I need a less ethical HT surgeon

[whyevenbother]

I'm 34 years old and I've had two FUE procedures so far. 1700 grafts 7 months ago in the front + mid scalp and another 600 a few days ago in the temples + reinforcing the left and right edges of the frontal hairline (no more on front point).

 

Yes I know I can hopefully still expect improvements from the 1st procedure, but the doctor was very clear that he only transplanted enough for ~17% coverage, whereas 50% would be needed to actually appear dense.... although he didn't tell me that on my initial consultation, only after I had already paid in full and traveled across the country, minutes before the surgery.

 

Based on those numbers I wanted to do more in the first session, but he cautioned against it as mega-sessions are risky. Okay, so I tried to tell myself it would be okay somehow and just did what he suggested. I was NW 2A at this point.

 

Over the next few months the temples just melted away. Easily an NW III right now, if you look past the transplanted hair. Which is all too easy to do.

 

So I booked the 2nd session as soon as he had a surgery slot available, which he was agreeable to. It takes forever to get an appointment with this guy so I wanted to plan the 3rd procedure ASAP to actually get age-appropriate density in the frontal area, as opposed to what I have now where the entire front of my entire scalp is visible under anything brighter than dim lighting.

 

I really want to believe that it's actually going to be acceptable after the 1st procedure has fully matured, the doctor was emphatic that for being only 7 months from the initial procedure I've made really good progress.

 

But how could it be if I've only got 17% coverage in the front region? Where I live it is sunny every. single. day. I might as well have done nothing at all, either way I look like a bald guy desperately trying to cover it. I avoid friends and people my age - women especially - like the plague. It's fucking killing me. I've had to completely abandon social hobbies and pursuits that were my entire life. I would give anything just for a few more years of relative normalcy.

 

But when I tried to schedule a 3rd procedure to address the frontal density, the doctor said it would be better to wait for him to examine me in person, especially since the date of the 2nd procedure wasn't too far off at that point.

 

Okay, so fast forward to the 2nd surgery date, he examines me and says he found no evidence of active shedding, which supposedly is a very good sign? And yet he still says I need to wait another 2 years to even consider another procedure! After which obviously I would have yet another "ugly duckling" period to suffer through.

 

There's just no way I can wait another **3 years** just for a *chance* at looking presentable. Jesus christ I'll practically be 40! I've already lost the last 5 years of my life to my garbage genetics.

 

I know that I'm going to look like donald trump or worse when I'm older, I accepted that many years ago when I first went on the big 3 with no noticeable results. I even did 5mg fin daily + dut 1x/week for awhile until the sides got unbearable.

 

My dad has been bald as fucking shit for as long as I can remember. There's obviously no way this ends well for me, barring some miracle scientific advancements. So the question I keep coming back to is, why the hell am I trying to conserve donor for years down the road?

 

The only reason I pursued surgery was to hopefully eek out a few good years before everything goes completely to shit. I'd rather have that than a lifetime of only looking passable in dim lighting. How the hell does anyone cope with that at a young age?? Maybe I could live with that at 45-50, but not in my early thirties. I'm afraid I'm going to end up having to just shave bald regardless, but now with a bunch of fun scarring.

 

You see all these pictures of people with successful transplants online, I wish someone could have told me that in the absolute best case it was going to take me years of surgery and looking like absolute trash to maybe get to that point. Which doesn't seem likely to ever happen, now.

 

Sorry for the rant. I guess my question to the board is: has anyone here been in a similar situation? Are there any doctors who are both known to do good work and who will actually do dense packing if that's what I want, regardless of the fact that I'm clearly destined to run out of donor and look like absolute trash before long?

 

I've tried discussing all this with my doctor but after the years of what have essentially been solitary confinement my verbal communication skills are not very good. I feel like I'm just frustrating him by not accepting what he appears to consider a foregone conclusion: that a low-density, obviously balding appearance is just the best I'm ever going to get.

 

To make matters worse, when they buzzed my head for surgery the other day, I think I'm now noticing thinning at the vertex for the first time

 

I've attached pictures taken today. The donor is shaved all the way down but the other, non-recipient areas (the top basically) are just buzzed

 

Before I noticed the vertex thinning I was thinking that maybe at this point keeping it at the buzzed length is my best hope. But obviously if I lose any more vertex that won't look good either... and it seems like the doctor put a lot more grafts around the edges of the thinning area, rather than spreading them evenly, despite my telling him I prefer to wear it short (the whole reason I went FUE...)

