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Good result there, Dr Lindsey! Can I ask the main benefit over direct excision of the excess skin in the middle of the neck as opposed to a standard necklift where the skin is pulled up behind the ears? By the way, since general plastic surgery is one of the many strings to your bow, it would be nice to see more of these from you - you're clearly a very accomplished physician.

Not at all. For various reasons, I've been on medication and dietary supplementation for most of my life, so this really just fits in with my normal pattern of life. And even if you don't take medication normally, the cost (price, inconvenience) to benefit (keeping your hair!) ratio is substantially weighted to the benefit side of things. Besides, if you want to put it into perspective, look how many pills cancer patients have to take just to continue living. With this in mind, I really, really don't find taking pills electively a problem at all. Now cutting them up into fifths...well, that's a pain in the ass.

This is a complicated one that also feeds into plastic surgery as well as people who diet and exercise. It is entirely human to have insecurities and it is not confined just to hairloss. Some people may feel they are too fat or thin, too tall or too short, perhaps they have a disproportionately large nose, or narrow shoulders, a big chin or weak chin. For women (and some men) it gets even more complicated with insecurities around having weak or low cheekbones (zygoma), even the appearance of - God forbid - wrinkles. I have seen some people justify HT and yet condemn plastic surgery and I think that this a little narrow-minded. We all have insecurities in one form or another as a result of perceived defects or weakness that have been genetically inherited. If someone seeks to address that via diet, exercise, medication or surgery, it is a very personal issue and not for us to judge or condemn. That said, when a person begins to lose a sense of perspective, that's when it becomes a little worrying. People who have changed the entire way they live their lives (personal and professional) based around their appearance have lost their sense of perspective. Which I would then class as BDD. There's a possibility here that if one problem is resolved via surgical intervention (HT or otherwise), they'll simply find another flaw to dwell on and the cycle begins again. Moreover, if surgical intervention fails to meet expectations and need further surgery later on, what will that mean for the patient? How will they mentally and emotional respond to that? I think there is also blurring of lines between what is a healthy interest with appearance and self-improvement and what is not. I don't think that there is a distinct black and white dividing line between interest and BDD, there's a large grey area and a lot of us are somewhere in that grey, myself very much included. Personally, I'm very liberal-minded towards surgical and non-surgical forms of self-improvement and maintenance. If you want to look after yourself or make yourself look better, more power to you. To my mind, the problem is when that person becomes so consumed in their appearance and self-criticism that everything else in their life grinds to a halt. Whether it be having interests outside of self-improvement, sacrificing your professional life for it, or - worse still - neglecting your friends and family. That's my two cents, for what it's worth.

Jessie - if you're already based in the EU and you've met the great man himself, Bisanga is who I'd go for. In terms of consistency of FUE results, nobody comes close to Bisanga in Europe. I'm at my 3 months post-op stage with him at the moment, and I hope that mine will also be one of those great results.

Surely HT is should be readily offered to those who are physiologically appropriate for it and those who can afford it? Unless transsexuals use some other form of 'creepy' currency that I'm not aware of. I don't want to get into rant, but I think the synopsis of your experience was basically that the office was a little dark and he does work on transsexuals. Neither of these things necessarily make him a bad or unprofessional hair restoration physician. Unless he was wearing stillettos at the consultation, whilst wildly attacking you with a FUE punch and singing an impromptu version of 'Sweet Transvestite' from The Rocky Horror Show. Seriously though, if there are legitimate reasons for not liking or trusting this physician (i.e. poor results, bad aftercare, poor patient treatment and so on) - fine. I'm sure many would back you up. However, so far I'm not convinced by your appraisal of his abilities or lack thereof.

Hi Corv, Congrats on the second procedure - everything looks predictably clean. Let's hope this'll now get you to where you want to be. Can I ask what your density is like in the donor area?

Lisco, I've just seen your updated pics and it wasn't as bad as I thought. The front at least, is definitely FUE. I wouldn't say that it was the best example that I have seen, but the fact that it isn't micrografts means that at least you probably won't get a pluggy look. That said, coverage, density, biting the FUs into the miniaturised areas (there are clear gaps between balding areas and transplanted areas) and a natural look are still a concern. The crown...I honestly don't understand what's happening there. Perhaps the scabbing needs to clear before we can give it a full appraisal. That said, I'm reluctant to continue posting on this thead as I'm not sure if the negative remarks are causing you distress and/or panic. As much as I feel anger, concern and sadness that a clinic would churn out a result like this, I know that there is a very real human story beneath all this - yours. With this in mind, unless I am specifically addressed, I'm going to bow out of this thread until Bill can get some form of update from Transmed as slinging negative remarks about the job done is not constructive any more. I just hope we can get some feedback from the powers that be soon. Again, chin up, happy healing and look after those grafts.

