FUE HLC Ankara | NW 5/6 | 5762 Grafts | November 2022

[GeneralNorwood]

21 minutes ago, Stewie said:

Surely there was some sort of conversation about the approach?

You have to know things to start convo about approach. Beginners don't know much about HT's so they don't know right questions. And it leads to dissapointment. 

 

21 minutes ago, Stewie said:

This is not a bad result and can be easily sorted for sure?

Can be sorted out for sure. But doing HT's it is not a hobby or vacation trip. We can't do surgeries every year...

Edited September 6, 2023 by GeneralNorwood

[Drew-83]

11 hours ago, GeneralNorwood said:

For me this matter is simple. Although the treated area was big and OP needed second procedure for the crown, HLC promised him uniform result in the first surgery. And they didn't deliver uniform result. 

Now HLC admitts that something went wrong and they offer a touch up. However, midscalp doesn't need a" touch up", but far more, 1000 grafts i would say. 

 

My advice. Don't go back to HLC, find a new clinic that will make you tailored plan. 

They said me about 500-800 graft for touch up,at that point there would be less uf left to use for the crown though.  They anticipated me that for that area there will never be total density, however a minimum of 2000 uf to be implanted.  I remember that at the first consultation in a clinic I had been estimated about 10,000 available grafts including those for the beard.  I m really undecided about what to do, for me the crown is not a big problem anyway, obviously it can't stay as it is now but at least have a nuance with the rest.

[jjalay]

1 hour ago, Drew-83 said:

They said me about 500-800 graft for touch up,at that point there would be less uf left to use for the crown though.  They anticipated me that for that area there will never be total density, however a minimum of 2000 uf to be implanted.  I remember that at the first consultation in a clinic I had been estimated about 10,000 available grafts including those for the beard.  I m really undecided about what to do, for me the crown is not a big problem anyway, obviously it can't stay as it is now but at least have a nuance with the rest.

Sorry for my words but judging from your donor i don"t think you are a candidate for another fue procedure:

 

[Drew-83]

1 hour ago, jjalay said:

Sorry for my words but judging from your donor i don"t think you are a candidate for another fue procedure:

 

Any clinic contacted said me that it will be ok

[jjalay]

4 minutes ago, Drew-83 said:

Any clinic contacted said me that it will be ok

I would consider strip in your place. Get in contact with Hattingen hair and dr. Muresanu in Switzerland for a consultation too. They can asess your donor and see if strip is a possibility in your case.

[Drew-83]

57 minutes ago, jjalay said:

I would consider strip in your place. Get in contact with Hattingen hair and dr. Muresanu in Switzerland for a consultation too. They can asess your donor and see if strip is a possibility in your case.

No strip, no scares for me . I will continue with the fue.

[Gramatik]

1 hour ago, Drew-83 said:

Any clinic contacted said me that it will be ok

your donor looks fine. You could do a second procedure for the rest of your scalp with fue + bht. Eugenix is good clinic for higher norwood cases.

[GeneralNorwood]

1 hour ago, Gramatik said:

your donor looks fine. You could do a second procedure for the rest of your scalp with fue + bht. Eugenix is good clinic for higher norwood cases.

 

Yes, if OP doesn't want to do FUT, best option is propably Eugenix or Pittella. 

[Turkhair]

6 hours ago, Drew-83 said:

They said me about 500-800 graft for touch up,at that point there would be less uf left to use for the crown though.  They anticipated me that for that area there will never be total density, however a minimum of 2000 uf to be implanted.  I remember that at the first consultation in a clinic I had been estimated about 10,000 available grafts including those for the beard.  I m really undecided about what to do, for me the crown is not a big problem anyway, obviously it can't stay as it is now but at least have a nuance with the rest.

Have you talked to Pekiner? 

 

[Drew-83]

In the next days I will contact other clinics too

[Stoner]

Having read this thread I wanted to comment that I do not think the result is great or even good. I would say it is a 5-6/10. This might be okay for a cheaper clinic, but it is not what you expect from HLC, which is supposed to be a top one.

HLC itself, for that matter, does not consider it a good result; I do not suppose they would have offered a free touchup otherwise. The other benchmark by which we can judge it as a mediocre result is survival rate. Granted, OP could have provided better pics with longer hair. But I seriously doubt this is the result of 5762 grafts growing, even taking into account a 20% of them were beard grafts. My very rough estimate would be that the survival rate is anywhere between 60 and 70%-not great. We should bear in mind that a portion of the midscalp and the entire crown were not even treated during this surgery. And there are similar cases to this that have seen good coverage by Gur, HLC, Laorwong, Freitas, Pekiner, Couto, just to mention a few other surgeons.

Overall, rather than lowering our own standards, I believe we should hold the clinics and the industry to higher standards, especially as years go by and their expertise accumulates. 

@Drew-83 My advice would be that you need to take a more holistic approach, given this result. I would advise you to get on some kind of DHT blocker (finasteride or/and dutasteride) and oral Minox and give it some time for it to work. You can have a look at the video in which Servio Vano discusses the most effective treatments currently available with Melvin, on the HRN youtube channel. In the meantime, you can try to get a slot with a surgeon with expertise in beard and BHT. In your place I would consider Pekiner, Couto, Pinto, Ferreira, Nader, HDC, and Laorwong, probably in that order, taking their price into account, although you would have to confirm they work with beard and body hair (Pekiner, Couto, HDC and Laorwong do).

