Donor Problem - any advice?? with pics

[bw77]

Hi all,

 

I'd like to start by thanking everyone that has responded to my private message questions. I really appreciate it.

 

I've been doing my best to research hair restoration options over the last year and I thought I was a decent candidate for a transplant. My hair has always been thin but my overall loss has occurred slowly. I'm 38 and I would say I'm probably a Norwood 3.

 

I recently sent some pics to a prominent surgeon in the hope of scheduling a future procedure. I was HUGELY disappointed to hear that the doctor felt as though my donor area was not strong enough for surgery.

 

Donor 2 is the pic that I sent with side, front and top views (not included here). Admittedly this pic makes my hair look patchy but this is because I had my hair cut to a half blade length and it is still very short. I've included a half blade pic. If you have a look at my side view pic when it is long I think it looks okay. When my hair is that length I thought it looked like the donor area of other patients I have seen. I took another pic of the back of my head in the bathroom tonight just to show the difference lighting can make.

 

Anyway, long story short I'm interested to know if anyone else out there has had a successful transplant with similar donor density? If so, which doctor did you see? I'm willing to travel anywhere.

 

I should also say that I very much appreciate the doctors honesty and I don't doubt he knows what he is talking about. I'm just disappointed and I'm hoping there is still a chance for me to have a procedure. Possibly 2500 grafts to fill the frontal third.

 

Thanks for reading

[Bill - Seemiller]

bw77,

 

Thank you for sharing your concerns. It's hard to tell by the pictures, especially since one of them shows the donor area shaved down to the lowest level. But to be honest, it doesn't look like your donor area is so thin that you wouldn't be a good candidate. I would suggest emailing a few additional top doctors recommended by our community to get their opinion.

 

On another note, you do still have a lot of your own hair. I would suggest considering non-surgical treatments such as Propecia and Rogaine to attempt to keep the existing hair you have. Perhaps you won't even need surgery or if you do undergo surgery, you can simply refine the hairline and add a little more density without using too much of your donor hair.

 

Just be aware that Propecia and Rogaine do come with the possibility of side effects so it's important to research all treatments you are considering thoroughly and make your own mind.

 

I hope this helps.

 

Bill

[bw77]

Thanks for this quick reply Bill. And thanks for kind words about the hair I do have. To be honest, my hairline is pretty poor. I just do some tricks with product and spray to make it look thicker and lower than it is.

 

I'll contact some others and see how I go.

 

Thanks again

[Melvin- Admin]

This is why a microscopic donor evaluation is so important, I actually went to my first ever microscopic donor evaluation yesterday with a recommended doctor. My previous doctors had evaluated my donor area but I was not able to see what they were seeing, the doctor I went to was Dr. Mohebi, he charges $150 for the evaluation but it's worth it for peace of mind.

 

The process is he'll place a microscope on your donor area that will appear on a screen in front of you, its fairly easy to spot any hairs that are miniaturized, this is important in finding out whether or not you have any hair loss in your donor region. In my evaluation Dr. Mohebi was able to estimate how many follicular units I have on average, I believe he said 1.7 which is not bad considering I've had two FUE's.

 

I think you have naturally thin hair, this is a tough one, because thin hair requires a lot more grafts than someone with thick coarse hair. But having thin hair does not mean you're not a suitable candidate. My advice is find a surgeon who performs a comprehensive evaluation of your donor area. Not all surgeons perform this type of evaluation though so it may take some research.

[mahhong]

Like Bill said, I don't see anything in particular that makes me think you're definitely not a good hair transplant candidate.

 

In the donor2 photo your donor region does look a little thin, but not that bad. In addition, you look to be outside, possibly with fairly strong sun shining down. Also, and this may be a completely erroneous observation, but I wonder sometimes if some digital cameras (particularly on smartphones/tablets) sort of up the contrast slightly on photos, as quite often I see more contrast between hair and scalp in a photo of someone than appears in real life. I may be completely wrong about that.

 

At 38 you seem to have relatively minor hairloss and although your donor may not be the best, it doesn't look hopeless to me either, and I've seen a lot of men with what at first glance appears to be sub-par donor go on to have very good transplants, without compromising their donor area.

 

I think your goals seem realistic; to spend maybe 2,000 to 2,500 rebuilding a conservative but improved hairline and adding some density in that frontal third. Are you able to go to an in-person consult with somebody? Photos are good but I think a proper examination of your donor area is the only way to get real answers about what kind of candidate you are.

[bw77]

Thanks Mahong,

 

My wife said the same thing. She said that the pic doesn't look anything like the back of my head. Maybe I should have sent a different pic but I wanted to send one that didn't look too hot rather than one that wasn't a true representation.

 

I've taken your advice and booked a session with a doctor. I live in Sydney and there aren't too many doctors with the experience of the Northern Hemisphere docs but I'm assuming he will be able to give me some more specific information.

 

bw77

[mahhong]

Thanks Mahong,

 

My wife said the same thing. She said that the pic doesn't look anything like the back of my head. Maybe I should have sent a different pic but I wanted to send one that didn't look too hot rather than one that wasn't a true representation.

 

I've taken your advice and booked a session with a doctor. I live in Sydney and there aren't too many doctors with the experience of the Northern Hemisphere docs but I'm assuming he will be able to give me some more specific information.

