Dr. Laorwong, Absolute Hair Clinic Bangkok | 4,178 grafts | 2023-08-04 | NW3+

[HatMaster]

Hello everyone. First, I want to thank the forum contributors for the many useful posts that helped me make my transplant decision. In particular, @A_4_Archan 's detailed posts about his experiences with Dr. Laorwong influenced my decision. I would love to hear your thoughts on my operation and answer any questions.

Key information

• Age: 31
• Norwood: Every clinic I contacted that gave me evaluation said NW3, although I feel like I am on the advanced side of 3
• Meds:
  • 1mg finasteride daily 3/2022-6/2023. Stopped my hairloss from progressing. No side effects apart from increased libido at first and watery semen. I wish I had started a lot sooner!
  • 0.5mg dutasteride daily 6/2023-present. I had minimal side effects on finasteride so decided to switch hoping for further regrowth. I had some testicle pain at first, at which point I decided to switch to every other day. The pain went away, and after two weeks I began taking daily. No further side effects except maybe like 5% decreased libido, which is honestly fine by me.
  • 2.5mg oral minoxidil 6/2023-present. I'm considering switching to 5mg as after the first few days I have had no side effects.
  • Collagen + biotin supplement 6/2023-present.
• Balding history: first noticed thinning around age 20. Progressed gradually first at the hairline and then the midscalp/crown until I started finasteride.
• Family history: My dad is full blown NW7. We have similar hair and appearance generally. No one on my mom's side has hairloss, nor does my younger brother.
• Price: 65THB / graft, for a total of 271,750THB or ~$7.8k. 20kTHB deposit over Wise, then the remainder with Visa or Mastercard after surgery for no additional fee. Included a PRP injection.
• Grafts: 4,178 total. 1,257 triple, 2,292 double, 315 1.5 (I actually don't know what this means), 314 single. 9,299 hairs total.

Decision process

I first started thinking about a transplant 3/2022, which led me to start finasteride after a consultation with a local surgeon. I made the decision to get a surgery 4/2023. Budget was not really a consideration for me, but I didn't feel that the results from top clinics were significantly better so I focused on doctors in the $3-10k range. Location was not a major factor, but I am based in Asia so Bangkok was a positive. I felt ready for the surgery and didn't want to wait, so I preferred clinics with short waiting periods. After seeing many good results from Dr. Laorwong on here and Reddit and positive initial communications with his clinic, I decided to go with him. I also appreciated that they provide 5 full days of aftercare.

Consultation and lead up

I communicated with the clinic over Line in mid May. I believe I was talking directly to Dr. Laorwong the whole time. He provided me with an MS-paint style hairline drawing a 4k graft estimation. There was some availability in June and July with significant availability in August-October. Due to my travel schedule, I decided on 8/4 and confirmed the date with a 20kTHB (~$572) deposit. I was told to stop oral minoxidil one week before surgery.

I arrived in Bangkok a few days before the operation after a diving trip in Koh Tao (recommended place to visit). I met with Dr. Laorwong on 8/3 at 3pm for the in-person consultation. To be honest, his hairline designs were I thought the weakest part of his performance in reports that I had read, but I liked the first one he drew on me. The hairline went down to my retained forelock, which was what I wanted and expected based on my facial proportions. After a bit of discussion, we decided to slightly increase the arch so that I would have a bit of widow's peak to slightly improve hairline density and generally be conservative. He measured my donor area and confirmed that I was all good for surgery.They took pre-op photos and did a finger prick HIV test as well. I was told to eat breakfast the following day but avoid coffee and to not drink that night. In general, I found Dr. Laorwong to be concise and business like, but he happily and thoroughly answered all of my questions.

They gave me antiseptic shampoo that I used that night and in the morning before surgery.

Surgery

I arrived at 8am on 8/4. I changed into surgery attire, then a kind nurse checked my blood pressure and gave me medication. I think it was amoxicilin, arcoxia, and two valium. Then Dr. Laorwong came in. He redrew the hairline and marked up my scalp, then proceeded to shave my head with the help of a few nurses.

