TC17

B Spot, Assuming you lose 4% of your grafts via FUE, each 4,000 grafts harvested you would still get around 3,850 viable grafts. Do you feel that that seemingly minimal loss is worth choosing strip over FUE? Can such a small number of grafts really make any cosmetic difference? Last, why is the donor area only harvested up to 30%? If we can lose 50% of our hair in a given area without noticing, why are doctors reluctant to go 35%, 40%, 45%? I measured the donor area of my dad (a NW 6.5), and in my best estimate his safe zone measures 6.35cm x 29cm for a total area of 184.15cm2. Assuming he has average density of 80 fu's per cm2, and you take only 35 fu's per cm2, you come out with around 6,500 grafts. That would still leave him with about 44% of his donor area intact. I'm sorry for all of the questions, but I really do not want to commit to strip, but I know that I will one day be at least a NW 6 and the 3,000 to 4,000 grafts available using current FUE techniques will surely not be enough to reach my goals.

No offense taken Tom R, many attorneys that I have come in contact with have been nothing short of repugnant. However, I must defend this attorney in this case because he was doing his job. Even if the client is offensive or unpopular, the client still deserves the best representation his attorney can possibly give. No ruling has been made in this case yet, but based upon today I would say that he is going to get probation and nothing more. More importantly for us though is that the attorney was citing what the American Medical Association and the American Psychological Association gave to the US Supreme Court. This was not an attorney making scientific judgments, nor was it some crackpot doctor charging "expert" fees who would say whatever the defense wanted. While I'm sure the statements in the amicus briefs are debatable by physicians, the fact that that is the official position of those organizations is compelling. *also, the poem was AWESOME*

I have to disagree with you P.J., as I am pretty sure that the survival rate of FUE is essentially equal to that of strip when performed properly. I also believe that total yield from exclusive FUE is less than that of strip. However, if hair cloning or a cure never become available, and I find myself at 40 years old with no more grafts available via FUE, I can then decide to continue with transplantation via strip, or buzz down. According to B Spot, you do not decrease the overall number of grafts available if you undergo FUE first. Consequently, undergoing FUE first (while hoping for better remedies for baldness and avoiding a long strip scar) seems to make more sense to me because I can always get strip performed in the future if no improvements are breakthroughs are discovered. Flexibility and choice in the face of an uncertain future are the biggest virtues of FUE in my opinion. All of my conclusions have been built upon the premise that final graft count will not be compromised if I undergo FUE first. If that is a faulty premise, then everything I have said after that is wrong as well. If I'm wrong PLEASE someone correct me.

I've mentioned a few times that I'm attending law school, and this summer I have been fortunate to have the opportunity to clerk for a judge. Just yesterday, a 17 year old came before the court accused of armed robbery. His attorney put on quite a show, but more importantly, in his brief he cited amicus briefs by the AMA and the APA that were developed for a supreme court decision a few years ago. I will paraphrase the important parts for the younger patients that may visit this forum. Please keep in mind that these are generalities, and these observations stem from "the results of psychological and biological studies, with the latter showing notable differences in brain structure". 1. Those under the age of 23 are less focused on the future, and less likely to appreciate the true costs and benefits of their actions. 2. Those under the age of 23 focus on short term benefits, and they discount future consequences more so than older adults. 3. The prefrontal cortex, which is associated with impulse control, risk assessment, and moral reasoning, is one of the last regions of the brain to develop, often between the ages of 23-25. 4. Those under the age of 23 are risk takers, and they lack the ability to perceive and weigh risks and benefits accurately. 5. Those under the age of 23 focus on "opportunities for gains", rather than "protection against losses." - keep in mind that these are generalizations about a class, and merely because you are a member of that class does not mean that you personally share those characteristics. However, the most interesting part is that the people who do fit within the generalizations, often do not realize that they lack proper risk/benefit analysis, or that they value the present more than the future, etc. I do think it's important though to think LONG and HARD before undergoing any surgery. Also, realize that statistically speaking, if you are younger, you most likely are a "risk taker", even if you don't recognize that in yourself (keep in mind, you probably wouldn't) This is why it's so important that you thoroughly research your doctor, and do not merely seek out the one who will give you what you want now, at the expense of the future. Anyways, I hope this was insightful and further elucidated why the truly honest doctors are so reluctant to cater to the whims of the younger patient.

Dr. Shapiro, Out of curiosity, why wouldn't you plan for a person in my shoes to become a Norwood 7?

Your temple points look slightly different to me.

How old is this patient?

Dr. Konior's skill made this a good result. I've said it before and I'll say it again, in my opinion there is no doctor better than Dr. Konior. There are some doctors who are on his level, but none that I feel are better. Of course, even the best doctor is not a miracle worker, and anytime we see a great result I feel it is important to remember that the patient's characteristics play a major role in the success of any transplant.

BeHappy, What doctor performed your surgery? Based upon your statements, it would seem to me as though you would not have been a candidate for a surgery. I'm astounded that a scrupulous doctor would take on the case of a 22 year old who already has donor thinning.

