NotUrAvg

Hey djames, congratulations! If I remember correctly, it was a long road for you getting to Dr. Path. I remember you had to cancel your surgery due to the Red Shirt demonstrations. Anyways, I'm happy to hear everything went well. I have my HT with Dr. Path 10 weeks ago and though it's still very early, I couldn't be happier. Looking forward to hearing your experiences!

In my non-expert opinion, I think you have to differentiate the role of medical therapy versus surgical therapy. They have two different functions. Surgical therapy can only serve to replace lost hair in areas of concern. And even then, there are limitations, as you cannot replicate your natural hair density with surgery. Medical therapy, to a certain degree can cause some regrowth, but in my opinion, it's greatest stregnth is prevention of hair loss... especially for younger people with active hair loss. There is no question it is better to maintain what you have, then to try to replace what you lost. The $2880 you quoted for 20 years of rogaine use is much less than what a typical HT surgery costs. If it can prevent you from slipping from a NW3 to 4, or 5 to 6, it has more than paid for itself. In regards to being "stuck on rogaine" I don't think it will cause you to lose more hair than you are destined to. The worst case scenario for non-compliant rogaine use is that you would end looking the way you did if you never used rogaine. That being said, medical therapy is not indicated for everybody, and you would probably best be served by being examined by an experienced doctor so they can decide it's appropriateness for you. It's is definitely an additional cost to consider, and there are no guarantees, so only you can make decision if the price is worth the potential benefit.

Jacksonbrowne, you have made a very thorough and passionate critique of my comment. You make some good points. I will be happy to address any concerns you have about my dangerous naievity. You are absolutely right, I am not an HT surgeon, so I am not qualified to say that the society is the most respected in the community. I was speaking out of place. The reason I mentioned the ISHRS was because I wasn't sure if HTQuestions resided in the US or not and this is the most credible international organization I know of. I am basing that statement on the fact that 100% of the Coalition of Indpendent Hair Restoration Physicians are all active members and are going to conferences. Here is a example of some of the top docs and how often they participate:Wong - 14 conferences Hasson - 8 conferences Rahal - 8 conferences Pathomvanich - 14 conferences B Farjo - 17 conferences N Farjo - 16 conferences S. Lam - 5 conferences since 2004 Epstein - 14 conferences Dorin - 4 conferences since 2003 True - 14 conferences R Shapiro - 15 conferences P Shapiro - 5 conferences since 2005 Cooley - 13 conferences G Charles - 12 conferences Rose - 14 conferences. Though this doesn't equate with credibility, it shows that many doctors consider these conferences of some worth. Make of these stats what you will, but personally for me, I see a lot of 'elite' names who frequent these conferences and lecture at them, and that adds some credibility for me, but you obviously don't feel that way, and you are more than entitled to your opinion. Someone's decision should definitely NOT be based solely on this. My original point is this is just another source of facts not clouded by physician-to-patient marketing strategies to throw into the decision making process. It helps reveal who is involved on a more academic level. By the way, that AMA has no business dictating the activities of an international organization. The AMA has it's purpose, but they aren't qualified to speak about an international society in a very subspecialized field of medicine, and I would be more than happy to engage in a private discussion about the politics of the AMA with you. I was an active member for 4 years, and have attended numerous AMA conferences. What are you referencing btw when you say the AMA has issues with the ISHRS? And what experience do you have that gives you the impression that the AMA has credibility and authority in giving their opinion on such matters? You also said that I 'sounded like I'm new'. I'm not sure what that means and why that should place my opinion into question. I am definitely no expert. As far as I can tell, we both have the same number of posts, and both joined the forum at roughly the same time. I have been suffering from advanced MPB for 10 years, researching it for a little less than 10 years, and saved up for an HT for 4 years. And as far as I can tell, I've had more transplants than you have, so what exactly am I new at? Though there are companies advertising directly to physicians and staff, this is not material that will bias an individual who is on the website looking at who the keynote speakers are and what topics they are covering. You probably don't realize there is actually a very rigid peer review process involved in deciding who is speaking and what topics are discussed. I have attended and presented at many medical conferences in the US and internationally. Though I am not a member of the ISHRS, I do not think my opinion in this matter is naive. I wholeheartedly agree. Anyone can probably become a member of the ISHRS. But not just anyone can lecture, run symposiums or present medical posters and papers. These professional organizations do their best to establish some set of standards, which doesn't exist in this unboarded speciality. Though they not perfect and are not free from politics, they provide more reliable information than watching a physician's ad on TV. I do not know why you are bringing this up. I have never mentioned the ABHRS. The ABHRS is not the same thing as the ISHRS. These are two separate entities. According to the ISHRS website, Dr. Feller is an active member of the ISHRS and has attended a couple of conferences. You are absolutey right that I was ambiguous when I used the phrase 'cutting edge'. What I meant was that at these conferencs you weren't going to have antiquated surgeons advocating placing macrografts into the hairline. Those people practicing HT below community standards will be weeded out as presenters. You will have physicians who practice HT surgery with modern high standards. If you feel that the field of HT surgery is perfect and needs no advancement, that's fine. But there are going to be innovations on how to improve technique and that information is going to be shared through peer reviewed journals and at scientific conferences in the form of papers, posters, and lectures. That's an entirely separate topic. If you want to discuss how doctors are influenced by company advertisements then I invite you to begin a different post. It's a great topic and we probably share some of the same opinions. Also if you want to talk about the validity of HT conferences, and their purpose, I'd also be glad to discuss that too with you in private or another post. But this post is about trying your best to gather some information about HT doctors without their marketing getting in the way. Looking at physician participation in conferences/jourals/research provides some insight into their academic investment in the field, and how they interact and are perceived in their community by their peers. It sounds like your mother's boss's decision to get an HT had a strong impact on you, and i'm sorry for his bad experience, but I think we both have the same goal to try to help others in an open and respectful manner. This is a forum of adults, and I hope many of the users understand that our opinions are just opinions and we are not experts.

