Advice on Progress so far

[TD]

Hi Guys,

 

First post I hope of many to come- thought I would update on my progress so far trying to find a surgeon for HT and my opinions so far.

 

Little about me, been taking propecia and minoxidil on and off for 7 years- first started to notice loss at 21, now 28- not sure if meds have had much affect- guess impossible to tell as nothing to compare to- now taking minoxidil and dutastaride.

 

Think I an NW 3 or 4- pics attached. Currently looking for surgeon but finding it a little confusing and keen to avoid mistakes.

 

Ok, so far I have been to see 4 clinics- and I have had one online consultation with BHR (DR Bisanga - will come to that in a sec) ok so in order- who I have seen and impressions.

 

1. FUE Clinics - (Link removed by moderator) Met in office in London- I found this initially confusing as I was expecting to meet in a surgery tbh- Consultant very young and I was unconvinced by him although he was friendly. I told him I was most bothered by crown- he suggested 500 fue grafts at ?2500 for surgery in Birmingham. Consultation ?25- lasted 1 hour, no reference to which doctor would undertake procedure- left unimpressed- no follow up email or conversation from them. Will not be choosing- seems like a lottery

 

2. Nu/Hart - (Link removed by moderator) Met at clinic near Earls court- New place- this put me at ease because I thought it was more professional. Again I said crown bothers me most- Consultant suggested 750 fue grafts at ?3000 and suggested which surgeon she thought would be best- a Dr Mir Malkani who is is a Fellow of Royal

College of Surgeons, a member British association of Cosmetic doctors

and a member International Society of Hair restoration Surgeons. GMC.

She thought medication would be enough to keep what hair I have left- unsure if this is sound advice- she hadn't heard of dutasteride when i asked her about. I was more positive on this one at the time but subsequently have heard of this companies reputation and this had put me off. consultation free. Have seen no feedback on forums about Mr Malkinis work

 

3. Vinci hair clinic - (Link removed by moderator) First consultant who started to try to talk to me more about FUT and the front of hair line which I now feel more up for doing! I am a susceptible person obviously. Anyway- I didnt feel like he listened to me as I specifically said I wouldnt be interested in flying to Spain to have it done but he emailed me prices for this anyway. Again no mention of what doctor would be doing it- he just said something about harley street- consultation free. He provided no number of grafts required- and prices were more expensive- one on the photos in particular he showed me looked very fake- not impressed- wont be going there

 

4. Harley street hair clinic - (Link removed by moderator) initially suggested 400-500 grafts for the crown- now increased on email to 500-600 at price of ?3900- for front they suggested another 800 grafts at a price of ?6400. I probed consultant for name of doctor- he mentioned one and I asked for full details to be sent via email- which I have not received. Again this is a bad sign to me and I wont be going here either.

 

5. I have had an online consultation with - (Link removed by moderator) Their conultant suggested 4000 grafts for front, to build upon native hair , and do the crown and therefore suggested FUT over FUE although Fue can be used but in two sittings. I found this a little surprising as it is a lot more than the others suggested- but Dr Bisanga enjoys a good reputation on the forums so any feedback on opinions here much appreciated as my instinct is that less reputable clinics are the ones who should be trying to get me to do more grafts than is necessary. cost 10k EUR for 4000 fut, or 11k EUR for 3000 fue

 

I am waiting for a consultation with Dr Farjo in London of Farjo medical centre- July. Also waiting to hear back from Dr Rogers who I now believe is in a westminster clinic. And Dr. Feriduni from Dr. Feriduni Hair Clinic. Also interested in getting an online consultation with Dr Feller of Feller Medical.

 

Any opinions on what you guys think I should get done- and on the above much appreciated-

 

thanks a lot

Edited May 10, 2011 by TakingThePlunge

[TakingThePlunge]

TD,

 

Welcome! Please see our Terms of Service regarding linking to outside sources.

