Shadow of the EMpire State

Six months? Looks pretty damned good. Rahal's on my (very) short list when I finally pull the trigger.

 

This looks a bit more conservative than some of his other work. I wonder whether the patient's age entered his thinking or whether the patient wanted something a little less aggressive.

Well done.

Please allow me to be blunt and use an example to clarify my point. I would like to date 20 year olds while I am still in my early twenties. Looking 30 because of my super high temples does not help.

 

Whether you get women really has very little to do with your hair. The men who think that baldness prevents them from getting women are the ones who never got many women in the first place. They judge women on looks, so they assume that women feel the same way about men. Only they don't. Women respond to game, not what your hair looks like. Men with no game think that they didn't get the girl because they weren't handsome enough when, in reality, that usually has nothing to do with it. You want to talk about dating 20-year-old women? Right now, at my local bar, we have a 37-year-old scumbag who comes in. Total loser. Criminal record, been in a motorcycle gang, etc. Well, he's got a shaved head with an extreme NW3-4 dracula hairline. Plus, he's short! Well, two weeks ago, I found out he's banging a 21-year-old waitress who works there. The rest of the guys and I sat on our asses watching the clock go around while we stared at this girl's ass. But this guy actually went up to her. And that's why he got her. You could have Brad Pitt hair, but if you're not approaching women with game, you won't get them.

How old is the patient?

I think he looked better before. His hairline was farther back, but it was thick. Now it's been pushed forward, but it looks sparse and slightly pluggy.

Obviously, this is a great result---the kind of thing that only a few clinics in the world could likely pull off. And this is why Hasson & Wong has the reputation it does. But ironically, I think the result actually underscores the limitations of modern hair-transplant surgery. After all, here's a patient who had everything going for him. First, he had great donor density. Second, he had great scalp laxity. Third, he was a strong NW 5 without much lateral or vertical drop. Fourth, he was able to get a startling number of grafts. And last, he had one of the best surgeons on the planet. But despite all these advantages, the midscalp and vertex are still see-through in the pictures, which, it should be noted, are notoriously lenient when it comes to judging HTs. And that's not a knock; after all, this guy was slick bald. It's just a reminder of how many grafts are needed to obscure baldness. They were able to pour nearly 8500 grafts into a NW5, and the daunting reality of it all is that he could probably use another 8500. That's what we're up against here.

Wow! A rare appearance from Dr. Umar. I guess this is my best chance to ask some questions that I've had for him.

 

1. Lately, it seems that the FUE technique is coming under increased attack from some of the more-prominent surgeons, who claim that it produces inferior yield and, most alarmingly, carries a substantial risk of a depleted, moth-eaten donor area. How do you respond to that criticism?

 

 

2. I've been told that the efficacy of FUE is much to do with whether the patient's skin allows the grafts to be extracted easily. Is this true, and is there anything you can do to treat a person with tougher skin?

 

 

3. Do you think the total available donor area is smaller for a FUE patient than for a strip patient?

 

 

 

Thanks.

Good point rhof625933. Thankfully I don't have any noticeable thinning in my crown at this point but yes, the hairline is what everybody sees the most.

 

I'm scheduled to get a transplant in 1.5 months but I haven't paid anything yet bc honestly I'm nervous about shock loss (since a good portion of the transplanted grafts would be placed in frontal and temporal regions where hair still exists). Also, I do have some miniaturized hairs in the temple region (and some in the front) that would most certainly be lost due to shock (or so I think). Anyways, I seem to go back and forth on whether or not to go through with this hair transplant based on my good and bad hair days. As of now The idea of getting a fuller looking hairline is SO tempting! I think I'm driving myself crazy lol. Any more advise would be greatly appreciated.

 

It's an easy call. Operating on a 23-year-old NW2 is madness. You haven't even cleared the stage at which the mature hairline develops. No transplants before 27, at the earliest. After 30, would be better, and after 35 would be best.

i knew that the best thing to do is to stay on medications and have a surgery when I am older and my hair loss pattern is more clear. But to me. I wanted to have a decent hair while I was still young. Waiting till I am 35 or 40 didn't seem like a wise thing to do for me as I may not even care about my hair at that age so much that I want to go through with a hair transplant.

