arfy

Costco for Minoxidil, I think it works out to be something like 10 bucks a month. Try Costco.com Try to get a prescription for Proscar (5mg Finasteride), and split the tablets into fourths. That would be the cheapest way to use Finasteride. But even if you use Propecia, it will still be cheaper than the Hair Club plan, probably. As far as fancy shampoos and scalp treatments, herbs etc, in my opinion you don't need any of it. Finasteride is the most effective treatment (Proscar, Propecia), and the second best thing to add after that would be Minoxidil. Everything else seems to be unessential, as far as I can tell.

Male Model Here is the problem with your strategy, with your suggestion that the young man should "do it now"... A young man will not look right, or be happy, with a hairline that is mature and recessed. However the mature and recessed hairline is the correct choice when getting a hair transplant. For one thing, if a guy is losing his hair at a young age, his odds are very high that he will become totally bald. Since there is not nearly enough donor hair to cover a totally bald head, this young person will possibly end up with a BIZARRE appearance, as his hair continues to fall out over the years. He will have a low "young man's hairline" as an older man, with a huge thinning area (or baldness) behind it, and it will look weird. Nobody should bet their entire future that Propecia or any other drug will work at stopping hair loss forever. Yes, we can all hope that Propecia does work forever, or that new treatments will become available. But it would be foolish to bet your future and your appearance on it! It would also be FOOLISH to trade 5 or 10 years of "looking good" in your twenties, for spending the rest of your life with an abnormal appearance. Guys who gamble with their appearances are being fools, in my opinion. And doctors who allow this, or carry out this wish, are reckless and irresponsible, in my opinion. Agreeing to create future problems in a patient is malpractice, in my opinion. Male Model, if you personally had a hair transplant to restore a young "perfect" hairline, that is your choice. I would NOT recommend it to other people. And you should not tell guys it is the right thing to do, without warning them of the serious risks involved. Someday you will realize that life doesn't end at age 30 or 40, and neither does your desire to look normal!

Beachboy You are asking the right questions! More guys should be thinking about what will happen 5 years down the road. What Norwood level are you? Because 1800 grafts is not going to cover a huge area. You might need a series of surgeries just to accomplish your immediate goals.

Hepcat The crown area in a non-balding person has MORE density than their donor area. Think about that. I've also read that when transplanting the crown, you should expect to need twice as many grafts to get the same type of coverage you would get in the front and top. In the front you can take advantage of the hair "shingling" effect, where the hairs lay on top of each other and add coverage. In the crown area, the hair goes in multiple directions and the shingling effect is not really a big factor. That's why many doctors think it is a mistake to start a transplant by working on the crown first... the crown requires tons of donor hair. Donor hair that you will probably need later in the front, just to look normal as you continue to lose hair. It is more realistic to expect a bare crown (bald spot) or a very sparse coverage of donor hair in the crown. If you luck out and can have more than a "dusting" of hair in the crown, you should consider yourself extremely lucky. Also, use preventative medicine like Propecia to make sure that your hair loss doesn't progress to a level 7. Stopping the progression is very important.

I believe Dr. Vogel has a good article about repair strategies, that you should read. There is also some good repair info on the NHI website www.newhair.com Different doctors can have different strategies. Some doctors think it is important to remove plugs, and others think it can be okay to just surround them with good grafts. Part of it will depend on how many plugs, how bad they are, and where they were placed. Try to get some different opinions and also read up on this. Personally, I think the removal and suturing strategy makes sense, however if you have lots of bad grafts, you may not be able to address every one. So a lot of this "depends".

Well, if your hair ever becomes "un-stablized" you could look pretty bizarre with a tuft of permanent hair in the front, and balding hair behind it. Can you guarantee no more hair loss? Probably not. Part of this would depend on how low you want to place grafts. Is it a hairline that will still look natural at age 50? These questions do not change based on the graft-harvesting method. You still need to be careful and think about long-term implications whether it is FUE or not.