That is what I have heard too thana, but I don't want to undergo a strip surgery. While there aren't any full blown 7's in my family, my dad and maternal uncle are both NW 6.5's. I'm only 26 years old, and am cautiously optimistic that within the next 10 years we will have better tools to fight baldness. I would hate to undergo a strip procedure now, and live the rest of my (hopefully long) life with a 30cm long scar if it proves to be unnecessary in the very near future. After all, hair cloning or a baldness cure would render strip surgery an antiquated method very quickly. I look at FUE as buying me the time necessary for hair cloning to be viable, or for a cure to arrive. Now, if neither of those occur, I would still benefit by retaining the option to cut my hair very short without a strip scar showing. I do realize that FUE is not scarless, however, all will concede that the appearance of the scar is less conspicuous than in strip surgery 99/100. I have no idea if in 10 or 15 years if I would want to keep up with my hair loss. I might decide that I would prefer to just buzz it short and be done with it. FUE should be able to afford me that option. Most important for me is the fact that I have no idea where my hair loss pattern is going. As I said above, my dad is a NW 6.5, his brother is a NW 2, paternal grandpa is 89 years old and a NW 2, maternal grandpa was a NW 3 when he died at age 75, and my mom's four brothers are NW 6, NW 6.5, NW 2, and NW 5. If I bald to the level of my dad, it is likely that I will not have nearly enough donor to cover more than the first 2/3rds of the scalp, and even then it may only be a light dusting. For me personally, I think that men look better when they are noticeably bald when they keep their hair very short. One final point. This may be wrong, but it seems to me as though when hair is cut very short that it appears to be thicker. Bill is a great example of this. When he shaved down for his recent surgery his hair looked great in my opinion. It looked like he had much better coverage than he did when it was long. If I progress to a high NW level (which is likely), I might better be able to utilize my limited grafts if I keep my hair very short.

I apologize if this question has been answered before, but I did not see an answer anywhere. If you undergo a FUE procedure before strip, is your total availability of grafts decreased? For example, if I have 6,000 grafts available via strip, and I undergo a 2,000 graft FUE surgery, would I still have the 4,000 left (via strip or FUE) if necessary?

I agree that it looks like the start of MPB. However, as of today you still have a very nice head of hair. I also think that you should see a physician and consider using propecia. Just hope that you are not in the 10% that it does not work for.

It sure looks like you're starting to thin to me...

That's a very bold statement emperor.

I have to disagree with you PGP because I think this is a nice result. I do agree that if this patient was younger it would be poor, but it is extremely natural for a man of his age, and keep in mind that only 2635 grafts were used. I personally feel that the best results occur when a man has the hair color of this gentleman.

Dr. Shapiro, When you say "significant balding in their early 20's", what exactly does that mean? I'm 26, and would describe myself as closest to a NW 3v. However, upon magnification I was told that I have miniaturized hair hair in a class 5 pattern. Would that fit with your definition of "significant balding"?

Any updates on Julia, Dr. Lindsey?

Let's pump the breaks on this train for a second and make a stop in Realistiville. At 19, you are most likely NOT a candidate for a hair transplant. You have no idea how far your hair loss will progress. Even the most conservative of approaches can potentially backfire if you run out of donor, or if your safe zone thins to the point where your scar becomes visible. In addition, any scrupulous doctor would insist on such a high hairline that at your age you would probably look better with a shaved head than with a transplant anyway. If you can, upload some of your photos so that we can see what you're dealing with. We can all better help you if we have some visual representation of where your current hair loss pattern is.

Dr. Tykocinski has not posted nearly as much of his work as have other physicians on this site. That being said, he seems to enjoy a very good reputation by a number of highly regarded physicians of this forum. The work of his that I have seen is very impressive, and I would place him in my personal top 10. As for cost, with the exchange rate, his per graft fee for the first 2,000 grafts is about $4.38 Canadian, and $2.90 Canadian for each additional graft. While those fees are in line with what other physicians charge, you do have to consider air, hotel, and miscellaneous expenses associated with traveling so far. I hope this helps.

This is the nicest result I've seen of yours Dr. Ross. You say that you spread the grafts evenly throughout the entire bald area, but it appears as though more grafts were placed in the front and mid scalp region than in the crown. If the grafts were placed at X number per cm2, then shouldn't he have even density throughout the area? All in all, a very nice result, but I would like to understand why the front and mid scalp appear thicker than the crown.

I would think that a headband would be deleterious to the healing process even if it reduces swelling. Wouldn't the headband just inhibit the healing process by not allowing the fluids to drain properly? I can understand that by placing pressure on the forehead the swelling may not occur, but the fluid that would cause the swelling would still exist and it has to go somewhere, right? If you do not allow it to drain down, it makes sense that it would stay right up by the scalp, and wouldn't that be bad for healing?

No doubt about it, that is a fantastic result.

Before this devolves even further I'll try and give janna77 my opinion. The things written on this site are not favorable towards Dr. Jones, but as Bill mentioned above none of the patients gave Dr. Jones the ability to defend himself here. That's not fair to Dr. Jones. That being said, my belief is that there are better doctors out there than Dr. Jones. That is purely my subjective opinion based upon what Dr. Jones has presented here.

aaron1234, I totally understand where you're coming from. Anyone who is not concerned with Secretary McNamara's hair loss pattern is either very confident in medicine and his family history, or very foolish. I do not think that losing your hair so severely so late in life is common, but it is possible. Odds are good that if he had undergone a transplant at age 50 or 60 his scar would have been very visible, and a majority of the transplanted hairs would have fallen out. I personally believe that the reason this topic has received so few responses is because nobody likes to be reminded of the downside of anything. Nobody likes a critic, a Negative Nancy, or a cynic, but hair transplantation carries future risks that even the best of doctors cannot predict. This is merely a visual reminder of what may happen in the future.

Thank you very much for posting this picture Dr. Beehner. It's clear that the patient had a receding hairline at age 28, but judging from his current hair loss pattern, I would have guessed that he would have had far greater loss by age 28. I must say, every young patient should carefully look at this guy prior to undergoing a transplant, because this very well may be any of us someday. - this is the link to the original post that has far more photos of the patient. http://hair-restoration-info.c...=392102603#392102603 also, on a related note, fmr. sec of state mcnamara died today, google his pictures from when he was in his 40's, and 50's (where he appeared to be at most a NW 2.5, and compare them to the more modern ones, where he is a NW 7, very scary)