Diffuse thinner, not a winner?

[67mph]

Hi,

 

What is the bottom line on diffuse thinning?

 

Recently, (via an online consultation) i was told by a rep of one of the bigger clinics I was not an 'ideal' candidate, and in their opinion 'at this point do not appear like the right candidate'.

 

 

I understand there could be a whole heap of reasons why i'm not the balding head of choice, but the short info i was given put me on the back foot a little and also disshearting to say the least.

 

Does anyone have any thoughts, experiences with diffuse thinning and being told that quite possibly getting a HT is not the right move?

 

Regards,

57mph

[Thehairupthere]

Diffuse thinning is an issue because you may not have enough donor to get you the look you are trying to obtain. Also it could cause your scar to be more noticeable. You should see a doctor in person to examine the area ,and perhaps they'd like to see you on minoxidil and propecia for a year and you may see an improvement in the donor area.

[67mph]

thanks for the reply hairupthere,

i was taken back by the 'may not be an ideal candidate' comment, though all the rep had seen was a few pics and therefore to me a little dissapointing, how do you get solid detailed informative guidance from online consults?

 

What good are the online consults if all they are there for is either a no, or a, go see the doctor first hand kinda thing?

 

This is where the whole 'don't let geography play a part in your decision making going for a HT with the right surgeon' falls a part, how can anyone consider a HT with a surgeon that isn't within a financially sound doable distance to their home state or country?

It's hardly financially possible for some guys to get a HT let alone travelling to all corners of the Earth to get individual consults with several possible physicians before the HT, do you not agree, upps or have i go slightly of thread?

 

...sorry, back to diffuse thinning...

[Thehairupthere]

Online consults can be difficult but also great, it really depends on how sharp and clear your photos are. If the photos were very crisp than the doctor would be able to tell you if the diffuse donor was a problem. Also I'd recommend having the doctor give you the answer not a rep, hopefully he or she had the doctor take a look at it. Try another clinic for another online consultation.

[jessie1]

Hi 57mph,

 

I don't think that being told that you are not a good candidate over the phone is either fair or an accurate comment to make for the simple fact, how can anybody 'accurately' assess your situation by looking at photos alone.... I have serious reservations about this.

 

In terms of diffuse thinning, I have seen some excellent HT results, although I do appreciate that receeders do make better candidates for many reasons. I think I'm a bit of both. My hair line is receeding and the frontal zone only seems to be diffusing. I think I would be exaggerating my situation if I was to categorise myself as a diffuse thinner though.

 

In terms of travelling, I agree. I travelled to NYC from the UK for my last HT without benefit of a face to face consult with Dr Feller prior tothe day of my HT. Far from ideal looking back on this, and you only have to look at my thread to appreciate the issues surrounding this, regardless of your view of the whole regrettable saga.

 

The crux to the whole face to face consult is ease of communication. I believe that it is essential to see the Doc first hand and not even a patient representative, as this can often present a platform for miscommunication regardless of their experience or reputation.

 

Travelling a huge amount of miles for a consultation is sometimes not feasible. However just as important an issue is accessibility to the Doc post HT. Folow ups are in most cases essential, and even more so if you have concerns about the result. It's for this reason that I would need to have a huge surge in confidence to travel across the pond again after my experience.

 

I have settled for a consult in Brussels with Bisanga as a happy medium I suppose. I will feedback on this of course. I will be very interested to see what Bisanga says about my situation. I do require some thickening in and behind my hairline where I am thinning which will mean planting between hairs. Let's see whether he thinks that I am a good candidate and that my 'wish list' is realistic.

 

Try not to let those negative comments knack your confidence. I do not want to give you false hope of course as I have no awareness of your situatin, but a face to face consult with a top Doc will help you realise your potential. Lets face it, its only in exceptional cases that no possibilities exist.

 

All the best,

 

Jessie

[Levrais]

I agree that face to face is the best way to do the consult. The online consults are a great place to start but wouldn't make any final decisions based on them. I was told by one doc that I wasn't a good ht candidate also. I did some in person consults which turned out better but either way you will get the most accurate assessment that way.

[67mph]

Hey, i appreciate the replies so far, informative and constructive so thanks.

