Jotronic

B, You might want to lighten up on those exercises for a while. I don't want you doing them vigorously until six months post-op from HT #1. Let the donor area heal my friend then get busy.

B-spot and Gorpy, I respectfully disagree regarding hairline graft placement. It depends on the technique used for making the incisions and of course experience. Using our clinic for example, when using the lateral slit technique the grafts can only go in one way. The incision site is made by blades that are custom cut to the size of the graft going into it. This means not only the width but the depth as well. When the technicians are placing the grafts the grafts go in to that depth and are snug. They will not deviate from the direction and angle pre-determined by the doctor's incisions.

wesley949, I experienced the same thing. My first two procedures in the early nineties left my donor area permanently numb. After my first with Dr. Wong the feeling returned 100%. I imaging that the scar tissue was so thick (scars were wide) that they blocked the nerve endings from reconnecting. Each subsequent procedure with Dr. Wong had my donor returning to normal within six to nine months. Glad to hear you've got some feeling back.

"I need a slight bit of density near the crown. " This alone tells me that your crown should be offlimits. If you are not on meds (you didn't say) then start yesterday. At 23 and with only slight thinning there's a good chance your crown could return.

Dr. Shapiro, Great to see you participating on the boards. Dr. Hasson is out of town at the moment but I'll be sure to point our your questions so he can respond when he returns.

Kansas, One needs to consider the FACT that adult men, save for a rare few, simply do not have aggressive temple closure. Aggressive temple closure is only found, for the most part, in juvenile males and females of all ages. Mature adult male hairlines are those that are about a NW2. The Norwood scale starts with 2 as being the basis from which one starts to gauge hairloss. It denotes mature adult temporal recession which is normal and does not necessarily indicate hairloss. This is where one hopes to get with hair restoration without looking like a kid. If you are one that has any thinning whatsoever behind the hairline then aggressively closed temple angles will not look appropriate. It is one thing to be able to dense pack. I see it everyday but it is another in knowing good judgment in the placement. This is not to say that NO patient should have aggressive temple angle closure but as candidates they are few and far inbetween.

Icks-nay on the icks-chay for me too. I've got a woman right now that I'm happy with

Hairbank, It was great to meet you. I only wish I had more time to talk but I gathered that you were in good hands (per usual). I have to say, when we were chatting that I couldn't help but compare you to a kid at Xmas. You had a bad case of perma-grin going on I'm envious of the crown placement as I looked at it quite a bit before I went back to my office. Maybe it's time for me to get a fill in to match yours? Anyway, good to know you enjoyed yourself and please do update your progress. I know others here are anxious to follow along.

bennstu, You know, what you say is very important and spot on the money however you have missed the remark regarding scientist. He is not the only much less the first to document his progression. Way back in 2002 I started my site that is still up today. Do a Google search for Jotronic and you'll find it. On the Hasson & Wong website you'll see a link to patient stories. Almost thirty patients in total that have done the same thing and I believe there are perhaps about twenty more that I have yet to have time to set up links to. In addition, this site was started in the very same manner and it grew into what it is today. Again, good post but I think you should take a few moments to look around. You'll see more documentation than you may expect.

Kendall, Hairbank, and KG007, Shall I arrange for a Hair Transplant Network party when you guys get here? Anyone else want to come?

Perfect Few, "Bosley should give away a free jar of vaseline with every appointment, otherwise I think the "ride from behind" will be a little rough." Heck, I'd like for you to be a patient of ours just so I can meet you in person. I 'bout fell out of my chair on that one. Good for you for finding this site. You mention a few points that I think are worth touching on. Flash photography. Yeah, it does make the hair look thinner, from the top. It makes the image flatter and shows more scalp. However, if you take a flash photo from the side of the hairline or directly at the hairline it usually makes it look much thicker, by at least 50%. While I won't go so far as to say that some clinics literally alter their photos I will say that some will use flash to their advantage. If you ever want to know if flash was used, look for a slight shadow outline either to the left or the right of the patient. It's almost impossible to hide completely.

Guitar Player, I'm not aware of this. Trichophytic closure only adds a few minutes to the procedure. Once the strip is removed it only entails the trimming of a few millimeters along the edge of the bottom side of the wound. Instead of a right angle on the bottom half of the wound there is a "bevel". A few rows of hair are cut (not transected, just shortened) and they eventually grow through whatever scar forms. I'll try to put together a visual representation of how this works soon.

ifloss, Honestly, I don't think it would be. I searched hardcore for several minutes with a comb and saw NO evidence of ANY scar whatsoever.

