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My Story

  1. Background: Thinning hair, very fine hair. No HT...yet. Not on any medication...yet I'll be honest, I'm not so open to getting on oral finasteride. That is just my personal feeling. I don't like the idea of messing with my hormone profile for the rest of my life. I'm not here to cause an argument about it, it is just my personal feeling.. I have heard that TOPICAL finasteride, however, while there are no side effects, the positive effects in thickening existing hair and keeping hairloss at bay, aren't that great... So, I'm wondering if it would be possible to jump straight to TOPICAL Dutasteride...? As far as I know, Dr. Mwamba already offers such a topical treatment, and Dr. Wong seems to have something in the pipeline also, so, my questions is, would there be any downsides for me going this route...? I appreciate all constructive answers. Thanks, guys!
  2. I'm almost 29 and my hairline has gotten to the point where I'm starting to feel like my receded temples are beginning to limit my styling options. Over the last year or so, I've noticed my hairline has gotten worse to the point that I started to realize I was receding. I always noticed very minor recession at the temples but didn't think much of it and just assumed it was just a normal hairline. The last year though with all the WFH stuff, all my terrible procrastination/playing catch up habits have really manifested and it's taken a toll on my hair due to missing sleep and whatever else. If not for the last year, I think my hairline would still be decent enough to try all the hairstyles that I was doing before. Anyway, I did a consultation with a local surgeon in Toronto as well as an online consultation with Hasson & Wong. I signed up for a consultation with Dr. Rahal but his sales guys feel like the type of people would try to sell you a hair transplant at a funeral if they thought it would get them anywhere. Dude called my phone at like 10 Saturday morning to ask me for photos of my hairline. So I talked to the local surgeon and he recommended 1200 grafts to fill in the temples. No hairline lowering or anything. Just temples only. And it would give the appearance of mild thinning I believe he said. Overall he seemed really conservative and his estimate though he did tell me that my hair donor density was about average while my hair thickness was a bit above average thickness. I also did an online consultation with Hasson & Wong and I was basically told that I'd need 3000 grafts. I'm assuming the reason H&W said 3000 and my local surgeon said 1200 is because my local surgeon is very conservative and Hasson & Wong are more on the aggressive side and are capable of achieving some ridiculous hair density. I don't believe H&W recommended to lower my hairline either though I was only thinking like half a cm at most. Not that any surgeon recommended lowering my hairline Recently, I've been looking into Dr. Rahal because the hairlines on his site are jawdroppingly good and I've just been super impressed overall with all the photos I can find. Obviously, they're his best work, but to have a gallery of hairline results probably means you're doing something right. I haven't got the opportunity to consult with Rahal but it'll happen soon. So I've been trying to decide between Dr. Rahal or Dr. Hasson. For Rahal, I really like his gallery and he seems to specialize in hairlines. He's supposed to be a bit cheaper than H & W which is very nice bonus assuming all else is equal. Also he has an office in Toronto and it would be nice to be able to just go to see him in person for whatever issues after the hair transplant. The one reservation I have about Dr. Rahal is I'm unsure about his consistency/techs. I haven't done much research on them but I was wondering if his techs were experienced and had been with him for a long time. For Dr. Hasson, (I'm leaning towards Dr. Hasson over Dr. Wong since Dr. Hasson seems to work with hairlines more), what draws me to him is probably his reputation and what I feel is the closest thing to a guarantee out there. I like the crazy density that H & W can achieve (not sure if Rahal attempts the same?) and he's got a few patients in his gallery that have left me impressed. But he doesn't have the sheer quantity of great hairline results. Especially since it seems like Dr. Hasson does just about everything well. H & W seem like they've got the entire process down to a T so I'm not too worried about their techs or their consistency. Also, H & W are a bit out of the way so followups after the transplant seem like it would be difficult. Right now, my personal feeling is that Dr. Hasson is all but guaranteed to do a good job. But Dr. Rahal might be more likely to hit a home run and do something jaw dropping. I'm not sure how much density Dr. Rahal will get however I know Dr. Hasson dense packs with the best. Anyone have experience with one or both of them? How did you guys feel about Dr. Rahals process? Any personal recommendations for one or the other?
  3. I finally took the plunge this week and spent a long overdue 16 hour day at the Hasson and Wong clinic in beautiful Vancouver. I've been on minoxidil for over 10 years and finasteride for over seven years (on and off with both - not consistently). Switched to dutasteride about 14 months ago. I had planned a 4,000 FUT but that changed when Dr. Hasson got his first in person look at my donor area and my temple recession. We decided on FUE instead and he showed me where the sweet spot would be for my hairline. An unexpected advantage of FUE that I wasn't aware of is that the extraction technician can target single and multi hair grafts and around 3,200 FUE grafts can give the same appearance of density of 4,000 FUE because once 300 single hair grafts were taken for the hairline, the rest of the grafts could be multis. Dr. Hasson said that FUT can also be done later without compromising much in the strip from the prior FUE. I'm also one of those people who suspects that an inelastic scalp will cause more loss over time, and I'm pleased that I won't have to worry about a scar. At least not yet in my hair journey. While the hairline was higher than I had in mind, I decided to put my faith in the expert surgeon who hails from my part of the world. He's from Zimbabwe and I'm from South Africa. The two displaced African brothers spent some time discussing my options, we decided to leave my weak crown area alone this time and reassess a year from now. The team at H&W were so professional and reallly work as a TEAM. They took shifts on my head placing the grafts into the incisions, I slept for a good part of it too so the time passed quite easily. Great pain management too, it helps that it was all FUE in this department too. Very caring and careful people all around. Dealing with the saline draining down behind my face after the surgery was more hairy than I'd expected. I had to regularly massage bubbles of saline away from my eyes, managed to avoid the bruising and shut eyes that some people get talk about. The two women who did my daily washes for me four days in a row were wonderful and I'm glad I stayed in town for these extra days as they had to switch me to stronger anti biotics and give a solid clean into a minor surface infection that appeared on day 2 post op. Flying back home tomorrow with my face looking almost normal and my head very scabby but very glad I've finally done something about my hair. I'm in my early 40s and so it's over a decade of disliking how my hair looks. Now I'm looking forward to a year of watching a good portion of it look progressively better.
