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HLS2015, The forum can be nasty, in starting a exchange, but I hear what you are saying.....however, our doctors don't dissect the donor with FUT either our technician do, but Dr. Shapiro understands the best approach and method to do it. And, we didn't hire a doctor to do it, we felt he was one of the most promising young doctor out there and we brought Dr Joe on board to grow with us and he embraced FUE. With Dr Shapiro presence at world conferences and respect within the industry, FUE elite who started FUE before most, have embrace him and been forthcoming in share their experience and techniques ,just like he has shared what he has been doing with FUT over 25plus years.

Well we did just returned from Greece in late June, one of 13 part of the faculty of "World FUE Institute Workshop" and only three from the United States, where Dr Shapiro lectured on hairlines and Dr Joe preformed a live surgery. Dr Shapiro also is behind the last three major textbooks, 4th, 5th and the upcoming 6th edition, but whether it's FUT or FUE, density is density, 70-90 is probably the average and on the sides and near the hairline even less. In regard to our FUE, Dr Ron Shapiro doesn't extract the grafts but we have a doctor that specializes in our extractions, Dr Joe, and Dr Paul has been training over the last few years. Something we offer that is quite unique which I don't believe anyone else does in the industry, is with larger cases of 2000plus, we have two doctors work on one patient; one to focus on the recipient area and the other to focus and labor on the donor. This might change in time.....but one patient and two doctor's what care!

To be clear. My post above has nothing to do with Dr Cooley skill, we know him well, and again knowing the industry well, he's a doctor that does it right. We would be happy for you to go to Dr Cooley, because we know you will be well cared for.

As the medical consultant for 27yrs with Shapiro Medical, and knowing the industry very well. I would say we are very analytical and not conservative unless we have to. We do what's appropriate; when we need to be a bit conservative we'll be conservative, when we can be aggressive we'll be aggressive. It is a matter of the patient we want our patients happy now and down the road. If donor was unlimited and we knew where the progression would end, why not slap as much work down as we can and lowering hairline to whatever, but that's not the case. By being too aggressive on the wrong patient; we could give him something that could look peculiar down the road, use up too many grafts for other areas later and increase over all surface area to the pattern....all things that could hurt a patient and back him into a corner. We really haven't posted here much for a year, while being on here for a good 20yrs as a world leader and nothing has changed, if not gotten better at our group. We do 20-25 surgeries a month, with a approx. a third being sessions of 3000-4000plus. Unless one came to our office very few are seeing what we have been doing recently. Our group has grown and are very excited about the future!

I am 53 and you can search for my results on the forum. Wally, there are a number of very good hair transplant doctors out there today. It is not like 30years ago. It is a matter of consistency, but most of the industry leaders are consistent; with high quality, using donor efficiently (minimizing waste maximizing survival) and using hair affectively (using the right amount, distributing the hair in a way to get the most from it and rationing it for future progression). This is the key behind the genius of hair transplantation. The leaders and most proven are quite consistent, but none of us can match normal density, even using the donor as a efficiently as possible. So you need to set proper goals even in the best of hands for density and what transplant can provide in regard to normal density. If the clinic is consistent and your goals are in line with density a coverage you will be happy. At your age, my age it is also about being age appropriate.

Hello Bullitnut, It has been a while since we've seen you on the forums, we all hope you are doing well in the UK. We haven't been posting to much lately, our Fall/Winter/Spring does not allow a lot of time to be on the forums. But, we do feel it is important to get our work out periodically, to public, and we feel video is the new medium, so we hope to post more soon. All the best. Regards, SMG

Hi Lorenzo, Never have meet or corresponded with you. Have seen your posts over the years, I felt you spoke truthfully and contributed honestly helping patients navigate the industry. You assisted a very reputable clinic very consistent in preforming the highest quality of work within the industry. You should be proud. Serving others while fighting the fight, that's the sign of an honorable man. I think you have done more then one could ask. These forums can be helpful in many regards but unforgiving and contemptuous a battle field even when you are doing your best to help. I wish you the best, in fighting your fight.....and hopefully you will feel the love and support of all you have helped. Just felt compelled!!!

