Need help for Repair - How many grafts? Which approach? [+Photos]

[Blub10]

Hey there,

I need your advise in order to repair my botched Hair Transplant from exactly 12 months ago

See here:

 

I totally regret that I did no proper research and fell for their Youtube Marketing Strategy. Now they destroyed half of my Donor area

 

Infos about my hair status and myself:

Living in Europe

Age 32, Hairloss advanced at the age of 27 when I went regularly to the gym and increased daily protein (slowly receeding Hairline)

Family history: Father has a high forehead and also miniaturization (age 58), Grandfather from mothers side was bald completely at the age of 22

 

Medication experience:

10 years ago: Finasterid oral 1mg for only 3 weeks. Result: Total erectile dysfunction

1 year ago: Finasterid oral 0,25 mg eod / e3d for 6 months (seemed to work, I lost not more than 10 hairs per day).  Side effects: Low Libido, less pleasure during sex, low energy and seeing many things negatively (not exactly depression but towards it). Stopped using it for 3 months: Total shedding and thinning of the complete hair - Wanted to start again with 0,25 mg eod / e3d. Result after 2 pills: Total erectile dysfunction

Testing medication at the moment:

Since 1 month: Topical Finasteride Gel 1% on the hairline and crown - no effect yet on the hair yet , no side effects

Since 1 month: Topical Minoxidil 5% twice per day on the crown - no effect yet (not even shedding)

1-2 times per week: Ket Shampoo

I am thinking of a second try with 0,125 Mg oral Finasteride every 3 days

 

Infos about the botched transplant:

- Unknown Clinic performed by turkish technicians

- 12 Months ago

- Supposed to be 1500 grafts but is probably less

- Performed with a Micro Motor

- Half of the donor area is destroyed/patchy

- Hairs/plugs are growing all in a wrong angle

- Some multiple Grafts in the front

- Not enough density, approximately around 30cm²

 

Surgeon Approaches:

I went to various here recommended surgeons in the forum which are located in western Europe (and one in Asia) and everyone suggested a almost completely different approach and other amount of needed grafts so I am a bit confused. I do not want to mention their names  because I believe all of them are skilled enough and trust them - the question is which approach I should choose.

Measured Hair density: Donor and sides around 40cm² - Hairline around 60cm² (but mostly single grafts) due to miniaturization

My aim is to repair my donor area and the hairline. Attached are photos of my current status

 

Doctor A (Radical Approach): FUE 2500 Grafts (1000 Grafts of Head Hair 1500 Grafts of Body hair)

- No removal of wrong growing plugs

- Increase the Density in the Hairline

- Lower the Hairline by 1 centimeter (total hairline length is 17 cm)

- Repair the Donor area with body hair

Costs: 16.000 €

 

Doctor B: Big Plug removal + FUE 1200 Grafts (Head Hair) + SMP (After that optional 400 grafts Body Hair)

- Removal of the plugs 1cm after the start of the hairline and place them into the donor scar

- After 9 Months place 1200 Grafts into the frontal area in the right direction

- SMP in the Donor

Costs: 13.000 € (Body Hair not included)

 

Doctor C (conservative approach): Low Plug removal + FUE 800 Grafts Head Hair (After that optional 400 grafts Body Hair)

- Removal of 200 plugs (moslty multiples and the most obviously set in the wrong direction in the front) and place them into the donor

- After 9 months correct the Hairline with 900 Grafts of Head Hair

Costs: 7400€ (Body Hair not included)

 

Doctor D (conservative approach): No Plug removal: FUE 1000 Grafts Head Hair

- Place 500 Grafts into Donor Area

- Place 500 Grafts into recipient area for higher density

Costs: 5500€

 

Which Approach would you choose due to my limited donor resources and depleted donor? I am very confused due to the different estimations of needed grafts for the front

Side Note: The donors looks better on the photos than in reality because these pics were made with flash + the hair is wet so it blends in better to the untouched area. The longer the hair in the donor area, the more it looks patchy

 

 

 

 

 

 

 

[VicTNYC]

Your donor area looks obviously very sparse from over harvesting, so not good at all.

As for your frontal area, I don’t really see it as “botched”, lacking some density sure but given that you did not do enough research on a proper clinic/surgeon and this was from an “unknown” tech operation, I think you got away lucky that it was not way worse in your recipient area. Although, it’s hard to tell since you haven’t posted a before photo of your frontal area / hairline you had before the procedure....I’d suggest doing so.

[Blub10]

Well there is no before photo

So which surgeon approach would you follow to fix this?

[VicTNYC]

5 hours ago, Blub10 said:

Well there is no before photo

So which surgeon approach would you follow to fix this?

You have no older photo, selfie etc, at a distance or up close of what your frontal hair looked before the procedure?...in 2018?...  

