(UPDATE: Photos are here! See in the replies below)
Hi everyone,
I know there have been others who have sung Dr. Gabel’s praises, but I feel it’s important I share my experience as well for anyone doing their own research. Here are some general notes for Dr. Gabel, followed by a detailed breakdown of my surgeries:
He is an elite master surgeon. I've been thrilled with my results, and it's tough to imagine how it could have gone better.
He has the flexibility to plan a procedure that is the best for the individual patient. For me, as a young person with more hair loss ahead of me, that meant fewer grafts and evaluating how my hair loss proceeds. All this in spite of the fact that that means less $$ for him. I get great results that look and feel good now, and I've still got lots of grafts "in the bank" in my donor area, depending on how my hair loss proceeds as I age. Even after 2 FUE's, I've still got thousands of grafts left in my donor area because I took this approach from the get go.
His staff are well trained, confident in their jobs, kind, and knowledgeable. Between my two FUE procedures, which were 14 months apart, I counted 1 person of turnover, out of a team of six working on me the day of surgery.
Overall, he has a philosophy of doing what’s best for the patient, not what makes the procedure the most expensive. He makes his money not from juicing clients, but from building a well-earned sterling reputation, by providing stellar results. Guy is in it for the right reasons, and makes his money for the right reasons, by giving clients great results.
Originally, this post had pretty detailed price information. Upon reflection, I decided that wasn't a fair approach to prospective patients or Dr. Gabel. So I've removed the price breakdowns. Every patient and procedure is different and I don't want to set a flat standard -- surgery is complicated. I'd just say his prices are standard. My FUE's were pretty straightforward, but other's may have complicating factors that require the surgeon to adjust the price. You can DM me if you want more price info, but I'll still probably just tell you to ask him. I will say that when I originally reached out to Dr. Gabel, I asked him for his price per graft (even though I now realize this is not a good way to shop for a HT surgeon, you should focus on quality first). He was very prompt and transparent in answering me. So if you want that info, just send him an email and ask him yourself. Everyone values money differently, and if you want the cheapest option, he's not the guy for you. But if you want one of the absolute best surgeons around and the highest possible chance of getting the results you want, start a conversation with him. If patients want a little more price info, just shoot him an email. I didn't have any surprises; it was actually less than I thought it would be.
He performed 100% of the incisions in the donor area, 100% of the lidocaine (pain meds) administration, 100% of the incisions in the recipient area (making holes to put the grafts in), and most of the actual graft placements. He placed all of the grafts on the outline of the hairline (to ensure we get the shape right), and then split the filling in of grafts with a single trained assistant. My healing/recovery was easy. In case people get hung up on a doctor not placing 100% of the grafts, I'd encourage them to get over that. Here’s my overall view on it. Based now on the experience of 2 surgeries, I believe the gold standard of care is NOT that the surgeon place 100% of the grafts themselves. It's not necessary, probably not even common among the best surgeons, and honestly, if a surgeon tried to do 100% of everything during a multi-hour surgery, I'd start to worry about mental fatigue and making a mistake. Giving some work to a single trained assistant frees them up to focus on the things that matter most. I believe the gold standard is the surgeon placing a substantial portion, and staying present in the room and observing/supervising placement of grafts. I had the same assistant helping with placement in both FUE's, 14 months apart. It was just one person, and always supervised. So again, if anyone’s hung up on that, I’d encourage them to get over it, SO LONG AS the doctor is in the room watching what’s going on. As far as I could tell, Dr. Gabel still did 100% of the incisions (donor and recipient sites), 100% of the extractions from the donor area, 100% of the pain meds, 100% of the planning and designing of where the hair is going to go, 100% of the placement for the outline, and maybe 50% of the placements overall, working side by side with his assistant. So in short, Dr. Gabel is following what I'd view as the gold standard on this subject.
His facilities are very clean, his staff is very professional and enjoy what they do. Great space, good vibes.
This post won't have pics for a day or so. Be patient, they're on their way.
All follow up appointments are included in the price, and they will get you in for extra visits if needed. Anecdotally, he's good at answering emails and really willing to spend time communicating with patients.
Photos -- you get lots and lots and lots of pictures to document everything. He uses a secure hosting service that's HIPAA compliant and has strong privacy protections, and I got access to all 400 of my photos on request.
Today I'm on Day 6 after my 2nd FUE, and I've needed to use zero pain meds. I had 500mg Tylenol day of, 500mg Tylenol night of, and literally have taken NOTHING for pain since then. It's been a cakewalk recovering.
Okay, with that out of the way, here are the details of my two procedures.
I. Gathering research and early meds
My family has hair loss. We just do. I probably noticed hair loss by my early twenties. I tried finasteride and rogaine. I don’t have the discipline to stick with the rogaine (I’m still working on flossing!), and I experienced mild side effects from finasteride. So those were out for me.
