Newbie seeking advice

[Ronnie]

Mick arrived shortly after (I’d arrived early!) and we started having a good chat. I covered my journey to date, including my current regime of topical Fin/Min twice daily, Microneedling once per week and Nizoral shampoo twice weekly. I said that I do feel that my hair has improved somewhat from this, including generally feeling healthier and thickening and also that some hairs which had only part miniaturised had come back. All this is very hard to quantify and realistically I‘d shaven my hair down to a no1 on 31st December, so I genuinely do have a lot more hair than at the start of the year! Nevertheless, I’m more likely to stress that it isn’t working, so my feeling that it is, albeit any results can only be limited after 16 weeks, has to be a good sign.

We then had a good chat about my expectations and I took him through what I thought were the 4 possible outcomes as detailed in my post above and I think it was obviously good for them to hear that I’d done my homework and knew to be realistic. Then it was time to get a proper evaluation of my current condition!

The consultation room was all set up to do a full examination under microscope of what we had to work with, but it turned out to not be required. Mick had a good look at my hair and did some comb throughs and was able to deliver some good news. My hair was in much better shape than my photos on the forum had suggested. I think my early photos didn’t help, I’d been cutting my own hair during lockdown and so it was a rough job at best. Also I’d probably been keeping it too short and with my hair being light in colour now, I think it all combined to give the impression of being more bald than I really was. I’m definitely still very thin and have lost my hairline so a good Norwood 5 I’d say, but the news was good nevertheless. Mick said in my case there was no need to look any closer, my donor was in good condition, the hair was good quality and he estimated I could expect to get between 4,000 to 7,000 grafts without overharvesting. This was pretty much music to my ears and the best news I could have received.

Time for some piccies!

 

[Ronnie]

This is my current condition. You can see where I still have some hair in the middle at the front. My view was to reinstate a hairline from there and sweeping back, so not flat and then to hopefully fill about two thirds back. You can see I have some coverage through the mid band already, once I’ve allowed it to grow out a bit.

 

[Ronnie]

This is my donor…..definitely looks a lot healthier than before, having allowed it to grow out a bit.

 

[Ronnie]

The next stage then commenced with the arrival of Dr Bessam Farjo. We had a similar conversation to that which I had with Mick and covered my hopes and expectations. Dr Farjo then took Me over to the mirror and set about designing a hairline and his suggested overall design for surgery. The red marker came out and I had a mild moment of panic that I’d be walking around with a red head for the next week, but they reassured me that would not be the case. Spoiler alert - it did indeed clean off later like it had never been done, which was a sizeable relief!

Dr Farjo drew a hairline which was in line with my expectations and also included a slight improvement to the forelock which was something which I didn’t expect would be possible, but would I think really improve the end result. The final part was to address some portion of the midscalp. The outcome was a suggested conservative procedure of 2,200-2,300 grafts, leaving a healthy donor supply for possible future surgeries. Dr Farjo’s assessment of my donor was in line with Mick’s in that it could support 3 such surgeries without any overharvesting.

The consultation concluded with some more questions and answers to cover all my thoughts and concerns. My natural inclination is to stick to my initial plan and to not schedule surgery until early next year and they thought this sensible, though did let me know that given my current situation, surgery could take place sooner, if that was my desire. We also discussed medications and numerous other little details.

Once everything had been covered and just a little more than an hour after arriving, we bid each other a fond farewell and I was on my way.

 

[Ronnie]

I’d like to finish by emphasising what a positive experience I felt I had. Both Mick and Dr Farjo were absolute gents and clearly know their stuff, back to front and inside out. What I’d hoped to get from this session is clarity on my current condition, what my expectations should be and to gain a good platform from which to take this project forward. I absolutely feel that this is what I’ve gained and without any hyperbole or hard sell. I’d absolutely like to place on record my thanks and appreciation to both Mick and Dr Farjo. It’s worth noting that as you might expect, additional questions popped into my head following the consultation. Dr Farjo emailed me a summary of our session the following day and I replied with additional questions which were answered very promptly and I even received a follow up call from Mick. It really felt like I’d received the personal touch which I think is very important in a situation like this. It’s an emotional, not just a surgical journey and I’d say the whole experience hit the nail on the head for me. I’d absolutely thoroughly recommend a visit to Farjo to anyone considering a surgery as I felt they were extremely professional and I can’t fault the day from beginning to end.

