Advice/opinion required for my first HT

[Britanium]

Just now, MrMJ said:

I am thinking of consult Dr Reddy face to face and get his opinion. I think that will give me a good picture 

Good idea. Be great to get a opinion from a Dr face to face. 

[MrMJ]

4 minutes ago, Helios said:

Agree with John. Since donor management is so important in this case I would consider asking HDC clinic what their opinion is on your case.
 

That’s of course only a personal recommendation and your choice of surgeon is your decision alone. 

Thank you. I will give a call to HDC and see

[Britanium]

2 minutes ago, MrMJ said:

Thank you. I will give a call to HDC and see

A HDC rep is also on the forum @Doron Harati

[MrMJ]

I just received an email from Dr Bisanga’s clinic and they think 3500-4500 grafts... However, recommend me to come to Brussels and meet the Dr.

[MrMJ]

1 minute ago, JohnAC71 said:

A HDC rep is also on the forum @Doron Harati

Many thanks 🙏 

[MrMJ]

4 minutes ago, MrMJ said:

Many thanks 🙏 

Just sent a message to @Doron Harati

[Britanium]

Just now, MrMJ said:

Just sent a message to @Doron Harati

Always good to consult with as many decent clinics as you can. HDC have done some really good Norwood 5/6 work 👌 

[Helios]

24 minutes ago, MrMJ said:

Just sent a message to @Doron Harati

Excellent decision. HDC are experts at higher norwood levels which is why they are recommended. Simply listen to their opinion and then you can see which clinic or doctor you think is best for you.

[MrMJ]

4 minutes ago, Helios said:

Excellent decision. HDC are experts at higher norwood levels which is why they are recommended. Simply listen to their opinion and then you can see which clinic or doctor you think is best for you.

Thank you 🙏 

[j1mmy]

It's important to pick a good Dr, which you are doing your due diligence with, but it helps to be as educated as you can be so that your expectations are as accurate as they can be. That way you don't need one place to tell you 2000, another place 4000, and not know why there is such a discrepancy. A hair transplant is an illusion of density, and can never look as full as a full head of hair. For that to be possible, you would probably have to remove every hair on the back/sides of your head and place them on top.

If you look at for example Dr. Lorenzo on youtube who has hundreds of patient cases, positive and negative, you can find patients similar to yourself to get an idea of how many grafts can do what. This does not take into account hair thickness, colour, curls vs straight, but you will see that you usually require more grafts than you think you will. You will see that many of the higher hair loss scale patients were 3-5 surgeries, and sometimes up to 10000 grafts to get an ok coverage. You will see that often patients are most often recommended to focus on the frontal half of the scalp first, which might be 2500-4000 grafts for you, and a second surgery to focus on the crown.

All of this is just to say, educate yourself to know what you want, 4000 grafts is not going to get you a head of hair like you used to have. It might get you the illusion that the frontal 2/3 is decent, or the back 1/3 is decent.

[MrMJ]

4 minutes ago, j1mmy said:

It's important to pick a good Dr, which you are doing your due diligence with, but it helps to be as educated as you can be so that your expectations are as accurate as they can be. That way you don't need one place to tell you 2000, another place 4000, and not know why there is such a discrepancy. A hair transplant is an illusion of density, and can never look as full as a full head of hair. For that to be possible, you would probably have to remove every hair on the back/sides of your head and place them on top.

If you look at for example Dr. Lorenzo on youtube who has hundreds of patient cases, positive and negative, you can find patients similar to yourself to get an idea of how many grafts can do what. This does not take into account hair thickness, colour, curls vs straight, but you will see that you usually require more grafts than you think you will. You will see that many of the higher hair loss scale patients were 3-5 surgeries, and sometimes up to 10000 grafts to get an ok coverage. You will see that often patients are most often recommended to focus on the frontal half of the scalp first, which might be 2500-4000 grafts for you, and a second surgery to focus on the crown.

All of this is just to say, educate yourself to know what you want, 4000 grafts is not going to get you a head of hair like you used to have. It might get you the illusion that the frontal 2/3 is decent, or the back 1/3 is decent.

Thank you very much for your input. Yes, as others pointed out, it seems like I will be needing lot of grafts to cover ☹️. Best option is get a good Dr’s advice hence I will get a face to face appointment with Dr Reddy soon. I think that will give a good idea where I will be heading with my HT journey.

[Al - Moderator]

Looking at your pictures it appears that you aren't someone who would ever want to shave his head. If that is the case then you may be a good candidate even though you have a large area to cover and your donor may not be that great. The reason is that if you are going to be doing a comb over anyway then any amount of grafts you can get in the front half will make it easier to comb the hair over the top and get better coverage, so even if you can only get 2500 to 3000 grafts it will at least help you get some coverage. I would stick with thinly covering the front half first with a maximum of about 3000 grafts, so you don't over harvest your donor area. I would probably also choose to go for a thinner frontal half coverage rather than a thicker frontal third. The reason is the same as I was mentioning, that even light coverage will help your comb over look better and with a larger area covered it will, of course, help cover a larger area. I would wait to think about the crown later once the front transplant grows in and you can see where you are in terms of both donor availability and if you want to add more to the front half at that time. Definitely think about using beard grafts as that will increase the amount of donor hair you can use. Good luck!

