Not enough density?

[twf123]

Who does this forum mainly suggest in regards to a balance of skill/cost? I'm in Ohio but I can travel anywhere if it need to get it done a second go. Which I was expecting before going into it the first time.

 

Considering Mcgrath again, he would take off ≈$2000 for me returning to do the same amount of hair again (Comes to around $6000 for roughly 2100 grafts), and then put fue hair into the scar for free after a year.

 

Is his work really so bad that this wouldn't be my best decision? I'm just curious

[Speegs]

Who does this forum mainly suggest in regards to a balance of skill/cost? I'm in Ohio but I can travel anywhere if it need to get it done a second go. Which I was expecting before going into it the first time.

 

Considering Mcgrath again, he would take off ≈$2000 for me returning to do the same amount of hair again (Comes to around $6000 for roughly 2100 grafts), and then put fue hair into the scar for free after a year.

 

Is his work really so bad that this wouldn't be my best decision? I'm just curious

Grafts or hairs? McGrath has tried to sell people by the hair and not by graft in the past.

 

Most elite US physicians charge between 4 and 6 bucks a graft, so 2100 grafts for $6k would be a red flag.

 

I have a personal bias for Dr. Gabel because he's done me right and I admire his ethics.

 

He's a little bit more affordable than his highly respected friend and peer Dr. Konior, who I also can only say great things about.

 

I live in Austin and flew to Portland for Gabel, twice.

 

But ultimately do your homework by consulting these guys and I know money matters, but don't let it be the difference between going elite and making a mistake because in the end going elite is cheaper if you do it right the first time.

 

My opinion of McGrath is that he does average work and has a lot of undesirable trappings surrounding him.

[curiousgirl]

I live in Austin too. I noticed Dr McGrath was here in town, but I went with Dr Arocha instead because he was highly recommended on here, & there were positive remarks stated about his hairline work (which was a HUGE concern of mine), & my hair loss is a special case. I didn't see McGrath mentioned on here much at all when I researched it this past summer. I'm over 4 months post-op, & so far this new hairline will look nice once it grows in more. I've seen many videos online, & some of them were women that went to places like Bosley... eek! I can't vouch for McGrath's work, but I chose to pay more & travel slightly for a reputable surgeon. I'll need to get another procedure as well... hopefully this year or next.

[twf123]

Grafts or hairs? McGrath has tried to sell people by the hair and not by graft in the past.

 

Most elite US physicians charge between 4 and 6 bucks a graft, so 2100 grafts for $6k would be a red flag.

 

I have a personal bias for Dr. Gabel because he's done me right and I admire his ethics.

 

He's a little bit more affordable than his highly respected friend and peer Dr. Konior, who I also can only say great things about.

 

I live in Austin and flew to Portland for Gabel, twice.

 

But ultimately do your homework by consulting these guys and I know money matters, but don't let it be the difference between going elite and making a mistake because in the end going elite is cheaper if you do it right the first time.

 

My opinion of McGrath is that he does average work and has a lot of undesirable trappings surrounding him.

 

I had paid around $8300 for 4800 hairs. His pricing is in stages, and he said if I returned to get the same amount of hairs (4800) he would lower the cost to a stage lower. This would be around $6300. Granted when I agreed on the cost of $8300 I was expecting less hairs, but after talking with him and agreeing I would need more he said he would do it without raising our agreed price. That's where I am getting the $6300 from for a returned visit.

[Speegs]

I had paid around $8300 for 4800 hairs. His pricing is in stages, and he said if I returned to get the same amount of hairs (4800) he would lower the cost to a stage lower. This would be around $6300. Granted when I agreed on the cost of $8300 I was expecting less hairs, but after talking with him and agreeing I would need more he said he would do it without raising our agreed price. That's where I am getting the $6300 from for a returned visit.

Have you already paid him and booked? This doesn't sound like a good deal to me. It's very difficult to see what you're getting, I hope he isn't slicing up larger grafts into singular hairs.

[twf123]

Not paid or booked, but it is in writing, and nope he doesn't cut them up. Hair count would be the same regardless whether you cut them or not so no reason to. My procedure had 503 single hair folicular units for the front, 475 transition zone 2-3 hair follicular units, and 585 Multiple folicular units. The average hairs per graft the in multiple folicular units is 5.

