arfy

Propecia is preventive medicine. It should help you retain the hair you still have, if you are a responder. Propecia is not so great at regrowing hair, but it is the most effective treatment available right now. Nothing is really available that is great at regrowing hair, it is easier to keep hair than regrow hair. Propecia CAN work on the temple areas, it can work anywhere you have miniaturizing hair follicles. That's what male pattern baldness is, the relentless miniaturization of hair follicles. Propecia helps prevent miniaturization. Some guys choose not to use Propecia, it is a personal decision. But not even trying Propecia because there is a chance it won't work, is not smart in my opinion. I recommend you rethink your strategy regarding preventive medicine. I've heard it takes about 150 follicles to recreate an eyebrow. You're talking about putting an eyebrow's worth of hair in each of your temples. It's really not worth creating a linear scar in your donor area, for that trivial amount of grafts. And as you continue to lose hair, you will have 2 little islands of hair in your hairline, unless you do something to stop the progression. I recommend that you don't get any surgery until you've learned a lot more about hair transplants, because you may be on the verge of making a big mistake.

About one out of every five guys will not respond to Propecia. There's a chance you may be a non-responder. However, I would give Propecia at least 6 months minimum, and as much as a year or year-and-a-half to judge the results. This is a long term treatment, and you need to take a long-term view. Also, remember it is normal to lose some hairs every day, and this happens even for the guys who don't have male pattern baldness.

No doctor bats 1000, and no doctor bats "zero". In other words even the worst doctor can show examples of a few nice results, and even the best doctor might have a couple of patients who are not satisfied. What you want is to pick a doctor who has consistently great results, with very few unsatisfied patients. How much weight to give to the reports of dissatisfaction is an individual decision.

If you really only need 400-500 grafts, my opinion is that you are not bald enough to get a hair transplant yet. The payoff you'll get is not worth going through the surgery. Also, you probably still have quite a bit of remaining hair, and you may be at risk of "shock fallout" from the surgery. The worst-case scenario is that you end up with less hair AFTER your transplant, because of shock loss. I'm guessing that you want to get a hair transplant to touch up your hairline. In my opinion this is a mistake for many guys. You haven't mentioned important factors like your age, your level of hair loss (norwood scale) and whether or not you have halted the progression of hair loss with Propecia. Be careful because very few doctors can do consistently excellent work with hair transplants, and you don't want to do anything that creates more problems than it solves. I recommend that you avoid the big franchise clinics no matter what.

It's not considered libel if you are telling the truth!

Mahair Ask Dr. Shapiro if he will send you copies of your pics. You are entitled to have copies of your own photos. These will probably be better quality than you can do on your own, too. I am curious to see your photos as well as everybody else.

What I've heard is losing one graft per every thousand is considered acceptable. If you lost what looks to be a small kernel of rice, it may very well be a graft. Sometimes you will bleed if you lose a graft, if it happens recently after surgery. But sometimes, a graft just doesn't survive, and eventually it works its' way out. In a case like that, there may not be any blood... the scalp healed without including the graft, so to speak. Maybe the best way to tell what you've got is by how much dried tissue is surrounding the hair. If it seems like a graft, it may very well be a graft. Look at photos of what a healthy graft looks like:

Beware, some of the worst doctors in the field work for the big franchises like MHR, Bosley and NuHart. Unfortunately, the average person usually has no way to tell whether a clinic can do good work or not, because every doctor SEEMS nice, professional etc. I would avoid any of the big franchise operations, they do not use the latest techniques, and they also pass the high cost of advertising on to the patient. Women are often not good candidates for hair transplants because they don't have a stable donor area. If you are losing hair from all over your head, you do not have a stable donor area. In my opinion there is a very short list of doctors doing top quality hair transplants. An average quality transplant will look like a transplant, and isn't worth paying a penny for. Look around for which doctors could be considered "the best" or don't do it at all. The doctors working at the big franchises are usually mediocre, in my opinion.

Didn't your doctor explain to you that there is a dormant phase that lasts about 3 months (more or less) during which most if not all of the grafted hair will fall out? The hair-producing root is still intact, and your hair will start growing in after about 3 months. If your doctor is "reputable" I wonder how he can operate on you without explaining everything to you beforehand?

