Impossible repair?: BHT in action -Dr Umar

[Atticus]

Originally posted by Pat - Publisher of this Community:

Please Grow Please,

 

I hear your concerns. I will email Dr. Umar to provide more information about his philosophy and to encourage him to provide more examples of straight FUE work.

 

My sense is that he has recently posted the most difficult cases that a physician can encounter and that standard FUE would be less challenging. But I agree that we should hear more from him about his overall philosophy and see more of his work.

 

Thanks for your thoughtful input.

 

Pat

 

Hi Pat,

 

As far as I am concerned, Dr. Umar is the leading BHT repair expert in the HT realm. Let's face it, BHT is much more difficult to do than FUE. Only the most qualified and artistically inclined gifted surgeons can pull it off and have it look natural.

 

Having said that, Dr. Umar performs many, if not mostly, FUE HT's. I am a prime example. Dr. Umar added 500 grafts (added 100 more free) and devoted all day to me, and me alone. My point being? He does FUE only jobs, and more importantly takes on small jobs like mine with the same passion and dedication of a huge job. FUE or BHT, he is tops! In my case, BHT was never even discussed. I would recommend him to anyone, whether considering a small hairline job like mine, or a major repair. Though my HT was small, it has made a huge impact on my life! Thanks Dr. Umar!

 

I hope my comments help. Here is my forum blog:

 

http://www.hairtransplantnetwork.com/blog/journal.asp?CopyID=1628&WebID=773

 

 

Atticus

[Bill - Seemiller]

Atticus,

 

I really appreciate your comments on this thread.

 

I completely forgot that you were a Dr. Umar FUE patient. Your result looks great.

 

Can you take some after photos of various angles and add them to your blog so we can get a better view of the result?

 

Best wishes,

 

Bill

[hairzone]

what the percentage of growth with BhT has any one done a study on that?

[Dr. Sanusi Umar]

Thank you all for your kind words and for considering my membership in your community.

 

My philosophy to HT is that of adopting the most minimally invasive approach towards attaining the patient's goal. In the overall, I always emphasize the utilization of the best available donor source in a manner that takes into account the trajectory of the patient's degree of hair loss.

 

By my observation the quality of donor source is in the order of Head; Beard; Body...

If a potential patient presents with NW4 or less degree of hair loss for instance, I would not ordinarily consider BHT as an option in such a patient unless there is a relative or absolute lack of head donor supply for one of many reasons. Many patients that come to me requesting the use of non head hair as a donor source are turned down mostly for the reason of not meeting my criteria for BHT usage. I have in fact incurred the wrath of some potential patients for the same reason. The foregoing is an example of a potential patient who I disqualified that decided to go to another hair loss forum to complain about it. Embedded in my response is a synopsis of my selection criteria for BHT:

 

 

 

ORP967 posts on another forum :

 

Friday May 23, 2008 11:00 PM

 

 

 

Hey Sofar,

 

I see you respond quite often to post regarding BHT... as well you should because of your results (they're great!). I was wondering if you had any trouble getting Dr. Umar to go ahead with your BHT goals pre-op? I'm currently in talks with Dr. Umar for my BHT hairline goals and I'm noticing he is very hesitant (you could even say against BHT) yet he advertises BHT results pretty religiously.

 

 

MY RESPONSE:

 

 

"

Although we have gathered a significant number of cosmetically significant BHT related results, I have always maintained that like any and all other surgical or medical procedures; not everyone is a suitable candidate. There is no procedure in medicine in which everyone qualifies with absolutely no exceptions. That is simply the nature of medicine. The process of a surgical procedure begins with the consultation process, in which your doctor acquires all necessary details with which he/she would base his/her decisions. At some point he/she would have to determine if you are a suitable candidate for the procedure. This selection process has been credited by many doctors as accounting for over 50% of the success of the procedure. In hair transplantation (an elective and cosmetic procedure), the process of patient selection should even be more rigorous. This process of selection is not unique to BHT or hair transplantation. It applies to all medical procedures.

