Rejected twice for HT due to not using fin?

[zztop01]

I just got rejected from another EU doctor due to being in my 30s, NW5/6 and not using medication (fin/minoxidil or dut).

Got told that if I get the HT, the effect would be minimal and not lasting, and it's not worth it financially. On the other hand, doctors in Turkey did seem eager to operate, so I'm not sure who to listen to?

Do any NW5/6 have successful HTs without medicine?

Edited May 15, 2022 by zztop01

[HappyMan2021]

I agree with the European doctors. 

[NARMAK]

I would say the doctors who rejected you and could have probably made good money from you and turned you away for complaining of a "failed HT" down the road when not using medication shows they've out ethics above profit. 

Turkey however you have people willing to put your short term perceived gain front and centre to prey on you for profit. You're likely to end up in one of numerous Horror Mills who will do what can only be described as butchering of a precious donor area and have no accountability in the post-op. Their entire MO is to reel people in via fancy marketing, get your money and then brush you away if you complain. 

[Britanium]

Please let us know the names of the clinics/Drs who you have been consulting with so far. Being a higher Norwood the only one in Turkey I would consider would be Dr Bicer. Of course many clinics would just agree as they want your business, they are not considering what would be best for you. That’s not to say that some clinics might be able to take on you without being on Meds though… 

Maybe you could get some consultations done with @DrTBarghouthi(Vertex), HDC @Doron Harati, @Dr. Felipe Pittella, @DrMunibAhmad(Fuegenix), @Eugenix Hair Sciences, Hattingen & Dr Zarev.. 

[Britanium]

Would you also mind sharing some pics ? Thanks 🙏 

[ML488]

Would love to see some pics

[Hair4Days]

Why would the effects be minimal and not lasting? Meds just hold onto the hair on top longer. Your donor is long lasting hair

Edited May 16, 2022 by Hair4Days

[GaryStruthers]

Yep. Count yourself lucky that you found this forum, as I imagine many other younger guys wish they did post Turkey. Transplants are available medication free, but just be prepared for 2 to 4 surgeries as you age. Are you able to try meds to see how you’ll respond? I jumped on 1mg of Fin and Minoxidil foam for a year just to see. No real side effects (I was worried) I got a lot of hair back, and my Eugenix surgery in August will be significantly cheaper. You’re in good hands here. 

Edited May 16, 2022 by GaryStruthers

[mrmane85]

Reach out to @Dr. Felipe Pittella. He doesn't recommend fin and is a  high NW specialist.

He will recommend oral and topical min as an alternative.

[general-etwan]

North American and European transplant doctors are the most strict in the world because most only want to operate on cases that they feel will turn out the best. They also want to keep your expectations in check and they don't want to charge you so much for a procedure that you'd then complain about.

Transplanted hair doesn't need finasteride, but the idea is that original hair that is still left on your scalp, behind the transplanted hair, will continue to disappear without medication, leaving an unsatisfactory appearance that could lead to complaints. I always use Joe Biden as what I believe to be an example of this. It seems almost certain that he had a transplant when he was younger in the hairline area because his hairline strengthened up and has remained intact for all the years since. That would be extremely odd if he hadn't had a transplant. However, he has a giant bald spot from the middle of his scalp to the crown because there was no hair transplanted there and either he didn't take medication or the medication didn't work for him to help keep or regrow that hair.

I consulted with Bernstein in NYC in 2020 and they rejected me because I had not tried finasteride and was a NW6. They told me they'd never charge me for a procedure that would not make me happy. They told me I'd need to take finasteride for a year first and see regrowth and then reevaluate. 

At the end of last year I decided to go on finasteride, and luckily since I'm young and my hair loss was more recent, I've been able to regrow a decent amount of hair, and now I'm in a stronger position to have a procedure done. 

Turkey hair clinics are more likely to do whatever you request and just take your money.

I strongly recommend everyone try finasteride (+ minoxidil, + microneedling) for a while prior to getting serious about having a HT. At worst, you won't get regrowth or you'll be a non-responder, and at best, you'll regrow native hair which will mean a HT can be fewer grafts meaning lower cost. Finasteride is a very safe and widely used medication and 95% of men who take it experience no negative side effects at all, and much of the remaining 5% who do can tolerate the side effects. 