We proceeded to the surgery room where I laid face down for extraction. They massaged my calves and used a vibrating machine on my head while administering the anesthetic. It didn't hurt much at all, maybe a 2/10. They had music (I think Thai music? It was vaguely dancy and pretty good) on in the background and chatted a bit, but generally were pretty quiet throughout the operation. The valium began to kick in and I was in and out of consciousness for most of the morning. The most uncomfortable part was lying face down for so long. The gel pillow was nicer than a massage pillow, but still felt uncomfortable against my forehead. I had to lay my head on its side while they extracted from the parietal area, which was aggravated my neck (perpetually stiff from too much desk work). Overall, though, not too bad.

We broke for lunch around 1:30pm. I had requested chicken pad thai, which I ate in the room where they shaved my head. After 30m or so we restarted.

For implantation I sat in the same chair, face up this time. They drew blood for PRP then covered my eyes with a gauze blindfold. They administered more anesthetic to my forehead, I believe just above the center part of each of my eyebrows. Also about a 2/10 on the pain scale. I could feel the doctor making the initial incisions which stung a little, but when the anesthetic fully kicked in I didn't feel anything. Again, I drifted in and out of sleep for most of the operation. I'm not sure who performed most of the implantation, but I know that Dr. Laorwong was present for much of the time as I recall hearing his voice on a number of occasions. I was conscious for the last hour or so as the valium wore off and started to feel pretty bored, so I was quite happy when Dr. Laorwong told me that they were all set. They It was 8:30pm when we finished, for about 11 hours of surgery time after accounting for the lunch break.

The same nurse who checked my blood pressure bandaged me up. They served me a light dinner, gave me medication (amoxicilin, arcoxia, prednisone, and tylenol, which I didn't end up needing) and instructions, handled payment, and sent me home. After enjoying a delivery smoothie, I took a valium and went to bed. Per their instructions, I slept on my back with two pillows supporting my head and a towel under my neck. Again thanks to the valium, I enjoyed a good night's sleep.

Overall the surgery was a bit more comfortable than I expected. The entire team acted with utmost professionalism and kindness. If I could offer one piece of feedback to the clinic, I would have appreciated some progress updates as the surgery proceeded. 

Aftercare

I went back to the clinic at 3pm on 8/5. The same nurse who had gotten me settled the previous day undid the bandages and washed my head. She spoke decent English and had a warm, positive demeanor. The doctor came by for a checkup and confirmed that everything had gone well the previous day. They gave me a headband to wear for 3 days to prevent swelling in my face and a very comfortable black bonnet. I also did about 30m of low level laser therapy (LLLT) on the donor and recipient areas. They gave me a saline spray to use every hour until I went to sleep, which I adhered to carefully. They told me to resume oral minoxidil on this day.

I returned to the clinic the following three days for further cleaning and LLLT. I saw different nurses on these days who were still kind but didn't speak much English. As a minor complaint, I had to wait in the lobby for over an hour past my appointment time on one of the days. Today, my last day before I depart, Dr. Laorwong checked up on me again and confirmed that things looked good. I thanked everyone for their excellent service and went on my way.

In general, I felt pretty good after the surgery. My donor area was a bit sensitive and stung for the first two days, and there was some blood on my pillow after the second night (first night without bandages). The clinic said that this is normal and not something to be concerned about. The recipient area feels quite numb, which I understand is common. I also felt like I had to clear my throat a lot for the first two days after surgery, kind of like I gotten water in my windpipe. However, this could be allergies or just me being bad at eating.

Logistics

Bangkok is a very comfortable place to recover from surgery. Food and grocery delivery is cheap and tasty. I stayed at Pattern hotel and would recommend it -- kind staff and excellent breakfast. I have been to Bangkok before so didn't do much sightseeing, but there are a number of high end malls with air conditioning and good food courts that are nice places to kill time. I saw Oppenheimer in imax at Iconsiam and have to say it might be the nicest movie theater I've ever been to.

Miscellanea

Some of the post-op instructions were different from what I've read about with other clinics. In particular, I am a regular snus user, and the doctor told me that it was fine to resume using the day after surgery. He also told me that I can start exercising 7 days after surgery as long as I avoid contact sports. I was not instructed to sleep sitting up or anything like that.

