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  1. Hi there, New member, first-time poster, longtime lurker on forums like this. I'm 31 y/o, been slowly losing my hair since I was 19. I had shaven my head when I was 18, and as it grew back, I noticed something was off. Of course family and friends all assured me nothing was wrong, but no one knows the hair on someone's head like the person under it. I went to a dermatologist, and sure enough, she said "don't listen to your family, you absolutely have male-pattern baldness." I was devastated, but thankfully was able to get on Propecia from an early age. Fast-forward 12 years. I never regrew hair with Propecia, but I'm sure it slowed it down my hair loss. I had very slow loss for about 5-6 years, at which point I started incorporating Rogaine foam into my daily regimen. The last 3 years though have seen even more accelerated loss, so I switched to Dutasteride. It's hard to say at this point if loss has stopped entirely, but even if I maintained what I have, my hair line is very weak and going out everyday is an entire process of Rogaine + blowdrying + hair product to create the illusion that I'm treading on very thin hair. I don't know if it's my genetics or a result of the decade of Propecia, but I have both a receding hairline and very diffuse loss. On one hand the hairline makes it look like I might have more hair than I do, but I'm worried it also poses a challenge as surgery would mean not just strengthening/filling in my hairline, but also filling in the back and crown. So here's where I'm at: I looked at doctors in Chicago, and have felt very "eh" about most of what I've seen, but kinda figured that's how it goes with transplants these days. But as I read through forums, three doctors caught my attention (if their photos are accurate and testimonials aren't sponsored): Dr. Konior in Chicagoland Dr. Rahal in Toronto Dr. Shapiro in Minneapolis In an ideal world, here's what I'd get out of transplants: * Stronger, lower hairline and temples * Crown and vertex filled in Here are my questions: * What are people's opinions on results I could achieve if I'm looking at FUE? (I don't want a big scar strip in the back of my head) * Given my age (31), where I'm at with thinning, and that I've been on Propecia all these years, would transplant be fighting a losing battle? * Lots of doctors (whose photos I wasn't as impressed with) seem to advocate using Artas. What's the latest thinking on this, and is there any reason doctors still believe "feel of the hand" can out perform the benefits of a machine analysis? * Outside of Konior, I'll have to travel for a consultation, follow up, etc. I make a decent living for a 31 year old, but I'm not rolling in money. How do people travel for these surgeries? Do they have to make multiple trips across the country (or world in some cases) to get FUE? Anyway, sorry for the long post, but this is the closest I've ever come to making the plunge, and any and as much info as possible would be very appreciated. You can see the progression of my hair below (shaved head at 20, hair at 24, unblowdryed at 30, blowdryed with product at 31) (un-blowdryed), and the kind of illusion I can create with it when blowdryed and with product. Thanks so much!
  2. Recently just had a 1550 FUE HT with SMG. Feel like I needed more grafts placed in the crown and middle area but Dr Shapiro advised me to wait due to my age and density at the current time. What do you all think? Not sure how to add pictures to this thread yet so I just added a photo blog to my Profile page. Please visit to view pics from my Pre Op Stage and Post Op. Its been 3 days after surgery now and its healing well and the redness has gone down alot. Everybody at SMG was really great and took wonderful care of me. I hope its enough grafts! Now for the waiting game. Oh forgot to mention that I used the ARTAS machine. It felt fine and no pain. Only the shots stung a bit but we all know that already. Feel free to ask me any questions. Thanks! Hair Restoration Social Network ? Community for and by Hair Loss Patients - Nowsthetime9's Profile
  3. Intro In August 2011 I underwent an eyebrow transplant with a leading doctor. The results were not good. I feel duty-bound to share the results and the lessons of that experience with those who have already been through similar journeys, as well as those who are yet to in the hope that it may inform, educate and enlighten. Specifically, I would like to impress upon readers the following three things: firstly, a better understanding of the risks and dangers involved in hair (particularly eyebrow) transplantation; secondly an understanding of what sorts of questions they should be asking as part of their due-diligence; and thirdly, an awareness that no doctor can be automatically assumed to be competent in all aspects of hair transplantation simply because they carry certain seals of approval. Background The journey to the operating table can be traced back to the age of ten… It was then when, in response to a great deal of stress and pressure, I reacted by pulling out my eyebrows. This I did certainly