Hi all. I just joined. I'm starting to notice my hairline recede and the crown start to thin a bit. I've researched my options for a month. I just had a consultation with a very popular hair transplant doctor . And during the consultation, I noticed a few things that were red flags to me. I'm hoping you guys can tell me if you think they're red flags, too. I don't want to name the doctor because I just want an unbiased opinion.
Here are the things I thought were red flags during my consult:
We had a video conference consultation (he never saw me in person), and with just a few pictures and literally 2 second look at my hairline over video (he spent majority of the time looking away, including at his computer), he recommended 1,500 to 2,000 grafts. No talk about where the hairline I wanted should be, no talk about where he thought the recession was, nothing. It was 1500 to 2000 grafts and how soon can we schedule it.
The number of grafts seems very high since, to be honest, he uses .9 to 1 mm punches and if I measured 1 mm squared across the area where I think he'd put in grafts, it seems too small to fit in that many grafts unless you overlapped them.
He said he would insert some grafts where there was already hair to anticipate future hair loss. And said shock loss "is rare," and "minimal." But I've seen a lot of anecdotal evidence of people realizing after surgery that inserting grafts in an already fairly populated area was a bad idea. I'll concede here I haven't researched shock loss or where the grafts are actually inserted but generally from before and after pics it seems limited to areas that have very little to no hair (not areas with a good amount of hair).
When I mentioned I was considering trying topical finasteride with minoxidil, he said topical finasteride doesn't work. Period. He said only oral finasteride works, and there were tests done on different types (oral, injection, topical) and they show only oral works. That's not true. A quick search for related studies shows that it does work topically: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/
I mentioned using Rogaine (5% minoxidil). He said it might work for the crown where it was just starting to thin (not bad enough to do any transplant there). But he said it won't work on the hairline that he wanted to fix. Period. Won't work at all apparently and that's why companies that sell it can only say it works on the crown (which is where it works). But my understanding is that minoxidil was approved by the FDA based on studies done only on the crown, and so that's what it was approved for. Since there were no studies on the hairline presented, the FDA didn't approve it for the hairline and prevents companies from saying it works on the hairline. But that doesn't mean that it does not work on the hairline. The vast majority of hair specialist say it does work on the hairline, there's nothing that would suggest it doesn't, and there is a lot of anecdotal evidence showing it does.
He seemed to want to schedule me to do the surgery this month or maybe next. He says people are backing out because of the Coronavirus situation and so easier to get in sooner than later since those who booked appointments at a later time likely won't move their appointments. But how can I schedule an appointment for my surgery in less than a month when the only thing substantiating his recommendation for the surgery is a few photos and a glance at me on video (no talk about where I wanted the hairline to be, he looked at his computer most of the time, etc.).
I asked about specifics, and he said it would be determined the day of the surgery, including where my hairline should be, what size punch he'd use, etc. So I would have to put down a downpayment and agree to pay the remaining balance a few days before the surgery, all before even figuring out these specifics....
I asked if he would do the surgery. He said he would, he always does. Yet I've seen many posts on here and other forums suggesting the day some people showed up it was a technician who did the work.
Do you think the above are red flags or do you think I'm overreacting on some points? Please let me know your thoughts. This doctor is supposed to be good at what he does. But it seems so inappropriate to jump into $15,000+ commitment based on the above.
I'm leaning toward holding off on it and using the topical finasteride/minoxidil solution for a few months and see how it works. Below is a video of a guy who makes it himself (I'm getting it from a dermatologist directly though so easier) and on his channel you can see results after 7 months from bare scalp at the hairline to hair. And after 6 to 9 months, if I'm at a worse position I think I'll come back and consider the transplant again. But I don't want to waste a year to only find out I might as well have gotten a transplant.