Hopeful looking for HT option (from SEA)

[mafpe]

Hello there!

I've been considering hair loss treatment for years, and only start to seriously considering HT as slowly my hairline keeps receeding.
I'm glad i found this forum and some others as apparently i was considering a "hair mill"

i live in SEA region (south east asia), and would like to ask for help and opinion on where and who to go to.
i saw reccomdation for dr. kongkiat (thai) and many seems to love dr.bicer's work.
can anyone help with with a budget estimate ? (distance isnt much issue as its still way cheaper than the procedure itself)

currently i'm 26 y.o, and have been noticing big forehead and loss since 16,
below are pictures of me, and for reference, i think my family have norwood 6 at advanced age.

Edit : currently not minoxidil, finasteride (might stop soon), biotin and dermarolling

thank you!

 

Edited February 3, 2022 by mafpe
Adding info

[Mike10]

If you are not on medication and stable, I do not see much sense in doing a HT in your case at 26

[mafpe]

thanks for the input mike!

i'm on minoxidil, finasteride, and biotin atm (started around 5 years ago)
the only thing new to me was derma rolling which i just started for 4 months (gave me lots of mini hair that minimize and darken the triangle on my temple.

i'm considering HT atm because my hairline receded about 1cm compared to around 1.5 years ago
i was looking for another way to help, and then when i saw my lates side profile picture.... i realised that it has gone way far more than i thought it has
i think this year with stress from covid and work have made the condition worse faster as half a year ago, i can see my crown from the front
(my hair thinned overall around at that time, most likely due to stress)

for the crown area, it has been thinning for around 3 year slowly (i had multiple hair dresser telling me that its getting thinner),
just that i haven't really realised it because you dont normally look at your own crown unless its been shedding very badly

i'm not sure if i have diffuse thinning, but i have always shed around twice as much hair as any other people since high school.

[Sean]

Stay on meds if you can.  You can see some density loss in crown zone.  If you were not on meds, maybe that area would not be with hair today.  Do you take meds daily?  Minoxidil may be a good addition to assist in healthier follicles in crown area.  Nizoral shampoo may also help(every 3rd day application).  
 

i would tell you to hold off any transplant until you see how you last with meds alone until age 30+.  You can use toppik or hair fibers to get by, do not go under the knife as your existing hairs can possibly be shocked permanently if you were bound to lose them without meds. 
 

stress does play a role as well.  Try not to stress.  Also, have your vitamin d levels in blood checked and labs done to make sure there is no underlying condition.  

I was in a similar position regarding forehead and the doctor has put me in a very bad position jeapordizing my scalp and by leaving me as a repair patient.  I am still trying to get fixed and stuck in a very bad situation suffering quite a bit.   He did not keep his word based on emails and agreements and broke the agreement.  

i do not want you to end up this way or be taken advantage of.  Best wishes

[mafpe]

will do! i browsed and now know that me picking up the meds again when i left it saved my hairs.
sometime i forget to take it daily, but i do take them regularly, im not using any medicated shampoo as the one i used had minimal effect.

i'm thinking of using a mix of topical minoxidyl + finas to subvert my oral finas,
my country made purchasing them very hard without doctor, and i might have been affected by finas's sides.
just that this topical mix, only have 0.05% finas, so i don't know if its enough...

tbh i was actually considering those hair mills but thankfully my research led to this forum among many...
i had been reading and searching for 'good' doctors based on this forum and other discussion websites, and tried to contact several drs.

so far from what i seen, it seems dr.demirsoy seems to be budget friendly, while dr.bicer have a large demand

although now from what both of you said, it seems like i shouldn't consider HT yet?

[Melvin- Admin]

We have two excellent options in Thailand, feel free to submit some consultations

https://www.hairtransplantnetwork.com/Consult-a-Physician/surgeon-list/TH/Thailand

[NARMAK]

OP, how much Finasteride are you taking? Because you said you have been on it for 5 years, and your hair loss seems to have been relatively stable but the thinning and progression around the slight frontal recession and crown thinning are indicators its not being fully inhibited but is doing really well. 

There could be some options for you. 

[mafpe]

7 hours ago, Melvin- Moderator said:

We have two excellent options in Thailand, feel free to submit some consultations

https://www.hairtransplantnetwork.com/Consult-a-Physician/surgeon-list/TH/Thailand

Thanks melvin, i'll be sure to consult with them

7 hours ago, NARMAK said:

OP, how much Finasteride are you taking? Because you said you have been on it for 5 years, and your hair loss seems to have been relatively stable but the thinning and progression around the slight frontal recession and crown thinning are indicators its not being fully inhibited but is doing really well. 

There could be some options for you. 

Just 1 mg, but im taking it daily. (Except when i occasionally forgot it in some days lol)

Im actually going to change to topical in a few days because i think i got some slight sides...

The frontal recession doesnt seem bad esp the triangle doesnt seem pronounced from the front because i scrunched my forehead to give better picture of where the hairline "should have been" for young non balding people, and i dermaroll the triangle. It helped a little from the sides as well as while it doesnt grow well it did gove a darker look on the site.

I haven't been hearing bad side effect from dermarolling except when applied incorrectly or using too big of a needle, i think people can try it before fully considering hair transplant

[Sean]

12 hours ago, mafpe said:

will do! i browsed and now know that me picking up the meds again when i left it saved my hairs.
sometime i forget to take it daily, but i do take them regularly, im not using any medicated shampoo as the one i used had minimal effect.

i'm thinking of using a mix of topical minoxidyl + finas to subvert my oral finas,
my country made purchasing them very hard without doctor, and i might have been affected by finas's sides.
just that this topical mix, only have 0.05% finas, so i don't know if its enough...

tbh i was actually considering those hair mills but thankfully my research led to this forum among many...
i had been reading and searching for 'good' doctors based on this forum and other discussion websites, and tried to contact several drs.

so far from what i seen, it seems dr.demirsoy seems to be budget friendly, while dr.bicer have a large demand

although now from what both of you said, it seems like i shouldn't consider HT yet?

