First job- first paycheck- and spending it on HT

[Shadow of the EMpire State]

Now, I ask you a question.......would it make sense for this Patient to "wait" another 15 years until he is 40 years of age OR do something about his baldness "now"? Would you not agree that your statement that "Demanding things "NOW" is a root cause of failure in all endeavors" does NOT apply here?

 

If you're asking for my opinion about the case to which you linked above, I would not recommend a hair transplant for that gentleman regardless of age because I think that that degree of loss is likely too extensive to produce an undetectable, cosmetically acceptable result for patients without extraordinary hair characteristics. But if he's of a mind to proceed anyway, then I don't see a significant downside to doing it now. After all, he's already so far gone that the surgical plan would presumably take stock of a terminal pattern of Norwood 6 or worse.

 

Again, I believe that there should be no set rules here. It should be a case by case decision. Also remember with the advances in the HT techniques and technology, a Patient has the option to tap into body hair to supplement the scarcity of scalp donor hair.

 

Body hair looks terrible, and everyone knows it. The bottom line is that the surgical aspect of the procedure can advance and advance and advance, but until they find a way to produce more scalp hair (via cloning, multiplication or some other similar procedure), the surgery will have limited efficacy, so donor hair must be conserved to the greatest extent possible.

Edited November 1, 2015 by Shadow of the EMpire State

[esrec]

The challenge is age / relative to hair loss, not simply "age, "or degree of hair loss''. If you were 24 and needed 2500-300 grafts I dont think you'd see the same reaction. Conversely, if you were 50 years old and needed 1500 grafts you wouldn't see any reaction.

 

The patient absolutely needs to do whats best for his condition. Its a personal decision, one that must weigh the practical (Age, donor supply, candidacy) and psychological ( how much are you currently suffering?)

 

I think its important to delay at least a year from when you first hit your mental breaking point. Not just to exercise patience, but to really calibrate your situation.

 

I waited 3 yrs after my first mental breaking point. Slightly too long, as I suffered more than I should have allowed myself to, but it also makes the decision to move forward that much easier.

 

Best advice--be your own devils advocate. Ask the tough questions and be honest with yourself. The worst lies are the ones we tell ourselves.

 

Best of luck.

Edited November 1, 2015 by esrec

[California]

If you're asking for my opinion about the case to which you linked above, I would not recommend a hair transplant for that gentleman regardless of age because I think his loss is likely too extensive to produce an undetectable, cosmetically acceptable result. But if he's of a mind to proceed anyway, then I don't see a significant downside to doing it now. After all, he's already so far gone that the surgical plan would presumably take stock of a terminal pattern of Norwood 6 or worse.

Are you saying that this Patient shows no detectable and cosmetically acceptable result? Are we looking at the same Patient case?

http://www.hairrestorationnetwork.com/eve/181391-dr-bhatti-2526-fue-grafts-type-5-patient.html

 

Body hair looks terrible, and everyone knows it.

Really? Please see the attached pictures. Just picked a random Patient case (out of scores of Dr. Bhatti BHT cases that we have posted on this Forum). Does this Patient's hair look "terrible"....?

 

This case shows the results of BHT for a Patient with a poor scalp donor.

28 years old patient, for whom 2000 scalp grafts and 600 beard grafts were used.

Beard hair has been transplanted just above the hairline.....can you tell the difference?

Post-op pics are from 7 months after the procedure.

 

Best regards,

California

[Melvin- Admin]

Body hair as a standalone does not produce good aesthetic results just like SMP. However, when combined with traditional hair restoration i.e scalp grafts I think both procedures add to the procedure, I think I will have BHT and smp to add overall density at some point. I view them as just another weapon to keep in my Arsenal.

[Shadow of the EMpire State]

Are you saying that this Patient shows no detectable and cosmetically acceptable result? Are we looking at the same Patient case?

 

Anyone can cherry-pick patients like Bobman and Futzyhead (famous H&W patients from years ago) and claim that that kind of result is representative for advanced Norwood classes. But I've seen enough to know that it's not. You cannot disprove with one patient what has been proved with thousands.

 

Really? Please see the attached pictures.

 

I've spent the last 12 years looking at pictures. I've seen thousands of them. And I can say a few things about them.

