Doctor and Strategy Suggestions and Feedback - NW6 Case

[dmtek]

Hi All –

Quick introduction: I'm a 45yr old Asian Indian NW6 residing in California with stable hair loss and do not take any hair loss drugs. I am considering FUE for 4-4.5k grafts on my first procedure with intention to get a natural front hairline with a little density tapering to the mid while sacrificing the crown somewhat. My original hairline has always been quite high (see pics) with hair combed back. I’m ok with being thin on the back for now as I’ve accepted I'll require at least one additional procedure.  Perhaps SMP can help the crown somewhat.  Hopefully the first procedure will allow me freedom to decide on another while preserving the donor area. I'm considering a procedure early next year and am reaching out for further guidance from this great community.

Upon considering cost and doctors, with further research, I realize my original desire to remain within North America and under a certain budget is shortsighted.  I’m interested in ethical doctors who perform majority of the procedure themselves and feel that is reasonable for the price point.  Remaining in California would make logistics quite a bit easier as I could drive vs. flying.  I’m not sure why some of the superstar doctors in LA area aren’t discussed more here.  Some folks mentioned Europe doctors are blockbuster with a lower price point than NA so I am open to that too with an early next year time frame.  My shortlist of doctors include:

1. Hassan & Wong – they have a great reputation but I have found limited patient results to make a better decision.  Their work does appear to be excellent. 
    
2. Dr. Pak – great reviews on all forums with plenty of results. 
    
3. Dr. Vories – I like his direct and no-nonsense approach and use of an implanter pen. His work seems consistent.  
    
4. Dr. Ferudini – great reviews all around with plenty of results. 
    
5. Dr. Konior – also has a great reputation but someone mentioned his costs are around $12 graft which may be out of my budget.  I’ll confirm. 
    
6. Dr. Diep – while a local friend went to him with good results, for some reason his work always appeared good with the exception of the donor area.  That along with a recent experience posted here somewhat confirms my gut feelings. I'll be doing more research.  

I'm definitely open to other doctors as my research is limited.  Thank you to all the forum members for creating such a wonderful environment for everyone to share.  I appreciate any feedback and hope to share my experiences. 

Cheers!

Edited December 8, 2019 by dmtek
Modified

[Sean]

If you need an ethical doctor, ask each of those doctors questions like have you done touch ups To COMPLETELY rectify a situation Where there were (if any) issues for free?  are you about patient satisfaction and ethics?  since this is an elective procedure, what do you provide as a gaurantee for patient satisfaction and safety?

it’s wise not to reveal your total budgets online, by now youve probably gotten messages asking you how folks are ready to help you .

I havent gone to any of the docs you mentioned nor any marketer. However, i know a lot of folks that have went to some of those docs.  
 

H&W does have a large portfolio and have plenty of results.  They are very patient centric and make sure their patients are happy.  Ive actually spoken to Dr Wong before and he really cares for the patient and probably has really high ethics. Dr Nadimi has out out some good work as well it seems.  You even have other doctors that also put out great work that they have a waiting list if 5 years.  So forth so forth. Yaar research it and see who will cater to your goals safely, for your hair type, and what they offer as gaurantee (if they do) to make sure  you are satisifed in the end.  At the end, this is face changing surgery and you should be covered from all ends.

Be careful with smp as well, there is a patient here that is trying to get it removed.  Look at a couple of those threads for limitations as well.  

[Al - Moderator]

Since you are in California and would prefer staying nearby then take a look at Dr Parsa Mohebi and Dr Sanusi Umar. Dr Umar does a lot of extensive balding cases.

 

[Sean]

Whilst no surgery may be the best option, No body hair, nape hair, beard hair should be utilized here.  FUT should be maximized and considered before FUE can be tapped. Transplantedphil made some great points about it.

