Dr. Sanusi Umar

Jayc would have you believe that he was not condescending to my staff and he was just a distressed repair patient. The fact is Jayc made the process as difficult as possible and perhaps because he perceives that being a physician gives him special status he refused to follow the clinic’s protocols. He states that he found out about our payment policy much later and attributes his prevarication with the loans to this fact. This is untrue. Jayc was aware of our payment policy before he even commenced the booking process. Here are excerpts of my last email correspondence (of 2 years) with him before he was referred to my staff for booking: Sent: Sat, October 9, 2010 9:11:39 PM Subject: RE: further questions Jayc: Thanks again. Maybe plan on doing around 2100 to 2500 grafts. I'd like the concentration to be prioritized as follows: 1) scar line 2) left crown whirl pattern 3) right crown coverage 4) mid scalp 5) frontal hairline. The primary reason for that order is my scar line and crown are more difficult to cover up. My goal is one day to have a full looking head of hair. Dr. Umar: We'll start in order of the above stated priorities. And stop wherever the number of grafts booked takes us. Jayc: Regarding dates: I'm available Nov 29- Dec 10. Anytime after Dec 22........ Dr. Umar: We have no openings in 2010. The closest is in January. once you are ready to start booking, the available date are given to you by my staff and you decide which you want. Here is our booking procedure: 1. You decide the exact number of grafts (not a range) you are having. From this, the total cost and the number of days needed to perform the surgery is determined. 2. This next step is preferably done by phone. You call the clinic or the clinic calls you to arrive on surgery dates that would work for you and the clinic............... 7. The remaining fee (total cost MINUS the deposit paid) is due 4 weeks before the date of surgery. What is more, Jayc would not even properly complete his consent forms. He refused to hand write his signature or initials. Rather these were typed in and technically invalid, and in the course of his discussing the schedule change with my staff he threatened to go to the blogs if his demands were not met. There was a change in our schedule that was regrettable and we apologised to him for it and made efforts to make it up to him as indicated in my first post. However, we were faced with an individual who from the outset did not want go by the rules we have established for our clinic, and who made a mountain out of a molehill when there was a small change in the surgical schedule. Our clinic cancelled this patient and lost the $27,000 in fees that he might have paid but, in my opinion, would have cost us much more in grief and aggravation in the long run.

Jayt contacted our clinic about 2 years ago regarding hair transplant surgery. He has had surgery in the past with other surgeons. He was happy with earlier work but mostly wanted density added using head and non-head hair. I advised roughly 3,600 grafts that could be transplanted over multiple sessions. He stated that he could only afford 1,500 grafts. However over the course of 5 days he changed his mind and decided on 2,100-2,500, and then to 4,000 grafts. He was going to look into financing. In my clinic, 4,000 grafts requires about 2.5 days to accomplish. This meant that we booked 3 days in surgery for Jayt because we only perform 1 transplant surgery per day. Prior to any surgery, we send the prospective patient our consent form and other paper work, which is detailed. The forms have a section which allows patients to ask any question and express any concerns regarding the transplantation process, consents, payment terms, booking process etc. We require the patient to read and sign the consent forms before we will accept a deposit. It is our policy that payment for the full cost of surgery be made 4 weeks in advance of the first surgical date. Why? Because patients have shown up on the day of surgery unable to pay (e.g. rejected credit card charges). It is more efficient and productive to have the payment for surgery completed in advance of the surgery date. As to Jayt, we fully disclosed this payment term to him before he decided to schedule a surgery, which was months in advance of the selected surgical dates. If he didn’t find it acceptable, he was free to go to another clinic. He did not state any reservations in the questions and concerns forms provided him. Scheduling a surgery date with Jayt was difficult. At the same time Jayt was in communication with the clinic staff regarding a surgery date, he was attempting to secure a loan to cover the cost of surgery. His loan request was approved for about half of the total cost. For whatever reason, Jayt rejected that and let the loan period lapse, saying he would pay for the surgery himself. He still had the option of rescheduling his surgery dates but never did. It was only after repeated efforts by the clinic staff that Jayt finally committed to surgery dates and allowed us to charge a deposit to his credit card, the dates of January 19th, 20th and 21st. As this process was occurring, this prospective patient requested and was granted a discount on the price for his transplants. When the time to pay for surgery was due, Jayt indicated that he was going to contact the loan company to obtain the same loan he had rejected earlier, and that he planned to charge the balance to his credit cards. As the dates for surgery grew ever closer, Jayt indicated that he was still seeking a loan to pay for his surgeries. He began voicing displeasure with our payment policy, and said that he wanted to pay for his surgeries after they were finished. We continued to indicate that the surgeries had to be paid for in advance, but we were flexible in allowing him extra time (as of January 12th) to secure a loan. As to the changes in schedule which Jayt complains about, a local hospital where I have privileges required me to appear on January 19th to renew my i.d. card and take care of other administrative items so that my status would be renewed. We notified Jayt that the normal 1 hour lunch break would be extended to 2 - 2.5 hours and that this would not affect his transplant. After this was explained to him, he indicated that it was acceptable. I volunteer the third Thursdayof every month in the morning at a dermatology residency program and clinic, running clinics and teaching dermatology residents in training. My secretary was supposed to go into the computer and block out the third Thursday of every month for the entire year on my schedule. Regrettably, this was not done for the new calendar year of 2011. If this information had been entered into the computer, January 20, 2011 would have been blocked out on my schedule. When I realized the scheduling conflict, we informed Jayt of it. We told Jayt that we would start the surgery of January 20th in the afternoon and would open the clinic on Saturday, January 22nd to finish his surgeries if his transplant was not completed by the close of business on January 21st. Note that 4,000 grafts does require 2.5 days to accomplish. Thus it was still possible his surgery would be completed on schedule after starting January 20th in the afternoon. However, we decided that in the event we had not reached our graft total by the time we finished on Friday, we would open on Saturday, we would not rush our work. In connection with this, we also offered to pay for any additional hotel and airfare expenses that Jayt would incur. It then emerged at this point (one week before the first scheduled surgery date), Jayt had not purchased an airplane ticket nor had he booked a hotel room. Nevertheless, Jayt wanted the clinic to pay for his hotel for the entire stay and to provide free grafts. Further complicating matters was Jayt’s new demand that he wanted to complete payment for his surgeries after they were done and after he determined he was satisfied with his results. What is more, a member of my staff revealed to me that the phone conversation with Jayt was fraught with negative comments directed at her. He stated that being a medical doctor himself, he should not be talking to her but instead to me (a fellow physician). I perform the surgeries, however, my staff are an integral part of the clinic and I rely upon them to schedule patients, no matter what the patient’s occupation or station in life may be. They are courteous and respectful to all that we have the privilege of serving. After all of this, I decided that it would be best for Jayt to have his transplants with another clinic. I wish him the best, but I think I have been reasonable under the circumstances described herein. Incidentally, Jayt’s deposit was refunded to his credit card the same day we cancelled his surgeries.

