Dr Erdogan online consultation

[Dench57]

If you're that desperate, and a Doctor is turning you down because of finasteride. Why not just lie and say you're on it? Or use a different maintenance treatment like RU? If you're prepared to take full responsibility if/when you continue to lose despite the hair transplant. There may well be other treatment options available by the time this becomes a problem though, if you think your hairloss is that slow. Especially if the encouraging news regarding Replicel+Histogen from the Hair Congress follows their projected timeline.

 

[Pequod]

WITHOUT THE SPACINGS ---> hair_transplant_network.com/blog/journal.asp?CopyID=10467&WebID=2864&ProcID=4631

I mean wtf is that?? What are those red pimples around the implanted hair? Will that be visible if that guy shaves his hair? He was better off not having a hair transplant at all than having that.

Based on the photos I would never use them for a hair transplant, sorry. At 3 and 4 months in you could tell it was a loss. Also the follicles were pointed down his scalp instead of up, very strange overall. Looks like a beginner did the procedure, wow.

 

[arfy]

And the ironic thing is that I can still comb the hair in a way that no MBP is visible at all, it looks like a full head of hair, only the hairline in the corners receeded on my already long forehead but I can always comb it forward and mask it. But I feel like my life is going to be over pretty soon. Well at least love life. xP

If you can achieve a good appearance with styling tricks, then that's obviously what you should do, IMO... NOT a hair transplant. In my opinion, it's a bad idea to get a hair transplant until you absolutely NEED it (and not based on an "emotional" need). The risk of shock loss is nothing to take lightly, especially on patients with diffuse pattern hair loss. Your outcome could be absolutely disastrous, and not "later in life", I mean in the months right after your surgery. In general, "preventative" hair transplants are often a bad idea. Trying to stay ahead of your hair loss with surgery is only a good plan in the imaginations of desperate newbies. Doctors don't turn patients down because they're insensitive jerks (although they might very well be jerks too), they do it because there is a track record in the industry that they can refer to. Shock loss is a known risk.

I don't know if with finasteride there is less shock loss for the native hair and that Dr. might do a different approach because he thinks I am using finasteride that would end badly for me. Also he could go outside the safe donor area to collect the grafts and that could end badly.

Yes, exactly.

Also, family history is useful only to a limited degree. You could certainly be the first person in your family to have significant hair loss. Hair loss also might have skipped generations. It might have been a recessive trait until you came along. Who knows, perhaps there are environmental reasons you are losing hair.

Also, donor density is a specific type of measurement of your donor area. Just seeing a visual surplus of hair in the mirror isn't necessarily relevant.

The doctor is well within his rights to decline you as a patient. Tight control of patient selection is good for the patients and good for the clinics. Good for the clinics because if they only accept good candidates, it raises the odds that the patient will be highly satisfied. This leads to positive reviews and referrals of friends and family. Good for the patient, because hair transplants already have built-in risks, it is a flawed procedure and has limitations. If your hair loss is emotionally unbearable, that's still not a valid justification for permanently altering your appearance with a hair transplant, and risking a disappointing outcome. There's little justification for getting a transplant if the risk of a negative outcome is considered too high. Hair transplants are not a perfect solution for hair loss - if they were, the problem of male pattern baldness would be considered solved. It's simply not the case though.

Even so, most of the doctors are in this business strictly to make as much money as possible, so it should be easy to find a different doctor with different ethical standards, who will be happy to take your money.

Those surgeons don't realize the harm they're doing. They're the only ones who could help you, yet they're like "Nope, sorry, won't do it, what are you going to do?!"

Nobody was ever harmed because a doctor refused to perform a hair transplant.

 

[GoldenMane]

Dr Reys assistant informed me that shock loss is quite avoidable and that Dr Reys never sees shock loss of native hair in his patients. Not sure if that's true or not, but I hope so. He also did Fred's hair transplant knowing Fred wasn't on finasteride so he may be a good option for you. Do you have any pics? It may be easier for us to assess, but if you think you want good hair now and are prepared to potentially pay the price down the line, then you should go for it. I too can style my hair in such a way that most people don't know I have male pattern baldness, but it's such a pain in the *** and takes a constant mental toll, worrying about if people can see it. I keep my hair dry at all times and use shampoos that dry my hair because any bit of greasiness and my hair looks like ****. A minor hair transplant at the front and things would be much better.

