HLC: 23 years old, 3000 grafts - August 2022 - Dr. Cengiz

[Raskolnikov]

23 years old. Stabilized hair loss after one year on finasteride. In early March I browsed this forum (as well as Reddit) and narrowed my choices to Dr. Pekiner and HLC, both based in Ankara, Turkey. At the time, I was hoping to have Dr. Pekiner do my procedure, but it was several weeks before his advisor responded to my email/initial inquiry. HLC quoted me 2200-2600 grafts. Dr. Pekiner quoted me 3000 grafts.

Initially, HLC recommended that I wait a couple of years to do a transplant, but since I insisted that I would take finasteride for the rest of my life (and I wished to proceed with the procedure) they accepted, and wrote "nevertheless, we will not plan an aggressive/low hairline, due to your age. (...) we can rebuild the hairline and close the temples. We will also give the front area more density."

For now, I will not allocate any energy to describing the minute details of my time at HLC, as many others on this forum have already painted an accurate portrait of how the clinic operates, etc. That said, I'm an open book, and I'll answer any questions that are asked below.

For starters, I feel extremely lucky. One of the main concerns that many people have with HLC—myself included—is that you don't know which doctor (or how many doctors) will do your procedure. As of last week, there are four doctors who complete the procedures: Dr. Cengiz, Elif, Umut and Bekir. This means that the clinic will, at most, take on 2-3 new patients each day (because there is a roll-over from the previous day—some patients require two days). Only one other guy was set to have his procedure the same day(s) as me, and as it turns out, he had to cancel. I'm uncertain whether his cancellation significantly affected the itinerary for my procedure, but I'd like to think that his cancellation is partly the reason why Dr. Cengiz was the only doctor who worked on me over the course of two days. Additionally, I was the only patient he worked on both days.

Since my procedure last week, I've had a thought that has repeatedly resurfaced, and I'd like to hear what others think. Every once in a while, we see results from clinics that are subpar—HLC included. Of course, the clinic and doctors always receives the blame. I contend that the patients should be held more accountable. I'm an NCAA athlete, and I do my best to maintain a healthy lifestyle: I eat a nutritious diet, I've never smoked cigarettes, and I don't drink alcohol. I take a scoop of AG1 (formerly known as Athletic Greens) each morning. It leaves me to wonder how critical our post-op daily routines may play a role in the success of our hair transplant. I think as humans it's only natural to deflect responsibility onto others, and when we are at fault, we seldom admit it. Instead of blaming the doctor when the desired results aren't achieved, we should instead ask ourselves what we did different than the other 80-90% of patients (an arbitrary number) who received a good result.

To be sure, I am not making the claim that doctors don't make mistakes. Instead, I think that considering how crucial post-op care is during the first month, the patients should be held just as responsible (if not more) for the success of their results—specifically and especially if they had their procedure done at a reputable clinic.

day 1 post-op

day 5 post-op

day 7 post-op

Edited August 15, 2022 by Raskolnikov

[BaldReaper]

Your results will look great, good luck

[LookMaxx]

You forgot to censor yourself in the mirror lol

The HT looks good 👍

[Mike10]

Doing 3000 on a 23 year old with that kind of head of hair is not what I would call a conservative approach, particularly as the clinic did not even want to do surgery in the first place.Honestly there remain now only a handful of Drs I would trust my head with. As for lifetime Finansteride, who know if that will work. 

Edited August 12, 2022 by Mike10

[mister_25]

The hairline design looks well balanced and good. I think you will age well into to it if you dont continue to lose your hair behind it.

I also agree that 3000 grafts for the area is covered is a huge risk for the future. Based on your current hair loss you have no certainty of what your final Norwood pattern is. You could be super incredibly lucky and are destined for a Norwood 3 and just hit it early unfortunately. Or you could be like a majority of people and end up somewhere around 5-7. 3000 grafts is getting close to about half your donor capacity without compromising it. The work looks clean and I'm sure the results are going to be great, its just whether you maintain this head of hair for decades to come.

