JoeTillman

LondonHT, Because you are considering Skalp that means you are considering permanent SMP. It is rare to see permanent SMP clinics offering thickening procedures and I believe they normally don't offer this because permanent SMP needles typically go deeper than tricopigmenation needles, 1.5 to 2mm vs. .5mm. The typical hair follical extends roughly 4mm into the dermis so while there wouldn't be obvious carnage the miniaturization of hairs may exasperate the issue with excelerated if not temporary shock. This is admitedly conjecture because I've not read where any permanent SMP company addresses why they normally don't perform thickening procedures so take that for what it's worth. Stil, talk to Skalp and ask these types of questions. There is a tricopigmentation specialist in the UK as well, London in fact, if you wish to consider that option too.

My gut tells me it is the beggining stages of thinning. You should visit your local doctor asap to get a professional opinion and discuss the options that are available to you, including Propecia/Rogaine.

Johnny2000, Every doctor can and does have bad results but if you are going to Lorenzo you are putting yourself in a postion of having probably the best possible odds in your favor. There may be a few that are rougly equal but none that I know of that are superior. Some may disagree but it is a decision as safe or safer than any other.

Hi Spanker, In most cases they are unhappy with density, coverage, angles, direction or anything else you can dream up. Anyone else looking at the same result would see a miracle before their eyes but the patient sometimes can never be happy with the best hair transplant on the planet and I suspect in some cases they would not be happy with their own original hair. It is rare but it happens and it points to larger issues being involved.

I don't think there is a problem with that but I would recommend allowing Avodart to have a full year to make a difference for you before considering adjunct options like SMP. Avodart is powerful stuff and in my opinion the earlier you start in your thinning process the greater the chance for a strong comeback so you might wind up not needing SMP once one year has passed while on Avodart.

6000 grafts on a NW7 will not achieve what you ask, for the average patient. 3000 grafts for the frontal third would probably give you a nice result (assuming at least average characteristics) but with an additional 3000 grafts for the remaining 2/3 you will not get a direct ratio of coverage as what would be achieved in the frontal 1/3. In other words, your density won't be half that of the frontal 1/3, it will be much less. The rotational direction of growth found in all crowns, and the need to reconstruct this pattern, reduces the degree of coverage that can be achieved in the front due to the lack of "overlap" from one follicular unit to the next. When you think of tiles on a roof you can see how the front can have coverage just from proper placement to achieve a similar overlap for coverage. The same is much more difficult to achieve when the direction of growth is changing from one folliucular unit to the next as is found in the crown region. The general rule of thumb is that it takes roughly 1000 grafts per NW level to achieve a satisfactory result but it is my opinion that the number of grafts per NW level climbs as one increases on the NW scale itself with the real differences occuring once the crown opens up. The only way to get meaningful coverage for a NW7 with 6000 grafts is to pack them in the front 2/3 and grow the hair long to cover the back as much as possible. If you are hoping for shorter hair styles, your chances of meaningful coverage are next to zero. If you are a probable NW7 in the future then do whatever you can to prevent yourself from actually getting to this point. This way your question will potentially only be a hypothetical:)

Just stop, Bill. Please. You all know how to let me know these things privately. I'm done posting on this matter in this thread. If you have anything further to say to me please do so in private message or email. If you wish to continue posting publicly then start a new thread. Of course, calling me as you was originally suggested is the preferred method (as I've been saying all along) of discussing whatever it is that bothers you. Again, my apologies to Dr. Vories and the membership.

Agreed. Always thought so myself.

What concerns? First, the problem was that Bill said I'm duplicating the work of HTN. The two doctors I work with publicly refuted his claim. No more problem. Then the problem changed when both of you said I should have a link back to this website on my website. I have for thirteen years. No more problem. Why do the problems keep changing? Once one problem is shown to be non-existent, you come up with a new problem and then that too is rendered moot. What is it that you wish for me to do that no one else has to do? I've been waiting for a call since yesterday so instead of updating everyone on matters that don't actually exist try picking up the phone to call me.

