HT with 30% miniaturised donor

[Johnny129]

Im looking to do a 2nd HT after a substandard one from Turkey a few years ago where my donor was over harvested.

I've been to see 2 of the leading doctors in Turkey face to face and they didnt mention concerns about the donor apart from it being limited to around 2000 but 2 elite doctors in Europe have said they wouldn't be comfortable carrying out a procedure and one qouted my donor as being 30% miniaturised. BHT from chest and beard was given as an option which I am considering. Waiting on some details from the surgery.

How risky would it be to carry out a procedure using the hair from my donor? Im erring on the side of caution currently and taking the advice not to do it but Im not sure if the European docs may be being overly cautious.

[im_not_a_robot]

Hard to tell without any pictures, knowing your age or if you are on any medication.

[Johnny129]

39 years old and have been on topical minox for 5 years. Will be starting topical dutasteride soon as soon as it arrives. I dont think photos will be of any use for this query

[Melvin- Admin]

Are you on finasteride? 

[Johnny129]

13 minutes ago, Melvin- Moderator said:

Are you on finasteride? 

No. I have tried before but experienced sides so thats a no go unfortunately 

[Melvin- Admin]

37 minutes ago, Johnny129 said:

No. I have tried before but experienced sides so thats a no go unfortunately 

Then I wouldn’t get an HT with 30% miniaturization. You most likely have DUPA. 

[Ryan Daniel]

Nobody can have hair transplants without taking any form of medication

[Johnny129]

49 minutes ago, Melvin- Moderator said:

Then I wouldn’t get an HT with 30% miniaturization. You most likely have DUPA. 

Its not just going bald I have to worry about. Its also my donor area going and an unsightly donor area on display!

[Melvin- Admin]

50 minutes ago, Johnny129 said:

Its not just going bald I have to worry about. Its also my donor area going and an unsightly donor area on display!

Smp is the better option 

[GoliGoliGoli]

Post pictures or this thread is moot. That said if your donor is bad quality it's probably not worth it, but I don't understand why people are shy about posting pictures of the back of your head. 

Edited September 13, 2022 by GoliGoliGoli

[Johnny129]

23 minutes ago, Melvin- Moderator said:

Smp is the better option 

Thats a good shout. Who knows hopefully it may even stabilise with the topical dut 

[Johnny129]

2 minutes ago, GoliGoliGoli said:

Post pictures or this thread is moot

How is it a moot without picture? What is a pic going to tell you exactly? I've had 2 doctors tell me I have a miniaturised donor after examining with a microscope and one giving me a percentage of 30%. I wanted to get ppls thoughts with those facts. I dont see how a pic will help.

[GoliGoliGoli]

Then why are you even posting here? Two elite surgeons told you it was a bad idea. How is anyone on here going to give you any worthwhile insights that differ from that without even seeing you donor. 

"Well even though I can't see your donor I'm going to go against the advice of the top European surgeons you met with and say go for it!"

What are you smoking mate? 

Edited September 13, 2022 by GoliGoliGoli

[Johnny129]

6 minutes ago, GoliGoliGoli said:

Then why are you even posting here? Two elite surgeons told you it was a bad idea. How is anyone on here going to give you any worthwhile insights that differ from that without even seeing you donor. 

"Well I have no idea what your donor looks like, but I'm going to go against the advice of the top European surgeons you met with and say go for it!"

What are you smoking mate? 

I wouldnt take what anyone said on board off the back of a visual assessment of some photos now. The 30% figure is what matters. It was enough for Melvin. 4 doctors, all of them recommended on here gave me differing opinions. 2 said yeah, 2 said no, 50/50. So I came to see if some of the knowledgeable ppl or clinics could give some insight if a procedure could be feasible, how it can be feasible or a complete write off.

[GoliGoliGoli]

And I'm trying to tell you, pictures would go a long ways in helping people give you better advice. But yes if your donor is 30% mini'd according to a reputable doctor then you didn't need to post this to begin with. 

I just don't understand why the hesitancy to post a picture of the back of your head. Are you really worried someone is going to doxx you from this? Even if they were to who cares. It just seems irrational to ask people a question like this without posting pictures as obviously a visual assessment is what matters. 

[Johnny129]

39 minutes ago, GoliGoliGoli said:

And I'm trying to tell you, pictures would go a long ways in helping people give you better advice. But yes if your donor is 30% mini'd according to a reputable doctor then you didn't need to post this to begin with. 

I just don't understand why the hesitancy to post a picture of the back of your head. Are you really worried someone is going to doxx you from this? Even if they were to who cares. It just seems irrational to ask people a question like this without posting pictures as obviously a visual assessment is what matters. 

I have no problems in putting up photos. I've put up photos up in previous posts but as I've previously explained photos won't help.

