Procedure booked w/ Dr. Rahal (second transplant)

[win200]

Hey guys,

 

Long-time lurker and poster at other hair loss forums. I thought I'd finally sign up here and share some info about my first transplant and create a log in advance of my upcoming procedure with Dr. Rahal this June. I'm 31 and hair a 1.450 graft HT via FUT with Dr. Robert Niedbalski in Seattle in June 2012. I like my result, but want some additional work, so I'm getting another 1,500 grafts from the hairline wizard this summer (FUT again). My blog is below; check it out and let me know what you think! Cheers!

 

Hair Restoration Site for win200

[Blake Bloxham]

Win,

 

Congratulations! Look forward to updates.

[win200]

Just bumped the procedure to October 23; some business travel came up that would have had me at conferences the week after the transplant, and who needs that. I'd also like to have a little more time on Avodart before I go under the knife.

 

I also had the chance to meet one of the world's top strip docs; won't identify him out of respect for his confidentiality, but he's probably one of the top 3-5 surgeons on this forum in terms of reputation. He took a look at me and I filled him in on my plans for a follow-up procedure, and he said, "Well, look... your hair looks great, and my mantra is usually 'If it ain't broke, don't fix it.' But 95% of transplant patients have supply issues, and at your age and with the way your native hair is holding up, you're not one of them. So if you really want more work done, I don't see a problem."

 

I'm paraphrasing a tad, of course, but this was the gist of what he said. It definitely helped me feel empowered to go forward, because this guy has an absolutely sterling reputation.

 

I also uploaded a few more pics of my current hair now that it's cut a bit shorter just for the hell of it.

 

Hair Restoration Site for win200

[win200]

I've shifted gears and bit and am now looking strongly at Dr. Konior for a second procedure. I just updated my blog with details and new pics:

 

Hair Restoration Journal for win200 - Consult with Dr. Konior

[Mickey85]

Man, I took a look at your recent pics... You have a killer head of hair with a really nice hairline as it is.

[win200]

Man, I took a look at your recent pics... You have a killer head of hair with a really nice hairline as it is.

 

Thanks, Mickey! I don't disagree... I'm just particular and really fastidious about my hair. I talked with Dr. K a lot about such an aggressive strategy, because 3,500 in the hairline is a lot. Buuuut, he felt that with my native hair in the state it's in, plus the fact that I'm on meds, he felt comfortable proceeding and I trust his judgment more than anyone's.

 

Bottom line is that I want a flatter hairline--I've never liked the widow's peak, which was not part of the plan with my prior surgeon, and I want the density beefed up in the dead-center area. Plus, I want stronger temple points. And seeing as though I have the donor supply and native hair to support that, I'm gonna do it. YOLO...

[chrisdav]

I think your hairline looks better before drawing the outline of new the one on - something in between maybe.

[win200]

I think your hairline looks better before drawing the outline of new the one on - something in between maybe.

 

Thanks! It's just the rough proposed hairline--we haven't sketched it out in person, so I'm sure it'll change a little. I'd to a perfectly straight hairline if I could, but the widow's peak is transplanted too low. I don't care for sloped hairlines much.

[hsrp10]

Hmmm... mixed feelings here :-)

as others have already stated looks good already, an additional 3,500 into the hairline at age 32? Really?

 

Going with Dr. Konior makes me say though that it should work out, and afterwards you'll have more hair than Brad Pitt in his 20's.... :eek:

[densedream]

Are you kitten me right meow! Where would 3,500 grafts go! Is this ethical on the surgeons part? I think you should step away from the website and consult a psychologist, no offense. You might have an obsessive disorder.

[win200]

Let's be clear, guys: when I said 3,500 grafts, I meant *in addition to* the first procedure. We're looking at 1,500 to 2,000 for the follow up, for a TOTAL of 3,500 at the hairline. That's much different than 5,000. It's aggressive, but not crazy when taking into account my native honor, donor characteristics, etc. I've had two top surgeons take a look at me and both signed off on that approach, so I don't think anyone's proposing a crazy donor dump here. Aggressive, yes; crazy or unethical, no.

 

And I'm extremely finicky about my hair. I'm not obsessive. I could leave it as is and be happy, but dropping a hairline a bit would make me happIER, so I'm doing it. Honestly, I think 3,500 hairline grafts on a 32-year-old with extremely stable loss and a NW2 head of thick, dense donor hair is much less crazy than pretty much any procedure on a 23 year old. You don't have a crystal ball, but with my hair at my age, you pretty much know a NW7 probably isn't in the works.

