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  1. @Huw in 2008 when I was chosing a doctors I had it narrowed down to Dr. Rahal or Dr. Feller and at that time the elite was these two plus Shapiro and H&W. Today I see that Dr. Feller and Dr. Bloxham are still the best choice in NY but prices changed dramaticly as I paid around 2US/graft in 2008 for my FUT with Rahal and I see that Dr. Bloxham charges 10US/graft for FUE. If you are set in the US and can afford this then Bloxham is the way to go but if you can catch a direct 6h flight to Porto then I advise you to look up Dr. Bruno Ferreira because he`s getting truly amazing results at 2.5€/graft and he works also in Madrid at Dr. Lorenzo clinic (one of the best FUE Docs in the world) but at this clinic you pay a bit more. Wish you all the best with your journey to a full head of hair.
  2. Hi everyone, Long time lurker, first time poster. I'm sitting here in my hotel one day post op after getting the morning cleaning and repositioning of the grafts, and I have some time to kill. So, I figured I would write out hairloss story as well as my experience with Dr. Steven Gabel and his team of excellent technicians. This is my baseline photo the day I started minoxidil and finasteride on September 21st, 2018. The photo on the right is when I resigned myself to being bald sometime around March of 2018. Photo on the left is three months into treatment, around December of 2019. I was a great responder to finasteride and minoxidil. I also gave dermaneedling a try, which I believe helped a lot. I only did it a couple times - I will attach a photo showing the aftermath. This was in January of 2019. After this photo, I stopped doing progress pics so much because I let my hair grow out. What I kept my hair at - I could conceal my balding very easily, but if the wind blew the wrong way, it was game over. This was in May 2019. This hurt worse than the transplant. Derminator II, 12 needle cartridge at 1.25mm on fast for 5 minutes. Photo in December 2018. Since January of 2019, I have basically been taking 1mg fin once a day, minoxidil foam morning and night, a collagen supplement and a hair vitamin supplement. I plateaued on regrowth at around September of 2019, and it wasn't really good enough for me, as I could only style my hair one specific way and I could still see the scalp. I started researching hair transplants around this time. I reached out to three places before finding this forum. The first was Dr. Lupanzula, which I found from Joe Tillman's youtube channel. I thought he was incredibly humble, talented, and ethical. I reached out to his team, and they were responsive. They said it would likely be 1800-2000 grafts, but would give a more accurate estimate on in-person consultation. I originally planned to get the procedure done in the summer of 2021, as that is when I graduate from nursing school and get married. However, I realized how ridiculous I would look at my first job in the hospital, and decided summer of 2020 would be better. As such, I realized travelling out of country wouldn't be an option. The second place I reached out to was Dr. Baubac, also from Joe Tillman's list. I hadn't found these forums yet. Short story made even shorter, it was a bad experience, and after two or three emails it was a no-go. The third place I reached out to was Dr. Sharon Keene. She was more in my price range, and had a lot of experience. I had a phone consultation with her where she quoted me at 1200 grafts. I was also dead set on FUE at this time, as I didn't want the linear scar. I don't know why, but I didn't feel comfortable going with her. I think going with your gut and only selecting a surgeon that you are 100% comfortable with is crucial. At this point, I was starting to get a little burned out on Joe Tillman's list of preferred surgeons and wanted to branch out to see what else was out there. I watched a lot of youtube videos, and found David DiMuzio's channel. The person on his channel, Steve Cook, made some compelling arguments surrounding FUT. The real gamechanger for me was stumbling on Feller & Bloxham's youtube channel, specifically the FUT scar search. After watching a few of those, I watched every other video they posted about FUT, what to look for in a surgeon, and what an ethical doctor is like. I considered going to New York, but seeing as at this point, approximately mid to late March, was when covid was going crazy in New York, I didn't reach out to them for consultation. Instead, I decided to do my own surgeon search, independent from coalitions. I googled surgeons in Oregon, my home state. Dr. Gabel popped up, and so did a lot of his posts from this forum. I read every post and blog about Dr. Gabel, and I saw how active he was in this forum still. What set Dr. Gabel apart for me was that he posts all of his own work here. He doesn't have a consultant. Sending out an email and getting a personal response from Dr. Gabel was astounding. I didn't even get to talk to Dr. Baubac at all. I scheduled a consultation, and he actually made it a web-cam consultation, and he spent a full hour with me. This contrasts to the 15 minute phone conversation I had with Dr. Keene before she quoted me 1200 grafts based on 9 pictures I sent her. Dr. Gabel recommended I get FUE based on the haircut I preferred, but I said I would like to get FUT. He didn't weigh in with his opinion until I made the case for FUT vs. FUE. He somehow projects a balance of calm confidence and humility, and he was incredibly forthright about his approach to hair restoration. He asks poignant, pointed questions designed to get actual information about what you want. As a forth year nursing student, I can recognize a good surgeon. This spoke volumes to me. I knew right after that consultation I would be having my surgery with him. He recommended 2400 grafts, and based on my level of hairloss, I knew that's what I needed. I sent out one email to Dr. Gabel regarding a theory I had on microneedling and hair surgery, in that microneedling can cause angiogenesis, which I thought would help with graft survivability. He responded within the day and asked for the scholarly articles I had read to prompt this idea, which also was crazy to me. I ended up not microneedling, because I read another article that proved wound healing isn't really improved by an increase of angiogenesis, but his response was still impressive to me and deserves mention. The day of the surgery, July 29th, I saw Dr. Gabel for the first time in person. I was incredibly nervous. I don't know how many of you are reading this that haven't had the procedure, but let me just say, the anxiety catches you off guard the morning of. His technician greeted me (I don't know if saying the names of the technicians is kosher so I'm going to avoid it) and she was awesome. Dr. Gabel came into the room, and his attitude is contagious. He pushes positivity into his immediate environment. He loves what he does and is passionate about it, and it shows. He took one look at me, pushed up my hair, and tied off my forelock, and said, "This is the problem area." Photo below of what I'm talking about. I had no idea the hairloss was so isolated. The procedure went by very quickly and was virtually painless. Having a pretty good background in surgical procedure, I can say confidently that their set up is well thought out and efficient. They have adequate staffing, everyone wants to be there, and they do their job well. The final hairline was basically the one above, but done with skin safe sharpie with variations in the line, of course. I have some photos from this morning, 1 day post op, and will update in a week or so. Final graft breakdown was 2,325. 212 singles, 955 doubles, 870 triples, and 288 quads. One thing to note is mid-procedure, Dr. Gabel said I absolutely made the right decision to go FUT, as my grafts were very large and "splayed" near the base, which would have lead to an estimated 50% transection rate, as almost half were triples and quads.
