More pics below.

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## topcat

Ask all these guys that are telling you to go for it to post pictures of their own results after going for it themselves.

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## mynameisrich

Wow, already an awesome transformation from the first HT, but i can see what you are going for with the temples.
Best of luck!

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## topcat

Win let me say that I only wish you the best just trying to keep it real.

Plenty of young guys over the years used a massive amount of grafts for a low thick hairline. They then came back 5-6 years latter realizing how screwed they were with not enough donor left. They always blamed the doctor and not having the information which would be partly true. If you search the history on some of the forums you might be able to find them as some spoke of suicide. Those guys are not coming back to advise you and hopefully they somehow came to terms with their situation. Many are holed up in a basement somewhere.

I am just giving you the information, what you choose to do is up to you, just make sure the numbers add up. I have seen one doctor basically draw out a schematic of the type of the head with the hair loss pattern. Noting the numbers and what goes where you should probably do the same with the possibility of future hairloss entered into the equation and knowing approximately what you donor can achieve.

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## win200

> Win let me say that I only wish you the best just trying to keep it real.
> 
> Plenty of young guys over the years used a massive amount of grafts for a low thick hairline. They then came back 5-6 years latter realizing how screwed they were with not enough donor left. They always blamed the doctor and not having the information which would be partly true. If you search the history on some of the forums you might be able to find them as some spoke of suicide. Those guys are not coming back to advise you and hopefully they somehow came to terms with their situation. Many are holed up in a basement somewhere.
> 
> I am just giving you the information, what you choose to do is up to you, just make sure the numbers add up. I have seen one doctor basically draw out a schematic of the type of the head with the hair loss pattern. Noting the numbers and what goes where you should probably do the same with the possibility of future hairloss entered into the equation and knowing approximately what you donor can achieve.


 Oh, totally understand, and I appreciate the honesty.  Obviously there's some element of risk with this strategy, but I'm also not a newbie that wandered into, say, Alvi Armani's clinic and pulled the trigger without knowing what he was getting into.  I've thought pretty long and carefully about the upsides and downsides of this strategy, taking into account my treatment plan, my responsiveness to medications, possibilities of new treatments available in the future, etc.  Of course I acknowledge the possibility that this all goes south.

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## Jotronic

Win2000,

I wish you all the best with your upcoming procedure, you nutty guy you :Smile:  I'm sure Dr. Rahal will do a fine job on you.

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## yeahyeahyeah

> Win let me say that I only wish you the best just trying to keep it real.
> 
> Plenty of young guys over the years used a massive amount of grafts for a low thick hairline. They then came back 5-6 years latter realizing how screwed they were with not enough donor left. They always blamed the doctor and not having the information which would be partly true. If you search the history on some of the forums you might be able to find them as some spoke of suicide. Those guys are not coming back to advise you and hopefully they somehow came to terms with their situation. Many are holed up in a basement somewhere.
> 
> I am just giving you the information, what you choose to do is up to you, just make sure the numbers add up. I have seen one doctor basically draw out a schematic of the type of the head with the hair loss pattern. Noting the numbers and what goes where you should probably do the same with the possibility of future hairloss entered into the equation and knowing approximately what you donor can achieve.


 To be honest, that is why HT technology pisses me off. 

It's about time donor supply is not an issue

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## rev3

> Thanks--I agree!  Just makes me with that I'd gone a little lower in the original, but oh well.  I think it looks like a knockout head-on, but the higher corners show a little more when viewed from the side, and the right temple is a bit higher than the left--that'll even out.  More pics below.


 sometimes it is better to go SLOW and add with subsequent surgeries...even though that seems like a pain
it is said that graft survival rates are better (although sometimes inconsequential with smaller sessions)
so...

also since you will be transplanting into the bald areas of the temples mainly
this

what made you choose Rahal for this
who seems great if a mega session is needed but your work looks much more delicate

have you consulted with someone like Konior in Illinois?

http://www.baldtruthtalk.com/showthr...ghlight=konior

i'm sure rahal can do this but i am curious about your thought process on this and if the amount of grafts transplanted in one session had anything to do with your choice

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## win200

> sometimes it is better to go SLOW and add with subsequent surgeries...even though that seems like a pain
> it is said that graft survival rates are better (although sometimes inconsequential with smaller sessions)
> so...
> 
> also since you will be transplanting into the bald areas of the temples mainly
> this
> 
> what made you choose Rahal for this
> who seems great if a mega session is needed but your work looks much more delicate
> ...