  4. Hello everyone - I've been on this site with an account for almost 3 years now, and I honestly can't believe I actually pulled the trigger haha. It still hasn't hit me yet. Some of you might be aware of the amazing results I have received from finasteride alone (here), but over time, those results haven't really held up, so I decided to get a hair transplant to rebuild my frontal third. I was originally planning to see Hasson and Wong in Canada earlier this year, but due to COVID and travel restrictions, that was no longer a possibility and I was losing valuable recovery time as each month passed. I am still working from home, and laying low as we get ready for the winter months is just too perfect of a time to get a transplant for me to pass up. I already had an in-person consultation with Dr. Bloxham last year, so he had already seen me, and I was comfortable going with him. Luckily he was able to get me in on such short notice. I won't bore everyone with the regular details, but overall the procedure was pretty smooth. Here are some quick notes: Procedure Date: 11/4/2020 Total Grafts: 2561. Singles: 1051. Multi (2s and 3s): 1510. I was kind of disappointed to learn I had so many singles, but oh well... When I asked him how my laxity was he responded "very good". A tech said I have "beautiful grafts". Fingers crossed that means a good result The numbing injections hurt much more than I thought they would. I would say 7/10 on the first pass, and then 3/10 on the later passes. The years of experience of all the techs working on me ranged from 20 years, 10 years, 10 years, 6 years and 3 years. So that was comforting that they had been with the clinic that long. They were all very nice. In the hotel after the HT: In the bathroom at the clinic. Last pic pre-HT😅
  5. Also Dr. Bisanga, "If you can keep your hair transplant good for 10 years you should be happy". And Dr. Wong, "Hair transplants absolutely do thin." I think thinning transplanted hair can happen even if the patient's donor region is healthy or if the patient is on fin, though it may be less likely. Long term planning should account for this possibility.
  6. Based on Dr. Wong he said once a week gets great results
  7. I could be wrong, however, I do think Dr. Bansal operates on more than one patient per day. Maybe @Abhinay Singhcan confirm. I am pretty sure at Hasson & Wong that each doctor will perform up to 2 surgeries per day. Eugenix I think may have a similar model in which the doctor designs hairline, performs slits and extraction technicians extract and other technicians place grafts. At Eugenix, they use the an FUE modification called DHT in which grafts are nearly simultaneously extracted and implanted.
  8. Hello guys, So looks like nowadays almost all doctors perform FUE operations. I am looking for FUT doctors (would be the best if they were in Europe as I live in Poland) to be able to maximize donor capacity. I know that dr. Bicer (Turkey) performs FUT but I was not impressed with the result presented on her webpage - low quality, some looked unnatural - and those were all FUE operations too. I know that Hattingen hair performs great FUT but this doctor rejected me during our consultation saying that I have too much hair (Im a Norwood 3 with thinned front). I also know about Hasson & Wong but they are far away (Canada) and are very expensive. Do you know any doctors that perform quality FUT in Europe besides Hattingen? Or should I just go with FUE? I am probably good FUE candidate as I have rather thick and straight hair - attached photos - one after shaving and one just a bit grown out.
  9. Hey @dotdashdashdash and @deeznuts! My first surgery was done by Dr. Torgerson 1.5 years ago now. I don't recommend him at all but rather suggest people look for more serious clinics internationally, or if staying in Canada and okay with higher price, look at Dr. Rahal or Hasson and Wong. I've made a deposit with Eugenix for late November. I'll be starting a new thread for that. Here's my latest thread with updated pics:
  10. Hi Everyone, First time poster, Started losing hair at around age 22, by age 24, became more significant but could easily comb it in ways that no one would notice, age 25 accelerated, loss of hair volume, hairline slightly receded, by age 26, hairline totally gone and was unable to cover up the hairloss anymore so took the plunge. Started Fin about 6 mon ago, take usually 4-5 times a week of 1.25mg Im a local, had a consultation in september, decided to book in december I think, and had the procedure a couple days ago. When I sent it my photos, they said my consultation would be for surgery under Dr. Wong, had my consult with him, He said FUT would better serve me. I like to wear my hair short, but a #3 clipper seems to be what conceals most scars. so I was okay with that Total break down below, I think my density was average to above average, Dr. Wong remarked during the surgery, I had great density, and great blood supply, and the results would be great so heres hoping to that LOL. The first few photos are pre consult, the ones with the mask are on the consult..could tell i lost more hair in the meantime. However started fin there after, dont really notice much effect on frontal zone, but Dr. Wong remarked it worked well in the crown. Dont really have photos pre-procedure that I took but ill try and find some 1 H: 613 2 H: 2639 3-4 H: 1523 Totaling 4775 grafts I have a few questions - how long does it take for your hair to get back to preprocedure levels?, . 2 - how long does the pain last, 3. when did you feel like your sleep returned to normal. 4. when does the pain and swelling peak, 5. is the graft breakdown high density then? Also I was surprised that they said no heavy wieghtlifting for 6 months, guess cardio it will be lol, I know 4 weeks no sports, but the heavy wieghtlifting was suprising. Also in the front on picture with the grey-black my forehead looks more swollen as the saline is already working its way done
  11. It really is HARD to believe...TEN years since my very first hair transplant with Dr. Victor Hasson of "Hasson & Wong". For those of you who may not know who I am and what amount of grafts that were available to me... Here's a Re-cap: Dr.Hasson Harvested: 4,849 Grafts for Hairline/Front - September, 23rd 2004 2,955 Grafts for Crown - June, 23rd 2005 671 Grafts for Temples - Nov, 6th 2007 Total Grafts = 8,475. What has all this meant to me?...someone asked. Freedom, from obsessing about the lack of hair in comparison to others. Appreciation, for having come across Hasson & Wong at just the right moment and time in my life. Sincere happiness in having helped hundreds, if not thousands of people either directly or indirectly make a positive decision, see them follow through and actually GET their hair transplanted (by amazing artists and surgeons in their own rights) and most of all get it done right. That is what I'm most proud of standing behind H&W so vehemently.
