Best HT surgeons to handle weak donor/DUPA cases?

[giegnosiganoe]

I'm wondering which surgeons people would recommend to handle cases with weak donor/DUPA?

I know Dr Lorenzo has experience, for example this video, plus his many patient videos:
https://www.youtube.com/watch?v=6ixoel0hEQE

It has been difficult to get through to him though. Any other surgeons that have experience with such cases and handle them carefully?

Here are videos of my donor area, for reference:

 

Moving across my donor area: https://www.youtube.com/watch?v=ORUt8UYWHu8

1cm sq of occipital donor area at 3/8 inch length: https://www.youtube.com/watch?v=Qrq9kTotVHM

1cm sq of occipital donor area shaved: https://www.youtube.com/watch?v=KWYYe1KxW-M

Also FYI I'm on dut and min for a bit over a year. I already have salvageable enough density apart from NW3V. I'm mainly looking to improve/strengthen the hairline between NW2 and NW3 for now, but I want to be very careful about the long term.

[Rolandas]

Now i know who was commenting on my YT videos for a while now!

I'm really impressed the length you went to record your donor area.

Sorry this doesn't help your case I guess. I would personally trust Dr. Lorenzo the most as he has extensive experience with it.

 

[giegnosiganoe]

5 hours ago, Rolandas said:

Now i know who was commenting on my YT videos for a while now!

I'm really impressed the length you went to record your donor area.

Sorry this doesn't help your case I guess. I would personally trust Dr. Lorenzo the most as he has extensive experience with it.

 

You caught me  keep up the vids man, you're one of a kind!

Yep, unfortunately I don't have any good surgeons near me to see in person, so I ordered a microscope to examine things myself.

I'd love if someone was experienced with such cases in the USA, but it seems not too many people take it seriously. I know Rassman and Bernstein wrote about the condition and would likely have some good insights, but I don't think they have the best results.

[Melvin- Admin]

I would caution against having a hair transplant if you have DUPA. 

[giegnosiganoe]

Does it not sound like I'm being cautious?  

[Melvin- Admin]

Have you been diagnosed with DUPA? Or are you being cautious? If you’ve been diagnosed, I would get a couple of opinions, and if they all say DUPA, personally I wouldn’t pursue an HT.

[Mike_2020]

16 minutes ago, Melvin-Moderator said:

 if they all say DUPA, personally I wouldn’t pursue an HT.

Not that I know anything in particular about DUPA, but out of curiosity, why is this?

 

[Melvin- Admin]

9 minutes ago, Mike_2020 said:

Not that I know anything in particular about DUPA, but out of curiosity, why is this?

 

DUPA means diffused unpatterned alopecia, which means all of the hair on the head is susceptible to thinning. For hair restoration to work, there needs to be a permanent donor zone, which is the back and sides of the scalp.

If you have thinning all over the scalp, you may transplant weak and vulnerable hair, and end up losing the transplanted hair, while revealing scars in the donor. Personally, I don’t think surgeons should accept these cases.

There are some surgeons who accept these patients on the basis of mandatory finasteride use, but finasteride doesn’t stop hair loss entirely, it slows it down, so the transplanted hair may still be affected regardless. 

[giegnosiganoe]

1 hour ago, Melvin-Moderator said:

Have you been diagnosed with DUPA? Or are you being cautious? If you’ve been diagnosed, I would get a couple of opinions, and if they all say DUPA, personally I wouldn’t pursue an HT.

I've been told that my donor is clearly prone to miniaturization, but that I wouldn't be classified as DUPA yet. I don't quite understand the distinction myself.

Most doctors haven't declined me, but some think there is a level of risk involved. Those who feel confident moving forward have said they can cherry-pick the highest quality grafts.

Edit: I have an in person consultation with Rosanelli soon, who said he could assess my donor, so hopefully I learn more from that. I know he rejected this patient:

 

Edited September 1, 2020 by giegnosiganoe

[Melvin- Admin]

Can you share pictures of your donor? Are you currently on finasteride?

[Mike_2020]

9 hours ago, Melvin-Moderator said:

while revealing scars in the donor. 

Would this particular point relate specifically to FUT, or also to FUE or DHI?