wylie

Baldken2,

 

Regarding your photos, you are certainly entitled to your privacy. It's just that I find that those that crow the loudest about one procedure being better than another, and claim to have had said better procedure, are usually the last ones to show what they're talking about with photos.

And, of course, there is no exception here.

Baldken,

 

It's obvious that you are happy with your results and I think that's great. Haircut, too, appears to be happy with his results so why are you taking such an aggressive position toward him? Toward tricopigmentation in general? You've done your research and it has paid off for you so I don't understand the attacks. Would you mind showing us your results? If they are so good I'd like to see them since it only adds information to the collective.

Totally agree. I do believe that Haircut has also posted pics.

Ken, it's time to either put up or shut up.

I too wouldn't go near permanent ink.

Clearly you don't live that far from SMG, if you saw Paul Shapiro, so why not see Nicole for work on your scar?

I did three sessions on my scarring and am very pleased with the results. Looking at your pictures I think you are an excellent candidate, definitely better than I was. And you've already done FUE into your scars, which is the optimal route for anyone considering doing SMP into scars.

First step: FUE into the scars and determine if any further work is necessary.

Second step: Determine whether or not you want to add more grafts, or add Temp. SMP

I would say you should determine whether or not FUE or Temp. SMP. is your next step.

I just wanted to say that I was using two other DHT resistant shampoo's, one of which was Revita, and the amount of hair left in my tub has changed dramatically since I started using this shampoo. I can count only one or two at the end of a shower, with the Revita I could count a dozen, maybe more.

I did not use the Revita every day, either, it has been expressed here and elsewhere that it is not a good idea to use daily, and now I'm wondering if I should even use it at all. I recommend getting the conditioner with this shampoo, it does leave your hair dry without it. The conditioner with the vanilla scent is wonderful smelling.

I would like to hear from those who had BHT (Body Hair Transplant) as I have the following questions

 

a. Since the texture of BHT (specifically chest hari) is very different from the hair on the scalp, how would this blend with already existing hair on the scalp?

 

b. Does BHT on the receipent site grow slower than regular (hair from the scalp) transplant?

 

c. Is the BHT extraction more painful than extraction from the scalp?

 

d. Does the donor site (for BHT) heal slowly compared to the donor site from scalp?

 

e. Since body hair is generally thicker than scalp hair, do we need lesser grafts compared to the grafts from the scalp?

A. Well, it depends on how it is utilized, how different your hair is from your scalp hair (for example, if you have thick and curly scalp hair, it might not differ much from beard hair) How it is utilized is determined by the doctor of choice, how much and where he uses it with your scalp hair.

B. Well, this is debatable and I'm not sure you can validate the answer one way or the other. Results vary. I think growing cycles are not that different in the beard hair I have added.

C. Not any difference.

D. Actually, beard extractions heal faster. In less than a week it will look like a minor case of shaving rash. My neck was slightly red and showed no real signs of extraction after 4 days.

E. My answer here is you need more hair. The reason for that is you cannot place these grafts as close as you can scalp, and usually require follow up sessions. If you want to gain the same level of density (which you cannot, in my opinion) you would need more grafts over multiple sessions. That is my experience.

And that is why everyone says scalp and beard should be used together, with scalp being ones first choice. Hope this helps.

Thanks for posting your pics. Tav, glad to see that area is looking normal again. That seems like a pretty quick recovery if you are looking like that in one month. You're in good hands with Dr. Umar.

Well, to be honest, I don't know why you are using Toppik, But if it were me and I was looking at your hairline I would be wondering if you are wearing a toupee. And I'm guessing that's what others think when they see that thick, dense hairline.

If you combed your hair back and quit using Toppik I would bet money no one would look at your hairline.

It's probably not a good sign if people are staring at your hairline, the only reason people do this is there is something that appears out of the ordinary about it. I never stare at anyones hairline unless I either see a hair transplant or a scar visible.

I would use these instances to change what you are doing and see if these looks go away.

Has anyone used this shampoo before?

http://www.amazon.com/Pura-dor-Prevention-Premium-Organic/dp/B0079R6BD2/ref=sr_1_1?ie=UTF8&qid=1431184556&sr=8-1&keywords=pura+d%27or+hair+loss+prevention+premium+organic+shampoo

I think "hair loss" claims of most, if not all, shampoos are dubious at best, but I purchased this shampoo primarily because it is organic and free of sulfates. I've read that it leaves your hair very dry so I purchased the conditioner by this company as well.

Another guy with a new lease on life. Good for him.

Yes, I'm very interested. I've only rarely seen cases of necrosis. I know that Dr. Umar is a dermatologist and was right on top of your issue, but I'd still like to see pictures. I remember one case years ago by a recommended doctor and the patient left the country on a vacation, posting pictures as the days went by. It was pointed out he might have a serious problem and a month later finally sought treatment. The end result was fairly ghastly and disfiguring. There is another gent who has a blog about a doctor in St. Louis who butchered him and left him with a bad case of necrosis that took months to finally go away and also left him disfigured. I have no idea if ever case had any satisfactory conclusion, either.

