Time to do something

Could I get input from anyone who has had a hair transplant from any of the following four doctors and your satisfaction levels and maybe a photo of the final results if possible? It would be nice to know what your original Norwood level was with the amount of grafts you had and the number of procedures it took to get you where you are. Thanks! Dr. Epstein Hassan & Wong Dr. Ron Shapiro Dr. Rahal

Could I get input from anyone who has had a hair transplant from any of the following four doctors and your satisfaction levels and maybe a photo of the final results if possible? It would be nice to know what your original Norwood level was with the amount of grafts you had and the number of procedures it took to get you where you are. Thanks! Dr. Epstein Hassan & Wong Dr. Ron Shapiro Dr. Rahal

Could I get input from anyone who has had a hair transplant from any of the following four doctors and your satisfaction levels and maybe a photo of the final results if possible? It would be nice to know what your original Norwood level was with the amount of grafts you had and the number of procedures it took to get you where you are. Thanks! Dr. Epstein Hassan & Wong Dr. Ron Shapiro Dr. Rahal

Yeah, that makes sense. I wonder if the doctor has a way of knowing what the final result of his work will look like at six months? If not I'm not sure why I'd be going back that soon. I sent him a photo at the four month mark and it is clear that I have a long way to go so I doubt I'm going to be in that 30% mentioned that has 100% results in six months.

Dr. Epstein is ready to do the second procedure in six months if certain criteria is met. I was under the impression that you felt the procedure shouldn't be done in six months under any circumstances from your reply below. "I personally have reservations however, of going for a second hair transplant too early especially if hair is being transplanted in the same area as existing hair. In my opinion, going for a hair transplant too early does not give the scalp enough time to restore normal elasticity. That means a lesser amount of grafts can be excised the second time around. Scalp exercises are only encouraged 6 months after the first hair transplant anyway which ultimately suggests that the donor area can be a bit sensitive before that point. Personally, my donor laxity started to really increase dramatically after about 8 months from each hair transplant surgery. Secondly, regarding the recipient area, new hair growth can occur up to 12-18 months though in the latter months, new hair growth will be minimal. Due to the projected new hair growth, it is possible that some will be transected before they actually grow. Additionally, it may be more difficult to determine the proper direction of a hair if that hair has only started to grow. Therefore, personally speaking, I wouldn't consider a second hair transplant any sooner than 8-10 months depending on your circumstances." I have no doubt that Dr. Epstein will do the right thing. I'm pretty sure I'm not in that 30% category because I am at 4 1/2 months now and have a sprinkling of hair certainly nothing cosmetically acceptable so I'm sure A LOT is still to come. I guess the bottom line is one size doesn't fit all and each individual has their own unique situation. Since Dr. Epstein is one of the highly rated coalition doctors on this site I'll just let him decide after looking at me in January if I'm ready or not and go with his decision. Just bear with us guys that are going through this for the first time. We don't know what to expect. I'm sure in a year I'll look back at others on this forum asking these kind of questions and remember I was there at one time.

Now I am more confused than ever. I can't imagine Dr. Epstein doing anything to risk a bad outcome and his reputation and it isn't like he is hurting for business. However, I also respect your opinions since you have been through all of this before and have done your research. I suppose I could compromise and do the second procedure the end of March which will make almost nine months. I have a week of vacation I am carrying over that I must use by then or I'll lose it so maybe that makes sense.

I'm behind him. I don't beleive he could be one of the top HT surgeons in the world and give out any advice that could compromise his reputation. He has been doing this for many years and is very good at what he does. So I'm putting my faith in him and just relaxing.

I am going in for my second HT in January which will be 6 1/2 months after the first one. There was some concern that I might be going back too soon. Because of that I posed that question to my doctor and here is his response. Let me deal with your questions, which are very relevant. I would not be doing your procedure in 6 months if you only have 80% of your hairs growing out. That was never my intention. The reality is, for some patients, by 4 months. 80% to as much as 95% of the hairs are growing out, meaning that by 6 months, we could expect that close to, if not all, 100% of the hairs would be growing. Anything less than that would be an indication for holding off on a second procedure for another 2 to 3 months, or even more. So, by no means would I ever consider compromising your long term results. However, every experienced surgeon knows that, around 30% of patients (or at least from my 15 years of experience) display 95% plus growth by 6 months. Now by saying growth, these hairs may be just coming to the surface, but they do show were they are, making it quite possible to avoid damaging them. Now obviously, if we determine that, come early January, that you are not one of those 30%, then by all means I would absolutely recommend holding off for a few months.