 

Either way it's still far from an ideal solution. When buzzed short the transplanted hairs in the front look a bit "off" on close inspection, as they don't quite have a uniform direction. Whereas if I grow it longer the transplanted hair pattern mostly evens itself out, but then the low density is more obvious and unnatural looking in that sense. Obviously you can see my scalp when it's buzzed too but it can almost, sort of pass as age-appropriate thinning....

 

Thanks for reading guys.

[Melvin- Admin]

Who is your surgeon, I understand the need to be conservative, but at 34 years old it's okay to be a bit more aggressive especially if your hair loss has stabilized.

[whyevenbother]

I don't want to say his name because I know he's just trying to do what he feels would be best for me and the last thing I want to do is slander him. To some extent maybe this is the result of me communicating with him poorly, I'm just such a fucking mess about this, I can't even keep my thoughts straight during a consultation.

 

I will say he's definitely one of the most recommended surgeons though.

 

> especially if your hair loss has stabilized.

 

I'm afraid it hasn't though. Other than him saying he didn't see any active shedding, everything points to it not being stabilized at all. I've certainly lost a lot this past year.

 

If he did think it was stabilized, wouldn't he be more willing to do a 3rd procedure sooner?

 

Thanks for the response.

[Legend007]

U probably going to the wrong doctor .. the clinic u going to is conservative due to ur current hairloss situation n also what they feel comfortable skill wise to do a decent transplant .. there’s better surgeons that can make the most of ur donor with the least amount of grafts .. u just didn’t find them . Don’t limit Urself to this clinic .: u spending a lot of time n money on a clinic thats not making u happy .. what’s the point in that ..

[whyevenbother]

Are there any top doctors who are known to be comfortable with an aggressive approach? I don't think it's a skill or confidence issue with this guy, he's world-renowned.

[Legend007]

Doctor diep will ..he be happy to take ur money n give u a good transplant .. that’s a why he always pushes for an aggressive hairline to get more money n also make u look ur best for the moment .. at the sacrifice of ur long term goal n potential future hairloss . . the conservative docs wants to minimize the risk n play it safe .. get a few consultations from other doctors however .. but if I were u wait until both ur transplants grow out completely , n hopefully u taking meds to stabilize ur native hair .. n see if u recede further .. u have less risk of shockloss into ur transplanted hair , so u should be able to get dense packing .. something That should of been done in the first place .. I don’t know why they didn’t do ur temple areas the first transplant .. 1750 grafts is not a megasession; 2500-3000 fue is a megasession nowadays .. it sux u had to go thru two ugly duckling phase already n still not satisfactory results ..

[whyevenbother]

Thanks Legend, I will do a consultation with Dr Diep and a couple others.

 

> but if I were u wait until both ur transplants grow out completely

 

I was thinking maybe I could just wait until the 1st one is totally grown out? Since the recent one is just the temples, and I don't necessarily need that area to be very dense. I know waiting for both would be ideal, but I've waited so long already.

 

> n hopefully u taking meds to stabilize ur native hair

 

I am, I've been on fin for about 4 years now, at 1.25mg/day currently. I was taking a higher dose + dut previously the but sides became too much. Also on oral minox and whatever that shampoo is called.

 

> That should of been done in the first place .. I don’t know why they didn’t do ur temple areas the first transplant .

 

That's what I thought! I specifically requested the temples, in fact he listed them as an option on the quote he gave me after the initial consult. But when I showed up for the actual surgery date a year later he talked me out of it. Major regrets

 

I'm afraid my loss is proceeding so fast that it made him want to be extra conservative.

 

> 1750 grafts is not a megasession; 2500-3000 fue is a megasession nowadays

 

Yeah to be fair he didn't actually use the word megasession, he just talked about smaller sessions being safer, better. "We can always do more later". Sigh.

[aWidowsPeek]

Yep a lot of doctors on here will indeed get aggressive and aggressive on your wallet haha. Diep and Konior give guys Brad Pitt style hairlines every day of the week.

[Spanker]

Yep a lot of doctors on here will indeed get aggressive and aggressive on your wallet haha. Diep and Konior give guys Brad Pitt style hairlines every day of the week.

 

Yeah, but it will never look ridiculous.

[BaldingtimetoLdar]

Doctor diep will ..he be happy to take ur money n give u a good transplant .. that’s a why he always pushes for an aggressive hairline to get more money n also make u look ur best for the moment .. at the sacrifice of ur long term goal n potential future hairloss . . the conservative docs wants to minimize the risk n play it safe .. get a few consultations from other doctors however .. but if I were u wait until both ur transplants grow out completely , n hopefully u taking meds to stabilize ur native hair .. n see if u recede further .. u have less risk of shockloss into ur transplanted hair , so u should be able to get dense packing .. something That should of been done in the first place .. I don’t know why they didn’t do ur temple areas the first transplant .. 1750 grafts is not a megasession; 2500-3000 fue is a megasession nowadays .. it sux u had to go thru two ugly duckling phase already n still not satisfactory results ..

