Cuervo

I can tell you stories of docs - all kinds of docs from various disciplines - who will staple for whatever reason for one patient, procedure, but stitch for another. Resect a growth in the GI? Stitch the inner fascia - possibly staple the outer skin. It's gonna be an ugly scar - some docs will choose to staple just like some people are ok texting "R U OK" as opposed to "Are you okay?" It's a bit arbitrary - but I wish to empower you with this distinction and the courage to ask for what you WANT. And it may be "acceptable" because, after all, it's a technique to close a wound, right? But, is it proper and appropriate in a cosmetic setting with the additional ethical consideration of it being a high profit procedure? I don't think so. So you should be armed with the information you need to have to get the result you want. The donor scar is a big deal. Staples lead to large scars. Pistone uses staples. NOT all hair transplant docs use staples. You decide what you do with that information. Intuitively, as a physician, staples for this is an atrocious act that warrants sanctions. As a layperson, you may not be able to see this. My two cents.

Thanks for the reply - this is why I'm posting: for your own personal intel. If you're going in to see Pistone, please know the facts of what he does, has done, is likely to do, and be prepared to ask and be informed before you walk in. What you're saying is that my two points are "way off" but way off of what - expectations or the standard? I KNOW staples are for butchers - that's my experience in hospitals and surgical suites. It has no place in cosmetic medicine, period. That's an opinion and a strong and educated one. If this is the standard, I don't believe it, and I disagree in the logic and rationality of it. Stitching is a skill in itself - you see surgeons perfecting this as interns through residency. Inner fascia, outer skin, etc. It's a tremendous skill. Seeing someone staple especially in an area that will then require you (the patient/client) to force a blade 4 and above, it's not acceptable, period. So, if this is standard for the practice of hair transplantation, and I know it's not because Brandon Ross STITCHES, then it's not acceptable. I suggest anyone going in for a procedure to go in and require that stitches be placed. If the doc is only used to stapling, then he probably CAN'T stitch. Then, you have to ask yourself, "Am I OK requiring a blade 4 or higher until I depart the earth?" This is the intel/information I wish to bestow on those pondering or about to go in. For techs, I understand this - but I think that when you're forking over cash flow of $3-$6K+ a MD would be the person to insert the grafts. And not all practices do this - it depends on the state and whether it's considered the practice of medicine to insert a graft. I would have likely thought twice had I known this because I had inferior grafts placed that were ingrown/indented. Brandon Ross added/padded my hairline with new grafts which concealed the ones done by Pistone/his army of inferior techs.

Went in at around 34 in 2010 to see Pistone - do not recommend which is why I'm creating this account and posting to Pistone threads! I learned of his tactics AFTER the procedure (of course) because you see the results. Who CARES of the courtesy of the staff, how polite the guy is, where he went to medical school - if the results blow, then it was not worth it. Basically, his practice committed FIVE TREMENDOUS no-nos of hair transplantation which most people simply do not understand or appreciate. 1) he used larger grafts (micro-minis) even though he was supposed to be a FUT guy. How do I know? Well, I have access to a camera to see the head and you can see larger grafts! I went to see another doc (Brandon Ross) who said I had larger grafts like mico-minis which is not really the standard nowadays. What this means is his staff spent LESS time cutting the strip and he spent less time making incisions (for placement of the graft) because there were less grafts because they were bigger. So, a lot less work, but more or equal money. So, he used micro minis which I did not want. Find a FUT guy. Here's how you thwart that. If you must use Pistone (don't recommend) go in there with a camera and a pic of your scalp and you know how many follicles you have per sq cm, etc. Something like a smartphone would be fine, I think. Make it clear YOU ARE EDUCATED. Make it clear you have a friend, Rocko, who's a surgeon and he's going to look at the incisions later on to make sure they're single follicular units. "Hey, doc, how many grafts do you think we'll get in here because my friend works over at CHOP and she's a surgeon. She says she'll stop by in a few days and she says she'll count the grafts to see how many I got...and can tell if there's multiple follicles per