It is more about the acceptable threshold of donor miniaturisation for a HT. I know Bisanga says 20/25%, anything more and he doesnt consider them a viable candidate however Bisanga is a very cautious doctor which is why his results are as good as they are. Others may say up to 40 or 50%, which is why the other 2 surgeries didnt raise it as an issue. Im not sure. Its not about how my donor looks now, it's how much is likely to retain once it goes into the recipient area.

[Raphael84]

On 9/13/2022 at 9:47 PM, Johnny129 said:

Others may say up to 40 or 50%

If 40-50% of the follicles in a donor area have miniaturisation meaning that they are unstable and no medication is utilised, then this may well continue to decline. Best case scenario is that it doesn't, but then possible surgery outcomes when extracting and placing unstable follicles can impact growth, yield and longevity.
If the doctor only extracts the other 50% (non miniaturised), this leaves predominantly miniaturised follicles in the donor area, meaning that the 40-50% pre surgery is now a higher percentage in the donor and with any further decline, the donor will not likely be in the best shape.

Either way, such a surgery in our experience would present significant risk and if yield is not acceptable, then a touch up is not particularly ideal as more grafts are being utilised that may again achieve the same compromised yield as the donor is not stable. 

I would not suggest that Dr. Bisanga is a cautious doctor at all. He takes on some of the most complicated repair cases that other doctors refuse. I would say that Dr. Bisanga is very thorough, vastly experienced (more than most) and that he does not want to jeopardise patients who present cases of high risk where the likelihood for a sub optimal result is more probable and this is always in the best interests of the patient.

However we as patients tend to search for options that suit our own narrative. I remember doing the same thing when researching for my first surgery around 2008/2009, and any doctors that suggested areas of weaker density in my donor, I discounted and only then pursued interest in those who feedback were inline with what I wanted to hear. The reality is that those doctors who present concerns are doing so for ethical reasons and out of experience. They present advice that is worth a listen.

[Gatsby]

22 minutes ago, Raphael84 said:

If 40-50% of the follicles in a donor area have miniaturisation meaning that they are unstable and no medication is utilised, then this may well continue to decline. Best case scenario is that it doesn't, but then possible surgery outcomes when extracting and placing unstable follicles can impact growth, yield and longevity.
If the doctor only extracts the other 50% (non miniaturised), this leaves predominantly miniaturised follicles in the donor area, meaning that the 40-50% pre surgery is now a higher percentage in the donor and with any further decline, the donor will not likely be in the best shape.

Either way, such a surgery in our experience would present significant risk and if yield is not acceptable, then a touch up is not particularly ideal as more grafts are being utilised that may again achieve the same compromised yield as the donor is not stable. 

I would not suggest that Dr. Bisanga is a cautious doctor at all. He takes on some of the most complicated repair cases that other doctors refuse. I would say that Dr. Bisanga is very thorough, vastly experienced (more than most) and that he does not want to jeopardise patients who present cases of high risk where the likelihood for a sub optimal result is more probable and this is always in the best interests of the patient.

However we as patients tend to search for options that suit our own narrative. I remember doing the same thing when researching for my first surgery around 2008/2009, and any doctors that suggested areas of weaker density in my donor, I discounted and only then pursued interest in those who feedback were inline with what I wanted to hear. The reality is that those doctors who present concerns are doing so for ethical reasons and out of experience. They present advice that is worth a listen.

Well said! 👏

[Johnny129]

8 hours ago, Raphael84 said:

If 40-50% of the follicles in a donor area have miniaturisation meaning that they are unstable and no medication is utilised, then this may well continue to decline. Best case scenario is that it doesn't, but then possible surgery outcomes when extracting and placing unstable follicles can impact growth, yield and longevity.
If the doctor only extracts the other 50% (non miniaturised), this leaves predominantly miniaturised follicles in the donor area, meaning that the 40-50% pre surgery is now a higher percentage in the donor and with any further decline, the donor will not likely be in the best shape.

Either way, such a surgery in our experience would present significant risk and if yield is not acceptable, then a touch up is not particularly ideal as more grafts are being utilised that may again achieve the same compromised yield as the donor is not stable. 

I would not suggest that Dr. Bisanga is a cautious doctor at all. He takes on some of the most complicated repair cases that other doctors refuse. I would say that Dr. Bisanga is very thorough, vastly experienced (more than most) and that he does not want to jeopardise patients who present cases of high risk where the likelihood for a sub optimal result is more probable and this is always in the best interests of the patient.

However we as patients tend to search for options that suit our own narrative. I remember doing the same thing when researching for my first surgery around 2008/2009, and any doctors that suggested areas of weaker density in my donor, I discounted and only then pursued interest in those who feedback were inline with what I wanted to hear. The reality is that those doctors who present concerns are doing so for ethical reasons and out of experience. They present advice that is worth a listen.

Many thanks for the info and your insight. It's greatly appreciated and I agree with what you say about Dr Bisanga from the results and testimonials I have seen.