Bittersweet feelings after Bisanga Consult

[Savemyhairline]

3 minutes ago, BurnieBurns said:

I'm also a diffuse thinner with slightly less thinning with yourself and I'm booked for Dr Wong. Feel free to message me if you'd like me to let you know how it goes.

Even the elite doctors have different 'philosophies'. E.g. some doctor wouldn't want to risk losing even half miniaturised hairs while others would agree that they're so find they may as well not be there.

Definitely make a thread about it! 

[John1991]

On 8/29/2022 at 7:48 AM, general-etwan said:

Yes, you’re not a good transplant candidate…Not because you’ve lost too much but because you haven’t lost nearly enough. Most people wouldn’t even notice your hair loss in public. Take finasteride and use minoxidil if you want. I’m personally not a fan of minoxidil though because I am convinced it ages the face more quickly when applied to the top of the scalp. 

 Couldn't you somewhat negate the impact of the oral minoxidil sides by using something like a collagen powder?  And wouldn't it only have a negative impact on one's face if they used it on, say, their beard?  It makes zero sense that applying minoxidil to the scalp would age the face.  None.

Edited September 3, 2022 by John1991

[Curious25]

I’ve only skim read through this thread, so apologies in advance if any of my advice has already been mentioned. 
 

Transplanting into areas where hair already exists, be that miniaturised hair, or stable hair, can be and is done - certain doctors and methods are superior at this, for instance the stick and place method tends to come up trumps for these types of cases. Being shaven is important to help aid the surgeon with the delicate placement, and being on medication will mitigate the risks of shock loss. 
 

I think in your particular case, your age, is the most limiting factor in terms of you being a candidate. And I mean that not because 26 year olds shouldn’t be able to get transplants - but the fact that you are diffusing and not stable, indicates you will continue to lose all of those hairs in that area eventually, and require further surgeries down the line, which, again, whilst a feasible strategy, given the donor is adequate, and you have the financial means - isn’t the optimum strategy, when considering factors such as recipient scar tissue, donor transection rates, and unpredictability of donor sustainability (you may have 8,000 available grafts at 26, and plan for restoration based on this figure, however without stabilising, due to potential miniaturisation may only have 5-6,000 total grafts available in your late 30’s).  

I haven’t read your stance on medication - which is a different discussion if there are any concerns there, but from a medicative standpoint, a combination of oral dutasteride and oral minoxidil would reverse you back into a NW 1 after 6-12 months (if Bisanga is correct, and you really do still have all your temple hairs, albeit miniaturised). 
 

This however is a pretty aggressive approach to take, and understandably wouldn’t suit all patients. 
 

Europe, in particular Spain, is really leading the way at the moment with innovative approaches to hair loss medication, and there is no question in my mind that oral dutasteride and oral minoxidil combined are as good a ‘cure’ to hairloss as we have ever, and will ever have, for a long time. 
 

At the very least, oral minoxidil 5mg daily and dutasteride mesotherapy is certainly something I would recommend you to look into, and I know that BHR offer and advocate both these treatments. 
 

You should read up as much as you can about medications from scientific literature and studies, and consult with the relevant doctors - do NOT listen to the online nonsense whether that is pro or against medication, and most importantly wait until you feel comfortable in your decision before making a commitment either way. It ultimately comes down to how much your hair means to you, and what lengths you are prepared to go to in order to help maintain and regrow. 
 

In summary - I think Bisanga has made a good call with his assessment. It’s not that you aren’t a candidate, it’s more so that you’re a much better candidate for a different route. 
 

Diffusers always feel like the hard done by demographic because they are typically less suited to surgery, particularly at a younger age, however if you flip that on it’s head, one could argue that they are in fact the lucky demographic, because they are usually much more responsive to the currently available medications, and often times don’t even have to worry about surgery, given they find a regime that works for them.
 

Much cheaper, no downtime, and no scarring 😉 

Good luck. 

Edited September 3, 2022 by Curious25
Spelling

[Savemyhairline]

9 minutes ago, Curious25 said:

I’ve only skim read through this thread, so apologies in advance if any of my advice has already been mentioned. 
 