Edited May 16, 2022 by general-etwan

[DrTBarghouthi]

Please share som photos if possible.

[mafpe]

it depend on what you're looking for, are you fine with the hair only lasting probably 2-8 years? it would stay probably for a couple of years, but after that it's a mystery.

 

now for the pessimistic and grumpy way of looking at it,

the doctors that rejected you are fearful that you become a bad example of their works, and the possibility that you rage on them because the transplanted hair either do not last, or is too sparse. The headache that people will brand them as incompetent if your head later keeps losing the transplanted hair and being compared to other surgeons are not something any doctor want to have.

you are on the far end of baldness already and don't plan on taking the meds to keep your hair loss progression in control, these factor won't produce a stellar result, especially not for the long term.

 

for those who agreed, it's possible that they just say yes to get client, or they are confident that donor hair does not miniaturise nor are they affected by MBP, so they think it's okay to give you an HT.

 

apology if the sentences are rather jarring or looking at things very negatively on the pragmatic side of thing.
i saw that other people already explain correctly on the why.
simply put... your HT carry a higher risk than those who are lower NW, and or are taking the meds.

[Eugenix Hair Sciences]

8 hours ago, zztop01 said:

I just got rejected from another EU doctor due to being in my 30s, NW5/6 and not using medication (fin/minoxidil or dut).

Got told that if I get the HT, the effect would be minimal and not lasting, and it's not worth it financially. On the other hand, doctors in Turkey did seem eager to operate, so I'm not sure who to listen to?

Do any NW5/6 have successful HTs without medicine?

It is ethical to tell you that your baldness will progress and new areas will get empty. Taking medications will prevent any further progression of baldness. Without medications, transplant would be a hassle as you would have to go for it again and again.

[zztop01]

Thank you everyone for the replies, I'm happy to get this much information and feedback! 

- Back when I was younger, I used to have the occasional ED, probably due to anxiety. That is pretty much solved with nofap, though I wouldn't really like risking that again. So I guess, my past issues do tell me that I may be prone to issues down there. I'll also have a wedding in August, so have to think of the children 😅

My hairloss started at 16, and is pretty much at the same level where my father and both grandfathers are. All three of them are diffuse thinners, around NW5 and NW6. How likely is for me to progress beyond my ancestors? I thought my hairloss is pretty much stable, that's why I was willing to risk it, but if you think it could get worse, then perhaps not doing an HT so I can shave without scars might be a better option.

 

 

 

 

 

 

 

 

Replies:

On 5/16/2022 at 12:19 AM, J-C said:

Please let us know the names of the clinics/Drs who you have been consulting with so far. Being a higher Norwood the only one in Turkey I would consider would be Dr Bicer. Of course many clinics would just agree as they want your business, they are not considering what would be best for you. That’s not to say that some clinics might be able to take on you without being on Meds though… 

Maybe you could get some consultations done with @DrTBarghouthi(Vertex), HDC @Doron Harati, @Dr. Felipe Pittella, @DrMunibAhmad(Fuegenix), @Eugenix Hair Sciences, Hattingen & Dr Zarev.. 

I got rejected at Lorenzo and Pinto. Ferreira never replied back, either denied or maybe too busy.

I did email Bicer, was told I'm a good candidate at that clinic. 3800 grafts first session for the front, then second session some time later for the crown.

 

On 5/16/2022 at 12:31 AM, ML488 said:

Would love to see some pics

Done, posted the pics!

 

On 5/16/2022 at 3:11 AM, GaryStruthers said:

Yep. Count yourself lucky that you found this forum, as I imagine many other younger guys wish they did post Turkey. Transplants are available medication free, but just be prepared for 2 to 4 surgeries as you age. Are you able to try meds to see how you’ll respond? I jumped on 1mg of Fin and Minoxidil foam for a year just to see. No real side effects (I was worried) I got a lot of hair back, and my Eugenix surgery in August will be significantly cheaper. You’re in good hands here. 

