HAIR TRANSPLANT DECISION - WHICH IS TH BEST?

[nikosgreece]

Hello, i am 24 years old.

I am NW3 vertex.I use toppik also, it makes things a lit better, but hairline and temples are not so good. All my family is like NW7 from young age around 30 years old.

I started with finasteride 1 year ago, when i was NW3.. It stabilizes me , i not loose more. And i take also dutasteride high dose because my hairloss was agressive to completely block dht on scalp.And i will keep taking. This is my personal decision.+ oral minox + other stimulants. In terms of drugs i am decide to use them forever, as long as i have not sides effects  I have much discipline, apply topicals everyday etc. In terms of mediation i have done all i can do.

My plan is : making consultation with Top surgeons , not matter where they are and book an Hair transplant. Since most of them has wait list 6+ months, i will use this time to confirm if dutasteride, oral minox and all the other drugs that i take, stabilize me. If stabilize me, i will do the surgery.

Since i am on extreme good mediation wth high dosage dutasteride, high oral minox, bimatoprost etc etc and since i can go to the best hair transplant doctor, use body hair on future if needs, do SMP and use toppik also, i think i should make an hair transplant to cover the hairline and temples(on crown i put toppik), as this age is the best. I mean not so many grafts, but enough grafts to give me a boost, and also can apply topik to make it look even better.

So, i post my photos. One is how i was at 18 years old. All the others is how i am now. with wet hair, dry hair, different lighting, short or long hair.

And my question is :

1) do you think my donor area is good? someone told me that i have retrograde alopecia. is this true? how many grafts you think can be extracted? 6.000? am i average or below average?

2) i will book some visitings to hair transplant doctors near me, just to check my donor area etc. And then i am going to send the file (fotofinder trichorizogramme) to the surgeons i want to book , to check donor area accurately, what density is etc and ask them if they can accept me for hair transplant. Do you know what examination should i ask from doctors to be done? digital trichorizogramme with fotofinder programm? or trichoscopy? or both? is there something else i can do? i am going to send this file to some clinics and remain their response about how they think my donor is.

3) I can pay as much money as need to go to to the best doctor, there is not limit.. Also, i can travell everywhere and i can wait also a lot. Which option you think is best?

Couto? Lorenzo? Freitas? ferreira? Hasson & Wong, Konnior, Eugenix?Zarev?

i thik the first should be couto, but the second one which shoud be? (because he needs 3 years wait list).

4) Does the choose of doctor depends if i have good donor area, retrograde or not and my face characteritstics? for example if i finally not have good donor area, should couto considered still the best choice? or now lorentzo is better?

5) Do you think for first hair transplant, i am going to FUT or FUE? 

6) Why Konnior price is like 3 times more than Couto? since couto considered the best of all?

[Melvin- Admin]

1) do you think my donor area is good? someone told me that i have retrograde alopecia. is this true? how many grafts you think can be extracted? 6.000? am i average or below average?

It looks below average, especially for your age. Can grafts be extracted? Yes, but how will your donor look afterward is the question.

2) i will book some visitings to hair transplant doctors near me, just to check my donor area etc. And then i am going to send the file (fotofinder trichorizogramme) to the surgeons i want to book , to check donor area accurately, what density is etc and ask them if they can accept me for hair transplant. Do you know what examination should i ask from doctors to be done? digital trichorizogramme with fotofinder programm? or trichoscopy? or both? is there something else i can do? i am going to send this file to some clinics and remain their response about how they think my donor is.

Good clinics will check your donor at a microscopic level. They will also taken into account your family history.

3) I can pay as much money as need to go to to the best doctor, there is not limit.. Also, i can travell everywhere and i can wait also a lot. Which option you think is best?

Couto? Lorenzo? Freitas? ferreira? Hasson & Wong, Konnior, Eugenix?Zarev?

There is no best surgeon, only best for your situation. In my opinion, I would hold off from surgery for a few years. You have aggressive hair loss, and surgery might not be the best option right now.

i thik the first should be couto, but the second one which shoud be? (because he needs 3 years wait list).

Cuoto is excellent, so perhaps 3 years is a good time to wait. 

