need doctor recommendation *pics included*

[stromhold]

Hi,

 

This site has been a wonderful read so far, almost like a novel. i have rarely seen this good drama, suspense and intrigue (from discussing doctors and results) on forums.

 

Heres my story. I started loosing hair around 17, which rapidly increased around age 20 (i suspect possibly due to change in drinking water/chlorine content) and now i am almost 23. I fall in between category V and VI on the oft quoted hair loss chart. I had an initial consultation at a clinic which gave me conflicting advice after meeting with 2 doctors. One doctor recommended that i do not go for a transplant so soon and wait till a permanent balding pattern sets in, while the other doctor (and owner) was quote adamant that i do a transplant and essentially said that his employee had done a mis-diagnosis. I decided to not do the surgery at the time, and have been taking finasteride and minoxidil almost daily for a year. I have seen my balding areas grow slightly longer hair at the front, which are still weak and fall regularly, but nothing positive for the crown area.

 

This year i think i am ready to try once more to get myself a HT. I am on a limited budget since i am a student, but also would like to attempt a 2500+ graft transplant, assuming my donor area supports this.

 

Can anyone give recommendations for doctors in Canada? I am also able to go to Pakistan if thats cheaper. I have heard rave reviews about Dr. Humayun in Islamabad. Also, can anyone give feedback on Hair Club (Dr. Nasir Rashid)? They seem to have a lot of celebrities on their payroll and are definitely charging the most as well.

 

Thank you very much for your help. I will try to add some pictures soon.

[MikeTheDane]

Hi stromhold

 

Well, most people would probably not advice you to get a HT given your age and loss, but rather get on meds and wait until 27+. As one of the most aggressive members on this site, this is probably going to sound hollow though.

 

There is ofcourse always the chance of ending up NW7 and not having enough grafts. If that happens, are you willing to

 

1) Shave down, show a scar, accept it

2) Possibly spend money on fue for the scar or make use of consealers and/or buzz-illusion-tattoo's (if you don't like option #1)

3) Hairpiece

4) Wait for hair cloning (could take many years from now)

 

If you accept the above, go ahead and start consulting with doctors. If you have ANY hestitation though, don't. You have to be sure of your decition, because it can't be undone.

 

If you're on a budget, and have family ties in pakistan, go to Mohmand and no one else. He is the only pakistani recognised by this community. I am 2 weeks post op of my surgery with him and it was a pleasent experience.

[stromhold]

Thanks MikeTheDane. Solid advice, no doubt there.

 

You're right, i am not sure i am willing to shave down and accept showing a scar. Tattoos and wigs are really a no go for me. I guess i will have to do some more thinking on this.

 

The fin is really hurting me though. I am afraid i started noticing the side effects a few months after use, and have stopped taking it for almost a week at a time - only to see myself in the mirror and start taking it again. Vin Diesel, i envy you.

 

I am going to see a local clinic soon to get a free consultation again.

 

Thanks a million for the support

[TC17]

Without seeing pics, it still seems that the first doctor at that clinic did you a favor. Post some pics of your current hair loss and you will get more opinions.

[stromhold]

Here are some quickly taken pics. I am not sure what people would be looking for so i tried to take various angles and w/wout flash. please let me know your thoughts.

[MikeTheDane]

I am sorry bro, but you seem like a really bad candidate for a HT. Considering your age and level of baldness, there's a good chance that you end up as a NW7 in 3-7 years (though propecia could slow this down)

 

Unless you have INCREDIBLE donor and several coalition doctors can attest to the fact that you have at least 10000+ donor hair available I would advice against any form of procedure other than medicine. On top of that, unless you go to Hasson and Wong, you will probably require several procedures to receive an acceptable result. It's going to be really expensive, and you will need to save up for future procedures.

 

Yeah, it's quiet a mess. I wouldn't do it. You're a NW6 at 23 and to make matters worse your crown is practically non-existent. I was/am a diffuse NW4 with a decent crown, and most people would call my case a bit of a stretch.

 

On the good side, you still have a fairly good front lock. My suggestion is to get on Propecia to slow down your hairloss as much as possible, and buzz your hair down to 1 mm. Who knows, you might like it.

 

Dr. Humayun will definitely turn you down, as will 99% of all ethical doctors. Sorry for the blunt delivery, I believe that honestly is much more important.

[TC17]

I'm curious as to see what some of the doctors on this site think about your candidacy for surgery. At 23 and a NW 6, I'd be extremely cautious about having anything done.

