MyKindaMoves

Appreciate the replies folks, thankyou. 

On 2/21/2024 at 7:26 AM, Stoner said:

Would very strongly urge you to get on meds, if you are not already. I am afraid a HT is not sustainable otherwise in your case.

Since these pics I've actually been on oral fin and topical fin and min for about 8 months. Here are some pics of my hair now in different lighting and my donor area. Would love to know what you or anyone else on the forum thinks of my suitability for a HT this year.

So last year I got a consultation with Dr Pathomvanich in Thailand and was set to go ahead with surgery the following day. However I basically panicked for a number reasons and cancelled the surgery. One of the reasons was as follows. As you can hopefully see in the pic below I have a few stranded hairs that still survived  years of receding. Dr P drew a new hairline but conservatively enough that these old hairs were outside it. Dr P explained that although those hairs are from my old hairline that at my age (31) it wouldn't look natural to have such a straight hairline now. Do you think Dr P's logic makes sense or should the new hairline be based around those few hairs from my old hairline? If not,  would I have to continually shave off these old stubborn hairs on either side if I went ahead with Dr P's more conservatively hairline?

I hope this  somewhat makes sense. Thanks for any kind of response in advanced.

Would just like to clear this up by quickly stating the Dr Path and his team were very understanding. They've even said that I've got a year to try finasteride and can do the surgery next year without losing any of my deposit. Considering I cancelled right at the very last minute this was very kind of them and I'm so grateful.

5 hours ago, YodaHead said:

I understand that starting finesteride earlier is always beneficial; however, does it really matter (in terms of long term HT results) whether you start now and delay the HT vs. have the HT now and immediately start the fin? 

For e.g

- Person A starts fin in Jan-2023, have HT in Jan-2024, and remain on fin.

VS.

- Person B does the HT in Jan-2023, and then start fin immediately.

Now, if we are to evaluate both persons in Jan-2025, everything else being equal, do we expect that Person A will have better results? How about in Jan-2026? Long term?

This is what I wondered too.

1 hour ago, Bhumik Shah MD said:

 

All these are things you should have considered months before your transplant not 16 hours before. If you are hesitant about the surgery, the best thing would be to pull out, step back and reevaluate. You may lose money doing this, so be prepared for that. 

 

 

I agree that I should've considered this more however after a year on oral minoxidil I thought my donor area had improved significantly and I would be ready for a HT. Looking through the microscope at Dr Path's clinic showed that I actually didn't have too many great areas.

24 minutes ago, Turkhair said:

The reason is finasteride will help thicken up your donor hair and make them more able to survive the traumatic experience of hair transplant. Healthy less damaged hair follicles can survive trauma better than miniaturised already under attack by DHT hair follicles already on the way out.

All hairs go through trauma, they’re being displaced from their cozy home to another part of body and have to get blood supply, connect to new blood vessels etc.

So being on finasteride will help you get a better result. 

Never considered that actually, interesting. 

1 hour ago, A_4_Archan said:

Medication is important before surgery because surgeon can see how you react to medication and thats how he/she can plan your surgery...for eg if you are good responder to meds and if you can tolerate it well thn your surgeon can take a bit of aggressive approach if you are not a high nw case and if the factors are favourable....and if you don't react positive to meds or can't tolerate it than he/she have to take a very conservative approach considering your future loss and need of multiple surgeries..

 

This is what I needed spelled out to me. Thankyou so much. I've cancelled the surgery and will reassess in one year.

1 hour ago, Ajamilo said:

Remember that you will have 4000 scars from the surgery and you can never go back once you do it or shave it off. Money comes and goes but the scars will stay for the rest of your life 

I never looked it that way, again you've helped me to go ahead and cancel the surgery. Thankyou.

4 minutes ago, A_4_Archan said:

Good idea ....if you can tolerate meds than have a go at it and that can make you a better candidate for surgery for sure if you respond positively to it

Appreciate you think it's a good idea. I don't have enough conviction in my choice right now and that means a lot. I still can't quite work out why it makes me a better candidate for surgery though. If fin does help then would taking it at the same time as my surgery mean that the donor hairs that are transplanted grow thicker anyway over the next year, so in that case what's the point of waiting a year. On the other side of the coin if I don't react well to fin then I'm in the same position I am now anyway. Thoughts?

