HotCreek

Honestly speaking, I think that the notion that what other people think about your appearance doesn't matter is one that sounds good but has substantive practical limitations. Like it or not, the way that other people treat you is, to a significant degree, a function of how you look. Numerous independent studies have shown that good looking people get preferential treatment from most people they meet. As a consequence, good looking people have an easier time in life. They get better jobs and have more opportunities in general. And regardless of how "shallow" you think someone may be (and he or she may be shallow indeed!), a man or woman who looks good will have more social or "romantic" opportunities than one who doesn't. In particular, cultural anthropologists have told us that men are almost always initially attracted to women based solely on her physical appearance. That women seem to know this is evidenced by the fact that more than 90% of all cosmetic surgery patients are women. In fact, with the exception of hair transplants, I don't personally know one man who's had cosmetic surgery. But, I know many women who have. On the other hand, men seem to get a sligyt break on the matter of physical appearance, at least as it regards attractiveness to women. In particular, if a man has lots of money, or otherwise appears to be a "high status" male because of his job, position in the community or anything else, women tend to find him very attractive. Just look at the wives of even the homliest pro athletes. So men and women do look at each other differently and cultural anthropologists say the differences are genetically based. When primitive man was trudging across the steppes looking for a mate, the guys who chose "healthy" women were more likely to have healthy children, which is to say children who could survive the rigors of primitive life, and in turn, pass on their genes. It is believed that the healthiest primitive women had physical appearances similar to what men find attractive today. (In fact, the experts have determined a wide variety of physical characteristics in women that define the current-day "ideal" of attractiveness. For instance, an "ideally" attractive woman will have hips about 30% wider than her waist.) On the other hand, the women whose genes were passed on were women who chose a good "resource provider," a man who could successfully club some animal on the head and thereby provide food, not necessarily an attractive man. In particular, women with children could not hunt nearly so efficiently as those without and were much more likely to perish, along with their children, if they didn't have a partner to support them. In fact, it has been shown that once a woman begins sexual relations with a man she undergoes hormonal changes that cause her to "bond" with that man. Primitive women who did NOT bond with their sexual partners, but went their own way, frequently had children and starved. And their genetic predispositions were lost. This is the biological reason why women are so much more concerned with "commitment" than are men. So today, women are more likely to be attracted to men based on money or status (the ability to provide "resources"). But, (unfortunately, some would say) men are more likely to be attracted to women (at least initially) primarily if she is physically attractive.

Paul148, Relax! Why expend so much energy convincing everybody here what we all already know? Namely, that people in the "field" of psychology are largely driven by their own need to deal with their own insecurities? Nobody here's really questioning your credentials, we're just trading ideas. Besides, were you there when the surgeon made his "diagnosis?" Do you really know exactly what he said and how he phrased it? Do you know what else he may have said? Do you know that the particular surgeon did not do a residency (at least four years at most med schools) in psychiatry too? Do you know that he doesn't have a doctorate in some field of psychology? Do you know anything about his background at all, except that he's a HT doc? I didn't think so. Nonetheless, after telling us that "Diagnostic work is extremely complex, (and) tricky..." you feel qualified to diagnose the physican as an "arrogant jerk," and that there's a lot of "swagger and arrogance" driving his behavior? Puhleeze!!! Give us a break! Or has your own arrogant attachment to the monumental training you presume we all know you've had convinced you that the hall mark of a good psychologist is complete abandonment of objective, logical and dispassionate analysis? The people who post here are all good men and women so far as I can see. We just want to exchange ideas and obtain information. And while it's one thing for a person with FIRST HAND empirical experience to "vent" over treatment he received from a physician, it's quite another for someone with NO FIRST HAND experience to engage in a childish fit of name-calling. I sincerely mean no offense to you, but if, as you claim, you work in the "field" you ought to know better.