 

Luckily, you chose a top-end surgeon. But the idea that you won't care about your hair when you're 35 is very naive. Let me tell you something: only the body ages. Everything else stays the same. If you think that lightning will strike at 30 or 35 and suddenly transform you into a fat dad who doesn't care about his hair, you're kidding yourself. In all likelihood, you'll be as concerned then as you are now.

 

 

Still a little iffy at the hairline, but the great thing about the faux hawk is that it lifts the eye off the hairline and makes it look a lot thicker.

The result looks good at the moment, but nothing can convince me that transplanting a 21-year-old kid is a good idea.

What's the big deal about post-op pics? Transplants pay off on results.

Not impressed at all for the number of grafts used. Very, very marginal improvement.

Looks quite good so far. Still, I don't see how anyone could have classed him as a NW3A before. More like a late NW4, early 5.

How can everyone compliment the result based on pics taken 3-4-3 feet away? Close-ups come closest to telling the truth.

Hello,

 

I had my HT with Dr. Path in Bangkok on the 29th of September 2011, and boy was I glad I did!! I received 3956 grafts and everything went very smoothly. Dr.Path is a very professional doctor and knew exactly what I wanted. I just couldn't thank him enough for making this a very pleasant experience, unlike my first HT with another Dr.

 

This was my 2nd transplant, as my first, performed by some doctor called Dr. Tahsin Al Wahab in Bahrain 2 yrs ago, was a complete waste of time, money, and 2200 grafts! I have asked him lots of questions prior to the surgery only to find out that he lied to me. I asked him if he would be transplanting the grafts himself and he said he would only to find out that the nurses did most of the work, and the only thing he did was butcher me!! He "literally" butchered my head while removing the grafts.. He actually was ripping off the skin with his fingers that I could hear my skin being ripped off like a piece of cloth which led to a severe cut in the blood vessels. I was in total shock seeing how brutal he was performing the surgery on me and blood was pouring from my head down to my shoulders that I actually felt so nauscious and light headed. He didn't even bother to at least stitch it, but rather stitched the outer skin in hopes that the vessels would heal their own. All of this which I didn't know was happening until later. I suffered from horrible pain for 3 weeks post op as my donor area was VERY swollen because of the blood accumulating under the stitched skin.I just couldn't bare the pressure it caused! I went to 4 doctors hoping that someone would help relieve the pain but no one did. they all asked me to go the doctor who performed the surgery to remove the stitches and fix the problem. When I went back to Dr. Tahsin for the 2nd time, begging him that there is something wrong and this didn't seem right, he was very rude and actually told me to "toughen up" and get over it and that this is all part of the healing process, which I knew was not true and that I didn't have to go through all this pain.

3 weeks post op, while I was working on my laptop trying to forget about the pain, all of a sudden the stitches split open because of the pressure of the accumulated blood and I was bleeding from head to toe, like a F*****G pig!! I don't know how, but I managed to call my parents who happen to live near by to come and rush me to the ER. I reached the ER completed RED from head to toe! The doctor was shocked and immediately rushed me to the operations room to perform surgery under full anesthesia, which I had to pay over a $1300 for!! Not to mention the money I paid for the HT surgery as well which I didn't see any good results except for a very wide donor area scar.

 

I decided to share my story with everyone to help other people make right decisions!! DO YOUR HOMEWORK!! research well and never let the price of an HT dictate your choice of a doctor!! An unprofessional doctor can actually kill you!! Its not worth it !!

 

anyway, here's my pics before and one week post op with Dr. Path... Its now one month post op and the transplanted hair is shedding.. which is making me worry a bit! But I do hope they will start to grow back in a couple of months .. I know that Dr. Path is a great doctor and I can't wait to see the results.

 

Let me know what you think

Simply put, I think the design is very, very aggressive, given your age, amount of loss, and previous use of 2,200 grafts.

