Scalp too tight - Doc says FUE only will work. Advice ??

[Mike V UK]

Hi guys!

 

I am 34 and have been experiencing hair loss since I was 20 years old. I am a Norwood II case.

 

I had a first hair transplant in Sweden when I was 23, a FUT procedure. It went well.

 

But I kept losing hair and propecia didn't do much for me, so I tried having another FUT procedure when I was 25... I experienced shock loss and none of the implanted hairs grew, so it was pretty pointless, a waste of money.

 

I am in the UK and last week I had a consultation with one of the top hair transplants surgeons from Belgium. He examined me in person and said my scalp is too tight and he can only do FUE for me because of that (although he does both FUT and FUE and is very good at both of them, I've seen the pics and he is a greatly recommended surgeon on the web, including here).

 

I have to make a decision on whether to go ahead and book the procedure, as I have an option down for surgery date in 2 weeks.

 

Do you guys think I should go ahead? The doctor is great, has an outstanding reputation and has achieved amazing results for other people. I guess I am just kind of weary because I never had FUE before. But I do still have a lot of hair (Norwood II).... Any thoughts?

 

Thank you so much in advance for any feedback, I really appreciate it.

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[TakingThePlunge]

Welcome Mike!

 

I don't think many guys would feel comfortable encouraging you to go ahead with surgery without seeing photos and knowing the identify of your hair transplant surgeon but it sounds like you've done your research and consulted with a top doc.

 

While not everyone is a great candidate for FUE, given that your hair restoration physician has recommended the procedure, he must be confident that you'll obtain the result you're hoping for. If you're apprehensive about FUE, you might consider consulting with another physician or two just to compare recommendations. You can always schedule some online consultations if it's more convenient.

 

Ultimately, you'll have to make the decision based on your own research, knowledge and experience. In my opinion, it really comes down to how well you trust the reputation of the doctor.

 

Best of luck and please keep us updated on your decision and experience.

[Mike V UK]

Welcome Mike!

 

I don't think many guys would feel comfortable encouraging you to go ahead with surgery without seeing photos and knowing the identify of your hair transplant surgeon but it sounds like you've done your research and consulted with a top doc.

 

While not everyone is a great candidate for FUE, given that your hair restoration physician has recommended the procedure, he must be confident that you'll obtain the result you're hoping for. If you're apprehensive about FUE, you might consider consulting with another physician or two just to compare recommendations. You can always schedule some online consultations if it's more convenient.

 

Ultimately, you'll have to make the decision based on your own research, knowledge and experience. In my opinion, it really comes down to how well you trust the reputation of the doctor.

 

Best of luck and please keep us updated on your decision and experience.

 

Hi David!

 

Thanks so much for your feedback.

 

The Dr. I consulted with is Doctor Christian Bisanga.

 

I consulted with 3 other doctors, but only online, they didn't get to feel my scalp in person so obviously they couldn't say "scalp is too tight, we rule out FUT"

 

Also, besides this doctor, the other one I'd want to do my procedure would be Feriduni, but he has a 6 month waiting period just for a consultation in person and over 1 year of waiting period to have the surgery itself... so that one is out of the picture, I don't want to wait a year and a half to have the procedure done.

 

I'm not working at the moment, so this is the perfect timing to have it done, as I can give it a few months while the hair grows back.

 

Also, since I still have a lot of hair, I think it's wiser to do the procedure sooner rather than later, as I am sick of styling my hair for 30 minutes every day to give it a fuller look every day, or having the same haircut that is more favorable to my receding hairline.

 

Yet I am in doubt. Funny how our mind works! lol

 

I've written to the doc and shall see what I get back.

[TakingThePlunge]

Hi David!

 

I consulted with 3 other doctors, but only online, they didn't get to feel my scalp in person so obviously they couldn't say "scalp is too tight, we rule out FUT"

 

True that! I was thinking more in terms of getting more feedback on your eligibility for FUE and potential for obtaining the results you want from it rather than ruling out strip if it's the FU that's your concern.

 

Sounds like you're covering all the bases. Did Dr. Bisanga rule out scalp stretching exercises? I've personally never done them but I've heard they can be very effective in preparing a tight scalp for strip.

[Speegs]

A Norwood 2 at your age is age appropriate to be candid, most guys fight tooth and nail to achieve that with a restoration.

 

You may just have a mature hairline and no real hair loss in terms of baldness patterns setting in.

 

I'd be cautious considering you have great hair for your age and apparently a physiology that isn't cooperative for all types of surgery.

 

Are you taking preventative treatments such as finasteride to ward off potential future loss or do you think you're genetically safe to not thin out elsewhere on your scalp?

 

I'm uncomfortable advising you to go through with any surgery without knowing much more about your situation.

[Mike V UK]

True that! I was thinking more in terms of getting more feedback on your eligibility for FUE and potential for obtaining the results you want from it rather than ruling out strip if it's the FU that's your concern.

 

Sounds like you're covering all the bases. Did Dr. Bisanga rule out scalp stretching exercises? I've personally never done them but I've heard they can be very effective in preparing a tight scalp for strip.