Gil is right but I think the average is higher with 6500 grafts being on the low end and up to 8500 grafts on the high end. Averages being what they are there are cases where much more can be taken and of course much less due to extremes (plus or minus) of characteristics. Doctor skill absolutely has a major role on this too as some doctors recognize how to take wider strips than others with a higher degree of skill and with almost zero transection. Of course, on the flip side, even the best of strip surgeons can have patients with wide scars when getting a lot of hair. Regardless, you most likely have an easy 3000 left and more for subsequent surgeries if you so choose.

Hi Bill, Shall I post a screenshot to show you that there is a link on my website that points back to this one? It's done, so what is the problem? You asked for me to put a link on my website to this one. It was already there. Problem solved. Now we can move on, yes? Where did I refuse anything? So there is no confusion; Will someone from HTN please call me? I ask that you stop posting on this already decimated thread. It's embarrassing.

I don't. If I took on too many clinics in one geographic region then my input on local marketing strategies could potentially be viewed as "compromised" by the presence of another client clinic right next door, so to speak. Besides, I'm a one man show, so I can't handle multiple dozens of clinics with what I do. I can only handle a relative handful in comparison because of the involvement I have with each clinic so it is better for me and better for my affiliates for me to spread out.

Congratulations. I guess I can no longer call you Blake but instead call you "doc".

I'd like to apologize to Dr. Vories, and Dr. Karadeniz, for this becoming such an issue that they felt compelled to discuss our respective relationships. It should not have been necessary. However, I hope this settles the issue, whatever the issue was. Thank you to Dr. Vories and to Dr. Karadeniz for sharing your time and your thoughts. Pat, It is good to see you back. You've not posted in a very long time. I'm glad that you too have stepped in to give some sense to this thread. To address the issue of my "forum", if you take a second to look at it (as that is all it would take) you'll see it isn't a forum. It is a venue for people to ask questions directly of me, publicly, so that others may benefit. There is no option to start new topics outside of the scope of what the "forum" is intended to be. It does not see much activity because most people prefer to contact me privately, which is fine. Regardless, you have a policy of not allowing third party links and I was asked to remove any links from my profile so what legitimate reason do you have to question why there is or is not a link on my "forum" that points back here? I contribute solid content to this website (more so than on other forums I might add) which is worth far more than any link exchange, especially with the latest Google algorithm updates. Links do not matter nearly as much as they used to because content is king. Despite the policy of this website to not allow third party links I still have a link to this website which is placed in the section about my history. It's positioning is more relevant than a link placed out of context. I welcome the contact however I don't understand the purpose at this point. My future involvement should be no different than it is at this moment or as it has been for the past thirteen and a half years. I post to give my opinions and to answer questions. The only difference is that if I answer questions about a doctor I'm working with it will not be as their consultant. I will also continue to challenge doctors that present incomplete points of view or views I disagree with as this only helps to serve the community better. It provides invaluable content for your marketing and SEO purposes and it helps to educate the community as a whole. You win, your readers win. Done. Furthermore, both doctors that I currently work with have dismantled Bill's accusations about what it is that I do so there can be no further legitimate discussion about my work being a "duplication" of his own or anyone else that works for this community. I am not working exclusively with HRN doctors so it cannot be said that I am piggy backing off of your screening process either as I am currently screening a doctor in Europe that is not listed here. The two doctors I currently work with are members here by coincidence. For me to do otherwise would be disrespectful of your process. If I accept this doctor he will not be mentioned by me on this website as a courtesy unless of course he himself comes on board as a member. Once (or if, it is still yet undetermined) you see his profile page on my website then you are welcome to approach him for membership, as would be your right. Therefore any policy changes that are being discussed between you, Bill, Dr. Bloxham and David are irrelevant to what I do and unnecessary. Finally, there are two issues I think should be addressed. First is that of the poster "spectstronic". Bill has acknowledged that this account is that of another poster... The creation of the "specstronic" account is a violation of your TOS and a smear on a thread about Dr. Vories. I respectfully ask that you remove the post and close the account. To leave it in place under the guise of "free speech" would tarnish the very essence of free speech as it is nothing short of free speech exploitation by whomever created and used the account. I suspect that more mystery accounts will appear to continue the smear campaign but of course you can deal with those as you see fit. It's your site. The second issue is Bill. I believe that Bill was out of line by calling me out and smearing my character on a thread about Dr. Vories. If he felt insulted or hurt he shouldn't have started the mudslinging to begin with but it was not my intention to hurt his feelings. It is clear that the public dispaly he put on was designed to shame me somehow regarding his "concerns". I can handle it as it doesn't affect me personally but I do strongly feel that Bill should publicly apologize to Dr. Vories. This is a thread about Dr. Vories and not so much about me and whatever problem Bill has with me should have been taken up privately but unfortunately Dr. Vories (and Dr. K respectively) had to take time out of their own schedules to address the "issue" that Bill has with me. To discuss or debate this will only contribute further to tarnishing Dr. Vories's good name so let's move on. I wish to return to posting and sharing information. Have a great day and when I pass through Ashville on July 23rd or 24th maybe we can have a beer together at Barley's Taproom downtown (if your'e in the area) All the best, Joe