 

First, in the hair-transplant arena, pictures almost always make the situation appear better than it actually is---sometimes radically so. If you've spent more than five minutes on a forum like this, you've seen a patient upload post-op pictures to rave reviews only to complain that it's not as full as it looks. By contrast, you almost never hear a patient gush that his hair is actually fuller than it appears to be. So rule number one is that pictures lie.

 

Second, clinics cherry-pick patient results. Every clinic has failures. They're unavoidable. But in 12 years, I've yet to see a clinic create a thread called, "Terrible Result from Our Office Proves that Results May Vary." Never happens. They show the winners. The failures never make it onto forums, and that's because clinics are in the business of selling hair transplants. And any clinic that does a reasonable volume will be able to post enough success stories to make good results seem routine when, in fact, they may not be. For example, until recently, Hakan Doganay seemed like Jesus Christ with a scalpel in his hand because his clinic posted one home run after another. It's only now, years later, that the more-checkered truth is coming to the fore.

 

Bottom line, I've seen thousands of transplant photos. And the vast majority are cherry-picked cases of patients with good hair characteristics or just abnormally good results. And even then, pictures often paint a more roseate picture than is true. So how do I know what to believe? First, I remember that all transplants are limited by math. In the vast majority of cases, you cannot cover a Norwood 6 pattern with donor hair in such a fashion as to make it look undetectable and cosmetically acceptable. The space is simply too big for the donor supply, so when you see results that appear too good to be true, they often are. Second, I always remember that clinics post exemplary results, not representative results.

[fortune11]

I am an example of NW6 , who has had successive hair transplants starting in my late 20s to keep chasing my hair loss over the years .

 

do i have perfectly good head of hair ? no . I have balding crown which I know cannot be covered completely given that I am a NW 6 .

 

But I do have a mature hairlines and midscalp hair which gives me a great look in photographs -- you know the ones at friends parties , weddings etc.

 

Very few people converse while facing the top of your head or the back of your scalp

 

and therein lies my argument -- you don't need to have a full head of hair to reap the benefits of hair transplants .

 

This is why forward planning is essential , as many others here, including HT soon have said . It is not about if you have complete 100% coverage (which is a pipe dream anyways) , it is about having age appropriate hair which takes away the possibility that you will be mistaken for someone 15-20 years older than yourself.

[Melvin- Admin]

I have to disagree with you shadow, that's your personal opinion and what you deem cosmetically acceptable may be different from what others may deem acceptable, I don't know your age or level of baldness, but I for one am a high Norwood at a relatively young age, I think a Norwood 6 can achieve a good result so long as he accepts the fact that he'll never have a full head of hair, now this may be unacceptable to you, but for me it's not, I'm totally fine with having a thin crown, I think having a framed face is important as I get older a thin crown will be less and less of an issue. Sure a 30 year old guy with a thin crown may not look good right now, but what about when im 50 or 60, I think looking at Dr. Bhatti himself is a good example of someone who has some balding but definitely does not look unnatural, to me that is an attainable look by a Norwood 6 with careful planning. The most important aspect when assessing someone for hair restoration is their level of baldness, donor capacity and most importantly expectations. I've come to terms with never having a full head of hair, I just don't want to be completely bald id rather have the look of Dr. Bhatti than Dr. Phil but that's just my opinion.

[Shadow of the EMpire State]

I have to disagree with you shadow, that's your personal opinion and what you deem cosmetically acceptable may be different from what others may deem acceptable

 

I'm sure that's true. I have high standards in that regard because I know how people think---particularly women. Sure, there are some men who wouldn't notice if you came in with a raccoon on your head, but women (and men like me) will notice. And that, I cannot have. I'm not going to be one of the people who gets laughed at behind his back.

 

I don't know your age or level of baldness,

 

38, Norwood 3.

 

but I for one am a high Norwood at a relatively young age, I think a Norwood 6 can achieve a good result so long as he accepts the fact that he'll never have a full head of hair, now this may be unacceptable to you, but for me it's not, I'm totally fine with having a thin crown, I think having a framed face is important as I get older a thin crown will be less and less of an issue.

