Big1

Today I helped someone close to me research hair transplant doctors. I spoke at length with 2 doctors: Dr. Charles in Boca Raton, Fl. and Dr. Nussbaum in Miami. Both Doctors were very pleasant and knowledgeable. I was surprised to hear that Dr. Nussbaum has 9 technicians disecting grafts for every case -- now that's service! Dr. Nussbaum uses inteneral dissolvable sutures and external traditional sutures. I for one, am very impressed with what I've learned from Dr. Nussbaum. The person who is interested in surgery has already met with one of Dr. Nussbaum's patients and was impressed. Dr. Charles is in his thirties and was extremely accessible for both the interested party and myself. My sense is that he is very ethical and talented. My first inclination was to advise my associate to solicit information from Dr. Jeffrey Epstein (in Miami). I called his office today and spoke with a girl (whose name rhymes with droolin). I never got a chance to speak with the doctor but based on my impression from the girl who answered the phone, I would NEVER step foot in his office. Too bad. As for me, it looks like I might have my 4th and last procedure

You actually look a lot like I did. I retract my initial suggestion and would recommend that you stay on Propecia for a year before you have surgery.

I can't believe how good Dr. Cooley is. I had never heard of him before the education center and essay competition. Great work Pat for bringing him to our attention! Social Drinker... couldn't have happened to a nicer guy.

I think that a hair transplant would be a very viable option for you. Generally, I would suggest that a prospective patient take meds for a year before they decide, but the truth is that it is very unlikely that Propecia will assist in significant regrowth; however, it will very likely slow down the rate of your hairloss (if not stop it in its tracks completely). The one thing that hair transplant requires is a commitment to taking medication --namely Propecia. Are you prepared to take it every day for the next 10 years (or perhaps even longer)? I was 23 when I had my first procedure, (and I am now 26), but my hairloss wasn't as severe as yours already is. One mistake I made was having the procedure without having been on Propecia (as it helps to mitigate "shock-loss"). As a result of undergoing surgery (without the assistance of meds), I had a significant net loss of hair (which really, really sucked). I don't think that it would really affect you the way that it affected me; that is, your receding hairline is already visible where mine was able to be somewhat concealed. You may have shock loss as well, but at least you'll get your hairline back -- my hairline receded even further as a result of the first surgery; however, if you don't have a particularly dense donor area, it may be wise to wait until the Propecia kicks in. I do not think that you are too young. If you believe that you need it then you should get it. Make sure that you go to someone who will leave you with a very fine scar, and perhaps most importantly (for a young man) that the surgeon is an absolute MASTER in dense packing. If you decide to go ahead with surgery you will want to get it over with a.s.a.p.; in other words, 2 surgeries or less so that you can get on with your life.

Question for Dr. Feller... Is is possible for you to transplant more than 50 grafts per cm2? What limitations determined a density of 50? Thanks.

I have never said that I've seen it all. My compunction isn't whether or not squaring temples is performed but is instead the remarks made about a doctor who does square temples. "One more thing: Lower hairlines = more grafts in the long term = more profitable for the doctor." More density also = more grafts. Many doctors who were accused of being unethical will provide fue if the grafts don't grow. FUE costs a lot more than strip. If it is only about making money, then why offer such a guarantee. The hair mills generally don't offer any guarantees. I should have been more clear. Let me rephrase. I think squaring temples does not automatically mean an absence of ethics. What is bullshit is saying a doctor doesn't have ethics or principles -- simply because he gives patients what they want -- when they actually do.

arfy said: "You might want to move your hairline back if it started to look strange as you got older." Doubtful. I have seen some strange looking hair transplants but none that looked "strange" by virtue of the fact that it was "youthful". "Think about how much your face changes over a period of 20 years. Your hairline may look unnatural if it's at adolescent levels, when you are in your 50s." Fine, proceed with caution. "This topic has been beaten to death, but if your point is that there are "IF'S" attached to warnings about temples, I agree." Thats only part of my point. You agree that in some cases squaring temples might not be such a travesty. Well, that being the case, it follows that it is actually irresponsible of POSTERS!!! to accuse a doctor of being unethical for providing this cosmetic service. It makes my stomach turn. We're not talking about cutting off ears here, and the mere fact that you tacitly allege that squaring temples is comparable to such a procedure acutely reveals that this topic has not been beaten to death -- contrary to your (the high priest of hair restoration's) opinion. "The younger guys are the ones who need to be the most careful." Agreed.