 Dmtek if you need to see limitations and ever swing by east coast to see just how shit looks like on the scalp, feel free to contact me and i can show you in person and being someone from similar background and hair type.  You’ll probably see how it really is versus any hooked up or paid rep or etc that may try to show you.  You really have to approach this carefully as it deals with your face.  key thing here is your hair type, texture, etc .  

 

[1978matt]

4000+ grafts in one sitting looks unrealistic looking at your donor zone.

A high 'bell shaped' hairline could be possible but there is never going to be enough to fully address that crown.

You might be better off investigating SMP first.  See if you like that and then maybe go for a HT to address the front, for a short cropped look.

[dmtek]

16 hours ago, transplantedphil said:

For higher case NW i'd STRONGLY suggest FUT first (really!), but as youre only interested in FUE ill only comment in respect to that.

You mentioned that you were only interested in doctors that perform the majority of the procedure themselves ... I believe it is required under US law that all docs perform the extractions and incisions themselves so the majority of your list would fit those guidelines naturally.

In terms of ethics Konior (my own surgeon x2) is astoundingly ethical to the point of perfection, but yes I believe he prices FUE at $12 a graft. His protege, Dr Nadimi )whom Sean mentioned) works at the same clinic with the same techs and follows the same protocols, so currently is a steal for a smaller budget and is churning out results better than the majority of her contemporaries who have decades of experience on her. Please bear in mind that 4k of grafts might be a 2 day operation whether you pursue FUE OR FUT if you decide to stay within the US.

The majority of docs you listed (except for one) are indeed the superstars of this industry and Id be comfortable walking into their clinic and letting them do whatever they want to me. As you want 4k grafts for your first session H&W are known as the mega-session kings and so that might be the best option if you wanted it all done within one day, however you should be aware that techs perform the extractions in that instance for FUE (if thats a dealbreaker for you). Having said that Hasson's FUE over the last few years have been consistently impressive to the point of shaming the majority of other clinics. 

If money is an issue I believe Dr Pak offers a more budget friendly option, although Ive seen occasionally issues with yield and suggestions of minimal patient support. The majority of his work though is incredibly impressive and Im a fan. 

Feriduni is awesome. Enough said.

In terms of ethics and results I'd probably add Bisanga to your list if you are looking outside the US, as Ive been increasingly impressed with him and his results are top notch ...I believe he is worth a consult.

Good luck whatever you decide, but if i was to offer any advice dont let budget, geography, or your desired extraction method determine your choice. Every patient has different needs and needs a different approach according to their situation. Consult with a few on your list and see what they suggest, then proceed from there. 

 

 

That is great advice considering my NW level.  I know FUT has come along ways but it seems most pictures of that procedure always leave a terrible scar and I don't know why it's rarely a cleanly shaped curve.  I've been a bit jaded towards FUT.  Do you know if both procedures can be done back to back?  FUT day one and FUE day two?  

Thank you for the additional suggestions.  I'll add Dr. Nadimi to my research list.  

15 hours ago, BeHappy said:

Since you are in California and would prefer staying nearby then take a look at Dr Parsa Mohebi and Dr Sanusi Umar. Dr Umar does a lot of extensive balding cases.

 

I do recall both of those names and know Dr. U is quite adept at BHT.  I'll look at Dr. Mohebi.  

14 hours ago, Sean said:

Whilst no surgery may be the best option, No body hair, nape hair, beard hair should be utilized here.  FUT should be maximized and considered before FUE can be tapped. Transplantedphil made some great points about it.

 Dmtek if you need to see limitations and ever swing by east coast to see just how shit looks like on the scalp, feel free to contact me and i can show you in person and being someone from similar background and hair type.  You’ll probably see how it really is versus any hooked up or paid rep or etc that may try to show you.  You really have to approach this carefully as it deals with your face.  key thing here is your hair type, texture, etc .  

 

Thank you for your cautious notes Sean - I'm slowly learning about this industry and it's somewhat eye opening.  I've only thought of using body hair for the crown down the road. 

