need help and advice with a clinic in England

[h8bald]

Hi all, please help I need lots of advice on which clinic to choose for my first ever ht and if anyone has had any experiences with these clinics or can offer an opinion on them or any others would be a great help! I am 32 and have lost all confidence from hair loss which started in my early 20s. I'm fed up of crying myself to sleep and It's a daily battle to pick myself up and even bother to get up each morning feeling like s***t all day.
Anyway I've been to a few clinics and each have a different view/plan on what to offer me.

First, i went to Farjo clinic who said I have a 62 year old hairline and they could offer me one fut for the crown for 8 grand but to concentrate on keeping my hair I have with medication as I will lose all of it in time. I don't want any medication for risk of the side effects as I don't have a good physical tolerance for any medication and just know I would get the side effects.

Second was a company called fue hair transplant clinics .co.uk (as seen on channel 4 apparently) and I had a great consultation with them however they said I could have 2 futs for 8 grand and have to hair places on the crown and frontal area. They said by opening the scar I could get up to 4 futs?

Lastly was Vinci who offered me 1 fut for the crown and 1 fue for the front for 10 grand.

My worries are that why are there such different opinions from each company? Who should I believe and who's plan sounds best and most realistic and achievable? I can't find many reviews of Vinci or this fue clinic but they both seem legit! Farjo is obviously well known but they worried me with their insistence on medication and advice that all my hair will fall out leaving patches of transplanted hair!

Please does anyone have any opinions on these clinics or has anyone been to them? Also what is the risk of having a ht and not taking the medication? I'm also looking at the crown clinic and regen but again have no idea if they are reputable companies? Are there any others in England I should consider? Totally confused and frustrated here!!

 

[h8bald]

I also don't understand if my hair is going to fall out further down the back of the crown, how are the clinic going to know what is the healthy strip area and what is the area that will fall out in time and surely if the loss is going to go further down over time then will that not mean once extracted they will fall out the top of my head in time once transplanted anyway?

 

[JoeTillman]

You have some thinking to do for sure. My take is that Dr. Farjo is correct in that you're going to continue losing hair, as is anyone that is suffering from androgenic alopecia, unless something is done to stop it. If you don't take medications, it's a guarantee that you lose more hair thus it is a guarantee you'll need more surgery. How many will you need? It is hard to say but I can say that your crown looks an awful lot like mine did when I was your age but I have no idea how the front looks but I can say that your loss is already considered to be aggressive. But the point is that you have to understand that having surgery doesn't stop your hair loss. It's just moving hair from one place to another.

Good clinics know where the "permanent" donor zone is which is why you can have multiple strips (FUT) with an extremely small chance of the recession continuing into the scar area. If that happens then yes, some of the transplanted hair will fall out from DHT as well but if the strip(s) is taken from the right spot each time then this shouldn't be a concern.


With FUE the donor zone is expanded outside of the narrow safe strip zone with hair that is still expected to be immune to the effects of DHT but you'll have fewer grafts overall available from this procedure if you opt to use only FUE for each procedure.

Your case is difficult because your loss is affecting you so much but you are staunchly against medications so it's basically a medical stalemate. You're damned if you do, damned if you don't (in your mind) but the odds are you won't have any issues with the medication so I ask that you at least consider it.

If you do not consider medication then you have two options.

1. No surgery at all and learn to accept your loss.

2. FUE only so that you can keep a shorter haircut in the future should you not be in a position to continue with more surgery. IF you go down this route you absolutely must find a clinic that adheres to the idea of proper donor management and with FUE that means expanding the area of extraction as far and wide as possible with the individual extractions as far away from each other as possible. This is to reduce the appearance of uneven extractions which keeps the donor looking natural. If the total # of extractions are taken from too small of an area then the donor will have obvious demarcations with the visible density and you'll have patches in your donor zone. It doesn't look good and defeats the purpose of FUE altogether.

Proceed with caution and understand that everyone wants your money. It's just a matter of finding the right doctor, with the right approach and the right ethics to give it to.

