HT - thoughts? (Held consultation with B Ferreira today)

[Antse7en]

Hi all,

Keen to get views from people on this forum please.

I’ve been suffering hair loss for 6-7 years, relatively minor but extremely impactful to me and my overall confidence levels as I know you all understand and appreciate.

I’ve been on both 1mg finasteride and 5% minoxidil for over 5 years. No sides from the finasteride thankfully. Various vitamins and tablets, the usual.

Held a consultation with B Ferreira today - he suggests 1500-2000 grafts to reimplement my hair line and add density to the crown area. He also suggested I could consider switching from generic finasteride to Propecia.

I had originally sent pictures to Dr Feriduni (5+years ago) who advised against a HT at the time “due to the high existing density in your recipient area, there is too much risk for a postoperative and maybe permanent shock loss at this stage”.

Here’s my question. Who are the other highest rated surgeons in Europe please? Particularly those focused on the aesthetics. I see so many names and conflicting views.

Money wise I have budgeted for a maximum of 10k all in.

Thanks everyone 

[Britanium]

Dr Bisanga, Dr Freitas, Dr Lorenzo and Dr Pinto would be some more decent European Names you could consider. I would say Couto if you can wait for up to 2 years 😳
@DrTBarghouthialso 🙏

Edited March 22, 2021 by JohnAC71

[ITA]

also Feriduni, in Belgium.

[Raphael84]

You have retained a good amount of native hair and in general appear to be in a relatively good position. You really shouldn’t rush into any procedure and my advice is that you really should consult with your preferred doctor in person before committing to surgery.

It’s positive that you have a medical regimen and have hopefully stabilised your native hair.

Placing grafts amongst native density does present more risk of shockloss, and for this reason I would recommend having your doctor assess your hair and scalp under magnification to rule out or have an understanding of any such risk, and inform you accordingly, allowing you to make the appropriate decision.

May I ask your age?

Best of luck.

Edited March 22, 2021 by Raphael84

[Antse7en]

36 minutes ago, JohnAC71 said:

Dr Bisanga, Dr Freitas, Dr Lorenzo and Dr Pinto would be some more decent European Names you could consider. I would say Couto if you can wait for up to 2 years 😳
@DrTBarghouthialso 🙏

Thank you

13 minutes ago, Raphael84 said:

You have retained a good amount of native hair and in general appear to be in a relatively good position. You really shouldn’t rush into any procedure and my advice is that you really should consult with your preferred doctor in person before committing to surgery.

It’s positive that you have a medical regimen and have hopefully stabilised your native hair.

Placing grafts amongst native density does present more risk of shockloss, and for this reason I would recommend having your doctor assess your hair and scalp under magnification to rule out or have an understanding of any such risk, and inform you accordingly, allowing you to make the appropriate decision.

May I ask your age?

Best of luck.

Yes of course, 32.

I think in all honesty, I am mostly concerned with the hairline and in particular the corner recession. Crown wise I would be happy to leave it alone for now given the potential risk element.

Fully agree with a face to face consultation,  ideally I would like a 2-3 person shortlist and see them all.

[DrTBarghouthi]

I echo your concerns. I think with such a pattern, I would personally delay any crown work (given age and current diffuse pattern) and focus on frontal and possibly mid section areas. Maintenance is a must too. What sort of family history exists?

[Curious25]

Your hairline looks good as it is - goes well with your current hairstyle and head shape. 
 

A skilled surgeon may be able to add density to your crown, 

[Gatsby]

Personally I think your current hair status looks great. Your hair styling really supports your hair. If your hair loss has stabilized have you thought of SMP to give the illusion of more density? I also agree with Dr Ferreira that switching from a generic to Propecia may give you an added benefit. I have read about using a generic compared to Propecia itself. Dr Lupunzula is another surgeon to look at. All the best.

[j1mmy]

Yeah, I don't say this lightly since many people might feed you this on the forum. But, 99,9% of people would have no idea you were balding. I can see what you mean, but your hairline is natural, your curly hair suits not being super dense. The only "tell tale" right now is the tinning crown. 

Have you tried derma-rolling, or laser cap? You are diffuse, but have so much hair, that you just need another minoxidil-like product to kick up the density. 

I am having surgery with Dr. BF in two weeks, and I spoke to Feriduni 5+ years ago like you. When Feriduni turned me away for the same reasons, I definitely had less density than you do now. I still think Dr. F is a top, ethical doctor, and he had a good point, we are/were not good candidates. I have significantly more recession and more thinning than you now, 10 years later, so it is the right time for me to go that route.

[Antse7en]

Thanks all for your comments. A few things to think about. 

[Melvin- Admin]

I wouldn’t do anything, definitely don’t need an HT at this time. 

[ciaus]

1 hour ago, Melvin-Moderator said:

I wouldn’t do anything, definitely don’t need an HT at this time. 

I agree, a HT doctor couldn't draw these hairline borders better, and if he tried to bring them down and forward it wouldn't look natural. Not sure what you mean when you said Dr Ferreira "suggests 1500-2000 grafts to reimplement my hair line" -does he mean add density to your hairline? Like others have said, you still have enough hair all over that you risk losing some of it from shockloss caused by the surgery.

There is some diffuse thinning on the top, but its harder to gauge how much because you are combing your hair back and upwards, and using some styling product it looks like. Both of those factors are going to expose more of your scalp. You could use a little concealer, like toppik and/or dermmatch, and look great for years until your actual loss progresses enough to where you can have a really impactful transplant that won't risk your existing hair.

