Advice for FUE - 2 FUT’s Down and Not Much Donor To Go

[Shouldashavedit72]

Hi everyone, I’m gonna try to keep this as concise as possible.

My name is Chad, I’m 52 years old and I first noticed hair loss in my temporal areas at around 28. 
 

History:

First FUT was in 2007- approximately 1200 grafts, hairline and density to frontal area.

Second FUT was in 2011- approximately 1200 grafts, frontal, mid, and crown.

I’ve also undergone plastic surgery for scar revision.

SMP in 2022- Initially to camouflage FUT scar, but I was so impressed with results that I pulled the trigger on entire scalp. 

I’m currently not on any meds except hair vitamins. But I’m about to try finasteride.

 

Options:

As you may have picked up from my forum name, I’m a slight resentful that i started this journey in the first place. Quite frankly, If I could go back and do it all over again, I WOULD have shaved my head. My advice to anyone considering a hair transplant is this: The journey you are about to embark on is NOT a quick fix. In fact, in many cases, you are signing up for a lifetime of “just one last time” products and procedures. As for me, I’ve given far too much energy for what amounts to dead skin cells that blow wispily on the top of my effing head! Oh, and once you start this madness, unless you wanna look like a burgeoning circus freak, you had better keep irresponsibly spending your hard earned savings (that I could have used for early retirement) to feed this beast that all  of your self confidence  is now held captive to! (Cue Gene Wilder’s maddening voice).

Sorry, a little satirical icebreaker lol. I know everyone’s experience hasn’t been mine, and I certainly don’t want to offend anyone. Ok, on to my options…

Dr Pekiner: Doesn’t consider me to be an ideal candidate. He recommends I start finasteride and biotin and report back in 8 months.

Dr Bek won’t accept my case.

Dr Bicer thinks I might have 2000 grafts in my donor area, and 800+ grafts available from my beard. Region of interest here:

Dr Turan (FUE Capilar) Can extract “as many grafts as possible from the donor area and the beard with the patient’s consent without causing over-harvesting and increasing the density of the frontal and mid-scalp area without lowering the hairline. *The crown area will not be implanted.” I’m intrigued by the DHI method and price from this offer.

Dr Nader: My number one choice, but no bueno! I’ve tried to no avail to get in contact with him.

Dr. Espinosa Custodio: Estimated donor graphs at around 1500. No mention of BHT.

 

Further Analysis:

After speaking with these docs, I realized that my donor area either appeared or actually was weak. Because of this I began to get in-person consultations with local hair surgeons.

 I’m in SoCal, so there’s not much to choose from. The range of opinions on my donor bank was from 3000 (LA FUE) on the high end to 1500 + 500+/- BHT (Modena, Dr Yazdan) on the low end.

 

Final Thoughts:

I’m leaning towards Dr Bicer, because I know she’s really good, but that 13 hour flight DO NOT sound fun. Dr Duran seems like a good choice as well, and at a fraction of Dr Bicer’s price. Finally, I know Dr Yazdan isn’t on this network, but I was impressed with him during the consultation. And also he’s on Spencer ‘Spex’ Stevenson’s “Best Hair Doctor’s” list- although I’m not sure that means anything. He has a decent instagram page as well. My biggest complaint with him is he is very conservative… almost to a fault. His highest goal is to do good work without any evidence that it’s been done. What I mean is, there doesn’t seem to be a healthy risk factor, like what I feel I’d get with Dr Bicer. He’s the most expensive at around $6/graft.

I just want to say I really appreciate this group, and any advice, particularly from the veterans, would be so helpful. And also, if there’s a doctor I’ve missed that you think would better fit my particular situation, please don’t hesitate to recommend.

Thanks all!

Edited July 13 by Shouldashavedit72
Added tags

[Gatsby]

You have traveled a very similar path to mine @Shouldashavedit72. I’m 57 and looking back if I had have shaved my head from the start I would not have gone through my journey of plugs, scars, scar revisions, SMP,  hair pieces and then giga sessions of scalp, beard and body hair. I can totally understand just how tired you are at this point. However you want to avoid jumping out of the pan and back into the fire. Definitely start finasteride now and give it up to 12 months to see how you respond to it. You want to position yourself for the best possible outcome. Secondly I would not let cost be too much of a factor. Look for a surgeon who is best suited to donor management and repair work and using beard hair artistically. Finally be prepared to travel. While taking finasteride use this time to research which surgeons are doing this work meeting the goals you are after. Have a look at patient posted results that you are chasing and coming from where you are today. Wishing you all the best. 

