Has anyone decided to go the hair transplant route without taking Fin or Min, do you have any pictures and advice?

[ITA]

1 hour ago, Hairtroubles said:

Stephen just did. Will email now.

There was no doubt that you would have received an answer here.👍

[Melvin- Admin]

@Hairtroubles

Were you able to contact Dr. Bisanga? He also has an Instagram @bhrclinicbrussels

[Hairtroubles]

11 minutes ago, Melvin- Moderator said:

@Hairtroubles

Were you able to contact Dr. Bisanga? He also has an Instagram @bhrclinicbrussels

I got through to a rep, then ian reached out to me via email, and now Dr. Bisanga apparently might reply by email to me, but i have to pay 50 euros to have a call with him?

[ITA]

43 minutes ago, Hairtroubles said:

I got through to a rep, then ian reached out to me via email, and now Dr. Bisanga apparently might reply by email to me, but i have to pay 50 euros to have a call with him?

This is the first time I've heard it, Although there would be nothing out of the ordinary, he is a doctor, and when doctors visit patients privately in their offices, they pay themselves.

Edited August 2, 2021 by Egy

[Melvin- Admin]

2 hours ago, Hairtroubles said:

I got through to a rep, then ian reached out to me via email, and now Dr. Bisanga apparently might reply by email to me, but i have to pay 50 euros to have a call with him?

Yes, that is customary, telephone calls, zoom consultations and in-person consultations are not free. The correspondence you have with the representatives and the initial email consultation is free. It’s customary otherwise there time would be consumed with giving consultations without being compensated for their time. 

[Hairtroubles]

44 minutes ago, Melvin- Moderator said:

Yes, that is customary, telephone calls, zoom consultations and in-person consultations are not free. The correspondence you have with the representatives and the initial email consultation is free. It’s customary otherwise there time would be consumed with giving consultations without being compensated for their time. 

Okay, thanks man.  I think I will wait for Dr. Bisanga's reply.  Just as a mod, Melvin, what are your thoughts on Bisanga, is he one of the safer options out there for me to go about this?

Any negative things or things to be wary of?

[ITA]

Dr. Bisanga is one of the top hair transplant surgeons in the world.

[Britanium]

1 minute ago, Egy said:

Dr. Bisanga is one of the top hair transplant surgeons in the world.

Always been in my top 3. Can’t think of many more ethical. 

[Hairtroubles]

9 minutes ago, Egy said:

Dr. Bisanga is one of the top hair transplant surgeons in the world.

Good to hear.  Why ethical?

[ITA]

8 minutes ago, Hairtroubles said:

Why ethical?

An ethical doctor is the one who tells you how things are, what you can expect from the transplant from your starting situation without promising results you could never have.  In addition, an ethical doctor can also be seen from the management of a bad case, which can always happen, even if I haven't seen any of Bisanga yet, but who does not abandon you once you leave his clinic.

[Melvin- Admin]

1 hour ago, Hairtroubles said:

Okay, thanks man.  I think I will wait for Dr. Bisanga's reply.  Just as a mod, Melvin, what are your thoughts on Bisanga, is he one of the safer options out there for me to go about this?

Any negative things or things to be wary of?

He’s in my opinion, one of the best surgeons in the world. His reviews here back it too.

[Hairtroubles]

12 hours ago, Melvin- Moderator said:

He’s in my opinion, one of the best surgeons in the world. His reviews here back it too.

Hey, 

I got an email from the clinic, not going to lie, I just feel a bit annoyed.  I was hoping to have a plan in place ,or some sort of consolation.  I requested that I want to think about all of this without Fin, but I basically just got told I am not eligible for a transplant, and to get on Fin... after in the notes they messaged me to provide, I said how terrified I was of it and wanted a plan with transplants and options to discuss.

I will show the reply below, but I guess, is there some good info here for Topical Fin? Is it as effective, and has anyone heard of Manual.Co in the UK as it's the only place I can see for Topical Fin/Min?

The reply:

Hi X, 

 

Thank you for providing your photographs and relative information. I have discussed your case with Dr Bisanga who has provided his recommendations.

