Dr. Paul Shapiro

[dmoor]

I'm thinking strongly about scheduling a ht with Dr. Paul Shapiro after meeting with Matt at SMG. Any feedback on his work would be appreciated. I currently feel very comfortable knowing he was trained by his brother and his brother recommends him. I've seen pictures of his work and to me it looks just as good as his brothers. Anyway, I read some of the old posts regarding Dr. Paul and there seemed to be a difference of opinion regarding his being admitted to the coalition too quickly. Seems one patient didn't agree to having him admitted so soon? Could anybody shed some light on this old post? I know he's slightly cheaper than his brother but to me that simply means Dr. Ron Shapiro is in extreme demand due to the reputation he has developed over the years.

[dmoor]

I'm thinking strongly about scheduling a ht with Dr. Paul Shapiro after meeting with Matt at SMG. Any feedback on his work would be appreciated. I currently feel very comfortable knowing he was trained by his brother and his brother recommends him. I've seen pictures of his work and to me it looks just as good as his brothers. Anyway, I read some of the old posts regarding Dr. Paul and there seemed to be a difference of opinion regarding his being admitted to the coalition too quickly. Seems one patient didn't agree to having him admitted so soon? Could anybody shed some light on this old post? I know he's slightly cheaper than his brother but to me that simply means Dr. Ron Shapiro is in extreme demand due to the reputation he has developed over the years.

[NW5a]

I think Paul S. is as good as Ron S., cause i have seen some very impressive results of Paul Shapiro. Good choice and good luck.

[nervous_in_WI]

dmoor,

 

I actually had extensive work done by Ron and in all honesty his work is nothing shy of artistry.... HOWEVER, I would suggest that pauls work is of the same degree simply working with Ron was a pleasure and his professionalism and results need be upheld for them to keep the reputation they have.

 

Mind you I do not have enough donor hair period so managing my expectations was a huge part of it. That I contribute to Matt.

 

Good luck and let me tell you a year down the road you will be happy as long as you have enough donor hair ... otherwise do remember you will afterwards never be able to shave your head for that look is in too.

 

If you have enough hair GO FOR IT !!!! you will love the results !

[dmoor]

Well, I do now have a ht scheduled with Paul and it's hard for me to believe! For years my hair loss has been eating away at me and a couple of months ago I discovered this website and it led me to compulsively research FUT, which I didn't even know existed. I researched a little on transplants some time ago but the results and many horror stories turned me off so much I never even considered it as an option. That is, until I discovered this site and the doctors listed and all the information. I've tried everything else and I feel I've done plenty of research. I just came to the point where I decided I'm going to do it rather than reading the same information again and again and most importantly I'm confident in my selecton of a doctor, especially after visiting SMG! A concern right now is I'm wondering if I have realistic expectations. Of course I would like to have just one session and be really satisfied with it and not have to go back but it seems like most people go back and many factors come into play. Only the future will tell.

[John_in_NC]

edit. Thought it was Dr Paul Rose.

[jfo]

I also have a surgery with SMG Jan 30 I just booked my flight out of Cleveland Ohio. I am very excited to get this done, I figure I am not gonna be happy with my appearance with thin hair and you only live once. I figure with my hairloss hopefully now stabilized with fin. and rogaine, if they can pull 2500 to 3000 grafts I will be more than happy with the results.This websight has been HUGE, the info and pics prove that if you choose the right HT team you will have excellant and natural results. Goodluck and you have made a solid choice with SMG.

[Tom R.]

dmoor, I had reservations about accepting Paul to the coalition too quickly. In late October 2006 I had a procedure with Dr Paul and didn't like the way my case was handled.

 

During my consult, I didn't feel Paul was convincing enough and I felt a little uncomfortable going into the procedure. What I mean by that is this. He answered most of my questions but I often felt I knew more about what should happen than he did.

 

Anyway, I went in and had the procedure because I trust Matt Zupan and he assured me that Paul was just as good as Ron. I had confided in Matt, my concerns about Dr Paul prior to the surgery. In addition, I had a previous HT at SMG with Dr. Paul Rose and I truly believe Ron would not allow anything or any employee (including his own brother)to cause someone to question his reputation or that of his clinic.