I think Jotronic is correct on this count. Coursework in psychology and psychiatry is part of the standard curriculum at most American medical schools. In addition, every med school graduate undoubtedly gets training in psychiatry as part of his normal "rotations" as an intern. Also, "psychiatry" is, by definition, a medical specialization in the field of psychology. So every psychiatrist is an MD and the training that surgeons and psychiatrists obtain, at least initially, is very much the same. Of course, no amount of training or degrees precludes the possibility that one person or another may act like a "jerk." So maybe the guy was a jerk and maybe he wasn't. But I do concur that the matter is suspicious as the "BDD" label in this case seems to have been affixed AFTER, rather than before, the HT surgery. So bottom line is that you want a doc who is highly competent as a HT surgeon and is honest enough that he won't "BS" you before or after the procedure.

Harborcr, If I were you (and of course I'm not!) but if I were, I wouldn't think in terms of finding a physician who is physically proximate to where I lived. I think most regular posters to this site would agree that you really don't want to take any chances with HT surgery. So, I would consider ALL of the Canadian and U.S. physicians recommended and discussed on this site. And I would pick the one I liked the best regardless of where his or her office was located! In addition, you may save yourself some $$ by traveling. The Canadian exchange rate is very good right now and some docs give you a discount and "credit" against your bill if you travel from out of state. You really don't want to pick a guy solely because he's close by. Best of luck and let us all know what you decide to do? And oh yes, please try to relax and take your time. No point in rushing things. Better to make a good decision!

Many celeb athletes are so accustomed to the public "spotlight" that once they're finished actively competing they actually enjoy it when people talk to them and ask questions. Out here in California, I've bumped into former 49'ers defensive back, the great Ronnie Lott. He is truly a nice person and seems to enjoy meeting and talking to people. Also, contrary to widespread belief on this site, celebrities DO NOT have access to some sort of "limited" pool of celebrity physicians. I know of several people who've been treated by physicians who treate celebrities, including the doc who did Joe Montana's back . And quite honestly, particularly when it comes to HT's, many of the physicians referred to on this site DO BETTER WORK!

Hi Pharmer, I cannot answer your question, however, I posted a question on "recipient" scarring on this thread. You may find the responses to my question relevant to yours. Cheers! [This message was edited by HotCreek on December 22, 2002 at 06:44 PM.]

Flap procedures for hair restoration are an old and highly risky technique. For starters, because the "flaps" are rotated from the sides of your head, the direction of the hair is always wrong. Flaps cause the hair to grow straight back on the top of your head. The natural angle is down and forward and produces the best cosmetic appearance even for guys who like to comb their hair straight back. Flaps also cause "buckling" of skin as the flaps are rotated. They also make it very, very difficult to create a natural hairline shape, as the rotation (and again that severe buckling as the skin is twisted) almost always make the hairline too low at the upper sides. I've been researching hair transplants for 15 to 20 years. I would NEVER consider allowing anyone to perform "flaps." They don't look good and frequently require lots of "followup" procedures (lots more $$$) to fix skin buckling, loose skin, thick scars (especially right in front where it's most visible) and unnatural hair growth direction. The all Follicular Unit (FU) transplants of today are far, far better with almost no risk for most patients. Do yourself a BIG FAVOR and don't make any decisions until you thoroughly understand the differences in various HT procedures. Good luck!

To what degree is visible recipient site scarring unavoidable? I've seen at least 20 guys in person who'd had HT procedures at a well-known and reputable office. In some of the guys, at the base of each transplanted hair, a small scar (or what I would presume is a scar) was visible. It looked as if the hair follicle was growing out of the top of a very tiny "volcano" (for lack of a better word) skin configuration; sort of like a "Hershey's kiss." Most guys did NOT have this look. However, a few did. Is this condition temporary? Is it a scar or some other "anomaly?" Is it a sign of poor work or a surgical "miscue" of some sort? In many HT patients I've seen, it's the only sign that a HT has occurred. Thanks!

To what degree is visible recipient site scarring unavoidable? I've seen at least 20 guys in person who'd had HT procedures at a well-known and reputable office. In some of the guys, at the base of each transplanted hair, a small scar (or what I would presume is a scar) was visible. It looked as if the hair follicle was growing out of the top of a very tiny "volcano" (for lack of a better word) skin configuration; sort of like a "Hershey's kiss." Most guys did NOT have this look. However, a few did. Is this condition temporary? Is it a scar or some other "anomaly?" Is it a sign of poor work or a surgical "miscue" of some sort? In many HT patients I've seen, it's the only sign that a HT has occurred. Thanks!

