Opinions Welcome - My Journey So Far

[BedHead]

Hi Guys,

 

 

 

Long time lurker, first time poster.

 

 

 

Ok so, I began to lose my hair at 19, I'm 28 now. At the age to 22, after 2 and a half years of stress and worry at my receding hairline, I began to use minoxidil and with success. Not only did my hair loss slow but I regrew hair and the hair began to thicken and restore to a good aesthetic look. Alas after two years the good work minoxidil was doing stopped and my hair loss continued.

 

 

 

The next step was to use propecia; which I used without an issue for 18 months. Eventually the sexual side effects began to rear their head and I had to discontinue. These effects were semi permanent and could only be managed through medical intervention - which is still on going. For that reason I would not take a 5ar inhibitor again.

 

 

 

Whilst on propecia I underwent a HT procedure in the UK with the Hospital Group. BIG MISTAKE. Sadly I didn't research and as such I was butchered.

 

 

 

 

 

Unsatisfactory initial transplant in 2009 which went as follows:

 

 

 

FUT: 28cm Donor Strip taken 1549 Follicular Units - 611 (1’s), 859 (2’s), and 79 (3’s) grafts (1549 follicular units), providing a total of 2566 hairs.

 

Less than 52% of harvest survived 1328 hairs in total. Trich closure was done with too much tension as a result I am left with a 27.5cm scar of varying widths and hair growing in an unnatural direction.

 

 

 

Since then I have been reading and researching looking for a surgeon who can help me. My problem is that I have miniaturisation in my donor area to match a large scar. As a result I will either need BHT or a combination of FUE and BHT. (see pictures attached).

 

 

 

I am a NW5a heading towards a possible NW6 - I don't think my goals (given the advent of BHT) are unrealistic. I would like the buzz cut look, with a NW2/3 hair line, top and vertex coverage and a thinning look in the crown.

 

 

 

Thanks to this forum I was steered in the direction of Dr Umar who has some impressive BHT results - however when I emailed with questions regarding surgery, pricing and assurances that his approach would best suit my goals and future hair loss - I don't want islanding. Needless to say I wasn't impressed when Dr Umar didn't reply, despite polite reminders that he had yet to address my email. This set alarm bells ringing and my search for a Dr continued.

 

 

 

I had consulted with a number of surgeons who wouldn't touch my head at all - Dr Villnow, Dr Feriduni to name but two. I think their relative BHT inexperience made them reluctant to address my issues. I then found, again through this forum, Dr Bisanga, Dr Devroye, Dr Mwamba and the Shapiro Medical Group -

 

 

 

Dr Bisanga had his reservations however after seeing pictures of my body hair donor wants to see me in person to assess the situation. I have a consult with him in Brussels in February. He would prefer a combination of BHT and FUE

 

 

 

Dr Devroye also would like to see me in person to better assess the situation (BHT and FUE). Again I am seeing him in February. Two birds one stone so to speak.

 

 

 

Dr Mwamba gave me a very interesting diagnostic - front filling the first 1/3 with scalp and using combination BHT and scalp through the vertex to the crown, with the crown favouring BHT. Unfortunately he wants me to use propecia for 6 months and then use minoxidil from that point on, as well as using supplements and proteins for hair for a period of 12 months that mywhtc will provide at a cost.

 

 

 

Dr Shapiro - I spoke with a guy called Matt; he held a very dim view of BHT and was not keen on using it, he advised I get back on the meds (which I will not do). He was also of the opinion that I should opt for a further FUT (an procedure I am not keen on undertaking) and then using FUE to disguise the scar (perhaps from the body). Matt believed that I have average to less than average donor area and with meds 3000-5000 grafts could be taken, possibly less without. He suggested 30-35cm per sq cm to enable greater coverage with around 40% of my crown covered.

 

 

 

 

 

 

 

So that is my journey thus far - I would welcome comments, suggestions, advice and input.

 

 

 

Thanks in anticipation guys

[Rootz]

Sorry to hear about your misfortune with the first HT. My 2 cents, don't expect to get a full looking head of hair. While technically with a ridiculous amount of body hair, a lot of luck, and a skilled surgeon that might be possible to do NOW... I don't think it's a reasonable goal, and in the future you will probably lose a lot more hair. I wouldn't worry about the crown too much.

 

But if I was you, before anything else I think my biggest priority would be to try to conceal the FUT scar as best as possible. You might benefit from a better surgeon redoing the scar, and then transplanting body hairs into it. Scalp pigmentation might be a good idea too. By the way, what are those dark spots inside your FUT scar?

 

Next I would focus on using regular hair to frame just the front portion of your face with a conservative, but stronger, hairline. Maybe have the first 1-2 centimeters of the hairline transplanted at relative high density, then taper off dramatically. I would use only body hair for your crown, even if you have spare regular donor hair... or maybe don't even touch your crown for now. The regular donor hair can come in handy again in your future for use up front.

 

About the doctors wanting you to go on meds... I wouldn't worry about it too much as long as you plan and expect to lose more hair. If a doc refuses to operate unless you're on meds, I'd just say "Ok sure" then just continue to use minoxidil. The doc who wanted you to go on procepia for just 6 months then resume with minoxidil doesn't seem to really know what he's talking about... as that doesn't make much sense.

Edited January 9, 2014 by Rootz

[1978matt]

Your donor situation does not look great at all.

 

I would say:

 

1)Scar revision + possible creation of conservative hairline (depending on laxity)

2)FUE into new scar

3)SMP for shaved look

 

Even with propecia and BHT I think you're really going to struggle for coverage.

[rev333]

since you will not go on propecia then MATT's post needs a BUMP

 

 

MATT'S POST:

 

1)Scar revision + possible creation of conservative hairline (depending on laxity)

2)FUE into new scar

3)SMP for shaved look

[gobble]

How in the world do you know exactly how many hair survived the first procedure?

[BedHead]

Hi guys,

 

thanks for your input; to answer your questions -

 

Rootz those dark spots are actually hairs growing through my scar and Dr Mwamba is the guy who suggested propecia for 6 months - I think he wanted to strengthen my donor and then maintain it with rogaine. He's recommended and part of the HTN coalition so I figured he was good, since the community here are hard to impress.

 

Gobble - I actually sued the surgeon who left me scarred and my solicitor sent me to a leading UK Trichologist and he assertained the graft survival in his report. He took very detailed photos with a special camera and compared pre and post op photos.

 

I know it is unlikely that I'd get a full head of hair - I have made my peace with that. Dr Umar believed I could get something akin to this http://www.dermhairclinic.com/strip-scar-repair-using-fue-bht-using-beard-hair-buzz-cut-results/. Which I would be happy with. To be honest a strong hair libe tapering off to a thinning look would be fine. Then later perhaps filling with SMP.

 

I do have reservations about SMP. Tattoos fade, can't be exposed to sunlight without uv protection even in winter etc.

 

I have seen some decent BHT buzz cut results and with scalp, beard and chest I could probably get around 6000 grafts. That should provide a decent enough aesthetic buzzed look - Don't you think?