Gorpy

Hi Dario, Those are the only two in Arizona that are recommended. You'll have to go outside of AZ for another consult. Try a phone consultation with pictures. Just pick another doctor from the Coalition list.

Dario, I had two procedures with Dr. Keene in Tucson. Both Dr. Keene and Dr. Alexander are high quality doctors. You might have a hard time finding someone who has had your situation. Maybe one of the doctors would have corrected that type of problem. Ask them about it in your consultations.

I posted this about Ian Ziering a while back. Ian, it seems probably had a transplant by Dr. Ziering. I thought his transplant looked good. Though you never know if he was wearing concealers or what his hair looked like before. See my post here. If you can go on line and see some re-runs of dancing with the stars, you'll get a good look at him.

If you read that post carefully you will see that he is doing his own study of laser therapy. He does it for free because as of yet he does not have any evidence that there is a benefit to it. I applaud him for doing this. He has guys coming in 3 days a week receiving this free service. You would think, that if it actually worked, there would be some visible improvement. In his own words he is: "unable to see objective benefits that I can measure."

Slow down there my friend. First of all, if you've been reading this site for 7 months, you would know that you should stay away from MHR. Second, 6,000 for 800 grafts is ridiculously high priced. Consult with one of the recommended surgeons on this site. Gorp

62 is not that old guys.

That looks great Craven. Wow, you did have a high hair count. You had a ton of 2's and 3's. The doctor even managed to find a good amount of 4's, something other doctors have trouble doing. Happy growing to ya.

Dr. Rassman has a very interesting article on the laser comb and the results they were "claiming". See it Here It seems there was a little fudging of the results.

Hi Jagdish, That looks great! Keep us updated. Gorp

It is an interesting discussion. I'm not one to "throw out the baby with the bath water". By that I mean, there are some extremely good things about western medicine and wester drugs created by greedy pharmaceutical companies. On the other hand there is value in holistic approaches. I think a balance is the best approach. I personally take Lipitor, as cholesterol reducing statin created by those evil western pharma's that are only interested in money. Believe me, I resisted this for a long time. I tried diets, including adding this and that. But guess, what? I am just one of those people who creates a lot of cholesterol. I can eat nothing but lettuce, exercise my butt off and my cholesterol will not go under 230 (I've tried). It's in my genes. So, it was either take the medicine or most likely suffer an early heart attack. So, let's go back to the Finasteride issue. Is it a no-brainer decision to ingest a drug - no, it requires some thought. In my experience I've found that if I drink a little too much, it can have a negative effect on the ol' "morning wood". Yet, I've never experienced any negative effect from Fin. So which is worse? Hmmm... interesting stuff. I don't know all the answers, but we all ingest "stuff" that's proabably not good for us. On the other hand, you can eat a normal diet, not be on any medication, not smoke or drink and die at 35 of cancer like my father.

So, God forbid you become ill, but if you do are you going to head East and try their medicine?

Dr. Rassman states on his blog: "The generic minoxidil and Rogaine do have the exact same ingredients. I do not see any difference between the two and their effectiveness should be the same provided that the concentration is the same, and they are using the same inert ingredients. The foam form seems to be better, because of distribution and penetration of the skin."

Yes, you are right about Dr. Alexander, but I think Chibbler was asking about doctors that "do not normally shave the recipient area".

Shapiro Epstein Rose Cooley

I think that's an excellent sign.

Some people are late sprouters. Your hair shaft could thicken up quite a bit over the next 3-4 months. It's hard to say for sure. Wow! You got a fairly small area covered. It looks larger in the picture. But now that you mention the dimensions 12x6, and it appears to be a half circle, we can calculate that area. Your radius is 6cm. Using the old pi r2 formula I come up with a 56.5 area. So, plus or minus a few and yes, you are close to 40 per cm2. Generally I would expect 40 per cm2 to give you a bit more coverage. That's generally what I have now. But like I say, your hair shaft diameter needs to thicken more. I might add that density also depends on hairs per graft. In other words, how many total hairs did you get, not just graft counts. If you didn't get many 3's and it sounds like you got no 4's, then that could leave you thin also.

