Help a newbie out - what do you guys think?..

[Troy31]

Hi guys!

A newbie here who would like to get the opinion of this forum as I embark on my maiden HT journey... 🚢

(Been reading a lot on the site over the past few days - theres a great community here and lots of amazing advice! 🙏 )

 

My hair loss is below:

 

 

- I'm 38 years old & embraced the shared head for about 3 years. However I'm coming out of a long-term relationship and fancy getting my hair back (if i can...)

 

 

- Would you say I'm a 5 / 6 on the Norwood scale?

(The sides are quite high - with the 'strip' down the middle only about 7cm wide - and I'm told the loss on the crown doesn't go down too low. Told the donor area is decent...)

 

 

- I've had an consultation with a well known Harley Street clinic, and they've said 2,600 - 2,800 grafts (going to a max of 3,000 in the day), for £6k. Thoughts?

 

 

- I've never taken Finasteride, but used to do topical Minoxidil when i was trying to maintain my hair. Would you suggest taking both of these alongside a HT? (If so, when should I start?)

 

 

- I actually live in Spain most of the year, so I could get to places in Spain/EU pretty easily... Any recommendations on surgeons?

 

 

 

Cheers guys! 

 

Any thoughts / feedback / honest opinions are warmly welcomed! 😊

 

 

Troy

[Curious25]

Hi Troy, 

- Would you say I'm a 5 / 6 on the Norwood scale?

(The sides are quite high - with the 'strip' down the middle only about 7cm wide - and I'm told the loss on the crown doesn't go down too low. Told the donor area is decent...)

Going off your pics, I’d probably place you at NW 5 heading towards 6, should your crown and sides show miniaturisation and dip further in the future. Glad you’ve been told you’ve got a decent donor, hard to tell from pics, but if you’ve had an in person consult - this is a much more accurate way to gauge the state of play. 

- I've had an consultation with a well known Harley Street clinic, and they've said 2,600 - 2,800 grafts (going to a max of 3,000 in the day), for £6k. Thoughts?

This amount of grafts is going to do very little in terms of coverage, is it part of a 2 or 3 step strategy? The price isn’t bad, but I wouldn’t recommend surgery in the UK unless you are unable to travel abroad. 

 

- I've never taken Finasteride, but used to do topical Minoxidil when i was trying to maintain my hair. Would you suggest taking both of these alongside a HT? (If so, when should I start?)

If you are comfortable with giving the medication a go - start straight away! Give it 6-12 months to see how you improve, and then look at planning a surgery. The two in combination are very effective - I would be inclined to point you in the direction of looking into oral minoxidil as opposed to topical.

 

- I actually live in Spain most of the year, so I could get to places in Spain/EU pretty easily... Anyrecommendations on surgeons?

Spain is great for surgeons - Couto and De Freitas are the two names that stand out. In Portugal you have Pinto and Ferreira who are impressive. In Belgium you have Bisanga, Feriduni and Mwamba. In Switzerland you have Hattingen. All of which are deemed amongst the community as world elites, and far superior than anyone in the UK. 
 

Good luck with your journey, and keep investing time into reading the boards and learning as much as possible before committing into any decisions. I would also add that your beard looks likely to be a pretty  decent source of donor, which will for sure come in to hang later down the road. You actually bear a striking resemblance to a member on here called @Zoomster who has had a very successful story over the last 3 years. Check out his threads to see what could be possible with smart decisions and good outcomes ! All the best. 
 

 

[HappyMan2021]

what are your goals? If you seek to become a NW1, you are looking at 2, perhaps 3 surgeries. 

Realistically, I think your hair transplant journey will be happiest if your goal is a more modest NW3 look at the end of it all. 

Definitely hop on Fin if at all possible. There are no excuses for not being on Fin or Dut if you have zero sides. 

[mister_25]

It’s hard to tell what Norwood you are / going into on your pictures, the lighting makes it difficult to tell. But I can atleast say you are Norwood 5 with potential thinning in the 6 zone, I can’t tell you how far in you are to becoming a 6 or if your already there.