 

First, although you describe yourself as a NW2A, the pictures suggest that you're probably closer to a NW4 with noticeable thinning into the NW5 zone. And given that you're only 26 or 27 years old, I'd hazard that you're probably a lock for NW5 within the next 5-10 years. Second, you selected a NW1 hairline design with rounded corners. Third, you already had a previous surgery in which you used 2,200 grafts.

 

Those are all major risk factors counseling against this kind of low, straight NW1 hairline. I hope it works out for you, but I fear that you could be in for a world of hurt when you're 35.

Maybe Im too young or "hip" but Im surprised I see so many parted hairstyles.

 

You're not that young, bro. You're in there with me!

OK result. Still very thin up front.

This guy needed at least 3,000. Maybe more.

Hard to comment on the results because this guy needs substantially more than 3,000 grafts to have effective coverage of the top.

Shadow,

 

Reread what you wrote me in your last post. Everything you said was prsonal attacks on me.

 

You started with the personal attacks. Don't start calling someone "ignorant" and then cry when you get your head handed to you. Did I attack mahhong? Of course not. Why? Because he raised a principled argument, not a slew of ad hominem nonsense.

 

I imagine these comments solifty who you are as a person. A person with limited ability that has formed narresstic tendencencis as a way of dealing with your shortcoming both physically and mentally. I may be unable to spell naccessicim ? but at least I know what the word actualy means.

Forget spelling "narcissism." After reading the above, I'm not entirely satisfied that you can spell your own name.

 

Bottom line: don't call people "ignorant" or attempt to psychoanalyze them and then claim that you were attacked.

No more comments for me, we will have to agree to disagree on some points.

 

Fair enough, buddy. Good luck with your next round.

Shadow,

 

I understand your prospective but I think you are making some gigantic assumptions about this patient, none of which are substantiated.

 

OK, let's see.

 

 

I think the way hairloss is treated today is significantly better than than the way we treated hairloss 20 years ago. The techniques used today are much more sophisticated than the techniques of 20 years ago. So although there is no current cure, we have made significant advancments in treating hairloss.

I admit all of that; there is no question that techniques have improved. But until we find a way to increase the number of available grafts in the safe zone, the efficacy of hair transplants will remain limited. In that respect, there's actually fairly little room left for improvement under the current scientific parameters. We can improve donor extraction with FUE and reduce transection rates to increase yield, but what we really need is more donor hair. Now if cloning becomes a reality, then the procedure can take a quantum leap forward. But until that happens, we'll be pretty much stuck where we are.

 

Regarding the future of hairloss, this is obviously debatable. My focus is on the fact that the way medicine in general is practiced is going through a revoutionary change. I know I have said it a bunch of times on here but stem cells are the future of medicine, and it is not unrealitic to think we are very close to treating all different kinds of diseases, including hairloss using this technology.

Stem cells may well be the future, but in contrast to you, I think it "is" unrealistic to think that "we are very close" to solving hair loss with stem-cell treatments. I'm no researcher, but the consensus among educated people is that it's not going to happen soon. You have to understand that the wheels of medical science grind very slowly.

 

The first thing I would like to metion is that wanting a hair transplant in itself is no way way narrristic.

Of course it's narcissistic. It's the very definition of narcissism.

 

This is a GIGANTIC assumption of other thoughts you believe patients may have. Also just because YOUR thoughts regarding vanity have remained constant over 13 yeras, in NO WAY makes this way of thinking the standard of human thought. What is "Naive" is to think everyones thought process is the same as yours has been.

Ye doth protest too much, methinks.

 

Also you make the assumption this patient got this surgery to get girls. You have absolutely no basis to make this comment, it is completely ignorant.

I never said that. When I commented about girls, I was referring to gotitgood4me's unrelated comment about some people's justification for getting hair transplants. I was not suggesting that it was this patient's motivation.

 

You might want to brush up on the old reading comprehension.

 

 

Maybe what this particular patient seeks is acceptance from people in general and he is aware that young, bald men are genenerally not accepted, unfortunately. (this is of course just speculation on my behalf) Finally, your comments are FARRR more narresstic in nature then is the idea of hair trasplanatation. I say this because you are seperating yourself from everyone else in suggesting that you are aware of your behavior and the rest of us are not, thus rationallizing HTS in such a way that you only think about the surgery, but would never truly consider it as a treatment option.(you would never go as low as to actually get a transplant) This is narcessism in its purest form!

