NegativeNorwood

48 minutes ago, Fue3361 said:

Lol!  There are pharmacies that do custom meds, and Dr. has those pills custom made for him.  He gave me the 3 month worth of pills as I was leaving the clinic day of transplant.

200 IQ doctor.

I did something similar and got a hand written authorization by my family doctor to get oral minoxidil compounded by a local pharmacy in case of Loniten shortage (which happens a lot). It has to be renovated once per year but is great to know that, regardless of what happens to Loniten supply, I'll always have it.

I've managed to know about it because it was impossible to get Loniten due to the shortage and the pharmacy stuff instructed me to do it that way, sometimes the stars align I guess.

Just now, decan19 said:

Only thing I dislike with Feridunis results are the high receding hairlines/hair line corners.

That's true, he is usually very conservative. But he has some results with low hairlines, I remember seeing a couple here and on his Instagram, I believe it's a matter of comunication. If the patient responds well to medications, has a stable and slow hairloss and enough donor, there's no reason why him (or any other doctor) woudln't give an aggressive hairline.

Freitas doesn't do temples and implants in row patterns, Feriduni's results are much more complete and natural looking in comparison (not talking just about hairline design, but about the naturalness of the implanted hairs).

IMO Feriduni is way better, his results are much more natural looking to me.

Amazing hair transplant surgeon...and photographer, the after pictures taken with the Iphone are much better and way more useful than many others taken with DSLR cameras at odd angles, distances and with very low light levels. It clearly shows that everyone can present their work clearly and honestly, without excuses, but don't do it because they don't want to.

Patient must be thrilled with the result, it's incredibly natural, as usual from you.

I don't want to come across as an @sshole, but how is it possible that someone goes to not just one, but several reputable clinics and gets botched in all of them? Clearly there's something wrong with that guy, the anomalies are too much.

I understand that every surgeon has botched cases, but what are the odds of going to not one but 3 very reputable clinics (Devroye, Konior, H&W) and get a botch from every one of them, and for different reasons. It's just too much. There are two possibilities here: 

- He has the worst luck ever.

- He must be doing something wrong.

Not even going to argue about him editing the posts when questioned, creating multiple accounts or being banned here, which make him lose a lot of credibility.

9 minutes ago, Rafael Manelli said:

@NegativeNorwood all very true, and in fact the average patient is so uneducated and misinformed by mediocre and poor clinics out there that they think their forehead is huge and the only way to get it back to "normal" is to pull the hairline down, sometimes way too far, making them look even more imbalanced - when really what they need is to pull it in from the sides like a pair of curtains. 

A (very rough) rule of thumb is that the distance between the two points of the temporal hairline should be roughly double the height of the frontal hairline from the glabella. 

 

Completely true. Most requested celebrity hairlines out there, like Brad Pitt's, are actually high-ish set, longer than his midface, but the very strong temples balances it and makes it look low set. My "mature hairline" is 6cm high, around 90% of my midface lenght, and looks much higher set due to the complete lack of temples.

The hair transplant world would be a much better place if the importance of temples were demonstrated and explained on a daily basis, lots of grafts would be saved on average, as it takes much less of them to build strong temples than to lower a hairline.

15 minutes ago, Rafael Manelli said:

Main reason most clinics don't do strong temple points is because of simple incompetence too. 

 

100% agree with that. "Your hairline is age appropiate, temples are a waste of grafts" is code for "I don't know how to transplant them but don't want to admit it".

I've seen an Oscar Muñoz video where he discusses the subject, and he said that because of the early instruments used for extraction were so big (and as such gave the usual big plugs in the hairlines), temples were ignored since the beginning. When new methods like FUT and FUE came out, only a few inquiring doctors ventured learning how to transplant them. In fact, he even said (rightfully) that the Norwood scale didn't take temple recession into account and he didn't like it for that reason, among others which he didn't explain. So, looking just at the Norwood scale, it makes sense for most doctors to ignore them, as it is very convenient due to the extreme difficulty of transplanting them properly (if they even bother to look at them, ofc)

OP was very lucky to have strong temple points before surgery tbh, still, Couto has plenty of cases where he builds the entire temples with amazing naturalness, he is one of the best in the entire world, and really knows how a good hairline design looks like.

7 minutes ago, Rafael Manelli said:

Dr Couto almost always seems to do temple points. With good reason, as this result shows

I agree. Couto's cases are perfect example of how much of a meme "mature" and "age appropiate" hairlines are. When donor allows, Norwood 1 with strong temples always look best, no exceptions.

Absolutely perfect result.

Dr Couto knows what he's doing and gave you a Norwood 1 hairline with strong temples, there's nothing more aesthetic than that.

Enjoy the perfect head of hair!

I wouldn't go because they present vague before and after pictures. "Good reputation" may have been enough in 2005, but time flies and competition evolves, and doctors like Zarev, Feriduni, Mwamba, Munib Ahmad, Couto, Konior or Bloxham (that's just off the top my head, pretty sure there's more) provide extensive, honest, high resolution before and after pictures to document their cases. Why would you want to risk when safer (and many of them even cheaper) options exist? 

