Advice for NW7 in need of repair

[Bamboo]

Hi all 

 

I'd be grateful for the community's advice regarding best options for my next step.

 

I’m 59 and NW7 with limited donor from a number previous botched jobs in the late 80s and 90s. I had a (mostly) failed outcome with a mega BHT attempt in 2004. As a result, I have limited scalp donor but still have an abundance of body hair on almost all other parts of my body.

 

I also had some BHT (mostly beard) with Dr Umar about 10 years ago where he successfully transplanted grafts into the temple area and into an old linear scar. Finance and logistics prevented me from taking things any further at the time. 

 

I've worn a system for about 25 years. Prior to that I used a hair thickener but it got to the point where there was little left to thicken and it looked ridiculous. My scalp was too scarred to buzz cut and it wasn't really in fashion then anyway. Even though the system looks okay and they've better over the years, I would still prefer to be without it. 

 

Given my age, any next attempt would definitely be my last so I’ve been nervous to progress. I would be heavily reliant on BHT and would hope that SMP would assist in creating the illusion of thickness. I would be happy with a relatively modest solution incorporating preferably a soft, back combed hairline. 

 

I'm encouraged by the significant developments in recent years in terms of successful BHTs and the use of SMP to increase the illusion of volume etc so I hope that some solution still exists. As has always been the case, there will some practitioners (both for BHT and SMP) that are more suited to my situation than others. 

 

Whilst I'd prefer a full solution, one of the options I would consider would be a transplanted hairline with the system set behind it. Acceptable, but not my preferred outcome.  

 

For BHT, I'm thinking of course of Dr Bisanga and Eugenix. Dr Bisanga is closer to where I live (Ireland) but is quite expensive. The cost of Eugenix is difficult to estimate. (They used to have a range of options displayed on their website but it doesn't seem to be there now). It's also a long way to travel by comparison.

 

I also hear good things about Pinto in Portugal but I don't know what he'd be like with BHT and repair cases. 

 

For SMP, I'd need someone who was used to applying it for "thickening" purposes rather than just applying it to buzz cuts. 

 

Grateful for any advice in terms of what route I should go (even if it means sticking with the system) and the options I might have in terms of surgeons and SMP practitioners etc.     

 

I'm attaching some photos which help illustrate my situation.

[hairman22]

your only options are Dr Zarev,Dr Pittella or De Sethi.

Zarev list is too long. I would schedule a consult with Pittella as he uses Body Hair.

It will cost alot of money though. You need probably between 12-16k grafts

[TorontoMan]

Its best to let it go. You don't have enough donor to achieve anything you'd be happy with. You will be far happier shaving down and keeping your money and moving forward with your look. 

[Britanium]

I don’t think you have enough donor hair to make enough of a difference. Yes body hair can and is used, but you really need it to be mixed with a good amount of scalp hair too. 
you don’t want to thin out the donor scalp hair you have, it could start to show you’re previous work.

Its not want you may want to hear, but with excessive loss and previously used body donor areas i just don’t think you’re a candidate for another transplant.

By all means consult with some of the Drs mentioned above, always good to get the professionals opinion 🙏

[Bamboo]

47 minutes ago, TorontoMan said:

Its best to let it go. You don't have enough donor to achieve anything you'd be happy with. You will be far happier shaving down and keeping your money and moving forward with your look. 

Thanks for your message.

 

Shaving down not really an option as there's still a number of strip scars from previous work. 

[TorontoMan]

25 minutes ago, Bamboo said:

Thanks for your message.

 

Shaving down not really an option as there's still a number of strip scars from previous work. 

That’s fine, no shame in your scars, you attempted to solve a real issue for yourself in the past and given the times you were in it didn’t pan out. Joe rogan also has a strip scar that can be seen most times he’s on tv, but he embraces it, it’s on the back of his head and he doesn’t care 

[Berba11]

33 minutes ago, Bamboo said:

Thanks for your message.

 

Shaving down not really an option as there's still a number of strip scars from previous work. 

Given that you don't appear to have enough donor resources to get decent NW7 coverage, what you could look to do is use your available donor hair on the strip scars so that you could buzz down and feel less conscious about it, if those scars are bothersome.