Norwood 5s generally need a large amount of grafts, usually in the 6500+ range which is a large amount of the donor supply for the average. Usually to hit 6500 grafts that is two big sessions or three moderate ones.

Finasteride / Dutasteride is always worthwhile to consider, these two medications are used to slow or stop balding and in more uncommon cases, regrowth. Topical Minoxidil isn’t worthwhile on its own, but with Finasteride or Dutasteride it will maximise its potential.  Oral minoxidil is also generally better and can be used exclusively for decent results, but it doesn’t address the root cause of hair loss. You should read up on the potential side effects of Finasteride / Dutasteride before you get on it.

Spain has some of the best options, I agree with everything @Curious25 mentioned you have Freitas and Couto, in Portugal you have Ferreira and Pinto, Belgium Has Bisanga/Mwamba there are other options as well. I wouldn’t go for a HT in the UK, the options outside of UK are much more consistent in my opinion.

FUT will get you more grafts and if you are heading into Norwood 6 it might be worth considering, but FUE is continuously being improved on and top surgeons that do gigasessions like Zarev, Sethi and Pitella all have shown that you can get a large amount from FUE as well.

 

 

 

 

Edited December 20, 2022 by mister_25
Clarity, made a mistake on one of my points

[Troy31]

32 minutes ago, Curious25 said:

Hi Troy, 

 

- Would you say I'm a 5 / 6 on the Norwood scale?

(The sides are quite high - with the 'strip' down the middle only about 7cm wide - and I'm told the loss on the crown doesn't go down too low. Told the donor area is decent...)

Going off your pics, I’d probably place you at NW 5 heading towards 6, should your crown and sides show miniaturisation and dip further in the future. Glad you’ve been told you’ve got a decent donor, hard to tell from pics, but if you’ve had an in person consult - this is a much more accurate way to gauge the state of play. 

- I've had an consultation with a well known Harley Street clinic, and they've said 2,600 - 2,800 grafts (going to a max of 3,000 in the day), for £6k. Thoughts?

This amount of grafts is going to do very little in terms of coverage, is it part of a 2 or 3 step strategy? The price isn’t bad, but I wouldn’t recommend surgery in the UK unless you are unable to travel abroad. 

 

- I've never taken Finasteride, but used to do topical Minoxidil when i was trying to maintain my hair. Would you suggest taking both of these alongside a HT? (If so, when should I start?)

If you are comfortable with giving the medication a go - start straight away! Give it 6-12 months to see how you improve, and then look at planning a surgery. The two in combination are very effective - I would be inclined to point you in the direction of looking into oral minoxidil as opposed to topical.

 

- I actually live in Spain most of the year, so I could get to places in Spain/EU pretty easily... Anyrecommendations on surgeons?

Spain is great for surgeons - Couto and De Freitas are the two names that stand out. In Portugal you have Pinto and Ferreira who are impressive. In Belgium you have Bisanga, Feriduni and Mwamba. In Switzerland you have Hattingen. All of which are deemed amongst the community as world elites, and far superior than anyone in the UK. 
 

Good luck with your journey, and keep investing time into reading the boards and learning as much as possible before committing into any decisions. I would also add that your beard looks likely to be a pretty  decent source of donor, which will for sure come in to hang later down the road. You actually bear a striking resemblance to a member on here called @Zoomster who has had a very successful story over the last 3 years. Check out his threads to see what could be possible with smart decisions and good outcomes ! All the best. 
 

 

Amazing feedback! Thanks @Curious25 🙏

 

 

- Yep, they were saying as part of a 2-step strategy. Next one would be another 2,500 for £4k.

 

 

- In terms of the meds, which would you go for between Finasteride or Dutasteride? Do they both have the same possible side effects?

(I actually walked into a Pharmacy in Spain earlier today and walked out with 28 tabs of Fin for 18euro!)

 

Oral minoxidil is a great shout...

