Advice needed for Hair Transplant repair.

[bigmistake]

Hi, I had a hair transplant 10 months ago from AKS clinic in Gurgaon,India,  by Dr Akhilendra Singh. 

The results are extremely poor, as seen from picturs attached below. The doctor claimed to have transplanted 4,000 scalp grafts and 200 beard grafts. But the images clearly show less than 1,500 grafts implanted in the recipient area. God only knows how many grafts he extracted. When I raised my concerns with the clinic then I was ridiculed by the staff at the clinic. After the transplant there was absolutely zero communication from the clinic. 

The doctor has implanted a strong hairline with almost nothing behind it and has killed my native hair.

Pictures of hair transplant 7 months post OP, looks the same today:

https://imgur.io/a/n5ZBJFw

 

Pictures showing condition of donor pre and immediate post OP:

https://file.io/Md8M2MzoIZ0D 

(above link has high resolution pictures in pdf format)

 

Edit: Working Link:

Immediate post Op with pictures of donor area

https://imgur.com/a/Jkp8OXx

 

Pre Op photos (before the transplant):

https://imgur.com/a/GKVmfBN

 

 

I need advice on the way forward. How should I plan my repair?

 

Edited May 17, 2023 by bigmistake

[Moazzam]

Unless you're using a DHT blocker/reducer like Finasteride or Dutasteride. there's no use in getting a transplant. Your native hair aren't killed by the transplant but by the lack of use of Fin or Dut. Get on fin first, use it for about 8-12 months before you decide to go for a second transplant. 

[bigmistake]

1 minute ago, Moazzam said:

Unless you're using a DHT blocker/reducer like Finasteride or Dutasteride. there's no use in getting a transplant. Your native hair aren't killed by the transplant but by the lack of use of Fin or Dut. Get on fin first, use it for about 8-12 months before you decide to go for a second transplant. 

I used finastride for five months and started to get side effects.

[Moazzam]

58 minutes ago, bigmistake said:

I used finasteride for five months and started to get side effects.

Without fin, dont do hair transplant, that's like trying to drive a sports car without learning to drive a normal car. Hair transplant is of no use without fin.your tansplanted hair may not fall but the other hair will (like what happened to you) take the dose of fin to 0.5 mg (half a pill) if you continue using fin long term, the sides will go away. 

[bigmistake]

1 hour ago, Moazzam said:

Without fin, dont do hair transplant, that's like trying to drive a sports car without learning to drive a normal car. Hair transplant is of no use without fin.your tansplanted hair may not fall but the other hair will (like what happened to you) take the dose of fin to 0.5 mg (half a pill) if you continue using fin long term, the sides will go away. 

What about topical finastride is it effective? I have been applying for the past one month, i have been applying it to my donor area as well.

If there is no alternative to finastride then I would prefer to get the unnatural hairline removed and get SMP.

 

[Moazzam]

1 hour ago, bigmistake said:

What about topical finastride is it effective? I have been applying for the past one month, i have been applying it to my donor area as well.

If there is no alternative to finastride then I would prefer to get the unnatural hairline removed and get SMP.

 

Topical works too. Not as effectively but it does. If you're going the topical route i suggest you add microneedling (buy dr pen m8 from aliexpress) at 1.5 mm depth once a month to your regiment (stay away from dermarollers)

Just remember this: without a dht blocker non transplanted hair will thin out and fall. Try taking 0.5mg fin along with topical (or 0.5 mg dutasteride on alternate days) and see where it leads you. In india you can find alot of liquid fin online. If not then you can mix fin tablets (use proscar 5mg and finely crush them, search reddit on how to) to your minoxidil. I advise you to find liquid fin online. Also apply 0.1 mg or 0.5 mg tretenoin to your scalp (just a pea size amount) three times a week- it increases the sulfotransferase enzyme in the scalp that is responsible for minoxidil working it's magic.

[ThePerseverantWarrior]

The second link is not working. Need better images of your scalp. 

Few questions: 

1) Your baldness grade before transplant 2) Age 3) Eventual baldness grade based on family history (6 or 7)

How can the staff of that clinic "ridicule" you? Did you visit in person? You have every right to have a direct conversation with your doctor. Don't let them off so easily. 

And if you live close to Delhi NCR, I can recommend clinics which you can visit for a proper trichoscopy of your scalp. This will help you get a decent idea of how many approx grafts were actually extracted from your scalp. 

 

 

[bigmistake]

4 minutes ago, ThePerseverantWarrior said:

The second link is not working. Need better images of your scalp. 

Few questions: 

1) Your baldness grade before transplant 2) Age 3) Eventual baldness grade based on family history (6 or 7)

How can the staff of that clinic "ridicule" you? Did you visit in person? You have every right to have a direct conversation with your doctor. Don't let them off so easily. 

And if you live close to Delhi NCR, I can recommend clinics which you can visit for a proper trichoscopy of your scalp. This will help you get a decent idea of how many approx grafts were actually extracted from your scalp. 

 

 

I am 29 years old, Norwood 6 before the transplant. Eventual grade of baldness based on family history is a norwood 6.