Perhaps you might consider learning how to spell "narcissism" before giving a wrongheaded dissertation on its meaning. Just a suggestion. Feel free to disregard.

 

I think your understanding of the word is flawed.

You can't even spell the word (or very many others), but you're worried that my understanding may be flawed. OK. Fair enough.

 

Finally You say "I know who I am, I dont con myself". No one ever accused you of not knowing who you are...What motivated you to say this? I think the real answer is because you dont know who you are per se. And conning yourself is precisley what you are trying to do in regards of hairloss treatment!

Boy, this is some trenchant psychoanalysis. I'll have to place a call over to Columbia and ask them whether they have a staff opening for a semi-literate clinician with no credentials.

Firstly, we don't know anything about him as a patient.

 

Well, we know that he was a diffuse NW5 at 27. That may not tell the whole story, admittedly, but it's a rather grim portent, wouldn't you say?

 

We don't know if he's been tested for miniaturization in other areas of the head; if any sort of potential balding pattern has been ascertained.

Tested for miniaturization on other areas of the head? How many other areas did he have left before surgery? When you're a diffuse NW5, most of your hair is already gone. But if you're talking about the NW6-7 zones, it's well to remember that many guys don't even show thinning at 27. So a miniaturization test may not be especially reliable at 27.

 

We don't know if or how long he has been on drugs. Yes, it's true to say severely balding men in their 20s don't make good candidates generally, but that's still a generalisation and with the improvements in the techniques of HT and the increasing donor yield, progressively more options are available.

Well, not to delve into semantics, but we can't really increase donor yield. We can increase transplant yield, yes, but the procedure will always be limited by total donor availability. Sure, you can increase the transplant "yield" from 85 percent to 95 percent, but you can't create more harvestable grafts in the donor area---not yet, anyway. And as long as we have that limitation, even 100-percent yield will not be sufficient to produce cosmetically acceptable results in many men with advanced Norwood classes. In the end, it's too few grafts for too much real estate.

 

In addition, we don't know much about his donor characteristics, save that he looks to have pretty good qualities. All this is vitally important in the long term.

They're important, yes. But my point is that once you get into the advanced Norwood classes, you're playing a numbers game. And at a certain point, most guys are going to lose that game. A few stars like futzyhead and bobman will overcome the odds, but most won't. My point is that it's a big risk---a risk that some men may be willing to take, but a big risk just the same.

 

I'm with you that this guy is probably heading to NW6, but that doesn't mean an HT was a bad idea. There are lots of NW6 patients who have successful results from (usually multiple) HTs.

I think this is where our most fundamental disagreement lies. In my opinion, the number of NW6 patients with cosmetically acceptable results is miniscule. That the number may seem greater is largely the product of well-funded self-promotion by top-notch clinics that have managed to pull it off in select cases. But remember: those cases appear on the front page of the web site for a reason: because they're all-star results.

 

Balding is balding - your genetic code is already ascertained. Yes, severe balding when young does suggest a high NW level, but that doesn't mean to say this guy is going to have massive lateral and posterial hairloss. Some guys are as bald at 30 as they are when they're 60 and, provided this guy doesn't have a sudden and massive continuance of hairloss from the back and sides of his head . . .this looks like a success to me.

I don't understand your provisos, seeing as how you already stated your belief that he's likely going to NW6. If you think he's going to NW 6, then you believe that he will, in fact, have lateral and posterior loss into the NW6 range.

 

In sum, the pics look pretty good. And yeah, he looks better. A lot better, for the moment. And if that's making him feel good, that's great. We should all get to feel a little better about our hair. But he did undertake a very significant risk, and I don't think we should minimize that. There are many younger guys on this forum, and they need to understand the limitations of this procedure---especially with respect to advanced Norwood classes.

This is what a great transplant will usually look like at 5.5 months. Next 100 days should really tell the tale.