shiba1985

Just now, shiba1985 said:

Prp is infinitely more expensive than finasteride and no where as effective as finasteride. So not sure the point you are making.

1 session of prp = life time supply of finasteride tablets if based on cost solely

28 minutes ago, Bucky O Hair said:

Well, if (for whatever reason) a person cannot take Finasteride then you could reallocate those costs toward PRP...which would then be a wash in terms of costs.  

Prp is infinitely more expensive than finasteride and no where as effective as finasteride. So not sure the point you are making.

1 hour ago, Mike10 said:

Hi, I am doing it since 6 years as a standalone treatment

The average person won’t be able to afford the number of treatments required to see results from prp. On top of that the cost benefit ratio of prp is very low compared to hair transplant, finasteride, minoxidil. 
on top of that the industry has a lot of hacks that want to make a quick buck.

all this results in patients labeling prp “snake oil” but in reality it is a treatment that works, if you can afford it. 

1 minute ago, Rafael Manelli said:

The key point is that a maximally youthful hairline is often ill-advised simply because patients lack the donor capacity to fill it in 

yep agree. 

I dont think you understand what the doctors are trying to tell you. Yes there are some people that will keep their pre pubertal hairline without any recession like Judge Napolitano from fox news. But those are extremely rare and an exception. 

It is more common to have maturing of the hairline. Even if someone has no androgenetic alopecia, most men will have some degree of this so called maturation. It is not a "disease" like androgenetic alopecia which is a disease and pathological. It does not continue to get worse like androgenetic alopecia.

If you have unlimited hair follicles sure you can try to get your prepubertal hairline, but with limited follicles the best you should hope for is the matured hairline foud most commonly in nature. if you try to get to the pre pubertal harline with androgenetic alopecia you will look foolish because of the unnaturalness that comes from lack of density not just simply cause the hairline is too low

Pay a bit more And say u want to choose a surgeon 

7 hours ago, DrMunibAhmad said:

Thanks my friend. 

I use premade incisions and we plant with forceps. When you use forceps without implanters one should handle the grafts with more care, compared to using implanters with premade incisions. Sometimes my assistent uses a implanter for some areas, but we haven't seen any difference in our practice. 

 

I'm not a fan of using direct implanters without premade slits. We've repaired many cases of this type. The yield is less, there is a higher chance of cobblestoning and persistent redness of the skin. 

 

I hope these answered your questions. If not, let me know. 

For pre made incisions what do you use needles or blades. What are typically the sizes of the needle/blade to create the incisions for single, doubles triples? etc. 

I have some technical questoins. Do you prefer placing with forceps or implanters? Do you see a benefit of one method over the other? 

If you use implanters, which I assume you are, do you utliize pre made incisions or direct implantation with sharp implanters. I believe in the past you mentioned you use custom cut blades so I am guessing you do pre made incisions. 

good result. 

Wow . Can you tell us your age? Medication status? 
 

can you post a pic of your donor area? How long was the average day ? 

you have selected a very experienced doctor, i am assuming you selected him for a reason. dont second guess yourself and trust he will do what is best for your situation. Your main focus should be conveying you goals, and expectations. The rest let him detrmine. 

Read that again :  Explain your goal in the clearest way possible so the surgeon knows exactly what you want. Dont worry about how you detrmine the grafts needed etc. It takes time and experience, and some of it is subjective. 

4 hours ago, Tommy1991 said:

Some close up shots of the hairline at a little greater than 6months post “repair”. 
 

Looks amazing. Way better than I expected 

the general opinion is positive. 

no. dont worry about the sizes of hte punch as long as you go to a doctor that is reputable. the size has to be adjusted to the persons hair characteristics and follicular splay underneath the skin. 

In fact using < 0.9 punch will have a lot less triples and quadruples, this is not bad, depending on what the surgical goal you are trying to accomplish. 

Out of those I vote Dr Ahmed. He is arrogant lol, me and him have had a few back and forth here. 
 

but his work his good.

there is miniaturization in your donor area, if that dermascopy pic is from donor zone (which you said it is). I am no expert but I would only pursue hair transplant if you are willing to take some strong 5AR blockers. Otherwise you will not hold on to the hair for long. 

Just now, Butterscotch7 said:

 Yes, waiting will be the hard part but hoping a HT in the future will fix it. Thank you for the support and kind words!