I'm still waiting for a quote showing how I'm supposedly insulting Bill or Pat and "undermining" their credibility. I would also like clarification on the multiple statements of how I'm "asking doctors" to pay me. I expected some new posters would come out of the woodwork on this one so I'm not suprised by "Specstronic" although I do appreciate the wit. However, I'm curious to see how long the account will remain active and the post will remain on this thread since it's very existence is a violation of the TOS. Bill acknowledges it is another user... Will there be more new posters slinging mud? If so, will they too be allowed to continue? What other surprises can we expect to find in this thread? Let's not lose focus on the issue. I've played within the rules and abided by the existing Terms of Service. If there has been a request to change anything about my profile or my signature or anything else deemed to be outside of what is considered to be acceptable, I complied without complaint. My current position in this industry is not sudden as I've been clear about my affiliations for two and a half months, since I first announced my "affilation" with Dr. Karadeniz. but suddenly I'm now being "contemptuous" and I'm "not contributing". My list of affiliations was made in the interest of transparency yet somehow this is being looked upon as nothing more than advertising. I can remove my signature and I can refrain from making any announcements of affiliations but then I'd be in violation of the TOS which states that everyone has to reveal if they have a professional relationship within the industry. I'm damned if I do and damned if I don't. Had this been about me repping doctors that are not listed on this site, then I would absoltutely understand the "concern". I am currently discussing an affiliation with a doctor in Europe that is not listed here and I would not pretend to be able to advertise anything with him on this site due to his lack of presence here but the doctors I am currently engaged with ARE listed here and what this attack on me and my reputation represents is the idea that somehow HRN doctors can be told how to spend their money and whom they can associate with. And that is what this comes down to, control. I've played within the established guidelines yet I'm not only being singled out, as Bill put it, but I'm being smeared. What is sad about all of this is that Bill and I had an open line of communication for many years and I just can't wrap my head around how this has unfolded. A call, a private message, an email to ask me questions or to express concern would have been nice but instead Bill has resorted to a publc smear campaign along with false comments. If I ever have a problem with someone I have a long relationship with, one that spans over ten years, and I need to speak to them about it then I man up and pick up the phone. I don't try to make them look bad and make up stories about them in a public setting. I ask that Blake be removed from such discussions as it is an ethical conflict of interest for a doctor that has a partnership in a clinic paying money to this site to be involved in policy making decisions that involve the general community, not to mention competing clinics and those they choose to have finanical affiliations with. Ultimately, there is nothing that I or anyone else can do about this. I mean, no where can anyone say I've broken any rules to the point that such treatment is deserved so all we can do is wait to see where the goal posts will be moved to accomodate what should be embraced as simply great content.

Delancey, Big:) I don't know the exact number. Sean, Thanks. I did get some footage of Dr. Shapiro. I interviewed him about the challenges and claims of FUE vs. FUSS and mFUE presented by Dr. Feller and he had some interesting things to say about it. When I get time I'll have it uploaded but I have other videos to edit first. I've also got info on several other points but I have to give it a proper write up and that will be a short while from now. Stay tuned.

