giegnosiganoe

Pics from 1 month - shedding is in full force, donor/crown in a bunch of different lighting

BTW I updated the OP with some more info about the procedure/recovery.

Pics from around 2 weeks. Also ignore the eccentric colors/art in the background, I'm in an airbnb lol.

On 2/26/2021 at 7:32 PM, MNIK said:

Yes i used to apply minoxidil religiously but not its on and off. I think ill start that again. 

For how long did you use it before the operation? And what changes did you notice from using it?

Do you have any other pics with longer hair, both recipient and donor? Might tell a different story.

Do you have any chest/beard hair? Those would be helpful to consider in long-term planning for your case.

In any case, I would recommend consulting with the reputable HT clinics in the UK, to get a proper microscopic assessment of your recipient/donor areas.

Do you have any immediate post op pics of your donor?

36 minutes ago, UnbaldEagle said:

No worries. But the same goes for FUE, really.  Since minoxidil inhibits fibroplast proliferation, which play a crucial role in the early stages of wound healing it may not be a good idea to take it when your body is trying to heal severed tissue and capillaries from thousand of incisions. It's not a big deal if you're healing fast, I guess.

(Not trying to disagree with you, I'm also an advocate of oral minoxidil otherwise.)

 

Interesting, how long did you wait then?

Perhaps I was a bit off base calling him insane I actually really like the new Connor. He's super kind, genuine, and caring. And I agree with a lot of what he preaches now. It's just a massive change for anyone who used to follow him, and he did go through a mental breakdown near the beginning of it. I figured most casual observers would see him as insane, but it's great to see how open some people are.

57 minutes ago, qui bono said:

why did Arocha agree to operate on this idiot?  It reflects poorly on his clinic.

I stay away from YouTuber/IG stuff, but I have a hard time believing this guy is popular. He talks like a religious fanatic and just seems lost. It's sad.

Well, he does have 2.5 million subscribers lol. I'm sure it'll get Arocha some customers.

He became popular within the fitness community by doing "pranks" in public where he'd end up taking his shirt off and impressing women, and he sort of became a meme. That's how he got to 2.5 million subscribers. Then he did ayahuasca, had a few mental breakdowns and became all spiritual/religious, and most of his subscribers are wondering WTF happened. He's not nearly as popular anymore, only getting a fraction of the views he used to. He basically threw everything away. He seems like a genuinely nice guy though and I'm sure he means well, but yeah he's definitely lost.

This fitness YouTuber fell off the deep after taking ayahuasca around a year ago. He whole personality changed, and he suddenly became very "spiritual". Just to demonstrate how insane he has become, about 6 months ago he did a 40-day water fast while livestreaming it 24/7.

He had dealt with hair loss in the past, and with this newfound spirituality decided to get off fin/min and treat hair loss the "natural way", using head massages and laser helmets. Obviously those didn't do anything, so he continued to lose hair, and was looking pretty bad recently.

Just the other day he put up a video of him going to Dr. Arocha. Before the video he states that he isn't going to use anesthesia, for whatever ~spiritual~ reasons. Apparently Dr. Arocha had to inject anesthesia about halfway through because the bleeding was out of control and anesthesia helps with that.

Felt like sharing this absurdity.

You can skip to around 4:20 where he talks with Dr. Arocha.

Agree on not touching the crown, from the photo you provided I hardly consider that to be balding. Definitely go for the front though.

14 minutes ago, Sitries1 said:

Like others have said, your description of your case makes it sound much worse than it looks. Your donor and hair in general looks very strong. Looks like you done a tonne of research and chose wisely. Would you say that getting the microscope analysis was worth getting In the end or did most surgeons dismiss it and want to do their own analysis ?

It must be due to the long hair + flash. I agree that the crown photo makes my hair look quite good, but the back + side photos are more telling. I'll post more before photos soon. You can also check some of my previous threads where I've posted photos.

I don't think anything can beat in person evaluations (including microscopes), but I didn't have any good surgeons nearby who were willing to do that. For my case, given I have general diffuse thinning and had a hunch that my donor was below average, the $30 USB microscope was worth the investment. It made me slow down and take a step back instead of rushing into surgery. If I was able to travel more freely, I would have been open to visiting many of the top clinics in Europe for consultations before booking any surgery. But given COVID, I couldn't wait. I've been putting my life on hold for too long over these past couple years.

