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Unable to comprehend what Dr. Said


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  • Regular Member

Hello,

 

I'd contacted an Indian doctor for Fue procedure. At first, he said I'd be needing 2000 grafts for my crown area.

 

I sent him more pictures following which, he sent this message

 

"You seem to have diffuse alopecia and that does not make you an ideal candidate for a hair transplant."

 

What does this mean? Do I not have any hope?

 

Here are some pictures taken last week. My scalp might appear shiny because I'd applied Minoxil 10% moments ago.

 

1. http://i.imgur.com/5NvKgPG.jpg

2. http://i.imgur.com/HXElsU5.jpg

3. http://i.imgur.com/9cPUXNL.jpg

4.http://i.imgur.com/uCsPKmn.jpg

5. http://i.imgur.com/QxmbQdV.jpg

6. http://i.imgur.com/qMWUZKT.jpg

7. http://i.imgur.com/4WXpLbp.jpg

8. http://i.imgur.com/jr5KFwH.jpg

 

 

What should I do? I'm really confused.

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  • Senior Member

Walker,

 

I'm on the fence. In some of those pictures, it does look like you're thinning in the donor area. If this is the case, I agree with Dr. Bhatti's assessment: you're not a good hair transplant candidate. Any transplanted hair could thin over time, and this just isn't fair to put a patient through a procedure that won't last.

 

In other pictures, however, it doesn't look like you're thinning in the donor region. It looks like you suffer from more of a female patterned hair loss. This is graded with the Ludwig, opposed to the Hamilton-NW balding scale, and I would rate you around a Ludwig 2-3. This means you have central thinning with a semi-preserved hairline. If this is the case, you would be a hair transplant candidate. It would be a challenging case, but your donor area would be stable.

 

Knowing this, I recommend two things:

 

1. Do not undergo surgery with with a doctor unless he/she has evaluated your scalp in person and feels comfortable moving forward. It's too hard to tell what's going on from those images alone. You need to be evaluated by a doctor in person.

 

2. If you are not already, you should speak with a physician about preventive medications. Patients with Ludwig hair loss patterns tend to respond pretty dramatically to these medications. This is because they are really tested for the midscalp, which is where you're really thinning. If you retained your hairline and restored the thinning regions in the midscalp with meds, you'd have a pretty good transformation on your hands!

 

Hope this helps. Please feel free to ask any additional questions or send me a private message.

"Doc" Blake Bloxham - formerly "Future_HT_Doc"

 

Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

 

All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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You should take new photos without a flash. In the second image, the flat of the crown is at a 90° angle to the camera lens so the flash is bouncing off of the scalp and reflecting directly back into the lens. The area just below the occipital hump is at an angle leading away from the lens so the flash is not affecting it as much and in fact it is potentially creating a shadow effect on this inverted downslope which makes this area potentially look thicker. Use good ambient lighting with no shadows and it will be more accurate. I also think your hair should be a bit longer as hair that is too short can be difficult to assess.

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  • Regular Member

Agree with Blake, it's hard to tell. I don't blame Dr. Bhatti one bit, if he sees anything indicative of diffused thinning, why would he make you travel all the way to India just to send you home. Darker skin doesn't help the pictures either. See an expert then see another expert. If multiple MD's give you the okee-dokee than move forward. In any case, meds should be of service to you.

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  • Regular Member

Thanks guys. Dr. Bhatti sent me another email saying Micor Hair Pigmentation or a hair system might be the only sources of hope for me.

 

 

I'll try to take a few pics without flash after I've let my hair grow a bit longer and then go from there.

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  • Senior Member

Have you thought about taking Meds such as Fin & rogain? Ive seen guys like your hairloss work wonders.

Looking at your pics IMO & I'm no Dr but I still think HT could be done down the line after you give meds a shot.

 

Wish you well.

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  • Senior Member

I think there is a very large portion of is that have general thinning of the donor as time goes on. Not everyone, but a lot.

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

View Dr. Konior's Website

View Spanker's Website

I am not a medical professional and my opinions should not be taken as medical advice.

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  • Senior Member

Agreed spank...

 

The more I look at them Pics & seen plenty of asia guys with same hairloss do really well on Fin & even Min & with short buzz hair Rogain / Min is easy to apply also.

 

& I guess this fella is under 30 which also helps & 12/18mths could very well be a different story.

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  • Senior Member
Thanks guys. Dr. Bhatti sent me another email saying Micor Hair Pigmentation or a hair system might be the only sources of hope for me.

 

 

I'll try to take a few pics without flash after I've let my hair grow a bit longer and then go from there.

 

Hi thewalker431,

 

Since you seem to have been in contact with Dr. Bhatti via email, I am sure that you must have realized by now that he tends to be very concerned about the Patient's future hair growth. If he feels that an HT would not meet the Patient's goals, needs and aspirations, he says that upfront without any sugar coating.

 

I wish you all the best.

 

Best regards,

California

 

DarlingBuds FUE's profile photo 
 
North America Representative and Patient Advisor for:
Dr. Tejinder Bhatti, Darling Buds Hair Transplant Center, Chandigarh, India.

Disclaimer: I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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  • Senior Member

I'd agree with Dr Bhatti on this one. You seem to have a lot of diffused loss and not much indication of where the safe zone is. Even if there is a safe zone it is going to be lacking in density.

 

Any limited grafts you can get should be saved for a hairline. Since you still have a hairline there would not be much point in wasting those grafts.

