good surgeon recommendations

[chibbler1]

I have had a total of six procedures over the last 22 years . The last two were with Dr. Sword , one 8 yrs ago and one in the middle of may 2007 - right after the procedure I discovered the blogs and the new coalition and I'm disappointed I didnt see the information sooner....... about Sword and the new ultra refined techniques .

My situation is this - I would like to find a good surgeon that does the new techniques to go to in about six months so I can have a chance after 23 years of obvious transplants to finally have something done that looks natural . I was going to try Dr. Hasson in BC - but I hear he will only do a procedure if he can shave the recipient area . I cannot go through 8 months again of hats and prominent scars - my question is are there any of the really good surgeons that can do the ultra refined unit procedures in the US that will do a procedure without shaving the recipient area ? I have had many procedures and have coverage but it just doesnt look natural - in other words there is enough hair to cover but what I need is a general filling in and softening of the edges - any suggestions or recommended surgeons - maybe in the southern california area - if not I am willing to travel but I really want someone that can do excellent natural looking work this time , its been too long - who do you guys recommend ?

 

bill

[chibbler1]

I have had a total of six procedures over the last 22 years . The last two were with Dr. Sword , one 8 yrs ago and one in the middle of may 2007 - right after the procedure I discovered the blogs and the new coalition and I'm disappointed I didnt see the information sooner....... about Sword and the new ultra refined techniques .

My situation is this - I would like to find a good surgeon that does the new techniques to go to in about six months so I can have a chance after 23 years of obvious transplants to finally have something done that looks natural . I was going to try Dr. Hasson in BC - but I hear he will only do a procedure if he can shave the recipient area . I cannot go through 8 months again of hats and prominent scars - my question is are there any of the really good surgeons that can do the ultra refined unit procedures in the US that will do a procedure without shaving the recipient area ? I have had many procedures and have coverage but it just doesnt look natural - in other words there is enough hair to cover but what I need is a general filling in and softening of the edges - any suggestions or recommended surgeons - maybe in the southern california area - if not I am willing to travel but I really want someone that can do excellent natural looking work this time , its been too long - who do you guys recommend ?

 

bill

[Gorpy]

In my opinion Dr. Keene in Tucson is a master at creating natural looking results. And you won't need to shave.

[NervousNelly]

Chibbler,

 

Gorpy is right that Dr. Keene is top notch but if I were you I would truly think that this may be your last chance. If I were you I would do whatever it takes to get it right for once. The hell with the down time of shaving. I personally don't want to have to shave my head either, but hey after 6 previous procedures, you can't afford to _uck around anymore. DO WHATEVER IT TAKES. You are running out of options.

 

 

NN

[Bill - Seemiller]

chibbler,

 

Welcome to our community.

 

I'm sorry to hear about your bad experiences with HT in the past.

 

I agree that Dr. Keene is an excellent physician as she is part of the coalition: http://www.hairlosslearningcenter.org/hair-loss-content...s/our_physicians.asp

 

However...

 

Take your time and do some research. Consult with at least 3 of our coalition doctors.

 

I understand that shaving can be an inconvenience, however, there are doctors who do not require shaving. At the same time, there have been cases made that show that shaving the recipient area will indeed make it easier for the physician during the surgery and possibly provide a more optimal result.

 

Bill

[beachair]

Dr. Siporin in West Los Angeles does very good work, according to this site.

[Jotronic]

Chibbler,

 

Thank you for considering Dr. Hasson. While the shaving requirement is a necessary one for our procedure it does not mean that the requirement is across the board. It depends on the amount of hair that you have now in the intended recipient area. If you would still like to consider Dr. Hasson then I recommend you send your photos and information in via our online consultation form.

 

Hasson & Wong Online Consultation Form

 

At the very least, you will have some of your questions answered and your case just might be one where the shaving is not an absolute.

 

If you have any questions just let me know.

[chibbler1]

Thanks for the recommendations..... but really at this point (50yrs) and all the down time Ive had , all the hats and stuff , along with being recently divorced I just cant go with the " to hell with the downtime" philosophy anymore . I'm newly divorced now and Im not 30 or 40 anymore there just arent enough years left to spend another under the hat . There is no guarantee what the results will be in any case.... always in the past I was told that I was going to the best guy and it would look natural etc. etc. - truthfully after my first experience 23 odd years ago (I was told it would be almost like a haircut by a shill for the doctor who gave me the first plugs) - I have really had no choice but to continue since then or get a hairpiece to cover and I just couldnt bring myself to do that . I think that if there is a really good surgeon with the new techniques that with care there is no reason he or she couldnt work around the hairs that are already in place . I have never had to shave the recipient area before and really , this is not the time I would like to start .