[Affectionatefail25]

@Shouldashavedit72 trying shaving it off once. I think you do have a great face and jaw structure. I love my hair as well and I understand your predicament. But if it’s affecting you so much. Just let it go. You tried everything as well. Kudos to you! 

[shiba1985]

While your caution is very well advised, 

 

you have to take some blame for the path you have chosen. Even now you are not looking at the upper echelons of surgeons based on the list you have created. 
 

there are surgeons that can take a case like yours and do some serious cosmetic improvement but most of your list doesn’t not include them. 
 

 

 

[shiba1985]

List like Spencer spex list etc is a joke. 
 

even the recommended surgeon on this forums should be viewed with a healthy degree of skepticism due to the nature of the business.

 

 

[Shouldashavedit72]

@Gatsby thanks for sharing your story with me and for expressing understanding for what I’m dealing with. Knowing what you’ve been through encourages me with new perspective. I think I’ve been in hurry up mode because the clock is ticking and my hair keeps falling out lol! I will definitely take your advice to start the finasteride, so hopefully this will slow the train down. And your point about donor management and beard hair usage is spot on! 
Honestly, my goal isn’t for maximum density by way of beard and BH grafts. Otherwise I’d be heading out to Brazil to visit the great Dr Pattella. SMP has done a great job camouflaging my hair loss, and I feel 3k in the area Dr Bicer pointed out would suffice. Perhaps some time in the future I would consider BHT for the crown, but idk. 
probably the most difficult part of this is loosing beard density lol! I really like my beard. 

[Shouldashavedit72]

3 hours ago, shiba1985 said:

List like Spencer spex list etc is a joke. 
 

even the recommended surgeon on this forums should be viewed with a healthy degree of skepticism due to the nature of the business.

 

 

If you’ve got some recommendations I’d love to hear them.

[A_4_Archan]

You've been through a challenging journey, my friend, and those with advanced Norwood baldness often face similar struggles. However, you've made significant progress, having completed about 80% of this path.

If you're feeling hesitant or frustrated about undergoing another hair transplant, know that it's not a necessity. Based on your photos (though they can be misleading), you appear to be in good shape, and your current level of baldness seems age-appropriate.

If you  decide to proceed with another transplant for the third time, it's crucial to select a highly experienced doctor who excels in donor management, using the minimum number of grafts effectively. I recommend a conservative approach, aiming for around 2,000 grafts. Alternatively, as one doctor suggested, you could opt for 1,700 scalp grafts and 500 beard grafts, 500 grafts wouldn't significantly thin down your beard.

The first doctor that comes to mind is Dr. Munib Ahmad, though he may be outside many people's budgets. Another excellent option is Dr. Zarev, who manages donors well and charges approximately 9 euros per graft. He would be ideal if you can extend your budget to that level.

If you need more budget-friendly options, consider doctors like Dr. Couto, Dr. Ferreira, Dr. Pinto, and Dr. Mwamba, who charge around 5 euros per graft. Dr. Mwamba is particularly experienced in repairs, making him a good choice for those with poor donors or multiple past surgeries.

For even more economical options, Dr. Ximena Villa and Dr. Michalis Georgiou charge around 3 euros per graft and about 2 euros per grafts. 

There are many good doctors worldwide, but I've suggested these based on your specific situation. They are known for efficiently managing donors and achieving satisfactory results with fewer grafts.

I hope this helps you. Good Luck Brother.

[bigmistake]

Whoever did your SMP seems to have done a really poor job. The ink seems to have migrated and merged. 

[Shouldashavedit72]

6 hours ago, A_4_Archan said:

You've been through a challenging journey, my friend, and those with advanced Norwood baldness often face similar struggles. However, you've made significant progress, having completed about 80% of this path.

If you're feeling hesitant or frustrated about undergoing another hair transplant, know that it's not a necessity. Based on your photos (though they can be misleading), you appear to be in good shape, and your current level of baldness seems age-appropriate.

If you  decide to proceed with another transplant for the third time, it's crucial to select a highly experienced doctor who excels in donor management, using the minimum number of grafts effectively. I recommend a conservative approach, aiming for around 2,000 grafts. Alternatively, as one doctor suggested, you could opt for 1,700 scalp grafts and 500 beard grafts, 500 grafts wouldn't significantly thin down your beard.

The first doctor that comes to mind is Dr. Munib Ahmad, though he may be outside many people's budgets. Another excellent option is Dr. Zarev, who manages donors well and charges approximately 9 euros per graft. He would be ideal if you can extend your budget to that level.

