Alexander

I agree, steroids are commonly used to prevent the hypertrophic or keloid scarring as the previous poster mentioned. It will not help with stretching directly, but I think keloid formation adds to the overall tension of the scar which can lead to stretching down the road, so preventing that will help. In general, injecting around a scar closure after surgery is a common preventive measure to aid in reducing inflammation during healing so it shouldn't raise a red flag.

Great point Gazza- I believe if most of the top notch docs used as many grafts as Armani their work would be as good if not much better time in and time out. Personally while I think Armani does decent hairlines, I still think others like H&W and Shapiro do much more natural-looking work w/ much fewer grafts anyway.

Bisanga seems to have a really solid rep, and from the different forums where his results have been posted he seems to have a really good artistic eye for hairlines. I think he's even got some videos up on youtube. Good luck.

This is old news, but I was on Bernstein's site and came across this info, and remembered this post about pioneering FUE, etc. Anyway, in the interest of putting the debate to rest, here is the article link http://www.bernsteinmedical.com/hair-transplant/follicular-extraction.php If you don't feel like reading it, here's the relevant quote from Bernstein: "Using direct extraction to harvest follicular units was initially introduced by Dr. Woods in Australia as the "Wood's Technique," but he did not disclose the details of his technique."

Just a guy, Don't feel bad man, this site is one of the more pro HT sites, so people in here take it personally when you bash the HT industry for some reason. I also wonder why people who are happy with their results post on this site. Are you trying to convince yourselves you made the right decision? If I wasn't in the situation I'm in (needing repair) I wouldn't be posting online at all. I'd be living my life, far away from the Internet forums that I feel compelled to read now to try and search for useful information in pursuit of getting things fixed. So, If hair transplants are so wonderful, why are people with "great" HTs still posting here? If your life was enhanced so much, shouldn't you be living it offline? Unless you are marketing it doesn't make any sense to keep posting everyday unless you are either: 1.) Unhappy with your results. 2.) You are not sure about your results or your decision and need validation from others. I think it's a very common thing for a guy to get a HT and then tell others to go ahead and get one done, it's no big deal, you'll look better, the surgery was painless, the doc was great, etc... just so they can feel like they did the right thing w/ their own HT, and have a sense of sympatico. It is basic human psychology. The board is full of guys like that. 3.) You are marketing/selling. 4.) You are happy with your results, but your lack of hair wasn't really causing the problem, since you are still unable to live a normal, socially functional life even after your appearance has been "enhanced" with the appearance of more hair. These are usually the guys who get an HT and love their new hair and then turn around and bash bald guys for being bald. Self-hatred manifests itself in strange ways. I've read a few posts in this very thread that represent this trend. 5.) You got good results, and you are a good samaritan, and want to do good deeds and prevent guys from getting bad results, so you recommend your doc or other good docs to them, in hopes of just lending a helping hand. If this is the case, go volunteer somewhere, there are people who really need help. If you are regulary posting on an Internet site, I think this is a socially unhealthy pursuit. This is my opinion of course. If you come in here every once in awhile, that's one thing. But guys who are happy with their HT and live on these boards- what are we to think? That they are doing it out of the kindness of their hearts? I believe there are other motivating factors to consider here. Not all HTs are bad. I've seen some really good ones, but they have been on older guys with limited NW balding. Maybe a nw3 or 4 recession (max) into their 40's. "Slow" balders. Younger guys who get HTs are headed for multiple surgeries to chase the hairloss, have to constantly use meds and topicals to preserve their hair, and if they are headed for NW6 or 7, will look ridiculous as they age, even if they got a "natural" HT because the pattern of hair loss will not be natural, and they will not have enough donor hairs to "spread the wealth," and the donor will recede and show the scarring, trico or not. We have been programmed to believe that baldness is socially unacceptable, the same way girls have been socially programmed to be thin. There are pleny of guys who like women with a little extra meat on them, and there are plenty of women who like balding men. Think about it. Guys think women don't like them because they are bald, but the truth is that women don't like a guy who is vain. If he is focused on his balding and insecure about it, then it will show in his body language, and a woman will have you marked as insecure and self-obsessed. It's not about the hair, it's about the vibe you are giving off. Not to shift the discussion to women, but that seems to be a real source of the fear/depression/anxiety surrounding MPB- a guy's apparent inability to appeal to the opposite sex.