There is no proof that Saw Palmetto works for hair loss, like there is for Finasteride. This is because the testing process is expensive, and since nobody "owns" SawPalmetto, there is obviously no motivation for anybody to test it. However, if you read and search around, you will find very few guys who say that Saw Palmetto actually produced results with their hair, even though on paper it is supposed to do something similar to Finasteride. Most reports I've seen were disappointed, with a couple of guys saying it works. The "anecdotal evidence" is very weak. Spencer Kobren wrote about Saw Palmetto and recommended it and other herbal treatments in the first edition of his book The Bald Truth. But lately, on the radio he has been saying that Saw Palmetto is basically not worth the effort, and he doesn't recommend using it any more. Saw Palmetto also can cause all of the same side effects as Finasteride. People think that "herbal" and "natural" will mean "no side effects" and it isn't true. If you are unlucky to get side effects with Finasteride, there is no reason to think you won't have the same problem with Saw Palmetto... you may or may not get side effects. No guarantees either way. If you are planning on using Finasteride and Saw Palmetto at the same time, you are wasting money... There is no extra advantage to adding Saw Palmetto if you are already on Finasteride. Maybe you will be one of the lucky ones with Saw Palmetto, but I would suggest the Finasteride instead, if I were you. That's my opinion anyway. Good luck whatever you decide.

Supposedly Bosley is working on it and want to have something out in 5 years. No, I'm not kidding. I would not get a transplant at Bosley, no way. But I would definitely get hair multiplication done there. Look at the bottom of this page:

Hi Arpma You should post this question in the forum called Post your questions for Hair Transplant surgeons here You will probably get some good responses from some doctors there, who have experience in this. Even though it is not exactly about hair transplants, they sometimes see patients who wear hair pieces, and will hopefully have some advice. Good luck.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR> Notice that they never give a top or rear view of his head and when they accidentally do, then look at it. The camera on a set, like the publicity is always carefully controled. Life would be a lot easier if we could limit everyone to a front-angle view. However your hair transplant must look good from every angle, as well as in the rain, wind, etc. Ask yourself (and your doctor) how many hair transplants can look good in those conditions? A Hollwood set has teams of hair and makeup people, and as Werewolfhead said, the camera restricts your view. Don't confuse show business for real life.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR> It has been widely acknowledged that the guy had work done.... Really? I have never thought Mel Gibson had a hair transplant. Where is this being "widely acknowledged"? Not that I really care, either...

I was never in Houston, I saw Dr. Puig when he worked in the Chicago area. I have had some corrective work from Dr. Bernstein.

ts808, good luck. NW I'm not sure what Dr. Bernstein's philosophy is regarding FUE. I am excited about the development of the technique and I hope it can help me. But I am still in the middle of revising bad grafts, and any FUE seems like it would be way off on the future until I am ready. I think FUE has opened the door to help a lot of guys similar to me, who are in bad shape... I think your hunch is correct in other words, and I hope it will be true for me as well. It's a little too early for me yet. So far I've had 4 corrective procedures (excising grafts, not strip sessions) and I bet I could easily have another 4 more, even 8 more...! There is a lot of bad work that needs to be undone first.

Hi HairHair Everybody who gets their first transplant is excited. Yes, I do understand. However as time goes by the excitement will wear off, and the reality will set in. Hopefully the new guy will still be happy with his transplant 5 years from now, but it isn't always so. Let me give you an example. A guy goes to "Bad Clinic X" and has a very nice experience there. Everyone is friendly, the doctor gives him lots of attention, and it all goes smoothly. However in a year from now, this fellow will start to realize that his hair transplant actually doesn't look so hot. But in the days and weeks after his proecedure, this poor jerk was all over the internet, telling everybody what a great experience they will have at "Bad Clinic X" and recommending that clinic to other guys who were brand new to this. So lots of guys read his posts and took his advice, and went to "Bad Clinic X" and followed in his footsteps. That kind of thing would be a disaster. That's why I made this thread in the first place. I'm sorry but if you have trouble understanding my point, maybe you are just still way too new to all of this yourself. I think you had your own first procedure only a month ago. I hope you remain happy about your experience, but I bet in a year or two you will realize the truth of what I am talking about, because things change slowly over time. I hope you do get excellent results, too. As I said, I think it's fine to relate your experiences at a clinic. But guys should hold off on recommending their doctors until they can really see their own results. Again, this is the main point I am trying to get across.

