How Many Grafts? I have a list of doctors and would appreciate any additional thoughts on them. Thanks

[Needadviceplease]

Hello,

I am in my 40s and am considering an HT.

For a variety of reasons I will probably have it done in Turkey.

After reading extensively, my list is Bicer, Demirsoy, HLC, Pekiner, Keser and Yaman. Possibly Turan/Gur. These seem to be the top doctors there. 

My plan is to hang out in Turkey for a couple of weeks and make sure everything is fine before heading home.

To be honest, I probably can't trust myself to say exactly what I need (i.e. right hairline etc), so hoping for the ones with the best judgement. Any advice would be appreciated.

I tried my best to get a shot of the back of the head. Hope it is enough to assess donor area.

Thanks!

Edited May 19, 2022 by Needadviceplease
additional comment

[RTC]

Bicer and FUECAPILAR (Turan and Gur) are great, I've only seen good results from them.

 

Not sure how many grafts, but I'm sure if you went to someone like Bicer she'd advise only doing the front and then the crown in a later procedure.

[TommyLucchese]

Looks to me like a H&W or Hattingen megasession of 5k grafts would be best way to go if the donor and budget is there. (plus if you actually care about sorting the crown out).

Why are you so set on Turkey?

[Melvin- Admin]

Are you on any preventative medication?

[1978matt]

The problem with Turkey is they charge a low graft rate.  This means they want to push the number of grafts high to get their money's worth out of you.

Instead of 5000 grafts and obliterating the donor in one go, I think you might actually benefit from a more conservative approach.

You could do about 2000-2500 at the front half of your head and frame the face, maintaining a side part hairline style.

 

[THE TRUTH]

Hard to say....You look like you are around Norwood 5 already. 

I would say at least 5000 grafts. Probably  more. And when I say 5000 grafts that would be just to provide some baseline "illusion of density" coverage and make you look less than bald in appereance. That wouldn't give you real density. 

However you wanna stay away from clinics that do giga sessions in Turkey...They often fail because they have very poor survival rate.  

You should get on medication first before attempting anything. 

Try the following stack for at least 6 months and see how it goes. 

Dutasteride 0.5mg daily

Oral minoxidil 2.5mg daily 

Fluridil or RU58841 once daily topically

You need to see if you can improve some of the existing miniaturized hairs as well as strengthen them enough to avoid potential permanenent shock loss in case you decide to get a transplant further down the road. 

Pekiner is solid although he has a controversial reputation on this forum. So far I've seen only 2 bad cases from him. His results are okay for the most part. 

Bicer and Gur are both good options if you are on a budget. They are not elite but so far I've seen solid work from both. 

HLC is good too but not comparable to the best clinics in Europe such as Couto, Freitas, Bisanga. They have quite a few subpar results on this forum...

Keser seems highly involved but Freitas or even Ferreira are probably a lot better for the same price. 

I'd stay away from Yaman. 

That's pretty much it. 

Even if you choose a good doctor I would do a small test surgery first to see how well you respond to it. 

Don't go all at once please. Never do like 5000 grafts in one session.  You run the risk of losing your limited grafts forever. 

Some doctors like Zarev, Pitella or Hattingen for FUT have mastered mega sessions but you'd have to increase your budget. 

Edited May 19, 2022 by lack of bludflow

[Needadviceplease]

Hi, thanks for the reply and suggestion. One reason is cost and another is I will be around that part of the world, so it is convenient.

[Needadviceplease]

10 hours ago, Melvin- Moderator said:

Are you on any preventative medication?

No. I have done some minoxidil in the past but been many years. I'd like to stay off meds if I could.

Edited May 20, 2022 by Needadviceplease

[THE TRUTH]

4 hours ago, Needadviceplease said:

No. I have done some minoxidil in the past but been many years. I'd like to stay off meds if I could.

Unfortunately the truth is you cannot really stay away from meds if you decide to go for a transplant because of the following reasons. 

You risk permanent shock loss of native miniaturized hairs on the recipient area. 

You risk further progression of balding which means additionnal surgeries may be required while your donor area is limited... You are Norwood 5 already so if your crown drops lower for example you will not have enough grafts left to fill in everything. 

You may have DUPA which is androgen caused thining in the donor area too. That means your transplanted hairs will start thinning too after a few years.

I would at least consider Finasteride 1mg. 

Minoxidil works by stimulating dermal papilla cells through potassium channels but it does not tackle the underlying rootcause of hairloss in men: genetic sensitivity of hair follicles to DHT. 

Good luck and all the best

[Doron Harati]

Around 5000 grafts, but you need to check with a clinic before how many max grafts you can you take without overharvesting your donor.

