Patient Physiology and Survival Rate.

[mister_25]

Hey everyone, I have a FUE hair transplant coming up nearing the end of the year and I'm super nervous but also excited. I've done research and I am going to a reputable surgeon and clinic and I'm definitely focused on trying to get the best result possible.

However one thing that makes me really nervous is the topic of Patient Physiology. From what I've seen, even if you get impeccable work done by a top doctor, you are true and diligent to the post operative care and you have stabilized your hair loss for over a year, on the correct medication, healthy lifestyle and healthy diet and you have all these factors in your favor. You can still get a bad result and poor survival rate because of your own physiology.

I'd like to ask how would I know before I jump in the procedure that my own physiology would be against me? This is one of my biggest fears, I've eliminated a lot of the obstacles. I've been on Finasteride and Minoxidil for over a year (16 Months Minoxidil, 17 Months Finasteride) which has stabilized and given me regrowth, I've decided to not cheap out of my money and are going to a elite clinic and surgeon, I don't smoke or drink alcohol or do any hard drugs and I'm trying to lead a healthy lifestyle (working on the diet + been exercising somewhat regularly for over a year).

Is there a test that I could do and I could send the results of that test to the surgeon and ask them about it? Like a blood test or a scalp biopsy. Is there anything I should look at? I don't have any diagnosed scalp conditions or anything like that. 

Otherwise what are things that I can do that would greatly up my chances of a successful surgery. Really interested to hear about this as I see patient physiology thrown around in the forums a few times as justification for bad healing or bad survival rate, and would like to eliminate this obstacle before my surgery and also to ease my nerves.

[Gasthoerer]

As you mention yourself: There is a risk in having a HT even if you chose a great clinic (even though the risk is minimized). 

Besides going to a top notch Derm and test for the usual skin diseases, my recommendation would be: Have a smaller procedure to start with. Of course it depends on your status which kind and size of procedure is suitable. I started with a 400 FU surgery before opting for a larger surgery (as shown in my signature).

Good luck. 

[THE TRUTH]

I would totally second what Gasthoerer said. 

I ALWAYS recommend doing a small test surgery first to evalute the graft survival. 

Way too many patients make the mistake of  going with a large procedure....

I've seen sooo many cases of guys throughout the years especially who are Norwood 4-5 and get 5000 grafts megassion and there is literally ZERO survival....

Most famous cases on this forum are the numerous ASMED bad results. But I've also seen a few  poor cases from reputable places such as Hasson & Wong and I remember even one from Dr. Couto on belicapelli ! 

So yes you are right. The risk of poor survival exists. Even with top doctors and even if you are on medication and doing everything right. Sad but true...

Hair transplant is always a big gamble and a lottery. You can never guess the outcome and it is important to be prepared mentally for it and you have to accept that before going forward and getting surgery. It's like playing poker. 

You have to accept the possibility of failure and losing it all before you start gambling...

Also discuss that specific aspect with your surgeon. Ask him openly what if things go wrong and my grafts don't grow back ? Will I be given a refund in case of total failure or free touch-up in case of sligthly  subpar result ? 

But of course it is a very bad idea to return to the same place if they give a bad result in the first place...

All in all, your chances of sucess should be quite high if you go to a great surgeon and if you are medication. But be prepared psychologically for all scenarios. 

There is not much more you can do except 3 things

1. Chosing a great doctor with a history of good and consistent results and as few bad results as possible. Remember no doctor is perfect. There is no such doctor that hasn't messed up at least one patient. For every great cherry picked result that you see online, there at least 5 or 10 unhappy patients with subpar results. 

2. Being on medication at least 6 months to a year prior to surgery in order to strengthen both your donor as well as the native miniaturized hairs on the recipient area and hopefully improve the outcome of your surgery. 

3. Checking with a very experienced trichologist if you are experiencing a rare skin condition such as scarring alopecia, Lichen Planopilaris, folliculitis etc... that may jeopardize the growth of the grafts. 

All the best and good luck ! 🙏

[mister_25]

9 hours ago, Hope everything is nova said:

I would totally second what Gasthoerer said. 

I ALWAYS recommend doing a small test surgery first to evalute the graft survival. 

Way too many patients make the mistake of  going with a large procedure....

I've seen sooo many cases of guys throughout the years especially who are Norwood 4-5 and get 5000 grafts megassion and there is literally ZERO survival....

Most famous cases on this forum are the numerous ASMED bad results. But I've also seen a few  poor cases from reputable places such as Hasson & Wong and I remember even one from Dr. Couto on belicapelli ! 

So yes you are right. The risk of poor survival exists. Even with top doctors and even if you are on medication and doing everything right. Sad but true...

Hair transplant is always a big gamble and a lottery. You can never guess the outcome and it is important to be prepared mentally for it and you have to accept that before going forward and getting surgery. It's like playing poker. 

You have to accept the possibility of failure and losing it all before you start gambling...

Also discuss that specific aspect with your surgeon. Ask him openly what if things go wrong and my grafts don't grow back ? Will I be given a refund in case of total failure or free touch-up in case of sligthly  subpar result ? 

But of course it is a very bad idea to return to the same place if they give a bad result in the first place...

All in all, your chances of sucess should be quite high if you go to a great surgeon and if you are medication. But be prepared psychologically for all scenarios. 

