dronay

The second operation is essential. It will likely be your last operation. Of course, it will be more understandable after the photos. We can talk about all the details with your photos.

If you are in the UK, you can also come to my clinic in London to take a closer look at your donor area.

Dr.Kuddusi ONAY

Hello,

I'm sorry that the first operation failed. Did you apply FUT or FUE technique in the first operation?  This is a very important situation for your second operation. It is very important in terms of setting your expectations.

It is necessary to examine your donor area and determine how much of an area to cover. Of course, we can comment on your photos for this.

If you have any questions, I would like to answer them.

Dr.Kuddusi ONAY

Hello,

As a doctor, I would like to help you with hair transplantation. It is necessary to examine your anamnesis and photographs to understand whether the graft numbers given to you and the planning are correct.

If you have any technical questions, I'd be happy to answer them.

As a Turkish doctor, there are many successful clinics in Turkey. But you need to be sure that there will be a doctor in operation. There are many clinics in Turkey where there are only technicians.

Dr.Kuddusi ONAY

Hello sir,

I can tell you my opinion on whether or not to have a Hair Transplant operation. I understand your detailed story in terms of drugs.

First of all, do you have any age and additional discomfort?

Can you share your photos from a few angles so that we can understand if you need a hair transplant?

12 minutes ago, mister_25 said:

In these photos, You look to be about a Norwood 4 who will clearly go into a Norwood 5

I highly advise waiting a full year on medication. 3-4 months on Finasteride is nothing for your long term goals. You will need to document 12 months too see if your hair has stabilised.

if you go now and your hair doesn’t stabilize. You will get a island of dense hair in the front and partially the mid scalp and a barren empty crown that takes up a large portion of your head.

No doctor in Turkey has the portfolio or skills for your case. I would recommend you go to a doctor that specialises in higher Norwood’s and has expert world class donor management skills. 
 

 

Your showing signs of Retrograde Alopecia above your ears and by your name. This limits your lifetime donor.

Also I can’t tell by the lighting clearly but you might be showing early signs of going into a high Norwood pattern (6 or 7). You will need to prevent this because it will give you a large challenge in the future. Luckily your beard doesn’t look too bad and could be used as a alternative resource if things go really bad.

having a Norwood 6/7 final pattern with retrograde puts you in a poor position. You will need to go to the very best to get the most out of your donor without compromising it.

With all respect. Cosmedica and ASMED have been producing poor results quite frequently and follow a hair mill like structure of quantity over quality and are doing their best to make sales, rather than successful hair transplants.

 

Of course, I cannot vouch for them. It would be better if they answered the questions themselves. In my own clinic, I see all patients before and after the operation. (Online or Face to Face. Because we work in two different countries.)

Thank you for your answers.

Dr.Kuddusi ONAY

Hello sir,

First of all, you have to be very careful because of your donor area. I roughly draw the regions where the grafts can be taken. It may not be possible to get very high numbers. With a relatively thin PUNCH, the max graft should be taken at the FUE stage. (4000 grafts and around)

The main plan is to create a natural hairline. Because the most important factor that changes you when you look in the mirror is a dense and natural hairline, afterwards, your existing hair should be tightened, especially Crown.

If the number of grafts is insufficient for crown tightening, it should also be taken from the beard area.

Dr.Kuddusi ONAY

A natural front line should be planned and created for you. Because when you look in the mirror, this will be the main factor that will change you. Afterwards, the Top and Crown Area where you have existing hair should be tightened.

This is roughly your donor area where we can get the grafts. It's not very wide, but it will be enough. 4000-4500 grafts can be planned. During the face-to-face consultation, if your existing hair is weaker than expected, grafts can also be taken from the beard area.

Dr.Kuddusi ONAY

It may sound ridiculous to you, but I have seen Hair Transplantation centers that work without gloves. You can even look at the instagram photos of some Hair Transplant Centers. As a doctor, I can easily notice that the gloves of the technicians are Non-Sterile during transplantation. (Because sterile gloves are more expensive than non-sterile gloves.)

This is a very simple sterilization example. I have examined many infective and necrotic patients. They had operations in different centers without a doctor and came to me for examination. I tried to help them regain their health by applying antibiotic treatments and hyperbaric oxygen therapy in combination. (As a doctor in my country, you should examine the patient free of charge and write a prescription in cases that threaten human health.)

Best regards.

Dr.Kuddusi ONAY

21 minutes ago, Baldyboy said:

Just shared! I’m 34.

If you don't mind, can I see your donor area as well?