 

I'm on the understanding that to be on your way for a result you desire you have to have a consultation with the surgeon with whom will be undertaking the HT, there just isn't any other way, even if it's just simply getting that first impression vibe. It's what needs to be done then both the doctor and client have no excuses further down the line right?

 

Diffuse thinner could be a winner is what i could call my next thread, haa.

 

Regards, 57mph

[jessie1]

57 mph,

 

This is what this forum is all about, sensibile and constructive advice.

 

You hit the nail on the head! Its all about communication and avoiding problems further down the line.

 

There are some excellent reps out there and they do a fabulous job, but adding a 'third party' to the mix, particulalry without personal access to the Doc pre op, is a potential recipe for disaster. Don't get me wrong, in most cases things will go 'swimmingly' but there will be the odd occasion where things don't.

Mine was one of those occasions. I would be using awfully polite wording here to chalk up my experience to 'miscommunication' but I will do so to keep us on thread. I experienced 'miscommnication' both before and whilst trying to reach out for help.

 

Bottom line is 57 mph, face to face with the Doc. You eliminate any miscommunication and will be able to ask the Doc a whole host of questions and work out their 'vibe' if necessary to weigh up how they will stand by you afterwards.

 

Quick one, I know that we discussed Farjo on another thread. I'm not exactly sure what your view of them is but would you consider an initial consultation with them given that you are a UK lad like me? Again, just because I don't necessarily think he is world class, Bessam Farjo has earned a sound reputation within the industry. Plus, you are not committed to him and it may provide you with a game plan of potential options without travelling across the other end of the planet!!

 

Good luck mate,

 

Jess

[67mph]

Sorry Jessie1 you've had to sum up your HT experience as 'miscommunication' and you're right that this can happen, has happened and will happen.

 

...And yes i'm in correspondence with the Farjo clinic.

 

So, back to thread, diffuse thinning, anybody like to raise concerns or add input etc.

Actually we could include thoughts on the whole online vs face to face consultations i suppose it wouldn't hurt but by all means if the online consult problem has been raised elsewhere then if you could point in that direction, many thanks

 

57mph.

[TC17]

If you are a diffuse thinner in both the donor and the traditional MPB area, then you're not a suitable candidate for surgery - period. If your donor hair is good shape and you are simply thinning throughout the MPB area, then the doctor might have felt that transplanting you wouldn't be worth it because you could shock out the remaining native hair and what would remain would be transplanted hair at the same, or perhaps even lower density, than what you currently have. Why invest the time, money, and hardship if the end result would not be an improvement?

[67mph]

I know TC17 you're right in regards to particular diffuse thinners but then there's a number of variants on diffuse thinning and (i'm sure we're all aware) many variations of mpb but with my experience i was told i was not a suitable candidate from the few pics i'd taken with my mobile phone, emailed to the rep, you can see the pics on my profile.

 

Hey, i guess i'm just unlucky and the rep has masses of hair restoration experience to easily spot a not-the-best-ht-candidate from a thousand paces, from behind a hedge with their sunglasses on.

 

Thanks and i hope there's others that can share their diffuse thining knowledge...

 

57mph

[RCWest]

I have more respect for clinics that turn someone down rather than the ones that push them into a HT and they end up scarred for life. Try and see a few doctors in Belgium. They have some excellent clinics there. I bet Dr. Devroye could do something for you!

[cardel25]

I was a diffuse thinner before starting minoxidil and finasterid allmost everyone told me that replied to my tread in here where i aksed about if i was a candidate for a HT that a HT would not be an good option for me. But after i started my regimen i regrow a lot of hair and where then ideal for a HT.

[multiplier]

FWIW, I chatted previously with 57mph about this and told him that I'd visited Feller, T&D and Shapiro this year and they all told me I was a candidate, yet the top of my head is what you'd call moderate diffuse thinning -- the donor area is not, though. I guess that is one major thing to consider.

 

But the overall advice here is sound, that you'll never really know for sure until visiting a clinic that can spend time with you face to face. I was impressed visiting the Shapiro group that they took time to do microscopic photos, counted hairs, calculated density, etc, so that we have much more clear, quantifiable data to work with in planning for the future.