 

[h8bald]

Hi many thanks for your reply. Option 1 isn't an option really. I have used hair fibres for 7 years and they worked great until recently so in my mind I'm just looking for permenant coverage/hairs that won't ever fall out in which I can grow it longer and put the fibres on it. I'm happy with 2 futs if possible or an fut and an fue whatever is best. I know I will need 2 surgeries but I need advice on the best surgeons to contact. I had a near miss in a plane years ago so flying isn't an option but I hear there are in Belgium? Also I am very sensitive to anything with my skin therefore I feel I would suffer side effects from the meds.


Here are some pictures.

 

[JoeTillman]

Thank you for the additional photos. You have what appears to be good density in your donor zone all the way around on both sides,which is a good sign for the long term.


The problem is that your crown is quite big and has basically no hair so getting an acceptable level of cosmetic coverage is going to take a lot of follicles. The good thing is that you have a lot of hair in the mid-scalp with only a receding hairline. I've seen this pattern a lot and I think it will probably stay with you awhile, but not forever.


Take your time with this and don't rush into anything. It's easy for desperation to cloud our judgement so just take a breath and read. Have more consultations with more clinics but, make no mistake, Dr. Farjo is absolutely correct about medication. However, as long as you don't try to use all your grafts in the hairline and the crown you should be relatively OK barring any extreme continuation of your loss. One possible outcome is that you get the top done with moderate coverage into the crown but then your sides begin to drop taking you to a NW7. Will you have enough to fill the gaps on either side? No one knows.

 

[h8bald]

Hi thanks for the advice. So without taking meds to stop further loss would you suggest an fut for the crown and an fue for the front to give moderate coverage that I can use the fibres with and take the risk of further loss down the road??

 

[JoeTillman]

H8bald,
I'm reluctant to "recommend" any procedure at all for you because I'm not fond of patients having surgery without making legitimate efforts to halt the existing process of loss. However, Given your position, I think FUE makes the most sense as you're not "marked" with the linear scar from strip if you decide want to have shorter hair cuts.

However, I must urge extreme caution with any FUE endeavours in that having a bad FUE can be just as bad, if not worse, than having a bad strip (considering aesthetics) This comes down to the extraction pattern of the follicular units as being too tight of a pattern will leave noticeable patches of thinning, even with longer hair lengths. Obviously, bigger punches will also mean bigger scars multiplied by by the number of total extractions. Doctors such as Dr. Lupanzula in Brussels, one of the doctors I work with, take steps to prevent these issues from becoming problems. You can see what I mean in my video series where I document his approach to FUE surgery. in one of the videos he demonstrates and discusses how he measures out each cm2 of the donor zone where he intends to extract and how he calculates the ratio of follicular units he can extract from each cm2 in order to remain under the threshold of visual density reduction.
[flash=425,344]http://www.youtube.com/v/?list=PLpyV-K01Tgdh5xtEW8QT61k4N_NdTaem3&hl=en&fs=1[/flash]

 

[balody]

At 32 you are still relatively young(in hair loss years) and are almost certain to lose that top area you have in coming years(sorry)
So if a surgeon builds the hairline using valuable grafts and you lose what's behind you will be using more valuable grafts playing catch up all the time with a finite amount of donor hair.
Bottom line is to halt the hair loss,or wait until your hair loss is stable in years to come and maybe have a conservative procedure/procedures.
I was a Norwood 6 at 35 and had 3 surgeries with Dr Farjo and went for conservative hairline and while we tackled the crown it has got bigger over the 8 years since my last surgery ˜¹ï¸
I feel your pain and frustration but listen to Dr F, he knows of what he speaks.

 

[Bigmac]

Hi h8bald.
Welcome to the forum.
You have been given some excellent advice already.
I was made aware of certain people elsewhere claiming all doctors in certain countries are rubbish. Take no notice of these so called experts, whilst they think they are providing you with the best information possible, reality is, they are providing misinformation and can`t possibly know the quality of every single doctor. What they are doing is providing you with their opinion on who they like etc based on what they read online.
We are having an HT meet up on the 13th May in London. You should come along, meet real patients and judge their natural results for yourself.