no more than a dozen times but the damage had been done. My eyebrows grew back largely intact but in their centre there were areas which were thin and lacking in density. And only a few years later seborrheic dermatitis developed, which may have contributed to further thinning. Whilst it was an issue for me and something I had been increasingly conscious of in recent years, it certainly did not exert a majorly deleterious effect on my life. All this however changed when I read an article on the net in February or March of 2011 discussing hair transplantation. An intriguing thought arose in my mind - if scalp transplants were possible, what of eyebrow transplants? It turned out they were very much a possibility. I put the whole question of solving my eyebrow problem on the backburner whilst I focussed on my finals. In June/July 2011 whilst visiting my maternal grandmother, I consulted with a number of local hair transplant surgeons. All of them said the same: namely that an eyebrow transplant would be a perfectly viable solution to the areas of thinness. Risks and alternatives were only raised in passing. The only discussion was over the method and timing of payment. The consultation I had with one surgeon, the leading one in that country, is particularly illuminating in that regard. During it he revealed both a disturbing lack of medical knowledge and ethics. I was rather surprised when he pointed at the yellow flakes on my eyebrows and said “What are those?” - it should have been as clear as day to a medical professional, not least a trained dermatologist, what they were. Nor did he bother to discuss what additional risks may arise from operating on an area with active dermatitis. And only a few hours later (just before midnight in fact!) he called me to arrange the surgery date. I prevaricated. Over the course of the next two weeks, he proceeded to repeatedly badger me, even speaking to my grandmother about my signing up to the procedure. Those who think that doctors are all-good and all-knowing should bear such episodes in mind. They are only human and when money is involved, it’s often all too easy for ethics to be cast aside in the interest of making a quick buck. Being of a somewhat sceptical bent myself, I decided to consult with two leading doctors (as recommended on a website). Both came back with similar recommendations, proposing around 75 hairs be implanted into each eyebrow. Both only briefly covered the risks and neither spent any time talking of alternatives. I resolved to go through with the operation - all the risks, if they were referred to, were always spoken of as an irrelevance. I booked it with a well-known doctor and was to have my consultation with him on the same day. Nonetheless, I still wished to allay my fears by seeing a portfolio of his eyebrow work. Despite assurances, I was never sent any photos and significantly the patient rep failed to pass onto the doctor that I had dermatitis (a factor which the doctor felt was a contributory factor to the final (poor) result). Operation The operation took place on 25 August 2011. I travelled with my mother the night before. I distinctly remember her saying during the journey, that I need no longer worry about my eyebrows and that soon they would be sorted. If only I knew what lay around the corner! I had the pre-op consultation with the doctor on the morning of the operation. We spent some time discussing the number of grafts required, and I was reassured that the risk to the native hairs in the recipient area was very low (“only those hairs on their last legs will be at risk”). I was told that the skill in this surgery was making sure the angulation was correct, the logical inference being that in his expert hands, this would be a non-issue. As regards density, I asked him whether he could assure me that the treated area would be as thick as the rest of my brows (“Yes, it should be”). Significantly, I was not advised that I could in fact end up with less hair in the treated area as a result of shock-loss and low yield. Nor was I told that as someone already greying, the transplanted hairs would likewise grey (and much earlier than would be the case with the native eyebrow hair). More importantly, we did not discuss either during the consultation or before signing up to the operation the various alternatives, such as eyebrow pencilling and tattooing which would (along with treating the dermatitis), probably, have been the most appropriate course of action in my case. I shan’t dwell much upon the details of the operation itself. It was fairly routine and after two hours it was complete. I came in for a check-up the following day and then returned home. Result Only a week after the op I developed dry eye and blepharitis. A few weeks later I developed dermatitis, with huge flakes covering my brow. This eventually subsided - the damage it caused I cannot be sure of. I waited till about six months to contact the doctor with my concerns about the result – I had lost almost all the native hair in the area treated as well as in some surrounding areas, the hairs which had grown were in some cases growing