I'm Confused

[vinto]

fit2betide,

 

I'm a new member also just like yourself, but one thing for sure, I've been reading this forum for less than a month.

 

One thing that caught my interest regarding your post however, is that coalition doctors actually have to pay a fee to get advertisement on this site. Of course this raised some concerns as you might imagine, but then I thought of how else would Pat be able to actually keep this sit going. A lot of hairloss sufferers are on this site, and it's started by Pat, also once a hairloss sufferer. It's hard to imagine that Pat and others just got whoever that pay enough money to become a member. He thoroughly researched the doctor and visited their offices to see whether or not they're ethical and capable. At least I hope that that's the case. A lot of other contributors on this forum are also very helpful and they know full well what we are going through, because they once use to be like us. As for my case, I was in a state of panic and lost and don't know what to do. They treated my problems as their own, they told me to calm down and research this throughly. But you're not talking about anyone's credibility here. I just want to be sure you understand what it takes to keep the site running I suppose. It might be a form of advertisement, but I'm sure and hopeful that Pat had chosen his doctors carefully and only selects the very best base on results. As you can see, he has cut down some doctors already and I doubt it's because of them refusing to pay the advertising fees.

 

Although I can see your point, I too get confused with some of the doctors. I spoke with two of the coalition doctors and they gave me a different graft numbers. I didn't ask for dense packing but Dr. DeYarman's method was to pack them in at 40 hair/cm^2 for me. He also requires me to shave my head. I imagine that's what it means by dense packing.

 

As for ultra refine grafting, I think it might be the process of using a smaller blade to do the incisions in order to fit in more graphs thus accomplishing the dense packing.

 

I'm speaking to Dr. Wong this Friday, and I will ask him more regarding the issue.

 

As for others, you read my post, you have a pretty good idea of how I am. Freightened and lost to say the least. I appreciate all the help that you've give me thus far but of course this is the internet. We don't know each other personally and the only thing we have in common is that sense of insecurity due to our problem. With this in mind, I'm sure no one is out trying to "screw" the others just because we all know how it feels of having self confidence being shot.

 

fit2betide, I spoke to Dr. Reed, and Dr. DeYarman personally and they both seem to genuinely care. Skillwise, I can't be sure, but at least they're very ethical in my case. They want me to stay on Propecia for 9 months to a year before doing anything. So ethicially speaking at least, they seem to pass that test. This just shows me that Pat did his homework in that part.

 

Regards

[Gorpy]

There is an important distiction here that is being overlooked:

 

Coalition doctors are performing to standards that meet Pat's criteria. That does NOT mean that they understand all of the terminology used on Pat's site. The phrase "Dense Packing" is arbitrary. So is the Phrase "Mega Session". The term "Ultra Refined" is a valid term, which is well defined on this site. Just because a doctor in the coalition is not up to speed on what it means does not mean that he/she is not performing ultra-refined. See what I mean? It's not up to the doctors to know all of the various buzz words. But it is up to them to perform up to a standard.

 

The doctors in the coalition are ultimately in competition with one another and do not all agree on every technique.

[NervousNelly]

 

Michael,

 

I appreciate where you are coming from but I have one word for you...SPEX

[Bill - Seemiller]

I love this...there are multiple conversations going on in the same thread

 

I seriously don't think I have anymore to add except this:

 

Fit2betide,

 

If you have any specific questions, perhaps we can address them. Otherwise, good luck in contacting every HT doc in the US.

 

Michael,

 

You are entitled to your opinion. What do you think of guys like JoTronic and Spex? They could be considered "sales" or "consultants". If a doctor is extremely busy, it makes sense to have knowledgeable people working for them that can help answer questions. Call them "sales", "customer service", "consultants", "helpers", "assistants", either way, I think there is a place for these people assuming that they are giving accurate information and remain ethical.

 

Bill

[Bill - Seemiller]

Nervous,

 

Seems like you and I are sharing a brain on this thread.

 

Bill

[the B spot]

Well, OK I am a bully now?

 

I guess when I decide to take someone down a peg for making overgeneralized, unsubstantiated comments without any veracity, if that constitutes bullying or "boorish" behavior, then yes, I am guilty.

 

Please note that I congratulated this poster on his choice of Doctor, because regardless of his personal research methods or opinions, WE WIN EVERYTIME a sufferer chooses a Coalition Doc, period!!!!! We know they are in great hands and our fellow man is being cared for properly.

