some Long ramblings, introduction and questions

[Jacareca]

Greetings my follicular fight friends, forum followers. Long rant and some questions follow, so please be patient

I have been around here for some time now, reading, learning...lurking

If you are reading this, chances are you hate your predicament as much as I do, and I don't have to tell you how much it sucks to be bald, especially at age 30, when you're still on top of your game. So I'll just skip that part and introduce myself.

30 year old male from Portugal, been balding for around 8 years now, during which I made the painful trip from a NW0 to a full blown NW 4.(like a thinner Varoufakis) You'll recognize the pattern, I'm sure: first, wish the problem away, then the undue placing of hope on the min/fin/niz combo, then the part when you realize you don't know what you hate more:the fact you're balding or the fact you have to do something about it. We are complex beings and sometimes just have to do things or we'll be stuck forever in indecision. Hence I've decided to take the plunge in a not too distant future. Of course, given the magnitude of this decision, there are some things I'd like to know, which is the reason I turn to your collective wisdom for some first-hand enlightenment. Some of the answers to these questions may be in the forum in dispersed form, others I'm not sure about...

 

1) Why does it seem as though HT clinics are a dime a dozen in Turkey, yet places from Germany, France etc are hardly represented on this website? Even here in Portugal there are about 4 places, one of which operates on our pseudo-famous and their prices are competitive wrt the turkish clinics. BTWI haveno problem with Turkey, but some of their clinics have suspiciously low prices, plus the latest goings-on, coupled with the fact that you have a lot of security checks and have to walk around with a swollen, red head like a tomato is not appealing at all.

 

2) The threads seem to be focussed by more than 95% on FUT (now outdated) and FUE. What about other procedures? E.g I know of a clinic in Switzerland that uses something called FENDI. It seems quite revolutionary if it lives up to their propaganda (but then I guess it's always like this when you blow your own horn...) anyone heard about that? And more generally why do other approaches receive so little attention?

 

3) time off after a fue if you are a gym goer. Say you do weightlifting and your objective is to minimize the loss of gainz. How long away from the gym ? And what is the risk?

 

4) Blood tests. Apparently it's standard procedure to submit one before your surgery. According to your experience, do most places do those in-clinic? It doesn't seem very practical to do a test in your home country and then takeit with you due to differences in requirements, language, and so on.

 

5) wearing a cap. How long do you have to wear a cap in public until you look normal again? And conversely, does not wearing a hat damage your recovery?

 

6) if you still have some hair (say you held the line with fina) do they work around it? If so, then of course the rest of your hair will miniaturize and you'll be kept with only the transplanted hair...what then? Do you need to bite the bullet and accept you need another procedure? Of course money and donor area limits are issues...

 

7) how painful is the anaesthesia?

[Mick50]

Hi I can answer some of your questions as I had hair transplant in Turkey

 

Prices do seem suspiciously low there I paid 1750 for 4200 FUE grafts you can check out my recent post in the patients results section at 13 month post op ,so far I am very happy transplant is still maturing.

 

How painful is the anaesthetic? Well thats very much a subjective answer I'm afraid everyone 's pain threshold is different, for me it wasn't a problem, first 2-3 a bit painful but after that no problem.

 

You can wear a loose fitting cap pretty much immediately post op as long as you are careful ,

most clinics provide a hat or a bandana, not wearing a cap won't affect the transplant just have to be careful with or without a hat about banging your head.

 

My clinic did a blood test pre-op as most do i would imagine.

Edited February 15, 2016 by Mick50

[Indi9]

Will start with no.3- 4 to 5 ,weeks Max post op you can start gyming

4-In any case they will do the blood tests at the clinic before the surgery

5-You will only look normal once the scabs come off and the redness on transplanted area is subdued. Scabs will come off in 2 Weeks time and then shedding so you will start to gradually look like u used to. But the redness and some of the transaplanted hair that remain on your scalpwill get attention of others for sure and there will b folks who will ask questions. It is very difficult to get it done with no one noticing it.

Cap is needed to protect you from infection initially when going out. But later on to protect from sunlight. You will need to protect you head from direct sunlight for at least 3 months or apply a sun screen but only after 6 weeks.

For people with larger areas to cover typically they end up getting multiple surgeries, at least 2 as doctors advice to save some for later to avoid shock loss and also allow the donor to heal back again for harvesting...which is the right thing to do.

 

7- Anaesthesia does not pain at all if your doc is good. Just the first one might feel like a prick.

 

Lastly the period after the shedding starts..week 4 to end of 4/5th month is the waiting game and what requires the most courage to hang in there waiting for some more hair to show up.Trust me...this is the period when most people feel...why the hell did I get this done.

