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Hair loss getting worse (on Big 3), weak donor area. What are my options?

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No disrespect intended Melvin (especially given we were thinking of the exact same case regarding Konior's operation on Nick1111), but biceps said;

1) he saw both Rosanelli and Diep for an in person inspection (within the same month) and was rejected only by Rosanelli.

2) The "tech-driven turkish clinic" he was rejected by was Asmed who are known for their donor management

3) Biceps provided a multitude of photos at different lengths, both wet and dry

When a patient has a weak donor such as Biceps appears to have, to undergo a HT they are essentially walking a tightrope between sacrificing what little remains of their donor for but a modest improvement in their recipient (which in itself might not be long term if Biceps has a condition like DUPA). So even in a best case scenario the rewards do not appear to be worth the risks. For a doctor to dismiss such concerns and seemingly not explain any of this is highly problematic - if it is indeed what happened.

In terms of advice Biceps I probably wouldnt get a HT in your case (as much as it sucks), but if you really wanted the peace of mind it might be worth exhausting all your options first. Try all the medical therapies for a year, take lots of photos to document things (same lighting, same length over time), then try some more in person inspections and get properly assessed. I personally found using concealers like toppik a good and bad thing - good as in its nice to have a full head of hair, but it also became a daily ritual that i hated and built up an unrealistic expectation of what i should look like rather than just accept who i was. Whatever you decide I wish you luck buddy :)

 

 

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On ‎12‎/‎13‎/‎2019 at 6:58 PM, Biceps said:

I see. Would a dermatologist perform this? I've gone to two HT surgeon consultations and I don't believe they did anything like this (for the donor area).

No, a dermatologist would not be ideal to do this type of exam, you need to find an experienced HT surgeon who performs this type of evaluation on all of their patients prior to enrolling them for any procedure.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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I would seriously suggest to have in person consultation with DR Konior. I had the same exact problem when I sent my pictures to Dr Konior initially. But when I had in person consultation, things went better than I expected.  Finally, I had a surgery with 2500 grafts (approx).  Dr. Konior used  combination of small strip(FUT) and some FUE.

It got only possible when he checked my hair physically.

Recently, I had another consultation with doctor for a 2nd surgery  where he suggested me the plan to get combination of FUE scalp (very small number to define the base ) + Beard Hairs + some chest hairs. (Totaling around 1500-2000 grafts).

So in nutshell, don't loose hope as you still may have option to use body hairs and combining multiple ways(FUT+ FUE) to get desired quality grafts. I would strongly suggest to meet Dr. Konior.

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10 hours ago, nick1111 said:

I would seriously suggest to have in person consultation with DR Konior. I had the same exact problem when I sent my pictures to Dr Konior initially. But when I had in person consultation, things went better than I expected.  Finally, I had a surgery with 2500 grafts (approx).  Dr. Konior used  combination of small strip(FUT) and some FUE.

It got only possible when he checked my hair physically.

Recently, I had another consultation with doctor for a 2nd surgery  where he suggested me the plan to get combination of FUE scalp (very small number to define the base ) + Beard Hairs + some chest hairs. (Totaling around 1500-2000 grafts).

So in nutshell, don't loose hope as you still may have option to use body hairs and combining multiple ways(FUT+ FUE) to get desired quality grafts. I would strongly suggest to meet Dr. Konior.

Great advice man, thanks for chiming in. There is no replacement for in-person consultations. I hope you document your second surgery, as I feel that your example will be a great hope for a lot of guys out there. 


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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Hi all, 

So I consulted with a few other doctors. 

Rassman

Quote

Dr. Rassman said that my donor area could be fine because my donor area has coarse hair. He asked me to buy a magnifying lense, send him a picture, and reevaluate based on a blog post he wrote https://newhair.com/baldingblog/how-to-quantify-your-donor-area-hair-supply/

It appears Dr. Rassman is not doing procedures himself though, but delegating through Dr. Pak?