 

The difference between a Recommended Doc and a Coalition Doc is not marketing fees. I wish people would remember that it takes MONEY to drive a website of this magnitude, and that if it was simply membership fees that decided the inclusion of Docs, the list of our Coalition Docs would be much larger and would include Docs that do NOT belong. Many of us, myself included, owe a great debt to this site, because it led us to a TOP HT Doc, and not some schmuck with an office, medical degree, 1 tech, and a multi-blade.

 

Excuse me if I get pissed when some ill-informed malcontent decides after a few phone calls that they have a grip on the HT industry and can crown a king.

Years of visits, thousands of posts, thousands of individual experiences, plane trips, photos, have brought us to where we are today.

 

Oh, BTW, Thanks Pat for having the vision to hold Doc to a higher standard when NONE existed. Yeah, you sound like a real greedy bastard, to be sure.

 

UNBIASED, INFORMED, SOLID, ADVICE and a collection of Docs held to a higher standard that WE KNOW have the best interests of the PATIENT at heart. Not so bad when stated in that manner, hmmm?

 

Again, I have spoken with innumerous patients from everywhere, seen quite a few BAD Ht's, personally called at least 40 clinics, looked at thousands of photos, belong to and read 5 hairtransplant sites, read medical articles posted by HT Docs themselves, and willingly offer my cell phone # DAILY to anyone who needs to talk some of this out or needs any help sorting out all of the information.

Many of my fellow members do the same thing, so I am not alone in this.

 

This site serves a higher purpose, so lets just get back on track doing what we do best--- leading a directing fellow sufferers to great, life-changing hair transplant docs.

 

Bill, if you HONESTLY think I was too harsh, after reading this entire thread, then I offer my apology to all, and will look to amend my comments to reflect a more personable, educational manner in the future.

 

PS--Consultants are necessary, period. We might as well ask every Doc to answer the phone during surgery. For a clinic that is booked out 3 months and has 5-10 appointments everyday, it is irresponsible to think that an intial assessment and information gathering session is not in order.

 

Cheers!

[fit2btide]

B-Spot,

 

I don't care how much Pat makes to run this website. God bless him if he makes a million dollars year. Did I ever say that there was something wrong with that?

I also do not have a problem with doctors advertising on a website to get business. I'm just saying that these doctors admit that the Coalition is not different that the other doctors except for the advertising tier they choose to pay. It's no big deal. It's just the way it is according the the doctors who I've spoken to.

 

I'm sure that Pat works very hard to run this website and it is a very informative place. I have nothing bad to say about him or this website.

 

It just seems that some of you actually think that this isn't a business. Why would Pat allow inferior doctors to advertise on his website, those who are not Coalition members if it was all about telling people who the best doctors are. Does this make sense.

 

The choice is yours, you can go to a Coalition doctor and get a superior hair transplant or if you're stupid you can go to one of our not so good doctors who are also recommended on this site. Does this make sense to you B-spot?

People you have to agree that this is silly.

Anyway, I'm glad I can see straight. I'll continue to research, but all the short lists seem to be the same. Hasson&Wong, Shapiro, Feller. This website sells advertising to many doctors but most of the consistent posters tell you to go to these three. Am I wrong about this?

 

Thank you.

[Badger]

Hey fit2btide,

Im new to the site as well. I haven't had a HT yet, i haven't consulted any coalition members yet. But i appreciate how hard it is to make a decision. God i know. Its not something to be taken lightly. I can just imagine myself gettin laughed at by my mates, walkin into the pub with a bad ht job.

I've been logging on to this forum for months. I have to say that this forum has been far more informative then any wishy-washy tricologist/ consultant, or some surgeons flowery pr scheme. I ve met and consulted people that i don't trust or like.

I think the threads on this site/forum are worth taking seriously. I feel they're genuine. There are a lot of varying experiences. Different surgeons etc. From my perspective that gives it credability.

[Bill - Seemiller]

so many things to address in one thread...lol.

 

B-spot,

 

Bill, if you HONESTLY think I was too harsh, after reading this entire thread, then I offer my apology to all, and will look to amend my comments to reflect a more personable, educational manner in the future.