[Speegs]

Not paid or booked, but it is in writing, and nope he doesn't cut them up. Hair count would be the same regardless whether you cut them or not so no reason to. My procedure had 503 single hair folicular units for the front, 475 transition zone 2-3 hair follicular units, and 585 Multiple folicular units. The average hairs per graft the in multiple folicular units is 5.

So you would pay $8,300 for 1563 alleged grafts making that $5.31per graft.

 

That's more than a lot of elite surgeons on this forum are charging, many are in the $4 per graft range.

 

I hope it turns out well for you, but I think better options exist for you in terms of physicians and finances.

 

Also, that is a bit concerning he's saying you're getting over 500 grafts with 5 hairs, those don't occur that plentifully in nature, and are tantamount to micrografts, a procedure that predates modern follicular unit transplantation.

[twf123]

Maybe. I do have very thick hair though in my donor and everywhere else besides my corners. Also, he typically charges by the following:

 

Stage 1 – (hairline harvest) $6,200

Stage 2 - $8,300

Stage 3 - $10,400

Stage 4 – (Ultra-DENSITY™) $12,500

Ultra-DENSITY PLUS $13,000 - & UP

Please review the following pricing schedule:

Stage#1 (The Hairline Harvest) 10cm X 1cm 2,000 hairs

Stage#2 17 1/2cm X 1cm 3,500 hairs

Stage#3 25cm X 1cm 5,000 hairs

Stage#4 (the Ultra-DENSITY™) 30cm X 1cm 6,000 hairs

 

I was charged stage 2 because that's what we agreed before I flew out there but in the in person consultation we agreed I would probably need the stage 3, but he didn't charge me that price.

[twf123]

In regards to other doctors, I am really wondering who would be another great option for me.

[Speegs]

Maybe. I do have very thick hair though in my donor and everywhere else besides my corners. Also, he typically charges by the following:

 

Stage 1 – (hairline harvest) $6,200

Stage 2 - $8,300

Stage 3 - $10,400

Stage 4 – (Ultra-DENSITY™) $12,500

Ultra-DENSITY PLUS $13,000 - & UP

Please review the following pricing schedule:

Stage#1 (The Hairline Harvest) 10cm X 1cm 2,000 hairs

Stage#2 17 1/2cm X 1cm 3,500 hairs

Stage#3 25cm X 1cm 5,000 hairs

Stage#4 (the Ultra-DENSITY™) 30cm X 1cm 6,000 hairs

 

I was charged stage 2 because that's what we agreed before I flew out there but in the in person consultation we agreed I would probably need the stage 3, but he didn't charge me that price.

I really hate the marketing he does, it's so used car salesman, even if he is a competent surgeon he does himself no favors with his presentation.

Coining terms like "Ultra-Density" and trademarking it is a huge turnoff to me.

 

Peruse this site, take a bunch of consults and compare and contrast them.

 

No need to rush, and since you're willing to travel your options are great.

 

Like I said, I live in McGrath's backyard and traveled from Austin to Portland twice for Dr. Gabel, and it's worth it to travel for the right surgeon.

[jjsrader]

I really hate the marketing he does, it's so used car salesman, even if he is a competent surgeon he does himself no favors with his presentation.

Coining terms like "Ultra-Density" and trademarking it is a huge turnoff to me.

 

Peruse this site, take a bunch of consults and compare and contrast them.

 

No need to rush, and since you're willing to travel your options are great.

 

Like I said, I live in McGrath's backyard and traveled from Austin to Portland twice for Dr. Gabel, and it's worth it to travel for the right surgeon.

------------

McGrath is putting in mulit-follicular 'line/slit' grafts on your 5 hair count FU's btw.

 

It's outdated thinking and I think you are getting spot-on advice from Speegs.

 

This really isn't a debate anymore - your next surgery should be with a qualified up-to-date surgeon who only does true follicular unit surgery and examines each graft under the micrscope before implanting.

 

Good luck.

[twf123]

Maybe i'm confused, each graft was definitely looked at under the microscope. What do you mean by "line/slit" grafts?

[Speegs]

Maybe i'm confused, each graft was definitely looked at under the microscope. What do you mean by "line/slit" grafts?

He means they're mini-grafts or micrografts, an outdated procedure.