If you need more budget-friendly options, consider doctors like Dr. Couto, Dr. Ferreira, Dr. Pinto, and Dr. Mwamba, who charge around 5 euros per graft. Dr. Mwamba is particularly experienced in repairs, making him a good choice for those with poor donors or multiple past surgeries.

For even more economical options, Dr. Ximena Villa and Dr. Michalis Georgiou charge around 3 euros per graft and about 2 euros per grafts. 

There are many good doctors worldwide, but I've suggested these based on your specific situation. They are known for efficiently managing donors and achieving satisfactory results with fewer grafts.

I hope this helps you. Good Luck Brother.

Wow! Thanks so much for sharing your knowledge with me! I don’t mind being told what I’ve done or am doing wrong, but I really appreciate it when guys like you share their wisdom with me. 

“Donor management” is a reoccurring theme that I’ll make sure and give priority to. I’ll definitely be returning to this list often to do my research! Also, I’m hearing you loud and clear that I need to find a surgeon that is skilled in doing a lot with a little! Thanks again for the excellent advice.

BTW, I meant to tag you in to my original thread, so I was stoked when I saw your comment! 
 

Blessings my friend!

[Shouldashavedit72]

Update:

My appointment is set for mid December with Dr Michalis. Initially, we planned 2000 from my donor area and up to 1000 from my beard. But after some thought, I decided I’m only going to do the 2000 for now. He did give me the option of discussing it on the day of surgery, so I’ll continue considering it. He has an exceptional bedside manner and his offer was more than fair.

@A_4_Archan I took your advice and researched and reached out to many of the docs you recommended. Dr. Mwamba’s staff emailed me, and it sounds like he’s not taking new clients anytime soon. Dr Pinto finally got back to me, but after I had settled on Dr Michalis. I’d love to go with Munib Ahmad, but I can’t bring myself to spend that much. 
I’ve also been taking fin for about 3 months with no side effects. 

[kapow552]

On 7/14/2024 at 5:15 PM, Shouldashavedit72 said:

@Gatsby thanks for sharing your story with me and for expressing understanding for what I’m dealing with. Knowing what you’ve been through encourages me with new perspective. I think I’ve been in hurry up mode because the clock is ticking and my hair keeps falling out lol! I will definitely take your advice to start the finasteride, so hopefully this will slow the train down. And your point about donor management and beard hair usage is spot on! 
Honestly, my goal isn’t for maximum density by way of beard and BH grafts. Otherwise I’d be heading out to Brazil to visit the great Dr Pattella. SMP has done a great job camouflaging my hair loss, and I feel 3k in the area Dr Bicer pointed out would suffice. Perhaps some time in the future I would consider BHT for the crown, but idk. 
probably the most difficult part of this is loosing beard density lol! I really like my beard. 

With your SMP does it  cover your bald spot in the crown without being detectable even in sunlight and if this is the case I'm guessing no one tell that you have a bald crown?  And will the 3k that Dr Bicer mentioned be allocated to only your front and midscalp?

[Shouldashavedit72]

Yes the SMP makes the baldness on my crown nearly undetectable. Also, I think hair-loss on my crown has stopped because of fin.

Yes, when I was talking to Dr. Bicer, she was only going to focus on my front and mid scalp. And this is the area that Dr. Michalis will focus on as well. I may consider beard and body hair later for my crown.

[Shouldashavedit72]

I want to also add that, while I truly appreciate the advice  @Gatsby gave me to take a longer preparation period, due to my career, I had to strike while the iron was hot! I’m uncertain of when I’ll have another opportunity to take two weeks off.

[KB88]

Hey why not just stick with smp, keep it subtle on top and keep scar fairly hidden?

[Shouldashavedit72]

Great question- I’m really just looking to reduce the “see through” appearance on top. 

[KB88]

2 minutes ago, Shouldashavedit72 said:

Great question- I’m really just looking to reduce the “see through” appearance on top. 

 

2 minutes ago, Shouldashavedit72 said:

Great question- I’m really just looking to reduce the “see through” appearance on top. 

I’m in the same position, just never did smp (yet) two fut procedures done, only thing keeping me from being able buzz head is the scar, I have debating doing smp, would it remove the see through appearance if you kept it buzzed with smp?

[Shouldashavedit72]

I would definitely recommend SMP for your scar! If you find a great artist, they’ll make it disappear!

As far as buzzing to get rid of see-through appearance, my hair is much too thin in the front and mid scalp, so that won’t work for me. But if you look up Michalis, there is a gentleman that went to see him, and he keeps his hair buzzed all the time. It works for him.