Fozzie

Just to add, your results have come along very nicely and there's a massive positive difference compared to where you were pre HT so congrats. Regarding the crown, 1500 has given you pretty decent coverage and you may well get some more density in the next few months but generally the crown needs a lot more grafts to make a real dent on the density front. Clinic were absolutely right to put the emphasis towards the front of the head and seeing as they can only put in a certain number of grafts in a session, a lot of people go in for a 2nd procedure to add in more density in the crown with say another 1000-1500 grafts if it's an issue they'd like to address, obviously donor supply permitting.

I've thought about this recently and think if going abroad there maybe something in staying and and resting for a week after a procedure rather than rushing off a day after or so afterwards. A HT is still surgery at the end of the day and it can't do no harm staying over for a while longer and giving the body a chance to recuperate. After a HT, the body needs time to heal and for some people, flying can compromise blood circulation which is probably a very important factor in healing and ensuring grafts have the best possible conditions during the period they anchor. Again everyone is different, but maybe worthwhile spending some extra time at the location. Just to be clear did you stay an 7 extra nights in total or 7 extra nights on top of the 5 nights included by the clinic making it 12 nights?

Congrats, progress is looking great. Big positive transformation in that last before and after comparison. Liking the nice age, appropriate hairline, think it's spot on.

Dr Keser is a good option for lower norwood's. If you are say 4 onward's, you may have to look elsewhere. Lorenzo is a good shout if you have extensive balding. Bisanga is another good surgeon although I believe he does a maximum of around 3500 grafts in a session if I'm not mistaken so you'd have to plan 2 sessions with him if you require more, donor permitting.

Definitely worth travelling if you feel H&W give you the best shot at achieving a desirable result with your remaining donor hair. Saying that, some great surgeons in the US. Really depends on what you are trying to achieve. Is there any area in particular you are looking to strengthen (hairline, crown etc)? How many grafts were used in your first procedure and was it via FUE or FUT? Also what Norwood are you?

Have used it but really don't think it does much on it's own to be honest. As an adjunct treatment alongside finasteride, it may provide a little extra in terms of inhibiting DHT however even then, not convinced it does enough to warrant being a serious treatment in the fight against hairloss.

Does sound like the Dr performing the procedure is a dermatologist rather than a HT specialist. Reiterates the importance of going to a surgeon who specialises in HT's.

Redlord (member here) had amazing progress at only 6 months after his procedure at ASMED in July last year. However, one thing to consider is his hair characteristic's were extremely conducive in producing a good result.

https://www.dailymail.co.uk/health/article-6808607/Businessman-43-dies-undergoing-hair-transplant-India.html Mentions patient had asked for 9000 grafts in one sitting although it is not clear whether the surgeon in question agree to this. Hopefully he didn't, because it would be utter madness.

Finasteride should be your first port of call. Your still young with clear noticeable, thinning/hairloss and the first aim should be to try and prevent any further loss and if you are a good responder, may even thicken up what you have at the front. Would probably stay on fin for a year and than evaluate where you are. Zinc, biotin and saw palmetto won't do much for male pattern baldness.

Has been looking good in recent weeks. Speaking of footballers and hair transplants, it looks like Christian Eriksen may be looking at another procedure. Think he had one around 2014 at a young age (21-22) and it resulted in a marked improvement from where he was post procedure. Fast forward 5 years and looks like he has lost more of his native hair in the front and crown (clear bald spot developing). Still looks in a better position compared to pre-transplant but not sure for how long for as hair loss has clearly progressed and he may be looking at another procedure in the near future.

If you like his work above everyone else's, I wouldn't really let travel put you off to be honest. End of the day, as you've mentioned cost isn't a major factor for you, I'd suggest travel shouldn't be either if it means going to someone who you feel will give you the best chance of a great result.

