Clinic suggestions as a NW6-7

[Macpod]

Hi guys,

after a lot of research and reading the forum I finally decided to make my own account and be part of the community.

 

After contacting fuecapillar I've been told that according to Dr. Turan I'd need "at least 7000-8000 FUs" to have a decent result and that they think that with FUE its not possible according to them as my donor area can only supply around 2500-3000 FUs with the FUE technique. "The level of your alopecia is a Norwood VI to Norwood VII where the lower crown has been affected and also the lateral humps also receded".

Of course I want to get 2nd and 3rd opinions but it seems like I have to look for a new clinic after all.

 

Do you guys have any advice for people who are very far into their hairloss journey as to which surgeon / clinic you'd recommend?

Ideally its somewhat affordable, which is one of the reasons I chose fuecapillar originally.

 

As a side note, I'm 33 years old at this point, balding since my early 20s and from Germany if that helps.

 

Thanks a lot.

[LaserCaps]

Donor limitation often drives this industry, particularly when dealing with an advanced pattern.  There's typically not enough to allow for density throughout the front, top and back.  It's for this reason most doctors, initially -at least - will concentrate their efforts towards the front.  It's the area you see when looking at yourself.  It's also the area others see when they interact with you.  Now the crown.

Think of the crown as a circle.  You fill it.  Because you've shown the propensity to lose, you'll continue losing.  You go on to lose everything around the island worth of hair and now you've created a target area and an unnatural pattern.  Retention of the native hair is imperative. What are you currently doing to mitigate the progressive nature of this condition?

Review the Norwood chart and notice the progression.  As patterns advance, a number of things happen. The hairline recedes, there's deep recession of the temporal areas, the crown begins to expand, etc.  Be both age and pattern appropriate.  It's unlikely you'll ever see an advanced pattern with a hairline in the middle of their forehead.  

Given the basics, I'm not sure if I agree with the "I'd need "at least 7000-8000 FUs" to have a decent result," unless your expectations are unrealistic.  Having hair in the front will always serve you well.  It'll frame your face and give you styling options.  And, the farther back you start, the farther back the doctor can work so as to help minimize the size of the crown.  The range of 2000-3000 grafts, is that per time? Or is this the number of grafts you have lifetime?  

[Melvin- Admin]

I suggest you research on here, look up Norwood 6/7 reviews. We have a list of recommendations, feel free to research these doctors and submit free consultations.

https://hairtransplantnetwork.com/best-hair-transplant-surgeons

[Macpod]

Quote

The range of 2000-3000 grafts, is that per time? Or is this the number of grafts you have lifetime? 

Per time. He did say tho that you never know if the donor area is available a 2nd time.

 

I've actually messaged a bunch of surgeons in the past few hours to get more consultations including Bicer, Pinto, Ferreira, Eugenix and others and will let you guys know about the results.

I should probably mention as well that I'm on Finasterid and Minoxidil since Jan 2022 and that I've gotten a bit of hair back, especially after switching to oral minoxidil and just recently, 4 months ago, to dutasterid.

[mr_peanutbutter]

if you are in germany contact hattingen in switzerland

 

since you need most likely beardhair pittella and eugenix are probably the way to go

[Macpod]

2 minutes ago, mr_peanutbutter said:

if you are in germany contact hattingen in switzerland

 

since you need most likely beardhair pittella and eugenix are probably the way to go

I did contact eugenix a few hours ago, hattingen however I skipped due to their prices. Considering I probably need 6k+ grafts I'd be at 20k Euro or more which sadly is out of my budget.

[mr_peanutbutter]

55 minutes ago, Macpod said:

I did contact eugenix a few hours ago, hattingen however I skipped due to their prices. Considering I probably need 6k+ grafts I'd be at 20k Euro or more which sadly is out of my budget.

i think then you can only go to eugenix

 

zarev and pittella will be out of your budget too

 

https://www.instagram.com/drzarev/?hl=nl

 

https://www.instagram.com/dr.felipepittella/reels/?hl=nl

 

 

 

 

 

 

[Renegade]

4 hours ago, Macpod said:

I did contact eugenix a few hours ago, hattingen however I skipped due to their prices. Considering I probably need 6k+ grafts I'd be at 20k Euro or more which sadly is out of my budget.

In that case Ferreira will be out of your budget as well.