"Squaring" the temples is what I should have written. Arfy wrote: "If the patient has Male Pattern Baldness and continues to lose hair, he could wind up in big trouble as he gets older." The same thing may be said about high density transplants; if a transplant is too densely packed it may prevent adequate coverage over the rest of the patient's head. No doctor is "warning" patients about avoiding high density though. If they did, then obviously, THEY would be the ones to go out of business. No, doctors indeed provide the density that is sought after by the patient. Squaring of the temples should not be faux pa (is that how you spell it?). "When talking about squared temples, you have to discuss the age of the patient, and the risk of extensive future hair loss in the context of a limited donor supply." I agree. It should be discussed and shouldn't be dismissed wholesale. "Moving a hairline back can be one of the harder repair surgeries, in some cases." Yes, but why would anyone want to nove it back? We move hair to look younger. I assume that I will look good in 25 years and would not want to mess with a good thing.

Thank god you're not a doctor. How do you "know" that a procedure will be regrettable. It may be exactly what the patient needs. And using Michael Jackson as an example is weak. Are you talking about skin bleaching? I don't think that he regrets that. Or are you talking about his nose jobs. Do you also "know" that a nose job is regrettable? Sometimes doctors are unethical. But many people need to be more careful with such a destructive word.

If the patient is informed I don't see the problem. I personally wouldn't choose to have my temples closed but I would suggest to live and let live. I do understand and agree that when a doctor closes a patient's temples but does not first explain the consequences of such an approach to the patient, that it is unethical (and perhaps criminal). Cosmetic surgery is solicited because a patient wants to change. The patient pays for the service and in turn should ask for and receive what he wants. In an age where face lifts are pedestrian, doctor-assisted suicide is legal, face transplants are quickly becoming reality and sexual reassignment is rampant how can anyone seriously have a problem with doctors delivering the very result that a patient requests -- closed temples? I honestly think that the "controversy" is bullshit. A good doctor is a good doctor; its pathetic to accuse a doctor of being unethical or greedy just because they give the patient what he asks for.

If the patient is informed I don't see the problem. I personally wouldn't choose to have my temples closed but I would suggest to live and let live. I do understand and agree that when a doctor closes a patient's temples but does not first explain the consequences of such an approach to the patient, that it is unethical (and perhaps criminal). Cosmetic surgery is solicited because a patient wants to change. The patient pays for the service and in turn should ask for and receive what he wants. In an age where face lifts are pedestrian, doctor-assisted suicide is legal, face transplants are quickly becoming reality and sexual reassignment is rampant how can anyone seriously have a problem with doctors delivering the very result that a patient requests -- closed temples? I honestly think that the "controversy" is bullshit. A good doctor is a good doctor; its pathetic to accuse a doctor of being unethical or greedy just because they give the patient what he asks for.

Paco For the love of God, listen to these posters!!! You are about to make a MAMMOTH sized mistake!

Dr. Epstein is a true gentleman. Way to get it right the first time!

What is the survival rate for grafts that have first been transplanted into a scar and then moved into a different area?

What is the survival rate for grafts that have first been transplanted into a scar and then moved into a different area?

Dude, that guy's results suck! Go elsewhere.

D- You are getting some pretty great results at month 4 and 1/4. I can't wait to see how it looks in 6 months...WOW! The "Recommendations" page is a great help. Nice job!