2 hours ago, 1978matt said:

4000+ grafts in one sitting looks unrealistic looking at your donor zone.

A high 'bell shaped' hairline could be possible but there is never going to be enough to fully address that crown.

You might be better off investigating SMP first.  See if you like that and then maybe go for a HT to address the front, for a short cropped look.

I've consulted with a doctor who didn't seem as if 4000 grafts would be an issue.  I'll be consulting with a few more and will get their opinions.  As mentioned in my original post, I'm ok with lower density up front to middle and sacrificing the crown with that balding look.  I've heard it is possible to create a natural hair line packing the front and tapering towards the middle.  

[Melvin- Admin]

You are a very difficult case, before you decide to have surgery ask yourself this, will a bad result bother you more than your hair loss? Because after you have surgery you will NEVER be able to return to being a normal bald guy. 

That said, I think you should definitely consider strip first, and I don't think you've searched our forum enough if you think there aren't a lot of hasson and wong reviews. I think they have a ton of reviews on here and examples of cases like yours. Also, I think $12 a graft for Konior is false. Last time I checked he was around $10 for FUE and $8 for FUT. I suggest submitting online consultations to each of these surgeons here for the actual price. Dr. Pak, works with Rassman who actually trained Dr. Diep, as for gut feelings I think you should always choose a surgeon you trust and have faith in, I chose Diep, and so did one of my best friends, and his results at 4 months look amazing. 

 

https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN

[dmtek]

@Melvin-Moderator It's probably safe to say a bad result would bother most of us more than our hair loss.  I think some of my pictures don't completely convey the correct scale of my head as it is on the smaller side with high hair line. 

I definitely need to research a bit more on multiple forums and have reached out to a few doctors for their opinions. 

Here's a case somewhat similar with a lower hair line except my crown is worse.  I wouldn't mind even less density in the front than this fella with similar amount of grafts: 

 

Edited December 9, 2019 by dmtek

[Melvin- Admin]

Well that's not true. Before I had surgery, I figured that my hair had reached rock bottom. I thought, if the procedure doesn't work I will cut my losses and move on with my life. Given your level of hair loss, you need to keep your expectations in check. Looking at the back of your scalp, the crown dips down very far, and I would say you are very close to Norwood 7. I just want to make sure that you are fully informed and educated before you decide on having a procedure.

[dmtek]

Thanks for looking out Melvin.  I'm not expecting to have anywhere near the density as in my before pictures as I mentioned minimal density in my original post.  I figure I'll decide on a second procedure focusing on the the crown with BHT and maybe another 1k for additional density up front/mid if I'm up for it. 

I'm waiting for feedback from a few docs so let's see how it goes.  

Cheers!

 

[dmtek]

Update: looks like I have retrograde alopecia around the ears and on the back of the neck limiting donor supply; silver lining is that it's limited to those common areas and is not the random version called DUPA.  I may need to consider a hybrid FUT+FUE approach.  Will be getting an in-person consult at the beginning of the year.  

On another note, does anyone know more about exosomes?  I know there are a few videos out there on this cutting edge technology.  I'll be doing more research but this seems to be fairly promising yet should be approached with caution.  

https://www.orangecountyhairrestoration.org/services-treatments/xoflo-mesenchymal-stem-cell-derived-exosomes/

[LaserCap]

On 12/7/2019 at 2:25 PM, dmtek said:

Hi All –

Quick introduction: I'm a 45yr old Asian Indian NW6 residing in California with stable hair loss and do not take any hair loss drugs. I am considering FUE for 4-4.5k grafts on my first procedure with intention to get a natural front hairline with a little density tapering to the mid while sacrificing the crown somewhat. My original hairline has always been quite high (see pics) with hair combed back. I’m ok with being thin on the back for now as I’ve accepted I'll require at least one additional procedure.  Perhaps SMP can help the crown somewhat.  Hopefully the first procedure will allow me freedom to decide on another while preserving the donor area. I'm considering a procedure early next year and am reaching out for further guidance from this great community.

