Should I proceed with a HT now or think twice? (with pictures of my scalp)

[Lach]

Hi everyone! This is Lach and I am from Bulgaria.

At the moment I am seriously looking into the option of going to Istanbul for a hair transplantation procedure. I was even supposed to be in Dr. Serkan Aygin's clinic at this very moment, but when I was at the border it turned out that my passport was out of date and I had to return to renew it. I considered this as kind of a sign from the universe that I need to think twice and not rush into a hair transplantation. This is exactly what I did. I have cancelled my appointment with Dr. Sergan Aygin's clinic and now I will take some time to perform a better research before potentially going to Istanbul for a hair transplantation.

I am 33 years old. My hair has been falling since I was about 20 years old. I do not take any hair treatment medicaments at all at the moment (I used Rogaine Minoxidil a few years back and I was actually happy with the results until it stopped working for me).

I am posting a few up to date pictures of my scalp.

Could you guys please provide me with any advice about:

1. Whether I am at the right age and the right hair loss stage for a hair transplantation?

2. Whether I should get more than one hair transplantation procedure done, having in mind my severe hair loss? (honestly I am not looking for an amazing hair density, rather than that I just want to have some hair everywhere on my scalp)

3. Which hair transplantation clinic in Istanbul should I choose?

4. Should I take any drugs for a certain period before a possible hair transplantation, instead of rushing to the procedure straight away?

Actually any advice would be highly appreciated!

Thanks! 

[Berba11]

Your passport issue has saved you from going to a cheap, budget clinic which would be a total lottery as to what the result would be. I'll never quite understand why guys don't do some serious, serious research before getting an operation done on their head that could mess them up for life in the wrong hands, but that's just me...

You have quite a lot of hair loss and quite a lot of coverage needed. You'd honestly be better off getting in touch with a clinic that are good with higher norwood cases like Eugenix in India and seeing what they say. Don't limit yourself to Istanbul just because it's nearer to Bulgaria. The best clinics in Turkey are going to cost quite a lot more than the cheap and terrible clinics such as the one you were booked in with originally.

Your age is ideal - 30's. Whether you'll be a good candidate for a HT will really depend on the strength of your donor area and beard (in your photos your donor appears a little thin, but that could just the lighting) - you'll probably need a combination of grafts from both to reach the desired number of grafts for good overall coverage. Again, only way to truly tell is get yourself looked at by a good clinic. Luckily you're in Bulgaria - reach out to Dr Zarev for a consultation as a minimum to find out how many grafts you'd have available and what you would need overall.  

You should be on finasteride to preserve what you have left of the crown & midscalp. Ultimately you need a proper in person consultation/examination from a reputable clinic before you move forward in my view.

[Britanium]

I agree with @Berba11save yourself from a poor hair mill clinic in Turkey. You can do so much better in Europe. And as mentioned Dr Zarev ! Who is putting out very good and consistent results. 
With some other really good options in Spain/Portugal and Belgium. Have you seen the forums recommended list:

https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN-MOB

 

Edited September 9, 2021 by JohnAC71

[Lach]

thank you for the great advice @Berba11 I believe I now have a very good second chance to do a proper deep research and take my time before I make such a decision. I will surely check out Dr Zarev as well

Edited September 9, 2021 by Lach

[aaron1234]

Get on fin to see if it will rejuvenate the top half of your crown.  Either way you have an advanced pattern which means demand outweighs supply.  This would need multiple surgeries and still you would never achieve full coverage with HT's.  Accepting your baldness would be better than getting work done at some cheap clinic in Turkey.

[Lach]

@aaron1234 could you please share details about fin (finasteride)? So far I have only heard about it, but have no actual knowledge about it

[aaron1234]

DHT is a byproduct of testosterone which is the main cause behind male pattern baldness.  Finasteride works to suppress DHT.  It won't regrow all of your hair but might preserve and strengthen what you do have.  It works for many men but not everyone. 

