newbie33

The hairline is looking good. Sure, it needs to thicken out, but it's only four months into the process. You know you'd be telling anyone else it's early days and not to freak out at this stage - and it applies to you too! The odds are well in your favour for this to turn out great.

Sometimes I imagine - even believe - I am a handsome, intelligent, charming man with a full head of hair. Alas, what I can imagine or believe is not necessarily true. I think what we can say from Fellers's posts are: patients are informed of a lead surgeon and that others will participate. They have no say in how much participation and by whom.

Seems there are two basic points here. One about how Professor was treated and another about how in general surgeries are performed at Feller & Bloxham. On the first point: have we actually verified what Prof said is how it happened? I remember the gist of the allegations, but seeing as he took them down before he was banned, and I can't recall reading anyone confirming them, difficult to know how to treat it. Shocking if true, yeah. But that is if it is true. Second point: as ever, if it's up front and you know what you're getting into (or rather don't know who will do what in your operation) and you're fine with that, happy days. As a one-time aspirant medical student, I have sympathy for a senior doctor taking responsibility for the overall operation, in which he decides how much is performed by juniors - everyone has to learn. But as Stig points out (and this might be a peculiarly British perspective, where we tend to think of general medicine as 'free' because of the NHS), if I was paying top dollar for an elective procedure, my instinct would be for the senior to do everything from writing my prescription to tucking me into bed at night.

So, Dr Feller, what is the answer....

Blimey, was it two years since he was in Manchester. Where does the time go? Cheers James.

James, guessing you had your HT in Madrid, not Manchester? Who did the extractions?

Lorenzo does temple points. You'll find them if you look at site site. And I'm not sure I'd say his hairlines are always conservative, but they do tend to swoop back in a similar pattern. I have him down on my very short list, but the hairline - which is something really important to me - is my main negative with him. Also, as others have pointed out, techs and other doctors there do extractions. I'm told he still does all the implanting, though. For what it's worth, I think Feriduni's hairlines are about the most natural out there. But he doesn't have as many examples of high graft counts in one HT as Lorenzo. And again, techs do all the extractions with him.

Sam, chap, you're 5-6 months out from a procedure, right? You don't know your final result - time spent planning the next one now is likely a waste of time. For what it's worth, I think it looks pretty reasonable at this stage. Sure, I'd want it to thicken up - and it might. And perhaps in time, knowing the final result, maybe I'd get the temple points done. But, bearing in mind the emotional trauma you went through - sounds like you're still going through - after the first HT, I'd really ask yourself if you want to put yourself through a HT again.

Needmorehair Who was on your surgeon shortlist? I also went to Madrid to see Lorenzo and I've had consults with pretty much all the docs I'd really consider getting a HT with - apart from Bisanga. For whatever reason, I've never really looked into his results so not pursued a consultation. Why did you boil it down to Lorenzo above any of the others?

Difficult to guess from that pic, and without any before shots, so there's a lot of assumption going into this. However, like all good maths students who know they've got the answer wrong, I'm going to show my workings out and hope to get a point for it. His hairline looks to have been in a V shape and they've tried to fill in the recession, making it more into a U shape, but not quite got the hairline right (leaving a slightly pronounced widow's peak - giving a sort of W shape) and the grafts haven't all taken, especially as it nears the temporal peak. (Please see technical drawing 1 for an illustration). If that is the case, I'd estimate it's an area of around 10-12 cm2 that they've tried to fill on both sides. At the hairline, let's say they're aiming for about 45 grafts per square centimeter. So, 12 x 2 = 24 square centimeters x 45 grafts = 1080. But, let's make another assumption that this is fue and they may have gone higher, knowing the rate of non-growth would be higher (and also make an assumption that this is what you're trying to show). So let's say 55 grafts per centimeter on average, making it around 1,300 grafts. On the face of it, looking at the picture, I'd say the growth is about 30-35 grafts per cm2 tops and in some places it approaches nil. So let's say an average of 25 grafts over the area of 24 cm = 600. So the guy's had over 1,300 grafts but barely half of them have grown. He's got an unnatural hairline, with patches of no growth, and some hairs are growing at an odd angle. In the UK, this would get me an A* at GCSE.

Thanks for the pics. Looks good for eleven days. Doesn't appear to be too red or obvious either. (Love the hand covering the face too!). Good luck.

So you did! Thanks, man. Any idea of the techs names, or how long they had been practising? This was one of my concerns when I met Dr Lorenzo. He said he sometimes does some extractions, or they are done by Dr Vila or techs. He led me to believe this had been going on for some time in his Madrid practice. But it was the element of uncertainty about who would carry out the extractions which put me off slightly. And I think Dr Vila has recently had a baby, so not sure she's actually there currently.

Thanks. Yes, I have consulted with him. But I'm not really sure I made most of it. In your op, who did the extracting and implanting?

