General advice on HT

[1978matt]

 

The only concern I have with Rahal is that I have not seen many results on this forum (or anywhere else) from patients with a similar loss (NW5) as mine. Maybe I'm not searching correctly. If anyone can help with searching that would be great.

 

 

Dr Koray's results seem to be popping up everywhere and he seems to be producing great results. I've not seen a bad result yet. However, is it wise for me to think about FUE at this stage or would it be better going through the FUT method first and then maybe FUE in the future?

 

 

CantDecide had a great result with Rahal and was a high NW.

 

Stick to FUT. Much more reliable and you need big numbers of grafts for a satisfying result.

[Dr. Rahal]

Hi UKLad81

 

here, quickly, are some links to previous patients posted, with higher norwoods

 

http://www.hairrestorationnetwork.com/eve/182198-dr-rahal-4862-fut-norwood-5-6-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/182149-dr-rahal-5130-fut-norwood-5-a-2.html

 

http://www.hairrestorationnetwork.com/eve/182285-dr-rahal-4324-fut-norwood-5-10-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/182795-dr-rahal-4960-graft-fut-norwood-6-6-5-mos-post-op.html

 

 

http://www.hairrestorationnetwork.com/eve/182455-dr-rahal-4129-graft-fut-norwood-5-8-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/138905-dr-rahal-2-sessions-total-grafts-6282-a.html

 

http://www.hairrestorationnetwork.com/eve/165151-dr-rahal-4381-grafts-2-years.html

[mattj]

Hi Mattj, its still the same bud! A friend of mine who is thinning in the crown area also consulted with his GP and surprisingly offered no help whatsoever. Its a shame as the GPs just don't realise what hair loss actually does to someone's confidence!!

 

Yeah, I'm happy that all the docs have suggested the same amount of grafts via FUT. I'm still toying with the idea of FUE as I wear my hair quite short on the sides (#1)!! Any advice to help with the decision?

 

I'm slowly getting used to the idea that to achieve a good result I would need to shave the entire head first. Spend all that money, its better to do the job properly!

 

So I'm born an bred in the UK however, my father is from India and although some balding in the crown still has more hair then me!

 

Would you recommend Propecia or Minox? Or just bite the bullet and get to Rahal (or H&W) and get the job done?

 

Thanks for your reply Mattj!

 

It might be worth trying out different GPs within the surgery that you're registered with. Years ago I didn't like my GP and started booking my appointments with a different one.

 

There's no harm in trialing the treatments to see if you're a good responder.

 

Here are some results we posted of patients who were high on the Norwood scale.

 

http://www.hairrestorationnetwork.com/eve/182198-dr-rahal-4862-fut-norwood-5-6-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/182149-dr-rahal-5130-fut-norwood-5-a-2.html

 

http://www.hairrestorationnetwork.com/eve/182285-dr-rahal-4324-fut-norwood-5-10-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/182795-dr-rahal-4960-graft-fut-norwood-6-6-5-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/182455-dr-rahal-4129-graft-fut-norwood-5-8-mos-post-op.html

 

http://www.hairrestorationnetwork.com/eve/138905-dr-rahal-2-sessions-total-grafts-6282-a.html

 

http://www.hairrestorationnetwork.com/eve/165151-dr-rahal-4381-grafts-2-years.html

[UKLad81]

Hi folks! Hope you're all well! Once again, thanks for all the forum posts, no doubt they are all useful and extremely helpful!

 

Now I'm still researching in to doctors for a FUT surgery. Given the level of my loss I think FUT is the way forward without compromising the donor. Based on this and 1978Matt's result I went out to Chicago and met the main man that is Dr Konior. I must say he came across in exactly the same way that so many of you have described. He recommended somewhere in the region of 3000-4000 grafts (fill frontal third and some light coverage in the crown area to begin with and maybe another procedure later) and advised that I had excellent donor as well as good laxity. Now if it weren't for his long wait list I would've booked something there and then! He was that good! His next available slot is Sept '18.

 

I'm now researching in to Dr Cooley and Dr Gabel (on Dr Konior's recommendation) and have had an initial conversation with Dr Cooley's patient advisor. She came across very professional, humorous and knew her "stuff". Her recommendation is almost identical with Dr Koniors i.e. 3500-4000 grafts). Wait time of around a month or so. I like the fact that Dr Cooley does one surgery per day and he would spend majority of the time performing the procedure.

 

Waiting to hear back from Dr Gabel (time delay due to a conference going on in Prague). However, I understand he does all the surgery, including strip removal, incisions and graft placements similar to Konior.

 

Seeing H&W (Dr Wong) in Zurich next week for an in person consult. Were I to go with H&W my preference would be to have surgery with Dr Hasson. His results seem to over shadow Dr Wong's slightly. Initial recommendation was a mega session of around 4000-5000 (or more). Wait time I believe of about 3/4 months.

