HCH

Thanks guys for your help.

Actually, i have consulted many doctors including Konior who assessed my case based on the below pics. Definitely i am not thinking to touch my crown as it will need at least 2000 grafts and my priority is my hairline and and frontal area. I am still looking to do a lab test for my donor density but it's hard to trust any local clinic here. Maybe i should go to India or Turkey for a week to check it and so a face to face consultation. Unfortunately, i can't afford going to Europe as it will cost me a fortune.

I have been reading a lot about SMP, i guess it needs a lot of maintenance and daily grooming. Not sure also if it suits me as i never shaved my head. Do you recommend such treatment ? 

Dr Konior : You have an advanced pattern and your restoration will be limited by donor supply as your needs surpass graft availability in the donor region.  Understand that surgery will not halt the progression of male pattern hair loss, meaning that your preexisting hair will continue to thin despite any hair restoration procedure.  I believe that it is important for you to consider using minoxidil and finasteride if you hope to maintain your current hair population.  You may want to try non-surgical means for up to one year prior to surgery in order to determine if there will be stabilization or possibly density enhancement.  Your short hair style will require you to use FUE harvesting as a strip harvest could potentially leave a visible scar in the donor area.  Your donor area looks average and should have perhaps 3000 grafts available for a first session.  I would need to know more details as to your goals, i.e. desired hairline location, thoughts on the current frontal and midscalp density, and your thoughts about the crown.  One should opt for the most conservative restoration possible when supply is limited.  This equates to maintaining a high hairline, prioritizing density in the front half of the scalp, and avoiding or limiting graft placement in the crown"

I wish so Phil  it's 4 or 5 i guess.

Btw, Dr. Bhatti told me first that my donor doesn't look good and then i sent him the below photo and he advised me the following:

"Sorry for that. On the contrary the donor is lush and hairs are thick as seen in the pictures.

You will need a staged procedure for the best result.

In the first- 3500 scalp grafts for the hairline, and mid-scalp.

After 6 months the crown area shall be covered with 1800-2000 scalp grafts.

Both will be single day procedures."

Also, i have consulted Dr. Bansal who recommended a mix of scalp and beard HT but after doing a video call she suggested 2500 to 3000 for the front and mid only. A reassessment will be done after 4 months of using medicines. 

The only 2 doctors who rejected my case are Erdogan and Lorenzo, i am so worried as HT is my only option left  

Hello guys,

I just took these pics today before my hair cut and would like to know your thoughts.

I am still on minoxidil (twice a day) & Finasteride (alternative days) and added micro-needling 1.5 mm (once a week).

5 hours ago, transplantedphil said:

IMO its VERY aggressive. lowering hairlines takes up a lot of grafts, and even when you lower them the hairline is the most important feature so you want the most density behind it

if this is the same doc saying he wants to place 1000 grafts in the crown well you can guess what i think of

as for bht there was a thread posted by melvin recently which was insightful, but again its ultimately about the patient's individual donor characteristics. while the results ive seen from eugenix are quite impressive, they mostly deal with indian patients (whod id assume) have similar calibre hair from their beard to scalp hair, and have less contrast between their hair and skin overall which makes them the ideal patients for this. bht also cycles differently so most surgeons ive spoken to seem to reserve it as a last resort. 

Agree with you but honestly if you see his results you would be really surprised. Also he's one of the few Doctors here who takes 1 patient /day.

In fact i have also consulted Dr. Devroye 2 years ago (see below his recommendation). he draws a very conservative hairline roughly at the same position.

"The thinning areas (1 to 5) represent an important surface. Probably it would be better to limit the transplant from the area 1 to 4. 

If you use to wear your hair short, as on your pictures, I recommend you the FUE technique. With this
technique, in one day we are able to reach from 1700 to 2000 grafts. It would be possible to plan two
days of surgeries or one day an half to reach 3000 grafts for example. 