We all know what we're doing Arfy, we're trying to look and feel our best while we are young, we accept that further down the line, in middle age or old age we may have some issues, but we've made that decision and hope that future treatments will pick up the slack if things do turn south.

Can you imagine, if in 10-15 years, there was a genuine treatment available like replicel? We waited throughout our 20s and 30s, unhappy with our hair, just to be safe and conserve donor hair, only for replicell to make it a non issue? Wouldn't you kick yourself, knowing that you could have had good hair and confidence in your 20s and 30s but didn't because you decided to play it safe? I also understand that you're a fair bit older than most of us, and didn't experience hair loss until later in life. A young man thinks quite differently, our 20s and 30s is where we make our career, find our partners, get married, make our friends, learn our skills, make our contacts and gain our qualifications. This is the most important time in our lives, make or break time, our prime, and it needs to be the best prime it can be.

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Dr Reys assistant informed me that shock loss is quite avoidable and that Dr Reys never sees shock loss of native hair in his patients. Not sure if that's true or not, but I hope so. He also did Fred's hair transplant knowing Fred wasn't on finasteride so he may be a good option for you. Do you have any pics? It may be easier for us to assess, but if you think you want good hair now and are prepared to potentially pay the price down the line, then you should go for it. I too can style my hair in such a way that most people don't know I have male pattern baldness, but it's such a pain in the *** and takes a constant mental toll, worrying about if people can see it. I keep my hair dry at all times and use shampoos that dry my hair because any bit of greasiness and my hair looks like ****. A minor hair transplant at the front and things would be much better.

We all know what we're doing Arfy, we're trying to look and feel our best while we are young, we accept that further down the line, in middle age or old age we may have some issues, but we've made that decision and hope that future treatments will pick up the slack if things do turn south.

Can you imagine, if in 10-15 years, there was a genuine treatment available like replicel? We waited throughout our 20s and 30s, unhappy with our hair, just to be safe and conserve donor hair, only for replicell to make it a non issue? Wouldn't you kick yourself, knowing that you could have had good hair and confidence in your 20s and 30s but didn't because you decided to play it safe? I also understand that you're a fair bit older than most of us, and didn't experience hair loss until later in life. A young man thinks quite differently, our 20s and 30s is where we make our career, find our partners, get married, make our friends, learn our skills, make our contacts and gain our qualifications. This is the most important time in our lives, make or break time, our prime, and it needs to be the best prime it can be.

 

[arfy]

If a doctor tells you with confidence that shock loss won't be an issue, then you should ask him for a money-back guarantee (get it in writing) especially if shock loss would be a really negative blow. You'll see how confident they are about shock loss when you ask for a written guarantee.

If you are stressed over concealing your hair loss via styling, there's also a chance you'll feel stressed about concealing your hair transplant, does anybody notice I have grafts, does the wind reveal a linear donor scar, etc. A transplant isn't a guaranteed solution to 'hair worry'. Sometimes, it just changes the focus of your worry onto something else.

Negative outcomes aren't guaranteed either, of course -- they are only just possibilities which need to be evaluated honestly. A patient could certainly also be thrilled with his results, with no problems at all -- perhaps I don't say that enough. But there are negative possibilities too, and they should be assessed on an individual basis. The goal is to minimize risks as much as possible, and some guys might decide that a transplant isn't suitable for their situation. I urge you guys not to gamble with your appearance out of desperation. Only make good bets!

As far as future treatments, I remember when the "Nova" science TV show did a program about upcoming advancements in hair loss treatments. They talked to Dr George Cotsarellis doing research at the University of Pennsylvania, and some other researchers too (an hour program on public television, so no commercial breaks). According to the program, exciting new treatments were on the horizon. But that program aired in 1990! New treatments have been on the horizon basically forever, and if the past is any indication, they may never arrive.

 

[GoldenMane]

Nobody intends to be a repair patient, and personally I'm not banking on future potential treatments, but speaking of my case at least, I don't think a 1000 graft hair transplant at 30 to reverse a finasteride stabilized NW2.5 to an NW2 is all that risky. Life is short and youth is even shorter, and as Wolf Pack once said, much like money, you can't take your grafts with you. Most hair transplant surgeons start at the front anyway and gradually move back leaving the crown as the lowest priority since face framing is most important and the crown eats up grafts. Worst case scenario, you transplant all the grafts to the front, don't have enough for the middle or crown and either look like a guy who is balding on top, or shave/be a hat/system prisoner, which is what you'd probably have to do anyway, even without a hair transplant. The benefits of conserving donor grafts so you can have a thin NW3 at 50 just isn't worth it. It's simply more valuable now. And shock loss hairs do grow back, it sucks, but it probably shouldn't be a determining factor in a decision to get a hair transplant.

