Tiger2050

2 hours ago, WhereIsMyMind said:

"Hair transplants are not perfect" is an ethos that no one should forget. I think people are judging the situation more on expectations they had or were given for their transplant rather than actual facts.

Is it fun to have a 2cnd proccedure or touchup? not really. But in terms of ethics, if the clinic covers the costs and admits its a sub-par result, you lost nothing in the sense that if density is "lacking", you would have needed the grafts that they impanted you regardless no matter what. In some cases it might even save you money.

For repairs, its even more delicate because the tissue is scarred by previous bad surgeons, which decrease survivavility, and also because you can't extract all bad grafts.

Nonetheless, in the forum, we now have all sort of flavours for Mwamba advocates (lets forget about Mustang and focus on genuine people like Callico and others narrating his story with great results) and a lot of recent detractors, so I imagine most people considering Mwamba will be very confused right now.

I hope whatever judgement we make on another doctors is well deserved and that's exactly what this forum is about but im skeptical about some negative claims which are mostly argumented as "I was promised this, but instead, I got this". HTs is not a 100% exact science, and every person is different, and there's a lot of context and flavours in every story.

 

Don’t think the patient is obligated to a free touch-up unless something goes terribly wrong and there is an issue with growth. Mwamba seems to take on very difficult repairs without an in-person examination that other elite surgeons will avoid and doesn’t seem to have the best communication. I might be wrong about the communication part since I’ve never had surgery with Mwamba but the sense I get from all the stories on this forum is that his staff does a poor job with communication. 

Look up repair cases similar to OPs on this forum, most successful repairs require multiple small surgeries. Doing a lot of research is important so you don’t set yourself up for disappointment but an elite doctor should also communicate reasonable expectations. 

This is why a lot of great repair surgeons like Dr. Cooley and Dr. Bisanga will not take on repair patients without a thorough in-person examination and setting reasonable expectations that most repairs require multiple surgeries. There is no surgeon in the world capable of fully restoring your botched hair transplant with one surgery OP. Your donor is much improved and there is a lot of density improvement that happens in months 6-9 despite your skepticism. I’ve never had surgery with Mwamba but it seems like his clinic needs to do a better job with communication and setting reasonable expectations.

Also for the people complaining about Mwamba spending too much time in surgery you can always go to a Turkish hair mill if you want a fast surgery, they work very efficiently to implant 5000+ grafts in a few hours and leave you disfigured. You can’t expect a surgeon to meticulously preform surgery and also rush through as fast as possible. I doubt Mwamba enjoys working tirelessly for 16 straight hours, he takes his time because he wants to ensure the best possible result.

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3 hours ago, Harry Bosch said:

Curious for thoughts on this.

Fwiw.  The timeline.

I had been using Topical Min for 10+ years alongside Fin.

In January 2021 I started Oral Min and used it concurrently with Topical Min + Fin for 15 months up until my surgery (May 2022).

Post surgery I ditched the Topical Min but stayed on the Oral Min.

So I’ve really been taking Min all along.  I don’t think reintroducing Topical while staying with Oral, too, would create a significant shed?

I think there is something to the localized effect of Min when applying to weak spots.  Can’t say I’ve been a huge responder to Oral Min alone, and I’ve got a fairly large sample to determine that conclusion

Abruptly stopping topical minoxdil will cause a shed. Below is an article about transitioning from topical minoxidil to oral from Dr. Jeff Donovan who’s contributed to several studies on oral min for hair loss. In short, the transition is not that simple and you might’ve experienced a shed but probably didn’t notice because your hair was buzzed for surgery. I would give oral minoxdil a few more months and the transplant 12 months to fully develop before introducing any new medications. There is a study that compared the efficacy of oral min alone and oral min combined with topical min that determined combining topical and oral is not more effective.
 

https://donovanmedical.com/hair-blog/switching-topical-to-oral-minoxidil

https://donovanmedical.com/hair-blog/topical-oral-minoxidil

The worst thing you can do at this point is re-introduce topical minoxidil back to your regimen, it will certainly cause another shed. Just stick it out with oral minoxidil, the hair you lost from stopping topical minoxidil will come back in the next few months. Speaking from experience, stopping topical minoxidil induced a shed that lasted several months and it took me a long time to recover on oral minoxidil but it all eventually came back. You have to be patient with hair loss meds, constantly changing medications will cause more shedding.

