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  1. Today i had my staples removed and it felt like a pressure release, it felt great. Dr. Haber was not in the office today. I talked to Jessica, who I would consider Dr. Haber's Right hand Women. She said everything looked good. When I got home I noticed a lot of crust on the tips of the grafts, So I got my hands all soapy with Baby Shampoo and gave myself a gentle scalp massage. What do you guys think. You can see all my daily updates if you click on my name..
  2. Hi folks, I am new to this type of forum so please bear with me. I had hair transplants procedure back in the earley 1990's. It was 4 procedures that resulted in 1000 mini and micro grafts. To my misfortune the procedures were performed by a Doctor that is not listed on this web site. The grafts are horrable to look at. I have had these grafts for over 15 plus yrs. I live in the Cleveland Ohio area and have consulted with Dr Robert Haber. I have to say, Dr Haber is a straight shooter who was very honest with me. I only wish I had met Dr Haber 15 yrs ago. Dr Haber said I was a good candidate for surgrey. I am a NW 6 my balding is like Jotronics of Hasson&Wong fame. I am 45 yrs old with average donor hair and good laxity. My question, is the results that guys like Jotronics and Bobman of Hasson&Wong a fluke or can NW 6 folks like myself get the same results or something close. I want to say the folks that this message board have been a real help and inspiration. Please excuse my grammer and typo errors. Johnny4hair
  3. Thanks everyone. I couldn't be more happier! My hair in the photos at 1 year is longer then I usually keep it. I will post more photos this week of what it looks like shorter. @KM77 - I would highly recommend Dr. Haber from my looking at my results. But after reading post after post on HT's...everyone's outcome seems slightly different. I guess it all depends on the individual. As far as advice.....If you don't already know....Dr. Haber will excise the donor strip and make the recipient sites, His techs separate the grafts and then place the grafts into your scalp. At least this is how mine went. I think a lot of people think the Dr. will do it all. But from what I read this is standard. Also, the HT takes a while depending on how many grafts you are getting. (Mine took all day) So bring a couple of movies to watch. If not, they have a decent selection on hand. They will also provide lunch. They let me choose from a menu of a local place and let me and my wife eat in private in one of their offices. The biggest advice I could give anyone getting this done is to have PATIENTS! Just relax, let the Dr. and Tech's do their thing. Then sit back and wait for your results. Most will say "visible results in as little as 4 months". However, mine took 6 months. This is where the "patients" part really comes into play. Well, I hope this helps a little and good luck with your HT with Dr. Haber. Looking forward to seeing your results.
  4. Yes, i had the artas procedure. Dr Haber and his staff were great, no complaints at all. I had 1126 grafts with the breakdown in my first post. Dr Haber made all the incisions the day before. The following morning all the grafts were extracted from the donor area and then transplanted by the nurses.
  5. Congrats. I am also considering going to Dr Haber, from the comments that I have read on this site he has a very good reputation. It appears that you had the FUE procedure? Did Dr Haber use the machine to implant the follicles from the donor area, or did he do this manually? Over all, how many grafts did you have done, and how long did the procedure take?
  6. John, There is plenty of solid evidence on this forum that Dr. Haber is a world class medical professional with a proven track record of excellent results. Our Publisher Pat Hennessey even visited with and observed Dr. Haber in live surgery and was impressed with the quality of care he provides his patients. See Pat's Visit to Dr. Bob Haber's Clinic. I think if you are going to make such defammatory remarks, you need to have just cause. And since you haven't had surgery with Dr. Haber and no very little about his practice, it appears that you are just angry because he won't support your legal case against Dr. Weiss by signing the affidavit you requested. We understand you are upset. But you are not going to use this forum as a means to slam high esteemed doctors simply because they won't help you win your lawsuit. Bill
  7. Burned, First, I am sorry to hear about your poor hair transplant experience. Having said that, it does seem like - by the time you reached Dr. Haber - your case was complicated, and I'm wondering if this affected the final results? Regardless, I truly believe sharing some images of your hair restoration journey and final result would help the community analyze your case and come to an informed conclusion. What's more, I'm sending Dr. Haber an emailing explaining the situation and asking for him to review and leave a comment. Again, I am sorry to hear about the poor experience. If there is anything I (or any of the other moderators) can do to help, please let me know!