 

Hey David!

 

You know what, I heard back from the doc's office yesterday and they suggested for me to film a video doing a scalp exercise and send it back to them if I' like the doc to reconsider possible FUT.

 

I tried the exercise with my fingers in the back of my head and my scalp barely moved, compared to the guy in the video tutorial they sent me, who had the skin of his scalp moving up and down with the exercise. That was enough evidence for me. I definitely see that Dr. Bisanga is right and I'm gonna go for it and have FUE I feel very positive about it now.

 

I also chatted with Steven Cook from McGrath Medical, a very knowledgeable and honest guy in the hair restoration industry, I follow him on David DiMuzio's YouTube Channel (a fantastic resource, with lots of info and honest videos). He also said he knows Dr. Bisanga very well and is 100% behind his work and expertise. Having seen lots of videos with Steve and David about FUT and FUE and advantages and disadvantages and so many experiences and cases, I was very reassured.

 

I have paid the deposit and will have the procedure done next week (I had already reserved a date, months ago!). I feel very good about the whole thing now. Even though I will have to shave my head, which I have never done my whole life...

 

Thank you sooo much for replying and commenting, it really helped me out.

 

A Norwood 2 at your age is age appropriate to be candid, most guys fight tooth and nail to achieve that with a restoration.

 

You may just have a mature hairline and no real hair loss in terms of baldness patterns setting in.

 

I'd be cautious considering you have great hair for your age and apparently a physiology that isn't cooperative for all types of surgery.

 

Are you taking preventative treatments such as finasteride to ward off potential future loss or do you think you're genetically safe to not thin out elsewhere on your scalp?

 

Hey Speegs! Thanks for your feedback.

 

I don't know what you mean exactly when you say "Norwood II at your age is age appropriate" I know plenty of guys at my age who don't have a receding hairline. (And yes, there are also plenty of guys who have less hair than I do.)

 

I have been experiencing considerable hair loss since my last effective procedure, which was over 10 years ago... particularly in the crown area, but also losing density overall... also in the front area where I had my first hair transplant done.

 

I'm generally very private, but here are a few pictures of how it is now. Though the pictures do look a bit better than in person (even the doc's assistant said so)

 

I used finasteride for 6 months when I was 25, but it didn't do anything for me. In fact, I remember losing even more hair than usually at that time. I dropped it.

 

But I took great care of my hair and scalp throughout the years, namely using a combination of scalp-balancing shampoos with hair thickening & growth stimulation shampoos, a combination that has worked for me in terms of decreasing hair loss.

 

I am definitely going to look into a laser helmet (or whatever it's called). A guy I follow on YT, who has also tried finasteride and did not have any results, he has recommended it, I might try it at some point after the procedure. I'll talk to the doctor about my options on that, as well.

 

Cheers for replying guys. I really appreciate it.

 

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[Speegs]

Thanks for pics, you're more of a Norwood 2a moving toward a 3a than a mere Norwood 2 in my opinion, you also have vertex thinning, meaning you're getting hit on both ends by hair loss.

 

This is male pattern baldness and not the natural age maturation almost all male hairlines will experience even in the absence of male pattern hair loss.

 

Finasteride and Minoxidil could help keep that vertex from getting worse and perhaps even grow a little hair back, if you decline to use either of those preventative treatments then your hairless will progressively worsen it and attempting to address it surgically knowing you have donor harvesting limitations will be a frustration for you I fear.

 

The more you can keep via preventative treatments, the better off your long term results from a restoration procedure, otherwise you'll be chasing your hair loss surgically as it progresses, and knowing that your scalp is tight, it doesn't sound like you have the full array of options available to you when considering surgical restoration.

 

Laser light could be a good option for you, I'd peruse docs on this forum to see what products they recommend, not all are created equal so do some homework.

 

I've never done laser therapy, but I know that the physician that didn't my procedures, Dr. Gabel, uses Capillus products and he's not quick to endorse things.

 

You are correct that laser light therapy may be a good option for you, be careful though as not all products in the market place are created equal.

 

I'd peruse recommendations from docs on this forum, I've never used laser therapy, but I know that my physician, Dr. Gabel, uses Capillus products and he's pretty particular about ever endorsing a product.

 

 

 

I don't think 6 months was enough time to gauge effectiveness of finasteride, you really need to commit a solid year to it and reassess after that.

 

I'm not a physician, but without placing you on preventative treatment and if your laxity is truly almost inoperably tight, I wouldn't consider you a good candidate for surgical hair restoration.

[Speegs]

Hey David!

 

You know what, I heard back from the doc's office yesterday and they suggested for me to film a video doing a scalp exercise and send it back to them if I' like the doc to reconsider possible FUT.

 

I tried the exercise with my fingers in the back of my head and my scalp barely moved, compared to the guy in the video tutorial they sent me, who had the skin of his scalp moving up and down with the exercise. That was enough evidence for me. I definitely see that Dr. Bisanga is right and I'm gonna go for it and have FUE I feel very positive about it now.