Caseinpoint, If you're looking for an HT doc that has a very "hands on" approach to the entire procedure, you may wish to consider Dr. Sharon Keene. I believe Dr. Keene does use technicians but according to at least one post by a patient who is also a physician, she's involved "side-by-side" with the techs as they work. The patient uses the name "mtsurgery" and his post on Dr. Keene is on this site under the "Hair Transplant Experiences" forum. Dr. Keene's "home" office is in Arizona, not really that far from Texas. Also, she performs surgery for a week each month in Dr. Shapiro's clinic in Minnesota, which has a reputation second to none. Of course, Dr. Limmer's fine reputation speaks for itself. Also, I've been to several NHI seminars in California and have seen five or six guys in person who've been done by Dr. McClellan. They all looked terrific. Of course, five or six guys may or may not be considered a "representative" sample. Let us all know what you do. But DON'T do anything until you've completed exhaustive research!

And let's not forget Homer Simpson's hair transplant. Of course his hairline is what you might call a little bit "conservative;" probably got some consulting from some of our "local" experts. Of course that "Z" shaped configuration on the back and sides is a little weird. But hey, Homer's really just a figment of your magination, and exists only in those small illusions of space and time created when electrons smash into the front of those ubiquitious cathode ray tubes known as television sets,... and of course, computer monitors. Anybody know if those lone hairs popping from the top of his head are FU's? And what about Marge Simpson? I understand that Marge was formerly in the World Wrestling Federation and then went to a really bad HT doctor in Denmark who accidentally performed a sex change operation. Of course Marge woke up halfway through the procedure and smashed the doctor with a conveniently placed folding chair and then dashed out the door in her fluorescent orange leopard pattern speedos. Anybody know the name of Marge's doctor? He probably works for Bosley Europe. You may wish to consider having some other surgeon perform your procedure. On the other hand,...you may not.

Other celebs who've had HT's that I know of are: Former Dallas Cowboys head coach Barry Switzer. Actor Ian Ziering, formerly "Steve" on "Beverly Hills 90210." Actor David Spade on "Just Shoot Me" and formerly on "Saturday Night Live." I don't think that Bruce Willis has had work beause he so frequently sports the completely bald look; which I think looks extremely good on him. As for Kelsey Grammer, I don't think so either. He seems to have had a natural progression of MPB ever since his days on "Cheers" that appears to have advanced but substantively changed much. I've heard, but cannot confirm, that Robert Redford has had some work. And of course, guys already mentioned such as Burt Reynolds, Billy Crystal, Tom Arnold, Nicholas Cage and Steven Seagal.

While it's true that most celebrities have more money than the rest of us, as a simple matter of "supply and demand" most cosmetic surgeons must maintain a competitive pricing structure and therefore are NOT altogether unavailable to the rest of us. Big money celebrities represent an extremely small percentage of the entire population or "market" and in particular out here in California, there are LOTS of cosmetic surgeons. Any businessman will tell you that profitability is a function of both price and VOLUME (number of units sold, or in this case patients). This is not to say that cosmetic surgery of any kind is "cheap." It isn't. (Although certainly HT surgery has come way down over the years.) But I know of at least two well-known California physicians' offices who've done celebrity work and who are reasonable enough that they're available to the "rest of us." I also know of several people up here in Northern California who have had assorted work done by some of the Hollywood "big shots." And while they can be somewhat more expensive than a physician that the "average" person might see, their fee structure is not necessarily prohibitive. So I think that viewing and discussing celebrity work can be informative and useful, in particular because we see celebrities so frequently. [This message was edited by HotCreek on December 06, 2002 at 03:49 PM.] [This message was edited by HotCreek on December 06, 2002 at 03:51 PM.]

Sandman, Any of the "regulars" who post to this site will tell you to avoid Bosley. While the Bosley clinincs may have performed a few acceptable HT's, the concensus is they are a very high risk operation. Please DO YOURSELF A BIG FAVOR, don't schedule surgery with anybody until you've been reading and posting on this site for at least a month or two. That way, you'll get a good idea of what to expect and which physicians you can trust.