 

All doctors have advised that they can perform a procedure without shaving the frontal hairs, which is exactly what I want.

 

Questions for all:

 

1) Is it better to go small in terms of the number of grafts (rather than a mega session) and not compromise on the length/width of the scar?

2) What are people's thoughts on Dr Cooley and Gabel (would like to hear from previous patients)?

3) Currently i have shortlist of Hasson (maybe Wong), Konior, Cooley and Gabel (all great doctors, I'm certain of). Now I'm sure others have had shortlists as well but how have people decided on A doctor? What's been a deciding factor for you? Given the list and me being a NW5ish, who would you choose?

4) Should I just wait it out another year and go to Konior?

 

Cheers!

[Speegs]

Hi UK, I can 100 percent vouch for Dr. Konior's professional trust in Dr. Gabel, the two are practically tied at the hip in some of the work they do, including writing literature about their field together.

 

Dr. Gabel did my last two procedures, and his beside manner won me over quickly.

 

He's worth a trip to Portland to see.

[Sean]

Great choices. Id advise you to see if you can meet actual patients with similar loss and hair texture from each surgeon. Aside from that, make sure the doctor is great with larger sessions and working in between native hairs. Smaller sessions probably give lesser risk imo. The larger the session, the larger the risk imo now. Sometimes you just wish you can turn back time. Best of luck to you.

[UKLad81]

Hi UK, I can 100 percent vouch for Dr. Konior's professional trust in Dr. Gabel, the two are practically tied at the hip in some of the work they do, including writing literature about their field together.

 

Dr. Gabel did my last two procedures, and his beside manner won me over quickly.

 

He's worth a trip to Portland to see.

 

Hi Speegs, thanks for the reply. I do like the fact that Dr Gabel like Dr Konior personally replies to all patients. Gabel has a very similar set up to Konior which I like. I know both of them are in Prague earlier this week as he mentioned it, in one of his replies.

 

When you had your procedure, did he do the majority / all of the work? How Also I see on his website that he does ultra refined, what does this exactly mean?

 

I doubt I can see him in person but as I said I'm waiting for his schedule to free up a little and then I can get a Skype session booked in.

[UKLad81]

Great choices. Id advise you to see if you can meet actual patients with similar loss and hair texture from each surgeon. Aside from that, make sure the doctor is great with larger sessions and working in between native hairs. Smaller sessions probably give lesser risk imo. The larger the session, the larger the risk imo now. Sometimes you just wish you can turn back time. Best of luck to you.

 

Cheers Sean for your reply. I've reached out to a few patients already and they have been very forthcoming in providing their experiences but not actually met anyone. That said 1978Matt has given me the offer to meet him!

 

I think I'm inclined to try to keep it relatively small session and not get too carried away with the number of grafts. I completely trust Dr Konior in his estimation and would feel that grafts within 3000-4000 (not exceeding 4500) would make quite a considerable cosmetic difference. I have next to no hairs in the crown and mid-scalp region. Any grafts placed in these regions would be more than I currently have!

 

You make a good point about placing grafts in between native hairs, and that's why I have got Cooley as a possible. I've seen that he does a lot of his procedures without shaving these hairs and seems to produce consistent results.

 

Konior / Gabel both agreed that shaving the hairs would not be required. Like I said, if wait list was not an issue, I would not hesitate to go to Konior! Anyone considering him should do so without thinking twice!

[Speegs]

Hi Speegs, thanks for the reply. I do like the fact that Dr Gabel like Dr Konior personally replies to all patients. Gabel has a very similar set up to Konior which I like. I know both of them are in Prague earlier this week as he mentioned it, in one of his replies.

 

When you had your procedure, did he do the majority / all of the work? How Also I see on his website that he does ultra refined, what does this exactly mean?

 

I doubt I can see him in person but as I said I'm waiting for his schedule to free up a little and then I can get a Skype session booked in.

Hi Uk, Dr. Gabel is in the room to supervise everything, and even places many of the grafts personally.

 

Ultra refined is just describing the meticulous process of individual graft placement, particularly in the hairline, to give a soft realism that blends in with existing hair or recreates a hairline.

[UKLad81]

Thanks Speegs. I may reach out to you privately for some advice.

 

Also, i been on Propecia (1mg daily) for the last 6 weeks. I'm still noticing some shedding and noticed that the hair seem to be a lot drier. Is this normal? Also how long does it normally take for Propecia to have some sort of effect. I'm not looking for anything radical but i am hoping that i get to see a some difference in the crown area.

[DavidAnderson]

Just saw your thread as have not been active on the forums for a while. Your scalp and hair can feel drier on Propecia, my forehead was always drier from the start of taking it.

 

I wouldn't expect to see much changes with it but if you do it will take 3-6 months to happen in general. I would expect the borders of your crown to thicken up a little but if it can hold you where you are that is a big result for you. From the back photo it looks like your crown will drop down a good few fingers width without it.

