Alpine

I am sorry to hear that. Any clinic offering "a couple hundred grafts" is incompetent and not too concerned with client satisfaction. That is not enough grafts to do much of anything. This decision to get a HT is not something you skimp on or consider lightly. A bad HT is likely going to be worse than your situation before. Natural looking bald is better than unnatural looking bad transplant job, IMO. Go big or go home. I flew out of state to visit Shapiro's office (more travel expense). There is nobody in the top 5 within driving distance to me, so I went to them. It has to be a top notch job or it is not worth getting. There are already so many factors and variables that can lead to it not turning out optimal (regrowth yield, recovery, etc.). It's too risky to allow doctor/technician inexperience to be another factor in outcome. Even with the BEST clinic, your result may not be the best considering your starting point (degree of loss) and your donor quality and final yield. These are out of the doctors control for the most part. That is my recommendation to the general forum. Spend the money and go with a reputable, EXPERIENCED clinic. If nobody has heard of them, stay away. A "budget" HT is asking for trouble. You get what you pay for and I dont mind paying a premium or getting ripped a bit for extra piece of mind.

I recently chose Shapiro's office for a FUE procedure. We got about 2,285 units the first time and several weeks later, I went back (at no additional expense) for another 400 or so to balance out a frontal hairline portion. I can say that Shapiro's office stands behind its work. If you are unhappy or want to tweak something, they will work with you. It was abundantly clear that they want happy clients and will do what it takes (within reason) to get that. The biggest issue with NW5-6 candidates and FUE is unrealistic expectations. In my case, we targeted density in the frontal & middle portion and left the rear crown pretty much untouched as I do not mind having some normal MPB in the rear crown area. I needed all of the grafts for my frontal/mid section. If you want whole head coverage, you are realistically talking 2 procedures or grafts placed in a way that will give thinner density (not ideal). The average donor quality of mid 30's NW5-6 is not perfect and you're probably maxing out at 2,500 units per procedure. The first day they did a small number of slits and FUE extraction to gauge your donor quality and skin thickness, etc. I also opted for PRP + A-cell during the procedure to help improve recovery and yield. Anyway, I was impressed with their office. Matt Zupan (experienced consultant) bends over backwards to help and answer questions and Dr. Paul Shapiro and Dr. Josephitis -"Joe" (younger, new doctor who they hand picked) both worked on me. Ron Shapiro has scaled back some and does less procedures I'm told. In my experience, Dr. Paul Shapiro makes all of the incisions. And yes, they do all of the incisions first, then later move the grafts via technicians. Dr. Joe did the hybrid manual FUE (motorized) portion of the procedure. They do not like the results they get with the patented auto/robotic option. Like Konior, they use custom punch depth and blades to best meet the clients criteria (skin thickness, donor quality, dept, ect.). The main difference is that Konior uses the "stick-and-place" technique where after each slit is made, a technician then puts the FU graft in right after. The theory is you can make smaller incisions and so have less trauma to the recipient area, quicker healing and possibly better density because of incisions made closer together. That last portion is a bit of a stretch though (sounds good). I do not think there is enough difference in graft placement (due to incision size) to give better density. But I think its possible there is some benefit to smaller incisions and getting the grafts in immediately. Regardless, I still chose Shapiro based on some other feedback. I don't think this difference in technique matters much. I do not think you can go wrong with either Shapiro's office or Konior. They are both top 5-6 offices in the world, in my opinion. I am only about a month out form the procedure. Recovery is as expected with minimal pinkness/redness in the recipient site at this point. It increases with alcohol, stress, exercise - anything that would increase blood flow to the face/head or cause flushing. I would expect (hope) that that too will be gone by month 2. I'll probably wait a minimum of 4 months before direct, intense sun on the scalp. Shapiro's office also offers some really good SMP too (separate SMP specialist). I was talking with an older patient when I was there. He is a veteran to the HT world and said he visited several offices before choosing Shapiro. He has maxed out his donor and has a full head of hair that looks natural. He has been getting "fill in" SMP around his existing hair to improve the appearance of density and the results were rather impressive. He showed me some before and after photos and it has definitely improved the density and looks really good. SMP, in the right hands, is a pretty good adjunct for someone who has maxed out donor or doesn't want the hassle of another procedure but needs some improved density look in certain areas.

Of Shapiro specifically? I've yet to see any. Please link me, I'd be interested. They seem to be one of the top US based choices.

Ya I'm certainly not rolling the dice. The leap is uncertain enough as it is. I want to be using a reputable person even if it is expensive. I am sure there are unknown guys out there doing decent work, but I'm not testing the waters!

No worries, I understand. That is cheap! So I would assume cost was a large incentive. In the U.S., FUE with top names is $6-7 as I am sure you know. Dollar and Euro are essentially the same (euro is .95 the value of 1 dollar). It is a large savings.

Rather childish post. I'm genuinely curious. That isn't necessarily personal, sensitive and/or private information. We all know what various doctors charge and what the ballpark cost of these procedures are. If you want a god damn travel buddy, explaining the merits of the trip might make sense, no? Jeez.

What is the procedure and projected cost in US dollars?