I am the coordinator of HDC clinic with Dr. Maras and Dr. Christina in Cyprus which is near to Turkey, we're also recommended by this forum, for consultation you're welcome to PM or WhatsApp +972526542654

[Gramatik]

U have to use oral finasteride not only hair transplant. U are already a Norwood 5 and u need at least 5000 grafts for a decent result. All doctors you mentioned are safe and good choices to go to Turkey. So depending on your budget you could select the appropriate for you. Good luck 🤞 

[GoliGoliGoli]

On 5/20/2022 at 8:20 AM, Gramatik said:

U have to use oral finasteride not only hair transplant. U are already a Norwood 5 and u need at least 5000 grafts for a decent result. All doctors you mentioned are safe and good choices to go to Turkey. So depending on your budget you could select the appropriate for you. Good luck 🤞 

 

On 5/20/2022 at 3:10 AM, THE TRUTH said:

Unfortunately the truth is you cannot really stay away from meds if you decide to go for a transplant because of the following reasons. 

You risk permanent shock loss of native miniaturized hairs on the recipient area. 

You risk further progression of balding which means additionnal surgeries may be required while your donor area is limited... You are Norwood 5 already so if your crown drops lower for example you will not have enough grafts left to fill in everything. 

You may have DUPA which is androgen caused thining in the donor area too. That means your transplanted hairs will start thinning too after a few years.

I would at least consider Finasteride 1mg. 

Minoxidil works by stimulating dermal papilla cells through potassium channels but it does not tackle the underlying rootcause of hairloss in men: genetic sensitivity of hair follicles to DHT. 

Good luck and all the best

Don't listen to these guys. You don't have to go on Fin or oral Min as long as you're donor area is fine and you're realistic about what results you can get out of a HT and how many you may need to get the results you want. But the big question is how much ammunition you have in your donor. It's hard to tell from your pictures and really can only be assessed in person if you want accurate assessment. 

 

Topical minoxidil does seem worth it and fairly side effect free, but maybe best avoiding depending on your particular cardiovascular situation. 

Edited July 26, 2022 by GoliGoliGoli

[Needadviceplease]

On 7/26/2022 at 10:24 PM, GoliGoliGoli said:

 

Don't listen to these guys. You don't have to go on Fin or oral Min as long as you're donor area is fine and you're realistic about what results you can get out of a HT and how many you may need to get the results you want. But the big question is how much ammunition you have in your donor. It's hard to tell from your pictures and really can only be assessed in person if you want accurate assessment. 

 

Topical minoxidil does seem worth it and fairly side effect free, but maybe best avoiding depending on your particular cardiovascular situation. 

Thanks. Isn't there a topical fin now? I may be willing to risk that for a few months just to help in the initial stabilization and recovery. I am 50 and my hair loss seems to have stabilized.

Edited July 29, 2022 by Needadviceplease

[Needadviceplease]

Small Update. I am leaning towards Dr. Kongkiat Laorwong.

He wrote me the following:

"Your donor hair is good, I think 6000 grafts can be extracted. 

We can do 2 separate sessions. 

First, 2500-3000 grafts for the frontal area, 1 year later do the rest. 

I normally do 3000-4000 grafts in big balding patients. 

You can stay a bit longer for LLLT , we can remove the scabs for you after 1 week.

This price we include free PRP injection during the procedure and post op medications, wound care and LLLT (low level light laser treatment) for 5 days.  "

I have a few questions please. I plan on staying in Thailand for a couple of weeks after surgery to make sure everything is ok. 

 

1) Would my crown benefit from SMP? I wonder if I could have that done after scabs have been removed. Or is that too close to when I had the HT. I figure I could have a more complete look while waiting for the HT the following year.

 

I tried searching, but no luck seeing if others have had done something similar.

 

2) I can buy topical Fin in BKK? I used to use minoxidil and felt ok using it. But someone warned me of potential heart issues. I caught a small case of Covid (I am vaxxed-so easy recovery) but had weird minor lingering things. So I am trying to be cautious

 

3) Thailand requires a PCR or proof of covid vax. Will a photo be acceptable? Or a copy? Don't have the original on me (traveling).

 

4) If I get there a couple of days before, I can find a neck pillow, etc right? Plenty of time?

 

5) any suggestions on where to stay?

 

6) Is there value in trying to add another PRP session right before I head home? Just trying to improve my chances of a good recovery.

 

Thanks!

Edited July 29, 2022 by Needadviceplease

[mafpe]

27 minutes ago, Needadviceplease said:

Small Update. I am leaning towards Dr. Kongkiat Laorwong.