 

Post-operatively I was open to all of the known negatives such as pain, swelling and temporary hair loss from the transplanted area as well as the donor site. What I didn't expect was suffering two thumb pad sized areas of ischemia below my donor scar. Within a week of the surgery, while washing and viewing my donor area, I noticed these very bald patches of skin. I initially attributed this to the well discussed topic of shock loss. Little did I know.

 

After several months I had no regrowth and contacted Matt at SMG. I arranged and post-op visit and returned to SMG at about 9 months post-op. I asked to meet with both doctors and Matt and they agreed. During the discussion and viewing of my donor area, Drs Paul and Ron said I suffered from ischemia (lack of blood supply). The cause-I was told the donor closure was very tight and Paul noted it in the file.

 

The problem I have is two fold. If the doctor had taken the time to note this in my file, he should have informed me of this and any potential complications. In addition, I learned that doctor Paul DID NOT use my old scar but went below and created a new scar thus leaving me with two scars. Again, I was not informed of this.

 

Despite all of this, I am returning to SMG in February to have a scar revision where the two scars will be combined, the bald skin will be removed and the grafts between the two scars will be placed along the hairline. I figure while they're slicing me up back there, I'll have them put a few grafts to good use. BTW, Ron Shapiro will be my surgeon for this procedure.

[Bill - Seemiller]

Tom R,

 

I'm sorry to hear about your negative experience with Dr. Paul Shapiro. This is the first negative experience I've read about his work.

 

I am pleased to see that you are working with the clinic to rectify the problem. I have however, sent a note to Pat about your case so that he may look further into it.

 

How is your donor area currently? Has the ischemia been properly treated? Did the hair around the scar grow back? Do you have any pictures of this?

 

Thanks,

 

Bill

[Tom R.]

Bill, There is only one way to treat the area and that is to excise the tissue. The lack of blood supply simply killed off otherwise healthy tissue (hair follicles).

 

I understand the explanation I received but I am not entirely convinced something else didn't go wrong. I've emailed Matt Zupan and a few other hair restoration surgeons for more opinions. No response yet.

 

P.S. I do not have any pictures and prefer not to remind myself it's there )-:

[Bill - Seemiller]

Tom,

 

Was the reason for "tight donor closure" described to you? Is Dr. Paul Shapiro admitting poor donor closure in your case or does he have a physilogical reason?

 

If you are willing to send me pictures privately, feel free to PM me.

 

Shapiro Medical is a first-rate respectable hair restoration clinic so I trust they will take care of you.

 

Bill

[Tom R.]

Bill,

 

I suspect Dr Paul removed more donor tissue than the scalp would allow. He didn't actually say the words but without pinning him down, I simply conclude it as an error in judgment.

 

And before anyone finds fault with the way I've conveyed my opinions on this situation, I'm NOT a doctor and I still don't have all the facts or a complete explanation as to what happened. I am the patient and at this point I still have an open mind about Dr Paul and his abilities as a hair restoration surgeon.

 

When I have all of the facts and information, I'll be more than happy to share that with all of you.

[Bill - Seemiller]

Tom R,

 

Thank you for the additional information.

 

I believe you are sincere and are just expressing your experience and opinions. Thank you for your honesty.

 

I agree with you that a "tight" donor can be caused by excising too much donor and over-taxing the elasticity of the skin. Whether or not that is true in this situation is yet to be known.

 

I would therefore like to hear an Dr. Paul's medical explanation on this situation if he is willing to share it publicly.

 

I will notify the clinic so they can respectfully share what happened (without revealing any personal information and maintaining confidentiality).

 

Bill

[Pat - Community Publisher]

Tom R,

 

Thanks for sharing your experience. This forum is committed to being open to all experiences, good and or bad, with all physicians - no matter how revered.

 

Those who are regulars know that the Shapiro Medical Group has an outstanding reputation. A search for "Shapiro" on this or any credible hair loss forum will yield hundreds of glowing patient reviews. In fact, in over ten years Ron Shapiro's reputation and patient satisfaction is virtually 100%.

 

I expect that the SMG will do everything possible to make things right for Tom.

 

I have gained a strong respect for Dr. Paul Shapiro over the past few years. He really strives for perfection and has learned from the very best.

 

Two months ago I was in Minneapolis and watched both Paul and Ron doing surgery. Both of their cases were exceptionally refined and artistic in my opinion. Their attention to the finer points is unmatched in my opinion.