Point to one insult. Quote me. How have I undermined your or Pat's credibility? The bottom line is this. You started this, not me. You've peppered your posts with innuendo, enough to choke a horse. If you were really concerned and truly had questions you would have called me. Forget about my original call to you and this claim that I'm trying to make you look bad for not calling me back. There is something called communication and we've had open lines of it before. Even if I did not call or you did not get the voicemail, it is irrelevant. We go back far enough that you could call if you truly wanted to know what I'm doing. Funny how these "concerned" people have emailed you but not me. Why wouldn't anyone just ask me directly? You've done so in the past so the question begs to be asked; why not now?

Hi Bill, I'm not sure what the problem is my friend. Regardless of whether or not you received my message, which was left on your work #, not your cell #, you have my # so if you really want to discuss this I fail to see why you can't pick up the phone. Have you gone to Turkey to document what it's like to do so? Have you gone to any clinics with a video camera to document and film? I know Pat has gone to a few clinics in the past but none with a video camera that I recall and if he has in the past he certainly isn't doing so now. Have either of you ever worked in a top clinic? How about two? Do you know what constitutes proper medical practices? I do. How else am I supposed to say I'm being compensated for my time? Yes, and if you clicked the "Forum" link you'll see it has one section and one section only called "Ask Joe" and the "link" is not in the "Ask Joe" section. It is somewhere else on the website. Once again, how else am I supposed to say I'm being compensated for my time? You've asked me multiple times what I'm doing and I've answered multiple times more but now you have a problem with the way I worded it? First, my fee is what my time is worth and no one is forced to pay but when someone contacts me and asks me what it takes to be affiliated with me then I dont think I should say that I shouldn't work with them because I don't want to upset Bill and Pat. Does that make sense to you? You say "by your own admission.." as if there should be an element of guilt in utilizing my experience to various clinics. However, how would you react if I were working with any clinics that were NOT listed here? Would you ask for them to join the site if they were not already listed or would you prevent me from posting if they refused? Should I have set up my own forum, you know, one that has more than one section called "Ask Joe" and gone into direct competition? I don't think so and I wouldn't want to do that to begin with. There are enough forums as it is. You've mentioned more than once that you think I am offering what you are already offereing. If that's the case, where are the video reviews? Where is the investigative work you've done to infiltrate a "technician" clinic in Turkey by posing as a patient? Yeah, I've done that (video to come soon). If what I'm doing is no different than what you're doing why are doctors contacting me to ask how they can be affiliated with me? I've only contacted one doctor, all the others I've spoken to have contacted me first and I have the emails to back it up and no one has anything to the contrary. Obviously there are doctors that see value in my experience but I really REALLY hope you aren't equating my experience as a patient, with two bad strips and then repair with Dr. Wong, having worked in two top clinics for a total of over 11 years and having practically invented the idea of patient documentation (among other things) to what can be found in a 35 page manual. Seriously old friend, do you think that is fair? Again, I've got docs contacting me and we are not offering the same services. You're in your house in Pensylvania. I'm on a plane for a week out of each month, away from my family,for the past three months documenting clinics with more to come. I mean, it is what it is and if you can point to one person on your staff that has as much clinical experience as I do, as much experience as a patient as I have, is hopping on planes documenting for YOUR readers what a clinic is like, showing what the journey involves, staying in and showing the same hotels that patients stay in and trying to dig into the subject matter, again on video, that people are interested in knowing about, then I'll gladly step aside and hang it up because the last thing I'm going to be is a "me too" kind of guy. I am an original thinker which is why you can not legitimately point to anyone else doing what I'm doing. You're not doing it, neither is David or Blake. Pat's not doing it because he's doing his thing away from the "job". In fact, Pat said something interesting yesterday that I think suits this situation... That quote was by Pat just yesterday on his Facebook page. This is what I'm doing, I'm being my authentic self so how can this put a bad taste in his mouth, much less yours? For this to put a "poor taste" in your mouth is silly, really. If you thought differently you'd realize that what I'm doing is a benefit to this community because none of you have done what I'm doing and quite frankly none of you have the time to. You'd have to hire someone to globetrot and you'd have to dedicate time each day to each of your doctor members to help them with improving their policies for the betterment of the patient and for the betterment of the industry. I'm not going to work with 80 doctors, I'm going to work with a handful because to work with any more would be spreading myself too thin. Well, I think it is obvious that if you truly wanted to talk about this man to man, you'd have done so by now, instead of trying to shame me publicly. As I said, you have my #. You have my email and you have the voicemail, and caller ID that shows I called. I still have the record on my phone as well. Shall I send a screenshot of my phone record to prove I called? So the question begs to be asked, Bill. What am I to do? Continue to offer unique and original ideas for clinics to utilize for their patients and keep shooting original video footage for your readers to take advantage of or should I disappear and let my experience go to waste? Experience that quite frankly no one else has. I mean, it's obvious you want me to do something or else you wouldnt' be initiating this one man lynch mob. So instead of wasting everyone's time, lets get to the heart of the matter and tell me what you think I should do.