With the FUT technique we could transfer more grafts in one day, depending on the quality and the
density of FU on your donor area, we perhaps could place more than 3000 grafts. So, with this
technique we could be able to cover the vertex (zone 5) as well, even if we do not want to reach the
maximal density. To preserve the existing hair the only solution should be to use minoxidil and/or finasteride. 

You are welcome to our clinic in Brussels for a consultation so I will be able to make a more precise
diagnostic. The consultation is free, and lasts about one hour. 

If you need any other information do not hesitate to contact me and I could also call you by phone. 

Best regards, 

Dr Devroye"

11 hours ago, Dr. Glenn Charles said:

I agree that 1000 grafts in your crown would accomplish very little. It does appear that your donor density has decreased over past 2 years so you need to be careful not to over harvest. You might want to consider having done only in frontal and mid scalp areas before committing to crown area.

Thanks Dr for your time and valuable advise.

According to my Doctor, he can do up to 3500 grafts in one session. So his plan is to focus on the front and mid scalp and then try to work on the crown with whatever grafts left. He's expecting to implant around 7500 hairs.  

What makes me step back from his plan is the hairline design which is a bit aggressive (maybe 2 cm below my existing one). Something similar to the attached pic including the temples. I don't think 2000 or 2500 grafts can cover this huge area (see Dr. Erdogan plan in 2017).

Appreciate your honest recommendation.

6 hours ago, paddyirishman said:

Hello HCH .  I hope you are well.

Take your time before making any major decision as you need to get your doner area properly assesed while pictures can only give a general guide  .  You must consider that medication might not help you in the long term for a variety of different reasons , so it might be wise not to totally depend on it helping you. You seem to have retrograde alopecia which is thinning over the ears and at the lower down on the back of your neck so that is another factor which leaves your doner restricted to a smaller area to harvest grafts from.  

Having said the above you still have options.  Find out how much doner you have. ?  What are your realistic expections ?  Seriously consider BHT in the form of beard grafts to help with more potential of doner for decent density and coversge of your transplant. If put in the right surgeons hands with lots of experience and proven results with combination of HTs and Beard grafts together it could make a significant difference.  

One of the clinics that are experts on the above and are recommended on this forum and beyond with great doctors are EUGENIX Hair Science's  who have proven results with patients with limited doner supply .  I think it was Harin and more patients ( or a very similar name ) who posted a thread of their situation which proved an amazing outcome.

I hops the above helps HCH. All the best.

.................Paddy..........

Hi bro, i really appreciate your advise.

Currently i am trying to use medicines and see how it goes. Definitely, i am not going to consider HT unless my hair loss stabilize.

I have seen some patients with BHT but not really convinced about it especially that the hair caliber and texture makes it look unnatural.

Worst case scenario, i will buzz my hair and live with it.

10 minutes ago, transplantedphil said:

Pretty awesome a doctor took the time to post on your thread.

If I were in your shoes I'd exhaust all non surgical first for at least a year and try and see if my hair loss stabilised. Take photos every 3 or so months so you can keep track of things. Im no expert but based on the thinning areas id be worried youd end up a NW7. The hair above your ears looks quite thin as well so id be concerned about your donor generally. Erdogan and Lorenzo are both highly respected surgeons in this community who are known for their donor management skills (they both also use graft calculators) so their recommendations should be taken with some weight.

What worries me is your assertion that your donor looks good at 5 or 6cm ... even those who have had their donors overharvested,look good at that length. And I personally don't think it's good enough for the doctors there to not to do a proper test. While I have seen some doctors perform surgery on patients with weak donors those cases are rare, and those patients were properly assessed and taken through all the risks. 

Wish I knew more to help bro. Good luck

Thanks bro for your honest advise and yes i am so happy to hear Dr. Glenn opinion

I just wanna mention that Dr. Erdogan and Lorenzo recommendations are based on pictures and not in person consultation.

