View Full Version : My Surgery with Dr. Feller UK Patient - 2000 grafts

04-24-2012, 04:21 PM
I am currently 33 (2012), and started to notice my hairline receding up the sides at the front when I was about 29.

Like everyone who is visiting these websites, I started to follow closely the progress of my follicular retreat, and styled my hair to best mask it. The longer time went on, the harder this task became, and as well as continuing to recede up the sides, my hair immediately behind the front started thinning. This would ultimately have lead to a horsehoe-shaped hair-loss zone, and effectively have created a little hair-island tuft at the front, like a homage to Tintin!

I weighed up the various options - I didn't want to spend money on treatments that only offered a small possiblity of working, or having only a small positive effect, so laser combs were not an option for me. I took some considerable time to decide to go on Finasteride - I don't like the idea of being on long-term medication, regardless of how low the chances of side-effects are, but I decided to start taking them in February this year (2012). Liquids or foams that you rub directly onto your scalp twice a day simply don't appeal to me (not at the moment anyway!) - the daily routine seems like a lot of hassle to adopt for the rest of your life!

I decided at the beginning of the year that a hair transplant was the path I wished to take, and so began my research. I visited a couple of local clinics who offered free consultation. The first one said that they would not wish to proceed as there was still too much hair on my head, and really the minimum procedure they undertake is about 2,700 grafts. The second suggested around 1,700 grafts and asked me to have a look online to consider which surgeon of theirs I would like. Looking online, I noted that all surgeons were part-time hair-surgeons, with their main job being in the NHS. Whilst that meant one of them for example was practising plastic surgery every day, they were not doing hair-surgery 5 days a week. Also, no examples of their individual patient results were available to view, but rather the clinic's result as a group. As they have clinics in the UK, Spain and the U.S., this didn't tell me which, if any had been undertaken by the surgeon who I would potentially be letting loose on my noggin!

At this point, I started to concentrate my search online and examined this website, as well as many others. This was a place that the surgeons who are connected with this site actually post their patients, allowing their work to be seen and scrutinised, and as far as I am aware, anyone can freely post, comment or ask questions about the op's. This instantly appealed to me far more than generic pictures with no follow up story. I don't know how many surgeons out there do hair surgery, but I would rather go with someone who's work is transparent and in my opinion appears unbiased.

From this point, I got in contact with Spex. I explained that I had a window of opportunity between jobs to have my surgery done and was keen to move things along. I took loads of photos of my head (I've spent so much time staring at my hair over the past few years, that it was easy enough to do!), and passed them on. Spex forwarded them on to Dr. Feller and gave an assessment of whether I was an appropriate candidate and what level of replanting I would need (he reckoned between 2,000-2,500 grafts). Spex gave me links to examples of patients with a similar balding pattern and stage of retreat to mine, and shortly after I had a very informal conversation with him where my questions both general and personal (and there were a lot!) were patiently answered by Spex. Within a few emails, a date in February had been set for my op!

Clearly, before I paid over any funds as a deposit, I checked over all of the operations and posts that Dr. Feller had made, and grew in confidence of his professionalism and ability. I can tell you that when the day of the op. arrived, I found that the man in person did not fall short of my expectations.

I think this is as good a time as any to say that Spex really did make the path from from the UK to Little Neck was made as smooth as possible. His 'hair manual' which was (and still remains) a big help and comfort in the process is well worth a read!

Day 1 - D-Day (or should that be T-Day?!)
When I arrived at Dr. Feller's premises, I was as you might expect, somewhat nervous about the day's events which lay ahead! I don't think I could have been put more at ease however, or made to feel as confident that I was in a safe pair of hands (or multiple pairs of hands!) by Dr. Feller's attitude. He was personable, engaging, attentive and without any trace of arrogance, exuded a quiet confidence that relaxed me so much! Whilst he chatted freely during the pre-op stage, when the surgery began, I liked the fact that his full concentration was dedicated to the work being carried out - except for the apologies for the injections, and regular updates as to what was going on - which were once again reassuring! His staff were also friendly and comforting throughout the day - I only regretted that I wasn't able to thank them at the end!