  8. Here's some comments posted on 7/25/2012, that basically summarize my history of hair transplants/doctors/having comparison photos/etc. These were made under another username I have, but forgot about until this morning. Having not posted much on any or many hair loss message boards and basically trying to forget about the bad procedures, I somehow came up with 2 usernames with different emails. They are HT3 and Burned. From this day forward, I will use Burned only. I think in many cases, after having a hair transplant, the patient sits back for some time (I know I did) and after complaining to the doctor about being unsatisfied, is told things like "don't worry, time will take away the pits at your placement sites" or "we have some things here in the office we can use to help with the healing process" and the next thing you know, it's a year or two gone by. Then the doctor drops all offers of support and the patient who's been "burned" doesn't have much other than words to back up their disappointment with the doctor. I've had some transplants. 1 with Robert Bernstein was the best ever and did a lot to cover up the bad transplant I had before that. It doesn't change that the 1st transplant was terrible!!!!! Do I have photos to document my 1st transplant? No. After Bernstein, I had another with Francis Badamo. He was hired by N.H. I. (Bernstein/Rassman) and after being promised by staff that Dr. Bernstein would oversee this procedure, he wasn't there that day. Result? Badamo had some difficulty with placement direction of the hair. What was I told would help this? Start plucking. I've plucked and plucked and plucked and they continue to grow. The plucking plan was offered as they will come back thinner and thinner, then not at all. Never happened. My last transplant with Dr. Robert Haber was where I got all the pitting at the placement areas. It's next to impossible to show in photos, due to the Dr. Bernstein Transplant still holding up the "masking". Dr. Haber is the doctor who made the comments in my 1st paragraph and then after the healing/pitting never changed told me "it's caused from you getting transplanted so much" and the procedures that would remove the pitting (lasers/injections) would not work (lasers) and were only temporary (injections). It was a very different attitude than a few months earlier and a whole new agenda for the doctor. Can I prove this to this message board with photos, dates, etc.? Not most of it, but my point here is many folks who have inferior transplants are in the same boat. I forgot to add, after Dr. Bernstein left N.H.I., I decided to complain about Dr. Badamo (since fired from N.H.I. I believe) to Dr. Rassman in California as my wife & I were going to be in LA for another reason. Basically, Dr. Rassman couldn't be taken seriously and just joked & joked with me and gave my hair/scalp a view and said I had almost no miniturization. When I kept pointing him back to being serious about the hair direction, transplanted by Dr. Badamo, he agreed to give me a 10% discount on future transplants, but stressed, "if I needed one". Again, my point here is I'm not making this stuff up, but can't back it up with photos on this board. I can't say enough good things about Dr. Bernstein. Healing/direction of hair transplanted was great. My only criticism, if any, would be too conservative for me. In closing, I'll be more than happy to meet/speak to anyone considering trying the other doctors. The pitting can be seen fairly well when close up and in proper lighting. Thank you and I look forward to participating a bit more here if I can. I am considering Dr. Rahal if and when I go for the next one and trust me, I'll be doing photos and keeping much documentation this time.