There is not much more you can do except 3 things

1. Chosing a great doctor with a history of good and consistent results and as few bad results as possible. Remember no doctor is perfect. There is no such doctor that hasn't messed up at least one patient. For every great cherry picked result that you see online, there at least 5 or 10 unhappy patients with subpar results. 

2. Being on medication at least 6 months to a year prior to surgery in order to strengthen both your donor as well as the native miniaturized hairs on the recipient area and hopefully improve the outcome of your surgery. 

3. Checking with a very experienced trichologist if you are experiencing a rare skin condition such as scarring alopecia, Lichen Planopilaris, folliculitis etc... that may jeopardize the growth of the grafts. 

All the best and good luck ! 🙏

Thank you for the input. I do have a 4000-4500 graft transplant scheduled with Dr Hasson and it’s getting quite close. I don’t think I would be able reschedule just for a small 400-600 graft transplant although I wish I could. The emotional baggage that comes with this procedure is a heavy burden on myself for various factors (early 20s, regressed to a high norwood quite early, bullying and affecting opportunities in life) And I just wish for people to not mock me everyday for being 22 and having the hair of someone in their 50s

I will schedule a appointment with my trichologist as early as I can. I might even contact the clinic and ask getting a small 100-150 graft procedure locally as a test before my surgery with dr Hasson in December would be plausible or a good Idea.

A small question though. If your physiology was against you and you did your test procedure and the results were pretty poor. Do you just give up on the HT and move on to a hair system or SMP? Emotionally it’s taken a massive toll on my Self esteem and confidence, and even with the advice which I’ve seen before which is “prepare for all scenarios” I just don’t think I would be able to, it’s not just affecting my looks and confidence but my real life relationships, friendships and opportunities as well.

I also have done a blood test outside of this hair transplant for another problem that came up recently and I’m awaiting for the results. Anything in particular I should look at or ask?

Also is there any signs that a person would respond well to the transplant? Such as responders to minoxidil or Finasteride or anything like that?

Once again thank you for the input, if you have any other advice that I could possibly do and or incorporate into my life to increase yield/survival rate/etc. Please let me know

 

Edited July 2, 2022 by mister_25

[Mike10]

you're only 22 and you're already doing surgery.?Who is your surgeon?

[mister_25]

39 minutes ago, Mike10 said:

you're only 22 and you're already doing surgery.?Who is your surgeon?

Dr Hasson from Hasson and Wong

[Mike10]

I do not know man. what norwood level are you?

[THE TRUTH]

34 minutes ago, mister_25 said:

Dr Hasson from Hasson and Wong

Actually you are going to be operated mostly by the technicians from Hasson & Wong clinic. 

Dr. Hasson will only perform the planning and incisions. 

Extractions and Implantation is done by the technicians.

[mister_25]

11 hours ago, Mike10 said:

I do not know man. what norwood level are you?

Norwood 5. My front is very thin, I have a somewhat strong mid scalp but some work in it would still go a long way and a almost bald crown although on a phone consultation with Doug from H & W he did mention that my crown was quite small. I would probably need two procedures according to the consultation. I’ll post some photos later.

EDIT: Here are some photos to give you a idea of where I'm at.

Pic 1: Hair combed back, bathroom lighting, taken on the HD lens on my Iphone (Taken in July)

Pic 2: Hair Combed Back, darker lighting (early morning, without a overhead light) HD lens on my Iphone (Taken in July)

Pic 3: Hair parted from the middle. Bathroom Lighting, HD lens on my Iphone (Taken in July)

Pic 4: Hair wet with Minoxidil, Combed back, Bathroom Lighting, Selfie Camera on my Iphone (Taken in June)

Pic 5 and Pic 6: Holding up the long terminal hairs that are on my mid scalp. Note: I haven't cut my hair in 3 years, I started minoxidil in March 2021. Those hairs I am holding are about 3 years of growth and were not shedded when starting minoxidil, whilst I do have miniaturized hairs that are somewhat long but pale in comparison. Selfie Camera on my Iphone (Taken in July)

Pic 7: Crown, Spread part and made to look as bad as possible, Bathroom Lighting, (Cant remember which camera) (Taken in July)

Pic 8, Pic 9 and Pic 10: Taken by my Trichologist on Feburary 2021. Before medication. (These pictures were taken when I was 20 years old. Hard to look at) (Started Saw Palmetto the day these were taken, 2 weeks later started Oral Finasteride 1mg, two after that started Topical Minoxidil 7% 2mL once a day)

 

11 hours ago, Hope everything is nova said:

Actually you are going to be operated mostly by the technicians from Hasson & Wong clinic. 

Dr. Hasson will only perform the planning and incisions. 

Extractions and Implantation is done by the technicians.

I am aware of this, Although I believe that this is mostly standard that the doctor does incisions and the technicians with years of experience and trained under the doctors often become very talented and skilled at extractions and implantation.

I chose Dr Hasson cause I’ve noticed that most of his work is quite dense and he is very consistent. After researching many pages worth of his results on this forum I was only able to find about 5 disappointing results and out of those 5 you could consider 2 to be failures. I also chose him due to the years of experience and his contributions to the industry, his reputation that this and other forums have of him. There were also other reasons such as that Vancouver is a bit familiar to me as I have family over there. 

Edited July 4, 2022 by mister_25