I get what you're saying, you're advocating a cautious approach, and there is definitely value in it. But I hope you can also see the tradeoff between a cautious and more aggressive approach. Shock loss is temporary, many hair transplant's start at the front anyway, if it looks bad and you have to shave, then that's what you would have to do anyway, even if you don't get a hair transplant, we've come a long way in stem cell tissue cloning in recent years, and mostly, the importance of hair, looks and confidence in our youth. These are all very valid reasons to make the uncertain tradeoff vs waiting in later in life, when appearance matters less (I know we will always still care, but not as much as we do now) getting a more conservative hair transplant starting at the back/crown, and likely still not having good hair...

 

[arfy]

Thanks for your reply. It's great that you've stabilized your progression with Finasteride. Knowing what I know now, I would not get started on surgery just to go from NW2.5 to a NW2, as things can go wrong or take unexpected turns (hopefully not).

And shock loss hairs do grow back, it sucks, but it probably shouldn't be a determining factor in a decision to get a hair transplant.

Shock loss can be permanent. It depends on how robust the original hairs in the recipient zone are. In your case, perhaps not an issue, since you've stopped the progression of loss with Finasteride. It's certainly something everyone must evaluate for themselves. If your hair isn't stable, shock loss can be a major problem. Even if your hair seems stable, surgery can still accelerate your hair loss - there's no guarantees. It's definitely a 'determining factor' that needs to be considered.

getting a more conservative hair transplant starting at the back/crown

Not sure what this means, as starting at the crown is extremely rare.

I certainly wish you the best of luck!

 

[GoldenMane]

I'm putting my faith in Dr Reys. Maybe that's stupid, maybe hair transplant doctors are mercenaries, but I've seen his results, and in cases worse than mine, and i have been very impressed. I'm a diffuse thinner, and while I have no visible scalp on top anymore, my hair is still thinner than it was in my youth. Yes I am worried about shock loss, I doubt that I will have permanent shock loss though, and once more I'm putting my faith in Dr Reys, whether it's right or wrong to do so.

Many hair transplants do start at the back, particularly with more advanced cases where NW4 or 5 patients focus on getting a thin coverage on top rather than building a strong hairline at the front.

The alternative for me, would be to wait until I'm bald on top and go for thin coverage. If I'm going to start at the front anyway, may as well start now when I'll get the most benefit than wait until the front thins and place the hair in the same place anyway. I'm not going for a low NW2, my hairline is higher than most to start, maybe for some NW2 might seem less conservative, but for my head it's about as conservative as I'd like to go. NW3 for me would just look awful. Regardless, I've booked my surgery, I've seen other people's results on here, and I want to be like them, to look how I want to look. There won't be a scar with FUE and I still have dutasteride as a fall back if finasteride loses it's effectiveness.

All our cases are different, we're all dealing with a large number of unknowns. Out of curiosity, at what Norwood stage would you consider getting a hair transplant? and What Norwood hairline would you consider a safe hairline to build with a hair transplant?

 

[arfy]

I've already had multiple transplants, I am a repair patient. I had my first surgeries in 1982 with Dr Puig (horrible) and then corrective work with Bernstein, Campbell (Dr Woods sister) and Cole (expensive and nothing grew, I have a long thread here about it). 18 surgeries so far, and I look terrible. On the positive side, I've researched this topic pretty thoroughly, about as much as anybody who doesn't actually work for a clinic (I've read a couple of medical textbooks on hair transplant for example, as well as following the subject over a very long period of time).

I'm not aware of hair transplant surgeries commonly starting at the back (only extremely rarely, for very specific cases). Are there examples? Is there a certain doctor who seems to do this a lot?

If you have diffuse thinning, I think it's wise to make sure your hair transplant results in a definite "net gain". So that even if you lose some hair from shock loss, the amount of transplanted hair is large enough that you end up with distinctly more hair than before. Just swapping out original hair with new grafts is a waste of time and money (and won't look as natural as your original hair) and the worst case scenario is ending up with a net loss of total hair, after surgery. In other words, you don't have to wait until you're bald on top, as you said. But you should estimate the planned total hair "net gain" after surgery, and only pull the trigger when you can be sure you'll be gaining a large amount of hair. If it's not a clear improvement in total hair, I don't think it's worth doing it. When you transplant hair, it creates scarring in the recipient area too. This is a whole different tangent, but many doctors think the first pass has the best yields. So it might be a good idea not to make your first procedure a half-measure (that is debatable). But even FUE is surgery, and a permanent alteration to your scalp, in the donor area and recipient area too.

