the B spot

I sincerely appreciate everyone qualifying their comments, it puts everything into perspective and lends a little humor to the thread As far as market trends go, I find that most clinics charge what they charge....I know people speak about certain clinics charging more or less, but location seems to play a major factor in the cost of services. West Coast/New York will always be higher than the midwest region on average. Space/Labor generally cost much more in these locations. Even if a particular doctor wanted to charge less, he or she may not be able to afford to lower the cost. I do think cost is important, but it should not be the most important factor. If a particular doctor stands up to all of your scrutiny and research and you determine this is the doctor for you, then cost should be secondary. Additionally, in these tough economic times, it seems most clinics are willing to work with patients to fit a budget. Ronald, 6.00 per graft is for any size session 0 grafts to 2500 grafts. Our travel discount applies for sessions of 500 grafts or greater. Take Care, Jason

Hey J! Getting close to the big day! I look forward to seeing your pics. Take Care, Jason

As a quick bit of history, back in the middle of 2007 when I started really delving into FUE, one of the goals I set was affordable pricing for the procedure. In speaking to many, many patients the general consensus is 5-7 dollars a graft is: #1 Fair #2 Affordable when compared to strip costs. When Dr. Shapiro, Matt, Janna, and I talked about what types of patients we generally felt would desire an FUE approach, they would be hairline/frontal zone patients and generally need 2500 grafts or less to accomplish their goals. In that vein, if you take a person who needs 2000 grafts. Strip would cost 9000.00 FUE would cost 11,500.00 In this instance the cost differential allows a patient to choose the method they desire, without placing the emphasis on cost alone. I want to say that there are no plans to raise our FUE cost in the near future. I also want to point out that Dr. Ron is in HIGH demand for his hairline work and has been in high demand for 10+ years. If he wanted to engage in gouging patients, he could have done so at any point in time. Something to consider. Obviously, economics will eventually force cost augmentation as the cost of labor/supplies/etc.. rises, but we feel the current cost is a proper representation of a fair price now in the foreseeable future. I'm going to let the guinea pig comment go because I think people are perhaps confusing us with some other clinic. Irresponsibility is a fault easily remedied with proper research. Take Care, Jason Edit--wanted to point out that even if we had to raise our costs, just like our strip costs, it would be reasonable and nothing outrageous. Dr. Ron has always maintained a fair cost to value over 15+ years.

I know I haven't spoken to you in a while Bill....we should get on the phone and yak, for sure. All I do want to point out that a HT at 20 is different at 25, 30, 40, etc... At 20 with extensive thinning, you may be a NW7 at 25, should you perform ANY type of surgery at 20, you may be actually taking non-DHT resistant hairs that were destined to miniaturize regardless of extraction zone. The BEST way to combat younger patient loss is through meds/topicals/education. It is not convenient. It hurts. But it is what is BEST. As far as financial, yes, this stuff is expensive, but again, patients should know all of this up front. At this point, there has been excellent discussion from all involved. There is no magic "age" to start treating your balding with a HT. I know we prefer our patients to be at least 25. However, we do the occasional 23-24 year old. Additionally, there is no "right" way to approach a younger patient. I gave my opinion as to why I feel the way I do. Others have disagreed to a certain extent and provided reasons why. Let me end by saying that it has been my experience that most determined younger men WILL get a HT, despite any information to the contrary. They will also go from doctor to doctor until they find someone who tells them what they want to hear. We end up repairing so many of these young men by 27-35 because they just look unnatural...hairline too low, hairline too dense, temple points overbuilt, donor over-harvest via FUE, recipient area scarring, ridging, cobblestoning, wide/raised scars, etc... The common mantra is "I wish I would have waited" or "I wish I would have just buzzed my head and forgot about all of this" Take Care, Jason

Jason, I wholeheartedly disagree. I'd really like to know your rationale for this statement. Best wishes, Bill Bill/All I would prefer that these type of patients NOT have any type of surgery. We have no idea what level of loss they are headed to, but one axiom that generally holds true is the younger you are when you start balding and more aggressive your balding is, your going to end up a fairly high norwood. Using BB as an example, there is no HT doctor that could forecast how far the sides will drop or if he will recede "up" from the neck. Patients in this scenario IF they choose to go forward with a strip session, remove all future options for simply walking away. It has nothing to do with strip/fue argument it is an options for the future argument. It is readily apparent that a top clinic will generally produce an acceptable scar for most patients. However, there is no guarantee that a patient will heal thin. Because we are dealing with younger patients, patients we already must be conservative with, it only serves to drive the point home that the "worst" result via fue is poor yield and perhaps some white dots in the donor region. Using BB again (sorry!) I think most of us would be horrified and outraged should a clinic perform a 3-4K strip session, target his crown and plan for a second session. That same argument applies should a clinic perform a strip session of 1500-2000 grafts and only target the frontal half---in your early to mid 20's, your "locking-in" patients to future sessions. Again, this is not a FUE/Strip related comment--it is simply a future options discussion. It is also my personal opinion. An opinion I hope going forward many people begin to share. I certainly can accept an alternative opinion...this is not right/wrong discussion...more a patient first discussion. Take Care, Jason