We have nothing to gain from cancelling surgery. I will be posting the full detail of what occured as soon as necessary clearances are obtained.

LMS, Your presentation of sofarsoggod's case is false. He had over 1000 leg hair used to soften the pluggy hairline imparted by his prior multiple strip procedures. No one claimed all his hair to have resulted from BHT surgery. Rather his hairline was refined by BHT. You claim that his result is c/o an opportunistic well staged single picture. On the contrary, his result was viewed by many of the paying doctors on this site at an ISHRS meeting 2 years ago as well as numerous posting by sofarsogood himself and an objectively documented youtube video shown here: http://www.youtube.com/watch?v=n_8uYbMTa4I&feature=channel I have my name and clinic attached to every statement I make on the internet. It is easier to spew fantasies and slanderous remarks with only the reputation of a pseudonym at stake. My reputation is evidenced by my work, the words of numerous patients I have been honored to work on as well as other HT doctors that presently refer their 'hopeless cases' to my clinic for repair. I started offering BHT in 2005. And as of 2005 we have produced successful cases that are still widely discussed on the internet today including active forum participants (sofarsogood, heliboy, praying to name a few). I stand by the statements I have made since I started offering BHT. The same statements have remained unaltered on my website to date. Please do not attribute the statements or work of other clinics to me in your accusations. As a physician with a very busy 'hands-on' practice I would have very limited time to spend in endless and pointless blog discussions that center around the conversations going on in the heads of certain individuals regardless of their motivations. The majority of the patients that get BHT at my office are hapless victims of various procedures that I don't see you complain about. These are real individuals whose lives were literally destroyed and in many instance redeemed successfully by the procedure you seem determined to undermine. To those who would like to deny the role of non head hair donor, I would refer you to these well documented cases. Let the public determine for itself on merits and/or demerits. Various BHT and FUE videos on my website or Various FUE and BHT videos of my patients on Youtube A NW6-7 individual should not have a head only based strip surgery since he stands very little chance of getting a natural coverage and concealing his strip scar at the same time. Yet I see these cases in my clinic. They had been promised a solution to their NW 6-7 using 4000 strip derived head grafts. We have resolved such cases using head and non head hair to garner the necessary number that can even begin to address the graft count needed to cover that level of hair loss. A decent proportion of my repair patients that have required BHT for completion were patients that have had strip procedures in the past. Poor yield and depleted head donor supply as well as bad scarring are usually the recurring theme in these repair cases. Has that justified a blanket criticism of strip HT procedure in general?

At the risk of starting an endless discussion, I can see how speculations and imaginations can run rampant. The fact is that I make all efforts to secure follow-ups in my patients. Despite best efforts, it is not unusual for some patients to choose not to sustain follow-up requests. Regardless, it is rather unfair to expect a doctor to account for all patients posting on the internet regarding none follow-up to threads they had initiated on their volition. It may be a good idea for readers to sometimes consider the fact that individuals have various things in their lives that could equally compete for their attention and sometimes it is much more important and pressing than the forums or even hair recovery treatment follow-ups. The majority of my patients have posted follow ??“ ups in a statistically significant fashion that should put to rest wild speculations at this time.

I met Dr Yu at the ISHRS in Canada last year. However, this release and its content is news to me. I will hope to be consulted in the future. I wish him well.

PGP, Bill, What ever the "Feller punch" is, It would seem something its creator is very proud of. However, I have never seen the "Feller Punch," let alone use it. Last September I attended the ISHRS scientific meeting in Las Vegas. There was a large room in which vendors who sell supplies to the transplant industry exhibited their products, products such as cutting blades, scopes, solutions, automated FUE devices, punches of all shapes and an assortment of curious FUE and strip paraphanelia.... To the best of my recollection, I don't recall seeing a product called the "Feller Punch" for sale in the exhibition room.

$6 per graft

Bill, There are better suited media for the teaching of medical procedures and sharing of complex medical processes...journals, books, professional seminars, training programs etc, and as mentioned already I am well on track to getting that accomplished. I would rather not continue along the lines of providing information prematurely to a medium that could be subject to misinterpretation. For instance 70-80% figure estimate mentioned does not imply a 20-30% failure. I do not think the production process of a custom made instrument is of paramount importance at this point However, as I get the chance to organize data and thoughts in a more comprehensive manner, I will as appropriate share these with the community. I have done so previously and would continue to do so. My website has several articles written in this vein. Most of these articles were written over 2 years ago: Some of them do address some of your questions. For instance regarding Dutasteride, Finasteride etc. Most of the thoughts shared in that article still remain relevant: The pathway that leads to the production of the 3 androgens (DHT, testosterone and Androstenedione, also has a route that leads to the production of Estrogen). When you block DHT production by 5AR inhibition, the path to testosterone and/or estrogen production tends to be up regulated. The degree to which either of these two hormones (testosterone and Estrogen) are affected by 5AR inhibition should depend on several factors including the patient's idiosyncratic predispositions, drug dosage, drug type and actions (e.g. Dutasteride blocks both 5AR-1 and 5AR-2 hence leaves less room for DHT production via the 5AR1 pathway -the case with finateride) etc. In healthy individuals, most body hair (relevant to BHT) responds especially to testosterone positively. Hence if DHT blockage results in more testosterone production than estrogen, you may actually end up with a positive effect on body hair than in pre-medication periods. If however, more estrogen is produced than is testosterone, you may well have a slowing of body hair growth and/or breast enlargement and/or loss of libido etc. If these hormones (Testosterone and Estrogen) are raised to the same degree activity-wise, then you may have no change in body hair status as the effects of the 2 will balance out (most patients on alopecia reduction doses). This is the basis for my previous statement "Some activities of 5AR inhibitors (dutasteride and finasteride) are not a direct result of DHT or lack of it" found in the post you pasted above. As you can judge from the aforementioned, some activities of 5AR inhibitors is as a direct result of Testosterone and/or estrogen up regulation, rather than DHT. A study on chest hair suggests that when slowing of hair growth occurs with finasteride use, it sustains for about 6 months following which it ceases to affect it either way as evidenced by observations in months 6 through 12. It is believed that even in these cases, the effect of testosterone increases to balance the initial estrogenic burst that may have occurred in the earlier months. Also these uncommon negative effects tend to reverse with cessation of meds. Please note: All the studies leading to the aforementioned statements have been based on prostate studies whereby higher doses of 5AR inhibitors are used compared to the standard doses for hair loss indications. Conclusion: I do not generally dissuade my patients from using finasteride or dutasteride post BHT, but certain caveats have applied. I have thus far advised caution in the following events: 1. Breast symptoms have occurred and persist. 2. Libido problems have occurred and persist. 3. 5AR inhibitors have been used for less than 6 months. 4. I pay special attention to the use of dutasteride (an effective 5AR-1 and 5AR-2 inhibitor) and patients using higher doses (of either meds) than is the standard recommendation for hair loss treatment. I have also re-emphasized pre-operative wet shaving and the intra-operative selection of only actively growing body hair for transfer. These would constitute anagen hair that has weathered any real or imagined negative effects of any agent the patient may have been using. Other useful read include: Importance of hair cycles and extraction: http://dermhairclinic.com/dhc_artdetail.aspx?id=12 Hair cycles and BHT: http://dermhairclinic.com/dhc_artdetail.aspx?id=11 Role of minoxidil in BHT: http://dermhairclinic.com/dhc_artdetail.aspx?id=8 BHT testing, basic principles: http://dermhairclinic.com/dhc_artdetail.aspx?id=13 Wounding and healing in BHT: http://dermhairclinic.com/dhc_artdetail.aspx?id=10 Wound healing variations in BHT: http://dermhairclinic.com/dhc_artdetail.aspx?id=9 I would continue to show results as I have been for the past years. As mentioned there are results that are beyond the 2 year mark already from active (once active) blog members. As we continue to get them from patients willing to have their results in the public domain, more long term results would emerge. It is going to be a slow process given that we are dealing with a procedure that takes a while to show and patients that do get lost to follow-up sometimes because after a while some just want to get on with their lives. Regards,