I don't want to sound too negative, it seems like you have some distinct positive attributes (stable hair loss, your hairline isn't naturally low to begin with, it seems like you picked a good doctor who will steer you right). Also sounds like you are putting a lot of thought into it, and still open to hearing other viewpoints too. All good, positive indicators.

As far as which Norwood stage for a hair transplant, the ideal candidate has a distinct pattern of frontal loss (limited to a specific area, not diffuse thinning). Diffuse thinning is a bad trait if you want optimal results. That doesn't mean optimal results are impossible for the diffuse thinner, it means they have to be more careful than other guys, for reasons I covered above. Guys in their early 20s will remember their teenage hairline and sometimes they want to restore their hair to "Norwood zero" so it helps if the patient is a little older, because the younger guys often don't want to transplant a NW2.5 hairline... ("what's the point, if I still look like I'm losing my hair?") As far as hairline placement, it depends on pattern of loss, donor supply, hair characteristics (coarse hair covers better) and so on. There's not enough donor supply to meet demand, so it helps to be extra careful and spend your donor supply wisely. Staking out an aggressive hairline can often mean you've over-reached as far as your donor supply is concerned. I see guys saying they would be okay if they're older with a low hairline and a large area of hair loss in the back. The problem with that is it's not a natural pattern of hair loss. You almost never see guys who have a naturally low, dense hairline, but a large bald area in the back. That can look odd, and looking odd should be avoided at all costs. It would be more natural pattern to have some recession in the front, and a smaller thin or bald area in the back. That strategy doesn't conform to the younger patient's desire use hair transplants to pretend that they don't have any hair loss at all, at least temporarily.

I'm rambling and I'm taking this thread way off topic, I apologize. It sounds like you are doing a good job of researching. You're already ahead of most patients then.

 

[GoldenMane]

Now that I see your pictures, I would say Erdogan was right to reject you. You're definitely not a candidate.

What do you mean he's not a candidate? Thick hair, an intact hairline? I would say he's a great candidate? Well actually I'd say he doesn't need a hair transplant with that hairline. The density is a little low, but not visibly balding thin. The only issue I would say is that there's nowhere for the grafts to go, and putting them between existing hairs may compromise the blood supply...

Oh you mean he's not a candidate because he doesn't need a hair transplant?

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Hair actually looks thicker short, when long the front looks noticably thin, but when short you can't tell. Some thinning at the vertex though, no sure ig a hair transplant would be advisable there at this stage. I would almost certainly say that further down the road, if this progresses, a hair transplant could be quite successful.

 

[GoldenMane]

Here's what I heard from Dr Reys assistant:

1. Shock Loss



Shock loss is something that can occur when grafts are placed too close to existing hairs. The reason that shock loss occurs is that when grafts are placed, new blood vessels form below the surface of the skin to supply them with nutrients.



If the grafts are placed too close to existing hairs then the new blood supply can affect the blood supply of the existing hairs. When this happens, the existing hairs fall out.


Shock loss is, however, always temporary and both the new grafts and the existing hairs always return. Avoiding shock loss is down to the skill of the surgeon in placing incisions in the scalp.


With Dr De Reys you have a guarantee that the surgeon and no one other than the surgeon will make every single incision.


Surgeon skill is how our clinic avoids shock loss. Dr De Reys has never had a case of shock loss.


2. Your hair loss is minimal and very far from Norwood 6.


It appears to be following the standard path of Male Pattern Baldness which is extremely common and quite natural.


A hair transplant is the ideal solution for your situation since medication cannot restore lost hairs.


3. We ask patients to stop taking Minoxidil one week prior to the operation.


I’m wondering if you think these are good answers to your questions.


Kind regards,


Nick


What do you guys make of this? "Dr Reys has never had a case of shock loss". Is this b/s? Is he telling the truth? Should I trust him?

