Bittersweet feelings after Bisanga Consult

[Savemyhairline]

So I finally had my in-person consultation with Dr. Bisanga. He told me it would be a mistake to get a hair transplants for me. I’m 26 y/o diffuse thinner, but really the most intense thinning is in my temples. He said I haven’t actually lost any hair, it has all just been thinned out on top. He did say my donor density was good at 75.  I’m on fin and foam minoxidil. He recommended I switch to oral minoxidil. Kevin Mann’s videos have made me apprehensive in taking oral minoxidil, though Bisanga really was saying it could reverse the loss I have. I’m going to look into it more.

 

i wish I could just at least get a small procedure to fill in my temples which undoubtedly have the most thinning, but he really felt it would be a mistake and do more harm than good. H&W and Rahal were willing to schedule a HT appointment, I’m wondering if they would’ve changed their minds after I flew out to them and they saw me in person, or they’d just have a different opinion. Do you think it’s worth getting another opinion in person from someone reputable? I consider Bisanga to be amongst the best of the best so maybe I should just take his opinion and hold off. 

[davidn]

"Do more harm than good" in a sense of permanent shock loss?

Anyway, I think you know what is right. Bisanga is a conservative doc, but in the most positive sense imo. I think he is a very ethical person who really advises what is best in your situation and if I were you I would follow his advice (not necessarily for oral minox if you feel uncomfortable with that but regarding having no surgery).

Edited August 27, 2022 by davidn
specifying

[HairRun]

Can you post pics? Not for assessment, just curious.

I would also defer to Bisanga. 

[Savemyhairline]

8 minutes ago, davidn said:

"Do more harm than good" in a sense of permanent shock loss?

Anyway, I think you know what is right. Bisanga is a conservative doc, but in the most positive sense imo. I think he is a very ethical person who really advises what is best in your situation and if I were you I would follow his advice.

Yeah shock loss/trauma to the skin and existing hairs. I will most likely follow his advice, though still want to do do more research Into oral minoxidil before trying it.

[davidn]

Just now, Savemyhairline said:

Yeah shock loss/trauma to the skin and existing hairs. I will most likely follow his advice, though still want to do do more research Into oral minoxidil before trying it.

Makes sense bud!

[Savemyhairline]

3 minutes ago, HairRun said:

Can you post pics? Not for assessment, just curious.

I would also defer to Bisanga. 

Sure

[DHI Turkey medical]

Dr. Bisanga told you what you needed to hear and not what you wanted to hear. 

He is 100% correct on this one. 

Terrible idea to do a large FUE session on a 26-year old diffuse thinner.  

You could end up with insatisfactory growth, permanent shock loss and of course unecessary scarring in the donor region. 

 

[Savemyhairline]

2 minutes ago, DHI Turkey medical said:

Dr. Bisanga told you what you needed to hear and not what you wanted to hear. 

He is 100% correct on this one. 

Terrible idea to do a large FUE session on a 26-year old diffuse thinner.  

You could end up with insatisfactory growth, permanent shock loss and of course unecessary scarring in the donor region. 

 

Yeah, silver lining is I will save a lot of money and not have scars, but definitely a bit disappointed. 

[WhereIsMyMind]

idk, personally I dont see any issue with a small temple restoration transplant leaving more donor for future. I think its way too conservative take.

As long as you don't go full blown full head transplant should be fine.

[John1991]

Have you at least tried Niz to see if it'll thicken you any?  Niz and Rogaine might do a good deal to help your situation.  Honestly, your pictures are way less bad than I was expecting based on your description in your first post - not that that's any consolation.  

Edited August 27, 2022 by John1991

[Savemyhairline]

2 minutes ago, John1991 said:

Have you at least tried Niz to see if it'll thicken you any?  Niz and Rogaine might do a good deal to help your situation.  Honestly, your pictures are way less bad than I was expecting based on your description in your first post - not that that's any consolation.  

Naw I haven’t. Seems like it doesn’t really do much other than help with dry skin from minoxidilx, which I haven’t had. I guess I could experiment and see but I don’t have high expectations for Niz

[Mike10]

Bisanga is giving sound advise here. There is a risk you could be worse off than before the HT. 