  9. for what it's worth have been emailing all the so called top ht docs re: current use prp (+-acell) and so far general concensus is not good. not good for me cuz i really wanted to try but not now and going to save my money. the following is just a sample email reply i rec'd which pretty much sums up the general feelings among majority of other top ht docs who replied back to me. buyer beware is basically what they are all emailing me. at least the docs who took the time to email me back were honest and ethical. Email from Robert Haber, MD "Jerry Cooley and Gary Hitzig are both friends of mine, but I am not aware that either of them are claiming that ACell and PRP are reliable treatments for hair loss. Unfortunately, there are no reliable unbiased studies that support the use of either of these treatments at present, so all results and claims are anecdotal. There are also a variety of methods of producing and administering PRP, so there is no standard protocol that all surgeons use. The only two products that have passed FDA scrutiny for hair growth are finasteride (Propecia) and minoxidil (Rogaine.) LLLT is very likely to grow in popularity as clinical evidence of effectiveness is reported. We are hoping to achieve FDA 510(k) clearance in the near future for the LaserCap. The most effective treatment to date is finasteride (which I've been taking myself for 12 years without a problem) and while I certainly respect your decision not to use the drug, you will most likely experience a slow progression of your hair loss over time. Ongoing treatments with ACell and PRP over many years would far exceed the cost of LLLT as well as surgery. Each doctor will have slightly different methods of obtaining and administering PRP. ACell is the same for everyone, but administration techniques may vary. Most ACell is use at the time of surgery in cases where there is a concern about hair growth. It is gone very quickly, and would be prohibitively expensive to use for ongoing hair loss treatments. There is no formal training for ACell or PRP. These techniques are discussed at our meetings, and sometimes a doctor will arrange to visit a colleague to learn a particular technique. Some doctors offer PRP purely to make money. If you choose to undergo these treatments, choose a doctor recommended by *both *the IAHRS and the Hair Transplant Network, making it more likely to end up in the hands of an ethical practitioner. I use ACell during surgery in selected cases. I personally do not offer PRP, as I have seen no data whatsoever to support its use. Sincerely, Robert Haber, MD
  10. I went to bosley I live outside of Cleveland ohio interviewed dr haber in Cleveland with 20 yrs exp. and rewards also interview a bosley dr krenitsky in Columbus ohio couple hour drive for me hes been doing hair transplant at same location since 2002 I decided 14 years same location still there cant be all that bad. but ill let you all know soon enough
  11. Joe, I think this patient got great results from Dr Wong. This guy does not look creepy. He is just an average guy trying to improve his hair. i think he looks great and it is another outstanding job by Dr Wong. Hasson&Wong, IMO are the best in the field of hair restoration. Joe, you put yourself out on this forum and others forums which shows that you and the clinic you work for have nothing to hide. I have the greatest respect for you as a patient advocate and Hasson&Wong! I am leaning toward H&W for my future HT! I live Ohio where we have a fine Doctor in Dr Bob Haber. But I have to say I haven't seen the results from Dr Haber that I have seen from H&W. That is not a knock on Dr Haber, he is a great HT Doc, but no one can dispute the work of H&W Keep up the great work! Johnny4Hair
  12. Hi everyone, I was really happy when I found this forum, because I got lots of information regarding HT's. I am 27 years old and I am experiencing hair loss from age 20. Right now I am at level-3 on NW scale. I had a free consultation with Bosley and planning to have a HT in December, 2007 with Bosley, Philadelphia. Doctor's name is Dr. Eric Carlson. Meanwhile as I stay in Cleveland, I am also planning to consult Dr Bob Haber in Cleveland, Ohio. I need your inputs regarding Bosley and Dr. Haber's clinic. Bosley Consultation: 1. They said I needed 2400 grafts. 2. They are charging me $6 per graft. Questions: 1. How good are Bosley with HT and especially Dr. Eric Carlson? 2. What is the reputation of Dr. Bob Haber and how much does he charge? 3. Anyone undergone HT with Bosley or Dr. Haber? Please reply back to me ASAP as I need to make an appointment for the HT. Friends this is really an important decision in my life and please get back to me. Thanks, Maddy.
  13. I think in many cases, after having a hair transplant, the patient sits back for some time (I know I did) and after complaining to the doctor about being unsatisfied, is told things like "don't worry, time will take away the pits at your placement sites" or "we have some things here in the office we can use to help with the healing process" and the next thing you know, it's a year or two gone by. Then the doctor drops all offers of support and the patient who's been "burned" doesn't have much other than words to back up their disappointment with the doctor. I've had some transplants. 1 with Robert Bernstein was the best ever and did a lot to cover up the bad transplant I had before that. It doesn't change that the 1st transplant was terrible!!!!! Do I have photos to document my 1st transplant? No. After Bernstein, I had another with Francis Badamo. He was hired by N.H. I. (Bernstein/Rassman) and after being promised by staff that Dr. Bernstein would oversee this procedure, he wasn't there that day. Result? Badamo had some difficulty with placement direction of the hair. What was I told would help this? Start plucking. I've plucked and plucked and plucked and they continue to grow. The plucking plan was offered as they will come bak thinner and thinner, then not at all. Never happened. My last transplant with Dr. Robert Haber was where I got all the pitting at the placement areas. It's next to impossible to show in photos, due to the Dr. Bernstein Transplant still holding up the "masking". Dr. Haber is the doctor who made the comments in my 1st paragraph and then after the healing/pitting never changed told me "it's caused from you getting transplanted so much" and the procedures that would remove the pitting (lasers/injections) would not work (lasers) and were only temporary (injections). It was a very different attitude than a few months earlier and a whole new agenda for the doctor. Can I prove this to this message board with photos, dates, etc.? Not most of it, but my point here is many folks who have inferior transplants are in the same boat.