5 hours ago, Raskolnikov said:

ince my procedure last week, I've had a thought that has repeatedly resurfaced, and I'd like to hear what others think. Every once in a while, we see results from clinics that are subpar—HLC included. Of course, the clinic and doctors always receives the blame. I contend that the patients should be held more accountable. I'm an NCAA athlete, hence I take great care to eat a nutritious diet. I've never smoked cigarettes before, and I don't drink alcohol. I take a scoop of AG1 (formerly known as Athletic Greens) each morning. I'm not trying to signal anything about myself, but rather am considering how critical our post-op daily routines may play a role in the success of our hair transplant. I think as humans it's only natural to deflect responsibility onto others, and when we are at fault, we seldom admit it. Instead of blaming the doctor when the desired results aren't achieved, we should instead ask ourselves what we did different than the other 80-90% of patients (an arbitrary number) who received a good result.

Also a large majority of Hair Transplants that fail are from surgical error. There can be many reasons to dictate a failure such as poor angles, multis in the hairline, coarser hairs in the front, cobblestoning, etc that are all from the surgeon's performance. Poor growth however can be attributed to either the patient or the surgeon. And usually when its on the patients behalf its not necessarily their fault. Usually its underlying scalp conditions, or even just your body has poor healing and most of the grafts wont take. Although this is pretty rare and most of the time avoidable because if you have something that gets in the way of hair transplants its usually something you would be aware of (dermatitis, scalp psoriasis) which you could get a handle on before the surgery and still get a good result. However there are cases where you might have a underlying scalp condition that is not as easily detectable and slips through the cracks on why you have poor growth. Once you get a poor growth case, I believe everyone should get a scalp biopsy to determine if it really was surgical error or something else. 

Also how long have you been on finasteride? 

 

Edited August 12, 2022 by mister_25
im a idiot, didn't look at the pictures properly.

[Dillpickle123]

Ngl it’s gonna look good, Im the same age about the same amount of loss but 3000 grafts is a lot to use up for the donor it’s risky I wonder why they went so high? I think 2000 grafts would’ve been enough 

[Kent]

Looks awesome! Clean and densely packed! 

So happy for you!

[Gramatik]

Looks clean job mate. Happy growing. The fact that you take finasteride and you willing to take forever, means that your hairloss will more likely stabilise and you wont progress to a big norwood.

[stephcurry30]

Never heard of this doctor but posting to keep track of progress! Happy growing!

[HappyMan2021]

On 8/12/2022 at 9:10 AM, Raskolnikov said:

the clinic and doctors always receives the blame. I contend that the patients should be held more accountable. I'm an NCAA athlete, hence I take great care to eat a nutritious diet. I've never smoked cigarettes before, and I don't drink alcohol. I take a scoop of AG1 (formerly known as Athletic Greens) each morning. I'm not trying to signal anything about myself, but rather am considering how critical our post-op daily routines may play a role in the success of our hair transplant. I think as humans it's only natural to deflect responsibility onto others, and when we are at fault, we seldom admit it. Instead of blaming the doctor when the desired results aren't achieved, we should instead ask ourselves what we did different than the other 80-90% of patients (an arbitrary number) who received a good result.

To be sure, I am not making the claim that doctors don't make mistakes. Instead, I think that considering how crucial post-op care is during the first month, the patients should be held just as responsible (if not more) for the success of their results—especially if they had their procedure done at a reputable clinic.

this is ridiculous. 95% of a HT's success or failure goes on in the operating room. 

also, randomly stating that you are a college athlete to try to establish authority on a scientific issue....it's having the opposite effect you are intending

Edited August 13, 2022 by HappyMan2021

[sukh123]

42 minutes ago, HappyMan2021 said:

this is ridiculous. 95% of a HT's success or failure goes on in the operating room. 

also, randomly stating that you are a college athlete to try to establish authority on a scientific issue....it's having the opposite effect you are intending

Edited August 13, 2022 by sukh123

[Raskolnikov]

On 8/12/2022 at 12:23 PM, Mike10 said:

Doing 3000 on a 23 year old with that kind of head of hair is not what I would call a conservative approach, particularly as the clinic did not even want to do surgery in the first place.Honestly there remain now only a handful of Drs I would trust my head with. As for lifetime Finansteride, who know if that will work. 

