mayhem

I really don't know how else to describe Dr. K's reply, because it seemed like a dictionary definition of what we all more or less understand regarding family history, donor strength, current age, current regime, etc. It did not seem to me to address this particular case. Instead, Dr. K referred to past patients (not specifically) who did not progress further in their hair loss. I questioned whether that has any bearing on this case (or to each other). But of course, if this patient is meant to stay at a NW3 with either zero or minimal further loss then he's really fortunate and I'm worrying for nothing. I just don't see how anyone can know that for certain. Mind you, I'm not saying this patient should never get a hair transplant. I'm just saying why go so low right away. Again, from the doctor's perspective. I'm sure the patient wanted this. I would too if I knew I wasn't going to lose more hair.

Matt, what exactly do you think a doctor can SEE during a consult? Sure he could check for miniaturization but that doesn't preclude future hair loss. If he is indeed going to be stuck as a NW3, then this is awesome. I just don't see how Dr. Konior (or anyone else) can predict that. It's irresponsible to suggest that he can.

I was being facetious. You have absolutely no data to back up your claim. You've conducted no survey. You have an 'impression' that does not even rise to the level of anecdote. Even if you did, the sample size is this forum. Hair loss affects most men to some degree, not just those who talk about it on THIS particular forum. Didn't think I needed to state the obvious. You're erring on the side of optimism. IMHO, I think all doctors should be cautious. Especially when it comes to a finite resource like hair. I'm voicing my opinion on this case. Just because someone disagrees with you does not make them a fear monger. Completely irrelevant. Once again, I'm not looking at this from the perspective of what the patient wants. I'm sure there are doctors out there who will provide the patient with whatever they desire even if it's not in their interests. While Dr. Konior is one of the best HT surgeons around, I do not think this case was ethical. Dr. Konior's rationale was very weak too. I'm looking at this from the perspective of the doctor, who should be operating ethically.

Hair loss is unpredictable. However if someone has advanced hair loss when they're young, then it's not a good sign. We can't predict when they will go bald or whether they will go bald at all. But no one would look at this patient pre-op and bet confidently they'd have no further loss until 40. Can you support this statistic with some evidence please? Can you say whether this statistic, if valid, generalizes to the rest of the male population outside the forum? Age isn't the issue in and of itself. TIME is the issue. If you have an advanced pattern at a young age, then you have much more TIME to keep potentially losing more hair as you get older and older.

Yes I did. Dr. Konior's response seems bizarre. He acknowledges that an ethical doctor would consider the patient's family history, current hair loss, age, regime, etc. Yet, if one were to do all those things - how could he justify giving this patient a juvenile hairline? Hair loss can strike at any age and it is unpredictable. Dr. Konior cannot predict this young man's hair loss. As others have said, you can always lower the hairline - but if you start off by giving a patient a NW1 or juvenile, then you take away any consideration for further loss. I wonder how much donor this person has left.

Matt, no doctor can PREDICT a person's future hair loss. You're implying that we all must ignore our common sense here. Dr. Konior gave him a juvenile hairline when he clearly is going to lose more hair down the line. He brought the guy's hairline down an inch.

The patient was 28 when he had the surgery, correct? Everyone is different, but is his advanced horseshoe pattern not a red flag? Put it this way, if this patient were your son and they had the same NW3+ advanced hairline - would you have given them a juvenile hairline as a 28 year old?