 

Rahal

Quote

"Dr. Rahal reviewed your file and photos and he feels that is hair transplant is not the best option for you. With hair restoration, Dr. Rahal evaluates your donor supply (on the back & sides of your head) relative to your current & potential future hair loss. You have an advanced pattern of hair loss and many areas that require coverage. Your donor supply is very limited. Therefore, Dr. Rahal does not feel we can offer significant improvement with a procedure. Surgery is not the best option for you."
 

Vories

Quote

Dr. Vories quoted me a 3000 FUE graft procedure, with 1500 grafts in the frontal forelock/hairline, and 1500 grafts to the vertex. I have concerns because:

1) The consult was done through webcam and the software was putting out what looked like 720p resolution. No pictures were asked to be provided.

2) I brought up the fact that multiple doctors have rejected me for a weak donor area but he did not say much besides that he was confident he could extract 3000 grafts from my donor.

 

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12 hours ago, nick1111 said:

I would seriously suggest to have in person consultation with DR Konior. I had the same exact problem when I sent my pictures to Dr Konior initially. But when I had in person consultation, things went better than I expected.  Finally, I had a surgery with 2500 grafts (approx).  Dr. Konior used  combination of small strip(FUT) and some FUE.

It got only possible when he checked my hair physically.

Recently, I had another consultation with doctor for a 2nd surgery  where he suggested me the plan to get combination of FUE scalp (very small number to define the base ) + Beard Hairs + some chest hairs. (Totaling around 1500-2000 grafts).

So in nutshell, don't loose hope as you still may have option to use body hairs and combining multiple ways(FUT+ FUE) to get desired quality grafts. I would strongly suggest to meet Dr. Konior.

Thank you for sharing. Dr. Konior recommended an in-person evaluation rather than just flat out rejecting me which was heartening. After looking at your weak donor area and your great results, I was also thinking - if Dr. Konior can do it why can't all these other doctors? Why do they choose to reject instead of requesting an in-person consultation? 

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4 hours ago, Biceps said:

Hi all, 

So I consulted with a few other doctors. 

Rassman

 

Rahal

Vories

 

It appears that you are getting mixed results submitting photos online. It appears that a few renowned surgeons have turned you away, and a few have said you could have surgery. At this point, if you are serious you will start visiting surgeons in person. 


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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7 hours ago, Biceps said:

Thank you for sharing. Dr. Konior recommended an in-person evaluation rather than just flat out rejecting me which was heartening. After looking at your weak donor area and your great results, I was also thinking - if Dr. Konior can do it why can't all these other doctors? Why do they choose to reject instead of requesting an in-person consultation? 

Not all docs are created equal, not all docs can take on difficult cases, and some docs actually want to inspect someone before making a decision that will effect their patient for the rest of their lives. Whether or not it is the right choice comes down to a serious discussion about the limitations of surgery and the expectations of that patient.

In Nick's case I believe Konior did a FUT/FUE combo with the intention of adding body hair at a later date (?), so I would assume DrK is just doing his due diligence. It's also worth mentioning that not every clinic offers FUT and FUE and some don't offer body hair transplantation at all, as every clinic is run differently and every patient has different needs.

5 hours ago, HairGone29 said:

what would cause someone to have a weak donor? I thought in even the baldest of men the back and sides tend to remain.

DUPA is one where the pattern of balding is "Diffuse" and "Un-Patterned" (thus the acronym) and occurs everywhere - even in the donor zone.

Or say if you were progressing to a NW7 but still had miniaturised hairs in the donor zone then transplanting those hairs would be redundant long term as they would eventually fall out and the donor zone would be left scarred. Im sure there are other conditions as well. 

 

 

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I cannot emphasize enough the importance of having an "in-person" examination.  Photos help but do not provide the needed basis for an accurate evaluation.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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If after the in-person consultations it turns out your donor is suspected to be too weak for a hair transplant, then you are facing two options:

1. Look like a normal bald guy with a shaved head and a proper look.

2. Going for the hail mary and risk ending up in a position where people turn their heads to stare at you because you look like an accident.

