Set A Date W/ Rosanelli --Review of Procedure, etc

[Guest sac95816]

Balding Brethern,

 

I'm a newbie but have done intensive research over the last several months and this site has been invaluable. I went for a consultation with Dr. Rosanelli, S.F., on Friday. I had previously viewed his website with skepticism, as it advertised outdated techniques and offered very few patient photos.

 

For anyone doing research and desireous of a HT in the Bay area, here's the DL on Dr. Rosanelli. First, He doesn't believe in FUE as clean extractions are difficult and he believes it can result in transecting folicules. Second, he uses single blade scalples, which one should expect. Third, he performs FU, placing single hair grafts on the hairline and micro (two to three FU's, behind the hairline. Fourth, he has a sizable surgery team, 5 to 6 assistants. I was able to meet them and most were vetrans with at least 2 years of experience. Fifth, Rosanelli has 5 to 6 stereo microscopes in the operating room. Sixth, he is flexible on price and will structure payment plans (huge selling point to me as I'm in my last year of law school and don't have 10k in the bank). Seventh, pricing seems reasonble, 1200 grafts for 5K with payments...not bad.

 

The BAD: First, Rosanelli seems to favor multiple smaller sessions rather than the much heralded "mega session." His reason for this is greater survival rate and reduced shock loss. I'm not sure of the merit of this view but that's it nonetheless. I certainly don't want to undergo three surgeries in a year. Second, he's very conservative with the hairline. His rationale for this is that future hairless will likely occur, even if you're dedicated to life-long medication. Also, at my age (27), he doesn't want to deplete the donor area. (he originally estimated my need at 1500 grafts but I had to argue strenuously just to get 1200 grafts in a single session.)

 

So that's the good and the bad with Dr. Rosanelli. I'm scheduled for surgery on Oct. 28th and have already paid my deposit. I fully intend to plead for 1200 + grafts on the day of surgery, as I'd like to wait a few years before my next surgery.

 

Hope this is helpful. Also, I'd appreciate any feedback from you Vets out there.

 

Rookie question, 1200g on the hairline and top third of the head should make a visible difference, right? But is it enough to re-create most of a hairline (I have little hair remaining on my hairline).

[Guest sac95816]

Balding Brethern,

 

I'm a newbie but have done intensive research over the last several months and this site has been invaluable. I went for a consultation with Dr. Rosanelli, S.F., on Friday. I had previously viewed his website with skepticism, as it advertised outdated techniques and offered very few patient photos.

 

For anyone doing research and desireous of a HT in the Bay area, here's the DL on Dr. Rosanelli. First, He doesn't believe in FUE as clean extractions are difficult and he believes it can result in transecting folicules. Second, he uses single blade scalples, which one should expect. Third, he performs FU, placing single hair grafts on the hairline and micro (two to three FU's, behind the hairline. Fourth, he has a sizable surgery team, 5 to 6 assistants. I was able to meet them and most were vetrans with at least 2 years of experience. Fifth, Rosanelli has 5 to 6 stereo microscopes in the operating room. Sixth, he is flexible on price and will structure payment plans (huge selling point to me as I'm in my last year of law school and don't have 10k in the bank). Seventh, pricing seems reasonble, 1200 grafts for 5K with payments...not bad.

 

The BAD: First, Rosanelli seems to favor multiple smaller sessions rather than the much heralded "mega session." His reason for this is greater survival rate and reduced shock loss. I'm not sure of the merit of this view but that's it nonetheless. I certainly don't want to undergo three surgeries in a year. Second, he's very conservative with the hairline. His rationale for this is that future hairless will likely occur, even if you're dedicated to life-long medication. Also, at my age (27), he doesn't want to deplete the donor area. (he originally estimated my need at 1500 grafts but I had to argue strenuously just to get 1200 grafts in a single session.)

 

So that's the good and the bad with Dr. Rosanelli. I'm scheduled for surgery on Oct. 28th and have already paid my deposit. I fully intend to plead for 1200 + grafts on the day of surgery, as I'd like to wait a few years before my next surgery.

 

Hope this is helpful. Also, I'd appreciate any feedback from you Vets out there.

 

Rookie question, 1200g on the hairline and top third of the head should make a visible difference, right? But is it enough to re-create most of a hairline (I have little hair remaining on my hairline).

[Pat - Community Publisher]

sac95816,

 

Thanks for your excellent detailed report on Dr. Rosanelli. I think you clearly have learned what to look for when evaluating a surgeon.

 

It's great to get your first hand feedback regarding a surgeon. Interesting that I just arrived tonight in NYC to review clinics in this area, while you're out on the West Coast reporting on a physician in San Fran.

 

Not that much is ever reported on this forum about Dr. Rosanelli. I've met him at various meetings but I've never had the chance to visit his office. I also found that his website provided contradictory info and that the photos were not particularly compelling.

 

However, having 5 to 6 microscopes and trained techs to cut grafts under them is impressive. With such a staff he should have the capability to do a larger session for you. A 1,200 graft by todays standards is small - assuming you have extensive baldness.

 

When a patient is an appropriate candidate for a mega session, I do not agree that sessions of between 2,500 to 3,500 have any less successful growth than sessions of 1,200 - when done by a top notch clinic that is using minimally invasive incisions and highly refined grafts.