 

The staff at the clinic made fun of me when I had raised my concern about the hairline. Before the transplant the doctor had said only single hair grafts are used in the Hairline, after the surgery double and triple hair grafts were visible clear as day. On raising these and other concerns the staff at the clinic made fun of me and said "don't you have a girl friend". Implying I am sexually frustrated. 

I will upload the pictures in the second link soon.

I would really appreciate if you can guide to a clinic who can tell me how many grafts were extracted.

[Phillyman1996]

15 minutes ago, ThePerseverantWarrior said:

The second link is not working. Need better images of your scalp. 

Few questions: 

1) Your baldness grade before transplant 2) Age 3) Eventual baldness grade based on family history (6 or 7)

How can the staff of that clinic "ridicule" you? Did you visit in person? You have every right to have a direct conversation with your doctor. Don't let them off so easily. 

And if you live close to Delhi NCR, I can recommend clinics which you can visit for a proper trichoscopy of your scalp. This will help you get a decent idea of how many approx grafts were actually extracted from your scalp. 

 

 

Sent you a pm

[ThePerseverantWarrior]

16 minutes ago, bigmistake said:

I am 29 years old, Norwood 6 before the transplant. Eventual grade of baldness based on family history is a norwood 6.

 

The staff at the clinic made fun of me when I had raised my concern about the hairline. Before the transplant the doctor had said only single hair grafts are used in the Hairline, after the surgery double and triple hair grafts were visible clear as day. On raising these and other concerns the staff at the clinic made fun of me and said "don't you have a girl friend". Implying I am sexually frustrated. 

I will upload the pictures in the second link soon.

I would really appreciate if you can guide to a clinic who can tell me how many grafts were extracted.

If your eventual grade is NW 6 and you're already NW 6, then there may not much of a point in trying medication. Nevertheless, you could try topical dutasteride (since you had side effects) and oral minoxidil to see if any regrowth is possible. 

Wtf!! Try and talk to the doctor. And don't hesitate to give back to that staff in the same tone. Hairloss can be a rather frustrating issue and no professional clinic makes such jibes. 

Saraswat clinic has a branch in Faridabad. Check their website. You can get a detailed trichoscopy done there. The doctors can also guide you further on your present dilemma

Edited May 17, 2023 by ThePerseverantWarrior

[bigmistake]

38 minutes ago, ThePerseverantWarrior said:

If your eventual grade is NW 6 and you're already NW 6, then there may not much of a point in trying medication. Nevertheless, you could try topical dutasteride (since you had side effects) and oral minoxidil to see if any regrowth is possible. 

Wtf!! Try and talk to the doctor. And don't hesitate to give back to that staff in the same tone. Hairloss can be a rather frustrating issue and no professional clinic makes such jibes. 

Saraswat clinic has a branch in Faridabad. Check their website. You can get a detailed trichoscopy done there. The doctors can also guide you further on your present dilemma

Updated with working links. I respond in kind to the staff, but the doctor doesn't seem to care much. I have never heard of Saraswat, people mostly talk about Eugenix.

[ThePerseverantWarrior]

31 minutes ago, bigmistake said:

Updated with working links. I respond in kind to the staff, but the doctor doesn't seem to care much. I have never heard of Saraswat, people mostly talk about Eugenix.

Pictures of your transplanted hairline? That's not there

You still had a lot of native hair. I'd recommend trying topical dutasteride + oral minoxidil

Obviously we should respond in kind to the staff, provided they don't act without an iota of professionalism

The doctors at Saraswat are quite experienced, and do trichoscopy regularly. I'm not sure if detailed trichoscopy is done at Eugenix. Check out Saraswat for a trichoscopy related consultation. You won't regret it. They also do SMP quite frequently. (Obv that's not the best place to get a repair transplant done though)

And I won't get another transplant if I were you until I achieve some of stabilisation with medication. Your pre op pics looked closer to a NW 5 diffused thinner. Medication is a must if you want to sport a headfull kinda appearance

[mr_peanutbutter]

 

 

make an appointment with eugenix or pittella in brasil, you will need beard hairs

 

medication is recommended to prevent the sides from going further down(lateral humps) but i dont agree that you shouldnt proceed with a hairtransplant if you cant tolerate medication since you already norwood 6 and you already started the hairtransplant process. the scars and the transplanted hairline are already there anyways so i dont think you will lose much aesthetical speaking if you go for a second round even if you gonna lose more hair

Edited May 17, 2023 by mr_peanutbutter

[bigmistake]

43 minutes ago, ThePerseverantWarrior said:

Pictures of your transplanted hairline? That's not there

You still had a lot of native hair. I'd recommend trying topical dutasteride + oral minoxidil

Obviously we should respond in kind to the staff, provided they don't act without an iota of professionalism

The doctors at Saraswat are quite experienced, and do trichoscopy regularly. I'm not sure if detailed trichoscopy is done at Eugenix. Check out Saraswat for a trichoscopy related consultation. You won't regret it. They also do SMP quite frequently. (Obv that's not the best place to get a repair transplant done though)

And I won't get another transplant if I were you until I achieve some of stabilisation with medication. Your pre op pics looked closer to a NW 5 diffused thinner. Medication is a must if you want to sport a headfull kinda appearance

Yes, I still had native hair. The doctor seems to have transected them. I feel he knew what he was doing, and still decided to transect them. 