Transplanting into areas where hair already exists, be that miniaturised hair, or stable hair, can be and is done - certain doctors and methods are superior at this, for instance the stick and place method tends to come up trumps for these types of cases. Being shaven is important to help aid the surgeon with the delicate placement, and being on medication will mitigate the risks of shock loss. 
 

I think in your particular case, your age, is the most limiting factor in terms of you being a candidate. And I mean that not because 26 year olds shouldn’t be able to get transplants - but the fact that you are diffusing and not stable, indicates you will continue to lose all of those hairs in that area eventually, and require further surgeries down the line, which, again, whilst a feasible strategy, given the donor is adequate, and you have the financial means - isn’t the optimum strategy, when considering factors such as recipient scar tissue, donor transection rates, and unpredictability of donor sustainability (you may have 8,000 available grafts at 26, and plan for restoration based on this figure, however without stabilising, due to potential miniaturisation may only have 5-6,000 total grafts available in your late 30’s).  

I haven’t read your stance on medication - which is a different discussion if there are any concerns there, but from a medicative standpoint, a combination of oral dutasteride and oral minoxidil would reverse you back into a NW 1 after 6-12 months (if Bisanga is correct, and you really do still have all your temple hairs, albeit miniaturised). 
 

This however is a pretty aggressive approach to take, and understandably wouldn’t suit all patients. 
 

Europe, in particular Spain, is really leading the way at the moment with innovative approaches to hair loss medication, and there is no question in my mind that oral dutasteride and oral minoxidil combined are as good a ‘cure’ to hairloss as we have ever, and will ever have, for a long time. 
 

At the very least, oral minoxidil 5mg daily and dutasteride mesotherapy is certainly something I would recommend you to look into, and I know that BHR offer and advocate both these treatments. 
 

You should read up as much as you can about medications from scientific literature and studies, and consult with the relevant doctors - do NOT listen to the online nonsense whether that is pro or against medication, and most importantly wait until you feel comfortable in your decision before making a commitment either way. It ultimately comes down to how much your hair means to you, and what lengths you are prepared to go to in order to help maintain and regrow. 
 

In summary - I think Bisanga has made a good call with his assessment. It’s not that you aren’t a candidate, it’s more so that you’re a much better candidate for a different route. 
 

Diffusers always feel like the hard done by demographic because they are typically less suited to surgery, particularly at a younger age, however if you flip that on it’s head, one could argue that they are in fact the lucky demographic, because they are usually much more responsive to the currently available medications, and often times don’t even have to worry about surgery, given they find a regime that works for them.
 

Much cheaper, no downtime, and no scarring 😉 

Good luck. 

Thanks. I believe my hair loss has been stabilized for now, as it does look better after one year on fin/topical min that it did one year ago. Just obviously hasn’t been restored to baseline. I’m considering dut, idk how much improvement it’ll make me have. It seems oral minoxidil is the one that would make the real improvements but currently I don’t feel comfortable taking it.

Edited September 3, 2022 by Savemyhairline

[BurnieBurns]

59 minutes ago, Savemyhairline said:

Thanks. I believe my hair loss has been stabilized for now, as it does look better after one year on fin/topical min that it did one year ago. Just obviously hasn’t been restored to baseline. I’m considering dut, idk how much improvement it’ll make me have. It seems oral minoxidil is the one that would make the real improvements but currently I don’t feel comfortable taking it.

Fact is, no one should force you into using medication you're not comfortable with. That said, if you ask yourself, we all have a minimum level of coverage we'd be happy with, sounds like you're below that thresh-hold. There is value is waiting until you're older of course but it does sound worth getting more credible opinions.

Ultimately, there is no true oracle of doctors who's word is absolute.

Opinions of elite surgeons, while with ethical intentions, can vary hugely.

Some are conservative / much more aggressive, some pro others cautious of certain medications, some pro or anti FUT/FUE. 

While note the same of course, it may be worth getting other free online consultations from the likes of Eugenix or Shapiro MC. Not to give you a solid answer, got help guide your navigation.

[mrmane85]

If Konior isn't too far away I'd get a consult with him even if it costs $500, just for the peace of mind.

For me he is the best of the best and his opinion would be very valuable, even if you don't do the surgery with him.

He's very generous with his time too and will look after your best interests. 

If he says you're not a good candidate I'd look into low dose oral min (1.25 daily) which should alleviate your concerns surrounding side effects