 

In my opinion, you are too young to start transplanting the crown. I see you've been using Propecia (finasteride) and Rogaine (minoxidil) "on and off for 7 years)". As I'm sure you know, the real value of these drugs is only seen when they are used consistently. How long have you been on dutasteride and minoxidil and do you intend to continue to use them daily? If you started to notice hair loss at 21 and are now 28 I'm going to guess that using these medical hair loss treatments has probably helped keep the hair you have now.

 

Have you tried any concealers?

 

Regarding your experiences with the clinics you've consulted with, I'd say your instincts are spot on. Signing up for a hair transplant with a faceless, nameless doctor is akin to playing Russian Roulette.

 

Drs. Nilofer and Bessam Farjo, Dr. Feriduni and Dr. Feller are all members of the elite Coalition of Independent Hair Restoration Physicians and highly regarded on this forum. Click here to see the Coalition membership standards. Choosing one of these physicians or any of the other hair restoration physicians recommended by the Hair Transplant Network means that you will have direct access to your surgeon and literally hundreds of patient reviews, discussions, opinions and photos to help you make that all important decision.

 

Don't make any hasty decisions. We are all here to help! Good luck!

[Mick from Farjo]

TD,

 

This could develop in to a great post for a number of reaons.

I am simply listing a few pointers but all are open to different interpretation.

 

Should you be having surgery at all, David made a good point relating to the crown.

This can be problematical, especially as the area can expand and the additional treatment commitment it will bring.

Would it be ok to do a little in the crown that will make things a touch better but not bring to much additional commitment.Slightly contradictory but with the right design could this be feasible.

You note that you are more concerned with the back but you have been advised to work at the front as well.Would trimming the front short and having a larger procedure be of help to you?

I dont think that we could comment without actually seeing you as we all know pictures can be somewhat deceptive.More than this i would personally not make up your mind until you have seen an actual doctor and they will be able to get a better feel of the situation.As well as looking at all the very important background information.Belgium is not far to go and you could see a couple of doctor's in a day.Dr Lindsay is over here in June and getting an opinion would certainly help.

There are many places offering FUE but there are really only a limited number of people with the neccessary expertise and true class to carry off this procedure.Feriduni and Bisanga certainly are on the ball but i would also definitely consult with Dr Feller.

Hair restoration is definitely not a one cap fits all and i think that you have found this in your research.

Should you wait and use concealers,the cheapest option by far.

I think it will be a while before you can really get a grasp of the best way forward and good luck with the journey.

Mick

[RCWest]

The Farjos are the only surgeons in the UK that I would let touch my head. All the clinics you listed have had many bad stories on here. Use the search function and type in those clinics and you will find stories of butchering that have made peoples lives very miserable.

 

I noticed you're interested in Dr. Feriduni in Brussels. Now there is a doctor who is up to date on things and very highly respected.

[Starkid]

bisanga adviced FUT??

[RCWest]

Another thing, like David mentioned, is you need to consistently use the treatments every single day. Now that you are on Dutasterid it won't hurt if you miss a day every now and then, but you really need to take the pill one a day and use the minoxidil twice a day for at least 6 months, preferably a year, before you see any real benefit. Battling hair loss takes more patience than anything else in life. It's a very slow uphill battle but I believe that if people used the medication consistently for a year and had a before photo that more people would see actually how much it helps.

[TD]

Guys, Thanks for the replies - I feel I need to clarify the medication history- Im affraid Im going to have to be approximate here as its over a long period

 

Age 21- First notice hair loss

Age 22- Visit Belgravia centre, London- start Propecia and minoxidil

Age 24- Decline: Switch to Rogaine instead of Belgravia's Minoxidil as cheaper

Age 25- Switch back to Belgravia's as see decline seen again- Belgravia's has "MPG 0.0125%" (surely good salesmanship?! I dont see this anywhere else...!) - Start going to GP to get prescription for Propeica and buying online as cheaper- this leads to less frequent use of propecia as getting it is more hassle

Age 27- Start Advanced hair stuido- on their advice stop taking Propecia- use their brand of Minoxidil again.