  14. Each year the International Society of Hair Restoration Surgery (ISHRS) holds its annual scientific meeting to discuss hair loss and advancements in medical and surgical hair restoration. This year, the ISHRS meeting was held in Chicago. As always, we interviewed a number of recommended physicians in order to provide our members with their input on the meeting. These highlights have been presented on our popular Hair Loss Q&A Blog. As you might expect, FUE was a hot topic again this year. A number of FUE related topics were discussed including; body hair transplantation, a comparison of strip vs. FUE yield and the advantage of pre-making FUE recipient incisions before harvesting among others. To learn what's new in hair restoration from expert hair transplant surgeons, see: Highlights from the 2015 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting in Chicago Physicians directly contributing to this article are: Dr. Mike Beehner Dr. Robert Bernstein Dr. Tejinder Bhatti Dr. Jean Devroye Dr. Robert Haber Dr. Bill Parsley Dr. Damkerng Pathomvanich Dr. Sanusi Umar Dr. James Vogel We hope you enjoy reading about these interesting developments. All the best, Pat, Bill and Dave
  15. Hi Everyone. This my first post on this site. I have been lurking around for a long while and thought I'd share my story and HT results. I had a HT just over a year ago and I'm very happy with my results. My experience was a good one. Although I have to say I feel lucky to have had these great results. It seems a lot of people do not. I really think doing research and gathering up all the information I could find assisted me with my decision and positive results. My Story: I'm 43 and started losing my hair almost 10 years ago. Not fast....just typical receding and thinning over the years. But it really bothered me. Especially these last few years. I started spending more and more time on it in the morning using hairspray and a blow dryer just trying to cover up what was happening. It got to a point where I wouldn’t leave the house until it was just right. Then it started to effect my personality. I lost confidence in my appearance and fell into depression. So I started searching the internet for hair restoration options and stumbled on to Hasson & Wong's website. I was blown away by the blogs with HT results. I knew I had to look into this further. I then found the hair loss forums and my life changed...I had hope! I also had support for what I was feeling. I was not alone!! I did a lot of research and looked at just about every post related to HT’s. By the time I made my decision to do it...I felt like an expert on the subject. However, I needed to find the right doctor. Again, I searched and read reviews on a lot them. I made my choice based on several things (doctor’s results/reviews, travel, down time, cost, etc.) I picked Dr. Robert Haber and made an appointment. He put me on FIN immediately. (3 months pre-op) I probably should have been on it years sooner. I let my hair grow longer in back for the surgery so it could help hide the donor site once complete. I took 2 weeks off work and scheduled my surgery for a Friday so I would have 16 days to heal as much as possible before returning. (I work in an office environment and can’t wear a hat.) I also asked the Dr. not to shave the donor area or the recipient area. Again, I did this to help hide the HT once complete. The surgery was a breeze. Although it did suck to have to sit there for so many hours but other then that it was easy. The first 2 days post-op were a little painful and the tightness in my scalp was weird feeling and annoying but that went away within a week. Not much swelling at all either. On the 15th day post-op my hair stylist shaped my hair to help hide the HT. Not much she could do to the recipient area but she was able to hide the donor scar real good. With some Dermatch and my new haircut, I returned to work without so much as a question as to what I did. Either people really didn’t notice or they were just being nice not to say anything. My wife said she couldn’t tell. I did everything I was asked to do by the doctor pre and post surgery. There were no surprises before or after the surgery. Here I am 12 months later and I am completely stoked on my results. I don’t even need Dermatch anymore. My only regret was that I had this done at the end of April which made for a rough summer. Special thanks goes out to Dr. Haber and his staff for their great work. Here are some pictures of my journey. 1 year
  16. Whacked How many grafts are you needing?? What did Dr Haber tell you?? FUE is a great surgery, however if you are needing a BIG case you will probably be better off going with strip!! FUE definitely has its place in the industry, but strip still produces top notch results in the best of hands...ie Dr Haber... If you are dead set on FUE...look at Dr Shapiro, Dr Feller, or Dr Rahal!!