Overall impressions

Although I reserve judgment until time reveals my results, I had a very positive experience. The doctor and his staff came off as consistently competent, professional, and kind. They were responsive to my concerns before, during, and after surgery. All details about pricing and logistics were presented clearly. The clinic is modern, clean, and fairly conveniently located. Assuming that my eventual result is positive, I would happily return if I need another procedure as well as recommend to family, friends, and strangers on the internet.

Thanks for reading my wall of text. I plan to update with photos periodically.

Photos

• First 5 photos are pre-op on 8/4
• Next 7 are one day post-op on 8/5
• Final 3 are 4 days post-op on 8/8

 

Edited August 8, 2023 by HatMaster

[A_4_Archan]

@HatMaster

Amazing write up brother ...very detailed explanation of everything....i am happy that my journey (post) helped you so much and yours will help many more like us...

Imo its good that you took a bit of conservative approach which saves lot of grafts and can be used if you need them in future as you are still fairly young and hairloss can slowly progress (i wish it doesn't)...so its wise decision to stay on a safer ground...plus personally i like widows peak more than those U shaped hairlines....

Its good that your are on medication and your regime seems to be pretty robust and i would just like to ask you to consider adding ketoconazol shampoo twice a week to this...

As usual with almost all of dr laorwong's cases work looks super clean and there are micro irregularities on the hairlines..plus density looks very good and you will get a pretty dense outcome if everything turns out well..(touchwood) 

By the way i also had my breakfast at pattern boutique hotel and they serve amazing breakfast ...actually i was staying at hotel white ivory bed and breakfast which is exactly near to your hotel(at a corner of the street which takes you to the doctor's clinic) and actually both the hotels are owned by the same person and they serve breakfast at pattern hotel to the ones who even stays at hotel white ivory ...

Finally i wish you all the best and am happy and thankful to you for mentioning me and appreciating me and i would say many more people will do the same to you after seeing such a detailed write up about everything....Happy growing and keep updating brother...

Edited August 8, 2023 by A_4_Archan

[HatMaster]

Thanks for the kind words and advice man! 

[davidn]

Amazing Report, enjoyed Reading. Did the doc give you an indication how much donor might be left for future procedures?

[HatMaster]

He said I have about 2k grafts remaining. I don’t feel too self conscious about my crown area and want to see if the medication helps there. But assuming I get good results this time I may consider getting a touch up in a year. 

[Gatsby]

Excellent write up @HatMaster. Excellent planning and I look forward to seeing your updates. 💯👌

[Britanium]

Very nice indeed, thanks for the very detailed account of you’re experience so far. Look forward to the subsequent updates 🙏

[Hairwolf]

Just catching up to your report now. Your experience was synonymous with mine with  clean work carried out overall. Look forward to your updates.

[Fue3361]

Work looks good!  I look forward to seeing it in 6 months!

[HatMaster]

Hi all, I'm now one month after the procedure. 

The recovery process has been mostly fine. About five days after the procedure, I started to experience stinging and itchiness in the donor area as it began to heal. The discomfort peaked in the period 7-10 days post op. Not the worst thing in the world, but I did have some trouble sleeping during this period. I used a topical lidocaine and antihistamine OTC solution after clearing it with the doctor, which helped a fair bit. The donor area feels and looks completely normal now, although if I run my hand through my hair in this area I can tell that it's less thick than before.

I started gently scrubbing the recipient area to remove scabs/crust 7 days after the procedure. They were gone within three days. The recipient area felt a bit numb for about two weeks, but I never felt any discomfort there. It feels normal now.

The transplanted hairs began to fall out starting three weeks after surgery. As you can see from the photos, they are basically all gone at this point 😭. I knew the shed was coming, but it was still a bit jarring to see so many hairs on my hand if I touched my head or on my towel after showering. Fortunately, the native hairs seem fine, so I don't think I'm experiencing any shock loss at this time.

I have increased my oral minoxidil dose to 5mg each day (2.5mg morning and night) and begun using 2% ketoconazole shampoo twice each week. No side effects from either treatment.

Otherwise, life is normal. The redness has subsided to the point that I don't feel self conscious without a hat, although of course I always wear one outside during the day. I have returned to all of my usual activities.