[densedream]

Okay that sounds more reasonably even though you have many of us envious of your hair as is. I thought you were going to add another 3500 and I was wondering where they could possible go. Anyways, whatever makes you happy. Good luck you with your new elvis hair.

[CAMPBELL]

Personally I think your hair and the hairline is great (many folk would give their right arm for that hair). But... I guess 'you' are the one person living with it daily & you know at the end of the day what feels right for you.

 

Good Luck with that next session.

[Noodles123]

I think your current hairline is very believable and age appropriate. But hey, if you have cash to burn and going to a top notch surgeon, then go for it.

[win200]

Hey everyone,

 

Just thought I'd return to this thread. I'd been considering a second procedure in late 2014, either with Dr. Rahal or Dr. Konior, but never ended up going through with it for various reasons. But the prospect keeps tugging at me, and while I think I have a good head of hair, I really don't care for the deep V shape and it continually bothers me. I'm on dutasteride and finasteride, and that seems to be holding my loss stable. (Take at look at my pics in the site below; my hair is totally unchanged from the June 2014 pics.)

 

My question is, is it absolutely stupid to tinker with a great result? I know it's age-appropriate and all that; the issue is just that I'm not personally thrilled with it. And if you don't think there are any red flags with proceeding, should I go with Dr. Rahal? Dr. Konior? Consider others? Rahal has always been my first choice due to his outstanding acumen with hairlines, but his recent round of slightly bad press here has me a little spooked.

 

Bottom line, your thoughts would be appreciated. Thanks!

 

Hair Restoration Websites

[Gram]

I've heard that Rahal is "participating" in multiple procedures a day where as Konior is still extremely hands on and performing one procedure per day for what it's worth. If I'm you that might be my first question to both docs

[win200]

I've heard that Rahal is "participating" in multiple procedures a day where as Konior is still extremely hands on and performing one procedure per day for what it's worth. If I'm you that might be my first question to both docs

 

That's my chief concern with Rahal. The man is an incredible surgeon, clearly, and he's produce, IMHO, the best results for the type of surgery I'm looking for--a relatively aggressive, dense, natural hairline. That moved him to the top of my list. But I'm concerned about some of the issues being raised about the consistency of his results and his level of involvement in each procedure.

 

I'm fine with a surgeon running multiple operations per day provided that they're able to maintain a consistently outstanding level of result. However, I've gotten the impression that there's been a rapid turnover of techs at Rahal, which is a huge red flag for me. I know how integral great techs are to a procedure--especially if the doc isn't doing every step of the operation (as most are not). Bottom line is that I know Rahal can do the job, but I am legitimately concerned that his operation is in the condition it needs to be in to turn out a reliably first-tier result. I have all the good ingredients--stable loss, thick native hair, good donor hair, etc. etc. I don't want to blow it.

 

I love Konior, and have met the man and am completely confident in his exactitude and patient dedication. I am not convinced, however, that he can quite match Rahal in the hairline design department, and that's what gives me pause.

[Dr. Rahal]

Hi guys!

 

Couple of points...

 

I'm fine with a surgeon running multiple operations per day provided that they're able to maintain a consistently outstanding level of result.

 

If there are two hair transplants in one day, there are two teams of techs… always

 

One hair transplant is performed in the morning. The other hair transplant in the afternoon.

 

Both patients have their own team of techs and Dr. Rahal’s full attention.

 

This continues after the procedure… our after-care is exceptional.

 

However, I've gotten the impression that there's been a rapid turnover of techs at Rahal, which is a huge red flag for me

 

Let’s squash this rumor started now

 

It's 100% not true. Most of our techs have been with us for 10-20 years.

 

Combined, it’s over 100 years of experience.

 

Our techs are VERY good at what they do.

 

It’s a VERY important role at Rahal. A position we deeply respect.

 

Why do our techs stay for so long?

 

1) Full benefits…

2) Free massages on breaks…

3) Free lunches…

4) And many, more perks…

 

Hope this helps!

[win200]

Hi guys!

 

Couple of points...

 

 

 

If there are two hair transplants in one day, there are two teams of techs… always

 

One hair transplant is performed in the morning. The other hair transplant in the afternoon.

 

Both patients have their own team of techs and Dr. Rahal’s full attention.

 

This continues after the procedure… our after-care is exceptional.

 

 

 

Let’s squash this rumor started now

 

It's 100% not true. Most of our techs have been with us for 10-20 years.

 

Combined, it’s over 100 years of experience.

 

Our techs are VERY good at what they do.