  3. Looks completely natural. Amazing results. Dr. Feller is amazing at his craft
  4. Hi Dr. Lindsey I’m the “hater” you reference in your video that asked a question in your previous thread. All I asked was if the punch size was on the larger side since the artas uses around a 1.1mm punch and gets criticized for heavily scarring up donor areas of patients. I also was asking what the wall thickness is on the feller punches you use. So instead of answering you made a video referring to me as a “hater?” Not sure if I’m following the strategy correctly... thread in question:
  5. I would see if you could do another FUT and in the process revise your scar. I've seen Dr. Bloxham of Feller & Bloxham do some amazing scar revisions. Of course if not possible because of scalp laxity issues, then FUE or combination with SMP should take care of it. Best of luck.
  6. If you wanna stick to a specific area, use the Surgeon locator on this forum. Off the top of my head, I believe Dr. Feller and Dr. Bloxham are in NY and I imagine both do very thorough consultations.
  7. Dr. Feller in New York used to do small afternoon FUE procedures of up to a few hundred grafts in what he called lunch time FUE. Dr. Feller doesn't practice much (if at all) anymore, but you may try contacting Dr Bloxham there from Feller and Bloxham and ask if they still do small FUE procedures. I think Dr Lindsey also does some small FUE scar repairs, so you may try contacting him as well. I see you're in California, but unfortunately both I just mentioned are on the east coast. I don't specifically know who does small FUEs on the west coast.
  8. Hey! I had a procedure 2.25K grafts w/Dr. Feller in 2004 with a similar balding pattern & similar grafts up to then (1400 grafts). Bloxham will pack 'em in tight and you'll have at least 5-6 years of good hair if you do probably 2.5K grafts or so. As a 1st strip you'll probably see really good results by month 5 to 6 (believe it or not). I was completely transformed in the frontal zone & hairline by month 8. If you have regular laxity - your scar (say 2k-3k grafts) will be most likely neglible except at the lowest haircut level. Feller & Bloxham never do megasessions, so the scar shouldn't be a huge issue for you. Sure staples sting a bit having 'em taken out after like 12 days - but it won't take long. My sister did that for me (she's a nurse). Having strip is a major surgery - stay on top of the pain meds and you'll be fine. I won't lie - it is crazy having a chunk of your scalp excised out of your head and stitched back. It will be tight and sore for several days. And numb. But just deal and be careful and after a week or so you'll be used to it as symptoms lessen. From there on out it will become less and less noticeable especially after stitches are out. Since you are a balding guy before 30 - and probably started before age 25 - if you want to conserve the quality of your donor and delay balding in mid-vertex into crown as long as possible. Consider Dutasteride (Avodart) or Propecia & at least minox 1X per day (if foam) or a very small dose of oral minox. Also consider laser therapy 4-5X's per week to keep your current hair in the best healthy state & a longer growing cycle. This will help delay the inevitable depending on how fast you bald as you get older. Hairloss continues and sometimes accelerates in late 30's into mid 40's - we never really know. About 7 years after my work was done by Dr. Feller I noticed more balding (I was 44 by then) in the mid-vertex and going into my crown. So, if you are 30 you can probably get by until near 40 before another surgery if you continue to bald into your crown and vertex. Good luck! The clinic you are going to is outstanding - a bit pricey - but you'll get excellent results & bang for your buck for many years. Keep us informed! Keep those painkillers handy - but you are local and not having to fly after strip surgery is a big bonus (pressure from flight levels right after surgery are painful in the strip area). Don't drink for at least a week after surgery and if you can - get daily aftercare at the clinic for a few days after if you can.
  9. I don't do pictures - no thread on my experience. I post alot though. I'd say my scar has stretched in some places to about a centimeter or maybe a bit more. With so many scars - the best one is from my surgery w/Dr. Feller 2.25K grafts (new scar at the time). Right now I have very long hair (12+ inches) - I really cannot buzz my hair in the back at all (obviously). Look up a thread from the guy 'garageland' in this forum - his scars are alot like mine. He has one part of his head that is very stretched - mine isnt' that bad though. Anyways, I'll be having the worst sections excised and re-closed and probably alot of beard hairs put in my scars for when I want to wear my hair alot shorter again in another year or so. peace...