Lack of good, standarized after pictures is a red flag, regardless of reputation. There's no way you can tell this result is good or bad with this pictures:

Meanwhile, this is how a true top tier clinic presents it's work:

That's an entire world of difference, you can clearly tell the work is of great quality, because the pictures are good enough to judge it fairly.

I would stay away not just from Hasson and Wong, but from any clinic without proper before and after pictures, regardless of price and reputation.

Excellent thread, should be pinned.

There's no excuse for clinics to not present proper before and afters taken in the same angles, with the same lighting and using good cameras.

No good pics = bad clinic, regardless of reputation and price.

Verteporfin will greatly help and improve hair transplants in the following years, that's for sure.

No. OTOH, balding makes you less attractive to women (and no, don't post a model, football player, actor that looks good bald. They are rich, famous and looked even better with hair, thus not a relevant example for the average person).

1 hour ago, New_Barnet_Please said:

Good stuff, I agree with most, I would take issue with the idea that you can’t grow new follicles with minoxidil though - that’s what it does! See the Reddit link in my previous post on this thread for a huge amount of evidence of that. Although it’s true if there’s no hair there at all there’s less chance of getting a good result on the beard with minox.

Thanks! Maybe there was some hair that was not visible to the naked eye, and minoxidil made it grow. It happens to people who lost some scalp hair, but regrows it with minodixidil. The hair was there in the scalp, but not visible. No one gets a better hairline, with larger temples than at 16 years old with minoxidil. Same with beard.

I wish it improves mine, I'm at 2 weeks with oral minoxidil and oral finasteride with no sides, but I'm sure that to achieve a beard like the ones above, I would need a beard to beard transplant. If I'm lucky enough (and I'm skeptic) to get such a beard with oral minoxidil, I would be extremely happy tbh, as I don't want to bother with topical.

Eager to see your results man, best luck! It's super rare to see a beard to beard transplant here ngl.

Dr Mwamba has the best results I've ever seen for beard to beard transplants:

Also not discussed here in any form or shape, ideal beard shape has to have a certain height, and has to be right below the cheekbone, to give good facial framing and the impression of sharpness.  This is better seen with beards shorter than 5-7 mm ("stubbles"), but all the beard transplants I've seen, understandably, want to keep the beard longer than that. A good jaw development and a low body fat percentage obviously help a lot with framing and determining the actual beard shape, as it is much easier to see without excess adiposity distorting the jawline and cheeks.

Examples of perfect beards. Notice how everything above is a constant despite the different ethnicities:

My case would be similar to this, the difference is what I want to get transplanted with beard grafts:

I'm lucky to have a decent beard but with some grey hairs that are not very visible (this should improve with dye) and only lack the upper part for my desired beard shape. I don't know how many grafts that would be but it doesn't seem like a huge number of them (albeit the difference they make is big). Along with eyebrow and a small temple transplant, this would be my other priority.

Scalp hairs are a subpar solution compared to beard grafts. Sadly, not everyone has enough beard donor to get a satisfactory beard to beard transplant.

Copy pasted from Bruno Ferreira's website, he advocates for beard to beard transplants when possible instead of scalp to beard:

"The best area to extract beard hairs from is right below and up to the edge of the mandible, as this zone usually has a higher hair density and is less visible. I can say though that healing in this area is remarkable and extractions are imperceptible after recovery, which is very good since it’s still a very exposed area and of course we wouldn’t want to make something look significantly worse whilst trying to fix/improve something else. I can actually go as far as to say that even from the cheek, hairs can be extracted as it heals excellently, although I do prefer to avoid that zone.

Extraction isn’t especially difficult and it’s also not very painful for patients (anesthesia is rather simple and painless). I tend to make shallower cuts and usually will resort to the manual punch for beard extractions as it’s more easy to handle when you’re extracting in a more odd angle. You do need to be a bit more gentle when excising the grafts as they are a bit more tightly anchored and will break if you aren’t perfect with your cuts.

Some beards are very rich and have a total donor capacity of more than 1500 grafts, but we do have to take into account that beard follicular units are usually limited to single hairs (the most common ones) and doubles."

PS: Minoxidil won't grow hair where there isn't any. It will strenghten existing hair, but it won't create new follicles. I've seen an Oscar Muñoz video where he said it would strenghten existing hairs by 20-25% at most (rough estimate), but of course it won't cause new hair follicles to grow and give someone like me a beard like Toni Mahfud's. Only a transplant can do that.

Great naturalness. Outstanding hairline and temple design.

Brutal. Meanwhile, non oficially recommended by the forum doctors like Zarev take an average of 2 hours to assess donor zone and design a very thorough plan before touching a single hair (screenshots taken from a Youtube video):

On top of that, you paid for the top package that includes Dr Sethi. IIRC, the price is 8.3$ per graft (this man paid 25k usd for 3k grafts):

As a reference, Zarev charges 5$ per graft, and so do many top tier doctors that take hours inspecting the donor area with microscopes. I would expect this kind of eyeballing and lack of planification by a hairmill that charges less than 1$ per graft, but at 8$ per graft this is unbelievable.