4) Does the choose of doctor depends if i have good donor area, retrograde or not and my face characteritstics? for example if i finally not have good donor area, should couto considered still the best choice? or now lorentzo is better?

I believe Dr. Cuoto and Dr. De Freitas are more hands-on, Lorenzo relies on technicians, though he is still good, I would put the other two above. 

5) Do you think for first hair transplant, i am going to FUT or FUE? 

I would probably choose FUE if I were you.

6) Why Konnior price is like 3 times more than Couto? since couto considered the best of all?

Prices vary from surgeon to surgeon and region to region. 

[JoeMan]

You are still young with aggressive hair loss. Your donor looks weak and like Melvin said above, how would it look after missing 3k grafts. I'd say hold off a few years and see how you respond to the meds. 

In the meantime, maybe see if you can get on a top Dr's wait list. Cuoto being 3 years out might just be perfect timing for you. 

[Gatsby]

After what I know now at 55 after what I went through from 18 onwards I would forget it. I would try and take advantage of medication to arrest and stabalize your hair loss over the next couple of years and then revisit your situation. I know this is not the answer you want to hear. But if you go ahead now you will be in a far worse situation for may years to come. The real problem is that MPB is progressive.

[civic]

I would not even entertain the idea of transplant at this age & stage. Hair loss is progressive as you are aware, use meds, toppik, till it doesn't work anymore. And if you can sustain that till late 30s or early 40s, thats is best time for ht. I was in similar situation as you & glad a doc i went to at young age (28)  told me don't rush surgery. I used rogaine & toppik till the wheels fell off ,  now in early 40s booked for 5k grafts, glad i waited as techology progressed ,  more research options are available. As you get older , you will be more acceptive if HT doesn't pan out as you hoped. During younger yrs it is almost impossible to accept, but surgeries have risk. I fully accept the risk at this point of my life.

[nikosgreece]

i am thinking of just put 1.000 grafts only, can i do this?

[mmokin]

3 hours ago, nikosgreece said:

Hello, i am 24 years old.

I am NW3 vertex.I use toppik also, it makes things a lit better, but hairline and temples are not so good. All my family is like NW7 from young age around 30 years old.

I started with finasteride 1 year ago, when i was NW3.. It stabilizes me , i not loose more. And i take also dutasteride high dose because my hairloss was agressive to completely block dht on scalp.And i will keep taking. This is my personal decision.+ oral minox + other stimulants. In terms of drugs i am decide to use them forever, as long as i have not sides effects  I have much discipline, apply topicals everyday etc. In terms of mediation i have done all i can do.

My plan is : making consultation with Top surgeons , not matter where they are and book an Hair transplant. Since most of them has wait list 6+ months, i will use this time to confirm if dutasteride, oral minox and all the other drugs that i take, stabilize me. If stabilize me, i will do the surgery.

Since i am on extreme good mediation wth high dosage dutasteride, high oral minox, bimatoprost etc etc and since i can go to the best hair transplant doctor, use body hair on future if needs, do SMP and use toppik also, i think i should make an hair transplant to cover the hairline and temples(on crown i put toppik), as this age is the best. I mean not so many grafts, but enough grafts to give me a boost, and also can apply topik to make it look even better.

So, i post my photos. One is how i was at 18 years old. All the others is how i am now. with wet hair, dry hair, different lighting, short or long hair.

And my question is :

1) do you think my donor area is good? someone told me that i have retrograde alopecia. is this true? how many grafts you think can be extracted? 6.000? am i average or below average?

2) i will book some visitings to hair transplant doctors near me, just to check my donor area etc. And then i am going to send the file (fotofinder trichorizogramme) to the surgeons i want to book , to check donor area accurately, what density is etc and ask them if they can accept me for hair transplant. Do you know what examination should i ask from doctors to be done? digital trichorizogramme with fotofinder programm? or trichoscopy? or both? is there something else i can do? i am going to send this file to some clinics and remain their response about how they think my donor is.

3) I can pay as much money as need to go to to the best doctor, there is not limit.. Also, i can travell everywhere and i can wait also a lot. Which option you think is best?

