Some questions re: choice of doctor, medication etc.

[ichigo]

Hi all,

I've wanted a hair transplant ever since I discovered they were actually a thing, but back then I didn't have the money and then when I did, I didn't have the time. This coming December, I will have time so I am going to jump on it. I have 2 months off from work so I will be able to spend plenty of time recovering. I've been suffering from hair loss since age 19, and I am 39 now.

In terms of a doctor, I had a consultation here in Australia a number of years ago during my research stages, and if I had the money I probably would have jumped on it back then. In hindsight, probably a good idea I didn't have the money considering I have read that there are no decent hair transplant doctors here.

I'm not interested in travelling to Turkey, so instead have decided Thailand as my destination considering I travel there often. I've had consultations with Dr Laorwong and Dr Pathomvanich. Dr Laorwong suggested 3500 grafts FUE (around 10k AUD), and Dr Path suggested a combination FUT/FUE of 4000 grafts (around 18k AUD). Despite the more expensive cost, I am leaning towards Dr Path. The premises is beautiful, all staff I encountered were friendly and spoke excellent English, and all questions I had were answered. And I know that Dr Path has been in the game for a long time. I didn't get the same level of reception at Dr Laorwong's consultation, but then again, it's the results which is most important. I guess my question would be who would you choose, and why one over the other.

Regarding medication, I have been on finasteride for quite a while (probably over 10 years) and was currently taking 1.25mg (splitting a 5mg tablet) 3 times a week (Mon/Wed/Fri). As of late I have found that there has been a lot more hair fall than usual which makes me think perhaps it is not working so well anymore, so I have added another 1.25mg each week (on Sun) so 5mg total per week. Or should I add more? Dr Path did recommend getting on dutasteride even just replacing one of my finasteride doses with dutasteride once a week. I've taken oral minoxidil in the past but not for a long time, so this may also be an option. Can oral minoxidil be taken every other day like finasteride or does it need to be a daily thing? I'll need to keep researching this before talking to my doctor to get a prescription for either dutasteride or oral minoxidil.

And just one more question - what shampoo/conditioner does everyone use (mainly those in Australia). I'm using an Australian brand called Patrick's and it's good, but just seeing if there was anything better.

Thanks for reading, and I'm excited that this all will be finally happening soon. Below are some photos taken at my consultation with Dr Path.

[eladnm]

I initially wanted to book with Dr Laorwong but he avoid scheduling the surgery so I stopped messaging him and choose dr Path(booked for this July) who really impressed me in our video consultation. I think Dr Laorwong is more popular due to his lower price and he produces good results but Dr Path is more expriened and seems like the clinic is more upscale. 

[Kixinit]

17 hours ago, eladnm said:

I initially wanted to book with Dr Laorwong but he avoid scheduling the surgery so I stopped messaging him and choose dr Path(booked for this July) who really impressed me in our video consultation. I think Dr Laorwong is more popular due to his lower price and he produces good results but Dr Path is more expriened and seems like the clinic is more upscale. 

Why did Dr Laorwong avoid scheduling the surgery exactly?

[eladnm]

1 hour ago, Kixinit said:

Why did Dr Laorwong avoid scheduling the surgery exactly?

Good question.the responses I got from him on whatsupp were really strange. I think he has a lot of work and he cannot handle such a large volume of patients. I gave up and prefer to go to more organized clinic. I hope I will ge good results from Dht clinic and Dr Pathomvanich 

Edited March 5 by eladnm

[Lewis Horsley]

Do you have any photos just before you started finasteride out of curiosity? 

[ichigo]

On 3/5/2024 at 3:52 AM, eladnm said:

I initially wanted to book with Dr Laorwong but he avoid scheduling the surgery so I stopped messaging him and choose dr Path(booked for this July) who really impressed me in our video consultation. I think Dr Laorwong is more popular due to his lower price and he produces good results but Dr Path is more expriened and seems like the clinic is more upscale. 

That's a shame, Dr Laorwong does great work at a decent price point. But I think you won't go wrong with Dr Path. Let us know how it all goes.

