rp1979

Hey Fella, There are some great coalition doctors in the Western US area of the country: -Dr. William Reed in La Jolla, CA -Dr. William R. Rassman in LA, CA -Dr. Scott F. Alexander in Phoenix, AZ -Dr. Sharon Keene in Tuscon, AZ Take clear pictures of your scalp in different angles and email them to these doctors for advice. These coalition doctors by default should be ethical doctors. So if they agree to perform a procedure on you and you have educated yourself about the risk of doing a HT at a young age, then go for it. I understand what it feels like to loose your hair in your twenties. Good luck.

I've heard some really good feedback about Dr. Wolf as well as some great work done by him. I'm surprised he is not a recommended doctor on this site.

Hi nervous, Hope you are doing well. I sympathize with your concerns. Some questions I would to ask which might help to assess your situations are: 1). Did your surgeon discuss shockloss with you prior surgery? Did your doctor mentioned your chances of shockloss? 2). Were you required or encouraged to buzz down the recipient area for surgery? 3). When the doctor was placing the grafts along with the technicians, did the doctor placed the grafts more in the front of the scalp or more in the midsection of the the scalp? 4). are you using monoxidil? If so for how long? 5). Have you expressed your concern about your pos-op shockloss with the doctor? If so, what was told to you? Thanks. I hope your hair grows back soon. -RP

Hi Bill, You mentioned in your post to research doctors in the coalition. The intention of my post is more geared towards prospective patients who have already narrowed their selection to only coalition doctors, the best of the best. "Coalition doctors" being the operative word here. Obviously if someone asked me if they should go to some unknown doctor versus one of the coalition doctor, that answer is a no-brainer. I, for example decided, that I will select only from the coalition doctors so the next logical question is how to choose a COALITION doctor that is right for me? For example if I narrowed my list down to: Hassoun, Wong, Shapiro, Feller, Rahal, Rose, Cooley, True? Who is better? Then it really bowls down pretty much to subjective personal preferences, those of which I forementioned in my previous post. Anyways just offering my two cents. I've learned a lot from this site as well as from veteran posters like yourself. THanks again. -RP

From my consultations, that price that was quoted to you is quite reasonable since most other top docs charges $4-$4.5 per grafts for the first 2000 grafts. What kind of a price range were you expecting?

Very good advice. Below is to complement with what you said: These are the issues/questions that I asked myself when I was choosing among the coalition docs: "How to choose a coalition doctor that is right for me"?: 1). Does the coalition doctor requires you to buzz down the recipient site? Buzzing the recipient site will give the doctor the most optimal condition to work, however excellent results can be achieved without doing this. Ask yourself if you feel comfortable with buzzing the recipient site. 2). Does the coalition doctor place grafts on the hairline himself (i,e. not the techician)? Excellent results can be achieved with the doctor not placing any grafts, however some would argue that it can make a difference if the doctor places the grafts through a final stick and place method. The majority of the coalition do not place grafts themselves, but some do such as the Shapiros, Keene, Glenn and Cooley (there might be more). Ask yourself are you comfortable with having the doctor not placing any grafts on your head. 3). If you are doing a consultation remotely or doing a phone consultation, are you able to speak or correspond via email with the doctor directly? Obviously doctors are extremely busy and thus most of the time you are corresponding with the consultant/patient educator, which is understandable. But I applaud those doctors who give out their emails to remote prospective patients and respond directly to them. If you cannot do an in-office consult and you are willing to travel for an HT, ask yourself if you are comfortable with not speaking to the doctor directly before BOOKING surgery. Part of choosing an doc is to see if you CLICK with the doctor, not from just seeing his work alone. 4). Will the coaltion doctor do a larger session on you if you want more grafts? Do you your research and you can accurately assess for youself how many grafts you need. If you truely believe that you need and WANT more grafts than what the doctor assessed, tell him this and see if he can accomodate. 5). If you want generic finasteride (Versus propecia), will the doctor write a prescription for you (assuming you are uncomfortable going to an online drugstore to get medication). Due to various reasons (eg. active ingredient distribution in pill), some doctors are uncomfortable precribing generic finasteride to patients. Do you research and see what is best for you. 6). Compare prices among coalition doctors. Theoretically choosing one doc from another coalition doc is like choosing between excellent and excellent. Some doctor will provide allowance for air fare and/or hotel stay. Ask if this doctor is THAT MUCH better than another doctor that warrants him to charge a bit more per grafts or for you to have to travel further away from where you live.

LOL not only are the regular posters here are helpful as hell they are also damn funny as hell. That comment above literally had in on the floor crying. Anyways to add to the orginal poster's concern. I don't know what you use for style, but I use the a little bit of forming cream from American Crew on dry hair, which really adds volume to my hair.

WOW that is overwhelmingly impressive!