It happens to the best doctors, and the worst doctors, and immediate treatment neither of these patients ever received.

Why are you bringing up Dr. Feller? There is no need to go down memory lane, everyone is entitled to their opinion. Trying to start a pissing match is out of the scope of this thread, unless that is your intention.

If you don't have anything constructive to add, just move on.

Heliboy,

 

I would agree with you to some extent but there are a number of accomplished posters on this forum posting in this thread who have all had transplants and some with professional experience in the field making the same comments. So I do not believe you can classify a number of people having as no idea what they are talking about.

I was going to write up a detailed analysis of my own experience with beard hair (over 5K grafts from Dr. Umar) but I feel compelled to comment on your post.

I'm not discounting the accomplished posters on this thread, of which there are many. However, some of these accomplished posters still have no idea what they are talking about when it comes to patients like the one featured on this thread. Having someone with only minor recession at the hairline get 1500 grafts so he can look like Elvis has no idea what this patient has gone thru to get to where he is today. And that is not an insult to their powers of perception, that is simply real life experience. Heliboy and myself know what he has gone thru, and I doubt anyone else commenting on this thread really does. What passes as "repair" threads on this forum I often find myself chuckling at. Dr. Umar has redefined "repair", I can say that with certainty. I spoke with other doctors (three recommended, one not) who all looked at my hair and could do no more than shrug.

So, in effect, Heliboy is correct, they have no idea what they are talking about, especially the ones who say "He should have done FUE into the scars and shaved his head"

None of those posters, thankfully, have found themselves in the position of this patent, Heliboy or myself. That dismissive advice is not real world advice, and it ignores the many challenges one would have to deal with if they followed it.

To hear people say his hair is too kinky, looks like a Brillo pad, etc, etc, well, take it from me, that patient loves to hear it! Why? Because people are discussing his hairstyling challenges, something that he now has to deal with. Before Dr. Umar, this was not an option. And over time, that kinkiness will begin to fade, as he achieves his desired look. His desired look might be cut real short, which works best for me. Beard hair can be tough to manage when grown out, and often requires gel to keep it in place. When I cut mine short, it is wash and wear. Practically maintenance free.

And before I sound like a fanboy, even after 5K beard grafts I still have not achieved a level of density that I am completely comfortable with in all situations. I still feel like I need to do more to break up the contrast between dark hair and pale complexion, hide the previous work, etc., etc. But I'm really lucky to even be in the position I am in and have these concerns, because without the addition of beard grafts, I would never go out in public without a ball cap. Now I do it almost all the time.

Let us know what you find out, I hope it's nothing serious. I'm sure Dr. Umar can handle it regardless.

Please keep this thread updated with photos, I want to see your progress. Great write up and looking forward to seeing your new look.

I can certainly see why you are concerned, you need a greater density at the hairline than that.

Normally, I would not recommend anyone see a doctor for a third time if the 2nd pass was not enough for you to be satisfied. I certainly would not recommend strip for the amount of work you need done, which is minimal. Donor is not an issue. So I can see where this puts you into a tricky position, due to the lack of qualified FUE practitioners in the U.S..

Personally, if it were me, I would give Dr. Umar one more chance to make things right. He's done a number of successful hairlines before, including mine, so it's not like there is a question as to whether or not he can achieve your goals. It always helps to have multiple opinions, that's how you learn. Ask Dr. Umar if the surgery can be done with minimal shaving. Perhaps the front can only be trimmed short, and the back and sides shaved.

Good luck, I hope your third time is a charm.

You shouldn't remove anything, but you need to soften that hairline a bit.

Another thing: You shouldn't get a strip for 1600 grafts, in my opinion, you shouldn't get a strip at all, you are only adding another scar. You can also likely harvest more grafts with a competent, experienced FUE doctor.

You might also consider using some beard hair as a filler in lieu of scalp donor. Your precious scalp donor is likely going to be wasted if you use it behind the hairline. It should be preserved for hairline.

You might be able to harvest more than 1600 grafts, but rethink getting another strip scar. I was tapped out completely for scalp donor thru strip surgery, but FUE from the back and sides yielded me 1500 grafts, all of them used at the hairline.

U.S. docs stick with strip because it's the easiest way to get a good result, it's far more difficult to be an expert at FUE, but with strip, the learning curve is comparatively small. I have seen all the same critics of FUE also go after body hair, specifically beard hair, and I know that it works, as it saved me from a lifetime of wearing a hat.

Just because a doctor pans FUE/body hair does not mean that the procedure itself is ineffective, it often just means that the critics are not proficient enough at the procedure to practice it effectively. If they were, they would be shouting from the rooftops of its benefits.

They won't last.