straight out (i.e. vertically rather than horizontally), my dermatitis had become severe, and the thin areas were now much thinner than they had been before the operation. In addition I now had in their place hairs which were not natural eyebrow hairs. Post Op communication with the doctor I met the doctor for a post op check up 7 months after the result. Following on from it I sent an email to him listing my concerns. Despite several chasers I received no response after six weeks, just periodic responses by his patient rep assuring me that I would be receiving one. It was only when one of his colleagues stepped in that I received a satisfactory response. He offered a full refund as well a touch up procedure. Not wanting to risk further damage I declined his offer as well as the offer of the refund. The damage is long-lasting and permanent. We resolved to meet at the end of the year (December 2012) to discuss the final, final result. Experiences with other leading doctors Around this same time, I had started to re-explore the situation with a view to understanding what could be done to improve the result. It so happened that Jotronic and Dr Hasson were visiting London. I decided to schedule a consultation. I spoke with Joe for twenty minutes, and was most impressed by his technical knowledge as well as the fact that far from ‘selling’ a procedure, he was at pains to discuss risks and alternatives. It was at that point that I realised that not all hair transplant surgeons should be tarred with the same brush. I then decided to find out how other high-profile doctors would have treated my condition presented with the same, initial information as I had my surgeon. What I found was disturbing, though not surprising. Many of these well-respected doctors claimed to have 100% success rates, with no unsatisfied patients. Most claimed there were few to no risks involved and most spent no time discussing alternatives. One doctor’s office, at my third request for photographic examples of their doctor’s eyebrow work, provided me with cropped out copies of another, now discredited former coalition doctor’s patients. There were however two notable exceptions (in addition to Hasson and Wong, mentioned above): they were Dr Keene and Janna, at Shapiro. Janna from SMG said that eyebrow pencilling would be the safest, easiest and most effective solution. She further stated that to transplant more than 20 hairs to my eyebrows would be ‘unethical and risk shock loss’ (I had had 150 transplanted!). I want, in particular, to thank Dr Keene. Dr Keene spent countless hours responding to my emails, discussing possible options on the phone, and, in general, being a great source of advice and support. She is, without doubt, one of the most sincere, ethical and compassionate doctors in the Coalition, to say nothing of the wider medical community. I cannot thank her enough for her kindness and decency, and my only regret is that I didn’t consult with Dr Keene (or Janna or Joe) a year before. Final meeting with my doctor During my final meeting with the doctor, I came with an open mind. I was not interested in refunds or top ups, my aim was to ensure that the hard lessons from my experience were learned. To his credit he didn’t seek to deny the result, he accepted it for what it was. He apologised for his mistakes in his staff not discussing my dermatitis with him, for his not having discussed alternatives. He is now taking a much more pro-active approach with pre-operative consultations and discussions of all risks and alternatives to eyebrow transplantation. This was welcome news to me. His work as a scalp hair transplant surgeon is excellent in those cases I have seen, and for those who are prepared to risk an eyebrow transplant, he is now enabling them to give informed consent. It is only a shame that these lessons had not been heeded prior to my operation. Lessons for Patients and Doctors I just wanted to finish by sharing what are, in my humble opinion, the key lessons both for patients and doctors. Lessons for patients 1. Do not rush into cosmetic surgery: This is a decision with life-long consequences and which in many cases the results of which cannot be reversed. As Jotronic repeatedly says “Research, research, research”. 2. Consult with a wide range of surgeons: Do not think it enough to speak to three of four surgeons. Speak to at least ten (and I’d recommend that Drs Hasson & Wong, Dr Keene and Drs Shapiro should be definitely on your list). The more the better, and use your own common sense, intellect and intelligence to weigh up the pros and cons of surgery, other treatments, or no treatment at all. 3. Ask for photographic evidence: I asked on a number of occasions to see photographs of the doctor’s eyebrow work and was told it would be forthcoming only for it never to materialise. In the end I was shown one example 10 months after my procedure. Other leading doctors seemed to have similar problems providing evidence. One, as mentioned above, used a different doctor’s! Another, despite his repeated claims of excellence in the field was unable to provide any photographic evidence. A third provided photos where you no difference was discernable whatsoever between the before and afters. Make sure you see several examples of your doctor’s work, and make sure the examples are similar cases to your own. If possible, speak and see former patients. If a doctor says they have done this work but can’t show photos for privacy or other reasons, then that should be a serious red flag. Sorry to quote Jotronic again but as he says in one of his videos on youtube “Promises, results” - make sure you see results, lots of them, and that they are similar cases to yours. 