"I've decided to do so to prevent any misinformation from spreading." Me too. "While increased blood pressure does impair wound healing, this is in uncontrolled hypertension (sustained elevations in BP which does not occur in normal individuals)." Increased blood pressure is a consequence of exercise (if you're doing it right). "Now for a healthy individual, while exercise does raise BP, it most likely would not be raised to such levels at sustained periods of time. There is no medical study specifically targeting the effects of weight lifting on donor scar stretching (I looked), so there can be no firm recommendations that can be made." You said that there isn't any documentation --"you looked"; how do you know that a scar doesn't stretch unless one engages in sustained periods of exercise? "Please don't make assumptions." Got me there. Sorry. "Then I had my donor scar revision and started lifting weights 1 month afterwards" This may or may not have been poor judgement. I hope your scar has improved. "Now I've had this recent HT procedure and plan to do the same regimen." Good luck.

I am not an expert but I know the basics. Keeping stitches in for a couple of extra weeks may make a difference (especially if you are predisposed to stretching) but it won't prevent the scar from stretching over the course of your life; however, some people's scars never seem to stretch and instead constrict over time. Predicting whether a scar will stretch is not hard and fast science, its merely nature.

ARGH said: "weight lifting, increasing blood pressure, etc. after the stitches are removed should not cause stretching of the scar." This is complete misinformation. Any cosmetic surgeon emphasizes how important it is not to engage in strenuous exercise post surgery; hair surgeons don't espouse this same admonishment for their OWN health; it's for the patient's! The sad reality is that one need not exercise to have one's scar stretched -- some people simply are "stretchers" (even with good laxity) while others aren't. It is totally reckless to begin lifting weights after h.t. surgery and is BEGGING for trouble. "Which means most of you shouldn't worry" This is bullshit. It is extremely assinine and misguided to risk the results of surgery. "Scars reach over 85% of their maximum tensile strength 6 weeks after the wound is created. So I would avoid having that area physically stretched for around 2 months. But weight lifting before then should not be a problem." MORE MISINFORMATION! Scars can stretch over the period of one's entire life so ARGH, why in the hell would you encourage patients to lift weights less than two months after surgery? I question your judgement and seeing that you have 2 weeks of personal experience, could you please resist dumping your "expert" opinion on people that actually give a shit about their results? "That being said, I personally am going to hold off on weight lifting for 1 month post-procedure" Do you find surgery to be fun? Cheap? Harmless? Convenient? I would suggest reconsidering your position on weight lifting unless you enjoy being operated on, throwing your money away and enduring all of the other inconveniences that are associated with h.t.'s and scar revisions. Its grossly irresponsible for you to offer a regimen to people when you have no experience yourself. If you insist on lifting weights 1 month after surgery, HOW ABOUT DOING IT FIRST, and then reporting your findings? Hey, I have an idea. I feel like going for a swim...let me piss my pants -- NOTE: this actually works well 85% of the time as long as it is done 6 weeks after! Commenting on post surgical care should probably be reserved for people who are veterans of surgery and have some experience to draw from lest we pollute the stream we drink from.

Originally posted by FUTzyhead: "Maybe you can drive up with me when I do my 3rd!" YOU GREEDY BASTARD!!!

Good news! In early October I saw my 18 year old brother for the first time in many months and discovered that in a matter of a few months he had transformed from having a normal head of hair to a NW 3. His doctor told him to use a topical product from a saloon to stop his hairloss. After speaking with me, he dropped his previous regimen and got on Propecia immediately. He told me today that he has begun to regrow his hair.

Good news! In early October I saw my 18 year old brother for the first time in many months and discovered that in a matter of a few months he had transformed from having a normal head of hair to a NW 3. His doctor told him to use a topical product from a saloon to stop his hairloss. After speaking with me, he dropped his previous regimen and got on Propecia immediately. He told me today that he has begun to regrow his hair.

The FAQ's are definately looking sparse.

That was fun.