dreamingofhair

1 hour ago, Curious25 said:

Go to a reputable hair surgeon rather than a dermatologist - derm’s are too hit or miss when it comes to hair loss. Some won’t even be aware of what DUPA is. 

1 hour ago, digi23 said:

Someone who specialises in hair would be good, not sure if there are someone in your area. You might need to go to more than one aswell. Maybe you can ask H&W if they can recommend someone since they are in Canada aswell. Not sure where in Canada you are and how far it is to H&W but worth a try maybe.

Makes sense. 

To establish baseline before taking Finasteride - i just got the following blood work requisition done 

"Testosterone panel, Estrogen / Estradiol, FSH, LH, DHT, Free DHT, SHBG, PSA, Prolactin, Semen Analysis"  - Anything else that's a must ? 

I know that ^ may be un-necessary but i just wanted to be sure and able to evaluate the drug after few months against the baseline - especially considering it might end up being a lifelong companion

11 minutes ago, digi23 said:

To visit a Dermatologist. This does look like possible DUPA, but impossible to say by looking at a photo.

Great, any Dermatologist can diagnose it accurately ? If yes,  I will speak to a GP to get a referral to a dermatologist here in Canada. 

Thanks a lot

Can someone advice me what will be the best way to rule out DUPA ? 

5 hours ago, DrTBarghouthi said:

I just came across this post. I strongly urge you to be on finasteride for 6 months and keep a close eye on the donor. You do need a good number of grafts and the donor would better be in its best form before jumping in. 

Thanks, Yes - just got a prescription for finasteride. 

I had come to the reality that given my current stage, for optimal results regardless of procedure & surgeon - I will need to be on medication (Finasteride) for foreseeable future. So I think it is better to evaluate finasteride first and see if I can tolerate it without significant damage. If in case, I have adverse effects with finasteride - then there is not really much point in spending $$$ on surgery as the results will be relatively short lived. 

As of now I had decided to get some blood work done - Testosterone (Total & FSH), Sperm count and DHT (i read about LC/MS analysis - need to figure out where I can get it done in Canada) to establish a baseline. Get on Finasteride for ~3 months primarily to evaluate adverse affects rather than potential gains (as they are evident only after 6+ months time frame). Get my blood work done again after 75-90 days and compare against baseline. If i don't see tragic demerits - i can conclude that, I will be able to pursue Finasteride for the long run. 

Once that's established - will proceed with surgery from one of the clinics. 

2 hours ago, deeznuts said:

Most of what I was gonna say has been said by other people already (i.e. donor looking kinda weak) but one thing I do have to add on is that you would need to curb your expectations since your donor and your degree of balding mean you should not be expecting native density or perfect coverage.

Hear Hear, i don't have insane expectations - just would like to do whats best possible given circumstances. 

2 hours ago, digi23 said:

You should probably start with FUT and you should be on Finasteride for 6+ months before you go through with surgery.

Hasson & Wong would be the best option since Hattingen is almost the same price.

Would not really recommend Medispa, seen some questionable behaviour from them, like doing a pre surgery consultation 1 am and the surgery should be 7 am. Not sure if its a India thing, but in Europe that would be pretty crazy behaviour.

H&W against Hattingen - preference of H&W is primarily based on my geographic proximity or quality of work / results ? So far Dr. Wong's clinic had been excellent with respect to addressing my concerns - prompt and informative. I am yet to hear back from Hattingen & Eugenix

Medispa is enticing when it comes to cost as its easily palatable. I read about the 1am consultation & agree that it was very unprofessional. Kudos to the chap to have the balls to pull out at last minute. Having said that, If I am proceeding with surgery - I plan to block a weeks time and hope I could mitigate aforesaid experiences with better communication in person - may be a day or two before the surgery. 

Still contemplating whether 1 Mega - FUT + FUE (with or without BHT) makes sense or to take it slow and have smaller FUT session initially and then one FUE to close it off (along with covering the FUT scars) - all spread over few years. 

4 minutes ago, Berba11 said:

You look like you could be a difficult case, and on that basis, I think a $3 per graft a budget is going to be limiting. You'll want the very best of hands on this and that won't come cheaply.

Someone like Mwamba in Belgium or Dr Pradeep Sethi at Eugenix might well relish such a case (if Hasson & Wong aren't interested).

Yea, $3 is not an absolute number. Flexible on it as i rather have it performed close to perfection. 

Waiting for evaluation from Eugenix. Never contacted Mwamba. Will explore that. Any other recommendations?

54 minutes ago, Z-- said:

The back of the donor looks solid to me and it's good that you have beard grafts as with your level of loss, you'll certainly need to pull from there. The concern here is that the sides are very, very diffuse. I'm not sure it's DUPA given the strength of the donor, but I think I'd check with Eugenix to see what's feasible.

Why did Wong deny you? If he thinks you aren't a candidate, I'd very much think twice on this.

Wong didn't deny me. Infact they responded favourably - it's just that the cost is tad on the higher side. 

H&W estimates ~5000+ Grafts for complete coverage but they aren't fully confident (as of now with just photos) if my donor area can support that much. They classified me as a DPA 6 candidate. 

As @Curious25suggested, I am getting a feel from all major doctors to figure out what are their preliminary analysis & to gather sense of direction. Just got response from H&W, Medispa & few others. Waiting for Eugenix & Hattingen to have a comprehensive view.