 

But no human can bat 1000 all the time. Sooner or later a patient is going to experience a complication in even the very best hands.

 

I hope that Tom's experience reminds all of us that even in the best hands a hair transplant is a calculated gamble.

 

What really matters is that the physician and their staff perform the best surgery possible and stand behind their patient from A to Z. I know the SMG will do exactly that.

 

Pat

[Arrie]

Tom

Its unfortunate that you had to endure something like that. I hope all is well in your situation and come out completely happy. Two things if you don't mind me asking Recipient hair growing now (and did the give you an explanation why it has or has not grown)? 2. I am sure they are taking care of all costs for repair and travel expenses correct?

[Tom R.]

Everyone, In reading the responses to my posts, I sense that readers may think I've been disfugured in some way or my surgery has gone awry. Allow me clarify.

 

My donor area is well healed as I am one year post-op from about 1500 grafts to the crown area. This is also my second procedure with SMG, the first @2200 grafts from Dr Paul Rose. In their entirety, both procedures were first rate. The entire staff at the SMG are absolutely wonderful people and I have scheduled a third procedure. I trust and believe they will address my concerns and all will be just fine.

 

Getting back to my donor area...the hair on the back of my head is fairly short and does cover the bald patches. When I say bald, the patches are hairless and truly about the size of a thumb pad or the surface area of a nickel. That should give most of you an idea of the size of slick/bald tissue that hides below my scar line. The first one is nearest my right ear and the other somewhere left of center. A good stylist is essential (-:

 

I don't exactly know the cause for the ischemia but only what I've been told thus far. I'm hard pressed to believe a tight donor closure would cause this reaction. Nonetheless, it has happened and hopefully I/we will eventually learn the true cause of such an anomaly.

 

AND TO ARRIE

 

I can safely assume that all or most of my transplants have grown. If you are also referring to the area which was subjected to the ischemia; that hair will never come back. The blood supply to otherwise healthy tissue was simply compromised in some way and caused all the follicles in that area to die.

 

And yes, Drs Ron and Paul agreed to do the scar revision for free and reduce the price of my next procdure by taking into account my travel expenses.

 

In closing, I hope that this has clarified things for most of you. When I know more, I will share everything I learn with those willing to listen. Follicularly grateful.

 

Tom R.

[Bill - Seemiller]

Tom,

 

Thanks for the clarification on your situation.

 

And just as I figured they would, I'm glad to hear that SMG is taking good care of you!

 

Bill

[PLEASE GROW PLEASE]

Glad to see they are going to take care of you. Only the top clinics will stand behind their

Im a little confused though. Are you going to have a scar revision then later have another procedure,becuase if its only a procedure then there is no scar revision since the scar would be removed anyway.

[Arrie]

Tom

I am glad to hear that everything for the most part has worked out. I am glad that you are happy with you results and you are going back with confidence...

[dmoor]

Tom R., I appreciate hearing about your experience with Dr. Paul. It's unfortunate but I'm impressed the way SMG is working with you to improve the situation. I've heard Dr. Paul really strives for perfection and if anything this probably made him strive for even greater perfection. I'll be keeping my appointment with Dr. Paul because I still have a lot of confidence in SMG.

[Tom R.]

PGP, I guess, in a sense, you're right. However, given the area of the bald skin, my scheduled procedure won't be as simple as normal strip surgery. Dr Ron will have to go about 1/2 inch below the bottom of my two scars in two separate areas and remove the troubled skin.

 

While combining the two scars, the grafts from between will be used instead of being discarded-can't have that. If I simply went for a scar revision, I'd still be left with two scars and only the follicle dead tissue would be removed. Hope that eliminates your confusion but that's how it was explained to me.

[baxter]

dmoor

I had a hair transplant with Dr. Paul Shapiro a little over two months ago. And I would recommend him highly to anyone who is thinking of a hair transplant. The Hair Transplant from beginning to end was a great experience. Dr. Paul spent ample time explaining to me the procedure and the risk and benefits.

I am a type 6 and had a large area to cover. See my previous post for photos.

I decided to go for a large procedure of 4,000 FU. I am 63 and my donor site is a bit tight which Dr. Paul said he often sees in older patients. I do remember Dr. Paul letting me know that the risk of a larger scar was possible with large donor strip removal. So at least with me he was clear about the risk involved in the surgery. I still opeted for the larger session because I have such a large head and wanted as much hair as possible. I know my situation is very different from Tom R and I am not sure if it comparable.

