destorius

Bill,

 

I respect the balancing act you're up against and need to remain diplomatic. But im sorry, this statement below is unacceptable and a slap in the face to the group:

I am waiting to hear back from them on this and have suggested that the doctor consider getting more involved like he used to which may take care of any possible quality control issues that exist. If the doctor does agreed to become more involved again, I think perhaps we can give him another chance and possibly just put him on probation to see how things go and whether or not they improve over time.

 

"Suggested that the doctor consider getting more involved" ? He's the doctor!

 

Would we condone a technician doing a heart transplant? What about an assistant doing a knee replacement? What about brain surgery? Why are we so accepting of this horrifying trend in an already unregulated yet growing area of medicine.

 

Couldn't agree more. If this Doctor continues to be recommended, the credibility of this website is totally shot.

Yes, 1000 FUE in 2011 with Feller.

Difficult to say unless they see you in person I guess. At least you haven't flown out there and ended up disappointed. Also, last thing you want is to make things worse so if they don't feel you are suitable then perhaps give yourself time to really consider if more FUE is right for you? Either way, I miss you the best of luck!

Where in London are you based? I'm over in Surrey.

Sorry to hear it didn't work out for the procedure London. Are you not worried about going back to Turkey for FUE after your last experience? May I recommend you do a consult with Dr Bisanga? Eurostar is only ?120 return and he is €5/graft. He is very ethical and is an expert in FUE. I had a consult with him before and I couldn't recommend him or his representative "SL" highly enough.

David - it is looking great so far. Really happy that you are progressing well and I would say your HTs have all been pretty successful (esp #1 IMO).

Thanks for documenting but also for doing such a stand up job in moderating this site.

James

Hey there!

Well first of all, don't despair, it's going to be ok, I mean that. I started losing my hair at 19 and a few people called me out on it and it decimated my confidence, but confidence is simply a state of mind! No one is going to live your life for you so you have to make the most of every day, I didn't do this and I regret it greatly.

Fast forward 12 years and I am still losing my hair, just very slowly. I got on Propecia early on and it has essentially bought me a ton of time. It not too much further gone than when I first noticed it. I am married and have a great job, life can be good- you just need to let it be.

My advice for you is get on Propecia once you have read up on (rare) possible side effects. Then if you want a chance of regrowth, you need to get on rogaine. Give it time and enjoy your life.

James

I think 1500 is about spot on. 800 graphs will not do a great deal and IMO 2500 is far excessive. I really respect how you are taking such a long term viewpoint on your hair! Having met Bisanga, I think you would be in good hands!

Give that man a cigar.

You got it, Destorius .

It doesn't matter one bit what he had done, the point is that the donor area can't be seen.

A simple concept, but one that has been lost, purposefully in many cases, on this and other chat sites.

 

99.9% of patients couldn't care less about being able to shave their donor area because they never intend to shave their hair down...especially after they've spent their hard earned money on a hair transplant. That's what makes the FUT vs. FUE "debate" invalid.

 

So Destorius you not only got it, but you "get it". Well done. More to come.

 

Here's the link to the patient by the way:

 

http://www.hairrestorationnetwork.com/eve/180969-video-3000-grafts-10-months-feller-bloxham-great-neck-ny.html

So Doc, what do I win?

The issue of front loading was the "hot debate" of it's time in the late 1900s and early early 2000s. When 3,000 grafts are packed into the front on someone with questionable hair loss potential in the top and back this can lead to an unbalanced look and not enough hair left in the donor to cover it years down the road. In some patients it can be done, but by and large should be avoided. I'm seeing a lot of FUE-only doctors "front loading" because they attract a very young patient population and that's what they want, but that doesn't mean it should be performed.

100% on point. Whilst we would all love 5000 graphs in our front third, that is often not the sensible approach to follow. You could get a good cosmetic improvement and provides more doner to address further thinning in the future. I do worry about some of these young guys using 80% of their donor when they are in their late 20's and a Norwood 2-3.

Thank you for posting such an informative video Dr Lindsey. When you showed the closed up MFUE sites, it looked like they ran in a line... Won't this increase the likelihood people can make up the scaring?

Also, I find it crazy he put the bandana on in the past... Why do some patients don't help themselves!

Looks fab.

Work looks clean. You had a great result with the scar on the original FUT! I hope you tolerate fin this time as that is key to your results holding up over time.

I know it is a cop-out but it could be any. Scars for either FUT or FUE could be covered as th hair looks grade 4 or above. Reduction in density due to FUE would also be undetectable.

Point should be that either surgery is undetectable above certain grade.