  12. Age 26, Norwood ~3V + retrograde + diffuse thinning (including donor) Medication: dutasteride 0.5mg/day, foam minoxidil 1-2mL/night Hair characteristics: high contrast with skin, fine, straight Cost: 2.15 euros/graft which is a discount from 2.25 euros/graft because I agreed to provide them anonymized photo updates for their own use. Posting this thread is my own choice. Though, I wish clinics would offer discounts for patients to post threads from start to finish. I see nothing wrong with that. Also, I think the price has gone up recently. Hair loss timeline: 18 - Looking back at old pictures, I had signs of thinning at the hairline 20 - Barber mentioned uneven nape, now I know it was the beginning of retrograde. Started noticing loss at the hairline/crown, found out about finasteride and tried to get on it but my awful dermatologist wouldn't prescribe it to me saying my loss wasn't bad enough 22 - Went back to the dermatologist, still wouldn't prescribe finasteride to me (I think because of side effects? don't remember). He instead prescribed topical minoxidil (requires a prescription in Canada) but he didn't make it sound like it was worth it (annoying to apply, need to use it for life), so I never went through with it 24 - Hair was looking awful, finally decided to do something about it - did my own research, went to a different doctor who was not a moron, and got a 5mg finasteride prescription. Quartered that for 6 months. Also started 1mL liquid minoxidil at the same time 25 - Didn't notice any changes after 6 months, seemed to have maintained. Switched from finasteride to dutasteride to keep as much hair as possible. Got a microscope and analyzed my donor, saw greater than average thinning 26 - Seem to have continued to maintain. Switched to foam minoxidil because liquid takes forever to dry Moral of the story - Many doctors are crap. Take medical matters into your own hands and leave nothing to chance. I carried those learnings over to my HT research. Choice of surgeon: I sent the following clinics (in no particular order) pictures/videos of my hair/recipient/donor. The main point of contention between their opinions was regarding the microscopic videos/images of my donor. Hasson - "Dr. Hasson felt there was more miniaturization than the typical 10-15% and therefore a procedure would involve a bit more risk." Wong - "Dr. Wong on the other hand did not believe there was any signs of dupa and would have no reservations performing a procedure." Bhatti - He was concerned, felt that my donor density was quite low and wanted me to get evaluated in person Bloxham - Wasn't concerned, was more interested in if I noticed any changes in my hair, and said a proper in person examination would be in order Konior - Not concerned, said my donor area was about average Bisanga - More miniaturization in the donor than they would like to see for someone my age, and suggested an in-person consultation Ferreira - Said my donor isn't great, but that I'm far from DUPA, and that my prognosis is good Lorenzo - Said I didn't have DUPA but didn't go into any more details. I feel like they may not have seen the microscopic videos. Wish they would have at least acknowledged my weak donor. Tried following up multiple times to get clarity, but they never responded Diep - saw him in person since I was nearby, he said I had 10k+ grafts available in my donor. 'nuff said. Rassman/Bernstein - said I have more thinning than average but not yet DUPA, suggested I wait a few years, but said I could get a small HT Hattingen - said they would not operate on me, suggested I send them yearly updates of my hair loss situation to see if their opinion changes HLC - didn't want to say anything regarding my microscopic videos, said I would need an in-person dermascopy evaluation, but didn't seem too concerned Pekiner - noted the miniaturization but said my donor was good enough and that they select the highest quality grafts At some point, I decided I was mostly interested in clinics where the surgeon does most, if not all the work. I understand the benefit of technicians doing parts of the procedure like extracting/implanting grafts, but I just feel more comfortable knowing that the surgeon is doing all the important aspects of the procedure themselves, and that I can hold them fully accountable. This left me with a few options at the time: Konior, Ferreira, HLC, Pekiner. Ferreira - I couldn't travel to Portugal because of COVID and wanted to see more results Konior - I think he is one of the best, but I was disappointed that he didn't acknowledge the miniaturization in my donor. My guess is he did notice it but that he's confident in his skills/work and doesn't want his patients to overthink things. I'll likely still see him in the future for temple point work or if I need any touch up on the hairline HLC - Didn't like not knowing which doctor would work on you, and the fact that you could have multiple throughout your procedure. Also have seen some cases where I felt the graft count was a bit aggressive for the patient's age. Have heard communication is also an issue Pekiner - I liked the technique, the small number of grafts per day (~1000), the fact that he is conservative and honest with his patients. Liked that he had a lot of patient reviews from start to finish (mostly on the Italian forum). Very experienced with hairline work and liked his hairlines and density (especially needed with my fine hair). Communication with his rep Alex has been very good. Aborting was a concern, but they told me that they now inform the patient of any findings but ultimately let them decide whether to proceed. Given he would select the highest quality grafts available, I was not too concerned. Also knowing that the graft count could be adjusted on the day of procedure (say down to 1500), my mind was more or less at ease. In the end, he said my donor was slightly better than expected. Procedure: Each day lasted from around 8am-5pm. On the first day of procedure, I had a discussion with Dr. Pekiner about my hair loss history and goals. We then took the photos, designed the hairline, and shaved the head. Then we moved on to the actual extraction/implantation. The way it works with Dr. Pekiner, similar to HLC, is you have two sessions of extraction/15min break/implantation per day, AM and then PM. In between these sessions, they have a chef who provides a meal for you (bonus points for catering to a vegan diet - the food was delicious). At the end of each day, they wrap your head in a bandage to protect the grafts/donor. On the third morning, they give you a final clean up and provide you with the aftercare kit including saline spray for the recipient and bepanthol lotion for the donor. 