 

I left town the day after surgery for a week long meeting. And when I returned from my trip (7 days post op) no one noticed I had a transplant. The scabbing had all cleared up and the transplanted hair looked completely natural. As warned my little transplanted hair did fall out but I can feel it growing back in.

As for my donor site, it is healing fine. I have to look hard to see that it is even there. When I go for my 6 month follow up I will post more photos.

This is just my experience and I know it is one of many, but I did want you to know about my positive experience with Dr. Paul and I would highly recommend him to anyone considering hair transplant surgery.

[Dr. Paul Shapiro]

I would like to thank all the patients who gave me positive comments and I am glad that Dmoor is still confident that he will have excellent results with my surgery. Dmoor is correct in saying that I do strive for perfection and that any time my results are less then this, such as in TomR's case, I do review the case and try to see if there was anything I could do better.

 

One thing I know I could do better in TomR's case is communicate better. It is very important to me that all my patients go into surgery fully understanding the surgery, my approach to their specific case, and that the patient fully understands the risk and benefits of the surgery.

 

From TomR's comments I can tell he understands that a scar like his can occur in hair transplant surgery and that even the most skilled surgeons can not bat 100% of the time. But I could have done a better job describing his specific risk and letting him know about his tight closure.

 

In many hair transplants, the removing of the strip is a very straight forward process. In a case like TomR's the strip removal is not straight forward and some decisions need to be made. Usually I review this carefully with my patient, explain the pros and cons of different approaches to the strip removal, and together, we come up with the best plan for a strip removal. Some how this was not done in TomR's case and I am take full responsibility for that.

 

In TomR's case he had already had two previous surgeries. The first surgery was in 2000 at a different clinic then SMG, and the second was at SMG in 2006. His donor laxity was not great, but not terrible. Usually in a case like this I discuss different options with the patient. I discuss that if we try for the maximum number of FU I can get, the closure may be tight which increases the risk of a larger scar. I always assure the patient that if they do end up with an unacceptable scar I will do a scar revision at no cost. As a side comment I have had many tight closures in which there was no unusual scarring.

I also usually discuss that if I go along the old scar line, the yield will be less. It is just common sense that there is no living hair in scar tissue and often the tissue around the scar has fewer hair follicles.

 

TomR is correct in saying that I made a judgment call when I decided how wide a strip of donor tissue I should remove for his surgery. I take out a piece of tissue that I think will close with no tension. In his case I judged that a 1cm wide strip would close easily. Unfortunately it was a bit tight, resulting in tension. All hair transplant surgeons end up in this situation at one time. In patients with a tight donor area, the difference of only 1mm, or .045 inches can make the difference between an easy or tight closure. I like to use the analogy of packing a suitcase. Many of us have had the experience in which we pack a suitcase to the max and it closes. Then we add just one more shirt and it is difficult to close.

 

In summary, when a patient has had previous surgeries and/or a tight donor area, there are some difficult decisions to be made. If we want to maximize FU yield then we may chose to not go along the old scar and this results in two scar lines. I we choose to maximize yield then I need to take out a donor strip with a width that has a chance of resulting in a tight closure. I am always thinking of what is best for the patient and in these difficult cases try for the best yield with the least risk for additional scarring.

[EmuSteve]

http://en.wikipedia.org/wiki/Ischemia

 

Does this mean that there was necrosis on your scalp Tom? I am unclear on this.

[Bill - Seemiller]

Dr. Paul,

 

Thank you for providing your feedback into this situation.

 

Clearly there are always risks that go along with surgery. There is seemingly a delicate balance that must be found between excising as much donor hair as possible while being sure not to over-tax the donor. In this case, it appears that taking a bit less donor may have avoided the complication of a "tight closure" which led to healing complications. But as you said - decisions often have to be made on the fly.

 

I admire your willingness to accept responsiblility for the lack of communication in this matter and I apppreciate your explanation of the situation. A world class hair restoration physician does not always bat a 1000, but they do take care of their patients. I'm glad to see that Shapiro Medical is taking care of Tom free of charge for the repair.

 

Best wishes,

 

Bill