the B spot

TC, it varies from patient to patient for FUE---I'd say 260-320cm of possible donor via FUE for most patients. I'm on the lower end, I think I am around 270cm. Flyby, yes, if your hair is longer, we can buzz small strips around your head and take grafts from there and your existing longer hair will fall over the buzzed strips disguising the FUE extraction zones...this is not perfect, but we can do this. It severely limits the size of session you can have, and that can only be determined with an in-person visit to measure your donor density and plan things out accordingly. Unless your just doing some scar repair and we are only doing 2-400 grafts. Cheers, Jason

The cost of good staff certainly impacts what a clinic can charge per session. However, even the cheapest clinics, with slave labor wages, still have to pay for a clinic, proper anesthetization, punches, blades/needles, microscopes, lighting, bandages, tape, garbage bags, etc.... still MUST cut corners to offer surgery at this price. Generally clinics do one of 2 things: They do as many patients per day as they can, or they cut corners on staffing/equipment/material---in many cases they do both. All I can do is offer my advice to you. It is up to you to take it or reject it. I certainly hope you take your time as you are very young before making any decisions. Take Care, Jason

We try not to go past 20%---generally if we do more than 500 grafts, we buzz the entire donor and spread the extractions out. Average donor density 80-90 FU'scm/2 So, at 20% 16-18 grafts. 25% 20-22.5 grafts 30% 24-27 grafts. This is kind of a good tool to use because you can measure your available donor and see what a decent estimate of available grafts via FUE you might have. While I am no way saying this is "THE" approach, because other doctors have made claims of up to 50% extraction, but I have found most conscientious clinics are 20-30%. Obviously, if a guy has insane donor density, taking 35% would be 100% fine in his case. Conversely, there are those that taking 20% of the donor is the maximum. Another point I like to make is the 2 session approach. Taking say, 15-20% of a persons donor the 1st time may not impact them at all...no scarring, no noticeable thinning in the donor. Then you go back in and take that additional 5-10% and there is now some gaps, thinning, etc...just less coverage, so it is certainly NOT an exact science. However, taking 4-5K from the donor at one time does not give the patient or the clinic to assess the impact of removing a % of grafts, determining a safe approach or at least properly advising the patient that X may occur as a result of taking additional donor via FUE,and let them make this decision beforehand. Take Care, Jason

And there is the problem. Hairtransplants are relatively expensive. The staff and facilities are expensive. EVERY clinic that offers this type of "low cost" approach must cut corners. They have to. That can include the fast-food type service of doing 2-3-4 patients a day to make up the difference in cost. Your also young, and while I am glad your opting for FUE, you may want to hold off and do some research. You may not even be a candidate for a HT at this time. Take Care, Jason

Guys, it does not get any better than Dr. Charles for post-op treatment and concern. Every patient of his he treats as if they are his only patient, ever. This is an often overlooked aspect of a clinic, imho. Glad you had such a great time syk...look forward to seeing your results! Jason

