deeznuts

is couto even open for consultations? i emailed him last year and i believe his rep said they were reopening consultations starting this year. I do recommend reaching out ASAP if that is the case. 

anyway, you've got a great list of doctors.

looking at your hair loss, I strongly suspect that you will be told to go on fin for the crown. So you're basically looking at a hairline transplant and you might want a doctor that knows how to deal with diffuse loss if you have that. Based on that, I think you should be looking at doctors who can give you a great hairline and maybe add some density throughout your midscalp

i didn't have the huge list you have. I had a good idea for the most part of which doctor was my preferred doctor (usually between one or two the entire time) and I continued to do research until I finally booked a date.

My list was pretty much H&W, Rahal and De Freitas. Rahals reps were quite pushy like they were getting paid commission so I axed Rahal pretty quick. It left a bad taste in my mouth even though I really liked some of the results, he was located near me, and my case (hairline only) would have been right down his alley. It didn't really matter all that much anyway since I preferred Dr. De Freitas' results more. 

Then with Hasson and Wong, they're fantastic. Their patient coordinator James was fantastic. I loved the results especially some of the crazy ones where they dense pack like 3k/4k grafts into the hairline and the patient looks better than many guys at 20.

With De Freitas, I was similarly impressed with his results. He seemed like a hairline magician and I had a similar sense of awe seeing his work. Especially going through the Spanish forums (recuperarelpelo) and being wowed by some of his patient results as well. What really was the tiebreaker for me, was the cost. I love Hasson & Wong and feel like they consistently hit home runs or at the very least a triple but I De Freitas also puts out some incredible results for half the price. If price were not a factor, I would have had an extremely hard time picking between the two but with price, it made my life a lot easier. But with Dr. De Freitas I felt like I was getting the best price and quality so it was a pretty straightforward decision.

I would have liked to go with Couto but I didn't want to wait 3 years for a transplant though not entirely a deal breaker I guess.

In you case, if you need to use BHT (which I don't think you need just yet), you'd have to pick a BHT doctor. Though I suspect most of them won't recommend BHT just yet since you've still got a solid head of hair. They'll probably put you on fin though.

You can also eliminate a couple doctors if you feel like excessive wait list or excessive cost are not something you're willing to deal with. While it's not a great reason to pick a doctor, it could be a decent enough reason when used as a tiebreaker. If it's something like 50-50, then you pick the one that's cheaper. And the reality is that some doctors are just prohibitively expensive enough that you can't afford them. 

Next, you can do some consultations. See whether the doctors proposals agree with you. For example some doctors might recommend you put some grafts into the crown while others might suggest you use fin and see if it regrows. (Though I think most will suggest fin for the crown at this point). Some might offer temple peak reconstructions. Others might offer 3500 grafts while another might suggest 2500. 

You can also reference patients with a similar situation to you and figure out if you like it.

My only experience with Dr. Cotterill is when I went to a consultation with him. He budgeted me for 1200 grafts to fix a NW2ish hairline when other clinics put me at 2500-3000 with the doctor commenting that it would look as if I was thinning in the area (as opposed to just no hair there at all). I found him a bit too conservative for my taste and there were other doctors who would put 2500-3000 grafts in the area and make it not look like I was thinning.

He sounds like a nice guy and Dr. Rassman seems to like him. I'm sure he's a great doctor but his goals just didn't align with mine. 

On 11/5/2021 at 1:18 PM, JC71 said:

Eugenix have a varied price menu, Bicer is €1.50 for automated FUE and €2.50 for manual (at present) 

I always wonder when I see that, is there any real point in getting the manual FUE from Dr. Bicer? Seems like a bit pointless since manual FUE can't be much better than motorized if at all. But maybe I'm missing something here

1 minute ago, hotrod999 said:

I considered H&W and had a consult. They recommended the most grafts (4000-4500) and were the most expensive (around 20k for FUT & 30k for FUE based on the graph recommendations). My two choices came mainly from to wanting to stay in the US. 