We started with a very relaxed chat in his office, discussing goals, which were mutually agreed upon - to retain my current hairline, fill in the sides to an appropriate level, and graft follicles in the front third area. 2,000 grafts were deemed to be required for this task.

After some lovely lines were drawn on my head in marker pen, I was taken through to the surgery room to have my hair shaved! I was given a very stylish cut by a very nice lady and was left with the front third of my hair shaved off completely and the thin strip at the back shaved down to the appropriate length for transplant! I felt like I had just joined a new order based on the Franciscan Monks!

The worst part of the entire op now followed - the round of injections - first at the donor site to harvest the 'seeds', and then before planting, the second set of injections into the front third of my head. I would describe this as a medium discomfort really - on a par with injections for dentistry or jabs for going abroad. Dr. Feller was thorough in ensuring all areas of interest were fully numbed in both cases - which I can say were fully realised as that was the last of the pain! In between the injections around the donor area and jabs at the transplant site, there was the removing of the donor strip. This was something I didn't really want to think about too much, but comforting words and reassurance were given throughout and this helped a lot! The donor area was extracted in three parts. Each time a strip was removed, I believe that part was cauterise, clamped and then stapled together. The only feeling was the tightness from the clamping and the noise of the stapling - it wasn't particularly scary, but did let me know what was being done. Oh, the radio in the background was tuned to a radio station playing some classic 80s tunes, which was a nice comfort!

Once the donor strip had been removed for dissection, Dr. Feller numbed the front of my head and then set about making the slits for the grafts plantation! My next revelation may have you thinking that I am a bit of an oddball, which is probably fair enough, but here we go! I found the slit-making the most rewarding part of the surgery! For the past 18 months, on many occasions, I had found myself examining my cranial deforestation and imagining roughly how many grafts would be required to fill the bald parts at the side and restrengthen the front, imagining how good it would be for it to be done, and here I was finally, sitting in the chair of Dr. Feller's surgery, having those slits made. I didn't feel any pain per se, but I was aware of the action of the slit making, and roughly where they incisions were being placed, starting at the front and working back. Each one gave me a bizarre kind of satisfaction - knowing a new graft were shortly to be installed!

It was done in three or four stages. First was to fill in the front & sides, and then the planting of the crops began. Then Dr. Feller came back for round 2, which took us back to probably about 90% of the extent of the transplant, then the last 10% of slits were made, and finally I think some reinforcement was made possibly at the sides. I assume that this is done to ensure the most important areas are covered first, and then when the exact number of follicles remaining are known, the last parts are dealt with. Dr. Feller was delighted that he was able to go further back than anticipated - all the way to where there was any evidence of decline in the local hair population, so this was all good news to me!

Before the last 50 or so grafts were given their new home, I had a very tasty chicken mayo sandwich, a coke and a quick pit-stop. I avoided looking into the mirror and thought I would save that surprise until I got back to the sanctity of my hotel room!

The donor area at the back of my head had a pad applied to it, although I was told there would be minimal oozing from it, and it was bandaged in place. I was given a complimentary cap (how funny I thought it would have been had it said "Caution - Re-planting in progress", but perhaps not that subtle!), and then one of the ladies from the surgery instructed me in the post op. events, including the staple-removal procedure! I was given a note too just to refresh my memory later on (which I was glad of!), and then went through to Dr. Feller's office for a wee post-op pep talk!

We had a chat about the procedure, he went through the post-op instructions again and provided supplies in the form of antibiotic pills to eliminate the chance of infection, as well as some strong pain killers to take care of the first few days. I took these diligently, ahead of any potential pain, and indeed no pain was experienced as a result!

I had a look in the mirror when I got back, and my head looked very similar to the countless photos I had seen of transplant patients who have posted online, which was quite reassuring in a way. The transplanted area was a general reddish colour, and a few of the graft sites had some blood or ooze coming from them. The first afternoon, I ventured out only for a burger down the road, which I promptly retreated to the hotel to consume! I felt quite conscious of myself - with a baseball cap and bandage visible below, but it's amazing how people can be oblivious as they are too caught up with their own business!

