With regard to Dr. Unger in toronto...

[Dirge]

I recently had the opportunity to consult with Dr. Unger in Toronto, and contrary to everything I have read on this Board, he basically does nothing but FUI grafts and has been doing this for years. He has been a convert ever since the research has showed a significantly improved survival rate of transplanted hairs, which previously had been a concern...he acknowledges that this is the only way to appropriately do a trnsplant and createan untectable hairline, except in the most exceptional cases. This is in direct contrast to what I have read on this board as to be being a a dinosaur who would not change etc...from the momement I walked in as a formers patient FUI was the only option discussed...no more punches or strip grafts of any sort. I am not surprised

that he is not listed as an approved surgeon on this site as he has alaways stayed away from advertising and the internet etc...he, I am sure, if asked, would decline an opportunity to go through the evaluation process, as he does not need this at this stage of his career, and as the "pioneer" in the field before sites like this and the internet existed, no need to subject himself to that process. Bottom line is he does only FUI's, unfortunately he now charges more do to longer sessions, but all this stuff I have read about him still using punches and strips is just not accurate. I was also impressed with his associate Dr. Marla Shapiro, and I had recently visited Dr. Rahal in Ottawa. I am seeking a natural

hairline following transplants in the early 80"s and mid nineties which reflected the technology at the time...so now I am needing to make a decision. I am a past patient of Dr. Unger's for all of my past surgeries but this was the first time I have seen him since 95, certainly not an associate or employee in any way. My point is that there is significant misperception re Dr. unger's practice that needs to be corrected, and his web-site needs updating to reflect his current practice...FUI, state of the art microscopes, experienced teams, and the primary and most significant influence on the field when nobdy knew what state of the art would eventually look like. Dr.unger has evolved and is doing everthing this site advocates...hope this clarification is helpful to others.

[John_in_NC]

you seem awfully too concerned with him.

 

Suspicion aside, Pat should just take your word and add him?

[Dirge]

Not overly concerned, other than trying to correct what I think is an outdated preception. I would not be surprised if Dr. Unger has een asked before to join the co-alition but turned it down as he does not seek exposure that way...my point is, that after my visit, he said everything that we would all want to hear as to how he would approach the procedure...he confirmed that his views changed several years ago as the technology improved and hair survival during the procedure was garunteed...this was not the case, in his opinion several years ago, particularly when it came to acheiving density...but as he said in closing,due to improved results, do here now... this is all we do here now.

[John_in_NC]

i think you're just pulling my chain. He said the right things so that makes him a great doctor?

[Dirge]

No...but as a newbie, I see that I am obviously going to have to adjust the complexity of my posts to communicate effectively here...

[hairbank]

If Dr. Unger performs state-of-the-art, ultra-refined follicular unit HT's, it's not that though to determine. I'd just like to see proof via former patients who post their pics, or even if he or his clinic wishes to take the time to post the pics I'll give him a chance.

 

If his website needs updating, and he wants a better reputation on this site or any other, he or his office manager need to "take the bull by the horns" and do something about it.

 

I'm not here to promote Docs, but if I have personally experienced or seen results from Docs that I like, over and over again, I'm always glad to recommend them so they can help someone else.

 

I'm still not quite sure the point of your post, as there really won't ever be a time when we can take someone's word for fact of successful HT's. We need to see proof via pics and satisfied HT patients.

[Bill - Seemiller]

I do not think it is fair to speculate one way or the other about why he is not recommended on our network.

 

I am familar with Dr. Unger and his origin (in fact, I am reading a hair transplant manual edited by him and Dr. Shapiro).

 

Truth is, I haven't seen any of his work for some time on our forum.

 

This community however, is not opposed to work displayed from any hair restoration physician regardless of whether or not they are recommended on our site.

 

If you have some evidence of his work or are a patient of his and would like to post your experience pictures, you are welcome to do so.

 

For the record, I am not opposed to FUE - but clearly there are additional forces placed on the hair graft that create additional risks to graft damage. I believe that some ethical hair restoration clinics have performed high quality FUE hair transplants however, there are yet some less ethical ones that oversell its benefits while failing to acknowledge the risks.

 

We are all about proof on this forum community!

 

Bill

[gazzasgoin2]

I too have heard of Dr. Unger due to some of his publications but never seen any evidence of his work online.

 

Dirge, im confused by your post. Are you saying Dr. Unger is noW doing solely Follicular Unit Strip Surgery (FUSS) or FUE surgery which is extracting each follicular bundle one by one from the donor?

 

Thanks for the clarification.

[Dirge]

Yes, that is exactly what I am saying...exclusively FUT, for the past few years as techniques and survival rates have improved...now that is all they do at his clinic...this is what he told me Monday...

Dirge

[Dirge]

To clarify, he does grafts of 1-3 hairs, whatever is extracted witin that range...

Dirge

[gazzasgoin2]

...no more punches or strip grafts of any sort. Bottom line is he does only FUI's

 

Dirge, I'm still not getting it. You say here that he no longer does strip surgery? So is it only FUE surgery he does now. You say he only uses Follicular Units which is good but how does he harvest them from the donor area? If he no longer harvests via strip then they must be taken individually by Follicular Unit Extraction (FUE/FIT) with a small punch?