PGP, That is a good question. . I have been using nape hair in suitably qualified patients in the past 2 years to be precise. The ability to use nape hair (Like BHT) is another advantage of FUE over strip surgery, since these areas are realistically harvested only by minimally invasive methods which as of today means and FUE-type technique. Nape hair is a little bit trickier to extract intact, hence clinics/doctors contemplating it should note that certain nuances do apply. Nape hair is more delicate and subject to damage if the procedure is not nuanced to account for this. Here are some grown results from the past that have been featured in one form or the other on this forum: 1. Done exactly 2 years ago: http://dermhairclinic.com/dhc_galdetail.aspx?id=8">http://dermhairclinic.com/dhc_galdetail.aspx?id=8 2. Atticus: http://www.hairrestorationnetwork.com/eve/showthread.php?t=144218]Atticus 3. Hooray for hair; Hooray for hair 4. Schmoe In the coming months, more cases would be posted from my clinic depicting the compelling advantages of using nape hair for hair line refinement. Advantages of Nape hair: 1. The best hair for the creation of soft less detectable hairlines 2. It adds to the donor supply, hence saving the traditional donor areas to meet the recipient demand On the average about 600-900 grafts can be obtained form the nape area and the 1cm wide area immediately adjacent to the ears After taking nape hair from a variety of demographic groups, African American, Asian, caucasians, it is emerging that the nape area heals remarkably well. IS IT SAFE? This is were patient selection comes in. Observation would confirm that contrary to untested statements, nape hair is not always lost in baldness. In fact most bald men would retain their nape hair while some would even experience an increase in that hair. Patients who would go on to loose their nape hair often are the type that would develop very severe baldness, and if BHT or hair multiplication cannot be counted on, these group of patients should not be ideal candidates for hair transplantation in the first place. Such patients tend to manifest nape hair thinning that is often evident even at an early age. Here is an example of a patient that has nape hair thinning that visited me for body beard and head hair hybrid transplantation a few months ago. He had undergone strip surgery at another clinic couple of years prior. This patient should not have undergone transplantation using head hair by strip to begin with given the extent of his hair loss if BHT or hair multiplication cannot be counted upon. A young Man (Early 30s) showing marked nape thinning: The thinning nape area (to be avoided) demarcated: The nape are is avoided, while the wreath area is harvested: I would be writting about nape hair in transplantation in due course. I hope this helps. Regards

Dr Mejia, I thank you for your input. Hopefully we would be exchanging ideas at the next ISHRS meeting in Montreal. Regards,

Dr Carman, I thank you for your input. The result is just as the patient wishes it. I do spend a considerable amount of time in setting expectations right. This patient's outlook from the outset was ideal in that regard. Regards I can also tell from his posts that his expectations were/are realistic, and his tone suggests to me that he enjoys the benefits of a good doctor-patient relationship. Very nice.

