mister_25

1 hour ago, HHH said:

I havent actually seen any poor Pekiner results yet, seems very consistent for the hairline

I’ve stumbled across a few (about two or three) cases of no-little growth on other forums dating back about a year or two. Still a solid choice as I said but this shakes my confidence in selecting him as a potential surgeon. For other surgeons like Bisanga and Ahmad I’ve actually had to really search for the poorer cases. 
 

I will say that I like him enough to consider him the only “good” option in Turkey.

10 hours ago, ScottyM said:

Yeah I am seriously considering Bisanga but I have been hearing a lot that it’s mostly tech and Dr Kostis that doesn’t it now so I’m now really sure why his clinic is so expensive if he isn’t really Doing much hence it might not be as good a result.

I am looking at Feriduni also who gets decent reviews.

Not sure of anyone in the U.K. or Turkey as good as Bisanga or Feriduni

I don't believe that the introduction of Dr Kostis and these Techs is a rather recent/new thing for Bisanga and his team, what I am trying to say is if their results and their team were the one that delivered the results that ultimately impressed you and swayed you towards considering Bisanga as a top option, then its worth still considering him. Ultimately, having trust in the doctor you select is a extremely important thing to get you through your ugly duckling phase, if this is a deal breaker there are other surgeons that will fit your criteria.

In the UK I would say no one is on the level of Bisanga or Feriduni. In Turkey I would say Pekiner is a name that gets thrown around as a "equal" to Bisanga or Feriduni but whilst I find his results impressive, I wouldn't say he is as consistent as these two.

Bisanga is a surgeon that made it to the top of my initial list, he seems like a straight shooter from what people have said in their consultations and I like his results on Lower Norwoods / Surgeries with lower graft counts. 

No Opinion on Manish Mittal or Lupanzula. I have not read nearly enough cases to form a opinion worth anything

I originally really liked Mwambas work when I was first discovering picks for surgeons, but over the past year in my opinion the quality of his work and the communication between patient/doctor/clinic have been unacceptably poor. I've seen no growth, poor growth, shady behavior and poor communication associated with his name as of the past year/

2 hours ago, Balding Bad said:

Appreciate you chiming in and opining on the matter.

I just want to make sure I'm understanding your response correctly, but you think my overall yield of the grafts I received was low (poor)? I'm curious what percentage you would say my overall yield was?

When I had my one-on-one with Dr. Joe he stated that my growth/yield was looking to be on track, but when he said that I personally didn't believe that to be the case. I'm of the opinion that the yield wasn't great also. Not sure if my quantification is accurate, but I'd say the overall yield is give or take about 60-70%?

According to my assessment, I feel like an additional 1,000 grafts would help achieve a more fuller/dense looking hairline, but you think upwards of 2,500 would be optimal? I dunno, I feel like that may be overkill because that would mean in total my frontal third (including my 1st procedure) would be at nearly 5,000 grafts, which seems quite excessive!

I'm open to hearing what other folks think though.

I would say you have three factors that are affecting your results for your first procedure. I'll try to give you my insights on why I think this way as well.

The first is low graft count, generally speaking to cover the frontal third in its entirety I would say the average amount of grafts it takes is somewhere between 2700-3600. You had 2300 which in my opinion and observations is below the "minimum" required to restore the frontal third. This is a good thing for donor preservation/your final result after the 

The second factor is in my opinion there is rather lower yield. On the positive note since there was a smaller size of grafts used (Low 2000) your not losing much on your "future" results and that the "potential" of all your transplants put together is still rather in tact. On the negative note, I don't think your aesthetically much different than where you started, I feel like you could start using fibers and see some big change though. I would say your yield is probably about something like 62-65% when I eyeball it into a small range.

The third factor which is a bit of nitpicking is the "inconsistent, assymetrical growth". It looks like one side is doing significantly better than the other and that stands out a bit in certain angles. This is what I am struggling with the most in my case as of now. In my case, my left side hairline is significantly weaker than the right side, but the area behind the hairline my left is doing much better than the right. It has this wonky shape to it that makes me look like I'm balding more on one side of my head. In your case I don't think its that bad, but it makes your weak points stand out alot more specially that bald spot at your peak.

Overall, my opinion is that whilst it is disappointing, in the long term (multiple surgeries) this result isn't enough to make me think that you've done damaged to your potential, just delaying.

2500 comes to mind if you were trying to restore to some form of density rather than illusion. Albeit that's at a high length and I think that is seen as the "at most" end. I would think you can be perfectly happy with something along the lines of 1800-2000 depending on how you yield

7 hours ago, Balding Bad said:

I'm curious to hear the community's opinion on this question:

Should I undergo a potential 2nd procedure, how many grafts do you believe would be needed to achieve a satisfactory illusion of density / fuller looking frontal third?

🤔

We are in similar situations

First and foremost, I feel like you had less grafts than what is generally prescribed for your area of loss. So its not only just "lower yield" but it was also a lower density transplant to begin with. Which is good for your long term donor preservations

Most people on this forum stress enough that hair transplants are all about restoring a "illusion of density" which isn't being done here. There is no possible method, or illusion that you can create without using further concealing products like hair fibers to have a "dense" look even if it isnt real. 