The better they get, the more they destroy their own bodies.. Manual FUE takes a terrible toll - speaking as an expert, you must realize! Seriously, they won't do it for a sustained period- at least most will not, which will encourage the odd maverick to suck it in and reap the short term rewards.

 

Even if they suffered no long term damage, what sort of mood is Dr X gonna be in when she/he comes home to see his/her kids after having spent six hours crouched in an awkward position, toggling a tiny but heavy thimble between her/his fingers.

 

The only time it makes sense, is when one is building a reputation, and then once that is established, we switch to techs.

Manual extractions are going the way of scalp reductions, extraction tools make doctors life easy, the time it took to extract my beard hair grafts (1500 per day) was only a few minutes when Dr. Umar used an extraction device of some kind. I suspect the use of such equipment might even increase the survivability of the grafts, lessening the transection rate and leaving more fatty tissue surrounding the root of each follicle.

At least in theory.

Looking really good, thanks for sharing your progress with us, you should be very pleased with that result.

http://www.hairrestorationnetwork.com/eve/178460-input-needed-fue-2521-grafts-1-year-post-op-results-post2422212.html#post2422212

From the link:

The Reps for Restoration Robotics only come if there is a Artas case scheduled

So I guess they are still using the Artas, which I thought they had abandoned. For manual extractions, this is who the Shapiro's employ:

Dr. David Josephitis

I will make a small correction here, as I know Hakan Doganay has technicians implant the grafts for the midscalp using the Choi Implanter. I believe he suffers from arthritis.

 

As for techs extracting grafts, in North America, Rahal and Shapiro have technicians doing extractions. Still they charge $7-8/graft for FUE.

 

Dr. Shapiro does not have a technician doing any extractions, they have a medical doctor doing the extractions (now that the Artas is gone) and he works at the clinic. He is not a technician.

Wylie,

It really depends on which clinic you're talking about. In Turkey there are reportedly hundreds of technician-only FUE clinics, where technicians perform the entire surgery (extractions, graft incisions, graft insertions) and the doctor plays no hands-on role and is not even in the operating room (1966kph recently had his FUE transplant done at one such clinic). The doctor uses his license and name as a "supervisor" of the FUE surgeries performed at the clinic. In terms of actual involvement, at most, the doctor will do the pre-surgery consult with patients and mark the hairline and transplant areas with a pen. The rest is all technician work.

 

None of the Turkish/European doctors and clinics recommended here operate in this way. At a bare minimum, the doctor will personally cut each graft recipient incision site -- which is where the artistry and surgical expertise for FUE hair transplantation really comes into play, imo. Most FUE clinics outside the United States, including the majority of the Turkish/European docs recommended here, have technicians do the FUE extractions from the donor (using a handheld motorized punch), and technicians usually do most or all of the graft insertions into the graft recipient sites cut by surgeon, as has long been one of the customary roles of technicians in FUT transplant work. However, there are still a few docs in Turkey/Europe who do the FUE extractions themselves in whole or in part. I believe one such doc is Dr. Emre Karadeniz (recommended here), if I'm not mistaken.

Thanks for the clarification Pup, I replied before reading your post.

I find it both fascinating and troubling at the same time how this new crop of Turkish clinics is operating. It may be driving the cost of FUE way down, but it is also driving the risk way up.

Hello Wylie.

In Turkey in a lot of places yes they do both extractions and incisions and have been doing it for years and in europe a awful lot of techs are charged with the graft extractions.

Have a good day.

Well, if that is the case, the doctor is primarily involved only in planning of your HT, not in the execution of it. If techs both extract grafts and place grafts, then doctors in Turkey and elsewhere should only charge a dollar or two per graft, based on their participation level.

This raises the troubling question of a patient not knowing who will be performing their surgery. The doctor is there in the event of a medical emergency and to plan where the grafts will be placed, while the technician does all of the actual work, a technician you have never met or discussed your concerns with.

It's a risk, yes, but it also shows that with practice anyone can do these types of surgeries. The greater risk is will you get a technician performing their first surgery, or their 500th surgery?

I know prices are lower in Europe, and still do not know the level of involvement of technicians there. Outside of the branded doctors recommended on this forum (and even including some of these doctors) comes the very real concern: Who is actually doing the work? I know when I see a U.S. doctor that they will be involved in two main aspects of the procedure: The harvesting of grafts, and directing where these grafts will be placed. The tech's are expected to do the work of actual placement of grafts. For this I pay a premium in the U.S., in comparison to Europe and India.

I don't doubt that many technicians in Europe and India are very good at what they do, but my greater question is, what exactly will the doctor be doing in comparison to his U.S. counterparts? Do technicians extract the grafts also? Surely they do not make the incisions where the grafts are placed?

Doctors are no different than any industry, they try and do less and get more. From everything I read, they do even less outside the U.S., but the cost is far less than in the U.S. The risk is you have no idea who your "technician" will be the day of surgery, so as a repair patient myself, I would be inclined to pay more for a U.S. doctor, unless I knew exactly what to expect from someone outside the U.S.