U.S. vs International - Quality and Cost

[elicash80]

Howdy forum - Very long time lurker here and first time poster.

 

I am finally going to take the HT plunge after considering it for about 5 years and researching it for much longer.

 

My question is about traveling internationally to save money. I have $10K saved for the procedure and I feel this is definitely adequate, but I am wanting to have a pretty aggressive hairline. Not Jamie Foxx weird or that of a 10 year old, but something similar to Hugh Jackman's hairline. I understand to think realistically and that I'm not going to have Brad Pitt's hairline or density.

 

I am going to schedule consultations with all recommended surgeons within a one state radius, but I am wondering about international surgeons that are and are not recommended. I am seeing some amazing results out of Turkey and India for low cost per graft. I suspect though that they may just be packing the hairline without any improvement on scalp density.

 

Conversely I would also be willing to travel to any state in the U.S. if the cost per graft and quality/skill of the surgeon was top tier.

 

Can anyone speak on an international or low cost per graft U.S. surgeon that could cut my cost and/or give me more grafts for my buck? Also I know cost is not everything, so I would like the surgeon to practice at least some level of ethics/safety protocol.

 

I am guessing I am going to need around 3000-5000 grafts as I want to get a lot done on my first HT. Please have a look at my pics as well and see what you think. Thanks.

[1978matt]

Your donor area looks of worryingly low density which is down to one of two things: 1)Donor thinning, or 2)Naturally low density.

 

Hugh Jackman is likely to be an unrealistic expectation unfortunately.

 

Scheduling some in person consultations is a good idea, as would starting to take finasteride.

 

Based purely on your pictures the most I could suggest is a few thousand FUE to create a hairline that frames your face. I don't think you will be able to get more than 3000FUE grafts without the donor area starting to look very thin.

[hairweare]

Not the best photos which are also out of focus but I agree it appears that your have diffuse alopecia with low density and would be a challenging HT case even for the most skilled surgeons. I would only rely on an in person consultation before deciding whether or not to proceed or not. Keep in mind that a bad HT looks much worse that a someone who is just naturally balding. I would consider a trip up to Chicago and meet with Dr. Konior to discuss options. Good luck!

[elicash80]

Yes, they are terrible pics. I am going to get some more photos put up tonight. I keep my hair quite short on the sides - Like a 1-2 razor guard. Do pics with wet hair provide a better analysis? My donor hair is thin-ish, but I don't feel it is terribly low. The pics are very bad and this is just after a close cropped haircut.

 

As far as the original question, is there a cost/value advantage to international surgeons once you figure in the travel expenses? Or are there any particular U.S. surgeons that could have seem to be having great hairline results with 2500-4000 grafts on someone with my range of MPB (Norwood 4)?

 

I am trying to get the best overall value for the money I have. I do not want to rule out places such as Turkey, that seemingly have amazing results for low cost, just because they are international or non-recommended.

[elicash80]

I have appointments set up with Edmond Griffin, Jerry Cooley and Mike Vories this coming up week. I want to track my progress and share with the forum.

 

Should I start a new thread or use this one?

[refuse2lose]

I would use this thread to share your consultation experiences and then create a new one once you have had your procedure.

 

I had my surgery with Dr. Cooley and he is awesome! I know he does fue but I think his wheelhouse and general recommendation leans towards fut. do you have a preference? In the usa to maximize grafts for 10k you would be getting about 2500 - 3000 grafts fut which is not going to give you a low hairline without sacrificing density. Fue can cost as much as double per graft

 

Turkey does amazing fue and much cheaper. I would do an online consult after your us a consults and then you can have a ballpark for how many grafts for 10k you can get. Can't hurt. Good luck!

[elicash80]

Well I had four consultations with the surgeons I mention above and one additional one (or their assistants) yesterday and the day before. I want to share my experience so that anyone in Tennessee or the southeast, particularly the Carolinas and north Georgia will have a bit more to go on if they do not want to travel to four different surgeons as I did.

 

I will go chronological. My first appointment was with Dr. Edmond Griffin. For the first half hour to hour I met with his assistant and went over the usual of what causes hair loss, what are my options and what a hair transplant surgery entails. As a side note, I can't believe how many people don't research online and must be explained everything at this late in the process. My dad was bald at 21, so I have been researching since I was 18, I'm 33 now.

 

Anyhow, we took some much better photos of my head (which I will post soon) and went over strip vs Fue and how many grafts I might need. I ordered Dr. Griffin's blend of Finasteride, Minoxidil and R.A. because I like the idea of avoiding another pill (I take several already) and it was actually about the same cost per month compared to name brand Rogain. Dr. Griffin came in and met with me for about half an hour. Both he and his assistant were both very professional and polite. Being a dermatologist, Dr. Griffin even let me ask about a few other concerns I had not related to hair.