 I have to admit I'm a little puzzled by your comment.  My impression of Dr. Rahal has always been that he's NOT primarily a megasession guy; his practice seems primarily focused on detailed hairline work of sessions 2,000 grafts or smaller--the type of "delicate" work you talk about.  I could be wrong, I suppose, but that would contradict everything I've ever read about and seen from Dr. Rahal. 

That's not to denigrate Dr. Konior, of course--he's a great surgeon and that's a fantastic result that you linked to.

And, of course, you're right about the advantages of spacing surgeries over time.

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## DAVE52

Based on the pics in Post # 26 
You don't need a HT
But good luck

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## rev3

> I have to admit I'm a little puzzled by your comment.  My impression of Dr. Rahal has always been that he's NOT primarily a megasession guy; his practice seems primarily focused on detailed hairline work of sessions 2,000 grafts or smaller--the type of "delicate" work you talk about.  I could be wrong, I suppose, but that would contradict everything I've ever read about and seen from Dr. Rahal. 
> 
> That's not to denigrate Dr. Konior, of course--he's a great surgeon and that's a fantastic result that you linked to.
> 
> And, of course, you're right about the advantages of spacing surgeries over time.


 oh okay

was just wondering what went into your decision to choose rahal and who else you might have consulted with

you chose rahal due to his work primarily with detailed hairlines in smaller sessions

got it

thanks and good luck

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## win200

> oh okay
> 
> was just wondering what went into your decision to choose rahal and who else you might have consulted with
> 
> you chose rahal due to his work primarily with detailed hairlines in smaller sessions
> 
> got it
> 
> thanks and good luck


 Thanks!  I didn't consult extensively, mainly because I spent ~2 years chatting with patients of various surgeons and getting familiar with those surgeons' work.  When I contact Dr. Rahal, I was extremely specific about what I wanted--essentially, my email laid out where I wanted grafts placed, a range of number of grafts that I wanted to use, and my understanding of the risk involved with such a relatively aggressive approach.  This was different from my first procedure, in which I had no idea how to begin and asked doctors what they would recommend doing.  I know how I want to proceed here, but wanted the doctor with the best combination of experience and artfulness with this type of procedure.  I felt that was Dr. Rahal.  No doubt there were and are other great choices--Drs. Feller and Feriduni are two that come immediately to mind for this type of procedure.

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## rev3

> Thanks!  I didn't consult extensively, mainly because I spent ~2 years chatting with patients of various surgeons and getting familiar with those surgeons' work.  When I contact Dr. Rahal, I was extremely specific about what I wanted--essentially, my email laid out where I wanted grafts placed, a range of number of grafts that I wanted to use, and my understanding of the risk involved with such a relatively aggressive approach.  This was different from my first procedure, in which I had no idea how to begin and asked doctors what they would recommend doing.  I know how I want to proceed here, but wanted the doctor with the best combination of experience and artfulness with this type of procedure.  I felt that was Dr. Rahal.  No doubt there were and are other great choices--Drs. Feller and Feriduni are two that come immediately to mind for this type of procedure.


 yeah, leaning toward Ferudini FUE, myself.

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## win200

> yeah, leaning toward Ferudini FUE, myself.


 That's a great call.  I've seen some amazing outcomes from him.  Are you in the EU?

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## Jazz1

I myself need book consult with dr Feriduni his uk rep never contacted me back I think il call the office.

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## rev3

> That's a great call.  I've seen some amazing outcomes from him.  Are you in the EU?


 for the next 3 years so with a 1 year recovery i gotta make up my mind soon!