Not sure about Pinto. 

[thatguy776]

Have you tried HDC in cyprus? I'm in the same exact situation and I will be going through them.

[Gatsby]

If you are Norwood 7 then Dr Pitella would be my first choice. Also Dr Sethi and Dr Zarev. All the best. 👍

Edited June 22, 2023 by Gatsby

[Melvin- Admin]

7 hours ago, Macpod said:

I did contact eugenix a few hours ago, hattingen however I skipped due to their prices. Considering I probably need 6k+ grafts I'd be at 20k Euro or more which sadly is out of my budget.

To be quite honest with you, 20k is a reasonable amount when you consider how many grafts a Norwood 6/7 requires. If you require 8,000 grafts, 20k is $2.5 per graft. If you can’t afford a decent surgeon, best to do nothing. Perhaps SMP is a better option. Hair systems might be an option as well.

Definitely do not go to a surgeon just because you can afford them. A Norwood 6/7 requires a specialist, especially because you have a huge area to cover with a minimal donor. 

[sftraderHT]

In CA, I've seen quotes from $7/graph to $15/graph

[Al - Moderator]

Do you have any pictures you can post, so we can see your situation? Do you have a lot of beard hair you would be willing to use? High NWs can usually get a good result by mixing scalp donor with beard and/or chest donor. You would need to go to someone who is good with using body hair as a donor source.

 

[Gatsby]

4 hours ago, Melvin- Moderator said:

To be quite honest with you, 20k is a reasonable amount when you consider how many grafts a Norwood 6/7 requires. If you require 8,000 grafts, 20k is $2.5 per graft. If you can’t afford a decent surgeon, best to do nothing. Perhaps SMP is a better option. Hair systems might be an option as well.

Definitely do not go to a surgeon just because you can afford them. A Norwood 6/7 requires a specialist, especially because you have a huge area to cover with a minimal donor. 

Totally agree with what @Melvin- Moderator has said. The surgeon has to have the skill and experience for the hairline, temple points, crown whirl, donor management, utilization of beard grafts, etc, etc. I’m speaking as someone who was a Norwood 7 when I began my surgery/repair. All the best. 

[A_4_Archan]

If you budget is low than don't be greedy for a large session ...wise thing would be to plan your surgery in 2 or may be 3 phases thats how you can go slowly and steadily and also can manage your finances ....so imo for the first surgery you can go with around 2.5k grafts for your frontal area which will frame your face well..for this you can go with a surgeon whose hairline work you like and who is managing donor very well so you can..

Now i have read that you were saying about 2000-3000 grafts and you seems to be confused if they are a lifetime figure or first session figure...so first of all go to in person consultation with a clinic in your country which is good and know how many lifetime grafts are available to harvest...so you can plan accordingly...and do post your scalp pics so people can understand your situation well and guide you accordingly....

[hairman22]

a nw6/7 cant be repaired on a budget.

Better to do nothing if you cant afford a top surgeon like Zarev,Pittella or Sethi.

[Macpod]

 

8 hours ago, Melvin- Moderator said:

To be quite honest with you, 20k is a reasonable amount when you consider how many grafts a Norwood 6/7 requires. If you require 8,000 grafts, 20k is $2.5 per graft. If you can’t afford a decent surgeon, best to do nothing. Perhaps SMP is a better option. Hair systems might be an option as well.

Definitely do not go to a surgeon just because you can afford them. A Norwood 6/7 requires a specialist, especially because you have a huge area to cover with a minimal donor. 

I was just under the impression that I'd need multiple surgeries instead of one larger one if thats the case then I have quite a bit of time to save up money inbetween.

8k grafts at once sound hard to do, even with beard hair? I just try to get the best value for money otherwise I'd prolly pick Zarev. I am really open to suggestions, I can also wait longer and safe up more money but currently I cant put more than 500€ away every month for my HT.

3 hours ago, A_4_Archan said:

If you budget is low than don't be greedy for a large session ...wise thing would be to plan your surgery in 2 or may be 3 phases thats how you can go slowly and steadily and also can manage your finances ....so imo for the first surgery you can go with around 2.5k grafts for your frontal area which will frame your face well..for this you can go with a surgeon whose hairline work you like and who is managing donor very well so you can..