To answer your questions. In my opinion your looking at something in the 1000-2500 range;

I believe 1000 will give you a weak illusion to work with to help you confuse the people that aren't in the know, this will only apply to milder conditions

somewhere in the 2000-2500 range will give you something solid to work with in my opinion

10 hours ago, stephcurry30 said:

 

Also looking at the pre and post op photos it seems like OP''s bald spot in his crown got larger. Probably due to 2 reasons:

1.) continued hair loss without being on medication (which it seems like OP has been on medication and he said his hair loss stabilized for 2 years before surgery

or

2.)  Existing hairs/transplanted hairs got transected or were lost due to low blood circulation for being placed way to close to one another. This is why I am in fact against placing grafts in rows and columns instead of placing them between existing hairs. 

I know Wong responded here about placing grafts in rows and columns in thee following thread below, BUT he did not mention placing grafts grafts in rows and columns in between existing hairs. If anything you SHOULDN'T be placing grafts in rows and columns between existing hairs but rather between them. Again something that has been discussed on this forum and at all my consultations with surgeons. 

 

Seven photos, two taken in the 9th of September, one of these is exposing my crown but not the worst it can look and the other is what it looks like combed back in my ideal style right now.  

Two taken at around 2 weeks post op. To illustrate that the angles/placement looks much more acceptable when taken from a direct crown shot.

One taken two weeks post op, and two taken around 3 weeks post op.

I do not believe it’s a angle/placement issue, in my opinion the primary issue is yield and the secondary issue is hair thickening. In fairness to the conversation the photos you shared of my hair pointing up were taken at 6 months, when the hair only started to properly grow and was very immature, this was especially obvious when my hair is combed forward but it’s slowly improving from 9 months onward.

the crown expanding is a scary thought, but I do not believe this to be the case. You can see the outline of my Norwood 5 pattern remains the same when you lineup from the where my part transitions from donor to mid scalp/top of my head.

10 hours ago, GoliGoliGoli said:

I hesitate to say this, but something I've noticed on this forum is that people tend to "err on the side of optimism" when it comes to stuff like this. If people say you have an above average donor, that likely means you have an average donor. If people say you have an average donor, that likely means you have a sub-average donor. "Donor" of course doesn't just mean the amount of grafts available, it also means the caliber of the grafts, # of hairs per graft, ect 

This isn't to imply you did anything wrong. This doesn't mean you aren't a candidate for HT. But I do worry that this forum sometimes creates a false hope for people when it should be a bit more discerning. 

That isn't to say HW did everything right. I'm not smart enough on HT's to really get into the fine details the way some are. But to be honest I don't think the people who told you you have an above average or fantastic donor are correct at all. 

100% agree that people tend to be optimistic towards donors, especially on other forums like reddit and foreign forums, but I do not believe that this point accurately fits my case

I heard the complete true opposite ends of the abstract donor spectrum.

I am hearing the doomsday diagnosis of DUPA which can not be described as “bad” but more “horribly unreliable” and hearing the true opposite of “fantastic donor”. It’s not simply just people saying my donor is good when it’s average. It’s people saying I am in the best of the best and the worst of the worst, you cannot get any more different.

10 hours ago, Savemyhairline said:

Everyone here meant that as in you are responsible and not impulsive, nobody meant that to make you feel bad about yourself, on the contrary.
 

on this other point, I would listen to a Doctor over a poster on a forum. 

I am aware, it’s just that this particularly bothers me because I’m a practical person, I believe hard work, effort and efficient processes are what you need to do to get what you want. The fact that I did all this but still got a result that is disappointing is frustrating enough, but what is more frustrating is that there is genuinely nothing to fault me for and that it could be entirely possible that this is genuinely the best result I could of possibly gotten due to physiological reasons. Which is probably the worst case scenario for a surgery to fail outside of necrosis and really terrible and irredeemable angles.

10 hours ago, stephcurry30 said:

f my assumptions are correct. if OP's angulation was just placed a bit different his hairline wouldn't have the see through effect that it has now. I don't think yield/Density is as import here as much as angulation is. Again this was stressed by multiple TOP surgeons that I have consulted with. 

Also hair standing up at 90 degrees rom the scale or even at 70 degrees is not natural you don't see that on a virgin/non balding scalp. 

The bigger issue here is the surgical planning, design, angulation, direction, and graft placement. 

These are the three photos I have that are closest to mimicing these photos back when I was a few weeks post op.

I believe this photo below might of been taken during the beginning of the shedding phase.

10 hours ago, stephcurry30 said:

Going forward OP I would honestly have ion person consultations with other surgeons. Seems like you're locate in canada?

No I'm from Australia, any consultation with a noteworthy clinic would require me to travel half way across the world or at the very least a flight outside my country. 

11 hours ago, stephcurry30 said:

That being said it did effect how I "lived' my 20's and why I understand you'd want to get a surgery so young. 

If the surgery met my expectations, I would probably of had "breathing room" by now all the way to June 2024 for my next procedure, and then have met my goals by the age of 25. Early 20s may of been ruined because of the hairloss but I would atleast have mid/late twenties with confidence. But because that the outcome does not match what the expectations were and the fact that most of the surgeons I am able to place my trust in are booked all the way into 2025, its looking like to meet my goals I would probably be 28-29. If I am able to meet them at all. 