Thanks! The problem is, I have had past ED issues, and don't want to aggravate them again (and have a wedding in August). Plus I may need to have an orthopedic surgery some time later, and it's probably not good to risk experimenting before that.

 

On 5/16/2022 at 6:10 AM, general-etwan said:

North American and European transplant doctors are the most strict in the world because most only want to operate on cases that they feel will turn out the best. They also want to keep your expectations in check and they don't want to charge you so much for a procedure that you'd then complain about.

Transplanted hair doesn't need finasteride, but the idea is that original hair that is still left on your scalp, behind the transplanted hair, will continue to disappear without medication, leaving an unsatisfactory appearance that could lead to complaints. I always use Joe Biden as what I believe to be an example of this. It seems almost certain that he had a transplant when he was younger in the hairline area because his hairline strengthened up and has remained intact for all the years since. That would be extremely odd if he hadn't had a transplant. However, he has a giant bald spot from the middle of his scalp to the crown because there was no hair transplanted there and either he didn't take medication or the medication didn't work for him to help keep or regrow that hair.

I consulted with Bernstein in NYC in 2020 and they rejected me because I had not tried finasteride and was a NW6. They told me they'd never charge me for a procedure that would not make me happy. They told me I'd need to take finasteride for a year first and see regrowth and then reevaluate. 

At the end of last year I decided to go on finasteride, and luckily since I'm young and my hair loss was more recent, I've been able to regrow a decent amount of hair, and now I'm in a stronger position to have a procedure done. 

Turkey hair clinics are more likely to do whatever you request and just take your money.

I strongly recommend everyone try finasteride (+ minoxidil, + microneedling) for a while prior to getting serious about having a HT. At worst, you won't get regrowth or you'll be a non-responder, and at best, you'll regrow native hair which will mean a HT can be fewer grafts meaning lower cost. Finasteride is a very safe and widely used medication and 95% of men who take it experience no negative side effects at all, and much of the remaining 5% who do can tolerate the side effects. 

Thanks for the info... Perhaps I may change my mind on fin, though probably not this year, or at least not before December since I have a few things to sort out.

Though I'm not really looking for perfect hair. Even Biden, I think he looks OK for his age.

Do you think if I'm older/balder, then the surgery would be easier to manage without medication?

 

On 5/16/2022 at 6:31 AM, DrTBarghouthi said:

Please share som photos if possible.

Done!

On 5/16/2022 at 7:45 AM, Eugenix Hair Sciences said:

It is ethical to tell you that your baldness will progress and new areas will get empty. Taking medications will prevent any further progression of baldness. Without medications, transplant would be a hassle as you would have to go for it again and again.

Thanks for the message, I posted some photos.

 

On 5/16/2022 at 6:47 AM, mafpe said:

it depend on what you're looking for, are you fine with the hair only lasting probably 2-8 years? it would stay probably for a couple of years, but after that it's a mystery.

 

now for the pessimistic and grumpy way of looking at it,

the doctors that rejected you are fearful that you become a bad example of their works, and the possibility that you rage on them because the transplanted hair either do not last, or is too sparse. The headache that people will brand them as incompetent if your head later keeps losing the transplanted hair and being compared to other surgeons are not something any doctor want to have.

you are on the far end of baldness already and don't plan on taking the meds to keep your hair loss progression in control, these factor won't produce a stellar result, especially not for the long term.

 

for those who agreed, it's possible that they just say yes to get client, or they are confident that donor hair does not miniaturise nor are they affected by MBP, so they think it's okay to give you an HT.

 

apology if the sentences are rather jarring or looking at things very negatively on the pragmatic side of thing.
i saw that other people already explain correctly on the why.
simply put... your HT carry a higher risk than those who are lower NW, and or are taking the meds.

I guess I'm not really looking for perfect hair like these football players.

I just wanted the front to be slightly stronger so I can keep my hair longer, and perhaps something on the crown so it isn't completely bald, just thinned out.