This is the reason I have not even bothered to discuss this topic....because everyone is still trying to score individual points against each other. Ron...TC is not the enemy..TC...Ron is not the enemy, bad doctors, shills, and the uneducated making poor decisions are the enemy. You do what you feel you must, but from one bald brother to another, it is starting to feel ultra personal. I love the passion and willingness to mix it up...in fact you and TC remind me of Bill, myself and several others about 4 years ago You guys will make better allies and achieve more "good" than as enemies. Notjustyet....Dr. Feller can charge 50.00 a graft...if someone educates themselves, looks at the quality of his work, looks at the quality of other clinics, and decides as a consumer that 50.00 a graft represents a satisfactory cost to value ratio, then so be it. Expressing your opinion that you personally feel 10.00 a graft is high, is 100% fine. Stating that Dr. Feller is "wrong" or casting him as some profiteering goon is uncalled for. Dr. Feller and I disagree on some things, but the man is transparent, up front and took the time to explain the reasons for his pricing. Fair enough in my book, and certainly deserving of respect. On the topic of cost. FUE is expensive, it takes time to learn. It costs a lot of money to learn FUE because to do it right, your doing free work, reduced rate work, and paying overhead such as staff, etc... that is just business. To truly make FUE viable, you have to offer large enough session sizes to be impactful, without over-harvesting the donor, or speeding up the process to the point where waste occurs. Thus the balancing point. FUE 5.00 to 10.00 seems like a fair price range...that puts the average at 7.50..which if many of you recall I said I spend many months in 2007 polling those I came in contact with who said they felt 6-7dollars a graft was very fair, due to the benefit the patient sought and the difficulty the doctor experienced achieving this. Additionally, using Dr. Feller as an example, he has offered the "lunchtime" FUE session at a lower cost, in addition to several patients reporting Dr. Feller doing more grafts than the patient paid for, without charging them. Others have reported Dr. Feller working with their budget, as most clinics do. I use Dr. Feller as an example, only because of the unfair negative criticisms expressed toward his FUE costs. Others have mentioned SMG due to our current pricing schedule, which, while not changing in the immediate future, is going to change to a certain degree..it has to, I previously mentioned that the economics of retaining a large staff, and 3 fully functional O.R.'s would force the change at some point. The issue at SMG is that we are not actively seeking to do more than 1000 grafts per day...Dr. Ron feels that number allows us to do impactful work, then the patient can come in the next day for additional grafts for refinement. He does not intend for that to change. In that vein, we are spending 2 and 3 days on our patients to ensure growth and refined end results. So in this case, what do people believe is a fair cost for FUE? Currently we are 6.00 per graft with a 500.00 travel discount. Would a pricing schedule like strip costs be better? Say, 8.00 per graft for the 1st 1000 grafts, then 5.00 per graft thereafter? That would make our 2000 graft session 12,500. Right now it is 11,500. It takes us 3 days to do this. We expect to eventually do this in 2 days. A 2000 graft strip session that takes ONE day is 9000.00, for frame of reference. Taking the information I have given, what is a reasonable cost for FUE? What would you as the patient, expect to pay for a top clinic, with an ethical doctor and highly experienced/trained staff, educating you, and properly designing a treatment plan that encompasses your short and long-term goals? Take Care, Jason

I think I am more anti-"how this is being presented and how those who represent this machine as something that actually works" than I am anti-Neograft. You still have to mirror graft angulation, which changes as you move around the head, and grows more difficult as you get to the side of the head. Claiming physicians can expect 5% or less transection rate the first time using the machine is ambiguous and deceptive, in my personal opinion. Physicians who have never performed FUE? or Physicians who have never used the machine? If anyone wants to look on another forum and see my initial positive remarks on this machine to Dr. Bauman, who is claiming this is the next generation FUE process, that cooled after many, many excellent, non-attacking questions were asked by doctors and educated posters alike. Again, I then suggested we hold some form of meeting where the machine could be demonstrated in front of interested and respected doctors. Ignored. By both Dr. Bauman and Doug. I have no financial interest whether this machine works or does not work. If the Neograft machine provides clear benefits to the patient over traditional FUE, then I will certainly support its use. I am always wanting a better approach for patients......but that means in turn a healthy form of skepticism when discussing issues of this nature. Take Care, Jason

Hey M...happy for you mate....It was nice to get you back in the chair to get the final results you were looking for. Your hairline is going to look amazing with the added density.....your a lucky fella' for sure. Can't wait to see the updates! Jason

Doug, you don't have to be sorry. Your a "tool" salesman. Your interest, just like the many that have come before and many that will come after, is units sold. Mine is focused on the individual patient experience from one of the most recognizable hair transplant doctors in the world. You patently ignored a debate on another forum that included Dr. Feller, Dr. Epstein, Dr. Law, Gillenator, myself and others, because you know that you cannot hope to debate your unproven machine against those with a differing opinion. Questions were asked by both doctors, yet you waxed quiet? I even proposed a "meeting of the minds" after initially being very intrigued by the machine. You certainly did not respond with the level of vigor you have on this site. Doug, the introduction of SPEED into the FUE process is detrimental to overall yield. Efficiency and experienced staff cannot be confused with speed. I'm sorry if that rubs you the wrong way. This forum is generally unreceptive to BS..... And while I have only been around for a short 5 or so years, after seeing all the latest "Technology" to keep popping up, the real truth is more than likely your machine will simply take it's place among the hundreds of other innovations that have gone by the wayside. So, I have nothing against you or your machine...I hoped it worked. It may "work" for all intents and purposes, but excuse my skepticism when your entire "pitch" is that this is the future...and everything else is just falling behind. I do not care to enter a debate with you. You had that opportunity months ago. I look forward to one of the Coalition clinics trying out your new-age machine.