Dr. Erdogan 2 years back suggested 6000 grafts FUE with a bit lower hairline but i wasn't really convinced as i don't believe any Dr. can harvest more than 3000 grafts in one session from the donor safe zone.

Back to your comment about my assertion about my donor, i am just trying to say that the comparison between my donor 2 years back and now doesn't help for assessment as the hair length makes a huge difference. i am thinking to keep my hair grow a little more and then reevaluate.

Doctors here will do a proper test only when you book for a surgery. My last consultation was even paid and when i asked the Dr. for the exact density he said it will take long time to test and need tattooing which can be done only before the surgery. Honestly it's like a fish market here.

Thanks all for your advice, much appreciated.

Actually, I have been exploring the HT option for 3 years and have consulted many Doctors in Europe, Turkey & Middle East but still hesitant to proceed.

Everyone suggested a different treatment plan (FUE/ FUT/ FUE + FUT) except Erdogan and Lorenzo who refused my case due to donor hair instability.

As i noticed, my donor density looks good when my hair grows up to 5 or 6 cm (as you can see in my 2017 pics) while it looks thin when i cut my hair very short.

Now after long research, i started using Minoxidil 5% twice a day and Finasteride 1 mg on alternative days (trying the microneedling also is not a bad idea as Cosmo advised). This will help me determine the effect of the medicines in case i decided to go for HT in future.

I am not really focusing on my crown and not sure if i can lower my hairline as my donor will be depleted assuming that it's very weak.

Now my main worry is my donor density and unfortunately all the Doctors who i have consulted here don't do a proper test to provide you the exact density %. They just say it's average.

Is this approach makes sense? what do you think about my donor density? 

Hi Guys,

I just had a face to face consultation with one of the best Doctors here in UAE.

He suggested a 2200 grafts to restore the hairline and 1000 for the crown.                                                                                                                                                                                                          Of course the medical treatment (Fin + Monox) is very essential in my case as this is the only way to maintain the existing hair and prevent future hair loss.

The donor hair is average but he can easily extract 3000 to 3500 in one session without over harvesting the safe zone.

Basically, i have seen 3 patients who did their procedures with the same Doctor and it looks like they got a good result after 1 year. Not sure how things will go after 3 or 4 years.

I need your opinion guys as i am really confused especially that two surgeons advised that i am not suitable for a hair transplant based on my donor hair pictures.

I have posted 2 sets of pics (1st in 2019 & 2nd in 2017). 

Hi Guys,

I just had a face to face consultation with one of the best Doctors here in UAE.

He suggested a 2000 grafts to restore the hairline and 1000 for the crown.                                                                                Of course the medical treatment (Fin + Monox) is very essential in my case as this is the only way to maintain the existing hair and prevent future hair loss.

The donor hair is average but he can easily extract 3000 to 3500 in one session without over harvesting the safe zone.

Basically, i have seen 3 patients who did their procedures with the same Doctor and it looks like they got a good result after 1 year. Not sure how things will go after 3 or 4 years.

I need your opinion guys as i am really confused especially that two surgeons advised that i am not suitable for a hair transplant based on my donor hair pics.

2 hours ago, Melvin-Moderator said:

3000 grafts will give you a change, but not a huge change. You will look less bald, but still balding. If you're okay with that than you can start to move forward. It really comes down to expectations. Your donor doesn't look that dense, so I don't see you getting 6,000 grafts. Maybe 4,500 tops before it starts looking depleted. I mean you can definitely restore the hairline with light coverage in the middle.

 you are the the only one saying my donor is weak and very limited. I will go for a face to face consultation and check my hair density first. 

thanks for your assistance.

On 6/15/2016 at 3:39 AM, HCH said:

Gents,

 

I need your help and support to decide on a suitable treatment plan for my current hair loss issue.

 

My local surgeon suggested a 6000 FUE grafts in 2 days consecutive sessions + Finasteride .

 

Do you think HT surgery is a good option in my case?