He wrote me the following:

"Your donor hair is good, I think 6000 grafts can be extracted. 

We can do 2 separate sessions. 

First, 2500-3000 grafts for the frontal area, 1 year later do the rest. 

I normally do 3000-4000 grafts in big balding patients. 

You can stay a bit longer for LLLT , we can remove the scabs for you after 1 week.

This price we include free PRP injection during the procedure and post op medications, wound care and LLLT (low level light laser treatment) for 5 days.  "

I have a few questions please. I plan on staying in Thailand for a couple of weeks after surgery to make sure everything is ok. 

 

1) Would my crown benefit from SMP? I wonder if I could have that done after scabs have been removed. Or is that too close to when I had the HT. I figure I could have a more complete look while waiting for the HT the following year.

 

I tried searching, but no luck seeing if others have had done something similar.

 

2) I can buy topical Fin in BKK? I used to use minoxidil and felt ok using it. But someone warned me of potential heart issues. I caught a small case of Covid (I am vaxxed-so easy recovery) but had weird minor lingering things. So I am trying to be cautious

 

3) Thailand requires a PCR or proof of covid vax. Will a photo be acceptable? Or a copy? Don't have the original on me (traveling).

 

4) If I get there a couple of days before, I can find a neck pillow, etc right? Plenty of time?

 

5) any suggestions on where to stay?

 

6) Is there value in trying to add another PRP session right before I head home? Just trying to improve my chances of a good recovery.

 

Thanks!

1. i think you would need to wait for months until the area is fully healed. it's best to not risk the area just after the operation.

2. if you are fine with using it, unless you increase the dose, it's unlikely for you to experience the increased heart rate unless some specific health condition is achieved.

3. usually each country have their own way of tracking their citizen vaccination and or PCR test, you can use these, or if not, any proof of them (vaccine cards, PCR result from clinic, etc)

4. imo you can just get a neck pillow before going there, so that way you can be stress free. if not, yes, you should be able to find one.

5. -

6. It might help, but as far as i know, LLLT or PRP doesn't give a significant amount of boost, but perhaps they do so marginally. it's up to you whether to get it or not.

[Ramons]

2 hours ago, Needadviceplease said:

Small Update. I am leaning towards Dr. Kongkiat Laorwong.

He wrote me the following:

"Your donor hair is good, I think 6000 grafts can be extracted. 

We can do 2 separate sessions. 

First, 2500-3000 grafts for the frontal area, 1 year later do the rest. 

I normally do 3000-4000 grafts in big balding patients. 

You can stay a bit longer for LLLT , we can remove the scabs for you after 1 week.

This price we include free PRP injection during the procedure and post op medications, wound care and LLLT (low level light laser treatment) for 5 days.  "

I have a few questions please. I plan on staying in Thailand for a couple of weeks after surgery to make sure everything is ok. 

 

1) Would my crown benefit from SMP? I wonder if I could have that done after scabs have been removed. Or is that too close to when I had the HT. I figure I could have a more complete look while waiting for the HT the following year.

 

I tried searching, but no luck seeing if others have had done something similar.

 

2) I can buy topical Fin in BKK? I used to use minoxidil and felt ok using it. But someone warned me of potential heart issues. I caught a small case of Covid (I am vaxxed-so easy recovery) but had weird minor lingering things. So I am trying to be cautious

 

3) Thailand requires a PCR or proof of covid vax. Will a photo be acceptable? Or a copy? Don't have the original on me (traveling).

 

4) If I get there a couple of days before, I can find a neck pillow, etc right? Plenty of time?

 

5) any suggestions on where to stay?

 

6) Is there value in trying to add another PRP session right before I head home? Just trying to improve my chances of a good recovery.

 

Thanks!

1) I just had 3800 grafts by Dr Laorwong and would highly recommend him

2) I have taken oral finasteride and minoxidil for over 15+ with no side effects…everyone is different but I would consult your Dr and at least try

3) Thailand requires a few things for entry; proof of vax which you will need a legitimate copy of - should be able to obtain from whoever administered your vaccinations (the Australian government was easy), you need a Thai Pass also (an electronic entry application and finally insurance of at least $US20k…there a few Thai providers and it is cheap

4) Neck pillows are on sale in just about every airport around the world…plus you will have no problem finding one in Thailand 

5) Can not talk highly enough of Avani+ Riverside hotel. It is close to the clinic, beautiful rooms, breakfast included and has a centre attached with restaurants or take out plus a 7-11 for when you want to lay low and recover.

6) If you can afford the PRP why not