Wow. 4k is higher than I would have guessed but I got a similarly high recommendation at first before they revised the number down a bit to maybe 3k. They've got some examples of lower norwoods where they put in like 4k grafts and the results are insane but obviously it's also using a ton of grafts. H&W try to dense pack a bit more due to how they operate but you could always ask for a lower density. I doubt they'll say no. 

Any reason you're staying in the US? Vancouver is right on the border so it's not like you're going out of the way.

If you're doing FUT, I would go for Hasson & Wong who live in Vancouver. They're honestly my pick for the best price and arguably the best work. Many people consider them a top 5 FUT clinic though they are moving away from FUT due to them believing FUE is just superior. 

Who have you even contacted so far anyway? Or is it just Dr. Diep and Dr. Cooley? 

edit: nevermind looks like you decided on dr. cooley

What's the point of Dut + fin? Doesn't really make sense to me

Well 2600 grafts in an area that size seems a bit low. The knowledge wouldn't really help since it's too late and if you get another transplant they'll probably measure you anyways.

I want say yes but I also want say no.

Being able to transplant good doesn't necessarily mean you're good at talking to patients. 

But on the flip side, most doctors should be with you the entire way because that's what you would expect from a hair transplant especially if there are complications. I feel like a good clinic would have reps at the very least that can address your concerns and allow you to address your issues.

So it's a red flag in the case that you're dealing with complications but I think the preoperative might also be different from the postoperative so it's hard to say

I think the general rule is to wait until 25 or even 30 so that the doctor can have a good idea of where you're headed. So I've definitely noticed a few people who are under 25, with significant loss, and an almost desperate attitude towards getting a transplant. Combine that with low disposable income and you have a recipe for disaster. And for a lot of these guys it's like the end of the world for them.

The reason you want to wait until you're 25 or after is because hair loss can be quite unpredictable before then.

I hate resolutions personally. There's a connotation to it where people pick up a resolution and drop it about 2 weeks later. A month if they're a bit more committed.

In the gym, back when gym was still a thing, at the start of every year we'd always notice the resolutioners who crowd the gym for the first 2 or 3 weeks and then give up after. Some people feel obligated to make resolutions every year and every year they give up on them once there's enough distance from New Years. I don't know why but New Years resolutions seem to never stick. 

The number one thing about resolutions is that you should worry less about resolutions or some arbitrary start/end date, and more about going out and doing whatever it is you're planning to do now. If you want to improve your job, I'd literally just start now instead of waiting until Jan 1 2022. Start studying, start job hunting, start writing your resume.

Same with girls. Just do it. No need to wait until 2022. Get into the grindset today. Keep on trucking.

Another thing is that I find goals don't get me anywhere so much as habits do. They say excellence is a habit. It's just something you do every day not something you switch on at 12:00 AM Jan 1 2022. The way I've always got into the habit of doing things is just to figure out a way to work it into my daily routine. Like after work, hit the gym. No questions asked. After gym, go study. After studying, make sure you hit the hay by a certain hour. Some people are legitimately passionate and obsessive about hitting their goals and it's easy for them. But for a lot of others, it's just about successful habits and staying consistent through your life. 

Successful habits are everything.

Maybe the doctor expects regrowth with finasteride and is only looking to address your hairline at the moment?

i've always heard the effect called shingling. Like the shingles on a roof where each "row" of hair layers over the last to create an effect where any given spot on your scalp is covered by several "rows" of hair. Though hair doesn't technically grow in rows

Well I generally don't like to leave reviews on stuff. 

The only reason I would leave a review here is just because the community has been super helpful. And I guess with an HT, there's always the random concerns that come up so it's nice to post progress. Normally though, I don't leave reviews on anything cause I can't be bothered. 

24 minutes ago, hairlossguy said:

I agree with a lot of what you said, but I think there is a graft survival due to blood flow issue when you go too high above 3000. I'm just trying to get confirmation on this or a source? As an example, someone who gets 5000 grafts moved in one session might have 1500 of those die but still be satisfied because they still had 3500 moved even though they destroyed a lot of their donor hairs. But if that same procedure was done in 2 sessions of 2500, maybe all would survive.

I've always thought it was more an issue of how densely packed the grafts are

10 minutes ago, Mihaly said:

Interesting discussion so far. 
 