Lisco, is there any way you can post some pictures of the donor area? A good look at this area, plus a close look at the follicular 'units' in the crown should give us some idea of what we're dealing with. Again, I suspect that this is mini/micro-grafting which is pretty shocking to see on a forum dedicated to quality HT work in 2011. Even worse that a recommended physician was supervising it. That said, I would still try to remain positive and let the grafts heal and grow. If we can get those pictures from you and Bill can get a response out of Transmed, we will have some solid information to build on.

Racerx, I think it's fair to say that we've established what has happened here. You've continued to lose hair though not looking after your existing hair with a DHT blocker like finasteride. If you're not prepared to take fin despite the sound advice given to you here, you will continue to lose hair, ending up with an 'island' of transplanted hair at the front and bald hair behind it. You have two choices here: 1. Listen to the advice given, take fin (start on low dosages and work up to your tolerance level to reduce the risks of the side effects you're afraid of) and look after your native hair. 2. Do not take fin and accept that the fact that your male pattern baldness will continue to progress. You can either cut your losses from the HT, shave it and accept the fact that you will be bald or spend the rest of your life chasing your hairline with HT after HT. The later would be expensive, in advisable and eventually unlikely as you start running out of donor hair. Pick your path and best of luck with whichever one you choose.

Same thing here - I suspect your native hair is miniaturising and shedding. If you're not doing so already, it would serve you well to get on meds like finasteride to help prevent further loss. Minoxidil will only go so far.

Don't worry, this is commonplace. The surgeon will generally punch the donor or cut a strip and make incisions in the recipient. The technicians will separate out the individual follicular units and place them into the incisions made by the surgeon. If the surgeon did EVERYTHING, surgery would take a lot longer, cost more and not necessarily yield a better result, possibly even worse as FUs would have to spend more time out of the head and thus face greater trauma. That said, every surgeon should communicate this very clearly to all prospective patients before surgery to avoid confusion or distress.

Lisco, Firstly, I wouldn't panic just yet. Until you see the final results in 12-18 months time, it would be wrong to assume that it was a failure. So, for now, just remain positive, try to keep your stress levels down, look after the recipient and follow the post-op procedures to ensure the best yield possible. The advice they gave you regarding Propecia and Rogaine was certainly good advice, so following that is important. Particularly the former. That said, if you could take picture closer up of the individual FUs, it might be able to give us a better idea of what is going on. To my eyes, they look like micrografts, not follicular units of 1-4 hairs. Everything they said (0.8mm punch, 1-4 hair FUs) sounds like a standard FUE procedure, but the appearance seems to indicate that something else is going on. I'm judging this by how dark the transplanted units are and the spacing between them. This looks particularly evident on the transplants on the crown. Anyway, as I said, try to remain positive, follow post-op instructions, and keep us updated with photos and further developments. Hopefully Bill can get the clinic's side of things early next week.

The good news is that he is on the ISHRS. The bad news is that we have simply not seen enough evidence that he is a consistently good physician to recommend him for HT. There are a handful of great HT surgeons in the world, there are hundreds upon hundreds or mediocre ones. Not only that, but they'll charge the same amount of money per graft as their more esteemed competitors. Rogers for example, will be charging around 5GBP per graft when to start getting to the 1,000 graft figures. If you're a UK resident and you're happy to opt for strip, Farjo is your best bet. Within Europe you have Bisanga, Feriduni and Devroye. There is choice and you don't have to travel to the US to find a good surgeon.

Bill, please can you ensure that this is followed up by Transmed? Is this a genuine case from one of their patients or is this an elaborate hoax or attempt to besmirch the clinic - and surgeon's - name. The two main questions here is whether this was genuinely done by Dr Kaluhci and, worse, whether we're actually looking at FUE at all here. This, to me, looks like micro-grafts and not follicular units that have been transplanted. I've not seen something like this in a long time, and was certainly not something I was expecting to see on the forum. Lisco, you've been silent since putting these pictures up, we would like your side of the story on this as well. Please clarify on some of the questions and concerns that have been made so far. I don't mean to come across as accusatory, but your input would be appreciated.

It's an old school peroxide-based gel, so will work. Just be careful with that stuff. Professional dentists will use the same kind of thing (carbomide/hydrogen peroxide gel on teeth under a UV light) but they're more practised with it. Provided you are very careful, use it sparingly (too much in the teeth tray will cause 'overspill' and burn the gum) and not too often, it should be fine. However, if in doubt, leave it to a professional. That said, I would still be registered with a dental professional regardless. The health of your teeth is just as is important as the whiteness of them, so ensure that you treat them well. You only have one pair, after all.