Topical dutasteride is not available in India, but I am applying topical finastride religiously.

[Bucky O Hair]

6 hours ago, bigmistake said:

What about topical finastride is it effective? I have been applying for the past one month, i have been applying it to my donor area as well.

If there is no alternative to finastride then I would prefer to get the unnatural hairline removed and get SMP.

 

Topical Fin works according to many on here who use it.

Moazzam is giving you some bad advice, so I would take what he says with a grain of salt.  He's not a doctor and his claim about "taking fin long term will make your sides go away" is foolish and possibly harmful to you. 

There are many on here who use Fin (both orally and topically), but the results of any DHT blocker will vary from person to person.  It's difficult to measure the rate at which it slows down your loss, but people take it as a preventative measure and to increase your chances of slowing down the loss and keeping your hair as long as possible.  It's never a guarantee to continue to slow down (or stop) your loss, and there are cases where it loses it's effectiveness over time.

Re: your HT...

The good news is you went with FUE (so no scar to worry about) and you look like you still have donor hair available.  There are options in India (as people have stated above) and you could use that donor hair along with beard hair to fill in the area behind the hairline toward the vertex.  If you don't have enough hair to get the desired density you'd like, you could supplement it with SMP (since you're open to SMP) and you could probably pull off a nice "HT with SMP blend" giving you a dense but realistic looking buzzed look.  You have options. 

 

 

 

[bigmistake]

17 hours ago, mr_peanutbutter said:

 

 

make an appointment with eugenix or pittella in brasil, you will need beard hairs

 

medication is recommended to prevent the sides from going further down(lateral humps) but i dont agree that you shouldnt proceed with a hairtransplant if you cant tolerate medication since you already norwood 6 and you already started the hairtransplant process. the scars and the transplanted hairline are already there anyways so i dont think you will lose much aesthetical speaking if you go for a second round even if you gonna lose more hair

Eugenix doesn't see patients 12 months before a transplant. I'm applying topical finastride, I hope it works.

Edited May 18, 2023 by bigmistake

[bigmistake]

14 hours ago, Bucky O Hair said:

Topical Fin works according to many on here who use it.

Moazzam is giving you some bad advice, so I would take what he says with a grain of salt.  He's not a doctor and his claim about "taking fin long term will make your sides go away" is foolish and possibly harmful to you. 

There are many on here who use Fin (both orally and topically), but the results of any DHT blocker will vary from person to person.  It's difficult to measure the rate at which it slows down your loss, but people take it as a preventative measure and to increase your chances of slowing down the loss and keeping your hair as long as possible.  It's never a guarantee to continue to slow down (or stop) your loss, and there are cases where it loses it's effectiveness over time.

Re: your HT...

The good news is you went with FUE (so no scar to worry about) and you look like you still have donor hair available.  There are options in India (as people have stated above) and you could use that donor hair along with beard hair to fill in the area behind the hairline toward the vertex.  If you don't have enough hair to get the desired density you'd like, you could supplement it with SMP (since you're open to SMP) and you could probably pull off a nice "HT with SMP blend" giving you a dense but realistic looking buzzed look.  You have options. 

 

 

 

FUE is not always good. People who have had FUT and need repair tend to have a strong donor as the rest of the donor area is not disturbed. Some Eugenix best repair cases have had previous FUTs like Gatsby and Rahul Raichand. 

[Chiku]

On 5/18/2023 at 8:59 AM, bigmistake said:

FUE is not always good. People who have had FUT and need repair tend to have a strong donor as the rest of the donor area is not disturbed. Some Eugenix best repair cases have had previous FUTs like Gatsby and Rahul Raichand. 

You have a good scalp donor. I believe EUgenix can easily work with the kind of donor you have. 

Another option would be Pitella, he has given some great results even on advanced Norwood 7s.  

 

Somewhere you mentioned you were on oral finasteride for five months and now on topical for a month. Just to clarify, you not on finasteride at the time of transplant?

[bigmistake]

2 hours ago, Chiku said:

You have a good scalp donor. I believe EUgenix can easily work with the kind of donor you have. 

Another option would be Pitella, he has given some great results even on advanced Norwood 7s.  

 

Somewhere you mentioned you were on oral finasteride for five months and now on topical for a month. Just to clarify, you not on finasteride at the time of transplant?

I was on oral finastride five months after the transplant. 

My donor looks better than it is in pictures.

[bigmistake]

5 hours ago, Chiku said:

 

5 hours ago, Chiku said:

5 hours ago, Chiku said:

You have a good scalp donor

 

Not really, this is a picture of my donor in strong light with short hair.

[Chiku]

On 5/20/2023 at 3:01 AM, bigmistake said:

 

Not really, this is a picture of my donor in strong light with short hair.

Still a lot can be extracted. They may need to tap into so called unsafe zone. 

Though, the picture is overestimating the depleted areas due to harsh light and magnification/zoom which occurs once the pic is posted on this forum.