Based on the photo you have provided I would wager that your expectations are not realstic. Most men would give a body part for a hairline and overall frontal fullness like this. I'll reserve final judgement for the rest of the documentation but from what I see here you have nothing to be upset about, unless of course you started out like this. Then you'd have something to complain about.

As she should be. Great job, doc!

Hi Bill, No question about it, HRN does a great job prescreening doctors. I’m sure you’ve spoken to each doctor or clinic multiple times to make sure they live up to HRN standards before they’re accepted. Everyone here appreciates that, including me, but I’ve never seen anyone from HRN go into clinics with a video camera. I’ve mentioned on more than one occasion what it is that I’m doing so for you to say that I've been "vague" is not entirely accurate. Maybe you just didn't see my posts in this regard but Blake also asked for clarification about three weeks ago. It is difficult to define because no one has done what I’m doing before and to say that I’m building a “recommended” list is too simplistic. My list is simply a disclosure of whom I’m working with so no one can say I’m hiding anything. Would it be fair to continue posting as I always have and not disclose that I’m affiliated with clinics that are members here? I don’t think so and I believe it is important to let people know that there is a professional relationship between me and the doctors that have enlisted my services. I’m also required to reveal this per the Terms of Use for members of HRN just like I had to during my ten years with Hasson & Wong and my tenure with Dr. Rahal and same as SL from BHR, Voxman from Darling Buds (Yay Voxman!!!), Spex from his clinics as well anyone else that has a job in this field and posts on this website. What I do: I’m working with clinics that are recommended here and I’m offering assistance with their online presence. The work you do is obviously thorough for pre-screening these doctors as they all obviously do very good work but few know their way around the online world so I use my experience to help them and guide them in this respect so you can refer to part of what I do as online presence management. Being an SEO or general online marketing guru is useless because I utilize my experience from posting for 13 years and working in a clinical environment for 11 years to the benefit of clinics I work with. Having been on both the negative and positive sides of being a patient for 23 years and having 27 years of customer oriented sales experience means I have ideas on how patients can be better served before, during and after their procedures. From what I’ve seen most clinics have similar follow up procedures and patient care protocols but my experience tells me there is a better way and I’m also lending my input in this regard. Clinics that I work with have an open mind about how things can be better and I’m going to be helping to improve the industry by encouraging changes to how patients are looked after. No one else online has the combination of experience that I have so that is what makes me uniquely qualified to work with clinics for postive change. Then there is video. I’ve started a hair transplant documentary series that started with Dr. Karadeniz and it will continue for each and every doctor that I work with including Dr. Vories. Patients want to know what it is like to go to these clinics, whether they are in their own backyard or half way around the world, so I’m showing them what to expect above and beyond that which a two-dimensional text and photo review or testimonial can give. Finally, I have a separate website that is not in my signature because I’m not sure how to present it without violating the TOS so I simply state that I have an affiliation with Beauty Medical as well. That’s it; that is what I get paid to do, so far. On the flip side I work with patients every day that have used my Hair Transplant Mentor toolkit and I also act as an intermediary in case of patient/clinic disputes regardless of whether or not I work with the doctor. I’m currently working with two separate clinics and patients that I have zero financial connections to but I want to help the patients find answers to their problems and I’m talking to the clinics that they went to, all free of charge. Two things people should understand. Just because someone is on my “list” doesn’t mean I’m saying they are superior to any other doctor. It does mean that I like their work and they get positive recognition from me but it mainly means they have not only demonstrated the ability to perform excellent hair restoration but they have also demonstrated to me an open mind to making things better for patients and I have a LOT of ideas on how to do this and for this they get positive acknowledgement for what they do. My time is not complimentary so like you and everyone at HRN I receive a monthly retainer for my time. There has never been anything vague about this and it has been disclosed multiple times since I first started working with Dr. K. I have to make a living and this is one way in which I do this. Finally, old friend, had you simply returned my phone call from June 5th you would have known all of this because this is what I wanted to speak with you about when I called and left the voice mail. If you for some reason you did not get my voice mail you have all of my contact information in which you can inquire. You have my phone number and you have my email address, as does most anyone else that has been around for a while. Anyone that is emailing you to ask about me and what I’m doing can also just as easily contact me through private message here. It is easy to do and I don’t bite. I hope you're doing well and if you ever call me back we can catch up;)

Alpine1, You have had an excellent experience and that is what matters but you have no right to insult any of the respected clinics that perform surgery in the regions you label as substandard just because of their location. That's a prejudiced view that wreaks of financial elitism at best, and borderline veiled racism at worst. It's one thing to support your doctor of choice but it's another thing altogether to use the excuse of clinical manipulation of forums when everyone you insult decides to call you out on your BS. I hope your second result turns out as well as your first but FYI, since you are mere days out from your 2nd procedure your donor scar is a complete unknown that has ZERO guarantees of perfection. Because Dr. McAndrews took two relatively small strips as opposed to one larger one, it most likely will be fine, but again there are no guarantees. Remember that.

Blake, Maybe you missed my point, so I'll reiterate. Alpine stated... I then replied with the following point... I stand by my statement because the worst HT surgeon in the world can charge 20.00 per graft and give an equally horrible result while "the best" hair transplant surgeon in the world can give a procedure away and have, again, an equally stellar result. Price can be a result of regional cost of living and what intended market will bear just as much as it can be a result of one's ego or lack thereof. Price does not indicate whehther or not a doctor or clinic follows proper sterilization protocols, infectious prevention protocols, etc. I've been in surgeries where some of the top surgeons in the world wore ZERO face protection. I have seen a top surgeon sneeze into his own bare hands then continue handling a patient with no effort in between to wash his hands. I have seen one surgeon's OR that has a toilet IN the OR with no door separating the two. None of these doctors were in Turkey, India, or any other low cost region. They were in western Europe and North America. These issues are also part of the reason why I'm currently working with no more than two surgeons, because multiple others have not deomonstrated what I consider to be proper standard operating practice. I know what surgery is supposed to involve but more importantly I know what surgery is supposed to NOT involve. Price shopping isn't recommended if that is the only deciding factor, I wholeheartedly agree, but if after one completes a long process of legitimate research and winds up in the end comparing two well respected doctors with equally good reputations and the only thing separating the two is price (assuming similar estimates and game plans), what else is there to consider? Choosing the least expensive option is not price shopping, it is separating marketing from reality and using common sense to complete the journey.

I feel I need to clarify something about Dr. Bauman. He does use the Neograft but he doesn't use the suction device. He disabled it long ago and uses the motorized punch portion which he feels has the best balance of any motorized punch in the industry. I think he's made adjustments to make it even better, in his opinion, to increase it's efficiency. So, while he is indeed using the Neograft, he isn't using the Neograft as it as orginally intended. What that means in the end is up to the patient to decide.

Alpine, With all due respect, the amount of money one pays for a hair transplant has zero influence on the final result. L. Lee Bosley used to charge more than 9 bucks a graft and he easily got it too. I mean seriously, I've seen some of the most expensive hair transplants in the world and some of them did not hold a candle to some much less expensive results I've seen. I personally know someone that has spent 125K and he reverted back to a hair system. He was a virgin scalp, non-repair patient too. I've seen some results from what you would call "third world" clinics that would shame some of the biggest names in the business. They're all using the same tools, they're all using the same techniques. No one has "the secret" and no one has a monopoly on "cutting edge" technology. It just comes down to natural talent, enough experience, knowing which tools to use that are freely availabe on the world market and actually giving a damn about doing the best work that can be done. Money can't buy that, but research can find it.