I’d been doing research for a little while, and made the decision that I wanted to move forward with FUE. In the beginning of 2020 I happened to be in East Asia on an unrelated trip, and started intently doing research on the Turkey option. Not because I thought it was the best option, but because I was already pretty close to there geographically, and I might as well vet that option, and possibly make a detour to get it done, before taking the long journey home to Oregon. While still in Asia, I emailed two surgeons in the Northwest USA area, and heard back from Dr. Gabel. I made the decision to not do the Turkey option, and do a consult with Dr. Gabel.
Who knows, maybe I would have gotten lucky in Turkey with a good surgeon. I’m sure some people do. But it’s the wrong thing to roll the dice on, and it’s worth paying U.S. prices for a good surgeon.
II. Procedure 1 (May 2020, 1400-1700 FUE w/ PRP applied to hairline, I can’t remember the exact graft count and will edit when I look it up)
My consult with Dr. Gabel was great. He’s obviously experienced, knowledgeable, and has well-developed views on the best approaches to hair transplant surgery. My hair loss had always bothered me more in my crown than my receding hair line, so I’d prioritized that for surgery. He explained to me that, to put it simply, it would look ridiculous to go crown first, and tackling the hairline first was the way to go. I don’t know if that’s the case for every patient, so don’t take that the wrong way if you did things differently. That was his view for my individual case and I agreed.
So we made a plan, I put down a deposit, and waited until my procedure date.
On my procedure date (May 2020), I arrived at 6:30 in the morning and the rest of the day moved like clockwork. Every single moment of the day, I was in someone’s care from his staff. First I finished up my paperwork, spoke with a team member to do an overview of the day, and had my hair shaved down. Then Dr. Gabel came in, looked at my scalp, drew my new hairline, and discussed it with me. I would definitely say he drew my hairline in a conservative direction, which is absolutely the way to go. First, it looks more natural. Second, it requires fewer grafts and leaves options open for future FUE. Third, I’m in my early thirties, and less surgery means allowing my natural hair loss to proceed without creating a weird mishmash or gap between donor hair and natural hair. Fourth, when all is said and done and the hair is grown out, it doesn’t look conservative, it looks like I have a full head of hair. It’s worth repeating: this conservative direction means less money for Dr. Gabel, better results for me, and a better shot at future procedures if needed. Ethical doc right there.
We went into the operating room, and got started. He administered all of the lidocaine throughout the day. He numbed my head, and started making incisions for donor grafts. I would say extraction is the more tedious/painful part of the process. My advice to people considering getting a procedure is BE VOCAL with the team about what you can and can’t feel. It’s very important that you be pretty darn numb. It’ll make the day go easier. So if I felt pokes or pinches, I’d say “pain” and they’d get that spot numb (of course, Dr. Gabel numbs the whole area as best he can at the beginning). Pretty simple. I never felt a pain greater than a 4 out of 10, and the vast majority of what I felt was a 1/10 or 2/10, so for those spooked by pain, don’t worry about it. Just be vocal!
So we got the grafts extracted, his team began sorting and processing them, and I took lunch for 20 minutes. After lunch, we started placing grafts. Once again, Dr. Gabel administered all of the numbing agent. He began placing grafts, along with an assistant. So two people placing grafts at the same time, at least some of the time.
We finished the placement of grafts, I did the PRP (see below), I went into a post-op room, got some wrapping on my head and a hat on, and got sent home. Something I like about his whole work-flow (and boy, he REALLY has his work-flow all thought out to a T) -- the patient goes home day 0 with almost no instructions to need to remember. You go home, keep hands off your head, sleep carefully depending on the surgery area, and come home the next day for a follow up. That’s it, very simple. Just focus on resting.
Day 1 post-op, I went in and had my bandages removed, hair washed, polysporin applied to the donor area, and had a chance to thoroughly go through the post-op instructions, which take the patient to about day 14. Also, Dr. Gabel’s assistant spent a few minutes reviewing my grafts and pushing a few in if they didn’t look securely placed. She did this to maybe 4-5 grafts, very minimal. I got a general antibiotic taken 2x a day, instructions to deal with crusting, neosporin, how to shower, chucks to put on pillows to keep my pillows from getting ointment on them, a business card with Dr. Gabel’s email. I love being able to email Dr. Gabel directly, and how attentive he is to answer questions as they arise throughout recovery.
Day 3-4 was when I had my “lumpy face” stuff happen. For those who don’t know, the head is draining a lot of fluid, including lidocaine, and these funny pouches can appear on your faces. It’s natural, normal, harmless, but man it looks really funny. So bear that in mind in case you have a keynote speech scheduled 3 days post-op :-D.
Day 7 I soaked my head in the tub and got the initial crusting off.
From here, my memory is light on details, but I went through a normal recovery. Shedding, ugly duckling, regrowth. I’m looking for pics and will add later.
