need advice:

[berliner]

hi folks, newbie here

I started loosing my hair in my mid 20s and am 37 years old. I am not obsessed about it. Indeed these days I shave my head and am comfortable with the look. However, I witnessed some amazing outcomes with friends and family members that went through hair transplants. So before it is too late I would like to give it a shot 🙂

I plan to have it in Turkey as I travel to Istanbul for business every now and then. I have an upcoming trip in March so I want to have the operation then.

I consulted with a few clinics in Istanbul over email and were given a few options, which got me a bit confusing. Some estimate that I will need 5-6k grafts to completely cover the bald areas with reasonable density. They can't tell how many grafts I can provide by simply looking at the pictures (attached) but they estimate that by also using grafts from the beard we should be able to reach north of 5k. Hence I have the following questions;

- Assuming I indeed have 5k+ healthy grafts, should I go for a mega session spread over two days and be done with it or do 3K now and the rest next year? Setting aside the financial, convenience and recovery aspects, what are the pros and cons of the each option in terms of success rate?

- I am leaning towards doing it over two sessions separated by at least a year. In this case, what should be the strategy in the first session: aim for wide but sparse coverage and increase the density next year? or should we aim for dense transplant in the frontal and mid-scalp and save the crown for next year? 
 

 

[Dillpickle123]

There’s only a few good options in turkey that aren’t hair mills, dr bicer, dr gur, hlc, dr turan I would choose bicer of those options though if I were you who did you consult with?

[Gatsby]

@berliner welcome to the forum. Are you taking finasteride to help strengthen your donor? I'm not a doctor but my recommendation would be to give finasteride a good six months (before any surgery) to see how well you respond. Your donor to be honest looks like it has retrograde alopecia. Jumping into this without doing your due dilligence in researching surgeons who turn out lots of great results with patients who have the same hair loss as yourself in Istanbul is just a car wreck waiting to happen. There are a few good surgeons in Turkey but going there because it's on your business route is risky research. All the best.

[Doron Harati]

You have a good strong donor area, 5-6k session demands that only a high skilled MD surgeon will do the punch and incisions, these amount of mega session grafts take 3 days of surgery without rushing anything.

 

In 1 session you cover the frontal area and middle scalp, maybe touch a bit the NW5 zone.

 

Maje sure, the clinic you choose use microscopes to divide the single grafts for natural look so you won't have a doll hairline that can't be reversed.

 

I was botched badly by a hair mill in Turkey named Arenamed with horrific experience, they overharveste and scared my donor with 5000 grafts in one day only and overdosed me with anesthesia, then ambulance camd to rescue me.

 

Years later I had 2 repair procedures by Dr. Maras at HDC clinic, I was lucky because not everyone can have a repair procedure.

[berliner]

15 hours ago, Dillpickle123 said:

There’s only a few good options in turkey that aren’t hair mills, dr bicer, dr gur, hlc, dr turan I would choose bicer of those options though if I were you who did you consult with?

I have consulted with dr gur, dr turan , dr bicer, dr karadeniz and dr. yaman so far. dr gur and dr turan has no availability in the short term, so unless i postpone it, i will need to go with one the remaining ones. HLC seems solid but i want to have the operation in Istanbul.

 

12 hours ago, Gatsby said:

@berliner welcome to the forum. Are you taking finasteride to help strengthen your donor? I'm not a doctor but my recommendation would be to give finasteride a good six months (before any surgery) to see how well you respond. Your donor to be honest looks like it has retrograde alopecia. Jumping into this without doing your due dilligence in researching surgeons who turn out lots of great results with patients who have the same hair loss as yourself in Istanbul is just a car wreck waiting to happen. There are a few good surgeons in Turkey but going there because it's on your business route is risky research. All the best.

thanks @Gatsby -- this forum is such a wonderful resource thanks to you folks.  my next trip will possibly be in summer time, and i want to avoid a summer surgery if possible. but you have some valid points so i will follow up with a local doctor first regarding finasteride and retrograde alopecia. I never though about it - good catch!

after some quick reading my understanding of retrograde alopecia risk is that it requires additional diligence in selecting donor area and graft. but i also understand it is hard to know where it will stop. does that mean i should wait more maybe, eg 1-2 more years?
 

[Dr. Guncel Ozturk]

My first concern as a hair transplant surgeon would be that you are properly educated about the treatment and have realistic expectations for the outcome.

The amount of grafts needed for a hair transplant might vary substantially depending on the individual and the extent of their hair loss. In general, 5-6k grafts can offer proper coverage and density, but it is critical to remember that the amount of grafts you receive is only one element in establishing the procedure's final outcome.

In terms of the alternatives you mentioned, having a mega session in which you receive all 5k+ grafts in one go, or having the process done in two consecutive sessions, each has its own set of advantages and disadvantages.

Mega sessions are advantageous since they may be done in less time and result in a more dramatic alteration. Mega sessions, on the other hand, have a larger risk of problems, such as poor healing or infection.

The treatment can be carried out in two separate sessions, which reduces the chance of problems and allows for more incremental outcomes. However, it also means that you will have to wait a little longer to see the final result. In terms of strategy, you should strive for a dense transplant in the frontal and mid-scalp areas, and save the crown for the following session, since this will give you the most natural-looking results. In any instance, it is essential to seek guidance to decide the best course of action for your specific situation. 

Be aware of the risks and recovery time of the surgery. Have good research on the clinic and surgeon. Make sure they have good track records and testimonials. Will be here if you need more assistance. Good luck on your recovery!

[berliner]

On 1/16/2023 at 2:16 AM, Dr. Guncel Ozturk said:

My first concern as a hair transplant surgeon would be that you are properly educated about the treatment and have realistic expectations for the outcome.

