TC17

I think what hdude46 is trying to say is that just because a man has X number of grafts at age 30 or so, does not mean that he will have that same amount at age 55. Look at bald men in their 60's and above and you will see that a sizable number do have a thin donor area. I've had two in person consultations with doctors who are held in the highest regard on this site, and each told me the same thing. As of right now, at age 26, I have very good donor density. However, I was also told that what I must be aware of is that any surgery must be done with an eye towards what I will become, and not what I am now. Who the hell cares if at age 26 I have great donor in the "safe" zone, if by age 55 or so it is thinning? I'm not trying to stir the pot here, but each time I see a NW 6 who is younger (like Bill, comb, drew35), it seems as though the doctors are managing to get A LOT of grafts, and provide good coverage. Yet, I very rarely see older patients who are equally as bald get anywhere near the number of grafts as the patients I mentioned above. (dr. rassman has an example posted on his site that is the exception to that point) Maybe the younger patients have better scalp elasticity, maybe the younger patients all have better density, or maybe the younger patients merely had grafts moved that will eventually fall out? One final point. I have an uncle who was a NW 2 until age 30, and he was maybe a NW 4 at age 45. In the past 10 years though, he has progressed to a NW 6.5. He thought he was "in the clear" at age 30, he though certainly that by age 45 he wouldn't become "totally bald", and now he is just hoping that he doesn't lose his little tuft in the front. You can't predict the unpredictable.

Thank you Dr. Shapiro. I too appreciate you taking the time to respond. This post is certainly one of the most informative that I have read on this site.

Dr. Shapiro, I do have one question regarding your chart. While I recognize that there are a number of variables and that the chart is only a guide, I see that in the front 2/3rd you have listed 3,000-4,000 grafts as appropriate for when the patient has little to no hair. Extending that further, would you say that 6,000-7,000 would be enough to provide a cosmetically pleasing result over the entire scalp, the full 3/3?

This video is absolutely ridiculous. http://www.youtube.com/watch?v=EvAsM4OVK3E This shows just how unscrupulous some people in this business can be. I'm astounded that anyone would even consider purchasing this garbage, but it shows how there is such a tremendous lack of knowledge regarding hair loss.

This video is absolutely ridiculous. http://www.youtube.com/watch?v=EvAsM4OVK3E This shows just how unscrupulous some people in this business can be. I'm astounded that anyone would even consider purchasing this garbage, but it shows how there is such a tremendous lack of knowledge regarding hair loss.

I completely agree PGP. The fine hair on the top of his head should act as some nice filler as well. I will be shocked if this result doesn't end up jaw dropping.

You're 23 years old and already experiencing relatively severe balding. The average person only has around 6,000 grafts available for transplantation, so with all due respect to TheEmperor, even entertaining the possibility of placing 4,000 to 4,500 in such a small area would be beyond foolish. For starters, the cosmetic difference between 4,500 and 2,500 may be negligible, you are most likely going to become extensively bald and would leave yourself only a few thousand grafts to cover a large area, and even if you do plant such a high number in an area there is a strong possibility that a number of the grafts will no grow. I would suggest that you consult with a number of physicians and get their opinion. In my opinion though, you need to be conservative. Anything exceeding 2,000 - 2,500 would be a big mistake. Read this post by Dr. Paul Shapiro. http://hair-restoration-info.c...=615103223#615103223 The number of grafts that SMG suggests for a given area might be considered "conservative" in the opinion of a lot of patients and doctors on this site, yet you will be hard pressed to find anyone who feels as though SMG does not produce truly outstanding results.

LMS, I have yet to see a poor result from Dr. Konior, Dr. Alexander, Dr. Bernstein, Dr. Reed, Dr. Keene, Dr. Paul Shapiro, Dr, Parsley, or Dr. Arocha. Granted, that in and of itself means little because I have only seen a very small percentage of their work, but your opinion is based upon the EXACT same photos that are available to all of us. Either you and I share dramatically different opinions as to what looks good, or you have not closely examined the doctors I listed above. I respect your viewpoint, and I'm not attacking you personally, but I would really appreciate some support for your sweeping generalizations. By the way, if you have looked over every doctors work and are dissatisfied with some of it, that is your prerogative and I would completely understand. There are some doctors on this site who everyone seems to love, but from whom I would not even accept a free surgery because I am not satisfied with their results.