 

They recommended around 500 in the crown and 1500 to restore an age appropriate hairline. They totally gave me the option, but seemed to lean towards FUT due to higher yield and the fact that my donor area is average density or maybe slightly below average.

**I do not know if I am allowed to speak on cost for the procedure, maybe a mod will let me know, but let me say that while it was reasonable for the nation, (as far as what I have seen on this forum) it came out to be a little high compared to the other doctors I saw in the subsequent consultations.

 

I am going to post the other consultations and posts below. I am afraid with such a long post, something will mess up and I do not want to type this again.

Edited December 18, 2014 by elicash80

[elicash80]

I had only planned to have three consultations, all with recommended surgeons, but on a lark and since I had time to kill until traveling to Charlotte, I called HRS of Atlanta after seeing a billboard advertising $2 a graft.

 

They were able to fit me in the following morning and make the consultation brief as I had to be in Charlotte not long after that. I met with Marshall Boyd. I am not sure if he is a doctor or just consultant, honestly it was my mistake not to ask, but I was rushing the staff to get out in time. He showed me a pic of himself from 21 and his hair looked great now coming from a Norwood 6.

 

I was especially weary of this place for all the same reasons Bosley, Nu-Hart and the like get bashed on this forum. Deservedly so I might add. I was not sure if this was the same type of operation and would really welcome anyone (not a one time poster) who has had a transplant with them to chime in. They recommended roughly the same number of grafts as Dr. Griffin with roughly the same hairline. They do not practice trichophytic closures and I was told by them that the advantage is negligible as hairs from the suture often do not grow well through the scar.

 

The cost for the same amount of grafts in the same regions was much, much less that Dr. Griffin. I understand this is often a sign of a transplant mill and not meeting with the surgeon is also not really ideal, but at this cost I could literally afford 2 for the price of 1, due to their promotion. The first 1000 grafts are not really $2. The first 1000 is $4 per and subsequent grafts would be $2 per.

 

Are there any members here that have had a positive experience with a low cost transplant? It is not all about money for me, and I have the budget, but since I am going for a rather young look I am considering this as an option. Even if they only delivered on 75% of promised density, at this cost I could come back in a year and have it thickened up. Of coarse, this would not make the best use of my average or slightly below donor hairs, but I have to admit, it is tempting because my budget could essentially give me double the grafts.

 

Please let me know what anyone thinks on this or if you have more questions about this consultation.

[elicash80]

Third I met with Lollie, Dr. Jerry Cooley's patient coordinator. This woman knows her stuff. It was obvious from the get go that Dr. Cooley made a great choice as having her as part of the staff. I was admittidly running late, as the GPS took me 20 minutes away. She worked with what little time I had, but I was not able to meet with Dr. Cooley.

 

She went over many advances in pre, during and post op solutions that Dr. Cooley uses during his surgeries such as ACell and PRP and a specific wound healing compound. I will do more research on this forum, but essentially (as anyone that has read Dr. Cooley's posts knows) this is all to either prolong graft survival, in and out of the head and/or to maximize wound healing - and possibly regenerate transected grafts.

 

She recommended a higher count of grafts, but I feel this was due to me implying I would like a strong post-op density. As with the previous consultations, the option was given, but I was definitely swayed towards FUT for my situation. I feel this may also due to my budget and not that any surgeon is trying to push either method onto you. Lollie reccommended 2000-2500 grafts, but I feel that since the cost per graft goes down as the # goes up and since I want to spread out transplants as long as possible, I would probably lean towards the 2500 grafts.

 

This higher number would also give me enough grafts to work on my receding temples and maybe add a bit of density between the front forelock/hairline and back crown. Every consultation assured me that no grafts would be wasted. Lollie offered also that since I wear my hair short, that if an FUT scar was too visible for my liking, they could do FUE into the scar after the transplant at little to no cost.

 

Dr. Cooley's cost was competitive for the amount of grafts I am considering and his skill level. The only problem I had, is that PRP/ACell would be a seperate cost as opposed to included as with Dr. Griffin and HRS. Let me state that Dr. Cooley uses PRP/ACell as well as other proprietary solutions, so this may be why the added cost for the PRP. Also since his cost per graft is competitive, maybe he does the PRP/ACell as a separate transaction to keep the cost of the actual surgery down. This added cost, if I went with the PRP/ACell would pretty much tap out my budget, which is higher than what is stated in the original post, and I am not sure if I want to do this.