It appears to me that the survey was done on the same day the patients had surgery. That would explain why they asked questions about satisfaction with the receptionist, the staff etc. Nowhere does it say anything about Bosley patients being satisfied with their long-term results. My hunch is that (other than a handful of top doctors) the majority of doctors in the business would not have a good long-term satisfaction report from their patients. Your hair transplant has to look good 5-10-20 years from now. Patient satisfaction on the day of surgery really means nothing... patients are doped up, they are nervous, and they WANT to believe that they just had a "great experience". I would like to see a legitimate poll of long-term patient satisfaction conducted by an independant firm that was not hired by the company it was reporting on.

I'm pretty sure it's just overpriced Minoxidil with some herbs which aren't going to do anything. If you want to use Minoxidil you can get generic 5% Minoxidil for like 10 bucks a month. Right now the most effective treatment is probably Propecia, with Minoxidil in 2nd place. Avodart may be on the short list too.

Smoking is supposed to be bad for grafts and optimum healing. Check with your doctor.

and lots of 2 and 3-follicle FUs = high donor density lots of 1-follicle FUs = low donor density

Cripto I think what Vocor means, is that we who are interested in hair transplants wish we could have hair like YOU already have, right now. I think your hair looks great as it is.

As it says in my post, the booklet is from 1994. I'm not concerned so much with the bad surgical techniques (which were common) as I am with the misleading claims from Puig's clinic... for example the suggestion that you can do a full restoration of your whole head, and that it will only take a year at the most. Again, this booklet is supposedly used to "educate" patients. [This message was edited by arfy on December 26, 2003 at 07:27 PM.]

BelgiumDude I think I recall reading that a Norwood 6 has lost approximately half of his total hair, so that would mean about 50,000 follicles left over (average). I am pretty sure this doesn't mean 50,000 FUs, but 50,000 follicles. If there is an average of about 2 hairs per FU, that means 25,000 FUs (I think it might be something slightly less than 2 hairs per FU average). Not all of those grafts are available to transplant: some are too near the "edges" where you'd want to maintain a buffer (example: right next to the crown area, or close to your sideburns). My point here is that not every single follicle is up for grabs, and should not be counted when making calculations. I'm not sure how many FUs are available in total. Like I said already, many people seem to think about 5-6 thousand average for a strip patient. We don't know how many are available for FUE only, I have seen some estimates thrown around but I don't think there is a conclusive number. The same goes for guys who want to combine FUT and FUE. A lot of the numbers people claim are just guesses, like we are doing here. Some people seem to think that FUE means the door has been busted down, on the limitations of donor hair (that FUE means donor hair is no longer a limitation) and that full restoration of your hair is now going to be common. I disagree. I think planning ahead and conservative use of donor hair is just as important as ever.

Some folks may not understand just how badly Dr. Puig conducted himself in the 25-plus years he did transplants before joining MHR. In my opinion he is one of the biggest HT crooks of all time. Below my post is a page from one of Puig's booklets from 1994. At this point he had over 20 years of experience, so he isn't making bogus claims as an "honest mistake". First, look how he claims that you'll go from a Norwood 5-6 to a "final result" in only 8 to 12 months after your consultation. Look at the illustration that shows a FULL RESTORATION of the patient's hair. Then he claims that a transplant using line grafts (aka "slot grafts") and large plugs will "duplicate nature's original hair patterns as closely as possible." (Remember that in 1994 there were doctors like Limmer actually doing a more natural looking all-FU hair transplant). He claims that a hair transplant is a "solution to baldness" that will result in "your own head of hair". He says "you know you have a problem or you wouldn't have requested this material". Here Dr. Puig is stooping to try to embarass the patient into surgery. Maybe the guys who don't choose to get hair transplants "don't know they have a problem"? Would a rhinoplasty surgeon tell a patient "you know that big nose is a problem" (so you better get surgery)? This is the kind of material I have been documenting on my personal web page. It goes on and on... Consider this a hint of things to come. This booklet was given to Dr. Puig's patients to (*ahem*) "educate" them about hair transplants. Disgusting! I've been spending time researching false advertising in the hair transplant industry, gathering materials, reading the medical textbooks that have been available over the past 30-40 years, etc. Based on my research, I have come to think that Dr. Puig is one of the biggest crooks in the field of hair transplantation (in my opinion) the epitom???© of a doctor who puts profits ahead of his patient's well being. If anyone has examples of false advertising or false claims made by ANY hair transplant clinic, please contact me at hairtransplantdisaster@hotmail.com It could be material from any era, recent or old. Even simple things like bogus yellow pages ads are of interest to me. I will put them up on my web page as I update it. All responses are 100% confidential. [This message was edited by arfy on December 25, 2003 at 11:28 PM.]

