Mr Sinister

my thoughts - don't do you front hairline just yet. my hairline is similar. a little thin. some double grafts. poor angles. but we are in the unfortunate position where we have very limited donor. you want to save as much donor for future years. 500 to the hairline doesn't sound like a lot, but when your mid scalp and crown completely go you will be begging for 500 more grafts on top 🤣  at least for now, you have some sort of hairline which is an improvement on before. don't aim for perfection. think long term. and in the future if you still want to improve the hair line you can look at it then.

also, just remember, beard donor success rate is lower than scalp. And chest/belly even lower still. a lot lower. so that 2,700 number could easily look close to 1,500 when transplanted. that's why my advice is to think about preserving as much donor as possible for the future. but with mwamba you're in good hands.

good luck

“When grafts are taken from one focused area, overharvesting suggests that also blood vessels have been disrupted, and scarring will have occurred in the skin tissue, even if not visible, meaning the scalp's response will be unique, and there is no guarantee of growth“

Bisanga told me the same and I completely agree. That’s why I only did a small job. It’s a tough decision only you can make. Risk losing donor with no guarantees or save some for the future. We took 800 beard and 200 chest. I think I had approximately 50% success overall. They also had to remove 2 cysts they found in my donor due to the bad work of my first surgery. So they are completely accurate about damage and scarring as a result of poor donor care.

I had mostly the right side behind the ear repaired. 

hi @VladRojas, responding from the other thread 🙂

so definitely wait at least 12 months before doing anything. i did smp 7 months post surgery to my donor and wish i hadn't because it didn't give the desired outcome. in my experience smp only works well if you keep the hair really short as above or you have enough density in your hair so that the naked eye can't really see the individual dots as it is mostly covered by hair. in my case, i was very thin in the donor and adding smp. you could easily see the dots through the hair when it grew longer. the eye can easily detect a difference between 3D (hair) and 2D (smp). a few of my friends spotted it easily.

donor restoration is the only way you'll get some fullness back in the area, but it won't be perfect. then maybe look at smp to add some density if you require.

i had a small donor restocking from bisanga. 1,000 grafts. mostly beard and some chest grafts. it's not perfect. go in with low expectations. mustangs result is superb and a rare case. so don't go into it thinking you're going to get 90% success rate from beard into scarred donor. he's a rare case, and one i envy hahah. i think bisanga is maybe saying no to you because he's probably seeing so many cases and would rather focus on new surgeries rather than repairs. just my thoughts. plus, i think mwamba is the better of the 2 with repairs. his strategy to homogenize the area is a good one.

it looks like you'll need anything from 1,000 - 2,000 grafts. bare in mind you will still lose hair on top in the future so you want to save some grafts for future surgeries. that's why i went in with a small repair. i've saved some beard, chest and scalp donor for future surgeries on top. i'll still need 3,000+ grafts which i barely have left now in all donor areas. 

ALSO... are you on any meds? try and exhaust all non surgical avenues to maintain what you have. unfortunately for me fin gives me extreme side effects and i'm still waiting to see results after years of minoxidil with micro needling 😒  i've done prp, used all the shampoos and tried all the herbal supplements. at best i've only ever slowed my hair loss. but everyone is different, so make sure you try all these routes to maintain existing hair.

final advice is to give it time. not just for your hair to heal, but for your mind to heal. it's tough to go through, but i am in a much more secure and comfortable place now mentality wise just because I've accepted what i have. i know it's never going to be perfect.

good luck x

9 hours ago, VladRojas said:

Hi @Ricardo Pizzolatto & @Mr Sinister
These posts helped me a lot. Would you mind checking my post? id really appreciate it. 

I was overharvested almost 5 months ago. I am considering getting Beard to scalp transplant with Dr.Mwamba.  Ill wait until 7 months, is that a fair amount of time? 
What do you guys think of my donor?

thank you
 

 

i've responded on your thread.