graft." YOU SAY THIS and YOU WILL IMMEDIATELY GET RESPECT because you will cease being an idiotic patient like this guy thinks you are. You will cease being an ATM machine for this guy and he will probably feel the pressure to do the right thing: single follicular units. (OF COURSE he will say this is what he does, BUT it's NOT!) 2) he used staples!!! Unbelievable. I thought it was pretty clear that with a cosmetic procedure you would never use staples - wow! so much for intuition. But nope, this guy used staples. Even sent me home with a staple removal kit!! Staples result in LARGE SCARS. And I have a massive one. The next transplant guy was like, "Whoah!! Who did THIS??" God forbid, you use a few minutes extra to suture the inside and the outside. God forbid!! GO MONEY. So, tell the guy: "I want to make sure you do not use staples at this reputable practice because that's for butchers." They'll thread you - if they say they will use staples, run!! 3) He uses techs to insert the hairs (or is simply incompetent)!!! Lord, there's a few things a hair transplant practice must do well: cut the graft into follicular units, poke the little holes, and then insert the grafts into the little holes. Who cares about buying you lunch?? When I went to the next guy Brandon Ross, he showed me many grafts right at the hairline!! that were "indented" or ingrown meaning they were placed in such a way that they were BELOW the surface of the skin. This results in a graft that looks pretty bad. It should be even with the skin so it looks natural. So, either Pistone was DRUNK, HIGH, or he used incompetent techs to do this and went off for a smoke. I was OUT like a light so I didn't see who inserted the grafts. ASK, "hey doc, who does the actual insertions of the grafts because I understand that constitutes the practice of medicine and I want to make sure it's an MD who does this not a tech..." (I understand inserting grafts is a skill that techs can do in some states so maybe my complaint can be watered down to "I had inferior techs insert my grafts...") 4) He does not do his own consults. I know this is common - but in general, see the doc who is going to do you - if you get a tech/some other person, this is points off for that doc. 5) LIED about the graft numbers: this is related to number 1 above. Of course, if they do a micromini graft in their head they might think there's like .... 4 follicular units so they might equate that to four grafts even though its ONE graft and tell you it's FOUR. This is a lie. I had them counted by three different people: 789, 817, and 830. He said I had over 1500 grafts!! BULL! And yes, I paid for more grafts. So, would you go to this guy? I'm not spending much time praising Brandon Ross in La Jolla, but I should: he is a cool un-cocky guy who sits with you for the consults. He gives you what you ask for. He calculates accordingly. He doesn't do larger micominis and he uses stitches! THIS should be the gold standard. Pistone does not meet this so I cannot recommend him. Brandon Ross charges a flat rate of $3 per graft and there's no room to cheat because whatever strip you get will get cut down to whatever native number of follicular units there are. You get billed for what's harvested and he has natural results - my result looks so much nicer AFTER Ross went in and fixed up my ingrown hairs that Pistone did. Go Ross, Boo Pistone.

As a quick reply to above, you need to go in there and know everything. They will say anything - lies or not - and you have no idea if they're truthful! Get a camera, zoom in on your scalp, measure your own density. OR go to 2-3 different consultations (Bosley is good for this) get a picture of your scalp: right there on the screen when they use the camera whip out your smartphone and snap a pic! This way you'll have evidence of what your density is and you don't even have to invest in a microscope camera. You should use a little ikea-type measuring tape to have a reference. Key point, don't ever say, "I was told I had so and so density" you need to know this stuff BEFORE going in to the guy who's doing the work. More power for you - or you'll get rammed. So, walk in, "hey, I know I have about 20-30 grafts per sq cm presently in my 150 sq cm of key areas over my scalp and I believe my donor density is - actually, can you tell me what my donor density is, please?" And make sure the number meshes with your number, Have more info, be less ignorant and you will reign supreme. Chances are, you will leave some practices. Background and review on Pistone: Started losing early around 21. Went in at around 34 to see Pistone - do not recommend which is why I'm creating this account. I learned of his tactics AFTER the procedure (of course) because you see the results. Who CARES of the courtesy of the staff, how polite the guy is, where he went to medical school - if the results blow, then it was not worth it. Basically, his practice committed FIVE TREMENDOUS no-nos of hair transplantation which most people simply do not understand or appreciate. 