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Old 09-04-2012, 12:39 AM
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Default Hair Transplant Journey with Dr. Ramachandran

After my first hairtransplant in 2000 with Bosley, I was ready for the 2nd transplant and this time around I wanted to do my homework. I interviewed Dr. Cooley in Charlotte (as this was my closest HT clinic recommeded by this site) and found that his procedure and techniques was very impressive. But cost was also a factor (with new child, job loss, job change, state change etc) and I was givien a quote of approximately $9K at Dr. Cooley office. This was around 2008. Then In 2011, I was visiting India for some work and decided to look at quality surgeons as cost will be 1/4 th of that of US.

Now, one has to do extensive research in India as there are many self proclaimed "experts" who will doctor any docuement (heck even their medical licenses could be fake) they can. Without an internal network and time, it would he hard to uncover such crooks in India. To narrow my list, I decided to start with the recommendations from this forum, Dr. Radha and Dr. Madhu. The issue about Dr Madhu that I heard through my sources in hyderabad is that he runs his shop like a Ford Assembly plant. He does 2-3 procedurs in a day and none of it, he personally do the work. Its all his assistants who do the cutting, insertion etc. He only gives them instructions on what to do. To me that is not acceptable. I'm paying for doctors expterise, skill and time, and not for assistants do the work. So he was ruled out. And my sources here in India ( I worked in Hyderabad in year 1996-1998 and have good friends base there), also told me that some of the profile pictures he has were not his original work. So I ruled out Dr. Madhu

However, I heard good reviews about Dr. Radha and also her personal attention to each patient. So she was my first choice, however, I was in Bangalore and could only afford two days for this trip and procedure. During my school reunion, I met a friend of mine who is an opthamologist in Bangalore, so I inquired him about qualified surgeons in India and his recommendations. Surprisingly, he himself had done HT and he recommeded Dr. K. Ramachandran in Chennai, India. So I decided to visit Dr. Ramachandran and made an appointment on Aug 23rd. During my first consultation, he evaluated my donor area and said, I could expect a realistic of 1300-1500 grafts. As I had already done a FUT in year 2000 through bosley, he said that donor area, above and below would be good candidates for FUE technique as a strip above that area would yield less. This was the first time that I had heard a doctor recommending FUE, as all other doctors, Madhu and Radha, were FUT proponents. So I clarified this with the doctor on why would everyone recommend FUT saying it yeilds better results. Dr. Ramachandran's candid response shocked me. Doctors use FUT for the following reasons.

1) FUT is less work compared to FUE
2) Doctor has to be there all time when performing FUE (for extraction and insertion)
3) More grafts in FUT so more money charged (This is a myth that FUT gives more grafts, I got to know that after my procedure. EVen though my FUE yeilded less grafts, I got more 3's and 4's in FUE than FUT. So if i multiply my 3's and 4's per graft, i got more on FUE and much less visible scar. In essence you can target 3's and 4's donors on FUE. In FUT you are stuck with what you get on the strip. So a less quality donor strip can yield more singles. I like more home runs on my extraction than singles...sheesh who wouldn't)

So more work, less money and cannot employ your assitants to do the work deters most of the doctors from FUE and they promote FUT. As an informed patient now, I would recommend FUE over FUT if you are given a choice.

I wanted more info, references, from Dr. Ramachandran and I scheduled another appointment with him on Sep 1st. Spent an hour with him on what to expect and he was very patient in answering all my concerns. I also spoke to people who were visiting his office and got confidence in his ability. So I set the date for my procedure on Sep 3rd 2012.

I arrived his surgey clinic at 11:30 am and was taken care by his friendly staff. I was given light snack and they prepped me for the procedure. Doctor arrived at 1:30 pm and made all the arrangements for the procedure. We had a video session as well (I will post that soon) of the initial discussion on what he was going to do and the approach. He recommeded a combination of FUE and FUT to get the optimum results.FUE was to be performed above and below my prior HT scar area and a fresh strip will be take from the left side of the head.

Surgery started at 2:30 pm and the only small pain was the local anasthetic needles pricing throug my head. After few minutes I did not feel a thing. He explained to me in each step on what he was doing and making sure that I was feeling comfortable. After the FUE and FUT donor areas were selcted, his staff, dissected the follicles to be transplanted. Everything went smooth as the doctor and his staff was very friendly. At 8:30 pm the process was complete. During the 6 hours, Dr. Ramachandran did not leave the side of the table even for a break. WOW, THAT IS CALLED DECICATION. Even when I got done in Bosley, the doctor walked away while the insertion was happening.