43 minutes ago, Gi29 said:

Does this mean that the doctors are not involved in the extraction step? With doctors from Turkey (both from Reddit and this forum), I have seen problems with donor over harvesting (often with high transection rate). And so, extraction step is a crucial step in this surgery. 

For you personally, do you perform both extraction and incision steps? How many patients do you take care in a day? 

In our clinic, the doctor always determines the number of grafts to be taken from the donor area. The doctor also determines how many grafts will be taken from donor area. When experienced technicians do in accordance with the doctor's directive, there will be no problem.

Incisions are made by doctors without exception, both in London and Istanbul. Technicians can never make incisions with us.

We accept 2 operations per day (1 Morning and 1 Afternoon) in London and 6 operations (3 Mornings and 3 Afternoons) in Istanbul. Thus, 3 doctors can keep all operations under personal control. In this way, the quality does not change from patient to patient.

Dr.Kuddusi ONAY

7 minutes ago, Gi29 said:

Dr Onay,

In those operations that you witnessed, what are the involvements of the doctors? Do they only “supervise” or perform any part of the surgery? It is safe to say that at least the extractions and the incisions parts should be done by the surgeon (not the technicians). Does that happen to the operations you witnessed?

Doctors in Turkey generally perform the operation planning and the second stage, the Incision stage, directly. Experienced nurses continue the operation at other stages. The operations performed by Dr. Acar and Dr. Koray, who are among the cases of these clinics, were successful.

There is the same order in our clinics in London and Istanbul. In some different cases, doctors can enter 3 stages in person. For example;

-Patient's excessive bleeding due to alcohol, drug use or other factors
- Difficulty in transplanting or FUE due to the patient's skin structure is damaged (like past FUT operations)
- If thinness is noticed in the first 200 grafts taken at the FUE stage

In such cases, doctors can directly enter all stages themselves.

Dr.Kuddusi ONAY

We never put the beard grafts in the front area as it spoils the natural look. Indeed that should be taken care of. If you still have questions, please don't hesitate to ask. Make sure your operation is managed by a doctor.

Best Regards.

Dr.Kuddusi ONAY

Of course, I respect your opinions. Apart from my own clinic, I can only say that they are successful clinics for Asmed and Cosmedica. I witnessed their very successful operations.

Dr.Kuddusi ONAY

Your donor area looks good after your first operation. You just don't have a huge donor area.

2. Your operation should be planned as the last session for you. Max root should be taken from your donor area. The target must be 3000 roots or more. 4000 grafts should be averaged by getting support from your beard area.

In planning, I will try to show it by drawing below. Only visible gaps can be filled if you are happy with your front line. Most of the grafts can be divided into the middle region and crown.

Dr.Kuddusi ONAY

Hello ,

Some of my staff used to work at COSMETICA. I can easily recommend that clinic to you in Turkey. A clinic that cares about sterilization.

 If you share your photos and information such as age, I can offer you a second doctor's opinion. You can easily compare.

Dr.Kuddusi ONAY

Hello,

Smile clinic is one of successful centres in Turkey. The best and most experienced centre is ASMED. Only the cost is slightly higher. If you share your photos and information such as age, I can offer you a second doctor's opinion. You can easily compare.

Dr.Kuddusi ONAY

9 hours ago, Parasol said:

I’m confused by this. 

What do you mean by taken in “phase 1?” 

What do mean by “the rest were broken?” Do you mean they were transected? Or just not very good grafts?

If grafts were transected or if the surgeon didn’t pick the very best grafts from the donor, I don’t see how the surgery could be considered “successful.” 

Can you please clarify?
 

 

Sure, let me give you more details.

Hair transplantation consists of 3 main stages.

Stage 1 is the FUE stage, where the grafts are collected. The grafts are collected one by one and taken to a cold place where they can be fed.

Stage 2 is the incision stage. Opening of the places where the grafts will settle. (This is not necessary for the DHI procedure. DHI pens both open channels and place grafts. In the Sapphire technique, there is a channel stage.)

In the third stage, the placement of the grafts.

After this summary, let me explain what I mean. Since I have patients from many parts of the world, I can easily say that there are many types of grafts. Even in the same patient, there may be very thick grafts in the middle of the donor area and thin grafts to the sides. In our clinic, we determine the thickness of the hair follicles before FUE with the help of magnifying glasses. The tool we use in the FUE phase has a tip that I call "PUNCH". Its dimensions are;
-0.6mm
-0.65mm
-0.70mm
-0.75mm
-0.80mm
-0.85mm

They have sensitive differences more minor than 1 mm in shape.