 

It’s a VERY important role at Rahal. A position we deeply respect.

 

Why do our techs stay for so long?

 

1) Full benefits…

2) Free massages on breaks…

3) Free lunches…

4) And many, more perks…

 

Hope this helps!

 

Hey, thanks for the follow up... greatly appreciated. I've actually got a call scheduled with Chad in an hour.

[PupDaddy]

Hi guys!

 

Couple of points...

 

 

 

If there are two hair transplants in one day, there are two teams of techs… always

 

One hair transplant is performed in the morning. The other hair transplant in the afternoon.

 

Both patients have their own team of techs and Dr. Rahal’s full attention.

 

This continues after the procedure… our after-care is exceptional.

 

 

 

Let’s squash this rumor started now

 

It's 100% not true. Most of our techs have been with us for 10-20 years.

 

Combined, it’s over 100 years of experience.

 

Our techs are VERY good at what they do.

 

It’s a VERY important role at Rahal. A position we deeply respect.

 

Why do our techs stay for so long?

 

1) Full benefits…

2) Free massages on breaks…

3) Free lunches…

4) And many, more perks…

 

Hope this helps!

 

Thanks for providing this information regarding Dr. Rahal's current practices. I hope you won't mind if I ask some additional questions:

 

1. Do I understand correctly, then, that Dr. Rahal performs a maximum of 2 ht surgeries per day, one in the morning and the other in the afternoon? Could the two surgeries both be FUE, both FUT, or one of each?

 

2. If there are 2 FUE surgeries scheduled for the day, and each patient is assigned his or her own team of techs, what do the techs who worked the morning session do for the rest of the day? (I suppose they continue inserting grafts into the recipient sites until all the grafts have been placed, whereas Dr. Rahal has, by then, moved on to the afternoon surgery?)

 

3. Do your techs operate as set, distinct "teams" so the same techs always work together, or is it a mix-and-match situation?

 

4. How many techs comprise a team for an FUE surgery? For a strip/FUT surgery?

 

5. Are there separate, distinct tech teams for FUE procedures vs. FUT procedures? In other words, is there a team(s) that only assists with FUE surgeries and another team(s) that only assists with FUT surgeries?

 

6. Related to questions 4 and 5, do all techs perform graft strip dissection, FUE excisions-extractions, and graft insertions, or do certain techs specialize in one/some of these tasks to the exclusion of other tasks?

 

7. For FUE surgeries, is the division of labor: Dr. Rahal designs and marks the hairline & other recipient areas, and later makes the graft recipient incisions, whereas the techs are responsible for graft excisions-extractions and for inserting the grafts into the recipient sites made by Dr. Rahal?

 

8. How can an FUE patient be assured he is getting Dr. Rahal's "A team" for his or her surgery, if he is one of two FUE surgeries schedules for that day?

 

I might have some follow-up questions, but thank you very much in advance for answering these. I really appreciate it.

[wazaam]

Quote:

Originally Posted by Rawkerboi

Hi sean! Good to see you back! I did followed you in the beginning

Wish you good luck.

 

Quote:

Originally Posted by PupDaddy

Welcome back, Sean! Very, very best luck with the growth and outcome of your touch-up/repair session!!

 

This go around, were there differences you noticed from last time in the FUE procedure/protocol/approach/tools used/method/extraction personnel/etc. at Dr. Rahal's clinic?

 

 

Thank you guys. I really appreciate it.

 

Well, prior procedure was definitely longer.

 

1st FUE:

-most extractions were done by a lead technician, who was very new to FUE extractions/learning, some were done by the doctor. Doctor was also attending other surgeries.

-the Harris SAFE punch system motorized tool was used.

.8mm punches were used, some at .9mm supposadly

-doctor made incisions

-2 technicians placed grafts (one technician was new to Dr. Rahal's clinic from US, white) and one was an older Asian lady

-1 other new technician was holding, passing grafts to these other techs, rising the operating table chair, up and down and positioning.

-more than one surgery was going on

-clinic was small to mid size , 2 - or maybe 3 operating rooms?

 

2nd FUE Repair

-the same lead tech from first procedure was extracting my grafts about 60% and doctor did the rest. this time he did seem to be more confident, needing no instruction. doctor again was attending to other surgeries.

-the same FUE motorized extraction tool was used, .8mm punch sizes used as confirmed by clinic (like last time)

-doctor made incisions

-for recipient graft placement, did not see same new white technician from US from last time, other then the two Asian ones, and another newer face from last time,

-the younger Asian one that rose my chair up and down last procedure seemed to be partaking in surgeries now

-this clinic is a lot bigger, more than 3 operating rooms, a lot more techs working there, some newer faces.