Pat had put forth these questions: 1. How the "Umar procedure" works and how it differs from techniques used by other surgeons. 2. Body hair growth cycles and their longevity when transplanted to the scalp. 3. How he qualifies candidates for surgery. 4. BHT success rates in his experience, including typical growth yield and overall success in the 150+ cases he's performed. 1. How the "Umar procedure" works and how it differs from techniques used by other surgeons. FUE was first made popular by Dr Woods. It long emerged that the crucial aspect of the procedure entails dissecting the hair follicle free of the surrounding tissue without compromising the integrity of the follicle. The generic procedure was adopted by many different Drs to transfer head hair grafts. Later on it emerged that body hair can be made to grow in the scalp. It became soon evident that body hair differs from head hair because of the difference in its orientation relative to the skin surface and the anatomy of its attachments and the investing tissues, as well as its sturdiness. All these factors vary from one individual to the other and within the same individual from one location to another. The basic tenet of FUE remains the same. My procedure is a total protocol that begins from before the surgery is performed to nuanced techniques of scoring using custom made devices that ensure the intact removal of the grafts with minimal challenge of their integrity as well as the treatment of the grafts thereafter ending with the post operative management of the patient. It brings into play my background in dermatology and enhanced understanding of hair medicine. The total protocol (The Umar procedure) has resulted in a good success rate in my BHT procedures the result of which started manifesting as of 2005. The first major case that resulted in compelling transformation was of an active forum member "Heliboy" whose surgery in September of 2005 was well documented amidst a lot of skepticism and rancor. His result received the acclaim it did not only for the unquestioned transformation that was evident but also because his surgery was documented in public when his outcome was not known. Heliboy is now over 2 years since his surgery and his results have held well. He has since gone on with his life as is the overall goal of the process in the beginning. My current protocol for performing BHT is something I developed independent of any party. I started sharing my thoughts on the forums as they emerged several years ago, but realized that many mistook my motives for self promotion while other doctors are quick to adopt ideas while claiming to be the originators of it. I stopped doing so afterwards having decided that it is best to focus blog interactions to result sharing (as much as possible) while methodically working towards a formal introduction of lessons learnt through professional forums and publications. I began the process by formal presentation of results at the ISHRS, and was glad that these results have dispelled certain misconceptions amongst the HT providers. I am currently rounding up the training of a board certified dermatologist from Thailand (at no charge) who has been with me for over 10 months, and would be free to set up shop in Thailand should he so choose without preconditions afterwards. I have no problem training, I just would not subscribe to underhanded tactics by ego driven forces bent on usurping ideas through disrespectful blog interactions disguised as challenges. I have concentrated on showing results for the past several years for this purpose. Hence I would ask that for those practitioners asking that I differentiate my protocol from theirs, they provide me with a similar track record for the kind of BHT results I have thus far shared with the public along with relevant timelines to buttress their point. It would be absurd for someone to claim that my protocol is his when he cannot produce my kind of results with relevant timelines to make their point. Again I would stress that if a doctor has difficulties with a procedure a colleagues seems to be succeeding with, the way to do it is the old fashioned and tested way; recognize the achievement gap, contact the colleague directly with a view to learning something new that might help you improve your approach. You do not go to the public disparaging this colleague while challenging him to show you/teach you how he does it. 2. Body hair growth cycles and their longevity when transplanted to the scalp. Body hair cycles have been researched by other workers using phototrichography. There are old publications to this effect. However, with BHT, the importance is whether or not sustainable coverage can be achieved regardless of the hair source. I have seen only one instance of possible cycling problems in one patient who was later lost to follow-up. The compounding factors in that instance is the heavy duty usage of a combination DHT inhibitors in a sensitive period before and post transplant in spite of my verbal and written admonitions to a contrary actions. At the time other facilities purveying BHT had offered contrary opinion regarding DHT inhibitors and BHT, hence we have a scenario where patients even mine may have been confused as to what exactly is the way to go with regards to DHT inhibitors post BHT. A poignant point in this regard is the instance of one other patient that received leg hair transplantation from me 2 years ago. He would not respond to my enquiries for a while until 18 months afterwards when he confessed that despite my instructions he had gone on Dutasteride. When he was not experiencing growth, he deferred his follow-up "not wanting to disappoint". He later stopped the medication on his own and to his surprise, the transplanted leg hair started gaining in length once again. It was at that point he felt confident enough to resume his follow-up with confessions to boot. He has since gone on to have a second procedure to address other areas, and has promised this time to take his post ??“operative instructions very seriously. We already have known blog personalities like "Heliboy" and sofarsogood whose well documented surgeries and results continue to hold at 2 years and beyond. That said I have treated patients that have lost head hair that was transplanted previously. Any transplanted hair can be lost for different reasons regardless of the donor source. By those accounts even patients receiving head hair transplants should be aware that loss in the long term is no impossibility, if informed consent is to be strictly observed. 3. How he qualifies candidates for surgery Patients are assessed for their relative lack of head donor to decide on the justification for BHT. Once this is determined, then the body hair is assessed for quality, quantity and location to determine likelihood of success based on observations of previous cases. That is the basis of my consultation. I have incurred the displeasure of some because of the rigorousness by which this is done. I had written on this subject already on another thread which can be accessed by going to this link: http://hair-restoration-info.com/eve/forums/a/tpc/f/746...861/m/2381064283/p/2 4. BHT success rates in his experience, including typical growth yield and overall success in the 150+ cases he's performed. While I may have performed over 150 cases of FUE and BHT, the BHT cases per se may not amount to that. Many of my surgeries go on for 2-5 days. Some have lasted almost 2 weeks, while we have patients that a patient that has had surgery for perhaps 30 days collectively. So for my clinic, the number of cases is not the emphasis. Thus far I have had reason to be dissatisfied with perhaps 10 clear cut BHT cases that I have had the chance to evaluate fully. I have redone most of these, some of whom had surgeries much earlier in our inception. Some of these cases have clear reasons (eg infection etc) that could account for their outcome. The yield I have observed varies with the location of the donor, and the quality of the hair. It has ranged from 70-80 percent allowing for hair that is not showing on the surface because of the skin owing to resting phase. BHT results could take 1-2 years to fully manifest. These are still anecdotal numbers and patients are informed that their results could and do vary. We have encouraged patients to go for test procedure if in doubt before proceeding (See Sofarsogood). In conclusion, perhaps 60 percent of my patient pool comes from patients seeking repair of one kind of the other from earlier procedures done at other facilities. The majority have had head hair transplanted with complaints ranging from lack of graft take, loss of grafted head hair that had initially taken, plugginess, scarring, pitting etc. In short the myriads of complaints from procedure performed at times from well regarded clinics is such that could lead one to question the legitimacy of head hair transplant regardless of how the hair is harvested. All medical procedures have the possibility of ending up in unsatisfactory outcome. Patients must beware of clinics or doctors that boast of guarantees and a record devoid of unsatisfactory outcome.