  17. It's been about a month since my surgery with Dr Haber. The surgery itself was rather long (I had 2700 grafts or so) but not unpleasant or painfull. I went back to work after 5 days and didn't think it was noticable. I had somewhat long hair at the time though and had been combing it over the recipient area for quite awhile. I really liked Dr Haber and his staff. Every effort was made to keep me as comfortable as possible, and I was very comfortable. I must say, I know it's only been a month, but I'm really nervous. I'm starting to get some shock loss and it's a little scary. I really like the hairline that was built for me, but again, I'm still nervous. I'll update in early summer or so.
  18. Well, Dr. Konior has my money so you know who I'd recommend. If you want to talk about credentials, Konior founded the American Board of Hair Restoration and is certified by the American Board of Facial Plastic Surgery. Konior is a plastic surgeon first and foremost, Haber is a dermatologist and pediatrician. So, in the end it's about results, but Dr. Konior has an impeccable resume and is a Fellow of the American Board of Surgeons. Go with your gut. Not your pocketbook.
  19. Konior is MORE POPULAR that Haber, though... Seriously, who did you feel really listened to your concerns and questions and you feel will help you set realistic expectations?
  20. I certainly think Ray Konior is a great physician, but Bob Haber has a number of credentials that sets him apart from the field. Past President, Board Member, and various committees for the ISHRS Maintains clinical appointments and active in research Past editor of Hair Transplant Forum Prolific Inventor Selected top physician by ISHRS and he has performed thousands of HRS, with great patient satisfaction
  21. Gettinold, Stay with Dr. Haber and forget Nuhart. Seriously dude it's your head if u want a future of costly repairs.. There isnt going to be much of a difference in graft count if u consult with clinics like Haber, SMG, Konier or True and D. U pick any of these u will be safe and they have yr best intrests in mind.
  22. Recently, the Publishers of this community attended the 16th annual ISHRS scientific meeting held in Montreal from September 3rd to the 7th. See the official Press Release. Though many topics were discussed, this report will highlight topics that may be of most interest to hair loss sufferers. Many of these topics have been discussed and debated by patients for years on this hair loss forum. Topics include optimal hairline design and density, minimizing the appearance of the donor scar, using all follicular units (FUs) verses some multi follicular units (MFUs), FUE Megasessions, and complications with perpendicular (coronal/lateral) incisions and dense packing difficulties. There was a brief presentation on advances in hair biology discussing the latest research on cellular and molecular controls of follicular development and growth. However, because the Publishers of this community were not able to attend this presentation, this report won't contain any new information on this topic. The attention to detail at these meetings is certainly very impressive and surgeons who regularly attend deserve to be commended for their dedication to continuing education. Background on the ISHRS and Meetings The primary mission of the ISHRS (International Society of Hair Restoration Surgery) is to educate hair restoration physicians from the beginner to the master. It is by far the most prominent hair restoration professional organization in the world and the host of the five day annual scientific meeting. Their website (http://www.ISHRS.org) provides useful information about hair restoration and profiles and contact information for its 700 worldwide physician members. Many of the physicians well recognized by patients online for achieving excellent results have also become well known and respected by their colleagues as leaders and teachers in the industry. Many leading physicians recommended by this community led or were a part of every discussion panel. This year, Coalition member Dr. Arthur Tykocinski of Brazil did the hard work of chairing the meeting with help from his co-chairs. Last year's ISHRS meeting was chaired by Coalition member Dr. Sharon Keene of Tucson, Arizona. At the meeting, recommended surgeon Dr. Bill Parsley of Louisville, KY replaced Coalition member Dr. Bessam Farjo as the acting President for the coming year. Physician Recognition and Awards: The "Platinum" and "Golden" Follicle The "Platinum" and "Gold" follicle awards are the highest honors given to leading surgeons in hair restoration by the ISHRS at each meeting. These awards recognize outstanding achievement in basic scientific or clinically-related research in hair pathophysiology or anatomy as it relates to hair restoration. This year, two outstanding physicians have been recognized by their peers and given the highest honor of the "Platinum" and "Golden" follicle