Considering FUT - Dr. Bernstein or Dr. Hasson & Wong

[DartDaric]

Hi all,

Long time reader but it's now time for me to get a Hair Transplant. I'm over 40, Norwood 4 and have been doing a lot of reading and trying to narrow down a surgeon. Cost or travel are not a factor.

 

I know I need a FUT after consulting a few local doctors and doing online consults. I've read good reviews for Dr Hasson and Wong on this site and the patient profiles on his site are impressive. There does not seem to be much mention of Dr. Bernstein on these forums or patient testimonial however going through his history and wealth of information on this website its clear that he's a luminary in the field.

 

A few questions I have that will help me decide and I'd appreciate your opinions.

 

My biggest confusion is in the basic philosophy that the two doctors seem to differ in. Dr. Bernstein strongly favors two smaller FUT's for someone in the Norwood 4 scale (around 2500 / 2000 based on patient profiles). His approach which is documented on his site is to try to get the best results with a single smaller (2500 range) HT and then consider a second based on the outcome of the first. He acknowledges that the effect after the first HT will be less "fuller" than a megasession like 6000 grafts but feels that it leaves more room to plan for the future and also that the second HT can be crafted based on the results of the first.

 

Dr H&W seem to prefer the one and done approach of megasessions. For example a Norwood 4 patient on his showcase page got a HT with 6500 grafts. The results look good and fuller in contrast to NW4 testimonials after the first transplant by Dr. Bernstein but it's that the better long term decision? Or perhaps some pics were taken in better lighting or styling than others? I'd imagine having a single 6500 graft FUT rules out all possibility of a second FUT should the results not be optimal.

 

I think I read Dr. Lindsay say that in his opinion larger number of grafts is generally better but no larger than 3000 for single session (forgive me if the number is a little off).

 

From an end results perspective, and if cost wasn't a concern, is there any disadvantage to having two HT's spaced by a 1 - 1.5 yrs period over a single megasession of say, 6500 grafts? (besides the fact that you have to wait a year or so longer to see full effect of second HT).

 

Do people chose on a single megasesion (for NW4 level range) because they prefer to only go though this once? Or if they have a long distance to travel to get the HT? Is scarring more with a single megasession or two sessions in the 2000 - 2500 range?

 

I'm also curious to know why there is so little mention of Dr. Bernstein on the forums, despite being one the list of recommended surgeons. Is it any indication that not as many people go to him compared to the others that are more frequently mentioned or recommended? Is it because he may be more expensive. I'm not certain he is in all cases, just mentioning it based on the math of $6-$7 / graft. It adds up to more than a single megassion with most surgeons I looked up for the same number of grafts.

 

There is mention of him and Dr Rassman being the ones that introduced FUT in 1995. Is that an indication that he's currently one of the best or has newer technology and more aggressive surgeons that produce faster results taken over?

 

Apologies for the long first post and thanks in advance!

 

DartDeric

[Louisjams]

All of these docs are excellent; you should do well with either.

 

Bernstein is a very smart guy. He is more conservative but does meticulous work. He does not do mega sessions per se but his outcomes, imho, are excellent, age appropriate, and natural looking.

 

H&W also are top notch and go for mega sessions. Lots of nice work by these two. Remember, if this works for you it is great but if not you burned a lit of grafts.

 

Why not consult with both?

[hairlosscpa]

I'd go with Hasson and Wong.

 

Why have yourself cut up multiple times when you can potentially achieve your desired result in 1 session? Hasson and Wong have continuously proven their high quality of work and have the resources to perform these megasessions which may not be cost effective in an office located in NYC (Bernstein).

[KO]

I don't think a nw4 needs 2 ops even with a more conservative doctor. Those are typically for patients with both frontal and crown work. While HW have done great results, there are risks, so I think 2 ops are better than one big one. You have to remember that more grafts means a bigger strip and therefore a bigger scar.

 

How did you narrow your search to these 2?

[Al - Moderator]

In my opinion a 2 session approach can be more customized to your likes. Let's say you plan 2 sessions of 2500 grafts each. The first session fills in the front half. When you go back for the 2nd session you can then decide if you want the front a bit thicker and maybe put 1000 more in the front half and go with 1500 for the crown, or maybe you feel the front looks great or perhaps just a few touch up grafts here and there and decide to use most of the grafts to really fill in the crown nicely.

 

With a one step approach, you are more limited in that you already used 5000 grafts, so if afterwards if you feel like maybe the front should be a little thicker, you may find yourself going back for a 2nd session anyway, but due to the fact that you already used a large number of grafts you may be more limited in what changes can be made.