Is natural look result guaranteed after 15 years from surgery?

Any recommended doctors for advanced NW scales in the Middle East?

 

Appreciate your valuable feedback and suggestions

3 hours ago, Legend007 said:

I honestly think u look fine the way U are. It looks natural to me .. I never looked twice at someone with natural hair loss .. it’s when they start covering it up with some weird combover or hairstyle , that puts attention to their hair , that’s when people notice .. 

ur hairloss seems quite extensive ,. N ur donor doesn’t look plenty . I’m not sure what kind of result u are looking for.. fut will provide u with the most hair overall, but I don’t think u have enough hair on the back to cover the scar in the future after 2-3 transplants..

u really need to find a top doc , that can give u masterplan n provide u with some realistic expectations ,. Best wishes .. 

Hi Legend, many thanks for your feedback.

I am just looking to build my hairline and have some coverage in the middle.

As i quoted to Melvin, i am not comfortable going with FUT as i want to keep an option for buzz or shave head in future.

Do you think going for 3000 to 3500 grafts is wise at this stage and doesn't make a significant change cosmetically?

Any recommendation for an experienced Doc in Asia?

4 hours ago, Melvin-Moderator said:

hmm your hair loss has gotten worse since 2016, I don't think it's stabilized, but truthfully you barely have hair left so it's not going to make a difference anyways. At this point I really think your best option is to start with a large strip procedure and finish with FUE. You are going to need a lot of grafts. As for will the results look natural after 15 years, check out our YouTube video. Hair transplants definitely last more than 15 years.

 

Thanks Melvin, i get your point but i don't think my hair loss was too progressive for the last 3 years.

If you noticed my hair style is very short now that's why you see the difference. 

Going for FUT is a real concern for me as i am looking to keep an option for buzz or shaved head.

If i can have a well designed hairline with decent coverage in the middle that would be fine for me. Definitely i wouldn't touch my crown for now as i need to manage the use of my donor hair efficiently. 

Previously, Dr. Erdogan (top surgeon in Turkey) suggested 6000 grafts FUE but i am not really convinced with his plan.

Do you think going for 3000 to 3500 grafts is wise at this stage and doesn't make a significant change cosmetically?

Hello guys,

It's been almost 3 years since i joined this forum and still very hesitant to embark in the HT journey.

Now i am back to reassess my options as i think my hair loss has slightly stabilized (37 years).

I have consulted few surgeons and most of them recommended 3000 to 4000 grafts FUE or combo FUT + FUE to cover the front and mid scalp.

I have posted my recent photos and counting on your opinion to decide on a proper treatment plan.

• Do you think natural look result is guaranteed after 15 years from surgery?
• Do you recommend FUE or FUT + FUE
• How many grafts do you think it would give me a decent coverage ?
• Any recommended doctors for advanced NW scales in Turkey or India?

NB: I used finasteride previously and stopped it after 1 month due to the presence of side effects.

On 6/15/2016 at 3:39 AM, HCH said:

Gents,

 

I need your help and support to decide on a suitable treatment plan for my current hair loss issue.

 

My local surgeon suggested a 6000 FUE grafts in 2 days consecutive sessions + Finasteride .

 

Do you think HT surgery is a good option in my case?

Is natural look result guaranteed after 15 years from surgery?

Any recommended doctors for advanced NW scales in the Middle East?

 

Appreciate your valuable feedback and suggestions

1 month update (35 days)

 

Shock loss is finally stopping. Donor Area is completely healed and covered. I am using Fina and Xpecia.

 

It is a frustrating period but I hope to see first results soon. Let"s wait....

Hi Arwin,

You have to be patient it's a matter of time

I am pretty sure you will see a great results so wish you all the best !

Did you discuss with Dr. Yaman the plan for future hair loss and when it would stabilize?

I guess this is an important point to consider if you stop using Fin after 8 months.