Just now, nicoandgello said:

I think you are too harsh for yourself. Your hair looked pretty damn good before. If your density is 66% of what it was before those 50 grafts/cm will look great in 12 months.

Oh trust me, I'll add some more revealing photos soon  but yes, I do think the midscalp density is passable. One example of a change I've noticed is that around the age of 20, I could put a comb through my midscalp hair and it would stay there. Now if I tried that, it falls off.

Just want to add I just got a prescription for 1.25mg/day oral minoxidil so I'm excited to try that out and see if it helps with my diffuse thinning. I've never noticed any real benefit from topical minoxidil.

Thanks for the comments guys.

10 hours ago, TommyLucchese said:

Your description set us up for a very balding fella in the pics but you looked pretty good anyway to be honest. What did they say about the donor quality in person compared to the average patient? Was it better than expected but still below average? Or were the concerns unfounded?

Looks like great work anyway, look forward to seeing the end result!

Thanks!

Haha, I can see that. It's a bit difficult to accurately describe my situation just over text. Between NW2 to NW3 I wasn't completely bald, but very diffuse, maybe 25% remaining density. Similar for the vertex/crown, maybe 50% remaining density - the whorl doesn't help with coverage. The retrograde is obvious, I think. The diffuse thinning elsewhere (midscalp, sides, back) isn't too visible at the length I had my hair, but I'd say it's around 66% remaining density. I think this will be more obvious when I post pics with short hair. I get that some people have a much worse starting point though.

He said it's below average in terms of density and % of miniaturization, but the hairs/graft were better relative to that. For example, I met up with a guy who had his procedure the days after mine, who had an average donor in terms of density and miniaturization, but only had around 2.2 hairs/graft. Regarding the aspects which were below average, I just need to stay on DHT blockers to try and avoid them from getting any worse.

8 hours ago, BLE123 said:

Pekiner's work always looks very clean and meticulous, hopefully you will have a great result like @kiokbs

How did the design of the hairline go? Did Dr Pekiner draw what he thought would look right and then you gave your input or was it more the other way around? Either way it looks good.

Thank you I hope the same, @kiokbs has a wonderful result. At the same time, I have realistic expectations and know that anything can happen.

I just let him draw the hairline. He made some minor adjustments, and his technicians were offering their input. Honestly, I found it hard to evaluate at first, but I trusted his judgement. It followed my existing hairline pretty closely so it was easy to get the shape right (always had a bit of a widow's peak, and not so much a rounded hairline), and looks very similar to the hairline I had when I was around 20, so in the end I'm super happy.

7 hours ago, nicoandgello said:

Do you know how big was your recipient area exactly? Looks clean, happy growing.

Thank you. The recipient area was 31cm, which he calculated at 50 grafts/cm = 1550 grafts, plus a couple hundred for reinforcement on the connection areas. My head is probably bigger than average though.

2 hours ago, UnbaldEagle said:

It's very commendable you took your time and did your research so thoroughly, contacted so many top clinics. There's nothing wrong with your donor if someone like Pekiner accepted your case.

Work looks very refined and you have a high avg. of hairs/graft. I think you'll be happy with the result. Good luck.

Thank you! My donor is below average apart from the hairs/graft though. Actually that's one of the reasons I chose Pekiner - he is pretty good at targeting those better quality/higher hair grafts. And even though my donor is below average overall, given that I am on medication, have noticed stabilization, and only needed a relatively small number of grafts for hairline work, he didn't see any problem with taking my case.

Age 26, Norwood ~3V + retrograde + diffuse thinning (including donor)
Medication: dutasteride 0.5mg/day, foam minoxidil 1-2mL/night
Hair characteristics: high contrast with skin, fine, straight
Cost: 2.15 euros/graft which is a discount from 2.25 euros/graft because I agreed to provide them anonymized photo updates for their own use. Posting this thread is my own choice. Though, I wish clinics would offer discounts for patients to post threads from start to finish. I see nothing wrong with that. Also, I think the price has gone up recently.