 

It will. Don’t worry. Most people on this forum, including me have chosen the wrong surgeon the first time around. 
 

Being a female you have an advantage as you are unlikely to have androgenetic alopecia, at least not until in to your post menopausal years. 
 

Just treat your hair well, no excessive tractions, weaves etc.. 

9 hours ago, Butterscotch7 said:

I am an African American woman who recently (1 month ago) got a hairline lowering surgery done by Dr. Jeffrey Epstein in Miami, Florida. The surgery was under general anesthesia and I had a really good experience with Dr. Epstein and his team. However, from what he advertises on his website and videos on YouTube, the surgery should leave minimal to no scarring, with hair growing through the incision. This does not seem to be the case for me.

I had a naturally high hairline before, with no loss of hair. I am satisfied with the way the hairline was brought down but I am worried about the scarring, as I cannot wear my hair up, which was the point of getting the surgery in the first place. I understand that I am only a month post op and the scar might look better as time goes, but from the looks of it, it will still be pretty noticeable.

I feel that Dr. Epstein was not completely honest about scarring and how unnatural the hairline would look, and felt like he pushed the hairline lowering procedure over a hair transplant, which I now know would have produced much better results. All in all, I regret not doing more research before moving forward with the surgery.

I am currently exploring getting a hair transplant to hide the scars...any recommendations for doctors who work with African American hair who can help with my situation? How long do I have to wait for the scar to mature before I can get a transplant? I am willing to travel for a good doctor. Any suggestions and comments are much appreciated!

 

I am sorry you are going through this. Your option now is to transplant the area. The bright side is you will have even a lower hairline then now so dont beat yourself up too much. 

Reach out to Dr Sahar Nadimi of Chicago hair institute. She is an expert when it comes to females hairline lowering surgery and its complications. she can guide you well. 

What defines top clinic?

What defines failure? poor growth? patient dissatisfaction, unreal expecations?

Hair transplant is not like BP or diabetes where a doctors success can be objectively measured. 80% of Doctor As panel haas BP less than 120/80 while Doctor Bs patient only 60% are at goal blood pressure so Doctor A > Doctor B. 

JT makes money of his list and charging doctors to be on his list. He come from the marketing camp that believes the more controversial your topic the better the publicity. So he makes outrageous statements and exagerrated videos often.

Does he give you a follicular break down? Like how many triples or quadruples etc? 
most of them look to be 1 or 2 FU grafts. 
 

is he splitting them in the scalp or outside ?

Looks A+ , very good.

Tony, 

He is trying to intimidate you. Don’t let him. Stick your ground. 
 

He is not your buddy and he hasn’t done you a favor (free or discounted surgery). You didn’t go to eugenix for hospitality you went there for a medical service and you paid a pretty penny for it. He has an obligation to you once he accepted you as a patient and formed a doctor-patient relationship. 

7 minutes ago, Tony711 said:

Honestly I don’t know.  Some are telling me it’s not a good idea to get another transplant because of my history and my scalp.  So, I don’t know.
 

 I thought Dr Sethi knew best but now I do have my doubts too. 

Yeh. it is a difficult choice. If you are able to figure out a way to shave it and accept it, maybe it will be a less stressful route to take. Otherwise imagine going to India again and going through the whole process and the up and down post op. 

One thing I find interesting, is that your post op photos are looking good and everything is going well, looking like its gonna grow then all of a sudden you had sub par growth. If the follicles were "dead" they would not have germinated in the post op period like they did. So why did they not grow back after the shed?  I cant remember but have you had a biopsy? maybe you have a scarring alopecia. but its low incidence so unlikely but worth checking it off.

23 minutes ago, Tony711 said:

I’m suppose to talk to Dr Sethi tomorrow.  Hopefully we get it resolved 

Would you consider another transplant? What would be your preferred resolution? 

17 minutes ago, Tony711 said:

Hey Guys,

Just an update 

No new improvement obviously. I have started topical dutasteride last week, so will see.  
 

Dr Sethi contacted me but it was after 12am and I was a sleep last week.  So the next day I contacted him and he said he would contact me the next day which he didn’t. 
 

His team contacted me two days ago asking for follow up pictures but I told them it’s now 11 months out and no improvement, not sure why sending pictures would do any good. 
 

A friend told me one of his friend went to Turkey at the same time I went to india,  and after 6 months he was happy and just went back again for second procedure.  My friend told me that he saw his results,  and it was amazing and the guy paid $3K.  
 