[beachair]

You are not alone with the "it should only take two or three procedures" routine. I fell for it: the tedium of the plugs, bandages, and healing. Add to that the "touch-up," and you have a lot of years and disappointment behind you.

However, I would "suck it up" and find the best surgeon for the last surgery. The FUT method is the way to go, and do not accept anything other than an excellent doctor who is proficient at performing it. You won't be sorry, and you'll finish your years happier and better looking.

[MrJobi]

I went to Dr. True as I could not shave my head either.. There are several good docs on here who don't require shaving

[its752]

chibbler1, I just had my head shaved for my HT and wished my prior doctors would have suggested it. There's a technical reason to do it so that you keep more of your native hair plus what you get from the transplant! It has to do with "transecting of hairs. Nobody could care less whether you have a hat on or not!! I'm keeping my head shaved for the next year, so after a quick year I'll have a better final. result.

[Gorpy]

It sounds like this gentleman has plenty of coverage. What he needs is some filling in to provide a level of camouflage which in turn will produce a very natural result.

 

There is no technical reason for you to shave your head. A doctor like Dr. True or Dr. Keene can gently move your existing hair out of the way and will NOT transect any existing hair. If you want further details on this please send me a PM.

 

Gorp

[chibbler1]

Thanks for the explanations guys . I dont think I'm going to go for the shaved head though....but it looks like it does make a difference in the results the transecting of the hairs , and other factors I guess I just couldnt really get the density and might loose hairs if I didnt get my head shaved , but again with my work and the scarring etc. it just wouldnt work for me ....but in response to the guy from seattle ( the assistant for Dr. Hassan ) I will get some pics to send just in case you think I may be an exception to the shaving rule - but how long do you think I should wait before taking pictures ? Remember , I have just had a procedure done (may 15, 2007)

[beachair]

How was your procedure with Dr. Sword?

[tisab]

honestly i agree with on what has been said, 6 months of being shaved down is not too long. this is your last HT, you NEED to make it perfect

 

there are reasons for shaving down, which have been discussed.

 

you say you are 50 years old and do not think you have many years left? comon now think more cheerfully than than!

the average white male lives up to 76, and that number was taken several years ago.

sorry to bring up race, i dont know the statistics for other races, i dont want to just throw out a wrong stat out there

given that you are white or any other race you STILL have 20+ more years to live!!!

 

live happy, and may luck follow you from now on

[its752]

tisab, I think you have it correct in what you said. It could be just the begining for chibbler1--many good years ahead!

[Jotronic]

Gorpy,

 

"There is no technical reason for you to shave your head. A doctor like Dr. True or Dr. Keene can gently move your existing hair out of the way and will NOT transect any existing hair."

 

You knew this was coming

 

I will go on record with this statement. Quote me to whomever you wish. Any doctor that says there is no transection from making incisions in recipient areas with any appreciable amount of hair is lying or just doesn't know any better. That is a fact. Why do you think that shock loss is always such a big concern? Permanent shock loss is something that we rarely see and I would wager much much less than what "non-shave" clinics see.

 

Fact. Doctors tell patients that shaving is not necessary because shaving scares patients away. It is not necessarily the biggest thrill for patients to look forward to.

 

Fact. Shaving the area makes the recipient area easier to work in. The spaces between the hairs are easier to see. The exit angle and direction is easier to see. Transection is easier to avoid because of this.

 

Fact. If the native hair is pushed to one side the exit angle is distorted thus reducing the accuracy of incisions that are supposed to mimick the native angle and direction. If the hair is left long the very weight of the hair shaft can distort the angle and direction.

 

When you are dealing with a procedure that requires even a couple thousand incisions much less several there is absolutely no way, none whatsoever, that native hairs are not transected and permanent shock loss induced. I do not have statements of "my doctor says so" to back this up. I have seen this with my own eyes on dozens of occasions because I sometimes like to sit in on surgeries to gauge these things for myself. I've worn loupes and looked at what the doctor and the technicians see.

 

Does any of what I said mean that a result won't be good? Of course not but it does say that while good may be good enough the best is the best and shaving the recipient scalp is the only way to get the absolute best result. When your hair grows out, you want it to be indistinguishable from native hairs with regards to angle and direction and shaving is the only way to accomplish this.

