BurnieBurns

Nerve damage is very much a legitimate risk in hair transplants and should be discussed more. It can exist as numbness and/or pain. I admit I haven't heard of a case of symptoms coming and going for a few weeks at a time.

Try addressing it with your general physician if no luck best bet is a neurologist or a dermatologist with experience removing skincancers.

Have some hope the sensory nerves can heal well beyond 6 months even years after the damage so it's unlikely to stay as it is now.

Beautiful amount of early growth. Going to be an ace hairline!

Who did you consult with? Most docs are not comfortable operating on diffuse until it's very sparse but there are also a good handful of elite ones who are confident inmaking incisions between existing hair. Some have also developed techniques to mitigate shockloss. Your case looks similar to my did and I had a great result with Dr Jerry Wong 

Could be worth just contacting the clinic to follow up

Farmacia Parati if you can get a prescription

14 minutes ago, Savemyhairline said:

I’m not sure I would classify this as “severe” but to each their own. This is wet hair in what appears to be harsh lighting, on a 30 year old. Children coming out of a swimming pool can have some scalp show. But anyway, in person is really the only way to assess, and OP obviously wasn’t happy pre-surgery. I hope you get the results you are after, OP.

Objectively, yes he could have had a great result with a lot less grafts. It’s safe to say that expectations of density are extremely variable for different patients and this has to be balanced with the quality of his donor and future loss. In this case his goals were possible.

I think it frames you perfectly. Please let us know the surgeon

1 hour ago, Needhelpwithscar said:

@BurnieBurns the scar is very bad. Between 3-5mm in different area as you can see in the pictures. The clinic advertised their scar will be very small and mock other surgeons’ scar for being 3-4 mm on their website. I have asked for reference but they didn’t provide any comparable examples saying that they don’t have patient’s approval to share. I have to keep my hair to as long as 18mm to hide the scar, but it’s a horrible look because my crown doesn’t have any hair and the front and mindless is also very thin. And I really just don’t have enough hair for a second procedure. Now I just want to shave my head and be bald. But the scar is not allowing me to. Guys, DO NOT get a hair transplant if you are reading this. Shave it and accept being bald. Bald is healthy and beautiful. 

I’m sorry for what you’re going through but it doesn’t sound like you were a suitable candidate for surgery in the first place. While your account suggests the clinic misled you, 3-4mm is nowhere near what truly bad scars are out there.

While 1-2mm scars happen most of the time in expert hands its not always the case . It’s widely known not to rely on cutting your hair super short after a strip procedure in these communities. Scars are by their nature, not totally predictable.

Thousands of FUT patients have scars exactly like yours that aren’t bothered due to their hair length. I too had some stretch back on one side, probably close to yours.  It’s never seen with regular hair styling and I’ll likely get FUE into it once I’m certain I won’t have another strip.

Sorry to hear they don’t have reference pics but surely there’s some examples posted here. I’ve seen some in the past.

Generally speaking it works exactly like you’d think. Once sprouted hair will grow from the scar. It won’t hide it 100% due to differences in skin pigmentation but it will be significantly more undetectable. 

These are your options:

- FUE 
- Scar revision (still a gamble and only if a good surgeon feels it worth trying)

- Trichopigmentation or SMP

Whichever option make sure you go to someone too if their game.

Also (and might not like hearing this), I highly recommend doing your best to get to a place of sounds mind, and get at piece with what’s happened before making another big decision. Your case could and still does have the potential to be a lot worse than it is now.

48 minutes ago, Needhelpwithscar said:

I also got a FUT surgery from dr Wong. (6 months ago). My scar has stretched so badly now I don’t know what to do. Really regretted getting the surgery. @TimeForAChange

Based on pictures you've posted recently, I'd call your scar average but no means 'bad'. Your hair is very short atm and it will be hidden if you let it grow more As OP mentioned, FUE into the scar is definitely an option. Why don't you ask H&W for some reference pics of successful cases?

6 hours ago, TimeForAChange said:

Does anyone know if you can use topical dutasteride as an adjunct therapy? I'm currently on oral finasteride 1.25mg every other day and am looking to bolster my hair loss stack by adding a topical antiandrogen. The plan is to start at once per week and work my way up.

Many doctors recommend dutasteride once or twice a week on top of daily finasteride when they require a boost 

I'd say agree if you're NW5 + and destined for further hair loss, you should heavily consider FUT unless you just cannot forsee living with a scar. 

While known a lot for big FUT sessions, Hattingen have been doing FUE for a long time and take the craft as seriously. 