I do not know how much donor supply I have, but the only thing I know that can point me in a general number or idea is this. Dr Hasson originally planned my transplant around achieving my goals that I would be happy with, I would of needed the 3872 grafts I had implanted and a further 2000 grafts for the midscalp/crown. Because of the conservative hairline choice, I would also have a further supply in case I would ever be approaching NW6/7 territory. In my opinion, its looking like to achieve my original goals, I will need to dip into these reserves partially or fully. I am hoping I am wrong.

And if anyone is wondering If I have been in contact with the clinic, my last email from them was on the 13th of September with the reply being "Dr Hasson has reviewed the latest photos, he feels its looks pretty good and has improved from the 8 month post-op mark. He believes you are experiencing delayed growth. He expects further improvement and wants to give it to the 12 month mark to see where it's at then" 

Obviously all I can do is wait, and even if I have significant improvement like Dr Hasson expects I generally have to be realistic and I have my doubts/reservations on how much this improvement will be.

Crown Photos (9th September)

Early Days Post Op

On 9/10/2023 at 4:16 AM, shiba1985 said:

 

as you know,absolutely NOTHING can 100% guarantee a successful surgical result. All you can do is try your best. 

You did your best researching and planning. Things did not work out but you can hold your head high that you crossed all the Ts and dotted all the Is and made a very informed decision, which as a patient is all you can do. 

I would say before you commit to another full blown procedure, who ever you select for the next surgery do a test run with 300-500 grafts. See how they take. Then plan on a larger procedure. 

I do not think getting a test procedure of 300-500 grafts is a option, the surgeons I am interested in charge per session so I would be paying something like 60$ per graft. At the end of the day, I am 23 years old with the resources of a 23 year old. What your asking is unreasonable and will never be achievable for me.

I keep hearing the “you did everything right and as a patient made a fully informed and correct decision” arguement here, but what does that mean for my case exactly? That no matter what and that even if I selected any other surgeon that my results were destined to be poor? Is that what is being implied here?

To be honest, this comment and many others like it just make me feel worse about myself. I honestly feel like I could of gotten a similar result for a fraction of the price at a hairmill, but I paid a premium for a feeling of security in my choice which completely backfired.

A small update here, I had to attend a sudden funeral and a hat wasn’t a option, I also didn’t have fibres yet. I received two comments from people that haven’t seen me in years that something was wrong with my head. Very embarrassed and ashamed of myself.

I am also losing confidence in the advice/input I am receiving here and from elsewhere. Here are the direct contradictions that I will point out.

1. Mixed comments on the state of my donor, I have been told by one group of people that my donor hair is fantastic, above average and will accomodate all my needs and future loss. On the other hand on a previously deleted thread, I was told that I have DUPA and should never of had a transplant to begin with.
2. A poster here implied that my tonsillitis could of had realistically a massive effect on my yield, which implies that Dr Hasson was negligent and lied to me saying it would have no impact on the surgery. 
3. Mixed Comments in the actual result of my hair transplant, people are saying it’s natural but if people in real life can point out that something is wrong is it really natural?
4. Constant back and forwards of people saying my expectations were delusional and reasonable.

Please give me advice on what to do. These contradictions are overwhelming and have left me lost. I have no confidence in my ability to research myself because my choice and selection has placed me through a painful ordeal with a result that has left myself and others questioning. 

How do I turn this around to meet my goals?

Also does anyone know how to contact Dr Ferreira?

I would not go through with your procedure.

ASMED as of recent (past few years or so) has completely plummeted in quality and yield, its one of those names that I feel are riding off the reputation they once had as a better option in Turkey, but now they are just as bad if not worse than the rest of the mills.

I understand that the chances are you would be losing a large deposit, but money you can always make back, grafts/donor supply are finite.

2 hours ago, Turkhair said:

I would suggest you do small procedures after this. 1500-2000 grafts procedures. You don’t have a big bald area to go for big procedures anyway

I like this approach. Whoever I select for a second procedure I will be asking towards surgeries/procedures tailored towards maximizing yield in every possible way. I think 1500 at a time is the safest bet I have and will only take me two or so procedures I think to get me somewhere I want to be.

If its anything worth noting, I believe the crown is coming in at the expectations that I had, and it only had 950 grafts implanted in that area compared to the 2900 in the front. Might be a sign that I am sensitive to more tightly packed grafts.

2 hours ago, Turkhair said:

You have a massive beard probably 8k-10k beard grafts if you don’t mind above chin grafts perhaps even more. Be grateful for that. You can use that to get add density even if your scalp donor is thinned out. 

I think my beard hair might not be ideal for my situation because of the very big difference between my scalp characteristics and my donor characteristics. It is something that I will have to ask. Are any of the options I listed renowned or have notable skill in using beard hair?

Also I will never know until I get my beard checked, when I first posted photos of my donor asking opinions on it everyone was telling me that it had fantastic characteristics such as high density, coarse hair and numerous other factors. I even had my scalp examined under a microscope and they told me I had a large amount of triples compared to the average person.