 

 

Haha, will take a look over at @Zoomster's profile and follow his story.

 

Thanks again!

 

[Troy31]

37 minutes ago, HappyMan2021 said:

what are your goals? If you seek to become a NW1, you are looking at 2, perhaps 3 surgeries. 

Realistically, I think your hair transplant journey will be happiest if your goal is a more modest NW3 look at the end of it all. 

Definitely hop on Fin if at all possible. There are no excuses for not being on Fin or Dut if you have zero sides. 

Thanks @HappyMan2021 

Yep, i think getting to a NW2/3 would be great from where i am now.

What do you reckon - 2,800/3,000 grafts in first, then another 2,500 in the second?

 

Do you have any preference between Fin or Dut? They both come with possible sides?

[Troy31]

16 minutes ago, mister_25 said:

It’s hard to tell what Norwood you are / going into on your pictures, the lighting makes it difficult to tell. But I can atleast say you are Norwood 5 with potential thinning in the 6 zone, I can’t tell you how far in you are to becoming a 6 or if your already there.

Norwood 5s generally need a large amount of grafts, usually in the 6500+ range which is a large amount of the donor supply for the average. Usually to hit 6500 grafts that is two big sessions or three moderate ones.

Finasteride / Dutasteride is always worthwhile to consider, these two medications are used to slow or stop balding and in more uncommon cases, regrowth. Minoxidil isn’t worthwhile on its own, but with Finasteride or Dutasteride it will maximise its potential.  Oral minoxidil is also generally better. You should read up on the potential side effects of Finasteride / Dutasteride before you get on it.

Spain has some of the best options, I agree with everything @Curious25 mentioned you have Freitas and Couto, in Portugal you have Ferreira and Pinto, Belgium Has Bisanga/Mwamba there are other options as well. I wouldn’t go for a HT in the UK, the options outside of UK are much more consistent in my opinion.

FUT will get you more grafts and if you are heading into Norwood 6 it might be worth considering, but FUE is continuously being improved on and top surgeons that do gigasessions like Zarev, Sethi and Pitella all have shown that you can get a large amount from FUE as well.

 

 

 

 

Awesome, thanks @mister_25 🙌

 

Some great shouts on the surgeons there... I'll follow up with them (just seen that Freitas is not too far from me....).

 

Let me know if there's anything else I should be looking into too. 👍

[HappyMan2021]

Dut is basically just a stronger more potentr version of Fin. I would say get on Fin first, and if you have zero sides from Fin, upgrade to Dut. That is what I did. 

I'm not sure specifically what your graft count should be and how it should be broken up, but yea as a NW 5/6 you are going to have to use up all the donor you have available. Most people have 7-10k grafts available in their donor region. 

[Pbaird98]

When I see a high level of loss like yours then I think of a few Drs/Clinics, ones that are particularly adept and the larger cases. One that springs to mind in particular is Hattingen, they are good with both FUT/FUE, Dr Bisanga is another that can do either as well as combos of both. Eugenix have a lot of cases and are mostly doing good work when utilising beard grafts. 
Dr Pittella, Dr Zarev, Fuegenix, @DrTBarghouthiare some others. Waiting lists vary greatly with these.. Much as I like both Dr Couto and Dr Freitas I don’t see as them as go too for Norwood 5/6. It’s all about planning for not just now but the future, it’s highly likely you will need more than one procedure. 
I really don’t think any choices are good for you in the Uk, especially the quote you already got, that’s just simply not enough grafts. 

[Troy31]

1 hour ago, Pbaird98 said:

When I see a high level of loss like yours then I think of a few Drs/Clinics, ones that are particularly adept and the larger cases. One that springs to mind in particular is Hattingen, they are good with both FUT/FUE, Dr Bisanga is another that can do either as well as combos of both. Eugenix have a lot of cases and are mostly doing good work when utilising beard grafts. 
Dr Pittella, Dr Zarev, Fuegenix, @DrTBarghouthiare some others. Waiting lists vary greatly with these.. Much as I like both Dr Couto and Dr Freitas I don’t see as them as go too for Norwood 5/6. It’s all about planning for not just now but the future, it’s highly likely you will need more than one procedure. 
I really don’t think any choices are good for you in the Uk, especially the quote you already got, that’s just simply not enough grafts. 