Would I be of lesser risk once I'm older and balder? I kind of feel like between choosing a risky/bad HT, or getting symptoms from fin 😅 Maybe I can just shave it off in a few years, and not risk having scars on the back of my head.  

Edited March 11, 2023 by Hans - Webmaster
Removed images for privacy reasons

[mafpe]

6 minutes ago, zztop01 said:

I guess I'm not really looking for perfect hair like these football players.

I just wanted the front to be slightly stronger so I can keep my hair longer, and perhaps something on the crown so it isn't completely bald, just thinned out.

Would I be of lesser risk once I'm older and balder? I kind of feel like between choosing a risky/bad HT, or getting symptoms from fin 😅 Maybe I can just shave it off in a few years, and not risk having scars on the back of my head.  

then technically you should be fine, like what eugenix rep said, you would need multiple transplant if you don't take preventive measure.
some people say that donor hair would never fall out or fail, but there are other sources, even doctors who says they have seen these hair miniaturising, so it's a mixed bag of opinion, i do hope that it would never, but the fact that other people do claim it happens, i think should be a thing to consider.

 

your hair is not norwood 5/6 yet, it might go there, but what you have right now is not as bad, just that you do have a vertex variant. i think you should be an okay canidate though, i guess the people who rejected you does so because of the meds. some surgeons refuse those who doesn't take it, unless they're only like, NW1-3.

it's hard to say honestly. the older you are, the more mature your pattern is, but by that point, you "might" not care if all other youre age is just as bald. you only minimize risk of losing the native hair because... they already falls out.

if you take meds, i'd say you should be able to get great results, otherwise it is a bit risky if not long lasting, but it's not really useless, you bought yourself a head full of hairs for several years, and if you're lucky, they'll be there to stay for long. 

on the side of meds... the chance of it giving you lasting harm if you just test it out is rather minimal, there are sides, but they are not guaranteed, and in most case, the effect is slight. if this is a dealbreaker for you, imo you can choose to either "buy time" or just shave it off.

 

if you're thinking about this because of your marriage in august, i say don't. the result wont be out in 3 months, you can rethink about this after the marriage. if you want a great looking hair at the date, i suggest you use hair fiber on the crown. and if you want to adress the front, i suppose a hair system can help.
after the marriage, if you still want a head full of hair, i say you think about it then. don't make hasty decision, in a way, HT is life altering.

[Eugenix Hair Sciences]

Cannot say how much it will progress but it definitely will progress in the crown. You will require 2500 grafts in the frontal zone and around 1500 grafts in the crown area. But without finasteride in the equation, progression of baldness seems inevitable. You can try and use topical finasteride and observe if you seem to have any side effects with it. While planning for the conception of a child, you need to stop the use of finasteride for at least two months prior to you trying.

Prevention of baldness is better than going in for multiple transplants. Hence, using medications along with going in for the transplant is better rather than waiting for more hair to disappear due to baldness.

You can have a perfect head of hair if you choose the right treatment plan.

Edited March 11, 2023 by Hans - Webmaster
Removed images for privacy reasons

[DrTBarghouthi]

Thanks for sharing. You do have a good donor area. Things may progress in your crown but generally if you decide not to prevent your loss , then you will definitely need a top up in the future. Have you considered oral minoxidil or topical finasteride along with possibly low level light therapy? I think some sort of maintenance will definitely help you but in general you can get good results with a HT.  You will likely need 3500-4000 grafts for both areas. This can ofcourse be staged (delaying crown) or using only moderate amounts in the crown so as to keep donor for future use. As long as you have reasonable expectations and are sensible about what to expect and the risks of having low maintenance, then you should be ok. 

[Rahal Hair Transplant]

Zztop,

Frankly, I’ve seen a number of individuals with hair loss similar to yours undergo hair transplant surgery quite successfully with exceptional results without taking finasteride.  And if your hair loss is truly stable, personally I see no reason why you’d be rejected for surgery unless you simply don’t have the donor or there is risks of future hair loss that transcends what is being discussed and shown here.

You still seem to have a good amount of hair on top of your scalp but even if you lost it and advanced to a Norwood five or six, if you have the donor for it, you could still restore a lot of hair making it look both natural looking and quite dense.