After surgery, I was are advised to sleep with head and back supported by pillows, raising my head at a 45° angle, which is a little awkward, but to be honest, I was pretty tired from the day's events so got a fair amount of sleep. I was told that the first 24 hours are when the grafts take root and are really the only time they have any chance of being dislodged, but for safety, 3 days are given to ensure they are 100% attached and not going to accidentally come out. I was acutely aware of this and ultra careful with the hat for the first few days! Needless to say, no grafts were dislodged nor from the conversation I had with Dr. Feller, has any of his previous patients. Still, better to err on the side of caution - I paid for them, so I want them to remain on/in me!

Day 2
I went down to the buffet breakfast and sat in a corner, still with the bandage visible just below my cap. I was once again surprised that no-one was staring at me! On the way back up to my room, I requested a late check-out, and after explaining to the receptionist that I had had head surgery, he was only too obliging to allow me to keep the room til two or half two, (can't remember which!) as the maids leave at 3pm.
After returning to the room, I watched a wee bit of TV and then just after midday, removed the bandage. There was very little seepage on the pad from the donor area since the op., so that was a reassurance! I had a nice bath, and then vacated the hotel, venturing across the road for another burger! The only moment of panic was when I was crossing the road and a gust of wind made me feel like my cap was about to fly off, revealing to the stationary traffic my somewhat unusual haircut to the world! Luckily it didn't, and I enjoyed another tasty burger!

I checked in online for the flight from the hotel and printed my boarding passes, able to arrange seats in an empty aisle at the back - much to my delight. I bought a fantastic neck pillow from the airport for $40 - which although expensive, was definitely worth the money over the cheaper options as it made the flight (and consequent nights' sleep) much easier, bearing in mind the staples at the donor site are uncomfortable to sleep on).

The journey back was pretty good really - I was apprehensive about clearing security without having to remove my hat, but I think I got out of JFK without having to do this, and it was only in London Gatwick when I was asked twice (once on entry, and then again when I was boarding the plane up north) to remove my hat. Having read advice from the forum here, I was prepped for this. In both cases I had a quiet word with the security guy and told him that I had just had head surgery, I lifted my hat a little, and he was happy to let me through without any further scrutiny.

Day 3
I arrived home, and was once again able to remove my hat in the confines of my house, which was a nice relief! My forehead at this stage was fairly swollen (which had been covered pretty well by the cap). Also, the central area just above the donor area had been a little numb since the surgery, but reading up this is perfectly normal after a transplant as lots of small nerve endings will have been cut and will re-establish themselves in time in the coming months. I had a nice bath in the evening and ran water gently over my scalp, which was lovely! The redness in the transplant site was a little less pronounced, and some of the crusts came off.

Day 4
The swelling had progressed down my forehead a bit, and indeed the bridge of my nose was a little swollen as the fluid drains downward! I had a shower, and let the full force of the water hit both donor and transplant site, which was nice as it was getting itchy! More crusts came off, and it looked better afterwards. The transplanted area looked as if I had dried skin, but I decided it was best not to apply any moisturising lotion.

Day 5
Most of the swelling in my forehead had gone, and in fact went out for dinner and a few beverages afterwards. Felt a lot more at ease with my cap now as it didn't need to be quite so loose. Made a saline solution by boiling water in a pot for a while, adding it to a plant sprayer and I think I added 8g of salt for 1L of water (check online to see what concentration is required to create saline). Seemed to do the trick and kept the grafted area moist, making it a lot less itchy! Should have used this several days earlier!

Day 6
A lot of the redness in the transplanted area had died away, and things were looking considerably better. There was the odd graft hair which came off with or without a wee scab, but I had read that this would happen so was prepared!

Day 14
Staple removal day! By now, there is no redness on the top of my forehead, and the grafts are regularly shedding - all to be expected! I go to my friend's house, who is a nurse and she promptly removes all 54 staples! With the exception of a half dozen that nip a bit, and maybe another dozen that are noticeable, they are all removed with not too much discomfort. A nice Scotch before and after definitely compensates! A wee bit of oozing from the staple holes, but my friend comments that the incision is healing very well and has knitted together very neatly indeed! Now I can lean the back of my head against a couch or pillow with a lot more ease, although still more comfortable using the awesome neck pillow, which has by now paid for itself many times over!