Depends. How old are you? Has your hairloss stabilised? How many grafts you reckon you've still got there for extraction (fue or strip?)?

 

The real answer, though, is get a consultation with few good surgeons to see what's achievable. If what they can achieve matches your expectation then it's worth looking into further.

Very sound advice. +1

Maybe I exaggerated by saying tons, but I have seen them. And their FUE cases routinely do have average donor. Especially Feriduni's.

 

Bisanga is overly conservative anyway. He pushes finasteride more than anyone and seems more concerned about the possibility of an awkward looking transplant down the road than he is of a patient ruining his health. So I admit he was a bad example to use. He isn't an option for me anyway.

I think you are being a bit unfair here. The general consensus is that if it can be tolerated, Finasteride is a valuable ongoing tool after having an HT. In addition, wouldn't you want a doctor who is conservative in his approach? Lots of people years down the line regret packing 3k graphs in the hairline!

Dest,

 

I know! Fun, it's it?

 

I think the difference in what Dr Feller said in another video has to do with the patient's age. If you have a 55 year old gentleman with a NW V pattern but a persistent forelock, there is a pretty good chance that this will be fairly stable. In this instance, you may be able to "count on it" somewhat and include it in the surgical plan. However, this is a very different story in a late 20s, early 30s patient. And this situation is a perfect example. These guys have very active hair loss, and it's very difficult to count on anything. And this was all discussed, in detail, with the patient while we created the surgical plan.

 

So, how difficult is it for an HT surgeon to predict how someone's hair loss will progress?

 

Honestly? Quite difficult. In my humble opinion, at least. However, we're not completely "shooting in the dark." You can always bust out the magnifiers and really do a miniaturization analysis of the hairs along the fringe and in the middle of the areas in question. You can also take things like the patient's age, medication regimen, and pattern along the rest of the scalp into account. Even with all this, however, it's still tough. And we have to plan accordingly!

Thank you for such an informative reply. Now I just need to find someone who can check mine to check for miniaturisation!

In a case like the one I presented here it is just a matter of time that the forelock would be targeted and eaten away "pac man" style.

.

Dr. F, I'm not looking to pick holes at this (interesting case), but this is different to what you said in one of your recent videos where you highlights a NW5 with a forelock which you said he was very unlikely to lose.

The point I'm making is, as a HT doctor how difficult is it to make a solid judgement call on where someone's hairloss will go? To me, this is the million $ question which drives everything - technique used, density planted and hairline design.

I find this stuff fascinating, I should have studied medicine at college instead of computing & maths!

Bill - yes I looked at all. Some good work in there, but I struggled to see how there can be enough breadth to justify including him at this point. He has only posted 11 times on he site!

I am surprised to see this - he hasn't posted that much work and seemingly nothing in the last year. I wouldn't support.

Hey fella! You can get Nanogen from some larger Boots stores. Good luck on the hair- should look ace!

Have you thought about waiting? You only have one head and there is no rush. People think "right I just want to get this fixed ASAP". It doesn't really work like that as Hairloss is progressive. You will almost certainly have to have further work done. Your Hairloss is probably genetic - no one in my family has it really but I got it, it just happens.

If I was you I would go for a face to face consultation where they can try and map your head for miniaturisation. This will give you an idea where you are heading and keep with the Fin. It will allow you to make an informed decision. I also think to myself, if I was a NW6 and had a HT... What would it get me? How conservative would I need to be? Remember you can always go for a second pass to add density if 1500 wasn't enough.

End of the day, it is up to you but I wouldn't be doing the right thing if I wasn't trying make you step back and have a think.

James

Absolutely. Look I think the work the various clinics do in Turkey is great but it is pretty aggressive. Have you had other consultations? If not, at a minimum send your pics to people like Lorenzo, Bisanga and feriduni (and other FUE clinics willing to do 1500+) and get their thoughts. What is your age? What meds and what result have they had on your Hairloss? Family history?

I personally think you should be looking at more 1200-1500. Think about the future loss and donor capacity. You absolutely don't need 3000 for a comestic improvement.

Ha! Random Pink Floyd music!

Had no idea they were paying patients to practice, their website quotes a cost per graft of $8 for the first thousand, and then decreasing to $6. H&W are bad men, once they perfect FUE, they are going to be golden. What kills me is why would any well educated patient pay that amount of money to go with FUE with any American doctor, when proven FUE specialists like Lorenzo, Erdogan, and Feriduni charge less than $3 a graft. It absolutely blows my mind!

I think it is about €6 which is prob $7-8?