[SeanT1]

To be fair I'm 26yo and I got a hair transplant to bring back my temples.
Didn't have any permanent shockless either.  It's in no way perfect but it's much better than the hairline I had before.

My hair is naturally thin too whereas @Savemyhairline looks to have thicker hair.  Just food for thought.

 

(Before hair transplant)

(After hair transplant)

(Donor after transplant)

 

 

Edited August 27, 2022 by SeanToman

[Savemyhairline]

2 minutes ago, SeanToman said:

To be fair I'm 26yo and I got a hair transplant to bring back my temples.
Didn't have any permanent shockless either.  It's in no way perfect but it's much better than the hairline I had before.

My hair is naturally thin too whereas @Savemyhairline looks to have thicker hair.  Just food for thought;

 

 

That does look like a nice result. I wish I could slick my hair up or back but it just looks stupid so I have to comb it to the side to hide my temples. I feel like fibers don’t really work well for temples either, they’re more for midscalp and crown. Though I’ve only ever just used the fibers and no spray or anything so I guess I’ll experiment.

[SeanT1]

Just now, Savemyhairline said:

That does look like a nice result. I wish I could slick my hair up or back but it just looks stupid so I have to comb it to the side to hide my temples. I feel like fibers don’t really work well for temples either, they’re more for midscalp and crown. Though I’ve only ever just used the fibers and no spray or anything so I guess I’ll experiment.

Maybe get a second opinion regarding a transplant also.
How long have you been on finasteride for?

[HairRun]

It seems that your middle goes down a bit more than most people, giving sorta an optical illusion that the corners are more recessed. I mean they are probably recessed, at some point they were lower for sure but for an average person, it looks like it's around where it should be, your right profile pic seems like there is very little recession. 

At most it kinda looks you could do a few hundred at most but you would introducing scarring into those areas. A quote from Dr Bisinga / His Patient advisor

Quote

When placing into a recipient area that has had previous surgery, skin tissue is no longer virgin. With every recipient site that has been made, your skin has been cut. This then triggers a response from your body that creates scar tissue to heal. This may not be visible to the naked eye when surgery is performed to a high standard, but as with any cutting of the skin, this will occur as the bodies natural healing response.

This changes the physiological status of the skin and potentially the response in further surgery.

Blood vessels below the scalp will have been disrupted and whilst will have recovered, they are no longer "untouched" and will respond accordingly with potentially different efficiency.

Whilst repair/non virgin surgery with Dr. Bisanga is generally very successful, each patients situation will present unique challenges that virgin scalp does not present and your scalp may respond differently. With this in mind, growth is not able to be guaranteed.

So I wouldn't do a transplant unless a higher number of grafts is needed. Like 1500 maybe? 

I would definitely defer to Dr Bisanga, it's what I would do in your position. Even if I were to get a 2nd opinion, it would be someone who has a very long track record of highest ethical standards like Shapiro or Konior, and even then, only after an in-person consultation. I think your case is really tricky since it's a unique pattern, and requires an in-person much more than the usual case. 

Maybe get on the phone with his patient advisor. It seems that you still have more thoughts about it and I bet they would give you a lot more details of the science. Or perhaps someone could tag the patient advisor here, they have an account here. I am scheduled with Dr Shapiro and everytime I have some thought or question, his patient advisor Matt fills me in with a world of detail. 

 

Edited August 27, 2022 by HairRun

[Savemyhairline]

1 minute ago, SeanToman said:

Maybe get a second opinion regarding a transplant also.
How long have you been on finasteride for?

About 14-15 months 

[Savemyhairline]

3 minutes ago, HairRun said:

It seems that your middle goes down a bit more than most people, giving sorta an optical illusion that the corners are more recessed. I mean they are probably recessed, at some point they were lower for sure but for an average person, it looks like it's around where it should be, your right profile pic seems like there is very little recession. 