Day 20
Finally got around to posting! I am considering how short to cut my hair next week to balance it out! Still trying not to keep looking in the mirror at the head stubble - especially as 90% of the new stuff will be gone in the next few weeks! Donor area is continuing to feel less lumpy and more comfortable when I'm resting it on the back of a couch or pillow! Just above the donor strip still feels a little numb in places, but once again this is all normal from what I have read and can take a few months, up to 6 months plus to fully return to normal. Contemplating whether inventing time machine will speed the process along or indeed will just catapult me forward in time with my hair at the same stage!

04-25-2012, 04:04 AM
All I can say is good luck. I am going through the same thing as you... wish i could turn forward time to see the results...

I am bloggin about my results...check my profile... if you want to put up a guest post your more then happy...

I am up to week three...I still have a little redness but nothing that anyone has commented on, its just something I noticed...

Things look good... hope you put up the results and they rock...

04-25-2012, 07:44 AM
Welcome aboard ODBLK! :cool:

Heal and grow well and please keep us updated with you very informative posts!


04-26-2012, 02:23 PM
Thanks kd@fuehairtransplanttruth, I wish the best results to you too!
I shall check out your journey so far. Don't worry about the redness - if you're anything like me, you're familiar with every inch of your scalp by now and will have started naming your hairs! (no not really... yet! :P )

04-26-2012, 02:24 PM
Thanks Spex, I'll keep you & the forum informed!

04-26-2012, 05:41 PM
Cheers for sharing bro. Good luck.

04-27-2012, 05:21 AM
Good luck dude, I hit 20 weeks Wednesday. It's a loooooong process

04-27-2012, 05:41 PM
hahahah... i agree!!! Its a loooooooooooonngg process... and both of us are at the start of it all.

04-29-2012, 03:10 PM
Cheers guys,

don't worry - I've taken up crochet to pass the time :p

04-29-2012, 05:05 PM
Any new pics? Especially interested in seeing the scar if you don't mind?

05-20-2012, 12:45 PM
Hi Chrisis,

Some Scar photos just for you! Also Some general photos for anyone else who might find them of interest.

These were taken last week (Post Op Day 43).

Just for a quick update,

Day 25,
I had a grade 3 all over from my hairdresser.
Up until this point, there was still quite a noticeable step change around the donor area (at least in my eyes, examining it with multiple mirrors/lightsources/microscopes and other paranoid means (not really, but kind of! :D)). To be honest, it looked like I had been wearing a baseball cap all day and had helmet-head!!
After the haircut, it looked a lot better, and I ditched the cap permanently. I would say that for the first week after having it cut, I felt aware that the scar was visible through through my hair at certain angles and lighting conditions (bearing in mind my above comments, I was checking it under a bathroom spotlight, with my head tilted completely forward.). Needless to say, no-one commented on it, and indeed the following weekend I saw a mate I'd not seen for a few years, and he said nothing. Well that's not true, we had a joke over the sudden shortness of my hair (I've never had a grade three all over in my life!), and that I now resembled him (he is considerably more advanced than I am/was in the deforestation situ!).

Day 43 Post Op - I have included photos of the scar.
I would say that at this point, I now feel that evidence of my op is very well concealed. I now feel that I have reached break even point - i.e. I am as I would have been pre-op, had I cut my hair all over to about a grade 6.
I am trying to avoid checking as much as possible until at least day 60 - the three month period. I am not expecting a major change at that point, but it hopefully will be the start of the new crop coming in. If nothing else, it will be a good marker for the coming months and hopefully the significant progress that everyone else who has posted on here seems to realise at this juncture!

As well as pics of the withdrawal site, I have also included photos of the depositing side of the op. Incidentally, as I'm sure many of you are aware, different lighting conditions (and the use of a flash, and also where exactly the flash 'hits') makes a huge impact on how the coverage looks in a picture. I've taken several photos so that you can at least get an idea of the variation. A couple of points for reference...

1) I reckon this is how my hair would have looked pre-op, although I had it longer so it wasn't quite so pronounced.

2) You can see that in some of the photos, the crown actually looks quite sparse. I'm not in denial, but I can assure you that I have no signs of thinning in this area, so this is the penetration of the flash reflecting through my short hair.