1 hair: 249 2 hairs: 682 3 hairs: 710 4 hairs: 164 Average hairs/graft: 2.43 Recovery: Sleeping - I'm normally a side sleeper, and started practicing to sleep on my back a couple months in advance. I don't think this is necessary, I just wanted to learn to sleep on my back anyway. Regardless, you'll need a travel/neck pillow anyway to make sure you don't turn in your sleep, and I think you'll be tired enough to fall asleep on your back even if you're not used to it. Another recommendation I have is to zip your arms inside a sweater, so you don't damage your grafts in your sleep. I've seen this happen enough times on these forums, even over the past few months, that I didn't want to take any risks. At one point I was very tired and fell asleep without zipping up my arms, and I actually caught myself lightly reaching up and tapping my recipient area as I was waking up. Nothing bad happened, but I was much more cautious the next times I went to bed and ensured that I zipped up my arms each time. Swelling - I noticed swelling mostly on days 3-4, but nothing too bad compared to what I saw online. I just let it pass with time. Pain - No pain for the first week really. From days ~6-10 I had some donor pain when I'd lay down on my pillow, so I'd just take paracetamol 20 mins before going to bed. Crusts/scabs - was instructed to start gentle massaging them starting day 6, increasing intensity with each day. By day 9, pretty much all of them were gone. Redness - I started using aloe vera as I've read that it helps. Haven't noticed too much improvement yet by day 30. The donor is still red but it's harder to see as the hair is growing longer. The recipient is still red, and the shedding is making that more visible. Feel free to ask any questions. I can add some recent photos soon. I'll probably update monthly.
  13. Dr. Yaman only does one patient per day?? I thought he did several patients a day. Where did you hear this? Other places that I am interested in are Dr. Demirsoy and Dr. Sahinolgu in Istanbul, Dr. Sikos in Budapest, and Dr. Path and Dr. Thitiwat in Bangkok. If I had lots of money, then Hasson and Wong might be my first choice, in my home country of Canada. Dr. Alba Reyes was an early contender for me as well in the Dominican Republic, but I think I have crossed her off my list.
  14. First post ever. I was all set to finally start getting serious about booking an appointment for my first transplant after 13+ years of hair loss hell. Research over the last 6 months was wild. I'm a NW4/5 with a highly recessed hairline (hello huge forehead!), badly receded temples and thinning throughout the rest. I've tried basically every medication there is except for Fin(Would rather not get into why, just know it's a decision I came to a long time ago). Currently using Minox and dermarolling. If my Father's family history is any indication I'll be a NW6 later on in life. Naturally my brother has every speck of hair left having been blessed with my Mom's side's amazing hair genetics! The one thing that always kept me going towards the transplant route and somewhat "happy" was that I always had decent sides that were very "squared up" leaving only the traditional rectangular oval thinning shape in the middle which would be ready for the transplant. That was until recently. When to my absolute horror I began noticing something funny everytime I'd come out of the shower with my hair wet. As you'll see in the photos with my hair now dry, it appears 100% that my sides are now "dropping" a bit at what I would assume is called the very often unspoken about "lateral hump" upside down U area. I was horrified and devastated. Forget about my transplant plans I thought. Now I wouldn't even be able to pull off a hair system!!! Not to mention based on all my knowledge of hair loss it seems as if these lateral hump areas only seem to become a problem much later in life for men. There was a good horror story on these boards about a guy who got a transplant young and was then left with an awkward island of transplanted hair as the humps went and there was no longer any connecting hair. I am almost certain it was @Dr. Jerry Cooleywho did the repair which came out amazing. Maybe if he's out there he can provide insight on my situation... I am most wondering and concerned just how difficult of any area this would be to even perform a transplant on. Anyway, I'm now lost, deflated, and feeling as depressed about my hair loss as I did when I first discovered it at 23. For so many years it didn't bother me much anymore, and when the time came to start getting serious about a transplant I was more than comfortable looking into some of these top clinics overseas. I live in New York btw, and don't even want to tell you about some of the prices in Manhattan. ($4,000 for 500 grafts anyone?? Insanity.) As a side note - the doc DID say I had amazing quality donor hair, though it is a very narrow area of about 4500 grafts max in his opinion. So now what I wonder. My ultimate original plan was this: Transplant #1 in 2022 - Restore the hairline and temples with a rather high/conservative hairline to simply reframe my face and get me my confidence back. Estimate of 2,000 densely packed grafts to create a lifelong nice frame. Transplant #2 years down the road - after the rest of the forelock and front scalp goes, get another 2,000 grafts into that area for what would end up being a final result of a good frontal region of transplanted hair and face framing. As far as the crown goes I have no problem not caring about that. Fibers and dermatch have been a very good friend to me and would continue to be. Also I'm just not up for anything more than two surgeries/two trips overseas for this. I would be over the moon to have something that Rolandas has right now for example. Zero hair greed here. But now with this disaster that looks like lateral hump thinning, EVERYTHING is off the table and I don't even know where to start. What I DO know is that even if I ever wanted to try a hair system, I would have to get a surgery to even repair the HUMPS so they could connect to a hair system's hairline. That alone could be 1,000 grafts at least. Bottom line is I am not in a good place right now, at all, with my hair. I feel stuck, and almost hopeless. I've never seen a guy my age dealing with lateral hump hair loss. Any advice or thoughts are very appreciated. Also, before anyone thinks I have so much hair still on my head please understand I absolutely do not. What you are seeing is a combover of terribly thin hair with a few fiber still in it. My hair is shot and on top of that, the hairline and temples of course are completely gone. No medication could ever bring them back as we all know.
