hsrp10

Are you using Nizoral man? I lost transplanted hair to Niz overuse after my Hasson procedure (I suffer from chronic scalp excema).

Don't overuse the 2% especially.

Also HT results peak around the 12-15 month mark as all the new hairs are in the growth stage at the same time, but after a while things balance out some hairs shed as part of the regular cycle.

You often see this on forums and is why people recommend to wait 18 months or more before a second procedure.

My guess is that the cause is one of the above.

There is no other more skilled and patient focused hair restoration surgeon out there whether it be FUT or FUE than Dr. Raymond Konior.

Last I spoke with him last winter he was doing 50% FUE cases recently.

The only drawback to a Konior FUE procedure would be the cost, especially compared to the overseas FUE clnics, but it would be likely worth it with a nearly guaranteed chance of an excellent result.

Erdogan in Turkey and Maras in Cyprus

Konior, no brainer.

Hey HSRP,

How’s the temple points coming along? I remember that thread vividly, it’s always important to stay grounded, at the time many members were touting Dr. L as the second coming of Christ. I still stick to my original assessment, the work is good, natural, but no wow factor, and that’s why it’s important to find doctors who perform surgery on patients with the same level of hair loss.

 

With that said, this case I think is a bit more of expectation management and perhaps yield. KO for as much fin +dut that he takes is still a Norwood 6, the pattern is there 3K+ grafts will never look the same on a Norwood 6 then it does on a Norwood 3, that’s why you see Erdogan cases where the hair loss is Norwood 3 and the graft count is the same, obviously the result will look way different. I do think the approach may have been done differently, I think more grafts should have been tightly packed in the band of the hairline, this would’ve allowed for a solid looking result,the hair layered the middle wouldn’t appear as weak even though it would be in reality.

Hey man! I was able to get a last minute booking with Dr. Konior last January. Was really really fortunate with that.

The temple points were done aggressively and natural by Dr. K in a FUE procedure where I also had some minor final density boost done in the frontal third for a total of 700 grafts approx.

Even though I had been off of fin for 7-8 months until recently, overall things are just great. I'm 99% cured with no more minor trouble spots (did decide to restart Fin just for long-term maintenance's sake about 1x week).

Back to the thread at hand, there was something that concerned me about Dr. L's density as I could see in it pics especially in those two links I posted in the original thread.

When you've had multiple procedures and have done as much research as we have along the way, it comes in just one pic or look - you can tell it immediately.

Just like your comments in that thread, I know that you as a veteran made a highly experienced call about the lack of "wow" factor.

It's either there or not and us veterans can spot it quickly.

I think a follow up repair procedure with one of the elite docs will make a world of difference here in his case.

With a concentrated focus on the density in the hairline and frontal third.

As we know, it sometimes takes a second or even further procedures to perfect things just right.

wazaam said:

Bill,

I believe that HLS2015 has already given you info on unhappy Rahal patients in a previous post;

 

"Why he has a consistent pattern of over harvesting donor areas. Let's get Sean, Sharkman, Bridget Jones, The Flyer, Marco (FUT), etc to chime in here."

 

 

I think most forum members who have been around for awhile are very much familiar with Sean's unfortunate experience with Dr Rahal.

As a member of the HRN since 2010 I agree with this statement and have read these stories and posts.

If they have been edited, modified or deleted or if someone is trying to say these stories never existed in some type of coverup, then I'm here to attest to the fact that something very fishy is going on, at least previously such testimonials and patient accounts existed here on HRN.

Do your research carefully folks, especially when people are trying to cover up negatives about a certain clinic.

I had mentioned in an older thread that though I like his work and the clinic's feel and reputation, I wasn't overly impressed with Lupanzula's density.

http://www.hairrestorationnetwork.com/eve/185449-dr-lupanzula-pros-cons.html

Cons

- Possibly not a density king?! If you look closely at his hairlines and some areas behind the hairline you can see scalp even in pictures with many patients. I don't know, even though my transplanted hair does not have "amazing" density at least in pics you cannot see my scalp. Bit worried about this..