1) he used larger grafts (micro-minis) even though he was supposed to be a FUT guy. How do I know? Well, I have access to a camera to see the head and you can see larger grafts! I went to see another doc (Brandon Ross) who said I had larger grafts like mico-minis which is not really the standard nowadays. What this means is his staff spent LESS time cutting the strip and he spent less time making incisions (for placement of the graft) because there were less grafts because they were bigger. So, less work, but more or equal money. So, he used micro minis which I did not want. Here's how you thwart that. If you must use Pistone (don't recommend) go in there with a camera and a pic of your scalp and you know how many follicles you have per sq cm, etc. Something like a smartphone would be fine, I think. Make it clear YOU ARE EDUCATED. Make it clear you have a friend, Rocko, who's a surgeon and he's going to look at the incisions later on to make sure they're single follicular units. "Hey, doc, how many grafts do you think we'll get in here because my friend works over at CHOP and she's a surgeon. She says she'll stop by in a few days and she says she'll count the grafts to see how many I got...and can tell if there's multiple follicles per graft." YOU SAY THIS and YOU WILL IMMEDIATELY GET RESPECT because you will cease being an idiotic patient like this guy thinks you are. You will cease being an ATM machine for this guy and he will probably feel the pressure to do the right thing: single follicular units. (OF COURSE he will say this is what he does, BUT it's NOT!) 2) he used staples!!! Unbelievable. I thought it was pretty clear that with a cosmetic procedure you would never use staples - wow! so much for intuition. But nope, this guy used staples. Even sent me home with a staple removal kit!! Staples result in LARGE SCARS. And I have a massive one. The next transplant guy was like, "Whoah!! Who did THIS??" God forbid, you use a few minutes extra to suture the inside and the outside. God forbid!! GO MONEY. So, tell the guy: "I want to make sure you do not use staples at this reputable practice because that's for butchers." They'll thread you - if they say they will use staples, run!! 3) He uses techs to insert the hairs (or is simply incompetent)!!! Lord, there's a few things a hair transplant practice must do well: cut the graft into follicular units, poke the little holes, and then insert the grafts into the little holes. Who cares about buying you lunch?? When I went to the next guy Brandon Ross, he showed me many grafts right at the hairline!! that were "indented" or ingrown meaning they were placed in such a way that they were BELOW the surface of the skin. This results in a graft that looks pretty bad. It should be even with the skin so it looks natural. So, either Pistone was DRUNK, HIGH, or he used incompetent techs to do this and went off for a smoke. I was OUT like a light so I didn't see who inserted the grafts. ASK, "hey doc, who does the actual insertions of the grafts because I understand that constitutes the practice of medicine and I want to make sure it's an MD who does this not a tech..." (I understand inserting grafts is a skill that techs can do in some states so maybe my complaint can be watered down to "I had inferior techs insert my grafts...") 4) He does not do his own consults. I know this is common - but in general, see the doc who is going to do you - if you get a tech/some other person, this is points off for that doc. 5) LIED about the graft numbers: this is related to number 1 above. Of course, if they do a micromini graft in their head they might think there's like .... 4 follicular units so they might equate that to four grafts even though its ONE graft and tell you it's FOUR. This is a lie. I had them counted by three different people: 789, 817, and 830. He said I had over 1500 grafts!! BULL! And yes, I paid for more grafts. So, would you go to this guy? I'm not spending much time praising Brandon Ross in La Jolla, but I should: he is a cool un-cocky guy who sits with you for the consults. He gives you what you ask for. He calculates accordingly. He doesn't do larger micominis and he uses stitches! THIS should be the gold standard. Pistone does not meet this so I cannot recommend him. Brandon Ross charges a flat rate of $3 per graft and there's no room to cheat because whatever strip you get will get cut down to whatever native number of follicular units there are. You get billed for what's harvested and he has natural results - my result looks so much nicer AFTER Ross went in and fixed up my ingrown hairs that Pistone did. Go Ross, Boo Pistone.