 

 

[asterix0]

Why did Dr.Feirrera suggest brand name Propecia might be more effective than generic Finasteride?

[AronnRoi]

My first post here, and needed to write it. Antse7en your hair looks fine. Moreover a lot of can dream about such a density. Be happy and do not think about it.

Edited March 24, 2021 by AronnRoi

[ciaus]

On 3/23/2021 at 3:29 PM, asterix0 said:

Why did Dr.Feirrera suggest brand name Propecia might be more effective than generic Finasteride?

Probably quality control, but that's alot of extra cash over time to be parting with. I cut 5mg generic finasteride into quarters primarily for the cost savings, but also because each dose is then 1.25mg. So if there is some degradation or potency issue with that pill I'm still getting more finasteride per dose than someone with a degraded 1mg pill.  

https://www.wolfhair.com/wp-content/uploads/2016/02/Brand-Name-vs-Generic-Finasteride-Jan-Feb-2016.pdf

 

[Melvin- Admin]

I’m interested to see how your hair looks a little longer and dry, bet it looks 10x better.

[Britanium]

Your hair does look good already. Can you post some pics with no product in ? And yes be interested to see it a bit longer also as Melvin mentioned. Thanks 🙏 

[SD1984]

a hair transplant????? Shoot about 1 spray of fibers in each temple and don't think about surgery for another 5 years, minimum. 

[hairman22]

id look into smp if i was you

[Antse7en]

Hi guys thanks all again for the comments.

I’m just coming back to a few specific points now.

On 3/23/2021 at 3:38 AM, DrTBarghouthi said:

I echo your concerns. I think with such a pattern, I would personally delay any crown work (given age and current diffuse pattern) and focus on frontal and possibly mid section areas. Maintenance is a must too. What sort of family history exists?

By diffuse is this something I should be concerned about in terms of potential candidacy for a HT? I’m afraid my Dad passed away at 37, so I’m unsure beyond that point however he was most definitely thin all over the top of his head by that age.

On 3/23/2021 at 6:24 AM, Gatsby said:

Personally I think your current hair status looks great. Your hair styling really supports your hair. If your hair loss has stabilized have you thought of SMP to give the illusion of more density? I also agree with Dr Ferreira that switching from a generic to Propecia may give you an added benefit. I have read about using a generic compared to Propecia itself. Dr Lupunzula is another surgeon to look at. All the best.

Can you tell me how you see SMP fitting in please? It’s not something I know too much about and thought it was only for the look of a shaved head/illusion.

I will be switching to Propecia - financially I’m lucky I’m able to so figure why not? 

On 3/25/2021 at 4:02 PM, Melvin-Moderator said:

I’m interested to see how your hair looks a little longer and dry, bet it looks 10x better.

Not longer I’m afraid (just cut it) however I’ve attached some pics with no product. I’ll attach one with my hair a little longer (but please keep in mind I am not at all comfortable with longer hair - it’s a little OCD almost). 

42 minutes ago, hairman22 said:

id look into smp if i was you

Again I’d love to understand a bit more about what you think could work there? Thanks!

To everyone else thank you for your comments once more, I know I’m not in a bad position but it’s all relative right - for me it’s enough degradation that it does significantly impact my self confidence and I critically obsess over it. (I examine everyone’s hair during conversations for example, if that makes sense. Same thing on TV. It’s all I think about as relative to where I was approx 5 years ago it’s a huge difference which I really find hard to accept.

[ITA]

For me, you don't need any transplants.

[Britanium]

looking at these pics with dry hair and no product then I would say you do not need a hair transplant at all. That’s a very nice head of hair indeed. Excellent density 👏

[j1mmy]

You are doing absolutely the best thing being on fin/min. Are you consistent? Are you using minoxidil on the crown?

My opinion is your hair looks better slightly longer (in these pics), and if you have to use product don't use wet products. 

A surgeon could disagree, but my understanding is that your hair density is essentially higher than the limitations of what transplants try to achieve. The only area diffuse enough is maybe placing 500 grafts near the crown. If it was me, I would absolutely not consider a transplant right now. Try some toppik or dermmatch to help you go outside feeling confident.  

[Antse7en]

1 minute ago, j1mmy said:

You are doing absolutely the best thing being on fin/min. Are you consistent? Are you using minoxidil on the crown?

My opinion is your hair looks better slightly longer (in these pics), and if you have to use product don't use wet products. 

A surgeon could disagree, but my understanding is that your hair density is essentially higher than the limitations of what transplants try to achieve. The only area diffuse enough is maybe placing 500 grafts near the crown. If it was me, I would absolutely not consider a transplant right now. Try some toppik or dermmatch to help you go outside feeling confident.  

Completely consistent. Haven’t missed a drop (evenings before bed) or 1mg (mornings) since first starting years ago.

What is dermmatch and how does it help please? (Naturally I’ll Google in a second) 

[DrTBarghouthi]

11 minutes ago, Antse7en said:

Completely consistent. Haven’t missed a drop (evenings before bed) or 1mg (mornings) since first starting years ago.

What is dermmatch and how does it help please? (Naturally I’ll Google in a second) 

Yes with the first photos I may have sensed some more diffuse thinning. In such cases we usually delay any transplant until a clearer pattern is seen or until things stop progressing and then you can add some density. HOWEVER, with the recent photos you posted, I do think that nothing should be done at this stage medically apart from maintenance.