  15. While I didn't create an account on this forum over the last couple of years it was invaluable in my research process and I want to pay it forward, especially since I seem to be seeing fewer patient posts with recent dates, at least for Dr. Cooley. Thus I will try to be thorough here in describing my process. Apologies in advance for the length of the post and the variability of the quality of the photos. I know they aren't the best. I am still only a few days/weeks out and will update this with before photos and after photos from the clinic and exact graft count(s) when I get them and try not to disappear throughout the process. My Past Situation I had an ill-advised FUT procedure when I was 21 to address temple recession. I wasn't on meds, it was premature, and I went to a cheap chop shop. CLASSIC, young guy being really stupid. :sigh The procedure (unknown # of grafts) involved putting grafts on the temples and unfortunately also some around the front of my hairline. It did very little cosmetically unless you count triggering massive loss of existing hair (most of which did grow back in fairness). The only saving grace here is that we were talking about a fairly minor temple area and because of my light hair/skin contrast I've been able to get away with a forward brush hairstyle that hid really poor work. Oh and it wasn't big plugs and the scar wasn't horrendous and avoided being in any disastrous region(s) thankfully. No matter what you do STAY AWAY from Samson Hair Restoration in Los Angeles regardless of what doctor they currently have cycled in. Why now Now, 11 years later at 32 with some additional thinning and some recession the previous work was becoming harder to cover, especially when swimming or my hair was wet. Plus, I just wanted it fixed to open up different hairstyles and to get ahead of managing what I believe will be future loss. Almost a gradual "replace" strategy I guess. In terms of meds, I had been on finasteride w/ no side effects for 4 years but then went off for 5+ years (don't really know why). I went back on 6+ months ahead in prep for a procedure and plan to stick with it this time. Not on finasteride or any other shampoos etc at the moment. Picking the surgeon In terms of research this time around I did a lot more homework using this forum as the basis for creating a smaller list of doctors. Ultimately I narrowed my list and research to consults with Lindsay, Bernstein, Cooley, Bloxham, and Nadimi. I felt these were really great doctors that didn't necessarily require a flight based on my East Coast USA location (I was intrigued by Rahal, Hasson/Wong/Kronior and some of the other staple of well regarded doctors as well but with only so much time felt good with my short list). I did not consider India/Turkey etc., not because I don't believe quality results can't be achieved there, but because I didn't want to take the risk and conduct an extra level of due diligence with respect to many of the practices and I was willing to pay $ for that peace of mind. Notes on my Consults During my consult with Dr. Lindsay I felt like he just didn't think I needed a procedure yet. He cited 1200 grafts and it was all relatively cursory. So not a fit for me Dr. Bernstein was a good consult (worth the cost) where I learned a bit and I felt comfortable with him and his work, but ultimately I wasn't blown away by the results I've seen from him either on his website or on this and other forums My consult with Bloxham was really terrific and I got a great feeling from him. He was ultimately my #2 but I did not choose him mostly because he is just relatively newer with fewer posted results. And right or wrong, some of the (rare/older) negative comments about customer service/interactions from Feller put me off. I did NOT have any of this sense from Dr. Bloxham and have never met Feller but the posts are there nonetheless. I will also say, they need to upgrade their facility. Not the medical side hopefully, but the rest of the place was old and run down feeling. Dr. Nadimi was also great (via Skype) and matter of fact but I got the sense she did more FUE than FUT. Similar to Bloxham there are just fewer patient accounts out there that I could find, but based on what I've seen and this consult I was very comfortable and impressed with her Why Cooley Ultimately, I went with the only doctor I didn't meet/ have a convo with directly in Dr. Cooley. I appreciated the consult with Lollie and a deeper understanding of their procedures and liked what I heard about use of Acell, how he preserved grafts out of body, his hands on approach, the tenure of his techs, and so on. But most importantly Cooley's track record of consistent results and patient experiences tipped me over (including one detailed repair write-up by a Blonde haired individual, of which there are relatively few results). I also literally did not find a single negative review (of outcomes) for Cooley in all my research and I valued that apparent consistency. Procedure - Why FUT I knew I wanted FUT as I (a) already had a scar I felt could be improved, (b) wanted to maximize future grafts and survivability, and (c) wanted to minimize recovery time. I am lucky enough to have a lot of Donor and existing hair that can be used to hide a procedure. Pre-Procedure and Day of All things posted about Cooley experiences were true for me. I followed pre-op instructions for scalp laxity. I think this helped as I could feel the sides definitely loosen up, and while the back still felt tight Cooley said it was great and helped with suturing (+ sutures out at 2 weeks vs. 3 weeks). The hotel they set you up in is excellent, easy, convenient and they already know why you are there and what you need. Shuttle drivers, check-in staff, and others there were helpful and discrete and the breakfast and gym is open early enough for day of eating and a last workout. On the day of the operation we met at 7am, had a calm and not rushed discussion where any other questions I had were answered, and re-affirmed my choice of 2500 FUT + PRP/Acell. In terms of hairline we were on the same page to opt for a conservative/mature hairline though Cooley jumped straight to the need for work on the temples which he said he does not always do. This process of agreeing on this was FAST as a lot of it was bridging existing hair and the past work plus a little bit of pulling temples out/down. In terms of PRP, Cooley was candid that for me he didn't know if PRP would make much of a difference as he didn't see a ton of minituraization but (a) I'm paranoid and think there is more than there is/I have very fine hair already, and (b) I am hopeful that it will help somewhat with avoiding shock loss or speeding up recovery. I know there's no real scientific evidence to back that up, but I was willing to spend the $ on the chance it helps. I will say that to make sure you get what you need before surgery begins you should 100% come prepared with your questions. For