I can see where many may say temporal peaks because they frame the face, the problem is in nature generally you don't see temporal peaks on type 6 individuals. So, in reversing your thinning before you can have temporal peaks your crown needs more coverage otherwise it could look odd. The problem is some type 6 can't cover their crown and therefore should not do their temporal peaks. The degree of your temporal peaks should be in relation to how much crown is covered. Type 6 can also get caught up in needing to back fill if it recedes, with no donor left available. Be a bit careful.

It's been awhile, and I really don't like getting involved. Consistence is the key with the world leaders.....in creating very natural results, using donor efficiently and effectively over time. Shapiro Medical and many of the others clinics listed have not had many patients in the last 15 plus years complain about naturalness....and today with FUs no clinic is creating cornrows, but artistry and design does matter. -Using donor efficiently; requires minimizing waste and maximizing survivability....no easy task. It requires strong experienced staff, instrumentation and quality control. -Using hair effectivity means using the right amount in the right area distributing it where you get the best appearance of fullness (art of distribution) and rationing it for future hair loss. Making a density-cool hairline, if that means; low, broad and strong is great for the appropriate patient. Things it depends on: If for the patient the hairline will look appropriate down the road with the density and coverage left behind it, if it doesn't use up too many grafts for the patients future progression and increase over all surface area too much, by pulling the hairline to far forward. Shapiro Medical, can and will create aggressive-cool hairlines on the appropriate patient. All it takes is using more grafts, but the plan should be based on long term progression....not just for the here and now, immediate gratification. There are a lot of variable is hair transplantation, but there are three one never wants to lose sight of; hair loss is progressive, transplants deal with a limitation and unknowns....not knowing where one is going to be in time with their hair loss. Hope this to be valuable.

Mamzuka, I just wanted to provide some additional insight regarding this patient's work and approach, at Shapiro Medical. I can understand your point. I guess if you considerseeing a little scalp through the hair on the crown, in the photo warrants disappointment. Actually in person you don't see much scalp through the hair. If you examine the immediate post-op photo no work was ultimately placed there, possibly a bit around the anterior border. The work was primarily placed in the frontal half with most of the emphasis in the front third ,very little work in the back half and no work in the back third. Because the patient is fairly young we suggested meds to maintain the crown and surgery in the front which he agreed with. Right now he does comb the hair a bit forward in the crown while he waits with hope that the meds could thicken it up a bit, which they're capable of doing. All men, generally need in the crown is just enough hair hide the scalp and he's close to that now. With a concealer he could take care of it with no problem. He is very happy. He feels the work looks great.

To All, Having worked with Janna for 20 years, I would say behind the scene she lives up to the title "Distinguished Assistant". She has served her role at Shapiro Medical to the highest standard. Her care for the patient and the clinic has been well demonstrated over the years. Well deserved Janna, your friend and colleague!!!!

Arrie, Of course I remember you. I also remember the time you came to the clinic with a friend, and you were off to catch the White Sox play the Twins. And, our receptionist impressed you with stats. Your a cool dude. Thanks

Thanks, to everyone......all of you are long time posters and your opinions are respected and appreciated. Spanker, GQ....I don't know about that, but it makes 51yr old feel good. Regards,

8months post-op photos, both with my hair shaved and unshaven before surgery

Thanks guys. I am very pleased with the progress, but like every patient.....I'll take as much blossoming as possible, but it is a big improvement. I'll let it mature over the next 6mths and determine if I want to add icing to the cake and a cherry on top!!!

6mths post-op comparison photos....taken pre-op with hair unshaven and shaven.