 

Then comes the 6th month when one starts seeing viwible overall change in look and from 6 to12 months it only gets better and denser.

 

Also in some cases the transplants may not yeild good density and eventually after all this, one has to re do it.

 

And medications for lifetime ... with or without transplant. You can reduce the dosage but there is no end to it.

[Jacareca]

Thank you very much for your replies. I got a bit disheartened especially with the having to use meds for the rest of your life but I prefer having the cards on the table than clinic talk, where they seem to sugarcoat everything...

[Indi9]

That's exactly what this forum is for... We got each other's back here.

 

The meds are needed to protect the remaining hair.

 

Ever in dilemma shoot a question here.

[WantSephirothHair]

The meds are very unlikely to work for a lifetime. Many people report a decline in effectiveness and resumption of hair loss (possibly at a slower than natural pace) after 5-8 years.

[thisguy1]

1 - Good question why Germany and France are not represented. I'd like to see more countries represented and it provides a fun road trip for mods of forum to check out more clinics.

 

As for Turkey specifically I think I read the other day here they now get $1B revenue annual from HT which is probably a nice sliver of GDP. As with anything labor is cheaper there vs western europe and then you have a lot of what are called tech shops where the doctor (from what I read here) only outlineds the hair line and then cheap labor do the work. Often they do many surgeries a day where a typical western europe or US doctor will do 1-2. There are exceptions to the rule but it seems many places in Turkey are assembly lines that focus on volume. So with volume and cheap labor you can have cheap price. There are a handful that dont do that - but they will still be cheaper than W. Europe or USA/Canada because cost of living / labor cheaper there. Same reason we buy so much product from China.

 

It is interesting Portugal has become a go to place in W Europe - who knows why exactly. Looks like you live there so you are very much in luck as some of the best clinics are there.

 

2 - I dont think the forum is 95% FUT, probably 60% FUT v 40% FUE from what I follow. FUT is not "outdated" - it is generally useful for very large coverage. FUE until recently was for smaller coverage but newer technique / science is closing the gap. Dr. Shapiro did an interview I saw a few days ago where he is stating only recently (past 24 months) does he believe the yield of the 2 procedures are getting equitable as there was a lot of hit and miss and refining of technique for FUE the past 8-10 years. Just like I am sure with FUT 17-20 years ago. Also it is easier to damage the follicle if you are not hiring the best doctors / clinics with FUE than FUT so less margin for error and potential less yield as you move away from the "top doctors".

 

If you need over 7-8K grafts you probably still will need some combination of both just due to density in donor area for FUE. If you are NW3 at age 42, maybe it will be "oudated".

 

Other approaches dont get attention because I assume at this point these are the 2 accepted approaches. And as I stated in paragraph above even if a new approach comes out it is going to need to be tested on human guinea pigs for 6-8 years before it becomes widely adopted and refined. FUE process 6 years ago is not as good as FUE process today so whatever is "next" today (if there is anything) has to go thru same process. There are plenty of conferences these doctors all attend so I am sure the latest and greatest - if readily applicable to mass populace - would be being rolled out if widely accepted as useful.

 

5 - you can wear a very loose cap (very loose) within hours really. Some doctors will say days rather than hours. As for being out and about it depends on if procedure - with FUE you will shave entire head down. So other than protecting from sunshine no reason to wear a hat after say 1 week when you have your scabbing etc. With FUT you will often get recepient area shaved (some choose not to due to job) and then have different hair lengths and it is ugly duckling stage so I guess hat wearing depends on confidence. Takes until probably month 4-5 before growth really kicks in for most so you probably wear a hat a lot unless you choose not to have recepient area shaved.

 

Your head where new hair went in will also be pink for an extended period with both surgeries - anticipate 30 days as the floor, and can be up to "many months" depending on luck of draw of your skin type.

 

Main thing with cap is keeping head shielded from sun for extended period. Most say for 4-6 months. So if you work outside or play outside for long periods a hat is needed for either surgery to protect the traumatized skin. Honestly I dont think that is stressed enough even on these forums not to mention doctor's websites I have been to.

 

6 - yes they work around what you have. Every case is different. A guy who is 29 is going to have a different expected outcome than age 42. Even with meds a doc who operates on age 29 is going to assume some of these hairs are going to be gone (or all) if he is say NW5 at age 29. If he is NW2 then a different situation. Meanwhile a guy in his mid 40s who has been on fin for 5 years and is relatively stable - most doctors will assume you are going to hold onto most of what you have. So your age and level of hair loss all matter - and even with that everyone is guessing. Sometimes you hear stories of guys with no hair loss and within 3 years are NW6. Other people begin hair loss at age 24 and then with medicine can stay NW2 for decades. No perfect answer.