 

Don't rule out Dr Wong he is a really talented Doctor and a very nice guy and can hit the big numbers if appropriate.

 

David

[Speegs]

Thanks Speegs. I may reach out to you privately for some advice.

 

Also, i been on Propecia (1mg daily) for the last 6 weeks. I'm still noticing some shedding and noticed that the hair seem to be a lot drier. Is this normal? Also how long does it normally take for Propecia to have some sort of effect. I'm not looking for anything radical but i am hoping that i get to see a some difference in the crown area.

Propecia works the best for the crown and vertex, it can slow down hair loss all over, but it really seems to hold strong at the crown and vertex.

 

 

Early shedding can be part of the process, but Propecia will not make you lose any hair that wan't already on the way out.

[UKLad81]

Just saw your thread as have not been active on the forums for a while. Your scalp and hair can feel drier on Propecia, my forehead was always drier from the start of taking it.

 

I wouldn't expect to see much changes with it but if you do it will take 3-6 months to happen in general. I would expect the borders of your crown to thicken up a little but if it can hold you where you are that is a big result for you. From the back photo it looks like your crown will drop down a good few fingers width without it.

 

Don't rule out Dr Wong he is a really talented Doctor and a very nice guy and can hit the big numbers if appropriate.

 

David

 

Thanks David for your reply. Glad I'm not the only one with a dry forehead.

 

Absolutely, I have low expectations from Propecia although I'm hoping things will stabilise a little and also thicken up a little in the crown area. Anything else would be a complete bonus.

 

Also, I did meet Dr Wong in person over the weekend and yes he is a great guy, very simple and says it how it is.

 

I do have a question about planning from a graft placement. The area that needs to be covered is approximately 187cm2 (as measured by Dr Wong) and have been quoted about 4000 grafts (maybe more laxity dependent of course) which would give me about 21 grafts per cm2. Whilst this will give me more coverage then what I already have I cant help but feel that that number is a bit low. Therefore, I was thinking that maybe the frontal and midscalp be concentrated initially with the frontal area being the most dense. Second procedure adding more to the midscalp and the crown area next year sometime. Hopefully this will give Propecia a little more time to work some magic in the crown area. What are people's thoughts? Or am I going about this completely wrong? Any advice about planning would be highly appreciated?

[mattj]

That is a sound plan and actually a very common strategy. Often patients are happy with just the first procedure. Is there a reason why a higher number of grafts wasn't quoted?

[DavidAnderson]

Thanks David for your reply. Glad I'm not the only one with a dry forehead.

 

Absolutely, I have low expectations from Propecia although I'm hoping things will stabilise a little and also thicken up a little in the crown area. Anything else would be a complete bonus.

 

Also, I did meet Dr Wong in person over the weekend and yes he is a great guy, very simple and says it how it is.

 

I do have a question about planning from a graft placement. The area that needs to be covered is approximately 187cm2 (as measured by Dr Wong) and have been quoted about 4000 grafts (maybe more laxity dependent of course) which would give me about 21 grafts per cm2. Whilst this will give me more coverage then what I already have I cant help but feel that that number is a bit low. Therefore, I was thinking that maybe the frontal and midscalp be concentrated initially with the frontal area being the most dense. Second procedure adding more to the midscalp and the crown area next year sometime. Hopefully this will give Propecia a little more time to work some magic in the crown area. What are people's thoughts? Or am I going about this completely wrong? Any advice about planning would be highly appreciated?

 

I think that sounds a very solid plan if you are talking about the entire balding area being 187cm2 then that is too big an area to try to cover even with 4000 or so grafts. Unless you have really good hair characteristics with coarse hair and high groupings it is going to look quite thin. If you have accepted the need for a second surgery which most likely you are going to need then I think it makes sense to cover front and top and then deal with the crown in a second surgery. At the same time you can still add more density to areas that need it once you have seen how it looks and lived with it for a while.

 

There is a chance that the meds might help in the crown and having a bald spot here won't bother you once the front is fixed. I have seen it a number of times where guys have left the crown untouched. In reality if you have a good experience and money is not a big concern most return for the crown.

[UKLad81]

That is a sound plan and actually a very common strategy. Often patients are happy with just the first procedure. Is there a reason why a higher number of grafts wasn't quoted?

 

Thanks Matt and David. Great to hear the plan is a good one and that others do the same. David your completely right, total coverage is not possible and if it was the end result would look a little on the thin side. I'm happy to go with the frontal third and if possible an attempt at making the crown area smaller (from the outside - in) and then in the second procedure concentrate on the crown. I'm mentally prepared for at least 2 procedures.

 

With regards to FUT, I've read quite a few times that patients feel some tightness in the donor area for a bit. In your experiences how long does the tightness last? And what's with the itching, read a lot of people experience this, what causes this? Regarding the redness how long does this generally last for?