HTQ, while you may be right that money is one of the largest motivating factors for doctors to go into the field of HT, I do not think it automatically brings their credibility into question, or serves as the sole motivating factor. In physician surveys, patient satisfaction ranks extremely high in influencing physicians into choosing specialties. I could imagine how rewarding it must feel to have a patient who returns after a year looking 10 years younger, and beaming with a new found self-confidence. I'm sure most if not all of the surgeons recommended here take great pride in doing good work. It's not so simple to generalize that serious, self respecting doctors with a sense of gravitas and responsibility would avoid the field of HT surgery. What helped me evaluate the ethos of my HT surgeon was to see where his time was invested. He did not seem to be a flashy self-marketer, but instead has numerous publications, writes books, is actively involved in research, organizes and speaks at conferences, and teaches fellows in his practice. For me, this displayed an enthusiasm for the science of HT, and made it clear that he had a strong intellectual investment in what he was doing. I felt I was getting my surgery done by an academician and surgeon and not a salesman. One thing you can do is go to the ISHRS website (a very respected HT surgery society), and look at the their 2010 conference roster, and see who is speaking and about what topics. The HT world is very small, and it seems like most people know each other. The way I see it, if other respected HT doctors are going to let another surgeon lecture them, that surgeon must have some credibility. It also shows who is at the cutting edge of their field. The conference is targeted towards other surgeons and not at patients, so it gives insight into the world of HT surgery without the distracting marketing and advertisements. I agree with you, it's so difficult to sort through who are good doctors, and who are just good businessmen, but this website (HTN) and looking at patient results/testimonials is a good start. I think your cynicism will be a strong asset in choosing a good doctor.