Is there is any hope of a hair transplant that will have enough of a result to satisfy you, you're limited to a very tiny number of elite surgeons.

[Grouse]

I'd also suggest you consult with Dr. Sethi at Eugenix and Dr. Pittella. @Gatsby's case may be worth looking at - recall he used a lot of body hair and had former surgeries too. 

[baddecisions]

What about removing all the existing grafts on the recipient and moving them back to donor to recover a normal bald patern?

I remember a case by Lorenzo similar to yours, i'll see if I can find the video

 

[asterix0]

Hair systems I think are your only option. 

[AB2000]

3 hours ago, Grouse said:

I'd also suggest you consult with Dr. Sethi at Eugenix and Dr. Pittella. @Gatsby's case may be worth looking at - recall he used a lot of body hair and had former surgeries too. 

Pittella does body (non-beard) hair, Eugenix does not.  Search the forums for his work.  This is an example of a NW7 patient.  The problem you seem to have is your beard is already depleted.

 

[A_4_Archan]

@Bamboo

Considering that your donor does not look fit for surgery, I do not think you make a good candidate. However, if you still want to go the surgical route, you can use scalp donor along with your body and beard grafts. You can then implant the rest of the grafts throughout the scalp and then do smp to give the impression of density and maintain a buzzed appearance.

You may consult dr pittela for this and take his opinion 

[Gatsby]

Hey @Bamboo. I can certainly empathize with you. I also had two 'punch graft' surgeries in the mid 80's and was so distressed by the results I spent six years having them stripped out by a plastic surgeon. I then wore a hair piece for 25 years to hide the frontal strip scar along with my continuing baldness as it continued to progress. I then came to the point where I was just so damn sick of wearing a hair piece that I then had SMP and shaved my head. It was such a relief but ?I never felt 100% confident as my scars could still be seen but the SMP was a massive improvement. As a Norwood 7 I went to Dr Pradeep Sethi and had in total 14,468 grafts taken to cover my hair loss in two session. You can see my journey in my signature line. In the first session we used over 3,200 scalp grafts, 3,940 beard grafts, 856 grafts taken from my chest and 490 taken from my mustache. Also 232 pubic grafts were used to implant into the old donor scars. I had a second procedure seven months ago to address the hair line scar and the crown. We used another 3,062 scalp grafts and 2,783 beard grafts.

I was also previously offered to have a halo of grafts placed in my hairline so that wearing a hair piece would look more natural. However I was just done with hair pieces and I think eventually the majority of people reach that point if they wear them long enough. If you were to choose surgery then their are only two surgeons who have enough Norwood 7 experience on the boards. Dr Sethi and Dr Pittella. Also you will have to be realistic with your goals and full coverage would not be obtainable IMHO. You may be able to get a frontal area that you could comb back to get more of an illusion of coverage. For SMP to work with hair it has to have hair to work. Looking at your beard I don't know how many grafts you would be able to extract to give you enough coverage mixed in with scalp grafts. The problem with chest hair is that yes it can be used as a filler but it is a last resort because it has an anagen phase of 1-6 months and a telogen phase of 2-6 months. Scalp however has an anagen phase of 2-8 years and a telogen phase of 3 months. The best thing to do would be to arrange a consultation with both Dr Sethi and with Dr Pittella and ask them for their opinion of what can and what can't be achieved. I wish you all the best. 🙏

[Bamboo]

6 hours ago, Gatsby said:

Hey @Bamboo. I can certainly empathize with you. I also had two 'punch graft' surgeries in the mid 80's and was so distressed by the results I spent six years having them stripped out by a plastic surgeon. I then wore a hair piece for 25 years to hide the frontal strip scar along with my continuing baldness as it continued to progress. I then came to the point where I was just so damn sick of wearing a hair piece that I then had SMP and shaved my head. It was such a relief but ?I never felt 100% confident as my scars could still be seen but the SMP was a massive improvement. As a Norwood 7 I went to Dr Pradeep Sethi and had in total 14,468 grafts taken to cover my hair loss in two session. You can see my journey in my signature line. In the first session we used over 3,200 scalp grafts, 3,940 beard grafts, 856 grafts taken from my chest and 490 taken from my mustache. Also 232 pubic grafts were used to implant into the old donor scars. I had a second procedure seven months ago to address the hair line scar and the crown. We used another 3,062 scalp grafts and 2,783 beard grafts.