 

"Mini grafting and micro grafting is an older form of strip surgery, which is where a "strip" of hair-bearing flesh is removed, dissected, then re-grafted onto the recipient scalp. In the early days of hair restoration, technicians would have to wear jeweler’s loupes when dissecting the hair bearing tissue, which only allowed a limited range of magnification. This meant less refinement, higher transection rates as well as "chubbier" grafts. This describes grafts that have a substantial amount of tissue surrounding the follicle and hairs. The resulting micro-grafts would contain one to two hairs (micro-grafts) but the amount of tissue left behind would be more than that found on properly dissected follicular units with the same hair counts. Mini-grafts, which are larger than micro-grafts, would contain as little as three or more hairs but many of these mini-grafts containing six to ten hairs."

 

"What are the Side Effects of Micro Grafting and Mini Grafting?

The side effects of mini grafting and micro grafting can include:

 

Necrosis – if enough blood pools under the skin due to too many mini-grafts placed too close to each other then the size of the incisions to accommodate the larger nature of the grafts can be too traumatic for the skin causing subsequent tissue death.

Infection – Again, if the skin is traumatized excessively from attempts of dense packing then infection can easily take hold.

Ridging – This occurs when excessive tissue is inserted into a concentrated area and it cannot be absorbed by the body. This potential side effect is one of the main reasons why multiple passes are required to achieve cosmetic density when compared to follicular units from FUE or FUSS."

 

Timeout, have you or have you not had a procedure with Mcgrath, you use past tense in some of these posts like you've had a procedure already.

Edited January 11, 2018 by Speegs

[twf123]

He means they're mini-grafts or micrografts, an outdated procedure.

 

"Mini grafting and micro grafting is an older form of strip surgery, which is where a "strip" of hair-bearing flesh is removed, dissected, then re-grafted onto the recipient scalp. In the early days of hair restoration, technicians would have to wear jeweler’s loupes when dissecting the hair bearing tissue, which only allowed a limited range of magnification. This meant less refinement, higher transection rates as well as "chubbier" grafts. This describes grafts that have a substantial amount of tissue surrounding the follicle and hairs. The resulting micro-grafts would contain one to two hairs (micro-grafts) but the amount of tissue left behind would be more than that found on properly dissected follicular units with the same hair counts. Mini-grafts, which are larger than micro-grafts, would contain as little as three or more hairs but many of these mini-grafts containing six to ten hairs."

 

"What are the Side Effects of Micro Grafting and Mini Grafting?

The side effects of mini grafting and micro grafting can include:

 

Necrosis – if enough blood pools under the skin due to too many mini-grafts placed too close to each other then the size of the incisions to accommodate the larger nature of the grafts can be too traumatic for the skin causing subsequent tissue death.

Infection – Again, if the skin is traumatized excessively from attempts of dense packing then infection can easily take hold.

Ridging – This occurs when excessive tissue is inserted into a concentrated area and it cannot be absorbed by the body. This potential side effect is one of the main reasons why multiple passes are required to achieve cosmetic density when compared to follicular units from FUE or FUSS."

 

Timeout, have you or have you not had a procedure with Mcgrath, you use past tense in some of these posts like you've had a procedure already.

 

Yes I already had the procedure with Mcgrath. I showed the pictures early in this thread. Now I just have a couple of questions:

 

1. You say mini or micro grafting is the older way of performing strip surgery. What would the new way of Strip surgery be?

 

2. How can you tell that I had micro or mini grafts in the procedure that I had? I was informed that I did not receive a micro-mini graft surgery. "All your grafts were dissected under high powered microscopes. Dr Mcgrath asks for the grays to be cut a certain way depending on many variables, (hairline, density, grafts, transition zone, etc)"

Edited January 11, 2018 by twf123

[Speegs]

Yes I already had the procedure with Mcgrath. I showed the pictures early in this thread. Now I just have a couple of questions:

 

1. You say mini or micro grafting is the older way of performing strip surgery. What would the new way of Strip surgery be?

 

2. How can you tell that I had micro or mini grafts in the procedure that I had? I was informed that I did not receive a micro-mini graft surgery. "All your grafts were dissected under high powered microscopes. Dr Mcgrath asks for the grays to be cut a certain way depending on many variables, (hairline, density, grafts, transition zone, etc)"

Those 500 plus 5 hair grafts he put in you for density are not found in nature, he just didn't separate a group of hairs as they grow.

 

A true follicular unit cut under the microscope has 1 to 3 hairs on average, two being the most common, seldom does nature create follicular units that yield 4 or 5 hairs in them.