  10. I've had a frontal row removed (from 1mm punches in '90 & '91). Dr. Feller removed that row in 2004. No scarring (visually). Your probably looking at several sessions if you want to excise the majority of your plugs and want them refined under a microsope and re-implanted elsewhere. In a year from now I don't see why you can't get to where you want to be.
  11. In 1989 I was a college freshman with thin hair that was starting to fall out. Graduated in 1993 and had considerable hair loss. By 1994 I was almost done hair-wise, very traumatic for a young man who is just starting his life, I freaked. That winter, watching a late night informercial on HT's, I though I had the answer. After two consultations with the 'Dr.', I fell for the micro/mini graft, very small scar, full head of hair, etc from this Long Island Medical practice. No internet at the time and I didn’t even know plugs were a thing and as been repeated as I have recently read up on numerous message boards, “You trust a doctor and never would you think they could be so unethical.” This is much different thn a snake oil salesman selling a hairpiece. This is a doctor doing surgery that lasts a lifetime. As a young man I should have understood the supply and demand model and I still kick myself in the ass falling for the full head of hair BS. 3 Procedures winter and spring of 94. By fall I was obviously very unsatisfied. Unnatural small plug look with a few large ones, bad distribution, horrible donor strip scarring, etc, etc. My hair is kind of fine/thin so I feel it was not as bad as some I saw as I noticed more people with plugs (never really noticed them until after my ordeal started) but now I was stuck and stupidly went for one more ‘free’ procedure as I was told they just need to make it more dense.The next 4 years I got by and since my hair is fine/thin texture, under certain lighting, dark, sun, etc it just looked like a young man getting pretty bald. Under many other situations, angles, etc you could see the plugs, cobble-stoning, unnatural hairline, etc. I got by, met a nice girl (now my wife) who never really noticed until I opened up to her, etc, etc. Some days, and even to this day, people don’t notice. Other times in a conversation I could see eyes look at my hairline. Sometime when I am out I see, or just maybe imagine, people checking out my hair/hairline. Myself, as I wrote, I got by but was, and still, always self conscience.In 1998 I visited Dr. Bernstein (at the time he was with NHI in Ft Lee NJ) and felt he was very honest though understandably I lost all faith in the medical community, especially cosmetic medicine. He explained what he and Dr Rassman were doing (which now made more sense to me) and how he could try to camouflage. I can say that I think Dr. Bernstein used some of the best technique that 1998 technology provided and he tried to camouflage my pluggy look. I forgot how many grafts I received and the ones he added were the size he stated but my coverage, and at that point I was very realistic, was still less thn desirable. This is in no way a bash of Dr Bernstein as he never up-sold me, never promised a full head of hair, etc. He was ethical and honest with his graft size/hair per graft, no bumps from his grafts, and it was definitely an improvement though not what I thought it would be. I understood a full head of hair would never be in the cards for me but thought I would get more camouflage in my hairline and coverage. I’ve lived the most normal life I can since thn though I am always self conscious. So here I am today, 25+ years in this journey and things are changing. I have lost even more hair recently (crown area getting even larger) and I am graying. The contrast between my skin, gray hair and dark have given me a more pluggy look. Also, I don’t mind being bald but so is the case of a 48 year old compared to 23 year old staring out life. I actually think I pull off the very thin/very balding look ok and I do not even mind my gray hair. That said, I’d like to look more natural (or at least less pluggy) and maybe even fill in more spots to even out the thinness. My donor area seems kinda depleted so I am not sure how possible any of this is. I am looking at a few possibilities to just move forward being less self conscious as my life moves on. I have no problem with my scalp showing and just want a more natural appearance. I could care less if the plugs in my crown are removed/re-distributed to other areas as my crown will never be covered anyhow. Some things I’d like to accomplish if even possible or recommended. 1) Remove larger plugs in my crown area slice them into smaller grafts and redistribute them to areas of need to try to maybe balance out my thin appearance 2)Remove larger plugs in my hairline and a lil behind hairline dissect and re-distribute them to that same area or others depending what doc says. (Does plug excursion and re-distribution grow at a decent rate or is the return rate poor? What about scarring? Blood supply/flow to the head if plugs are removed and redistributed.)3) See how that goes and if I have any hair left to use in my donor area, just use that to even out some coverage for a thin or more natural appearance in areas of need. With FUE has the donor hair expanded to your sides?4) Fixing my donor scars if even possibleI do not know what is possible but I do know technology and techniques have changed since 1998. I also know, though many docs are very reputable I am very nervous having someone touch my scalp again. I have started reading message boards on HT repairs, articles, researching Dr’s etc. For you young bucks and older gents out there thinking of getting HT’s, you have great resources and you truly need to do your HW. I am shocked that there are still ‘doctors’ who will do bad work and destroy peoples lives. It is all really sad and sickening on so many levels. I live outside of Princeton NJ. Some of the Dr’s in my area that have popped on my radar in my short research are Dr. Bernstein, True and Dorin, Dr Carlos Wesley, Feller/Bloxham, . Anyone have any experience with their plug excursion and re-distribution? What other Dr’s should I put on my radar as I start my research? I am not against travel and have just started reading up on Dr. Cooley in NC, Dr. Lindsey in Va (against excursion), etc. Thn again, I have no clue and do not want to fall for some sales pitch again. Cost is also a factor though I will cross that bridge when it comes and make my decision. That said, who else should I look into? I’m sure I will have more questions but here we go with my first post. Thank you for reading and I look forward to answers and more discussion on this in this thread. Thank you in advance to any and all who read my journey and help answer any questions I've asked and will ask.
