Shera

Hi Jonnyboy17, If after 8 months there is no sign of any growth in the recipient area then I would say there is a problem. You should consult with your doctor first. As already mentioned, some clear before, post procedure and present pics as well as your procedure details will be useful if you wish to have a more precise response from the forum.

Hi Andag, A transplant at this time will more than likely end up with you looking the same as you do now over the course of a year. The transplanted grafts will simply replace the grafts that are currently in the miniaturization phase and are likely not to recover after the trauma of surgery. However the transplanted grafts will theoretically be lifelong grafts and they will not be prone to the affects of DHT. Therefore there is the possibility that you can do further passes over the whole area to increase the density over time, the plan being to eventually get to the stage where you will have a result that resembles a full head of hair that is permanent. Unfortunately you do not seem to be blessed with the best donor area either so it will be necessary to utilise body grafts too, beard and chest. Every reputable doctor will advise you to go down the medical route first. I totally understand your fears over Finasteride use, but if there is a remote possibility for you to give it a trial then I would at least give it a bash. As for hair cloning, its probably a long time coming yet and I suspect the expense will be astronomical in the early years of its introduction, way out of the price range of many of us mere mortals. Another option is for you to use hair fibres, a relatively cheap solution that if applied correctly will have you looking like you a have a full head of hair for a number of years until the time comes when the fibres have little native hair to attach too. I myself used this approach to great affect. If you are not willing to go down the Fin route then this may be the best solution for you to carry on with your life without worrying about your hair for now. Feel free to call me if you wish to discuss your options in person.

Body grafts are usually used in tandem with scalp grafts in a 5:1 or 4:1 ratio if scalp grafts are insufficient to cover a larger area. Body graft are more likely to have just a single hair unlike scalp hairs that can have upto 5 with the average being about 2.2. Body grafts are more expensive because of the additional skill and resource needed to extract them. Some patients who have very limited scalp donor supply have gone on to have great aesthetic results utilising mainly body hair. The beard (under chin shadow area) and the mid chest have been proven to give the best result. In your case judging from the clearer pics of your donor, it will not be a necessity, more an additional option.

Hi Sadhairlossman, To summarise, you had a HT 10 years ago of 3200 grafts to rebuild your hairline and provide coverage to your mid-scalp. At this point I will assume you went for a strip FUT surgery. The surgery was successful and now 10 years on your native hair has continued to recede and and only the previously transplanted hair is now providing coverage to your front hairline and mid scalp. Furthermore your crown area has also thinned out over this same time period. Judging from the quality of the photos you have provided I would guess that your donor area is very good. I would also guess that you have adequate grafts that can be taken from your beard and chest if need be. Clear pics of these areas would be useful in a consultation. So bearing the above in mind, I would go for another pass across your hairline and temple points (if required, photos are not clear?) mid-scalp and your crown area. At 35 years old I would go for approximately 3500 scalp grafts and possibly 1000 body grafts. I don't think you will need to address the hairline and mid-scalp again but you may need a further top up in the crown area if you continue to recede here. I hope that's useful for you, feel free to contact me if you need me to be more precise.

I think he just turned up like this at the clinic on the morning of surgery. I suspect he'd just had enough and had got to a stage when he was even too paranoid to visit a barber/hairdresser. So unsure on how he should turn up, he turned up having attempted to cut his hair himself in the hope of looking half decent for his doctor. Unfortunately, it didn't quite work out that way. For those younger readers, please don't try this at home! So you can all see that the new hair has given him a massive new lease of life. Since the surgery his confidence appears to have gone through the roof to the extent that he now is even willing to visit a hair salon and attempt the blonde highlight look favoured by his hero, Bhangra sensation JazzyB. Fair play to him! For future patients it is not necessary to cut your hair, leave that to Dr Bhatti on the morning of surgery.

Hi Kiranjainn, Congratulations on your amazing progress so far, you must be elated. I wish you all the best in your 2nd procedure with Dr Bhatti, if your growth is anything like the first then you will look brand new!