Looks awesome and still a lot of time for improvement, congrats. Dr. Hasson has been catching some heat lately on this forum because of @Nordster34 temple points not looking great but all of the elite surgeons have some subpar results. Hasson is still a top 5 surgeon in the world and the best doctor at mega sessions for higher norwoods.

1 hour ago, Nordster34 said:

 

I only see good results from Ferreira but it’s impossible to book him. Contacted him 1.5 years ago and was told online consultations were closed temporarily but never heard back again. I tried reaching out again several months ago and got the same response. 

Looks fantastic, almost matches native density which is really impressive for one surgery. You seemed concerned about the high number of grafts but if Dr. Hasson used fewer grafts you would’ve been unsatisfied with the density.

You’ll see some improvement in the next few months but doubt it’s gonna be enough to not look see through. I would start consulting with other surgeons at this point, strongly consider not limiting yourself by location or no-shave otherwise you might end up with another poor result. Mwamba, Nadimi/Konior, Hasson/Wong, Bisanga, Cooley, Gabel, Pinto, Feriduni are some names to consider, much higher chance of success with any of these surgeons. Not sure exactly how much Wesley charges but I suspect he’s more expensive than all of the names I suggested except Konior.

Do you have any more pre-op pics? Was most of the recipient area empty or did the doctor have to implant between native hairs? Looking good btw.

On 12/7/2022 at 8:21 PM, Rolo said:

I am now 9 months and not happy with the results. I think if it were to improve it would have by now.  The front is what bothered me from the start and why i did this in march.  The temples have filled in but the growth very strange, fuzzy almost like carpet hair and it hasnt grown much, its not like the rest of my hair.  
i live outside the country and was in ny in october and asked to stop in.  There was much resistence because he wont see anyone before 12 months but i feel as i live outside the country they should understand that.  They finally received me and took images but the dr came out to the reception area for only about 2 minutes saying basically he wont make a determination before one year.  I cannot see myself going thru this again, i am in my 70s.  

Sorry to hear you’re not happy with the result. It’s unlikely the density is going to improve after month 9. If you do consider a second surgery, I recommend reaching out to Dr. Nadimi or Dr. Konior and discussing the option of doing FUE over FUT. FUE has a much easier recovery compared to FUT. The patient care with Konior/Nadimi is excellent, both of them respond to messages directly and would not dismiss your density concerns at month 9. A 2 minute consultation is very unprofessional. Also consider trying hair loss concealers like toppik if you don’t want to go though a second surgery.

8 hours ago, Vann said:

I mean your hair did go through surgery so the surrounding tissue was pumped with fluids whether anesthetic or loss of blood, etc. 

your hair will go through some form of ‘shock’ and take some time to heal. Good news from that is that when your skin is healing it can sometimes flourish the area so some hairs may come back that were dormant. Not always the case but it’s nice to temporarily see it all back.

I think you should give it a little more time because the shock is usually temporary and will come back in moderation. 

This is a good point. If the hair loss in the area is new, it’s probably from shock during the surgery and will come back eventually. I had shock loss in areas that had no grafts implanted and it fully recovered around 7-8 months. Don’t start experimenting with new medications if fin/min have been working for you. Wait 8-10 months for the transplant to grow and stop over analyzing your hair every day.