So what next for me? Well, I think I‘m inclined to stick to my plan and aim for surgery some time early next year. It just fits in better in terms of work and life commitments and I’m someone that has to research everything to death…….it takes me 6 months just to decide which telly to buy! In the spirit of arming myself with knowledge I’ll probably take some more consultations to then decide exactly which path to follow. Knowledge is power as they say, but knowing that I have a top surgeon/clinic literally on my own doorstep is extremely positive for me. Might also look more into oral Minoxidil and perhaps Viviscal Pro supplements for a short time. Whilst there is a benefit to improving my existing hair and with feeling that I’ve seen some improvements already, I reckon I may just throw the kitchen sink at it for a while to see how far I can take things obpver the next 8 or 9 months before I go through with surgery.

Hope this is helpful, feel free to ask me any questions you might have.

Cheers!

 

[Bigmac]

Hi Ronnie, that was a thorough write up. I’m pleased to hear you had a positive consultation with Mick and Dr Farjo answering all your questions (except the ones you forgot to ask but were answered via email) Your hair does look better in these recent pictures. I think the surgery plan sounds good, see how it turns out and then decide if you want another. I think you should give oral minoxidil some thought. I’m hearing very positive vibes from doctors who say it is working better than expected. With you not planning a surgery until next year, you have a good opportunity to hopefully improve your hair more.
What tele did you end up buying?

 

[Ronnie]

Thanks Big Mac, yes, it really was a very positive experience.

I think I will give the oral Minoxidil a try, definitely feels like it’s worth throwing everything at it, if I could just make some progress on the crown it could go from something I’m assuming I’ll leave to something that’s worth tackling. If sorting the crown means depleting the donor and putting future possible surgeries at risk then it’s not worth it, but if it’s possible to tackle it and keep some in the bank, then it’s a no brainer.

The telly was a bad example actually as I’ve not bought a ‘good’ one for 15 years (Pioneer Kuro) but the same logic applies to everything…..home cinema gear, weight lifting kit, bikes……..literally takes me forever to finally commit to something!

Cheers

 

[Bigmac]

Crowns often respond well to the meds. Here’s hoping you get a positive if you choose to use them. Using a limited donor wisely is important. Planning ahead as opposed to live for the moment.
No tele, there was me going to pick your brains. I do a lot of research too when I’m purchasing something. I’ve learnt the hard way with impulsive decisions.

 

[Kevboy]

Just read the thread again. Very detailed account of everything which was a pleasure to read.
Thank you Ronnie.

 

[Ronnie]

Thanks for the positive feedback. I’m about to start on oral minoxidil so will provide feedback on my experience. Cheers!

 

[Bigmac]

Will you be having any blood tests done before starting? Maybe the doctor does not think they’re necessary with it being a reduced dose from the original intended use.

 

[Ronnie]

Will you be having any blood tests done before starting? Maybe the doctor does not think they’re necessary with it being a reduced dose from the original intended use.

Hi Bigmac

The doctor took my blood pressure at the consultation and was happy to prescribe it based on that. I’ll certainly be monitoring how I respond to it though.

 

[Bigmac]

Hi Ronnie. That’s good to hear there were no concerns after your blood pressure was recorded. Monitoring it is a wise decision and heres Hoping you a very good responder to it.

 

[Ronnie]

Hi

I really have high hopes it will bring decent benefit. I’ll emphasise again that my starting photos were when I had my hair very short and had been cutting it myself, so probably made my condition then look worse than it actually was. Nevertheless, I genuinely feel that in just 4 months I’ve seen benefits from the meds. I’ll post a couple of piccies where I’ve tried to capture the current state of my crown. It definitely felt to be actually bald in places at the outset, whereas now I seem to have some coverage everywhere. How ‘bad’ it looks depends a lot on how bright it is, but I’m certain there have been improvements. If oral Minoxidil is as potent as I’m hearing then there is hopefully room for further improvement in the next 6-9 months.

I‘m pleasantly surprised by the meds so far TBH, I genuinely expected very little from them but 4 months into this my overall expectations of what might be possible have changed, for the better. I set off believing I was a marginal candidate with perhaps just 3,000 grafts available, so maybe just a frontal repair and certainly not full coverage. Some later feedback suggested I could achieve full coverage though not without depleting my donor considerably. I’m very keen not to take the risk of using too much donor and being in a position somewhere down the line where further loss leaves the key areas on top looking ropey and I’ve no more donor to sort it due to using it too liberally at the start. Dr Farjo’s view that I have up to 7,000 grafts without over harvesting is a much better position than I expected to be in and does make aiming for full coverage a tantalising possibility. Maybe as I stand today it would only be possible by using too much donor, but I guess the dream is that the meds do enough over the next 6-9 months to close the crown sufficiently and also on top, that full coverage could be achieved whilst leaving enough donor for the future. The absolute best result would be to be able to achieve that in a single surgery……the thought of this being a one time and done exercise is incredibly tantalising, but I suspect not realistic. Would be lovely to think I wouldn’t need to go back a year later for the crown too….sigh we can all dream!

