TC17

This is one of the best results I've ever seen. That being said, do you know what the size of the strip was that Dr. Rahal took? In your picture on your weblog it looks huge, yet there is no visible scar whatsoever. I'm amazed by the lack of the scar from a strip that yielded over 4k grafts and would love to know exactly how big it was.

$10,000 for under 2,000 grafts sure is expensive, but judging from the results seen on this forum I am sure it is worth it. If what I have read on here is accurate, Dr. Shapiro charges $4.50 for the first 2,000 grafts and $2.50 for each additional graft. If that is not accurate someone please correct me. Did Dr. Konior offer any travel discount or pay for the hotel stay? Or was it a flat $10,000 for the grafts?

We keep hearing about how important hair color, texture, diameter, etc. is for having a successful transplant, yet what exactly would a good diameter be? I'm sure that finding loose hair on the pillow is not a problem for any of us, so why not measure our own hair to get a general idea of where we stack up? Does anyone have an idea as to how thick the average hair shaft is? (and yes, I do realize that hairs are very thin and measuring would be difficult, but it wouldn't be impossible)

We keep hearing about how important hair color, texture, diameter, etc. is for having a successful transplant, yet what exactly would a good diameter be? I'm sure that finding loose hair on the pillow is not a problem for any of us, so why not measure our own hair to get a general idea of where we stack up? Does anyone have an idea as to how thick the average hair shaft is? (and yes, I do realize that hairs are very thin and measuring would be difficult, but it wouldn't be impossible)

I don't doubt scalp exercises work, but wouldn't the scalp eventually return to its normal laxity? If so, wouldn't the scar be more likely to stretch because the strip was taken wider than if someone had not done the scalp exercises?

I know nothing about Lawrence Shapiro than what I've seen on this site, but it seems that every single time someone posts a favorable review of him it is from a new poster and is littered with comments that reek of promotion. Am I the only person who is reading this and shaking his head at the absurdity of what was written? sh3sw, if you are indeed a real patient I apologize in advance. But, after having read a few posts eerily similar to this about Dr. Larry Shapiro, I am skeptical. Therefore, absent any pictures I'm calling bullshit on this post and seriously hoping that an investigation into the validity of you is forthcoming.

I'm happy that you're happy, but that's a fairly aggressive hairline and you're only 23 years old. You say that there's no family history of hair loss, but what is the plan if MPB affects you further?

Dr. Arocha, Do you have any updated pictures of that NW 7 patient?

I think Dr. Rassman is very bright, and the concept of miniaturization mapping seems to make sense to me. However, absent already existing miniaturization what good is it? I understand that the miniaturized hair is visible under a microscope well before it becomes so to the naked eye, but what good is that if the only area that is miniaturized is for a NW 5 pattern because the guy is young and he ends up a NW 7? Now, if a NW 5 pattern at age 30 leads to a NW 7 pattern later in life in only 5% of the population, the risk may be worth taking. But, if the percentage is higher and the risks of a visible scar and/or transplanted hair eventually falling out are relatively high, maybe surgery should not be done. It seems that doctors use the age of 25 as the threshold for when they will feel comfortable in transplanting, and I just want to know why. If future balding is not predictable, why transplant someone so young when the risk of severe future loss (because anyone getting a HT at age 25 must have started losing hair early, and that would appear as though he is destined for a high NW pattern) is so plainly evident? What am I missing?

At what stage in the balding process can a doctor definitively state which Norwood pattern the patient will end up? I see on Dr. Rassman's baldingblog that almost all Norwood 7's have extensive balding in their early 20's, yet my uncle didn't begin balding until about 30 and he is now a Norwood 6.5 heading towards a full blown 7 at age 57. Even if he had been conservative at 25, 30, 35, etc., he might still look absurd right now with an exposed scar and/or islands of hair. And if anyone responds, please do not use the tired cliche of "well you need to go to a responsible doctor". I don't care how responsible a clinic is, no doctor is Nostradamus. Unless there are statistics that are accurate almost 100% of the time that correlate age and present balding with future balding pattern aren't we all running a huge risk of looking silly down the road? (one final thing, I understand propecia, but with that there are no guarantees it will work forever, and I for one would prefer to NOT stay on a drug the rest of my life) Any thoughts, preferably from a physician?