4. Assess whether you’re a good candidate: For those contemplating eyebrow transplants, I would say the only good candidates are males without eyebrows or who have areas totally or almost totally without eyebrows - there is no risk of shockloss in that case and tattooing or pencilling is not a suitable option for males in such instances. Females without eyebrows or who have thinning eyebrows should consider pencilling or tattooing. Males who have thinning eyebrows should consider pencilling or tattooing. 5. Sharing your experiences with others: Those patients who have had negative hair transplant experiences, should make sure they share them with others on such forums as these so other prospective patients can learn from them, and to hold doctors who make mistakes (and don’t make amends) to account. Lessons for doctors 1. Fulfill your duty as doctors to provide patients with informed consent: This means discussing all risks and alternatives. This is important not only from an ethical standpoint, but also a legal and reputational one. If you want to build a successful practice and not run the risk of tainting your name through negative online reviews, this is the only way to do it. Mistakes happen and cosmetic surgery has no guarantees so this is especially important. Indeed, I think there may even be an argument, that in the same way that all investment funds must by law carry warnings in their advertisements that the “value of your investments may go down as well as go up”, cosmetic surgeons should also be forced by law to warn patients on their websites, in their promotional materials and during consultations that surgery can result in negative as well as positive cosmetic effects. That might seem to be a statement of the blindingly obvious, but all too often - as my experience as well as those of numerous others attest - cosmetic surgery is sold as a no-risk procedure. 2. Have pre-operative consultations before the operation is scheduled: I am astounded by the fact that it is common practice in hair transplant (and cosmetic) surgery to have consultations on the day of the surgery. How can a patient be said to exercise informed consult when he/she has already travelled in some cases many thousands of miles, paid large non-refundable deposits, and taken several weeks’ annual leave. Pre-op consultations should take place on skype if the patient does not live in the doctor’s locality. 3. Include skin conditions on medical screening forms: I mentioned in my case that the patient representative failed to pass on the fact I had dermatitis to my doctor. However, mine is not an isolated example. I have seen many experienced doctors mention the problem of finding out on the day of surgery that a prospective patient has psoriasis or some other such skin condition. If along with questions about high blood pressure, diabetes and the myriad of other conditions about which information is requested, doctors ask about skin conditions this problem wouldn’t occur. 4. Provide consistent and clear HD before and afters: Hasson & Wong and SMG have been leading the field in this regard, but other leading doctors seem to be lagging behind. The quality of presentations by other doctors is not of an appropriately high standard in my view. The shots should be clear and the before shots should be placed next to the after shots to allow for easy comparison. 5. Make sure your patient reps are better trained on medical matters or don’t delegate such matters to them: Some patient reps/techs are incredibly knowledgeable about hair transplantation; Janna and Jotronic are to my mind, as knowledgeable if not more so than many of most respected doctors, and their clinics can feel comfortable delegating questions to be answered by them. Others are new to their jobs or do not have a natural interest in such things. In such instances the doctor should handle such queries. Dr Keene is unique amongst the coalition in making sure she has a very hands on approach to each patient and making sure all medical issues are dealt with by a proper medical professional – she should be commended for this approach. 6. Keep open lines of communication with your patients, particularly your unhappy ones: It is not enough to communicate promptly and punctually when registering patients for operations, only for those lines of communication to cease once problems arise after the operation. The relationship should be an ongoing one. Doctors should not go silent on those patients whose results are less than desirable. They should be supportive and communicative.