 

Dr Bisanga has evaluated the pattern of your hair loss and your candidacy for an FUE procedure based on all of the provided information. Dr Bisanga has determined that based on all details, that he would not recommend proceeding with hair restoration surgery.

As you have explained the amount of loss over the last 3-4 months has been "rapid", your hair loss is therefore clearly progressing at this stage and as you do not use and are not able to commit to hair preventative medication over the long term, your hair loss is not stable and therefore candidacy is currently not feasible nor ethical.

 

Dr. Bisanga explained that it would appear as though you are experiencing a diffuse and progressive pattern of loss with miniaturisation (decline in quality and strength in the cycle of loss) visible and some thinner areas of donor above your ears.

 

Proceeding with surgery at this time would present increased risk of potential shock loss of native hair due to the "trauma" of surgery that may not be strong enough to return post surgery if the cycle of miniaturisation has evolved and if miniaturisation is present in your donor area, this could impact yield and growth and also longevity of results of any procedure.

 

Implications of miniaturisation in the donor -

https://www.youtube.com/watch?v=95dQGwpM3Ck&list=PLa9i-qXi8d3ShCBs17ZApA5duaGon5uvZ&index=19&t=4s

 

 

----

 

For any individual that has experienced hair loss, you are genetically pre-disposed to lose further hair. We need to mitigate this as much as possible to preserve the best scenario long term for you.

 

Dr. Bisanga explained the need to consider a regimen of hair loss preventative medication. Without medication your loss will progress.

 

----

 

At BHR we always recommend patients to visit Dr. Bisanga for an in-person consultation if possible. This would allow Dr. Bisanga to more accurately understand the extent of your hair loss, measure your donor density, any levels of miniaturisation and rule out any scalp concerns. 

 

Dr. Bisanga is extremely ethical and any decision regarding surgery is always made in the best interests of the patient.

 

——

 

Many thanks X

 

Kind regards

 

 

[ITA]

This is proof of the doctor's ethics.  He could have said you are a good candidate, carried out the procedure, collected your money the way many hair mills do, but instead he informed you about everything you need to know in your situation.

[Hairtroubles]

13 minutes ago, Egy said:

This is proof of the doctor's ethics.  He could have said you are a good candidate, carried out the procedure, collected your money the way many hair mills do, but instead he informed you about everything you need to know in your situation.

Just leaves me super confused and not sure what to do... I hope he makes topical Fin and I can get on that?  

[ITA]

21 minutes ago, Hairtroubles said:

Just leaves me super confused and not sure what to do... I hope he makes topical Fin and I can get on that?  

You will surely find doctors who will tell you that they can operate on you even if you do not want to take Finasteride, they will ensure you an excellent result over time, perhaps they will even issue you a certificate of guarantee, and perhaps on the same day of the procedure you will meet other 4/5/6 or more guys who will tell you they are there for a procedure too, well don't trust that doctors.

[Hairtroubles]

25 minutes ago, Egy said:

You will surely find doctors who will tell you that they can operate on you even if you do not want to take Finasteride, they will ensure you an excellent result over time, perhaps they will even issue you a certificate of guarantee, and perhaps on the same day of the procedure you will meet other 4/5/6 or more guys who will tell you they are there for a procedure too, well don't trust that doctors.

Okay, thanks man - I get the point.  I just saw a place called Freshmans in the UK. They do Topical Fin and Min, what do you think?  Its 0.05% Topical fin, but they are saying to apply it twice a day, is it okay to use it once a day and get away with it?

[ITA]

24 minutes ago, Hairtroubles said:

Okay, thanks man - I get the point.  I just saw a place called Freshmans in the UK. They do Topical Fin and Min, what do you think?  Its 0.05% Topical fin, but they are saying to apply it twice a day, is it okay to use it once a day and get away with it?

Here, doctors who are present on the forum could help you by answering this question

[Britanium]

2 minutes ago, Egy said:

Here, doctors who are present on the forum could help you by answering this question

@Dr. Suhail Khokharfor example 👌

[Hairtroubles]

Any experience using Topical Fin/Min, nervous about it tbh, but it should be safe/fine right?