It doesn't hurt to ask your primary care physician, but don't be surprised if you get a blank stare in return, or their personal opinion (Which may not be based on anything tangible). I'm sure there will be a lot of variability in outside physician knowledge of HT. There is minimal overlap between hair transplant and general medicine, and there is probably zero exposure to HT medicine in medical school. But it would be excellent to consult with your primary care physician regarding medical therapy as they will be more comfortable speaking towards the systemic side effects. Remember that internists and family practice docs (and Danielkiwi's pediatrician), are used to treating sick people. It is not typical for them to put healthy people at a potential risk for a cosmetic benefit. So some physicians may not understand why a healthy person would take on a potentially harmful intervention for their appearance. It is hard to escape bias, even if it's meant to be harmless.

HTQ, I could not agree with you more. It cannot emphasized enough how important it is for physicians to communicate in a crystal clear manner. Whether it is about their training, how they do their surgery, what the patient's expectations should be, or what complications were encountered, communication has to be done in an honest and unambiguous manner, and anything less is a disservice to the patient.

Hey J85. I'm right there with you brother. We must have gotten our surgeries done at the same time because I just hit my one month mark on 8/5. Not the most fun place to be right now, huh? it's been hard for me, because I was using concealer everyday for the last 5 years, but after my surgery, I chose to stop wearing Toppik, so for the first time I'm walking around looking balder than ever. I started a new job in a new city this week, so my appearance is all I can think about when I meet people. But you should feel comforted that you went to one of the best surgeons in the world. Out of all the factors that will affect an HT, I think the surgeon is probably one of the most important, if not the most important. So you have all the cards stacked in your favor. Just remember, EVERYONE at the 1 month mark goes through what we are going through right now. Trust me, we both have a lot to look forward to in the upcoming months! I'll be excited to hear from you in a couple of months when the growth starts coming in.

cheers to that!

Dr. Feller has clearly been meticulously vetted to be a recommended surgeon, and there are more than enough patients on this site to attest to his skills. But I do not think this makes any doctor forever immune to scrutiny. I think HTQuestions question is not simply, where did Dr. Feller go to school, but whether he intentionally misrepresented himself in his website biography. If it was an intentional misrepresentation (which it very well may not be), it may speak towards the integrity of how this physician markets himself to patients. And for some patients, integrity in their doctor is an important factor, especially when you're entrusting your appearance and thousands of dollars to them. In my opinion, whether you have 2 or 200 posts, this should be an appropriate forum to ask other people their opinion, especially if it's done in a professional and non-libelous manner. I know it may look suspicious when someone's first post calls a surgeon into question, but I don't see HTQuestions mention Dr. Feller's name once. Based on the website, I absolutely agree that his training is presented in an incomplete and very ambiguous way (again the issue is not whether he is a well trained or talented surgeon, but rather, how he chooses to represent himself). The biography may have just been written hastily and without unscrupulous motives, as the very first sentence states that Dr. Feller was born, raised, and went to medical school at his HT clinic (that's one impressive clinic!) Go to the same website and click on Dr. Lidsey's name if you want to see how to clearly present your medical biography. After all, the purpose of a medical biography is to tell the patient why and how this physician is trained and qualified to do surgery on them.

Hey HTQuestions, I now understand where you are coming from, and have checked out said physician's website. I agree with you. I think this is an intentional omission. I do not know if it was intended to mislead the reader, but it is very easy to misinterpret that statement if you do not know any better. In fact, it was difficult to find any information on this surgeon's medical training, residency, or HT training on the internet (But I found plenty of info on how enthusiastic of an "inventor" he is...haha). A physician's website serves little purpose other than to sell the physician (and to a much lesser part to educate the patient). Though very undeserved, there exists a stigma in some peoples minds that a DO is less qualified than an MD, or could not get into an allopathic school. Most physicians who go to a good medical school or residency brandish this information in a gratuitous and unsolicited manner. Physician's who hide their training (which I think is the case here), do so because they don't want it to negatively impact how they market themselves. In the world of cosmetic surgery, the only way to be successful is word of mouth and good marketing . In my opinion (many may disagree), I find this instance deceptive. But you can't judge a physian's skill as a surgeon based on his website. I know many good surgeons who are unscrupulous businessman, and many bad surgeons who are very honest businessman. For this doctor, I would place this as a small negative in a sea of many positives (based on patient results and satisfaction). In regards, to your second question about placing importance on where a degree is received. I couldn't care less if the doctor was an MD, DO, or went to medical school in Tonga. Very little of what you learn in medical school is utilized in HT surgery. What is much more important is where he did his residency and HT fellowship, what kind of experience/volume he has had at this point, and what his results are like (like others have said). I wouldn't rule a skilled surgeon out just because they were a little shady on their website.