At most it kinda looks you could do a few hundred at most but you would introducing scarring into those areas. A quote from Dr Bisinga / His Patient advisor

So I wouldn't do a transplant unless a higher number of grafts is needed. Like 1500 maybe? 

I would definitely defer to Dr Bisanga, it's what I would do in your position. Even if I were to get a 2nd opinion, it would be someone who has a very long track record of highest ethical standards like Shapiro or Konior, and even then, only after an in-person consultation. I think your case is really tricky since it's a unique pattern, and requires an in-person much more than the usual case. 

Maybe get on the phone with his patient advisor. It seems that you still have more thoughts about it and I bet they would give you a lot more details of the science. Or perhaps someone could tag the patient advisor here, they have an account here. 

 

I definitely trust his assessment, just a bit saddened by it I guess. Idk I guess I was thinking I could finally put an end to my #1 insecurity, my hairline. Diffuse thinning sucks. 

[mavigo]

1 hour ago, Savemyhairline said:

Yeah shock loss/trauma to the skin and existing hairs. I will most likely follow his advice, though still want to do do more research Into oral minoxidil before trying it.

I was told the same by many doctors about my midscalp. I'm going for a second HT early next year for my frontal but my midscalp is thinning and I wanted to get that touched up. But I was told the same that there still was enough hair and that transplanting over it might accelerate the hair loss via shock loss. 

I'm also looking into oral minoxidil, I quit the foam because it was a pain and wasn't really working. I would get at least 2 - 3 more assessments from reputable doctors. But I would be shocked if they don't tell you the same. I would wait and stay on fin another year and then go from there. 

[SeanT1]

3 hours ago, Savemyhairline said:

I definitely trust his assessment, just a bit saddened by it I guess. Idk I guess I was thinking I could finally put an end to my #1 insecurity, my hairline. Diffuse thinning sucks. 

Honestly, looking at your photos I think your hairline can be saved with a solid 3500 or so grafts.  I'm sure others would have more insight.

People in worse situations have had good results.

Edited August 27, 2022 by SeanToman

[HappyMan2021]

it can be very discouraging when you are at the beginning of the HT journey and your "dream doctor" rejects you. But there are enough good HT docs out there I'm certain you will find your match. 

IMO Bisanga is a wizard at repairs, but since you aren't a repair patient its not something to be really upset about. There are plenty of good options for 1st time HT patients.

 

Edited August 27, 2022 by HappyMan2021

[HairRun]

8 minutes ago, HappyMan2021 said:

it can be very discouraging when you are at the very beginning of the HT journey and your "dream doctor" rejects you. There are enough good HT docs out there I'm certain you will find your match. 

IMO Bisanga is a wizard at repairs, but since you aren't a repair patient its really not something to be really upset about. There are plenty of good options for 1st time HT patients.

 

I think diffuse thinners are in a tricky spot though, cuz of the scarring and potential for shock loss.

[follically challenged]

3 hours ago, SeanToman said:

To be fair I'm 26yo and I got a hair transplant to bring back my temples.
Didn't have any permanent shockless either.  It's in no way perfect but it's much better than the hairline I had before.

My hair is naturally thin too whereas @Savemyhairline looks to have thicker hair.  Just food for thought.

 

(Before hair transplant)

(After hair transplant)

(Donor after transplant)

 

 

This is great for fine hair. Where did you get your procedure and are you on meds?

[SeanT1]

1 minute ago, follically challenged said:

This is great for fine hair. Where did you get your procedure and are you on meds?

Elithair in Istanbul, something like 2400 Euro I think.
Been on finasteride for a year prior to the surgery & ongoing.

Full journey here;

 

Edited August 27, 2022 by SeanToman

[Savemyhairline]

23 minutes ago, SeanToman said:

Honestly, looking at your photos I think your hairline can be saved with a solid 3500 or so grafts.  I'm sure others would have more insight.

People in worse situations have had good results.

Think I need to take a few days, let the disappointment settle then decide. I do find it interesting that Hasson was willing to book me without an in-person consult based on my photos. I am booked for June with a fully refundable deposit with him as of now. I definitely don’t want to make a permanent mistake here though, of course.