example in my consult with Bloxham he indicated that my past FUT scar had a small area branching into the danger zone for donor and advised forking the scar near my ear. I really did NOT want to do this, so asked Cooley about it. He decided to implant 10-15 hairs in the end of the old scar as part of the procedure and end the new scar in a safer location. I do not think we would have ultimately done this if I had not asked. H/T to Bloxham for noticing it in a really thorough, caring consult. I also asked about a few grafts poorly placed in the front of my forehead below the 7CM mark we agreed to for the new hairline. He said if I was OK With it that he would remove those with electrolysis which I agreed to and am relieved about as they were definitely not natural looking. Overall, it was a good conversation. I, like most others, felt comfortable and cared for by Dr. Cooley and all of his other wonderful team members. I do think the clinic could get better about having all their pre and post op documentation organized and sent in a big PDF but that's super minor overall and has nothing to do with the in-person interactions I had. One other area that I felt could be improved is in discussing recovery times. The clinic (not Cooley himself) were fairly aggressive in terms of discussing post HT recovery periods and timeline (no redness 5 days, not visible procedure at 8 days etc). It's not that they are totally off, it's just that they are definitely giving the aggressive, "best-case" scenario in my opinion and shaded this as an absolute vs. discussing the potential ranges of recovery times based on patient characteristics. Still thus far in my case it has proven to not be too far off the mark so far (devil's always in the details though isn't it). Procedure itself From the Cooley consult we moved into the procedure. Numbing/valium etc was painless. Unlike others I don't think I really went fully under for the ENTIRE duration of the procedure, I even heard a nice little "ripping" type sound on removal, but no pain whatsoever. By 11:30 the donor was removed, there were 5-6 technicians on the microscopes, I had had PRP and he had done the few electrolysis removals needed. I stopped for lunch and then we carried on. Cooley performed all of the donor incisions, with Brandi hovering nearby, and was present for probably 90% of the graft placement. I know for sure he was doing all the immediate hairline grafts. I believe he left for a little over an hour in the middle of the procedure (basically the length of a movie), but I'm not 100% on whether he popped his head in a few times during that time or not. While he was not actively working on my head Brandi was performing graft placement and I believe Amy also worked on placing grafts. Cooley returned and was essentially there the rest of the day long after many of the other techs had left post dissecting the grafts (easily 4-5+ more hours). It was clear he reviewed and had ample time to change, correct, or ensure any grafts not placed with him in the room were to his liking. Like others have mentioned it was clear throughout the day that this was a well-oiled machine, with team members that had worked together for years (decades even). Everyone was friendly and taking a dedicated and personalized approach to the operation, and I couldn't imagine going somewhere with a doctor doing multiple ops in a day. Throughout the process Brandi was constantly checking Cooley and making sure anything "controversial" about his approach was discussed (a few graft placements here and there, reminders about how many grafts were left etc). All of this was reassuring. I am sure the reverse also happened. Ultimately for the 2,500 graft procedure Cooley was able to get over 3,000 grafts (I will get exact counts later) and we did not finish the day until a bit after 7pm, meaning I was there for nearly 12 hours. This extra time and attention, plus the grafts that were not something I had to pay extra for, all speak to his long-running record of caring about his patients and working tirelessly to get results. I am obviously grateful for this. Post Op - Healing, Pain, and Experience (Week 1) Donor got painful at the end of the day during the operation so I was numbed up again before I went home. I was obviously a bit red and beat up but it wasn't as bad as I was expecting and they had already done a pretty good job cleaning a lot of the blood off. Plus I was wearing Saran wrap + a hat so able to avoid any weird looks. On night 1 I took some Tylenol but nothing stronger--which is good because I didn't get the prescriptions until day-of for stronger meds. Cooley's post-op care uses an ATP spray + saran wrap to increase moisture and prevent any graft damage and antibiotic ointment on the donor scar. You basically spray every hour you are awake and wake up and spray every 2 hours for the first 2 nights along with taking some preventative Prednisone for swelling. I followed the instructions religiously here and I think it really helped calm redness and speed healing. On night 2 I was falling back asleep pretty quickly so it didn't feel too onerous to keep getting up. For sure it kept the itchiness to a real minimum in the first 6 days. I went back the next morning for a post-op clean and got the all good from Dr. Cooley. During this cleaning Amy took time to answer any questions I had about the next week of care and was patient with what I am sure are the same questions everyone asks. In terms of the documentation they gave me to follow, I actually think it could have been a bit more detailed. It wasn't that it was bad, but I felt like an "FAQ" or just more exhaustive detail would have helped. For example, I asked about caffeine / alcohol / ibuprofen which were not listed (Cooley says moderate amounts of both are fine), and it doesn't give you much about how to sleep (when can you sleep sidweays on the grafts) and so on. To give you a sense of how smooth this was, I drove almost 7 hours home the very next day, which was completely fine and painless. Overall I found the post-op regimen easy to follow, the spray and saran wrap seemingly very effective even if I did probably use it too quickly/aggressively to try to get it through the native hair as I ran out a day or two earlier than I think the clinic expects. One curious thing with post-op care from the clinic is that it seems that Cooley's overall instructions,are more aggressive than many other docs (like the timeline to shampoo (next day) and return to regular shampooing (7 days) . I'm sure this is because Cooley is confident in the healing/quality of the grafts and incisions etc and has refined his approach over time but it does make me just a little nervous when looking at the instructions online from so many other places that are much more conservative. But he's my doc and I'm in his hands and so far so good. On night 3 I slept poorly but not really due to pain, I think I just missed exercise. On night 