The original goal was to get 1300-1500 grafts and we actually got 1894 multiple grafts (see the single graft breakdown below). During Post-op, the doctor said based on these results in 8-10 months, we can decided if we need one more procedure (mainly through FUE) to cover any areas or spots. Breakdown of individual grafts

FUT - 1604
FUE - 1540
---------
Total - 3144

I was very happy with this whole process and my research of 2 years and paitence finally, I feel like, was paid off. Now, its too early to blow the horn as the jourey of 10 months has just begun. But I feel very confident that I will see the results from the procedure.

Link to my pre-op and post-op pictures

https://plus.google.com/photos/10263...73254648495601

Will upload periodically on the progress and also the video of the actual procedure.

Thanks
AKK, Atlanta, GA

Last edited by akk; 09-04-2012 at 03:49 AM. Reason: updating grafts
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Old 09-04-2012, 08:03 AM
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Quote:
Originally Posted by akk View Post
After my first hairtransplant in 2000 with Bosley, I was ready for the 2nd transplant and this time around I wanted to do my homework. I interviewed Dr. Cooley in Charlotte (as this was my closest HT clinic recommeded by this site) and found that his procedure and techniques was very impressive. But cost was also a factor (with new child, job loss, job change, state change etc) and I was givien a quote of approximately $9K at Dr. Cooley office. This was around 2008. Then In 2011, I was visiting India for some work and decided to look at quality surgeons as cost will be 1/4 th of that of US.

Now, one has to do extensive research in India as there are many self proclaimed "experts" who will doctor any docuement (heck even their medical licenses could be fake) they can. Without an internal network and time, it would he hard to uncover such crooks in India. To narrow my list, I decided to start with the recommendations from this forum, Dr. Radha and Dr. Madhu. The issue about Dr Madhu that I heard through my sources in hyderabad is that he runs his shop like a Ford Assembly plant. He does 2-3 procedurs in a day and none of it, he personally do the work. Its all his assistants who do the cutting, insertion etc. He only gives them instructions on what to do. To me that is not acceptable. I'm paying for doctors expterise, skill and time, and not for assistants do the work. So he was ruled out. And my sources here in India ( I worked in Hyderabad in year 1996-1998 and have good friends base there), also told me that some of the profile pictures he has were not his original work. So I ruled out Dr. Madhu

However, I heard good reviews about Dr. Radha and also her personal attention to each patient. So she was my first choice, however, I was in Bangalore and could only afford two days for this trip and procedure. During my school reunion, I met a friend of mine who is an opthamologist in Bangalore, so I inquired him about qualified surgeons in India and his recommendations. Surprisingly, he himself had done HT and he recommeded Dr. K. Ramachandran in Chennai, India. So I decided to visit Dr. Ramachandran and made an appointment on Aug 23rd. During my first consultation, he evaluated my donor area and said, I could expect a realistic of 1300-1500 grafts. As I had already done a FUT in year 2000 through bosley, he said that donor area, above and below would be good candidates for FUE technique as a strip above that area would yield less. This was the first time that I had heard a doctor recommending FUE, as all other doctors, Madhu and Radha, were FUT proponents. So I clarified this with the doctor on why would everyone recommend FUT saying it yeilds better results. Dr. Ramachandran's candid response shocked me. Doctors use FUT for the following reasons.

1) FUT is less work compared to FUE
2) Doctor has to be there all time when performing FUE (for extraction and insertion)
3) More grafts in FUT so more money charged (This is a myth that FUT gives more grafts, I got to know that after my procedure. EVen though my FUE yeilded less grafts, I got more 3's and 4's in FUE than FUT. So if i multiply my 3's and 4's per graft, i got more on FUE and much less visible scar. In essence you can target 3's and 4's donors on FUE. In FUT you are stuck with what you get on the strip. So a less quality donor strip can yield more singles. I like more home runs on my extraction than singles...sheesh who wouldn't)

So more work, less money and cannot employ your assitants to do the work deters most of the doctors from FUE and they promote FUT. As an informed patient now, I would recommend FUE over FUT if you are given a choice.

I wanted more info, references, from Dr. Ramachandran and I scheduled another appointment with him on Sep 1st. Spent an hour with him on what to expect and he was very patient in answering all my concerns. I also spoke to people who were visiting his office and got confidence in his ability. So I set the date for my procedure on Sep 3rd 2012.

I arrived his surgey clinic at 11:30 am and was taken care by his friendly staff. I was given light snack and they prepped me for the procedure. Doctor arrived at 1:30 pm and made all the arrangements for the procedure. We had a video session as well (I will post that soon) of the initial discussion on what he was going to do and the approach. He recommeded a combination of FUE and FUT to get the optimum results.FUE was to be performed above and below my prior HT scar area and a fresh strip will be take from the left side of the head.