[fortune11]

I know TC17 you're right in regards to particular diffuse thinners but then there's a number of variants on diffuse thinning and (i'm sure we're all aware) many variations of mpb but with my experience i was told i was not a suitable candidate from the few pics i'd taken with my mobile phone, emailed to the rep, you can see the pics on my profile.

 

Hey, i guess i'm just unlucky and the rep has masses of hair restoration experience to easily spot a not-the-best-ht-candidate from a thousand paces, from behind a hedge with their sunglasses on.

 

Thanks and i hope there's others that can share their diffuse thining knowledge...

 

57mph

 

I have diffuse thinning as well and have been thru 2 HTs. Some observations --

 

1. Diffuse thinners have to take minoxi / propecia. There are very few ppl in the world with enough donor supply to cover the entire head naturally

 

2. Be judicious about hair placement and # of grafts. I think if you go down the HT rout, plan on atleast 2 or maybe 3 procedures as placement of hair would have to go wt. how your hair loss pattern evolves. In my case, I got the hairline area done first and then the top of the head. The 3rd HT in the future will be more to fill the near-crown area. I am leaving the crown itself to the mercy of minoxi and propecia.

 

3. Diffuse thinner HT is difficult, but not impossible . Any good doctor can do it -- if your doc said no due to age etc reasons then its different but, if it is a matter of skill, there are several doctors on this forum and elsewhere who can do a phenomenal job (my HT#1 was ron shapiro #2 was ziering - I am satisfied with both, although waiting for #2 results to mature)

 

4 There is no relationship between donor scar width and diffuse thinning UNLESS the diffuse thinning extends all the way down to the back in which case your issue would be lack of good donor supply.

 

Hope this helps.

[jessie1]

57 mph,

 

We have discussed the shortfalls of on line consults and most people are in agreement that a face to face consult is always best.

 

Nobody is denying that 'honesty is the best policy' but your situation can not be accurately assessed until you see the Doc in person.

 

Don't let this knock you. That would be way too premature. Get on the meds and keep your chin up mate. Go and find some reputable Docs and speak with them. It could be a completely different story after a good stretch on the meds and some expert advice in person.

 

I'm not trying to give you false hope, just hope. It's too early in the game to give up.

 

I wish you the very best. You have conducted yourself admirably so far, despite feeling under the cosh. The support will always be there no matter what your situation..:cool:

 

Jessie

[RCWest]

I missed the part about the meds. It's probably best to wait and see what happens. Hair loss can definitely take a turn for the worse at any time!

[67mph]

Thanks Jessie1 for your post, despite where i may be at or likely to be at, your response was easy to digest so ta mate.

 

I'm not denying we've got to take the rough with the smooth but me myself i'd prefer the better constructed '...but there's still hope so don't give up' posts and messages any day of the week but hey, wouldn't we all, but deep deep down kinda knowing there's not much hope just yet.

 

I'll take this as a lesson and carry on the research, thanks everyone, i'm going to another thread me thinks...!

 

Regards,

57mph

 

Ps Spex in reference to using my pics in the thread, i've PMd you.

Edited August 16, 2011 by 57mph
telling Spex i'm PMing him to take my pics from the thread.

[Jotronic]

57mph,

 

I think that if anyone turns you down you have a few things to consider. First, they're obviously not after your money but are more rather interested in being fair and honest with regards to what they feel is in your best interest. That a big issue to consider when dealing with "big" clinics. Smaller unknown or unproven clincis may turn you down simply because they know they can't do the job so either way it's a big win for you. There can be extenuating circumstances when this happens but you get the idea.

 

Second, just because a clinic says you do not "appear" to be a good surgical candidate does not mean that you are or are not. If all they've had to go on are your photos then by all means spend a few bucks to go see them in person, be it with the doc himself or the consultant (if the doc is really far away). This way you can finally eliminate that clinic from your list and will have some solid information to really consider. We've had patients fly from from as far away as Beijing, the Middle East and even from Tasmania SOLELY for a personal consultation.