These things can be difficult to calculate because it's not a triangle and it's not a rectangle. It's not even a 'U'. It's more like a crecent moon. Your post op pics are a little dark and blurry so I could be wrong in my calculations. Your 2 week picture shows an area of pinkness, which looks like more than 50cm2, but maybe the pictures are deceptive. I thought it was deeper than 6cm. A medium sized post it note is 57.76 cm2. Do you think you covered an area smaller than that? If you only did 50cm2 of area, then yes, you got around 40 per.

Hi Creepingback, Looking at your 2 week post-op, I can pretty clearly see where the grafts were implanted. It appears you covered an area of at least 70 cm2. If you only got 2080 grafts, then you are looking at an average density of about 30 per cm2. Plus, just eyeballing it, I would say that 30 per/cm2 looks about right. Combine that with your fine hair characteristics and you end up with coverage, but somewhat thin coverage. Having said that, you are still early at 7 months. Although most of your grafts have probably sprouted, they are still very immature and wispy. They will mature and the hair shaft diameter will thicken over the next year. So you are nowhere near your final result now.

Bill, Joe said ANY doctor who says XYZ is either lying or doesn't know any better. Dr. Keene told me XYZ. That is indirectly saying she is either lying or doesn't know any better. I'm not speaking for Dr. Keene. I'm just telling you what she told me in response to my question on this issue. That's different. Sorry, I will not go into the technical detail of our discussions. I don't have permission to share that. Anyone reading this should feel free to ask her about it, although she is extremely busy. (Keep in mind that if I attempted to get into the technical detail, I would probably make some mistakes, there would be follow-up questions that I couldn't answer, etc. See what I mean? It could become a mess if I tried it.) If you look back at my original argument you can see that I am just saying that there are differing opinions on this among the doctors. So saying something is fact and anyone that says different is lying is not the right approach.

I agree with your assessment Pat. I'm glad you were not transected in your last procedure

chibbler1, Yes, that is in the scope of Dr. Keene. Joe, It's hard to play nice when you make outrageous statements. I don't simply state something "because my doctor said so". Although I do weigh things heavily, analyze various OPINIONS, question things, look for more information, add a dose of common sense and draw a conclusion. I think if you look back, my entire point was that there are varying OPINIONS on this among doctors, so you can't simply state it as FACT. Dr. Hasson's post has been out quite some time now. So I, having a strong desire to get the best transplant available (which I did BTW), asked Dr. Keene about this directly. She stated in no uncertain terms that she CAN see the true exit angle without shaving and that she would NOT transect any follicles. There is much more technical detail involved and I won't even attempt to speak for Dr. Keene in detail. So in essence, what you have done is call Dr. Keene either ignorant or a liar by making your reckless statement about transection. So here you have it ladies and gentlemen. A doctor who is very highly regarded by her peers, given multiple awards, vastly experienced, published, this years chairman of the International Society of Hair Restoration Surgeons' conference and a member of this coalition is said to be ignorant or a liar by Joe. Uh let me think... who am I going to believe, Joe or Dr. Keene? Dang, it's a tough choice.

Joe, you have not really made any valid points here. You just keep repeating the same thing. Point one: I already stated what point one is about and you just repeated what I said. Yes, the "gaps" are more easily identified, but that has nothing to do with transection. Point two: Point two - the point of contention. Point three: Without point two, this point doesn't exist. You seem to be stuck on this idea that a bunch of transection is occurring. Maybe by some bad doctors, but not by the good ones. Point four: It only causes shock if you roughly brush through it. I'm sure that if you are trying to squeeze in a 5000 graft session in one day then that's what the techs have to do. Have you ever heard of gently moving the hair aside? No shock Joe. Point five: We were talking about transection of hairs which is much more serious than temporary shock loss. I don't believe I ever said that transplanting into longer hair is easy. In fact I think it is probably harder. But you're out there claiming that doctors are transecting grafts left and right and they are liars for saying that they are not. That's simply not true. I'm expecting an apology to this community for stating that. I have a novel idea Joe. Have you ever tried to reach out to other doctors to get their opinions on issues? Instead of just regurgitating the H&W song and dance, you might actually learn something.