3) In all photos, where the camera has the hair/scalp in good(sharp) focus, the coverage looks thinner. I guess taking the example of a microscope, hair coverage - even in dense donor areas - appears thin! At one of the consultations I had with an HT consultant, I was able to see both donor area and the thinning regions, and as I said, the gap in-between hairs on my scalp at the donor area looked huge. I must point out that I have normal donor density!

Anyway, long way round of saying that in reality, if the photo is slightly out of focus (or if I don't use the macro mode at least!), this probably represents how my hair looks to a pair of prying eyes!
As an example of this, I've included two photos which are quite out of focus (so they exaggerated the coverage that I have more than I would say is the case in reality!)

Will keep update photos at the next milestone! In the mean time, if any one has questions, I'm more than happy to answer if I can!

ODBLK Over & Out!

05-20-2012, 01:17 PM
Thanks for the pics. Looks like the scar isn't so bad, even at this relatively early stage. I imagine by the year mark it'll be very difficult to see.

05-20-2012, 03:49 PM
Yes, still early days for the scar, so it's definitely getting less pronounced each week. I would hope that by twelve months' time it should be pretty faint. Time - and the 365 day post-op photos shall tell!

05-20-2012, 03:51 PM
Just curious if you've tried using Bio-Oil? I dunno if it's recommended or not, but worth considering?

bio-oil (http://www.bio-oil.com/en-us/)

05-20-2012, 04:31 PM
To be honest Chris, the scar isn't something that has played on my mind much - other than being keen for it not to be visible in the early stages. I don't intend to have my hair shorter than a grade 3/4 at the back so it won't really ever be visible no matter what the final appearance of it is.

That said, I appreciate the link and I'll have a look into it - if it looks like it is very beneficial then I might well use it!

Either way, thank you!

05-21-2012, 04:14 AM
Great update mate - thanks for keeping the community informed :cool:

Grow well :)


07-22-2012, 05:25 PM
Sorry for the delay for anyone who might be interested in following this thread - have been meaning to post these for a while. There will be a lot less of a gap with my next update...

With regards to the photos, these were all taken on the same day. You'll notice that my coverage looks different depending on whether I used the flash or have wet/dry hair, or even how I brush is (to reveal the thinner areas, or to cover them). So I have taken several photos with the different conditions to give a hopefully comprehensive reflection of my hair at 90 days post-op.

So the three month mark is often referred to the minimum wait time before the action starts in earnest (and so as not to give hair transplant patients a bit more patience, this is qualified with 3-6 months before you start to see a major improvement (with up to a year suggested before the complete effect has been realised).

Anyway, I would say that at this point, I had now reached a a position where to the casual observer, there is no evidence of my surgery. If someone were to comb through my hair at the back, they would see my donor scar, but having a shower or going swimming does not reveal it. I would say that there is currently a slight dimpling (if that's the correct word) of my hair line as a result of the donor area, but would qualify this by saying this is really only noticeable when my hair is shorter (has just been cut), and only noticeable to myself (who scrutinises it every day!). To be honest, looking at the photo of the back of my head, I'm struggling to see any evidence at all!

At the donor site, there is a small strip which had no growth at it, but now has a few hairs starting to poke through, which in time should hopefully further lessen any visible dimpling as a result of the donor area. That said, the area is actually where the head naturally tapers in, so to be fair it could just be as a result of this - and certainly to anyone but myself or possibly a transplant surgeon, if anyone ever stared at it for a long period and actually noticed any thing, they would almost certainly put it down to this (I would think!). Perhaps this is why the donor strip is taken from this area? When I hit month four, I shall take some more snaps of the back!

In terms of growth of the new stuff, there has definitely been a little progress (I'd say as a completely uneducated guess, possibly 5-10% of the donor stuff has started to come in). I can definitely feel short 'spikey' hairs over the entire recipient region. I should probably stop playing with them as I'm getting a sore arm from searching my scalp to check for new ones! They're quite difficult to photograph as all the other (native) hairs represent around 8 weeks' growth in terms of length and these ones are probably about a week's worth in length. So in effect, it'll be another 7 weeks til the first lot of new ones achieve the same length as the native ones, by which time I'd imagine there will significant emergence of the new crop!