Surgery started at 2:30 pm and the only small pain was the local anasthetic needles pricing throug my head. After few minutes I did not feel a thing. He explained to me in each step on what he was doing and making sure that I was feeling comfortable. After the FUE and FUT donor areas were selcted, his staff, dissected the follicles to be transplanted. Everything went smooth as the doctor and his staff was very friendly. At 8:30 pm the process was complete. During the 6 hours, Dr. Ramachandran did not leave the side of the table even for a break. WOW, THAT IS CALLED DECICATION. Even when I got done in Bosley, the doctor walked away while the insertion was happening.

The original goal was to get 1300-1500 grafts and we actually got 1894 multiple grafts (see the single graft breakdown below). During Post-op, the doctor said based on these results in 8-10 months, we can decided if we need one more procedure (mainly through FUE) to cover any areas or spots. Breakdown of individual grafts

FUT - 1604
FUE - 1540
---------
Total - 3144

I was very happy with this whole process and my research of 2 years and paitence finally, I feel like, was paid off. Now, its too early to blow the horn as the jourey of 10 months has just begun. But I feel very confident that I will see the results from the procedure.

Link to my pre-op and post-op pictures

https://plus.google.com/photos/10263...73254648495601

Will upload periodically on the progress and also the video of the actual procedure.

Thanks
AKK, Atlanta, GA
What is the total cost you do the hair transplant with Dr. Ramachandran?
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Old 09-04-2012, 08:27 AM
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Dr. Ramachandran charged me Rs.60 for FUT and Rs.80 for FUE (per graft). He puts in self absorbing sutures at no added cost with nylon enclosing inside to reduce the scar area. ( I think Dr. Madhu charges Rs.10K for self absorbing sutures)

Also, my main requirement was not to shave off my hair in the front as I had to go to work within few days and wanted minimal reaction from my co-workers. So he did not shave of my hair. I think Dr. Madhu charges extra Rs. 20K to not shave your hair and Dr. Radha does not have that option. Dr. Radha's clinic said that they will shave off my front head ( I could think of myself looking like "Bozo the clown" with no hair in front and hair in side and back).

So all in all the cost worked out great and along with cost the quality I think was well worth the money. I might go back to Dr. Ramachandran based on how this progresses to cover any spots using FUE in the future.
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Old 09-04-2012, 08:35 AM
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Quote:
Originally Posted by akk View Post
Dr. Ramachandran charged me Rs.60 for FUT and Rs.80 for FUE (per graft). He puts in self absorbing sutures at no added cost with nylon enclosing inside to reduce the scar area. ( I think Dr. Madhu charges Rs.10K for self absorbing sutures)

Also, my main requirement was not to shave off my hair in the front as I had to go to work within few days and wanted minimal reaction from my co-workers. So he did not shave of my hair. I think Dr. Madhu charges extra Rs. 20K to not shave your hair and Dr. Radha does not have that option. Dr. Radha's clinic said that they will shave off my front head ( I could think of myself looking like "Bozo the clown" with no hair in front and hair in side and back).

So all in all the cost worked out great and along with cost the quality I think was well worth the money. I might go back to Dr. Ramachandran based on how this progresses to cover any spots using FUE in the future.
So you mean that he put the self absorbing sutures on your donor area and you not need to go to your clinic to take out right.
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Old 09-04-2012, 09:58 AM
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That is correct. My surgery was on the 3rd September and I told him that I will be flying out to US on the 6th. He told me that I do not have to go to any clinic to remove my sutures as they will fall off within 2 weeks.

Even before I asked about the sutures, he told me that he will be using self absorbing sutures. That kind of worked out for me as I dont want to go to a clinic in Atlanta to get those sutures removed.
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Old 09-04-2012, 02:41 PM
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Hi Akk

Thanks for sharing your HT experience with Dr. Ramachandran, looking forwarding is see your video. Also you mentioned " So he did not shave of my hair. I think Dr. Madhu charges extra Rs. 20K to not shave your hair and Dr. Radha does not have that option. Dr. Radha's clinic said that they will shave off my front head ( I could think of myself looking like "Bozo the clown" with no hair in front and hair in side and back)."...I spoke to dr Radha and she told me that, it was up to me to shave or not shave the donor area (where the grafts will be inserted in the front), but the whole HT procedure will take longer but the end result after 12/18 months will be the same as if had shaved my hair.
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Old 09-04-2012, 11:34 PM
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I have seen patients with shaven off donor areas and then with shaven of recepient areas. I see this more prevalent in Indian surgeons opting to shave off the areas.