  4. Hi guys. I'm new to the site, but I've lurked for some time now... after several years of debate, and many struggles with propecia (extreme mental sides -- brain fog, migraines, terrible vision problems, anxiety, etc.) I recently decided that now was the time to pull the trigger and to undergo surgery. After much research, I landed on Shapiro Medical Group in Minneapolis (Bloomington), MN. My FUE procedure took place roughly 10 days ago with Dr. Paul Shapiro -- here's my experience thus far: Heading into my surgery date, I had a whole plethora of emotions -- nervous, anxious, hoping for the best, etc...My biggest concern at the time (and still today), however, was "what will people think of me if they knew I underwent a hair transplant?" Because of this, I've decided to keep this to myself. And so, for the past 10 days now (as well as the next 10 days, as is the plan), I've basically been camping out at my home and have been making up excuses and lies to my friends & family to avoid seeing anybody until my donor region grows back to a length where I can pass it off as just being a shorter-than-usual haircut. I feel terrible about having to go through these tactics, but it's the decision I've made and I'm working through it...Along these same lines, this is why I chose to not shave my entire head (to leave the recipient area unshaven -- the "goal" of mine is that after a few weeks, I'll be able to pass my haircut off as just being a shorter cut. All of that said, SMG did an excellent job of making me feel comfortable upon arrival. Dr. Paul Shapiro was able to go through my history, answer my questions, and work with me to determine a surgical plan. I believe that my goals were realistic -- for me, this procedure was equally (if not moreso) pro-active/preventative as it was corrective. I only wanted a slight increase to the hairline (I'm still fairly young, so I wanted to consider having a mature hairline moving forward), and the rest of my grafts I wanted to use to increase density & to prolong my current aesthetics. I've documented my progression, which I'll use the next couple posts to bring this up-to-speed with where I stand today. Please let me know your thoughts on how things appear to be going. My absolute biggest concern right now is in regards to shock loss -- I've been trying to do some reading on it (without scaring myself too much), but I haven't come across an answer of a.) how often extreme shock loss occurs? b.) at what point shock loss starts at, c.) what (if anything) I can do to prevent it? ...I'm concerned mostly because I have existing hair in the transplanted region today, and because I've been off propecia for roughly 9 months now, so I may be susceptible to loss as it is. Just yesterday, I began noticing shedding starting to occur when running my hand through my hair in the bathroom...can I owe this to the fact that I've been off of my rogaine/s5/nizoral for 10 days now, or is this potentially shock loss starting already? Another FYI: I've been taking biotin 5000mcg 2x's daily as well as MSM 1000mg 2x's daily to help increase the donor region hair growth. I also plan to start using rogaine in that area starting the next couple days (once my scabs have fully healed). Let me know if this is advised/ill-advised. Thanks! One last note: I was in heavy contact with Matt Zupan this past year and a half and if you've had the opportunity to speak with him, then you'll know that he's super easy to talk to and I couldn't be happier with my communications. Likewise, Janna Shafer has been very helpful post-op, taking my texts/calls in the evening & weekend hours -- if either of you two happen to read this, then I thank you very much for your hard work.
  5. I had the distinct pleasure of undergoing another procedure at SMG for a 357 FUE touch up (mainly on the left side of my hairline). The last three years have been excellent after my initial 1538 FUE procedure (also performed by Dr. Shapiro) and the perfectionist side of me opted to undergo a minor touch up when the opportunity arose. Going in for a one day procedure (that ended a little after 1 PM after arriving at the clinic at 7:30 AM) was a walk in the park compared to the three day procedure three years ago. Besides this just being a smaller procedure, I went in psychologically with much greater comfort having already went through the arduous research and decision making process of considering at HT. Additionally, knowing how comforting and accommodating SMG is made the process immeasurably easier. I came in fully prepared to shave my head and was extraordinarily happy I was able to leave around 3/4 inch on top due to the small procedure. SMG having an in-house stylist is beyond awesome! The extractions were performed by Dr. Josephitis (new to SMG in 2013). while Dr. Paul Shapiro created the incisions. Janna expertly placed in the grafts. So a big thanks to all the staff from the start (Matt Zupan for coordinating) to finish. I am impressed so far by the progression of healing as the ATP Liposomal spray seems to be working well. I am pretty stoked on the results so far and will post updates accordingly. Please see the attached post-op day three pictures.