If you decide to remain with with FUE, noth have great track records so it will come down to a degree of personal preference and feel the most comfortable with. Then you can start considering elements like cost / travel. 

Surgery is never guaranteed and in this case was never promised. I do not know any elite ethical surgeon who ‘guarantees’ their result. Please let me know is if there is.

Most would not offer any refunds even if the result was utterly botched.

15 hours ago, duchaine said:

I agree.

50% of the result is not equale to 50% of the price.
If you give me a car with 2 wheels, it is a completely useless car, not a car that I can use at 50%.
A bad tranpalnt, where you get 50% growth is a disaster. You go from bold to odd.

1 hour ago, george_nz_1 said:

Thanks for your advice. Sorry to hear your procedure in NZ did not go well, hope you got better results elsewhere

I have some faith in this Dr. Yaprak . There is even a Stuff article about an eyebrow transplant he preformed

https://www.stuff.co.nz/national/health/69338357/head-hair-transplanted-to-eyebrow

In some ways you would hope extensive plastic surgery experience would mean good FUE surgery, but maybe not

I will explore many more options don't worry !

At the end of the day, hair transplants are an extreme specialisation. Follicles are tiny, delicate, micro-organs which only have a limited supply of. It’s good you’ll explore more options and here are some pieces worth noting.

- An eyebrow transplant may seem novel and newsworthy in our country, but on the global stage it’s very commonplace.

- it’s extremely rare if ever for someone to master all forms of cosmetic surgery. Hair transplants are also the least regulated.

- it’s entirely possible you may have a good result from Dr Yaprak and by all means consult with him. Just remember that most hair transplant patients range from dissatisfied to disfigured, especially over the long term. Even the top 5 in the world have patients who claim they ruined their life. Point is, by going to an ‘exceptional’ surgeon rather than a ‘good’ surgeon means you mitigate this risk substantially. 

- you’re only 30 with potential for future loss, even on finasteride. True specialists can account for this. Also as you have advanced balding, this will very likely affect parts of your donor region. Many FUE surgeons harvest non DHT resistant hairs which leads to non lasting results. 
 

- Most great surgeons will have information on where they originally trained, often under the wing of another surgeon. In my opinion it would be shortsighted to believe having cosmetic surgery experience automatically qualifies them.

Good luck!

23 minutes ago, george_nz_1 said:

Hi all,

I am based in Auckland, New Zealand and considering getting FUE treatment. 

I am 30 y/o, using finasteride for 3 years, reasonably advanced balding

Basically I am trying do research on a surgeon to use

There is a doctor Bulent Yaprak here in New Zealand.

Has anyone hear of him?

Here are his websites:

https://hairclinic.nz/

https://dryaprak.co.nz/

 

Other than him I am considering DHT Clinic in Thailand

Any advice appreciated,

Thank you 

 

I am a NZer too and have been to a very poor one here (not Bulent). It needed major fixing and also resulted in nerve damage. I don’t know Bulent thoroughly but hair transplants look like a very minor part of his practice. He also has only one picture of his work public and it’s very blurry. What does that tell you in 2023?

FOR THE LOVE OF EVERYTHING do not go to anyone here or in Australia.

DHT Clinic and Dr Path are leagues above them for similar price. But why only Thailand? Do not let location be the main factor. Consult with multiple accredited surgeons on this site and go from there

On 11/8/2023 at 11:51 AM, Vancouver said:

I've booked in with Medical Park in Turkey, very excited but getting nervous. Does anyone have any bad experiences attending this clinic or heard any bad reviews? I did my research, but now I'm getting naturally antsy about it! Thank you!

I strongly urge you to cancel it. It sounds like you fell (like many) for the marketing/coms of these places. Go back to square one, investigate the surgeons on this forum and visit their sites and view their educational material. No ethical surgeon will be 'hiding' the Hair Transplant process or use marketing gimmicks e.g. Sapphire DHI.

In years to come you'll be so thankful you played the long game.

If you had no sides on fin I can't conceive how you would again. Fin doesn't 'lose efficay' the hair loss can just eventually catch up due to increasing severity in age despite lowering DHT. In many people, finasteride only noticeably slows down hair loss. you're better off stacking it with oral minoxidil. If you  want to live dangerously you could also look into adding pyrilutamide. 

There's always new treatments in the pipeline but waiting on those is a fools game many have become bald during over the past decades. 