 

I would probably not go with him personally if I only had a low number of grafts needed such as 1000 or less, but since value gets better with a higher number of grafts, I am strongly considering him.

Edited December 18, 2014 by elicash80

[elicash80]

Lastly, I met with Dr. Mike Vories right outside of Charlotte. I literally drove from Dr. Cooley's to his location. I was able to meet with him personally for the whole consultation. He practices FUE exclusively and no longer, from what he stated to me, practices NeoGraft. The reason being in that his efficiency is such now that he no longer needs the machine, therefor hand placing of the grafts is typically ideal, but usually less efficient. His speed now has let him eliminate the NeoGraft.

 

He recommended the same number, roughly 2000, as the first two surgeons as said that my donor density was definitely adequate for FUE. He punches, typically a 0.8 punch if I recall correctly, and places the grafts all himself. He does only one patient a day as with every other consultation I spoke with. He let me ask away, like all other consultations and was frank and honest with his responses.

 

The cost for this was quite competitive considering this is FUE and not FUT. If I was to come out with a high survival density and acceptable aesthetic look a year later, this would definitely rate as the best value if you consider FUE is typically more expensive. Not the lowest cost though.. HRS was the lowest estimate. Dr. Vories guaranteed me an 85% graft survival density and said that this is not actually a great number, but that the very high number of smokers in the south force him to be in this range. If he dealt with only non-smokers, he could guarantee a higher number. I do not smoke and apparently this lowers your typical graft survival rate.

 

One thing is that he does not practice PRP or other added solutions such as Dr. Cooley due to, what he feels is lack of empirical evidence. I will have to do more research and see what the advantages/disadvantages and evidence are for PRP and whether it could be a deciding factor in selecting a surgeon.

[elicash80]

I am open to all suggestions as this is a huge decision for me, and I guess it would be for any of us, and I want to make the right choice.

 

Right now I have only eliminated one surgeon from the 4. Essentially it boils down to these factors with each surgeon.

 

HRS: The cost is the deciding factor here. Like I said above, even if it does not come out ideal, I still have over half my budget to go back in and have it redone. I am guessing that since I am a forum poster they would take care of me. Also since they are using essentially the same equipment and techniques as others, they can not have bad results continually, they would be out of business.

 

Cooley: From what I have seen of his posts, this Dr. is an artist and does not typically ever have a bad result. Also, crossing my fingers here, he goes above and beyond to correct (within reason of course) any dissatisfaction a patient has. His cost is at the literal top of my budget, but I think I would be paying for quality. Since I aiming for a few other non-hair related procedures after this, I am not sure about exhausting my resources.

 

Vories: I like the idea of FUE much better than FUT, but am afraid if I need more surgeries in the future that this might make my donor area look moth eaten. This Dr. is a straight shooter and I believe could deliver a great result, but I have seen 1 patient of his that was not ideal. I believe though that this had nothing to do with his skill, but the low number of grafts selected by the patient. He could be a good combination of skill and value.

 

Thanks for reading my long posts, hopefully this will help young guys in my area considering these surgeons. Let me know what you all think.

[ontop]

First of all well done for doing your homework.

Taken pics & posting on here is one thing seeing a HT Dr is another & a proper look by several different HTs under microscope gives the better understanding.

 

You proberly hear many times don't make money or travel be the factor & to a certain degree these things do play a role such as work commitments & putting bread on the table for you family.

 

I wouldn't put to much thought about PRP/Acell tho it can help short term at the time of HT but this I feel is just short lived IMHO.

 

I'm not sure if i read that your on Meds such as Fin / propicia? If not then I would defo advise you to at least try for at least 12/18mths prior before going in the O.R.

 

I have a few other things to say on your research which is great for anybody looking to have HT done in the future.

[elicash80]

ontop - Thanks for the response and suggestions. Yes, I am also not sure that the results of the separate PRP/ACell justifies the cost. I feel that this does help many people, such as women, who may have diffuse thinning and do not want to go through an actual surgery such as a full blown HT.

 

If I eliminated the PRP/ACell - I would still be near the top of my budget, but have roughly 1K-2K to save. For the number of grafts per $, this would then put Dr. Cooley and Dr. Vories almost exactly the same at my graft #. Dr. Vories would be performing the typically more expensive FUE though. All in all roughly still double the cost of HRS.

 

I am still considering International travel and am going to do more research on this forum and others. If I can get a stellar result for say, 7K, this would definitely help with the cost of another procedure I feel is necessary. Now the flight and stay could set me back 1K, so this must be factored in, but I am still going to do my homework.