Are there any benefits to starting fin a year before your surgery compared to starting it on the day? If fin does help then would taking it at the same time as my surgery mean that the donor hairs that are transplanted grow thicker anyway over the next year? So in that case what's the point of waiting a year. On the other side of the coin if I don't react well to fin then I'm in the same position I am now anyway. Thoughts?

For some context I have a hair transplant surgery booked with Dr Path in about 16 hours. I went to BHT in Belgium last year to get a consultation with Dr Bisanga and he put me oral minoxidil for a year. I thought I noticed thicker hair on my donor areas on the sides and the back but one year later yesterday at Dr Paths clinic, after using the microscopic tool to check could see for myself as they told me some areas were okay for donor hairs but most weren't ideal. I know Dr Bisanga told me if I still didn't have good donor hair then he would put me on oral finasteride for another year and then reassess and I feel that's what I should do now. Rather than get my first hair transplant as 4000 graft surgery which includes 500 beard hairs, I should wait another to see how I react to oral fin first. It could increase the density in my donor hair. 

Sorry if I'm flooding this forum right now, as you can quite easily guess I'm feeling incredibly stressed about this and I know the real well informed opinions come from this forum. Time is of the essence to make a decision though. 

1 hour ago, A_4_Archan said:

Seems to be allrite ..but still you may draw yours and than show it so evryone can see it and give their suggestions accordingly....

Good idea, It's all a bit rushed now though with surgery tomorrow. I could pop down to 7/11 and get a marker pen though I guess.

My main concern now is actually the density of my donor hair. I went to BHT in Belgium last year to get a consultation with Dr Bisanga and he put me oral minoxidil for a year. I thought I noticed thicker hair on my donor areas on the sides and the back but one year later at Dr Paths clinic, after using the microscopic tool to check they told me some areas were okay for donor hairs but most weren't ideal. I know Dr Bisanga told me if I still didn't have good donor hair then he would put me on oral finasteride and I feel that's what I should do now. Rather than get a 4000 graft surgery which includes 500 beard hairs, I should wait another to see how I react to oral fin first. It could increase the density in my donor hair.

On 5/7/2023 at 9:23 PM, mr_peanutbutter said:

get a 3rd opinion. id choose eugenix bc they are not so far from you (india) and also specialised in high norwoods with often poor donor

What norwood would you say I am? I did actually email eugenix and the say I was 3

2 hours ago, mr_peanutbutter said:

i think the hairline looks okay, can you draw a line how you would prefer it?

 

the thing is you are just 30 and youre balding can still progress, so you need to take that into account. you dont have an unlimited number of grafts

 

also you would need to do something at the temples too if you get the hairline lower i think

It's more that I'd like it flattened out a bit, it seems incredibly curved to me but what do I know. Would flattening it also increase the need to do something with the temples.

1 hour ago, Melvin- Moderator said:

Looks like they’re following the symmetry of your face. There’s no perfectly symmetrical hairline.

Perhaps I'm misunderstanding but I'm not worried about how symmetrical either side is, more that I'd like a straighter hairline that's all

I told himself before going in that he's the expert who's been doing this for decades and I should just go with whatever he recommends. Now I'm back in my hotel and looking at the pictures I feel like the hairline could be a little straighter. Dr Path explained that he wouldn't recommend me getting the same very straight hairline I had when I was 10 years younger (I'm 30 now) yet I feel this is too curved. I sent it to some friends and family and they shared the same concerns. I really wish I just asked him to draw a less conservative one but I can always reassess with him on the day of surgery. 

Could anyone weigh in please? I'm really quite stressed about the whole thing, especially since he also mentioned that he'd like to take 500 grafts from my beard (the total is around 4000) and I hadn't considered that all being an option.

Appreciate your reassurances lads. I always imagine having very short hair after a HT but perhaps with an FUT scar and thinning on my midscalp I will now consider mid to long hair styles. It's actually been quite fun looking up different styles I could sport. Thanks again fellas. 

Hello everyone, 

I have a transplant coming up next month with Dr Pathomvanich in Bangkok with around 2000 grafts for my crown and 2000 for my hairline and deep temples and am wondering if should be worried about my mid scalp area.

