Eli_Avdikian

16 hours ago, newpatient12 said:

What would you recommend for a maximum of 2000 grafts? 

You can get 2000 grafts for 6000 if you decide to go with Bruno Pinto or Ximena Vila

19 hours ago, newpatient12 said:

Thank you for your answer. 
I mean costs in Turkish comparison with the doctors mentioned. Basically, it doesn't matter to me whether it's 3,000 or 5,000 euros. But I don't want to pay European prices (15,000). 

I also have no experience or information about clinics outside Turkey. 

I will be happy to have a look at the clinics mentioned. 

Everything depends on how many grafts you need. If you go with Keser or Bicer, you'd be paying "european prices" anyway (both charge 3 euros per graft). 

In OP's defense, there are some documented cases (see Dr. Lorenzo's YouTube channel) of "hidden" DUPAs that don't appear to the naked eye. However, if OP wishes to substantiate his claims, he can provide us with some microscopic images.

How could that be DUPA? Most the hairs you have are thick. You have a ngeligeable amount of thin hairs, and some "mid" hairs. Your donor area, which comprise the temporal and occipital regions contain mostly thick hair. Average hair thickness is 60 microns. Nothing points towards DUPA. 

Indeed very lazy and reckless on the part of the surgeons who accepted you. But I also wonder whether you saw them for a consultation in their clinic, where they could potentially examine your donor area under a microscope, or you just corresponded via email. 

6 minutes ago, Dr. Wipawan Vathananai said:

You can try these products;

- Ketoconazole shampoo

- Tar shampoo

- Selenium sulfide or Selenium disulfide shampoo

- Clobetasol shampoo (severe cases)

- Topical desoximethasone (moderate cases)

For the shampoo, please use it every 2 days in the beginning and make sure you leave it on your SCALP for at least 5 minutes before rinsing it off. Normally, seborrheic dermatitis is caused by an imbalance of the yeast called Malassezia furfur and normal flora (bacteria) on your scalp. Basically, there's too much yeast. The shampoo will help keeping control of the organisms while the Clobetasol shampoo and topical desoximethasone will help decrease the inflammation during in the beginning of the treatment.

Thank you !

What kind of treatment would you usually prescribe for seborrheic dermatitis?

3 minutes ago, Dr. Wipawan Vathananai said:

Hello,

Based on the photos provided, I can observe perifollicular scales, scalp redness, and moderate hyperkeratosis (the white desquamation). My initial diagnosis would lean towards seborrheic dermatitis, judging solely from these images. However, to ensure an accurate diagnosis, a physical examination and microscopic examination should be conducted in conjunction.

While there are no studies indicating whether seborrheic dermatitis affects graft survival in hair transplantation, it is not considered a contraindication. From my  experience, I haven't encountered any issues with graft survival. However, if the donor hair carries seborrheic dermatitis, it's possible for the recipient site to develop the condition as well once the hair starts growing. Seborrheic dermatitis isn't a dangerous condition, but it's not entirely curable either. Its occurrence can be influenced by factors such as weather, stress, and scalp hygiene. Perhaps seeking a second opinion from another dermatologist would be beneficial in obtaining an accurate diagnosis.

I hope this information proves helpful.

Best,

Wipawan Vathananai

Hair transplant surgeon & Dermatologist

BHI Clinic, Bangkok, Thailand

Thanks a lot doctor! I highly appreciate your response

Were the antibiotics you were prescribed topical or oral ?

I had a hair transplant in the frontal third in 2022. I'm set to have a second one at the end of this year. However, I still feel some mild stifness and pain in the recepient zone. Microscopic images show redness at the root of some hair follicles. I consulted a dermatologist who told me there's nothing to worry about. Nevertheless, I'm still very concerend, thinking that there's a serious condition that might affect the results of my second transplant 

This is what chatGPT had to say about the difference between topical route and the mesotherapy method of administering dutasteride to the scalp. That's why I think that it is completely worthless for many individuals (who have a thick stratum corneum) to apply hair loss drugs topically

any updates?

On 3/16/2024 at 10:29 PM, LeveledUp said:

For me it was.

So yes in this world it can be more effective.

good for you

I agree with gatsby. There is a tradeoff when reconstructing temporal peaks. On the one hand, more extractions are made in the donor area to harvest fine singles (typically found in the nape and behind the ears), on the other hand, a natural look is acheived. The singles obtained through dissecting the multiple grafts are naturally thicker than the naturally occuring singles in the nape and behind the ears.

Wait until the full year mark. If you see that it's still not working, make the switch to oral dutasteride

In no world is topical minoxidil more effective than oral minoxidil. If you're experiencing sides, try to lower the dose instead of quitting completely

Do yourself a favor and stay away from all hair loss forums and channels for a while. It's only adding fuel to your anxiety. If you ask me, your hair line doesn't look aggressive at all from this angle. I believe you've been reading a lot about some patients' hair lines being placed too low, and in all honesty, I think you're reaction is a little bit over the top, with all due respect. I have rarely seen a patient insisting on placing their hair line higher than what the doctor is proposing. Usually it's the other way around.

This is an oudated view now. Top-tier surgeons are now more than capable to perfrom top notch transplants on the crown area. The main challange that suregeons face in this area is the recreation of the naturally-occuring swirl found on the crown, where hairs grow in different directions. Another specificity of the crown is that it's less vascularized than the frontal third and midscalp, therefore takes more time to grow.

I don't use topical dut in any shape or form, nor do I believe that it's an effective medication when it comes to fighting MPB, so, don't construe my comment as a defense of the use of topical fin or dut. However, I wonder who's spreading false information here, me, or that who's preaching 5AR inhibtors fear-mongering, in both oral and topical forms, claiming that 5AR inhibitors are "anti-androgens", and dissemenating the pseudo-scientifc talk about the so-called "sensitivity to anti-androgens".

On 3/5/2024 at 11:47 PM, aykay7 said:

Or have you experienced any bloating? Easier to gain weight, harder to lose weight?

No not really. I even lost some weight in the beginning (part of my diet plan at the time), and it has been steady ever since

On 3/2/2024 at 9:11 PM, 12345 said:

its a myth. it will still go systemic. the whole too heavy dalton theory is just a rumor. 

That's such an ignorant comment. As if topical medications' scalp pentration is a matter of yes or no, white or black. All topicals penetrate the skin , wether we like it or not. But that's not that real question. What we need to answer is how much excatly of the medication is being absorbed by the scalp/follicles, and how much permeates into circulation. The dalton rule is a very legit rule in dermatology, and topical medications like dutasteride are absorbed systemically by many individuals in negligeable amounts.

8 hours ago, Tommy1991 said:

Personally I don’t want their apology, the responses I have received from the very beginning have been pathetic, they have just offered a “touch up” as they worded it. Apology is nothing to me, they got their revenue from the surgery and that’s all the wanted. 

Seems like a clinic that when you have a result like this and complain they don’t like, which is disgusting.
 

any person with years of research should never indicate it was shock loss. It is why I raised concerns about ethics well back. 

I hope ithis post serves well in your judgment. 😊

 

This "recommended" "clinic's" treatment is beyond shameful. What a disgrace 

I don't think oral minoxidil causes weight gain. I personnally have been on it for a year and I didn't notice any weight gain. 

I didnt have your density even when I was 18

Tbh I don't think it's that low. Looks normal to me