 

bw77

 

Sounds good! I think a face-to-face consult with a trichologist or hair restoration surgeon is the best way to go. I'm sure they'll at very least be able to look at your scalp and get some sense of where your hair is at, and then you can use that info to plan how you go forward.

[Spanker]

A face to face is very important but only with a trusted doctor.

 

Honestly, I do have some concern with your donor and would put you in a 3V patterned level.

 

You almost look like you have are diffused throughout the top and the donor, but since it is fairly even, it doesn't look as bad. Let us know what the doc says.

[Dr Tejinder Bhatti]

Dear Mr. bw77,

 

Thank you for sharing your photos and your personal situation. I cannot imagine the feeling you had upon receiving your evaluation. I personally do not see any red flags with your photos and I would imagine you are a candidate for a FUE procedure of approximately 2500 to 3000 grafts. I would recommend you consider finasteride to halt any additional loss in the vertex. You may even reverse some of your loss.

[ontop]

Not sure why a doctor would tell you no, just on the poor evidence of pictures you sent.

yes looking at your pictures all be it not the greatest, on first glance there would be a little concern but to flat out say no on just what you showed me...nah If I was the doc I would of said.....ive got some concerns but I would like you to come in so I can probably evaluate you then we go from there....to point blank say No makes me wonder is this Dr cherry picking his patients which I suspect what goes on more than people like to believe in this greedy business trust me, it does happen.

 

@ 38 yrs old with still a lot of hair left, I would consider medications for a yr or 2 & my bet is that this would give you a boost all over your scalp, then look into surgery.

[Pete-from-Farjo]

There's no substitute for a face to face with a doctor for donor evaluation. Even the best photos don't really tell the full story.

 

Hope you get the answers you're looking for.

[chris39]

is this Dr cherry picking his patients which I suspect what goes on more than people like to believe in this greedy business trust me, it does happen.

.

 

Couldn't agree with this more . Plenty of surgeons posting results of transplants on the lower NW's and far fewer posting results of the higher NW's. That , coupled with some surgeons insistance that prospective patients are on Fin' bears this out .

[HairsGone]

A mistake I made at the start was to send poor quality photos with my hair trimmed short, I think grade 2-3. I sent these to a few recommended surgeons including Dr Erdogan who said I wasn't a candidate due to my donor, he advised using Finasteride then re-evaluating after 6 months. I then grew my hair longer and visited a surgeon who said my donor was fine. I've since had 7000+ grafts and told I still have grafts in the bank if needed! My advice is to grow your hair longer then resend good quality photos and also visit a top surgeon for a closer evaluation.

[ontop]

Hairsgone, great advice buddy.

The only true way is to have onsite consultation.

 

We see so many bad pictures taken, so many of us has used the clippers ourselfs & messed up the donor to make it kinda patchy where it looks kinda suspect or a concern to a doctor looking at such pictures, there is so many veriblables which can not give you the correct info just by picture's alone.

 

Bottomline is to go to some free consultation local HT Clinics in person so at least it would give you a lot better idea of what your up against.

Edited August 17, 2016 by ontop
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[Rashid36]

Some doctors would still do a transplant even if there was problem with the donor relying on fin to stable things...

I don't think this approach is correct

[ontop]

Some doctors would still do a transplant even if there was problem with the donor.

I don't think this approach is correct

 

Well them type of doctor's shouldn't be in the practice of medicine & should have license revoked period.

Edited August 18, 2016 by ontop
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[bw77]

Dear Mr. bw77,

 

Thank you for sharing your photos and your personal situation. I cannot imagine the feeling you had upon receiving your evaluation. I personally do not see any red flags with your photos and I would imagine you are a candidate for a FUE procedure of approximately 2500 to 3000 grafts. I would recommend you consider finasteride to halt any additional loss in the vertex. You may even reverse some of your loss.

 

Hello Dr Bhatti,

 

Thank you so much for responding to my post. It's very encouraging to hear that you don't see any red flags with my donor area. It's particularly encouraging to hear from you because you were the doctor I was hoping would perform my surgery. I've been reaching out to a number of the doctors recommended on this site for an evaluation and based on the service I've received from you and Kanika and the results you have posted on your website I've been hoping you would perform my surgery.

 

I've been reaching out to a number of doctors and all have recommended graft numbers similar to the amount you recommended. I was just shaken by the doctor that questioned my donor area.

 

Again, thank you so much for responding to my post.

[bw77]

Thanks everyone for responding to my post. Your advice makes sense.

 

I'm less concerned about my donor area now. I had my hair shaved to the skin and this pic was taken about three weeks after. So it's about a 1 or 2 clipper blade. I've been looking at pics of myself and when my hair is scissor length it looks completely different.

 

I know I have thin hair, but this pic was pretty unflattering.

 

I'd like to have a good doc evaluate my donor area but there aren't too many in Australia, or at least not many that can post a solid portfolio of good transplants. I'm booked in to see someone next week but I don't want him to try and convince me that FUT is the only option for me or to low ball my donor amount....I would like to get an idea of what is available though....I'll think about it and keep you posted.

 

Thanks for all the replys.