Age 28- stop Advanced hair studio- switch to Rogaine- this itches scalp (now know i should just get the alcohol free one to stop this) Panic a bit and go back to Belgravia to get Minoxidil which I never had a problem with (am i an idiot for this?! haha probably yes)- buy a laser comb as Im sure this is just the same as advanced hair studio- buy a 1 year course form Belgravia- which I am still taking

Recent: Start to look at hair surgery for more permanent solution- start taking Dutasteride along with the Minoxidil.

 

With Regards to am I too young. Yes I have given this some thought in that I am concerned about how my hair loss will progress.Here are my thoughts...

 

1. I do think I have given medication enough of a try over the years to now consider more permanent solutions.

 

2. My hair loss has been gradual and in a quite predictable pattern- therefore planning for the future is more attainable.

 

3. Financially I am able to cope with future surgery costs if needed.

 

As mentioned, I am very concerned about future loss- This is why I started off in consultations only wanting to talk about the crown as I thought that the front was not as bad- and I could see how medication helps maintain the rest over the next couple years.

 

The flip side to this is the medication, to my understanding is meant to be most effective in the area I was looking to have surgery on.

 

This is why my first consultations which suggested using 500 or 750 grafts was positive because at least this was not a massive number and should leave me with a good amount of donor left for future eventualities.

 

This of course has been confused by Dr Bisanga's consultant in the UK who has suggested 4000 grafts are needed and therefore recomends FUT as FUE is capped with them at 3000. Read previous thread for description on what he suggested in full.- (so the answer to your question Starkid is yes- although he did say FUE possible but not optimal)

 

RCWest: I am aware that the clinics in Question are not of the highest reputation before writing my initial thread but I decided to share experiences anyway- Rest assured- I will not only be considering the best and most reputable surgeons- but what does worry me a little in truth is Dr Bisanga's surgery's recomendations- I am not saying it is wrong- I am trying to find exactly that out- but it does seem like a lot of grafts and I am unsure of their plan over the future. - To be completely fair as Mick from Farjo points out- this consultation was done by photos and the others have been in person. Mick- you plan on doing a little in the crown is something along the line I initially was thinking of- I look forward to my consultation with Farjo in July

 

I have not tried concealers to be honest- I am constantly scrutinised at work for my hair due to wear i sit- people always walking by and making comments etc so I dont think I would be comfortable trying them to be honest....

Edited May 10, 2011 by TD

[TD]

p.s just wanted to clarify- I do think within the timeline described above for medication usage I could have been more conscientious

 

Also- Mick- you say "Should you be having surgery at all, David made a good point relating to the crown.

This can be problematical, especially as the area can expand and the additional treatment commitment it will bring."

 

But how does this differ from the front hairline- this too can surely expand and also therefore can also require additional treatment as the original hairline recedes back....

 

As always- all comments, feedback and questioned much appreciated

Edited May 10, 2011 by TD

[TakingThePlunge]

TD,

 

The crown has the ominous distinction of being referred to as the "black hole" for hair transplants. Rather than reiterate what's been said many time over, I'll point you to some articles/discussions on the topic. In the end there is no substitute for an in-person evaluation by a skilled, experienced and reputable hair restoration physician.

 

Is a Hair Transplant in the Crown an Option for Younger Men? - by Dr. Beehner via our Hair Loss Q&A Blog

 

Why is the crown area referred to as the "black hole" for hair? - Discussion thread

 

Should Young Person Start with Hair Transplant at Crown? - by Dr. Bernstein

 

Hope this helps to explain our caution.

[Anouar]

500 to 700 grafts is not going to get you anywhere cosmetically and Bisanga is the only artist I would trust with my hair.

[TD]

very very helpful- thanks so much for the information