4 and 5 I had more pain when putting the back of my head on pillows (I slept elevated with an inflatable travel pillow partially inflated these nights to help with any potential swelling) and I did take a valium one night and the other pain killer + tylenol combo prescribed drug the fifth night. It almost felt like the donor was a little more stretched these two nights with whatever position I could find that didnt have too much pressure. If this continues I'll call the office to make sure it's normal. Some posters here have mentioned this as the return of nerve sensation but I'm not sure. Otherwise I have had some very very minor swelling which made me break out some ice on my forehead and eye area a couple of times and take ibuprofen periodically as well. It was never uncomfortable or especially noticeable to anyone else however. Last point, I am using the Hair Shake protein. I don't really think it'll do much but I've used protein powder a lot anyway so I don't mind and if it helps at all with speed of growth or minimization of shock-loss, then it's worth a couple months of it for me. I am not planning on using it long term and no one at the Cooley office actually mentioned it directly despite having it stocked there and having it listed as an optional part of the post-op procedure. Post Op Appearance - First Week The scar in the back is perhaps slightly visible with wet hair (first 3-4 days) but completely hidden with normal dry hair. As mentioned it wasn't giving me much trouble the first 3-4 days, although of course everything felt really "tight" there. At night or with pressure on it day 5-6 it actually has felt a bit worse and I've taken some of the prescribed meds just to make sure I get decent enough sleep. We will see of course on final healing and appearance, it is early days. Redness in the recipient has subsided each day, and now at day 6 is not bad at all. It's probably worse in the pictures than in real life. I am fairly pale skinned but had a deep tan going which some say can help. There is definitely scabbing, it is super mild/light and looks like when I return to regular shampooing and rub the grafts a bit it will easily flake off and be gone within the 7-10 day timeframe that they gave. In any case, it's really mild and not that noticeable. I have used their given shampoo and started leaving the conditioner in a bit longer which I think has helped. I have a couple spots of dried blood left but overall it's pretty clean and I haven't noticed anything remotely like grafts falling out. Really, not even many/any hairs yet. The kicker here for me is that I 100% had to hide from the world during this time because I was (a) spraying every hour and (b) couldn't style my existing hair for fear of touching/disloding existing grafts. So you could see the grafts taking hold and small stubbly hair, plus weird caked native hair that was a bit long already awkwardly plastered to my scalp. So all in all, a real lovely mess. Now had I managed this aggressively with a blow dryer on cool or if I was more comfortable touching and styling my scalp in this period I am sure I could have made it look better but I didn't want to take any risks. On Day 6 I did a bit of finger styling and with my existing hair I can make it look decent (see 1 of the pictures). Decent is not invisible however. The temples are harder to disguise and any close inspection things are definitely still visible so I feel I am very much still in hat land. To be fair, my wife says it's pretty hard to tell unless you get up close and personal already. We will see if my extended family at Day 11 notices anything. Summary of first week So far the difference from my first procedure has been remarkable. Basically instead of an immediate "oh shit what have I done" I felt more like a "I'm already looking better than I expected 12 hours later. and everything is going exactly like they said" It's nice to already feel like I made the right choice. The recovery seems to be text book according to their expectations, but I most certainly don't want to be out and about without a hat yet as it would be noticeable. The things I am worried about are (a) appearance at 10 days and masking it, (b) avoiding shock-loss as no work was done in the middle of the frontal third, and (c) continued management of the donor scar pain. All the rest is of course the standard, hurry up and wait, concerns about linear scar etc that we all have but if I can avoid shock loss I feel comfortable looking like I did for 6+ more months. I hope this is helpful and of course any feedback on the pics and actual quality of the work is welcome as well. Again, apologies on the photo quality I will get better ones from clinic later. I will try to post periodically as I hate the posts where people disappear but I also intend to try to live my life and not obsess over the progress over the next few months.
  16. Hey everybody. Hope y’all are doing well in COVID-19 times. So I went ahead and did a hair transplant. Thought I’d post my results as the months go along. I lurked this forum for a while before deciding to get my scalp harvested. I appreciated the honest feedback/recommendations here so I thought I’d make a post so others with similar level of baldness/hair type can get an idea of what to expect with the # of grafts I got. I’ll update as things progress. Details: -31 years old -Had the surgery on 17/08/2020 - Started finasteride 8 months before FUE. Seemed to slow things down as I was losing a shit-ton of hair before starting it and ... that stopped once I started. (Still taking it, not using min or Nizoral... fin seems to have had the opposite effect that a lot of guys report. Dunno why but that’s neither here nor there.) - not using hair concealer Photos aren’t the greatest. I’m taking photos under the harshest light I can find in the moment. I’ll post photos from the clinic if/when I receive them! If anyone has questions about the clinic, procedure, aftermath, whatever, I’m happy to answer. I was pretty freaked out before I did the deed, and am still pretty anxious (but hopeful) about the end result. Take care errybody! Pre-transplant, taken the morning of the surgery: Right after surgery: Six days after surgery:
  17. I recently had a skype interview with Dr. Wong. Nice guy, made me feel at ease, said all the right things. I felt comfortable with him, and am pretty close to booking a procedure with him. I recently googled H & W, and quite a few horror stories online. Stories about patients being double booked, surgeons disappearing during procedures, aggressive sales tactics. This is my second, and most probably, last procedure. Not sure if i will recover if i botch this by selecting the wrong surgeon. Been there, done that. I need some advice from all the wonderful people here. How are Hasson and Wong viewed in the hair transplant community? Am i in good hands? Should i stick to someone in the States? Thanks. Really counting on some feedback.