 

If you're talking about having a full head of hair except for a thinning crown, that's one thing. But unless you have superb hair characteristics (coarse, curly, low contrast, etc.), it's more likely that you'll end up with a bald crown if you progress to a full Norwood 6. Also, if they use more grafts to cover your crown, will there be enough for credible density in the front?

 

Sure a 30 year old guy with a thin crown may not look good right now, but what about when im 50 or 60, I think looking at Dr. Bhatti himself is a good example of someone who has some balding but definitely does not look unnatural

 

Did he have a hair transplant?

Edited November 3, 2015 by Shadow of the EMpire State

[Melvin- Admin]

I'm sure that's true. I have high standards in that regard because I know how people think---particularly women. Sure, there are some men who wouldn't notice if you came in with a raccoon on your head, but women (and men like me) will notice. And that, I cannot have. I'm not going to be one of the people who gets laughed at behind his back.

 

 

 

38, Norwood 3.

 

 

If you're talking about having a full head of hair except for a thinning crown, that's one thing. But unless you have superb hair characteristics (coarse, curly, low contrast, etc.), it's more likely that you'll end up with a bald crown if you progress to a full Norwood 6. Also, if they use more grafts to cover your crown, will there be enough for credible density in the front?

 

 

 

Did he have a hair transplant?

I don't think women or men laugh at bald men behind their back, if they do I certainly don't think they're the type of people anyone would want in their lives. But I think you're meaning people who've had really botched hair transplants, and I for one feel sorry for them, but I don't think that the majority of Norwood 6 men who go to good surgeons will end up looking like this, unless they try and get too aggressive with the hairline. Overall, I think the key is confidence, at this moment even though by your standards I'm still bald, I have a lot more confidence because i can at least style my hair and conceal my hair loss somewhat, and I think that's what everyone is seeking to achieve which is confidence.

 

Even if you end up with a bald crown, that's not a bad look especially once you get older, 38 that's still relatively young, so I understand where you're coming from, at this moment it would not look good, but it's a look you can definitely grow in to as you age. I also think just sprinkling the crown with some grafts is enough so that you could at least use toppik and conceal it.

 

Dr. Bhatti has had two hair transplants as far im aware, one strip and one FUE, I also believe that he'd be a norwood 6 if not for the transplants. Don't you think that look is better than being like Dr. Phil? It's hard for someone with minimal hair loss to relate because you probably have the expectation of looking like you're not bald at all, but trust me when I say this, the more hair you lose, the happier you are with less hair. As you can see from the pic Dr. Bhatti is quite advanced in his hairloss, but now he looks good in my opinion.

 

[Shadow of the EMpire State]

I don't think women or men laugh at bald men behind their back,

 

Bald men? No. Men with noticeable hair transplants? Without question.

 

But I think you're meaning people who've had really botched hair transplants,

 

Or any detectable hair transplant.

 

but I don't think that the majority of Norwood 6 men who go to good surgeons will end up looking like this,

 

That's where you and I part company.

[Melvin- Admin]

Bald men? No. Men with noticeable hair transplants? Without question.

 

 

 

Or any detectable hair transplant.

 

 

 

That's where you and I part company.

 

Hair transplants no matter how good will some way be detectable to other guys who've had work done, I have a coworker that I noticed an indentation in his hair like he was wearing a hat, when I looked close I could see the scar of a strip surgery underneath his hair, but I wouldn't say that's detectable to the average person if I told other coworkers they probably wouldn't believe me, you're looking at things from a skewed perspective, you think that your everyday person will look or pay close attention to your hair than you're wrong, the only people who pay close attention are other men who are balding themselves. I can look at a 20 year old kid with a full head of hair and pretty much tell whether he's going to lose his hair or not, the slightest change in diameter at the hairline I pick up on, but that's me, the majority of the population don't give a crap, it's only people like the ones on this board who analyze and pick apart hairlines and crowns etc. My main point was that a Norwood 6 can get a transplant and place the grafts in a way that would make them still look like they're losing their hair just not completely bald prime example was Dr. Bhatti.