awards. A special congratulations to Coalition member Dr. Jerry Cooley of Charlotte, NC who received the Platinum follicle award and Coalition member Dr. Paul Rose of Tampa, FL who was given the Golden Follicle Award. These two surgeons have been recognized for years by their patients online for consistently producing excellent results. No wonder their peers have recognized them as leaders and teachers in the hair restoration field. Both surgeons were respectfully given a standing ovation by their colleagues. Based on the outstanding reviews online by their patients, had they been there, the applause would have shaken the foundation. Presentations at the ISHRS meeting of particular interest to Hair Loss Sufferers: Hairline Design and Optimal Density Natural hairline reconstruction is probably one of the most important factors considered by prospective patients and one of the greatest challenges hair transplant surgeons face on a daily basis. Combining numbers of grafts with artistic design, a surgeon must recreate an age appropriate, natural looking hairline with suitable density to achieve an optimal cosmetic improvement. Hairline Design In a hairline demonstration panel discussion led by Dr. Knudsen of Australia, a few top surgeons in the field including Dr. Ron Shapiro, Dr. Arthur Tykocinski, Dr. William Parsley, and Dr. Walter Unger presented their approach to hairline design on the same few patients for compare, contrast, and discussion. Though each hairline design was aesthetically pleasing to the eye, each hairline was uniquely and creatively crafted based on scientific principles of measurement and individual experience and artistry. Patients needing hairline reconstruction should discuss a surgeon's approach with those they are considering and look through patient photo galleries that demonstrate their artistry. Hairline Density High density hair transplants are often hyped online giving forum members the impression that surgeons who produce the greatest densities (in FU/cm2) are the best in the industry. But are higher densities always superior? What about in particular for the hairline? In a presentation and discussion led by Coalition member Dr. Sharon Keene on maximum verses cosmetic densities, a few leading hair restoration physicians presented varying densities. Surgeons representing the 35-45 FU/cm2 side of the debate include Coalition member Dr. Robert Bernstein, recommended physician Dr. William Parsley, and Dr. Walter Unger. On the 50-70 FU/cm2 side of the debate, Coalition member Dr. Thomas Nakatsui and recommended physician Dr. Melike Kulahci were represented. Each set of photos including those representing lower and higher densities were artistic with attention to detail. So the question remains, are higher densities necessary if lower densities can achieve the same cosmetic appearance? Where higher densities may be needed is when a patient steps under harsh lighting. Hair characteristics surprisingly were not discussed, but plays a huge role in the number of FU/cm2 needed to achieve proper hairline naturalness and density. Dr. Keene believes that studying natural hairline density in non-hair loss suffering patients is the only way to conclude appropriate density needed for the hairline. Dr. Keene suggests based on her anecdotal findings that natural hairline density in non-hair loss sufferers is only between 40-50 FU/cm2 on the average as opposed to the conjectured 80. If her findings prove accurate, surgeons may very well re-evaluate the need to densely pack greater numbers in such a small area. Before Dr. Keene feels comfortable drawing final conclusions however, she intends on increasing her sample size to at least 50 subjects. Creating an Optimal and Invisible Scar Minimizing the appearance of the donor scar is a high priority for most hair transplant patients and leading hair restoration physicians alike. That's why creating an optimal donor scar is a hot topic not only on our hair loss forum, but also amongst leading physicians at the ISHRS scientific meeting this year. The trichophytic closure technique has been labeled the "Gold Standard" by a number of leading physicians including Coalition member Dr. Robert Haber. This method involves trimming the edge of one side of the wound and overlapping the layers to complete the procedure. This allows non-harvested hair to grow through the wound, masking the appearance of the scar. But should the trichophytic closure technique be used during every hair transplant procedure? Coalition members Dr. Robert Haber and Dr. William Reed admit that there are always exceptions, but advocate its use in all cases "possible" since it increases the probability of a minimal scar. Coalition member Dr. Bill Rassman and recommended physician Dr. Michael Beehner argue that use of the trichophytic closure technique is best reserved for the "last" procedure in order to preserve scalp elasticity for subsequent procedures to come. Surgeons