I was also previously offered to have a halo of grafts placed in my hairline so that wearing a hair piece would look more natural. However I was just done with hair pieces and I think eventually the majority of people reach that point if they wear them long enough. If you were to choose surgery then their are only two surgeons who have enough Norwood 7 experience on the boards. Dr Sethi and Dr Pittella. Also you will have to be realistic with your goals and full coverage would not be obtainable IMHO. You may be able to get a frontal area that you could comb back to get more of an illusion of coverage. For SMP to work with hair it has to have hair to work. Looking at your beard I don't know how many grafts you would be able to extract to give you enough coverage mixed in with scalp grafts. The problem with chest hair is that yes it can be used as a filler but it is a last resort because it has an anagen phase of 1-6 months and a telogen phase of 2-6 months. Scalp however has an anagen phase of 2-8 years and a telogen phase of 3 months. The best thing to do would be to arrange a consultation with both Dr Sethi and with Dr Pittella and ask them for their opinion of what can and what can't be achieved. I wish you all the best. 🙏

@Gatsby Many thanks for taking the time to provide such a comprehensive reply. It’s very much appreciated. Congrats on your outcome. Your story is simply amazing and very encouraging for NW7s everywhere.

 

The last time I checked Eugenix, they had a range of charging structures which varied quite a lot in price (the prices don’t seem to be on their website currently). I think there were four options which became more expensive depending on the involvement of the more senior surgeons (probably the two you mentioned).

 

For NW7s, would you think it wise to go with the option that maximised the involvement of the senior doctors or would one of the less expensive options suffice.

 

Like yourself, there would be a lot of grafts needed.

[mr_peanutbutter]

why dont you go to dr umar again if you had a good experience with him

[Bamboo]

40 minutes ago, mr_peanutbutter said:

why dont you go to dr umar again if you had a good experience with him

Well as I said in the introduction, finance and logistics.

 

It’s a long journey from home to LA. The exchange rate at the time between the euro and the dollar made it a viable option but the rate has worsened considerably since and it’s now become a much more expensive option.

Edited August 31, 2023 by Bamboo

[Gatsby]

8 hours ago, Bamboo said:

@Gatsby Many thanks for taking the time to provide such a comprehensive reply. It’s very much appreciated. Congrats on your outcome. Your story is simply amazing and very encouraging for NW7s everywhere.

 

The last time I checked Eugenix, they had a range of charging structures which varied quite a lot in price (the prices don’t seem to be on their website currently). I think there were four options which became more expensive depending on the involvement of the more senior surgeons (probably the two you mentioned).

 

For NW7s, would you think it wise to go with the option that maximised the involvement of the senior doctors or would one of the less expensive options suffice.

 

Like yourself, there would be a lot of grafts needed.

I would choose Dr Sethi. The other surgeon who I would pick is Dr Pittella. Both these surgeons have lots of experience with Norwood 7 repair patients. It will not be cheap so you really need to ask yourself if you want to go through with this. There's no point trying to save a dollar at this level of hair loss only to jump out of the pan and back into the fire. All the best!

[Bamboo]

6 hours ago, Gatsby said:

I would choose Dr Sethi. The other surgeon who I would pick is Dr Pittella. Both these surgeons have lots of experience with Norwood 7 repair patients. It will not be cheap so you really need to ask yourself if you want to go through with this. There's no point trying to save a dollar at this level of hair loss only to jump out of the pan and back into the fire. All the best!

Good point @Gatsby A bit to think about. Thanks for the reply 

[mrmane85]

The only 2 surgeons I would personally look at would be Dr Pittella or Dr Zarev.  

They are the best NW6/7 surgeons in the world. 

Dr Pittella seems a lot easier to connect with so you can reach out through this platform and organise a zoom consultation. He is extremely honest will let you know what is possible . 

I haven't seen one poor or even average result from him. 

