NYC Guy

Dr. True, Thank you for your apology for the brevity of my consultation with you and for your thoughtful and comprehensive post. First let me say that it is obvious by the many posts here that you have a lot of very happy patients and that should speak volumes more to any interested parties than the initial impressions of someone who attended one consultation - i.e. myself. Patient satisfaction necessarily must be the truest measure of success. Having said that, I just posted my honest perspective of the one consultation I had and I think any and all feedback is valuable to contribute to these forums. I do not recall having been told upfront that the consulation would need to be short (as you suggested you sometimes do if you know you are pressed for time due to a live case), but I appreciate your invitation to come back for a second consultation. Given the feedback of others here, it sounds as though my experience was the exception, rather than the rule. I will allow that "consultant" was my word and I am happy to use the term "patient educator", so my apologies if the word I used seemed to have any negative connotations in your mind - that was not my intent. I would have had no issue with talking to a patient educator first if I felt I was then given adequate time to talk you, Dr. True. Although I wanted to have more time to talk with Dr. True, I will say that the patient educator was very compassionate and seemed to want to make sure all my questions had been answered. The problem was that, although I did ascribe some value to the educator's answers to my questions, I really came to the consultation to get these answers directly from Dr. True. Again, this all comes down to having more time with Dr. True, a problem which could be remedied with a second consultation. In terms of the results of the educator I met with, I clicked on your link and that is indeed the gentleman I met with. I will grant you that in those pictures on your site, his results do look very good. Perhaps "pluggy" was too extreme a word to use (certainly I would never use that word based on those photos), but the results did not look entirely natural to me in person. Wally Wonka suggested that perhaps I had not done my homework and did know what to expect, but I have researched HTs extensively. In terms of the treatment size of 800 versus 2000 grafts, I believe you did indicate that 2000 could result in more shock loss as you suggested you likely did. If memory serves, either you or the educator indicated that you typically don't transplant into an area of scalp unless 70% of the original hair has already been lost (please correct me if I am off here). I guess this is the threshold at which the benefits of new grafts can outweigh the risk of shock loss in the recipient area. The 800 versus the 2000 option was of great interest to me and I wanted to make absolutely sure that I fully understood the pros amd cons of each option. It was when I was asking questions to you about one option versus the other that you needed to go. I will say that another doctor did think I could do 3000 grafts without risk of significant shock loss - I will qualify that statement by noting that this was a phone consultation based upon photos I had submitted online. I have no doubt that an in-person consultation is far more accurate at gauging what an appropriate plan of action should be and that this 3000 graft recommendation may have been different had I been diagnosed in person. At the same time, another live consulation I had did result in a 2000 graft recommendation without any input from me. I am not saying one recommendation of any of these doctors is necessarily better than the others, but it is interesting to note the disparity and leaves me less confident in going with any of these options. Consensus in opinion would have been far more comforting and reassuring. In terms of FUE, it was very much the educator who I felt tried to steer me away from that option, even when I said cost wasn't a major issue ( I was aware of the significantly higher cost of FUE). By the time I got to talk to Dr. True, I had felt I had been dissuaded from looking further into the FUE option by the educator. Finally, to be clearer, I will elaborate on my inability to see examples while I was at your office, photographic or otherwise. Dr. True, in your post you say, "I regret that although you were shown many examples, we were not able to find result examples you found precisely pertinent." That could be interpereted by a reader that I was overly finicky about finding a case fitting my exact hair characteristics and loss pattern. In fact, while I was introduced to one other gentleman with good results who worked at the clinic (but whose hair was very different than mine), I WAS SHOWN NO PHOTOs AT ALL while I was at the clinic, despite asking the educator for them (I asked the educator for photos before and after talking to Dr. True, though I did not get a chance to directly ask Dr. True for photos). Therefore, I certainly was not shown "many examples". I did comment to the educator that I had seen photos on the website, but I was really hoping to see more when I was at the clinic. I have no doubt that you have an extensive result portfolio as you state, but for some reason I was not able to see any of it. While I'm sure you do have an open door policy to see live results as you state (which is admirable) and are open to prospective patients speaking to references, neither of these options were suggested to me by the educator. The way I left hings with the educator was that if I decided I wanted to pursue a HT further with Dr. true that I would I give the educator a call. Perhaps if I had, at this point he would have suggested these other possibilities. Respectfully, NYC Guy

