Dr. Mehmet Demircioglu - Diamond Hair Clinic on Reddit

Let me share my perspective as Dr. Mehmet Demircioglu, a hair transplant doctor based in Istanbul, Turkey.

First, you're taking oral Finasteride and Minoxidil, which is excellent. These medications have likely helped stabilize your hair loss, providing a strong foundation for hair transplant and improving chances of long-term results.

Regarding transplant, thinning is not limited to your crown, as I can see in that photo. Your mid-scalp area also appears to be thinning and would benefit from graft implantation. The photo doesn't provide a frontal view, so I can't assess whether hairline and front area also need graft or not.

I would strongly advise against no shave option. Although it's technically possible, in my opinion as a hair transplant doctor, it can limit the quality of the procedure and may increase risk such as infection on recipient area.

When a patient request no shave hair transplant, I decline it, not because I am unable to perform it, but because it's not the best approach for achieving best possible result.

Huge difference!

Undergoing hair transplant without medical treatment (Finasteride or Dutasteride combined with Minoxidil) can waste limited, valuable donor grafts, time, and money.

Without medication, you may not achieve the best possible result from a hair transplant and maintain it over the long term.

Even if the initial outcome is good, it may last only three to five years. After that, some transplanted grafts, perhaps 10–20%, may shed, while others may gradually thin. More importantly, your existing native hair may keep falling out.

For example, imagine you have hair loss in the frontal and crown areas but strong hair in the mid-scalp. A transplant may restore the front and crown, but if the mid-scalp hair is lost five years later, the overall appearance could become unnatural.

Similarly, some patients undergo surgery in the early stages of hair loss, when only the hairline has receded slightly. A clinic may densely fill that area, producing excellent initial result. However, without medication, patient may eventually lose the surrounding native hair, leaving transplanted hairline isolated in a large U shaped or horseshoe pattern.

A hair transplant is only surgical redistribution of hair, it does not stop biological processes responsible for ongoing hair loss. Undergoing surgery without also trying to slow or stabilize those processes is generally not the wisest approach.

This is a lot more than I hoped, because its questionable if I even have enough lifetime grafts to implant such an amount.

Based on a preliminary assessment of your donor area’s strength, I believe it could support approximately 7000 grafts over two sessions. Although you did not upload a clear photo of the back of your head, part of it is visible in the top view photo, and I assume the same good density extends throughout donor area.

Nearly 7000 grafts may sound like a lot, but if the procedures are performed in two sessions at least 12 months apart, with careful and evenly distributed extraction, your donor area should tolerate it well. If you shave your hair very short. particularly after the second session, some thinning may be visible. However, this may become unnoticeable after one or two weeks of hair growth.

The key issue is not simply the number of grafts extracted, but how the extractions are performed. Poor technique can visibly deplete and damage the donor area with as few as 3,000 grafts. In experienced hands, however, even after 7,000 grafts, the donor area may appear almost untouched when the hair is kept slightly longer.

A common problem in poorly performed procedures is when the surgeon or technician concentrates extraction in a small, rectangular section rather than distributing extraction points evenly across the entire donor area. If this happens, even 2000 grafts can result in overharvesting.

Additionally, if two sessions are planned from the outset, the person performing the extractions should carefully position the extraction points during the first session to preserve sufficient spacing and graft availability for the second.

In short, based on this preliminary assessment, I believe your donor area could support approximately 7000 grafts over two sessions.

Would you advise against spreading 4.5 grafts and really go for one section first (front and mid) and the other section after?

Yes, exactly. I advise against spreading 4500 grafts across the entire bald scalp, and I recommend a staged approach with two sessions.

Not even waiting to see if the result after the first one is satisfying enough?

I’m not sure how you inferred that. I've reread my comment several times, and I clearly wrote that the second session should take place at least 12 months after the first, which allows enough time to evaluate the progress and results of the initial session.

You are saying that its not smart to think the current hairs that are still present in front will be there in another decade. But isnt that also totally dependent on what regimen im on? Currently im considering upping my dosage from 0.5 dut to 2.5. My father who is 65 still has a hairline although hes a nw7 crown wise.

It depends on your medication regimen to a certain extent, but beyond that, there is an element of chance.

Based on what I have observed in my patients over the years, consistent treatment with dutasteride or finasteride and minoxidil can slow hair loss and miniaturization. However, for most patients, it does not stop the process completely.

For example, without medication, you might lose your remaining frontal and mid-scalp hair within five years, whereas treatment could potentially extend that timeframe to 10 years. These figures are only illustrative.