[Bill - Seemiller]

Dart,

 

Welcome officially to our hair restoration discussion forum. I'm glad you finally posted. By the choices of doctors you are considering, I can tell that you've been doing your homework. Hasson and Wong, Dr. Bernstein and Dr. Lindsay are all excellent doctors and I would personally trust my scalp with any of them.

 

Best wishes,

 

Bill

[DartDaric]

Wow, thanks for all the replies!

 

@Louisjams Good point about burning grafts with a megesession and the results are unsatisfactory. I guess there are two factors here. First, if the doctor didn't do a good job one has the opportunity to find an different one for the second HT. Secondly if my scalp / body doesn't respond well to the HT and if this is the case, doing two HT's instead of a megasession might not necessarily help. I'll try to consult with both

 

@hairlosscpa Getting the desired results with one HT is obviously the more attractive option, just trying to weigh the pros and cons. Interesting thought about staffing costs in NYC that might limit him from doing megasessions. Feels like someone who has spent a career on this and is probably pretty wealthy would not consider this tradeoff if they believed there was a better option. Having said that I believe Dr Bernstien uses only 3 technicians (please correct me if I'm wrong) while I've read and seen videos of doctors in Turkey use over 12 assistants. Is there a correlation to the end result? I don't know..

 

@KO I do have front and crown work to be worked on. I thought that's what NW4 (as opposed to NW4 A) was. Excellent point about larger scar. On these forums I recall reading some of the megasessions with Dr H&W had 70 staples or around 35cm. Dr Bernsteins strips are in the 24 cm / 50 staples range for 2500-2800 grafts. This reminds me of a H&W post op staples picture, the strip length was somewhat scary and went from the back of the head to way up on the head above the ears. I narrowed my search down to these two because in the megasessions FUT category of doctors Dr H&W seems highly recommended on this forum. I heard about Dr Bernstien through a friend of a friend but he had no personal experience. He fell in the conservative category. Lots of his articles on google and tons of info on his site. His ability to do a FUT without shaving the recipient area is a huge plus for me. I know some doctors like Feller and Bloxham insist on shaving the recipient area.

 

@BeHappy What you say makes total sense but I want to make sure I'm not overlooking any non-obvious details. Are there any circumstances under which results of 2 smaller 2500 graft HT's is inferior to a megasession? Will the density / laxity after the first HT affect the second HT to a degree where it's less fertile than the grafts obtained from a megasession? Would shock loss of more permanent hair with 2 HT's be greater than one? Dr. Bernstein does say in one of his videos that for some reason the results of the second HT seem to take longer and in the range of 18 months while the results of the first HT are fully seen after 12 months.

 

@Bill Thanks and I really appreciate the service to the community you're providing

 

I would also like to bring up the topic of "art". I've read that with the number of grafts being equal, Dr Bernstein is good with the "art" of the HT hairline to produce the most pleasing appearance. Initially my naive thinking was that I want my receding hair on temples filled up with hair but the more I read, the more I appreciated that it's important to maintain a natural look and an artificially low hairline might not necessarily look the best when the same grafts could be used elsewhere or preserved for the future. I would love to hear what your personal experience (good or bad) with the "art" aspect has been.

 

 

Thanks!

DartDeric

[JayLDD]

Hi all,

Long time reader but it's now time for me to get a Hair Transplant. I'm over 40, Norwood 4 and have been doing a lot of reading and trying to narrow down a surgeon. Cost or travel are not a factor.

 

I know I need a FUT after consulting a few local doctors and doing online consults. I've read good reviews for Dr Hasson and Wong on this site and the patient profiles on his site are impressive. There does not seem to be much mention of Dr. Bernstein on these forums or patient testimonial however going through his history and wealth of information on this website its clear that he's a luminary in the field.

 

A few questions I have that will help me decide and I'd appreciate your opinions.

 

My biggest confusion is in the basic philosophy that the two doctors seem to differ in. Dr. Bernstein strongly favors two smaller FUT's for someone in the Norwood 4 scale (around 2500 / 2000 based on patient profiles). His approach which is documented on his site is to try to get the best results with a single smaller (2500 range) HT and then consider a second based on the outcome of the first. He acknowledges that the effect after the first HT will be less "fuller" than a megasession like 6000 grafts but feels that it leaves more room to plan for the future and also that the second HT can be crafted based on the results of the first.

 

Dr H&W seem to prefer the one and done approach of megasessions. For example a Norwood 4 patient on his showcase page got a HT with 6500 grafts. The results look good and fuller in contrast to NW4 testimonials after the first transplant by Dr. Bernstein but it's that the better long term decision? Or perhaps some pics were taken in better lighting or styling than others? I'd imagine having a single 6500 graft FUT rules out all possibility of a second FUT should the results not be optimal.

 

I think I read Dr. Lindsay say that in his opinion larger number of grafts is generally better but no larger than 3000 for single session (forgive me if the number is a little off).

