Decision making time - would LOVE some feedback!

[abraxas]

Hi All,

 

Some of you old-timers may remember me, I've been gone for 5 years now but to refresh you on my story, I had scheduled a HT with Dr. Wong, flew up to Vancouver for my procedure and right before we were going to start, was told by both Dr. Wong and Hasson that I was not a good candidate for a HT. They said that I had too much miniaturization in my donor area, so they put me on Proscar, and said to come back in a couple years to see how I'm doing. It was a big let-down (though H&W were outstanding professionals in refunding me everything!). Some of you also recommended I keep my hair short to mask the loss, which I've done.

 

So I've been stabilized on Proscar for nearly 5 years now, and started back into my research over the past year or so (finances got to a bit of a better place to allow me to start thinking about it again).

 

I have modest goals - I am 44, and don't need a 20 year old hairline. I have had diffuse thinning for years, have very fine hair, and I just want to get enough coverage on the frontal and mid-scalp areas so that in pictures and when I'm outside and such, I don't have the horseshoe look (that most men in my family have had). And I just don't have the face or body-type to be bald, believe me. I've attached a few pics for you to examine.

 

So over the past year, I have had consultations with all the leading docs, and I have gotten wildly different opinions which is confusing. Some have said that I still am not a good candidate for FUT/strip but that I am a decent candidate for FUE. I think that based on my modest goals I would be fine with getting around 2,500-3,000 and ignoring my crown for the rest of my life.

 

The strange part of my story are these wildly different recommendations these top doctors have given me, so I'd like to briefly share it and I would love any feedback you might have as I hope to do my HT over Christmas holiday.

 

Like I mentioned, I've consulted with most of the top US docs over the past year (I'm really reluctant to travel overseas), and here are their recommendations:

 

 

• Dr. Konior - only one I had an in-person visit with, he said he agreed with Dr. Wong that I was a poor candidate for FUT but thought he could "cherry pick" 2000 and create nice coverage. Dr. Konior seemed so professional and I trusted him completely. The negatives with Dr. Konior is his long waiting list and honestly his prices were out of my price range.
  
• Dr. Wong - thought that my donor may have strengthened enough to do 2-3000 FUT, but wasn't sure without doing an in-person.
  
• Dr. Rahal - thought I wasn't a good candidate at this time for either and to wait a few years to track the progression of loss.
  
• Dr. Gabel - recommended highly by Dr. Konior, and he thought that Dr. Konior's assessment made sense and thought between 2-2500 FUE. My concern with Dr. Gabel is there are very few of his FUE before and after pictures, even his office only had 1 to send me, which concerns me. I'd really like to see more photos of any doctor I will choose. But I really enjoyed our discussion and his prices were doable for me.
  
• Dr. Diep - also thought somewhere in the 2500 range for FUE made sense. I must admit I didn't love our discussion as he wasn't as personable as some of the other doctors, but the major blocking point was his prices which are out of my price range.
  
• Dr. Vories - also agreed I am a good FUE candidate and thought somewhere in range of 2500. I liked Dr. Vories. But my concern with Dr. Vories is I didn't read a lot from folks on here that have done procedures with him, he was one of the least recognized for me. Big plus is prices were definitely in my range and I have family in the Charleston area that I could stay with comfortably.
  
• Dr. Bloxham/Feller - thought that with my modest goals I could do a FUT safely.
  
• Dr. Cooley - we haven't completed our consultation but have been in contact, and he also thought I may be able to do a FUT safely depending on where they take from my donor.
  

 

So as you can see I've done my homework. In an ideal world, I think I would go with Dr. Konior, but based on his long waiting list and prices which are truly out of my range (I have kids going into college!). But I am also just very confused about why some docs think I would be OK with a FUT and some strongly feel I am only suited for a FUE.

 

 

So I'd love any suggestions/feedback you may have. I've uploaded 4 recent pics and 2 from when I had my initial meeting with Dr. Wong (5 yrs ago before proscar). I'd really appreciate your input as I need to make my final decision soon! Thank you!