agree that the trichophytic closure technique is best implemented with minimal tension to reduce the risk of scar stretching. In the event of a difficult wound closure, even those presented advocates of always using the trichophytic closure technique will use a standard closure to minimize tension on the wound. It makes sense to preserve scalp elasticity for patients intending to have multiple procedures however, whether or not the patient will return for subsequent sessions is not guaranteed. All Follicular Units verses Mixed Grafts Since the advancement in hair restoration and the preference by many leading hair restoration physicians toward all follicular units (hairs as they occur naturally in the scalp), there has been some debate on whether or not it's acceptable to mix multi unit grafts (called MUGs) with follicular units (FUs) and still create a natural looking hair transplant. Multi unit grafts contain follicular units similar but distinct from minigrafts. However, when MUGs are carefully trimmed under microscopes into refined double follicular units (DFUs ??“ two distinct follicular units very close together) or follicular families (follicular units in close proximity), MUGs are often much smaller and can be easily camouflaged. Old school minigrafts are typically bulkier even though they may or may not contain the same number of hairs as MUGs. Arguments for using all follicular units include creating the most natural looking head of hair without appearing "pluggy" or "grafty" and the ability to densely pack grafts close together in a single session. Advocates of the occasional use of MUGs mixed with follicular units argue that the transplanted MUGs cannot be spotted in qualified patients, looks completely natural, and create a greater illusion of density. Coalition member Dr. Bill Rassman admits that using MUGs should be reserved for male patients with blond fine hair and in female patients where scalp to hair contrast ratio is minimal. He also notes that MUGs should also be used in minimal quantity. Some also feel that using some MUGs in patients with gray hair is acceptable. No surgeon on the panel advocated the use of all multi unit grafts to replace follicular units. Perpendicular (Coronal/Lateral) verses Parallel (Sagital) Incisions Perpendicular incisions (commonly referred to as the "lateral slit technique" or coronal incisions) have a number of cited advantages such as maximizing the shingling effect of the follicular units, increased dense packing, and optimizing angulation control of the hair from the scalp. However, as Coalition members Dr. Jerry Wong and Dr. Thomas Nakatsui pointed out in their presentation, there are a few complications to overcome with this technique. While parallel (sagital) incisions slide easily in and out between existing hairs, perpendicular (coronal/lateral) incisions increase the risk to transect existing hair if a surgeon is not extremely careful and accurate. Additionally, perpendicular incisions also tend to disrupt the scalps vasculature more than parallel incisions. Thus parallel incisions transect less hairs and blood vessels, assuming the same size blade. Disrupting the scalps vasculature can lead to an increased risk of avascular necrosis (a disease resulting from temporary or permanent loss of the bloody supply to the bones). Both Dr. Wong and Dr. Nakatsui noted that minimizing these risks include to avoid dense packing in areas of poor vasculature and to avoid making incisions too deep. Dense Packing Complications Large session high density hair transplants are desirable to patients since it typically limits the number of subsequent surgeries needed. And though a handful of leading hair restoration physicians have taken on this challenge when appropriate for the patient, some complications have been cited in a panel discussion led by Dr. William Parsley. Dr. Ron Shapiro and Dr. Michael Beehner shared their experience and expertise on this subject. One debated complication is graft survival at higher densities. Previous studies have been done on graft survival rates that indicate graft survival decreases when density increases. Whereas just about anyone can transplant higher densities, growth yield is debatable. The introduction of smaller blades to make recipient incisions has convinced many leading surgeons that higher densities may produce adequate growth yield, but not in all cases. Dr. Beehner believes that the staff's experience and ability to trim and place grafts safely into recipient sites plays major role in graft survival at higher densities. Dr. Ron Shapiro agrees but also believes that more scientific study is needed. Other complications include increased risk of necrosis, "shock loss" to existing hairs, abnormal distribution of hair in the event the patient loses more hair, and using an abundance of a finite donor source in a concentrated area. Most surgeons will agree that cases exist where extreme dense packing is suitable. But