 

This is culminating into a cost vs quality vs travel experience as I have always been a value shopper, but believe that there is usually a reason something is cheap and most of the time it is worth it to spend the extra money.

 

Oh yeah, I am about to add meds, but, against most recommendations, I am still going to go ahead with the HT before 6 months from now. I have been on Minox. for more than 10 years and have sporadically taken generic Finast. from the UK or India.

[ontop]

IMHO...

I would rather pay the extra to have the best HT I can find as you only have 1 head & I've seen some bad HTs done over the yrs.

My advise would look for consistant results, when I say that I mean look for HT clinics who constant gives good results, this can be a mine field tho as many people only see the stella HTs & never the bad ones.

What your looking for is the same Dr popping up all the time & yes even that Dr would have a few bad eggs but looking at the bigger picture if that Dr has say 95% good feedback then the odds are defo in his favour.

 

This hair Business is a 3.5 billion yr turnover & a lot of sharks out there, I'm not saying your Drs you spoke to are sharks by any means in fact there are a handful who's on top of there game.

 

Thought about Dr K, Dr yates , or even H&W in canada? They have consistance in there results.

 

You never answered my Q if your taking Fin ....this should be your first line of defence is Meds first before HT.

 

Best wishes.

[elicash80]

Sorry, the answer about the meds is in the last line of my last post. I am going to add it in, but will only do the once every Monday, Wednesday, Friday as suggested by Dr. Cooley's assistant due to the long half-life and because I already take several other medications for health issues.

 

Yes, you are probably right about almost eliminating cost as a factor. I have not really considered other HT docs in North America, simply because I feel Dr. Vories or Dr. Cooley could deliver stellar results. I have heard quite a bit about H&W, but I feel I might be adding a few grand to my total, when the doctors in my area are recommended and are delivery quality results.

[ontop]

Hi again,

Sorry I re read your last post again about Meds...

I guess the Drs you seen all mention this to you & give one of them a call & have them call in your Meds such as 5mg of Fin & cut 1pc in 4 & take 1.25mg a day & if you get sides then take it every other day.

 

You can get Fin from walmart at $9 for 30 days of 5mgs & if your Dr would write out for you 90 days refill to collect every month, you will be covered for at least 1 yr for just $27.00 now that's a bargain to hold on to what you have left on top of your head & even can have some gains also.

 

Get on Meds & stick it out & see where your at in 12/18 mts from now.

[ontop]

Nice one...

Yep every other day is better than nothing & very mature of you to at least give it a go before HT.

You maybe surprised of how you may take but keep it up & stick with it as its the best we have right now I hate to say.

 

Yep H&W is not bad on there prices plus I've hear they will work with you with travel also, its worth a call anyways me think.

 

Good luck keep in touch.

[refuse2lose]

Great write ups. You are right about Lollie she is great, I really enjoyed talking to her. Are you sure that Acell is extra? I know that he offered PRP as an "add-on" but I thought all his transplants used acell in the closure. I could be wrong though.

 

Was Vories FUE quote on par with Cooley's FUT? If so that is a hell of a value, especially in the US. I would have gone for FUE if it was affordable, but it is SOOO expensive in the states.

 

I would really caution you on the cheaper "hair mill" type places, its not only about the graft number, but if they mess up your transplant and you get a low yield, those grafts are gone forever and you have a limited supply. We can't afford both monetarily and physically to not get things right the first time during the surgery.

 

I would still give the Turkey and Belgium guys and ping for a consult. They really are on the cutting edge of FUE right now, and Turkey has very competitive prices if you are looking to go for a more aggressive hairline. Good job researching so far and good luck.

[ontop]

I think cooley will cut you a deal $1500 on PRP/Acell when you have HT the same time.

Stand alone he would charge $2500

 

I still think its a bit pricey & not a cert that you would get good results from it anyways.

[refuse2lose]

I think cooley will cut you a deal $1500 on PRP/Acell when you have HT the same time.

Stand alone he would charge $2500

 

I still think its a bit pricey & not a cert that you would get good results from it anyways.

 

Ah yeah I declined that option and put it towards more grafts. Getting good growth so far though!

[elicash80]

Thanks for the replies. Yes generic Finasteride from Wally World is a deal. I am going to add this in on a three time a week basis, but will likely give it 3-5 months to see what happens. I will be honest, Dr. Cooley and Dr. Vories results just have me so ready to pull the trigger early before I see what Finast. can do. You have to realize, which I am sure a ton of posters on here do, that I have been dealing with this since age 18. Also we are often our own biggest critic. It has always been a bigger deal in my head, no pun intended, than it was to others.