I've never heard of it. Turkey has MASSES of clinics. There's a few quality outliers but the vast majority range from subpar to utter butcher shops. What led you to choose them?

35 minutes ago, mister_25 said:

This will be a long post, it will serve as addressing some comments I want to reply to, what I am doing, thoughts on doctors I am consulting with, and a small description of my hair at 11 months in.

I've had my donor examined at my current trichologist three-seperate times (Once during my donor shockloss at about two months in, and twice during my areata checkups at the 7/8 month mark). I've also had Doctor Hasson previously operate on my donor before. In-fact I am going in for a third Areata checkup next week making it the fourth time this trichologist has examined my donor. Just for full context, this trichologist I currently visit was recommended to me by a notable forum member who is very knowledgeable about the hair transplant situation going on in my country.

I have retrograde alopecia, so I have a reduced donor zone. If I can only get 2000 grafts out it would make me only able to harvest about 5900-6000 grafts in total. Doug once told me that if someone's retrograde alopecia were to take up 20% of the donor, then they would probably only get 5500-6500 grafts out of their donor. I was expecting this to be honest.

Regardless, what Dr Hasson told me at the clinic when he had finished operating on me, and what he is telling me now contradict each other.

Dr Hasson told me that if I opted for a conservative hairline (which I did), that I would be able to address the frontal third, and the crown whilst also having grafts saved for future hair loss, whilst also achieving my goals after the second procedure. Now Dr Hasson has told me that I will have to "choose" between the frontal third or the crown.

If I'm looking at every bit of information confirmed about my donor, this is what I can list that concerns my donor.

• Average Density (From Dr Hasson) and "Average at best density" (From Dr Konior), Seems to be Good Density (From my Trichologist)
• Average Characteristics (From Dr Hasson) Coarse and Wavy Hair (From Dr Hasson)
• Retrograde Alopecia
• NW6/7 Potential

 

When you say wait, how long are you talking about? The options that I am very impressed by have spots probably around some time at the end of 2024 or the middle of 2026. Is that a sufficient wait?

I am very confused by people telling me to wait because of my mental health. The reason why I am miserable is because I have blatantly obvious hairloss now. Isn't my best interest for my mental health actually addressing the problem? It seems counter-productive to me.

 

 

And to really reiterate, the whole idea of "focus on other avenues of your life" to "distract myself of my hair loss" doesn't work for me. I have acted on this forums advice both publicly and privately. I see a therapist now, I actively go to gym more consistently with a stronger sense of routine and discipline, new and improved diet that I find is giving me better results and even progressed at my job. I do not feel better or fulfilled in the slightest. 

I hate myself for my hair loss, my whole purpose in the past three years of my life is to rapidly improve myself in every conceivable way, especially since I lost almost all of my social circles and friendships because of my rapid and sudden hair loss. All my earnings are put towards funding future procedures, gym membership, psychiatrist appointments, flights, food that fits under my diet and accommodation. It is all to address the one insecurity that makes me feel less about myself and has made others treat me as if I am less.

I am not sure if I would get a second procedure with Dr Hasson or H&W. I will say that I have a scheduled phone call with Dr Hasson and after that phone call I will make up my decision and post all the input I have received from the clinic and my collective honest experience. 

Also a thing worth noting. Due to my Areata, Dr Hasson has said that he wants to delay my second procedure to November 2024, the reason for this is that he wants one year without active areata before performing a proecedure.

 

I am not saying that there was no significant improvement, because in its own way there clearly is. I cannot describe this procedure as a failure or a success when you look at hair transplants objectively. But the miss match from expectation and reality is devastating.

I asked the doctor at the very start. In fact its in the opening paragraph of the original post "are my expectations reasonable and achievable" here is the exact quote

My expectation, that I had reinforced on Day one post-op. Does not line up with reality. 

3800 was not enough to address my balding, I have stated multiple times I was and I am still aware of this. I always knew, from the very beginning that I would need two procedures. My problems do not arise from this understanding.

What I was told, was to meet my goals I will need to do two two personalized surgeries. The first surgery would address the frontal third and add some coverage to work with in the crown (3872 grafts). The second procedure would boost that crown to the satisfactory degree and boost the mid-scalp by reinforcing the weak point. At no point did Dr Hasson indicate to me that my frontal third would be insufficient in a first pass. (This quoted second procedure was somewhere in the 2000 range. Getting me to a grand total of something around 5872)

Yet again I'll say it plainly. The reason why I am unhappy is the frontal third is weaker than what the doctor reinforced in my expectations.