[ichigo]

On 3/6/2024 at 12:13 AM, Lewis Horsley said:

Do you have any photos just before you started finasteride out of curiosity? 

I don't sorry.

[ichigo]

So after more research, and seeing some really decent results, I'm now kinda leaning towards booking with Dr Laorwong, over Dr Path. I know that price shouldn't be my main factor, but when considering he produces decent results for a lower price, I'm definitely going to consider it. Plus he offered FUE, whilst Dr Path opted for a combination FUT/FUE. I'm not opposed to having FUT, but I think I would much rather go down the FUE route. And I don't think my case is particularly complicated. I think I'm NW3(v) leaning towards NW4. I also want to book quite soon before he gets booked out for December. Thoughts?

Edited March 15 by ichigo
More things to say

[Dr. Wipawan Vathananai]

On 3/2/2024 at 2:41 PM, ichigo said:

Regarding medication, I have been on finasteride for quite a while (probably over 10 years) and was currently taking 1.25mg (splitting a 5mg tablet) 3 times a week (Mon/Wed/Fri). As of late I have found that there has been a lot more hair fall than usual which makes me think perhaps it is not working so well anymore, so I have added another 1.25mg each week (on Sun) so 5mg total per week. Or should I add more? Dr Path did recommend getting on dutasteride even just replacing one of my finasteride doses with dutasteride once a week. I've taken oral minoxidil in the past but not for a long time, so this may also be an option. Can oral minoxidil be taken every other day like finasteride or does it need to be a daily thing? I'll need to keep researching this before talking to my doctor to get a prescription for either dutasteride or oral minoxidil.

And just one more question - what shampoo/conditioner does everyone use (mainly those in Australia). I'm using an Australian brand called Patrick's and it's good, but just seeing if there was anything better.

Hello ichigo,

Regarding your concern about medication, I recommend switching to oral dutasteride 0.5 mg once daily and oral minoxidil 2.5 mg daily due to your youth and apparent acceleration in hair loss progression. Additionally, conducting blood tests to exclude other correctable causes such as anemia, thyroid disorder, and vitamin/mineral deficiency (ferritin, vitamin D) would be prudent. The reason I prefer a daily dosage of both dutasteride and oral minoxidil is that, at 39 years old, I typically aim to preserve existing hair before adjusting the dosage if side effects arise.

As for shampoo, I'm uncertain if you can find ISDIN Lambdapil, but based on positive experiences from my patients, it's worth considering. Alternatively, you might be interested in other brands like DERCOS by Loreal (the red variant).

Regarding your choice of surgeon, as a hair transplant surgeon, I believe it's best not to offer opinions on specific doctors. However, both Dr. Laorwong and Dr. Pathomvanich are esteemed in their field.

I hope this help

Best,

Dr. Wunny

Hair transplant surgeon and dermatologist

BHI Clinic, Bangkok, Thailand

[ichigo]

16 hours ago, Dr. Wipawan Vathananai said:

Hello ichigo,

Regarding your concern about medication, I recommend switching to oral dutasteride 0.5 mg once daily and oral minoxidil 2.5 mg daily due to your youth and apparent acceleration in hair loss progression. Additionally, conducting blood tests to exclude other correctable causes such as anemia, thyroid disorder, and vitamin/mineral deficiency (ferritin, vitamin D) would be prudent. The reason I prefer a daily dosage of both dutasteride and oral minoxidil is that, at 39 years old, I typically aim to preserve existing hair before adjusting the dosage if side effects arise.

As for shampoo, I'm uncertain if you can find ISDIN Lambdapil, but based on positive experiences from my patients, it's worth considering. Alternatively, you might be interested in other brands like DERCOS by Loreal (the red variant).

Regarding your choice of surgeon, as a hair transplant surgeon, I believe it's best not to offer opinions on specific doctors. However, both Dr. Laorwong and Dr. Pathomvanich are esteemed in their field.