A higher dose may be more effective, but increasing the dosage of hair loss medication does not necessarily increase effectiveness proportionally. I recall a study comparing patients who took 1 mg of finasteride daily with those who took 5 mg daily. It found no clear advantage for the 5 mg dose in preventing hair loss.

I'd like to share my perspective as Dr. Demircioglu, a hair transplant surgeon based in Istanbul, Turkey.

If you applied to my clinic for an assessment, I would recommend two hair transplant sessions.

The first session would involve recreating the hairline and covering the frontal third and mid-scalp, using approximately 4000-4500 grafts.

At least 12 months later, I would perform a separate session just for the crown using around 2500-3000 grafts, since your crown area is quite large.

Also, during the second session, I would assess any areas from the first session that show weak or insufficient growth and selectively reinforce them with around 500 grafts. That would refine the result a lot.

Actually, there is no absolute rule against placing grafts in areas affected by diffuse hair loss because of the risk of damaging existing hair follicles. However, that risk is higher when the surgeon creating recipient site incisions doesn't use surgical magnification, such as 5x or 10x zooming loupes. I recently shared a comment for a similar issue regarding a patient who seeks additional density after an itinally low density result.

That said, I wouldn't assume that the thinning hair currently present in your front and mid-scalp areas will remain in long term. The safest approach is to plan as though those areas may eventually become completely bald. I emphasize this because I've seen cases in which surgeons relied on miniaturized native hair remaining stable and therefore placed too few grafts around it. When that native hair was eventually lost, it left patchy, weak looking areas.

You mentioned 5500 grafts, but I don't agree with that estimate. If 5500 grafts are used to cover the hairline, front, mid-scalp, and crown, the overall density would likely be insufficient.

On the other hand, if all 5500 grafts are used only for the hairline, front, and mid-scalp, excluding the crown, it would be slightly more than necessary for those areas.

I feel you've done your homework, so there's no need to emphasize the importance of combining medical treatment with a hair transplant to maintain long-term results.

We don't have enough context to offer proper guidance.

It would've been helpful if you had shared more details about the clinic's proposed surgery plan.

However, as a hair transplant surgeon, I can highlight three important points.

1- You will certainly need a well planned staged approach. Your case can't be treated properly in only one hair transplant session.

Avoid so-called "mega" or "giga" sessions. Even 5000-5500 grafts in one session would likely be insufficient for a satisfactory result through Front, Mid-Scalp, and Crown Area.

However, I understand patient's perspective, people often travel abroad for procedure and don't want to return for a second, or even necessary third session. As a result, they may choose clinics promising %100 coverage in one session. Reputable quality oriented hair transplant surgeons don't make such promises.

Be cautious high volume hair mill clinics claiming full coverage in a single hair transplant session. You should also view before and after photos they may share critically, as photos can now be edited easily using AI or basic Photoshop tools.

Patients who expect full coverage from one session, despite needing at least two, are often disappointed by the resulting low overall density in all grafted areas, and seek another corrective surgery. It's harder to fix a botched result than to plan well from the beginning, take a staged approach, and follow the plan.

2- The existing hair in your front, mid-scalp, and crown areas will most likely continue to thin and eventually fall out. Your surgical plan must account for this, as the weak native hair currently present can't be considered reliable in long term.

3- You will need to follow a strict post-operative medication regimen, typically including Finasteride or Dutasteride and Minoxidil. This is not important only for achieving best possible result but more importantly maintaining it over long term. Without medical treatment, your hair transplant result may be less successful and less sustainable.

Hope my words can help you.

Let me share my perspective as Dr. Mehmet Demircioglu, a hair transplant doctor.

Without photos from previous months, after crust removal, particularly immediately after surgery showing graft placement, and hairline design, it's difficult to assess overall quality of surgery done based on only two photos taken at 6th month. It's quite early to judge things.

First 3-4 months after a hair transplant are mostly a dormant phase, during which implanted hair grafts haven't yet begun growing, only a small portion of implanted hair grafts may grow during that timeframe.

When 3.5-4 months passed, nearly all the grafts start entering growth phase. Therefore, if you are on 6th month, your main growth stage began only 2-2.5 months ago, making it far too early to evaluate.

I can't determine whether recipient site incisions and graft placement angles were natural, as they should be in a professional hair transplant clinic.

However, even if the grafts were placed at natural angles, this may not be apparent during the early stages of growth.

Newly growing hair can sometimes look slightly unusual at first, but as the progress matures over 12-18 months, hair typically settles into its final direction, angle, and thickness.

Consequently, be patient, stick to your medication regimen, and let things flow. When you complete 12-18 months, we can judge it more accurately.

I sincerely hope your results turn out well.