I respect everyone on this forum and I agree that it is EXTREMELY important to EDUCATE yourself on whatever issues that affect you. But to put things in perspective, in the US, by the time we are 21, we are of age to: -vote -be accountable for criminal offense -get married -give informed consent to any legal contract all of which requires far more responsibility and emotional maturity than getting an HT. To question that 21 years is too young is to question our laws, not the doctors.

The highly respected Dr. Wong himself has recommended the works of Dr. Pathomvanich of Bumrungrad Hospital. Just ask Dr. Wong and see for yourself. My parents lived in Thailand and my younger brother was born at Bumrungrad Hospital in Bangkok. I can tell you first hand that the facilities and service at Bumrungrad Hospital rival that of any top hospital/clincs in the US. I live in the US so have the convenience and benefit of easily being able to go to one of the coalition docs in North America. But for those based in Asia and think that crossing the Pacific ocean to get to a doc in North America might be of an overkill, I feel that they should definitely consider Dr. Pathomvanich. I think I might know of a few patients who had work done with Dr. Path, PM if you are interested.

Sorry to hear what you're going through. I don't know if this issue has ever been discussed before. But can you counteract the adverse sexual side effects of of avodart with erectile dysfunction medication such as viagra? Also are you taking any form of supplements? I've also heard that certain supplements can interact with medication in a negative way. Perhaps you can talk to you doctor about this.

Yes I've heard of the lunchtime FUE session. It does some interesting. To answer your question on propecia, a HT doc told me that the studies of finasteride (propecia) show that men on average have more hair five years after starting the medicine. What happens ten or more years later is unknown. For men that have noticed loss of effectiveness of finasteride after several years, a lot of them switch to dutasteride.

Hi thank you all for your inputs. I have an additional question on this matter. Perhaps Janna, Hairtechnican or others who have experience placing grafts can better answer this: When you are placing the single-hair grafts on the HAIRLINE one by one, do you need to be selective and consider each graft's "caliber"? For example: "This single-hair graft is of particular high caliber and should be placed at the very front of the hairline to capitalize on its cosmetic benefit to accentuate the hairline, while this other single-hair graft looks a bit frail, and perhaps should be placed further back in the scalp where its frailness can be hidden" If you do need to be selective with each single-hair graft, is it easy enough with a trained eye to decide which grafts are of better "caliber" and thus better suited to be planted on the hairline? Thanks.

Hey vinz, Keep in mind that for an FUE procedure, you'll be required to shave a fairly large area in the back and side of your scalp for donor extraction if you're going to 1000 grafts. To answer your question and from what I've gathered 1000 grafts for is close to maxing out for 1 FUE session. Also, you'll hear some people argue that FUE has lower field than strip.

To date, what is the record for the largest amount of grafts extracted in a single session without splitting grafts? Or maybe I should say what is the record for the largest donor strip in square cm extracted in one session? Do you think it will ever be possible with medical advancement that in like 5-10 years time, we'll be able to safely extract all of a patient's donor supply, in one single, flatout, 9000+ grafts Gigasession? If let's say for example, someone is in their forties, have their hairloss stablized, wouldn't extracting all of the donor supply in one session be the logical thing to do if that large amount of grafts are needed? Would be interesting to hear people's comments.

To date, what is the record for the largest amount of grafts extracted in a single session without splitting grafts? Or maybe I should say what is the record for the largest donor strip in square cm extracted in one session? Do you think it will ever be possible with medical advancement that in like 5-10 years time, we'll be able to safely extract all of a patient's donor supply, in one single, flatout, 9000+ grafts Gigasession? If let's say for example, someone is in their forties, have their hairloss stablized, wouldn't extracting all of the donor supply in one session be the logical thing to do if that large amount of grafts are needed? Would be interesting to hear people's comments.

hey vinz, I too know what you're going through. i'm 27 and after a lot of reseach i've scheduled an HT with a coalition doctor, which i'm very excited for. i'd say at your age if you have: -done your research on your potential doctors -definitely decided against the 'shaved head' look -committed to keeping your native hair through medical treatment (eg finasteride, minoxidil) -understand and accept the short-term (eg shockloss) and long term risks of doing the transplant then i advise you do go for it. i argue this is the time of our lives when our hair gets the most "bangs for their bucks". i have not heard of Dr. Karamikian. But these are the questions that you MUST ABSOLUTELY ask him: 1). Do you perform Follicular Unit Hair Transplantation? (If the answer is anything other than a literal "Yes", run like the wind) 2). Do you use microscropes to dissect the grafts? (If the answer is anything other than a literal "Yes", run like the wind) 3). Do you perform Trichophytic Donor Closure? (If the answer is anything other than a literal "Yes", run like the wind) 4). Of course you should also ask about his staff experience and see if you can see actual patients. Concerning the other questions that you raised. Most doctors do not require you to shave your head. A week off work is what most people seem to take off and for many this seems to be enough. From what I've gathered, donor scar should be undetectable with a guard 3 even guard 2 after 4-6months of healing as long as the doctor is using advance techniques such as cutting the donor long and thin and using the Trichophytic Donor Closure which allows hair to grow through the scar tissue. Hope this helps. Good luck.

