Dr Yaman - second hair transplant NW6/7

[Dazzler123]

Hi all,

I am a silent reader on this forum for years now and am contemplating on going to Dr Yaman for my second hair transplant.

I have had a FUE surgery before with 2500 grafts back in 2014 where the results weren’t that satisfactory. I am not taking any medication and my hair loss has subsided over the years. 

I got in touch with a few doctors these past few months in Turkey which include Dr Turan, Dr Bicer, Dr Cinik, Dr Serkan and Vera Clinic.

Dr Turan asked for a year on finasteride before any surgery. Dr Bicer has no availability until the end of the year. Dr Yaman has agreed to do the surgery with 4000 grafts, 3000 from the donor area and 1000 from the beard. Dr Cinik has recommended FUE sapphire with 3500 grafts. Dr Serkan has recommended 3200 grafts using the DHI method. 
 

Dr Yaman has recommend manual extraction over 2 days to cover the front and mid region at a cost of USD 4350 - 6 days stay using the Yaman extractor method. 
 

I wanted your expert opinion if I should proceed with Dr Yaman and if you think there is another doctor which will be suitable for my hair loss since this is my final approach to get a good result and fix my hair line and get some density. 

Thanks

[Pbaird98]

Out of the options you have mentioned then I would be choosing Dr Turan or Dr Gur, but if you don’t want to take Fin and wait then yeah Dr Yaman, or even Dr Demirsoy. Not the others though as they are notorious hair mills or just known for sub par results. 

[Belve]

First of all you have a huge area to cover. 4000 grafts it’s a good start but u also need to do a second hair transplant with the remaining donor since you need 7-8 k grafts in total for the whole scalp area. 
 

I think dr yaman’s plan is very good for a 2 day surgery with manual extraction so your donor will be handled carefully with 3k grafts from scalp donor and 1k grafts with beard grafts. You could also consider dr Gur or even dr demirsoy too. Good luck 🤞 

[Dazzler123]

Thank you for the prompt response. Do you think after the second transplant, there will be enough donor left for my crown? 
 

With the manual implantation, will that damage the existing grafts on top? They no longer look like the 2500 grafts I had back in 2014. It wasn’t the result I had hoped for previously. Been silently thinking and reading multiple reviews on this forum for years, Dr Yaman is someone I narrowed it down to based on circumstances, results and this forums recommendation.

I am really hopefully that I get the density I required with a natural looking hairline and temples. Currently, it’s so noticeable that I had a transplant and it’s spaced out with no density. 
 

 

[Pbaird98]

18 minutes ago, Dazzler123 said:

Thank you for the prompt response. Do you think after the second transplant, there will be enough donor left for my crown? 
 

With the manual implantation, will that damage the existing grafts on top? They no longer look like the 2500 grafts I had back in 2014. It wasn’t the result I had hoped for previously. Been silently thinking and reading multiple reviews on this forum for years, Dr Yaman is someone I narrowed it down to based on circumstances, results and this forums recommendation.

I am really hopefully that I get the density I required with a natural looking hairline and temples. Currently, it’s so noticeable that I had a transplant and it’s spaced out with no density. 
 

 

Dr Yaman would no doubt give you a better idea when you see him in person and have the 2nd ht, who was the first one with? So the plan for this one is concentrate on the front and reinforce the hairline in particular? 

[Dazzler123]

The plan for this one is to achieve density, get a better hairline and try to achieve as much coverage as possible. 
 

The first one was with Dr Hamayun in Pakistan which I think was impulsive and not well thought out.

This is the reason I want to make sure Dr Yaman does a good job on my 2nd ht.  I am hoping that there is enough donor left for the crown later as over harvesting is not what I want.

Plus donor scarring aswell is something I am concerned about, maybe that’s the reason I have asked for the surgery to be split in two days. I have been provided the 1 day option aswell.

Is there any benefit to split the surgery into 2 days. Maybe because it’s manual extraction which I have chosen, don’t want them tired out and get a bad result. 

Does the beard extraction leave a scar? I have seen examples on the forum that it doesn’t leave a scar. 

[Pbaird98]

2 minutes ago, Dazzler123 said:

The plan for this one is to achieve density, get a better hairline and try to achieve as much coverage as possible. 
 

The first one was with Dr Hamayun in Pakistan which I think was impulsive and not well thought out.

