PupDaddy

orangehair, First, beautiful work by Dr. True with relatively small amount of grafts but with a patient having great hair characteristics (wavy, salt & pepper, medium caliber, somewhat course). Second, I have a question about the patient's scar (great photos of it, by the way, and a very thin scar indeed): In the right hand photo with the hair above the scar taped up, there appears to be about a 1.5-2 cm ribbon of scalp below the scar with little to no hair growing from it. Did the patient suffer permanent shock loss below the scar, or am I seeing something else? Thanks!

We were waiting to hear how thing went, man, it sounds like it could not have gone better. You are going to have one great hairline! Congrats!!

Go, Spanker, go! Hoping your ht is going/went GREAT!

For physicians, lawyers, accountants, and many other professionals, their time and expertise are their stock and trade. Top plastic surgeons usually charge for consultations. Some credit the consultation fee against their surgical fee if the patient subsequently has a procedure with them, some don't. I think plastic surgeons and hair restoration surgeons are a good comparisom because hair restoration surgeons are essentially cosmetic surgeons. I personally have no problem with hair restoration surgeons charging a consultation fee. I would hope that my ht surgeon's time and expertise are valuable and in demand. The fact that a number of ht physicians have chosen to forego consultation fees as a business/marketing/competitive decision is fine, but I don't hold it against those who make a different decision.

Sean got it right. This approach and result by Dr. Umar is groundbreaking. Given this patient's facial structure and amount of hair loss, a low hairline, restored temporal points, and blocked temporal peaks looks fantastic even without exceptional density. For this patient, the available donor was better used for aggressive facial framing than it would have been for a denser packed but more conservative hairline. He should look good for the rest of his life. Terrific, creative work!

Thanks for the bump, Spanker -- and very best luck on your ht with Dr. Konior next week! (not that you will need luck with this talented, experienced surgeon, but good luck anyway) You're right, this Hasson result is an excellent example of a terrific looking transplant on a mature patient.

It's really the last (bottom) two before-after photos posted by Jotronic that capture what a remarkable transformation this is. Way to go Dr. Wong and vinbald!

Very, very sweet work! Perfect hairline for his age, face, and hair characteristics, and great coverage for the amount of grafts. This is one of those SMG results that don't scream at you, it just looks right. Excellent!

Hairchop8, Compiling a list of "top 5" hit docs is subjective, and it you follow this board you will see that particular docs' popularity can spke and wane over time. What I would tell you is this: Nearly every ht doc's web site will have one or two "wow' results. But in compiling YOUR list of favorite docs, look for consistency of excellent cosmetic results demonstrated in patient after patient. This is subjective as well. You will find as you peruse hundreds of results on doc's web sites and results posted by docs and their patients on this board, that different docs have different aesthetics, approach, and technique that manifest over time in their results. You will find yourself often being able to peg a patient as having been done by this doc or that doc. There is just a "look" to the work. Not always, of course, but you will see what I mean. And here's the thing: what looks great to some might look odd or "off" to you, and vice versa. That's what I mean about the subjective component of rating ht docs. And don't ignore your gut when assessing a doc's body of work. If a few of their results give you pause, even though much of their results look good to you, keep in mind that they posted the "odd" results as examples of their work too and you could be that patient. Beyond that, you will want to research whether they specialize in FUT v. FUE, or are equally adept at both, and, of course, you want to compare consistency of result with these docs' FUE and FUT work. You will also want to focus on these docs' results with patients whose hair loss is similar to your own. And you will want to determine whether a particular doc whose results appeal to you with patients of similar hair loss to yours generally achieve these results in one-pass (so called "mega" sessions) or prefer to take a more conservative approach to session size and divide them into two sessions -- both approaches being valid but presenting different considerations for the patient. It is fun (and sometimes maddening) to compile a list of "top" ht docs. Just make it your own list and not someone else's.

Good question, bnash79. My guess is that if you asked 10 different docs you'd get 10 different answers. FUT is, by definition, not the mini graft/micro graft transplantation approach of old. So what, if anything, is the difference between FUT and the popular marketing term "Ultra Refined" FUT? Some docs would say nothing, that by nature and definition FUT is ultra refined compared to non-FUT transplants of old. Others might say it refers to the doc and his team's skill set in executing FUT. Others still might say it refers to particular methods or instruments used to implant the FU's, such as custom cut blades for making the recipient sites, lateral slit technique, etc. I don't think there is an industry standard for what the term "ultra refined" means when used as a prefix with FUT, but it would interesting to see what the docs on here say.

Holy cow! Great doctor + great hair characteristics (although you wouldn't have thought it from his before photo) = great result. Looks like a lot more than 4,000 grafts and he looks like a totally different person.

I agree that this is beautiful work. I think the before photo under-depicts the extent of this fellow's hair loss because of the little clump of forelock hair he had front and center. I've said it before but I really like Dr. Wesley's hairline work. That unusual pattern he uses results in some of the nicest and most un-transplanted looking hairlines I've seen from the docs who post on this board. It would be great for patient convenience if Dr. W would offer these kinds of graft numbers in one session, although I understand why some docs favor a more conservative approach with smaller sessions.