  12. I do all FUE cases either by hand with a feller .9 or 1.0 punch OR the Harris Safe system. Frankly it seems like if one isn't working...the other will do great. I don't necessarily agree with the safe system's dull punch blade--which in theory pushes roots out of the way decreasing transection rate. Rather it seems doughy scalped guys do better with the sharp punch and the normal scalp consistency do better with duller blades. Remember the U in fue is unpredictable. We all know what the F stands for and its not follicular. FUE is a challenge that current automation has not solved. To date we have now repaired around 150 of the cheaper automated "system" cases and around 40 of the real expensive "system" cases. And currently the people coming in that have had the robot procedure appear to all have been shot in the donor region with 1.6mm derm punches, had essentially minigrafts removed and then either reinserted immediately or those were slivered into micrografts, like I learned in 1994. And some look like its 1994. Dr. L
  13. Hi Guys. I am a new member. I was about to go ahead with my hair transplant with Dr Matt Huebner untill i found this website. Can anyone who had a hair transplant with him share your experience and pictures. Some one did mentioned in one off the past that Dr Huebner does not do Fut Instead he does mini graft surgery. Any prove ? Plus i came across Dr Feller & Bloxham. Why are they better then Huebner. Would really appreciate your feedback. Thanks C
  14. I thought Dr. Alan Feller was recommended on here? I don't see him on the list. I've heard great things about him. Is Dr. Rahal the only recommended doctor in Toronto? It's a huge city, so I would have thought there'd be more great options
  15. Oh that's interesting. It used to be free when Dr. Feller was the only Dr. there. That was a while back though. I had a consultation with him about 10 years ago. I wonder if the fact that a lot of people are getting multiple consultations is causing some places to have to charge now since they may be doing many more consultations that don't result in the person having their surgery with them. Hmmm....
  16. I don’t know much about the medical field as I am not a doctor but Dr Lindsey is a plastic surgeon with a FACS board certification that trained under dr feller. Dr. Diep is a graduate from some Caribbean medical school that trained under dr rassman at nu hair clinic. Does that give any insight? You tell me btw r u Indian? U said you were consulting with eugenix correct? I’d be curious to see what they recommend
  17. While I didn't create an account on this forum over the last couple of years it was invaluable in my research process and I want to pay it forward, especially since I seem to be seeing fewer patient posts with recent dates, at least for Dr. Cooley. Thus I will try to be thorough here in describing my process. Apologies in advance for the length of the post and the variability of the quality of the photos. I know they aren't the best. I am still only a few days/weeks out and will update this with before photos and after photos from the clinic and exact graft count(s) when I get them and try not to disappear throughout the process. My Past Situation I had an ill-advised FUT procedure when I was 21 to address temple recession. I wasn't on meds, it was premature, and I went to a cheap chop shop. CLASSIC, young guy being really stupid. :sigh The procedure (unknown # of grafts) involved putting grafts on the temples and unfortunately also some around the front of my hairline. It did very little cosmetically unless you count triggering massive loss of existing hair (most of which did grow back in fairness). The only saving grace here is that we were talking about a fairly minor temple area and because of my light hair/skin contrast I've been able to get away with a forward brush hairstyle that hid really poor work. Oh and it wasn't big plugs and the scar wasn't horrendous and avoided being in any disastrous region(s) thankfully. No matter what you do STAY AWAY from Samson Hair Restoration in Los Angeles regardless of what doctor they currently have cycled in. Why now Now, 11 years later at 32 with some additional thinning and some recession the previous work was becoming harder to cover, especially when swimming or my hair was wet. Plus, I just wanted it fixed to open up different hairstyles and to get ahead of managing what I believe will be future loss. Almost a gradual "replace" strategy I guess. In terms of meds, I had been on finasteride w/ no side effects for 4 years but then went off for 5+ years (don't really know why). I went back on 6+ months ahead in prep for a procedure and plan to stick with it this time. Not on finasteride or any other shampoos etc at the moment. Picking the surgeon In terms of research this time around I did a lot more homework using this forum as the basis for creating a smaller list of doctors. Ultimately I narrowed my list and research to consults with Lindsay, Bernstein, Cooley, Bloxham, and Nadimi. I felt these were really great doctors that didn't necessarily require a flight based on my East Coast USA location (I was intrigued by Rahal, Hasson/Wong/Kronior and some of the other staple of well regarded doctors as well but with only so much time felt good with my short list). I did not consider India/Turkey etc., not because I don't believe quality results can't be achieved there, but because I didn't want to take the risk and conduct an extra level of due diligence with respect to many of the practices and I was willing to pay $ for that peace of mind. Notes on my Consults During my consult with Dr. Lindsay I felt like he just didn't think I needed a procedure yet. He cited 1200 grafts and it was all relatively cursory. So not a fit for me Dr. Bernstein was a good consult (worth the cost) where I learned a bit and I felt comfortable with him and his work, but ultimately I wasn't blown away by the results I've seen from him either on his website or on this and other forums My consult with Bloxham was really terrific and I got a great feeling from him. He was ultimately my #2 but I did not choose him mostly because he is just relatively newer with fewer posted results. And right or wrong, some of the (rare/older) negative comments about customer service/interactions from Feller put me off. I did NOT have any of this sense from Dr. Bloxham and have never met Feller but the posts are there nonetheless. I will also say, they need to upgrade their facility. Not the medical side hopefully, but the rest of the place was old and run down feeling. Dr. Nadimi was also great (via Skype) and matter of fact but I got the sense she did more FUE than FUT. Similar to Bloxham there are just fewer patient accounts out there that I could find, but based on what I've seen and this consult I was very comfortable and impressed with her Why Cooley Ultimately, I went with the only doctor I didn't meet/ have a convo with directly in Dr. Cooley. I appreciated the consult with Lollie and a deeper understanding of their procedures and liked what I heard about use of Acell, how he preserved grafts