 

But generally all doctors want you on fin until you die to hold the line. Maybe NW7 is it moot. Some patients choose not to due to side effects and if you are a relatively young guy with advanced norwood then you probably should expect to lose what you have in MPB pattern and need surgeries to replace those hairs down the road.

 

So with you being NW4 at age 30 I would assume you are headed to NW5/6 so you'd "work around" what you have and then hope the meds stabilize your current hairs. Some might get hit with shock loss and be on their way out anyhow and not come back after the procedure.

 

7 - barely any pain; 1/10 in most cases unless you had a bad doc.

Edited February 16, 2016 by thisguy1

[Jacareca]

Thank you Mick50, Indi9, Wantsephirothhair, thisguy1

 

I am very happy I found this forum and can, at the very least, have someone who will be sympathetic towards my moping as regards this issue

 

apparently I?m stuck with Fina till I die, which is a bummer since I?ve been taking it for the last two years and successfully "held the line" but seem to have developed a somewhat mild depression while at it. Also, in the last 4 months I?ve been having supply problems and my Hair loss came back full force, even though I also use Minoxidil /Spectral DNC.

They strongly advised me against Fina in a clinic here in Portugal but they seemed too eager to sell me a HT, which made me wait and get more info. Good decision in hindsight.

I will definitely do mine abroad, since I?ll be moving out to another country in a year?s time, and somehow psychologically it?s more comfortable to do it in a place where noone knows you and you can have a fresh start...

 

Also, thisguy1, I wonder why do those clinics you mention in Turkey actually have a doctor, if he?s there just to sketch the hairline, something I could do myself. Maybe they just do it to have the power of authority...?

[thisguy1]

Thank you Mick50, Indi9, Wantsephirothhair, thisguy1

 

I am very happy I found this forum and can, at the very least, have someone who will be sympathetic towards my moping as regards this issue

 

apparently I?m stuck with Fina till I die, which is a bummer since I?ve been taking it for the last two years and successfully "held the line" but seem to have developed a somewhat mild depression while at it. Also, in the last 4 months I?ve been having supply problems and my Hair loss came back full force, even though I also use Minoxidil /Spectral DNC.

They strongly advised me against Fina in a clinic here in Portugal but they seemed too eager to sell me a HT, which made me wait and get more info. Good decision in hindsight.

I will definitely do mine abroad, since I?ll be moving out to another country in a year?s time, and somehow psychologically it?s more comfortable to do it in a place where noone knows you and you can have a fresh start...

 

Also, thisguy1, I wonder why do those clinics you mention in Turkey actually have a doctor, if he?s there just to sketch the hairline, something I could do myself. Maybe they just do it to have the power of authority...?

 

I am sure some people on fin get depression but I wonder how much of that depression is due to the hair loss itself. It can sap confidence in men simply because we are a superficial society and you take away one of the few differentiation factors among men aside from height and $$$.

 

So if you put a full head of hair on that guy and put him on fin I bet a lot less people would be depressed!

 

Sorry I mixed up Belgium and Portugal for some reason. Belgium is a reasonable flight or train ride for you. Definitely worth going and exploring the clinics there - someone did a road trip to 4 clinics from UK a few years ago for 4 consultations.

 

If you want to go to Turkey there are a handful of doctors who are much more involved so I'd explore those guys. But it sounds like HT clinics have become a big business there so have to dig carefully. All that said I am sure some of these techs do a good job but its way more luck of the draw - the main reason to go to a doctor and a well known one is to limit variability of results. There are no guarantees but with good hands you limit a bad outcome. I think this is esp important in FUE where the follicle can be damaged more easily if handled improperly.

 

Any clinic that tells you not to use fin but to get a HT is IMO a bad clinic. Every well known clinic I have seen here on forum advises fin - up to patient if he wants to take it of course but it is advised. So to give 180 degree different advice would be bad sign. In fact a lot of reputable doctors if you are NW2 or something will tell you to take fin for a year and then come back to see them and only decide then to do HT.

[Melvin- Admin]

Fin is an adjunct to an HT but if you get side effects you should stop taking it, there are other treatments, Nizoral, Minoxidil, Dermarolling etc. It's rarely discussed but the more aggressive the hair loss the less effective medical therapy is, the reason is that Fin only blocks 60-70% DHT, the other 30-40% still attacks the follicles, on someone who has minor hair loss their sensitivity to DHT is not high so its enough to stop hair loss altogether, for someone who is very sensitive to DHT like a Norwood 6 or 7, the fin will delay the hair loss for sometime but they will still inevitably go bald.

 

As for going to the gym and having FUE, I returned to the gym after 14 days, you could return sooner, its best to follow your surgeons orders however.