Now that my result is less than stellar, other people have come out and said I probably have DUPA and that my donor was below average and quite poor. Who knows if this could also apply to my beard and it could be very below average as well.

2 hours ago, Turkhair said:

More than likely your tonsillitis had something to do with it. Sorry but I don’t believe that it didn’t. When our bodies fight infection, hairs are the bottom in priorities list.

I generally doubt that this is the case. I imagine H&W could be liable to some form of negligence in their duty if they saw a potential sickness/illness arise that could compromise the surgery and continued anyway. Correct me if I'm wrong on this.

Also if this is the case I would of been lied too which isn't ethical in anyway.

2 hours ago, Turkhair said:

Good luck and try to be positive. There are people who were in far worse position who now have fantastic heads of hairs. 

This is true and is a saving grace, but most of these people come from stories where they made foolish ill thought-out decisions at the beginning, and they come back with the right research, planning and selection. I am stumped on where to move forward considering the universal conclusion is that I did everything right since the very start.

1 hour ago, jjalay said:

Have you considered doing strip with dr. Wong this time as a repair? This will be i persume without cost and you might be able to obtain more grafts as doing another fue.

I don't think I would get a FUT or a procedure from Dr Wong. 

I was told originally that I have enough donor supply where FUE is more than enough, If I had to have FUE and FUT Scars and still face the prospect/possibility of poor yield, I would be deeply unhappy. 

As for Dr Wong. I am not a fan of the rows as many people have brought up, mainly because I wanted the possibility of having a shaved head in the future without things looking unnatural or being a standout feature. Also there was a recent case of a pretty horrible FUT Scar from Dr Wong that shakes my confidence in this option.

5 hours ago, Turkhair said:

You mentioned you had tonsillitis during surgery, could that have affected your outcome? How long did it last?

Recovering from stress hairloss takes a very long time ( a year almost) , perhaps that’s what is happening with you. You should wait few more months in hopes this is stress hairloss before doing another surgery. 

Dr Hasson assured me that the tonsillitis would have absolutely 0% affect on the outcome, if he had said that it could then I would of asked him to stop the surgery.

In my opinion it’s not about my current hairs being wispy, there is in general a very little amount of hair. The left side as you can tell has about <10% yield that goes across the whole left side hairline. And the right side whilst doing particularly better than the left side still has rather poor density all over. To further reinforce this point, when I comb my hair from left to right, the forelock and the left area reveals bald circles of no growth.

Just a reminder these photos are flipped.

I will have to reiterate what I was told by the clinic, “the plan was to reinforce the front to a strong degree, anything else would work towards giving me a illusion to work with on my crown”. It was agreed upon that the front would look good enough to meet my expectations with only needing minor touch ups if issues were to arise (I was under the impression that these minor touch ups would not or barely exceed 100 grafts). Also if you look at my post scabs photos the density looks sufficient and strong on the hairline. Just to really state it here because I was called delusional last time. Dr Hasson told me my expectations on a strong frontal third were very achievable and reasonable

I spent two years researching on what was possible, and I’ve had non stop comparing graft numbers, hair caliber, thickness, multi and etc other factors. I had 4364 hairs implanted which should look a lot better than this.

I don’t feel any less bald, I was constantly told before the operation that I was about a NW3 with a diffuse NW5 pattern, i only feel like it’s moderately gotten me closer to being a NW3 altogether.

I’m not saying I’m botched, because a botched person would have hairs growing in unnatural directions with the wrong hairs scattered across everywhere. I just feel like my growth is that poor that barely anything has grown in the front. 

I don’t know how to move forward here. All I want is my hair back, not any new stress relief hobbies, not any more expenses towards my third psychologist, not any new concealer although I might have to due to the damage done to my donor reserves for future HTs. All I want is to feel like someone my age, I’ve been bald since I was 19/20 and I’ve never heard the end of it. Unlike what people say, people actually do care on what your hair looks like and they will never make you forget it.

What are my actual options here? What can I do to almost guarantee that the same mistakes and outcome won’t happen again?

1 hour ago, Savemyhairline said:

So essentially H&W will give you a 100% refund? I am a big fan of Dr. Hasson’s work but I understand where you’re coming from on choosing a different doc after all this. Especially if you’re getting refunded. If they were to not refund you and you had to start over financially, I’d maybe have a different opinion.  I’d say at 9 months that is disappointing and you are right to not be happy. 
 

My advice emotionally would be to try and look at guys like Melvin and Gatsby who did not have a successful first go around but with perseverance and patience, look great today. You’re a very young guy and you have a great beard, so you should have options as far as grafts down the line. It seems you did all your research beforehand and you did choose a world class clinic, so nobody can fault you, you did nothing wrong, try to remind yourself of that.

 

Any doctor can and has had less than satisfactory results. Them refunding you fully is nice, though of course you can’t be refunded on all the time, energy, and emotion you’ve inevitably put into this. Try to keep your head held high man, don’t quit. I think Bisanga and Rahal could both do you well, I feel like I’ve seen multiple impressive repair cases from Bisanga.