 

I also chatted with Steven Cook from McGrath Medical, a very knowledgeable and honest guy in the hair restoration industry, I follow him on David DiMuzio's YouTube Channel (a fantastic resource, with lots of info and honest videos). He also said he knows Dr. Bisanga very well and is 100% behind his work and expertise. Having seen lots of videos with Steve and David about FUT and FUE and advantages and disadvantages and so many experiences and cases, I was very reassured.

 

I have paid the deposit and will have the procedure done next week (I had already reserved a date, months ago!). I feel very good about the whole thing now. Even though I will have to shave my head, which I have never done my whole life...

 

Thank you sooo much for replying and commenting, it really helped me out.

 

Hey Speegs! Thanks for your feedback.

 

I don't know what you mean exactly when you say "Norwood II at your age is age appropriate" I know plenty of guys at my age who don't have a receding hairline. (And yes, there are also plenty of guys who have less hair than I do.)

 

I have been experiencing considerable hair loss since my last effective procedure, which was over 10 years ago... particularly in the crown area, but also losing density overall... also in the front area where I had my first hair transplant done.

 

I'm generally very private, but here are a few pictures of how it is now. Though the pictures do look a bit better than in person (even the doc's assistant said so)

 

I used finasteride for 6 months when I was 25, but it didn't do anything for me. In fact, I remember losing even more hair than usually at that time. I dropped it.

 

But I took great care of my hair and scalp throughout the years, namely using a combination of scalp-balancing shampoos with hair thickening & growth stimulation shampoos, a combination that has worked for me in terms of decreasing hair loss.

 

I am definitely going to look into a laser helmet (or whatever it's called). A guy I follow on YT, who has also tried finasteride and did not have any results, he has recommended it, I might try it at some point after the procedure. I'll talk to the doctor about my options on that, as well.

 

Cheers for replying guys. I really appreciate it.

 

Save

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Also you may be a great candidate for laser light therapy as you've noted. I'd peruse this site carefully for doc recommendations on products as not all are created equal.

 

I've never used laser light therapy, but I know that my physician, Dr. Gabel, favors Capillus products in his practice and he's not quick to endorse things.

[Mike V UK]

Hey Speegs,

 

Thanks for the great comments!

 

Yes I do agree that I'm somewhere in between Norwood II and Norwood III

 

I appreciate the comments about finasteride and minoxidil, I will definitely discuss those options with the doctor going forward and might try them again for a longer period than 6 months and see if anything works differently (better).

 

I do agree that prevention is key. But we have to find what works individually, the right type of product. We're all different and not everyone has the same results, as we all know. I will definitely try more stuff from now on, to see what makes a positive and lasting impact on my hair loss. Including laser therapy.

 

I appreciate your opinion on my eligibility for surgical hair restoration, but I really don't think Dr. Bisanga would accept me as a good candidate if he didn't genuinely think I was one, just like he was very honest about FUE being the (only) sane option for me vs FUT, even though I wanted FUT initially. He's a pretty honest guy.

And I also got feedback from other reputable doctors - like Dr. Feriduni and Dr. Devroye - who told me I am eligible for another procedure, besides all the research I've done watching videos from patients who've done several procedures sharing their experiences and advice, exchanging e-mails with them, reading a ton of articles, etc. I think I've made a great decision I feel very positive about it.

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[MAGNUMpi]

I used finasteride for 6 months when I was 25, but it didn't do anything for me. In fact, I remember losing even more hair than usually at that time. I dropped it.

Hi MikeV,

You have to give it more time. At first you might get a little shed but then finasteride really helps to hold on to what you have. I would seriously consider it. Fin kept my recession to a snails pace for YEARS. Good luck with the coming procedure.

p.s I don't think laser therapy has been proven to help hair loss but I could be wrong.

[Mike V UK]

Hi MikeV,

You have to give it more time. At first you might get a little shed but then finasteride really helps to hold on to what you have. I would seriously consider it. Fin kept my recession to a snails pace for YEARS. Good luck with the coming procedure.

p.s I don't think laser therapy has been proven to help hair loss but I could be wrong.

Thanks Magnum! I will definitely reconsider Finasteride and try it for a longer period.

 

It seems that laser therapy has helped some guys, who didn't really have great results from finasteride nor minoxidil.

 

Like this guy called David DiMuzio, I've watched a lot of this videos on YouTube. He's done several hair transplants and has tried Finasteride/Minoxidil to keep his results and avoid further hair loss and it didn't work for him, but laser therapy did.

Check it out:

 

[jjsrader]

If you are gonna' do laser I suggest you go LARGE or not at all.

 

Contact John at overmachogrande.com and order about 400 diodes.

 

If laser is going to work his helmet (although not pretty and is heavy) is most heavy duty on the market.

[Benjno]

If you are going to order a lasercap, take a look at the one I bought at hairrestorationlaboratories.com. It appears to work the same as Capillus for 1/5 the price. Not sure where they ship to or still sell the model I bought.