Pat had put forth these questions: 1. How the "Umar procedure" works and how it differs from techniques used by other surgeons. 2. Body hair growth cycles and their longevity when transplanted to the scalp. 3. How he qualifies candidates for surgery. 4. BHT success rates in his experience, including typical growth yield and overall success in the 150+ cases he's performed. 1. How the "Umar procedure" works and how it differs from techniques used by other surgeons. FUE was first made popular by Dr Woods. It long emerged that the crucial aspect of the procedure entails dissecting the hair follicle free of the surrounding tissue without compromising the integrity of the follicle. The generic procedure was adopted by many different Drs to transfer head hair grafts. Later on it emerged that body hair can be made to grow in the scalp. It became soon evident that body hair differs from head hair because of the difference in its orientation relative to the skin surface and the anatomy of its attachments and the investing tissues, as well as its sturdiness. All these factors vary from one individual to the other and within the same individual from one location to another. The basic tenet of FUE remains the same. My procedure is a total protocol that begins from before the surgery is performed to nuanced techniques of scoring using custom made devices that ensure the intact removal of the grafts with minimal challenge of their integrity as well as the treatment of the grafts thereafter ending with the post operative management of the patient. It brings into play my background in dermatology and enhanced understanding of hair medicine. The total protocol (The Umar procedure) has resulted in a good success rate in my BHT procedures the result of which started manifesting as of 2005. The first major case that resulted in compelling transformation was of an active forum member "Heliboy" whose surgery in September of 2005 was well documented amidst a lot of skepticism and rancor. His result received the acclaim it did not only for the unquestioned transformation that was evident but also because his surgery was documented in public when his outcome was not known. Heliboy is now over 2 years since his surgery and his results have held well. He has since gone on with his life as is the overall goal of the process in the beginning. My current protocol for performing BHT is something I developed independent of any party. I started sharing my thoughts on the forums as they emerged several years ago, but realized that many mistook my motives for self promotion while other doctors are quick to adopt ideas while claiming to be the originators of it. I stopped doing so afterwards having decided that it is best to focus blog interactions to result sharing (as much as possible) while methodically working towards a formal introduction of lessons learnt through professional forums and publications. I began the process by formal presentation of results at the ISHRS, and was glad that these results have dispelled certain misconceptions amongst the HT providers. I am currently rounding up the training of a board certified dermatologist from Thailand (at no charge) who has been with me for over 10 months, and would be free to set up shop in Thailand should he so choose without preconditions afterwards. I have no problem training, I just would not subscribe to underhanded tactics by ego driven forces bent on usurping ideas through disrespectful blog interactions disguised as challenges. I have concentrated on showing results for the past several years for this purpose. Hence I would ask that for those practitioners asking that I differentiate my protocol from theirs, they provide me with a similar track record for the kind of BHT results I have thus far shared with the public along with relevant timelines to buttress their point. It would be absurd for someone to claim that my protocol is his when he cannot produce my kind of results with relevant timelines to make their point. Again I would stress that if a doctor has difficulties with a procedure a colleagues seems to be succeeding with, the way to do it is the old fashioned and tested way; recognize the achievement gap, contact the colleague directly with a view to learning something new that might help you improve your approach. You do not go to the public disparaging this colleague while challenging him to show you/teach you how he does it. 2. Body hair growth cycles and their longevity when transplanted to the scalp. Body hair cycles have been researched by other workers using phototrichography. There are old publications to this effect. However, with BHT, the importance is whether or not sustainable coverage can be achieved regardless of the hair source. I have seen only one instance of possible cycling problems in one patient who was later lost to follow-up. The compounding factors in that instance is the heavy duty usage of a combination DHT inhibitors in a sensitive period before and post transplant in spite of my verbal and written admonitions to a contrary actions. At the time other facilities purveying BHT had offered contrary opinion regarding DHT inhibitors and BHT, hence we have a scenario where patients even mine may have been confused as to what exactly is the way to go with regards to DHT inhibitors post BHT. A poignant point in this regard is the instance of one other patient that received leg hair transplantation from me 2 years ago. He would not respond to my enquiries for a while until 18 months afterwards when he confessed that despite my instructions he had gone on Dutasteride. When he was not experiencing growth, he deferred his follow-up "not wanting to disappoint". He later stopped the medication on his own and to his surprise, the transplanted leg hair started gaining in length once again. It was at that point he felt confident enough to resume his follow-up with confessions to boot. He has since gone on to have a second procedure to address other areas, and has promised this time to take his post ??“operative instructions very seriously. We already have known blog personalities like "Heliboy" and sofarsogood whose well documented surgeries and results continue to hold at 2 years and beyond. That said I have treated patients that have lost head hair that was transplanted previously. Any transplanted hair can be lost for different reasons regardless of the donor source. By those accounts even patients receiving head hair transplants should be aware that loss in the long term is no impossibility, if informed consent is to be strictly observed. 3. How he qualifies candidates for surgery Patients are assessed for their relative lack of head donor to decide on the justification for BHT. Once this is determined, then the body hair is assessed for quality, quantity and location to determine likelihood of success based on observations of previous cases. That is the basis of my consultation. I have incurred the displeasure of some because of the rigorousness by which this is done. I had written on this subject already on another thread which can be accessed by going to this link: http://hair-restoration-info.com/eve/forums/a/tpc/f/746...861/m/2381064283/p/2 4. BHT success rates in his experience, including typical growth yield and overall success in the 150+ cases he's performed. While I may have performed over 150 cases of FUE and BHT, the BHT cases per se may not amount to that. Many of my surgeries go on for 2-5 days. Some have lasted almost 2 weeks, while we have patients that a patient that has had surgery for perhaps 30 days collectively. So for my clinic, the number of cases is not the emphasis. Thus far I have had reason to be dissatisfied with perhaps 10 clear cut BHT cases that I have had the chance to evaluate fully. I have redone most of these, some of whom had surgeries much earlier in our inception. Some of these cases have clear reasons (eg infection etc) that could account for their outcome. The yield I have observed varies with the location of the donor, and the quality of the hair. It has ranged from 70-80 percent allowing for hair that is not showing on the surface because of the skin owing to resting phase. BHT results could take 1-2 years to fully manifest. These are still anecdotal numbers and patients are informed that their results could and do vary. We have encouraged patients to go for test procedure if in doubt before proceeding (See Sofarsogood). In conclusion, perhaps 60 percent of my patient pool comes from patients seeking repair of one kind of the other from earlier procedures done at other facilities. The majority have had head hair transplanted with complaints ranging from lack of graft take, loss of grafted head hair that had initially taken, plugginess, scarring, pitting etc. In short the myriads of complaints from procedure performed at times from well regarded clinics is such that could lead one to question the legitimacy of head hair transplant regardless of how the hair is harvested. All medical procedures have the possibility of ending up in unsatisfactory outcome. Patients must beware of clinics or doctors that boast of guarantees and a record devoid of unsatisfactory outcome.

This patient had introduced his surgery on this thread several months ago. His result at 6 months is hereby presented in video Previous thread started by cdnla310 soon after his surgery A soft hairline was created using Nape hair. The

This patient had introduced his surgery on this thread several months ago. His result at 6 months is hereby presented in video Previous thread started by cdnla310 soon after his surgery A soft hairline was created using Nape hair. The

Dr Feller, Unless you are indeed the person performing the surgeries on my patients in my Redondo Beach office, I would advice that you desist from further characterizing my work as "brute force" or any other phrase that occurs to you. If you have been using "brute force" to perform BHT, then I would not be surprised at your apparent lack of success in the procedure. If strip HT defines the limit of your horizon in hair restoration, I would respect that. However, do not judge me by the standards of your limitations. Stop haranguing my cases. No brute force was used on this patient... As you can see "Schmoe" is very happy with the outcome of his surgery. If a doctor hasn't put in the time to perform proper strip surgery to the level of expert then he doesn't know what he doesn't know. In this case it is very easy to put too much faith into an experiemental technique which is what all mega-FUE/BHT procedures are. Unfortunately, faith in an experimental procedure can be artificially strengthened if it is the ONLY hair transplant procedure you are capable of performing due to lack of a trained staff and inexperience in modern mainstream HT techniques. I extend kudos to Dr. Umar for his massive brute force approach. For those patients going in for such procedures with their eyes wide opein it is indeed a blessing, but only in so much as it doesn't confuse other would be HT patients into believing that mega-FUE/BHT is an alternative to mainstream techniques. The very techniques that allowed this industry to be reborn with credibility and respect.