I did not say they are giving a refund, but a refund is on table if the areas do not have growth. Here is what they said word for word.

"Dr. Hasson stands behind his work so if after a year there is an area that has not regrown he would either replace those grafts for free or refund your money for those grafts."

The thing is, I did my research obsessively and followed specifically Melvin's and Gatsby's cases and advice to avoid the same pitfalls they had so that I can have my hair when I was young like I am now. However, it doesn't matter how much research I put in or if I did everything right because I still fell in those exact same pitfalls regardless.

It was implied by Doug from H&W in a previous email that a person of my retrograde alopecia severity probably/is estimated to have a total of 5500-6500 Grafts in their donor. Which would mean that my donor reserves equal out about 1628 at its lowest, to 2628 at its highest. Which is either half of the amount that Doug said I would need to restore my hair following this outcome, or mildly less than the requirement to restore my hair following this outcome. I believe that I probably have enough donor to meet my original expectations, but the issue arises on how well the yield will go the second time around.

When everyone tells me "I did nothing wrong and nobody can fault me or my methods" its puts me in a loop because it makes me feel like any other follow up choice I am going to make will merit the same results, which I am destined to be unhappy with.

Another thing that wasn't stated is not only can they not refund me the "emotion, time and energy" that I had to go through but they can't refund the potential grafts that were burned through the procedure, which equates to the final long term result for both your donor preservation and your hair on your head. that's is what is really bothering me.

I really don't want to come across as someone begging for pity, But I do want to show that for just as much as a good result can change your life for the better with restored confidence, a result your unhappy with has the opposite effect and makes you have doubt in yourself and reinforces the insecurity to some degree. 

Here are some 9 Month Photos.

9 Months Well Lit Room (no overhead lighting)

Right:

Left:

Harsh Lighting (Infront of my monitor)

Right:

Pre-Op

As a reminder, the midscalp is untouched, it seems like some decent improvement from Oral Minoxidil

So I am now at the 9 month mark, which is one of the two points that H&W requested for me to send photos specifically. I thought it would be important to post here because of the milestone that is 9 months.

As you can tell, when looking at me on the right and left, it can look somewhat decent and not that much see through effect is going on. But If I slightly tilt my head down, I still have my original balding pattern on full display with varying degrees of severity by how much light is present.

On the positive notes;

I am getting more comfortable walking around my house when a visitor has arrived because I am in control of the lighting and conditions, this was something that I could not control before the operation as it would always look bad.

I am also hopeful that fibers would be very impactful for the level of hair I have now had restored. I have yet to buy them, but I have decided to have a look the next time I visit my trichologist (they have someone that should be able to help with that)

Another positive factor that almost never gets mentioned, is that my height has been somewhat of a saving grace, most people I interact with are significantly shorter than me or about the same height, and only really see the "good/decent angles" whilst taller people (or when I am sitting down) will easily see the "bad angles"

This is as much of a negative note as it is a positive, but for this case because the photos I took are up-close it applies in a positive. But the closer you are to me, the worse it looks. The further away you are, the better it looks.

A last final positive note before I mention the negatives is that the camera here does "exaggerate" the poor aspects, What I see in the mirror or even holding two mirrors and moving into various lightings, is not as bad what I see in these photos. 

Now the negative notes; 

I am going to expand on the previous point in a negative way that probably no one has ever talked about before. My vision is quite poor (to the level I am not allowed to drive without glasses) and that when I look in the mirror, the weak points of my hairline blur onto the good parts, another way of "exaggerating" it to look a lot worse than it actually is. Obviously this is rectified with me wearing glasses but it bothers me that my eyes literally generate a "worse than it actually is" picture constantly.

The term "bad hair days" really applies when you have a hair transplant I believe. Some days I have these hairs that just do not want to stay in the same position for over 5 minutes, whilst other days they can stay like that for hours.

I am still deeply insecure about my hair, nothing has changed about that. I also have a new insecurity/dread that has emerged since this procedure. Considering I was going into a Norwood 5, and now that I have 3900 grafts with questionable yield, how much donor do I feasibly have left? And how much potential area can I cover with the remaining donor?

The asymmetrical growth very much bothers me, the left side at the very front hairline looks very bare compared to the right side, It has got me concerned on how future surgeries will react in that area.

Overall, Mixed opinions (leaning more towards negative) on the transplant. I see that I have my own victories and defeats I have to accept that have left permanent impacts on my life. I wouldn't call it a failure, but I wouldn't call it a success either. My personal opinion is that I think the label "below average" is a good fit for it. Not enough to call bad, but not meeting your average standards or the standards that H&W have set either.

My main worry right now, is that I acknowledge this as a "first step in a two step plan" but since this is not the foreseen outcome that I had in mind, are my original expectations achievable?

I've made a bad habit of not taking crown photos, I will say that the crown is on the lines of what I was expecting (a improvement enough to help me conceal with longer hair, but not anything substantial)

On 8/27/2023 at 1:20 AM, GoliGoliGoli said:

If I were you I would opt for #1 if the work is free of charge. I know everyone says not to go back to a clinic whose result you weren't happy with the first time, but I think when you're talking about a clinic that is in the top 50 worldwide, the skill difference between that clinic and other clinics in the top 50 is fairly negligible. Maybe I'm wrong but I would just hate to see you pay more money to go to a different clinic to get the same results you could get from Hasson for free. 