In my opinion, I would probably go with the Doctor D option....I would be too afraid of making things much worse by removing the transplanted grafts and then getting others implanted into the same now-scarred 2x tissue, I’d much rather have single hair grafts implanted in the area for filler, better density and softer look.

Though, I sort of agree with @Phil36fromaus comment.

[VicTNYC]

1 hour ago, Phil36fromaus said:

I'd personally choose Option D as well but I also included Option C because I was uncertain whether plug removal would cause further scarring, so option D might be the best approach at this stage to achieving a modest improvement. So if you are by chance unhappy with that result I'm guessing you can always go back and remove the plugs for a future surgery.  

Yeah, I agree.

[ILtrooper]

Read the first few sentences and was like wow. I felt bad. Then saw the pics and was like okay it isn’t bad honestly. Donor area appears to be a bit patchy, nothing screams at me. Your hairline could be better but faaarrr from botched. If you can’t even name the doctor, I say you are very lucky and should be a lottery ticket.

 

i am sure there are many surgeons out there who can easily fix things up for you a bit. Consider SMP for the donor area for an easy fix?

[Curious]

I don't see the plugs that you want removed from your recipient area.

[Blub10]

Thanks for all the feedback guys, I really appreciate it!

The problem with Doctor D is that he only works with a micro motor which scares me since my last experience and since I do not have too much donor hair left with my very low hair density. What makes me wonder is the difference of hair needed for the frontal area, Doctor D said 500 Grafts, Doctor C 800/900 Grafts and Doctor B 1200 Grafts

@VicTNYC

I really have no photo because I used to hide these areas. I attached 2 photos 2 months after the procedure (but my hair is dry and I was on 0,25 Mg Finasterid E3d since several months)

@Phil36fromaus

I totally agree with your opinion of a conservative approach since I did not figure out yet how to stop the hairloss atm. Both trouble me, the donor and the hairline

I have to use topic every day in the front otherwise it looks terrible with dry hair. I have no grown out photos. The donor looks worst at a hair length of 0,9 - 1,3 cm. If it is longer than 1,3cm than it is okay but I always prefer a more short hair cut. The barber said (pics have been taken one day after the barber visit) that below the donor it is 4mm, 7mm on the scar and 4mm on the sides around the scar, so he did a pretty good job for blending it in. I dont know if it makes sense to reveal the name of the doctors here publicly since some of them are here on the forum. Therefore I do not want to reveal their names and end up that I am unable to receive a correction from anyone or not from the preffered surgeon. I opt more for BHT first since it doesnt have to be renewed every year like SMP. SMP would be my last solution if the BHT fails to the job. Would be BHT a better solution for the donor scar than head hair? My Body Hair is much more dark and thicker than the donor hair. I will ask each doc for some photos of similar cases.

Price is not the determining factor, I will not repeat the same mistake as in the first place this is why I am posting and asking you here and only visiting the most recommended surgeons in western europe.

@ILtrooper

I know that I am lucky given the fact that a technician performed the job although a doctor has been promised, never the less I have to pay a repair procedure which will probably cost me more than 7000,-€ at minimum. As I said SMP will be last solution due to the highest costs of renewing it every year

 

Edited December 18, 2018 by Blub10

[Shera]

Hi, I think you should wait another 6 months to let your hair return to its natural state and then reassess.

As for only taking 1500 grafts, I have seen this numerous times before where a so called minor procedure of 1500 grafts totally ravages the donor area. I'm afraid some clinics take a lot lot more than 1500 grafts, maybe for a number of reasons. One theory being that the more they implant using their crude methods the more chance the paid for amount will grow out. You're not the first to fall for a slick youtube and and certainly won't be the last!

Anyway going back to the repair, if your hair stays the same after 18 months then I would go for about 1200 additional grafts to shore up your hairline which will I'm afraid leave your donor looking slightly more sparse than sparse.

 SMP in the donor area a few months after extraction is one solution you can look at to rectify this.

I can't see the point of removing any of the implanted grafts.

Edited December 22, 2018 by Shera

[Blub10]

Option C does a manual approach. I could ask him for doing the D Approach. But to be honest I really do not want to waste too much head hair for the donor since I will need it for future balding. So maybe 400 Grafts BHT for the scar and 500 Grafts for the front without the removal. As from the BHT perspective I am asking myself what can go wrong despite that it would not cover too much of the Scar. I have some chest and beard hair which I don't need and a lot of straight thin long arm hair (and tons of curly long leg hair). Doctor A said leg hair would a good option which Doctor B and C said is not true

In the front I am really concerned about wrong direction of the hairline.

Which doctors are known most for repairs in europe? I am a bit biased about Turkish doctors after the first result by turkish technicians

Waiting 6 more months is also a good advice

Edited December 25, 2018 by Blub10

[Al - Moderator]

It looks like they took out 3000 grafts to get 1500 good ones which really messed up the donor area, but if I were you I would do nothing. The hairline doesn't look bad to me. It will never be exactly like your native hair was.