Now i have read that you were saying about 2000-3000 grafts and you seems to be confused if they are a lifetime figure or first session figure...so first of all go to in person consultation with a clinic in your country which is good and know how many lifetime grafts are available to harvest...so you can plan accordingly...and do post your scalp pics so people can understand your situation well and guide you accordingly....

Like stated above, this is what I thought would be the go-to anyways. I do think I need multiple surgeries instead of one large one. I do wonder tho - if they take 2.5 - 3k grafts from my donor area the first time, does some of it grow back etc so it can be harvested again a year later? Wish Verteporfin was already available.

 

As a side note, I got my evaluation from eugenix:

Quote

Your pictures have been evaluated by our doctors. Their assessment is mentioned below:

Currently, you seem to have Norwood Grade VII of baldness but this may progress in future

The marked area could require: 3500

Proposed Harvest from Scalp: 3000

Proposed Harvest from Beard: 500

The above evaluation of the Grade of baldness and graft assessment is tentative as it's a preliminary (and pictorial) evaluation. However, the final evaluation may vary during Face-to-Face assessment by a doctor.

The “miniaturized hair” might improve with the help of medications.

You will also require finasteride for the preservation of your pre-existing hair. 

Finasteride is a medication that slows down the progression of baldness. It is a Dihydrotestosterone (DHT) inhibitor.

Duration of post-transplant Finasteride: lifelong (but we can take breaks of 2 to 3 months in between). The dosage can be revised periodically.

The progress in the mid scalp and crown can be assessed with Finasteride for 1 year further the medication will help in increasing the density in those areas.
 

They didn't really read though that I'm already on finstaride or rather dutasterid for over a year (dut for 4months now) so not sure how much those miniaturized hairs will improve tbh.

Their packages range from 75 INR to 500 INR for Dr. Sethi.

Quote

1. Comprehensive Package 
Procedure Lead By – Eugenix HT Doctors
Cost Per Graft – INR 75 + Tax
Planning & Designing & Complete Slits to be Performed by Eugenix HT Doctor and further assisted by our Senior Eugenix Technicians under the supervision of the leading doctor
Value Added Benefits - Hotel stay and food available at discounted rates on request, based on availability. This facility is available only in Gurgaon.

2. Exclusive Package
Procedure Lead By – Senior Eugenix HT Doctors 
Cost Per Graft – INR 120 + Tax
Planning & Designing & Complete Slits to be Performed by Senior Eugenix HT Doctor and further assisted by our Senior Eugenix Technicians under the supervision of the leading doctor
Value Added Benefits - Complimentary two nights’ accommodation with airport pick up and drop off. Seven days post-op medication will be provided by us.

3. Premium Package with Dr Priyadarshini Das
Procedure Lead By – Dr Priyadarshini Das 
Cost Per Graft – INR 210 + Tax
Planning & Designing & Complete Slits to be Performed by Dr Priyadarshini Das and further assisted by our Senior Eugenix Technicians under the supervision of the leading doctor.
Value Added Benefits - Complimentary two nights’ accommodation with airport pick up and drop off. Seven days post-op medication will be provided by us.

4. Super Premium Package with Dr Arika Bansal/Founding Surgeon
Procedure Lead By – Dr Arika Bansal
Cost Per Graft – INR 350 + Tax
Planning & Designing & Complete Slits to be Performed by Dr Arika Bansal and further assisted by our Senior Eugenix Technicians under the supervision of the doctor.
Value Added Benefits - Complimentary three nights’ accommodation with airport pick up and drop off. Seven days post-op medication will be provided by us.

5. Dr. Pradeep Sethi’s Flagship Package
Procedure Lead By – Dr Pradeep Sethi
Cost Per Graft – INR 500 + Tax
Planning & Designing & Complete Slits to be Performed by Dr Pradeep Sethi and further assisted by our Senior Eugenix Technicians under the supervision of the doctor.
Value Added Benefits - Complimentary three nights’ accommodation with airport pick up and drop off. Seven days post-op medication will be provided by us.
 

I wonder if the 2. Package is sufficient when people talking about eugenix is a decent choice or do they always just talk about Dr Sethi?

[Macpod]

Here are some pictures btw.

 

Thanks for all the comments and guidance btw!!

 

Edited June 22, 2023 by Macpod

[mr_peanutbutter]

45 minutes ago, Macpod said:

Here are some pictures btw.

 

Thanks for all the comments and guidance btw!!

