• Welcome to Hair loss Experiences hair loss forum.

    Free impartial hair loss advice, hair transplant advice, hair loss medications and hair loss news.
    You can contact us directly at [email protected] if you experience any problems.

Help Deciding

R

Rudiz31

member
Hi Everyone,

First, I wanted to thank all of you for everything you do here. This forum is one of the best and most informative I've seen for a while.

I've finally decided to take the final step in my hairloss journey and going with the surgery. A little bit of background: 34, male, men go bald in my family around 28-30, I've never took any medicins or other treatments to avoid hair loss.

I've started investigating different clinics 2 years ago, especially in Turkey due to a limited budget. At the beginning, I consulted with a well known hair mills such as Dr. Cinik & Dr. Serkan Aygin, however the more I studies, the better I realized that doctor's involvment would be a key factor for me. Second important factor for me would be someone who has a well-proven and tracked record of working on low-density & a VERY thin hair type (please see pics attached). On the other hand, my budget is limited to roughly 5K€.

Therefore I've narrowed down my search and come up with the following list -

1. Dr. Bicer - awaiting diagnosis.

2. Dr. Ilker Apyadin - awaiting diagnosis.

3. HDC clinic Cyprus - Dr. Christina ( because she's a bit cheaper than Dr. Maras) - awaiting diagnosis.

Interested in getting volume in front/close the temples as well as my vertex, and some work on the crown.

Based on my two most important concerns (doctor's involvment/well-experienced team, preferably nurses + high success rate with very thin hair types, who may be your best choise out of the three (or amongst other clinics)?

Appreciate all of you!
 

Attachments

  • 20210929_183742.jpg
    20210929_183742.jpg
    140.6 KB · Views: 23
  • 20210929_182317.jpg
    20210929_182317.jpg
    118.7 KB · Views: 15
  • 20210929_182209.jpg
    20210929_182209.jpg
    108.9 KB · Views: 16
  • 20210929_182154.jpg
    20210929_182154.jpg
    128.9 KB · Views: 14
  • 20210929_182154.jpg
    20210929_182154.jpg
    128.9 KB · Views: 16
  • 20210929_181716.jpg
    20210929_181716.jpg
    389.9 KB · Views: 12
  • 20210929_181734.jpg
    20210929_181734.jpg
    393.1 KB · Views: 11
  • 20210929_181748.jpg
    20210929_181748.jpg
    417.8 KB · Views: 9
  • 20210929_181758.jpg
    20210929_181758.jpg
    418.5 KB · Views: 11
  • 20210929_181701.jpg
    20210929_181701.jpg
    357.8 KB · Views: 12
  • 20210929_181603.jpg
    20210929_181603.jpg
    88 KB · Views: 13
  • 20210929_181537.jpg
    20210929_181537.jpg
    84 KB · Views: 14
  • 20210929_181505.jpg
    20210929_181505.jpg
    401 KB · Views: 13
  • 20210929_181452.jpg
    20210929_181452.jpg
    493.9 KB · Views: 18
Bigmac

Bigmac

Administrator
Staff member
Hi Rudiz, welcome to the forum. I’m pleased you find it helpful.

Your hair loss has progressed quite a bit, somewhere around the Norwood 5 plus area. Looking at your pictures I see your crown has dipped into the donor area and your sides are thin above the ears. All this will limit the number of grafts that could be safely harvested. Is there a reason you’ve not tried any hair loss medications? They have the potential to improve your situation and help make you a more suitable candidate. Your beard looks to have a decent supply of donor grafts that can be utilised to add density.
You still have some hair on top. Any hair that is miniaturising could be at risk from permanent shock loss when new grafts are placed. Meds help to reduce this risk. You’re probably go to to need 2500 - 3000 to achieve a decent coverage that will provide a nice illusion of density. That’s my guess which of course could be totally different to what you receive back from the clinics listed.
Having a hairline with with the temples closed off will look better. I would keep the hairline high, no lowering, a more mature look that will save grafts that can be used behind. All of this depends on if the clinics say you’re suitable.
Without meds, your loss may continue.
 