Speaking of good celeb HT's, what about martial arts action actor Steven Seagal who always combs his hair straight back?

Only one person can make sure that no one messes up your head: YOU! Please do your homework before you let anyone perform surgery.

Just an "FYI" to whom it may concern. There are actually TWO HT physicians named "R. Jones." One is Dr. ROY Jones of New Hair Institute in California. The other is Dr. ROBERT Jones in Ontario, Canada. Both are recommended on this site and both are reputed to do good quality work. However, if you're going to discussing pricing structures, and whether the $$ are Canadian or U.S., you should know that one is based in Canada and the other in the U.S.

Just an "FYI" to whom it may concern. There are actually TWO HT physicians named "R. Jones." One is Dr. ROY Jones of New Hair Institute in California. The other is Dr. ROBERT Jones in Ontario, Canada. Both are recommended on this site and both are reputed to do good quality work. However, if you're going to discussing pricing structures, and whether the $$ are Canadian or U.S., you should know that one is based in Canada and the other in the U.S.

Wizard, Noreaster, Monty et. al. I think a new thread on "what it takes" to get a satisfactory hair transplant is a good idea. It would separate that topic from this thread which started out on the topic of picking a physician (which is WAY important, but a somewhat separate consideration). I, for one, wouldn't want a repetitive, highly expensive, long-term commitment to another HT every year. Yet, I have no idea as to how much "density" is satisfactory. Sure, I've seen the photos "John Q. has had 1800 grafts" but that doesn't tell me how many grafts per cm2, and the photos don't usually show you the back of the head, only the facial, or front shot. And there are lots of considerations regarding the "caliber" or thickness of your hair shafts that are never mentioned with the photos. So, I think a new thread would be appropriate.

Thewizard, I think most posters to this site would agree that if you decide to have a transplant you will save yourself much grief by going to a physician who does ONLY FU transplants and INSISTING that he agree to put only one FU into each recipient site. In my opinion properly cut FU's are ALWAYS better than mingrafts AND FU's with fewer hairs utilize each hair more efficiently than FU's (or any graft) with more hair. First, any procedure which "bunches" hairs together into one graft runs a higher risk of producing a "clumpy" or "tufted" look than one which doesn't. And in some cases, bunching of any kind can make it difficult to insert the graft at the correct angle and orientation. Second, a hair transplant procedure doesn't give you anything you don't already have. It only moves hair from one location to another. So the surgeon's job is to make those transplanted donor hairs (which are in limited supply) cover the underlying scap as efficiently as possible. It would seem to me that a procedure using grafts with the FEWEST hairs utilizes each hair more efficiently than one using grafts with more hairs. The reason is simple: As hair grows you comb it over or it flops over on its own. In any case, hair which "layers" over other hair is NOT as preferrable as hair which covers scalp because it's scalp you want to cover, not other hair. And I would think that hairs in groups or bunches would tend to cover each other to a greater degree than they cover scalp; at least compared to hairs which are not planted in bunches. Taking this logic a small step further, it is clear that the most efficient use of a single hair is a one-hair follicular unit; which is to say a graft with the smallest number of hairs. However, there's a problem. Because there's a limit to the number of holes (recipient sites) a surgeon can poke into a given area of scalp, transplanting only single-hair FU's would reduce the overall number of hairs moved. Clearly, putting more hairs (larger grafts or multiple grafts)into each of a limited number of holes would move more hairs. It may very well be that the best compromise between all single-hair FU's and larger multi-hair grafts is the FU as it naturally occurs on your own head. Of course physicians love moving hairs in clusters or groups (larger grafts) because they get more "bang" per recipient site and the entire process from dissecting the donor strip to implanting is less work. Indeed, this is undoubtedly one reason why so many physicians still use minigrafts. Nonetheless, this practice almost always comromises cosmetic results. So you really have to choose your surgeon carefully. [This message was edited by HotCreek on November 21, 2002 at 10:06 PM.]