out of body, his hands on approach, the tenure of his techs, and so on. But most importantly Cooley's track record of consistent results and patient experiences tipped me over (including one detailed repair write-up by a Blonde haired individual, of which there are relatively few results). I also literally did not find a single negative review (of outcomes) for Cooley in all my research and I valued that apparent consistency. Procedure - Why FUT I knew I wanted FUT as I (a) already had a scar I felt could be improved, (b) wanted to maximize future grafts and survivability, and (c) wanted to minimize recovery time. I am lucky enough to have a lot of Donor and existing hair that can be used to hide a procedure. Pre-Procedure and Day of All things posted about Cooley experiences were true for me. I followed pre-op instructions for scalp laxity. I think this helped as I could feel the sides definitely loosen up, and while the back still felt tight Cooley said it was great and helped with suturing (+ sutures out at 2 weeks vs. 3 weeks). The hotel they set you up in is excellent, easy, convenient and they already know why you are there and what you need. Shuttle drivers, check-in staff, and others there were helpful and discrete and the breakfast and gym is open early enough for day of eating and a last workout. On the day of the operation we met at 7am, had a calm and not rushed discussion where any other questions I had were answered, and re-affirmed my choice of 2500 FUT + PRP/Acell. In terms of hairline we were on the same page to opt for a conservative/mature hairline though Cooley jumped straight to the need for work on the temples which he said he does not always do. This process of agreeing on this was FAST as a lot of it was bridging existing hair and the past work plus a little bit of pulling temples out/down. In terms of PRP, Cooley was candid that for me he didn't know if PRP would make much of a difference as he didn't see a ton of minituraization but (a) I'm paranoid and think there is more than there is/I have very fine hair already, and (b) I am hopeful that it will help somewhat with avoiding shock loss or speeding up recovery. I know there's no real scientific evidence to back that up, but I was willing to spend the $ on the chance it helps. I will say that to make sure you get what you need before surgery begins you should 100% come prepared with your questions. For example in my consult with Bloxham he indicated that my past FUT scar had a small area branching into the danger zone for donor and advised forking the scar near my ear. I really did NOT want to do this, so asked Cooley about it. He decided to implant 10-15 hairs in the end of the old scar as part of the procedure and end the new scar in a safer location. I do not think we would have ultimately done this if I had not asked. H/T to Bloxham for noticing it in a really thorough, caring consult. I also asked about a few grafts poorly placed in the front of my forehead below the 7CM mark we agreed to for the new hairline. He said if I was OK With it that he would remove those with electrolysis which I agreed to and am relieved about as they were definitely not natural looking. Overall, it was a good conversation. I, like most others, felt comfortable and cared for by Dr. Cooley and all of his other wonderful team members. I do think the clinic could get better about having all their pre and post op documentation organized and sent in a big PDF but that's super minor overall and has nothing to do with the in-person interactions I had. One other area that I felt could be improved is in discussing recovery times. The clinic (not Cooley himself) were fairly aggressive in terms of discussing post HT recovery periods and timeline (no redness 5 days, not visible procedure at 8 days etc). It's not that they are totally off, it's just that they are definitely giving the aggressive, "best-case" scenario in my opinion and shaded this as an absolute vs. discussing the potential ranges of recovery times based on patient characteristics. Still thus far in my case it has proven to not be too far off the mark so far (devil's always in the details though isn't it). Procedure itself From the Cooley consult we moved into the procedure. Numbing/valium etc was painless. Unlike others I don't think I really went fully under for the ENTIRE duration of the procedure, I even heard a nice little "ripping" type sound on removal, but no pain whatsoever. By 11:30 the donor was removed, there were 5-6 technicians on the microscopes, I had had PRP and he had done the few electrolysis removals needed. I stopped for lunch and then we carried on. Cooley performed all of the donor incisions, with Brandi hovering nearby, and was present for probably 90% of the graft placement. I know for sure he was doing all the immediate hairline grafts. I believe he left for a little over an hour in the middle of the procedure (basically the length of a movie), but I'm not 100% on whether he popped his head in a few times during that time or not. While he was not actively working on my head Brandi was performing graft placement and I believe Amy also worked on placing grafts. Cooley returned and was essentially there the rest of the day long after many of the other techs had left post dissecting the grafts (easily 4-5+ more hours). It was clear he reviewed and had ample time to change, correct, or ensure any grafts not placed with him in the room were to his liking. Like others have mentioned it was clear throughout the day that this was a well-oiled machine, with team members that had worked together for years (decades even). Everyone was friendly and taking a dedicated and personalized approach to the operation, and I couldn't imagine going somewhere with a doctor doing multiple ops in a day. Throughout the process Brandi was constantly checking Cooley and making sure anything "controversial" about his approach was discussed (a few graft placements here and there, reminders about how many grafts were left etc). All of this was reassuring. I am sure the reverse also happened. Ultimately for the 2,500 graft procedure Cooley was able to get over 3,000 grafts (I will get exact counts later) and we did not finish the day until a bit after 7pm, meaning I was there for nearly 12 hours. This extra time and attention, plus the grafts that were not something I had to pay extra for, all speak to his long-running record of caring about his patients and working tirelessly to get results. I am obviously grateful for this. Post Op - Healing, Pain, and Experience (Week 1) Donor got painful at the end of the day during the operation so I was numbed up again before I went home. I was obviously a bit red and beat up but it wasn't as bad as I was expecting and they had already done a pretty good job cleaning a lot of the blood off. Plus I was wearing Saran wrap + a hat so able to avoid any weird looks. On night 1 I took some Tylenol but nothing stronger--which is good because I didn't get the prescriptions until day-of for stronger meds. Cooley's post-op care uses an ATP spray + saran wrap to increase moisture and prevent any