Curious25

Ultimately, it depends on what results you are looking to achieve. The more modest a restoration you are willing to compromise with, then potentially, the higher the likelihood of candidacy. You look pretty young, so the extensiveness of your loss relative to your age isn’t ideal - and I don’t detect huge density in your facial hair in order to be utilised as a donor resource, which again stacks up things that are going against you just now. If you are open to it, I would recommend doing an online consult with Dr Sergio Vaño for his medical recommendations - he will likely recommend 0.5mg daily dutasteride and 5mg daily oral minoxidil - which as of now, are the two most powerful hair loss medications available . . And there are plenty of case studies of people in your position and further gone, with pretty dramatic reversals. You would have to be motivated and at peace with starting the regime, and will need to wait for at least 12 months before making judgement on the next step. All depends on your appetite for regaining your hair, and how far you’re prepared to go - but by no means are you a lost hope. There are options available to you. Good luck

I think you have a NW7 pattern, and the thinning you are seeing in your donor area is retrograde alopecia starting to become more aggressive - creeping up towards leaving you with the small strip across the middle of the occipital region of your head, as seen in a classic NW7 pattern.

Great result - and a very modest number of grafts used for what wasn’t the smallest of recipient areas, very impressive. Its interesting to see how the texture of your hair has changed somewhat quite dramatically from your pre op photos - you looked to have had very fine and straight calibre hair pre surgery, but I’ve actually seen this phenomenon across a few different cases now. What could be the reasons for this @sl ?

You are not balding, but you certainly are wasting your life by this endless paranoia. Go and enjoy that fantastic head of hair, and fixate on something that is a positive focus.

Italian barber/influencer. Characteristics, density and hairline/temple point placement . . All perfect.

I was on oral minoxidil monotherapy for the first 8 months, and definitely noticed some strengthening of miniaturised hair that I had. At 8 months, I added finasteride, so it would be impossible to attribute the further improvements I have experienced up until now solely on the minoxidil.

5mg daily is the standard dosage by prescribing doctors in Europe. If side affects are of concern, you can work your way onto this dosage - I took 2.5mg daily for 6 weeks, and then moved onto 5mg daily, split between 2.5mg in the morning and 2.5mg in the evening. Been on this coming up to 15 months and zero negative side effects.

I don’t think there was ever any claims that Konior ‘botched’ him - his FUT scar was textbook perfect, FUE extractions were above average, and he yielded likely to be upwards of 95% growth. The issues from what I remember were that he allegedly transplanted a density of 90cm2 into his frontal band, which left a vast contrast between his diffusely thinning scalp and frontal hairline, which bought into question the ethics of the planning and design stage, and then later this information was supposedly withheld from him in the medical reports. I then believe Wong had said to him during his surgery with H&W that the angles were incorrect. To add balance to this, I have personally had what I deem to be a good result years ago with one of this forums preferred surgeons, however have since consulted with other forum favourites whenever they have been in my city, two of which spent the entire time criticising the work lol . . Maybe they’re right with what they said, maybe they were just trying to fortify their superiority, who knows, but I’m happy with where I’m at, and I just see it as one of those things to be expected in an industry that is largely dominated by fragile egos, hence the at times unbearable forum politics that we see before us. In my opinion, this forum is still on the whole the best English speaking source of information online for all things related to hair loss and hair restoration, there are a huge number of very informed posters that contribute neutrally, and they’re not hard to pick out once you spend enough time reading the boards - so if you can get past the white noise without it affecting your judgement, and take it for what it is, you’ll hopefully get further towards your goals than what you would do by looking on Instagram. I also want to add that the podcasts and interviews are brilliant sources of information, and provide what would otherwise be unavailable opportunities for many to be able to ask questions to elite level doctors who are based halfway across the world. Anyway, the best way forward for the community, patient and clinic during cases like this, are to not lock and delete threads, however to invite the clinic to address them openly, add their perspective into the situation, and provide the required transparency for everyone to make up their own mind, which thankfully Melvin has orchestrated. Hopefully a positive resolution will come from this for all involved.

What you’re missing, is that due diligence requires the ability to distinguish the criteria between an acceptably poor result and an avoid this clinic poor result.

- If you commit to continue with your medication, then I don’t see your age being too much of an issue relative to the amount of loss you have. -Depends on your hairline design. For a gauge of potential graft numbers, post up a pic with a rough outline drawn on of where you’d like your hairline to be. -far too broad of a question to provide any real answer. -For your case, I would look at Europe; Feriduni, Bisanga, De Freitas, Pinto, Ferreira, Hattingen, Reddy, North America; Konior, Bloxham, Shapiro, In Turkey, Pekiner and Keser have notable hairline results - however the former has a bit of a hit and miss reputation online.

With reference to the account of this particular procedure - if what has been stated is indeed accurate, then this would warrant genuine concern in my opinion.