See my comments after the bullet points. The question you ask about shaving is a good one and one that I would like to address. When you ask if it is necessary to shave the pre-existing hair before surgery- the answer is- "it depends". Depends on what? It depends on the quality of the result that you are looking for. Some patients (and doctors) will be satisfied with a less than optimal result while others will want to achieve the very best result possible. For this long term gain a patient may have to endure some inconvenience including buzzing of the recipient area. "?? This is just the doctor's feeling, like many others, that his method is the best. Nothing new here. There are multiple technical factors that come into play during the creation of recipient sites and the subsequent graft placement. These include: 1.) When thinning areas are shaved down the "thinning process" takes on a different meaning. With the use of magnification it will be seen that some follicular bundles are absent (and there are wider spaces between remaining bundles) and that some bundles are significantly miniaturized. It will then be possible to place new recipient sites in the place of absent bundles and alongside miniaturized bundles to recreate the density. This can also be done in a uniform manner so that if the pre-existing hair eventually disappears, due to progression of hairloss, the transplant can still look reasonably natural. If the recipient site is not shaved the surgeon must part through the hair again and again looking for any empty spaces and trying to fill the spaces as best as possible. This is not really as exact a process but much more hit or miss. "?? This addresses placing grafts next to miniaturized bundles so that when they eventually die, some transplanted hair will be there. The claim is that it is easier if the hair is buzzed. It's not about transaction, but about identifying miniaturized bundles. 2.) The hair exits the scalp at an exact angle. The only way to precisely match that angle is to buzz the recipient hair down (in a way similar to how ALL doctors need to shave the donor hair when taking out the donor strip). "?? This is the point I made that all doctors do not agree with this statement. This is the opinion of Dr. Hasson. 3.) Transection of existing hair below the skin surface is possible if the incisions are not made exactly parallel to the surrounding bundles. We often see this as a "halo" type effect when performing repair procedures. "?? This point is obvious and is related to point 2, IF a transaction were to occur. What is a bit cryptic is the "halo" reference. Typically the halo effect refers to the old type plugs where the central hairs in the plug would be starved for blood and die, leaving a halo of hair. This has nothing to do with transaction or modern transplants. "?? If by the "halo" effect the doctor means that someone stuck a huge blade in an area and destroyed several surrounding follicles ??“ well that just doesn't happen with the coalition doctors so it is a moot point. 4.) When inserting grafts the technicians can easily identify the recipient sites and ensure that all sites are filled. This can be achieved with no trauma to the pre-existing hair. "?? This is about techs finding the recipient sites and not causing trauma. 5.) When hair is buzzed no manipulation of the pre-existing hair is required at all. When the hair is not shaved it needs to be combed through (hundreds of times) by the physician who makes the recipients sites and again by the technician who places the grafts into the sites. This repetitive trauma of combing through the hair again and again will result in "hair shock", a shedding of the existing hair. When this hair falls out in 2 to 3 weeks there will be a 2 to 3 month wait before it returns. Whereas if the hair were buzzed it would grow from day one 1 and keep growing. A number 3 buzz cut often will look good at 10 to 14 days post operatively and blend in with the recipient site well. "?? This is about how the techs find the recipient sites and the trauma they could cause. Bezane, all these factors are relatively unimportant if you are trying to place to 2 or 3 hundred grafts into recipient sites however if you wish to have the ultra refined type of result that Pat Hennessey advocates, the difference will be night and day. I apologize if what I've said in any way contradicts what others have told you but I feel you should hear this from the doctors who basically developed the process you know as "ultra refined follicular grafting". "?? More salesmanship I have attached photos of a patient who has undergone a mega (mega mega) session into a large area of thinning scalp- before and ten days after surgery. Hopefully my reasoning will be self explanatory. Sincerely, Victor Hasson MD"

While this is nice of you to post this, it only addresses transection in one spot, point 2. That is exactly where I was saying there was contention. Some say you can only see the exact exit angle by buzzing the hair others say that's wrong. Who's right? It's just differing opinions, not facts.

How 'bout a pic of me with my mom. Will that do?