graft damage and antibiotic ointment on the donor scar. You basically spray every hour you are awake and wake up and spray every 2 hours for the first 2 nights along with taking some preventative Prednisone for swelling. I followed the instructions religiously here and I think it really helped calm redness and speed healing. On night 2 I was falling back asleep pretty quickly so it didn't feel too onerous to keep getting up. For sure it kept the itchiness to a real minimum in the first 6 days. I went back the next morning for a post-op clean and got the all good from Dr. Cooley. During this cleaning Amy took time to answer any questions I had about the next week of care and was patient with what I am sure are the same questions everyone asks. In terms of the documentation they gave me to follow, I actually think it could have been a bit more detailed. It wasn't that it was bad, but I felt like an "FAQ" or just more exhaustive detail would have helped. For example, I asked about caffeine / alcohol / ibuprofen which were not listed (Cooley says moderate amounts of both are fine), and it doesn't give you much about how to sleep (when can you sleep sidweays on the grafts) and so on. To give you a sense of how smooth this was, I drove almost 7 hours home the very next day, which was completely fine and painless. Overall I found the post-op regimen easy to follow, the spray and saran wrap seemingly very effective even if I did probably use it too quickly/aggressively to try to get it through the native hair as I ran out a day or two earlier than I think the clinic expects. One curious thing with post-op care from the clinic is that it seems that Cooley's overall instructions,are more aggressive than many other docs (like the timeline to shampoo (next day) and return to regular shampooing (7 days) . I'm sure this is because Cooley is confident in the healing/quality of the grafts and incisions etc and has refined his approach over time but it does make me just a little nervous when looking at the instructions online from so many other places that are much more conservative. But he's my doc and I'm in his hands and so far so good. On night 3 I slept poorly but not really due to pain, I think I just missed exercise. On night 4 and 5 I had more pain when putting the back of my head on pillows (I slept elevated with an inflatable travel pillow partially inflated these nights to help with any potential swelling) and I did take a valium one night and the other pain killer + tylenol combo prescribed drug the fifth night. It almost felt like the donor was a little more stretched these two nights with whatever position I could find that didnt have too much pressure. If this continues I'll call the office to make sure it's normal. Some posters here have mentioned this as the return of nerve sensation but I'm not sure. Otherwise I have had some very very minor swelling which made me break out some ice on my forehead and eye area a couple of times and take ibuprofen periodically as well. It was never uncomfortable or especially noticeable to anyone else however. Last point, I am using the Hair Shake protein. I don't really think it'll do much but I've used protein powder a lot anyway so I don't mind and if it helps at all with speed of growth or minimization of shock-loss, then it's worth a couple months of it for me. I am not planning on using it long term and no one at the Cooley office actually mentioned it directly despite having it stocked there and having it listed as an optional part of the post-op procedure. Post Op Appearance - First Week The scar in the back is perhaps slightly visible with wet hair (first 3-4 days) but completely hidden with normal dry hair. As mentioned it wasn't giving me much trouble the first 3-4 days, although of course everything felt really "tight" there. At night or with pressure on it day 5-6 it actually has felt a bit worse and I've taken some of the prescribed meds just to make sure I get decent enough sleep. We will see of course on final healing and appearance, it is early days. Redness in the recipient has subsided each day, and now at day 6 is not bad at all. It's probably worse in the pictures than in real life. I am fairly pale skinned but had a deep tan going which some say can help. There is definitely scabbing, it is super mild/light and looks like when I return to regular shampooing and rub the grafts a bit it will easily flake off and be gone within the 7-10 day timeframe that they gave. In any case, it's really mild and not that noticeable. I have used their given shampoo and started leaving the conditioner in a bit longer which I think has helped. I have a couple spots of dried blood left but overall it's pretty clean and I haven't noticed anything remotely like grafts falling out. Really, not even many/any hairs yet. The kicker here for me is that I 100% had to hide from the world during this time because I was (a) spraying every hour and (b) couldn't style my existing hair for fear of touching/disloding existing grafts. So you could see the grafts taking hold and small stubbly hair, plus weird caked native hair that was a bit long already awkwardly plastered to my scalp. So all in all, a real lovely mess. Now had I managed this aggressively with a blow dryer on cool or if I was more comfortable touching and styling my scalp in this period I am sure I could have made it look better but I didn't want to take any risks. On Day 6 I did a bit of finger styling and with my existing hair I can make it look decent (see 1 of the pictures). Decent is not invisible however. The temples are harder to disguise and any close inspection things are definitely still visible so I feel I am very much still in hat land. To be fair, my wife says it's pretty hard to tell unless you get up close and personal already. We will see if my extended family at Day 11 notices anything. Summary of first week So far the difference from my first procedure has been remarkable. Basically instead of an immediate "oh shit what have I done" I felt more like a "I'm already looking better than I expected 12 hours later. and everything is going exactly like they said" It's nice to already feel like I made the right choice. The recovery seems to be text book according to their expectations, but I most certainly don't want to be out and about without a hat yet as it would be noticeable. The things I am worried about are (a) appearance at 10 days and masking it, (b) avoiding shock-loss as no work was done in the middle of the frontal third, and (c) continued management of the donor scar pain. All the rest is of course the standard, hurry up and wait, concerns about linear scar etc that we all have but if I can avoid shock loss I feel comfortable looking like I did for 6+ more months. I hope this is helpful and of course any feedback on the pics and actual quality of the work is welcome as well. Again, apologies on the photo quality I will get better ones from clinic later. I will try to post periodically as I hate the posts where people disappear but I also intend to try to live my life and not obsess over the progress over the next few months.