The amount of grafts needed for a hair transplant might vary substantially depending on the individual and the extent of their hair loss. In general, 5-6k grafts can offer proper coverage and density, but it is critical to remember that the amount of grafts you receive is only one element in establishing the procedure's final outcome.

In terms of the alternatives you mentioned, having a mega session in which you receive all 5k+ grafts in one go, or having the process done in two consecutive sessions, each has its own set of advantages and disadvantages.

Mega sessions are advantageous since they may be done in less time and result in a more dramatic alteration. Mega sessions, on the other hand, have a larger risk of problems, such as poor healing or infection.

The treatment can be carried out in two separate sessions, which reduces the chance of problems and allows for more incremental outcomes. However, it also means that you will have to wait a little longer to see the final result. In terms of strategy, you should strive for a dense transplant in the frontal and mid-scalp areas, and save the crown for the following session, since this will give you the most natural-looking results. In any instance, it is essential to seek guidance to decide the best course of action for your specific situation. 

Be aware of the risks and recovery time of the surgery. Have good research on the clinic and surgeon. Make sure they have good track records and testimonials. Will be here if you need more assistance. Good luck on your recovery!

Thank you Dr. Ozturk for the detailed response. Do you think I might have retrograde alopecia ?

[mr_peanutbutter]

 

it looks like your crown is about to dip here, look at the difference of density. if that hair goes you will realistically need 8k-12k grafts for an aesthetical pleasing result no?

 

 

where do they get the 5k numbers? dr zarev needs 11k grafts on patients with similar norwood status and haircharacteristics

 

https://www.instagram.com/p/CX_fjhpqTBE/?hl=de

[HugoX]

You look like I used to except crown where you still have a bit more but you certainly loose that within a year or two. 

I don't know what you think is a mega session but I did just over 7000 grafts first time and over 3500 grafts 10 months later to get the coverage I have. 

With 5000 grafts you won't get good coverage all over, sure if you put those 5k grafts in the front and a bit of middle then you would get good coverage in those areas. 

You will definitely need a doctor with good donor management and the experience doing larger sessions. 

Have they shown you examples( several, not just one, with good quality pictures) of other patients similar to your case that have done 5k grafts and gotten full coverage? 

Edited January 19, 2023 by HugoX

[mr_peanutbutter]

2 hours ago, HugoX said:

You look like I used to except crown where you still have a bit more but you certainly loose that within a year or two. 

I don't know what you think is a mega session but I did just over 7000 grafts first time and over 3500 grafts 10 months later to get the coverage I have. 

With 5000 grafts you won't get good coverage all over, sure if you put those 5k grafts in the front and a bit of middle then you would get good coverage in those areas. 

You will definitely need a doctor with good donor management and the experience doing larger sessions. 

Have they shown you examples( several, not just one, with good quality pictures) of other patients similar to your case that have done 5k grafts and gotten full coverage? 

wow did you publish your result here?

[HugoX]

7 hours ago, mr_peanutbutter said:

wow did you publish your result here?

Yes, I have shared my journey here 🙂. 

 

Edited January 20, 2023 by HugoX

[mr_peanutbutter]

4 hours ago, HugoX said:

Yes, I have shared my journey here 🙂. 

 

wow, insane result. you lucky you have coarse and and a bit curly hair. ideal coverage characteristics. would love to see dr zarev do work on patients with rather thin hair in diameters

 

anyways this result supports my idea that op needs at least 10k grafts (and a miracle dog like doc zarev) everything else probably wont look good. 

[mtb]

I just had my procedure with Dr Zarev. I am one who does not have as good of characteristics as Hugo. I have thinner, straighter hair than him and some blonde hairs as well, which won't provide as much contrast. However, Dr. Zarev is confident we will get a good result. I'll post a follow up on my review thread once I have gotten the pictures from his clinic.

Regarding your initial post I have not seen any Turkish clinic that will get you the result that Dr. Zarev can. I chose him because I believe he is the best in the world and scalp-hair only FUE for high norwoods. All the Turkish clinics I talked to wanted to do like 5k grafts which is just never going to be enough to cover a slick bald NW6 like you or I. However, if you're open to using beard hairs or doing an FUT in conjunction with your FUE then Dr. Pitella, Eugenix, and Hasson and Wong are excellent choices in my opinion. 

[mr_peanutbutter]

1 hour ago, mtb said:

I just had my procedure with Dr Zarev. I am one who does not have as good of characteristics as Hugo. I have thinner, straighter hair than him and some blonde hairs as well, which won't provide as much contrast. However, Dr. Zarev is confident we will get a good result. I'll post a follow up on my review thread once I have gotten the pictures from his clinic.

Regarding your initial post I have not seen any Turkish clinic that will get you the result that Dr. Zarev can. I chose him because I believe he is the best in the world and scalp-hair only FUE for high norwoods. All the Turkish clinics I talked to wanted to do like 5k grafts which is just never going to be enough to cover a slick bald NW6 like you or I. However, if you're open to using beard hairs or doing an FUT in conjunction with your FUE then Dr. Pitella, Eugenix, and Hasson and Wong are excellent choices in my opinion. 

can you tag me in your result thread then. much appreciated. thank you

[HugoX]

9 hours ago, mr_peanutbutter said:

wow, insane result. you lucky you have coarse and and a bit curly hair. ideal coverage characteristics. would love to see dr zarev do work on patients with rather thin hair in diameters

 

anyways this result supports my idea that op needs at least 10k grafts (and a miracle dog like doc zarev) everything else probably wont look good. 

He does actually have those type of clients also, I have seen examples while I was there but unfortunately not many of his (mainly Bulgarian) client goes to forums or speak English, Dr Zarev has told he will try to share those type results when he has the time but time... Yeah he does not have much time to spare right now. 

But now we have mtb too look forward to 🙂