"So as you know, I was nervous about overharvesting, my donor area was so red, and there were gaps on that area I though I lost my hairs completely. But when I texted the clinic about my complaint, to be honest I was so angry, but I must say they were very into my problem, got a quick text that simply says when can we call you? So I said Yeah you can call me in the afternoon  then I am available. Most of the communications went from phonecall, they were helpful. 
They wanted new pics and videos to evaluate my donor area and try to understand what is wrong and how they can help me. The interest made me feel much comfortable but still I wasn't happy about the result. So even it is rarely they said that healing process of donor area might be so late for some people at first, I thought they were in denial and I think that I might have been a little too rushy. They gave me haircare treatment package for no cost and they wanted to see the process over a year so like they said I send them pics every month as they wish. 

So eventually the clinic gave me emotional support and was to be honest always there for me. And by the way, I was happy about the hairline. 
Now donor area is looking so much better, as time passed, my donor area seems to look more healthy, so being patient is very important. The transplanted area is very dense and natural, and overall I am happy with the result now."

@Doron Harati dr acar, cosmedica.

@Usef I did a session of smp, but that faded really quickly and didn’t really give the result. I had a repair surgery with bisanga last year. We did 1,000 beard and chest grafts into some of the depleted areas of the donor. It was a very very mild improvement. Again didn’t really give me the result I hope for, but that type of surgery is always a bit experimental.

I’ve just come to terms with what it is now 🤷🏾‍♂️

2 hours ago, Doron Harati said:

You in a better shape, mine was one of the worst procedures I ever seen.

I had 2 repairs by Dr. Maras at HDC clinic in Cyprus, I am the coordinator of the clinic, each repair session I had 2500 grafts.

Right now you just need to wait.

@Doron Harati I don’t know, I think my experience 2 years ago is maybe worse 😝😝

post is below, which includes recent pics of donor.

@Usef I know many people will say “it’s hard to tell,” but I’m going to say you have been over harvested. Sorry I know it’s not what you want to hear,  it I’m talking from experience. There are a few red flags for me - The extraction pattern. The number of wholes in your pic post surgery (too many). 4,100 grafts. Oh and the fact it was in Istanbul, the over harvesting capital of the world. Not trying to be negative, just speaking from experience as I’ve been through this. Here are some more pics of my donor post op. As you can see, it does get better. All the best 
 

5 hours ago, Rahal Hair Transplant said:

Mr sinister,

since this topic has been bumped, do you have any updated photos showing your donor area?  I’m hoping that your 6 month photos are still just showing signs that healing needs to take plane and shocked hair needs to brow back. After all, it can take yo to a year doe the donor area to fully heal and shocked hair to grow back.  Because the area is discolored also it does suggest that the area isn’t fully healed and needed more time.   Now that almost another year has passed, what’s the status of your donor area?  I know you were going to undergo SMP also, which I would have advised waiting on until 1 year post-op.  Hopefully you can update us with what’s going on so we can see the outcome

Best wishes,

Rahal Hair Transplant 

Yes, I posted my update above on the 3rd of December 2021. See pictures and comments above regarding smp and donor repair. So more pics below anyway.

Hello Guys, 

ive seen plenty of cases where once multiple fut’s have been performed, patients opt for an fue. This seems natural. But are there any cases of fut after fue? Is it advisable after the donor has been depleted? 
 

the reason I ask, is because after a poor first fue, I’ve been left with minimal donor, but I’ll still need to restore my mid scalp and crown as I continue to bald. I’m estimating a minimum of 4,000 grafts. There is no way I’ll get that using fue, so I’m wondering if fut might be able to help in this case? I appreciate the strip that is removed will not be as dense due to the over harvesting, but it will surely yield more grafts. 
 

I have ok beard donor so I’m sure I can get 1 or 2k grafts out of that and I’ve been using all the non surgical methods to maintain what I have. Ive also had a few SMP sessions to the donor, but they faded quickly so I do think future surgeries will be required.

pics of my donor are below

thanks 

Hello Friend, sorry you find yourself in this situation. It’s not a nice feeling!

I can tell by looking you have been over harvested. Some people may say “it’s shock loss so give it a few more months”, but your pattern is very similar to mine. Although I think not as bad as mine. I saw very little change from month 8 onwards so I’d say what you have now is close to the finished product.

I have another post which also shows more pics. 

