ASMED - I wasn't good enough

[abracadabra]

From the photo's below Dr. Erdogan from Asmed came to conclusion I did not have enough donor hair.  He "regrettably" (his words) informed me that I did not meet their requirements.  What he didn't know is that he was doing me a favour by helping me narrow down this list of clinics. 

I am taking a long term approach to take back what has been lost. My theory is start with 3500 graphs around the hairline and the following year do another 3000 graphs and repeat the process through out the crown using chest and beard hair.  I'm thinking realistically 3 or 4 procedures over the next 3 to 4 years.  Who knows I might have a solid hairline by 2025 but we will never know if I don't try and worst comes to worst I'm down 10's of thousands get additional SMP over any FUE extraction scars and go back to the chrome dome. 

I have reached out to several clinics most have been on board. I am leaning towards Thailand.  Dr Pathomnavanich and Dr. Kongkiat Laorwong had no hesitation in doing the procedure.

I think Asmed rejected me as they feel its likely going to fail or produce poor results and they don't want to risk a bad review or unhappy customer causing them problems. They probably make enough money and have enough straight forward clients that they don't need to bother with cases like this.  

Can anyone offer insight into why Asmed knocked me back but the majority of other clinics don't have an issue. Also if you know anything about Doctors in Thailand would you share your preference. Lastly if you have any warnings/criticism/advice feel free to share. 

I usually shave thus the shading around the hairline is SMP. 

Thanks in advance,
A.

[HappyMan2021]

I have a lot of respect for any HT doc who refuses to do surgery on a patient. I know its massively frustrating, but they are really looking out for you in the end. 

I can't speak to the specific reasons ASMED declined you. But they are declining to take what I imagine is a decent amount of money from you, so I would trust that the reason is in the best interest for you too. 

 

Edited December 21, 2021 by SadMan2021

[LaserCaps]

9 minutes ago, abracadabra said:

From the photo's below Dr. Erdogan from Asmed came to conclusion I did not have enough donor hair.  He "regrettably" (his words) informed me that I did not meet their requirements.  What he didn't know is that he was doing me a favour by helping me narrow down this list of clinics. 

I am taking a long term approach to take back what has been lost. My theory is start with 3500 graphs around the hairline and the following year do another 3000 graphs and repeat the process through out the crown using chest and beard hair.  I'm thinking realistically 3 or 4 procedures over the next 3 to 4 years.  Who knows I might have a solid hairline by 2025 but we will never know if I don't try and worst comes to worst I'm down 10's of thousands get additional SMP over any FUE extraction scars and go back to the chrome dome. 

I have reached out to several clinics most have been on board. I am leaning towards Thailand.  Dr Pathomnavanich and Dr. Kongkiat Laorwong had no hesitation in doing the procedure.

I think Asmed rejected me as they feel its likely going to fail or produce poor results and they don't want to risk a bad review or unhappy customer causing them problems. They probably make enough money and have enough straight forward clients that they don't need to bother with cases like this.  

Can anyone offer insight into why Asmed knocked me back but the majority of other clinics don't have an issue. Also if you know anything about Doctors in Thailand would you share your preference. Lastly if you have any warnings/criticism/advice feel free to share. 

I usually shave thus the shading around the hairline is SMP. 

Thanks in advance,
A.

If you were deemed to be a non candidate, why make all these plans? Oh, but wait.  You are tightly shaven...Sometimes this kind of gets in the way and the doctor may think you have poor donor when in reality the opposite is the case. Other times, and it's likely to be the case, you may be  experiencing some degree of thinning in donor which would result in subsequent thinning of the grafts.  So, my first suggestion, let your hair grow and reassess.  The second thing, take advantage of this time and get on a medical regimen, (Propecia, Rogaine, PRP, Laser). Do them religiously for 1 year and reassess.  If you do improve, you may end up having more options.

[Al - Moderator]

Adding to what LaserCaps said, it looks like some of your hair in the back may be gray. When it's very short that can make your hair look thinner than it is because your eyes see the dark hairs while the lighter colored ones blend in with the scalp. Let your hair grow a bit and if you have some gray hair then dye your hair. It may look much fuller then.

 

[LaserCaps]

44 minutes ago, SadMan2021 said:

I have a lot of respect for any HT doc who refuses to do surgery on a patient. I know its massively frustrating, but they are really looking out for you in the end. 