This is the reason I want to make sure Dr Yaman does a good job on my 2nd ht.  I am hoping that there is enough donor left for the crown later as over harvesting is not what I want.

Plus donor scarring aswell is something I am concerned about, maybe that’s the reason I have asked for the surgery to be split in two days. I have been provided the 1 day option aswell.

Is there any benefit to split the surgery into 2 days. Maybe because it’s manual extraction which I have chosen, don’t want them tired out and get a bad result. 

Does the beard extraction leave a scar? I have seen examples on the forum that it doesn’t leave a scar. 

I like the idea of 2 day surgery, I never like seeing bigger cases crammed in to 1 day. This is a good approach to you’re next ht, manual extraction is time consuming when done right, and they are taking from 2 different sources. 
The beard extractions that i have seen here in the forum don’t seem to show scarring, in particular i looked at @Gatsbyand @Zoomsteras they had a LOT taken! 

[asterix0]

Did you lose native or transplanted hair from your transplant in 2014? Were you slick bald when you had your first transplant?

[Dazzler123]

I did lose some transplanted hair for sure as it looked much better when I had it done. I think I was a NW 6 then and that’s the reason I went for the initial 2500. 

[Dazzler123]

Come to think of it, I may have been NW5 then as I wasn’t slick bald then. 

[Belve]

4 hours ago, Dazzler123 said:

Thank you for the prompt response. Do you think after the second transplant, there will be enough donor left for my crown? 
 

With the manual implantation, will that damage the existing grafts on top? They no longer look like the 2500 grafts I had back in 2014. It wasn’t the result I had hoped for previously. Been silently thinking and reading multiple reviews on this forum for years, Dr Yaman is someone I narrowed it down to based on circumstances, results and this forums recommendation.

I am really hopefully that I get the density I required with a natural looking hairline and temples. Currently, it’s so noticeable that I had a transplant and it’s spaced out with no density. 
 

 

The doctor will examine your donor in person. I’m sure he will do the best. You could discuss the whole plan with the doctor, for example to ask him how many grafts you could put in the crown next year.. You have low density on the top so you don’t have to worry about shock loss or damage on your existing hairs on top. 
 

[Dazzler123]

 

Hello everyone,

I wanted to provide an update on my surgery, which took place on March 21st and 22nd, 2023, with Dr. Yaman. The procedure involved a total of 4270 grafts, split over two days, with the following breakdown:

960 single grafts

1930 double grafts

1380 multiple grafts

 

Please note that this also includes 640 grafts from my beard. Dr. Yaman mentioned that my donor area looked surprisingly good during the planning phase, giving me reassurance about the final result. I underwent PRP therapy for these two days and also received oxygen therapy on the third day. To minimize risks, I stayed at the clinic for an entire week and had regular washes.

 

In preparation for the surgery, I quit smoking a day before and haven't smoked for six months, which was a positive outcome. I also abstained from alcohol. While I wasn't advised to take finasteride or minoxidil, I was prescribed multivitamins with biotin and saw palmetto, which I've been taking daily.

Around month 4, I decided to try minoxidil to stimulate further growth. Unfortunately, I had a severe allergic reaction to the liquid form, causing redness, flaky skin, and hives around my ears and neck. After consulting with Dr. Yaman, I took anti-allergy medication for about a week to alleviate the symptoms. Due to this reaction, I discontinued minoxidil use. I tried a spot test with the minoxidil foam (regain), the reaction was the same. 

 

I never tried finasteride as I was concerned about potential side effects. At month 6, I shared my progress pictures with Dr. Yaman and expressed my dissatisfaction with the results. There appeared to be overharvesting on one side of my head, possibly from the second day of surgery, and my beard hair on one side seemed to rise towards the jawline, leaving an uneven appearance. Dr. Yaman agreed with my assessment and suggested waiting for another three months to observe potential growth. He didn't recommend starting finasteride.

 

Currently, I'm at 6 months and 17 days post-surgery. I've attached my pictures for your assessment. I'm disappointed with the outcome after nine years of consideration and the pain of undergoing the procedure again. If you've read this far, thank you for taking the time to read my update.

 

[Dazzler123]

I am attaching my pictures from just after surgery aswell (Day 2)  . @Melvin- Admin I would highly appreciate some comments please. 