Absolutely, not to be considered at this time.  Here is why.

 

You’ve been losing hair from early age of 16

you’ve been on finasteride but still noticed some loss in crown.

you have yet to try minoxidil and ketoconazole

you have lots of native hair in recipient  zones you want to work in

it would be wise to wait till 30+ to see how these meds further hold your hair before you make this major decision

definitely tread carefully— please approach it carefully and get your blood levels checked for vitamin d and other concerns

It would be risky to get a procedure now  based on the current scenario-  wait it out- good luck

 

[mafpe]

27 minutes ago, Sean said:

Absolutely, not to be considered at this time.  Here is why.

 

You’ve been losing hair from early age of 16

you’ve been on finasteride but still noticed some loss in crown.

you have yet to try minoxidil and ketoconazole

you have lots of native hair in recipient  zones you want to work in

it would be wise to wait till 30+ to see how these meds further hold your hair before you make this major decision

definitely tread carefully— please approach it carefully and get your blood levels checked for vitamin d and other concerns

It would be risky to get a procedure now  based on the current scenario-  wait it out- good luck

 

I'm also on minox from the start and the shampoo, change shampoo though since it didn't help

Yeah i do have native hair, those are miniatured though, mostly sprouted from dermarolling, and i am worried that there might be shock loss

For the blood test, anything i need to pay attention to in particular? I do regular blood test but its for general health concern and i dont know which affect hairs

[Sean]

3 hours ago, mafpe said:

I'm also on minox from the start and the shampoo, change shampoo though since it didn't help

Yeah i do have native hair, those are miniatured though, mostly sprouted from dermarolling, and i am worried that there might be shock loss

For the blood test, anything i need to pay attention to in particular? I do regular blood test but its for general health concern and i dont know which affect hairs

Vitamin D workuP, check potassium and minerals related labs by the doctor

low vitamin d can cause miniaturization and random sheds by throwing your cycle off and preventing new hair growth.  Can make you lose hair and sometimes it usually recovers when doctor recommended vitamin d doses are given

many sources available on web regarding this, but here is a study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/

[NARMAK]

6 hours ago, mafpe said:

Thanks melvin, i'll be sure to consult with them

Just 1 mg, but im taking it daily. (Except when i occasionally forgot it in some days lol)

Im actually going to change to topical in a few days because i think i got some slight sides...

The frontal recession doesnt seem bad esp the triangle doesnt seem pronounced from the front because i scrunched my forehead to give better picture of where the hairline "should have been" for young non balding people, and i dermaroll the triangle. It helped a little from the sides as well as while it doesnt grow well it did gove a darker look on the site.

I haven't been hearing bad side effect from dermarolling except when applied incorrectly or using too big of a needle, i think people can try it before fully considering hair transplant

Ah, okay. I was going to say that if you don't have side affects, what some people start to do is introducing Dutasteride 1x a week instead of the Finasteride dose or sometimes even 2. That can initially increase the shed again but then levels out. 

[Gatsby]

If you are looking SEA have you considered Eugenix?

[mafpe]

1 hour ago, NARMAK said:

Ah, okay. I was going to say that if you don't have side affects, what some people start to do is introducing Dutasteride 1x a week instead of the Finasteride dose or sometimes even 2. That can initially increase the shed again but then levels out. 

honestly i've been on it long enought i cant even tell anymore... i do feel the lessening due to sides but back then i didnt care at all, my hair was more urgent.
but last year, im suspecting that there might be more sides than just the normal one, hence i'm planning to use just topical for better safety.

 

56 minutes ago, Gatsby said:

If you are looking SEA have you considered Eugenix?

i've looked up their results, and i have to say they done some really great jobs, especially i see dr. arika is in very high regards here.
unfortunately it's that if i want dr. arika's involvement, the pricing is quite high, around 2.5-3 $ per graft.

area wise, i don't really have any problem with long flight time or distance, just that its a plus because normally they will have more patients with same hair or ethnicity that they're more familiar with working.

i've also looked into dr.bicer, just that im confused with her pricing on "automated" FUE, and i haven't seen any explanation on them, wheter its full machine, or just using motorized punch

[NARMAK]

1 hour ago, mafpe said:

honestly i've been on it long enought i cant even tell anymore... i do feel the lessening due to sides but back then i didnt care at all, my hair was more urgent.
but last year, im suspecting that there might be more sides than just the normal one, hence i'm planning to use just topical for better safety.

 

i've looked up their results, and i have to say they done some really great jobs, especially i see dr. arika is in very high regards here.
unfortunately it's that if i want dr. arika's involvement, the pricing is quite high, around 2.5-3 $ per graft.

area wise, i don't really have any problem with long flight time or distance, just that its a plus because normally they will have more patients with same hair or ethnicity that they're more familiar with working.

i've also looked into dr.bicer, just that im confused with her pricing on "automated" FUE, and i haven't seen any explanation on them, wheter its full machine, or just using motorized punch

Regarding sides and seeing an increase. I would say to do a full blood work test and see if maybe you are deficient or anything else is affecting you. As we age, we sometimes might require a booster in something we don't naturally get enough of and when younger we managed okay, but as we age it shows. 

I personally had low Vitamin D and since i got it addressed, i think it has helped a little bit and that also factors onto hair loss apparently too 

Once you know what might be responsible you can explore your options. Personally i think applying topicals is a bit time consuming and why after a while, people tend to stop using them.