I have not seen any hair loss at all since I started Finasteride/Minoxidil at the beginning of February 2021. No hair loss at all for almost three years. My regime works and I do not want to risk changing one item for another. However, I do not mind adding something on top of another. This is the regime I was thinking off if I were to progressively bald again or If I can reasonable add more stuff without risking side effects

• Finasteride 1mg a day (currently taking)
• Oral Minoxidil 5mg a day (currently taking)
• Topical Dutasteride once a day
• Saw Palmetto once a day (currently taking)
• Ketoconazole maybe twice a week?

 

 

May as well say what my hair is like now at 11 months in terms of improvements;

The hairline seems to have improved in terms of how "natural" it is, the weak point that I deemed as "unnatural" at around the 8/9 month mark has softened up due to the hairs maturity. But it still stands out to a degree.

The hairs seem thicker, but as for "amount of hairs" there doesn't seem to be much improvement.

Crown seems to show more improvement, and even in poor conditions (example I am referring to is bedhair where my hair was all over the place) it is a significant increase in coverage/density.

In the plainest and simplest terms my hair right now has two states based on two major conditions

• Without direct light, I look like a NW2 with visible early signs on transitioning to NW3. This only applies outside of a top-down angle and frontal tilt.
• With direct light, there is a obvious mismatch in density between the transplanted hairs and the native forelock. And all those transplanted areas are very see through. It looks like I have hair in the NW2 area, but I am "rapidly approaching NW4, skipping the NW3 process"

As for the consults, here is a update

Konior - The difference between communicating with a Clinic (like H&W/Rahal who I consulted with) and a Doctor directly is night and day difference. I feel like I am getting personalized emails straight from the source itself. Konior seems rather straight forward and explains his reasoning and gives honest input. He told me that due to the information I provided (which he said is not entirely accurate due to lower resolution photos) is that I have up-to 2000 grafts and that would be pushing the upper limits of my donor capacity, and that he would transplant the best 1000-2000 I have in the frontal third to boost the density.

Ahmad - No update, I need to provide more information on my part.

Ferreira - Not taking online consultations, but I have been placed on the waiting list when they arrive.

Bisanga - Rejected as he does not take patients under the age of 28-29.

Pinto - Not taking assessments

Couto - Not taking assessments, I have been told when to contact them when they are available to book one.

 

So far after researching additional options, the doctors that I am leaning towards the most are Konior and Couto so far. This can be subject to change.

 

 

While the concerns people have of mental health do come from a place of good intentions, I understand the frustration that hair loss very much is the sole driver of it all. It makes sense you want to be proactive as possible.

Sorry if this was already stated but you you be open to FUT?

Looks like good clean work. I'd imagine he prioritised density in the front where is matters most since you couldn't get over 5k. 

The real question comes back to the notion of the recipient scalp increasing the DHT sensitivity of the transplanted follicles.

General age thinning is less of an enigma

It would be interesting to hear from Surgeons who have patients not on finasteride have noticed over the years

Sorry to give a cop out answer but for me it depends hugely with on how good are the technitions we’re talking about here. E.g a contractor who travel job to job not just for hair transplants vs one who might have worked closely with the surgeon for 10+ years

I say with with personal experience from both a very incompetent surgeon, and expert level technitions.

( not the same place)

No disrespect to dermatologists but the vast majority of them so next to NOTHING about what makes a good hair transplant. They could refer someone to them after randomly meeting them at a conference for all you know.

Mohebi and Carman have a great track record and you should consult with both of them. However I wouldn't limit yourself to one location 

As a general rule, I believe you should consult with at least 5 top surgeons before making a decision. This is not just about options, but it also informs you of a range of perspectives that you may not have considered when moving forward.

Even if verteporfin shows success in his trial you’re looking at a long wait before it’ll be offered in standard practice.

A scar revision from a top surgeon will likely make it look better than that. US based ones that offer FUT include Shapiro, Gabel, Konior, Wesley, Cooley, and there’s Hasson and Wong nearby in Vancouver.

The most common cause of bad growth is poor grafts handling during the procedure itself. Is the doctor you mentioned a Hair transplant Surgeon?

The fact DHT prevents scalp hair while increasing body hair is known as the 'Androgenic Paradox' .

We don't know the exact mechanism yet. Potentially something to do with the WNT pathway which studies have show reduces the effect of DHT.

A doctor who's name rhymes with 'Pole" used to sell a topical spray that targeted this.

Point is there are downstream effects of DHT that need to be discovered.