 

I don't honestly think you were too harsh...but I'm also biased a bit because I know you and the kind of guy you are. Your words were educational and helpful, BUT, it seemed that a bit of anger was coming through, mostly in the first couple lines. My statement is that I can see how someone who does not know you could feel attacked even though it's obvious to me that you weren't attacking. Does that make sense? You are far from being a bully...you are one of the most helpful members of this forum and my friend.

 

Michael,

 

The way I see it...we agree. The only difference is you are generalizing the word "salesman" to be this unethical pretend to be know it all, and I would argue that though that is true for a lot of salesmen, it's not fair to generalize. Whatever term you want to use "showcase" for people like Spex or Joe, they are still technically sales people...people hired by a doctor to bring in business for themselves. As you stated, "Spex porteays himseld as a patient and a sales rep and not as a medical person". You yourself called him a sales rep...the very thing you said was unethical. It sounds like what you are really saying is that you HATE unethical salesmen who pretend to be knowledgable about things when they are not. I AGREE WHOLEHEARTEDLY.

 

Fit2betide,

 

You seem a bit ambiguous regarding the coalitoin doctors..no offense...unless I'm missing some kind of hidden sarcasm in your voice. Your statements in the first paragraph allude to the fact that you don't think there is a difference between coalition doctors and recommended doctors other than the fee, and your last paragraph states it's smarter to go to a coalition doctor. So I'm confused...how do you actually see it.

 

Let me assure you that there is much more to being a coalition doctor than the fee they pay to be part of the membership. Is there a greater fee? Probably...though I don't know. BUT...no doctor who is not part of the coalition will tell you that they have less skill or experience than a coalition doctor. To learn more about coalition membership standards that a doctor must meet to be part of the coalition, see this link: http://www.hairlosslearningcenter.org/hair-loss-content...ership-standards.asp. Surely hair transplantation is also a business as well, so various people are paid for various reasons...but it doesn't minimize the quality work that coalition doctors do nor Pat for putting this site together. And as you said...you don't have a problem with anyone getting paid....so I ask...is there something you still disagree with or don't understand? I admit, when starting out, it is very difficult to differentiate between doctors...to know who is better than another, to know who uses the latest and best technology...and who has the greatest skill. But that's what research is for. Look up doctor's names (coalition or not) on this forum and others and see what you can find. Only then, will you be educated enough to choose a doctor that is right for you.

 

Bill

[the B spot]

Fit---- I am glad that you are pointing out a few oddities or unexplainables from your perspective.

This is good......

 

Let me address your concerns...... We do not steer people to recommended physicians before Coalition Docs. Usually, recommended Docs find business from local patients who cannot or are unwilling to travel. In addition, many recommended Docs do very SOLID work, with regards to achievable density and placement. The difference is that most recommended Docs are unwilling to transplant large sessions and are unwilling to provide dense pack sessions. This does not mean that their work is terrible or awful, just that their philosophy is a bit archaic and not completely current. Believe me when I tell you that many people/Docs feel it is BETTER to do 2-3 sessions than try 1 large session.

 

Aside from all of that--- the recommended list serves as a good/solid replacement for people who might have gone to Bosley, MHR, or some local hack. We have to remember, many people will NOT travel or simply will NOT risk leaving their immediate area, regardless of what they read or hear.

 

How hard do you think it is for me to tell those who live in Chicago that out of all the Docs that do HT's only ONE Doc (Konier) in the entire town that does world class hair transplants? Many find that hard to believe.

 

Here is some info on the Docs you called from my PERSONAL knowledge:

Leonard E. Aronovitz, D.O-- VERY meticulous, does great work, likes to do smaller sessions, a bit over-priced in the long run.

 

Robert M. Bernstein, M.D., F.A.A.D-- Produces tremendous results on repair patients, feels strongly about his position regarding safe transplanted density's and session sizes. A bit overpriced, but possesses unquestionable ethics and is to be considered a real "good guy" who does great work.

 

Jerry E. Cooley, MD-- possesses the ability to do large sessions, dense packs, uses a large staff and is reasonably priced, tremendous results (see Robert).

Jeffrey Epstein MD, FACS-- does great work and also does quite a bit of Pro Bono work for burn victims and those less fortunate. A bit higher priced but produces great results

Edmond I. Griffin, MD-- Produces very natural results does GREAT work on African American patients, likes to do sessions of 1500-3000 grafts. Would like to see more current patients willing to post photos here.