When he asked how much I paid he was shocked and thinks I was ripped off,   I paid almost $25K for 3000 grafts just so Dr Sethi would do the procedure and thinking I would get the best results because I was told it would be 30 to 35cm2 in density, but it seems the money was a waste.  
 

To be honest , I’m not happy with the Eugenix team.  All they do is send a monthly communication asking for pictures then saying wait another 6 months for improvement and let your hair grow out.  
 

At this point when the time is right will see what other options I have.  

I understand your frustration and agree with your sentiments overall. 

the one thing I don’t agree with is comparing apples to oranges , with your friend. Did you friend have a severely depleted donor etc. or was this his first procedure? I am guessing he had a virgin scalp so you can’t compare.

The rest is between you and how Dr Sethi wants to handle it. Hope you get a refund.

22 hours ago, Raphael84 said:

I post a response here as BHR Clinic and Dr. Bisanga are being discussed somewhat unfairly in terms of the requirement of consultation being "ridiculous".

We will all have our own perspectives which is understandable, but if I was in a position to invite any individual to come and attend a full day of consultation where the doctor will meet numerous individuals throughout the day I would very much like to do so. Of course I cant with patient confidentiality, but you would be extremely surprised to find that several individuals with apparently good heads of hair presenting lesser Norwood patterns and what would appear to be solid donors, to actually present an unstable environment in terms of their donor when assessed under magnification and the risk of yield and growth would be high.

I ask if you may have had the opportunity to assess donor areas under magnification and become intimately knowledgeable of them? I would suggest probably not, and there lies the lack of understanding.

Just these last weeks at the clinic, two patients who did not appear to present any problems in terms of candidacy from photos, showed some suspicions within their scalp and potential inflammation that looked liked LPP (scarring alopecia). In both cases upon biopsy with their own sourced dermatologists, scarring alopecia was confirmed and a years treatment has now begun for both patients. LPP can not be cured and even with treatment if becomes inactive, surgery itself can trigger the condition and cause further and extensive loss. 
What would have been the case if both of these individuals had proceeded with surgery based on their photos and achieved little to no yield and actually lost more hair due to surgery being performed? That would have been terrible and a "ridiculous" and unethical decision.
Consultations are not just about hair. They are about the integrity and the environment of the scalp, which in most cases, can not be seen to any degree in photos.

These consultations can honestly bring you close to tears. Being a patient myself and knowing how hair loss impacted me as a young man and the extents I went in terms of holding down 3 jobs and saving every penny to be able to finance my first procedure, to see men attend consultation and the pain of loss is written all over their faces. They are overcome with emotion, especially those who have had previous surgery and may be unsatisfied. Many patients due to loss have struggled with anxiety and/or depression, this is common and so the idea of proposing surgery to patients without any empirical data to support the fact that they may or may not be a candidate, and to propose surgery and encourage that hope to then potentially find that they may not be candidates for surgery or may be borderline at best and the objectives that they discussed and desired may not be within reach, can be very negatively impactful to individuals. Having committed to surgery, invested both emotionally and financially to their perceived outcome and result, only to find that this is not the reality of their case and situation.

We have never encouraged a patient from outside of Europe to travel to Brussels for consultation so to suggest the "private jet" and "demanding" theory is distasteful. I also understand the geography of the US and that Maryland consultations are not convenient or feasible for all, but obviously the doctor is not able to travel to each state and all locations.

Again, we will all have our own perspectives and whilst other clinics will book purely on photos, I very much hope that come the time of surgery that those who have concerns with the requirement for in person consultation do not then find themselves in a position where candidacy is declined after such extensive travel and expense, or exponentially worse, the clinic proceed with surgery on a patient who really is not a viable candidate and therefore concerns will present themselves either in the short or long term.

This forum presents many surgeons for your consideration. If you have concerns with one surgeons approach, then you can simply disregard him from your consideration. That is absolutely fine and actually encouraged. But to then publicly and on many occasions and threads, take issue with the fact that he is ethical is also "ridiculous".

For those that may be new to the discussion, please find a previous post linked further explaining and discussing this very point.

I genuinely wish that everybody was a great candidate for surgery but naivety and ignorance is not in anybodies best interests.

I wish everybody the best in their onward paths.

 

No need to explain. Any reasonable and sane person would understand.