III. PRP
We also did PRP (platelet rich plasma). This was something I opted for myself. It was NOT something Dr. Gabel ever pushed on me, or even brought up. I brought it up, he explained it to me from his point of view (his point of view is that it helps recovery and growth for sure, but it’s hard to know exactly how much), and we agreed to add it to the surgery. I’d already seen enough literature to convince me that it helps. It’s hard to determine exactly how much it helps, because there’s ONE THING healing and regrowing post-op. Hard to separate natural healing with the boosted healing from PRP. For the PRP we drew 120 cc’s of blood, and after being spun in the centrifuge, it was injected into my recipient area AFTER grafts were placed (in other words, it was administered at the very end of the procedure). I personally feel it made a huge difference in my tissue recovery and hair growth. I wouldn’t say it’s required, but I do think it speeds up your recovery. I’d guess as a rule of thumb that it makes recovery and regrowth go maybe 25-40% faster.
IV. Procedure 2 (September 2021, FUE applied to crown, 1599 grafts, PRP administered after implantation)
My graft breakdown was:
1-hair: 125 - 7.8%
2-hair: 947 - 59.2%
3-hair: 504 - 31.5%
4-hair: 23 - 1.4%
This time I came in to discuss where we should go next. There’s thinning behind my hairline, until we get to my crown which is basically totally bald. He felt we should tackle the crown and blend into the area behind the hairline, and I agreed. Excited to finally tackle the crown!
Now, an important disclaimer he gave to me, and any person doing research should understand the same. Providing full coverage to the crown requires a MASSIVE amount of grafts. It’s a huge mountain to climb. Anyone thinking they can get total coverage on the crown from a single surgery should disabuse themselves of that notion. I guess you can shoot for the monster surgeries, but it’s gonna take a ton of grafts, and even people who have “full heads of hair” often have a visible crown. So be realistic about your goal. I definitely appreciated the straight talk from Dr. Gabel. So proceeding with the conservative approach Dr. Gabel and I have been following, we shot for a 1600 graft goal.
This procedure was unbelievably easy. I took zero meds other than the local anesthesia and 500mg of Tylenol. I have a strong personal dislike of narcotics, and I made it through this one without needing anything. Surgery #1, I took a single small dose of diazepam (valium) which felt great, but surgery #2 it was totally unnecessary. After surgery #2 I made it through and very comfortably drove myself home with nothing but Tylenol and lunch in my system (only 10 minutes away). Dr. Gabel offered me some pain medication for home care, and I declined. It's been a day and Tylenol is more than enough for me! (Note: normally the home meds includes Tylenol and ibuprofen alternating. Because I had PRP, you want the inflammatory response, so no ibuprofen for me. The more you know!)
UPDATE: It's now day 6, and I've still needed zero pain meds post-op. Not even Tylenol. I just haven't had pain. Nuts.
Couple quick disclaimers:
Disclaimer #1: Everyone deals with pain meds differently. Talk to your doctor, don’t view my no-meds-experience as “the right way”. Just an indication they were doing their work carefully, things went well, and I responded well.
Disclaimer #2: DO NOT INSIST ON OR PLAN ON DRIVING YOURSELF HOME ON SURGERY DAY. It is against medical advice, it is absolutely not okay if you’ve had a benzo like valium, or a narcotic, and I very happily signed waivers explaining that this was my individual choice and that I would under no circumstances take action against Dr. Gabel if I ran over a mailbox or Fluffy the Dog. It was clearly safe in my case because I was totally sober, the procedure generally went well anyway, and it's a short drive home. *****!!! BE SAFE !!!*****
Okay, back to the procedure. Not much else to report about it, it’s a repeat of my first one. We met up, finalized paperwork, shaved, drew the recipient and donor areas, extracted, took lunch, implanted, did PRP, went home. This procedure finished probably 2 hours faster than the first one, and they definitely were still taking their time being methodical. So procedure 1, I probably left around 6 p.m., and procedure 2 I left at about 4 p.m.. A great experience. I turned to Dr. Gabel and twice told him “even if I TRIED to find a way today could have gone better, I can’t think of anything.” A perfect procedure. Excited to see how my results come in.
V. Final thoughts
In my view, I would bet that Dr. Gabel is DEFINITELY a top 5 hair surgeon in the U.S.. He’s probably top 3. Perhaps he’s the best! Who knows. I just know he is in an elite category of hair surgeons in the world. His results are excellent, he has a great team that I’m sure he’s taken great pride in training well, and they themselves take great pride in doing their jobs well. If you go, you’ll have the entire facility to yourself all day, with a big team totally focused on giving you a successful procedure. His costs are reasonable, his quality of care and results are outstanding. I didn’t realize how lucky I was to live so close and be able to reach him by car! I’ve read so many stories online of people driving or flying 100’s or 1000’s of miles to be able to reach this man. If you’re still thinking about procedure vs. no procedure, I can’t answer that for you. But if you think you MIGHT, get a consultation with him. If it makes sense for you logistically, and you’re already convinced that you’re going to have some kind of work done, and it makes sense for you to travel to Portland, let me save you time and say that Dr. Gabel is one of the best options you’ll ever find.
I'll get pics added onto here when I can, and I'll answer a few questions as they arise, but I've got a busy work schedule and don't expect being on here loads of time. Hope this extensive writeup is helpful to you!