Spiro is a topical anti dht, supposedly performing the same function as finasteride (propecia) or Dutasteride. Xandrox is a combination of azelaic acid, which is supposed to perform an anti Dht function (I believe the only tests done with Azelaic acid were done in vitro), and minoxidil, which has been proven to regrow hair in a limited fashion. So in theory, Xandrox will perform the function of regrowing hair and preventing further hairloss, while spiro will act in similar fashion to Propecia, which only blocks DHT, but doesn't really stimulate regrowth. Of course, with each product, you have to use them consistently for 6-12 months before you can really tell whether or not they are effective, and you will likely experience some shedding when you start to use them. Some guys claim great success using a combination of different meds, and some guys either get no results, or can't handle the scalp irritation from the topicals. Also, you need to continue to use them for life if you want to maintain any hair you gained while on the products. As soon as you stop, you will eventually go right back to where you would have been had you not used anything at all. Hope this helps.

Franklin, Exactly. I cannot understand people on this site who don't think Woods is the real deal.

Arrogant based on years of reading posts, articles, blogs, interviews, etc from both docs. I get bothered when docs constantly attack one another and fight for position in the public forum- it happens way too often in the HT industry, and it can be counterproductive and confusing for the patients. John, I wasn't suggesting you go to Australia, I was just replying to a "side" discussion about a particular doc. Sorry if things fell off track.

L'anonyme, I wrote a reply to your post, but it got "flagged" for content, and since it's been a few days since I posted it, I'll just assume it's not going to make it to prime time. Funny, I didn't use any profanity or other offensive language- I was just pointing out some things about the docs mentioned. Oh well, suffice it to say I'm not a fan of either of the these two docs we were arguing about- I think they are both arrogant. However, the one in Australia was doing FUE in the 90s, and definitely before the doc in the US came out with his publication in 2002. The fact that he put out a publication before the Aussie means nothing, other than he is a capitalist. If there's any doubt, take a look at his strip prices..$10 a graft!!! Outrageous. The best FUE docs are charging only around 8 per graft, and he's charging 10 for strip? Wonder what his fue prices are. whew Ask around diferent forums, the doc in Australia has plenty of patients to back up his work, he's been a big factor in the game for awhile, there's no doubt about that. He might be a bit unconventional, but he's a major player for sure.

Who is Dr. Woods? Are you kidding? You need to go outside of this site my friend- if you don't know who Dr. Woods is you are way outta the loop! Hint: He basically pioneered the FUE technique we see today! And his results are all over the net.

Brian, I'm sorry if I didn't catch the tongue in cheek nature of your response. Your post didn't come off that way, so I apologize if I was too critical. But this is a serious post, and guys in here are trying to support a guy who is really struggling with his hairloss, and trying to come to terms with his life and a possible decision about getting a HT. And you told him in a nonchalant way to just go ahead and get the HT, as if it were no big deal. Even though the surgery is much more refined these days, and the days of butchery are mostly a thing of the past, it is a very serious consideration to get cosmetic surgery, and there are ramifications and potential downsides that everyone should be made aware of. I just found your post a bit cavalier for the overall tone of this topic. No hard feelings, ok?

Brian, You said the following: "Make sure you break a few of those hearts that gave you the brush off because you were bald when you get your new hair." That is some really shallow shit my friend. If you live in the world of shallow (ie nighclubs, bars, frat parties, etc) trying to "score" every weekend, you can't be surprised when those tables turn on you. Men have it easier than women actually, because as women mature mentally, they don't care as much about hair or other aspects of looks. Men remain much more judgemental when it comes to looks than women over time. I've seen lots of attractive 30- ish women with men in their 50s, even 60s. It's too bad that through this process you've learned nothing but to get revenge on superficial women who brushed you off.

Never heard of Kelo Cote, have to check that out. A few ways to tackle this problem: 1.) Have an experienced FUE doc take out some of the FUs in the ridged area that are responsible for the ridging. This will decrease the volume, and flatten the area out. A really good FUE doc will leave imperceptible scarring in the extraction area. The reason for the volume is that fat grafts that were too large for their holes were stuffed into your scalp. Debulking the graft will excise some of that extra fatty tissue. 2.) Kenalog injections. Kenalog will atrophy the tissue, so it must be performed in small increments, and very conservatively, as if it's done too aggressively it will leave a "ditch" as opposed to a ridge. 3.) Dermabrasion/Laser resurfacing- will also help smooth out the area, but is more subtle. 4.) A combination of one or all of the above, depending on the severity of your ridging.