I tried liposomal finasteride back in 2018, 1% concentration, from Farmacia Paratti. I unfortunately got sides - even when applying it every other day. They did thankfully go away a couple months after stopping. 

Im considering trying again, maybe at an even lower dose (0.1%). I was micro needling at the time (always a few days break between needling and fin), and was also applying rogaine- which may have dissolved the liposomal gel. 
 

Maybe the place I got it from was bad. I’ll see if I can try this formulation. 
 

Very interested to try the dutasteride. Have read it has a molecular weight that cannot absorb thru the scalp so easily - maybe it’s less risky than fin in this case?

My memory is foggy but I think Dr. Hasson said that Liposomal actually increased systemic absorption 

Yeah it's gotta be what LaserCaps said. Your pictures don't look all that bad but we don't know the whole story

I just get costco shampoo and assume costco knows what's best for me.

Just kidding, I think Costco shampoo is pureology shampoo but rebranded. No sulfates and a lot of people say good stuff about it.

29 minutes ago, futurenow said:

2.6 €/ graft

at 2.6 euros/graft I honestly have a hard time imagining why someone would go to Turkey wow.

1. Just to add on, FUT is a lot less popular abroad. So you may not find as many doctors doing FUT. That said, you can consult multiple clinics to get a feel for whether you should go for FUT or FUE after which you can proceed to find doctors that do the surgery that you want. Basically figure out the type of surgery first, then figure out the doctors that perform that surgery

2. A lot of doctors don't think there's that much of a difference between FUE/FUT anymore. I honestly feel like in 90% of scenarios, it's a case of patient preference

3. If you don't want a doctor to do megasessions, just ask them not to. But a doctor who has the skills should not be a negative.

4. Board certification is great but the ABHRS is American. I'm not sure a European doctor would certify themselves with an American board

Would be kinda odd for a european doctor to be certified by the american board of hair restoration surgeons

Maybe it's a patient specific thing? Like the patients hair naturally grows left to right

Personally, I don't really feel easy about going to Turkey. I feel like Europe has more consumer protections, and with you being from Europe, you might find it easier to recuperate at home or somewhere you feel safe. Which country are you from by the way?

Benefits of FUT: It's cheaper, women don't mind the scar so much and it's pretty easy to just cover it with your hair. However not every doctor will do FUT. Turkey for example does a lot of FUE.

With FUE, more expensive, more doctors do it, no scar (or rather the scars are just a bunch of white dots), less recovery time and less invasive, able to cherry pick grafts

I'm not sure if you need to shave for FUT either. You may need to but I haven't really found myself interested in FUT

But really you'll have to weigh the pros and cons with FUE/FUT and do more research.

As for top 3, I'm kind of a fan of the Portuguese/Spanish doctors since they offer affordable transplants while not compromising on quality at all. There's a lot of great doctors though and you should find a doctor that works well with other people like you (i.e. hair characteristics, degree of loss). I don't want to rank doctors but I personally chose Dr. De Freitas and I think he has a few examples of female hair transplants.

The biggest thing in my opinion is to get a consultation with a doctor, discuss your concerns, your questions, and have them talk you through what will need to happen. My first consultation was with the H&W rep and he was very helpful and answered a fair number of questions for me. Not really a resource but it's nice to talk to someone who knows the process

Wow. You're pretty much textbook Norwood 7 with only the permanent safe zone remaining

7 minutes ago, jay80 said:

@deeznuts cheers for the info. I'll chase them up tomorrow and they may reply here, 11 months isn't too bad. I'm in a fortunate position that I can take Any cancellations with just a couple of days notice, not sure how often they appear though 

yeah np. I think my consultation took them like a month only though.

If you end up getting a cancellation could you post your results here? I'd be super curious to see how your experience turns out

I consulted with their rep on here (De Freitas Clinic) in June of this year and got an appointment booked for May of next year. So I'd say from start to finish it's roughly 11 months. Not really as bad as Ignacio (their rep) said it would be but he mentioned they had some sort of promotion to forum members where I think we'd get an expedited consultation? Not sure if that's a thing still but yeah 11 months timeline isn't so bad