It is necessary to choose the right size according to the structure of the hair strand.

What I mean in the above comment is that a mistake may have been made in a part of the hair where the hair has thickened or in the entire head. Grafts with 3,4, and 5 hairs may have been tried to be taken with a punch with a very narrow width. And these thick grafts were removed as 1 and 2 hairs. Thus, half of the hair strands are dead.

Of course, a second possibility is that the practitioner is not sufficient or hastened. It may have been removed by damaging the grafts.

Any problem in Stage 1 will ruin everything. Although the 2nd and 3rd stages are perfect, if the grafts are damaged, there is no compensation, and the hair is damaged.

Dr.Kuddusi ONAY

3 hours ago, baldingnw3 said:

Dr Kuddusi, Thanks for getting back to me and I really appreciate your input. Sorry about the pictures. I will try to upload flat images of my hairline tomorrow (I'm guessing this means flat in level with the hair so that the camera is 180 degrees to the hairline but I could be wrong about this). 

Thanks for mentioning the part about transplanting between the receded areas. I definitely had these areas in mind to be covered by the hair transplant. Will I require 2000-2500 grafts for the area that you showed (meaning the arrows) or will 2000 to 2500 grafts cover more than just the area shown in your markup? Also, if I wanted to have a square/boxed in look to my hairline so that the front of my hairline was just a straight line, is that something that can be achieved by surgeons or is it not done? 

I've attached 2 markups of what I had in mind (at least initially, maybe I was too optimistic or had unrealistic expectations) of what I wanted for a HT below. Can you please comment on if this is possible, if you recommend it, any other suggestions you have and if it is possible, how many grafts roughly would be required to achieve this? 

Thank you so much for your time and help, I really value your input. 

 

We do not recommend hair transplantation to the last part you drew at your age. Because the grafts planted in that area will be healthy and strong. But your existing hair between that area and your ear may weaken after 5-10 years. And as a result, the hair we transplant can cause an unnatural look like "Island". Because the transplanted hair will remain thick for a lifetime.

Your existing hair should be tightened so that the number of grafts does not exceed 2500. Your donor area is perfectly healthy. We can plan approximately 1500-1750 grafts to completely balding areas, 500-750 grafts to your existing hair.

Dr.Kuddusi ONAY

3 minutes ago, Melvin- Moderator said:

Are you saying this patient went to your clinic? Im confused.

No. As a doctor, I just gave a second opinion to this patient. I did not do this operation. I wanted to help the person. 

Hello,

First of all, I made a rough drawing for you because the angle of the photo is not precisely flat. Your hairline may be roughly like this, but the final decision can be your natural line with your frontal muscles.

  You are young and at average risk of hair loss until the age of 35. You can wait for the Hair Transplant operation. But if you don't want to wait, you should transplant between your existing hair marked with an arrow. Because if your existing hair falls out in a few years, a bad gap may occur.

You currently need about 2000-2500 grafts. Your donor area will still have 3000-4000 graft potential after the operation. If you need it after 10-20 years.

Dr.Kuddusi ONAY

We worked together for two years. Now we are performing our operations in London and Istanbul. We perform operations by doctors both in Istanbul and London. Our company name is FKS Clinic LTD in London.

When I find time, I will try to help people as a doctor on these platforms. Because in many centers, only technicians serve. And I don't find it true. 

Hello Sir,

Actually, you had a successful operation. But there seems to be a difference in graft quality in the middle between those in your hairline. Probably some of the Grafts were taken in Phase 1, but the rest were broken. Depending on this, thin hair strands are seen from place to place.

If you want to have a second surgery, you can share the current status of your donor area here. So I can comment.

Best Regards.

Dr.Kuddusi ONAY

Hello Macavelli,

After the average age of 35, I do not expect a dramatic shedding in men. You are 47 years old, and your hairline will stay that way. If you are not very concerned about your hairline, I would not recommend you a hair transplant operation.

But if you are not satisfied with your hairline, a single session hair transplant operation will be sufficient with 2500-3000 grafts. Since the number is low, it can be done unshaven.

Dr.Kuddusi ONAY

Hello Sir,

First of all, it is definitely not suitable for your hair type to exceed 3500 grafts. According to your hair loss, you need about 2000-2500 grafts. This would be equivalent to a 3500 grafts hair transplant for a person with a straight hair type. Of course, this graft range will vary according to your age, skin health and blood circulation.

If you have e more questions, please ask me.

Best Regards.

Dr.Kuddusi ONAY