Good luck with this, man. My hair is slightly darker, but very similar kind of balding pattern and skin tone to you - and also got Lorenzo on my very short list. So I'll certainly be watching your updates. Do you have any pictures to update? I think the most I can take off work is three weeks, so I'd be very keen to see your three-week mark!

Having long-ruled out Dr Doganay, I haven't followed all these threads very carefully. But it doesn't seem to me as if Paleo is bullying anyone (publicly, at least) - and plenty of members are less courteous than him. As for ranting, we none of us would be left if that was a membership disqualification. I'm sure you are doing your best to contact and get answers from Dr Doganay, Bill. But the slowness and vagueness of his replies would suggest he isn't doing his best to quickly clarify the topic of who, in effect, is carrying out surgery. That should, rightly, cost him dearly. Paleo, running with the hare and hunting with the hounds is a lovely phrase (and a good - probably unintended - pun!). I hope you end up with a decent result and that you are in a slightly better, calmer place a few months on from surgery. And as a post script, if masturbation, rocking to and fro in the corner crying, or shaking a fist at the sky while shouting obscenities are 'strenuous' no-nos after a HT, it doesn't augur well for me.

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Regrowing hair? Probably none. Maintaining hair: saw palmetto, biotin, a good multi vitamin... but only if you don't mind spending money on products that are very marginally effective or more than likely just plain ineffective. There's no magic beans for hair loss. If your nutritionist says herbs will regrow hair, he/she is more than likely a quack. I'm in a fairly robust mood this morning, so sorry if this sounds harsh, but there's no point sugar-coating the placebo.

Mosd, your hair loss pattern isn't that different from mine - and your goals are pretty similar. The haircut in the latter pictures are much better. If you're going bald (more than if you have a good head of hair) I think it's worth going to very good hairdresser, who knows how to cut to suit your face shape. I think you could probably go slightly less conservative with the hairline - not really lowering it, but making the recession more a U than a V shape. But, as you know, you've got to get a doc's opinion on how any grafts this will take and how many lifetime grafts you've likely got to cover future hairloss. Good luck.

Quite right David. I was having far too much fun quoting these lines from Airplane. Terribly childish of me. But on point - the guy has reasonable density for that amount of grafts over that surface area. Personally, I'd prefer to go denser and cover less area. But hey ho, each to their own.

Statistically significant of what, Matt? For anything to be statistically significant you need to have a statement to measure it against, so a null hypothesis from which you can calculate a p value and work out how accurate your statement is against the data (more fun with maths, kids!) The good thing about this study is that it's exactly the opposite of anecdotal (if it's reflective of all fue or fut, or even Dr Beehner's fue or fut, is another question). I've always been really curious why no data is really published from fue docs about the graft growth rates. It's obviously a massive area of interest and controversy and it wouldn't take that much to put some objective numbers behind it.

[quote @Newbie23 - Now I'm curious if there's a correlation between the guys that seem to have been the most ill-prepared for surgery and the country they're from. The consent form in the States, for example, may be a lot more detailed than in other countries. It'd be interesting to see if certain countries have a higher percentage than others of patients coming online in a state of panic over something that's standard and routine. Maybe I'll do some research "Newbie23", you flatterer, you! It's not the country the patient comes from, it's the one they get the operation done in that's important. In the UK, of which I know best, there are well developed laws about 'capacity' and what 'informed consent' means - with emphasis on the 'informed', which doesn't just mean you have signed a form. A patient can sue if they did not believe they were sufficiently informed to give full consent. And this tends to concentrate medical professionals' minds on having a process that makes sure the patient is in a position to understand the risks of their operation (or minimise their chances of being sued, which might not necessarily be the same thing). So it's normal for them to explain the complications and risks which might arise from the surgery and that the patient understand they may suffer these, along with the routine aspects of what they can expect after surgery. In the more litigious US, I'd imagine it's pretty similar. As I'd expect (but don't know) for most of Western Europe. But elsewhere, I have no idea.

I wonder, has anyone ever thought about creating a strip v fue thread? ;-) This is an interesting topic. I think a lot of point one would be covered in any discussion around 'informed consent' in most countries with a developed medico-legal system. Or at least it should be. Point two is a bit more difficult. People's expectations can be wildly optimistic, no matter what they are told and seemingly understand about a possible 'good' outcome. I would think most ethical doctors would be weary of operating on a patient who displayed those kind of unrealistic expectations. But realistically, how much time would there be to discuss and pick up on this in a pre-surgery consultation?

Thanks Dr Beehner. Very comprehensive response and much appreciated.

Very interests results. Would be fascinating to repeat this with different doctors performing the surgery, especially those who regularly do large fue sessions. Dr Josephitis from Shapiro shared a similar fue study on here recently and it really didn't get as much interest as it should have done. Dr Beehner, is an 86% graft survival for your strip work what you expected/normal for your strip results? And on the fue graft extractions, did you implant all you extracted, including any transected grafts? And if not, how many were extracted but 'wasted'?