Sorry it didn't work you for you man. Have a repair procedure with Konior, Erdogan or Lorenzo.

Konior being my top choice if you can get a booking with him.

best of luck

Since your balding/thinning extends back into the crown you will require more than that graft amount for a full restoration.

I would therefore concentrate on the hairline and frontal third with roughly that graft amount (trying to cover the entire area in one pass will require much more grafts and would be best left for a second pass.)

Since you have lost most of your hairline as you stated, dense packing a newly drawn hairline would be optimal about the same height as your current hairline height or maybe even lower a tad bit. This would give you a densely framed hairline and then the doc will be able to fill in the area behind this. The reason I mention a tad lower is so that they can dense pack aggressively without you worrying about "losing" your current hairline which may make you hesitate psychologically, and it also makes the dense packing easier if done into virgin scalp. You can discuss the actual height with your surgeon.

For density approach in terms of grafts/cm2 read this as a reference.

You want to address zones A and B as mentioned in the article.

<from Dr. Lorenzo a world renown FUE surgeon>

http://www.injertocapilar.com/English/density.htm

Your donor looks fairly decent so I don't think a clinic will reject you but at least give Fin a try after researching about the possible side effects.

As someone who experienced a failed transplant years ago (at Bosley) I don't fuck around with iffy type of recommendations, go with Erdogan or another elite world-class surgeon.

The other surgeon may produce some nice results but is more known for cheap price than elite level type of results.

good luck in your research

This topic often opens up a can of worms as there are some clinics where the techs do excellent work in graft placement and doing the necessary part of supporting the surgeon.

Excellent techs help to make an important part of an excellent clinic and its reputation.

But techs should never do the surgical work, and also techs have been known to mess up selection of follicular units for the hairline and temple points - placing multiple hair units where single units only are a must. You can search posts on here on this forum to see examples of this, including leading clinics.

So in a sense, asking the clinic which tech or possible techs and about their experience and training is an important part of your research and preparation.

Also ask the same question on the day of your surgery as techs can get sick or quit etc. Seriously don't forget to ask this on your day of the surgery.

My personal preference is to go with a doctor like Dr. Konior who does nearly all of the procedure himself for world-class results in nearly every case.

Due to cost and booking difficulties etc. this is not always possible, but in my experience has produced the most trouble free and optimal results.

Some quick thoughts here based on my experience:

If you go with Erdogan you are going to 100% have to shave your entire head (donor area and recipient both).

Just want to put this out there as for some people (like myself) there is not enough downtime to do this with work etc. This is even for smaller procedures.

For my last procedure in a limited area Erdogan and ASMED was in my final list, but I excluded them as I could not afford the long downtime.

Other clinics (Bisanga, Konior) will agree to a mohawk type of buzz cut for FUE where the donor is shaved and then only the immediate recipient area.

For diffused thinning I would dense pack into a slightly lowered hairline just below your current one - I'm saying this without seeing any of your pics which is not ideal but it's easier to dense pack into virgin scalp than it is in between existing hairs.

And concentrate on boosting the hairline and frontal third as your first goal.

As for H&W I would research their work here on this forum and choose the surgeon whose results matches your desired situation - which one produces amazing results in cases of diffused thinning patients.

My favorite of the two overall is Dr. Hasson who I believe excels at dense hairlines while Wong is more of a master at crown work.

And is H&W a proven FUE leader yet? I'm not sure yet and have only seen a limited number of FUE cases from them at this point..

Also have you actually been examined by a hair restoration surgeon yet or sent in photos?

Some clinics may reject patients if they demonstrate advanced balding/thinning and are not on Propecia for maintenance, especially if the donor is very thin and sparse.

Oh and as for your second choice for Turkish doctor I would skip him as the only people I see making him their first choice are those who are trying to save a buck.

I had seen some not ideal cases on here as well and I don't have the time to read each and every post but my researched opinion is that he should not be among your finalist list.

HDC and Dr. Maras produce more consistent work at fairly affordable prices for example.

Very intriguing case and I would choose no other surgeon in the world to boost naturalness in the hairline than yourself Dr. K.