Marc, I also met with Dr. Bernstein some time ago. I liked the fact that he meets directly with you and there was no consultant there (that I met with anyway). Dr. Bernstein struck me as very honest, as he was very candid about what was realistic to expect. He was defintely not a salesman and in fact he recommended that I not get a HT right away, but instead start on Propecia and then come back and talk to him in a year. I did get on Propecia which has worked well for me, but I am still probably going to get a HT at some point. I certainly think that the patient photos on Bernstein's site are impressive (superior to what I have seen on most other HT doctor sites), but I have not seen any of his patients independently document their progress online. I did meet one patient of Bernstein's in person who had a nice looking result. I think this patient is actually the handy man for Bernstein's building, as well as some others on the upper east side (I recognized him in the lobby of a friend's apartment building some months ago). I think Bernstein is worth seriously considering. Whoever you consult with, before you move forward you should make sure that you yourself meet with former patients in person. Do not be satisfied with reading accounts of others (myself included) having met patients of a particular doctor, as positive as these accounts might be. You need to see the work up close and meet with patiwents who have similar hair characteristics to yourself. I also had some telephone consultations with doctors outside of NYC, after submitting photos online. I would encourage you to also consider doctors outside of NYC as well. Hope this is helpful. Grateful Head, I just wanted to let you know that I did not vote in your survey at the start of this thread. I know you are looking for color behind the reasoning for people's votes.

I had a consult with Dr. True some time ago. Actually more of my time was spent with a consultant who worked there. While I really wanted to talk primarily with Dr. True, the consultant was firm that he could answer most of my questions and encouraged me to dialogue extensively with him before I could talk to Dr. True. Also, while the consultant had good hair density, his hairline looked pluggy to me and to my eye this was not close to an "undetectable" HT. He had dark hair and so the sharp contrast with his pale skin may have made it difficult for him to have a better looking hairline via HT. The strip scar is a concern of mine and I asked to see his. While his hair covered it in the back and no one would notice it due to this, when he lifted it up to show me the scar, the scar looked quite wide to me with a significant (in my mind) area of bald skin. I have seen other strip scars in person which look much less noticeable. I doubt this guy can cut his hair very short at all. Given his pluggy hairline and big strip scar, I was surprised that this guy had a job interacting with prospective patients. He told me that over the years he had something like 10 surgeries, which sounded like way more than I've ever heard anyone having (although this might explain why his strip scar was so big). He told me Dr. True had done work on him (and certainly all recent work), but it wasn't clear to me whether Dr. True had done all of his work. Seeing this guy did not give me a lot of confidence in the result I might get. Finally I was able to speak with Dr. True who was very nice and quite soft spoken. He was effectively answering many of my questions and he outlined what he thought my options were for a HT. However, he was unwilling to give me more than 10 minutes of his time. When I still had questions I wanted answered, he redirected me back to the consultant and left the room. Maybe he was very busy that day and had to go right back to surgery or something, but it didn't make me feel very valued as a prospective patient. In terms of his diagnosis, his upfront suggestion to me was that I get just 800 grafts via strip surgery. I am a Norwood 5A with diffuse coverage on top. Every other doctor told me I should start with at least 2000 grafts. I also believe 800 grafts is too small an amount to warrant strip surgery. When I pressed him and told him I thought I needed more, he did outline an option for 2000. I also inquired about the possibility of FUE. While their office (True & Dorrin that is) claims to offer it in their literature, I was seriously dissuaded from going that route. My impression was that they like to tout the fact that they do both strip and FUE as a way to get every type of prospective patient in the door, but that they actively try to steer everyone toward strip. I am actually a fan of good strip surgery, but I thought this was odd and my guess was that they have not had great success with their FUE patients - I certainly do not know this to be true, however. After Dr. True left, I repeated a request I had made earlier to the consultant that I wanted to see before and after pictures of past patients which had similar hair characteristics to mine. He responded by finding another who guy worked there to show me his results. This guy's hair did look very good, but it was nothing like mine. I have thin dirty blond hair and this guy had wavy brown hair. When I pressed the point that I still wanted to see pictures, the consultant rummaged around in another room for a while and then came back and said something to the effect that he didn't have any pictures handy of patients that fit my characteristics. I was silently incredulous when he said this. I know Grateful Head and some others have had great experiences with Dr. True, but I was not sold. Having had consultations with a couple of other HT doctors, I came away least impressed with my consultation at Dr. True's office. Needless to say, I decided to cross off Dr. True from my list after that.