Pat, Thanks for the props. We will be utilizing video more in the future for these and other types of results. With respect I need to ammend the information regarding the closure. The closure that we employ is a version introduced by Dr. Frechet in France. He trims the lower ledge of the wound to a bevel so the upper edge overlaps the lower edge. We then employ a few modifications that we have added. Dr. Marzola in Australia has been using a version of this as well however he prefers to trim the upper edge so that it is overlaped by the bottom edge. The "Ledge" technique is, I believe, unique to Dr. Rose where instead of a bevel he creates more of a "step". We reviewed all techniques and opted for our current version based on the work of Dr. Frechet. We made some minor modifications that we feel have improved this overall excellent technique.

All, Over the years innovations in this industry emerge that warrant investigation and review. Any clinic that wants to offer the best methods and care for their patients will consider these innovations and make the call as to whethor or not it is something that is truly benefitial. To Hasson & Wong most of these innovations have fallen short of their promises and have not offered true advantages for the patient. In some cases they were even counter productive. If we are going to change our methods or add to existing methods we must know that it benefits the patient and truly improves some aspect of the final result in some obviously measurable degree. One such innovation that we reviewed was the trichophytic closure. After extensive consideration of the evidence provided it was obvious that this relatively minor adjustment to our existing closure method made sense. We hope you agree. The following link highlights our first documented result thus far with more to come as we have more patients return for follow-up visits. The file is just under 7mb in size. Anything smaller would have jeopardized the quality of the video which for obvious reasons I simply could not do. Here is the link... Undetectable Scarring With Tricho Closure

D, Uh, me working for a clinic has nothing to do with my posts. I did not say that you should not go to him. I did not say to come to my clinic. I shared with you some common sense issues that apparently, to you, are not common sense. Regarding the papers and research comment, you pointed to a doctor with the Hershey Medical Group (name?) with great "credentials" and used the reputation of this medical institution as backup for your decision. I was addressing your choice of reference, not Dr. Pistone. Your comments about my motives for addressing your case are out of line but if that is how you operate then so be it. At least you are going to try Propecia so at least one of our suggestions got through to you. What is odd however is how you attack me for working for another clinic and that my suggestions must be some kind of subterfuge yet many others have chimed in with the same advice. Whatever could their motives be? I'll part by saying good luck and check back with any questions you may have after your procedure. I hope you will at least share some photos with us showing your post-op and continuously developing results as the days and months go by.

d, The problem here is that you think anyone with "MD" after their name, has a few papers published, and can pick up a scalpel can do a quality hair transplant. Considering what time and effort goes into getting a paper published how many procedures do you think he may have fit in "on the side". Truth is, the world's leading dermatologist regarding hair disorders also performs hair restoration not too far from us. We routinely correct his work in our clinic and he's gotten to the point where he just refers patients to us instead. I'll pose a question to you and leave this alone. Would you rather deal with someone that writes and researches about art and maybe dabbles in it from time to time or would you rather deal with Picaso or Van Gogh? D, I and others have given you sound advice. It is up to you to decide whether it is prudent to heed this advice and at least wait to learn more. I can't for the life of me figure out why one wouldn't want to take more time to make sure they're making a good decision, especially when this is a permanent procedure and cannot be reversed unless they are impatient to regain something that maybe hair cannot give. Remember, I'm not telling you to not get a procedure. I'm telling you to learn all you can about this (considering how you didn't even know about the scar)so that there are no surprises, either now or in one year when it's finished growing in. I'm not trying to sell you on something and this is not a simple opinion. I have 8000 grafts. I've been through five big procedures and I've seen and spoken to hundreds of patients and keep up with and witness in person all the latest techniques and procedures. The others here that have chimed in have also done their fair share of research and have been through their own experiences. Forums like this allow us to share our knowledge and experience so that newer guys like you don't make the same mistakes that some of us did. I've done all I can for you. It's up to you now to try and figure it out.