Due to the patient's frequent procedures he is also apparently very fortunate to be in close proximity to your clinic.

In addition to the naturalness transformation the patient has also maintained extremely well for his advanced age (deducted from the greying progression).

Is he on Propecia or other medications for maintenance?

DUT is a stronger medicine and comes with stronger side effects, even at 1x week I would be very careful.

I have also heard there is higher chance of DUT sides being permanent.

A high hairline is not a bad thing in hair restoration, as it can provide you with an age-appropriate framing to your facial features and also give you ample remaining donor graft supply left to perfect the required density and also do things like adding temple points etc for perfection - things you won't be able to do if you chased a very low hairline.

However there are important aesthetics that need to be taken into consideration (rule of thirds for facial features for example), not to mention what hairline height makes you the patient satisfied.

Here's a link to an oldie but goodie HRN thread below.

I believe 6.5-7cm is a good height to aim for depending on one's level of balding (mine is slightly lower than 6.5cm and feels slightly "high" for me with short hair, but the "higher" height than a juvenile hairline has allowed me to add density and temple points in subsequent procedures).

http://www.hairrestorationnetwork.com/eve/149969-hairline-height.html

The reputation out there is to go with Rahal for amazing FUT results but not for FUE.

I believe for FUE you should go elsewhere, Bisanga, Erdogan or Konior (if you can get the Dr. K booking & have the funds).

Best of luck.

It’s a no from me. He let his standards slip, and don’t think you can blame it on one bad Apple. Still think you need another couple of years of seasoning so we can assess whether the results remain consistent on an ongoing basis. Check back in 2019

Definitely agree with this.

Monitor and check back in a year's time for the sake of protecting the community.

After all, that is what this forum should be about.

A rushed decision will only help one side here, and we should be on the patient's side first and foremost.

Also as I've had similar final work done that was icing on the cake, I just will mention that adding temple points even subtle ones will be the perfect final touch to your current results.

Any plans for temple points? (if your donor supply allows it)

Congrats man, looking great.

Love to see threads like this with successful results.

HDC and Dr. Maras are one of the most underrated clinics out there, and I have researched all of the major ones out there exhaustively.

Looking effin fantastic man! I remember your first posts postop months ago.

These are the results you get when going with a world-class HT surgeon.

Enjoy it to the fullest.

I went with Dr Dan Mcgrath in Texas. I was told he got 4800 hairs, not grafts. 22.5cm per square inch was taken.I do not have fine hair. I actually have a great donor with very thick hair well over 200cm per square inch.

This reply is more for others still in the research stage, but why did you chose Dr Dan Mcgrath?

Can't say I've ever heard of him..

Did you research surgeons who were known for producing dense and natural results?

Even starting a thread on this forum something like "Who produces dense and natural results?" would be a good starting point.

Actually it's much easier to produce a very densed-packed HT during the first pass into virgin scalp, than it is to transplant in between existing hairs whether they be native hairs or transplanted ones.

Again not giving you a hard time, but trying to help those out there who are still researching dense result hair transplants.

Make sure that surgeon who is going to be cutting open your scalp is one of the best in the world before proceeding.

Hope the density works out for you in the end.

I agree with what's been said.

Also consider trying the shaved look and also researching temporary SMP as other ways to cope with your hairloss.

The donor area density worries me, and even getting on meds could make a hair transplant a very expensive cat and mouse game you're likely never to win.

Nice work man, looks really natural.

What is the maintenance time like for the SMP? (with temporary ink).

Will the patient have to travel down for future touchups?

Did you go with a highly recommended surgeon and one who has been vetted by this forum as a surgeon who does not produce subpar results?

My initial feeling is that you will not get the density you desire on this pass as the grafts are spaced out too far apart.

Looking very good man.

Congrats and enjoy it to the fullest everyday.

Excellent dense results for FUT as always.

If Rahal is not in your top 3 choices for FUT surgeons when researching you've not done your homework.

Um wow, you had two of the best doctors in the United States at your disposal...that's unique to say the least.

Exactly my comments, wow! I have no doubt the results will be stellar. Two week post op photos look like excellent clean work as expected.

Happy growing