R

Rudiz31

member
Thanks @Bigmac for your input!
Any suggested meds you'd use in my situation?
Bicer actually got back with an estimation of 3800-4000 grafts but suggested a session only for front and vertex area with high density, without the crown.

Would you immidiately start with meds (to avoid loss for donor area) regardless of the decision of doing a transplant?
 
Bigmac

Bigmac

Administrator
Staff member
I began losing my hair when I was 24. If I’d known about Propecia back then, I’d have jumped on it straight away. However, I never knew about, went ahead with hair transplants that were unsuccessful and continued losing hair. It wasn’t until 2005 I started using Proscar, then switched to finasteride. I still use Finasteride to this day. It certainly prevented further loss, improved my hair and still maintains it. For these reasons I would suggest Finasteride but it does come with possible side effects. You’ll need to research these and hopefully, get medical advice from a doctor before proceeding.
Minoxidil works well for many people. It comes as a liquid, a foam or pill option. The pill/oral minoxidil is becoming popular. Again, a medical opinion is advisable as they also have the possibility of side effects.

The graft numbers from Dr Bicer could change once she examines your donor and you both agree on where you want the grafts to go. Do you go for frontal 3rd/half with more density or go for all over coverage at a lesser density. If you do have 4000 grafts available, do you use all in one pass? If you leave the crown, will you have more grafts if you require a second surgery.

Just some of the things you need to consider before having surgery.
 
R

Rudiz31

member
Thanks @Bigmac for the feedback. Will definitely consider meds from now on. In regards to my question, sitatuion & concern - what do you think about the above listed clinics?

I also got a diagnosis from Dr. Hakan Doganay (AHD Clinic at Anatalya) of 3,000 grafts from hair (2€) and beard (2.5€) + 25% discount from 2,000 graft, focusing only on the front and part of the vertex (see attached pic). Any thoughts about the difference between him & Dr. Bicer?

IMG-20210930-WA0013.jpg
 
Bigmac

Bigmac

Administrator
Staff member
Looking at their clinic results and patient posted results they both look to be producing consistent results. The patients are happy. Maybe ask some questions to their patients in the patient section of the forum.
You need to decide what surgery plan you feel best suits your expectations.
 
R

Rudiz31

member
Thanks, @Bigmac. I've also consulted with Eugenix clinic in India, and they sent me the following evaluation (see attached pic) with a basic package of 1.4 EUR/gft (doctor do the planning, design and 100% slits, extraction & implementation under techs responsibility) -

Conservative Approach

You have Norwood – Hamilton Grade VI of Baldness
Total Grafts – 4000
Your procedure will be completed in 2 Days
Your scalp Donor will yield 3000 grafts.
Your Beard Donor will yield 1000 grafts
Marked Area will require 4000 grafts for reconstruction of hairline, corners, and rest of the frontal scalp with a natural looking hairline and density filling, with coverage
The remaining area will show improvement with medications

OR

Aggressive Approach Full Coverage

You have Norwood – Hamilton Grade VI of Baldness
Total Grafts – 6000
Your procedure will be completed in 2 Days
Your scalp Donor will yield 4000 grafts.
Your Beard Donor will yield 2000 grafts
Marked Area will require 6000 grafts for reconstruction of hairline, corners, and rest of the frontal scalp with a natural-looking hairline and density filling, with coverage
The remaining area will show improvement with medications

I'm a bit worried about the 2nd approach and concerned about if my donor areas can produce 6,000 grafts in 1 session and will be implemented successfully without any long-term damage? Overall - what do you think about this diagnosis, VS to Dr. Bicer's (3,800-4,000 grafts 1 session without the crown, just front + part of the scalp/forehead) VS. Dr. Ilker Apyadin (3,000 grafts - 2,000 for the front + 1,000 for the forehead, no crown) VS. Dr. Emrah Cinik (3,700-4,200 grafts 1 session without the crown, just front + part of the scalp/forehead) VS. Dr. Hakan Doganay/AHD Clinic (approx. 3,000 grafts from beard & head, focusing only on frontal + part of the scalp/forehead). I'm still waiting for an evaluation from HDC Cyprus & perhaps another one from Dr. Chris Tsakalos @ Choiexpert Saloniki.