 

For the reasons I stated in my earlier post, it isn't widely practiced anymore in western medicine.

 

I'm not trying to alarm you and I'm not saying he butchered you, I'm saying evidence suggests he did use mini-grafts by another name to bulk up your density behind the hairline, at least that's what 500 plus 5 hair grafts infers.

[twf123]

Those 500 plus 5 hair grafts he put in you for density are not found in nature, he just didn't separate a group of hairs as they grow.

 

A true follicular unit cut under the microscope has 1 to 3 hairs on average, two being the most common, seldom does nature create follicular units that yield 4 or 5 hairs in them.

 

For the reasons I stated in my earlier post, it isn't widely practiced anymore in western medicine.

 

I'm not trying to alarm you and I'm not saying he butchered you, I'm saying evidence suggests he did use mini-grafts by another name to bulk up your density behind the hairline, at least that's what 500 plus 5 hair grafts infers.

 

if you don't mind, what was your folicular unit hair spread? how many 1s,2s, etc.

[Speegs]

if you don't mind, what was your folicular unit hair spread? how many 1s,2s, etc.

Off the top of my head (no pun intended) I don't know, I'd have to ask my physician.

 

But I know nothing on me exceeded three hairs per unit, and the lion's share was one and two hair grafts.

[twf123]

Off the top of my head (no pun intended) I don't know, I'd have to ask my physician.

 

But I know nothing on me exceeded three hairs per unit, and the lion's share was one and two hair grafts.

 

Lol okay.

 

So you're saying that in today's FUT methods, no one should exceed more 3 hairs per follicular unit?

[Speegs]

Lol okay.

 

So you're saying that in today's FUT methods, no one should exceed more 3 hairs per follicular unit?

It's highly unusual, and very unlikely you had 500 plus 5 hair grafts at your surgeon's disposal.

 

You could be very unique, but I feel that is highly irregular physiology, especially since I think I just watched some youtube videos of that music guy that touts McGrath essentially say he had mini-grafts placed in the back to punch up the density.

 

It's wait and see time for you now, what's done is done, let's see how it grows in.

 

But in a year's time if you don't like it you may have to get a doctor to remove those, cut them under a microscope and replant them somewhere on the scalp.

 

I don't want to cause you undue anxiety, I know this is a nerve-racking time so let's just hope for the best and take things as they come.

 

We'll cross those bridges when we get there if we have to, so keep us posted.

[twf123]

It's highly unusual, and very unlikely you had 500 plus 5 hair grafts at your surgeon's disposal.

 

You could be very unique, but I feel that is highly irregular physiology, especially since I think I just watched some youtube videos of that music guy that touts McGrath essentially say he had mini-grafts placed in the back to punch up the density.

 

It's wait and see time for you now, what's done is done, let's see how it grows in.

 

But in a year's time if you don't like it you may have to get a doctor to remove those, cut them under a microscope and replant them somewhere on the scalp.

 

I don't want to cause you undue anxiety, I know this is a nerve-racking time so let's just hope for the best and take things as they come.

 

We'll cross those bridges when we get there if we have to, so keep us posted.

 

Right. I guess I'll wait and see what happens in the end. This is another quote I got

 

"In some areas of the mid-scalp it is better NOT to divide up the tissue into tiny one - three hair grafts. This is called a multiple follicular unit. It means stronger grafts, better survival, and less trauma to the tissue. The only reason many clinic will not use this is one simple fact. Since they charge by the graft, they will make less money. Dr McGrath and some other top hair docs will move more hair (as much as possible) into a given area and charge a fair price. This is better for the patient and provides better results"

[Speegs]

Right. I guess I'll wait and see what happens in the end. This is another quote I got

 

"In some areas of the mid-scalp it is better NOT to divide up the tissue into tiny one - three hair grafts. This is called a multiple follicular unit. It means stronger grafts, better survival, and less trauma to the tissue. The only reason many clinic will not use this is one simple fact. Since they charge by the graft, they will make less money. Dr McGrath and some other top hair docs will move more hair (as much as possible) into a given area and charge a fair price. This is better for the patient and provides better results"

I disagree with Dr. McGrath on this, I think he is rebranding the mini-graft, even if he thinks it's a well-utilized method for density, I think the language is a little misleading.

[twf123]

I guess? All I know is that he definitely used advanced microscopes to do the procedure.