[Lach]

@aaron1234 is finasteride harmless for the health? Do I need a doctor's prescription to take it? Can I have a link to check out the product?

[LaserCaps]

You are fairly young with a very advanced pattern.  It is important to realize, if you've shown the propensity to lose, you will continue losing hair.  Currently you are well demarcated in the back but there is plenty of native hair you can save.  Getting on the medical regimen is of outmost importance, (and stay on it).  It does not do you any good to be on it and get off of it.  Say you are on it for a year.  Not only do you retain but also get some enhancement.  Then you get off. You'll end up loosing what you would have lot in that time period.  So, let's pretend you would have lost it all, that's exactly what will happen.  The opposite is also true. I wish we did have a crystal ball at times.

The good thing here is you have lighter color hair and light scalp.  So, if you do end up doing any transplants, the lack of contrast will end up helping you.  I do think, however, you have unrealistic expectations.  There is simply not enough donor to give you a full - dense - set of hair.  But, if you do some homework/research, you could end up with a very natural "realistic" and pattern appropriate result.

Go to the mall...and look at people.  Better yet, look at yourself.  Look particularly at class 6 patterns and the way they lose.  They tend to keep a bit on the forelock/front, lighter density through the mid scalp and and empty crown.  So, concentrating grafts in the frontal area and blending some to the area right behind it should be the main focus.  This not only will help frame your face but will will give you a pattern appropriate design.  Keep in mind the front is what people see when you interact with them.

You did mention Rogaine provided some success.  I would consider getting on all modalities for 1 year.  Take photos every 3 months.  Rogaine, Propecia, PRP and laser.  Then, based on the results, you can then decide what to do.  If, however, you are adamant about having a full set of hair, I would leave things be and take a vacation.  You could consider SMP.

[Lach]

@LaserCaps thank you so much for your post. I has been extremely helpful. Actually I am not adamant about having a hair transplantation. I am definitely okay with looking into alternatives. Thanks to you I just learned about SMP and this seems like an amazing and natural looking alternative to having hair. I will seriously look into it.

I also think that a 1 year treatment with all modalities is another great idea. Could you please be so kind to share a bit more details about Propecia, PRP and laser?

[LaserCaps]

Sure.  Propecia is the brand name, Finasteride is the generic name.  Soon after patients started taking Proscar (5mg), they returned to their doctors with more hair.  Merck then did a study and soon there after Propecia came out as a 1 mg tab.  When Merck lost the patent, they suggested taking the 5mg tab and splitting it.  That's Finasteride.  The side effects reported at the time were less then 1%, (less interest in having sex).  This has been greatly debated through the years and every year, it seems, more light is shed on the subject. I am certain there are plenty of members in the forum who will be happy to share their experiences with you.  For myself, I have been on the med for 30+ years and expect to continue. The med can help with retention and enhancement of the native hair.  Most believe you have to give the med a year to see the total effect.

Rogaine/Minoxidil - oily, greasy.  Also available in a foam - a lot easier to use.  The med is systemic. That is, if you put it in any one place, it will affect the entire scalp.  Tends to help with retention.  Typically effective for about 7 years and then it loses some of its efficacy.  

If you do decide to get on the medical regimen, consider staying on it for a long time.  Getting on and off is just a waste of time and money.  So say the med is very effective and you end up enhancing some of the native hair.  If you get off of it, you will lose whatever you would have lost during the time you took the med.  

PRP - Platelet Rich Plasma.  Blood is drawn and put in a centrifuge.  This separates the blood.  Typically it will be used with a binder and reinjected. If done properly, it can help reverse the thinning and help with retention.  Most clinics have no clue how to do it - so do some research.  

Laser is yet another modality to can use.  External and now available in cap form which can be hidden with a baseball cap.  It uses diodes and the intermittent light helps promote blood to the area which can lead to more nutrients.  Quite effective when used with PRP.