 

SPECIFIC TO BHT: I have (and continue to) turn down some prospective patients requesting BHT from me because they are not suitable candidates by my assessment. Common reasons for rejecting a case includes (but not restricted to):

 

1. Poor body hair characteristics (By my criteria).

2. When head hair supply relative to present and anticipated hair loss is judged adequate

3. Unreasonable expectations. Some have concealed this at consultation. But often, it is very evident.

4. Other factors (often non technical, often psychological) that may make the individual unsuitable for most cosmetic surgeries including BHT. These factors are not often evident at consultation and some individuals could manifest these only after undergoing the procedure having successfully eluded the screening criteria which is not infallible.

 

Patients considering having BHT at my clinic should start with a formal consultation in order to (amongst other things) determine their suitability for the procedure. This can be done online by calling the office for an in-office consultation or simply go to the "free online consultation" page on my website. All consultations are conducted 100% by me personally. free online consultation page: http://dermhairclinic.com/dhc_consultation.aspx

 

ORP967:

 

We do not promote or advertise BHT "religiously". For the most, we have simply shown what we have achieved with a procedure that many other clinics have had difficulties with. For the most I have emphasized work on:

 

1. Repair patients: Some of these patients have had a positive life altering transformation from BHT. In most of these often disfigured patients, BHT has been more than just a cosmetic procedure. In these patients (eg the poster "newgrowth", and the patient on the youtube video link #2 below), the selection process is justifiable more lax compared to for instance a young individual with a virgin scalp with virtually no hair loss that only wishes to (perhaps unnecessarily) advance his/her hairline.

 

2. I have also used BHT (in combination with head hair) in significantly bald individuals that are not repair cases, whose hair loss (present plus projected) cannot be met by head hair donor alone.(See youtube video link #1 below).

 

3. I have also used used BHT in specialized instances like hairline refinement with finer body hair (Search the poster "sofarsogood") or eyebrow transplants.

 

A track record in producing good results in any procedure often builds with experience. This by implication means that over the years, one develops a better sense of what might work or not work. If after acquainting myself with your case I advise you against BHT or any other procedure in my arsenal, then it is likely you do not meet (perhaps glaringly) my inclusion criteria. This is most likely the case in your instance. I do not have an ulterior incentive for turning down a case. On the contrary, the reason is often altruistic. I will thus advise you against further pursuing the procedure. You are of course at liberty to consult other clinics, however, bear in mind that there would always be doctors /clinics that would be willing to do your bid for money regardless of the contraindications however glaring the may be. "

 

 

 

.

So yes I perform BHT in patients that meet the criteria listed above. It so happens that the patients are often without alternatives such as "newgrowth" or patients that have so severe a hair loss seeking global coverage that cannot possibly be met by head donor alone. In between are gray areas of course. The good news is that in suitably qualified candidates, we have shown our ability to make BHT work. Would there be failures...of course, but which procedure is without its share of less than stellar results. I have been up front with my patients who would be quick to inform that they can always count on the bald truth at all times. When other clinics feared that the revelation of a negative effect of DHT inhibitors may cut down on their BHT clientele, I wasted no time in pointing out the possible deleterious effect of these meds in the viability of BHT. 3 years later, some patients and clinics that ignored the warning have unfortunately discovered the truth the hard way.

 

 

Finally, at the risk of boring the readership, I perform scalp only FUE, a procedure that is less nuanced than BHT and more bread and butter, compared to some of the BHT cases I have been showing. These cases have been highlighted because of their unique nature and the fact that many clinics and doctors have disparaged the procedure as bogus partly because of their failed attempt at performing it or because of the reputation the procedure had garnered from actions attributable to its early purveyors. Some of my scalp-FUE-only patients have become active on this forum already. These are active forum members that can be reached by interested parties, both of whom I am sure would gladly meet interested parties in person (you may need to buy them lunch in the process though):

 

 

 

The poster Hooray for hair. NW 4 3000 graft scalp FUE only

 

Hooray's personal blog

 

 

 

The poster Atticus: Hairline work scalp FUE 600 grafts

 

 

 

There are more in my website and many more to emerge when the photogallery is updated.