[MrMJ]

2 hours ago, BeHappy said:

Looking at your pictures it appears that you aren't someone who would ever want to shave his head. If that is the case then you may be a good candidate even though you have a large area to cover and your donor may not be that great. The reason is that if you are going to be doing a comb over anyway then any amount of grafts you can get in the front half will make it easier to comb the hair over the top and get better coverage, so even if you can only get 2500 to 3000 grafts it will at least help you get some coverage. I would stick with thinly covering the front half first with a maximum of about 3000 grafts, so you don't over harvest your donor area. I would probably also choose to go for a thinner frontal half coverage rather than a thicker frontal third. The reason is the same as I was mentioning, that even light coverage will help your comb over look better and with a larger area covered it will, of course, help cover a larger area. I would wait to think about the crown later once the front transplant grows in and you can see where you are in terms of both donor availability and if you want to add more to the front half at that time. Definitely think about using beard grafts as that will increase the amount of donor hair you can use. Good luck!

Thank you very much for the input! 

[MrMJ]

Dear All,

I have contacted several Drs and Clinics (6 of them). Their recommendations as per below.

I really appreciate your expert comment to choose / shortlist best suitable Dr/Clinic for my HT.

Thank you very much in advance!

 

Dr Reddy ( I met him in person):

Number of Grafts - 3000

Donor area - Not great but more than enough to do the job. Even can take another 3500 -4500 in the future.

Suggested  to do the frontal with high density. Mid and crown later (after 12 months)

Recommended to take some vitamins and finasteride.

 

Dr Arshad (did a video consultation with his Manager. Was bit disappointed as Dr him self should have done the consultation) :

Number of Grafts - 2500

Donor area - Looks good 

Suggested  to do dense hairline and crown area 

Recommended to take finasteride.

 

Dr Christina at HDC (Photos sent) :

Number of Grafts - 4000

Donor area - Looks good 

Suggested  to do mainly crown and middle scalp , may be touch up on the front (after I reached the clinic Dr will check and decide)

 

Dr  Pekiner (Photos sent) :

He thinks I am not a good candidate at this stage due to the main androgenetic areas (Front, Mid & Crown) are thinning out specially hairline and crown.

He recommends to take finasteride/Minoxidil and supplements to strengthen the hair at least 6 months before the HT.

 

Dr Bisanga (Photos sent) :

Number of Grafts - 3500-4500

Suggesting to redesign conservative hair line add good density in the frontal 1/4

However, clinic is recommending face to face consultation with the doctor to examine further and determine the density of the donor and scalp area for the HT.

 

Dr Feriduni (Photos sent)

1st treatment - 3000-3500 grafts

Will cover 1 2 3 4

2nd Treatment after 6-9 months - 1000 -2000 grafts

Will cover 5 + 5V

 

Dr Bicer (Photos sent)

Need to mention costumer service was not great.

1st Treatment : 3800-4000 grafts

Will cover frontal with high density 

2nd Treatment : 2200-2400 grafts to cover vertex

However, she thinks donor area will be decreased permanently and white scars will be visible

 

 

 

[Melvin- Admin]

You have quite a variety of opinions which is great. Can you share some pictures?

[Gatsby]

Yes. Can you post the photo's that you sent perhaps so we can get a better idea of where your hair loss and donor appears to be at? Many thanks and all the best.

[MrMJ]

Hi @Melvin-Moderator and @Gatsby

please see photos.

[MrMJ]

Also I clarified again with Dr Reddy, it’s not 3000 grafts but it’s 3000 hairs he recommending for the 1st treatment. 

[Al - Moderator]

10 hours ago, MrMJ said:

Also I clarified again with Dr Reddy, it’s not 3000 grafts but it’s 3000 hairs he recommending for the 1st treatment. 

 

3000 hairs is only in the 1400 to 1500 range of grafts. This is not enough in my opinion. Looking at the latest pictures I see you do have some hair in the frontal area. I would think around 1800 grafts to fill in the front with another 1200 in the midscalp pushing back towards the crown would be a good first session. You will need another procedure later, but with the donor area looking like it may not be very wide due to the retrograde hair loss, I don't know if trying to get more than 3000 or so in a first session is a good idea due to the possibility of depleting the donor if the grafts must be taken from a smaller area than usual. If you are also using body hair grafts then you can increase the session size by that amount.

 

[HappyMan2021]

i haven't read every post in this thread, but my slapstick impression to these pics is this is really severe balding in the crown. I doubt even Dr. Konior or any other elite doctor could fix this crown just in one go. I do think ultimately you can have good coverage in the crown (maybe just some signs of balding there), but it will require 2+ HT's and will be a multi-year journey. 

Again keep in mind that even an "amazing" result in your case may reveal some crown balding still.