I am going in for my second HT in January which will be 6 1/2 months after the first one. There was some concern that I might be going back too soon. Because of that I posed that question to my doctor and here is his response. Let me deal with your questions, which are very relevant. I would not be doing your procedure in 6 months if you only have 80% of your hairs growing out. That was never my intention. The reality is, for some patients, by 4 months. 80% to as much as 95% of the hairs are growing out, meaning that by 6 months, we could expect that close to, if not all, 100% of the hairs would be growing. Anything less than that would be an indication for holding off on a second procedure for another 2 to 3 months, or even more. So, by no means would I ever consider compromising your long term results. However, every experienced surgeon knows that, around 30% of patients (or at least from my 15 years of experience) display 95% plus growth by 6 months. Now by saying growth, these hairs may be just coming to the surface, but they do show were they are, making it quite possible to avoid damaging them. Now obviously, if we determine that, come early January, that you are not one of those 30%, then by all means I would absolutely recommend holding off for a few months.

Very cool! Then it looks like I have a really good crop on the way! I thought the hair just came in like normal hair so I've learned something else. So at 4 1/2 months the hairs that have grown back sort of normal looking are shocked? What does that mean? It doesn't sound like something positive.

Someone on another forum answered this question this way. Who is right? I sure hope you are! In my experience it sounds like "vellus" hairs. Usually, when transplanted hairs start to come in, they come in just as they were transplanted. Baby fine hairs are a part of the miniaturization process. A sort of cascade of events by which the hair "caliber" and "length" decreases over time. The last stage is in fact baby fine hairs AKA the vellus hairs.

That's good news! If all of these hairs come in that look baby fine now then I should have a decent head of hair.

I am at the four and a half month mark of my HT and I noticed this morning a lot of very small translucent looking hairs all over the top of my head. Mixed in with those are some thicker darker more normal looking hairs. These translucent looking hairs are so faint and fine that I must hold my head up and look at them from that angle to see them. They seem to follow the line of where the doctor put the new hairline and don't go any further below that. I'm not sure why some of the hair would come in from the beginning looking like mature hair and others come in looking like baby hairs unless those were already there before the procedure but I don't think they were. I read something on the forum about hair coming in very fine almost invisible then maturing into normal hair. That would be great if these do mature in to normal looking hair. At this point I can see evidence of hair where there was none before but it is far from being enough to be cosmetically acceptable. Here is my question: Are these hairs eventually going to mature and turn into regular cosmetically acceptable hairs?

I am at the four and a half month mark of my HT and I noticed this morning a lot of very small translucent looking hairs all over the top of my head. Mixed in with those are some thicker darker more normal looking hairs. These translucent looking hairs are so faint and fine that I must hold my head up and look at them from that angle to see them. They seem to follow the line of where the doctor put the new hairline and don't go any further below that. I'm not sure why some of the hair would come in from the beginning looking like mature hair and others come in looking like baby hairs unless those were already there before the procedure but I don't think they were. I read something on the forum about hair coming in very fine almost invisible then maturing into normal hair. That would be great if these do mature in to normal looking hair. At this point I can see evidence of hair where there was none before but it is far from being enough to be cosmetically acceptable. Here is my question: Are these hairs eventually going to mature and turn into regular cosmetically acceptable hairs?

Phil, I just read your biography and WOW! You have been through a lot! Thanks for posting on my thread. I am 46 years old and live in Orlando but have property on a lake in Umatilla. Trust me my experience with hair pieces has been up and down. Sometimes they look really good and others they don't. They are a ton of maintenance which is one reason I decided to ditch it. I had my first HT in July with Dr. Epstein in Miami. I'm glad I waited all these years before doing it because the technology has improved so much and also by this point I believe I've lost all the hair I'm going to lose. I'm sort of nervous and don't know what to expect but I'm hoping for the best for the final outcome. The doctors you are going to are supposed to be among the best but Dr. Epstein is also one of the best in the country and specializes in repair work so you might want to think about checking him out as well. Right now my dilemma is going to be to decide where to put the next grafts. Do I put them on the crown or in the front where the first ones went to thicken it up. I guess I won't have an idea on how thick it will be until January. If I decide to put them in the front then I'll use a lace piece on the crown. Maybe one day when hair cloning is perfected I'll use that for the crown. Although I'm told I have enough hair left for a third and maybe fourth procedure. I had 2520 grafts in July and that is the number for the second procedure as well. Have you ever worn a piece? The lace ones are pretty undetectable and my doctor and stylist tell me that many people who don't have enough grafts for the crown use what grafts they have to concentrate on the more critical front region and put a lace piece on the crown. After wearing one that went from the front to the back for 20 years (I had to shave part of the top of my head to accommodate it) a crown piece should be a piece of cake. So if you are trying to conserve grafts and plan on moving some around it might be worth thinking about concentrating as many of them as you can in the front and wearing a lace piece on the crown. You could experiment with it to see what you think. The guy that cuts my hair here in Orlando would probably be glad to cut you a crown piece to experiment with. Also there is a place online called toplace.com that you can order from. They quoted me $190 for two crown pieces and these last around four to five months after that the hair doesn't look as fresh in my opinion. I hope some of this gives you some food for thought. Take care. Larry

Thanks Bill, I did see that and it is good info. I'm just looking for others out there with an opinion. I have read more since I made the last post and it appears that if done by a skilled doctor like H&W it shouldn't be a concern.