Couto? Lorenzo? Freitas? ferreira? Hasson & Wong, Konnior, Eugenix?Zarev?

i thik the first should be couto, but the second one which shoud be? (because he needs 3 years wait list).

4) Does the choose of doctor depends if i have good donor area, retrograde or not and my face characteritstics? for example if i finally not have good donor area, should couto considered still the best choice? or now lorentzo is better?

5) Do you think for first hair transplant, i am going to FUT or FUE? 

6) Why Konnior price is like 3 times more than Couto? since couto considered the best of all?

if you are 100% sure you are not losing anymore hair than i dont see the problem but be conservative first time like 1000-2000 grafts max and realise you will be fighting hairloss for the rest of your life if you start this journey.

also i wouldnt touch the crown just use concealer and stay on medication.

the donor is below average

[JoeMan]

1 hour ago, nikosgreece said:

i am thinking of just put 1.000 grafts only, can i do this?

1k grafts won't do much and you really need your hair to stabilize 1st. At your age I think most top Dr's will ask you to wait though. I know you want results now but honestly I think being patient will serve you better. It might take 1.5-3 years to get scheduled with a good Dr and in my opinion, this is good timing. Then maybe focus on the front with 2-3k grafts depending on how you progress in the meantime. 

[DrTBarghouthi]

Thank you for your message. I strongly believe that you should stay on the medications for now. Your age, donor area and desired plan can lead to undesirable results if you proceed at this stage. I would wait for few years to see how your pattern and donor progress. The donor is average and you do have thinning areas across the entire scalp. This warrants good medical therapy and above all patience. 

[Nw7HPE]

Definitely make sure it stabilizes for a couple of years before even thinking of surgery . Then maybe seek the counsel of two of the best surgeons and compare their solutions . Be logical and think long term . It is easy to do the surgery but if you don't take into account the bigger/longer term picture there would be irreversible harm at a very young age .

[Fue3361]

This is the easiest decision of your life.  Get on the Couto waiting list.

 

Why?  Not because he's necessarily the best (Konnior is on the same level easily) but because you really should wait 2-3 years to even get a HT.  The 3 year waiting list is a blessing in disguise.  

Getting a HT right at 24 with the aggressive loss you have is a mistake.

Also, you look pretty good right now, so waiting 3 years shouldn't really be that big a deal.  You pull off your hairstyle well.

At 27, and 3 more years to see how you respond to medication, you'll be in a MUCH better position of knowledge to know what the right move is.

[FUECAPILAR]

Hello Nikos,

Thank you for your message.

After reading your thread, there are several things Dr. Turan would like you to take into consideration here:

1) It is not possible to diagnose retrograde alopecia only from photos; a trichoscopical analysis will be needed to determine if the area is affected by it. Having said that, some of your photos seem to indicate retrograde alopecia. 

Once that is established, it is important to understand that signs of retrograde alopecia at an early age are an indication of a high norwood progression in most of the cases. Furthermore, you already mentioned that your family members are Norwood VII from an early age, thus it is likely that it would be your pattern of progression too - as your lower crown seems to be affected at this point in time and your safe donor area seems to be very small in size -.

2) In your case, the usage of medication seems paramount to maintain your native hair. You may consider dermarolling for your crown area. We have seen very good improvement in young patients who use this therapy.

3) From the cosmetic point of view, it is easy to understand the willingness of a patient of your age to try to fix the situation as soon as possible. But, in your particular case, donor area management will be key to achieve a long lasting solution. 

Best of luck on the journey.

Jose Navarrete
---
www.fuecapilar.com
email: myhair@fuecapilar.com
Tlf/whatsapp: +90 542 250 0909

[nikosgreece]

On 3/24/2022 at 10:06 AM, FUECAPILAR said:

Hello Nikos,

Thank you for your message.

After reading your thread, there are several things Dr. Turan would like you to take into consideration here:

1) It is not possible to diagnose retrograde alopecia only from photos; a trichoscopical analysis will be needed to determine if the area is affected by it. Having said that, some of your photos seem to indicate retrograde alopecia. 

Once that is established, it is important to understand that signs of retrograde alopecia at an early age are an indication of a high norwood progression in most of the cases. Furthermore, you already mentioned that your family members are Norwood VII from an early age, thus it is likely that it would be your pattern of progression too - as your lower crown seems to be affected at this point in time and your safe donor area seems to be very small in size -.