There is no correlation between oral minoxidil and issues with pregnancy, it’s a blood pressure medication. There have never been any reported complications with a baby conceived on finasteride. Don’t think there is much data on dutasteride and pregnancy but I assume it’s not much different from finasteride, if you are worried than switch to finasteride. Stop getting advice from random strangers on the internet who are scared of taking hair loss meds, discuss it with your doctor.

Looks really good, the second surgery made an already good result close to perfect. Congrats!

5 hours ago, Jayson1361 said:

You’re persuasive with this comment. I suppose there is a reason why some or most wait until thinning has progressed to get a HT. 

Dr. K is one of the best and known for his natural results which is why I chose to wait for him. But, even the best of the best can only do so much. I do have some things to consider. 
 

At the moment I think, logically, my approach is wait and see how meds and progression go this next 12 months. But I do have this feeling of progression, visibly as well over the past 24 months,  which makes me wonder what people mean when they say stabilization is needed for a HT. How is MPB ever truly stabilized? 

Considering your age and the fact you are on medication, I see no problem with getting a small procedure to get a more youthful  hairline. You will have enough donor leftover to last you a lifetime. Keep in mind you will probably need a second procedure to get native density if you lower the hairline. Dr. K is one of the best but it’s not possible achieve native density with one pass. 

23 hours ago, jjsrader said:

Don't think Medical Wellness Center will prescribe Oral Minox - I asked a few years ago - maybe they changed their policy.

They just started prescribing it, got an email a few days ago.

If you are in the US, MedicalWelnessCentre (google it) will give you a prescription for a $50 fee. All you have to do is fill out a survey.

Looking good. I found applying the aquaphor spray in the post-op instructions really helped loosen the scabs. I applied the spray at night for a few days and the scabs would be moistened and come off with very little pressure the next morning. 

Did you avoid the sun for a few weeks post-op? Sun exposure can cause redness, wear a hat when you go outside. Hair looks great at 5 months, gonna be a homerun result after your 2nd surgery.

Any updates?

The only option is finasteride, you’ll regret not taking it the longer you wait. Try topical finasteride if you’re scared of side affects. Getting a hair transplant without stabilizing your hair loss is a terrible idea. Hair transplants are just an illusion of density and will never bring back your hair to native density. 

On 11/9/2022 at 9:50 PM, Bragento said:

@Tiger2050 Sorry for the delay in my response - Dr Konior quoted me at around $16/graft which was just too steep for me (although I know his work is stellar)

@5BetaReductase Thanks for your input on different options! It's been very helpful

After reviewing many FUE options in the US, (I prefer not to travel outside the US for surgery), I'm very close to choosing Dr. Josephitis/Shapiro at this moment. I was also considering Mwamba, Cooley, and Vories.

My main priority is going with a rock solid surgeon with an awesome track record (without breaking the bank).  Dr Shapiro's clinic seems like a great choice, and they've taken the time to review everything with me via phone/email (Matt Zupan has been very helpful). My only very slight concern is that the surgery may only involve Dr Josephitis and his team without Ron Shapiro, as I've been told Dr Shapiro isn't always available for each surgery. A lot of the great results I've seen posted involved both Josephitis and Shapiro working on the same exact patients, but I can't find many results on work performed just by Josephitis.

Any feedback or reviews on work performed solely by Dr Josephitis is welcome!

 

Have you considered Nadimi? She’s Konior’s protege similar to Josephitis for Shapiro but has a lot more great results on this forum. Nadimi is significantly cheaper and has a shorter wait list than Konior.

McGrath medical in Austin will prescribe a compounded form of oral minoxidil and finasteride after an online consultation. I just called up a few local dermatologists and asked if they had experience prescribing oral minoxidil, it was pretty easy to find several dermatologists.I suggest calling some dermatologists and asking about oral minoxidil before scheduling a consultation.

Perfectly safe, there have never been any reported complications with children conceived on fin but this is a better question for your doctor. There is a lot of fear mongering about fin online and this forum isn’t any different. You can lose a lot of hair in 2 years without fin.