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@ Vincent,

I agree that if you're going to have to shave anyway, then it really doesn't make much of a difference if your hair is losing ground and your transplant is no longer doing what it should. And if your donor zone is also thinning, then you may as well transplant it to the front while you still have it, at least when it does go, you won't be stuck with silly tufts at the temples since it should go at a similar pace to the native hair. One thing that would concern me would be the rate of loss. That's a huge unknown. If it happens slowly over the next 10 years then a hair transplant would probably work quite well. If it happens quickly over one year, then by the time the grafts have grown out, the rest of your hair may have thinned and you'll be chasing your tail. It's a tough one. All hair transplants are a gamble, but if you're not on finasteride then it's a bigger gamble... Have you tried topical finasteride? RU? Some minoxidil solutions have finasteride in them (minoxidilmax).

 

[arfy]

I agree with Fred, a hair transplant doesn't make any sense whatsoever for someone with such a minor degree of hair loss. The potential gains are completely negligible (perhaps totally unnoticeable even by the patient) and the potential risks are high.

Soooo many newbs have totally unrealistic ideas of what hair transplants can accomplish, who are they suitable for, etc.

What do you guys make of this? "Dr Reys has never had a case of shock loss". Is this b/s? Is he telling the truth? Should I trust him?

You should ask for a money-back guarantee in writing. Any big promises or claims that the clinic makes, if they are really important to you - ask them to give you a written 100% money-back guarantee. You'll hear a lot of excuses and hemming & hawing in response. Maybe the doctor will tell you that he'll give you free grafts to replace the hair lost because of surgery... so what? There's not enough donor hair to cover your head. Using up your donor supply is hardly fair compensation for accelerating your hair loss. You need to retain as much original hair as possible for the best results.

 

[DoctorHouse]

GoldenMane, it looks better shorter because the hairs were overlapping each other in the center part, like a small combover so it looked thicker. But when they are longer they can go anywhere and you can part it in the center like that and it looks thin, so thin in fact that I don't part it there anymore. When it's oily under the strong light it looks apparently thinner, an average person could notice I'm thinning.

Like I said, I can still comb it in a way that it's not visible, I'm more concerned that my corners receeded a little to my already very large forehead. My forehead is almost 1/2 of my face, not the 1/3 that is a beauty standard.

Obviously I was thinking hair transplants were more advanced and they could fill in any thin area as I would like to have long hair with normal parting at the center. I'm quite disappointed how limited hair transplants still are. I understand that Fred the Belgium comparing his hair loss to mine might find me ridiculous but if I'm comparing my hair that I had before to this it looks really, really bad.

Vincent, I have seen Erdogan do cases like yours before and they come out awesome but I think they are on Propecia. According to Joe Tillman most diffuse cases can be done as long as you are completely shaved and the doctor is skilled like Erdogan and Rahal who know how to transplant in between exist hairs without transection. I have the exact thinning pattern as you Vincent but you seem to have slightly more loss than me but your hair seems thicker because its wavy. So I wonder if he would reject me too but I am much older than you and have been on Propecia for 10 years.

 

[TowerT]

Also strongly considering Dr. De Reyes now for a hairline restoration but would also like to see more of his work ? Does anyone have pictures of his work/experiences with him ?

 

[shookwun]

Almost all doctors will require you to shave to ensure proper graft placement, and accuracy.

Vincent, kiss your long hair good bye, if a transplant is the route you want to go. Erdogan, and Feirdnuni followed by De reys require a shave.

 

[GoldenMane]

Dr De Reys said shaving is unnecessary for cases with less than 1500 grafts. They just shave a small patch on the back of your head that you can cover with longer hair. Afaik, Vincent already cut his hair short, he doesn't have long hair anymore. There don't seem to me many examples of dense packing by Dr Reys online, most of the pictures seem to be of higher Norwood patients given lowish density hair transplants. He seems to do amazing work with high Norwood patients but I would like to see some of his work on lower Norwood patients, particularly hairlines. There really aren't many pics online, the same 4 or 5 patients come up again and again, but he is former prohairclinic, recommended at HRN and purportedly gets extremely high graft survival rates.

 

[Dench57]

Go to Feriduni if you want dat god tier hairline.

 

[TowerT]

Go to Feriduni if you want dat god tier hairline.

Why do you say that ? Is he clearly the guy for hairline restoration ? Pics/stories/opions valued ?

 

[Dench57]

Why do you say that ? Is he clearly the guy for hairline restoration ? Pics/stories/opions valued ?

He's the EU Rahal and does the strongest hairline work imo.

 

[TowerT]

Cool ! Has anyone here had work done by Feriduni or Rahal ? And are they far more expensive than the likes of De Reys ?