At what stage in the balding process can a doctor definitively state which Norwood pattern the patient will end up? I see on Dr. Rassman's baldingblog that almost all Norwood 7's have extensive balding in their early 20's, yet my uncle didn't begin balding until about 30 and he is now a Norwood 6.5 heading towards a full blown 7 at age 57. Even if he had been conservative at 25, 30, 35, etc., he might still look absurd right now with an exposed scar and/or islands of hair. And if anyone responds, please do not use the tired cliche of "well you need to go to a responsible doctor". I don't care how responsible a clinic is, no doctor is Nostradamus. Unless there are statistics that are accurate almost 100% of the time that correlate age and present balding with future balding pattern aren't we all running a huge risk of looking silly down the road? (one final thing, I understand propecia, but with that there are no guarantees it will work forever, and I for one would prefer to NOT stay on a drug the rest of my life) Any thoughts, preferably from a physician?

Personally, I think it looks great. It's only 4 months, so you can expect more growth in the future, but it looks very natural to me.

Cooley, Ron and Paul Shapiro, Konior, and Bernstein don't require shaving if you're under a certain amount of grafts, usually 3,000 or so.

This is probably a question more for the physicians, but does anyone have an idea at what stage a doctor will feel comfortable filling in a crown? For example, say someone is a NW 4 at 30 years old and has a family history of progressing to a high Norwood 6. Is it possible to reserve enough grafts to ensure that if the patient reaches that level of baldness that he has enough to fill in the entire area with maybe 40cm/sq? Can a doctor work around existing crown hair so that it buys you X amount of years with a fuller looking crown, and then an eventual thinning to maybe 30cm/sq of purely transplanted hair?

This is probably a question more for the physicians, but does anyone have an idea at what stage a doctor will feel comfortable filling in a crown? For example, say someone is a NW 4 at 30 years old and has a family history of progressing to a high Norwood 6. Is it possible to reserve enough grafts to ensure that if the patient reaches that level of baldness that he has enough to fill in the entire area with maybe 40cm/sq? Can a doctor work around existing crown hair so that it buys you X amount of years with a fuller looking crown, and then an eventual thinning to maybe 30cm/sq of purely transplanted hair?

latinlotus, I am hoping that within the next 5 to 10 years the technology advances to the point where strip harvesting is obsolete and great yielding (and cheaper) FUE is the norm, or hair cloning is around. Avoiding a strip scar would be awesome because I would still have the option of cutting my hair really short if I wanted. So, if you're in my shoes and you still have a lot of hair (NW 3V at age 26) and a virgin scalp, it might make sense to go smaller FUE sessions now and hope for better technology in the future. This is all assuming that getting FUE first won't lessen the yield of strip if it becomes necessary of course.

I don't think 100 is excessive because if you assume just 200 surgeries per year, and five years of performing hair transplants, that comes out to only 10% of the work. And let's be honest, these doctors perform more than 200 surgeries per year. Plus, many doctors already post in excess of that number for us to view. If for example, Dr. Epstein, H&W, Rahal, etc. can post literally hundreds of examples, why can't we holdexpect all doctors to do the same standard? Consider the fact that almost every member of this forum would never consider having a surgery with a non recommended doctor. The benefit then for a physician in being recommended is immeasurable. (probably one of the reasons why non recommended physicians keep suing) What is wrong with compelling them to post a small percentage of their work, continually updated, for us to see? I think it is only fair that if they wish to continue to reap the benefits of recommendation, that they must be willing to show us work.