Most people on this site recognize the importance of factors beyond the number of grafts transplanted needed to achieve a nice result, yet it seems that many of us are still preoccupied with graft number and relegate the other factors to the proverbial backseat. Graft count, hair count, hair shaft diameter, color contrast, hair texture, and hairs per follicular unit are the things that spring to my mind as being most often discussed on this site. In anyone's opinion, which of those do you feel is most important to achieve a nice result, and which is least important? In my opinion, my list would be from most important to least important as follows: 1. hair count 2. graft count 3. hair shaft diameter 4. hair per FU 5. hair texture (ie wavy, curly, straight) 6. color contrast between hair and scalp I'm curious to see what some of you guys think, and maybe for a doctor to jump in with his own opinion. (btw, I know some of the top docs use DFU's when appropriate, so I would place a DFU in the category of hair per FU)

I'm also very impressed with the work on Tessler & Aronovitz's website, but they seem to have ZERO presence on this forum.

First, if your law school is anything like mine, the professors will (at best) frown upon hat wearing in the classroom. I have seen a number of students be told that they either need to take their hat off, or leave the classroom. Second, if your hair loss is as bad as you're making it out to be, then you seem destined to wind up extensively bald and may not be a good candidate for a hair transplant. Even if a doctor does feel comfortable in performing a transplant on you, are you sure that you would be satisfied with a mature hairline and a bald crown at age 21? From your explanation of your current hair loss pattern and family history, that would seem to be the best case scenario for you. Last, do not go to Bosley. Putter around this site for a while and choose the surgeon that you like best.

Congrats Capello! I'm a really big fan of Dr. Wong's work, so I'm very confident that it will turn out amazing. I see that your density was slightly below the average of 2.2 hairs per follicular unit though, but with the number of grafts moved that should be a relative non issue. Do you by chance have any post op pics of the donor area as well as an idea about how many centimeters were covered? Also, if you don't mind disclosing, how old are you? If I read your profile page right correctly, you began losing your hair at age 22 but it stopped around 32? If that's accurate, it would appear as though you had very aggressive loss in only 10 years.

I think it's going to look really nice Dr. Lindsey. I'm interested in seeing regular updates on this patient.

I agree with Dakota on this one. This guy looked atrocious with those old plugs, but now his hairline looks very natural. I'm trying not to get too caught up in graft counts because there are a number of recent posts from physicians that show that hair characteristics play a far greater role in getting good looking coverage than a simple graft count. For all we know this patient may have had very thin hair. If he had 4,000 grafts exactly, his average would be 1.96 hairs per graft, a number that is below the 2.2 average. I would absolutely go for another pass (if possible) to add some coverage, but the improvement for a repair is truly outstanding in my opinion.

OUTSTANDING write up Dr. Shaprio, thank you.

Picture 3 looks as though you are thinning quite low into the "safe" zone. I would be very hesitant to do anything because it looks as though you might end up extensively bald. You definitely need to do an in person consultation with a doctor.

thana I totally agree with you on Dr. Tykocniski. Dr. Nakatsui has posted some really great results, but I haven't seen enough of his work just yet. I never looked at Dr. Gabel, but I will now. I think Dr. Reed in La Jolla has also posted some outstanding results as well.

livinthedream, I don't want to involve myself too deeply here, but vincehair did answer your question. He purchases his Finasterdie at Sam's Club for a very affordable price. I understand you may not have a membership there, but you can get one or just call around the pharmacies in your area and ask about the cost for generic Proscar. Nobody here will advocate you purchasing Finasteride powder off the internet and trying to mix up your own Propecia like you're Bill Nye the Science Guy.

The pictures are good, but the video is outstanding. Great job Dr. Feller and congrats Jan!