Kind of agree with that. I've watched his videos on Youtube and it is refreshing to see he is upfront in his thoughts on his procedure. However I do see signs he hasn't researched HT's enough. Think in his last video, he mentioned he asked the clinic what he could do to ensure his grafts grow and was a little surprised they couldn't give him a definite answer. To be honest, outside following post-op instructions, being careful with the recipient area and staying on medication, not sure there's much more someone can do and it pretty much comes down to the quality of the work and persons own physiology. Similarly in one of his earlier videos, he mentioned he wasn't aware he wouldn't be the only patient on the day or that Dr Erdogan would only be doing the incisions. Yes clinics should be advising patients about this for sure but for me prospective patients owe it to themselves to be clued up on these things and do plenty of due diligence through questions and research before they head into the chair and not just look go by before/after pictures on a clinics website to influence their decision. After his 2nd procedure, he has used 4600 or so grafts on the hairline and temple point area.......genuinely think that is a staggering amount in a fairly small area for someone who you wouldn't say is clearly balding from his starting position, especially when you you see NW4-5 patients go in and have 5000 grafts and come out the other end with major improvements in the frontal area and crown. In my mind, this is where HT's start getting murky and there has to be some push back from clinics. I've spoken with a recommended surgeon and he mentioned he see's it more and more where guys are coming in and wanting aggressive 'designer' hairlines and temple points to pull off a certain hairstyle before they've had any major loss behind the hairline and crown and it is a problem. I hope Planetstephen gets the result he wants after his second round but like you, there is a concern he is after something very specific that maybe fall's out the realms of what I'd call a real hairloss issue and he may still not be happy but let's hope that isn't the case. In Payam's case, I can totally understand his disatisfaction with his result. It's not a complete disaster in my opinion but even taking into account the idea of 'an illusion of density', I don't think he is wrong to be expecting more in terms of density. Saying that, as others have suggested, it would be good to see pictures with an overall view where the hair is styled and from different angles. Obviously he is the one who has to live with a result he is not happy with on a day to day basis so if it is making him self conscious, then can understand how in his eyes it is a disaster. End of the day, we are all emotionally/mentally wired differently, so understand where he is coming from. I do believe his concerns with his result are fixable however and in the hands of a good surgeon he is comfortable with, there's every chance he will come out the other end happy and hope he does.

Was your hairline was moved slightly lower in procedure with ASMED?

It's 8000 grafts before it becomes starts looking thin. Reason why Erdogan and some other surgeons numbers for total donor capacity are generally higher is because I think they feel they can target closer to the 35%-40% mark of total of donor area before they feel it starts looking thin. The Belgian and North American surgeons are more conservative and will probably stay in the 25%-30% range for FUE imo.

Couto has some very impressive looking results but he has 4 year waiting list. Think there's a 1-2 year waiting list just to get a consultation if I remember correctly.

To be honest, your hair loss is quite extensive (especially when looking at the 1st and 4th picture) and a pattern has formed imo... think any experienced, reputable surgeon would be fairly confident in predicting where your hairloss is headed in the future once you've been examined. You still have some hair on the crown but without medication, the assumption is that will go and key in your case is probably if the sides and back hold up which they seem to be doing at the moment. Personally think 3500 or so grafts with a conservative, mature hairline will give you decent coverage in the frontal/midscalp region. With a reputable surgeon, good chance you will be happy. Your crown still seems to have hair, however as mentioned, without meds you'll probably lose whatever remains there over time. I'd probably be looking at 1500 towards the crown in the first round as your crown isn't slick bald. Should improve coverage, just don't expect density in that area. Then after 18 months or so, can judge your result and look to target any lagging areas, maybe add 500 more to crown if your happy with the front. In your position, I think it may even be worthwhile having hair restoration in two procedures i.e target the front first and then maybe just get by with concealer on the crown as it appears you still have hair there and when the rest of the crown goes, go in for your second procedure. Obviously you can get it done in one go but I'd imagine in time your crown will start looking thinner when the native hair there eventually goes and you may look to go in again.

I think the answer to this question may depend on which surgeon you go to. In Europe, if you were go to a Belgian clinic for example, they general seem to be more conservative with the amount of grafts they feel they can extract from the donor area via FUE without leaving it looking thin. On the other hand, Turkish and some Spanish clinics push the boat out further and are comfortable extracting a larger amount without feeling they will leave the donor looking thin. Difficult to accurately say without having your donor area hair examined, measurements taken, check for miniaturisation etc but going by your pictures your donor area looks good and another thing you have going for you is your back and sides remain high (any family history where hair back and sides have dropped?) and I'd think 5000 grafts should be pretty comfortably extracted using FUE regardless of which clinic you go to. If by touch up you mean say 1500-2000 grafts, think that may well be achievable by some clinics but will only get an accurate answer after having your hair examined. Your expectations seem realistic and I think you can get a good result. For what you require and if budget is an important consideration, it would point to ASMED. However, if you have ruled them out, in terms of European options, I'd be saving up until you can go see someone like Lorenzo or say one of the Belgian clinics (will be over 2 sessions) etc. My figures may be off, but think for 5000 or so grafts, think I'd be looking to set aside a ballpark 16k-17k Euros figure as a minimum for one of the well reputed clinics in Spain or Belgium. Further afield, Hasson & Wong are also a great shout but sounds like cost may be an issue with them.