Rollins, there is no debate..there is a dearth of great FUE docs. However, please look at Dr. Feller, Dr. Harris, Dr. Bisanga, Dr. DeVroye Dr. Mwamba, HDC to start. At 39, your options are probably wide open if your only a NW2...but if you want to keep your hair short and you need 2000 grafts or less, FUE seems like a proper choice. Take Care, Jason

Peter...how long did your procedure take? Nice 1970's porn mustache btw Jason

There was a young man a few years back who we cautioned for going through a surgery. His hairline was rather unsightly, widely spaced, and his scar was not the best either. I think his handle was dhuge69. Basically a classic case of poor work. I keep saying this but it takes HARD WORK to be a great HT doc. It takes time and dedication, training your staff, and constantly striving to get better. Many clinics are happy to do the work Robert just described, which as we know leaves a lot to be desired. Ucity, if you post a photo or two we can see about getting you some advice on how to approach making you look and feel better. Take Care, Jason

Rollins, how old are you? Anyway, not sure why you "must" have strip. Not sure why you would want to phase in the FUE into 2 procedures. I could understand if you wanted more than 2500 grafts, but 1800 grafts is a manageable number imho. Unless you are unwilling to buzz down and are trying to conceal your surgery, there is no reason you must rule out 1800 FUE grafts. Additionally, phasing in 1000 grafts, then 800 grafts is fine, but as Ronald says,waiting that long for such a small session that you know you will need would be very tough. Obviously, your age plays a factor, but you need to be able to choose strip/fue based on a proper understanding of your goals and what can be achieved. I think you should continue to talk to clinics and perhaps post some additional reasons as to what your goals and mindset is, as well as some photos. Take Care, Jason

Dr. Reed and Dr. Carman are out there as well, I believe. I would suggest meeting up with them as well. Take Care, Jason

LMS---the first patient you asked about is the poster child for FUE imho....he has ALL the characteristics, exceptional donor density, excellent hair caliber, slight recession and no history of family loss. This guy has exceptional donor...should he progress further, he has enough donor to combat his baldness. We believe he is in no danger of running out of donor because he has an over abundance, is on propecia, and Dr. Ron/Dr. Paul both feel he will not excessively bald over his lifetime. Basically if your going bald, you want this guys donor and hair characteristics. Pharm is obviously a bit older, but I want to say up front, we tell EVERY patient there is the possibility of more work. No exceptions. In Pharm's case, he wanted to establish a hairline first, let it grow, assess his "look" and his donor and proceed from there. He likely has enough FUE donor to hit the frontal core and into the mid-scalp, but probably not the crown. However, he wears his hair short always---he is fine with that strong hairline and a thinner look at this time. In his case, one of my first comments was to say that he would need 2 sessions more than likely. He is more than aware that has the option of switching to strip later if he desires. However, he still has quite a bit of hair and he is not looking for a thick transplant...he wants the ability to buzz it down low and keep his options open. IMHO, this is where FUE used properly comes into play...by allowing Pharm to keep a natural thinning look, but still retain a natural, soft hairline...even if he loses the crown over the next 5-10 years, he can still rock the short cut and a tan and look great. His hairline "density" that he received in this transplant can be easily matched should he lose his frontal forelock (the part we did not transplant into that is surrounded by the hairline) and even IF in 5 years he loses everything else to a NW5-6 we could use FUE to hit the forelock and then get progressively thinner going toward the crown...natural, normal, with crown loss...but still able to retain the short cut...UNLESS, he decided to go more aggressive and switch to strip. Obviously his choice. A ton of thinking, talking back and forth and planning goes on...Hell, some guys get mad at me for taking "too long" to have Matt schedule them...but that's just the way it is..We're not in a hurry and we talk this out. I do want to be clear, these are informed adults, making reasoned decisions, advised of risks/side effects. While Dr. Ron/Dr. Paul and Janna have worked hard to minimize the risk involved, there is a level of risk involved in hair transplantation. If after all the information is presented, a guy says no way, we believe he has made a great choice. For others, the risk is acceptable, and for others, regardless of their acceptance of the risk, we would refuse them service. Take Care, Jason