 

Totally off topic but why do you type like that?

[gillenator]

Good doctors understand that every case is different and why their approach is going to vary between individual patients, depending on the merits of each case.

 

There are benefits to doing smaller to mid range sessions. The trauma level is not as great, the blood flow is better to the area, and ultimately, the yield has a better chance of overall improvement.

[hairlossPA]

I will admit that first pic of your front shaved looks rough. How long after your HT's is that?

 

do you have any pics of it grown out?

[Legend007]

I recommended dr diep because I know he can get the job done and I have an upcoming surgery date with him ..

.. u really should wait things out till everything grows .. there’s no point of u chasing ur hairline n fast hairloss .. I was about to do surgery for 1400 grafts in December 2017 .. my hairloss just started being noticeable and I panicked .. a lot of the members on here advised me against doing surgery until I’ve stabilized my hairloss .. but I was going to go n do it anyways , until the clinic informed me 1 week before surgery that they want me to wait until I was on finasteride longer n see where my hair will stabilize ..

At first I was very disappointed and kinda angry they canceled on me .. but six months later , today I’m very grateful I waited.. I lost a lot more hair during this time , hair receded more n gotten thinner .. now I I need about 2000 grafts .. I’m glad I waited , cuz I probably would of required another transplant soon n chasing my hairline .. I really only want one transplant , n hopefully in 5 years get another .. those back to back transplants seems really awful on the wallet n time n state of mind ..

[whyevenbother]

The images from my first post were taken about 48 hours after my most recent surgery.

 

Here are some more, taken just now (5 days after surgery):

 

 

Now that my hair is buzzed evenly, the vertex doesn't look nearly as bad as I was thinking when I posted the other day. So that's a pretty big relief. Although it also makes me even more determined to be aggressive about getting satisfactory density.

 

Unfortunately I didn't take any pics when it was grown out from the first procedure. I did post here a ~3 months after it http://www.hairrestorationnetwork.com/eve/188486-follow-up-procedure-after-fue.html notice in these pictures how much more concentrated the grafts are on the left.

 

When grown out, the low density on the right side was much more noticeable although it's not obvious in the pics from today. The left was actually fairly decent, except you could still see my pale scalp through the hairline. With these new hairline grafts I'm hopeful that part might be okay. He also used some nape hair grafts this time whereas the first he did not (why not?? no idea).

 

Maybe I could be happy with low density if it had a natural, age-appropriate thinning appearance. I'm not trying to re-create my teenage hairline, just an average look for a guy my age.

 

One thing that really surprised me, this last procedure was originally booked specifically for the temples. I was not expecting to be able to do any more hairline grafts in this procedure since it had only been 7 months since the last one. But when I related my overall density concerns during pre-op, he said okay we'll add some hairline. I was shocked and asked him, I thought we had to wait? He basically just shrugged and grumbled that it depends. Obviously I went ahead with the grafts but this is another concern weighing on me... I don't exactly have donor to spare...

[whyevenbother]

There are benefits to doing smaller to mid range sessions. The trauma level is not as great, the blood flow is better to the area, and ultimately, the yield has a better chance of overall improvement.

 

Yeah this is pretty much exactly what my surgeon said to talk me out of doing more grafts in the first procedure.

 

But I'm much more concerned about being able to enjoy at least a few years out of my thirties, than having nice hair when im 40-45+...

[whyevenbother]

Thanks everyone for your comments and Legend in particular, I really appreciate your perspective.

 

they want me to wait until I was on finasteride longer n see where my hair will stabilize ..

 

I've been on fin for 4 years though. And for two of those years I was taking 5mg fin/day + dut 1x/week.

 

My fear is that it's not going to stabilize until I'm completely bald. If the fin is helping it certainly hasn't been a miracle cure for me. And my father's hair has been practically non-existent since he was in his 40s... there's no amount of surgery that could rearrange that to look even halfway decent.

 

I'm afraid a conservative approach is never going to result in a head of hair I am comfortable going in public with.

 

One maybe bright spot for me: the FUE scarring is not very bad at all. My super pale skin probably helps a bit here lol. Maybe I go for high density now, and when I inevitably run out of donor I just give up and start shaving bald. I look fucking terrible bald but if it's going to look like trash when I'm old no matter what...