[jjalay]

On 8/30/2023 at 4:39 PM, Bamboo said:

Hi all 

 

I'd be grateful for the community's advice regarding best options for my next step.

 

I’m 59 and NW7 with limited donor from a number previous botched jobs in the late 80s and 90s. I had a (mostly) failed outcome with a mega BHT attempt in 2004. As a result, I have limited scalp donor but still have an abundance of body hair on almost all other parts of my body.

 

I also had some BHT (mostly beard) with Dr Umar about 10 years ago where he successfully transplanted grafts into the temple area and into an old linear scar. Finance and logistics prevented me from taking things any further at the time. 

 

I've worn a system for about 25 years. Prior to that I used a hair thickener but it got to the point where there was little left to thicken and it looked ridiculous. My scalp was too scarred to buzz cut and it wasn't really in fashion then anyway. Even though the system looks okay and they've better over the years, I would still prefer to be without it. 

 

Given my age, any next attempt would definitely be my last so I’ve been nervous to progress. I would be heavily reliant on BHT and would hope that SMP would assist in creating the illusion of thickness. I would be happy with a relatively modest solution incorporating preferably a soft, back combed hairline. 

 

I'm encouraged by the significant developments in recent years in terms of successful BHTs and the use of SMP to increase the illusion of volume etc so I hope that some solution still exists. As has always been the case, there will some practitioners (both for BHT and SMP) that are more suited to my situation than others. 

 

Whilst I'd prefer a full solution, one of the options I would consider would be a transplanted hairline with the system set behind it. Acceptable, but not my preferred outcome.  

 

For BHT, I'm thinking of course of Dr Bisanga and Eugenix. Dr Bisanga is closer to where I live (Ireland) but is quite expensive. The cost of Eugenix is difficult to estimate. (They used to have a range of options displayed on their website but it doesn't seem to be there now). It's also a long way to travel by comparison.

 

I also hear good things about Pinto in Portugal but I don't know what he'd be like with BHT and repair cases. 

 

For SMP, I'd need someone who was used to applying it for "thickening" purposes rather than just applying it to buzz cuts. 

 

Grateful for any advice in terms of what route I should go (even if it means sticking with the system) and the options I might have in terms of surgeons and SMP practitioners etc.     

 

I'm attaching some photos which help illustrate my situation.

I would have a consultation with Zarev in your place. You are a difficult case..

[BackFromTheBrink]

11 minutes ago, jjalay said:

I would have a consultation with Zarev in your place. You are a difficult case..

I don't think Zarev would be the best choice for BHT.

From the options you'd considered, I'd say Eugenix would be a good choice. However, it would be necessary to choose a package which included their most senior doctors to deal with the complexities of your case.

[jjalay]

1 hour ago, BackFromTheBrink said:

I don't think Zarev would be the best choice for BHT.

From the options you'd considered, I'd say Eugenix would be a good choice. However, it would be necessary to choose a package which included their most senior doctors to deal with the complexities of your case.

I think he splits grafts to maximize every possibility from scalp hair, in this case its an idea.

You mean the most experienced doctors at Eugenix?

[BackFromTheBrink]

I don't think he does anything unique with graft splitting post extraction. His USP is extracting grafts homogenously and with minimal trauma to maximise the amount possible from the donor area, and minimising contact with the extracted grafts to get high growth rates.

[jjalay]

30 minutes ago, BackFromTheBrink said:

I don't think he does anything unique with graft splitting post extraction. His USP is extracting grafts homogenously and with minimal trauma to maximise the amount possible from the donor area, and minimising contact with the extracted grafts to get high growth rates.

 

12.138 grafts from this patients donor area without splitting grafts or BHT? I don"t buy this.

Edited September 7, 2023 by Melvin- Moderator
Removed

[BackFromTheBrink]

24 minutes ago, jjalay said:

 

12.138 grafts from this patients donor area without splitting grafts or BHT? I don"t buy this.

Perhaps best to listen to the interview that he's recently recorded and hope it covers this in more detail. What I've read and heard him say in the past support what I said, whether you are skeptical or not.

Edited September 7, 2023 by BackFromTheBrink