[Al - Moderator]

I think this is a case where you tried to cover too much area in one transplant. I know it's hard to go through wth the surgery, spend all that money, take months to heal, etc, etc and then still have a huge shiny bald crown, but sometimes that's the best way to go as long as you plan for another transplant in the future. You are between a NW6 and NW7, so you'd need 10,000 + grafts to get a good result. Even with the 2500 grafts you had years ago, you're at 6720 grafts. That sounds like a lot, and it is for a lot of cases, but NW6 and up need more than that. Look at the picture below. If all of the grafts in the green circle were used in the front half instead, you would have a lot more density in the front half. You'd have a completely bald crown, but at least you would look like you had a lot of improvement because the front would have a lot more density. You would then have to go back for another transplant to try to get whatever grafts you have left to fill in the crown.

I'm not trying to put you down or say you did anything wrong. I'm saying the transplant is working, but you were spreading the grafts out over too large an area to get significant improve anywhere. What you need to do next is wait another 6 months until you get to the 1 year mark and see how many grafts you can still get. I'd put those in the frontal half to thicken that up. Another 2000 to 3000 in the front half will put you close to the 10,000 number of grafts that your level of baldness generally requires.

 

[Dazzler123]

Thank you for responding. I just went ahead with what Dr Yaman suggested.

If you look at my first question all those month ago if I should proceed with Dr Yaman, I specifically mentioned that density is what I am aiming for rather than covering the entire area. This was communicated to the Dr Yaman aswell, however he said that we will be able to achieve maximum result as the donor site looks good. The area that you mentioned was actually looked at during day 1 of the surgery where grafts were taken from the back and one side of my head. On Day two the green circle you have marked was worked on using the right hand side of the donor site plus 640 grafts from the beard. See attached picture. 

Are you suggesting that I should not expect a good result even though I am at 6months and 17 days at the moment? I am disappointed so far and literally it took me 9 years to push myself for the second surgery (split in two days). Is it slow growth or can I just expect a poor result? Have you come across anyone who has faced a similar concern. Thanks 

[Melvin- Admin]

6 months is still early, I wouldn’t cast judgement just yet. 

[Dazzler123]

Thanks @Melvin- Admin . From your experience, have you seen much growth from here on with what I am seeing at the moment with my results?

I have been following this forum for years. Maybe @Gatsby @Jackdaniels @A_4_Archan @mr_peanutbutter @Gramatik @Spring15 @Bald47  @BackFromTheBrink  @jjalay @Belve  @Berba11 @gillenator @SeanToman @BRITA-XL @StillAlive @BaldV @Mr.potato  @TEXAN35 @asterix0 @Balding Bad @BaldBobby @Henry @Sitries1 

Please guide me here. Should I be doing something differently to kick off growth. I am really confused why after almost 7 months, I am still seeing no density or growth. Thanks 

[Sitries1]

14 minutes ago, Dazzler123 said:

Thanks @Melvin- Admin . From your experience, have you seen much growth from here on with what I am seeing at the moment with my results?

I have been following this forum for years. Maybe @Gatsby @Jackdaniels @A_4_Archan @mr_peanutbutter @Gramatik @Spring15 @Bald47  @BackFromTheBrink  @jjalay @Belve  @Berba11 @gillenator @SeanToman @BRITA-XL @StillAlive @BaldV @Mr.potato  @TEXAN35 @asterix0 @Balding Bad @BaldBobby @Henry @Sitries1 

Please guide me here. Should I be doing something differently to kick off growth. I am really confused why after almost 7 months, I am still seeing no density or growth. Thanks 

You can expect some further growth but I wouldn’t expect miracles.  In tough cases such as yours (high Norwood/limited Donor) I would have spent the extra money and gone with a tier 1 surgeon. Of those surgeons you mentioned in your original post - Dr Bicer would have been your best bet but there are even better options out there for high Norwood cases (Dr Zarev would have been my top pick in your case). 
 

See how things develop over the next 6 months and then consider some SMP to improve density. You may still even have one bite of the cherry left and a potential 3rd transplant using the rest of your donor plus some body hair but you need to choose your surgeon wisely. 

Edited October 8, 2023 by Sitries1

[Berba11]

Hi @Dazzler123

Just so we can better assess what's going on, do you have the high resolution pictures (both pre & post op) that Dr Yaman took at the time of your surgery? I know you've supplied photos of your own, but the high res photos from all the angles, including your donor immediately pre & post op would be more instructive.

