Need help in taking a decision

[Lucian]

Hi everyone, 

 

For some time i am struggling with hair loss. I am 27 years old. I have used minoxidil in the past and have had great results but for some reason i stopped using it and hair loss reverted. I started again using Minoxidil, i am on it for seven months now but this time no hair has grown back. I started to interest in a hair restoration procedure. After hours/days of searching i decided to  contact two clinics in Turkey. One is ASMED and the other one is Dr. Resul Yaman. Now things start to become fuzzy to me. ASMED clinic told me that at the moment i have more miniaturized hair than hair loss so i should use Finasteride because a hair transplant now will affect my already thin hair and i should wait more years. Bottom line is that ASMED denied the surgery.  Dr. Resul Yaman clinic on the other hand told me that i will need 3500-3700 grafts and that i am a valid candidate.

I would really appreciate any support in making a decision as now i really don t know how to proceed next, there are two completely different opinions from two well known clinics.

[Gatsby]

Lucian. Thanks for posting and sharing your situation. If a hair transplant surgeon rejects you at the age of 27 then definitley take that on board! You may very well be thanking him one day. Give Minoxidil more time. Definitely commence Finsteride and if you have no side effects then give it a good 6-12 months before making a decision about proceeding with a hair transplant. My final bit of advice is FORGET TURKEY. Their are too many bad results that do not justify the odd (lucky) good one due to how surgery is performed (or not performed) there. Start looking at hair transplant surgeons recommended by this forum and from patients who are in a similar situation as you and have successfully realized their realistic goals. All the best and keep asking questions!

[jc80220]

Gatsby's post confuses me. I thought generally Turkey was considered the place to go and English clinics are garbage? Only forum I've ever used is hairlosstalk and only just found this one.

And to the OP, you look to me like you have the kind of hair most guys are would be thrilled to have after a transplant. Definitely seems too soon for you.

[Lucian]

Many thanks to everyone for replying. I am a bit confused also because Dr. Resul Yaman is the only doctor recommended by this forum in Turkey. So i will stick to using Minoxidil for now. I am too afraid of the side effects of finasteride to start using it. I started using Biotin and Saw Palmetto, biotin for hair strength and saw palmetto some studies say that is a natural DHT blocker. Will see as time passes if something changes. 

[aaron1234]

Fin is more effective than minox.  Asmed was right to tell you that you have lots of miniaturized hair, so a HT at this point would risk substantial shock loss.  If you're too afraid to try Fin then you can anticipate the miniaturized hair on your head falling out sooner than later. 

[Raphael84]

@Lucian It can be somewhat confusing when surgeons who you may be considering provide really quite conflicting information and recommendations. But it is quite common. Surgeons have their own ideas, approaches, comfort levels, some are by nature more careful.

Looking at your photographs, you appear to have more of a diffuse pattern of loss as opposed to more specific area of recession or thinning. In patterns of loss such as your own and considering your age, things can progress reasonably quickly as the area of thinning is general.

Whether to begin using finasteride or not is a very personal decision. Topical finasteride is an option that many individuals feel more comfortable using, as serum DHT is much less affected, whilst scalp DHT is restricted even more so than with oral. It is something to perhaps consider.
In my experience, patients who are extremely reluctant to use finasteride due to concerns of side effects, generally will experience side effects. Patients who have been given placebo pills in studies, have reported side effects. This shows that psychosomatic symptoms are very real. 

Scenario -

a) If you were to place 3500 grafts throughout your scalp whilst maintaining your current density, I would imagine that you would be pleased. 

b) If you were to place 3500 grafts throughout your scalp and lose much native hair due to shock loss as without medication your native hair is unstable, you would not be pleased.

But also please consider the next scenario which is longer term, even if scenario a) was reality, without medication you would continue to lose your native hair and would eventually arrive at scenario b) regardless.

In your case, medication should be seriously considered before proceeding with surgery. Dont rush into anything.

[Portugal25]

@Lucian you have selected two really bad options.

ASMED is a expensive Turkish Hairmill with technicians operating on up to 8 patients per day. They were kicked out of HRN because of unethical behaviour towards patients that are HRN members.

Yaman has several botched results on HRN and other foruns.

Turkey is the world capital of botched hair transplants because it`s mostly all inclusive hairmills or low cost doctors both using underpaid technicians without any medical background (former taxi drivers or dishwashers) to do your surgery.