  6. It looks like I'm among the first to post pics and share my experiences from the Artas FUE robot which took place in Feb'13. A total of 2007 grafts over two days. In my case, 100% of the grafts were transplanted using ARTAS, a first for SMG I believe. I guess I was lucky to be worked on exclusively by Dr. Paul Shapiro (And Dr. Ron for small bits of the procedure) because Tom (the tech) was out sick. Currently, I believe I've experienced all of my "shock loss" and my hair loss looks as bad if not worse than it did before the procedure. I'm anxiously awaiting signs that the procedure was successful and will update pics at month 3 and 6. I'm currently only on topical minoxidil + topical finasteride and ketoconazole shampoo. The procedure itself was awesome to observe and felt like I was in a science fiction movie! No pain and the rate at which ARTAS punches around the grafts is quite incredible. I guess I'll let the pictures do the talking and answer any questions you have About the pictures: Pic 1 - Shows diffuse hair loss treated only by topicals Pic 2 - Taken immediately after the procedure Pic 3 - Shows healing at nearly undectable levels by the 5th day
  7. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses what his hair restoration clinic offers hair loss sufferers considering him for a surgical hair replacement procedure.
  8. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses what can be realistically expected in terms of surgical hair restoration naturalness and density with today's state of the art ultra refined follicular unit hair transplantation.
  9. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses his personal philosophy on hair restoration patient care and education.
  10. In this hair transplant video interview, Coalition doctor Dr. Ron Shapiro provides important tips to hair loss sufferers on how to select a quality hair restoration physician.
  11. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses how the Hair Transplant Network helped and influenced his hair restoration practice.
  12. In this hair transplant video interview, Coalition surgeon Dr. Ron Shapiro discusses several of the advantages his hair restoration clinic has experienced in becoming a member of the Coalition of Independent Hair Restoration Physicians.
  13. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses the advantages of dozens of quality hair restoration physicians being involved and recommended on a single online community, the Hair Transplant Network
  14. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses the difference between educated prospective patients that come from the Hair Transplant Network who know their hair restoration clinic is among the best verses those who come in locally from the Yellow Pages.
  15. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses the advantages of realistic marketing that will stimulate interest while educating hair loss sufferers.
  16. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro shares the good news with hair loss sufferers that while they do have to learn about state of the art hair restoration techniques, they no longer have to be bald.
  17. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro shares the importance of helping hair loss patients meet their hair restoration goals and make them feel comfortable.
  18. In this hair transplant video interview, Coalition physician Dr. Ron Shapiro discusses his involvement in surgical hair restoration and how he became recognized as a world leading hair replacement clinic.
  19. Coalition surgeon Dr. Paul Shapiro discusses the many reasons prospective patients decide to choose their hair transplant clinic for their procedure. This includes their stellar reputation; proven track record of producing excellent results, commitment to patients, and honesty.
  20. In this hair trransplant video, Coalition doctor Dr. Paul Shapiro discusses his hair restoration clinic's strongest point - their commitment to their patients.
  21. In this hair transplant video, Dr. Paul Shapiro shares what factors are important for patients in receiving an excellent hair restoration outcome from an oustanding surgical experience to exceptional results.
  22. Coalition doctor Dr. Paul Shapiro provides advice to hair loss sufferers considering hair transplantation to treat baldness. He advises prospective patients to visit the Hair Transplant Network to research and speak to veteran hair restoration patients who've been through the procedure before.
  23. Coalition member Dr. Paul Shapiro discusses hair transplant specialty cases he's performed including hair restoration on patients with hair loss due to burns, chemotherapy, etc.
  24. Coalition physician Dr. Paul Shapiro explains what hair transplant patients should look for in a quality hair restoration physicians. This includes board certification, a surgeon's experience, and a consistent record of producing excellent hair replacement results.
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