[Dirge]

I believe he does harvest them from a narrow strip...sorry for any confusion...

Dirge

[gazzasgoin2]

okay thanks

 

Good luck with the surgery and it would be great if you could post some pics as i'm sure a lot of people would be intersted to see Dr. Ungers work.

[Dirge]

...although i have to admit, the extraction process is not something I inquired about in detail...my main point was that much of what comes up re his practice on a search seems outdated and inaccurate based upon my meeting with him...I am new to the new techniques as well as I have not been down this road since 95 and am currently looking for a surgeon to create the most natural hairline possible...that is my objective...Unger is one I have consulted as well as other's who are recommended on this site...my conclusion was that he is doing the same FUI type surgery as the other's, although he admits he was not initially sold on the method exclusively in all cases, but that has since changed as the techniques have improved in the last 5 years or so...in fact I consulted him almost 4 years ago but then did not follow through...he indicated that this was probably a good thing as there has been significant improvements in this method over that time period...

[spoon]

Originally posted by gazzasgoin2:

...no more punches or strip grafts of any sort. Bottom line is he does only FUI's

 

Dirge, I'm still not getting it. You say here that he no longer does strip surgery? So is it only FUE surgery he does now. You say he only uses Follicular Units which is good but how does he harvest them from the donor area? If he no longer harvests via strip then they must be taken individually by Follicular Unit Extraction (FUE/FIT) with a small punch?

In this context "strip grafts" means "slot grafts", not "strip surgery". You can easily do a search on this term to see that it is basically a minigraft but once upon a time it was the state of the art for transplantation. This term has nothing to do with the strip harvesting method per se.

 

FYI Unger was a pioneer in the field and one time was one of the foremost authorities on hair restoration in the world. He probably still is one of the foremost authorities in terms of knowledge and experience but times change and like with any other thing where economics are involved, and there's money and success to be had, competition catches up quickly.

[the B spot]

Spoon, I remember reading Dr. Unger used slot grafts, and the last time I checked his website, he still did.

 

Do you mean he is still using them?

I think that would be good information for anyone inquiring as to his services.

 

His daughter is supposed to be excellent, although I do not know much about her, especially with female patients.

 

Thanks for the info in advance,

Jason

[spoon]

Originally posted by the B spot:

Spoon, I remember reading Dr. Unger used slot grafts, and the last time I checked his website, he still did.

 

Do you mean he is still using them?

 

B Spot - Dirge said "no more punches or strip grafts". Someone confused that with "strip surgery" so I wanted to clarify that "strip grafts" and "strip surgery" were completely independent terms. As to your question I couldn't say if he still uses them. According to Dirge he does not.

 

I've seen in the past that websites can be very, very out of date. Look no further than Dr. Cotteril's and I know you are personally familiar with that one.

 

Unger is a legend but a doctor's website is the way they get their message out. Right now his website is awful. If Dirge's comments are accurate then the website does not reflect the current practice.

[Dirge]

...and based upon my visit there, and to other approved Doctors, I would say his web-site does not accurately reflect his current practice...he did show mw research that showed the significant increase in hair survival rates in the last few years, as cited in his new book with Shapiro...he also showed me other research to explain why FUI is all he does now, and he showed me his work which I would say were undetectable hairlines...the reseach and the results is what he was most anxious to share with me...and then the bad news...he does less patients and costs about twice as much (or close) and that practicing this type of surgery exclusively is why...

[John_in_NC]

Originally posted by Dirge:

...and based upon my visit there, and to other approved Doctors, I would say his web-site does not accurately reflect his current practice...

 

Than he should pay someone to update his website.

[gazzasgoin2]

Spoon, thatnks for the info. I'd never heard that term before and wrongly assumed it was strip surgery. Cheers

[Pat - Community Publisher]

Dirge,

 

Thanks for sharing your positive experience with Dr. Walter Unger. Dr. Unger is an early pioneer in hair transplantation.

 

As mentioned above, his website still makes a case for the use of larger grafts in certain situations. His website also expresses his skepticism toward physicians and websites which advocate the exclusive use of follicular unit grafting. However, I suspect that his website is out of date and does not currently reflect his views.

 

I received a phone message from Dr. Unger this morning regarding this forum topic. He expressed that he now does follicular unit grafting almost exclusively.

 

Dr. Ron Shapiro has also conveyed to me in the past that he thinks Dr. Walter Unger's follicular unit procedure is very high quality. Dr. Ron Shapiro has visited Dr. Unger's clinic on multiple occasions and recently co-edited the authoritative book "Hair Transplantation" with Dr. Walter Unger.

 

Dr. Unger has often had intense debates with physicians such as Dr. Bob Bernstein, Dr. Victor Hasson, Dr. Bill Rassman and other strong advocates of follicular unit grafting. Thus many physicians are not clear on what his current philosophy and actual procedure are.