Took it when I was younger and to be honest I was ignorant to potential side effects until I saw my Doctor who said my symptoms are most likely down to taking finasteride. Advised me to come off it so stopped and eventually things got better. Few years after decided to try taking it EOD and also experimented with lower doses but sides were still there so admitted defeat. Funnily enough, my father took it for prostrate issues and had sides to so maybe it's just in the genetic make up to be sensitive to anything that has an effect on hormones, who knows. What I will say is that I've also side effects when taking some natural supplements that supposedly have effects on hormones so also stopped using them to. So in my case I just seem to have a sensitivity to anything which has an effect on my hormones rather than the medication itself being the issue.

Good post. Seem to be coming across a worryingly increasing number of cases where it seems younger patients with minimal hair loss are getting a procedure to try and pull of an ideal look in their minds or a certain hairstyle . For me, this is somewhat going beyond the realms of hair restoration and is almost 'hair modification' and must admit these type of procedures make me uncomfortable, especially when they are overly aggressive. I agree surgeons/clinics should maybe be pushing back on these type of candidates for their own good imo.

Wouldn't worry just yet. 5 months is still pretty early on and if the recipient area is exposed or viewed in strong/harsh light at this stage, don't think it's a total surprise that it may not look great. Some people get exceptional results early on. For example redlord who also went to ASMED had amazing progress at 6 months however do believe that kind of progression is generally an exception. Know it's not easy but probably best not to compare your progress to others and again with some ASMED patient's currently not happy with their progress, naturally it can make you anxious. However you should reach out to the clinic with pictures for their view on progress...if you've emailed the patient coordinator who has left and no one has picked up his/her emails (they should really be doing this to be honest and it would be poor form if the coordinator has left and the cases he/she were dealing with have not been handed over to someone else), they have contact details on their website.

Yup, think it's a wise decision for smaller procedures, especially those around the hairline and should be in safe hands with Dr Reddy. If I required a smaller procedure, I'd definitely be having a closer look at Dr Reddy however as my hair loss is more extensive, might be better suited to another clinic.

Look's nice and clean. Do like Dr Reddy's work and if I were to go to a surgeon in the UK, it would be him. Can work out quite expensive compared to other surgeons as I believe he charges by the hair rather than graft but do like his results. Believe he went through an unsatisfactory procedure himself in the past so in a good position to understand a patients concerns.

Both surgeons have some amazing looking work. Especially impressed by Couto's results and I believe he does the hole procedure himself. On his youtube videos, most of the patients do tend to have dark, thickish hair, maybe suggesting a lot of the patients are Spanish so would be interesting to see some results with patients of other backgrounds.

That is sound advice. I've looked into transplants for a few years now and I've always got the impression ASMED are a good option for guy's with more extensive hair loss. More often than not, guys with that kind of hair loss are coming out the other end looking cosmetically better after a procedure at ASMED. Yes, refinement may be lacking in some cases, but overall the end result in these cases seem to leave the patient in a better position imo. Personally, if someone is looking to Turkey for surgery, for me it would be any case that is a NW3 and below, Dr Keser. Anything NW4-NW6, ASMED. Totally agree with you on the point regarding lowering of hairlines. Recently seeing a few examples of young guys lowering their hairlines and makes me uneasy seeing this trend of guys committing 3000 odd grafts to lowering hairlines and filling in temple points. For me, this is almost going beyond the realms of hair restoration and sometimes feels as though guy's are after the perfect 'designer hairline and temple points', an ideal in their minds as to what they want to look like/hairstyle they want to achieve and I totally understand that thinking when a guy is younger. However sometimes there needs to be a trade off between what they want and whats best for them long term. I may be wrong, but that's just the impression I get. Now if someone wants to go ahead with that, fair enough it's their choice but they need to do some thorough research and be consulting as many surgeons as possible. Even if a top surgeon is way out the budget, I'd be getting an opinion. Unfortunately, seeing as HT's are now so accessible and relatively affordable nowadays, sometimes feels guy's are maybe rushing into things and taking the plunge without arming themselves with the right/enough information.