Bill, I appreciate you guys taking the time to investigate these concerns and if you find that Dr. E is not up to par I fully support the decision to remove his recommendation. However, again I ask, how are we to know that the less "popular" doctors are still producing results that warrant recommendation on this forum? It would seem as though each doctor on here performs at least 250 surgeries per year, yet we only see a dozen or so pictures from a vast majority of the physicians. Is there anyway to compel the physicians to begin posting more work? Can you ask that each physician have a minimum of 100 or so pictures for us to look at?

I don't want this to come across as defending Dr. Epstein or any doctor for that matter, but, if Dr. Epstein is doing as poor of a job as this topic would indicate, why is he still recommended on this forum? The only thing I can surmise is that A. these are the exceptions to his usual work, B. the HTN is not ensuring that the physicians are maintaining the standards necessary for recommendation, or C. HTN does ensure that the physicians continually meet the high standards but have not yet made a decision on Dr. Epstein in particular. - Bill, could you please elaborate on how the HTN ensures that a physician continues to perform excellent transplants? For example, I recently expressed an interest in Dr. Tykocinski, but noticed that Pat's visit to his clinic was almost 4 years ago. There is very little information on him available, and the dozen or so pictures I have found are not enough for me to trust my head to him. How do we know that he is still performing tremendous results? I'm particularly curious because the topic of this thread is "Is Dr. Epstein still among the best". Reading older posts, it seems that Dr. E enjoyed a great reputation just a few short years ago, but, this post would indicate that he no longer does. Assuming arguendo that Dr. E has "lost his touch", how are we to know that other doctors, with a lower profile, haven't lost their touch as well?

Bill, I don't wish to stir things up, but when I look at Dr. Tykocinski's coalition profile I only see about a dozen pictures. Is there anyway that we can get him (and all other doctors for that matter) to post more? I would love to see a sampling of each doctors work on patients with thin hair, thick hair, extensive balding, moderate balding, light hair, dark hair, and everything in between. Any chance of making that a reality?

While I'm unsure of his prices, I assumed $5 per graft for 2,000 grafts and an additional $2,000 in traveling expenses. The $12,000 in U.S. dollars would work out to around $5,800 after the exchange rate. Under $6k for 2,000 grafts with what appears to be a great doc is an unbelievable deal. However, I can't find that much information on him and his website doesn't have any pictures of his work.

Drew, Thanks for your response. I only ask because I'm curious as to the approach Dr. Wong is taking with someone who has such severe hair loss at a young age and a family history of Norwood 7's. How confident was Dr. Wong that your hair loss will stabilize and that you will be able to achieve your goals even with multiple sessions? (I ask not because I wish to scare you, but rather because I have the fear that I will one day be at your level, and would hate to have an exposed scar or other similar problems)

Drew, Good luck with your surgery. Although it matters little, judging from all of the pictures I have seen on this website and others, I believe Dr. Wong to be one of the best in the world. I do have a few questions for you though. 1. How old are you right now? 2. What are your long term goals with regards to coverage, density, etc.?

Does anyone have any experience with Dr. Tykocinski? His work appears to be outstanding, and Pat's write up on him from a few years back is also quite impressive. Does anyone know what he charges? It seems that if he is as good as Pat said he was that one can receive a relatively cheap transplant from one of the best doctors. The exchange rate as of 4/13/09 is $1 U.S. equals .48 Brazilian whatevers. It looks as though he doesn't require shaving and that his transplant will would be roughly 40-50% cheaper than US doctors. Anybody?????

Does anyone have any experience with Dr. Tykocinski? His work appears to be outstanding, and Pat's write up on him from a few years back is also quite impressive. Does anyone know what he charges? It seems that if he is as good as Pat said he was that one can receive a relatively cheap transplant from one of the best doctors. The exchange rate as of 4/13/09 is $1 U.S. equals .48 Brazilian whatevers. It looks as though he doesn't require shaving and that his transplant will would be roughly 40-50% cheaper than US doctors. Anybody?????