[JDEE0]

1 hour ago, Hairtroubles said:

Hey, 

I got an email from the clinic, not going to lie, I just feel a bit annoyed.  I was hoping to have a plan in place ,or some sort of consolation.  I requested that I want to think about all of this without Fin, but I basically just got told I am not eligible for a transplant, and to get on Fin... after in the notes they messaged me to provide, I said how terrified I was of it and wanted a plan with transplants and options to discuss.

I will show the reply below, but I guess, is there some good info here for Topical Fin? Is it as effective, and has anyone heard of Manual.Co in the UK as it's the only place I can see for Topical Fin/Min?

The reply:

Hi X, 

 

Thank you for providing your photographs and relative information. I have discussed your case with Dr Bisanga who has provided his recommendations.

 

Dr Bisanga has evaluated the pattern of your hair loss and your candidacy for an FUE procedure based on all of the provided information. Dr Bisanga has determined that based on all details, that he would not recommend proceeding with hair restoration surgery.

As you have explained the amount of loss over the last 3-4 months has been "rapid", your hair loss is therefore clearly progressing at this stage and as you do not use and are not able to commit to hair preventative medication over the long term, your hair loss is not stable and therefore candidacy is currently not feasible nor ethical.

 

Dr. Bisanga explained that it would appear as though you are experiencing a diffuse and progressive pattern of loss with miniaturisation (decline in quality and strength in the cycle of loss) visible and some thinner areas of donor above your ears.

 

Proceeding with surgery at this time would present increased risk of potential shock loss of native hair due to the "trauma" of surgery that may not be strong enough to return post surgery if the cycle of miniaturisation has evolved and if miniaturisation is present in your donor area, this could impact yield and growth and also longevity of results of any procedure.

 

Implications of miniaturisation in the donor -

https://www.youtube.com/watch?v=95dQGwpM3Ck&list=PLa9i-qXi8d3ShCBs17ZApA5duaGon5uvZ&index=19&t=4s

 

 

----

 

For any individual that has experienced hair loss, you are genetically pre-disposed to lose further hair. We need to mitigate this as much as possible to preserve the best scenario long term for you.

 

Dr. Bisanga explained the need to consider a regimen of hair loss preventative medication. Without medication your loss will progress.

 

----

 

At BHR we always recommend patients to visit Dr. Bisanga for an in-person consultation if possible. This would allow Dr. Bisanga to more accurately understand the extent of your hair loss, measure your donor density, any levels of miniaturisation and rule out any scalp concerns. 

 

Dr. Bisanga is extremely ethical and any decision regarding surgery is always made in the best interests of the patient.

 

——

 

Many thanks X

 

Kind regards

 

 

I understand that you're disappointed, but I think you're just slowly coming to the realisation/understanding that hair transplants aren't simple quick fixes or solutions to the issue of hair loss itself. Yes, they can bring back lost ground to a reasonable density depending on the extent of an individuals loss, but they don't treat hair loss itself. 

To be blunt, you're losing hair in a high Norwood pattern (5+) right now, and it's clearly evident objectively speaking. If you were to have a HT without being on preventative meds right now then you face two issues.

1) all of your existing hair may be shocked out and may never come back from the trauma of the surgery as it's in a weakened state due to your MPB.

2) Even if this doesn't happen, you go in and get 3000 grafts lets say and it all grows well, in 5 years I can't imagine the native hair you have left will be around any more (if you don't use meds) and you'll be back to square 1. Maybe you go back in and get another 2500 or so and have decent coverage back to front after that grows in, but maybe not and you need more grafts that aren't there. Additonally, what happens If your NW5 goes to NW6 or 7 and you have no grafts left? Maybe you can't even get enough to cover a NW5 as is right now, I don't know. 

Now, no one knows what's going to happen. Maybe you'll get to a NW5 and not really progress much further, or at least not for a long long time. This is a good possibility, don't get me wrong, but the reason Bisanga has declined you is because he doesn't know either.