Robert Haber, M.D.-- A little known doc (not in the HT community, but online) that has been intregal in advances in the removal and closure of donor tissue. Does really nice work, likes to retransplant areas at about 25-30 to produce density's of 45-60 through the frontal zone and core. I do not personally like some of his hairlines, but others disagree with me. Still a great Doc.

Sharon Keene, MD-- Trained with Dr. Shapiro and does tremendous work. Will do large sessions and produces a nice natural hairline (see Gorpy)

Bobby L. Limmer, MD--Produces consistant results and is most concerned with optimal growth, will not transplant over 40 fu's cm/2 in one session, but his primary concern is long term patient care. Highly Technical.

William R. Rassman, MD.-- Doc that embraces the latest technology and also is willing to engage other Docs that possess views opposite of his own. Does really nice work, but is a bit pricy for me at this time. Does produce consistant results.

William Reed, M.-- Newer member of the Coalition, still waiting for some feedback on his approach, which differs slightly from other Docs, with regards to pricing/density/use of larger grafts. In Pat's estimation produces consistant natural results in 2 sessions.

Paul T. Rose, M.D.-- one of the BEST HT Docs in the world. Like Haber is known for his closure techniques (Ledge--variation of the Trico) and produces tremendous results everytime. Usually does sessions of 2000-2500 because he does not like excess tension on the incision closure.

 

Given the opportunity, the methods used by each of these Docs will rival the results of any other HT Doc. Again, there is something to be said for doing 2-3 smaller sessions and allowing the patient to work with the Doc to determine placement and density region by region.

 

Recommended Docs--

 

Alfonso Barrera, MD, FACS---Have heard nothing Good nor Bad. Cannot comment on him.

Dr. Mark Baxa-- would not recommend anyone over a NW3. Has several clinics, does good work, not enamoured with his ability to transplant into native hair.

Michael Beehner, M.D-- solid Doc, prefers to do several sessions-- I think his hairline design is suited to older men.

Dr. Ivan Cohen-- Solid, Good Rep-- would not recommend anyone over a NW4 for him.

Dr. Blaine Lehr--Solid,-- has had some disappointed patients pop up.

Dr. William Parsley--- Does Good work, perfers to stay conservative and low key. Technically, is very advanced, but does solid hairline work and is a bit dogmatic with his hairline work.

 

 

I hope this list helps you out, but it is very good that you have contacted these Docs and come away with good plan and you have chosen a TOP clinic. I personally believe every prospective HT patient should do a virtual consult with H&W and SMG. After that compare and contrast how YOU personally feel and then make an informed decision.

Just remember that even if a Doc is not considered "world-class" they still represent a much higher level of work than the fast food chain HT mills and local butcher shops and for some people that is enough. I hope that as our membership grows, we can keep directing people to these "Top" clinics

It seems that you have gotten off on the worng foot here, so I am glad that you are still engaging in continuous conversation. I hope that you will continue to offer your insight as your knowledge base grows and that you will document your hair restoration journey in order to help others make a quality decision.

 

Good Luck and please let me know if I can be of any assistance.

[MrJobi]

" Could that be partially due to shaving the area? I can't say for sure...but I would guess that incisions are easier to make when other recipient hair is not in the way, so I would venture a guess to say yes".

 

 

 

Good discussion

 

Easier does not translate to better. The point is; in my view, everyone has their opinion. Now, basing your argument on this i.e. " The best" is still an opinion.. If you say H & W is the best because he shaves the receip area that's implying all other doctors are not good by doing otherwise.. Also, Mega sessions i.e 5000-7000 graft HT's in my opinion are a bit dangerous.. With a limited donor area, what happens if 5 years down the road you have more loss and no more or little donor area.. You might end up with problems.. Guys, you can argue either way but personally, i prefer a more conservative approach. That's my opinion but I certainly respect each credible doctors preference and style ..

[Bill - Seemiller]

MrJb,

 

I agree good discussion...and I agree with you. I hope I didn't portray my argument as stating that shaving area = the best. All I meant to state is Dr. Hasson makes a compelling argument as to why it's beneficial. I think it's better to make things easier on the doctor to minimize risk. I think most doctors would argue that shaving would make it easier for them, but many don't require it. I believe we are on the same page here...