 

Remember, I say this with regards to bigger sessions. As I said to Chibler, we may be able to get away with not shaving in his case as we do from time to time make exceptions but not without making it clear that the best result will be from shaving. In cases like these exceptions, we give the patient a choice. Chibler may have that choice but we won't know till he sends us his photos.

 

I'm not attacking you, Gorpy, just telling it how it is.

[Guest wanthairs]

chibbler.....

 

if you really are willing to sacrifice optimal results so that you dont have to have a head shave, then you should also look into Jeffrey Epstein of Miami.....From what I understand he does not require shaving down if the patient does not require it, and speacialises alot in correcting old bad surgery....good luck !!!

[chibbler1]

Hello and thanks again for all the comments - just to clarify ..... I didnt mean to say that I'm not expecting to live much longer (I plan on living to 100 or so ) I meant to point out that in 15 or 20 years I'll have other things more important to consider besides my appearance - Thats why I mentioned that I just didnt want to spend alot more time at this point in my life with a scarred buzz cut - realize that Ive probably spent 4-5 good years under a hat already and as I said before - no matter what you guys say there is no guarantee of a great job next time - I would have gladly shaved my head over the first 15 years after my first so called HT if things were then as they are now . For me at my age there is a big difference between 3 weeks of wearing the hat (if I have a procedure done with my current coverage to hide the new work) vs. 8 months or so with the buzz cut and a head full of obvious scars.

Also , a question for Jotronic .... since I have had a treatment in may of this year at what point ( after how long ) should I have pictures taken to send to Dr. Hasson for an evaluation on the possibility of a future session ?

Someone asked me about Dr. Sword and how the work was.... well , I had a procedeure done with him 8 years ago - the work was better than the original work that I had done in my late 20's but it wasnt perfect and he only did around 1000 or so micro's or mini's , I just had another 1250 done in mid may of this year so its way too early to tell how that will turn out but the reality is I'm sure it would have been alot better to have just done 3-4000 FUT's eight years ago , or to make an analogy.... which is a more effective way to get drunk ....have one beer every hour for 10 hours or to drink 10 beers in one hour ?

I think Dr. Sword has fallen behind the times though at one time he probably was as good as anyone -does he have the will or inertia to keep competetive any longer ? I think that since he hasn't updated his methods yet he probably never will - he's to rich and comfortable now to be hungry and motivated. Really there is no reason to have an unnatural HT done (actually more like 3 with sword ), that could be done more naturally in one session for about the same price using one of the best HT doctors available .

just my thoughts;

chibbler1

[chibbler1]

I have an observation too.... since the FUT is now the gold standard and considered state of the art maybe the next gold standard will be a doctor figuring out a way of doing an FUT as effective as the current FUT's without shaving the recipient area - that would be something.....

[MrJobi]

Guys

 

With that being said, you can get an optimal result by not shaving your head..Ok,indeed it might be more difficult and not perfect but I digress.My result is as good as any I have seen by any doctor. Everyone does not have that option . In an executive role you cannot just shave your head and wear a hat to work.. Try working for a conservative company, it would not go over too well.. People need options.

[Jotronic]

I wish to append my last post. I want it to be clear that I was not implying that patients of non-shave clinics have results that are something they shouldn't be proud of. This is not the case because I've seen patients of other clinics that have every right to feel proud of their results. My point was to clarify the technicalities of the advantage of shaving. While it does present a problem for some the overall benefits, in our opinion, are indisputable.

[Pat - Community Publisher]

Interesting discussion. I can understand the reluctance of patients to shave their recipient areas, especially if they have significant amounts of hair in these areas. I too have not been willing to shave my head.

 

One of the reasons why many physicians have been reluctant to orient all their incisions "laterally" (incisions perpendicular to existing hairs) and prefer to create incisions"Sagitally" (incisions parallel to existing hairs) is in order to minimize the transection of existing hair follicles in the recipient areas.

 

To illustrate why, Dr. Ron Shapiro explained it to me by asking me to imagine a room full of people standing to represent hair follicles that are under the skin. Then to imagine a giant blade cutting across this room full of people. More people would be severed by the blade if it enters the room in a perpendicular orientation along the plane of the ceiling (laterally) rather than if the blade comes down in a parallel orientation in plane with the walls (sagitally) and thus slips in between most of the standing people.