I can't speak to the specific reasons ASMED declined you. But they are declining to take what I imagine is a decent amount of money from you, so I would trust that the reason is in the best interest for you too. 

 

I was just reading this "reply" and it occurred to me....Yes, the job of the doctor is to do what the patient wants - but also to keep him from doing things that will result in something less than natural.  Second, and the point I want to make, the doctor has the prerogative of not doing the case - for whatever reason.  Could be because the patient is an actual non candidate - or because he just has unrealistic expectations.  This, in itself, is scary.  The patient could then go visit with another group, perhaps one with no experience, and they will do what the patient asks.  Perhaps going back to the doctor that turned you down would not be a bad idea and find out exactly why he made that decision. A bit of leg work but better to make sound decisions.

[digi23]

1 hour ago, abracadabra said:

From the photo's below Dr. Erdogan from Asmed came to conclusion I did not have enough donor hair.  He "regrettably" (his words) informed me that I did not meet their requirements.  What he didn't know is that he was doing me a favour by helping me narrow down this list of clinics. 

I am taking a long term approach to take back what has been lost. My theory is start with 3500 graphs around the hairline and the following year do another 3000 graphs and repeat the process through out the crown using chest and beard hair.  I'm thinking realistically 3 or 4 procedures over the next 3 to 4 years.  Who knows I might have a solid hairline by 2025 but we will never know if I don't try and worst comes to worst I'm down 10's of thousands get additional SMP over any FUE extraction scars and go back to the chrome dome. 

I have reached out to several clinics most have been on board. I am leaning towards Thailand.  Dr Pathomnavanich and Dr. Kongkiat Laorwong had no hesitation in doing the procedure.

I think Asmed rejected me as they feel its likely going to fail or produce poor results and they don't want to risk a bad review or unhappy customer causing them problems. They probably make enough money and have enough straight forward clients that they don't need to bother with cases like this.  

Can anyone offer insight into why Asmed knocked me back but the majority of other clinics don't have an issue. Also if you know anything about Doctors in Thailand would you share your preference. Lastly if you have any warnings/criticism/advice feel free to share. 

I usually shave thus the shading around the hairline is SMP. 

Thanks in advance,
A.

Step 1 when sending photos for a consultation, you need to have grown out your hair for say 2-3 weeks. Basically any Dr would decline you with these photos.

[Future Hair Doc]

4 hours ago, LaserCaps said:

If you were deemed to be a non candidate, why make all these plans? Oh, but wait.  You are tightly shaven...Sometimes this kind of gets in the way and the doctor may think you have poor donor when in reality the opposite is the case. Other times, and it's likely to be the case, you may be  experiencing some degree of thinning in donor which would result in subsequent thinning of the grafts.  So, my first suggestion, let your hair grow and reassess.  The second thing, take advantage of this time and get on a medical regimen, (Propecia, Rogaine, PRP, Laser). Do them religiously for 1 year and reassess.  If you do improve, you may end up having more options.

 👏 👏 👏 👏 👏

[SD1984]

I think you are way overshooting things. 3500 grafts would be plenty for the frontal third and maybe even some midscalp alone, not just "the hairline". Then you would need one more surgery for the rest of the midscalp and crown which you could probably get away with doing 2500 if not less if you don't care about density.

[Gatsby]

I tend to see a hair transplant surgeon who says that you are not a candidate as a blessing. You could really be dodging a bullet. Otherwise have a consultation with several elite respected surgeons (Eugenix, etc) and see if you get the same reply. All the best!

[deeznuts]

Yeah it's gotta be what LaserCaps said. Your pictures don't look all that bad but we don't know the whole story

[juanjs84]

15 hours ago, LaserCaps said:

If you were deemed to be a non candidate, why make all these plans? Oh, but wait.  You are tightly shaven...Sometimes this kind of gets in the way and the doctor may think you have poor donor when in reality the opposite is the case. Other times, and it's likely to be the case, you may be  experiencing some degree of thinning in donor which would result in subsequent thinning of the grafts.  So, my first suggestion, let your hair grow and reassess.  The second thing, take advantage of this time and get on a medical regimen, (Propecia, Rogaine, PRP, Laser). Do them religiously for 1 year and reassess.  If you do improve, you may end up having more options.