When I did my first procedure with Bosley in Philadelphia, they did not shave off any hair (back or front) and transplanted within my exisitng hair. And I did have lot more hair back then than I have now. Because of that type of procedure, I was able to go to work the very next day and no one even noticed that I had HT.

I guess it takes lot longer for the surgeon to work through when you have hair vs when its completely shaven. I told Dr. Ramachandran that I'm ok with if he needs to buzz cut the front area (recepient area), but absolutley not to shave off my back donor area, as I do not want to see the scar showing out.

So he was careful to keep the hair layers in such a way that after surgery, he was able to comb down to cover my donor area. And also I have seen Dr. Madhu putting a bandage around the head like we had a heavy head trauma. Its not required at all. When I got my first HT in Bosley, I flew in to get my HT in the morning and few out in the evening to my home and I did not have any bandage around my head.

Even Dr. Ramachandran, did not put any bandage around my head, he applied some medicine and said my sutures will falls off in 2 weeks and there is nothing I would need to do.
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Old 09-05-2012, 12:16 AM
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AKK,

While I thank you for sharing your legitimate hair transplant experience, I wanted to clarify/ask a few questions about your post:

1. Where did you hear Dr. Madhu runs his clinic like a "Ford assembly plant?" Did you actually consult with his clinic?

From what I've seen, Dr. Madhu produces excellent results, and if he does do several procedures a day (my guess would be 2 max), it does not appear to affect quality.

There seem to be a few "jabs" at his clinic in the post, and I'm not 100% sure they are warranted. I was wondering if you could clarify this issue a bit, because he's always been very well received at our community.

2. FUE and FUT are both legitimate hair transplant techniques, but one isn't chosen above another because it's "easy" or allows physicians to cram multiple procedures in one day. Truly ethical hair transplant surgeons utilize FUT because in many cases, it's the best procedure for the patient. FUE is a great technique and possesses several advantages above FUT, but its success doesn't necessarily mean there isn't a place for FUT or that physicians still utilizing FUT do so for any reason besides its proven track record.

Additionally, I was wondering if you could post your images in this thread or make a photo album via our community instead of on google? I'll leave the link up until you have a chance to do this, but in general, we don't host outside links. Let me know if you need any help doing this. Once it's done, I'll go ahead and remove the original outside link.

Again, congratulations!
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Old 09-05-2012, 05:26 AM
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Hi Blake,

This site had given me tremendous knowledge to prepare for my 2nd HT. I was able to use that to interview/observe and have positive expectancy for my HT.

During my interview process, I had called all clinics through email communication, over the phone and also occasionally had chance to talk to few of the patients. I had talked to Dr.Madhu's staff and I got the information through them that he does 2-3 procedures a day and also a past patient confirmed this to me as well.

Based on my past HT experience, i know the process to be a 4-5 hour process. So I was curious on how Dr. Madhu did 2-3 a day. I have nothing against Dr. Madhu and I want only the best for his patients. But I was little uncomfortable when I get a feeling that I wont be given full attention during the process thats life altering.

Regarding FUE and FUT, my first HT was a FUT. However this time I had a combo of FUT and FUE. After watching my video and also discussing with the doctor, I was able to make a conclusion that FUE yielded better quality grafts. I was able to see that doctor had a discretion to get the good grafts and I had the most 3's and 4's on FUE. I did not even get one 4 on FUT. What the doctor explained to me made sense that on FUT, its whatever comes in the strip.

Whereas on FUE he was able to target the best grafts and the location of those grafts. If you watch the video, you can see it very clearly. And also the surgeon had to spend great amount of time to get the good grafts through FUE as it was more of searching for it as opposed to a direct strip.

I tried to upload the pictures directly and could not do it and so I put them through link. Could you walk me through how to post my video and picture directly? Is there a video clip size limitation. I have a 40 minute video of the whole process.

Thanks
Akk
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Old 09-05-2012, 05:38 AM
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"What the doctor explained to me made sense that on FUT, its whatever comes in the strip. Whereas on FUE he was able to target the best grafts and the location of those grafts"

This is very true indeed, a good point. Also, the quality of the grafts is entirely dependent on the experience of the people doing the dissection (often the assistants), as opposed to the surgeon removing each graft in FUE and the assistants simply arranging them into 1's, 2's and 3's in the trays ready for incision.

Never heard of anyone having FUT and FUE in the same session though, it's a new one to me.

I hope the scalp hasn't suffered too much trauma from this and you grow well.

Rob
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