  18. If you live in Canada why not consider Dr. Rahal, H&W, Feller and Bloxham aren’t that far either. Given that you will likely progress to a norwood 6 you may want to maximize grafts by going strip first. The price of strip is comparable to FUE.
  19. Nice work Dr. Bloxham. Looks very good. Wow....Dr. Feller may be $10 per graft? He produces very nice results but It still amazes me the disparity of costs per graft from excellent surgeons on this network. I’m used to $4-5 per graft with every graft extracted and inserted by the surgeon. I’m not trying to be critical because I’m a free-market capitalist. So...good luck to those surgeons charging quite a bit per graft. Glad we have a wide range of surgeons to pick from on this site.
  20. Do you use the "stick and place" technique when performing fue cases? Also do you charge the same as Dr. Feller for FUE, which is if I recall correctly something like 10 dollars per graft. Also, what is the best way to contact you? I admire your work!
  21. Hi Everyone, Today's presentation is a nice little FUE hairline case. The patient is a gentleman in his late 30's with otherwise excellent hair aside from some classic hairline thinning. He was set on FUE and initially wanted to go very aggressive in the front. After reviewing everything, we decided the most natural, strategic approach was to start a little more conservative. So, we did a 1,500 graft case to rebuild his hairline. I removed all the grafts manually using a 0.9mm Feller Medical Punch (a punch Dr. Feller patented many years ago). Extraction went very well. I saw the patient back 12 months later, and both he and I were very pleased with the results. Since he grew well with the FUE and the back seemed to heal up nicely, we decided to do a little more and close in the corners a bit. I will update with the results of this second procedure in the future. Here are a few "teaser" comparison shots with both dry and wet hair. As usual, I include only a few of these because I encourage all researching patients to watch the result video, which features both educational content and a much more detailed "comb-through" of the results. And here is the video: Thank you for reviewing. Look forward to the upcoming discussion. Dr. Blake Bloxham Feller & Bloxham Medical www.fellermedical.com
  22. Today's case is an example of a nice little hairline repair procedure. The patient in the video had "1,500 grafts" (a big emphasis on the quotation marks there) at an outside clinic years earlier. He had great hair elsewhere and just wanted to fix some slight hairline recession. The clinic used follicular unit grafting, but simply did not go dense enough in the frontal band/hairline. The result was less than impressive, but the patient assumed this is all he could achieve and lived with it. Years later he did some research and realized that, maybe, what he had was not standard of care and decided to seek out another procedure. He presented to our clinic excited at the prospect of improvement, but somewhat skeptical that what we did here was different. Because of this, a conservative approach using 1,200 grafts was undertaken. The hairline was not lowered or adjusted, just addressed using dense packing. He did well and was thrilled with the results. Several years later after realizing what can be achieved with a hair transplant, he came down with a little bit of the "hair greed" and decided he wanted to flatten the hairline a little bit and really get that perfect density in the front. We used another 1,200 grafts to perfect it. He came back 3 years later to show us the results. Here are a few "teaser" comparison pictures. I only share a few because I really encourage everyone to watch the detailed comb-through video. Remember that there is only so much you can get from still photographs. Ask clinics you are considering to show you comb-through video! I wanted to state that we probably would not have recommended using so much donor in just the hairline IF the patient had any other signs of hair loss elsewhere. But because of his age, family history, and the fact that we (both Dr. Feller and myself) had seen him over a period of around 7 years with no noticeable change, we felt comfortable accommodating his request. I also wanted to thank this patient for allowing us to use his full face. And here is the video: Thank you for viewing. Look forward to the discussion. Dr. Blake Bloxham Feller & Bloxham Medical, PC www.fellermedical.com
  23. On March 18, 2019 I had a 2000+ graft FUT procedure with Dr. Bloxham in Great Neck Long Island NY. Even though I'm only 4.5 months out, I'm already very pleased with the results. And I'm aware this isn't even the final result yet. So I wanted to share my before/after pics for those who may be considering getting a procedure in the future with the hopes my story/results might help. Quick back story: I had two small procedures in the early 2000s as my hairline was beginning to recede. The hair transplant company that did the procedures is now defunct. The results were sub-par but, if styled a certain way, I thought I could sort of get away with not looking so bald (sort of a comb over effect. But I probably wasn't fooling anyone, haha). Over the years, my hairline continued to recede pretty far back. So in 2016 I decided to have another procedure. I'd prefer not to name the doctor publicly as, although there was some improvement, the results weren't so great and I don't want to smear anyone's name or business. But if you're considering getting a hair transplant and would like to know, feel free to PM me. Or if you have questions in general or would like to talk regarding my HT experience, reach out to me at jamesnyt10@gmail.com. So at that point I had three procedures and still had sparsely transplanted hairs. I just assumed that maybe my physiology just didn’t allow most of the grafts to survive. But in 2019 I begrudgingly decided to give it one more chance with a new doctor. I researched several surgeons and decided to go with Dr. Bloxham at Feller & Bloxham. Not only was I impressed from seeing all the results and info on their YouTube channel, but in addition, his customer service from the very beginning was truly outstanding. So we had a consultation (actually a few) and he recommended a roughly 2000 graft FUT procedure. As I mentioned, I had it done on March 18, I'm now 4.5 month out and the results have been exactly what I had hoped. I included before and after pics and will post updates every so often. But even though I'm only 4.5 month out, I'm already very satisfied with the results. For the first time in my adult life, I don't appear to be balding, thinning, or have sparsely transplanted hairs. My story is a testament to the fact that results can truly vary depending on the surgeon. I included before/after pics.