Upon considering cost and doctors, with further research, I realize my original desire to remain within North America and under a certain budget is shortsighted.  I’m interested in ethical doctors who perform majority of the procedure themselves and feel that is reasonable for the price point.  Remaining in California would make logistics quite a bit easier as I could drive vs. flying.  I’m not sure why some of the superstar doctors in LA area aren’t discussed more here.  Some folks mentioned Europe doctors are blockbuster with a lower price point than NA so I am open to that too with an early next year time frame.  My shortlist of doctors include:

1. Hassan & Wong – they have a great reputation but I have found limited patient results to make a better decision.  Their work does appear to be excellent. 
    
2. Dr. Pak – great reviews on all forums with plenty of results. 
    
3. Dr. Vories – I like his direct and no-nonsense approach and use of an implanter pen. His work seems consistent.  
    
4. Dr. Ferudini – great reviews all around with plenty of results. 
    
5. Dr. Konior – also has a great reputation but someone mentioned his costs are around $12 graft which may be out of my budget.  I’ll confirm. 
    
6. Dr. Diep – while a local friend went to him with good results, for some reason his work always appeared good with the exception of the donor area.  That along with a recent experience posted here somewhat confirms my gut feelings. I'll be doing more research.  

I'm definitely open to other doctors as my research is limited.  Thank you to all the forum members for creating such a wonderful environment for everyone to share.  I appreciate any feedback and hope to share my experiences. 

Cheers!

i could not get passed the first sentence.  To think you are stable at 45.......I've seen cases where the patient thought the same only to observe years after, this was not the case.  He ended up with a less than natural looking pattern.  OK. I'll give you the benefit of the doubt since you are a strong 6 and do not seem to be demarcating.  

I have homework for you.  Go to the mall and look at the way people lose hair.  Particularly those with patterns similar to yours.  They'll keep a strong forelock, perhaps a bit of hair right behind it, but an empty back.  I would get started with that in mind.  A year later, you can adjust.  At least you'll have a pattern appropriate result.

You indicate you have retrograde.  Unfortunately your hair is shaven and it's difficult to discern.  Grow your hair for 10 days and post. This is a concern particularly since you mentioned the area affected is around the ears.  (That's the area where the finest hair is found.  It is typically where doctors harvest grafts from to work the hairline area).

Why not try medical therapy?  Perhaps you can enhance some of the very miniaturized hairs.  It could help you in the long run.

 

[dmtek]

18 hours ago, LaserCap said:

i could not get passed the first sentence.  To think you are stable at 45.......I've seen cases where the patient thought the same only to observe years after, this was not the case.  He ended up with a less than natural looking pattern.  OK. I'll give you the benefit of the doubt since you are a strong 6 and do not seem to be demarcating.  

I have homework for you.  Go to the mall and look at the way people lose hair.  Particularly those with patterns similar to yours.  They'll keep a strong forelock, perhaps a bit of hair right behind it, but an empty back.  I would get started with that in mind.  A year later, you can adjust.  At least you'll have a pattern appropriate result.

You indicate you have retrograde.  Unfortunately your hair is shaven and it's difficult to discern.  Grow your hair for 10 days and post. This is a concern particularly since you mentioned the area affected is around the ears.  (That's the area where the finest hair is found.  It is typically where doctors harvest grafts from to work the hairline area).

Why not try medical therapy?  Perhaps you can enhance some of the very miniaturized hairs.  It could help you in the long run.

 

 

The term stable was used by a doctor on a consultation.  I've observed enough hair loss in others to understand what you're saying regarding the forelock and I happen to fit into a particular category.  

Medical therapy in terms of Fin, Dut or Propecia or are you recommending another therapy?  I'm not into taking drugs with tough side effects as I tend to run sensitive to these things...I've only taken mixtures of saw palmetto formulated for prostate maintenance and a few other hair targeting herbs.