I would like to call on all past patients who had a procedure with a coalition doc and ask: Did your coalition doc place any of your grafts on your HAIRLINE HIMSELF (i.e. not the technicians)? If so roughly how much? Again I'm JUST talking about hairline, not the rest of the scalp. All of the grafts? 50% of the grafts on the hairline? In addition I would like to get people's opinion on what they think about doctors NOT placing ANY grafts on the patient's HAIRLINE HIMSELF. Because from my consultations, it appears that some docs don't place any grafts, let alone grafts on the hairline. Obviously the doc can't place all the grafts himself, but I'm not knowledgable enough to know if placing the grafts on the HAIRLINE requires a certain level of artistic and medical expertise where by having the doc doing it himself would result in a "better chance" of a good outcome. I've also heard arguments that graft placement is 100% dictated by the recipient incision (depth and angle) and thus doesn't necessarily require the docs to place the grafts. Not sure what to believe so I would appreciate your comments. THanks.

I would like to call on all past patients who had a procedure with a coalition doc and ask: Did your coalition doc place any of your grafts on your HAIRLINE HIMSELF (i.e. not the technicians)? If so roughly how much? Again I'm JUST talking about hairline, not the rest of the scalp. All of the grafts? 50% of the grafts on the hairline? In addition I would like to get people's opinion on what they think about doctors NOT placing ANY grafts on the patient's HAIRLINE HIMSELF. Because from my consultations, it appears that some docs don't place any grafts, let alone grafts on the hairline. Obviously the doc can't place all the grafts himself, but I'm not knowledgable enough to know if placing the grafts on the HAIRLINE requires a certain level of artistic and medical expertise where by having the doc doing it himself would result in a "better chance" of a good outcome. I've also heard arguments that graft placement is 100% dictated by the recipient incision (depth and angle) and thus doesn't necessarily require the docs to place the grafts. Not sure what to believe so I would appreciate your comments. THanks.

Well just offering my input. Those posters who advocate safety first are right and know what they are talking about. Like with my any forum, you have to filter through the info with some plain old common sense. Dhuge67 is saying that "fat intake should be higher than carb intake" - before you go off stuffing yourself with almonds and shugging down olive oil by the bottle, please do some research. And he is advising to buy a $7 book on Amazon - anything info worth $7 can probably be found for free from google. Anyways I just want to bring this discussion back to hairloss for bit. This thread really struck a note with me because one, I wanted to join in the fun since I'm a health nut also and two, because it just reiterates how our looks is really important to us eventhough vanity is one of the seven deadly sins. I have a picture very similar to what Bill posted i.e. a picture of me with my gym results wearing a CAP! a CAP! Because at times I do wish that my hair can better "match" the rest of me. Maybe after a HT, it will.... fingers crossed. Awesome thread. Keep it coming.

I have done a fair bit of lifting in my lifetime (have pictures too if you don't believe me) so I disagree with some of the advice posted above if you are NOT yet an advanced lifter. 1). Suggesting that beginners do exercises such as Cleans and Snatches is very dangerous without getting proper instructions from a qualified trainer. Plus, most commercial gyms, which are very different from college or military gyms, will not allow you do those two exercises because most don't have the proper equipment e.g. power lifting platforms. Those two exercises are really more geared towards serious atheletes looking to develop exposive strength, not your average joe. 2). Some machines are very useful for doing certain types of isolation exercises such rotator cuff exercises, which I recommend people should spend some time doing before attempting any free weights pressing exercises. Also most beginners will not be able to pullup their body weights. This is another example where cable machines will be a good substitute with pull downs. I do agree that the majority of one's exercise program should be focused on free weights to allow for equal development of stabilizer muscles. But machines definitely have their place. Here is my advice, realizing most us on this forum probably have full-time jobs and have limited time: -Weight train 3 times a week. Don't train for two consecutive days in a row. If you are working out as intensly as you are suppose to, going at it again the next day is counter productive. Muscle grows while you are resting, not at the gym. -When it comes to exercises, stick to the basics compound exercises that have stood the test of time: Squat (don't round your back), deadlift (again don't round your back), benchpress (do rotator cuff exercises prior), Military presses (again rotator cuff exercises prior), Pullups or cable machine pull downs. Reason why I emphasize rotator cuff exercises is because for most guys, unfortunately, the benchpress and chest development is an ego exercise and 9 times out of 10 you will start up with more weights you are handle. Rotator cuff exercises provides good warm and will prevent injuries. -Each time you go to the gym you should try make progress on at least one of these things: # of reps, # of sets, weight used, or time under tension (speed). -Getting a good body is 90% diet and 10% exercise. Alot of people don't realize that. To build muscle, you need more calories than your body expend. Don't try to loose fat and build muscle at the same time because calorie-wise they are two contradicting goals. So multiply your weights in lbs by 15 = calories you should intake per day. Spread those calories in a 40% carb, 40% protein, 20% fat ratio. Drink lost of water and spread your calories into 5 or six smaller meals evenly spaced out through the day. Be consistent and make sure you have a decent head of hair and you should be menshealth coverpage worthy in no time.