Thanks @Pbaird98 

Will take a look at those you recommended. 👍

[SoSoz]

2 hours ago, Curious25 said:

- I've never taken Finasteride, but used to do topical Minoxidil when i was trying to maintain my hair. Would you suggest taking both of these alongside a HT? (If so, when should I start?)

If you are comfortable with giving the medication a go - start straight away! Give it 6-12 months to see how you improve, and then look at planning a surgery. The two in combination are very effective - I would be inclined to point you in the direction of looking into oral minoxidil as opposed to topical.

 

You literally proposed finasteride to someone who has almost 0 hair on his mid scalp. Even Dr like Bicer says to her patients that its pointless at this point.

 

OP get HT and think about oral minoxidil

Edited December 20, 2022 by SoSoz

[pkipling]

It seems like you're definitely on the right track, particularly with having realistic expectations. That's something that's key to any successful hair restoration journey, but especially true for people like yourself experiencing more advanced hair loss. 

As a general rule, I think it's always a good idea to at least give finasteride a shot to see how you respond to it, however, as SoSoz pointed out - at this point, I'm not sure what good it would do you considering you've already lost the vast majority of you hair in the front/mid-scalp. Finasteride is most effective as a preventative measure, so I would imagine that that ship has sailed - but it's something you could always run by the surgeons you end up getting consultations with. 

Keep browsing the forum and staying active, and you'll naturally start compiling a list of surgeons that you feel drawn to, particularly by seeking out patient results who had similar hair loss to yours and who have results that you admire. 

[Gatsby]

@Troy31 I would consider (just my opinion) to commence finasteride and see your doctor for oral minoxidil. Finasteride (if you are a responder) will strengthen your donor area and prevent your crown from dropping down into Norwood 7 territory. IMHO I would rate you as a Norwood 6. But above all else you have waited this long so don't be in a rush to have surgery tomorrow. Give the medication and the time required to do your surgery at least 6-12 months. Don't have surgery before you can rule out the effects of the meds. Personally I would look at clinics like Dr Pittella and Eugenix (who are able to utilize beard grafts to supplement your donor supply) who excel in high Norwood cases. Wishing you all the best!

[gillenator]

2 hours ago, Gatsby said:

@Troy31 I would consider (just my opinion) to commence finasteride and see your doctor for oral minoxidil. Finasteride (if you are a responder) will strengthen your donor area and prevent your crown from dropping down into Norwood 7 territory. IMHO I would rate you as a Norwood 6. But above all else you have waited this long so don't be in a rush to have surgery tomorrow. Give the medication and the time required to do your surgery at least 6-12 months. Don't have surgery before you can rule out the effects of the meds. Personally I would look at clinics like Dr Pittella and Eugenix (who are able to utilize beard grafts to supplement your donor supply) who excel in high Norwood cases. Wishing you all the best!

Very good advice!

[Curious25]

3 hours ago, Gatsby said:

@Troy31 I would consider (just my opinion) to commence finasteride and see your doctor for oral minoxidil. Finasteride (if you are a responder) will strengthen your donor area and prevent your crown from dropping down into Norwood 7 territory

@SoSoz learn from this 

[dmc]

@Troy31 Thanks for posting this. You and I seem to be on similar journeys, similar loss and just starting out. I have just discovered this site and am finiding it a great source of information! I would be keen to swap ideas / experiences. I can't seem to direct message you yet but please reach out! 

[A_4_Archan]

@Troy31just compare results of them with higher grades of baldness...i guess eugenix & dr zarev are worth considering for high grade baldness cases...

You will ofcourse need beard grafts as well and eugnix is a great choice for that..