I applaud you Pat, I am sure it is hard to remove someone from your list and sever that tie. But it is the right thing to do, if you think any doctor is under-performing or over-selling. Honestly, there a few doctors I would like to see added (and a couple already there who I think should be reviewed more closely). The higher the caliber of your list, the more power it will have, and the better it reflects back on you. I encourage you to run a "tight ship". I wish doctors would get the message that every single case is incredibly important. This surgery has too much long term impact on the patient's entire life to tolerate any less-than-great results. Pat, you deserve credit for pulling a doctor from the list based on a patient's complaint. Give yourself a high-five.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>...thick hair will give better density but thick hair will also give the least natural hairlines. Or am i wrong here? No, I think that you are onto something. It can be hard to do a soft feathered hairline with extra coarse hair. Not impossible to do, but it takes some extra skill on the surgeon's part.

I believe a range around 5-6 thousand grafts via strip is considered an average maximum. You can say Jotronic had a "three" donor area but I don't know what the heck that means. What scale is that based on? That is a pretty silly "statistic" to quote. Jotronic has said that he has extraordinary scalp laxity (scalp like a "Bassett Hound") and that is the key to his higher yield. Do you understand the concept of "averages"? It means that some guys will be higher and some guys will be lower. But here you are pointing to a higher example and claiming that everyone will be that way... sorry, that is not correct, and that is not how to figure out what is average. Don't make the mistake of thinking that all patients are alike, and that if you go to patient X's doctor you will have patient X's exact results. I get my estimates of 5-6000 based on comments and articles written by modern FU strip doctors. Maybe you can point out some articles or comments that claim a higher number? Anything? It's great if a guy like Jotronic has some excellent characteristics like good laxity but most of us have average charecteristics. If Jotronic was average than there would be a whole ton of guys with similar number of grafts. I don't think that there is. There is a lot of assumptions in your post that I think are incorrect, for example that a guy who is Norwood 6 will still have 70 percent of his hair remaining. A lot of this information is already available if you are willing to read and research.

If I were you I would consider meeting with Dr. Ray Woods in Sydney. www.thewoodstechnique.com I try not to recommend doctors to people, but since you are in Australia you should consider meeting with him.

You shouldn't have gotten a transplant in the first place. The clinic admits this. It was derelict of them to transplant you, when you only had a trivial amount of hair loss. Patient screening is not some minor little detail or after-thought, it is one of the keys to successful results. The clinic admits they dropped the ball there. It's also disturbing to see that bad of a donor scar, for a trivial amount of grafts. The payoff was not worth the damage that was done.

If you see something roughly the size of a small grain of rice with a hair sticking out, then you've lost a graft. The part of the graft you need to be concerned about is below the surface. It sounds like everything is normal.

I don't think you are bald enough to need a hair transplant, not even close! I recommend not doing it unless you are at least Norwood 3 or Norwood 4.

Oh yes he does. Amazing, isn't it. Ever hear ANYBODY say that Dr. Puig is one of the skilled doctors in the field? I have never heard anyone say that. The best thing I've heard about Dr. Puig is that "he's a lot better than he used to be". After doing hair transplants for 30 years, he'd have to be a moron NOT to be "better than he used to be." Dr. Puig also gives lectures on "professional ethics" at some of the big HT conferences. I would compare this to a lecture on "good manners" given by Attila the Hun. Puig co-owned and ran the biggest hair mill in the world (Cleveland Hair Clinic) for over 20 years. I have examples of false advertising from Puig's clinic, with bogus claims and medically false statements, that he was responsible for. I suspect Dr. Puig's comments on "professional ethics" revolved around telling doctors not to tattle on each other... Because criticizing bad doctors is "unprofessional". Somehow, the word has gotten out about doctors like Bosley and Hitzig, while Carlos Puig has managed to fly under the radar. Interesting to see that many patients have been complaining about their results, at a franchise where Puig is in charge of their training program.