Thank you for the info. However I don't quite understand when you mentioned: "excess scarring in my donor area which was from scabs". How do the scabs create more scarring? Is it okay to apply pressure to the sutures with your fingers in order to clean them if there are still some tenderness on the donor closure? THanks again.

I'm also very interested in learning more about this whole issue of transplanting into diffuse thinning area. I found some interesting points that someone on another forum stated: ============================================= 1- Post HT shockloss is only a reaction. MPB is a chronic condition. MPB is not shockloss. Shockloss is not MPB. No matter how some people try to twist informations. 2- MOST of shockloss cases are TEMPORARY. That means that in most cases, shock loss is a passing phase. A trauma. Not a permanent condition. (with a top surgeon that is comfortable transplanting in diffuse areas). 3- PERMANENT and IMPORTANT shockloss is the 'exception'. In other words, it is RARE. Like in any surgeries, there IS a risk. But it is NOT the norm. (with a top surgeon that is comfortable transplanting in diffuse areas). 4- NOT EVERY DOCTORS ARE COMFORTABLE TRANSPLANTING IN DIFFUSE AREAS: Like not every cooks are comfortable cooking seafoods, or not every athletes are comfortable practicing many different disciplines. That may explain why some doctors, even great ones, are less comfortable than others with it. 5- Diffuse thinners have SMALL risks of important and permanent shockloss, but usually obtain SUPERIOR 'cosmetic' results from a hair transplant. Bald people have no chances of shockloss, but usually obtain inferior 'cosmetic' results from a HT. 6- NO SURGERIES ARE 100% SAFE: even if the risks of important and permanent shockloss is very small, it is a risk. No doctors can legally tell a patient that permanent shockloss is a myth. 7- MANY OF THE BEST DOCTORS ARE REGULARLY TRANSPLANTING INTO DIFFUSE AREAS: And they are successful doing it. They are the ones that create the very best cosmetic results. Period. They would certainly not jeopardize their whole reputation by doing regular dangerous and unsuccessful procedures. 8- DIFFUSE THINNER ARE CANDIDATES FOR A HAIR TRANSPLANT. And combined with proper medication to stabilize their hairloss, they make the very best 'cosmetic' results. ============================================= WHAT DO PEOPLE THINK OF THE CLAIMS MADE ABOVE?

jotronic and hairbank: no need for patients to fly back for a photo shoot. But I think it's fine to use patient self-taken pictures of their scalps (with no face) after a year postop and email back the photos, it's MUCH better than nothing eventhough format style of the shot may be inconsistent. A side note: why can't docs just post ALL of the pictures they'd show during the office consult on their websites, especially the faceless ones? nobuzz: i'm not even asking for any top doctors to make major changes to their websites. just add more recent photos ( labelled with a DATE and # of grafts) to continually show the results they can produce to this day. As you correctly said, some top docs are booked months ahead but at the same time continually have banner ads on hairlosshelp and hire people to post on forum threads, which i feel is a much more agressive form of marketing than simply supplying more examples/photos of the kind of good results the doc can consistently produce. Getting back to the topic, the most convenient way for prospective patients to evaluate a doctor's work and especially his/her ARTISTRY (which is SUBJECTIVE), is by looking at many many photos online. Pat: Thank you for your response, for this website, and for taking action on this issue.

As a noobie coming into the world of HT, I would like to do online research and have email correspondance as much as possible before paying for a plane ticket and taking time off work to travel to clinics across the country for a consultation. I want to reiterate what nervousnelly is saying about top doctors being too busy and making enough money. I think it's true and understandably so. I've contacted 6 top US clinics and I've experienced the following: -one doc is charging a fee for an office consultation, fine by me but I would like to see more pictures please -one doc would like me to take fin for a year before coming in for an office consultation -one doc currently advertises in his website saying he offers consultation in a city close to where I live, but when I called I found out that this info is obselete. -other docs/clinics are slow (over a week) to reply to an email/online consult. -in general I think it's very difficult to request a conversation with some top docs over the phone. fact of fiction?: top doctors have the market cornered.