Sparky, I think you have missed your calling mate

Hey Faces, you should do a search on Hasson and Wong (H&W) ask for a poster named Jotronic. With your level of loss, your age, and hair type you could be a great candidate for a large session. My advice is to start there. Take Care, Jason

Well, the odds are in our favor, but you try to PLAN like a person might be a NW6-7...the younger the patient, the more you plan. As a person hits 30's, 40's, 50's you can obviously get progressively aggressive with regards to density and use of the donor. My father and my grandfather have the exact same balding pattern that I have...my GF is 78 my dad is 51....my GF's donor is a solid 6, non-see through, my dad is a solid 6, non-see through. Both were this bald from 30. Again, the patient Dr. Feller posted was likely a marginal candidate from the beginning and had very realistic goals....lets remember not to place our 25-35 year old perspective on a guy who just wants some hair to comb and frames his face. We could debate the initial approach and which method of surgery should have been employed, but on another thread of course. Jason

I would estimate 1400-1800 grafts, but we would not transplant that low in the temple region....we would likely have no issue with the actual hairline itself, but at 31 I think filling in the temples like you have drawn would be excessive. Additionally, I would not target the temple points as aggressively. The reason for the graft range is that we would primarily use mostly 1+2 hair grafts to do this kind of work, so the graft total might be a bit higher, but with FUE we can target the 1+2 hairs. Most of us have 6-8K of donor...others have more, others have less. I have only see a few 10K strip patients, I have never seen a 10K FUE patient. With taking the Propecia you can certainly help prevent future loss, and at 31 your experiencing some loss, but nothing excessive. I'd say a HT done properly could be a positive for you. I would prefer you look at doing FUE, but you need to weigh the options and make a decision. The decision to simply buzz it down a bit or do nothing are great options as well. Take Care, Jason

Excellent show Dr. Feller. Guys, most men that bald do not end up, this bald....I think 11% of balding men end up a NW7. So in that vein it is ok to transplant guys...but this is why future planning is a must. I was talking with Matt Zupan last night about this, and he said generally you like to take 2/3rds of the donor and leave a 3rd for future recession. Obviously we do not hold true on this for every patient for a variety of reasons, but it is a good rule of thumb we like to work from first. My opinion on this gentleman is he can get a custom designed, low density crown piece to accompany his transplant work that will help with his over-all look....should he desire to do this. The work is standalone, but it is obvious he was bothered by it. Great example Dr. F and thanks for having the guts to show this. GREAT PERSPECTIVE. Jason