[stromhold]

Yup, i know its pretty bad. Whats surprising to me is that i don't have a family history of baldness. Anyway, I know i am going to kick myself later if i don't try and get more information, so i'd like to know the best way to get doctor feedback on this site.

 

I'll send off my pics to Dr. Humayun and see what he has to say, though i can't help thinking that since MikeTheDane has already suggested a 99% refusal rate, there really is no point.

 

What i would like to mention is that i dont really have major needs from a hair transplant. At 23, i at least want to be able to look somewhere in the late 20's. Currently im judged to be in my late 30's which is pretty annoying. Maybe if i go the FUE route and concentrate on the crown, then it would be easier to keep my hair short?

[MikeTheDane]

I wouldn't do it still. You would need atleast 1500-2000 fue grafts for the crown to look somewhat full with a buzzed look but for a longer head of hair 3k-4k might be needed. Not to mention the thinning front.

 

Your fue donor is generally much less than your strip donor.

 

On top of that, you might need another fue surgery in 3-5 years because your crown has advanced to nw7 stage creating a ring without hairs at all.

 

A controversial approach could be to not use propecia, and instead wait to become NW7. Then use as many FUE grafts as possible to achieve a thin, buzzed look, that would look good especially with some blended concealers. Until that time comes (it may take 3-10 years, but the odds are it will come) you might want to look into the option of using hairpieces. They are not inexpensive, but good ones can look very natural and stylish.

[Dr. Bernardino Arocha]

stromhold,

There is no doubt that you have an advance MPB, destined to be NW 6/7. It is a very good advice to start on maximal medical therapy consisting of Propecia, Rogaine 5%, and Nizoral 2%. Do not lose hope because cases like yours while challenging are able to be successfully restored if the donor characteristics are favorable. There are many examples of similarly severe MPB that were favorably restored, here are some:

Here is a link to articles: http://www.arochahairrestoration.com/en/art/128/

,

http://www.regrowhair.com/hair...patterned-hair-loss/

[stromhold]

Thank you Dr. Bernard for your reply,

 

I have been on exactly the medication you suggested for around 11 months.

 

I would like your advice on the use of propecia 1 mg though. I have been seeing side effects since the start of use. Can continued use cause permanent damage? I am a little worried about that.

 

Lastly, i would like to confirm that your opinion is that i continue medication till i reach NW7 and then consider a HT?

[MikeTheDane]

Originally posted by Dr. Bernard Arocha:

stromhold,

There is no doubt that you have an advance MPB, destined to be NW 6/7. It is a very good advice to start on maximal medical therapy consisting of Propecia, Rogaine 5%, and Nizoral 2%. Do not lose hope because cases like yours while challenging are able to be successfully restored if the donor characteristics are favorable. There are many examples of similarly severe MPB that were favorably restored, here are some: http://www.flickr.com/photos/d...57622894886881/show/

Here is a link to articles: http://www.arochahairrestoration.com/en/art/128/

,

http://www.regrowhair.com/hair...patterned-hair-loss/

 

Given that his crown is already NW6, there's a good chance he will end up as NW7. While this is a risk we all take, his is particular big given his age. If you were to fill in the crown as it is now, he might have to fill it in again as soon as 3-5 years because there's now a ring without hair.

 

While we have seen successfully restored NW7's on this board, they were the exception, and common for them was that their NW7 patterns had already been established rather than 'expected'

[Dr. Bernardino Arocha]

stromhold and Mike the Dane,

 

It is difficult to make recommendations without the benefit of an in person consultation. My comments are just my comments based on the information you are providing.It is worrisome, that in spite the foresight of the maximal medical therapy for almost the past year, there is no significant growth in the crown area. Well, if you had the benefit of reading the articles at the links provided, you would know the reasons that crowns require more work, frequently needing a second touch up procedure. My approach would be to restore the hairline, frontal and mid-scalp areas to your satisfaction, before embarking on the crown. MTD is correct in worrying about your crown, because of the vertical component, which in essence acts as a billboard because of the way the light hit the follicles. These vertical crowns can eat up a lot of grafts. I have successfully restored NW 7s with large vertical crowns but they require a serious commitment in both donor resource and time.

