Noob here: Summary of the thought process and journey into propecia and FUE

[Shacked]

So I have been balding for ~10 years. I receded quickly in my early 20s and its been a slow progression since then.

 

Although I knew I was loosing my hair, I always found I had lots more going for me and so never struggled with over all confidence and with the ladies (even bald guys can make girls laugh, and thats what it takes!).

 

I was resigned to the fact I would be bald by 40 or 50 and got over it. Still, I always tended to wear caps or beanie hats to disguise my crappy hair as it was generally of poor quality. I tried minoxodil for a few months a couple of years back, but just couldn't fit it into my schedule and really couldn't be bothered. I had "dealt" with me being bald one day a long time ago so I felt ok.

 

I then hear about propecia/finasteride a year or two ago. I read about it, and am immediately put off because of the potential side effects. Why would I take a medication for more hair, to get more women, if my organ which I want to use on the women doesn't work? Beside, I do just fine without a full head of hair.

 

I then hear about FUE, and was impressed. No more gross scars! Great!

To cut a long story short, I eventually bit the bullet and started genertic finasteride. My doctors have prescribed it to multiple people with no problems for years. After a week on fin I was at my dermatologists for a minor checkup and mentioned the finasteride. He informed me that he has been taking it for 15 years, and he was in fact an author on the publications surrounding its medical trials out of Harvard. He said "just you coming to this office today had a risk associated with it. Asprin has many risks associated with it. A VERY small amount of people have adverse effects, and medical trials of thousands of people show that any side effects are largely reversible". As a scientist myself, I already had come to the same conclusion, but one can not help to hear the loud yet few anti-finasteride voices on the internet. Generally those where it works, do not trail the internet looking for answers. They get on with their life and dont feel the need to drown out the negative reviews on the internet. What I am saying is that if you have concerns/understand the risks and have no prior history of sexual disfunction, give it a shot. i have had zero effects, and if anything has increased /promoted various aspects of my sexual function. Just to be straight, I pretty much had an over active sex drive etc anyway, even into my 30s. That isn't going away at the moment.

 

 

Then came the research into who was the best FUE surgeon?

I came across Dr Reddy and was amazed with the results he achieved with the amount of grafts he used. He seemed to have great ethics surrounding procedures and future planning. He seems to empathize, as he has too been though hair loss. I received a quote from Dr Reddy, and wasn't too surprised at all. I live in Canada but am moving back to London this year so he was an option.

 

I then came across Dr Rahal in Ottawa. His team provided quick and informative answers to my enquiries and Dr Rahal immediately responded with a graft plan and quote after receiving my photographs. Dr Rahal suggested 800 more grafts than Dr Reddy, yet the over all procedure would have been around $6000 cheaper, including my travel and stay in Ottawa.

 

Fine: London is expensive;Dr Reddy is a TOP surgeon (from my online research), and North America probably offers more competitive prices with more surgeons. But why so many more grafts with Rahal?

 

Rahal has clearly perfected the FUT procedure. Amazing results. However, looking at his FUE patients, I would say ~95% of those I could find had an extremely high number of grafts put in a very small space along the hairline (In my opinion most of these barley needed a procedure anyway). So essentially Rahal was aggressive with his FUE procedures i.e. high number of grafts to achieve dense packing. But I became concerned that 2800 grafts would be transplanted in just one day (increasing effects of trauma and surgeon fatigue). Also I learnt that his technicians have done the majority of the procedures in other people cases. This seems ridiculous. If every airline put a flight technician in the pilots seat after take off so the pilot could go do better things, would that be acceptable? Not in my book. If i am to lash out over $20K I want the undivided attention of the reputable Dr who has his name above the door.

 

After discussing with various other people, more concerns were raised about large FUE dense packed procedures in that grafts actually "pop out" when closely packed and they haven't had time to "take". So these should be done over at least two days. The fact that Rahal wanted to do it all in one session (rushed?) and I had seen some less than satisfactory Rahal results on line, it just didn't sit well with me. Obviously Rahal has had some great results, and no discredit intended to him. But I felt my chances of a great result were not maximized in my particular case.

 

I contacted Dr Reddy's team. They expressed to me that we would aim for 2000 grafts, and take out time over 2 days. This was to maximize graft uptake, and well, Dr Reddy's results speak for themselves! Sure, he is more expensive, but superior FUE technique, success, ethics, and results are the main candidates used to make a choice.

 

I am booked in for July and can't wait!

Edited March 20, 2014 by Shacked

[Shacked]

Just a quick update.

 

I just received a very detail and informative estimate of a proceedure from Dr Koray Erdogan in Turkey.

His work is outstanding and offers very reasonable FUE cost.

He quoted me 10,000 Euro for 4,000 grafts over two days.