Hi Chris/ Rev,

Thanks a lot for your advice and valuable feedback.

Unfortunately, after being on Fin for almost 6 weeks i started noticing some side effects (low libido & erection issues) so i have stopped using it right now and see if i will get back to normal.

My only option now is Rogaine foam, hope it will help

A few more photo's under different lighting conditions .

Hi Chris,

Congrats for the new look and great result, you look definitely younger and handsome

I have few things to clarify if you don't mind as i am considering Dr. K for an HT.

Here is my post if you have any comments.

,http://www.hairrestorationnetwork.com/eve/183794-hair-transplant-feedback.html

1- Did you take Finasteride pre/ postop?

2- What's your total baldness in square cm including your crown?

3- Did you discuss the long term plan with Dr. K if any additional surgeries would be required after addressing your crown?

4- How many grafts in total do you have in the donor area?

5- Reason why you preferred FUT over FUE so you can avoid the linear scar?

6- is it possible to show us a pic from top with a comb forward wet hair?

Cheers

I agree you should go more conservative than what you have drawn out. You can always drop it at a later date if you are unhappy, but I think a 3500 to 4k session will make you pretty happy now by basically beefing up the hairline that you have. You only get 1 shot at doing a placing a hairline right that lasts you til you die. Do it cautiously.

Thanks a lot Spanker, i really appreciate your advice

I am on Fin for almost a month and so far i didn't notice any side effects or any change in my hair loss condition so i will wait for another 4 to 6 months and then reassess my situation.

Meanwhile, i am still searching for a qualified surgeon in my region and checking what could be the appropriate method to go for FUT or FUE?

Some Doctors recommended a combination of both while others suggested FUE in 2 sessions

What's your opinion in this regard and do you recommend anyone in the Middle East?

Note: please see below Dr. Konior's recommendation

"2000 grafts placed at the front should make a good density improvement. Placing more would certainly increase the risk of shock as your preexisting hair population is significant. You could consider about 1000 for some coverage in the crown. It makes sense to use a much lower density in the crown so as to create a thinning look. Attempting full, high density coverage will surely deplete your donor area.

Rogaine is the only good alternative to finasteride, but it is not as effective. There is no way to predict how many surgeries you will need since I can’t fully predict how much more thinning you will have over the years and I can’t predict exactly what will make you happy in terms of final density. Some men are content with a relatively thin look while others demand high density. What you can do over the years is totally dependent on your donor supply, which unfortunately is limited. The more you keep your goals conservative, the more likely you are to achieve those goals."

Dear Forum Members,

I need more inputs regarding my case.

Any recommendation for an ethical Doc in the Middle East region?

any updates so far?

Thanks Arwin for your kind reply.

I have sent you a pm so i will be waiting for your feedback.

Thanks

Hi Arwin81,

Your surgery so far looks great, wish you a happy growing please keep us updated.

I have few things to clarify:

Did the Dr. Yaman advised you to stay on Finasteride for long life or you hair loss is stable?

What's your age?

How many remaining grafts do you have in total in your donor area?

Did you ask the Dr. why he lets the technician doing the extraction and not himself as this is an important part for getting any surgeon recommended here?

Is your Italian link working with the clinic so we can get a similar discount ?

Sorry for putting a lot of questions but i think your experience would help many of us choosing the right surgeon.

Thanks

Hi Dr. Yaman,

Your results are really impressive via FUE technique.

Could you please show us some cases via FUT technique and explain to us you protocol for using this method ?

Also, i noticed that you have different website clinics i.e. (Esteva Hair Transplantation & Medical Aesthetics) which shows your name and results but with different pricing packages.

We need a clarification in this regard, are you performing surgeries with other clinics or they just use your name for business and marketing while technicians are doing the job?

My last concern is your team email response which many members have mentioned, i have sent an email reminder twice but unfortunately with no response. Honestly you should find out a solution for this otherwise you will loose the trust of your patient.

Thanks