Hair loss timeline:
18 - Looking back at old pictures, I had signs of thinning at the hairline
20 - Barber mentioned uneven nape, now I know it was the beginning of retrograde. Started noticing loss at the hairline/crown, found out about finasteride and tried to get on it but my awful dermatologist wouldn't prescribe it to me saying my loss wasn't bad enough
22 - Went back to the dermatologist, still wouldn't prescribe finasteride to me (I think because of side effects? don't remember). He instead prescribed topical minoxidil (requires a prescription in Canada) but he didn't make it sound like it was worth it (annoying to apply, need to use it for life), so I never went through with it
24 - Hair was looking awful, finally decided to do something about it - did my own research, went to a different doctor who was not a moron, and got a 5mg finasteride prescription. Quartered that for 6 months. Also started 1mL liquid minoxidil at the same time
25 - Didn't notice any changes after 6 months, seemed to have maintained. Switched from finasteride to dutasteride to keep as much hair as possible. Got a microscope and analyzed my donor, saw greater than average thinning
26 - Seem to have continued to maintain. Switched to foam minoxidil because liquid takes forever to dry
Moral of the story - Many doctors are crap. Take medical matters into your own hands and leave nothing to chance. I carried those learnings over to my HT research.

Choice of surgeon:
I sent the following clinics (in no particular order) pictures/videos of my hair/recipient/donor. The main point of contention between their opinions was regarding the microscopic videos/images of my donor.

• Hasson - "Dr. Hasson felt there was more miniaturization than the typical 10-15% and therefore a procedure would involve a bit more risk."
• Wong - "Dr. Wong on the other hand did not believe there was any signs of dupa and would have no reservations performing a procedure."
• Bhatti - He was concerned, felt that my donor density was quite low and wanted me to get evaluated in person
• Bloxham - Wasn't concerned, was more interested in if I noticed any changes in my hair, and said a proper in person examination would be in order
• Konior - Not concerned, said my donor area was about average
• Bisanga - More miniaturization in the donor than they would like to see for someone my age, and suggested an in-person consultation
• Ferreira - Said my donor isn't great, but that I'm far from DUPA, and that my prognosis is good
• Lorenzo - Said I didn't have DUPA but didn't go into any more details. I feel like they may not have seen the microscopic videos. Wish they would have at least acknowledged my weak donor. Tried following up multiple times to get clarity, but they never responded
• Diep - saw him in person since I was nearby, he said I had 10k+ grafts available in my donor. 'nuff said.
• Rassman/Bernstein - said I have more thinning than average but not yet DUPA, suggested I wait a few years, but said I could get a small HT
• Hattingen - said they would not operate on me, suggested I send them yearly updates of my hair loss situation to see if their opinion changes
• HLC - didn't want to say anything regarding my microscopic videos, said I would need an in-person dermascopy evaluation, but didn't seem too concerned
• Pekiner - noted the miniaturization but said my donor was good enough and that they select the highest quality grafts

At some point, I decided I was mostly interested in clinics where the surgeon does most, if not all the work. I understand the benefit of technicians doing parts of the procedure like extracting/implanting grafts, but I just feel more comfortable knowing that the surgeon is doing all the important aspects of the procedure themselves, and that I can hold them fully accountable. This left me with a few options at the time: Konior, Ferreira, HLC, Pekiner.

• Ferreira - I couldn't travel to Portugal because of COVID and wanted to see more results
• Konior - I think he is one of the best, but I was disappointed that he didn't acknowledge the miniaturization in my donor. My guess is he did notice it but that he's confident in his skills/work and doesn't want his patients to overthink things. I'll likely still see him in the future for temple point work or if I need any touch up on the hairline
• HLC - Didn't like not knowing which doctor would work on you, and the fact that you could have multiple throughout your procedure. Also have seen some cases where I felt the graft count was a bit aggressive for the patient's age. Have heard communication is also an issue
• Pekiner - I liked the technique, the small number of grafts per day (~1000), the fact that he is conservative and honest with his patients. Liked that he had a lot of patient reviews from start to finish (mostly on the Italian forum). Very experienced with hairline work and liked his hairlines and density (especially needed with my fine hair). Communication with his rep Alex has been very good. Aborting was a concern, but they told me that they now inform the patient of any findings but ultimately let them decide whether to proceed. Given he would select the highest quality grafts available, I was not too concerned. Also knowing that the graft count could be adjusted on the day of procedure (say down to 1500), my mind was more or less at ease. In the end, he said my donor was slightly better than expected. 