 

dr pitella and dr zarev do fue-megaseasions where they move up to 10k grafts in one setting, for the others you will need several procedures

[Macpod]

42 minutes ago, mr_peanutbutter said:

dr pitella and dr zarev do fue-megaseasions where they move up to 10k grafts in one setting, for the others you will need several procedures

Yeah, just wonder where they take all those grafts from considering I've been told by Dr. Turan that I ~3k grafts in my donor area.

 

I just got another response btw from Dr. Seffen from Tunesia:

Quote

We have thoroughly examined your photos, these show a fairly extensive baldness (stage 6-7) , the 2/3 anteriors of the skull will therefore be treated exclusively during this procedure in order to ensure an optimal density of implantation and to achieve a good coverage of the area to be grafted while guaranteeing an adequate harvesting of the donor area.

A second intervention for the remaining part of the head ( vertex and posterior midcalp) may be considered after a few months and depending on the remaining capacity of the donor area.

 

Here is a diagnosis/estimate for a hair transplant that will interest the frontal line + temporal gulfs + anterior midscalp and posterior (zones 1,2,3+/-4 on the photo attached). This is a primary diagnosis based solely on the appearance of your hair according to the photos, a more precise common decision will of course be taken after physical examination during your pre-operative consultation the day before or the morning of the procedure .:

 

Proposed Response:

 

Hairtansplant of 3800-4000 grafts (equivalent to about 11000 hair) in 2 successive surgical sessions (2 successive days).

 

Alternating manual/motorized FUE extraction technique.

 

Implantation technique (according to medium size/hair texture) DHI (Direct Hair Implantation)/ implantation au (K.E.E.P).

 

 

Is Hair loss stable? Is the hair of the donor area (back and skull?) fine? Brittle? Is your hair loss hereditary or have you been treated for a scalp defect? 

 

The total area to be covered is approximately of 100-110 cm2; and a density of +/- 40-45 UF/cm2 should be achieved to reach a significant hair volume, nevertheless, the distribution and number of grafts will be revalued preoperatively according to the density requested  and the surface to redensify .

 

We prefer to practice our interventions over two days for several reasons [...]

So he's saying up to 4k grafts, without beard hair. Ive heard of Dr. Seffen from you actually @mr_peanutbutter.

Thoughts so far? Also about Eugenix' offer?

[Al - Moderator]

My beard looked a lot like yours and I was able to get over 3300 grafts from it.

 

[mr_peanutbutter]

32 minutes ago, Macpod said:

Yeah, just wonder where they take all those grafts from considering I've been told by Dr. Turan that I ~3k grafts in my donor area.

 

I just got another response btw from Dr. Seffen from Tunesia:

So he's saying up to 4k grafts, without beard hair. Ive heard of Dr. Seffen from you actually @mr_peanutbutter.

Thoughts so far? Also about Eugenix' offer?

i dont think you will get sufficient density with 4k grafts

if i was you id either go with

 

1. zarev

2. pittella

3. eugenix

 

the first 2 are out of your budget so eugenix it is

[Melvin- Admin]

5 hours ago, Macpod said:

Here are some pictures btw.

 

Thanks for all the comments and guidance btw!!

 

This is a HUGE endeavor. You require 8,000 grafts minimum, and you will likely need multiple procedures. First question, do you have the time? Second, do you have the resources? Realistically you need around 14k grafts. But 8,000 should be enough to cover the front middle, with a thin/balding crown. Is this sufficient? Like I said, surgery may not be the best option. Never ever go to a doctor because you can afford them. You’ve been given doctors that specialize in your situation, but you can’t afford them. So once the next best option besides surgery? 

[Renegade]

This is a difficult one. If I'd be in your place I'd just get a full head of hair by wearing a hair system and arrange consultations with the top docs like zarev and pitella without any expectations. 

 

I know their price is high but they're so busy, it'll take a long time until a surgery. 

In my opinion there's really only like 3 surgeons who could pull something satisfying off, if even possible. 

[Zoomster]

I have to say hair systems have come a very long way from what I can gather .

A guy I know living Ireland has ruled out a HT due to his fear of flying and has had a hair system recently..it looks absolutely fantastic..totally undetectable and non “ that’s a rug “ like ..

Each hair restoration route has their trade offs …systems have a more viable place nowadays if you ask me .