Pat and the community, Again thank you for your consideration. Communities like these serve a function that I wish had existed decades ago long before many of the patients I have had to repair lately made their decisions on how to go about restoring their hair. On the other hand.... Dr Feller starts by minimizing the "results" of the patients I have posted, then he goes on to say I have not published enough "results"...so which line of spin should we follow? If he considers the results unworthy and beneath his vast expertise, perhaps it would serve the readership better that he simply points them to evidence of his expertise in repair that should put to shame the ones he is disparaging and effectively end my attempt to self promote at the expense of my hapless patients who are evidently and extremely displeased with their "minimal" improvement. Dr Feller also goes on to imply that unless I perform strip surgery, I would not meet his imaginary criteria. The chat rooms are replete with aimless (often self serving) arguments of

One of the most challenging aspect of FUE surgery is the extraction of curled hair (under the skin). There exists racial variation in the degree of curliness of hair under the skin. Generally individuals of African ancestry tend to have curlier hair. In scalp only FUE, this is perhaps the true test of a surgeon's FUE skill. Grafts like the ones shown in the Petri dish taken from one of our patients are common in patients of African ancestry. The foregoing is a self explanatory sequence of photos depicting an 8 month outcome of a 1200 graft FUE performed to reinforce the frontal scalp and refine the hairline of this African American patient who seeks to be able to cut his hair short without looking bald. Prior to the transplant he needed to grow his hair long which he combs forward and matts down with hair products (A subtle comb over) to conceal his hair loss. Before: Patient is unable to cut his hair any shorter as it would reveal his significant frontal thinning. Before:[/u] With a short hair cut, significant frontal thinning shows[/u] 9 Months later[/u] with a uniformly short hair cut:[/u] DONOR Immediately after Donor 9 Months: The Surgery: Immediate post Extraction of 1200 grafts Recipient . .

One of the most challenging aspect of FUE surgery is the extraction of curled hair (under the skin). There exists racial variation in the degree of curliness of hair under the skin. Generally individuals of African ancestry tend to have curlier hair. In scalp only FUE, this is perhaps the true test of a surgeon's FUE skill. Grafts like the ones shown in the Petri dish taken from one of our patients are common in patients of African ancestry. The foregoing is a self explanatory sequence of photos depicting an 8 month outcome of a 1200 graft FUE performed to reinforce the frontal scalp and refine the hairline of this African American patient who seeks to be able to cut his hair short without looking bald. Prior to the transplant he needed to grow his hair long which he combs forward and matts down with hair products (A subtle comb over) to conceal his hair loss. Before: Patient is unable to cut his hair any shorter as it would reveal his significant frontal thinning. Before:[/u] With a short hair cut, significant frontal thinning shows[/u] 9 Months later[/u] with a uniformly short hair cut:[/u] DONOR Immediately after Donor 9 Months: The Surgery: Immediate post Extraction of 1200 grafts Recipient . .

Dakota, Your plan sounds plausible. I do not perform FUT (Strip) and would be unable to give you a first hand account of this approach. However, it is a possibility. If you are committed to strip surgery, you may want to also look into FUE of the scalp donor areas after the strip route is exhausted before resorting to non head hair. That again would maximize the coverage you would get given the increased input from head grafts you get by so doing. Also, the more head hair you throw into the midst of body hair, the more blending you get as the additional head hair adds to the camouflage of the body hair. In general the approach I would favor is as follows: In patients who for any reason are likely to resort to BHT as part of their hair restoration plan my advice is often to start mixing up the hairs earlier in the journey. You want to avoid distinct populations of hair types in different aspects of the head, thus avoiding the appearance of an unnatural mosaic. Mixing up the hairs from different sources throughout offers the best blend and most natural outlook. The nuanced approach is to vary the mixture to favor head hair in the front and non head hair as you go towards the crown. It serves a strategic purpose to use of longer hair in the middle of the crown. Regardless the transition in mixing ratios should be gradual to avoid the creation of unnatural boundaries in the head. All said, please check to see if your body or beard hair is suitable for BHT, before basing aspects of your hair restoration around it. I would be glad to look at photos of hair bearing areas of your body to offer an opinion with regards to that. Not all body hair is suitable for transplantation. Unfortunately not every one is endowed with the right kind of hair for the purpose of BHT. Finally, circumstances can result in the loss of even transplanted head hair and I have seen this phenomenon in some patients that have presented to me for work after having had surgery elsewhere involving head hair only. It would have been far fetched to cast doubts at head hair HT as a result of such an observation rather than finding out the cause of it. Several years ago some purveyors of BHT refused to acknowledge the possible deleterious effect of DHT inhibitors on BHT perhaps out of ignorance, perhaps out of fear of loss of potential clientele or something else; I wrote an article addressing this possibility and advised all my potential patients of this possibility. DHT inhibitors could hamper BHT growth and can potentially lead to the loss of BHT grafts that do take. Additionally, the use of body hair that is destined to fall for BHT could lead to failed growth or loss of grafts that do take...