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## rev3

> I myself need book consult with dr Feriduni his uk rep never contacted me back I think il call the office.


 yeah call but don;t be offended they are crazy busy there
it took a while for me too

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## gillenator

Win,

I have always thought that you had a very good result and come to think of it, you do look like a bit like Chris Isaak... :Wink: 

Best wishes to you my good friend and keep us posted... :Smile:

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## Jazz1

> yeah call but don;t be offended they are crazy busy there
> it took a while for me too


 October lol I booking it.

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## agenteye

Win, 

Congrats on your upcoming procedure with Dr. Rahal.  He is an amazing guy, and I had my hair restoration with him last November.  I was a NW IV, so unfortunately I needed quite a few more grafts than you do.  If you have any questions for me along the way on what to expect from your trip to Ottawa, don't hesitate to reach out to me.  Are you staying at the Brookline Guesthouse??  Your hair looks terrific by the way as it is now..doesn't look like you've ever lost a hair in your life.  This will polish it up really nicely!

Best, 

Mike

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## win200

Just resurrecting this thread; finally solidified a date with Dr. Rahal after plenty of delay.  I'll be getting roughly 2,000 to 2,500 grafts on October 8.  Can't wait!  I'll update soon with some pics of my hair pre-op.

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## JoeTillman

It took you long enough :Wink:  Congratulations!

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## brocktherock

> Just resurrecting this thread; finally solidified a date with Dr. Rahal after plenty of delay.  I'll be getting roughly 2,000 to 2,500 grafts on October 8.  Can't wait!  I'll update soon with some pics of my hair pre-op.


  Have you kept up with fin,dut and Ru? and if so did you lose any more ground because your hair looked awesome.
 y

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## FlightTL

> It took you long enough Congratulations!


 That Turkey video with JoeTillman and Spencer K was eye opening. It was like a James Bond suspense novel. Holy crap, with the whole them asking for JoeT's blood and then the big guy pushing him out of the operation room, and then him having to find an escape, and then after he goes outside, he ejaculates a huge sigh of relief....Suspense baby all day and daily!!!! Loved that vid.

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## win200

> It took you long enough Congratulations!


 Thanks, Joe!  It's such a pain to schedule and out of town surgery that I kept putting it off, but booking the flight locked me in.

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## win200

> Have you kept up with fin,dut and Ru? and if so did you lose any more ground because your hair looked awesome.
>  y


 I've kept up with fin and dut.  The RU is a pain, but I'd like to get back on it and keep it up.  I'm going to wait until after the surgery to do that, though, because I'd have to suspend it in two months if I started now anyway.

I can't tell if I've lost ground; some days I think that it might look a **tad** thinner right behind the transplants in front, but if it is, the difference is very, very marginal.  It's just so tough to monitor loss after a transplant, because the grafts cover up the native hair, and any gradual changes are very hard to detect because you see your hair every day.  I've taken pictures, but they're so dependent upon lighting; plus, as we know, it's really hard to measure density accurately in pics.  

So short answer, there has been no meaningful change in my hair in the three years since my previous surgery.

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## brocktherock

> I've kept up with fin and dut.  The RU is a pain, but I'd like to get back on it and keep it up.  I'm going to wait until after the surgery to do that, though, because I'd have to suspend it in two months if I started now anyway.
> 
> I can't tell if I've lost ground; some days I think that it might look a **tad** thinner right behind the transplants in front, but if it is, the difference is very, very marginal.  It's just so tough to monitor loss after a transplant, because the grafts cover up the native hair, and any gradual changes are very hard to detect because you see your hair every day.  I've taken pictures, but they're so dependent upon lighting; plus, as we know, it's really hard to measure density accurately in pics.  
> 
> So short answer, there has been no meaningful change in my hair in the three years since my previous surgery.


  I am getting 4000 grafts with Rahal on oct 20 lol. But I just can't see how you can get 2000 grafts if your hair was pretty much the same. It looked great.

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## Mountinvan

Win--followed your first transplant and shock loss. I was reassured with your favorable result as I have the same issue. Am wondering how the Rahal transplant turned out? Did you experience the same degree of shock loss?  Do you have any after pics? Your contributions to this Forum have been terrific and tireless. Where do you get so much time? Maybe I should try trademark law?

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## NSix

any update on this one?

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