Initial impressions are simply that you needed around 7-8,000 grafts to achieve decent coverage for what looks like NW7 loss on the basis of *roughly* (but far from strictly!) 1K grafts needed per NW level (slightly dipped crown but visible recession at the lateral humps indicated NW7 from your picts). Whether you have another 3K grafts mostly from scalp is hard to say without good quality donor pictures.

I also think that having blasted 2,500 grafts on a previous surgery that yielded poor survival left you in a compromised position and in my own view, there is no clinic in Turkey that I think would have been suitable dealing with your case, which is more complicated that first appears and you'd have been better off seeking surgery elsewhere. But what's done is done and if you have the available scalp donor + some extra beard or body hair, then in the right hands you're probably fixable. But your next choice of clinic needs to be absolutely spot on.

all of that said, the full range of pre & post op pictures will help us really see things in detail.

[AB2000]

You've barely touched your beard as a source.  If it is within your means, save up and consider going to Eugenix some years down the line.  I agree with the above.  You are a high Norwood and there is only so much you can achieve if the number of grafts you've had.  Putting many in the crown means less up front where you are lacking.  Also, going to a top tier surgeon can also optimize the outcome for high NW.

[Dazzler123]

Thank you for your response @AB2000 @Sitries1 @Berba11. I have attached two images from before the surgery. Unfortunately, I don’t have images which Dr Yaman took but can ask for them. 
 

I have gone through the pictures on my phone and have sourced a few I took after my surgery and then a few days down. 
 

I knew someone who had a good result with Dr Yaman and thought it was the right decision at the time. Dr Yaman checked my donor area on camera and said he was pleasantly surprised and said it was far better than he expected, which will yield good results. 
 

My beard has already been used slightly, around 600 grafts. 
 

I am not sure if you guys think finasteride will yield better results as I have never taken it. Yes, surgeons do matter and I thought Yaman was a good choice at the time, that being said my friend went to another Dr who was NW7 and has a good result which is considered a hair mill. 

Going for another transplant, a 3rd one will need some motivation tbh. It will all depend if this one improves. Do you think if I do go to another doctor, can this mess be fixed :(. 

 

 

[Belve]

With 4200 grafts in such huge area you can’t expect miracles and good coverage as you are a Norwood 7 patient. And you need 9000-10000 grafts for good coverage. 
I think your result with dr yaman is progressing ok at the moment and it will be also improved in the next months till the 12 month mark. 

[Gatsby]

@Dazzler123 it really is still too early to state that the jury is out on this one. Also I don't mean this in a negative way at all but in a factual one. As a Norwood 7 with previous failed work (not unlike myself) you need to focus solely on surgeons who specialize on Norwood 7 cases on a regular basis such as Dr Pittella, Dr Sethi, etc. Going to Turkey where they use terms like 'Sapphire surgery' is all just marketing jargon to get a patient in the chair. My advice would be to definitely wait for your one year result and then see how your surgery turns out. If you are not happy then you could look at clinics like Eugenix who are able to transplant large numbers of beard hair in the right way. But again give this time to grow. All the best!

[BaldDude]

6 hours ago, Dazzler123 said:

Thanks @Melvin- Admin . From your experience, have you seen much growth from here on with what I am seeing at the moment with my results?

I have been following this forum for years. Maybe @Gatsby @Jackdaniels @A_4_Archan @mr_peanutbutter @Gramatik @Spring15 @Bald47  @BackFromTheBrink  @jjalay @Belve  @Berba11 @gillenator @SeanToman @BRITA-XL @StillAlive @BaldV @Mr.potato  @TEXAN35 @asterix0 @Balding Bad @BaldBobby @Henry @Sitries1 

Please guide me here. Should I be doing something differently to kick off growth. I am really confused why after almost 7 months, I am still seeing no density or growth. Thanks 

I didn’t have any improvement in density after month 6 but everyone is different. 

[StillAlive]

Let your hair grow longer. 

Also, you started minox for a month or so, just enough to initiate it's early shed and then stopped, so you'd trigger more of a shed. Wait the full year, take saw palmetto and rosemary extract if you are not up for proper medication and then re-evaluate. It's not looking very good at the moment unfortunately, but as a late grower who did not use any drugs myself, I saw a MASSIVE difference between months 6-9 and I continue to grow going into my 14th month. (Check my thread for the full story.)

Really hoping that you get the turnaround that you are hoping for man!