It's very sad to see that a recommended clinic doesn't even care about inspecting your donor with microscopes (let alone a Zarev level examination), we really can't take anything for granted.

I'm very sorry for what happened to you OP and to @bobs person, it really doesn't make any sense.

It is a shame because I've seen great Dr Sethi results, and really like most of his temple work and hairline designs, in addition of the naturalness his hairlines usually have. He should take an hour or two to examine the donor closely before working, like any reputable doctor does, otherwise he's doing a huge disservice to his talents and to his patients.

36 minutes ago, mr_peanutbutter said:

i need oral minoxidil source in europe so badly 🥲

 

people from the usa are so lucky bc they can order it for cheap and without any prescription from india..

It's very hard to get it in Spain. I got it prescribed as Loniten 10 mg, but...there's a global shortage, so I had to get a hand written authorization by my family doctor to have it formulated by the pharmacy in case of shortage (normal prescription that said "Loniten" and not "oral minoxidil" wasn't valid for that). Such an authorization only lasts for a year, so I have to be vigilant and get a new one every year to avoid being without Loniten in case of another shortage.

A true PITA if you ask me, I hope it helps me to regrow my temples in the following months to compensate for the inconveniences haha

21 hours ago, Big Rome said:

what’s wrong with him asking his patients to post their journeys on here? the man’s pushing out really good work consistently, I for one am happy to see more results from the doctors on here, might help people make a decision on the doctor they chose in the future.. the more the merrier in my humble opinion lol 

Agree 100% with this. 

@Sin69 Happy growing, hope you get a home run result as usual from Munib Ahmad.

For that amount of money, you could add 30 minutes of browsing here looking for doctors with high quality, honest pictures and great results, read some patient reviews to see if they are on the same page as you, and book a consult with your doctor of choice. 100% sure you'll get much better info from it. 

21 hours ago, Digs49 said:

@NegativeNorwood what about H&W and Pittella?

H&W has a great reputation, but times change, competition evolves and I would like to see better pictures of their work.

Pitella achieves impressive coverage and is a very interesting surgeon, but still would like to see better pictures of his work too.

6 hours ago, Judelaw said:

The demand for transplants is so high that it literally doesn’t matter for elite surgeons. It’s like selling a new iPhone on eBay, you can take one picture of it on the toilet and it will sell immediately if priced $1 too cheap. 

What does a clinic with a constant wait list gain from hiring a team to promote results? 

Hair mills have much more demand than any reputed hair transplant surgeon, some of them have 3 million Instagram followers.

The point is, we need to be able to tell the "good, better than a hairmill" from the "excellent, elite level" clinics apart, and that only is possible with high quality, honest pictures.

Imagine having a "decent" transplant at a reputed clinic, posted the result here, with the usual low quality pictures taken with a phone, and everyone cheered it up, saying nice density, very natural, etc...only to find later that it looks good with your hair long and combed a certain way, but with your hair shorter, the implanting pattern is evident and even more with ligthing on top (can happen in social settings, for example at a restaurant when you are sitting with multiple people around, everyone that looks would notice your transplant or that there's something weird with your hair). You'll have nothing to complain about because you got a "home run" result by that clinic's standards and everyone here agreed with it, so you would still need a second transplant at a different (and better) clinic to fix it (and ofc, more expensive than before because now you are a repair case). This situation wouldn't happen if clinics had high quality, honest pictures posted that allow you to see the quality of their work clearly (talking about the decent ones, not about hair mills, which will botch you badly).

Me after seeing the high resolution, close up pictures:

Great result 👏

14 minutes ago, hairman22 said:

@NegativeNorwood

got my photos back

have to say my hairloss was better than i thought.

But you can see donor is thin at the back

Great pictures. Looks good, I expected you to have much less hair reading your original post. Great to see a Zarev patient who is not a Norwood 6-7, IMO you made a great choice.

20 minutes ago, takuma said:

If we are seeing full regeneration, then that could possibly mean that anyone can get their full donor back also by wounding previous fue scars and applying verteporfin to allow functional normal skin to grow in it's place, as underneath the fue scarred skin may lay dormant dht resistant hair follicles that are blocked from sprouting back from underneath the dermis due to scar formations. It may be that the only thing that was stopping hair follicles from growing back after an extraction was the formation of scar tissue where the follicles were extracted... 

That would be mind blowing. It would also put an end to scalp to beard transplants, since all the donor hairs could be taken from the beard itself in unlimited quantities (due to the regeneration). Same with eyebrow transplants, it would make the use of scalp hair redundant, since thanks to regeneration the surgeon should be able to use eyebrow hairs too.

Basically, not only the cure to hair loss but also a massive improvement to hair transplants of all kind, not just for the scalp.

1 minute ago, HugoX said:

Doesn't top doctors in USA charge between 6-8$ per graft? 

Konior reportedly charges 15$ per graft...if anything, Zarev is very fair priced in comparison @Mirash