 

The Caveat is that for such large cases to be successful and achieve excellent growth the clinic must be using ultra refined grafting techniques that minimize the impact on the scalp from each incision, which thus enables them to make more incisions without increasing the overall vascular trauma to the scalp.

 

Perhaps Dr. Rosanelli has not transitioned to using the tinier incisions and grafts and thus does not feel confident in going beyond 1,200 grafts in your case.

 

For example the typical incision for a standard follicular unit surgery ranges from 1mm to 1.5mm and even as high as 2mm. Surgeons who are performing ultra refined follicular unit grafting are using tiny instruments that enable them to make graft incisions as small as .6mm for one hair grafts and 1mm for multi hair follicular unit grafts.

 

I believe that Ultra Refined Follicular Unit Grafting has benefits in particular for patients who want to dense pack grafts in a given area to achieve "one pass" cosmetic density. I also believe that the healing is quicker and that shock fallout is often reduced.

 

Currently I know of no surgeon in Northern California who is providing ultra refined follicular unit grafting.

 

Please keep us posted on what you learn and welcome to our forum.

 

Pat

 

 

The evidence from both patients and physicians seems to overwhelmingly support

[spoon]

Hold up just a second. "he performs FU, placing single hair grafts on the hairline and micro (two to three FU's, behind the hairline. "

 

Do you mean "two to three HAIRED FU's" behind the hairline or minigrafts of two to three actual FU's, which would contain 4-7 hairs?? That, my friend, is a recipe for plugginess.

 

I hate to cast doubt when I have no experience with this doctor but you have only one chance to do your transplant properly and you have some red flags here. Just because there ARE microscopes doesn't mean they're always used. I urge you to exercise strong caution. Your deposit might be sunk but your appearance is worth more.

 

Edit: 1,200 is not even close to a megasession by today's standards. There is no evidence to suggest that smaller sessions grow better. In fact there is overwhelming evidence to suggest that large sessions grow just fine. Fewer larger sessions is much more beneficial to you as a patient than multiple smaller sessions. Now without pics it's difficult to say how many grafts you should be aiming for but I think you're setting yourself up for disappointment.

[the B spot]

Yes I would tend to agree with Spoon here. I am twenty-nine and just going for my HT with Shapiro after three years of research and waiting. 1200 is not that large a session if you see some of the work posted on this forum. Also, as far as price goes, 1200 for 5000k is not a great deal in my estimation. If you were doing say 2000 for 7k, bringing your cost to 3.50 a fu, that would be along the lines of a good price. I would check around a little more if I were you and change my date to allow for it. Of course this is just an opinion, but I get the idea that you would like more done at this time.

[Guest sac95816]

Thank you for your replies. First, I agree that 1200 grafts isn't a "mega session." In fact, I'd consider that a relatively small HT. Second, I've consulted a number of HT docs. in the bay area and most will not, or do not, perform single hair transplants behind the hairline. The norm seems to be to place double or triple follicular units behind the hairline. Of course, these docs. claim that this creates the appearance of greater density but it is convenient for them as well, requiring less work for them and their staff, perhaps at patient expense.

 

Still, Rosanelli seems honest and forthwright. He made no unrealist promises and was suprisingly earnist about my future hairloss and the need to preserve the donor area. I'm not certain how to percieve the lack of imput regarding his work. His patients either don't post at this site or, perhaps, he doesn't have as many patients as he claims. He suggests that he performs surgeries on two patients a day (not a good fact; it should be one). But if this number is accurate then he should have a considerable pool of post-op patients. right?

 

Spoon, I appreciate your comments and they're well received. However, disappointment is a product of expectation and, frankly, it'd difficult to disappoint me. I expect little more than a more complete hairline...I don't expect full/natural coverage or density. Dr. Rosanelli isn't considered a preimenent HT dr. and I know that. I merely expect competence. After law school, I hope to have my hairline "touched up." I believe that even lesser known dr.s can, and do, perform good HT procedures, though, perhaps, without stunning results or internet fan clubs.

[Guest]

Good luck with your upcoming surgery later this month. I too am new to all of this and have consulted with Dr. Rosanelli with a tentative surgery in late november. He seemed honest and straight forward but I've really not researched the newest techniques and procedures. I am really concerned about "shock loss" and was thinking of having a small procedure (700 graphs) on the crown to get an idea of how my head will respond. Any advice or suggestions?

[Guest sac95816]

Mojo

 

I agree that Dr. Rosanelli seems honest, straight forward, and charasmatic. As far as techniques go, Rosanelli does use follecular unit transplants, the most current form of transplant. This technique is an technological advance from the old micro and mini grafts used in the 80s.

 

I personally have only three reservations about Dr. R. First, the lack of information pertaining to him on the internet forums. Second, the shortage of patient photos. Third, his preference for multiple, smaller surgeries. Remember, he's performing strip surgeries which have potential for complication and can be painful and take time to recover from.

 

A strip surgery for 700 grafts is questionable, as is my own surgery, 1200 grafts. You only have so much scalp, and donor laxity, which means that additional surgeries aren't gauranteed. Shockloss is also a concern for me.

 

If you'd like to discuss this in greater detail, PM me and perhaps we can discuss other details and potential problems.

 

I'd like to hear about your consultation experience. It's good to hear that someone other than me has had some experience with the doctor; there's a paucity of information about him so he's difficult to evaluate.

 

Thanks for responding,

 

Sac