When researching a surgeon or clinic - you should always judge them off their worst results, considering; what went wrong, and why surgeons follow up and accountability proposed resolution To elaborate for new users on the difference between a bad result and a bad result, you have to ensure that the surgical variables have been to standard, eg. Good design, good harvesting technique and pattern, correct graft selection etc. Less than desirable growth, despite being the obvious benchmark we tend to all focus upon, isn’t always indicative of a bad surgeon or a bad surgery. Bad harvesting, bad design, bad graft implantation techniques - these are variables that should NEVER be apparent from a surgery with a so called ‘top tier clinic’.

Ideal characteristics for what turned out to be a very nice result.

This guy is top of the game when it comes to hair loss medication. The biggest shame with the Loniten shortage is the reliance on local pharmacy’s compounding to remain consistent - which is simply never going to be on par as to what a pharmaceutical giant such as Pfizer are able to execute. If the shortage is due to loniten not being commonly prescribed for hypertension anymore, then it would be nice if this medication for hairloss continued to gain further momentum, and they could perhaps upscale the production of their lower dose formulas, in a back door route to enter the off label hair loss market without having the drama of gaining FDA approval - similar to how GSK are able to do so with their Avodart.

This is true - hair calibre is obviously a variable that comes into play when considering density. A good example is general south east Asian hair characteristics - thick straight calibre hair, but typically with lower density. That is coincidentally why their hair whorls can look more sparse, despite not actually balding.

Between 70-80cm2 is the average. It depends on how many grafts you extract. If you only require a 3000 graft surgery, harvesting from a donor with a density of 63cm2 won’t be an issue, given the surgeon is skilled and reputable. However be mindful that you’ll be more limited than others for further grafts down the line, so it is worth considering your options in terms of starting a preventative regime alongside your transplant.

It would be easier to comment with immediate pre and post op photos, but to summarise; - given the placement of your FUT scar, it is right in the sweet spot in terms of a ‘safe zone’, so regardless of whether you have taken medication or not, you’d still expect to see more hair on the top of your head 13 years on than what you appear to have now -scar is bad -your native hair loss has seemingly progressed , which dramatises your current situation now compared to your pre op photos in 2010 -Hair restoration surgery in 2010 (regardless of clinic) was unfortunately not what it is today, that goes for both FUT and FUE -the comments regarding other Bisanga patients you know with unsatisfactory results, and other surgeons claiming to have lots of former repair patients of his should be dismissed as hearsay until they come online and speak for themselves providing evidence -you should be able to ask for an official statement from the clinic on this thread, as there are two or three very active BHR reps who regularly post on this forum, I hope you find peace eventually, in whatever form that may be. At least you got a refund, which I know doesn’t make up for how you have felt or must currently feel now, but it is still a small victory in this industry as very rarely do clinics actually follow through with a refund. Good luck!

There’s a Dr in the UK who sells his own ‘hair safe’ protein formula because of this 😂 What a world.

The most commonly known study that this whole school of thought derived from, demonstrated an increase in serum DHT of rugby players, I believe, after however many weeks it was of taking creatine. Regardless of whether one study is enough to conclude that this is the case or not - if creatine really does increase serum DHT, then this would only be an issue in the realms of hair loss for people (or follicles) who are susceptible to androgenetic alopecia - put short, it isn’t creatine itself that causes hair loss. OP - oral dutasteride is the most powerful 5AR inhibitor available. If you are taking this, regardless of what creatine does or doesn’t do, you are taking a medication that blocks the enzyme that ‘creates’ DHT. So unless Creatine somehow delivers pre made DHT into your blood stream (which it doesn’t) you are good to go, as you are essentially nullifying the opportunity for DHT to be reduced from testosterone.

And for what it’s worth - I’ve not read the ins and outs of the full thread, but have the general idea. My takeaway for you is that it’s important to consult with multiple doctors, because there will always be a variety of perspectives, skill levels/capabilities, surgical approach, restoration ethos etc. Therefore like all things in hair restoration, there isn’t a one size fits all answer, even for your own individual case. In the same light, I also think the former Eugenix patients chiming in with their own personal experiences should be taken with a pinch salt, because it’s pretty amusing to imagine a patient viewing your photos online, to feel they are in a better placed position to say what is and isn’t feasible for yourself, contrary to what a world class surgeon who has had the opportunity to physically examine you in person suggests. I hope you get to where you want to be in the end.

Well that’s just dumb. The NW scale has categorised commonly found patterns of male pattern baldness and labelled them as stages. Whether it is bald scalp or miniaturised hair - that is still your balding pattern, and what you can expect to advance to in years to come. If this is an attempt to justify the aggressive design on your surgery, it just doesn’t work. Any Dr worth his salt would have identified you were far beyond a NW3V pre op - your temple point/lateral hump area showed progression that is only really seen in NW7’s.

Very natural work carried out by your first surgeon, your hairline looks great.

Personally I would put back the surgery until you have a chance to fully assess how the meds have worked - you could potentially (and likely to, in my opinion) save a lot of finite grafts and a bit of money.

Stick with this routine consistently for a year, and I’m confident your mod section and forelock will be unrecognisable compared to where you began. Keep up the documentation 👍🏻

Perhaps something like this. Have a look at @Melvin- Moderator hairline and temple design from his latest surgery - gives you a rough idea of more natural looking temple points that connect to a widows peak style hairline.