 

I have looked into H&W and their prices are on par with Cooley and Vories (which were actually surprisingly fair). This makes me feel that I will most likely stick with one of the two after looking into the recommended surgeon Dr. William Parsley and a few international surgeons. I have completely eliminated HRS as an option, because you all are right about getting it done right vs cheaply. I don't have a ton of donor hair and I have to conserve what I have.

 

@refuse2lose - Let me clarify what I have said. Dr. Cooley does use ACell with the open wound and, possibly, with the actual graft punches, during his procedure as well as a few other medical solutions that are above a simple chilled saline. The jury is still out to whether this is actually better. What I was speaking on was specifically the PRP/ACell mix which is injected and can be completely separate from a transplant. As ontop has said, you get a deal on this, $1500 vs $2500 if you combine it with the transplant. I am still not sure though if this is worth it as I don't care too much to 'speed along' the results as I have been half bald forever it feels like so what would another added 5 months be. I can be patient if I save $1,500. Also I have heard about Dr. Cooley himself recommending that the $1,500 instead go towards more grafts, as in your case, and not PRP/ACell since budget was a concern for the patient.

 

@refuse2lose - Do you mind if I ask how many grafts you had, your pre-op hair loss situation and if you feel happy with the procedure. I looked at your profile, but did not see pics.

 

@refuse - Yes I am still going to look into Belgium, Turkey and a few other places, but some of Dr. Cooley's work just looks incredible. Can I ask you if a doctor or doctor's assistant recommended FUE to you over FUT? It may be because of my donor density, but I am generally hearing, except of course from Dr. Vories, to go for the FUT first. This is because, and again this may have to do with my donor supply, that you can get more total surgeries out of FUT first and then FUE later as opposed to FUE from the get go. Can a member speak on this specifically? What I have heard is that you may get one or two FUE surgeries tops, but with FUT first, you can do two of those and then since your scalp is going to be tight, you can do another 1, possibly 2 FUEs. I would really like someone in the know to comment on this. If FUE is generally accepted as a better option if budget is not a concern, I might then lean towards Vories.

 

I have contacted Lollie with a few questions, but I am thinking I am probably just going to spend the extra money on a close American surgeon. If you think about what the dollar per hour cost of worrying about your hair loss is worth, and that with a good HT, this can mostly be eliminated, how much is a great HT then worth to you?

[refuse2lose]

Got ya on the prp. Yeah I did not elect for that. It may thicken diffused areas but in the end I feel like $1500 in grafts will make more of an impact.

 

I paid for 2000 grafts per Lollies recommendation. One of the little talked about benefits of FUT is that its obviously impossible to estimate exactly how many grafts your strip will be. So the number you pay is the MINIMUM you will yield. I paid for 2000 and my strip actually yielded about 2500. So Cooley does not charge you extra for that and he implants every last graft. With fue they can obviously extract exactly what you pay.

 

My thread is here http://www.hairrestorationnetwork.com/eve/176341-29-yr-old-2300-fut-dr-cooley.html

 

I am super impressed so far with my results. Coming up on month 5 and its been one of the best decisions I have ever made. Its so surreal to not have to constantly worry about my hair.

 

FUT vs FUE is always a big topic. I have read that if you do FUT first followed by FUE you can maximize your donor. I have also heard that FUT yields better quality grafts and are "safer" because they come from the heart of the "safe" zone. This was a good article on the subject that was helpful for me FUE vs. FUT Hair Transplants | Pros and Cons of FUE vs Strip Harvesting | Bernstein Medical

[ontop]

Rufuse2loose

How did cooley close you up?

Was it staples or the old needle & cotton way?

 

Also FUE vs FUT there's defo pros & cons in both Methods

Some Drs who do FUE like using the Artis machine say they gets the same yeild & some Drs say no that's not the case.

It does make sense that going the FUT route that all is kept in tact until the tech start cutting the stript folical by folical where I can see doing that for such a long time day in day out can be a bit of a pain in the ass & human error can transect folicals.

 

I think with the FUE its not scarless but they can cherry pick there folical groupings again human error can & do play into this also as they are playing blind poker where as the FUT method they can see what is what under the microscope.

 

Again IMHO both are good methods aslong the HT Dr & his assistants are on top of there game....nothing should be wasted period.

[refuse2lose]

Rufuse2loose

How did cooley close you up?

Was it staples or the old needle & cotton way?

 

 

Double layer trichophytic closure. Sutures came out around 2 weeks.

[ontop]

There you go...

Nice & tight.