2) In your case, the usage of medication seems paramount to maintain your native hair. You may consider dermarolling for your crown area. We have seen very good improvement in young patients who use this therapy.

3) From the cosmetic point of view, it is easy to understand the willingness of a patient of your age to try to fix the situation as soon as possible. But, in your particular case, donor area management will be key to achieve a long lasting solution. 

Best of luck on the journey.

Jose Navarrete
---
www.fuecapilar.com
email: myhair@fuecapilar.com
Tlf/whatsapp: +90 542 250 0909

thanks! trichoscopical analysis you mean trichorizogramme with fotofinder trihoscale?

can i make this exam in an doctor in greece and then send the results of trichorizogramme fotofnder trichoscale here to check my donor area?

[nikosgreece]

Also, i have some questions, since i am preparing for consultations. (i will not do the transplant now, but i want to contact with some docs)

1. i read that with dose that they not have good donor area and have agressive hairloss (my case), FUT should be better, as more grafts can be extracted. So, if i do not cut my hair on back of head very short (so the scar is not noticable), that means that FUT is better long term option than FUE?

2.Ok, couto seems the best of the word. After couto, which iconsidered s the best independelty of the cost and region for the Natural hairline design? your personal opinion pls.

Freitas? Zarev? Konior? Hasson and wong?

 

[FUECAPILAR]

11 hours ago, nikosgreece said:

thanks! trichoscopical analysis you mean trichorizogramme with fotofinder trihoscale?

can i make this exam in an doctor in greece and then send the results of trichorizogramme fotofnder trichoscale here to check my donor area?

Hello Nikos,

Please find my replies below:

1) Can i make this exam in an doctor in greece and then send the results of trichorizogramme fotofnder trichoscale here to check my donor area?
By trichoscopical analysis, we mean that Dr. Turan assess your donor and recipient area with a trichoscope to identify if there is any miniaturisation or any other issues.

2)  I read that with dose that they not have good donor area and have agressive hairloss (my case), FUT should be better, as more grafts can be extracted. So, if i do not cut my hair on back of head very short (so the scar is not noticable), that means that FUT is better long term option than FUE?
The yield in a FUT extraction is greater than in FUE. Both techniques have their pros and cons, you need to assess them and choose what suit you better.

3.Ok, couto seems the best of the word. After couto, which iconsidered s the best independelty of the cost and region for the Natural hairline design? your personal opinion pls. Freitas? Zarev? Konior? Hasson and wong?
It is not our position as a hair transplant clinic to assess the job of other hair transplant surgeons. Though,  and this is my personal opinion, there is no best doctor in the world. Each doctor has his/her artistry and this will lead certain patients to like one and other patients to like others.

Best regards
Jose Navarrete
---
www.fuecapilar.com
email: myhair@fuecapilar.com
Tlf/whatsapp: +90 542 250 0909

[BDK081522]

You need to stop thinking about surgeons as the "best". There is no singular best surgeon. Best is subjective..What you consider to be a fantastic result may seem mediocre to some. You need to look at as many results as possible from the doctors you are considering. Then choose the surgeon you think is "best" for your particular objectives. With that being said, it's best to stay on your medical regimen and revisit hair restoration when your loss is completely stabilized. Closer to 30 years old is a better plan of attack. 

[NARMAK]

The "best" imo is the the one that is able to tackle your specific needs for hair restoration based on your specific hair characteristics and your goals. 

Some clinics and doctors regularly deal with a specific ethnicity and hair calibre and therefore become much more adept with those and thus produce results that might impress you more but you might be completely the opposite ethnic and hair calibre. 

The Spanish clinics/doctors deal usually with thick hair individuals very often that are usually more straight and have high graft yields but also high skin/hair contrast. The results might impress you but if you're a person with fine Caucasian hair with with a low skin/hair contrast, is that going to give you a good indication of how they'll deal with you? 

Similarly people of African descent with much more curly/afro hair should look to places that specialise and are adept with working with that hair type and calibre. 