 

I will be posting some more cases of scalp only FUE along with BHT-only and BHT-FUE-combo cases. Most of the cases I would post would have an educational angle in them.

 

 

In conclusion, I would ask that I be excused in the event of my slowness in response to enquiries going forward....I do all my forum postings and most aspects of my surgeries, consultations etc personally, thus accounting for the seeming delay / non response to forum enquiries on occasions..

 

I thank you all.

[Bill - Seemiller]

Dr. Umar,

 

I like that you are a realist and don't give into the hype by overselling FUE. I am impressed by your professionalism and concern for the patient first above all else, even if it means turning someone down.

 

Thanks also for providing links to some of your FUE scalp only patients.

 

Best wishes,

 

Bill

[exibel]

Great end result ,gives some kind of hope to those of us who have been unfortunate enough to go through similar experinces.

[Tembo]

Hi Doctor Umar! Great work.

 

I asked a question on the other site about the difference in your technique from the Dr. you went to see outside the US (whose name can't be mentioned here). I got no response.

 

Can you please spell out the advantage of your technique over the other doctor's technique. He is cheaper and I am contemplating visiting him, but not decided yet.

[Pat - Community Publisher]

Given Dr. Umar's impressive work and his willingness to actively participate on this community I think he deserves serious consideration for recommendation.

 

I have created a topic entitled " Potential Recommendation of Dr. Umar".

 

Those who would like to comment on his possible recommendation, please visit that topic and comment.

 

Thanks for everyone's input.

 

Pat

[wylie]

Originally posted by Tembo:

Hi Doctor Umar! Great work.

 

I asked a question on the other site about the difference in your technique from the Dr. you went to see outside the US (whose name can't be mentioned here). I got no response.

 

Can you please spell out the advantage of your technique over the other doctor's technique. He is cheaper and I am contemplating visiting him, but not decided yet.

 

How can he spell out this advantage if he does not even know the other doctors technique?

 

I know of at least three doctors performing this surgery, including Dr. Umar, who have developed (and thus named) their own surgical technique. Its kind of hard to answer your question when you do things a unique way

[Tembo]

wylie, Dr. Umar went to see him a while back, and that other doctor shares his technique freely unlike the one in Australia.

[wylie]

Originally posted by Tembo:

wylie, Dr. Umar went to see him a while back, and that other doctor shares his technique freely unlike the one in Australia.

 

I know who you are talking about. I also have alot of admiration for this doctor and think he is a genuinely caring physician who will always have your best interests in mind.

 

Trust is important, as is doctor skill, and while I would surely trust this doctor, I just dont think he is as accomplished as Dr. Umar.

[NewGrowth]

Pat,

 

Thanks for the best wishes thoughts, as far the body hair feels, it feels like scalp hair. The hair does grow long, I can't really say how long, but easily a few inches. It is usually at this point I've gone back for a surgery with Dr Umar and get the imfamous "surgical cut" where the hair is cut down really short so surgery can be performed in the surrounding areas. Beard hair has no problem growing and I think will allow a lot of men the opportunity to achieve more than they thought possible. A lot of the hair in the front from the chest and stomach area and so far it has grown without any problems. It has been cut down and grown out a few times, so it seems to act like scalp hair. So far so good.

 

NewGrowth

[uncjim]

Newgrowth,

I'm speechless. You have found a gem in Dr.Umar.

UNC

[Dr. Ricardo Mejia]

This case demonstrates the role for BHT when other possibilities may not exist. Very Nice. Dr. Umar also gave a very nice lecture at the International Society of Hair Restoration Surgery meeting demonstating the benefit of BHT. Kudos.

[Dr. Sanusi Umar]

Dr Mejia,

 

I thank you for your input. Hopefully we would be exchanging ideas at the next ISHRS meeting in Montreal.

 

Regards,

 

 

 

Originally posted by Dr. Mejia:

This case demonstrates the role for BHT when other possibilities may not exist. Very Nice. Dr. Umar also gave a very nice lecture at the International Society of Hair Restoration Surgery meeting demonstating the benefit of BHT. Kudos.