At this point, my trust in the clinics ability to restore my hair is close to being lost. Trust in your clinic is a invaluable asset and factor when getting yourself through the ugly duckling and the growth phase. If I were to revisit Dr Hasson and his team in my current state I would be anxious and nervous for months to come.

What I need is to find a surgeon that will talk with me throughout the whole process, one that shows that they are 100% committed to restoring my hair and informing me on how they are doing that and to meet my original expectations but also tell me if its a multi-step procedure going forward how much each procedure should do for me. Also if possible I want a surgeon to analyze and question me so we can find out what could of went wrong in the first procedure

I would like all comments from now on to be helpful towards guiding me to a path to restore my hair. I would rather not have comments that act as commentary on my situation

Does anyone know how to contact Ferreira or Couto? Ferreira isn't open to online consultations on his website and Couto's website still says that its coming soon.

On 8/27/2023 at 6:18 AM, Balding Bad said:

I need to start ramping up my research again, but for the time being I'm kinda leaning towards Rahal in Toronto since he is the self-dubbed "Hairline King" and the results I've seen thus far are quite impressive.

I originally sent in a online consultation to Dr Rahal for my first surgery, but he rejected me due to my age and told me to email him I believe 6 Months (October 2022) to a Year Later (March 2023)

So far I have been in contact with FUEGENIX, but am also planning on contacting Bisanga and Pinto soon, what do you guys think of those two surgeons for my case?

How do I contact Dr Couto? his website still says "coming soon" for about a year now when I was first interested in him.

2 minutes ago, Grouse said:

@mister_25 for what it's worth, I think your hair looks great and it looks like you're still growing nicely. Suspect this will end with a very strong result.

If you're open to it, it may help to trim the sides shorter and bring the beard in while you continue to grow on top. I've found less hair around the head makes the hair on top look thicker.

 

Have you looked into Toppik or Derma Match at all? Those would also help with harsh lighting and "less than ideal" appearances you mentioned while you wait for next steps. Best of luck man!

The reason why I havent gotten a hair cut yet (which would very much help) is because of the areata patch that I developed. I'm not entirely sure how obvious it will be with having the hair short so I am letting it grow back first before I get a haircut.

As for fibers/derma match. I am looking into it and I'll probably be trying fibers for a while. 

11 hours ago, Balding Bad said:

Hey @mister_25, hope you're doing well. Any updates?

I will post photos another time, I haven't been taking many photos of my hair as of much because I am trying to take my mind off it. So I'll provide a written update. This will not include the crown, as I haven't really looked at it in over a month.

A few days shy off 9 Months. Update

For the frontal third, there is definitely a aesthetic improvement to be had. However, as many of you have heard before, hair transplants are a illusion and in my case this very much applies more so than other people.

This "Illusion" only works in the following conditions.

• My hairline has to be combed in back with a slight sway towards the left. Any direction or style otherwise will make me look varying degrees of baldness or thinning.
• I cannot be in very bright lights, well lit rooms can still work but the issues arrives on how close someone is looking at me
• The further people are looking from, the better it looks. The closer up you are, the worse it looks.
• It does not hold up well from a top-down view.

The hairline itself is the problem for me, its see through still but at a much more acceptable degree than a month or two ago. The left side and widows peak are very far behind and probably have something on the lines of 5% yield in those areas. Behind the hairline, and the corners of my hairline and to the rest of the frontal third seems to be growing in well.

If I had to estimate how much yield I have, or what percentage I am from where I was, to where I thought I would be on a successful procedure. I am somewhere between 50-70%. Probably would say 65% is my own estimate.

I had a call with Doug from H&W, he likes to believe that my growth has really started to pick up (which I agree with) and that I am a few months behind. He thinks that the yield is somewhat good and that Dr Hasson purposefully decided to go lower on the density for this procedure due to the amount of loss I had and etc. This is a direct contradiction to what I was being told by Dr Hasson and the technicians at the clinic saying that the density would be good for the first time around.

I asked him what could of went wrong in the hairline to cause poor yield and what Dr Hasson would do differently the next time around, and Doug's response was something on the lines of "I am unsure but a thought could be that your single grafts could be extra fragile, on a second procedure Dr Hasson would take extreme care and be very meticulous with a touch-up on the hairline". It is also worth noting that on my post-op reports that the day one did have the words "fragile grafts" in the notes.

I also asked Doug that hypothetically if my hair stopped improving from where it is as of right now, and I were to get a second procedure to finalize and to meet my original goals, how many grafts would I need. And he replied that he thought 1500 grafts for the frontal third, and 1500 for the crown and the mid-scalp (3000 in total) would be to meet my original expectations and goals. Dr Hasson originally believed that I would need 2000 grafts to address the mid-scalp/crown in and finalize the procedure originally.

I would also like to thank @Melvin- Moderator in particular as I was having issues getting into contact with Doug at certain points and he made it happen quickly and cleanly.