-more than one procedure going on same time as mine

-definitly less backbreaking for me as I didnt have to be in the chair for such a long time, but again this is a streneous procedure to go through

-i did not have much swelling, like last time

-i did pay for my own hotel and travel costs for this repair, and used up my days off of work for this as well (eliminating my family vacation time)

-so far i got shockloss and nothings changed up front yet, but doctor rahals clinic said as a repair patient this may take longer to grow now, after I sent them some photos, so lets see

 

Hope i've answered your questions Puppdaddy.

 

 

 

Some of these statements from the clinic seem to contradict Sean's account and experiences from his 1st FUE procedure and repair procedure that we are still waiting to see final results???

[Dr. Rahal]

Hi PupDaddy... some great questions! Give me a couple of days to gets some specifics for you ok??

[Dr. Rahal]

1. Do I understand correctly, then, that Dr. Rahal performs a maximum of 2 ht surgeries per day, one in the morning and the other in the afternoon? Could the two surgeries both be FUE, both FUT, or one of each?

 

When it’s two cases, it’s either FUT/FUT or FUT/FUE and one nurse/RN. Never FUE/FUE.

 

2. If there are 2 FUE surgeries scheduled for the day, and each patient is assigned his or her own team of techs, what do the techs who worked the morning session do for the rest of the day? (I suppose they continue inserting grafts into the recipient sites until all the grafts have been placed, whereas Dr. Rahal has, by then, moved on to the afternoon surgery?)

 

 

It’s always FUT/FUT or FUT/FUE. Never FUE/FUE. There are times when techs from one FUT team will assist another (if needed), say for example we harvest 6000+ FUT grafts in one session. But for the most part, they would go home.

 

3. Do your techs operate as set, distinct "teams" so the same techs always work together, or is it a mix-and-match situation?

 

Distinct teams. Each is an expert at one specific task; however, they are also cross-trained.

 

4. How many techs comprise a team for an FUE surgery? For a strip/FUT surgery?

 

FUT - 10

FUE - 6

 

5. Are there separate, distinct tech teams for FUE procedures vs. FUT procedures? In other words, is there a team(s) that only assists with FUE surgeries and another team(s) that only assists with FUT surgeries?

 

Yes. There are seperate distinct teams for FUE and FUT.

 

6. Related to questions 4 and 5, do all techs perform graft strip dissection, FUE excisions-extractions, and graft insertions, or do certain techs specialize in one/some of these tasks to the exclusion of other tasks?

 

They specialize. Though all are cross-trained, dissection, etc.

 

7. For FUE surgeries, is the division of labor: Dr. Rahal designs and marks the hairline & other recipient areas, and later makes the graft recipient incisions, whereas the techs are responsible for graft excisions-extractions and for inserting the grafts into the recipient sites made by Dr. Rahal?

 

Dr. Rahal designs hairline, makes recipient areas, etc. Dr. Rahal and lead tech with over seven years experience for graft extraction. Techs for implanting.

 

8. How can an FUE patient be assured he is getting Dr. Rahal's "A team" for his or her surgery, if he is one of two FUE surgeries schedules for that day?

 

There is one team for FUE. They are guaranteed to get Dr. Rahal’s “A team”.

 

Hope this helps!

[win200]

Just wanted to share that I had a really helpful call with Chad yesterday, and asked him some of these questions. He clarified that Dr. Rahal performs the entire extraction process (with the help of techs of course) and makes all of the incisions. Techs perform the insertion process, and Chad said that honestly, it's best that they do it because they're the most experienced ones in that portion of the surgery. I raised the issue of rapid tech turnover or use of "roving" or "visiting" techs, and he said a) that Rahal absolutely does not use visiting techs; they're all Rahal employees; and b) that their tech ranks are very stable and include many techs that have been there for the full 19 years of the clinic's operation. Honestly, I found this pretty reassuring.

 

Just wanted to share that feedback. The US/CA exchange rate is pretty enticing now, too.

[win200]

So, I went ahead and booked a procedure for early October to transplant roughly 2,000 grafts (Dr. R will adjust based on his review before the procedure). I thought my chat with Chad was really encouraging, and the answers to the concerns that have been presented here were addressed to my satisfaction. I continue to think that Dr. Rahal has the best skills in the game right now when it comes to fairly aggressive hairline procedures in guys my age (though Dr. Konior and Dr. Gabel are also at the top of that list). I'll post some pics of my hair right now in the next day or two. Excited!