Well. there is State University of New York (SUNY) - which is a large system of public universities in NY. They have several SUNY's that have medical schools/residencies: SUNY-Downstate (Brooklyn), SUNY-Buffalo, SUNY-Stony Brook, SUNY-Upstate (Syracuse). These are legitimate schools and have some great training programs. SUNY-Downstate in Brooklyn is one of the most intense medical experiences in the US. There is also University of the State of NY - which has a misleading title. This is a state credentialing body, and not an actual university. They are a governmental organization that oversees education accreditation in NY state. If this is what the CV is referring to, then this is not the medical school or residency that he went to. You should look elsewhere in the CV, or ask the office, if you are curious where he got his medical training. This is not a DO school. Hope that helps.

like Monkey said, use your own bank for the transfer... no need for a website. I walked to my local Wachovia branch, gave them Dr. Path's info, and they did the transfer there in minutes. I wish I knew to transfer in USD, and have the money converted with the onshore rates. That would've saved me hundreds probably.

sure, just sent you a message

Hey RE001. You are in great shape. Yes, you have a slightly aggressive pattern of MPB, but you are on this forum early enough in your life that with some motivation you can save yourself a lot of regret 5-10 years down the line. At 22, do not assume that you have reached your final pattern. Assume it's going to get much worse, and if your assumption is wrong, all the better. I do not think that the importance of compliance with medications can be stressed enough. When you're young and early in your pattern of hair loss, you don't know if the meds are doing anything. You can look in the mirror daily for years and not notice a difference with medications, and it may be discouraging, but the truth is, not noticing a difference may be a huge victory. It's a gamble either way, but staying on the meds, is the safer bet in my opinion. It's a pain in the ass, rubbing nasty rogaine on your head 2x/day or taking a pill daily, but my biggest regret is that I wasn't compliant. Like you I tried rogaine for a few weeks here or there, but since I got impatient and didn't notice a difference, I never stuck with it. Finally 4 months ago I started finasteride and minoxidil, and have been faithfully taking it everyday, and for the first time in my life I am not waking up with hairs on my pillow or in my shower. Plus I have luckily had a lot of growth on my crown already with the meds. I am 29 and a NW5 going on NW6, and I am 100% confident if I was compliant with meds starting at your age, I would have had a lot less hair loss. And I wasn't as advanced as you are now. What did you not like about rogaine? Also don't worry about finasteride as the sexual side effects only affect 2% of patients (i think), and are reversible with cessation of the medication. So get on the meds now, stay compliant, and I promise you there is a good chance you could postpone the need for a HT, require less grafts (and retain your precious donor area), and save some money. If you are lucky enough to maintain this level of loss, I think you could even avoid a HT, as your hair suits the shape of your head very nicely right now. Good luck!

Hey Allan, I am almost 1 month post-op. I just got back to the US from Bangkok 2 days ago (so sad to be back). I stayed in the area for a month to recover under the radar. I went to Laos and Malaysia as well. I saw Dr. Path 4 times after my surgery. On day 2 and 3 for shampooing, day 5 for suture removal, and 3 weeks later for a last check up before I came back to the US. I had my HT 2 weeks after WB280, and by the time I got to Thailand the security lightened up quite a bit. Bangkok was business as usual, and I was in and out of Suvarnabhumi several times during the month without any issues. I loved recovering in Bangkok, because really high quality hotels can be had for very cheap prices, $5 massages were a great way to relax after the stress of a HT, and the Siam Sq area was fun to avoid the sun and walk around, eat well and catch movies. If you are trying to figure out how soon you can come back, I'd say after a week you're good to go. If you have any specific questions feel free to ask, as I just got back