I'm sorry I have to put it that harshly. But sometimes it needs to be done.

Think of it like this: you could have lost a leg or an arm. You could be born with a life limiting disease. You could have a disease that will kill you in a year.

You are healthy and you have a good headshape. Things could be worse.

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I agree...it's all a matter of perspective and many times it's hard to appreciate something until you lose it.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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So buzzed my head down to see what I would look like... not a fan. Gonna be awhile before I can use Toppik again haha. Still slowly getting evals from different docs. 

 

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I also don't have the best donor (retrograde thinning and donor hair is a bit sparse..), and it seems like you're in NorCal as well. I'll be following your updates. I think you look good with the buzz btw. It's surprising how much more hair it looks like you have when it's cut that short. I'd try it out if I wasn't blessed with a cro-magnon skull 😛

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Sometimes less looks like more when buzzing down...I also think the buzz cut looks good on you Biceps but maybe try to wear it a tad bit more longer like a number 1 guide?

 


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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On 12/12/2019 at 7:25 AM, CosmoKramer said:

Try microneedling in addition to the Big 3...you may get some nice results....check out my microneedling thread in the Open Topic section.

An example of someone whom got some nice regrowth in photo below.

97B3D5D4-80E7-46E4-8C57-11B9D9460038.jpeg

It is impressive how fast the results are.
From my personal experience, Dr gives 50% more hair growth. When I added DR, I increase my hair density and hair thickness and both decrease when I stopped (even if I was on fina, minoxidil and PRP)

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On 2/3/2020 at 10:48 PM, giegnosiganoe said:

I also don't have the best donor (retrograde thinning and donor hair is a bit sparse..), and it seems like you're in NorCal as well. I'll be following your updates. I think you look good with the buzz btw. It's surprising how much more hair it looks like you have when it's cut that short. I'd try it out if I wasn't blessed with a cro-magnon skull 😛

 

On 2/4/2020 at 9:37 AM, gillenator said:

Sometimes less looks like more when buzzing down...I also think the buzz cut looks good on you Biceps but maybe try to wear it a tad bit more longer like a number 1 guide?

 

I appreciate that guys. @gillenator the problem with wearing it longer is, the density difference between the sides and top become much more apparent at longer lengths. 

I could probably live with the buzz, though I'd want to add SMP.

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Got in contact with Dr. Konior. He has a $400 in person consultation fee which seems extremely high to me.

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On 2/5/2020 at 4:33 PM, Biceps said:

 

I appreciate that guys. @gillenator the problem with wearing it longer is, the density difference between the sides and top become much more apparent at longer lengths. 

I could probably live with the buzz, though I'd want to add SMP.

IMHO, SMP would definitely help provide a more uniform visual density.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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Update after speaking with 3 doctors:

Rassman: Dr. Rassman asked me to take photos of my donor area using a microscope, based on these instructions: https://newhair.com/baldingblog/how-to-quantify-your-donor-area-hair-supply/ . During our call, he noted that I have "Thick donor hair, many triplets, and 20% better donor area than other Asians he's worked on". Will be meeting him in person to clarify, as this goes against what many other doctors have said...

Diep: Saw Dr. Diep again as I am local. I asked him about Rassman's comments, and he noted that while the back of my head is strong, my sides are weak (at least visually, I can confirm). He quoted 2000 - 2500 grafts FUE, but I have misgivings about this number being worth the surgery, given that other Diep FUE patients at that graft amount had frontal hairline recession rather than the large diffuse thinning I have:

 

 

Konior: Dr. Konior neither approved or rejected me, and I asked for an in person consultation. He has a $400 consultation fee which I find odd considering no other doctor has had such a fee. I don't know if its worth the $400 to see him, especially since I have to fly to Chicago.

Edited by Biceps

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I had no idea he had a $400 consult fee...is this a trend?


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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