I since had 2 SMP sessions. This was not great as the pigment faded only after 2 months despite me using a “top” provider of smp. I also had a repair surgery with dr bisanga 5 months ago. He took 900 beard grafts and 100 chest grafts and placed them in the bottom and right side of my donor behind the right ear. There has been minimal improvement so far, but I’ll give it a few more months before judging. The chest grafts weren’t very successful. There are only a few cases I’ve seen where this is successful. @mustang has seen excellent results with this type of procedure. If you do choose this method be realistic with your expectations. Bisanga was clear to tell me this is not ideal or advised. And the result was not guaranteed. I appreciate that honestly , but it was me who pushed as I wanted to test it.

Honestly, yours doesn’t look that bad. You still have good donor at the back. Do you have beard donor? You want to ensure you save grafts for future surgeries on top. Maybe try 2 smp sessions and see how that goes.  But overall, just get used to having slightly longer hair back and sides. I also sometimes use toppik hair fibres when I go out to improve density. It’s a pain to put in on the back and sides, but does the an ok job.

Below are my current pics. My hair is long in these pics. Grade 4. If it gets shorter than you really start to see the over harvesting more. You can see better density on the right side since the donor repair. Left side there was no repair. The bottom above my neck is still thin.

Good luck 🤞🏾 

3 minutes ago, Raphael84 said:

@Mr SinisterI hope all is well.

The UK leaving the EU did have such consequences in terms of shipping and import taxes as you say, which is unfortunate.
A reliable UK source is ukhairmeds.com

As I understand, they are currently trying to find the most effective/economic option for patients in regards to topical finasteride so Im not sure if that is currently available, but it is worth reaching out to them and checking the status of that.

Great Thanks 🙏🏾 

Agree with the above. Try and search for the minimum effective dose. 0.25 has been shown to reduce scalp dht. I was using 0.25 every 3 days and still seeing pretty strong sides so just decided to put a nail in the coffin 😒

On 3/20/2021 at 8:50 AM, Raphael84 said:

@SJPayneIf you would like to send me a message and I will pass a contact on to you.

Hi @Raphael84, I was previously ordering my topical fin from BHR, but since the UK has left the EU, import taxes have gone up significantly making it very expansive to source from Europe so I had do stop. Do you know of a UK supplier? Thanks 

4 hours ago, qui bono said:

In terms of Feriduni's approach admittedly I havent seen any donor to donor transplant repairs before, but it could be an effective approach. Can you ask Feriduni to share any examples with you?  I guess the cons to this is that youre only 35 and have mentioned you cannot tolerate fin and are expecting further surgeries - which is to say at a NW3 if you experience any further balding you might regret utilising the remainder of your limited scalp donor to resupply your donor when the recipient area is generally seen as taking priority. The donor to donor approach also has the potential to accumulate more noticeable scarring (although this is highly unlikely given the standards of Feriduni) but I outline this as its important to be aware of the risks. Does Feriduni offer BHT btw? If not this might be the reason it hasn't been suggested.

Like @Sam818I think Bisanga has the better approach. If you experience further balding Bisanga's approach means you would still have some available donor grafts available for the recipient, and some of his BHT repairs are truly incredible (I think there was one by @Corbinite ) Ultimately though its going to come down to your body hair characteristics and how well they match your scalp hair. 

Ideally I'd get in-person consults with both before deciding. Do you know your projected NW and has Bisanga commented on your body hair?  I wish you luck.

Yep, this is my thinking too. To save as much scalp donor as I can for future surgeries. Feriduni does offer bht, but i think he might be looking at it from a final result only angle, rather than thinking about longer term planning.

bisanga has seen pics of my beard and chest hair and is happy there is plenty of donor. He’s estimated 750-1000 grafts split 50/50 between chest/beard. 

13 hours ago, Sam818 said:

The SMP actually did a really good job but the problem is you had really large gaps which become more obvious with longer hair on the sides. The SMP won’t replace the bulk of real hair. Whoever punched your grafts out during your first surgery had no clue what they were doing. I’m curious how it looks at a shorter guard like a .5 or #1 with the SMP.