TTaco Yes I was gullible, I believed that all doctors were ethical and were practicing medicine to help people. That's how I was raised, to respect doctors as authority figures and experts at what they do. I also assumed that any medical clinic that wasn't on the level, would quickly be closed down by the local authorities. Neither of those things are true. Many doctors are attracted to hair transplantation because it is fast cash, with no insurance or HMO hassles, and it is very easy to do if you don't care about results as much as you do profits. Basically you do the same thing over and over, it's a good field for guys who want to coast along and not have to push themselves or learn anything new (I'm not talking about the handful of good surgeons out there, I'm talking about the average hack, who does hair transplants for the bucks). And I have never ever heard of a successful lawsuit against a hair transplant clinic, or a hair transplant doctor who has had his license taken away. Have you? It's really "anything goes" out there. As far as seeing previous patients of Dr. Puig's, I was shown photographs that looked like full heads of hair. In retrospect, I would not be surprised if they were just photos of male models who had no hair work done. The consultant himself looked terrible, but he told me they were doing better work than he had gotten. I wish I would have seen that as a sign. Now I know how important it is to see lots of guys in person, that a doctor has worked on. Photos are deceptive. I did ask some tough questions but I was lied to. For example, I told my consultant I had seen some transplants on the street but that I knew they were very obviously hair transplants. He told me that those guys must not be patients of Dr. Puig's because Dr. Puigs transplants were "undetectable". That was one thing that really sold me... a hair transplant that didn't look like a hair transplant. Of course that was a total BS line he fed me. This was considered the early days of hair transplants, so nobody would know what questions to ask, because the procedure was not as common then. And there was no such thing as the internet. But Dr. Puig had been doing hair transplants for about 8 or 9 years at that point, so it wasn't that new. I am now in my 40s. I'm not a stupid guy... I was naieve and they conned me. A lot of other guys got sucked in as well. I once read that half of the guys who wear hair pieces are covering up bad hair transplants. Think about that for a while. A lot has changed since then, thank God, but on the other hand there is still some BS that hasn't changed much. One thing that is still a big scam in my opinion, is the selling of transplants to young guys who want to "stay ahead of their hair loss". The idea that if you get a hair transplant you will "never have to go bald" is one of the biggest cons there is. As Dr. Feller wrote, hair transplants look the best and work the best, the balder you are when you get one. Lots of good doctors won't operate on a guy who is less than Norwood 3 or in their early 20s, but there are lots of other clinics out there that try to sell a hair transpant to every guy who walks in with a hair loss problem, no matter what age or Norwood level. Tons of guys are being sold on the surgery before they have even tried things like Propecia first. I still seem to see lots of new guys who are Norwood 2s who really think a transplant is what they need (and plenty of clinics anxious to sell him one). Since Propecia came out, in my opinion lots of clinics have started marketing the surgery to younger guys. Propecia and more clinics have increased competition, and now hair transplants are being sold to guys who aren't bald enough to need one yet. This can cause all kinds of potential problems later in life. I really worry about the guys who get hair transplants, especially the younger guys. I don't want other guys to end up in my shoes, but I know it is still happening out there. The difficult thing is that the young guys often don't know what a mistake they've made until later in life. Sometimes it can take years to realize the full results of your procedure. That's kind of hard to explain to some guys, especially the guys who think that a hair transplant is going to solve all of their hair loss problems. The other big issue that most guys here already seem to know about, is that only a small percentage of the clinics are doing an excellent job of the surgery. Only a small percentage of the clinics use the microscopically-dissected FU grafts, most of the clinics out there use outdated techniques like Minigrafts and Micrografts, and don't use microscopes. This is because they make more money doing outdated (faster) techniques. The industry is still dominated by the "hair mill" clinics like Bosley, NuHart and MHR. These clinics are more interested in mass marketing, than they are in getting the best results. I think it is very telling that Dr. Puig currently works for MHR, it says a lot about MHR and also about Dr. Puig as well. Be careful, guys. It really is a jungle out there. [This message was edited by arfy on December 02, 2002 at 11:48 PM.]

HairHair Please read my post again. I do not say guys shouldn't post about their experiences on the day of surgery, just that it is typical of most clinics. That's not really the issue I am trying to address. The main point I am trying to make, is that newly transplanted guys should hold off from actually recommending their doctor, until they have actually seen their grafts mature. I hope that makes sense.