 

That is DOUBLE the amount estimated by Dr Reddy (2000g) and Dr Rahal (2800g: no crown work).

I don't think I would want so much done in such a short amount of time. However, Dr Erdogan will certainly be an option for another ~2000g FUE after my first, in a couple of years.

 

 

A break down of the FUE quotes I received in british pound sterling:

 

Dr Rahal - 2800graft in one sitting, working on only the hairline, frontal, and some mid scalp. Medication included in price. Flight and accommodation not included

 

~ 13,000 GBP (Great Britain Pound)

 

Dr Erdogen. 4000graft in 2 sittings back to back, addressing all thinned areas on scalp

~9000 GBP not including travel or accommodation

 

Dr Reddy. 5-6000 hairs, ~2000 grafts

~10-12000 GBP including medication. I live in London so no travel or accommodation fees apply

 

 

 

The moral of the story is, shop around! Each doctor is unique in their perception and perceived goals in a patient. I am extremely happy I am going with Dr Reddy for my first FUE. He seems sensibly conservative and probably wants to achieve greatest yield in shorter doses and minimize the risk of graft loss from overworking the scalp.

 

Bring on the hair!!!

Edited March 20, 2014 by Shacked

[Britanium]

Have you thought of Doganay ?? he is recommended !

[Shacked]

Sure. For now I'm with Reddy. I'll go cheaper in Turkey for my second FUE perhaps in a couple of years or so.

 

Cheers

[Dr. Rahal]

Thank you for your consideration of Dr. Rahal. I'm responding to your post because some of your comments are inaccurate and I'd like to address some of the issues you brought up.

 

 

You stated that you are concerned about the number of grafts being recommended for your case by Dr. Rahal when compared to the number of grafts recommended by Dr. Reddy. Every doctor will have varying estimates but this can be due to a few reasons.

 

 

1.) Ability to dense pack.

 

 

It is well known that Dr. Rahal is a recognized premiere doctor for high density so this alone requires that more grafts are to be used in a single session. The recommendation was based on what you stipulated as being your desired result so the estimate reflects the number of grafts necessary to achieve this result. Harvesting and transplanting 2000 to 3000 grafts in one day is not unusual as most of the better FUE clinics can and do perform these sized procedures every day. Popping can be an issue if done incorrectly but this actually has more to do with one's physiology than the density placed. If the patient has scalp tissue that is "oily" or "greasy" then even the lowest density transplant will have plenty of popping of the grafts being placed. However, there are some tricks of the trade that are employed to address this popping that prevents it from being an issue. Every clinic has cases where popping occurs so if someone has told you otherwise then you should question their integrity.

 

 

2.) Total area of intended coverage.

 

 

The recipient area can and often does vary based on what your doctor perceives as being your requirements. Many times follicular units must be placed into the native hair behind the target recipient zone so that the result will blend with the native hair for the most natural result possible. I am not aware of who you are specifically but your profile indicates that you are a NW3v. The general rule of thumb is that for each level one is positioned on the Norwood hair loss chart they'll need approximately 1000 grafts to get adequate density and coverage. Our estimate, assuming you are a NW3 (based on your profile), would be in line with this rule but it is not a rule without exceptions. Regardless, it does not appear that the estimate would be pushing the boundaries for density. Having too few grafts placed will leave the density lacking thus meaning more procedures along with an increase in expense.

 

 

3.) Differences in aesthetics preferences.

 

 

This is a big factor to consider as it will greatly separate one estimate from another. If the hairline is lower and more aggressive in design then logically more grafts will be necessary to achieve the desired result compared to a higher more conservative hairline which would require fewer grafts.

 

 

Our use of a technician for extraction of grafts is not unusual and Dr. Rahal works with the technician during the procedure to make sure the grafts are being safely extracted with no problems. Many doctors use technicians for extraction of grafts and this is not unusual. Any doctor that is worth considering will acknowledge that the procedure is only as good as their technicians and that it is a team effort that gets the job done efficiently and reliably. Each technician is highly specialized in our clinic and they do their job exceptionally well. In fact, we are working on a special project to showcase just how good Rahal FUE has become. It is very impressive and we are anxious to share what we can do.

 

 

We wish you luck with your procedure with Dr. Reddy and we hope that you document your procedure online for the benefit of all.

[Shacked]

Sure. As I said, every Doctor is different, and no disrespect to Rahal, but his approach was not for me.

I have seen some amazing Rahal FUE's. Really impressive. But I have also read testimonials on here and seen evidence of less than satisfactory results and people having to have touch up work.

 

I was simply summarizing a comparison between doctors for others to use, without a biased agenda.

I apologize if I grossly misrepresented or gave non-factual statements.

 

I will be sure to document my FUE with Dr Reddy.

 

Cheers!