I have to agree with B-spot in some ways- I'm not sure what kind of girls you are meeting or where you are meeting them, but I've dated girls as well who either didn't care about hairloss, or found it masculine and attractive. Seriously. I mean they really couldn't give a sh#t about hairloss at all. And I'm not trying to wave off what you are experiencing, but if women weren't attracted to bald or balding men, then the human race would cease to exist, because every guy is genetically programmed to lose his hair, some less than others of course, but still. I'm curious also about this quote: "I'm seeing a trend where a woman will look into my eyes as if she's found her dream man, and as soon as she notices the hairloss, she begins to distant herself slowly and carefully" So is this all happening in one instance? It seems like a weird comment. Wouldn't she notice the hairloss right away? It seems odd that she would look into your eyes first and fall in love, and then look up and fall out of love in a split second. Usually people take in the whole appearance when they are "eyeing" up someone. Or are you wearing a hat at first? Hair is such a small variable amongst a million other things that generate sexual interest. You must be giving off some other vibe, because a woman can sniff out a lack of confidence from a mile away. I know you say you're confident, but how can you be completely confident? If you were confident then you wouldn't feel as though you need any surgical enhancements at all. I'm not trying to burst your bubble, but what if you spend a bunch of money and time on transplants only to find out that wasn't the problem in the first place? There is a way to find out. Take some pics (without a hat) that at least show your face and hairloss pattern, and put them up on match.com, yahoo personals, etc. Write some stuff about yourself, what you're looking for, etc. Wait a few weeks or a month or two and see if you get any responses. If you get a good number of responses, then you know that hairloss isn't your problem, and maybe that will give you the confidence you need to go back out there and take what's yours! It certainly can't hurt.

Yes H&W get results. But let's make sure we realize why they get the results. It's not becaue of the lateral slit technique...It's becaue they figured out a way to extract larger numbers of grafts from patients. If the lateral slit technique is inherently superior, then they wouldn't need to use as many grafts to achieve a look of coverage, right? But they use more grafts than anyone else to get the results they do, so just keep that in mind. And there is no such thing as total coverage, there isn't enough donor hair to achieve such a thing.

Any good doctor does the following: Matches the angle of the transplanted hair as closely as possible to the angle of the existing hairs, or as closely as possible to the way the hair naturally would grow on a patient. If this is lateral slit, then so be it. H&W are not the only doctors in the world doing that.

IMO, If you're going to cut a strip of skin out of the back of your head, you should get as many grafts as you can safely, in terms of laxity and chances for a small scar. 1200-1400 seems like a very small number for strip. How old are you? How long have you been balding? What's your NW level? What doc recommended this to you?

Oh, did he do it on purpose? Or was it the webmaster? Not justifying it, just wondering, because sometimes docs have little time to know or see what's on their own site. Could it have been a slip?

Just curious, What did this Dr. in India do to get a bad reputation? False Internet marketing? In what way?

I'm curious, has there been a similar, recent controlled study of strip transection rates? I honestly don't know or recall hearing of any. Once again, Dr. Harris might have done a study, but he is not a proven commodity in terms of FUE results. I'm also curious about why Dr. Woods wouldn't be considered an expert? Hasn't he been performing/modifying/perfecting the FUE technique longer than anyone on the planet?

Btw..Where are pics/patients of Dr Harris? Any grown out FUE results to see? He might be an up and comer, but he's really just another HT doc who developed his own unique tool for FUE and calls himself a pioneer. How many FUE surgeries under his belt, and once again, where are the results? I would hardly say his results have been established in the FUE realm. I've been around these forums since FUE started catching fire, and I have yet to see very much at all from Dr. Harris. However, there are some well established FUE docs with tons of results out there. Patients I've seen in person, online, etc, with grown out results from FUE-only surgery. FUE has been moving forward for some time, and at some point, other docs might catch up.

B-Spot, I'm loving this debate btw Always a good thing to toss around ideas. I read that article quite some time ago. The same doctor did another study with his patented style of FUE that produced avg transection rates of 6.14%. This is another way of saying that he perfected his tools and his personal technique of FUE to get his transection rates down to a level comparable to that of strip. But even this rate is even a bit high. Better FUE docs are getting better rates. Bad FUE docs are getting 15-20% rates- don't go to them. This basically supports my argument, that docs who are COMMITTED to FUE achieve transection rates comparable to that of strip.

