Transplant (fue) + Scalp Micromanagement (smp) Combination

Hellocreatine

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I've diffused hair thinning, not typical Male Pattern Baldness (male pattern baldness) so I'm not sure if Norwood scale applies to me. If it does, I'm not sure what level of Norwood I'm at.

My haircare routine for past 2 years is Regenpure DR Shampoo + Minoxidil 5% at night. It hasn't helped or maybe it has slowed down the rate of hair-fall, can't be sure. Tried Finastride for couple of weeks and stopped because of sexual problems - erection/libido dysfunction. NEVER taking it again.

Decided to explore transplant options; spoke to a few doctors and got variety of advise:

Dr. Prasad (Manhattan, NY) - consulted in-person. Recommends two sessions (18 months apart) of ACell+PRP. My research shows it's mostly a gimmick so I declined.

Dr. Koray Erdoğan(ASMED Clinic, Turkey) - consulted with photos. He is unwilling to do any transplant without committing to Finastride because he thinks I've significant miniaturization and have extreme risk of shock hairloss in remaining areas after transplant. Not taking finasteride, so, not an option.

Dr Hakan ********* (Turkey) - consulted with photos, over 7000 Euros and recommends 4000 grafts (not hair). Quite expensive.

Dr. K (AEK, Istanbul) - says it looks it'd take about 4000 hair (not grafts) to get natural looking results. Cost is about 2300 Euros (hairline determining incisions performed by Dr. K.). So, I'm going to do this. But he said without finasteride, I could experience more hair loss etc.

Given that there is a significant risk of further shock loss, how is this strategy below?

1. Get hair transplant for now - 4000 hair at AEK - Turkey - focusing more on hairline/temples and front/midscalp. These transplanted hair will be resistant to DHT/hairloss. So, more or less will stay permanent. After 10 months when hair transplant results are apparent, I can go ahead and do:

2. Scalp micro-pigmentation to cover remaining thinning areas or wherever I experienced more shockloss.

Yes - I could do scalp micropigmentation without waiting 10 months but then it'd be difficult to visually see the results of transplant. While waiting for transplanted hair to grow, I can use something like Toppik.

Does this sound like a good strategy?

What if I need a second transplant. Can a second transplant be done over micropigmented scalp as well?

I don't want to keep my hair really short or buzzed look. I want to keep them medium length. So, is micropigmentation going to look similar to using something like Toppik and give illusion of density or will it be obvious that between long hair, there is black scalp (2-d, instead of 3-d)? Any experience with this?


My current hair picture below:
 

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Joseph Haston Green

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I am thinning but not really noticeable. I am going to try PRP. I have heard a lot of good things about it. I just don't know if I want to go the route with or without ACell added. I have a prescription for topical finasteride since oral finasteride gives me sides
 

Hellocreatine

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I am thinning but not really noticeable. I am going to try PRP. I have heard a lot of good things about it. I just don't know if I want to go the route with or without ACell added. I have a prescription for topical finasteride since oral finasteride gives me sides
Topical finasteride didn't do anything for me. Oral gave me sexual side effects so I stopped it. Normal PRP - I've tried twice (8 week gap between each session) and I didn't see a difference.

Acell added to PRP seems like a gimmick based on other people's review. And it is quite expensive (Dr. Prasad in NYC quoted me $3500 for two sessions, 18 months apart. No option to do only one session, same price). So, I've decided to pass.

My strategy now is to do transplant (in Turkey) and complement it with micropigmentation. Hopefully, that'd be a good strategy!
 

GrowPro

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Your strategy seems reasonable, 4K grafts all over the front and mid scalp is a good amount that you may not even need SMP since you still have lots of hair on top, but choose a clinic wisely as your DHT resistant donor grafts are like gold and you don’t want a cheap clinic to mishandle them and for them not to grow, you get what you pay for.
 

Hellocreatine

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I've arrived in Turkey. I'm meeting with AEK Dr. Ali Emre Karadeniz for pre-surgery consultation and then surgery is day after tomorrow on the 17th.

Honestly, I'm getting second thoughts - I hope nothing goes wrong and that he is a good surgeon. I've read horror stories of hair transplant and he doesn't seem to have a lot of reviews. All reviews are from people with very small number of forum posts. So, I'm getting cold-feet

Let's see how it goes in the consultation tomorrow. It's a big decision so I guess its natural to feel doubt and anxiety before a big surgery.
 

vhtm

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I've arrived in Turkey. I'm meeting with AEK Dr. Ali Emre Karadeniz for pre-surgery consultation and then surgery is day after tomorrow on the 17th.

Honestly, I'm getting second thoughts - I hope nothing goes wrong and that he is a good surgeon. I've read horror stories of hair transplant and he doesn't seem to have a lot of reviews. All reviews are from people with very small number of forum posts. So, I'm getting cold-feet

Let's see how it goes in the consultation tomorrow. It's a big decision so I guess its natural to feel doubt and anxiety before a big surgery.

Any updates?
I’m doing the hair transplant with Dr. K next week, and after checking the negative reviews I started feeling uncomfortable with the decision.
How was your experience?
 

Hellocreatine

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Any updates?
I’m doing the hair transplant with Dr. K next week, and after checking the negative reviews I started feeling uncomfortable with the decision.
How was your experience?
I'll write a detailed post later. But here are my impressions:

Logistics - airport pick-up, hotel etc were all arranged properly

Clinic - it is actually an apartment, not a hospital or a commercial clinic

Staff - friendly but the staff (technicians/nurses?) that work on you speak almost no English

Doctor K - poor bedside manners. He is not the kind that would comfort you or listen to you at length and have a discussion. He simply drew a hairline on my head and said this is it. I said I'd like to bring hairline forward. Especially add some hair to my receded temples. He said - no. But if you want to draw, go ahead. Handed me the marker-pen and asked me to draw whatever hairline I want and then he'd simply do the procedure per my drawing.
(now I'm not the f**ng surgeon. I'm ASKING you to bring the hairline forward and I expect you'll discuss pros/cons of my request and give me advise)

Surgery:

1. Honestly, I felt I was under competent hands. But I was disappointed that doctor never came in to the room to take occasional look at how surgery was going or offer any guidance to technicians or any encouraging words to me. I had chosen the package where hairline incisions are to be performed by the doctor. So, he came-in to the room for 10-15 minutes, no chat, just did the incisions and left without even a word. That said, I think the job was well-done.

Post-surgery:
I stayed extra 5 days thinking I can go and see the doctor and he can check on my progress/healing. But unfortunately the clinic was closed for next 4 days. So, I got to meet him one last day. I asked him - how is it healing? any concerns? He said -- post-surgery, bad transplant and good transplant look identical. Medically, there is nothing for me to see. We'll know in several months what the results are going to be. And then he said: because you drew your own hairline, I'm not that interested in monitoring your pictures etc. In my mind, I was like WTF?

But anyway, I feel confident that the actual surgery was performed competently. So, I'm NOT worried. But let's see.

I'll make a separate thread with pictures pre-surgery, post-surgery and progress.
 

Raphael84

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I’m sorry that the experience wasn’t what you hoped for. This is one of many issues that are discussed with clinic such as these.

How unethical to pass the marker to the patient to draw their own hairline and say that you will work to their mark. Without the patient having any of the knowledge the Dr should regarding donor management, density, miniaturization etc.

You said you felt your Dr was competent and you are not worried. Good.

Keep us updated on how things progress. I’m rooting for you!
 
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