d, Sorry I've been out of the thread. Gotta sleep, gotta work Ok, I'm going to take a moment to break this down for you. Once I'm done, if you have more questions you should call me at my office. Now, being 20 for a hair transplant is not necessarily THE biggest factor in why a doc should turn you down. IF any work done is conservative then it can sometimes be ok. What I mean by conservative is by taking the younger patient and working on him as if he's a NW6. High, mature hairline without 5000 grafts being thrown into the hairline for density. The future is what must always be considered and if it is done with this in mind then the patient should be *safe* from any future embarassment save for some more thinning. Hairline design: Hairline design must be custom for each patient (duh). Facial structure is the big one to consider in this as well as native donor density and a few others. Age however is not a big factor because the patient will ever continue to grow older. This is why a young, immature hairline is a bad idea. Low hairlines and filled temples are found , for the most part, on juvenile men, females in general, and primates. You are relatively young now and in between the transition from juvenile to adult male. Filled temples are what distinguishes female hairlines from males. You don't look like a woman to me and you certainly don't look like a primate (unlike some guys here, KIDDING). As men make the transition from juvenile to adult, the temples recede to somewhat of a right angle relative to the hairline. Even men with no hairloss have this happen to them. It is normal. It is the very rare individual that has their juvenile hairline throughout life (Ronald Reagan) and even more rare that one thins elsewhere on the crown or vertex while maintaining their orignial hairline. It just doesn't look *right*. Propecia vs. Procerin: You said that you've been on Procerin for four months. That is not enough time to see much hair fall out even if you were taking nothing at all. You can't say that your hairloss has stabilized because not enough time has passed to see anything significant. Like I said, put it in the cabinet and get on Propecia. Actually, you want Proscar (orginal version). It is 5mg compared to Propecia 1mg. You simply buy a 5.00 pill cutter and divide into quarters then take only one piece. They cost the same for 30 tablets so this will reduce your cost by 75%. This is THE standard and is so for a reason. It works. Shockloss: Shockloss can occur for a few reasons. Gorpy did a good job on telling you this but I'll add my version. Yes, if you have miniturized hairs then they can be shocked out permanently from the procedure. These are hairs that would have fallen out anyway in six months anyway and their cosmetic significance is usually low. There is permanent shock though to healthy hairs as well but that is from transection. Transection occurs when the instrument used for making the incisions (usually a needle) crosses into the path of a native hair thereby killing it. The ONLY way to avoid this on a large scale is to shave the area that grafts will be placed. When the hair is shaved the true angle and direction of hair growth is evident. This allows the doctor to more precisely match up the angle and direction of the incision with that of the neighboring native hair. NO doctor can dispute this with any sort of logic and I'll be happy to debate it here with them. I have more than enough photos and big words in my arsenal. Once the new hair starts to grow it matches the original native hair save for *maybe* being a bit larger in diameter. Oh, almost forgot. The "Hershey" people know two things about hair transplantation. "Jack" and "squat". I can name more docs than I care to count that have great credentials and are recommended by great institutions but they perform subpar work. It may be good enough to not be as obvious as a bird's nest on your head but it simply is not very good. The people that make these recommendations do not know good hair transplant work. Their recommendations are about as valid as a dentist recommending a heart surgeon. What you need to use to consider a surgeon is your eye. Learn what makes a HT GREAT, not good. Learn about how hair grows, angles, directions, hair shaft diameter, etc. If you want to still get a HT then good luck to you. Again, I am not saying anything negative about Dr. Pistone because I have never seen nor heard of his work. I am however saying that if he is the one for you then he will still be around in six months or a year if you decide to hold off and do some research. He looks to have a thriving practice (two offices) so he's not going anywhere.

d, No, I have not heard good or bad about Dr. Pistone save for what Pat mentioned in this thread. That is not my point. You need to take more time for research to make sure that you have done all that you can to be as educated as possible. Dr. Pistone may turn out to be the best doc for you, I don't know, but you need to exhaust all the resources at your disposal to make this decision. It is for life. You absolutely MUST see patients in person especially when they all should be so close.

d, You'll look like a boxer? Uh, as many times as I've been in the ring I've never seen this. Have you met any patients of his in person? I mean, he has a clinic in your city, right? You MUST do this before your procedure. Period.

d, If things worsen and you shave your head you'll have a scar to contend with so this option is out. I forgot to mention that nowhere on the doc's site does he even mention FUE (that I could see). The site plainly states "Dr. Pistone has performed over 6,000 procedures."