Your expectations would have to be reasonable but I don’t see any reason why you can’t re-create a conservative looking hairline that’s both natural and dense and gradually fade back into the midsection and crown leaving the crown a little thinner but still not bald.

As an example, I’ve undergone four hair transplant procedures and I have a pretty full looking head of hair even though I’m not taking finasteridw and would otherwise be a borderline Norwood class 6.   I used to wear my hair short and it looked quite dense in the front and midsection and only appeared a bit thinner in the crown. Now, I wear my hair longer and when I pull it up in a man bun, it looks like I have never seen any signs of hair loss. I also have a relatively youthful looking hairline rather than a conservative one.

That said, I’ve had close to 10,000 grafts to achieve this look but not everybody requires so many depending on many factors.  This includes the thickness of an individual’s hair (measured in microns), hair to scalp color contrast ratio, strategic placement of grafts, growth yield, etc. 

Keep in mind that you would very likely need more than a single procedure to meet your goals but as long as you’re in it for the long term, I think it’s very possible to achieve significant cosmetic improvement and thicker and fuller hair.

I’d be curious what Dr. Rahal would have to say about your case since you said others have denied you surgery. If you’re interested in a professional consultation with an expert surgeon who is recommended by this community and has been approved for advanced Coalition membership by this community, feel free to contact me privately I can get it set up.

Best wishes,

Rahal Hair Transplant 

[ciaus]

Hate to agree with the more pessimistic outlook, but I agree with the docs that think you're not a good candidate. You're hair is too long in the pics to effectively judge your donor area based off just looking at the pics. And that frontal pic here is showing your lateral humps are pretty much gone already, on your way to the most severe norwood 7 pattern.

However if you have realistic expectations, not concerned about others knowing you've had work done, just want some basic coverage and are ok with still having obvious thinning and good amount of baldness in your crown, you can try to go that route. I would strongly consider trying to avoid this whole mess though, shave your head and see how you and others like it. Much easier, less stress, less money.   

 

 

 

 

 

Edited March 11, 2023 by Hans - Webmaster
Removed images for privacy reasons

[Antlor]

Finasteride is FDA approved for hair loss. It is safe and effective. Why won't you take finasteride?

[Mike10]

At the end it is a personal decision whether to take the medication. Probably the majority does HT without Finansteride but this does mean it is a good choice. I have also decided to do a HT without medication https://www.hairrestorationnetwork.com/topic/63894-is-it-possible-to-predict-hair-loss/. However I am older with less extensive balding. The fact that some clinics are refusing should give you a pause.

 

 

Edited May 16, 2022 by Mike10

[zztop01]

Thanks for the responses, I'll check them out and post in case I make any decision.

Btw @J-C, did you have time to see the photos? Would love to get your opinion as well, cheers.

[Britanium]

6 minutes ago, zztop01 said:

Thanks for the responses, I'll check them out and post in case I make any decision.

Btw @J-C, did you have time to see the photos? Would love to get your opinion as well, cheers.

Just checked them out… I agree with the above that around 4k grafts will be needed. It’s a difficult call, on the one hand you do have sufficient donor area and a pretty fantastic beard that can be used to supplement the scalp grafts.. on the other hand you do show the dipping in the crown and dropping lateral humps mostly seen in Norwood 7s. With realistic expectations and a decent Dr/Clinic I do believe you can achieve a good result, as long as you realise the loss will continue without Oral/Topical Fin. Not all of us take Fin (I don’t) but I have chased the loss for over a decade. 

[RTC]

21 hours ago, Antlor said:

Finasteride is FDA approved for hair loss. It is safe and effective. Why won't you take finasteride?

This sounds alot like some of the propaganda we've been hearing for the last 2 years about certain other 'medicine' being pushed by big Pharma.

Just because something is FDA approved, it doesn't mean it's right for everyone. Many people have side effects on this medication which, imo, are worse than being bald.

Edited May 17, 2022 by Aslitarcan sucks

[RTC]

That said, OP I concur with @mrmane85, you could try topical Fin at a low dose as a compromise.