Where to start on Dr. Puig? He specializes in scalp reductions. This is something I recommend you avoid. He doesn't use microscopes to dissect follicular unit grafts. Click and read the article on this webite called "Best Hair Transplant" This is not Dr. Puig's approach. Dr. Puig is an "old school" doctor using outdated techniques. I also think Dr. Puig has serious ethical problems. He operated on me when I was 20 years old, and only had some diffuse thinning. The first thing he did was load my hairline up with grafts, where I still had plenty of hair. The consultant Dr. Puig hired promised me that I would get a transplant that was "custom-tailored" to my needs, and it would be "undetectable". Neither of those things were true to any degree. I was told a bunch of other lies, as well. The whole point of Dr. Puig's clinic (where he was the Medical Director) was to snare as many patients as possible. This went on for something like 20 years. I think Dr. Puig has poor artistic ability as well. He gave me a bowl-shaped hairline that looks lopsided, like the bowl started to slide off of my head. If you are wondering how something like Dr. Puig's clinic was allowed to continue, it's because it is basically impossible to stop bad doctors and bad clinics from operating on people. Case in point is the Bosley clinic, who has something like thousands of complaints against them, and has had their license suspended in 20 states. Yet they continue to advertise and bring in new clients on a daily basis. Look at the website www.BosleyMedicalViolations.com for more specific details. Let's not single out Bosley though, because the violations listed on their website there are actually fairly common amongst many other clinics, including MHR and NuHart in my opinion. Bosley is simply the most well-known. Dr. Puig operated his clinic (Cleveland Hair Transplant Clinic) in pretty much the same way described on the BosleyMedicalViolations website. Now Dr. Puig works for MHR (Medical Hair Restoration) another big franchise operation that is quite similar to Bosley, in my opinion. These big franchises care more about mass-marketing than they do about good results. MHR and Dr. Puig do not use the most modern approaches, despite what they say in their TV infomercials. I've heard that Dr. Puig is not as terrible a surgeon as he was when he worked on me. That is some cold comfort, let me tell you! Dr. Puig has screwed me up so badly, that other doctors are not going to be able to fix me. I am currently spending thousands of dollars and undergoing multiple surgeries to try and undo the damage from Dr. Puig. I was told that the best I should hope for is that I will end up looking "less terrible". Needless to say, there are many other doctors you could choose, who are MUCH better choices than Dr. Puig. I wouldn't let that guy touch me with a ten-foot pole, if I were you.

I posted this in another thread, but then it seemed like maybe I was picking on someone in particular. So I thought I 'd post this as an "open letter" instead. To the recent patients... You had your first hair transplant only a few weeks or months ago. You still don't know what your exact results will be. I agree that Dr "X" is a top doctor in the field, and you made a good choice when you picked him. But don't you think you should wait and see what your own results are, before you go around recommending him to everyone else in the world? I certainly think so. It can take a year for a transplant to really mature, and it can sometimes take several years (! yes, that's what I said) before you can really assess whether you made a good decision or not. Hair transplantation has a life-long impact, and sometimes guys have been happy with their results for the first few years, and UNhappy after that. It has happened! Your experiences at the 'X" clinic (friendly staff, attentive doctor, etc,) are all STANDARD experiences, and won't really differ even at the lesser clinics like Bosley or MHR by the way. They are just as friendly at Bosley as well as anywhere else. And if you stick around, you will see that I also tell this same message to everybody who posts immediately after surgery, telling everybody what a great experience they had: Please wait until your grafts are grown out, in order to decide if your transplant was a success or not. The first few months your grafts are dormant, and then after that, your hair only grows a half-inch per month. It can take a year or more for your grafts to fully mature. Enjoying your office visit is not as important in the long run. As I said, this holds true no matter who your doctor is. It takes time to decide how happy you are with your results. Once in a while a guy will post here and he's very unhappy, because he just went to Bosley and he's just come home and read some messages on the internet about how Bosley is not the best place to go. I tell those guys the same thing, well first I say that they probably could have picked a better place (sure) but wait and see what your results are (and keep your fingers crossed). The fact is that NO clinic bats a thousand, and no clinic bats "zero". So it's too soon for you to recommend Dr. "X" to other people. I know you are excited and you have high hopes, but please give it some time. Again, this is true no matter who your surgeon is. Good luck with your results, everybody. Thanks. [This message was edited by arfy on December 02, 2002 at 11:04 AM.]

I don't believe that Dr. Woods recommends using Propecia. So that is one thing I disagree strongly with him about. Guys who are Norwood 2 should not get a hair transplant, they should use Propecia and hopefully they will never need a hair transplant in the first place. I don't care who the doctor is or what the technique is!

I saw Pat Boone on TV yesterday and he does not appear to me to have a hair transplant. He appears to be wearing a very high quality hair piece. Of course I only saw him from one angle, which is easy to be fooled by. Rather than judge the results of celebrities, who have teams of hair and makeup people working on them, and who may use concealers and hairpieces when making public appearances, I suggest we stick to discussing the results of everyday guys like you and I.