  18. Melvin is right, you could easily test for yourself by just getting bloods done prior to using the topical Dut and then comparing to baseline down the road (ideally on multiple occasions over the course of many months to ensure that it isn't slowly accumulating and lowering DHT/affecting other hormones slowly over time until it reaches the same inhibition as ingesting orally would). I'd say if after 6 months or a year (just as a random marker) your DHT levels have stayed consistent at a small reduction in serum DHT compared to baseline, well you know that it indeed doesn't go systemic to any large degree. I do agree with @bald-and-bearded though, it is really necessary for some sort of actual clinical data/studies on its efficacy to be released to put the issue to rest and solidify the idea that there is actually a good alternative to oral finasteride/dutasteride for those who can't or don't want to take it. The main question is does it actually work? Without actual data from a properly controlled study, who knows. Yes, you can quite easily find out if it goes systemic to any large degree for yourself with blood tests, but we need studies to know if that's a good or a bad thing. Good because, if it actually does work and doesn't go systemic, that's great. Bad because, maybe studies will show it's not actually effective at stopping hair-loss due to the fact it doesn't go systemic. I'm not sure. Either way, up until this happens it's all anecdotal evidence, and there is no proof to state one way or the other yet. I do happen to think its promising though; a number of great clinics run by great doctors have been vouching for it for a while now and say that it works on their patients (H&W, Bisanga etc) so that is a good sign. As well as number of users from online forums, but really I would need to see some clinical data to know one way or another. If Dr. Wong says that there are some companies starting to do trials, then that's good news. Hopefully we will have some solid answers in the next few years.
  19. Hey Guys, Tomorrow I'll be talking to Dr. Devroye, he is the creator of the WAW system, the punch used by some of the world's best Konior, Hasson and Wong, Feriduni, Shapiro, etc. Some of you may not know this, but Dr. Devroye was the first European doctor to join the Hair Transplant Network well over a decade ago. The live session will be at 10am Pacific time, 1pm eastern time, and 6:00pm UK time and 7:00 pm Belgium time. Please ask your questions here, and be sure to join to ask any other questions. He is an authority on FUE and wrote many of the FUE terms along with Dr. Jose Lorenzo.
  20. I understand your concerns - and by the way, I wasn't suggesting you were neurotic or anything, I was just saying if you happen to be the overly anxious, paranoid sort of type then it's probably best to steer clear and not nocebo yourself into a bad state as people like this generally always tend to convince themselves of the worst, even when there's nothing actually physically wrong. Anyway, as I say, I can understand your position after reading that you've had bad experiences in the past. If you don't want to take it then that's completely up to you of course. You don't have to, you just have to accept that you're much more likely to experience further loss than if you did take it. Regarding your pic, you don't have too much more to lose on the top, no. But, you're essentially a NW5 from what I can see, however it looks like your crown doesn't dip down the back of your head at all, and your sides aren't too low, although they are dropping a bit right now by the looks of it. So all in all, based off that pic (would need to see different angles really to judge properly) you're a somewhat less severe NW5 maybe. So, although you might think you don't have much more to lose, go and look up a NW5 vs a NW7, that crown - could - easily drop another few inches deeper into the back of your head. Not saying it will happen, in fact, the fact you're 55 and it hasn't is probably a pretty good sign that you won't go that far, would be best to get examined by a good surgeon. You certainly could just go ahead with a couple of Hair Transplants and forego the meds, yes. With your age, you could well be correct that there is little left to lose, and you very well might not lose too much more hair now. But like I say, you could still progress to a NW7 in say the next 10-20 years, I have no way of knowing. If I was you I would consult with some great doctors and get their take. And get scalp examined for miniaturisation to predict future loss. A good doctor is probably going to advise two procedures a year apart; the frontal third first at probably 3 to 3500 ish grafts, followed by the crown/midscalp at around 2-2500 grafts. After this, you might have anywhere from 0-2000 grafts left for any future procedures. depends on your donor, but you'll probably be looking at being close to your limit (if you go straight FUE anyway). I don't think it is the most irresponsible decision in your case to go ahead without fin considering your age, and I imagine as long as your donor is decent and you're not clearly miniaturising into a nw7 pattern upon examination, most doctors will consider you to be an ok candidate without the fin. I would get in touch with Dr. Bisanga, Dr Bruno Pinto, Dr Ximena Villa, Dr Ferudini, Dr. Bruno Ferreira and Dr. Rafael De Freitas and get their take, but that's just my personal list of my current favourite doctors. Do your own research and come to your own conclusions of course. If you're in the States, and don't want to travel (all of those options will be considerably cheaper than US docs and just as good/better than some, but it is a long way) then look at Hasson and Wong, Dr. Konior, Dr. Shapiro, Dr. Cooley - there's more but that's just off the top of my head as I've never considered doctors over the pond.
  21. I believe there’s two factors, one is age. Every living person will have thin hair with age, even if you look at someone without hair loss their hair has thinned. Clint Eastwood 90 At 40 As you can see all of his hair has thinned out, the DHT susceptible area more, but still even his donor has thinned. The other factor is DHT susceptibility to the transplanted hair. Some hair may be taken from an area that is prone to thinning, these areas can be near the nape or the border of the crown. I feel with FUE there will be a portion of hair thinning, and FUT as well if the strip is taken lower near the nape. As @Dr. Ron Shapiro said some may thin more than others, it depends on how the surgeon planned and mapped out the procedure. That is why it’s important to go to a clinic like Shapiro, Hasson and Wong, BHR. They don’t just blast your scalp, everything is done with your future in mind.
  22. Dr. Bhatti just released a video which would compliment this video well. He talks about how the hair thins at the end of middle age - around 55 or so - when the body boosts the 5ar enzyme which then converts more testosterone to DHT. This would affect all hair, including transplanted hair. When Dr. Wong talks about a young patient, on a DHT blocker, still having thick transplanted hair after a couple of decades out from a HT, age is as much a factor for maintaining the caliber of the hair.
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