For males, DHT is significantly more androgenic than testosterone. It is the MOST potent male hormone and definitely can impact body composition, sex drive, strength, etc. If weight training and a lean muscular physique is a priority, I do not like the idea of wiping out DHT (and possibly increasing estrogen). To me, the use of a 5AR inhibitor was never worth it. I am into working out. I've just used topical minox/anti-DHT and it never helped anyway (shocker). If a male applies an exo DHT like the anabolic masteron, the body composition changes are drastic (and it murders the hairline). I ran finsateride for a short time when I first started thinning and got some nipple tenderness, the first sign of gyno. That was enough for me. If you are on TRT and maintain high test but lower DHT and control E2, its probably a better situation for using a 5AR. But in a natty aging male with already lagging test levels, lowering DHT to me spells nothing good over time. Its all priorities. What you value you more. I know many guys into bodybuilding that use finasteride and don't really complain of or notice any detrimental effects. Still, others say they felt "softer" in terms of their muscles and gained abdominal fat easier after many months of use. Anecdotal reports are all over the place. No doubts that exo DHT based AAS administration has a huge hardening/drying effect on muscle tissue appearance and is a natural anti-estrogen. Also no doubt that on paper and in real world, DHT is a profound hormone for males. This study is FAVORABLE for finasteride. So while I am a bit biased and a fan on DHT for body comp and just being "male", I acknowledge the studies do not seem to be too bad. The problem with this study is if you give older men T, they are all going to improve performance and body comp - no shit. So the addition of F isn't expected to drastically alter that result. You only get to see T+F or T alone in this study. For a natty male with sub-par test levels, taking finasteride will actually slightly boost your free test serum levels (less converted to DHT) and raise estrogen as well - quite a bit in some cases. I think its reasonable to expect slightly higher estrogen and a little softer physique after a year. Most people are out of shape and wont notice anyway, frankly. http://press.endocrine.org/doi/pdf/10.1210/jc.2004-1933 See also https://www.ncbi.nlm.nih.gov/pubmed/14624915 (F and BMI, also encouraging but against the large weight of anecdotal observations seen out there)

For 3 procedures.... that is literally dirt cheap. Shapiro is $7 per graft for FUE. LOL

Definitely encouraging feedback. You guys willing to post and pics?

Correct, but a real concern of mine is that if I do go back to buzzing after FUE, you will see the follicle spacing implants more and it will be noticeably unnatural. So the end result is a post FUE shaved look that is worse looking than before. I feel like that is a very real possibility. To me a clearly bad FUE or shaved FUE that looks unnatural is much worse than what I have now.

Ya I agree, I'm not ever going to pass for not balding. If I could get a good hairline and density in the front portion for a short style, I would be fine with that. Again here are two shots in 2012 when it was thinning but before I started buzzing it. If I could have something like that with a touch more density in that front portion I would probably be fine with that. One of these is bad quality but you get the idea. Or just go the other direction and keep buzzing it but get pigmentation. The photos I have seen of that approach are good if you have the head for it.

To get great overall density with anything NW3 or above, you really need multiple procedures. This is something else most people dont want to face. From what I have gathered over months of research and real feedback is that 1 procedure usually just wont cut it unless you are really lucky or have less loss than a NW3. How much have you spent, total?

Donor quality... I have always had fairly thin hair all over the head. I do not mean literally thinning. But I mean actual genetic follicle density. I've never had extremely thick hair. So I would guess my donor quality is not the best. I agree after looking at the pics, I am more of a NW5. It's quite eye opening looking at a top down view - depressing. I agree with all the feedback I have been given so far. I think one of the most important things in assesing hair transplant is knowing/accepting when you are just not a great candidate. Pigmentation could still make a decent impact I think. Shapiro is able to give some very natural results from what I have seen and I know of very little downsides to that procedure. Scalp Tricho Pigmentation | Shapiro Medical Minneapolis, MN http://www.vincihairclinic.com/scalp-pigmentation/micro-scalp-pigmentation/scalp-pigmentation-results/ (Some of the results look VERY good, IMO) And I think there is less risk of an adverse look when you use a highly reputable clinic for the pigmentation. Attached a picture from 2012 when the hair was longer to give another perspective. It was obviously probably not as bad then either though. Frankly, until a consultant from Shapiro advises me on what they think I should do its hard to pull the trigger. I dont want to get FUE if its more likely than not that the results will just be poor and ruin even the shaved head look. The thing that nobody likes to talk about or admit is that there are really very FEW OPTIMAL candidates, i.e. NW1-3 with good hair type. Everyone else is rolling the dice, big time, in my opinion. A good doc should probably tell you straight up to leave it be...

Hello fellas. I have read the forum several times and finally joined. I am 34, about a NW5, possibly 5A. Considering flying to Dr. Shapiro from Missouri. He is expensive but looks to be one of the best. I really do not want to risk this with some random Bosely guy from my state. I am contemplating not even doing it because of the risk of a non-natural hair-line or look. Right now, I buzz it, no guard. It does not look too bad really. My concern is that I get a procedure and its not all that great, density is not good and it looks unnatural. Then even the shaved look will be worse than I am now. That would be a real kicker. It may be that my best bet is to just keep the shaved look and add some pigmentation to balance it out. Shapiro is known for that as well. Obviously I will let his team decide because a poor result is worse than just keeping what I have now, in my opinion. This is my hesitation. The other issue is my recovery window and work. I need to look as normal as possible (in front of people in Court) in about 2 weeks. I'll keep it shaved until regrowth is decent so it just sort of looks like it already does now. Interested in thoughts, advice, etc. I am perfectly capable of handling a professional telling me I may be best to just leave it alone if I plan to wear it buzzed, or to just add some pigmentation to the frontal to balance it out for the buzzed look. I am not dead set on this, but I believe I could look better, perhaps. Pics attached.