I will keep posting updates on progress. My next steps will be to take a few more consultations and weigh up my options, I have time and don’t wish to rush into anything. My engagement and consultation with the Farjo Institute have been incredibly positive, I’m certain that if I have a hair transplant in the UK it will be with them, they are less than 5 miles from where I live and I have total faith in them…..they are for sure a ‘top tier’ clinic. I’m keen to explore all my options though so will be consulting with a few ‘top tier’ options from abroad. I feel I’ve researched this to death and the foreign clinics/surgeons which have caught my attention are Dr Ozlem Bicer and Dr Bruno Pinto. I think it will be worthwhile me consulting with them and seeing what my different options are.

Cheers

 

[Coopman]

Ronnie

Great news on your donor supply. Really shows that this can only be determined by an in person consultation and not via video/photo.

Where did you order your oral minoxidil from?

Progress from meds is always difficult to assess, i had great gains but did not even notice them myself Initially. It was only when friends commented i realised what was happening. A few weeks later i realised i was getting resistance when combing my hair and boy did that feel great.

Looks like your sides may be closing in on each other on top of your head, difficult to assess as your hair is longer. But finasteride and Rogaine work well in this area for responders.

A little toppik (concealer) on top of your head and you will be able to see how a hair transplant could transform your hair.

 

[Ronnie]

Cheers Coopman. It definitely feels a bit like rather than isolated islands of hair, I now have ‘some’ hair in between connecting them all together. It’s obviously not going to grow back in spades, but if I could just improve enough to make any possible surgery less challenging that will be a big win.

I ordered the Minoxidil from the Farjo Institute. I had a consultation with them, so filled in a medical questionnaire and they took my blood pressure on the day so they were happy to prescribe it for me.

 

[hopeful]

Cheers Coopman. It definitely feels a bit like rather than isolated islands of hair, I now have ‘some’ hair in between connecting them all together. It’s obviously not going to grow back in spades, but if I could just improve enough to make any possible surgery less challenging that will be a big win.

I ordered the Minoxidil from the Farjo Institute. I had a consultation with them, so filled in a medical questionnaire and they took my blood pressure on the day so they were happy to prescribe it for me.

May I ask what dosage of minoxidil Farjo recommends ?
Good luck with your decision

 

[Ronnie]

May I ask what dosage of minoxidil Farjo recommends ?
Good luck with your decision

Hi

I‘m starting on 1.25mg per day.

Cheers

 

[Bigmac]

Hi Ronnie. I’m enjoying reading your posts and will be following your progress with great interest.
It does look as though there is an improvement in your crown at this early stage. This is very encouraging for you and anyone considering oral minoxidil. I’m hoping you respond really well to it. Lighting does play a big part in how good or bad our hair looks.
7000 available grafts is great news. Depending on what size of surgery you eventually go for and the meds you could end up in a place you were only dreaming of this time last year.
Let us know how your other consultations go.
All the best.
Bm.

 

[Ronnie]

Cheers Bigmac

I certainly feel there’s been some improvement already, so am interested to see what the next 6-8 months brings on top. Pretty much everywhere there seem to be a few hairs at a similar length to the rest, but white and stood more upright, pretty sure these are hairs that were dying off that have been given a boost. Not expecting miracles but every hair saved is a hair that doesn’t need fixing as part of the transplant.

Taken oral Min now for 2 days. Taken it before going to bed and I think it may have actually helped me sleep through better, getting up in the night less and waking up feeling ‘pleasantly’ tired if that makes sense.

I don’t feel like I’m suffering any sides, the thing I’m most aware of which I will have to continue to assess, is that my scalp, for want of a better way to describe it, feels more ‘alive’. This is definitely something I felt with the topical Min/Fin and I think (albeit it’s early days) that oral Min is having a greater effect in this regard. The best way I can describe it is to think back to being a teenager when your body is full of hormones. At that time I had pretty bad acne and my skin used to feel ‘alive’ and the outcome was spots! I’m having a similar sensation which I hope means there is activity that could lead to some hair growth……though I have had a couple of random spots these last couple of weeks also!

I shall keep you updated on how things progress.

Cheers