dh67, Some of the posters may put a lot of stock into what "medically untrained patients" have to say but you are the one that was asking for "thoughts, experiences, and opinions". Remember that you should too because a lot of the guys have been through this, for better or for worse, while you have not. Having said that it appears that your request for input is not really sincere as you have just stated that you not only made the decision to move forward you already gave your 50% deposit. Well, here's my input so take it for what it's worth, (two failed HT's, three great subsequent successes, 8000 grafts total, personally inspected several hundred scalps). Two things medically proven to stop hair loss or regrow hair. Propecia and Rogaine. Put the Procerin back in the cabinet and leave it there. The website for procerin states that some uses see improvement in two weeks(?????). If it worked that good, or even at all, you'd hear about it on the news, just like when Rogaine and Propecia came out. Fact is, DHT inhibition does not happen over night and it takes much longer than two weeks to see new hair sprouting from any DHT inhibitor. "I would think that someone with his medical credentials would know such things." I can point you in the direction of dozens of docs in this industry that have great "credentials" but have not the apptitude for consistently great hair restoration. Now, this is not to say that you will not be happy. I'm simply pointing out the holes in your trust of credentials and marketing hype. The ONLY thing that you should trust is seeing more than one patient in person and look for as many photos that are NOT on his site as possible. If you must look at photos make sure there are no tricks used, such as flash photography, to make the hairlines look thicker. It's and oldy but a goody in the industry. Btw, who administers the exam to become "board certified" in hair restoration? I'll let you do some research into that if you have the time. The answer will certainly surprise you. Anyway, good luck with your procedure and report back on your experience if you can and of course your final results would be great to see in eight to ten months.

Redness is an issue that concerns a lot of patients however I feel it is not as serious as some would say. Yes, the redness can last several months but it is not "red" per se but more of a light pink, something more akin to a light sunburn. On top of that, you will have hair where the scalp is slightly discolored in only a few months. Overall, I have found from personal experience that the discoloration is not something that others focus on as we become hypersenstive to all signs that could indicate something was done. I'm not trying to downplay the issue so that you don't think it is there. I just think that it is not as bad as some may think going in. Of course, this also depends greatly on which doctor you choose, the size of the instruments and of course the technique used to make the incisions. Tanning before a procedure does help however but you do not want to overdue it by getting burned pre-op. If you are only taking one day off from work then you will have to consider the fact that you will not only have a reddish scalp (the pinkness comes a few days later) but you will also have scabbing which is a bit more difficult to explain away. Of course, you can simply bite the bullet and go commando knowing that in six months no one will remember because you'll have hair (I did).

Bspot, Thanks, buddy. It is an incredible feeling to be able to use a... wait, to NEED a hairdryer

Troy, All of the photos taken in our office are while the patient is sitting under direct overhead flourescent lighting, just like you'll find in any office building. This is the WORST lighting for hair transplant photos because it shows all the flaws. Many times people will see patients in person that they have previously only seen via photos. The comments will usually point to how the patient looks better in photos. I routinely hear the opposite of our patients when people meet them in person, that they look better in person than in the photos. Our photos for the past two years have been taken under these conditions and with NO flash photography. For hairlines, flash will add what I approximate as 50% more density. I have examples of this on my own website. Type in "Jotronic" in Google and you'll find it. What you said about understanding densities and what is realistic is spot on. Many times I'll be speaking with someone about what they can expect and they'll ask if they'll have results like Futzyhead or Jupiter etc. They ask this when they are a NW6/7 with fine donor hair and low donor density. People have a tendency to view photos and say "I want that" without understanding that their characteristics, even while having the same hairloss pattern, will lead to something completely different. Hair shaft diameter, scalp to hair color contrast, hair type (wavy, curly, straight) weigh heavily in the final outcome. So much so that one person with 50 per cm2 will look like he has better density than someone with 60 per cm2. This is only one example. Jupiter's results are phenomenal in person and it makes me extremely happy that he has undergone this transformation. On top of that, he's a damn nice guy too, so I know he means it when he says he'll meet up with any of you for a brew and hair chat. I suggest that if any of you are in the Seattle area you take him up on his offer. Me too, for that matter. I'd be happy to meet with anyone in Seattle or Vancouver.