I'm still taking Finpecia daily, washing my hair once or twice a week with Nizoral, and also using a shampoo called la biosynthetique at all other times showering times. I would say that I notice a small improvement since before the op. (which may or may not be down to my native hair thickening up) and can definitely say that there is a little less patchiness at the front of my hair line, where as before before it looked certain that I was on the way to an Alan Shearer style hair island at the front! I don't know whether any or all of the above can be attributed to this, but as I'm sure you can do your own research and make up your own minds as to how effective these all are with other transplant bloggers. I just figured (as with a lot of others in our position) that a combination of approaches couldn't hurt at all!

Anyway, that's it for now, but I'll post again early in August when I hit the Four month mark!


07-23-2012, 05:17 AM
Thanks for the update! Looking good!

Curious if there's anything you'd do differently if you had to do it again?

07-23-2012, 10:47 AM

I'm not quite sure if I understand the question but I'll try to answer it!

Ultimately I'd have liked to put everyone in suspended animation for a month or two whilst all returned to normal! In reality, it is a waiting game, so patience and spending time on sites like this (without becoming obsessed) is what's called for. First month is the worst, after that you are on your way back to normality. In terms of choice of surgeon and location, New York is obviously a bit more of a journey but the transparency of being able to see patients online at all stages of the process and read their comments made my choice for me. Plus being able to have a good long chat to Spex before hand, and have him as a guide and smooth the process out works very well.

Surgery is not like ordering a burger and comes with a fair amount of trepidation, but as I said in my first post, Dr. Feller has a fantastic way with him which really does calm you as much as is possible, considering what you're there for! I'm sure there are many fine surgeons out there, but I would have no hesitation going back to Dr. Feller if I had to make the decision again.

I started Finasteride at the beginning of the year, so I guess were I able to go back in time, I would give that a go maybe three years before. The problem with that is, that in reality, you don't know how quickly your hair is going to go and therefore are unsure what effect (if any) taking the pills would have on the thinning area, or indeed what would happen if you stop taking it!

Apart from that, I wouldn't change anything really - my journey to this point has been no more difficult than expected!

Hope that answered your question!

07-23-2012, 11:41 AM
Great to see you mate - keep us updated as you go. :cool:

07-26-2012, 06:32 AM
Looking good, thanks for sharing mate

09-17-2012, 03:50 PM
It's been a loong time since I posted - where does the time go?!

Anyway, Apologies, and here's a bunch of photos I took from just over the four month mark.

All photos are taken on the same day, spanning about an hour.

I thought the best way to do it was to take snaps immediately after having my hair cut (hence the hairs all over my forehead - these aren't misplaced implants! :p ), still a bit wet and combed.

I next took photos immediately after my shower, without drying my hair, so hair looks at its thinnest. Note by comparison the hair from the unbaldable region (I just invented a word!) i.e. the 'horseshoe bit on Patrick Stewart (Cpt. Picard) to get a reflection of what 100% unthinned hair looks like under lighting conditions/flash.

I then dried my hair a bit, then a bit more and brushed it forward as I have it to offer a bit more covering on thinner areas.

I've taken some WITH and some WITHOUT, as well as from different angles. You'll probably notice that the flash accentuates sparser areas and also different angles can make a big difference in terms of how 'full' areas look.
I'd say that the flash gives a pretty harsh effect of how the coverage looks, but hopefully you'll get a truer idea from a variety of conditions as to how progress was at this stage.

Definitely seeing and feeling a difference at this stage. Existing native hairs have become less curly/frazzled/thinning as well at this stage - possibly from Propecia & shampoo, so this is helping too. The side bits have the worst native covering, so these will (hopefully!) eventually be covered by a far larger % of donor hairs.

Will attach some pics of the donor scar in a mo...


09-17-2012, 04:00 PM
Donor Scar a lot less red, and most of it has settled down.

There are a few areas which I can only describe as feeling like spots which you can see in the pics. I'm not sure whether they're just bits that are taking a little longer to heal, trapped hair or what - answers on a post card to er.. here!

Shall try to post soon for Month 5!


10-04-2012, 06:32 AM
Apologies i missed this update Kojak! Looking good - grow well!!! :cool: