JoeTillman

I had to laugh at the Tropic Thunder reference:)

Hi Xabi86, It is true that one can have a fantastic result as a diffuse thinner and not take medications but because you are a diffuse thinner there is a very strong chance that the hairs in the diffused area are going to fall out in the future. I can almost guarantee it but I'm also not familiar with your case nor have photos to review. It is not so much a question of "if" but rather "when". The basics are always very important to consider. Hair loss is progressive and the more you do to fight existing hair loss the more long term enjoyment and benefit you will get from a hair transplant. If you do have a procedure as a diffuse thinner and do not do more to prevent future loss it does not mean you'll look unusual but the degree of thinning you have now may wind up being what you look like again in a few years once the native hairs fall out so in essence, getting a hair transplant without doing everything possible to maintain existing hairs may wind up being only a temporary (and expensive) fix to the problem.

Dr. Rahal does some of the extractions along with a small team that is dedicated solely to FUE extraction.

Hi Splitting Hairs, The patient is 33 years old and is on meds. I don't know how many grafts he may have left. At Rahal we use the SafeScribe motorized punch however it is has been modified to meet our needs. If you take a step back and consider, this is not a lot of grafts for a small area as you indicated. It is an accepted general rule of thumb that roughly 1000 grafts are needed for each NW level to achieve a cosmetically acceptable degree of coverage and/or density. This procedure falls well within this rough guideline. I don't have the specifics with me (being a Saturday) but the density is in the 50 per cm2 range. When you break it down, there are no more grafts being used on this patient's NW3 area than one would find at any other top clinic. I hope this clears up any confusion.

This patient from the United States presented with a classic NW3 pattern of loss. The patient had a reduced amount of hair styling options and wanted to regain a youthful appearance without drastically dropping the hairline. 2553 grafts were extracted via FUE in one procedure for the result you see below. The result is showing at 11 months post-op. 1's: 685 2's: 1135 3's:687 4's: 46 Total hair: 5200 NOTE: The after photo was taken at 9 Months as there was no corresponding photo at 11 months.

Congratulations, Voxman!

Thanks, Lucldh, for your support. I don't recall your case specifically but I'm glad I was able to help you in any way. I'll continue to do so if the need arises in the future. Just PM me:)

Thanks, Sparky. Delancey, I've got some coming:)

Thanks, Sparky. Delancey, I've got some coming:)

Well, considering I've posted three results since I've been with Rahal, I think the question needs to be asked. What do you consider to be "very young"? One patient was 34, one was 24 and the first was 40:)

Rahal is known for hairlines first and foremost. You should take a strong look at the results I've posted of Rahal FUE over the past few weeks. There are dozens and dozens more that were posted before I came on board with Rahal but you get the idea. The photos are also taken without the use flash which I have spoken about for years. Flash makes hairlines look unrealistic in density and fullness. http://www.hairrestorationnetwork.com/eve/176421-rahal-fue-1616-grafts-1-year.html http://www.hairrestorationnetwork.com/eve/176337-rahal-fue%99-result-2017-grafts-1-year-post.html http://www.hairrestorationnetwork.com/eve/176272-update-must-see-rahal-fue-results-1413-grafts.html

Hi Blake, Rahal FUE includes the use of a motorized punch along with some modifications to the extraction process that make it unique to Rahal. One thing I like about Rahal is that once I arrived at the clinic, one of the things that was shared with me is the documentation of the extraction process where they measure the transection rates which are quite low. Some of these numbers are being reviewed and verified and I'll be discussing these findings along with other facets of the procedure in the future.

FUE has been performed at Rahal since 2005 so the experience is there and over the years it improved to the point that it is a viable alternative to FUT in terms of yield and results. That is one reason why I came aboard with the clinic. You have not seen any large cases of FUE with excellent yield because there have been no large cases posted:) This will change over time as I post more and more results.

Hi Arsenal, Thank you for your interest in Rahal. I think there is a bit of confusion regarding your case if you are who I think you are. Forgive me as I don't have the notes from your consultation but I believe I met you during your visit. I recall discussing with you that your donor zone is not suited to deliver enough grafts for crown work. I was discussing with you how each procedure, assuming one is going for the max in each procedure, will yield a lower number of grafts with each subsequent attempt. In my opinion, when one is going for the max in each procedure there will be a general reduction in the amount of grafts available due to increased tension of roughly 30% to 40%. This will vary from patient to patient and scenario to scenario. This was not specific to your case but rather I was explaining why the same number of grafts cannot be taken each time. The numbers of 3500, 2000, and 1400 were given as reference and not tailored for you as an estimate. Your estimate was for 3000 grafts in one procedure, 3500 was mentioned as a best case scenario and then a second procedure was mentioned as a possibility IF your laxity returned enough so as to gain more coverage on the top but the 1400 as a third procedure is not possible via FUT. This was a continuation of the example I was giving you. With your pattern of loss and limited donor supply any attempt at crown coverage will simply be taking hair that would be used for the front thus making the front quite thin and not a cosmetically worthwhile endeavor. The crown can take a lot of hair to make a difference and our explanation of the details specific to your case was an attempt to temper your expectations. If we thought that 7000 grafts were possible for you in any number of sessions then crown work would be something to consider. However, Dr. Rahal does very good crown work and the explanation of the reality of your situation does not reflect a reluctance to address your crown because of a lack of ability but rather a lack of donor hair.

Glad to help:)

Hi NM156, Thank you for your support. I'm glad I've been able to help you. What Hairthere said is true, if hair is curly growing out of the scalp it is also curly growing under the scalp. I think I should clarify and reiterate however that curly hair can be taken just fine but a larger punch is necessary to reduce transection and when you start using a large punch the benefit of FUE begins to diminish. Like I said, some people don't care and will prefer a larger dot to a linear scar. I'm not advocating one way or the other mind you, just saying it how it is.

Bonkerstonker, I really appreciate your post. Thank you my friend. Reverse, Yes, Chad is still with Rahal. We were hanging out together just the other day. He's a good guy. Thanks, Pupdaddy. I appreciate your support. You ask a good question. The factors that would go into recommending FUT or FUE reflect the basic strengths and weakness of each procedure. The basics are simple, if one does not want a linear scar, then FUT is out and FUE is in but if this is the procedure of choice there may be some limitations that the patient must accept. If the patient is a more advanced Norwood then it is more likely that FUE will require two passes to get a cosmetically acceptable result whereas FUT may only require one pass. This is subjective of course but you get the idea. I think younger guys are also more geared for FUE because of the obviously different hairstyle needs that may come with youth. There are also some types of hair that do not respond well to FUE such as hair that has a strong curl to it. This too can be worked with but a larger punch may be necessary and this can defeat the purpose of FUE with larger dots that form as a result but to many this is still preferred to a linear scar. If one is not concerned with a linear scar and the complications that may be a result or the limitations with hair length then FUT is a great choice. It obviously served me very well and I have no regrets whatsoever with my FUT experience. If I had to do it all over again I would still have chosen FUT over FUE. However, as I've said in the past under my former account name, had FUE been available in early 2002 as it is today I probably would have gone for removal of my old mini-grafts and become a head shaver. This is not a regret, it simply reflects the reality of what may have been my path had FUE been available to me 12 years ago. I hope this answers your question.

CD, Thank you for your comments. I'll be showing larger results as time goes by including crown results as you asked for in another thread. These first few results I've posted are to show that regardless of technique an excellent hairline that is expected from Rahal is achievable. There is more to come:)

This 34 year old patient came to Rahal seeking hairline strengthening via reshaping and strong density. He opted for Rahal FUE as he tends to change his hair style from shorter to longer. The result shown is at 12 months post-op. 1616 Grafts 3341 Hairs

The degree of redness after a procedure is not relative to the form of extraction used. The recipient site creation can influence this but there may be other issues to consider. Was the second procedure a larger procedure than that of the first? Was more density being attempted in the second than the first? There also could be subdermal scarring from the first procedure that can make the recipient zone red for a longer period.

1.) Dr. Rahal is more known for his FUT results, yes, but his FUE results are one reason why I came to work for the clinic. I started posting FUE results every Friday a couple of weeks ago and I have a lot more to add over the next year. 2. Asian hair is definitely different from Caucasian or African hair but with 19 years experience Dr. Rahal has had a lot of exposure to Asian hair. There are a lot of Asians in Canada and many have made their way to Dr. Rahal. I was speaking to one Asian patient just the other day. 3. The cost of a procedure depends on how many grafts you need moved. Have you submitted an online consultation request? If not, that is the way to go about getting a quote. 4. My name is Joe, not John:)

Hi CD, I'm sure I will be in the future. I'm still familiarizing myself with the results on file. Oddly, while I am in Ottawa I'm staying at the guest house with the out of town patients. I thought it would be a great opportunity to mingle with patients in a relaxed setting and answer their questions while they recover before leaving to go home. There is a patient from Ukraine that is here to get 2000 FUE into his crown. He may set up a blog at some point so if he does I'll point you his direction to watch his progress unfold.

Hi Kil, Thank you for your post. Dr. Rahal did not present last year at the conference so I did not see his work at that time. I'll quote and reference each part that you highlighted in bold... I stand by this quote. You may not realize it but there are a limited amount of results shown overall during the live patient viewing each year, maybe ten or twelve, but this was the part of the conference where several doctors are invited to present their best work or work that may be of interest to the membership on live patients. It was underwhelming. I included the entire statement above for context. It was very good crown work, better than the FUE presented. And I stand by this statement as well. There is a strange mentality among some of the doctors in the hair restoration field in that they feel that good enough is actually good enough. Of course “good enough” is relative but you should get the point. What I also saw at this conference was an overwhelming amount of information being shared about, wait for it....FUE! Almost nothing on the program for the conference was about strip. If you do a search online for the program of the 2013 ISHRS Conference there is a list of activities, workshops and discussions. When you find the .pdf file of the program you can type and hold "Cntrl" and "F" if you are using a PC and search for the term "FUT". You'll get 12 results. Now do the same and type in "FUE". You'll get 78 results! Most of the 12 results for FUT were comparing FUT to FUE. This is one of the factors that sealed the deal for me. FUE was EVERYWHERE! FUE is not only here to stay, it is growing. I think I remember a statistic about FUE and this one was shocking. 2 new FUE clinics open each week. I'm absolutely positive there are no FUT clinics opening, at all. That is a damning statistic. What I took away from the conference was that FUE was going to be the dominant form of hair restoration, and soon too, but what I also saw was that the results that people will be getting will be of lower quality because of so many amateur/experts getting involved. The field of hair restoration is moving backward with regard to quality but forward with regard to technique. Why? Because anyone with 100,000 dollars can buy a Neo thingy machine, get a weekend of training, hire a tech and a receptionist and start making bucks. This makes it easy for anyone to get into the field with ZERO experience and ZERO understanding of what natural looks like. If I wanted to, I could open my own clinic and all it NeoJoe Hair Restoration:) It is the experts, the doctors that have the experience and the real understanding of what it takes to make a natural result that will continue to stand out but the glut of rank amateurs jumping into the field because of the low startup costs will dominate the field because of sheer numbers. Today you can see more and more cosmetic surgeons that are more used to lips, boobs and tummy tucks jumping into the fray with FUE because they feel it is a logical adjunct to their current services and wish to add to their bottom line. The problem is that they do not specialize in hair and do not have the experience much less the artistic eye for hair. This move was not a binary decision where I have turned against strip. Quite the opposite, I have embraced FUE publicly and still continue to support strip. Strip is the better choice for many patients and FUE is the better choice for many patients. I have never stated that strip is the total solution for everyone and I do not believe that FUE is the total solution for everyone What I find odd is that when a strip clinic can see the advantages of FUE and start promoting it everyone gets excited but if a consultant does the same, independent of the clinic he is associated with, and moves on to a clinic that shares the same ideals then it's questionable. This is a massive double standard that defies logic. I represented a wonderful clinic for eleven years but the last few years I noticed the tide turning. I could continue to beat my head against the wall trying to create change or I could choose to eventually move on to somewhere that change has not only already occurred but has been refined. I have chosen the latter. So to summarize, I still support strip and feel it is the best option for many patients. I have not turned away from this option and will continue to recommend it for the right patient but FUE is on the table now and it will continue to grow in popularity with or without my support. By making the decision to move on to Rahal I can offer this second option with confidence. I hope this better explains my position and I again thank all of those that have taken the time to support my decision.

Hairfarmer79, This is the first of several unusual statements. I think that if you were sincere about this approach I would have heard from you by now. You've been posting since late July with a third of all your posts targeted toward slandering me. I'm happy to discuss your concerns in private as you suggested but that will happen when you decide to actually engage me privately in the first place. I'm curious how it is exactly that I'm trying to eliminate "every trace" of my former self. My old account under the name "Jotronic" is no longer active but it is not going any where either. It will remain visible for all to see. My current signature states that I am the poster "formerly known as Jotronic". I have made several posts saying that I am the former poster named Jotronic and there are currently three threads on this forum discussing the matter. My website is broken at the moment as the transfer of the domain and files did not go smoothly (and other issues I cannot disclose as of yet) but there are videos of me on my website. Btw, the quote you shared twice in another thread was posted on my website about five years ago, so no, I did not change my views overnight and it has nothing to do with my feelings on FUE. If you have no issue with Dr. Wong, who you now state is your surgeon and that you referred to as a "quality surgeon", we can deduce that whatever work you have received from him is at least satisfactory. With this deduction, we can then surmise that you had "dealings" with me because you actually said you did. From this we can conclude that your dealings with me lead to a satisfactory result from your procedure with Dr. Wong. If I were giving bad advice, acted as a "shady salesman" or was pushing "snake oil" (these are your words) then logic would dictate that you had an outcome contrary to what was discussed which then goes back to your current level of satisfaction which continues this unusual, twisted circle of contradictions. I'm honestly confused as to what your problem with me is. I am not shady and I do not push snake oil. I talk about finasteride being a great medication, minoxidil can help some but not as many as finasteride does and I think Nizoral is a good shampoo to add to the mix. I discourage use of lasers and any other product out there but I do encourage healthy eating and a few supplements such as Biotin and MSM to help the quality of one's hair. Where is this snake oil you speak of? I try to lower expectations, I never tell anyone they will have a result like mine regardless of their starting point, and I probably tell more guys they should not have surgery than most anyone else in the field of hair restoration. I help a lot of guys that do not have any intention of coming to a clinic I represent as evidenced by the responses of many members which you disregarded. Anyway, if you wish to discuss the issues as you say you do then simply send me a private message. It's not very difficult to do and you may find that you might be getting upset over a misunderstanding but there is only one way to find out;) In fact, I'm going to message you now.

This 24 year old NW3 patient was seeking hairline reconstruction that would allow him to transform his temple recession into a more cosmetically appealing frame for his face. He received 2017 grafts via Rahal FUE™ in one procedure.He returned to the Rahal clinic one year after his procedure to show the result you see below.