Posted in a different thread but now starting my own on advice of M&M.

I am currently in process of online consultation with various renowned surgeons for HT, some of them have sent how many grafts i will need after looking at my pictures:
Dr. Rahal's office: 3750 grafts
Dr. R.Bernstein : 2400 grafts
Dr. Hassan&Wong : 3500 grafts
Dr. Pathomvanich : 2500+ grafts

I had a meeting with Dr. Bishan Mahadevia yesterday where Arnolder had his transplant done, I found him reasonable, not selling anything, no pressure, he just told me that whenever I intend to take HT with him just inform 15 days before.

But the main thing which worries me is:

His estimation of graft requirement: 1850+
He calculated it using a scale(a small aluminium sheet with marking in cms) on my head

Also, he said you dont need grafts at the top because hairfall should be stable and it looks like either more hair will fall from the crown or you will get it considerably dense by medicines itself.

Kindly comment although M&M has already said a detailed discussion is required but here the difference is 50% and I have already discussed in detail with Dr. Bishan.

And yes one important thing, he said in 1 sq.cm. area, you should have not more than 30-35 grafts or at the max 40 because your average scalp at back has not more than 80/ sqcm(specific to me) of grafts, 50% of which is maximum you should transplant.

Please comment based upon your experience.

Please see more pictures in the subsequent posts, these are the same set of pictures I sent to different doctors and Dr. Mahadevia I have consulted in person.

You will appreciate that the cost will also fluctuate humungously with these kind of estimates and geographies.
Luckily I have got Arnolder and Dreamer to post about both the doctors I am contemplating to undergo HT with, will follow closely with you my friends. All the very best with your recovery.

AND here I add, Dr. A advised I need 4000-5000 grafts

Regards,
tuja

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Tuja,

Good work creating a detailed summary of your research so far, along with posting some photos of your situation. Although they are a little dark, it does show the area of work needed. For the benefit of others, I'll repeat myself a bit here as to the range of grafts quoted by the Doctors.

Graft counts can vary widely depending upon some of the following information:

- Same photos shown to each doctor (I trust this was the case)

- Same description sent to each doctor about your thinning / balding, family history, age, etc.

- Description in detail provided to each doctor on your desired goals (ie. hairline only, hairline and crown together, hairline density with 'dusting' in the crown, etc.)

- Agreement by the Doctor on your goals (ie. if you are 21, ethical doctors may be less aggressive than you desire)

- Did either doctor show you with markings on your photos as to where they would restore your hairline, temple points, etc.? Some may bring it lower than others, some may keep it higher but more densely packed. Lots of choices here!

- Density -

- Doctor's ability - this is a huge one! Some of the top doctors can do session sizes of 5,000+ in one sitting. I'm pleased when I see the top two doctors (in my opinion) that you have received estimates from come very close (Dr. Rahal at 3750 and Dr. Hasson/Wong at 3500). These two (okay, three really) are so good at what they do and can do very large sessions, so if they thought you needed more, they would quote more. If they thought you needed less, they'd quote less, but they do prefer to minimize the number of passes. Based upon your photos, though, you may need one large procedure or two smaller procedures.

Now, on the other hand, some Doctors perhaps can only do 2500 in a single session and therefore, they are saying that is all you need... but then you'll require another procedure. To put it into perspective, I had 1662 grafts in my hairline - about the first inch only. There is no way that 1850 - 2500 is going to give you the density you require to cover all of that area. Did these doctors say that this was ALL you'd need... or that this was 'HT one' only.

Now, onto the next topic from Dr. Mahadevia, who I have honestly never heard of. Taking a conservative approach with the crown if you are new on the meds certainly makes sense. Is this something you've discussed with the others? Have you responded well to Propecia / Rogaine? Overall, this is good advice. But, when he says that 30-35 grafts per cm2 is the most you should ever get, I do disagree. Have you seen what that looks like? Typically, what Dr. H&W and Dr. Rahal will do is plant the hairline at a thicker density (say 50-60) and then taper back the density ensuring you have nice framing for the face, while not wasting any precious grafts (like some who receive 70-90 cm2 in the hairline).

I hope others chime in here as well, as I am certainly no expert!

M&M

__________________
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1662 with Dr. Ron Shapiro - Spring 2006
1105 with Dr. Ron Shapiro - Fall 2009
M&M Weblog

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I've never been wowed by Berstein, due to his conservative approach. I think the most should be done at once. Your basically giving up a percentage of your life (down time) in addition to the cost of HT. One pass max vs. 2 passes? No thanks. I'd agree w/ the 3500-3750. Honestly I'd go w/ HW or Rahal, as these Madevia/Dr. A, I've never seen their work. Also, that 30-35 cm2 would give a thin look, unless you have great hair characteristics (wavy, course, dense donor)

__________________
My Hair Loss Website - Dr. Hasson

Tuja:
You have hair already and you are not completely bald. Consequently there are different game plans.

1. Fill in the density between existing hairs to augment what you already have. In this scenario, graft counts can range in the lower numbers and above as you experienced without trying to push the limit. In this scenario, many surgeons would not necessitate shaving your head completely and 2400 grafts can be accomplished without shaving

2. Maximize the graft density count per square cm. In this scenario, it is alot easier to dense pack with a totally shaven scalp.

The differences may lie in what the objectives are for each physician, the desire to maximize the graft count per cm squared and the area in which they intended to place the grafts and the hairline locations as noted above. Can you comment if any of the physicians said you did not have your head shaven?

__________________
Ricardo Mejia MD, FAAD
Jupiter FL
Hair Transplant Network recommended physician; photos

Nobody asked me to have shaved head for surgery....
Thanks for feedback Leeson and Dr. Mejia.

I need to ask the doctors a little more questions to move further. Doctors in the west are anyways almost 4 times more expensive and are not affordable. Would either go with Dr. Pathomvanich or with Dr. Mahadevia as I am seeing some results from his patients as well on this website.