[Spanker]

I an not following you. What is the problem? Why not let it grow out and see how it looks before deeming it a failure?

 

Dont take this wrong but sometimes your hair problems aren't hair problems. Sometimes is unhealthy views or expectations of oneself. Say you put 4000 grafts into your hairline, would that make you happy? Probably not.

 

Try having a positive outlook. Having a natural look is infinitely more important than big time density. Putting 4000 grafts in a hairline will never look natural.

 

Try not to worry, give it a year, and take pics of your results so you can get honest opinions.

[whyevenbother]

@Spanker

 

Sorry I've rambled quite a bit. My specific problem and the reason I'm worried about waiting is that per my surgeon I've only got 17% density in the front area, whereas 50% would be required to create a normal, dense appearance. From reading these forums and looking at pictures online, combined with those figures I have the impression that dense-packing is required to create what I would consider an acceptable result. Not necessarily in the hairline but the whole front area overall, up to my mid scalp.

 

Certainly what I had before shaving the other day had a long way to go density wise. I realize I will still see improvement in the coming months but just based purely on the numbers I quoted above... that's a huge difference, it's not like it's close.

 

Bottom line, even assuming the hairline sides I just had transplanted come in perfectly, I'm afraid the front point / middle hairline will still be transparent. Again based on those numbers. It's very hard for me to imagine a natural-looking recession pattern that's transparent in the front, regardless how the rest turns out.

[hairlossPA]

dude you need to relax lol. those second wave of pics look way better than the first. where are you getting this 17% number and how are you/the doc getting this number?

[whyevenbother]

The lack of density is much less noticeable when it's buzzed this short, I think that's a major factor in the difference between pics.

 

The 17% number is from the doc, it's how much hair I have in the transplanted zone. Compared to 100% being what I had there before balding. That's overall, he specified that it's more in some areas, less in others.

 

It's not just the number. I did try to explain my concerns to him, specifically that it looks so thin and just bad under natural or bright lighting. His response was that I would just have to live with it, that maybe we could consider adding density in a couple years, depending. Is that what everyone else with HT's does? Just hang out in dark rooms only?

[Spanker]

Who is your doc and do you not trust him?

 

Try to not stress about an arbitrary number that alone, really has no meaning.

 

Did you pic a doc that has a bunch of unhappy patients?

 

You will definitely care about your hair in 6 years, so, doing the right thing for the long run is always a good idea.

[Legend007]

I agree with spanker in having some patience ..we in a hairloss battle .. it’s a lifelong war ..

But I totally understand where u coming from .. honestly I think ur first surgery should of included ur temple points , so u didn’t have to go through this second surgery .. but look on the bright side , u have ur hairline n temple points filled out now ..ur 3 rd procedure should give u the density u want .. n ur crown seems to be intact , so u can focus on ur midscalp for that density u desire .. how is ur donor area looking ? How many grafts do u have left? N what Norwood were u befor the transplant ?

[MAGNUMpi]

Having a natural look is infinitely more important than big time density.

I agree.

[Gasthoerer]

 

The 17% number is from the doc, it's how much hair I have in the transplanted zone. Compared to 100% being what I had there before balding. That's overall, he specified that it's more in some areas, less in others.

 

17 % is a very odd number.

Are you sure that this is not just miscommunication? Maybe you had around 17 % hair remaining before the surgey. To transplant 17 % of your original desnsity does not make any sense.

 

One more comment: Your regime is very (!) aggresive with 5 mg FIN and DUT on top.

[whyevenbother]

Who is your doc and do you not trust him?

 

Did you pic a doc that has a bunch of unhappy patients?

 

I'm not gonna say his name but you all know him and he's one of the best, unquestionably. That's why him trying to push this overly conservative approach and telling me to just accept having low density in the front is so terrifying. He has great pictures of dense-packing on his website and posted in these forums.

 

You will definitely care about your hair in 6 years, so, doing the right thing for the long run is always a good idea.

 

If I can't get my hair to a point where I feel comfortable participating in society then I'm going to be an empty shell of a person at 40 anyway.

 

Try to not stress about an arbitrary number that alone, really has no meaning.

 

Hope you're right. So let me put it this way then, I would be a NW3A without the surgeries. I know it varies but is 2350 grafts conceivably enough to take NW3A to a dense appearance?

 

I'm worried about density because the implanted hairs look so unnatural on my head in any areas that aren't dense. Like really, obviously unnatural. I don't know if it's my hair characteristics or it just hasn't been long enough yet. I'm 7.5 months from the first procedure now.