Hey Thana/BB--- an FUE only surgery is the only real option for such young patients with extensive loss. However, at 20 it is just too soon, imho... at 20 we only know that BB is thinning extensively throughout the male pattern. We do not know how progressive his balding will be. What I do know is that any transplant pattern would mirror the actual pattern of native hair he currently has... a bridge attaching the sides and a frontal forelock...ala Phil Collins/Bruce Willis (from Moonlighting) which would require him to maintain a rather short buzz type cut...... something BB can do right now and look great. Performing a few thousand FUE grafts, in a conservative pattern on BB seems rather harmless, but the commitment both financially and mentally is not to be taken lightly. Additionally, when I find younger prospective patients who have convinced themselves that losing and subsequently getting their hair back will cure or set the path of their lives, I generally discourage them initially from having a procedure. Achieving higher education, a better body/health, something that ends in success seems to dampen the fervor to get hair back. That is the point where proper planning and patient willingness to accept the limitations and drawbacks of a HT can occur. Obviously, this is my opinion..but in these situations I fall back on rule #1 when regarding a HT...It is NEVER a bad move to simply wait. Take Care, Jason

Generally speaking if your considering strip you need to be ok with keeping your hair at 1cm in length. A 3-4 guard buzz after a strip session is right in line with good clinics, with some patients able to get to a #2 in some cases. Your scar will continue to heal up and progressively get less noticeable in the next 3-4 months--- at 7-8months you can generally get a read on the width, but the scar will generally fade over time. Another thing to do is to go to a good barber and have them fade your cut right up to the scar say a 2 guard to a 3 guard, then a 4 guard right at the scar itself. Might provide a nice look. Also, if you get some Dermatch if you buzz to a #3 with a little scar showing you can a bit into the showing areas and be fine there as well. Hope this helps! Jason

Ok, well this is a recipe for disaster. First, at 8 months your not going to see much from Propecia....generally 12-24 months shows a true effect. Second, your NOT a HT candidate, period. It will interesting to know the name of your doctor who said 1500 grafts. Probably strip as well. No Way. You, nor your doctor know how you will end up. At 20, with that level of baldness, your basically the poster child for a NW7 and post-HT regret. Third, you need to buzz it down, tan your dome and live like that for a while. Your hair does NOT define you. Now, if you give propecia a chance to work, give yourself some time to really understand what your signing up for, maybe 23-24 you might be ready, imo. At that point, you might be a candidate for some FUE, only with the knowledge that you can have a bald crown/or work in a small crown hair piece to compliment your HT hairline. I would like to know which doctor recommended doing 1500 grafts on you. You look like you need 3500-4500 grafts AT 20. Your laterals are already dropping and your basically a NW6 pattern. Baldboy...I feel you, feel for you in the worst way brother.....please, please, please trust me and forget a HT right and forever forget a strip HT should you go forward later in life. I'll be happy to talk on the phone with you, counsel with you, offer all of my knowledge to help you through this time. I understand what Thana is saying, but I'm tired of repaired and fixing guys 25-30 who got HT's when 20-22 years old. Bad scars, low hairlines, poor FUE results, white dot scarring....etc. I hope you wait, hang-out, listen, learn, and formulate the right plan for you long-term. Jason

Hey Bash, I always stay at the Country Inn...make sure you take advantage of the free breakfast as well as the free cookies they have lying around all the time Got the good news that your sessions went well and happy that your feeling so good about everything. It is exhilarating, scary, exhausting, crazy, and fun all wrapped up into one!!!! Your going to look great and cannot wait to see your pics mate!!!!! Take Care, Jason

You should wait for a week or so to let things heal up. After that, you should be fine, imo. Jason

Heelz---I want to respond to you here as other then a few clinics, there seems to be a dearth of true FUE results posted regularly. It is true that SMG is performing FUE now, but we are just getting to the point where our first hairline patients will be sharing their results in the coming months. I have said from the start that while I believe patients should put their trust in SMG via FUE based on our long history of excellent results, I 100% support those who want to see grown out results before making a choice. Dr. Feller is certainly an excellent choice for FUE and has my full recommendation. I think it is silly not to consult with him for FUE. As far as yield, I think FUE yield is near strip yield when performed properly and without "speed stress" tossed into the mix. I also believe that .9-1.0mm punches allow FUE to get any grafts from any patients. Smaller is always nice, larger than 1.0mm is not necessary and increases the risk of noticeable scarring. Again, there is much disputed information, but it seems clinics who maintain excellent quality control and refuse to bow to the economics of doing several patients a day or targeting massive numbers of grafts per day, get good yield and nice results. I realize FUE might not be prevalent here, but in time that will change going forward as real results will show out over time. Take Care, Jason

Funny Dr. Reed =) Yes, I have seen this employed to the extreme and patients end up with a transplanted comb-over that closely resembled the one they sported pre-op :-/ Generally speaking, using your patient as an example, weighting just enough to handle the "part" so as not to look so thin when parted is perfect imho. Take Care, Jason