Started losing early around 21. Went in at around 34 to see Pistone - do not recommend which is why I'm creating this account. I learned of his tactics AFTER the procedure (of course) because you see the results. Who CARES of the courtesy of the staff, how polite the guy is, where he went to medical school - if the results blow, then it was not worth it. Basically, his practice committed FIVE TREMENDOUS no-nos of hair transplantation which most people simply do not understand or appreciate. 1) he used larger grafts (micro-minis) even though he was supposed to be a FUT guy. How do I know? Well, I have access to a camera to see the head and you can see larger grafts! I went to see another doc (Brandon Ross) who said I had larger grafts like mico-minis which is not really the standard nowadays. What this means is his staff spent LESS time cutting the strip and he spent less time making incisions (for placement of the graft) because there were less grafts because they were bigger. So, less work, but more or equal money. So, he used micro minis which I did not want. Here's how you thwart that. If you must use Pistone (don't recommend) go in there with a camera and a pic of your scalp and you know how many follicles you have per sq cm, etc. Something like a smartphone would be fine, I think. Make it clear YOU ARE EDUCATED. Make it clear you have a friend, Rocko, who's a surgeon and he's going to look at the incisions later on to make sure they're single follicular units. "Hey, doc, how many grafts do you think we'll get in here because my friend works over at CHOP and she's a surgeon. She says she'll stop by in a few days and she says she'll count the grafts to see how many I got...and can tell if there's multiple follicles per graft." YOU SAY THIS and YOU WILL IMMEDIATELY GET RESPECT because you will cease being an idiotic patient like this guy thinks you are. You will cease being an ATM machine for this guy and he will probably feel the pressure to do the right thing: single follicular units. (OF COURSE he will say this is what he does, BUT it's NOT!) 2) he used staples!!! Unbelievable. I thought it was pretty clear that with a cosmetic procedure you would never use staples - wow! so much for intuition. But nope, this guy used staples. Even sent me home with a staple removal kit!! Staples result in LARGE SCARS. And I have a massive one. The next transplant guy was like, "Whoah!! Who did THIS??" God forbid, you use a few minutes extra to suture the inside and the outside. God forbid!! GO MONEY. So, tell the guy: "I want to make sure you do not use staples at this reputable practice because that's for butchers." They'll thread you - if they say they will use staples, run!! 3) He uses techs to insert the hairs (or is simply incompetent)!!! Lord, there's a few things a hair transplant practice must do well: cut the graft into follicular units, poke the little holes, and then insert the grafts into the little holes. Who cares about buying you lunch?? When I went to the next guy Brandon Ross, he showed me many grafts right at the hairline!! that were "indented" or ingrown meaning they were placed in such a way that they were BELOW the surface of the skin. This results in a graft that looks pretty bad. It should be even with the skin so it looks natural. So, either Pistone was DRUNK, HIGH, or he used incompetent techs to do this and went off for a smoke. I was OUT like a light so I didn't see who inserted the grafts. ASK, "hey doc, who does the actual insertions of the grafts because I understand that constitutes the practice of medicine and I want to make sure it's an MD who does this not a tech..." (I understand inserting grafts is a skill that techs can do in some states so maybe my complaint can be watered down to "I had inferior techs insert my grafts...") 4) He does not do his own consults. I know this is common - but in general, see the doc who is going to do you - if you get a tech/some other person, this is points off for that doc. 5) LIED about the graft numbers: this is related to number 1 above. Of course, if they do a micromini graft in their head they might think there's like .... 4 follicular units so they might equate that to four grafts even though its ONE graft and tell you it's FOUR. This is a lie. I had them counted by three different people: 789, 817, and 830. He said I had over 1500 grafts!! BULL! And yes, I paid for more grafts. So, would you go to this guy? I'm not spending much time praising Brandon Ross in La Jolla, but I should: he is a cool un-cocky guy who sits with you for the consults. He gives you what you ask for. He calculates accordingly. He doesn't do larger micominis and he uses stitches! THIS should be the gold standard. Pistone does not meet this so I cannot recommend him. Brandon Ross charges a flat rate of $3 per graft and there's no room to cheat because whatever strip you get will get cut down to whatever native number of follicular units there are. You get billed for what's harvested and he has natural results - my result looks so much nicer AFTER Ross went in and fixed up my ingrown hairs that Pistone did. Go Ross, Boo Pistone.