 

From an end results perspective, and if cost wasn't a concern, is there any disadvantage to having two HT's spaced by a 1 - 1.5 yrs period over a single megasession of say, 6500 grafts? (besides the fact that you have to wait a year or so longer to see full effect of second HT).

 

Do people chose on a single megasesion (for NW4 level range) because they prefer to only go though this once? Or if they have a long distance to travel to get the HT? Is scarring more with a single megasession or two sessions in the 2000 - 2500 range?

 

I'm also curious to know why there is so little mention of Dr. Bernstein on the forums, despite being one the list of recommended surgeons. Is it any indication that not as many people go to him compared to the others that are more frequently mentioned or recommended? Is it because he may be more expensive. I'm not certain he is in all cases, just mentioning it based on the math of $6-$7 / graft. It adds up to more than a single megassion with most surgeons I looked up for the same number of grafts.

 

There is mention of him and Dr Rassman being the ones that introduced FUT in 1995. Is that an indication that he's currently one of the best or has newer technology and more aggressive surgeons that produce faster results taken over?

 

Apologies for the long first post and thanks in advance!

 

DartDeric

 

From reading your posts I don't think it sounds as if you have done enough research in regards to patient results and before and after photos, which are of paramount importance.

 

The first thing that should come into your mind is what YOU hope to achieve, and after this find a doctor who is both consistent, and in the case of a bad result treats their patient well. It matters what you prefer visually in terms of their results, not simply whether the doctor is respected, consistent and considered a good doctor. If you prefer the VISUAL result of Hasson + Wong (which it sounds like you do) and don't think they are any less consistent than Bernstein, I would be far more inclined to choose them over a surgeon who doesn't achieve the result you desire in one go. Even a small procedure can turn sour, what if the first pass turns out badly? Are you going to be fine going in for a third or fourth on those prices? I'm pretty sure even Bill mentioned in a post that he would have preferred to do a small group of larger surgeries rather than the 4 smaller ones he ended up with.

 

Just as one should be wary of a doctor that promises the 100% certainty of perfect results with one pass, you should be wary of a doctor who says it will take multiple passes to achieve your goals. It's 2017, there are plenty of doctors doing high norwood FUT megasessions and achieving consistently good results. If a doctor recommends against a procedure that that other highly regarded doctors like Hasson + Wong offer and achieve good results in consistently it is probably because they lack the skills to perform it and tend to be stuck in their ways.

 

On the issue of the "art" of the procedure, focus less on what a doctor tells you to think, and more on what you like the look of in terms of before and afters. Doctors are just that, doctors, not visual artists. Take their advice seriously, but at the same time think of YOUR goals, not theirs. Conservative is certainly easier, but not always better.

[Shampoo]

Both doctors are very skilled and leaders in the field. It basically comes down to if you want larger single sessions. I prefer large sessions. However for various reasons I was really only able to get one large session out of my 3 surgeries. I basically had one tiny session, one large session, and one med-large session. I would think most hair transplant patients "always want more" grafts. So my thinking was "get as many as you safely can in one session" because the post-op is long and no fun. Because of the long wait post-op I wanted to get as much bang for my buck in as few surgeries as possible.

[mav23100gunther]

Both very good but very different approaches. I have consulted with both. Dr Bernstein is very conservative. The hairline he proposed was just too high for my liking and on the conservative side for my age and my available donor supply. He also would not touch the temple points. I personally could afford something more aggressive which I got through other surgeons.. You also don't see many posted client results from this clinic. Not saying it's a red flag, but just something to consider. Finally, he quoted me something like $9 a graft for FUT. nothing wrong with that, but other elite surgeons charge $6 on average. I personally think his price is too high considering I could get an equal result with other top surgeons for less. Don't let price skew your decision though. If you would like to go with a conservative approach with less grafts and more passes, then I would advise looking into Dr Ron Shapiro or Dr Konior. Maybe even give Gabel or Cooley a look. They are elite surgeons who can also go with more conservative approaches than Hasson. They also have a lot of patient posted results on this forum. Hope it helps.

 

Btw- if I could start over, I would do a mega session with Hasson for my first procedure.

[KO]

Yeah Cooley, Feller, True and Dorian are all good and in that vicinity.

[mav23100gunther]

Yeah Cooley, Feller, True and Dorian are all good and in that vicinity.

 

You lost me after Feller!

[hairlosscpa]

I understand the concept of multiple small procedures as a conservative approach. For many, including myself, I just did not want to go through that recovery period consistently. It's not easy. Constantly taking the time off from work,repeatedly going through the post-op care including dealing with stiches/staples, swelling and hoping nothing messed up. Makes me cringe just thinking about it.