I hope this help

Best,

Dr. Wunny

Hair transplant surgeon and dermatologist

BHI Clinic, Bangkok, Thailand

Thank you for your advice!

[ichigo]

I keep flip flopping my decision in between choosing Dr Laorwong or Dr Path. It's been a little difficult getting in contact with Dr Laorwong to book my surgery, understandably he is busy, but my gut feeling is to choose Dr Path, despite the higher cost. They both do excellent work.

[eladnm]

1 hour ago, ichigo said:

I keep flip flopping my decision in between choosing Dr Laorwong or Dr Path. It's been a little difficult getting in contact with Dr Laorwong to book my surgery, understandably he is busy, but my gut feeling is to choose Dr Path, despite the higher cost. They both do excellent work.

I tried to schedule with Dr Laorwong BUT his responses were really strange. go with Dr Path. I am going to him in a few months

Edited March 31 by eladnm

[ichigo]

After much deliberation, I think I've decided not to go with Dr Path. Despite him being an excellent surgeon with great staff, I just cannot stomach the cost. It is above my price range. But now I have another decision to make - do I keep hounding Dr Laorwong until I get an answer, or, I have found another doctor who seems to be up and coming, and is doing some really good work - Dr Patty at Hairtran (also in Bangkok). Her price point is much more affordable, also cheaper than Dr Laorwong. The surgery won't be until early December but I have very specific dates, so I want to book as soon as possible. Right now, in this moment in time, I'm leaning towards Dr Patty.

[Bucky O Hair]

I'll throw in my (heavily biased) opinion.

#1 - Do not go with FUT.  Go with FUE only.  I'm biased against FUT, as I think that in the long term, the scar will become more trouble than it's worth.
#2 - Do not factor cost too much into your decision.  If you cannot afford the HT, then don't do it.  Save up, and do it in the future.
#3 - Do not base your decision on things that do not matter (i.e. the friendliness of staff, familiarity with a specific country, strict December time frame).  This should not matter in the least bit.

I know that #2 seems like a dumb thing to say because money is important...but it seems like you had picked your desired doctor, and are now looking for reasons to go with the others due to cost.  This could impact quality, and if it goes wrong, then you'll spend a lot more money trying to fix a bad procedure. 

With #3...it seems like you've narrowed your requirements to a specific country and a specific timeframe.  This cuts down your options drastically.  A flight away, is a flight away (whether it is Thailand or Europe) and your recovery time will still be 3-6 months whether or not you have a couple of months off work or not.  

If you can subjectively look at your current option and say that you would go with that doctor, even if you had limitless funds and limitless time off to recover...would they still be your pick?

Edited April 8 by Bucky O Hair

[wr1015]

11 hours ago, ichigo said:

After much deliberation, I think I've decided not to go with Dr Path. Despite him being an excellent surgeon with great staff, I just cannot stomach the cost. It is above my price range. But now I have another decision to make - do I keep hounding Dr Laorwong until I get an answer, or, I have found another doctor who seems to be up and coming, and is doing some really good work - Dr Patty at Hairtran (also in Bangkok). Her price point is much more affordable, also cheaper than Dr Laorwong. The surgery won't be until early December but I have very specific dates, so I want to book as soon as possible. Right now, in this moment in time, I'm leaning towards Dr Patty.

How are you contacting Laorwong? I tried via the “line” app on his website and WhatsApp. I had better success on line so maybe try that. 

[ichigo]

4 hours ago, Bucky O Hair said:

I'll throw in my (heavily biased) opinion.

#1 - Do not go with FUT.  Go with FUE only.  I'm biased against FUT, as I think that in the long term, the scar will become more trouble than it's worth.
#2 - Do not factor cost too much into your decision.  If you cannot afford the HT, then don't do it.  Save up, and do it in the future.
#3 - Do not base your decision on things that do not matter (i.e. the friendliness of staff, familiarity with a specific country, strict December time frame).  This should not matter in the least bit.

I know that #2 seems like a dumb thing to say because money is important...but it seems like you had picked your desired doctor, and are now looking for reasons to go with the others due to cost.  This could impact quality, and if it goes wrong, then you'll spend a lot more money trying to fix a bad procedure. 