[jttx85]

It's highly unusual, and very unlikely you had 500 plus 5 hair grafts at your surgeon's disposal.

 

You could be very unique, but I feel that is highly irregular physiology, especially since I think I just watched some youtube videos of that music guy that touts McGrath essentially say he had mini-grafts placed in the back to punch up the density.

 

It's wait and see time for you now, what's done is done, let's see how it grows in.

 

But in a year's time if you don't like it you may have to get a doctor to remove those, cut them under a microscope and replant them somewhere on the scalp.

 

I don't want to cause you undue anxiety, I know this is a nerve-racking time so let's just hope for the best and take things as they come.

 

We'll cross those bridges when we get there if we have to, so keep us posted.

 

I can attest to that. When the assistant did my extractions, he complimented how thick my donor was and how he was getting a lot of 2's and 3's. When I asked him what was the highest, he said he was able to get a few 4's and 5's but even with an amazing donor, you aren't going to get many 4's and 5's.

 

And to the OP, I'm only 11 days post op so I can't say how good my results are since it's too early, but I can also attest to giving Dr. Arocha a call and at least just meet him and see what he has to say if you end up deciding to do a second HT. Based on the before and after pics of all the recommended doctors on this forum, it would appear the density he is able to provide is definitely one of the best. And he doesn't have any complicated marketing system, he's pretty much upfront with how much he'll charge per graft. I paid for 2000 and right before the surgery,I was paranoid about 2000 grafts not being enough and said I can pay for more even though he thought 2000 should be enough - but he ended up giving me about 100 grafts more for better density and didn't charge me for it

[twf123]

I can attest to that. When the assistant did my extractions, he complimented how thick my donor was and how he was getting a lot of 2's and 3's. When I asked him what was the highest, he said he was able to get a few 4's and 5's but even with an amazing donor, you aren't going to get many 4's and 5's.

 

And to the OP, I'm only 11 days post op so I can't say how good my results are since it's too early, but I can also attest to giving Dr. Arocha a call and at least just meet him and see what he has to say if you end up deciding to do a second HT. Based on the before and after pics of all the recommended doctors on this forum, it would appear the density he is able to provide is definitely one of the best. And he doesn't have any complicated marketing system, he's pretty much upfront with how much he'll charge per graft. I paid for 2000 and right before the surgery,I was paranoid about 2000 grafts not being enough and said I can pay for more even though he thought 2000 should be enough - but he ended up giving me about 100 grafts more for better density and didn't charge me for it

 

Right. As I said before this is the response I received "In some areas of the mid-scalp it is better NOT to divide up the tissue into tiny one - three hair grafts. This is called a multiple follicular unit. It means stronger grafts, better survival, and less trauma to the tissue. The only reason many clinic will not use this is one simple fact. Since they charge by the graft, they will make less money. Dr McGrath and some other top hair docs will move more hair (as much as possible) into a given area and charge a fair price. This is better for the patient and provides better results""

 

Also, how much did roughly 2000 grafts cost you with Dr. Arocha? (I'm not in Texas btw, but that is just where I went the first time. Would you consider him over everyone in the US for Quality/Cost?)

[ArochaHair]

He has a sales consultant for one thing, a practice straight from the hair mill playbook, and the guy is a perfectly nice guy, but he's still in sales.

 

With all due respect to Speegs, this is not a "hair mill playbook" move as almost all clinics use consultants for helping to educate patients interested in hair restoration. In fact, it is an exception for doctors to perform all of their own consultations, not the rule.

 

There are two schools of thought on the subject. The first is to not have consultants so that the patient is not pressured by a salesman to have a surgery that he or she may not want or need. By this logic we have to assume that all a doctor needs to do is eliminate the consultant position and they get instant credibility. The problem with this logic is that the ultimate financial benefactor of any surgery is the doctor so the financial motivation still exists, but without the consultant, the doctor gets a larger profit as there is one less salary to factor into the equation.

 

The opposing idea is that a consultant helps to take the work load off of the doctor, whose only job is to take care of his or her patient. This allows the doctor to spend more time with the patient or patients and less time trying to sell his or her services to new potential patients. This is the approach we take at Arocha Hair Restoration, as do most Coalition level clinics.

 

In the end, neither approach is bad or good, but having consultants should not be labeled as being a tactic of "hair mills" because this essentially labels most Coalition clinics as being hair mills, and we all know that is not the case.