Procedure:

Each day lasted from around 8am-5pm. On the first day of procedure, I had a discussion with Dr. Pekiner about my hair loss history and goals. We then took the photos, designed the hairline, and shaved the head. Then we moved on to the actual extraction/implantation. The way it works with Dr. Pekiner, similar to HLC, is you have two sessions of extraction/15min break/implantation per day, AM and then PM. In between these sessions, they have a chef who provides a meal for you (bonus points for catering to a vegan diet - the food was delicious). At the end of each day, they wrap your head in a bandage to protect the grafts/donor. On the third morning, they give you a final clean up and provide you with the aftercare kit including saline spray for the recipient and bepanthol lotion for the donor.

1 hair: 249
2 hairs: 682
3 hairs: 710
4 hairs: 164
Average hairs/graft: 2.43

Recovery:

Sleeping - I'm normally a side sleeper, and started practicing to sleep on my back a couple months in advance. I don't think this is necessary, I just wanted to learn to sleep on my back anyway. Regardless, you'll need a travel/neck pillow anyway to make sure you don't turn in your sleep, and I think you'll be tired enough to fall asleep on your back even if you're not used to it. Another recommendation I have is to zip your arms inside a sweater, so you don't damage your grafts in your sleep. I've seen this happen enough times on these forums, even over the past few months, that I didn't want to take any risks. At one point I was very tired and fell asleep without zipping up my arms, and I actually caught myself lightly reaching up and tapping my recipient area as I was waking up. Nothing bad happened, but I was much more cautious the next times I went to bed and ensured that I zipped up my arms each time.

Swelling - I noticed swelling mostly on days 3-4, but nothing too bad compared to what I saw online. I just let it pass with time.

Pain - No pain for the first week really. From days ~6-10 I had some donor pain when I'd lay down on my pillow, so I'd just take paracetamol 20 mins before going to bed.

Crusts/scabs - was instructed to start gentle massaging them starting day 6, increasing intensity with each day. By day 9, pretty much all of them were gone.

Redness - I started using aloe vera as I've read that it helps. Haven't noticed too much improvement yet by day 30. The donor is still red but it's harder to see as the hair is growing longer. The recipient is still red, and the shedding is making that more visible.

Feel free to ask any questions.

I can add some recent photos soon. I'll probably update monthly.

2 hours ago, kipo said:

Some more photos straight from the shower and hair combed back, not touched with the towel and one towel dried. My hair transplant isn't dense packed but I still think it is a good result, especially for the amount of grafts. My hair is very thick in the back and on the crown where I didn't have hair transplant so you can see the difference between those two zones.

 

Very impressive, congrats!

Can you speak more to your finasteride usage though? Did you really use it for 20 years 1mg every day? I doubt you had much loss at the age of 17-18, so you must have continued to lose a lot of hair since then despite being on finasteride?

Clearly looks like another one of the countless hair mills. Not only that, they also provide dental work and "medical checkups", so they don't even specialize in hair transplants alone. And I highly doubt there are any patient posted reviews anywhere. Why even waste your time contemplating such a clinic when there are so many well known and proven ones already available at low price points?

Can you take a picture with the donor hair parted up in the middle, with good lighting?

2 hours ago, JayLDD said:

The case seems totally legit imo but I wouldn't conclude that they're are a particularly proficient surgeon because of it. It doesn't tell a lot. 

Their hair characteristics massively work in their favour and even in these mediocre photos it clearly isn't a high density, but the coverage is very good. It seems like low placement density with a high growth rate and very good donor quality and curl. A good result but for most patients they would require a very different approach. 

I agree. I didn't mean to say that I think he's lying, but rather that the pictures make it look better than reality. No doubt he has good hair characteristics though.

I'm skeptical too. I appreciate the new pic, but it still kind of hides a lot of your hair.

I'm also surprised how much loss you have in your pre op pics given that you were on finasteride for 20+ years since the age of 17-18?

It would be great if you can share pics in stronger lighting.

Wonderful results! And man, the rest of your hair is in great shape, I'll be surprised if you need more transplants.

I'm curious what made you archive your thread and step away from the forum?

Are you taking any medication for hair loss? Finasteride or minoxidil?

Hey one other question, I'm curious what made you decide to switch from Shapiro to Konior?

Looks like good work, get some rest and be safe with the initial 10 day recovery period! @Sukh, do you know what "1", "2", and "Minis" is referring to in the graft count sheet?