  24. Hi Phil, I always try to make the time -- though I will admit that I am falling behind on answering private messages, and I do apologize to anyone waiting for a reply! I truly like being a clinic that can offer patients both FUT and FUE. And not just in name only. While I think I have made my reputation with FUT and I am a very vocal proponent of it, I perform FUE every single week. We have an OR specifically for FUE; we have a staff cross-trained specifically for FUE (who have been assisting in the FUE process since 2002); and I feel very blessed to have learned manual FUE from my partner, Dr. Feller, who was one of the first three to perform the procedure in North America (the others being Dr. C in Atlanta and Dr. Jones in Canada) and someone who has multiple patients and publications in early FUE development. So, long story short, I think we do have the ability to recommend and offer patients both. I do not think there is a strict, binary decision as to when a patient is a candidate for FUT versus FUE. From a strict mathematical and scientific standpoint, I absolutely do believe there are instances where one should be utilized to the exclusion of another. And in these situations, it will absolutely be my recommendation to use one versus the other. In the real world, however, patients have different long-term goals, different lifestyles, and sometimes what may be the best technique on paper is not the best one in practice. So I do my best to come up with plans and approaches using both methods when patients request it or ask for one above the other. When they simply ask for my opinion, I try to always be objective as described above. Here are some generalizations about when I think you should do one above the other or who is a good candidate for FUT over FUE: Start with FUT: -Young patients with uncertain futures and all but guaranteed progression -People with advanced hair loss -People with limited donor (as long as the limitation is not the density; in patients with very low densities, I actually usually recommend conservative FUE) -Patients who need critical hairline work and cannot risk yield (print models, film actors, etc) - Patients who are likely to want to do more surgeries up the road -Patients with hair types that I do not believe will do well with FUE: very fine, light hair (fragile follicles), certain ethnic groups, etc -Patients with a lot of laxity or very "stretchy" or "mushy" skin -- which I believe will either deform or distort and just not let us accurately score the grafts -Patients who want to do the most possible in a single sitting Start with FUE: -Patients with obviously stable loss only requiring a small amount -Patients who must keep the sides very short (certain military guys; certain actors with crazy film/studio contracts; etc); however, you cannot undersell the scarring to these individuals because it is not a scar-less procedure -Patients with very tight scalps or very low density where the "scarring to graft number" ratio is just not good enough with FUT (IE: taking a 30+cm strip and only getting out 1,200 grafts because the scalp is so tight and the strip was thin or the density was so low) - Patients happy with their prior strip scar who just need a little more work -Patients with prior strips who cannot undergo any more -Patients requiring less than 1,500 grafts (which I now still split up into two days as I like doing everything manual and staying very involved with FUE procedures) - Patients who are not 100% ready to commit to transplants but want to "test the waters" a bit first (again, we need to be careful not to oversell anything to these patients) Surely I am forgetting a few here, and this list is not all inclusive; however, good generalizations. In patients who are not concerned with the scar or want to get as much as possible (the majority of patients) or just want to go with what I recommend, FUT is typically a great starting point. I also offer a "modified" approach to FUT where I break up the strip into smaller 2cm pieces, which are somewhat staggered and broken up. It allows patients to go a little shorter on the sides and the scarring, if it is seen, looks more like trauma than a telltale surgical scar, so it gives people a little more wiggle room up the road. I have probably shared a few of these cases on here before, and I will share more in the future.
  25. So, I had a procedure w/Dr. Feller in 2004 (my 1st large strip procedure of 2,250 grafts). Any really good doctor should leave a very small FUT scar on a virgin or near virgin scalp. It's only 2.5K grafts. It's when you are going for the 5K or 7.5K total of grafts where it gets tricky ('cause of less laxity). Regardless, very nice 1st surgery. Patient has very good hair characteristics and great donor and fairly limited hair loss overall compared to NW5 or NW6. Still, if this was to be his 1st and last transplant he should have gone FUE because then he can shave down much lower if he desires in the back. I don't know his hairloss history or if he is going to do his crown or vertex though?
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