Started losing early around 21. Went in at around 34 to see Pistone - do not recommend which is why I'm creating this account. I learned of his tactics AFTER the procedure (of course) because you see the results. Who CARES of the courtesy of the staff, how polite the guy is, where he went to medical school - if the results blow, then it was not worth it. Basically, his practice committed FIVE TREMENDOUS no-nos of hair transplantation which most people simply do not understand or appreciate. 1) he used larger grafts (micro-minis) even though he was supposed to be a FUT guy. How do I know? Well, I have access to a camera to see the head and you can see larger grafts! I went to see another doc (Brandon Ross) who said I had larger grafts like mico-minis which is not really the standard nowadays. What this means is his staff spent LESS time cutting the strip and he spent less time making incisions (for placement of the graft) because there were less grafts because they were bigger. So, less work, but more or equal money. So, he used micro minis which I did not want. Here's how you thwart that. If you must use Pistone (don't recommend) go in there with a camera and a pic of your scalp and you know how many follicles you have per sq cm, etc. Something like a smartphone would be fine, I think. Make it clear YOU ARE EDUCATED. Make it clear you have a friend, Rocko, who's a surgeon and he's going to look at the incisions later on to make sure they're single follicular units. "Hey, doc, how many grafts do you think we'll get in here because my friend works over at CHOP and she's a surgeon. She says she'll stop by in a few days and she says she'll count the grafts to see how many I got...and can tell if there's multiple follicles per graft." YOU SAY THIS and YOU WILL IMMEDIATELY GET RESPECT because you will cease being an idiotic patient like this guy thinks you are. You will cease being an ATM machine for this guy and he will probably feel the pressure to do the right thing: single follicular units. (OF COURSE he will say this is what he does, BUT it's NOT!) 2) he used staples!!! Unbelievable. I thought it was pretty clear that with a cosmetic procedure you would never use staples - wow! so much for intuition. But nope, this guy used staples. Even sent me home with a staple removal kit!! Staples result in LARGE SCARS. And I have a massive one. The next transplant guy was like, "Whoah!! Who did THIS??" God forbid, you use a few minutes extra to suture the inside and the outside. God forbid!! GO MONEY. So, tell the guy: "I want to make sure you do not use staples at this reputable practice because that's for butchers." They'll thread you - if they say they will use staples, run!! 3) He uses techs to insert the hairs (or is simply incompetent)!!! Lord, there's a few things a hair transplant practice must do well: cut the graft into follicular units, poke the little holes, and then insert the grafts into the little holes. Who cares about buying you lunch?? When I went to the next guy Brandon Ross, he showed me many grafts right at the hairline!! that were "indented" or ingrown meaning they were placed in such a way that they were BELOW the surface of the skin. This results in a graft that looks pretty bad. It should be even with the skin so it looks natural. So, either Pistone was DRUNK, HIGH, or he used incompetent techs to do this and went off for a smoke. I was OUT like a light so I didn't see who inserted the grafts. ASK, "hey doc, who does the actual insertions of the grafts because I understand that constitutes the practice of medicine and I want to make sure it's an MD who does this not a tech..." (I understand inserting grafts is a skill that techs can do in some states so maybe my complaint can be watered down to "I had inferior techs insert my grafts...") 4) He does not do his own consults. I know this is common - but in general, see the doc who is going to do you - if you get a tech/some other person, this is points off for that doc. 5) LIED about the graft numbers: this is related to number 1 above. Of course, if they do a micromini graft in their head they might think there's like .... 4 follicular units so they might equate that to four grafts even though its ONE graft and tell you it's FOUR. This is a lie. I had them counted by three different people: 789, 817, and 830. He said I had over 1500 grafts!! BULL! And yes, I paid for more grafts. So, would you go to this guy? I'm not spending much time praising Brandon Ross in La Jolla, but I should: he is a cool un-cocky guy who sits with you for the consults. He gives you what you ask for. He calculates accordingly. He doesn't do larger micominis and he uses stitches! THIS should be the gold standard. Pistone does not meet this so I cannot recommend him. Brandon Ross charges a flat rate of $3 per graft and there's no room to cheat because whatever strip you get will get cut down to whatever native number of follicular units there are. You get billed for what's harvested and he has natural results - my result looks so much nicer AFTER Ross went in and fixed up my ingrown hairs that Pistone did. Go Ross, Boo Pistone.