Edited September 8, 2023 by Stoner

[Stoner]

@Drew-83 And of course Zarev, but there is the problem with the long waiting list.

Last thing, I believe that not being on some kind of DHT blocker is something I notice in almost every HT with a poor graft survival and growth in here.

I understand the concerns with finasteride, but there is a chance that people are taking a significantly higher risk if they undergo a HT without being in DHT blocker treatment.

In the video I mentioned above Dr Vano suggests taking dutasteride 2*0.5mg a week has been shown as effective as taking 1mg finasteride every day while having notably less to no side effects, so you might want to look into that option (or topical dutasteride). 

[Drew-83]

9 hours ago, Stoner said:

@Drew-83 And of course Zarev, but there is the problem with the long waiting list.

Last thing, I believe that not being on some kind of DHT blocker is something I notice in almost every HT with a poor graft survival and growth in here.

I understand the concerns with finasteride, but there is a chance that people are taking a significantly higher risk if they undergo a HT without being in DHT blocker treatment.

In the video I mentioned above Dr Vano suggests taking dutasteride 2*0.5mg a week has been shown as effective as taking 1mg finasteride every day while having notably less to no side effects, so you might want to look into that option (or topical dutasteride). 

Hi, I've been taking 1 mg of Finasteride per day for 4 years now, so I don't think it could have negatively affected the growth process. Soon I will also start taking oral minoxidil 2.5% as recommended by the clinic for at least three months and presumably propose for a new transplant at the beginning of next year. I wouldn't want it to be a constant for the years to come, however, taking minox daily.

For the rest, as you said, it is clearly evident that mine is a poor result that I would never have expected from an elite clinic...

[Stoner]

7 hours ago, Drew-83 said:

Hi, I've been taking 1 mg of Finasteride per day for 4 years now, so I don't think it could have negatively affected the growth process. Soon I will also start taking oral minoxidil 2.5% as recommended by the clinic for at least three months and presumably propose for a new transplant at the beginning of next year. I wouldn't want it to be a constant for the years to come, however, taking minox daily.

For the rest, as you said, it is clearly evident that mine is a poor result that I would never have expected from an elite clinic...

Sorry man, my bad. I read that you had been on and off finasteride but skipped the part in which you said that this was in the past and you were now taking finasteride consistently for 4 years. So yes, what I wrote does not apply to you.
As you said, this reinforces the case that this is a poor outcome.

[Vann]

If I was in your position, I would work on the areas that need improvement... the crown. I wouldn't go full density but go with a thinning approach. That would be operation #2

I would later see if the minox you're taking has great growth over the year and with op #2 I would probably tackle the remaining areas (mid scalp/crown) as operation #3... 

This would not be an immediate approach. It is definitely, on the slower but more, conservative side. It sucks that with the volume and quality of grafts you used this was your result. Nonetheless, there's nothing further you can do to reverse this.

 

You should be thinking next steps because regardless of outcome you have a limited donor. The real question next is what do you want, realistically, as a final result with the remainder of grafts? (uniform across the scalp/denser frontal third/etc.)

Edited September 8, 2023 by Vann

[Drew-83]

1 hour ago, Vann said:

If I was in your position, I would work on the areas that need improvement... the crown. I wouldn't go full density but go with a thinning approach. That would be operation #2

I would later see if the minox you're taking has great growth over the year and with op #2 I would probably tackle the remaining areas (mid scalp/crown) as operation #3... 

This would not be an immediate approach. It is definitely, on the slower but more, conservative side. It sucks that with the volume and quality of grafts you used this was your result. Nonetheless, there's nothing further you can do to reverse this.

 

You should be thinking next steps because regardless of outcome you have a limited donor. The real question next is what do you want, realistically, as a final result with the remainder of grafts? (uniform across the scalp/denser frontal third/etc.)

I want an homogeneous transplant, aware that the situation I started from was not the best, however with over 5700 grafts in the front alone the result had to be decidedly better and even the clinic admits it.  I don't expect a great density which, among other things, is not visible from the photos, but even in the hairline and on the sides it is not high... but I accept it...but midscalp is not ! I want to fix the crown as best as possible as soon as possible, I will start with minoxidil in the next few days and I will consult with the chosen clinic to understand when to carry out a second transplant.

Edited September 8, 2023 by Drew-83

[Drew-83]

Hi everyone.  I wanted to let you know about my current situation, after I have integrated oral minoxidil for three months with the finasteride that I've been taking for years.  I have to be honest, it seems that the situation has improved slightly, especially in terms of hair quality and the density also seems better.  What do you think?

[KSA91]

1 hour ago, Drew-83 said:

Hi everyone.  I wanted to let you know about my current situation, after I have integrated oral minoxidil for three months with the finasteride that I've been taking for years.  I have to be honest, it seems that the situation has improved slightly, especially in terms of hair quality and the density also seems better.  What do you think?

Interesting! It looks somewhat dense!