There's a chance that, by performing surgery on you without meds, he may be placing you in a position where your level of loss will outpace your own donor supply. If this happens, you're left with 5000+ scars on the back of your head, so shaving isn't ideal, and at the same time a potentially strange looking head of hair if you leave it longer and wear it as is. 

It seems you're willing to try topical fin which is good. It works and should stabilise you. Maybe you could add in minoxidil and micro-needling at some point; I think you could potentially get good re-growth in your case. Either way, I would ideally use the meds until its clear I had stabilised/recovered a little bit and then go ahead with a HT, but only if I was committed to using meds indefinitely. Yours is a clear case of knowing exactly what would happen if you stop, so you'd need to commit. 

Just looked at the Freshmans place, never heard of it but it seems a legit telemedicine company. 44 quid a month for a bottle of topical fin/min is expensive though. 

0.05% would equate to 0.5mg of fin per ml, so the equivalent of half the daily dose orally as the recommended dose is 1mg per day. 

[Future Hair Doc]

Thanks for the tag @JohnAC71. I agree with what Dr. Bisanga stated. His response truly shows that he's an ethical surgeon. He could have taken your money and done the surgery and your hair loss would have progressed without medical therapy and you would not have been happy. You need to tackle hair loss from a multifaceted approach. Without finasteride/minoxidil, you're fighting with 1 hand tied behind your back. If you're not able to tolerate oral finasteride, then try topical finasteride or topical dutasteride. As always, feel free to reach out anytime. 

[Hairtroubles]

31 minutes ago, Dr. Suhail Khokhar said:

Thanks for the tag @JohnAC71. I agree with what Dr. Bisanga stated. His response truly shows that he's an ethical surgeon. He could have taken your money and done the surgery and your hair loss would have progressed without medical therapy and you would not have been happy. You need to tackle hair loss from a multifaceted approach. Without finasteride/minoxidil, you're fighting with 1 hand tied behind your back. If you're not able to tolerate oral finasteride, then try topical finasteride or topical dutasteride. As always, feel free to reach out anytime. 

Hi Doc, 

Thanks for the tip.  I have just bought a monthly subscription from Freshman (Topical Min and Fin). 0.05% fin, I believe to use twice a day.  What are your thoughts on this, and most of all, thoughts on Topical Fin and Min?

Could I get away with doing just 0.05% a day (one application)?

[bald-and-bearded]

Do you have good beard and body hair? If so, I think if you approach Dr Umar he will say yes. But then I have no idea how ethical he is. He does have impressive videos and pictures but we can't say if they are just his best cases.

[Curious25]

You're going to have to do a lot more research, stop panicking and trying to rush things through, learn what is capable with your situation, have a look at yourself in the mirror, and workout if you can accept being happy with what is capable to be achieved with your situation, and then you will be in a much stronger position to make a decision. 

You're young, but not so young. Your loss in a NW5 pattern is evident, however there are worse off people at your age. 

FWIW I think BHR have given you sound advice. 

However, I also think, there will be ethical surgeons who would be prepared to strengthen your frontal hairline conservatively, to give you a confidence boost and improve your appearance - as long as you are aware of the commitments down the line you have to make, the limitations that you will face, and they are happy that you are clued up enough to know that you will be happy with what is achievable. 

You need to research and learn about hair restoration a lot more. 

I, and many others don't take medication, however we understand the implications of this, and are prepared to face the consequences, albeit mitigating it as best as we can, with carefully planned surgeries, at top class clinics. 

You also need to go for in person consultations.

Good Luck  

[Hairtroubles]

On 8/3/2021 at 5:25 PM, bald-and-bearded said:

Do you have good beard and body hair? If so, I think if you approach Dr Umar he will say yes. But then I have no idea how ethical he is. He does have impressive videos and pictures but we can't say if they are just his best cases.

Yeah, I do. I dunno man, i dont know what to do, this fin thing is crazy to me, i dont know if i should mess around with my hormones and body.