 

Finally, your photos may not have revealed the whole story or maybe they revealed too much. By this I mean that sometimes photos can show thinning that actually isn't present in reality. Do a search and you'll see how I've spoken about this for years in that if you used a flash on your photos, especially for the donor area, the top or a straight on shot of your crown, you can make it look thinner than it really is. After seeing tens of thousands of photos over the years and trying to decipher the conditions that most people take their photos in I can say with absolute authority that your own photos could have been your undoing. I have no idea if this is actually the case for you since I have not seen your photos but it IS the case for a lot of patients.

 

Bottom line, 57mph, don't give up even with a clinic that may have turned you down initially. Only if they said absolutely do NOT get a hair transplant should you move on but if you have the idea that maybe they didn't see the full picture (so to speak) then by all means hop on a plane, a train or a mule if that is what it takes and see someone from the clinic in person. This is a life long investment so do what it takes to get the right answers for your case.

[aaron1234]

Diffuse thinners in the donor region should be very cautious. First of all, the weakened hair might not even grow when transplanted after the trauma of surgery. Secondly, there is a risk of shock loss in the donor area that could be permanent because the hair is in a vulnerable state. So in the end, you almost have more to lose than to gain - a visible scar and no hair on top.

 

That said, Jotronic is right. Actual in person consultations result in a far more accurate diagnosis of your hair loss. Get hair miniaturization mapping done in the donor region.

 

But if a clinic is turning you down for surgery then you should take that seriously.

[bonkerstonker]

I personally would never go down the ht route if i was told i was a diffuse thinner in the donor that's just common sense i'm not sure if you have or not but if you have there's no point pissing in the wind!

 

With regards to thinning on top well if you check my pictures you'll see i was a diffuse thinner nw5a and have been this way for 11 years with meds. I asked Jotronic and Dr Hasson if they could work on me with out killing the thin hairs i have on top and they were extremely comfortable with it which made me feel at ease which took the gamble out of my thoughts.

 

Dr Hasson even said to me during the surgery you will be back to where you were in 4 months and i got to give it to him he was bang on i am i do not feel that any hairs were killed during surgery but i have to say the shockloss over that 4 months was pretty bad. I'm in a position now waiting for the new hairs to kick in as i'm just starting to feel the new hair spikes poking through so hopefully it will be happy days.

 

My point is i have 11 year old miniture hairs that have had a huge operation around them that have even fallen out and gone into sleep phase but have still grown back!

 

You got to respect spex for telling you what he thinks, it just proves to me the quality of reps we have on these forums who actually care about us! We're very lucky to have trust worthy reps like Joe, Spex and Matt in a industry full of sharks!

Edited August 16, 2011 by bonkerstonker

[aaron1234]

You got to respect spex for telling you what he thinks, it just proves to me the quality of reps we have on these forums who actually care about us! We're very lucky to have trust worthy reps like Joe, Spex and Matt in a industry full of sharks!

 

Amen to that.

[hairthere]

57, The issue is that you have a ton of diffuse thinning--all over your head. It's not isolated to one area. So, the risks are that a) You experience shockloss and start at square one needing another surgery. b) Your thinning advances further, also putting you back at square one and needing another surgery. It's a bit of a roll of the dice. I personally would risk it and prefer to have permanent HT hair on top and go for another surgery if the native hair did collapse. Keep in mind though this is not for everyone as it is time consuming and very expensive.

 

The other unknown variable is your donor. Is it diffuse too? Hopefully not and you have plenty of it. As others recommended I would go for some in-person consults with as many clinics as possible. That being said, I agree with Spex that judging by your pics you are certainly not an "ideal" HT candidate although I can't say you should rule having one out.

Edited August 16, 2011 by hairthere

[67mph]

what's people's thoughts on someone who is Nw5/6/7 (pretty much bald) getting their first HT, therefore becoming a diffuse thinner by default and therefore would not be advised to go for further HTs down the line due to the transplanted hairs being prone to shockloss etc, or have i generalised this far to much?

 

Regards,

57mph

[hairthere]

57, that's a personal decision and there is no real answer to it. The danger with having strip and being a nw7 is that the scar can potentially be exposed. You also risk having an island of hair on top of your head. Regarding shockloss: only native hair is subject to this, and it's generally hair that has succumbed to mpb.