Again as people mentioned above, the artistry of a particular surgeon will also attract you to subjectively like some results over others. 

[nikosgreece]

Hello, i have an question :

i am NW3 vertex (but NW7 pattern), 24 years old , agressive hairloss, but medical treatment has stablized me (dutasteride, oral minoxidil etc). I considerdo a transplant in 2 years. My donor is below average(not good density and grafts). There is not problm on money or region.i am going put 1.200-1.500 grafts for first procedure.

Zarev seems that can extract many many grafts. like 30% more grafts from others.
But Couto/freitas seems that with less grafts he can do better job and give the illusion of having more hairs.(even if he can extract less)

Should i choose the first doctor for my first transplant based on what Norwood i am now (NW3) or what my pattern is? because based on what i am now Couto or Freitas is the best since they will fix my hairline But if i choose based on what Norwood i will be in 10 years (NW6-7) then Zarev would be the best option.

[nikosgreece]

Hello i have booked some appotiments with zarev and freitas

zarev will see me on person in bulgaria

Freitas told me can see me online in 30 days or in person in 3 months in spain

If freitas see me online will the prediction of my pattern, donor area grafts etc will be precise? Which to choose online or person in person for freitas?

[sl]

Looking at age, family loss, and even aside from density, what is the real safe area that a clinic can harvest from on you? From photos and age, loss potential and donor capabilities I think you really need to think twice before you have any surgery as some experienced voices here have said also...Keep on medication and see how things go but I would really not have surgery if I were you and with the knowledge and experience of the industry I have also in my mid 50s...Apologies it is not what you want to hear but I am being truthful on that I see but wish you all the best in any choice.

 

[asterix0]

5 hours ago, nikosgreece said:

Hello i have booked some appotiments with zarev and freitas

zarev will see me on person in bulgaria

Freitas told me can see me online in 30 days or in person in 3 months in spain

If freitas see me online will the prediction of my pattern, donor area grafts etc will be precise? Which to choose online or person in person for freitas?

You have picked excellent doctors, I think Dr. Zarev will be the best choice for you. He spends 3 hours with his patients during the consultation, will analyze your donor microscopically, and give you a thorough plan for the long term as your hair loss progresses. 

The only downside is, perhaps you have to wait a while for the consultation and procedure as he is very busy. But afterwards your donor will in excellent shape as he is maybe the best in the world in donor management. 

Edited April 13, 2022 by asterix0

[HairRun]

Hair transplants in bigger cities/metro areas will always cost more. Konier still has a 1 year wait time even at his prices. I think people with that long of a wait time could increase their prices even more if they wanted to. 

It might be the better value to get a top person in a mid sized city and save a ton of money even when factoring flight and hotel. 

[nikosgreece]

11 hours ago, asterix0 said:

You have picked excellent doctors, I think Dr. Zarev will be the best choice for you. He spends 3 hours with his patients during the consultation, will analyze your donor microscopically, and give you a thorough plan for the long term as your hair loss progresses. 

The only downside is, perhaps you have to wait a while for the consultation and procedure as he is very busy. But afterwards your donor will in excellent shape as he is maybe the best in the world in donor management. 

Hello, 

1. i had alread booked with zarev in bulgaria, he will see me in 7 days.
2. i want to see Freitas also. He told me can see me online with photos in 30 days or in person in spain in 3 months

My question is If freitas see me online will the prediction of my pattern, donor area grafts etc will be precise? Which to choose online or person in person?

i can travell to spain, for 1 day , no problem.

[asterix0]

12 hours ago, nikosgreece said:

Hello, 

1. i had alread booked with zarev in bulgaria, he will see me in 7 days.
2. i want to see Freitas also. He told me can see me online with photos in 30 days or in person in spain in 3 months

My question is If freitas see me online will the prediction of my pattern, donor area grafts etc will be precise? Which to choose online or person in person?

i can travell to spain, for 1 day , no problem.

I would go with in-person to see De Freitas, pictures are never the best representation.

You are lucky to have gotten such a quick consultation with Dr. Zarev, I hope you enjoy it!

[mrmane85]

Did you have your consultation with Dr Zarev @nikosgreece? 

If so, what was the outcome?