 

The people I've seen who are Norwood 6 like Sam B on YouTube and Dr. Bhatti don't look bad, you didn't even know Dr. Bhatti had a transplant that says it all.I've yet to see a high Norwood go to a reputable surgeon and end up with a ridiculous obvious transplant, its actually hard to find examples cause the majority of Norwood 6 guys get convinced that it's hopeless, but it's not.

 

I'll give you an analogy, ok I workout 5 times a week I maintain 10% body fat year round sometimes less in the summer, maybe up to 12% if I'm bulking, now my definition of someone in shape is someone shredded to the bone 6% body fat, would it make sense for me to go up to an obese person and say "listen buddy you're never gonna be 6% body fat so just give up accept being obese cause it's pointless" then the obese person might reply "that's not my goal, I simply want to lose weight and not be obese, I'm not looking to have veins on my abs" does that make sense? I feel like you're looking at it from your perspective which is very one way, but I can see where your coming from cause I think the same way about fitness, but that's not the way everyone thinks or feels everyone's goals and expectations are different.

[Dr Tejinder Bhatti]

Dear Mr. Shadow of the Empire State,

 

I honestly do appreciate your concern for the younger patient and that you have concern regarding the many nuances that one must understand before accepting the option of surgical hair restoration. When we make our assessments for the surgical option we absolutely take the future into account. As I type this I realize it is a bit cliche and is repeated almost as a standard response for many but it is true, at least for me.

 

The easy way to address your concerns is twofold.

 

1. The patient will not have a strip scar from the procedure, much less any sort of modified scars.

2. I do not plan on aggressively closing the temples or lowering the hairline on the young man as I wish for my work to stand the test of time. 1500 grafts is not a lot of hair and is minor compared to some of the cases presented by doctors that like to "dense pack" three and four thousand grafts into a small few centimetres of the frontal hairline. Cases like that are taking up to 50% of the patient's donor just for hairline work!

 

I wish for my patients to have a natural appearance now and as they continue to age. The chance of someone progressing to a NW6, even while on medication, still exists so we musn't throw the kitchen sink at the front and leave nothing for the back. In the end, naturalness is relative. Some say that naturalness is density. Some say naturalness is nothing short of a full head of hair.To me, naturalness means that the hairs placed by a surgeon's hand are done so in a manner that mimics nature, both in angle and direction and the exit point is not "pluggy".

 

Hair loss patterns occur in many styles not found on the traditional NW scale. I've seen many examples of grown men, some in their forties and fifties, maintaining their juvenile hairlines and strong frontal scalp density but developing large bald crowns, all without having ever had hair restoration surgery. I've also seen many men that have maintained much of their hair but developed channel recession down either side of the scalp including the disappearance of the lateral humps. These are patterns that many warn will occur only after hair transplantation has been performed and with continued loss however these patterns I have seen occur without any surgery whatsoever. So again, rhetorically, what is natural?

 

Again, I do appreciate the concern and it is warranted at first glance but I do take this very seriously and want the best for this young man as well as every other patient I am priviledged enough to perform surgery on. You have my word I will take great care in the design and execution of his procedure.

[JON86]

While I think I am personally kind of on the middle with this I find it nice that Dr Bhatti took the time to come on and post. I wish more doctors would do this. I know a few do but there could be more in my opinion. He addressed some of the concerns I had for the patient by stating he would not go too aggressive on the hairline or temples. I have met with a few clinics that in my opinion are too aggressive on those areas.

[Melvin- Admin]

Dear Mr. Shadow of the Empire State,

 

To me, naturalness means that the hairs placed by a surgeon's hand are done so in a manner that mimics nature, both in angle and direction and the exit point is not "pluggy".

 

 

 

well said I agree.

[darlinglocks]

I do think that Dr Bhatti will not take any cases lightly, so he is probably right if he estimates that 1500 grafts is the best choice for the patient.

 

I had my HT done by Dr. Bhatti who told me he could only take 1500 grafts and Yes, I was a bit disappointed as I hoped for more. It depends a lot of your donor area, hair quality and if you might need another HT later in life.

I think it is better when the surgeon tells you honestly what is possible and what isn't and in this regard I was told he couldn't take more than around 1500 Grafts.

 

I had FUE 1524 Grafts (3187 hairs) done by Dr. Bhatti and really believe that young man is in good hands.

 

Darlinglocks

 

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