[Turkhair]

Early shed means early regrowth so rejoice 😀

This is a good doctor, your result should be excellent with excellent density.

Happy growing 

[Hairwolf]

Similar experience to yourself with the shedding timeframe. I am almost 2 months in. Hopefully start seeing growth soon🤞. Hang tight !

[A_4_Archan]

@HatMaster

Good that everything fallen out to make way for the new ones soon....😊

[Newby888]

Thanks for the pics. Looking on the right track.

hows your donor area? Can you show some pics of that as well please.

[HatMaster]

Here are a few donor area pics. As I said, it looks totally normal to me. Apologies for the poor quality / lighting 😅.

[hairman4321]

you might have to change your username when this grows in!

[Hair4Days]

Very clean looking post op. It looks like you may have some shock loss of the native hair when comparing your 1 month photos to pre op. Did the doctor comment on this at all?

[Spring15]

Looking forward to seeing how this turns out - should be a great result

[HatMaster]

16 hours ago, Hair4Days said:

Very clean looking post op. It looks like you may have some shock loss of the native hair when comparing your 1 month photos to pre op. Did the doctor comment on this at all?

Yes, it's true that the native hairs in the recipient do look a little bit weaker, although this may be because of the short length and current lighting. I haven't asked because I was told that shock loss is a possibility.

[JP1972]

Thanks for sharing your experience 

im looking forward to seeing your results 

I’m interested in having my procedure done by this doctor 

 

[JP1972]

Hi Hatmaster,

would you mind sharing your experience post op in Thailand and on your return home?

how many days did you spend post op in Thailand?

How did you handle your healing process?  Did you cover your head when going out to eat or enjoy yourself or did you just stay indoors?

how much had you healed before you returned home?  Did you wear any head coverings at the airport or on the plane? If so did they cause any irritation?

sorry for my odd questions

[Cooper48]

2 minutes ago, JP1972 said:

Hi Hatmaster,

would you mind sharing your experience post op in Thailand and on your return home?

how many days did you spend post op in Thailand?

How did you handle your healing process?  Did you cover your head when going out to eat or enjoy yourself or did you just stay indoors?

how much had you healed before you returned home?  Did you wear any head coverings at the airport or on the plane? If so did they cause any irritation?

sorry for my odd questions

I can add a little here. I’m currently on day 5 post surgery from dr Laorwong.  When you leave after surgery they put a bandage around your donor, a headband around the bandage and a black bandana around your head. I didn’t sleep that well so was up early the next day. I walked all over Bangkok, visited temples and markets. I went back at 3pm to get my wash from the clinic. The clinic does 5 days of washing and LLL therapy. 
 

I repeated that for 4 days. They took the bandage off the next day which helped make my head not look so big.  No one really paid much attention to the bandana while out shopping, eating, etc. I skipped the last day of washing to head to Chiang Mia. I’m planning on being here a few days and then headed to Phuket. Can’t help but ty to get a vacation out of this. They do make you take your head covering off at the airport. I just made sure to move slow and deliberate as it is easy to do something dumb in a security line when. People are waiting on you. Hope this helps. Definitely no need to stay inside unless it makes you feel better. I averaged nearly 20k steps each day after. Ha. 

[JP1972]

Thanks cooper48,

im assuming when you were at the airport you no longer had the bandage from the surgery?

[Cooper48]

1 hour ago, JP1972 said:

Thanks cooper48,

im assuming when you were at the airport you no longer had the bandage from the surgery?

That’s correct. Just the bandana. Bandage was removed in day post op. Head band 4 days post op.  

[HatMaster]

More or less same here. I had been to Bangkok before so didn't do as much sightseeing, but the doctor is very clear that walking around etc is no problem. I wore the provided bonnet whenever I left my hotel. I only stayed for 4 of the 5 provided LLLT/wash days. Air travel was no issue at all, only had to remove the bonnet at immigration processing on each side. I did feel like the dry air in the plane irritated my scalp a bit because the donor area started to get itchy really itchy right when I arrived home, but it's hard to separate that from the normal healing timeline.

If I were doing the surgery again, I wouldn't plan anything differently.