[Melvin- Admin]

Honestly, I don't think anyone with miniaturization in the donor zone is a good candidate for FUT. Why? well that's simple, because in the future that hair will inevitably be lost even with finasteride, it is not permanent, once the hair in the donor zone thins out with age, the FUT scar will become visible. Additionally,the tension from the strip may cause shock loss, as you may know shock loss with miniaturized follicles can lead to permanent shock loss.

 

I went to Dr. Diep, his bedside manner doesn't bode well with all, nevertheless, he has an extensive FUE portfolio documented here and on youtube, but yes he is expensive, and his wait list is about 7 months for FUE.

 

I recommend going to Dr. Gabel in person, I went to him in person, I found him to be very personable, he is very hands on and even does the graft implantation, he will thoroughly examine you in the consultation, if he feels you are not a candidate he will be honest, he performs FUE regularly and he's confident he can achieve good results with either procedure. If he wasn't proficient in FUE he would probably be suggesting FUT like some of the other surgeons you mentioned.

[abraxas]

Thanks HTsoon! I really appreciate your feedback. If my HT can look 50% of what yours turned out, I'll be satisfied!

 

I'm looking forward to hearing from more of you! Any feedback will be useful for me.

[Bill - Seemiller]

Abraxis,

 

Well I'd say welcome to our forum community but it sounds like you've been here before. But I'm confused by your alias as it says you've joined just this month. Did you used to use another alias?

 

You've definitely been consulting with some exceptional physicians, most of which are recommended by this community. It's not surprising that even amongst the best doctors, that you'd be given various advice. Each surgeon has their own way of doing things and deciding what's best for the patient is sometimes very subjective.

 

Which physician or physicians are you leaning towards at this point?

 

Best wishes,

 

Bill

[abraxas]

Hi Bill, yes I had forgotten my log in info so signed up with a new one.

 

I'm leaning toward Dr. Gabel - while I respect what the docs said in regards to FUT I found Dr Konior's hands on evaluation most informative in terms of having limited donor supply and not trusting that a strip would produce the long term results. Since then I have been mostly focusing on FUE. Originally I was hoping for Dr Rahal but he didn't even meet with me fo our online consultation - he didn't believe I was a good HT candidate at this time. I liked that Dr Gabel, like Dr Konior, do their own work. But not having had a chance to see many FUE examples of Dr Gabel does have me somewhat worried.

 

It's a very difficult decision!

[DavidAnderson]

Good luck with your decision you have listed a number of good Doctors and I won't try to help you make a decision on who to go to.

 

It is great that Dr Wong was so honest with you and felt you were not a good candidate back then it speaks volumes about his character to cancel the surgery and give you your money back.

 

Do you think Propecia has stabilised your loss? The photos you present are not comparable as one has wet hair and the previous ones are dry but you had a fair amount of hair in the previous ones and it appears you have less now as I can see obvious gaps now where there was before hair, would that be fair or is it just the wet photos?

 

This is important as the meds may not have stopped your loss maybe just slowed it down, with this in mind you should be very careful and play it safe. I like Dr Koniors approach to cherry pick through with FUE.

 

HT soon is right about not going for FUT with a miniaturising donor area because hiding a scar will be more difficult but not just that. With FUE you can provided you take the time stick to extracting the full follicular units. Quite often when you see miniaturisation under microscope you may be loosing one hair from a 2 or 3 hair grouping. With FUT you are given what you get from the strip and that will be a % of miniaturised hairs, with FUE if you take your time and select the right groupings you can minimise this as much as possible.

 

My advice would not to book with a Doctor again until they have seen you in person as you do not want to have the same disappointment as last time. Make the time to fly out and meet the Doctor before making a commitment and make sure they are confident of a successful outcome.

 

Finally were are you going to place these grafts?

