Hair too dense for second transplant?

[Goblin82]

Hi,

I am seriously considering a second transplant (mainly on mid portion and crown) to increase density. I am also looking at using some beard grafts (beard is thick) but probably have enough doner without.

I have approached;

HLC -3500 grafts recommend

Pekiner - 3000 grafts recommend

HDC - Declined as surgery too risky with my current density... This has got me concerned as don't want to risk existing hairs

Dr Bicer - awaiting response but could be same as HDC in view of video call indication

 Dr Pinto - awaiting response

I also contacted Asmed, Hakan Doganay and Dr Arshad who all offered surgery without any indication of a problem.

Are HDC being too cautious? I've attached some photos 

Any recommendations on surgeons would also be appreciated (Pekiner is probably in front at the moment). I can't stretch to 4 euro per graft surgeons unfortunately.

 

Cheers

 

 

 

Edited November 7, 2021 by Goblin82

[Curious25]

Pretty awful quality photos I’m afraid. 
 

Were they the ones you submitted to the clinics? 
 

And what did Pekiner propose to do with 300 grafts.? 

[Melvin- Admin]

Just now, Curious25 said:

Pretty awful quality photos I’m afraid. 
 

Agreed 

[Goblin82]

Sorry I meant 3000, now corrected. He proposed this for adding density to the mid portion and crown

Yes same photos but without the red editing. Unfortunately phone is not the best!

 

 

[Curious25]

Just now, Goblin82 said:

Sorry I meant 3000, now corrected. He proposed this for adding density to the mid portion and crown

Yes same photos but without the red editing. Unfortunately phone is not the best!

 

 

That’s unusual for Pekiner , he normally only does smaller surgeries. 
 

Anyway - from what I’m presuming you to be, from the photos you have provided, you are a diffuse thinner in a NW5 pattern of loss, with some fully recessed temples.

Adding density to this whole area could risk shock loss of your native hair, and result in no net gain once your grafts have grown in, due to the possibility of losing the hair you already have on your head. 
 

If you really are insistent on a HT at the moment, I would address it in a 3 stage approach, of 600-1000 grafts at a time , targeting different zones each session, over a course of at least 18-24 months. This will mitigate the risk of shock loss, and also give you and your surgeon more of an idea of how to address things going forward into the new session. 
 

I would also look at surgeons who specialise in working with diffuse thinners, and use methods such as stick and place, as this tends to be optimum for these types of surgeries. 

[Goblin82]

Thank you.

Pekiner classed me as NW4 but didn't mention anything about diffuse thinner and neither has other surgeons but yes my fear is I may make things worse/little or no gain. My hair is very fine so wet/greasy it looks poor but washed and blow dried is fine.

HDC declined me with the words too dense and risking damage to existing hairs.

I will take this with Dr Pekiner before making any decisions.

[digi23]

Whats up with the red around the photos? There is no way we can identify who you are anyways if you cut out your face.

For anyone to make a judgement we need better photos, if you have a bad camera try to make somebody else take them outside in the daylight, usually gets more natural photos. 

I think most Drs would have trouble to estimate what you need with these photos, possibly they will decline you as a patient just because of that.

Edited November 7, 2021 by digi23

[Fego]

Go for pekiner as you will need bread graft and he excels in doing BHT with Scalp fue

[Goblin82]

Sorry went a bit OTT with the red and I think cropping the photos has reduced the quality.

Didn't get any issues from surgeons with them however will try and use someone else's phone

[Goblin82]

3 minutes ago, Fego said:

Go for pekiner as you will need bread graft and he excels in doing BHT with Scalp fue

Thank you, that's good to know

[Berba11]

If I were you I'd maybe reach out to Dr Bruno in Portugal. He seems to be good with cases whereby you're adding grafts to a more diffuse area, he's similarly priced to the clinics you're looking at and tends to offer very detailed analysis and plans. He's certainly one I'd be looking to at least speak with when it comes to cases where you're looking to add density to existing hair.

[Goblin82]

Thank you, will contact him!

[JayLDD]

Personally would opt for ASMED from that list. Its quite clearly a very significant area that is uncovered. Upon shaving your head I think its obvious you've lost 75-80% of your hair. Optimally you should undergo a megasession at minimum 4k+ grafts or you're going to be going back for surgery within a year or two after continuously. Most of the other clinics are oriented towards smaller scale hairline work. 

In terms of being too cautious, well you've posted no photos of your donor and the photos are poor quality. If 8 other clinics are saying they'd operate, then perhaps HDC have enough work and aren't interested in a slightly harder case here. 

[blackislback]

Sometimes happens some clinics not interested about potential HT, if they see "client" - future patient is one with higher expectations, and who knows solid this area HT, and then such clinics rather choose patients where need less work, and rather will perform 5x ht with 2-3k grafts, than 3.5-4.5k patients, and then replies are like "your donor area not fit to your recipient area, too risky" etc etc. , best way is contact more reputable docotrs-clinics, and got their reviews, if 5 of 7 reputable say it's ok patient, then do it, as sometimes some clinics reject it without some facts, but overloaded or whatever and not interested work on patient with bigger amount grafts, it's not rule, but it happens in practice.