I don't want this topic to turn into anything ugly, but I think it would be interesting if everyone would list some doctors that they feel are performing GREAT work that may not get their proper due on this forum. It seems that H&W, Feller, Rahal, R. Shapiro, and more recently, Konior, are the ones always being mentioned. Nothing is at all wrong with that, and each of those names have earned their spot at the top with dozens of great results, but I think that we can expand that list. I think Paul Shapiro is underrated. Looking at his results, I can't really tell a difference between his work and that of his brother, yet for whatever reason he is not mentioned in the same breath as Ron. I also really like the work of Dr. Arocha, Dr. Keene, Dr. Alexander, and if Dr. Parsley keeps putting out results like we've seen, I would put him there as well. Thoughts?

I don't want this topic to turn into anything ugly, but I think it would be interesting if everyone would list some doctors that they feel are performing GREAT work that may not get their proper due on this forum. It seems that H&W, Feller, Rahal, R. Shapiro, and more recently, Konior, are the ones always being mentioned. Nothing is at all wrong with that, and each of those names have earned their spot at the top with dozens of great results, but I think that we can expand that list. I think Paul Shapiro is underrated. Looking at his results, I can't really tell a difference between his work and that of his brother, yet for whatever reason he is not mentioned in the same breath as Ron. I also really like the work of Dr. Arocha, Dr. Keene, Dr. Alexander, and if Dr. Parsley keeps putting out results like we've seen, I would put him there as well. Thoughts?

Any updates Mike?

Well I suppose I'll be the first to respond to this semi controversial topic. In my opinion (and keep in mind that my opinion is bas,ed solely off of pictures I have seen on this site and others, or in some cases inside the doctor's office)Dr. Konior, Dr. Alexander, the Shapiro brothers, and Dr. Keene seem to get more with less. If Dr. Bernstein would post photos showing a top down view and it looked good, I would place him on that list as well. Unfortunately I have yet to see anything from him other than a full face shot, and at $6 per graft with no discount after 2,000, he is very expensive. Dr. Parsley has posted a number of results that are breathtaking. I haven't seen enough of his work just yet to finalize an opinion, but I would lean heavily towards putting him on the above list as well. Just keep in mind that there are a number of variables that make or break the success of a transplant. There is no way for me to know for sure whether my list is based upon an ability of the physician to place grafts in a way that maximizes the appearance of fullness, or whether the photos merely showcase patients with very favorable characteristics. (in fact, Dr. Parsley said that his one patient that he posted here had the best characteristics he had ever seen. the result for 3800 grafts was insane) I'm sure I left some doctors off my list, but off the top of my head those are the ones that I see using the least amount of grafts and still getting superb results.

I should clarify my above question. Say your father and paternal grandfather both suffer from hair loss and they are the only two members of your family to do so. Your father began losing his hair in the front and ended up a NW5. Your grandfather started in the crown and ended up a NW3v. If you start in the crown, is it accurate to say that you will be more likely to follow your grandfather's pattern rather than your dad's? I realize hair loss is unique to the individual, but if there is a member of your family with a similar balding pattern to you, doesn't it stand to reason that you will follow his pattern? I could be grasping at straws here, but I'm praying that because I'll be left with a tuft that my dad NEVER had, that I escaped his particular pattern and instead took after that of my maternal uncle.

Regarding hair loss and genetics, does anyone know if looking at the manner in which your male relatives lost hair can be used to accurately gauge your eventual hair loss pattern? For example, my dad started in the front and then quickly lost it in his crown. When he was 35 he was about a NW 3a in the front with crown thinning and no tuft of hair left in the hairline. My dad is 60 now and is a NW6. My mom's brother started in the crown as well, began losing some in the front and is a NW 5/6 at age 55, but has retained a tuft of hair that appears as though it will stay forever. I started thinning in the crown about 6 years ago and it has been a slow process, but in the past year or so I've noticed that my front is starting to get thinner in a pattern that more closely resembles that of my uncle. I will most definitely have that tuft of hair in the front because I can see the hair behind it thinning out. Do you guys think this matters? Is there a correlation between how the hair falls out and your eventual pattern? (meaning looking at the hair loss progression of your relatives and their final NW level)