Spursman, If both Drs said they would be willing to do HT on you, then one of the following must be true: 1.) Your hairloss isn't that bad for your age. 2.) They are both willing to do risky HT work on a young patient whose hairloss hasn't stabilized. 2000 grafts will do very little for a NW4-5, so you must be more like a NW3 if Dr. Feller said you only need 2k. Did Dr. Feller say you should get a strip? Getting a strip for only 2k grafts seems like a waste. You don't want to get more than one strip if you can avoid it- cutting into the scalp multiple times F###s with your laxity, and increases the chances for wider donor scarring. The more times you do it, the riskier it gets. Esp for the patient who faces potential donor thinning. Just a thought.

B-spot, I'm not sure where you get that rate, but those rates of transection seem outdated to me. 15-20% might have been an average rate 4-5 years ago, when FUE was still in earlier stages. However, if an FUE doc claims he is avging 15-20% transection, then he is way behind the curve at this point. The best FUE surgeons are producing transection rates comparable to that of strip, in the 3-6% range, sometimes lower.. The problem is that FUE requires a real commitment, and a low transection rate can only be the result of doing FUE day in and day out, perfecting the tools, constantly obsessing over technique refinements, etc. Docs who originally seemed to be committed have dropped off significantly, once they discovered that FUE was more labor intensive and involved more variables. While many strip docs now offer FUE, they often price it out of range, and leave it for the touch-up jobs and repair work. But generally it is discouraged as no more than a touch up procedure. Unfortunately, the top FUE surgeons who have commited to FUE are extremely few. I would personally let one, maybe two FUE docs in the entire world work on my head. But these docs are the best, and will get the same transection rates as strip, if not better. Remember strip in the hands of the absolute best docs transects 1-3% of the grafts during the taking out of the strip, and grafts are transected during the dissecting process as well- good techs will have a small transect rate of maybe 1-3%, but mediocre techs can have a much higher rate. So, the top notch strip docs will transect in the 3-6% range, but lesser docs will transect more, depending on their skill with a blade and the ability of the techs they have on board. Using tricho closure can transect grafts further during the beveling process- it is hoped that these grow back into the scar, but this doesn't always happen. So, with strip, you can transect during strip removal, during the process of cutting grafts away from the strip, and during the trico closure process. That's why a top notch FUE doc can get a really low transection rate if he has mastered the FUE process, since the extraction is the only time the risk of transection really exists. Once the graft is out, that's it. There are many good docs out there, but the difference between good and great is huge. In either case, FUE or Strip, I would only go to 1 maybe 2 strip docs in the entire world, and the same goes for FUE. But that's me- I wouldn't want to screw around with mediocre. HT is an artform, yes there is technique involved, but at the end of the day some guys will always be better with a blade in their hand than others. But, I do agree with you that it isn't cheap, and the really skilled FUE docs are even more costly. Each type of HT, strip/FUE has its advantages/disadvantages, it all depends on personal goals ultimately. But the high transection rate for FUE only applies to the less-skilled.

The problem with FUE is that it requires the additional skill of removing follicular units (as with any technique there is a learning curve with this), and it is more work. The cost is relative to the physical effort and extra time that it requires to take out the grafts one by one. It also is still a relatively new procedure, so few docs have embraced it. A few very experienced FUE docs in the world are practicing this method, and they are able to make the necessary adjustments to bring down the transection rates during a procedure to a rate comparable to that of the top strip docs. This requires a feel that can only be achieved through thousands of surgeries and a dedication to the development of new extraction tools. FUE in the wrong hands will yield poorly, but in the right hands there is no reason why a person couldn't get up to maybe 4k to 5k grafts via FUE, with a similar yield to that of strip. You might have to do it in two passes, but for some the absence of a strip scar means everything. If you need more than that, in the 6 to 8k range, then strip is the way to go. Most strip docs have abandoned FUE because it is too labor intensive for them, and they would have to become beginners again, but a few FUE docs have taken the science to a very competitive level. The problem, as the B spot mentioned, is that getting more than 3k via FUE can become pricy, and will require more time in the chair. A good FUE doc will probably be able to move around 800 to 1000 in a day, maybe more if things are going really well. So you will prob have at least 2 days in the chair. But, the pros of FUE can outweigh the cons for many if you choose the right doc.