View Full Version : Making the decision to have hair transplant surgery

09-02-2009, 09:45 AM
First of all I would like to thank the members for all the help and great information posted on this forum.

I am 24 and for about 8 months I have noticed that my hair is thinning on the back (toward the front) of my head.I have tried different products, until I decided to by Minoxidil 5%, but after the very first time I used it I have changed my mind because of the excessive hair loss I observed in the next day.
Now I started to use a combination of herbal supplements that can be found in a single product(and I wash my hear with Vichy Dercos Hair Loss Shampoo with Aminexil):

-saw palmetto extract (250mg)
-pygeum extract (100mg)
-beta sitosterol (50mg)

Anyway I am planning to make a step for better results, a hair transplant surgery preferable FUE. I was searching for weeks to find a good Dr. near to my country, and because I am living in Hungary my best bet is Dr. Bijan Feriduni from Germany, Belgium.

Suggestion are welcomed regarding my present treatment, especially the location and physician for the FUE transplant.
I have attached a photo about my current situation, could someone tell me please how many grafts do I need for some decent results?


Dr. Glenn Charles
09-02-2009, 11:55 AM
I recommend you continue your current regimen for at least 6-12 months to see if works. I cannot comment on the doctor you mentioned because I do not know him and have not seen his work. If you get to the point were you want to have a surgical procedure (especially FUE) it is critical that you go to a clinic that has experience with this type of procedure and has a good track record. Most reputable clinics will reimburse for travel expenses. So traveling to another country might be necessary to get the job done right.

09-02-2009, 02:11 PM
Thanks for the quick response Dr. Glenn, I hope my current regimen will show some results. In this time I will try to gather as many information I can about the potential hair transplant clinics in case if I will need to do some hair restoration.

king regards,

John P. Cole, MD
09-02-2009, 09:22 PM
Based on your area of loss and your age, i recommend that you delay surgery as long as possible.

Many will try to coerce you into a strip procedure. anyone under age 30 should approach a strip hair transplant with extreme caution in my opinion. Once the strip is done, you cannot ameliorate the damage.

You have crown loss now, but you are quite young. Expect it to move forward to the middle and frontal scalp over time. Your situation is quite dangerous so i would put off surgery as long as possible. Recognize that the donor area is finite. Once it is exhausted, it is gone. You can't purchase more at Walmart. If you fill in the crown area now, you can expect this region to widen over time and more loss to occur in the front of the scalp. This can leave you looking ridiculous with hair in the middle of the crown, nothing in the front, and a perimeter of bald in the surrounding crown.

Always think of hair restoration as a train trip up an arduous mountain. Don't get on the train unless you have good exit plan. In your situation, there is no good exit plan because you have no idea what the future holds. Therefore, it is best to stay off the train for now and try medications. Unfortunately, medications will most likely not work. Therefore, your best solution will be to mentally overcome your hair loss in a few years and no longer be concerned about it. This happens to more individuals than anyone would wish to mention, but now enough.

Surgery should be the last resort for anyone considering treatment for their hair loss.

09-02-2009, 11:09 PM
Hi Doctor Cole:

Great advice in my opinion; straight to the reality of the matter. I am 36, and I remember losing hair in my 20s was devastating. 10 years later, I moved into surgery. And so far, so good.

I was curious about your comment: "Unfortunately, medications will most likely not work". Do you put Propecia (finasteride) into this category? I had thought that this drug was effective in slowing down/stopping/reversing hair loss in about 9 out of 10 men.


John P. Cole, MD
09-03-2009, 12:01 AM
I wish I had more good things to say about Propecia. My experience is that about one in one thousand have great response, which means they regrow hair. When it happens, it is amazing for both patient and physician. it is uncommon though.

Perhaps 10% get some slight improvement. Perhaps 10% get nothing. Perhaps 80% slow it down, but then it progresses over time. We don't know about this 80%. I'm certain that some think they benefit, but it is just mother nature. Others get a true medical retardation in hair loss, but it tends to be temporary.

The bottom line is that most on Propecia eventually loose hair. Hair loss tends to go in waves. You remain stable for years and then "poof" there it goes. What held it? Perhaps Propecia. Perhaps time.

I'd say that if you are considering surgery, try Propecia first. If your loss accelerates, then try something else including surgery.

My experience with hair loss is that it goes in waves. you tend to stay on a plateau for years and then you drop off the cliff. was it a failure of propecia or an acceleration of hair loss based on your natural progression.. Only God knows. \\\

This is all crummy news, but it is my disappointing experience as physician.

09-03-2009, 03:17 AM
Thanks for the advice Dr. Cole, I appreciate and agree with.

I really don't know much about these techniques, but FUE sounds really promising. So why would they insist for FUT instead of FUE? I would newer try the strip method, better shave my head.

Besides (unfortunately), I have some strong and healthy body hair on my back chest and upper arms which I have trimmed for ages. I have read that this can be used (via FUE) for those who prefer short hair styles.

Could someone tell me if there is any chance for the above mentioned technique and if yes, what is wrong with it?


09-04-2009, 03:18 AM
Can I get an answer to my last post please?


Jeffrey Epstein, MD
09-17-2009, 05:56 AM
Body hair is far from consistent between patients. I have had some patients on whom chest hairs have provided wonderful grafts, but these are not the majority of patients.
I personally am a bigger fan of Propecia than it sounds like Dr. Cole is- or at least I have had more impressive results- not in terms of hair regrowth, but in how it makes my younger patients feel, knowing that they are doing something proactively to help fight their hair loss.

And I definitely feel that FUE should be used on nearly all patients younger than 27 years old, and for many 27 to 30 year olds- but like all surgical techniques, there are exceptions that only experience can help guide the physician to deciding.

Jeffrey Epstein, MD, FACS
Miami and NYC