I agree with you. I didn’t ask the doctors how much I have available in my donor area, but Dr. Cengiz (the one who did my procedure) told me that if I want/need to have another FUE procedure in the future (hopefully I don’t, but you never know..) I have an exceptional donor area and have enough for “several more procedures.”

[Kent]

20 minutes ago, Raskolnikov said:

I agree with you. I didn’t ask the doctors how much I have available in my donor area, but Dr. Cengiz (the one who did my procedure) told me that if I want/need to have another FUE procedure in the future (hopefully I don’t, but you never know..) I have an exceptional donor area and have enough for “several more procedures.”

If you need to be more efficient in the future with your donor area you could consider strip. Not sure why more younger guys aren’t choosing FUT. 

[Raskolnikov]

On 8/12/2022 at 2:16 PM, mister_25 said:

The hairline design looks well balanced and good. I think you will age well into to it if you dont continue to lose your hair behind it.

I also agree that 3000 grafts for the area is covered is a huge risk for the future. Based on your current hair loss you have no certainty of what your final Norwood pattern is. You could be super incredibly lucky and are destined for a Norwood 3 and just hit it early unfortunately. Or you could be like a majority of people and end up somewhere around 5-7. 3000 grafts is getting close to about half your donor capacity without compromising it. The work looks clean and I'm sure the results are going to be great, its just whether you maintain this head of hair for decades to come.

Also a large majority of Hair Transplants that fail are from surgical error. There can be many reasons to dictate a failure such as poor angles, multis in the hairline, coarser hairs in the front, cobblestoning, etc that are all from the surgeon's performance. Poor growth however can be attributed to either the patient or the surgeon. And usually when its on the patients behalf its not necessarily their fault. Usually its underlying scalp conditions, or even just your body has poor healing and most of the grafts wont take. Although this is pretty rare and most of the time avoidable because if you have something that gets in the way of hair transplants its usually something you would be aware of (dermatitis, scalp psoriasis) which you could get a handle on before the surgery and still get a good result. However there are cases where you might have a underlying scalp condition that is not as easily detectable and slips through the cracks on why you have poor growth. Once you get a poor growth case, I believe everyone should get a scalp biopsy to determine if it really was surgical error or something else. 

Also how long have you been on finasteride? 

 

Thank you for such a thoughtful response. I hope things turn out well and that finasteride prevents further hair loss. Even so, you’re completely right—it’s possible that I lose everything behind the new hair, and if that happens, I made a grave mistake. I suppose my 23 year old self is more of a risk-taker than my future (potentially bald) self would like.😉

As far as what I wrote concerning post-op care and how a lot could go wrong if the patient doesn’t do everything in his power to increase the likelihood of a successful transplant, I am not stating that failed hair transplants aren’t the results of doctors. That would be silly, especially considering how many hair mills are out there. “Absence of evidence is not evidence of absence.”  I could’ve written about all the things that doctors do wrong, but there are plenty of people who have already done that. Instead, I intended to pose a different way of viewing things amidst all the noise that is made by patients blaming doctors. Perhaps the majority of the patients that are blaming the doctors really did get screwed over.

And of course, my comment is for people who are healthy individuals who are ideal candidates for a hair transplant.

I’ve been on Finasteride for 16 months and it has been so helpful in helping stabilize and even regrow my existing hair.