I've been following your thread @Balding Bad and I've noticed that you like to rate your hair transplant on a scale from 1-10, so I will do the same.

I believe my hair transplant so far is a 4/10. I say this because I see 4/10 to be below average but not poor enough to call bad or any other label. Its not what I was expecting or what was being reinforced as reasonable expectations and is quite the let down. But I cannot deny that it is still a improvement from where I started. As for how it has improved my confidence, it hasn't at all. I still wear hats to cover it up because in my opinion there is a degree of unnaturalness due how the hairline has grown in well in the corners but poorly on the left side and the widows peak. But I will say that I do feel like I look about 10-15 years younger in the mirror. But regardless I feel like a 23 year old with the hair of someone in their mid forties

As for the bald patch I developed that I spoke off in a previous update. It was confirmed to be Alopecia Areata which I have received two injections to treat it so far. The dermatologist who was recommended to me by a forum member on here seems to think I am reacting very well to the injections and by the second injection he said that I probably wont need a third injection because its already started to come back.

I will be withholding final judgement on my hair transplant until the 1st of December. Then I can tell you whether or not I can personally recommend Dr Hasson and his team or not.

I won't be posting many updates moving forward, although I will include a 12 month update. That I can promise.

The reason I don't want to include updates is a fairly simple one, I feel embarrassed and ashamed to post on this website. I recently created a thread to ask specific questions and to assess the options that people believe are suited towards me, however I mainly received various negative comments (not about my hair, about things like my personal hygiene, mental health and my intelligence), various insults and in general patient shaming and unhelpful off topic comments, to the point where I just found it upsetting to look at to the point that despite the comments being removed, I wanted the whole thread to be removed. I request and hope that no one brings that behavior into this thread.

I am currently weighing my options and have the following ideas in mind, I would like to hear peoples opinions on the following options that I have. If you can also include information on the price/wait times of the following surgeons that would be helpful.

1. A touch-up procedure with Hasson.
2. A second procedure with FUEGENIX
3. A second procedure with Ferreira
4. A second procedure with Bisanga
5. A second procedure with Pinto

I also have a additional question, if you were in my position with the same donor reserves and same state of hair. Who would you go to or who would you believe would be the most qualified and most suited person to restore my hair?

I'm surprised that Dr Mwamba has not posted on your thread yet.

I've noticed on other patients threads, specifically Dillpickle123 and Ajamilo, that he will provide comments that do provide more context on what he is thinking and what he can do for you. Its a shame and also quite questionable that he has not done that here especially after accusations of broken promises, poor growth and overall shady practices.

The silence is not helping his and the clinics image.

Looks natural. Maybe a bit less on the density up close but no one is going to see that because no one stares at your face that close.

First photo looks great

Its hard to say, the area above the ears is naturally less dense and has finer hairs. You can't be sure unless you get a specialist to look at in person.

But if you had to ask strangers on the internet, which includes me. I would say I am slightly leaning towards it being retrograde alopecia rather than not. When the hairs are being pulled into opposite directions on your last picture it does indicate to me that there is less density than someone that does not have Retrograde Alopecia

12 hours ago, Sunset Dune said:

This is an interesting case and unusual for a highly regarded clinic to have a poor result such as this but I may have an explanation to it.

First off, a hair transplant does not always guarantee good results even from an elite doctor. Each individual case is different, there are slow growers and there are others who just aren’t good candidates for a hair transplant at all. 

The single most important factor that is directly correlated to the outcome of your surgery is the quality of your donor hair. No offense intended to you OP but judging from your pre OP pictures the quality of your existing hair/ donor hair isn’t really that great.

Your hair was already looking thin, the quality of your hairs is somewhere in the middle of below average and your hair loss is aggressive at a very young age. Your frontal region was already heavily receded you didn’t have much of a hairline left. The clinic did the best they could it’s just your case is difficult, even if you went to a top doctor in Europe the outcome may have been similar.

I don’t think you’re a good candidate for hair transplantation and quite frankly you shouldn’t have been operated on to begin with at only 22 years of age. You did your due diligence by going to an elite surgeon hoping to fix your hair situation but you didn’t factor in all your problems such as low hair quality, poor donor, very aggressive hair loss, very young age, etc. Or maybe you already knew this but decided to take a gamble and see how it might turn out unfortunately it just doesn’t work that way.

Your results may turn out a bit better than your pre op situation but your expectations shouldn’t be set high due to all the factors mentioned. 

That’s why the clinic said they would do nothing different because there is nothing else more they can do. They already did everything they were supposed to do.

Interesting take, this goes against everything I’ve been told by the clinic, doctor and other posters.

I was told by many others here that the characteristics of my hair and donor are above average, whilst the clinic told me my donor and hair was average, this is the first I’ve been hearing that my donor and hair could be below average

I was also told by Dr Hasson that due to my usage of medication and the results of said medication that I was a candidate for hair restoration as long as I continue the medication for life because I could potentially lose more hair.