Nburns, I wouldn't worry about the cost right now...we would like to have you in for a no pressure, no hassle chat...at the end of the day, your going to have to meet some criteria before going forward. LMS--this is a long write =) I don't have a percentage...to be honest, I think over the years our reputation is that we really prefer not to transplant under 25, with some exceptions. I would say that patients 26 and under makeup a very, very low percentage of our patient base. When we explain our approach and how we would proceed, they often choose another clinic who will give them what they want. I would say most of our patients are 28-50 years old. I would say I personally turn younger patients away on a regular basis, choosing to counsel with them and give them advice on how to deal. Dr. Ron/Matt is most concerned with future loss and the younger the patient, the more future loss comes into play. We do perform quite a few repairs on patients in their mid-20's who had transplants at a young age---some of whom require us removing the transplanted hairline via strip to move the hairline "up" to make them look normal. I do not consider them part of this discussion as we are repairing them, and #1 would not have performed surgery on them #2 would have approached the surgery differently. However, with the onset of FUE this line is wavering somewhat...I believe that people are individual, so when a person 23-25 comes to me and says, "I want to do this" but is mature, accepts advice, handles this in a mature fashion, and in general approaches the process properly...this is a person who understands the short and long term ramifications. I can feel comfortable forwarding his request to Dr. Ron/Matt. Another person this same age comes to me with a completely different attitude, generally with information from another clinic that will do 1000 or 2000 more grafts and really presses me on doing more grafts, gets argumentative, or has to get this done right away....those I try to slow down enough to get a feel for them, but most of these guys are poor candidates, and I turn them away. I really feel strongly about waiting and monitoring. If a person is unwilling to accept that, then we look at age, level of loss, type of hair characteristics, family history and miniaturization through the donor. Then I look at the patients "whole picture" --just how aggressive the approach is, how much a person has wrapped up into a HT--If someone has the notion that a HT is answer to everything it is a red flag. Another point I want to raise is that when patients contact me, I go through everything with them, from approach to cost, but Dr. Ron and Matt still retain the final say..so when I send photos & information to them, they can say no as well...it is a nice 2 level process that provides checks and balances and helps prevent improper candidates from slipping through the cracks. I think using FUE allows us to transplant younger patients, but we still have to approach it in a conservative fashion. If Nburns comes in and sits down with Matt, he is a NW4 and he wants to attack the frontal zone aggressively via strip/FUE, he will be turned away. If he says, I want to maintain a buzz-cut, retain the ability to keep his hair short, wants to establish a frontal forelock/hairline that frames his face and we can do this using 2000-2500 grafts via FUE/Strip..then that is a judgment call, which is difficult but certainly can be made if future planning/proper approach is used. However, the reason for not transplanting young patients is the long-term ramifications. In the scenario I presented, the ability to buzz down to a #2 and still maintain that shadow hairline look is certainly an excellent option. Doing strip takes additional thought and planning. We do not shy from transplanting younger patients, but we refuse to bend to patient pressure to transplant high densities, or aggressively lower hairlines...so in that vein we turn away a high percentage of younger patients just because they want what we cannot give. We do give education and philosophy for our approach. This is a sensitive issue for me as well as many others who are victims of poor planning/unethical clinics/bad work who see this in the mirror everyday. Take Care, Jason

I think you should consult with both. I am partial to Dr. Konior having seen his work, spoken to his patients and spoken to Dr. K himself. That is just my personal opinion, so I want to be clear on that. This is to take nothing away from the other doctors as I am sure they do fine work. Again, I suggest you consult with both clinics, even if it means waiting a bit. Waiting is NEVER a bad thing. You can then make a proper decision on which doctor can meet your needs. Take Care, Jason

Hi Nburns, at 23 and already a NW4 you should come into the office for an in-person evaluation. We should find out if a HT at this stage is proper...If not, you will gain valuable information and ways to combat your hairloss non-surgically. If you call the office, ask for Matt Zupan to set up an appointment. Take Care, Jason

Missed your question Thana!!.... in order to get high graft numbers you must either add length or add width (or both) to the amount of tissue being removed. For 4800 grafts, Dr. Ron could have left the strip shorter, but that would mean having to take a wider strip, so it is a balancing point and depends solely on each individual patient. BTW It is good to see you up and about Tos!!! Cheers, Jason

I've already known about this for several months. It allows those who refuse to put the hours of tedious work with .8-1.0mm punches, train staff to handle the fragile grafts, and create the smallest possible incisions, to perform FUE. It attempts to bypass the human handling of the grafts through suction. Ask Dr. Feller and others who have seen this what they think. FUE is HARD and hard to get good at..it takes time. Once a person goes through the learning process, any "benefit" gained through this machine is negated. Remember, a human still has to mimic the follicle angle. This machine is also very expensive. Obviously, this is just my personal opinion. Take Care, Jason