Robert, Your hair really does look quite good with dermatch. However, it is a little discouraging to hear that those who have had hair transplants still find a need to use concealers. You mentioned that Pat uses Prothik (sounds like it is for his crown only, granted) and I believe he is a veterean of more than one HT procedure. I know there was a thread not long ago about Pat getting another HT procedure for his crown. Does he think this will end his reliance on concealers? Will you ultimately go back for one or more hair transplants to end your reliance on concealers?

Hairworthy, I would be happy to drink a few beers with you in NYC! I hope you make it out here. You may recall I once mentioned that I spent some time in Godalming, Surrey (where you are located, I believe) and I may be out there this summer. I am planning a trip to London and want to visit the school in Godalming that I went to for a year (many years ago) - Charterhouse - an old English "Public" school that I imagine you may be familiar with. If and when I make it out there, we could grab a drink on your home turf as well!

Hairworthy, interesting observations. By the way, your results look great so far. Are you going to add any new photos any time soon? It looks like you last photos are from October - your hair looked nice and thick then, so I can only imagine what it must be like now. Robert, your results also look very good so far. I did think you adopted the "Satisfied Patient" moniker a little prematurely (this was before you knew how the growth from your HT would turn out), but fortunately this name was accurately prescient!

I have actually read a number of posts (including from doctors) stating the exact opposite -i.e. that while Propecia spurs regrowth and maintenance of the hair on the head, Propecia also tends to decrease the growth of body hair. If anything, back and shoulder hair should diminish. I have been on Propecia for over ten months with some success on my head and have not had any extra hair growth on my body (I have chest hair which has remained the same and I have never had back or shoulder hair, including since being on Propecia).

Scar looks great! Very subtle. Looks like you can still get away with a very short haircut. Hope your recipient area comes out just as well!

Hugh, You are coming along nicely. I look forward to seeing your pics around Christmas time!

Jimmy, Always nice to hear about positive experiences. Please post pics and let us know who did your work. Good luck with cotinued progress! Keep us updated.

Social, Looks like your results are coming along nicely. 3 months from now will be the real test to see how successful the yield from your HT has been. From your earlier pictures, I do think think Cooley designed a very nice hairline for you with very good temple work. We are all keeping our fingers crossed for you for continued good progress!

Hairworthy, Your hair is looking great. Congratulations on your impressive progress! I'm amazed how fast your hair has grown. That MSM really kicks the follicles into high gear I guess...

Gunner, Great posts. Hang in there. I am a diffuse thinner as well and I have been agonizing over whether to get a HT. Like you, I've been giving meds a chance (for about six months now) and at a full year;s time, I am going to reassess whether I need a HT. You're getting some good advice here. It is trickier to do HTs for diffuse thinners, mostly due to recipient area shock loss. As knowledgeable as many of the posters here are, there is no substitute for making an appointment with a live doctor who can examine you in person and give you an expert view. You should try to see a few different doctors and see what they tell you. Good luck!