 

Fortunately you have a great shaped head for the buzzed look which is some consolation. However, I am aware in countries like India people are not very forgiving towards people with hair loss, so that is a bummer.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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  • Senior Member

I don't think you have donor thinning. Your hair is very short, and you have lower density it is perhaps the curvature of the skin which makes some corners look thinner.

 

Personally, I'm a fan of the hairstyle you have as you have a good hairline, you should take finasteride of course if you consider surgery.

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  • Regular Member

Appreciate it, fellows.

 

I'm a Nepali-American that's moved back to Nepal. And since bald/buzzed looks aren't really appreciated over here, I'm thinking real hard about getting a transplant.

 

I used to have great hair 3-4 years ago, not just in terms of volume. Then I started losing it and my crown is making me feel super insecure.

 

I'd visited Dr. Ak Babbar in Oakland 3 summers ago and he asked me to wait. He'd also told me that my decision to discontinue Rogaine due to added hairloss was a poor was because that probably meant it was working.

 

I went to see a local doctor a couple months ago and he prescribed finasteride and Minox - 10% (I don't know if its stronger/better than Rogaine 5% that I brought from the US).

 

Back to Dr. Bhatti's comment. I get it that he was being honest and I prefer honesty over delusional comments but at the same time, I was really disheartened by his email that said wearing a hairpiece or getting Scalp Micro Pigmentation was my only hope.

 

I have emailed Dr. Radha in India but I'm kinda skeptical because she only does FUT.

 

I also emailed Dr. Dua but I honestly don't have 10-12k to spend on hair transplant at the moment.

 

I'm not sure if I'm going to be patient enough to wait for another 6-12 months to see if Minox and finasteride will do the trick. I tried Rogaine on and off for 3 years and it didn't really yield any result.

 

It's a shame that I never knew of finasteride until 6-7 weeks ago.

 

Just the thoughts of attending my best friend's wedding in May with a buzzed hair makes me feel awkward.

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  • Regular Member

A key question here would be if you are on medications and treatments to inhibit future and ongoing hair loss?

Ailene Russell, NCMA

Clinical Supervisor for Dr. Jerry Cooley

Carolina Dermatology Haircenter

Charlotte, NC

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  • Senior Member
Appreciate it, fellows.

 

I'm a Nepali-American that's moved back to Nepal. And since bald/buzzed looks aren't really appreciated over here, I'm thinking real hard about getting a transplant.

 

I used to have great hair 3-4 years ago, not just in terms of volume. Then I started losing it and my crown is making me feel super insecure.

 

I'd visited Dr. Ak Babbar in Oakland 3 summers ago and he asked me to wait. He'd also told me that my decision to discontinue Rogaine due to added hairloss was a poor was because that probably meant it was working.

 

I went to see a local doctor a couple months ago and he prescribed finasteride and Minox - 10% (I don't know if its stronger/better than Rogaine 5% that I brought from the US).

 

Back to Dr. Bhatti's comment. I get it that he was being honest and I prefer honesty over delusional comments but at the same time, I was really disheartened by his email that said wearing a hairpiece or getting Scalp Micro Pigmentation was my only hope.

 

I have emailed Dr. Radha in India but I'm kinda skeptical because she only does FUT.

 

I also emailed Dr. Dua but I honestly don't have 10-12k to spend on hair transplant at the moment.

 

I'm not sure if I'm going to be patient enough to wait for another 6-12 months to see if Minox and finasteride will do the trick. I tried Rogaine on and off for 3 years and it didn't really yield any result.

 

It's a shame that I never knew of finasteride until 6-7 weeks ago.

 

Just the thoughts of attending my best friend's wedding in May with a buzzed hair makes me feel awkward.

 

Hi "thewalker431",

 

I can understand how hair loss consequent to genetic balding is upsetting. I too am a hair loss sufferer.

The following points need to be pondered before you proceed further-

 

1. You have generalised thinning as it looks in the pictures provided. This is not an indication for a successful hair transplant. A successful hair transplant is one which not only grows hair but makes the patient and the surgeon happy!

2. Trying to get the hair better with use of DHT blockers and then getting a hair transplant means that you shall have to sustain these planted hairs lifelong with the same medication; an arduous and at times an impractical task with possible adverse effects.

3. Lastly, what I suggested to you- a hair piece or SMP are just mere options you could explore if hair loss is affecting your psyche deeply. That is something I am not an expert in and you should consider after due research. these 2 options do not compare with the result a hair transplant can give.

 

I wish you the very best. And never hesitate in mailing me if you wish advice.

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Hi "thewalker431",

 

I can understand how hair loss consequent to genetic balding is upsetting. I too am a hair loss sufferer.

The following points need to be pondered before you proceed further-

 

1. You have generalised thinning as it looks in the pictures provided. This is not an indication for a successful hair transplant. A successful hair transplant is one which not only grows hair but makes the patient and the surgeon happy!

2. Trying to get the hair better with use of DHT blockers and then getting a hair transplant means that you shall have to sustain these planted hairs lifelong with the same medication; an arduous and at times an impractical task with possible adverse effects.

3. Lastly, what I suggested to you- a hair piece or SMP are just mere options you could explore if hair loss is affecting your psyche deeply. That is something I am not an expert in and you should consider after due research. these 2 options do not compare with the result a hair transplant can give.

 

I wish you the very best. And never hesitate in mailing me if you wish advice.

 

I appreciate your response, Dr. Bhatti. Just can't help but feel disheartened as I've come across a ton of threads pertaining to successful transplant cases from you.

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