Ofcourse there are also good options in Turkey but from what we have concluded at HRN only HLC Ankara is a safe bet in Turkey. Here you have a Doctor doing your whole surgery using a highly skilled technique but the price goes to 2.5€/graft.

If you are looking for a low cost option you should consider Dr. Demirsoy at 1.25€/graft but be warned that he does pre-made slits and has technicians do the implating phase. However, he does only have 1 patient per day.

Edited October 1, 2020 by Portugal25

[Curious25]

Great little table of comparison there Portugal . . I didn’t realise how price competitive the Spanish doctors were! 
 

I have no idea how or where any clinic would be able to fit 3500 grafts on you OP. 
 

You may benefit from laser and prp therapy alongside Minoxdil - could be worth looking into. For now, hold off on the Idea of HT’s. Your hair colour/skin colour contrast isn’t too severe, hairlines still solid, and I’d bet that the majority of people wouldn’t even realise you’re thinning. 
 

There’s a lot worse positions to be in. 

[Lucian]

Many thanks to everyone for your support. Really appreciate all the support. After reading everything i will start taking a small dose of Finasteride and see how it goes. @Portugal25 thank you very much for that table. I will postpone the implant operation for the moment. 

[Portugal25]

@Lucian that’s truly the best decision!

You don’t need a HT and after 6 months of Finasteride you will most likely see a increase in density on your crown. Take Finasteride 3x/week as I had Doctors tell me it’s more than enough. 

You should also consider spraying minoxidil every night.

Wish you all the best!

[Kaya]

1 hour ago, Portugal25 said:

@Lucian you have selected two really bad options.

ASMED is a expensive Turkish Hairmill with technicians operating on up to 8 patients per day. They were kicked out of HRN because of unethical behaviour towards patients that are HRN members.

Yaman has several botched results on HRN and other foruns.

Turkey is the world capital of botched hair transplants because it`s mostly all inclusive hairmills or low cost doctors both using underpaid technicians without any medical background (former taxi drivers or dishwashers) to do your surgery.

Ofcourse there are also good options in Turkey but from what we have concluded at HRN only HLC Ankara is a safe bet in Turkey. Here you have a Doctor doing your whole surgery using a highly skilled technique but the price goes to 2.5€/graft.

If you are looking for a low cost option you should consider Dr. Demirsoy at 1.25€/graft but be warned that he does pre-made slits and has technicians do the implating phase. However, he does only have 1 patient per day.

This is an awesome work, great list Portugal!

I did not know Asmed was kicked out of HRN. I know that they were not getting good results last couple of years but was there more than that? What happened? Any links?

[Portugal25]

5 hours ago, Kaya said:

This is an awesome work, great list Portugal!

I did not know Asmed was kicked out of HRN. I know that they were not getting good results last couple of years but was there more than that? What happened? Any links?

Here`s the thread were Melvin said ASMED has been removed from the HRN community: 

Below the patients that were treated unethically by ASMED:

 

 

Edited October 1, 2020 by Portugal25

[Raphael84]

@LucianThis is your thread and so if the response from users has assisted you in your decision to postpone surgery for the time being and consider a regimen of medication, then this thread has already been very valuable for you. That is great and I believe it to be the right decision for you.

2 hours ago, Portugal25 said:

 

In terms of the above table @Portugal25, patients have already commented on its value to them. That is nice to hear.

As Dr. Bisanga is listed, if you could kindly correct pricing information that would be appreciated and more accurate for patients also.

At BHR the tiered system or charging x for the first 1000 grafts and then different pricing afterwards is a dated system that Dr. Bisanga has not used for some time.

Standard pricing for surgery with Dr. Bisanga in Brussels is €4.00 per graft. In Brussels, Dr. Bisanga will punch all extractions sites and make all recipient sites.

We always recommend individuals to reach out to the clinic and have a personal assessment which will allow Dr. Bisanga to understand any unique challenges and offer a thorough summary of recommendation, including associated pricing. This ensures accurate and relevant information on an individual and personal basis as some cases may be subject to unique costing such as a complicated repair case for example.

@LucianAgain I wish you the best of luck. I hope that you respond well to finasteride and if so, may not even feel the need to consider surgery. Keep us all updated.

[Lucian]

Thanks to all very much for the support🙂. I will update after several months with the results from finasteride and minoxidil.