Hairworthy, Thanks for the comprehensive reply. I look forward to tracking your further progress!

Hairworthy, Your front view picture for 28th of June looks great - no sign of redness that I can see and this is after only three weeks. Following your #2 buzz cut, however, your donor scar looks quite visible. In your view, is this mostly due to your previous scar at the Nobel clinic, or does it just take more time for the scar to be less apparent? After my surgey with Hasson on July 23,I am looking to follow your lead and get an overall buzz cut (maybe just a #3) after I get my staples removed 10 to 14 days afterward. I am hoping that my scar will not be especially visible - I currently have a virgin scalp. Have you tried to keep your surgery a secret at work? If so, have you been succesful?

So it sounds like the possibility of taking the staples out by yourself is not a good one. Has anyone done this successfully that any of you are aware of?

Hairworthy, Why did Dr. Hasson recommend 14 days for the staples versus the usual 10? I ask because I am going to H&W (Hasson) in August and I have been thinking about staying out in Vancouver and having the staples removed there. However, I don't want to do this if I have to wait 14 days. I actually thought you could have the staples removed after 8 days, but obviously it is better to do whatever is necessary to minimize the scar. Hugh / Hairworthy / Jotronic (if you are reading this), Do you know why Hasson doesn't also use dissolvable sutures like Wong does? I am surprised they both don't use the same method for harvetsing the donor strip. Could the amount of days before staple removal be brought down with the use of dissolvable sutures?

I'm scheduled for early August with Dr. Hasson so I look forward to tracking the progress of you H&W fellows just ahead of me: Hairworthy, Hugh Jordan, HairQless, Wanna-HT (others?) Hairworthy, I am a yank like most posters here but I did spend a year of my life in Surrey (Godalming to be precise) and it is a lovely area. Good Luck to All!

If Avodart is like Propecia but stronger, would it make sense to continue using Propecia if one started taking Avodart? In other words, does Avodart do everything that Propecia does and more, or does Avodart attack DHT in a different manner so that taking Propecia would still be of incremental benefit vs taking Avodart standalone?

Headline question: Is it better to wait a year (or some significant amount of time) after starting Propecia before getting a hair transplant and does waiting help to minimize shock loss? I know that shock loss of existing hair can occur following a hair transplant and that this hair may not return if it was near the end of its lifecycle (i.e. this hair would have fallen out shortly anyway due to progression of a person's balding). I know also that Propecia is supposed to be pretty effective at maintaining much of one's existing hair, but that the impact of Propecia can take many months to really take effect. As I have only been on Propecia for just over two months, if I get a hair transplant near-term, do I run a greater risk of permanently losing some existing hair through shock loss than if I waited ten months for the full impact of Propecia to kick in? In other words, might I have existing hair near the end of its lifecycle today that is vulnerable to shock loss now, but that might be "re-invigorated" by Propecia six months from now and be more likely to remain after a transplant done a year from now vs. a transplant done today? All thoughts are welcome.

Headline question: Is it better to wait a year (or some significant amount of time) after starting Propecia before getting a hair transplant and does waiting help to minimize shock loss? I know that shock loss of existing hair can occur following a hair transplant and that this hair may not return if it was near the end of its lifecycle (i.e. this hair would have fallen out shortly anyway due to progression of a person's balding). I know also that Propecia is supposed to be pretty effective at maintaining much of one's existing hair, but that the impact of Propecia can take many months to really take effect. As I have only been on Propecia for just over two months, if I get a hair transplant near-term, do I run a greater risk of permanently losing some existing hair through shock loss than if I waited ten months for the full impact of Propecia to kick in? In other words, might I have existing hair near the end of its lifecycle today that is vulnerable to shock loss now, but that might be "re-invigorated" by Propecia six months from now and be more likely to remain after a transplant done a year from now vs. a transplant done today? All thoughts are welcome.