If nothing else, this thread shows that FUE protocol and technique are still evolving. I think the trend (at least with manual punches or hand-held motorized punches) is away from consecutive day sessions to increase total numbers and towards multiple sessions separated by about 8 months. Dr. Rahal is an example of a world-class doc who used to offer consecutive day FUE sessions but now has gotten away from it because of compromises to yield from the next day’s session due to trauma from the first day. The closest thing we currently have to a proven mega-sessions doc looks to be Dr. Lorenzo in Spain, although even he achieves his big FUE numbers via 2 fairly large procedures separated by 8 months. I am really interested to see how the ARTAS is going to impact FUE practice and protocol. It appears to offer major advantages in terms of making the excisions: computer mapped excision pattern, computer-determined angle of the punch to precisely match the growth angle of the FU, speed, and precise robotic repetition of the ideal movement and depth to excise the FUs. And the excision tool itself is a modified Harris SAFE, which combines blunt and sharp excision and has become the motorized punch of choice for a number of top docs. It will be interesting to see whether ARTAS will significantly up total consistently achievable FUE one-pass numbers with the predictable yield of strip, or nearly so. For now, I personally would stick with 1,500 – 2,000 max for any single-session FUE, and if I needed more, I would space the sessions apart by eight months or so. I’m also not convinced that it really matters whether the doc or techs extract/remove an FU after the doc has cut/excised it, so long as the tech is trained how to do it. If it means the doc can devote more of his time and attention to the critical task of cutting/excising the FUs and making recipient sites, and that the FUs can more quickly be segregated by numbers and implanted into those recipient sites, I don’t have a problem with it.

Some docs have stopped doing consecutive day FUE because they have found that the second day yields are comprised.

WOW!! Dr. Konior seems to routinely hit 'em out of the park but this one is extra special. Just incredible.

They should rename their "Pixel Graft Cutting Technique" as "Pixel Cutting And Pasting Technique."

Holy cow, Gatsu! How did I miss this one? Yours is one of the most dense FUE results I've seen. Looks like your doc achieved ultra dense packing AND terrific yield (and a beautiful layout), which is no small feat with FUE. Congrats and thanks for posting. Are Dr. Teser's before/after patient photos available for viewing somewhere? It says on hnis web site that Turkish regulations don't permit publishing them on the site.

cimbom, You're being way too self-judgmental and hard on yourself, if I might be so bold. Do you know how many cosmetic procedures are had by women each year in the United States alone? Upwards of 10 million, according to the American Society for Aesthetic Plastic Surgery, and rising. With modern advancements in surgical and non-surgical cosmetic procedures and societal acceptance of them, it is almost more difficult to find a woman who hasn't had some sort of cosmetic procedure. You are in vast and good company. Once you relieve yourself of the stressof thinking about your hair loss everyday, you might well find that you are an even better companion and partner to your husband -- more confident, less distracted, and not feeling like you are hiding some dreadful secret. Many people who have had successful ht procedures report that it was life changing for them and a boon to their relationships. Good on you for taking this step and deciding to suffer no longer. Best luck!

"We believe HONESTY earns trust and we practice this everyday" It seems they need more practice.

Thanks, Joe! This fellow must have gotten nearly 100% yield. Dr. Wong did an amazing job with 4,500 grafts over quite a large area. Beautiful.

Not to minimize at all the terrific FUE work being done by Dr. Lorenzo, but keep in mind that quite a few of Dr. Lorenzo's videos show results of two staggered FUE sessions, separated by 6-12 months. Nevertheless, he does seem to achieve consistently good to great results with large session FUE, and as others have noted, he is a maestro with that implanter pen, and his techs are amazingly fast at loading the things up with grafts. From a personal aesthetic, I'd like to see a bit more irregularity in some of his hairlines. But I am with others here: I am keen to see whether he responds positively to Bill's approach about possible recommendation and membership.

I am not so quick to dismiss SugarHigh’s concern out of hand. Yes, the result so far is mostly excellent. However, he is understandably concerned that the center front, two centimeter square area of his hairline, which he says consists entirely of transplanted follicles, not only has lost the hairs that had grow in but is showing no signs of new growth breaking through. I think Sugar is sharing a reasonable concern without being alarmist. Ultra dense packing can, occasionally, backfire. Whether the next six months proves his concern to have been unfounded, or whether he will need a small touchup session to this area, remains to be seen. I appreciate him sharing both the highs and the lows of his hair restoration journey. Best luck, mate!

Joe, Would you have any immediate post-op pics of this patient so we can see the grafting?

Perfect! Excellent approach for a young HT patient, and a beautiful, utterly natural hairline that serves him well now and for the long term. I am especially impressed by how Dr. Dorin incorporated and built from the wisps of remaining native hairline hair. Spanker is right: T&D's photographic quality is tops.

This gentleman looks great, and the result achieved by Dr. Gabel is all the more impressive considering how challenging a case this was. Beautiful planning and work. Well done!