Thank you all for your kind words and for considering my membership in your community. My philosophy to HT is that of adopting the most minimally invasive approach towards attaining the patient's goal. In the overall, I always emphasize the utilization of the best available donor source in a manner that takes into account the trajectory of the patient's degree of hair loss. By my observation the quality of donor source is in the order of Head; Beard; Body... If a potential patient presents with NW4 or less degree of hair loss for instance, I would not ordinarily consider BHT as an option in such a patient unless there is a relative or absolute lack of head donor supply for one of many reasons. Many patients that come to me requesting the use of non head hair as a donor source are turned down mostly for the reason of not meeting my criteria for BHT usage. I have in fact incurred the wrath of some potential patients for the same reason. The foregoing is an example of a potential patient who I disqualified that decided to go to another hair loss forum to complain about it. Embedded in my response is a synopsis of my selection criteria for BHT: ORP967 posts on another forum : Friday May 23, 2008 11:00 PM Hey Sofar, I see you respond quite often to post regarding BHT... as well you should because of your results (they're great!). I was wondering if you had any trouble getting Dr. Umar to go ahead with your BHT goals pre-op? I'm currently in talks with Dr. Umar for my BHT hairline goals and I'm noticing he is very hesitant (you could even say against BHT) yet he advertises BHT results pretty religiously. MY RESPONSE: " Although we have gathered a significant number of cosmetically significant BHT related results, I have always maintained that like any and all other surgical or medical procedures; not everyone is a suitable candidate. There is no procedure in medicine in which everyone qualifies with absolutely no exceptions. That is simply the nature of medicine. The process of a surgical procedure begins with the consultation process, in which your doctor acquires all necessary details with which he/she would base his/her decisions. At some point he/she would have to determine if you are a suitable candidate for the procedure. This selection process has been credited by many doctors as accounting for over 50% of the success of the procedure. In hair transplantation (an elective and cosmetic procedure), the process of patient selection should even be more rigorous. This process of selection is not unique to BHT or hair transplantation. It applies to all medical procedures. SPECIFIC TO BHT: I have (and continue to) turn down some prospective patients requesting BHT from me because they are not suitable candidates by my assessment. Common reasons for rejecting a case includes (but not restricted to): 1. Poor body hair characteristics (By my criteria). 2. When head hair supply relative to present and anticipated hair loss is judged adequate 3. Unreasonable expectations. Some have concealed this at consultation. But often, it is very evident. 4. Other factors (often non technical, often psychological) that may make the individual unsuitable for most cosmetic surgeries including BHT. These factors are not often evident at consultation and some individuals could manifest these only after undergoing the procedure having successfully eluded the screening criteria which is not infallible. Patients considering having BHT at my clinic should start with a formal consultation in order to (amongst other things) determine their suitability for the procedure. This can be done online by calling the office for an in-office consultation or simply go to the "free online consultation" page on my website. All consultations are conducted 100% by me personally. free online consultation page: http://dermhairclinic.com/dhc_consultation.aspx ORP967: We do not promote or advertise BHT "religiously". For the most, we have simply shown what we have achieved with a procedure that many other clinics have had difficulties with. For the most I have emphasized work on: 1. Repair patients: Some of these patients have had a positive life altering transformation from BHT. In most of these often disfigured patients, BHT has been more than just a cosmetic procedure. In these patients (eg the poster "newgrowth", and the patient on the youtube video link #2 below), the selection process is justifiable more lax compared to for instance a young individual with a virgin scalp with virtually no hair loss that only wishes to (perhaps unnecessarily) advance his/her hairline. 2. I have also used BHT (in combination with head hair) in significantly bald individuals that are not repair cases, whose hair loss (present plus projected) cannot be met by head hair donor alone.(See youtube video link #1 below). 3. I have also used used BHT in specialized instances like hairline refinement with finer body hair (Search the poster "sofarsogood") or eyebrow transplants. A track record in producing good results in any procedure often builds with experience. This by implication means that over the years, one develops a better sense of what might work or not work. If after acquainting myself with your case I advise you against BHT or any other procedure in my arsenal, then it is likely you do not meet (perhaps glaringly) my inclusion criteria. This is most likely the case in your instance. I do not have an ulterior incentive for turning down a case. On the contrary, the reason is often altruistic. I will thus advise you against further pursuing the procedure. You are of course at liberty to consult other clinics, however, bear in mind that there would always be doctors /clinics that would be willing to do your bid for money regardless of the contraindications however glaring the may be. " . So yes I perform BHT in patients that meet the criteria listed above. It so happens that the patients are often without alternatives such as "newgrowth" or patients that have so severe a hair loss seeking global coverage that cannot possibly be met by head donor alone. In between are gray areas of course. The good news is that in suitably qualified candidates, we have shown our ability to make BHT work. Would there be failures...of course, but which procedure is without its share of less than stellar results. I have been up front with my patients who would be quick to inform that they can always count on the bald truth at all times. When other clinics feared that the revelation of a negative effect of DHT inhibitors may cut down on their BHT clientele, I wasted no time in pointing out the possible deleterious effect of these meds in the viability of BHT. 3 years later, some patients and clinics that ignored the warning have unfortunately discovered the truth the hard way. Finally, at the risk of boring the readership, I perform scalp only FUE, a procedure that is less nuanced than BHT and more bread and butter, compared to some of the BHT cases I have been showing. These cases have been highlighted because of their unique nature and the fact that many clinics and doctors have disparaged the procedure as bogus partly because of their failed attempt at performing it or because of the reputation the procedure had garnered from actions attributable to its early purveyors. Some of my scalp-FUE-only patients have become active on this forum already. These are active forum members that can be reached by interested parties, both of whom I am sure would gladly meet interested parties in person (you may need to buy them lunch in the process though): The poster Hooray for hair. NW 4 3000 graft scalp FUE only Hooray's personal blog The poster Atticus: Hairline work scalp FUE 600 grafts There are more in my website and many more to emerge when the photogallery is updated. I will be posting some more cases of scalp only FUE along with BHT-only and BHT-FUE-combo cases. Most of the cases I would post would have an educational angle in them. In conclusion, I would ask that I be excused in the event of my slowness in response to enquiries going forward....I do all my forum postings and most aspects of my surgeries, consultations etc personally, thus accounting for the seeming delay / non response to forum enquiries on occasions.. I thank you all.

This shows in a most poignant manner, the emerging role of BHT (As performed by Dr Umar) in the parlance of hair restoration. This self explanatory " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow">

This shows in a most poignant manner, the emerging role of BHT (As performed by Dr Umar) in the parlance of hair restoration. This self explanatory " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow"> " rel="external nofollow">