Matt 3480.... Yes....it is like a shoe polish for the head, works great in thin areas where one sees as much scalp as hair of more hair then scalp, easy to apply and virtually waterproof. Best in the mid section and crown, where one is just trying to eliminate the appearance of scalp through the hair. If you don't see scalp one looks full....the front third, requires a bit more precision, start about an inch behind the hairline and blend to just behind the hairline. When one gets to a point where they now are seeing more scalp than hair, it is time to hand the baton off to transplants...definitely can't color in a bald spot.

Gram: I definitely do not use it for any claims made on "Procapil". I use it for the cosmetic benefit, easy to apply, not messy and waterproof. Spanker:Product is fill-in Powder for men and I use black. My hair is no where near black, but a perfect match is not necessary, I believe it is best to go darker.

Thanks Thanks Thanks Nice to bring you out of the woodwork, Aaron.

2.5 months out......sitting in the limbo period. Getting by with a little concealer to darken things a bit (but you can't use too much when it is thin) and make things look more uniform. The transition period was my biggest concern going into surgery. It isn't easy plus you are anxious but there are little tricks that can help. It is best to take your mind off the transplant after doing it, until 4 mths because you are just not going to see much. Coping. Here are my 2.5 photos using a concealer.

Spanker In general, I understand completely and agree. I fell into using it one summer when I went too short with my hair on top. I had pale skin and the front third was broken up and patchy. To eliminate contrast and make it look more uniform I started using Dermatch. Initially, I had plenty of hair and the concealer just blocked the visibility of the scalp and if you don't see scalp you look full. Eventually, as one gets thinner one starts to need more of the product and there comes the chance others start to see it, especially in the front. But for some, done right the concealer can walk one right up to the prefect time to do a transplant. You don't color in bald spots with these products they're used for thin areas and preferably not the hairline. In many cases they're great for patients who are pre-mature for a transplant, they're thinner then they want to be but not thin enough to do surgery. The patient sees scalp, but the space may be more due to the hair being miniaturized then actual loss and by doing surgery we may cause more harm then good by knocking out weak hair or decrease the level of improvement where the patient does not see much change. It is not surprising, if one hasn't considered a concealer or are aware of them.....the patient will generally want nothing to do with them because they never thought about them. I was the same. Nearly every patient that has shrugged his head and said I just wouldn't do that. I've changed most of their opinions by showing them what they can do. Ideally, I do feel it is best for the mid and back third of the top of the head or patients who are pre-mature and need to wait a bit longer before doing a transplant. The great thing is it can generally satisfy ones needs in the immediate stages when they're not a great candidate and walk them right up to the point in which they are. If one goals are realistic and they only end up having minor to moderate hair loss they should be able to meet their goals with transplantation, only.

Squatch.....thanks. The right concealer, applied properly can do wonders. I believe being in this industry for 25 yrs. Many patients in order to get their goals meet will need everything.....transplants to add hair, meds to keep hair and concealers to enhance. Ultimately at SMG, I encourage patients to rely as much as possible on meds and concealers for the crown. WHY? Because they work best there and secondly we don't want to use any more hair in the crown than needed, in that we are dealing with a limited donor source, and want to make sure we always have enough to get the front where the patient wants it.

Haircut.....Thanks again, I appreciate the support. Squatch......I have used a concealer that a patient of ours told me about who is a make up artist from NY. It is similar to Dermatch but I feel better, it is called Fill-in powder for Men. The product is softer and applies easier then Dermatch and more waterproof. It is like a shoe polish for the head, it does an awesome job to make thin areas appear full, it is easy to apply, and I have no lack of freedom. I can be as active as I'd like with no fear it will run.....swim, workout, rain, saunas no issue. I've never been a fan of the shake on products.

Here is a layout of my first month and the progress. Showing how I could create an appearance of, more or less, a full head of hair using a concealer and the use of a lite application to help through intermediate transition period.

Pupdaddy....Thanks BUSA.... I understand.......this is how he wore his hair. I did take one with the hair combed straight back as much as I could. He had a fair amount of product (paste) in his hair, which looks good but with the clumping, can make the coverage appear more see through. I appreciate the observation.