in many patients, lower density hair transplants are appropriate. FUE Megasessions vs. Strip Surgery Most surgeons feel that small sessions of follicular unit extraction (FUE) can be a viable solution for qualified patient candidates. But just as strip surgery has evolved over the years into larger "megasessions", some hair restoration physicians continue to push the envelope with FUE by extracting and planting more follicles in a single session. In a panel discussion on the controversy "Regular" strip vs. "Big" FUE sessions led by Dr. Kolasinski, a few vital issues were discussed. Those who took the "Regular Strip" side of the debate which includes Coalition member Dr. Jerry Wong and Dr. James Harris who is recommended cited a few disadvantages of FUE Megasessions. Unlike with strip whereby a "session" is usually defined by what is accomplished on a single surgery day, an FUE "session" is defined by how many grafts can be removed and planted over several consecutive days. Therefore, a 3200 FUE "session" may sound impressive, but if accomplished over 4 days, the clinic is only averaging 800 follicular units daily. Using the FUE technique, additional forces are placed on the follicle and are removed blindly. Follicle transection therefore, is often higher than with strip, lessening the number of viable hairs for transplanting. Cysts can also form in the donor area and impact the surrounding hairs. Those who took the "Big FUE Sessions" side of the debate cited a few disadvantages of strip. Strip surgery will undoubtedly produce an irreversible linear scar even though it can often be well camouflaged. The danger however, of future scar exposure may occur if a hair loss sufferer loses enough hair to become a level 7 on the norwood scale. No consensus has been reached regarding the viability and maximum hair growth yield when doing FUE megasessions. Therefore, until more proof is provided by physicians regularly performing them to their peers, this controversy will most likely continue. Final Acknowledgements Though attending the ISHRS scientific meeting doesn't guarantee a surgeon is producing excellent results, it appears that most physicians who regularly attend these conferences are dedicated to continually improving their technique and level of patient care. A special thanks to all those physicians who attended the meeting and are working for the best interest of patients. Surgeons who are recommended by this community who attended the meeting include: Dr. Bernardino Arocha Dr. Michael Beehner Dr. Robert M. Bernstein Dr. Tim Carman Dr. Glenn Charles Dr. Jerry Cooley Dr. Robert Dorin Dr. Jeffrey Epstein Dr. Herbert Feinberg Dr. Christopher Gencheff Dr. Edmond Griffin Dr. Robert Haber Dr. Jim Harris Dr. Sheldon S. Kabaker Dr. Sharon Keene Dr. Richard S. Keller Dr. Raymond Konior Dr. Bradley Limmer Dr. Ricardo Mejia Dr. Bernard Nusbaum Dr. William Parsley Dr. Vito Quatela Dr. Bill Rassman Dr. Bill Reed Dr. Paul Rose Dr. Marla Rosenberg Dr. Brandon Ross Dr. Paul Shapiro Dr. Ron Shapiro Dr. Ken Siporin Dr. Martin Tessler Dr. Robert True Dr. James E. Vogel Dr. Arthur Tykocinski Dr. Jean Devroye Dr. Bessam Farjo Dr. Nilofer Farjo Dr. Bijan Feriduni Dr. Melike K??lah?§i Dr. John Gillespie Dr. Thomas Nakatsui Dr. H. Rahal Dr. Jerry Wong If you are a physician recommended by this community and attended the annual ISHRS meeting and don't see your name on the above list, please respond to this thread or contact us at help@hairtransplantnetwork.com and we'll be happy to add your name.
  23. Over at the other forum, no disrespect to Pat and this forum but it took me forever to figure it out over there and i havent even tried here yet, anyway this is a duplicate post i put up over there. Check them out and form your own opinion on my first surgery with Dr. Ron Shapiro, when i look at them now i think he did me VERY well, ive come along way so far and ive got a way to go but hey thats why im here posting and sharing instead of drinking and joking with my other friends, today i went to Shapiros clinic to get these pics and met Dr Haber & Dr. Paul Rose, they all checked out my surgery from Dr. Hasson and commented that the work was excellent and i was going to look great, Dr. Shapiro also commented that i had more donor left, F@CK YEAH today was a good day!!!!!!!. Im trying to share this so that anyone with recession as bad as mine was can have hope of letting it grow out and not having to shave to a #1 every 2 frickin days. Another thing is yeah i know im one UGLY MOFO but soon my hair might cover my face hahahaha, and it hasnt effected my success much because i got a great woman, make good money and overall not depressed about this shit, i just have the power to change it now and im gonna use it. Thanks for following so far and i will try to update my progress, oh yeah my girl took out my staples yesterday, yeah it stung like a beotch Sincerely, Mudpuppy
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