With #3...it seems like you've narrowed your requirements to a specific country and a specific timeframe.  This cuts down your options drastically.  A flight away, is a flight away (whether it is Thailand or Europe) and your recovery time will still be 3-6 months whether or not you have a couple of months off work or not.  

If you can subjectively look at your current option and say that you would go with that doctor, even if you had limitless funds and limitless time off to recover...would they still be your pick?

Thank you for your insight! These are all very good points for me to consider. 

[ichigo]

1 hour ago, wr1015 said:

How are you contacting Laorwong? I tried via the “line” app on his website and WhatsApp. I had better success on line so maybe try that. 

I have been contacting him on the Line app. My messages have been 'read' but just not replied to.

[Gatsby]

@ichigo you dodged a huge bullet by not having surgery here in Australia. Dr Laorwong is a sensible choice. 

[Melvin- Admin]

I would also consider @Dr.Ratchathorn Panchaprate

[ichigo]

6 hours ago, Gatsby said:

@ichigo you dodged a huge bullet by not having surgery here in Australia. Dr Laorwong is a sensible choice. 

I agree also!

 

4 hours ago, Melvin- Admin said:

I would also consider @Dr.Ratchathorn Panchaprate

Ah yes, great idea!

[ichigo]

So in an interesting turn of fate, I have secured a surgery date with Dr Laorwong in early December. I finally received a reply to my LINE messages late last night requesting to send some more information via email, to which I did this morning and after a few emails back and forth, the date was secured and deposit sent. I was actually very close to booking Dr Patty (at Hairtran), but as much as I like her work, Dr Laorwong has a more extensive track record. I am over the moon that this is finally going to happen!

[Hairwolf]

2 hours ago, ichigo said:

So in an interesting turn of fate, I have secured a surgery date with Dr Laorwong in early December. I finally received a reply to my LINE messages late last night requesting to send some more information via email, to which I did this morning and after a few emails back and forth, the date was secured and deposit sent. I was actually very close to booking Dr Patty (at Hairtran), but as much as I like her work, Dr Laorwong has a more extensive track record. I am over the moon that this is finally going to happen!

Glad to hear it! I’ve booked in with Dr Laorwong again for the summer but have been unable to reach him again since. I’ll try Line I guess. 

[ev1l]

Hi @ichigo,

Since you are taking Finasteride for 10 years now, did you find any improvement in your hair density, hairline, Crown or fin just stabilized your MPB?

 

Also can you distinguish between some year for MPB. For example in year 2 you get most result or may be year 3. Year 5 improvement declines??

 

Thanks 

Edited April 14 by ev1l

[ichigo]

15 hours ago, Hairwolf said:

Glad to hear it! I’ve booked in with Dr Laorwong again for the summer but have been unable to reach him again since. I’ll try Line I guess. 

He must be busy and probably clearing the backlog of work. Not sure why there wouldn't be some administrative staff that would be able to handle the bookings etc?

 

15 hours ago, ev1l said:

Hi @ichigo,

Since you are taking Finasteride for 10 years now, did you find any improvement in your hair density, hairline, Crown or fin just stabilized your MPB?

 

Also can you distinguish between some year for MPB. For example in year 2 you get most result or may be year 3. Year 5 improvement declines??

 

Thanks 

To be honest, I'm not too sure. I never really paid close attention over the years but I think for now it has stabilised somewhat.

[Kixinit]

On 4/14/2024 at 3:48 PM, ichigo said:

So in an interesting turn of fate, I have secured a surgery date with Dr Laorwong in early December. I finally received a reply to my LINE messages late last night requesting to send some more information via email, to which I did this morning and after a few emails back and forth, the date was secured and deposit sent. I was actually very close to booking Dr Patty (at Hairtran), but as much as I like her work, Dr Laorwong has a more extensive track record. I am over the moon that this is finally going to happen!

if you don't mind me asking how much is Laorwong charging these days per graft?