You have a thick beard it looks like. I think Bisanga’s game plan is better using beard and chest hair only because I remember you saying in another thread you also weren’t happy with the results in your recipient area so if you have any precious donor area hair that can still be extracted it should be used to improve the results in your recipient. But first things first you need to fill in the donor scarring. Good luck with whatever you choose to do.

Yep spot on. The spacing between hairs is so big that SMP in this situation doesn’t work, hence why Im looking at adding some density in via grafts, then perhaps more SMP. I would love to have my hair shorter so it blends better with SMP, but my scalp has been left pretty discoloured, even after 1 year, so it looks pretty bad at shorter lengths. Having tested different lengths, my best defence is to have slighter longer hair on the back and sides. Thanks 

1 hour ago, Curious25 said:

Why aren’t you considering Mwamba out of interest? He appears to be one of the pioneers in this donor replenishing movement, and also has a clinic in Belgium where your other two options are, as far as I am aware. 
 

I would contact @mustang RE. your case.  
 

Your hair quality looks good to me, 

Mwamba was my first choice, because of mustangs experience. However I haven’t had a response from them yet. I will try again.

Hello all, I’m currently considering a donor repair surgery, to restore a normal look to the back and sides of my head. I had a 3,000 graft fue 1 year ago but was over harvested, results of which you can find on this forum.

I’ve had some SMP sessions, but they’ve not really had the desired effect.

with that in mind, I’ve contacted 2 doctors and the 2 I am considering are dr feriduni and dr bisanga. Interestingly though, they have both proposed different strategies.

feriduni - donor to donor, in order to harmonise and even out the density in my donor area giving a natural look.

bisanga - body to donor, using 50% beard and 50% chest graft to replenish the donor and cover the scarring. 

here are some other bits of info to give more context. I’m 35, Norwood 3 (before surgery), using minoxidil for 1 year (minimal response), suffered bad side effects from fin, recently finished 3 prp treatments (awaiting results), as well using various other shampoos, supplements etc. I’ve tried most non surgical methods with minimal result. So I am expecting to have further surgeries in the future. The main issue is I have limited scalp donor, but good body donor.

has anyone had any of the above surgeries? I recently saw an excellent case on this forum from mwamba of donor repair so I’m hopeful. Any thoughts on pros and cons and which method to choose would be much appreciated. My pics attached at longer and shorter lengths. The longer length pics are post SMP. Thanks 
 

On 11/13/2020 at 6:52 PM, hair4tomo said:

There's very little research done with topical fin in comparison to oral fin, especially at around the 0.2mg dose mark. And around that level, you need to dilute it with ethanol or something (is water acceptable?), and store it with risk of the substance potentially degrading over time. Then there's the inconvenience of applying it, since it'd need to be over quite a wide area. Will it smell? Obviously we want it to be socially acceptable. Finally, I know of very few places in the UK where I can purchase topical fin, and I'm not sure I'd be able to trust the source.

I'd be happy with one or two of these drawbacks, but in combination, they compound. Maybe I can get the topical fin validated by a third party chemist or something for a fee?

I’d like to know the answer to your main q as well.

I have had experience with topical fin. I used a 0.1% gel as that was the lowest strength option, but got pretty bad side effects after 1 month. Worse than oral. But having done some research since, I think 0.1% strength is still equivalent to 1mg oral. Don’t quote me on that. It’s just so hard to find that info out. Annoyingly I binned all of the gel before trying to lower the dosage/frequency. So keen to know if lower doses actually deliver results.

some answers to your other questions on this... it doesn’t smell, my gel was more of a cream/gel consistency so no ethanol, although there are liquid versions out there. I’d apply it once a day before bed. Like minoxidil it’s going to leave your hair a little sticky and harder to style/add wax/gel too. It has a shelf life of about 6 months.

Dr bisangas clinic Bhr provide a prescription and have the gel compounded for you. Its not the cheapest, I paid 200 euros for the prescription, 3 month supply and postage. but it’s reputable.

Also Matt dominance has done some excellent vids on YouTube regarding this topic, so worth a watch.