Bill, The patient in question actually came to me for what is essentially a repair of previous hairline work done on him by another Dr.. By the patient's own account; about a year prior to seeing me, he had (at another clinic) about 2600 head FUE (to the hairline and frontal scalp) and 1200 BHT to the crown, leaving out the mid scalp. Result wise, the new hairline was harsh (because it consisted of thick hairs and many terminal doubles), too much of a V (not fitting his face well), grossly asymmetrical as it curved excessively to the right as well as being too sparse...in the overall unnatural looking. He wanted that hairline refined. He also felt there was no cosmetically visible growth of the ~1200 body hair he received in the crown. He wanted his mid scalp grafted. He was not happy with the transition between the frontal scalp and mid scalp which and wanted that eliminated. Because of his prior experience he was particular about not having abrupt transition margins between the different zones of the head. He wanted the transition between the mid scalp and crown sufficiently tapered to make for a natural transition in keeping with the basic tenets of hair transplantation. I did NOT work on this patient's crown, another Dr did over 18 months prior to the posting of these results...My surgery would appear to involve the crown, because of the mid scalp tapering that I had to do for a more natural transition between the mid scalp and crown. My basic approach is to have a patient not be compelled to come back for surgery to avoid an odd look. It is always best to assume that the patient might not return for more transplants in the future. Hence they should be left looking natural at the end of each surgery. Tapering transition lines helps in achieving this. MY SURGERY The hairline, temporal recesses and the right and left sides of the frontal scalp About 1600 Nape (~50%), and head (~50%) hair grafts were used to: 1. Reshape the hairline to a cross between a V and a U which framed his face better 2. Soften the hairline to obscure the thick terminal hair and multiple doubles 3. A more natural tapering density 4. Realign the hairline from a right curving to a more symmetrical disposition. 5. Close in the temporal recesses ever so slightly to just frame the face more naturally. 6. Fill in the bridge between the frontal scalps and the sides of the head to better compliment above changes PATIENT'S OWN STATEMENT REGARDING HAIRLINE WORK' Make the hairline softer and more natural. The devil is in the details, bare in mind when you're looking at the photos, you're seeing a fixed view.. in life and in motion we can start to pick out the details.. look at "Sides(Full)" and "Front(Full)". The temples are that detail, I HAVE a hairline before, but AFTER everything really looks complete and falls together. and it is much softer now. I'm VERY happy with it. As far as I'm concerned my hairline is DONE!! (well.. we'll see.. lol.. we're all hair addicts)" The mid scalp was transplanted with ~1600 pure body hair consisting of stomach and pubic hair with tapering towards the crown. Yellow=mid scalp grafting, Blue=tapering area All body hair PATIENT'S OWN STATEMENT REGARDING MID SCALP WORK: "I had a wall of hair in the front and it came to a halt in the middle.. making it look a bit dramatic. So the middle was filled in. It was ALL pubic and abdomen hair in the middle; I was happy with the results of the body hair. you can go through my gallery and maybe decide for yourself as to what you think Dr. X's yield was. The front came out well I wasn't too excited about the results in the back, however It's hard to tell if the survival rate was low OR that the body hair just wasn't robust enough (maybe both); the scalp hair clearly came in very well though. As far as Dr. Us yield rate go; everything came in well.. the front came in nice and soft, the middle filled up well to be comparable to the front, thus having a much less dramatic transition from frontal scalp to mid scalp. I DO feel much difference! here's the vain reasoning behind that.. I would see pictures before the surgery with Dr. U and I wanted to throw away most of the pictures, the hairline (although thicker) was MUCH more clearly defined, as opposed to before the surgery, where it was very thin, it was a very natural transition. This restored the natural transition and I actually see the pictures now and am pretty damn happy with them Here are relevant statements posted by the patient on another hair loss forum posted by schmoe, 28.12.2007, 22:45 Hey guys; sorry I haven't chimed in yet, to be honest, I'm no too worried about my hair right now (for the first time in 10 years), so i've been worreid about all the other things in life besides my hair! I'm gonna try to go down the list of questions here. First off, THANKS for all the support, as most of us know this is a taxing issue that lingers in our minds for way too long and drains us of valuable thought and energy (and money!) >>Schmoe, you look great, soft n natural hairline. How many grafts did you >>have combined counting both XXX and Umar? thank you! I dont have the EXACT numbers on me, the final tally for Dr. X's is posted in my blog. 3800 roughly with Dr. X, about 1200 of those being body hair I believe. 3200 with Dr. Umar; I believe it was half and half roughly 7000 grafts total now. >>What was the time frame of surgeries between Dr. X and your procedure Dr. >>U? In other words, how much time separates the procedures? Almost 1 year exactly. >>Once again excellent results from Dr.Umar. >>Honest pictures with the same lighting, hair conditions (wet or dry) and >>head positions showing the before and after results. >>Excellent job, excellent results, and I am sure this man is estatic. I'm VERY happy; the 2nd procedure addressed 2 issues; A) I had a wall of hair in the front and it came to a halt in the middle.. making it look a bit dramatic. So the middle was filled in. It was ALL pubic and abdomen hair in the middle; I was happy with the results of the body hair. B) Make the hairline softer and more natural. The devil is in the details, bare in mind when you're looking at the photos, you're seeing a fixed view.. in life and in motion we can start to pick out the details.. look at "Sides(Full)" and "Front(Full)". The temples are that detail, I HAVE a hairline before, but AFTER everything really looks complete and falls together. and it is much softer now. I'm VERY happy with it. As far as I'm concerned my hairline is DONE!! (well.. we'll see.. lol.. we're all hair addicts) >>People with light color hair are blessed. I don't think he would look as nearly good if his hair were black. I actually had it bleached platinum for awhile because of this and it looked AWESOME! but i grew bored of it.. I still use stuff like 'sun in' to keep the contrast minimal. It's true the hair overall is still pretty thin. I will be addressing this in another surgery this coming year. 1500 to fill in the crown, another 500-1000 to fill in the density of the front; it will be mostly beard hair; no scalp. >>I swear you had a lot of hair already after you went to Dr.X, u feel much difference after the additional 3000 from Dr. Umar? How do u rate the yield between dr x and dr umar ? this is difficult to answer; you can go through my gallery and maybe decide for yourself as to what you think Dr. X's yield was. The front came out well I wasn't too excited about the results in the back, however It's hard to tell if the survival rate was low OR that the body hair just wasn't robust enough (maybe both); the scalp hair clearly came in very well though. As far as Dr. Us yield rate go; everything came in well.. the front came in nice and soft, the middle filled up well to be comparable to the front, thus having a much less dramatic transition from frontal scalp to mid scalp. I DO feel much difference! here's the vain reasoning behind that.. I would see pictures before the surgery with Dr. U and I wanted to throw away most of the pictures, the hairline (although thicker) was MUCH more clearly defined, as opposed to before the surgery, where it was very thin, it was a very natural transition. This restored the natural transition and I actually see the pictures now and am pretty damn happy with them. As I said earlier, I'm not done yet. I don't believe HT surgery consists of ONE surgery... its a long road; and I think people should be aware of that when they go for a surgery.. I am WELL aware that my hair is going to continue to thin (yes I'm on meds); so I'm trying to be practical and slowly fill it in with body hair over time to maintain it. Yeah it's not cheap; but if you want cheap you can simply shave your head and move on.. you don't NEED hair.. you WANT hair. good luck to all, thank you for the support; if you have anymore questions, feel free to ask or just EMAIL me! (schmoe5000 @ hotmail.com) if you want any ADVICE on your own predicament, I can give you my opinion.. (bare in mind I'm not a professional, just someone who sympathizes VERY MUCH!) take care! ------------------------------------------------------------- posted by schmoe, 30.12.2007, 14:59 lordy.. I leave for ONE day! I think there may have been a little confusion regarding the yield results and late growth; While Dr. x's surgery was integral to where I'm at; Dr. Umar worked in areas untouched by Dr. x (there may have been some slight overlap in the back, I'm not 100%) BUT Dr. Umar did the midscalp that was left untouched by Dr. x at the time along with the very frontal hairline(in front of Dr. x's) So any growth you see in particular areas would essentially be the result of the Dr. that worked in that area. Hope that clears up any confusion (if there was any regarding that) posted by schmoe, 30.12.2007, 16:13 a few more things.. price. most of you know that you get a discount for large amounts of grafts by most Dr.s, so generally 'x per graft' doesn't really hold up. keep that in mind when you're pricing HT; there's many Dr.s that offer discounts for various things (photographed results; paying in cash vs financing etc) I don't know how at liberty I am to discuss my pricing so I won't. 35k is a bit higher than what I paid though. You guys also have to keep in mind, it's a process, or journey of sorts; you dont walk into a clinic, drop down 35k on the table and walk out with your Jake Gyllenhaal hair. set goals for each surgery then set a final goal; decide how much you can work on each time. some of that linear thinking is comparable to that of a really obese guy walking into a gym thinking he's going to walk out of there looking like nitro from american gladiators 1 year and 8 months later.. For those interested in the patient's hair loss state before he ever had any hair transplants, here are some photos he shared on another hair loss forum: Regards,