 

I will be calling Dr. Unger to encourage him to update his website and to share examples of his surgical results on this forum.

 

I know that this community is committed to enabling all physicians to be fairly represented.

 

Perhaps Dr. Unger has revised his approach and his public perception, on and offline, needs to be revised as well.

 

Best regards, Pat

[Dirge]

Thank you for your post which hopefully leads to Dr. Walter Unger being more accurately undertood, reprsented and appreciated for his past and current contributions, on this site and other's that try to steer people in the right direction with such a potentially life altering decision...

Dirge

[Pat - Community Publisher]

Dr. Walter Unger emailed and asked that I post his below reply and an accompanying table on hair survival. He also sent me a couple of sets of impressive patient photos that I will be adding soon.

 

I have also edited my report from my visit to leading clinics in Toronto so that Dr. Walter Unger is not unfairly associated with large grafts.

 

I understand that Dr. Unger will also soon be completing the many updates to his website, which he intends to have online within a month or two.

 

 

Dear Sirs,

 

I haven't written to a hair loss/hair transplant website for many years (if ever?) However, for better or worse I was shown your October 1/07 "Ontario Hair Transplant Visit" yesterday and was surprised as well as disappointed that you had represented me as still being opposed to follicular unit transplanting (FUT) and promoting the "old traditional techniques of large grafts". Nothing could be farther from the truth. For the last few years between 95% and 99% of my patients have been treated with FUT because I believe all of my earlier concerns with FUT were mastered over time. Initially, in the 1990s and the early millennium, FUT produced natural-looking results but hair death rates were in my opinion unacceptably high, because the smaller the graft is the easier it is to kill it. One need only look at sequential hair survival studies done by some FUT experts and proponents of the technique to confirm this view. For example, Table 1 summarizes the hair survival rates of FU at different densities/cm?‚?? in different years by the same acknowledged and respected FUT proponents. From 2000 to 2004 or 5, for example, hair survival at the commonly used 30 FU/cm?‚?? increased from an unacceptable 72.5% to 98% because of a variety of technique changes. Moreover, because of the higher rates of hair death in the early 2000s a trend began in which more grafts were transplanted per session and higher densities were used so as to compensate for the higher rates of hair death. If you plant enough grafts, densely enough, the results still look good even if you kill a sizeable percentage of them (see Table 2). There's no doubt in my mind now however that the procedure was steadily being improved and by approximately 2004-2005 one could expect acceptable hair survival rates, especially when FUT was performed in sessions of up to 2500 FU per session at 30 to 35 FU/cm?‚?? (see Tables 1 and 2). There may now be a very few clinics that may be able to do larger sessions and at a higher FU density and still get acceptable hair survival rates, but I believe they are very few and I have other concerns about "megasessions" of more than 2500 to 3500 FU per session and "dense packing" of more than 35 to 40 FU/cm?‚?? which I won't go into here... But I digress:

 

The main purpose I am writing to you is to clarify the fact that 95% to 99% of my patients are currently being treated with FUT because improved FUT technique has now made it the best option for nearly all patients. In the last few years, I've still written and lectured on the utility of multi-FU "old" types of grafts (for a minority of patients) because I am one of the few physicians still able to present that option rationally and I am asked to do that, but I have in each presentation stressed my preference for FUT for most patients.

 

I would appreciate you "putting the record straight" by including this note on your blog. No doubt, if you do that, it will stir up some controversy over my statements that I unfortunately don't have the time to address. I apologize for that in advance.

 

Yours sincerely,

 

Walter P. Unger, MD

 

TABLE 1

 

Hair Survival

 

Studies by Mayer with and without Keene and Perez

 

 

Year 10 FU/cm?‚?? 20 FU/cm?‚?? 30 FU/cm?‚?? 40 FU/cm?‚?? 50 FU/cm?‚??

 

2000* 97.5% 92.5% 72.5% 78.10% ---

2003** --- 95.0% 76.7% 70.0% 82.0%

2005*** --- 95.0% 98.0% 90.0% 84.0%

 

*Leavitt, M., Perez-Meza, D., Barusco, and M. Research Symposium 1999-2000: Clinical Update

on Research Studies (Mayer, M) reported at the World Hair Restoration Society/International

Society of Hair restoration Surgery Live Surgery Workshop, Intl. Jl. Cosm. Surg., and Aesth. Derm.

2001; 3(21):135-138.

 

**Mayer and Keene's Study Comparing FU Growth with Different Planting Densities, presented

at the 2003 annual meeting of the International Society of Hair Restoration Surgeons.

 

***Mayer, Keene, Perez 2004 Study Hair Transplant Orlando Workshop, presented at the 13th

annual meeting of the International Society of Hair restoration Surgery, Sydney Australia,

August 2005.

Table_1.txt

[NervousNelly]

A picture speaks a thousand words. We need to see his photos as well as unsolicited pics from patients.

[Dirge]

"a picture speaks a thousand words"

...so does a "handle"...assuming as a past patient you trust Dr. Shapiro's endorsement, that should hold you over until some pics get posted...

Dirge