[mister_25]

4 hours ago, Raskolnikov said:

Thank you for such a thoughtful response. I hope things turn out well and that finasteride prevents further hair loss. Even so, you’re completely right—it’s possible that I lose everything behind the new hair, and if that happens, I made a grave mistake. I suppose my 23 year old self is more of a risk-taker than my future (potentially bald) self would like.😉

As far as what I wrote concerning post-op care and how a lot could go wrong if the patient doesn’t do everything in his power to increase the likelihood of a successful transplant, I am not stating that failed hair transplants aren’t the results of doctors. That would be silly, especially considering how many hair mills are out there. “Absence of evidence is not evidence of absence.”  I could’ve written about all the things that doctors do wrong, but there are plenty of people who have already done that. Instead, I intended to pose a different way of viewing things amidst all the noise that is made by patients blaming doctors. Perhaps the majority of the patients that are blaming the doctors really did get screwed over.

And of course, my comment is for people who are healthy individuals who are ideal candidates for a hair transplant.

I’ve been on Finasteride for 16 months and it has been so helpful in helping stabilize and even regrow my existing hair.

The idea of healthy living having involvement in slowing/stopping hair loss is a myth. Sad reality is that people like me at 22 who are Norwood 5 are meant to be that way. I actually went bald rapidly around the time I started adding healthier habits myself, a shift in lifestyle for the positive.

You can even debate that healthier people have higher DHT production which could lead to a increase of hairfall. People that take creatine get increased testosterone and increased testosterone means increased DHT which leads to further balding. Creatine is associated with Bodybuilding which is seen as a healthy outlet for men/women. Personally I don't really believe that healthy living equates to more hair fall myself although I've definitely seen people argue about that, always seen that as a ridiculous notion. Only way to stop MPB in its tracks is to simple either reach your final balding pattern, reduce your DHT to a large degree where it won't affect your hair as much or super slowly. Or 100-1000 years down the line when we can either cure baldness or just edit our DNA to our liking where we can having baldness as optional. Wishful thinking.

[WillemJ]

Waiting for updates

[Dillpickle123]

Maybe it’s that you have fine hair but 3000 seems like a lot, 2-2200 is what I was quoted with similar loss bug risk if you lose hair everywhere else, does takin fin impact you at all in your sports career moving forward?

[Raskolnikov]

10 hours ago, Dillpickle123 said:

Maybe it’s that you have fine hair but 3000 seems like a lot, 2-2200 is what I was quoted with similar loss bug risk if you lose hair everywhere else, does takin fin impact you at all in your sports career moving forward?

That is a great question. When I first started taking it spring 2021, I was in the middle of my season (track and field) and I was concerned about the same thing (finasteride impacting my DHT levels) so I stopped. However, at the conclusion of my season I started taking finasteride again and haven’t missed a day since. I did make progress this year in my sport so I’m thinking that if there are any effects on sports performance, they’re marginal. But who knows?

[Raskolnikov]

10 days post-op. Most of the crusts are gone. Feeling super relieved that life will soon be back to normal.

[Raskolnikov]

[Raskolnikov]

The photos above are:

-2 weeks post-op

-1 month post-op

-6 weeks post-op

[Raskolnikov]

7 weeks post-op. Doesn’t look too bad from the front, but the left side is a sore sight to the eyes. Hoping to see some new hairs sprout up in the next couple of weeks. I’ve taken an “extended” trip to SE Asia this fall in order to pass time.

[Dillpickle123]

The ugly duckling fade you seem to not have shed that much though so not bad with a bit of fibers 

[Doood25]

On 8/12/2022 at 1:23 PM, Mike10 said:

Doing 3000 on a 23 year old with that kind of head of hair is not what I would call a conservative approach, particularly as the clinic did not even want to do surgery in the first place.Honestly there remain now only a handful of Drs I would trust my head with. As for lifetime Finansteride, who know if that will work. 

Curious if surgeons u trust?

[tyleribrahim]

Really good work!