 

Stromhold,

What side effects? Finesteride has been around in the form of Proscar (Finesteride 5 mg) and used for the treatment of BPH for 20+ years. We know that it is a safe and efficacious medication from having used it for that long. I don't think that it will cause permanent damage. Also, I am not saying that you should wait until you are a NW 7, I encourage you to get evaluated, in a personal consultation. All the best!

[MikeTheDane]

I believe that I've read certain parts of the worls population do not produce DHT1, do not bald and are perfectly healthy.

[stromhold]

Originally posted by Dr. Bernard Arocha:

Stromhold,

What side effects? Finesteride has been around in the form of Proscar (Finesteride 5 mg) and used for the treatment of BPH for 20+ years. We know that it is a safe and efficacious medication from having used it for that long.

 

Thank you for the reply. I was referring to issues with libido and erectile problems. I was getting worried since I was feeling some problems in these areas, but it they were probably unrelated and due to unhealthy eating or lack of exercise.

 

I was very glad to hear your view that finasteride is safe. You have really set me at ease! I will now continue to use it regularly, along with rogaine and nizoral. I talked to Dr. Humayun's assistant, Mr. Shahid, who also told me that the medicine is safe.

 

Also, i have received positive replies from Dr. Rahal and Mr. Shahid (Dr. Humayun's assistant) who have given a very similar analysis to Dr. Bernard. The gist is that I am a candidate for HT as long as i commit to at least 2 transplants, 1st for hairline and 2nd to focus on crown. Dr. Rahal is recommending starting off with 4000+ grafts, and i still have to personally talk to Dr. Humayun. I think i am very likely to go ahead with a HT within a month of two, not yet sure which surgeon though.

 

Here are additional pictures i sent to them:

 

[stromhold]

Just got word from Dr's Hasson & Wong, who suggest that it may be too early for a surgery ... i'm advised to continue on medication for a while

[MikeTheDane]

Did you tell rahal and shahid about your age? If so, I would be surprised that they're willing to do it...

[stromhold]

Yeah, told them both same description given above. Also got word from Dr. Marla who says i am most likely a candidate, and Dr. Humayun who says 90% that i am, but he can't confirm without seeing the density of donor area.

 

I think i am going to pay a visit to Dr. Marla sometime next week for a consultation.

[Dr. Mohammad Humayun Mohma]

Well I have seen Stromhold pictures and he is 23 with type v to vi MPH.

 

He does not have a strong family history of big type VII MPB.

 

I will have no reluctance to operate on him provided I see no miniturized hair way down his donor area.

 

My cut off point for any one with advance Hair loss is if I cannot harvest more than 4000 grafts in his life time.

 

If some one who is young but has a well developed hair loss and no obvious signs of miniturize hair in the viable donor area with especially the nape of neck then I believe its pretty safe.

 

They do have to understand one point is they will never ever have their crowns covered and have to live with the crown baldness. If they agree with the thinness of about 30 grafts/sq cm along with crown baldness, i think they are candidates no problem.

 

The problem with young guys start when they start demanding to have a hair line about 5 to 6 cm from galbella and cannot or will not compromise with the density and will force you to cover or commit the crown area. They are the ones who should not be touched till they reach either 28 or 30 or they grow out of that density issue and are ready to accept lesser density.

 

so I think have talked to stromhold over telephone, he seem to be reasonable enough gentleman who understand the limitations of the surgery makes him a very good candidate.

the only think that I have to assess is the availability of the minimum of 4000+ grafts.

 

so that is usually done when i see the person

[Romeono1]

Stormhold,

 

I have just HT surgery carried out by Dr Humayun last Friday, I am 26 years of age and suffering from NW5 hairloss. I had about 2500 grafts implanted to thicken up my existing hairline and the middle section of my head. The Dr would not bring down my hairline because my age + hairloss type and he only provided me with density of 30 hairs per sq cm, which I wasn't happy with but understood the reasons for this.(Age + hairloss type)

 

I am currently in the process of putting together a detailed review of my surgery with Dr Humayun please find a link below. I hope to post this and pictures of my hair transplant within the next week.

 

In short the I thought the support and help Dr Humayun and Shahid provided me whilst I was in Pakistan was excellent. They went out of their way to make me feel comfortable and help me with any issues I had.

 

 

 

I can't make a judgment of the results yet but will let you know as soon as the results start coming through.

 

http://hair-restoration-info.c...66060861/m/590109516

 

 

The side effects you are experiencing from Propecia will go away as soon as you stop using it for a month. I have been using it for over 2 years now and the only side effects I have noticed is pigmentation of the skin.