However, the prices I've just shared are accurate and reflect what top hair transplant surgeons across the U.S. charge.

Your doctor in Massachusetts may be excellent one, and a real professional. I don't know who he is, but his pricing apparently differs from what top U.S. surgeons charge. That doesn't necessarily mean your doctor isn't good enough, it's a different subject.

My point was simple in my long comment, compare the prices of top 5 hair surgeons in the U.S with those of 5 top surgeons in countries like Mexico, Turkey, Poland, or India. You will see my comparison ($40 vs. $10k) was accurate.

As for price per graft, I personally don't prefer charging per graft in my surgeries. Instead, I use flat rate pricing regardless of the number of grafts, whether the procedure involves 2000 grafts or 4000 grafts, I dedicate my full day to one patient with my strict one patient per day policy, so patients are essentially paying for my day.

However, I still wouldn't call per graft pricing "bullshit".

Many respected surgeons worldwide, including those who invented the FUE hair transplant technique, have used the per graft price model for years while consistently producing excellent results.

But you may be right that some low profile clinics may abuse per graft pricing, but that doesn't make that pricing structure itself inherently wrong or bullshit.

As a hair transplant surgeon, I'd like to offer my perspective.

What matters most isn't the country where you have a hair transplant, whether it's the U.S., U.K., Poland, Mexico, or Turkey. Every country has good and bad places.

I want to emphasize that you shouldn't choose a clinic based on its name or reputation alone. The clinic itself is just a brand, clinic will not perform your hair transplant, the surgeon will. So, you should choose a surgeon, not a clinic.

What if something goes wrong in another country?

Even in highly regulated countries like the U.S., poor outcomes and post-op complication risks are still possible. And if you choose the wrong place, even in your own country, it wouldn't matter much because you're in the same city or country, you'd not likely get sufficient post-op care.

Pursuing legal action can also be more difficult than many people expect, even in the U.K. and the U.S. The surgery consent form you sign before surgery may offer some protection to the clinic or doctor.

So, what is the solution?

I think patients should do their homework carefully and avoid choosing a clinic impulsively, simply because its website or social media profiles look impressive. Many highly skilled, reputable hair transplant surgeons keep modest websites and social media profiles because they focus primarily on delivering the best possible surgery and results. In contrast, many low profile budget clinics focus heavily on generating social media content, creating flashy websites, influencer marketing, and Youtube vlogs, or hidden promotion with fake patient accounts on forums.

Just a few days ago, I've operated on a hair transplant patient from the U.S, who told me that he had undergone an unsuccessful hair transplant in Dubai four years ago with a well known hair transplant doctor. He had chosen that surgeon largely because of his reputation for treating celebrities.

Unfortunately, that kind of marketing is a red flag, no reputable surgeon uses celebrity marketing, even if they operate on a celebrity, they don't utilize it for marketing purposes.

Elon Musk had a hair transplant done with a surgeon, but have you ever heard that the surgeon who operated on him used that for marketing? No, you can't.

If a hair transplant surgeon performs a procedure on more than one patient in a day, you can't expect full attention. Even treating just two patients in a single day should be a red flag. For the best possible outcome, the surgeon should focus entirely on you and be directly involved in surgery rather than merely supervising it. In particular, only the surgeon should create the incisions in the recipient area of scalp. Any assistant involved should be experienced, properly trained, and part of the surgeon's team for many years, not a staff assigned randomly.

A surgeon and team who meet all these standards are unlikely to offer low cost hair transplant regardless of which country it is. If a hair transplant procedure costs only 3,000 Euros, it maybe unrealistic to expect this level of quality. At current prices, a rate below 2 Euros per graft in most countries, including Turkey, Poland, India, or Mexico, likely indicates that the clinic and surgeon don't meet these standards.

If your budget is insufficient, it's better to postpone your plan until you can afford a reputable surgeon rather than rush into a cheap hair transplant at a technician led clinic regardless of its country. A poorly performed hair transplant can be extremely expensive to correct later and may also cause significant emotional distress.

So, what is the point of flying to another country for a hair transplant?

It shouldn't be about choosing the cheapest option and taking a significant risk. It should be about paying what you would for a mediocre surgeon in your own country, while gaining access to one of the top hair transplant surgeons in the country you visit.

If I give you a more concrete example, paying $10,000 will not enable you to access the best hair transplant surgeon in the U.S. It would likely cost you $40,000-$50,000 in the U.S., but in Turkey, Poland, Mexico, or India, by paying $10,000 you can access one of the best surgeons.

But if you go to Turkey or Poland to pay $3,000 for a no doctor clinic that operates 20 patients on the same day, it's a different story and a significant risk, you shouldn't take that risk.