I definitely can’t have a fade 😆  That was the original plan if my fue was done properly. But with the over harvesting and significant discolouration in my donor (even 1 year on), my best defence is longer hair back and sides. And then hopefully some additional grafts and SMP in there to add density. My current SMP is already quite dark so once it’s done, you can’t really have a fade 😫

good luck my friend 🙏🏾
 

15 hours ago, Chances101 said:

@Mr Sinister is it really that obvious? Has someone ever brung up the smp without you mentioning it? 
 

I think the smp artist is as important as finding a hair transplant doctor . 
 

also how many sessions did you get ? 
 

I have found some good smp artist on Instagram . 
 

This was a decent example I seen 

 

No one has said anything yet because I wear my hair fairly long around the back and sides, but I still use hair fibres in the back and sides as the over harvesting is still very apparent, so that also provides more coverage. ive had 2 sessions, I do think I could do with more to add more density, but am opting to place some hair grafts into the area first. And then I will revisit SMP if I still need it. The example pic you have posted is a little deceptive in my opinion. In the after shots, the hair is clearer longer, so that is also adding to the masking of the scar. From my experience, then best defence against scaring is simply longer hair.

So my advice would be to wait for the full growth of your new grafts or atleast for 8 months. Then decide if you want SMP. If you do, then decide if you want really short hair on the back and sides (0 or 0.5) or long (4+). As that will determine the colour pigment used. You will then have to always have your hair at that length for the next few years / until the SMP fades. I think usually from 5 years

On 10/22/2020 at 9:26 PM, Chances101 said:

How would smp look at this length 

Not great in my opinion. SMP only really works if your hair is really short (0 or 0.5). Once the grows longer than that you start seeing the disconnect between ink dots on the scalp and longer hair. Take a look at my attached pic. I recently had SMP done to camouflage fue overharvesting and I now realise that’s not the best option. I wish I had done what you did and get grafts placed into the scarring first, something I am looking at now.

The other option is to have your hair so long that you can’t quite make out the pigments. But then you have to go quite dark with the ink to match longer hair and will always have to have your hair long. Check my second pic where I’ve done exactly that. But again, you can see the pigments up close. 

1 hour ago, SethGecko said:

Thanks bro. I had it done 2 years ago in oct 2018. 

I could use some beard hair, but I've heard it's not a good option for frontal area. 

Btw which clinic in turkey did you go to? I went to elit hair transplant. I found out about them from youtuber matt dominance. Wisj I didn't.

I went to Dr Acar - cosmedica. Awful place!

I’ve always respected Matt dominance’s content. Might have to tread with caution in the future now!

I feel your pain brother, I was over harvested in Turkey last year 😫

How long ago was your hair transplant? If it was recent you can expect more density in the coming months.

do you have beard and body hair? You could use that rather than sacrifice further donor hair. 

As gatsby mentioned, SMP would help add the illusion of density in both the donor and recipient area.

good luck 

This is exactly what I have been looking for.

i had my donor destroyed 1 year ago by cosmedica dr acar in Turkey. See pics. I’ve started the SMP process but realise it won’t give the desired effect. I wasn’t sure FIT farming was as successful as it has been for you. I will look into this now 👍🏾
 

a few questions...

- body hair can fall out over time as testosterone drops in men as they age. Won’t these grafts eventually fall out from your donor?

- nape hair also falls out over time as the back of the scalp recedes up. Again won’t these grafts also fall out from the donor? my dad who is in his 60’s has very little body hair or nape hair left, even though he was very hairy as a young man.

- how many body hair grafts approximately do you think I would need to bring my donor back to a presentable look?

Thanks so much for sharing mustang.

I’ve already started the smp process. Had one session so far. Pics below. If you zoom in you can just about make out the pigments. I think I’ll need a few sessions to get any decent density. 
 

the new grafts on my hairline have grown, quite dense. But very wire like and at slightly odd angles. And a few double grafts along the hairline which doesn’t look great. Grafts on my scalp didn’t grow at all. 1 year on and I just have dead stubble on my crown area.

All signs of an amateur job, which I’m aware of now, but I didn’t do the required research beforehand 🤦🏾‍♂️