I don't remember exactly where it is but I'm sure you can find it on google like I did. I did chat with another member in a private message who said the following: "However most docs say that such a large session results in alot of transection....I dont know whom to believe". Is there anyone out there who is not a representative of H & W who can comment on this? Thank you.

Good question. I'm not really sure. I just read where transection is a potential problem with mega sessions. I see you work for Hasson & Wong. What's the exchange rate like these days between the US and Canadian dollar?

Another member that I chatted with today said he was thinking about a mega session and it got me thinking maybe that would be the route for me to go. Is there a danger of the grafts transecting? I assume most doctors that perform mega sessions charge a lesser amount per graft after a certain number correct? I just think as a NW 5 I'm going to need more than the 2520 I had in July. It looks like Hasson and Wong and Shapiro might be the best for mega sessions. I'd love to hear what anyone has to say about this subject good and/or bad. Thanks

How does these concealers make the hair look thicker? Does it change the texture of the hair?

They do look much better today if you get a good quality one. Mine looks like the hair is growing from my scalp and I can brush it back and even people I've told I'm wearing it can't believe it, and these are people that would be totally honest with me. However, they are a major pain as far as maintenance goes and they are expensive to upkeep and if you don't maintain them they will look really bad. That is why I got a HT to be rid of the maintenance and occasionally wondering if someone might know. I believe you are right I think I read somewhere a long time ago that Ted Danson wore a crown piece. I remember maybe back in the 80's he was going bald on the crown but today I think he has hair there. Anyway it is six on one side and half a dozen on the other. I can think of pros and cons on both sides.

Bill, You are talking to someone that has worn a hairpiece for 20 years. I am fully aware of the pitfalls and you are very correct when you say there is maintenance, that is why I want to ditch it. They can look very good if maintained properly but the fact of the matter is in the back of my mind I always wondered if people knew I had it and I never wanted anyone to touch it. I replaced mine every four months so it would look fresh and that was expensive. The ONLY reason I would consider a partial crown piece is because I have very thick hair on the sides and back unless the transplanted area in the front comes close to matching that area then it is going to look off balance. That is why I will more than likely put the grafts for procedure two in the same spot in the front. I'm sure I have enough donor grafts for a third and maybe a fourth procedure and one day I might use those for the crown but for now since I will have invested $18,000 for these two procedures I'm going to stop. I also understand that the crown takes a lot more grafts than the front due to the swirl pattern. I researched HT's for three months before I took the plunge but one thing I somehow didn't learn was most people go in for more than one procedure for the desired results. I thought after the first procedure that was it so you can imagine my surprise the day of surgery when I went in and the doctor said "today we are only going to address your front". I didn't say anything because after all he was the doctor and I didn't want any tension right before the surgery. Now after more than six months on the forum I see where multiple procedures is common place. So as much as I'd like to be rid of the piece completely I think a good compromise to my situation is to put a piece the size of a baseball on the crown. The crown is the EASIEST place on the head for a hair piece to look natural anyway. That will be a piece of cake compared to what I've gone through for the past 20 years. I can always hope that the results from the first transplant are adequate enough and I can use the next ones on the crown. : )

Well, I wasn't aware of partial pieces either but Dr. Epstein said some of him patients go that route and the guy that does my hair now says he has a lot of clients that have had HT's and he puts them into partial crown pieces. I've asked him if I could see some and he is trying to get some for me to see but so far I haven't. There is another stylist in the office who also says she has several clients with partial crown pieces some that have had HT's and some that only had hair loss on the crown. She swears they look totally natural and are completely undetectable and blend perfectly...but I haven't seen any of them in person.

I should also ask if anyone out there is wearing a partial piece on the crown and how it looks and if it blends ok, what the maintenance is, and anything else you can tell me. Thanks

I had a HT in July and will be going back for the second procedure in January. By the first of January I will hopefully be able to tell how dense the first HT is and decide if I want the next grafts to go in the front or on the crown. From what I've read on this site about density I will probably want the next grafts to go in the front to thicken it up more. In that case I am going to wear a hair piece on the crown. My bald spot there is about the size of a baseball. I wear a hair piece now so one the size of a baseball on the crown will be a piece of cake. Can anyone tell me where they would recommend for a partial crown piece? Thanks.