Be patient, follow the advice of @LaserCaps and meet more doctors, as @Gatsby says. Recently I met a guy who wanted to get a hair transplant, and the first advice I gave him was to start some medical treatment to improve his hair quality.

[Gasthoerer]

To give advice we need pics with hair a little grown out.

From the pics you shared I can understand why ASMED rejected you. Looks like you have retrograde alopecia in the nape area. 

[SLA]

Do not despair @abracadabra- I know of someone else, a NW4 who has posted very successful results in this forum who had a HT with Eugenix (AND is currently a few months out from his 2nd procedure for the crown) and he too was rejected by ASMED.

I think a lot of people hear different things from different clinics. Best thing I did was have an IN PERSON consultation with Dr. Bisanga who accurately measured my donor capacity, combed through and even cut a couple of snips of my hair, inspected with a dermascope and then told me my total donor capacity and laid out a surgical plan.

 

[SLA]

...and there is the beard hair option and plenty of surgeons such as Eugenix and Felipe Pittella (look at his most recent result on a NW7 guy with 'poor' donor) that know how to properly harvest, homogenously deplete and work with a non-optimal donor.

Some surgeons are more apt to do this....just take @Zoomsterwho was rejected from a couple of clinics (one that is recommended on this forum) and one reputable clinic even told him they would ONLY be able to harvest around 3,500 grafts combined FUT/FUE/BHT. Zoomster recently completed his 2nd procedure from Eugenix and has had a total of 11,600 grafts harvested and FUT was not even used.

Get other opinions for sure!

[Al - Moderator]

3 minutes ago, SLA said:

I think a lot of people hear different things from different clinics. Best thing I did was have an IN PERSON consultation with Dr. Bisanga who accurately measured my donor capacity, combed through and even cut a couple of snips of my hair, inspected with a dermascope and then told me my total donor capacity and laid out a surgical plan.

 

Yep. An in person consultation is always going to be better than online. I think most Drs who only see you online are going to be much tougher on who they judge to be candidates because they don't want to say OK and then you set up a surgery date, you get there for the surgery which is the first time the Dr sees you, and then you turn out to not be a very good candidate in person and he has to cancel the entire surgery. That is bad for everyone. If you are getting rejected online, try going to a quality Dr near you and see what they say.

 

[DrTBarghouthi]

I strongly urge you to grow the hair longer and to possibly get someone to see you in person to assess the donor. The photos may or may not be helpful. To be frank, I will not recommend any surgery by looking at these phots. However, proper assessment and maybe some growth can help make a better decision. 

[pkipling]

The advice here is solid, particularly that you don't want to completely dismiss Asmed's opinion on the matter. Growing your hair out and seeing an elite surgeon in person will really help give you more of the info you're looking for - but also keep in mind that even if it's true that you're not a good candidate, you won't have any problem finding a surgeon who's willing to work on you if you ask around enough. That doesn't mean that it will be a good idea. 

I hope it turns out that you're a good candidate and are able to get the results you're looking for. Just make sure to properly manage your expectations along the way as you get more info about what is actually possible for you. 

[Ryan Daniel]

Clearly that doctor isn't skillful enough to harvest your donor without making it look over harvested... anyway

As some people have said, it would be nice to see the hair longer

Yourdonor area looks full enough, and under the right people are can be guaranteed they will make good use of those grafts

You should think of this as a blessing... that you dodged this turkish clinic 

Edited March 17, 2022 by Ryan Daniel

[JayLDD]

ASMED tend to approach cases to achieve some sense of "full coverage", a little bit thin in the crown but basically have patients after 2 surgeries walk out looking like they have a full head of hair. If they don't see this as possible, then you're setting yourself up for disappointment relative to other ASMED cases and from a marketing perspective they would want you walking around as an advertisement to their work. 

I would reiterate what others have said that its difficult to tell what is going on when you are shaven, however its clear there is thinning behind the temples and at the bottom of the donor, likely retrograde alopecia. 

I'd also say that even from these photos you're hardly the most difficult looking case in the world, I would consider Eugenix as someone else mentioned or FUT. 

[Melvin- Admin]

As many have mentioned, the pictures can be deceiving. I suggest growing your hair out and sending your case to clinics that tackle tough cases. 

[Eugenix Hair Sciences]

You should grow your hair out (donor and recipient) for maybe two weeks and then send across your scalp pictures to different clinics. You will get an idea of what can be possible for your case thereafter.