Hey Karthikeyan, That's a fantastic repair job by Dr Bhatti, you must be thrilled after going through the disappointment of your last surgery. I'm very pleased for you.

Hi T20, You are 30 years old heading for a possible Norwood 5. You had an FUT of 2200 grafts to rebuild your previously balding hairline. To summarise, you want your temporal regions reinforced, you want your balding crown filled and you would like to address the issue of density in your previously implanted hairline. "The main high concern I have in covering the crown is the permanent shock-loss post HT which might happen for the weak miniaturising native hairs I have in the crown section." If these hairs are on the way out anyway then the trauma of surgery in this area might speed things up.....shockloss. You are on Fin so it looks like these hairs can't really be helped much more and a year down the line the end product of surgery will possibly look the same, shockloss or no shockloss. About 1000 grafts in this area seems appropriate, there is the option for you to compliment this area with beard/chest grafts to keep your scalp donor banked for future hairloss. You are already on Fin so you are doing your best to minimise the risk of shockloss to adjacent grafts. Dr Bhatti will not dense pack this area so that will further reduce the trauma to existing native grafts. No Doctor in their right mind will remove healthy grafts from your recipient areas. I think the decision to go with FUT or FUE lies solely with you. I personally feel that either surgery will give you the same look. Without being an expert in FUT I would probably look at the scar you have now and see how it looks. Do you want to risk it looking worse? If it looks bad now, is there a chance you can revise this with another FUT (kill two birds....)? If you feel you are heading for more surgeries further down the line, does it make sense to max out with FUT first? For FUE, depending on your donor area of course (pics would be useful) I would advise you to have 1000 grafts in the crown, 1200 in your hairline (which I feel will be adequate to add the density to ensure your hairline is uniform with your mid scalp) and maybe 300 grafts to reinforce your temple areas. That's 2500 grafts in total of which you have the option of taking approximately 500 of them from your beard/chest area.

Hey Corn, The 5mg pill is actually prescribed to male patients with an enlargement of the prostate gland so I don't think there will be anything drastically happening to you if you took the one pill. Saying that, I would probably give it a few days before I take any more. I would take 1mg once a day, preferably first thing in the morning. You can split the 5mg up into pieces using a pill splitter. Just do a search on Amazon, you could pick one up for 2 or 3 euros. The pill just needs to be split into approximate equal portions. Good luck.

Hi JG23, You should be fine commencing Fin now if you plan on going for surgery in mid December. In two months Fin can do wonders to some people, so to give your hair that boost before surgery should be fine as already mentioned by Mayira. Shock loss itself is quite rare but there's no harm in preparing for it prior to surgery. Furthermore Dr Bhatti will prescribe Finasteride for 6 months post surgery, however I always advise patients to pick up a years supply. Most patients will continue to use it for a year and beyond. Also a years supply of Fin, Biotin and Minoxidil from the clinic will set you back about 200 Canadian dollars, a fraction of what you will pay in the West so it makes sense to pick up your supplies whilst in India. Dr Bhatti also recommends you stop using Minoxidil 7 days prior to surgery, you can commence usage once your scabs have fallen off 10-14 days post surgery. When you walk away after the transplant, you'll feel immensely proud that you actually went through with it. You will also probably think to yourself what all the fuss was all about, it'll be a piece of cake.

Hi CJ, Just a thought, have you considered SMP, you seen to have the ideal head shape for it and there are some fantastic results recently posted on this forum. I suppose you could give it a bash prior to any hair transplant surgery. You might be pleasantly surprised by the outcome and knock surgery on the head altogether. If you still decide to go for surgery then the SMP will help create the illusion of a denser scalp once your new implants start to grow. With regards to surgery, your case is a challenging one and as mentioned you will not have that much left at the back so there will be a trade off. If you go down the FUT route you will find it difficult to hide the scar once you have had the proposed follow up surgery(s). As for body hair, the beard and chest are proven to work best. The pubic area is also an option. Generally these grafts are used as filler in areas behind your hairline usually in a 4:1 ratio alongside scalp grafts to help create more density.