Panther, If you feel you have "empirical" proof that he short-changed you, you can always call a lawyer. Of course, that may be a lot more time, effort and money than it's worth. Also, it would really "sour" your relationship with the doc and (at least for me) would preclude having him do any more work! Before you do anything though, you should think about exactly what you want to accomplish. Do you want a partial refund? Do you want more work done? Or something else? Most lawyers where I live will give you 30 minutes or so of free consulting time over the phone if they think you might be bringing them some business. So, even if you don't get a lawyer involved directly, you might call one for free, explain your situation and see what they think your options are. Frequently, having an attorney write a simple letter requesting information makes people very acquiescent about cooperating with you. So, maybe a letter would help. Also, each state has a medical review board of one sort or another (they all seem to have different names). You could contact the board for your state, once again for free, and ask them what your options are. Best of luck!

I find this story a little disturbing on two counts: First, if I understand things correctly, the physician actually inserted TWO grafts into single recipient sites, a single-hair graft and a two or three-hair graft. To me this seems contrary to the philosophy of FU transplants which is to move away from too many hairs in each recipient site (which is what you get with plugs or mini-grafts) and in the direction of fewer hairs per site. Also, another benefit of FU transplantation is that the grafts are implanted exactly the way they grow on your head! Seems to me that putting more than one graft into one hole defeats the purpose, a little, if not a lot. Also, what about graft "compression" which occurs when the base of the hairs is squeezed together too tightly and the hairs grow out in a "fan" like configuration, like peacock feathers or something? The other thing is that it really sounds like there was a communication "disconnect" between you and the surgeon. If you expected each graft to be inserted into a single incision site, then that's what you should have received. Granted, if the work was on the crown it may make little or no cosmetic difference. Nonetheless, I think the doctor needs to be very clear about what he's going to do. I hesitate to say this in the absence of more information, but it almost sounds like the doctor was just lazy (or overbooked!) and didn't want to make the additional incisions. Easier for him to make fewer and let the tech double-up on some graft insertions. But,...I'm just speculating. I can't tell you what to do because I think that's a personal decision that you have to make. However, I think I'd be a little upset about it too. Let us know what you decide and what the doctor says.

I have visited several HT offices here on the West coast including Bosley and Elliot & True. I can tell you with absolute certainty that I would NOT let anybody at Bosley touch me! I have no direct experience with NuHart (sp?) but have heard nothing good about them. I have a friend who was done by Dr. Elliott of Elliott & True and got far less than perfect results. I would not consider allowing anybody to perform the procedure on me unless they were recommended on this site. The people who post here (physicians, patients and prospective patients)have literally hundreds of years of combined experience in hair loss treatment. As far as pain goes, most patients say post-op pain is minimal and easily managed with mild pain killers. Pre-op pain consists of the discomfort of receiving hypodermic needle injections. I'm sure you've had shots before, so bearing in mind you'll get them in the head, you get the idea. Swelling seems to vary with the individual and some physicians prescribe various meds to control it. If you can't take a few days off work, you might want to forget about it. Remember, surgery is surgery and is always traumatic to your body. Your head will be red (especially if you're fair-skinned) and there will be scabs and crusting, and as indicated possibly some swelling. Anyway, just my "two cents" I'm sure you'll get more. Also, many of your questions are already addressed on other threads on this site. Best of luck whatever you do!

WW: I'm a new registrant to this site but I've been researching hair transplant technology for some time now. Although I've seen a couple guys who had fairly good work done at Bosley anybody who lets Bosley perform an HT is taking a very, very big risk in my opinion. I've read about many guys who went to Bosley and later regretted it. Whatever you do, don't make a decision to allow anybody to perform HT surgery on you without doing exhaustive research. Although the number of surgeons doing top quality work is small, there are enough that nobody really has to take the huge--and quite costly--risk of going to a surgeon without a proven record of performance. Remember the old slogan "caveat emptor." Some people will tell you anything to get your money. It's your job to make sure you're getting something of commensurate value in return.

I've attended several of the New Hair Institute (NHI) Open Houses and I've seen 5 or 6 guys who've been done by Dr. McClellan. Each looked extremely good! If the Dr. McClelland to whom you're referring is the NHI Dr. in Los Angeles he would appear to do very fine work. [This message was edited by HotCreek on November 19, 2002 at 07:42 PM.]