 

Regarding a more liberal or conservative approach...I don't think there is really any argument to proove what's "best" or not...it's just a preference. I would argue that a 5000-7000 session isn't dangerous if done ethically and correctly. Though I would agree that it CAN be dangerous like in a case where a 20 year old want to densely pack 4000 FUs into the hairline to achieve max density when his hairloss is so unpredictable. But 7000 FU megasessions on a NW5 for example who is 35 years old seems like a better (better is not factual, only opinion) option to me than doing 2 or 3 smaller sessions.

 

But yes, I agree...even those who are more conservative as long as they are yielding and producing excellent results, it doesn't take away from their credibility. After all...the Proof is in the pudding right?

 

Bill

[the B spot]

Shaving the recipient area is the BEST method for transplantation----- regardless of session size.

 

This is not to say that tremendous results cannot be achieved without shaving down, or that shaving down is the only way, but by and large I think most Docs and ESPECIALLY the surgical staff will agree that continual manipulation of the existing hair takes much longer and can create more shockloss.

 

In addition, the scalp looks much different under magnification, so when the recipient site is shaved it allows a Doc to reduce the risk of transection and work comfortably.

 

I don't know about you guys, but I want everything associated with my HT to easy and comfortable.

 

mrjb makes very valid points in regard to risk factors just as his argument about shaving down. Increased sessions sizes increase potential risk factors for complications......

ie-- If I hammer 3000 nails or 7000 nails, the greater risk of smashing my thumb occurs when I swing the hammer an additional 4000 times.

At this point, patient selectivity becomes paramount and for the Docs that are taking the Pepsi challenge for larger sessions, I think they are doing a better job qualifying patients in order to minimize risk.

Good Topic!

 

The fact of the matter is--- I know NOT shaving down can reduce session size, increase chances for transection, and increase potential for shockloss exponentially-------- IMO a better than logical argument for biting the bullent and pulling out the clippers!!!!!!

 

Great Topic Guys!!!!

[Bill - Seemiller]

B Spot...

 

You should be commended for that last post...thanks for taking the time to list all those doctors and share what you learned about them over time. Great post to come back to for later reference.

 

Bill

[tremblant]

Originally posted by the B spot:

 

Dr. Ivan Cohen-- Solid, Good Rep-- would not recommend anyone over a NW4 for him.

 

Can you please elaborate on why you have this opinion? Dr. Cohen is one of the surgeons I'm considering and he has proposed a 2000-2500 graft (mostly to front, some to crown) for me, and I am probably a NW5 now (close to what Bill was before any surgeries) and I am destined to lose all my natural hair. I know I will need more than 1 surgery down the line.

[Bill - Seemiller]

tremblant,

 

Dr. Cohen performs solid quality follicular unit hair transplantation which is why he is recommended on the Hair Transplant Network. However, he typically provides smaller sessions. This isn't necessarily a bad thing however, it means those with larger areas of baldness to cover will require more procedures to meet your ultimate goal.

 

While large megasessions aren't always appropriate for all patients, they're a Godsend for patients with an abundant donor hair supply and large areas of baldness to cover.

 

I hope this helps.

 

Bill

[tremblant]

Thanks, Bill. For some reason I didn't see your reply till just now.

[Hairtechnician]

When posters say that there is a problem with saying that lateral slits are used when appropriate, I think its possible they don't really understand what lateral slits are. Any Dr. who has done natural hair transplants slants the blade to match the angle of hair growth, and Dr. Keene has done that since she began doing hair restoration surgery. However, when a flat blad is used, turning the blade horizontally, like this _ rather than vertically i.e. like this l is what is meant by lateral.

 

So, one case for example of where there is no discernible difference is if you make a horizontal incision or a vertical incision and insert a one haired graft in the incision, you are not going to see any difference when the graft grows out--a one haired graft cannot fan out. The idea is that if a graft of more than one hair is placed horizontally the fanning effect makes it look like more from the front of the head. But what about from other angles? In some areas, like the crown, it helps to create a swirl pattern to slant the blades horizontally instead of vertically. At any rate, sometimes the lateral incision is useful, but sometimes it is not, and that is why Dr. Keene says she uses it where appropriate.

Edited May 1, 2010 by hairtechnician
typo

[Sparky]

If only my first surgeons had known about angulation instead of putting them all in at 90 degrees, I might of needed as much repairing as I'm going through now. Makes me so angry when I think about it, I mean how hard is it to follow the angles of the native hairs? I know I could do it, they just didnt care about me is all.