[KLHT]

Very professional and ethical from H&W! I'm not surprised. I think you'd be in good hands irrespective of which doctor you choose; they all have an excellent reputation from what I've heard/read.

 

It looks from the images that Proscar has improved your crown (assuming that the 5 year old pictures are the ones with the blue background). Did you experience any side effects while on it? And what dosage you were on?

 

Best of luck!

[KO]

Not considering H&W FUE? Also check with Shapiro. For more options, you'll likely need to travel abroad.

[abraxas]

Yes the blue background photos were 5 years ago and I think the propecia has strengthened my crown and hair overall. I have considered H&W but didn't consult with Shapiro.

 

I'm in the process of making my final decision and I've felt good about all the research I've been able to do on this website over the years, and all the honest impressions about the process. I've also enjoyed several of my consultations - my preference is always to talk directly with the doctors and so I've really gotten a lot out of my consultations with Dr. Konior, Dr. Cooley and Dr. Gabel specifically.

 

I'll post more once I schedule and begin the process.

 

If anyone has any more feedback, I'm interested. What I'm now researching is Dr. Cooley's suggestion of using Acell/PRP, does anyone have experience with that? Trying to figure out if it's beneficial to this process.

[lakes9925]

I am also considering these docs for FUE, Its just hard for me to determine which doc would leave you with the best looking donor zone months after the surgery or would they all be the same... this is important to me bc i enjoy wearing my hair short

[abraxas]

I have another question for all you HT experts - do most docs give Versed as part of the HT process? I'm wanting to stay away from Versed and wanted to know what other options HT docs use for sedation? Thanks!

[richter101]

I'm surprised no one mentioned my Doctor for FUE. Might be worth looking into for a final verdict. Extremely ethical/ honest as he is talented. My donor hair wan't too dense and was blown away with success of my procedure!

 

Dr. Mohebi has wrote books on this, invented technology for it, and serves on the board. Good luck with whichever was you choose to go and don't lose hope!

[abraxas]

An update: I have decided to go with Dr. Cooley for mid-December. Here's a bit into my decision-making process:

 

First of all, he was referred by Dr. Konior, whom I trust and with whom I had an in-person consultation. Second, I was able to have a consultation with Dr. Cooley and he was confident that he could do FUT with me - and in the unexpected situation that he can't, is willing to go FUE. I was surprised he was so confident but said that my hair looked like many of the patients he sees regularly and that with my conservative goals, he believed he could do it.

 

It has been frustrating to me during this process that I didn't feel like I was really getting my questions answered about why I was getting such different opinions from the various surgeons I consulted with, and he answered it directly and honestly, which felt like a relief. He also didn't seem irritated by all my questions, which I have felt by some other docs and particularly some of their reps. I understand they get overwhelmed by the same questions day after day, but they have to remember that this is elective surgery, and a very expensive one at that, so having Dr. Cooley be patient and understanding made such a big difference. He really wanted me to have my questions answered.

 

I do want to say that I'm not meaning to specifically bad-mouth any of the docs that I consulted with - I actually consulted with more than those that I listed, but those were the ones I was serious about, and most were very professional and direct with me.

 

I also of course spent many hours reading through everyone's opinions and experiences with the various doctors, and received quite some PMs from you all (thanks!), and I kept hearing the same things about Dr. Cooley and his staff. I like that he's more conservative, that he has the confidence in both FUT and FUE, and that he's committed to making sure his patients are fully satisfied.

 

So now that I have thrown down the deposit and booked my travel, I am starting to obsess about the FUT scar. Since my hair is thin, I find myself analyzing all these scar pictures and imagining what it will look like for me. Thankfully, Dr. Cooley allows for the non-shave procedures so I will grow my hair over the next couple months and hopefully that helps. I also have a good solid 3 weeks off from work, so I pray by the time I am back at work the scar won't be noticeable.

 

Thanks again for your help and please continue with any other feedback you may have!

Edited October 18, 2016 by abraxas