 

I think the transection risks associated with the perpendicular orientation of the lateral slit incisions makes shaving to better visualize the hair direction more critical.

 

While I advocate smaller and less invasive incisions (Ultra Refined Grafting) to increase densities and minimize transection and impact on the scalp's vascular, I do not believe that lateral slit incisions are necessarily superior to sagital incisions when all variables and outcomes are considered.

 

Many physicians who perform ultra refined follicular unit grafting use both lateral and sagital incisions depending on the amount of existing hair in the patient's recipient area and the area where they are creating the incisions.

 

This question of incision orientation (sagital or lateral) has been debated by leading physicians now for the past few years. Many physicians feel that they can control the angle, orientation and shingling effect of their incisions just as well with sagital incisions as lateral ones.

 

Best wishes to all, Pat

[Gorpy]

Originally posted by Jotronic:

Gorpy,

 

"There is no technical reason for you to shave your head. A doctor like Dr. True or Dr. Keene can gently move your existing hair out of the way and will NOT transect any existing hair."

 

You knew this was coming

 

- Yes, I did :-)

 

I will go on record with this statement. Quote me to whomever you wish. Any doctor that says there is no transection from making incisions in recipient areas with any appreciable amount of hair is lying or just doesn't know any better. That is a fact. ...

 

- Well Joe, this is an irresponsible statement. I can make irresponsible statements also. Watch - Any doctor that tells you that you must shave the recipient area to avoid transection is either lying or doesn't know any better. See, it's easy.

 

- Not a fact Joe, an opinion.

 

Fact. Doctors tell patients that shaving is not necessary because shaving scares patients away. It is not necessarily the biggest thrill for patients to look forward to.

 

- Opinion, not fact.

 

Fact. Shaving the area makes the recipient area easier to work in. The spaces between the hairs are easier to see. The exit angle and direction is easier to see. Transection is easier to avoid because of this.

 

- I agree that it is somewhat easier. See, we can agree on something :-). The key word being "easier" - not "impossible".

 

Fact. If the native hair is pushed to one side the exit angle is distorted thus reducing the accuracy of incisions that are supposed to mimick the native angle and direction. If the hair is left long the very weight of the hair shaft can distort the angle and direction.

 

- Opinion - not fact. If you look at your hair when long, it does exit at a clear angle and then a few millimeters up it begins to curve towards the way it lies on the head. The exit angle is CLEARLY visible and not distorted. It would only be distorted if you pulled very hard on the hair.

 

When you are dealing with a procedure that requires even a couple thousand incisions much less several there is absolutely no way, none whatsoever, that native hairs are not transected and permanent shock loss induced. I do not have statements of "my doctor says so" to back this up. I have seen this with my own eyes on dozens of occasions because I sometimes like to sit in on surgeries to gauge these things for myself. I've worn loupes and looked at what the doctor and the technicians see.

 

- More opinion. What you have seen with your own eyes is a layman's viewpoint. I don't care what kind of loupes you wear, you are still seeing one way of doing it. Of course you are going to agree with that way. Could we expect anything less? To say that doctors are transecting permanent follicles is another incorrect and irresponsible statement. Now, if we take a step back and look at it from a purely H&W way of implanting, them maybe, yes. However, not every doctor implants that way. See what I mean?

 

Does any of what I said mean that a result won't be good? Of course not but it does say that while good may be good enough the best is the best and shaving the recipient scalp is the only way to get the absolute best result. When your hair grows out, you want it to be indistinguishable from native hairs with regards to angle and direction and shaving is the only way to accomplish this.

 

- Opinion again. My hair IS indistiguishable from the native hairs. Angle and direction are perfect.

 

 

 

Keep in mind that I don't just pull this stuff out of left field. I have had extensive discussions with Dr. Keene on this issue. My point is, doctors will strongly disagree on certain technical issues. We are not usually privy to all of the debates. But, to say FACT this and FACT that is one doctors opinion, not necessarily a FACT.

 

Gorp

 

Oh and BTW - this is my 1000th post. It's only fitting that it would be in a debate with Joe :-).

[MrJobi]

I think this is a good discussion

 

It's funny because many doctors would most likely argue the same point.. Whether it's megasessions vs conservative , FUE vs FUT , or this debate, it is important we are honest to our peers on what is fact and what isn't.. Not to get off the subject but I feel sometimes people get a bit carried away with their opinions ( see the Propecia thread)

 

Regardless, we has some passionate people on this site