I also did factor in all appropriate variables, ever since I found this forum before surgery my goal was to make myself “ the best possible hair transplant candidate” to secure the chance of optimising a good result. When posting on here I came to the following conclusions both reaffirmed by my doctor and by the posters of this community

• My hair characteristic is average to above average
• My donor density is average to above average
• my results on medication were good
• my age is indeed a poor factor but stabilising your hair loss for two years is a good sign to move forward on a hair transplant.
• Aggressive hair loss does not have any correlation with whether implanted hair will grow or not, maybe with how long transplants will last if your not treating your hair loss.

I also personally asked Dr Hasson before the operation in emails and on the day of the operation if my expectations were unreasonable, unrealistic and attainable and he reassured me that they were attainable, but not in one procedure.

I would like to really put emphasis on the fact that I did not go into this procedure ignorant with unrealistic expectations. I did my homework and checked every single result from Hasson on this forum dating back to the early 2000s. I wasn’t expecting anything strong for the crown, but for the front I was expecting something on par with @Nordster34 factoring in that we had the same amount of grafts implanted in the front (2900) whilst he has finer hair than mine I should realistically expect something similar or even slightly stronger given hair characteristics and graft usage. 

I will also attach two photos just briefly showing what my hair looks like. These were taken in the 4th and 5th of July

6 months have gone by on oral minoxidil. I am at baseline after a few months of being behind it, hopefully i will see improvements from here on out.

18 minutes ago, Balding Bad said:

@mister_25 appreciate the thorough update and sorry to hear that there hasn't been much meaningful progress.

Surprised to see that H&W is willing to provide a full refund. While that's a very nice gesture, is that essentially their way of acknowledging that they flubbed this procedure?

I feel like their response at this point (7 months) would be to reassure their patient and to tell them there is still ample time for things to turn the corner, but for them to outright offer a refund, that's akin to throwing in the towel and saying yeah, this ain't gonna work out, so the least we can do is give you back your money...

I dunno, am I wrong with my line of thinking here?

They did reassure me by telling me that there are just as many slow growers like myself then there are faster growers, they also did not really offer a refund/touch up as of yet because there is still time for it to grow, they brought it up to illustrate that Dr Hasson stands by his work and to show what he is offering if my case were to fail. They seem pretty confident that I am a slow grower rather than a failed case.

I wouldn’t say that your line of thinking is wrong, it’s just that I was rather unclear of how my discussion went with the clinic.

3 hours ago, jnyc97 said:

Any updates? 

I’ll provide pictures another time, it helps to try and take my mind off it as it’s been a source of stress for me. I do have photos including the 6 month crown photo that I missed which I will include with the 7 month photos when I feel up for it. But I’ll give a general update.

the front is still rather disappointing and weak, but it’s still improving. I would say that if my 6 month photos were 20% growth/coverage, then my 7 months were 40% growth/coverage. The left side is lacking and much more see through compared to the right. The right side in particular now contributes aesthetically and looks somewhat decent especially in moderate to dimmer lighting.

before I said that the “skeleton” of the hairline has come in, now I would say it’s starting to have more to it and it is filling in. The area behind the hairline has some patchiness but still a overall improvement. When it comes to naturalness it is rather low density at the moment but natural on the right, the left side does look a bit artificial due to a moderately sized weak point that exposes the fact that it’s a artificially made hairline. The forelock itself has shown no improvement or invisible improvement. It is also worth mentioning that the front has matured and is starting to behave like my native hair now, it’s easier to comb into different directions and blend in. But there is still a lot of hairs that need to thicken.

the crown has started to rapidly grow in, it looks like there is a lot of thin hair in the crown now. Comparing photos from my 5 month to 7 month shows a massive difference for the crown. I also still feel a decent amount of stubble in the crown. If I had to estimate. 5 months was 0-3% crown coverage, 6 months was like 15% and 7 months is about 35-45% coverage.

another development is that a week ago I noticed a tiny slick bald patch that had developed on the right side of my donor. It has gotten the tiniest bit worse as there were 5-6 remaining hairs on it when I first noticed that have shredded of by today. It has not gotten any bigger since I’ve seen it.
 

It could be alopecia areata or the very possible chance that I scratched it out as I’ve had some large pimples there that never developed heads so I never popped them, and these pimples caused itchiness which was hard to control. I vaguely remember seeing blood on my fingers one time after intense itching about two-three weeks ago so it does line up.

I will be seeing a dermatologist to assess it, dr Hasson believes that if it is AA that a injection will most likely grow it back. I am hoping it is temporary but in reality it’s really tiny and something that I could live with as long as it does not get worse. It’s more the principle of having AA that worries me. It can be easily passed off as a scar as it’s a bit too perfect of a circle.

overall, I am quite unhappy at the moment but noticeable improvements can be seen in increments of 2 weeks. It’s definitely picked up in growth rather than slowed down.

In general, I can say that I am above baseline now in all areas except for the mid scalp which has grown in enough to be able to slick back like I was doing before surgery.

I should also mention that in a email they said that in the event that my growth is subpar or not meeting the standards, that they would offer a refund or provide a free touch up. I asked them on the free touch up and what they would do differently from the first procedure to ensure growth is much better next time and they replied that they would not do anything differently.

5 minutes ago, baldfighter said:

That’s interesting. How did you come to that conclusion?

I asked that question on a previous thread which I didnt receive a answer. I asked my surgeon and he told me that.