Overall how do you guys analyze & compare these clinics so far, given the above evaluations?
Appreciate your advice :)

WhatsApp Image 2021-10-01 at 12.06.47.jpeg
 
Bigmac

Bigmac

Administrator
Staff member
If I were you and knowing what I know I would error on the side of caution and go for option one. My main concern though is your hair loss pattern and future loss. You could be at risk of losing more native hair and transplanted hair.
Having an in person consultation before traveling is what I would do.
 
R

Rudiz31

member
Thanks @Bigmac , will definitely consult prior travelling.
Here's a summary of the estimations and offering that I received from the clinics that I'm in contact with -

1. Dr. Olzem Bicer - 3,800-4,000 grafts in one day FUE session, with a focus on hairline (without lowering it) + the entire midscalp with 40-50 gfts/sq.cm, no crown coverage. Mentioned limited donor area, small scars could appear after the HT, risk of future hair loss. However, didn't provide any particular recommondatiins about taking meds. Quoted 1.5€/gft, excluding accomodation (300€ for 2 nights+transportation).

2. HDC Clinic Cyprus - Dr. Christina - 3,300-3,500 grafts in two days FUE session, with a focus on hairline (without lowering it) + the entire midscalp, no crown coverage. Mentioned average donor area. Recommonded taking liquid formula of Propecia+Minoxidil. Quoted 2€/gft, including 7 days accomodation (apartment, transportation, washing the head in the follonwing days after the HT, also including travel expenses).

3. Choiexpert Clinic Saloniki - Dr. Christos Tsakalos (Worked for DHI Glasgow before) - 4,000 grafts in two days DHI session, with a graded density, including crown. No lowering of hairline. 40-50 gfts/sq.cm in midscalp area. Mentioned average plus donor area. Recommended minoxidil for 6 months after HT. Quoted 5,000€ package including accomodation (3 nights hotel + transportation).

I'm mostly curious to hear your thoughts on how these evaluations compare with each other? Based on my scenario.

Thanks in advance!
 
R

Rudiz31

member
Will 4000 grafts leave any donor surplus in the reserve bank?
@Techno1 Million dollar Q I guess :)
The only thing that I can tell for sure reg. my donor area supply - HDC mentioned I have roughly 7,000-8,000 hair grafts to utilize, therefore evaluated 3,500 grafts for 1st session. Eugenix offered 4,000 grafts ("conservative approach") to get to good coverage, or 6,000 grats in a mega-session ("aggressive approach") for almost full coverage. The other clinics that I'm in contact with (Dr. Olzem Bicer/Dr. Christos Tsakalos) didn't mention total supply although I didn't ask them yet.
 
Bigmac

Bigmac

Administrator
Staff member
On one side your hair is long but it’s still possible to see through to the scalp. Your donor looks to be generally good, if you discount that side, but it is obviously small and could get smaller. The rich occipital area that will harvest more grafts could also thin out.

You may be a better candidate for a big strip. Maybe achieve 4000 strip, leave your donor density mainly untouched and could probably still get 3000 FUE out of it. Or play safe short term and aim for 3000 FUE, use your hairline now and go back. Then hopefully once healed, you can get another 2500 FUE from the donor if available. Breaking it down to smaller numbers will conserve your donor, cause less stress on the remaining hair, better healing , less potential scarring, meaning over multiple procedures could potentially get a few more grafts without causing patchy donor hair growth or simply just much thinner.
Imo it’s not wise to use all the donor and not be on meds. Also,I think going down the body hair road on the first procedure might not be the best plan. Use the scalp donor as best as it can be used before considering a big body hair option. A small amount of body hair could be added, but, like scalp donor, you may need this resource at a later date.

It looks like you may have retrograde alopecia around the nape, that could creep up later in life, it’s already creeping up around the ears. Maxing the numbers is not what I would go for, better off being more conservative and planning over a couple of procedures. You’re not that old and your hair is very likely to continue to negatively change, especially with using any preventative measures.

This is just my own opinion if I were in your position. The surgical plans could change once you’re seen in person. Your donor may be better or worse.
7-8000 grafts sounds a lot to me considering your age, hair loss pattern and ongoing thinning.
 
Top