Lesser than optimal scars do happen, at every clinic. This is 100% true. WHY they happen can be a mystery sometimes, but they still happen. However, a less than optimal scar should be brought to your doctors attention and they should fix it. Using Emperor as an example, if his scar is 4mm wide and he has had only one session, taking a .5cm or 5mm strip to reduce the scars appearance should be no trouble and result in a better scar...unless of course the donor was subjected to extreme tension, but even then, just remove the scar tissue should result in a better scar. What makes a top clinic "Top" is not just the results over the long term, it is how they treat the occasional patient who experiences issues such as a wider scar, etc... making them a patient for life, not just the session. This particular topic is often heated on either side with no "right" answer. I like the idea of some future options, especially for patients under 30 needing less than 2500 grafts. It does not make me right or wrong, it is just my opinion. I hope that when people read my points and the other points raised, they can think about which approach might be best for them..but do so, not from a "fear" or unknown standpoint, but with some solid information. Take Care, Jason

I like this result, excellent write up as well. Dr. Reed, did you "weight" the area just above where the patient parts his hair to allow him to comb it over and realize more coverage and density than if you spread all the grafts over the entire balding areas? For patients who have established hairstyles this is a usually a great approach, imho. Thanks, Jason

Generally speaking, my personal feeling on FUE or Strip questions is: 1. 30 and under 2. 2500 grafts or less needed. 3. may or may not need some future work 4. Likes to wear hair short 5. Expresses some trepidation over having a strip scar. I think for the most part I would like to see patients fitting this profile strongly consider FUE as a first option. Obviously, there are those who could care less about a strip scar, and others who will never do anything but FUE, regardless of cost/time/yield, but for those doing their research and on the fence..I believe if they end up choosing a proper clinic to perform the FUE session, they will be happy with the choice. Both short and long term. Again, note the smaller session sizes and the relatively low impact on the donor region overall. When you start taking higher numbers or a high percentage of donor, other prohibitive factors such as donor depletion, noticeable scarring, lower overall yield compared to strip and cost are elevated. Hope this helps out. Take Care, Jason

Congrats Nic---Dr. T does excellent work. Look forward to seeing your progress. Take Care, Jason

I both love AND hate patients like this..... So much native hair, so little loss...add a great doctor and stir gently. This guy is going to look like 1.5 million, since he already looks like a million. Cheers, Jason

Hi Carly, just wanted to let you know some of the photos have the patients name in the filenames and can be seen when viewing the photos. It would probably be best if you re-named them. Just looking out. Jason

See the thing is, at your age we would have to keep the hairline a bit high---you would realize a nice cosmetic benefit for sure, especially given your hair style. I would say that giving you a nice frontal forelock right where your part your hair to add density, then conservatively go forward a bit--maybe 1400-1600 grafts as a conservative estimate---others have mentioned 2000---I would say that would be the max. Because you part your hair down the middle it will harshly expose any thin areas, so we would have to give you some nice density there first and foremost. I think you need to wait---if you do go forward, you should look seriously at only doing FUE because we just do not know what will happen with your loss going forward. I am 100% sure that if you do one HT, you will need at least one more in your lifetime, regardless of method used. Anyway, good luck going forward! Take Care, Jason

bereft, your account name is one of the BEST I have ever seen I think you should wait it out a bit....and do some more research. You need all frontal restoration at 23---who knows what your loss will be in 3-4 years? Take Care, Jason

I think Aaron has a right to feel great about his experience. Dr. Paul does amazing work and is a nice guy to boot, along with the rest of the staff. Aaron has MONTHS of waiting ahead of him, including the dreaded 3 month doldrums. Let's let him ride his wave of happiness for a bit. I 100% understand your point Emp, and your right, but without being privy to everything that has gone on, I hope you can cut him some slack. Jason

Good Job Nick! Your in good hands will All-State....er Doctor Feller Look forward to following your progress Cheers, Jason

Dr Charles is right on--- waiting a day or so is probably better. You need to make sure any hat you use is BRAND NEW. It needs to be loosely fitted as well. When you put it on, put the hat on your forehead first, then tip it back so it settles down over your head without contacting the hairline or transplanted areas. I bought a hat with a velcro adjustment so I could put it on, then tighten it to fit. Good Luck!!!

Hi Jon---the problem is regardless of what happened in the past, there is really nothing CURRENT to prove your theory that any doctor, not just the few you mentioned, has fully embraced the latest technology, staffing and approach. It is expensive AND demanding of both the doctor and the staff to achieve the amazing results we see by clinics who strive for such results. I think you should see Dr. Limmer or Dr. Arocha if your in the Texas area. I believe a drive up to Arizona to see Dr. Scott Alexander/Dr. Keene is 100% worth your time as well. You do not need to know why or why not a particular clinic is "bad"--you just need to know that the clinic you have chosen is transparent in their practices and provides excellent results and patient care. Take Care, Jason