Hi JG23, If you are considering going to India and Dr Bhatti in particular then please take the following into consideration. Travel Look into flights and aim to get to India a day before your surgery, preferable in the morning so you can catch one of the many connecting flights to Chandigarh either from Delhi (approx. 1 hour) or Mumbai (approx. 2 hours). If you have time on your side then you could actually do a multi-trip and stay in one of these cities for a day or so to take in the sites and the experience. I could even do you an itinerary if you wish. The actual journey from Canada can be long and tiring with a stop or 2 thrown in, so be prepared. Airport pickup from Delhi airport can be arranged with one of Dr Bhatti's drivers if your flight arrives later in the day. Long haul carriers that have been used recently by patients from Canada include KLM, Air Canada, China Eastern, Air India, Cathy Pacific amongst others. You can connect on the same journey otherwise you will have to check out and check back in if you book a separate connecting flight and you will be limited to standard baggage of 20kg hold and 7kg luggage, ample for your short journey, but maybe not enough if you go on a mad shopping spree. If you are booking a separate connecting flight you will need to allow approximately 3 hours for your connection to account for checking out/in, possible transfer to another terminal and any other delays. You also may want to avoid school holidays to avoid paying hiked up prices for your journey. You will be able to arrange the connecting flight online. (see http://www.makemytrip.com for a host of carriers with flight times, the prices here are generally the same as booking direct with the airline online). Once in Chandigarh you will be collected from the airport and all logistical arrangements including hotel stay will have been made for you. You can solely concentrate on your hair procedure without having to worry about anything else. Visa Another thing you will need is a visa, the Indian eVisa system is solely completed online and a visa can be obtained within 48 hours. It is however unnecessarily fiddly which sometimes makes me think they actually do this intentionally to make clients screw up applications hence making them pay more than once :mad: . The link to the application site is below. https://indianvisaonline.gov.in/visa/tvoa.html I generally get applicants to fill in their details and I then do the fiddly bits and finalise and submit the forms to avoid any errors and additional costs. Length of stay I would personally advise international patients to stay in Chandigarh for 3 - 6 days post op to relax, recover and explore. You are free to leave the day after the procedure once you have been checked out by Dr Bhatti and your dressings have been removed, but I would advise against this if you have a long journey back. You have just gone through a surgery which has probably cost you a small fortune, has taken you months or even years to build yourself up to so why take a risk in flying back so soon. Following removal/swapping of the dressings the day after the procedure you will receive detailed post op care advice from Dr Bhatti and clinic staff. You will be shown how to wash your hair and Dr Bhatti will personally provide you with aftercare advice. You will be free to visit the clinic everyday for a hair wash, any other advice or even just for a coffee during your stay in Chandigarh. You will always be made to feel most welcome by all. There is no extra charge for this, it is all part of the aftercare service the clinic provides. So I think it's wise to stay for a few more days and not rush back. Resuming Work This really depends on the environment in which you work. Generally you will be fit to go back to work as soon as you get back to Canada. However the scabs that would have formed on your implanted area will take about 10-14 days to fall out and you may have some redness in the implanted area for a few weeks. In rare cases this redness can even last months, there is a case documented on this site but I have yet to come across this with any of Dr Bhatti's patients. Also in your case, it may just be possible for you to grow your hair longer especially on the frontal third and the back and change your style so that it covers your forehead.This way you will get away with the no-shave technique and will be able to hide the implanted area with your existing hair. If you can get away with wearing a hat then there's no problem with going back to work on your arrival. If you have been open with your work colleagues, then there's no problem unless you are customer facing in which case you may want to wait the 10-14 days until you are scab free. If your transplant is top secret, then again give it 10-14 days. Any temporary visible redness you can pass off as a rash or similar. I hope that clarifies a few things for you, feel free to contact me if you need me to be more specific.

Thank you Mayira, Lets see the "end goal" first before we start comparisons with the "means goal". You know your result will not be final at 10 months so lets try not to assume Vermaj's is. Also, on another note, have you been drinking?