I recently shaved my hair off to get used to having shorter hair for after the transplant and noticed that my mid scalp looks quite thin. See pic below:

However before I shaved it off it looked like this:

I asked Dr Path about this and he basically said it would 6000 grafts and I should wait a year if I want my mid scalp done too.

Ideally I'd like to keep my hair short, probably inbetween the lengths of the two pics I've uploaded. My concern is if my crown and and hairline look good post HT but my midscalp thin looks thin compared. Did anyone else run into this stumbling block? Any insight would be appreciated. Thankyou

2 minutes ago, A_4_Archan said:

Actually it is advised to stop minoxidil so that during HT there is no excess outflow of blood

Thanks for the response, I've got a HT coming up in June with Dr Path in bangkok so I'll stop taking my oral minoxidil a week before.

On 5/12/2023 at 5:53 PM, A_4_Archan said:

Yeh am already on oral minoxidil and finasteride since long ....i just stopped oral minoxidil 7 days prior to surgery and than again started it 5 days after my surgery 

Can I ask, why did you stop taking oral minoxidil 7 days prior to surgery?

On 4/30/2023 at 8:12 AM, Sunset Dune said:

That’s not a name I’m familiar with and I don’t think that surgeon was very reputable over a decade ago either. Honestly there are very few surgeons to choose from despite the recommended list many surgeons on that list aren’t guaranteed to give you a good result, there are only a select few that can actually guarantee it. 

Who would you suggest can guarantee it?

On 5/6/2023 at 4:12 PM, mr_peanutbutter said:

how is oral minox working for you?

Below are pics from almost exactly a year ago. I think the donor areas looks thicker but perhaps am I being bias? 

22 hours ago, Gatsby said:

There is nothing more accurate than an in person consultation. DHR from looking at your photos say you have a good donor on the back and sides. BHR say you have a low quality donor with signs of high miniaturization in the donor. If you look hard enough you will eventually find a doctor who will say yes. I would try medication before surgery for 12 months and go with BHR's advice. You could even include finasteride (I'm not a doctor) to improve your donor even more. Remember whatever the results are they will be with you for life. Wishing you all the best.

'Remember whatever the results are they will be with you for life'  - This line hit me hard and has certainly made me reconsider things. Here's my logic for going with DHR - If I go back to BHR and they tell me after a year on oral minoxidil I'm now a good candidate then I'm sure they could provide me a great HT. In that case then I would still get just as good or even better HT at DHR who also have an amazing reputation on these forums. If however I returned to BHR and they told me I'm not a good candidate well I would feel I've exhausted all options and would still risk a hair transplant anyway, should the grafts fall out and the transplant be a failure I would just shave all my hair off and put up  with whatever small scars I have from the donor areas. I've tried topical minoxidil and dermarolling for many years, oral minoxidil was the last option for me. I would never try finasteride due to reading about the horrific side effects many people experience. 

I'm a 30 year old male living in Vietnam (just a 2 hour flight to Bangkok). Last year while visiting family in Europe I went to BHR clinic and got a consultation with Dr Bisanga. As attached below BHR said I was not a grade candidate and put me on oral minoxidil and said to come back next year for another consultation. That was my original plan however after further dialogue with BHR I found out that even if I was a good candidate I would have to wait another 4 months for my surgery which doesn't make sense for my situation working and living in Asia, the cost of flights plus my fear of long flights made look elsewhere. 

After some research I came across Dr Pathomvanich at DHR clinic in Bangkok. His reputation on this wonderful forum seems excellent and his before and after pictures are exceptional. I got the closest appointment I could and paid the deposit. Since then after browsing these forums I have 2 slight concerns.

1) DHT Clinic never once asked me about what medication I'm on or have taken in terms of hair restoration. It seems this is a pretty standard practice, should I be concerned over this?

2) They would like to perform the roughly 4000 graft surgery all in one day. Once again, my understand from browsing these forums is that it's better to break the surgeries up into 2 days. Should this also be a concern? I suppose writing this now I've realised I should email DHR directly and ask them if this could be considered however it would be great to hear some opinions from the minds of HRN too. 

Below I've attached an email from DHR and their recommendation for me and also pictures of my current hair. If you've got this far and read my post I'm very grateful, thankyou.