Micropose Here's how i understand the clinical testing for Propecia went... First they tattooed a small area in each guy's crown area, and did a hair count. Then at various points, or at least after the course of medication, they counted the hairs in the circle again. Supposedly Merck had to limit their tests to one area of the head, because testing more than one area would have been too expensive. So for legal reasons, Merck cannot claim anything about areas of the head that weren't officially tested. Make sense? Some people say that Propecia does work better on the crown, but actually it seems to be different for everybody. It seems to work best (and first) on the most recently-thinning areas, and not as good on areas that have been thinning longer. Remember that Propecia is best at prevention, and not as good at regrowth. Prevention should be attainable on all areas of your head. About FUE, it is a fairly recent breakthrough. Dr. Woods has been doing it for years, but only recently broke into the US market, via websites like this one. All of the FUE activity is relatively recent, compared to the 30-plus years history of commercialized hair transplantation. Many doctors still do not believe in FUE, including some doctors who are recommended on this website. There has been a lot of resistance from many doctors. Other doctors think it is good but only in certain cases, and is not for everybody. If you are interested in FUE and want to find out if you could be a candidate, just start reading up on it, start contacting doctors who perform it. Some doctors say everybody is a candidate. Dr. Bernstein and Rassman (NHI) say only certain guys are good candidates. FUE is slower than strip excision in one way (limited to 500 or 600 grafts per session) but faster in total... you don't have to wait 9 months in between sessions for FUE like you do for strip excision. FUE is more expensive than strip excision usually (although there are also some very expensive strip excision doctors out there too. There are also less-expensive ones too. In strip-excision, higher price does not mean better quality, by the way). As you noted, the benefit of FUE is no linear donor scar. Some people have speculated that because it is less invasive, that it results in less shock fallout. I don't believe this was proven yet, although it sounds promising. And because you can take FUE donor grafts from all over the head and not just in the certain strip-zone, FUE appears to be able to ultimately provide more grafts in the long run. FUE is an exciting development, but keep in mind the main difference there is just in the harvesting method. All the other usual warnings and limitations regarding hair transplants still remain.

Good question. Unfortunately, I believe Thor was banished from this website. I was very sorry to see that happen.

Give Propecia six months to a year to really work, before you decide it does or does not work. You might think about adding Minoxidil to your routine, because they work even better in combination. Minoxidil is really cheap nowadays. Yes you will need to stay on Propecia after a hair transplant. Otherwise you will end up with a few transplanted hair grafts in the front, and big balding areas behind that. That look is not in style. Hair transplants do not sound like they are your best bet, yet. They are really for guys who are balder than you are. Stay on Propecia and hopefully you can halt your hair loss. Then you will never actually need a hair transplant. As Martha Stewart would say, "That would be a good thing..." If you are dying to see a hair transplant doctor, and won't rest until you do, try Dr. Bernstein in New York and New Jersey. Look on the link of recommended doctors for his info.

I know you are probably sick of hearing from me, so I will try to make this quick, and then leave you alone... The difference between FUE and regular FU transplants is only in the harvesting. The harvesting method doesn't change anything as far as a guy being a good candidate or a bad candidate for a transplant. First and foremost make sure that you are really a good candidate for cosmetic surgery. There is a guy posting around here lately who is trying to hype FUE as a great idea for Norwood 2 patients. (Guess what, he says he's a Norwood 2 who just got a FUE. He doesn't know WHAT his results are yet). In my opinion, he is way off-base for trying to tell low-Norwood guys to get a hair transplant at all! Some guys are not bald enough for a hair transplant, no matter who their doctor is, or what his technique is. If I can paraphrase Dr. Feller, (a doctor who uses FUE, as you know) "The balder you are, the better a hair transplant will work, and look." PS. To answer your first question, Propecia can and does work in the front. For legal technicalities, Merck can't claim it works there, because the clinical trials were conducted in the crown area. Propecia can work on your whole head though. Good luck with Propecia, I hope you get good results with it.

Propecia is very good at prevention. It is not so good at reversing hair loss, though. If guys would get on Propecia early enough, they could prevent themselves from ever needing cosmetic surgery in the first place. Anybody who thinks hair transplants are risk free, needs to educate themselves more about hair transplants. There are potential issues with shock loss and the possibility of problems with donor scars, but the biggest risk is that you will not have a great-looking result. Even the best doctors do not hit a home run, every single time at bat! Since hair transplants are not reversable, that is something to consider. Getting a hair transplant is a huge decision, bigger than buying a house or getting married. You can't divorce a hair transplant, it is yours for life, for better or worse. If it isn't everything you hoped it would be, for whatever reason, you are in a real serious bind. Not everybody gets knock-out results, even when they did everything right. Dr. Parsely made an excellent analogy, when he compared hair loss to tooth decay, and comparing Propecia to toothpaste. You wouldn't just let all your teeth rot away, and then hire a dentist to replace your teeth. That wouldn't be smart. No, you use toothpaste on a daily basis, as preventative measure against tooth decay. Propecia is a preventative medicine that prevents "hair decay". Don't just let you hair "rot", keep it from falling out by using Propecia.