Amazing, literally blew me away!

Vermaj was a 25 year old patient when he came to Dr Bhatti. He was intent on lowering his hairline implanting grafts into a totally bald area knowing full well that statistically he was going to go down the route of a NW6/7 if all his older relatives and his current balding pattern at such a young age was anything to go by. Saying that his hair calibre was good so in agreement with him, Dr Bhatti made an ethical decision with his long term interest at heart. It was thought that he would have a good aesthetic result after 12-18 months with still enough banked grafts for future procedures. I have advised Vermaj to cut his hair to the length he mentioned, and take pictures without a harsh flash with dry hair. I have been in touch with him since a day or so before his surgery. He still has a few months of growth left, my own hair didn't stop growing and maturing till about 18 months and actually looks better now than my 12 month pics so there is no need to throw in the towel just yet. Also for the record, we are totally supportive behind Vermaj and we will do whatever to ensure he is happy, he knows that as I have told him personally numerous times. Dr Bhatti could have gone gungho with 3-4000 grafts, no doubt silencing the doubters but then what happens further down the line? It would be interesting to hear what some of the posters would have recommended, maybe a lesson can be learned.

Just looked at that pic again, it does look unreal!

Great advice Mattj. The bottom line is we are all different and as MattJ says you have to weigh up the risks and benefits. The benefits can indeed be great. The following patient came to me asking how many grafts he needed to thicken his crown. I informed him about Fin and how it had helped others delay the need for surgery. I sent him as much details I had about Fin including the potential risks to help him make an informed decision. So, he decided to commence taking it and after 2 months I was taken aback by the improvement. In the first picture he may have some product in his hair, but still the improvement is quite remarkable.

Theoretically Finasteride should help the few hairs you have left at the front to recover and thicken. I think you may well find Rashid's thread useful at the link below, http://www.hairrestorationnetwork.com/eve/183189-treatment-update.html

That's a fantastic SMP result. Very subtle, not overpowering, a near on perfect result. Hats off to you!

Hi Budhair, If you have asked Dr Bhatti to specifically cover all your balding area in the first surgery then there will simply not be enough grafts to give you the density I mentioned in my post. I incorrectly assumed you would leave the crown until the second surgery as Dr Bhatti usually recommends. I take it the 2nd surgery will bring you closer to the figures I mentioned, please correct me if I am wrong. I'm sorry for any confusion, I haven't spoken to Dr Bhatti about your specific case. Also if you are wearing a hair patch now, I don't see how you will be able to hide the drastic change you will have following surgery. You could just make something up like you got fed up with hair and fancied a change or maybe you can pass the shaved look off for religious reasons.There are lots of others, you just need to be imaginative, maybe I should start a separate thread. Anyway, I wish you all the best.

Hi Budhair, Dr Bhatti recommends at least a 6 month gap between surgeries to allow for the donor area to completely recover thus alleviating any danger of overharvesting, scarring and possible permanent damage to adjacent grafts in the donor area. The better the donor area, obviously the more grafts can be obtained in a single sitting without risk. Think of it as having any other surgery on your body, would you wish to be reopened the following day for Part 2. I guess not so why do it to your head? Therefore it is solely in the patients interests and the patients well being to do the surgery at least 6 months apart, there is no gain whatsoever for the Doctor. As for shock loss I would think that the surgery on the 2nd day would be on another implantation area so the risk of shock loss would not be any greater.

Hi Pocrockets, I would agree that it will be better for you to go for a smaller procedure to strengthen your hairline which I think when grown out will also help deflect attention from the other areas. I always think that a hair transplant should be a last resort. At the age of about 36 I think by taking Fin you have helped delay the need for a HT. I also think with the use of hair fibres on your mid section and crown you can probably go on for a number of years with what you have in that area, that's what I did. As for Dr Bhatti's hairline work, I can say that Dr Bhatti's hairlines have progressed throughout the years, I think you must be referring to posts over 3-5 years ago. Dr Bhatti's hairlines over recent years in my opinion are up there with the very best these days, just take a look at mine. Feel free to contact me should you require any more info or guidance.

Hi Jay, Three months is about the time when growth starts to kick in with most patients so there's really nothing for you to worry about at this very early stage. You should start to see small hairs sprouting randomly across the implanted area over the coming months. The hairs will gradually thicken and mature and you are right in saying that it can take up to a year or even 18 months to see your final result. You should now see a noticeable difference from month to month, exciting times, enjoy the ride!

HI Budhair, In response to your questions; 1. How may grafts I actually need to fully cover my bald area? I would say about 5000-6000 grafts should give you a good aesthetic result, I have a couple of guys in the UK very similar to you, one has had the two surgeries Dr Bhatti recommends for you and the other is just a few months past his first surgery. I can send you some pics to show you the first guys final result and the second guys progress. Also you will need to utilise beard and possibly chest hair. 2. Do I actually have enough donor grafts to meet this expectation? I think you will need the 2 surgeries at least 6 months apart to minimise the risk of over harvesting thus damaging adjacent healthy grafts and to minimise the risk of scarring. In general Dr Bhatti can usually harvest just over half the grafts in the second surgery. I think you will be looking at close to 6000 grafts once both surgeries are completed. Your scalp grafts (your donor appears to be good) along with your beard/chest grafts should just about give you enough grafts. 3. What kind of density I can expect after the transplant? To create the most natural looking hairline Dr Bhatti will select only the finest 1 haired follicular units for placement in the first two rows of the hairline. Dr Bhatti will dense pack up to 55 follicular units per square centimeter (FU/cm2) for your hairline. Your hairline will be planted with greater density, this density will be gradually decreased moving backward in order to provide you with more coverage. This will look the more natural when grown. I would personally recommend concentrating purely on the front and midscalp in the first session and coming back in 6 - 12 months to address the crown and maybe another pass over the previously implanted area (if required) once your donor area has recovered fully. 4. Do I actually a right candidate for HT? Judging from past patients, I would say you are a candidate for HT, a challenging candidate but a candidate nonetheless. 5. What about my looks? Will I look older after HT than what I look now I think with hair you are pretty much guaranteed to look younger than you do without. Speaking from personal experience, I'd say having hair has probably knocked 15 years of my own appearance. I hope that clarifies a few things for you, feel free to contact me personally if you wish to do so. I wish you all the best with your surgery whoever you choose to go to.

Hi Benny, I had no sides with Finasteride so continued to take it religiously for about 2 years following my procedure. During the past year, my third year post op I still take it but every 2nd or 3rd day. I think it has prolonged my native hair especially my crown area and even though the plan was to go and get my crown done at some point I think the use of Finasteride has delayed the need for any further surgery.........for now. I have personally managed over 50 patient hair transplant journeys over the past couple of years and I have yet to come across anyone who has had lasting side effects. About five of these patients suffered temporary loss of libido in the first few weeks but they recovered from this as their bodies adjusted to the drug. I always advise patients to halve the dosage if they suffer any sides, and then take it on alternative days if the sides persist. If there are still issues I would advise the patient to stop taking the drug. If not then patients gradually increase the dosage and frequency over the coming months. I have had two patients who refused to take Finasteride altogether and I do believe that their growth was slower compared to other patients who willingly took Finasteride. I also strongly believe it contributed to my own incredible growth, I kept in touch with a patient who had his HT a day after me who refused to take Finasteride and my growth was considerably faster and fuller than his although he got there in the end. Dr Bhatti advises that patients take Finasteride for 6 months post procedure but I always advise patients to purchase a years supply because I know in the majority of cases patients will continue Finasteride use long term in order to preserve their native hair thus delaying the need for further procedures. Also I always advise patients who no longer wish to take the drug to gradually cut down the dosage weening their bodies of the drug slowly. This is precautionary, I believe you can have an adverse effect to any drug if you suddenly stop, e.g. alcohol. I think it will benefit you to maybe give me a call so I can clear up your concerns in person, I have PM'd you my mobile number.