closing temples is not unethical

[Big1]

If the patient is informed I don't see the problem. I personally wouldn't choose to have my temples closed but I would suggest to live and let live. I do understand and agree that when a doctor closes a patient's temples but does not first explain the consequences of such an approach to the patient, that it is unethical (and perhaps criminal).

 

Cosmetic surgery is solicited because a patient wants to change. The patient pays for the service and in turn should ask for and receive what he wants. In an age where face lifts are pedestrian, doctor-assisted suicide is legal, face transplants are quickly becoming reality and sexual reassignment is rampant how can anyone seriously have a problem with doctors delivering the very result that a patient requests -- closed temples?

 

I honestly think that the "controversy" is bullshit. A good doctor is a good doctor; its pathetic to accuse a doctor of being unethical or greedy just because they give the patient what he asks for.

[Big1]

If the patient is informed I don't see the problem. I personally wouldn't choose to have my temples closed but I would suggest to live and let live. I do understand and agree that when a doctor closes a patient's temples but does not first explain the consequences of such an approach to the patient, that it is unethical (and perhaps criminal).

 

Cosmetic surgery is solicited because a patient wants to change. The patient pays for the service and in turn should ask for and receive what he wants. In an age where face lifts are pedestrian, doctor-assisted suicide is legal, face transplants are quickly becoming reality and sexual reassignment is rampant how can anyone seriously have a problem with doctors delivering the very result that a patient requests -- closed temples?

 

I honestly think that the "controversy" is bullshit. A good doctor is a good doctor; its pathetic to accuse a doctor of being unethical or greedy just because they give the patient what he asks for.

[NC30]

I guess everyone's definitions of what is and isn't ethical is different.

 

I, for one, would never want to go to a doctor who would perform any procedure for an "informed patient" as long as they were getting paid. A doctor with a sense of responsibility towards his patients is exactly what I'd want.

 

I'm sure Michael Jackson was informed or aware what his risks were at different points in surgical history....but hey...if you think that what he ended up with is "ok" and his doctors aren't unethical as long as he knew what he was getting into, then I guess that's ok in your terms.

 

I think the doctor does have a responsibility to not perform any procedure, which in the long run, would most likely be a poor decision. Especially in the realm of cosmetic surgery, you're dealing with people who are already disappointed with their features and often traumatized mentally by it. Some of it may be legit, and some of it may be just that the person isn't mentally capable of dealing with the issue. Some people, even though adults, are so narrowly focused on the present that all thoughts of the future never even cross their mind....or are just so obsessed with having a procedure that they've gone beyond the point of ever actually being capable of being "informed".

 

To perform a procedure which you know down the road will be most likely a regrettable surgery on someone as long as they're "informed" and their check doesn't bounce.....well....to me that's unethical.

[Bob C]

"Closing the temples" is only one area of controversy in HT surgery - perhaps the latest one to get lots of attention.

 

Discussing use of caution when considering closing the temples is no different than discussing the possible downside of transplanting the crown, doing scalp reductions, placing the hairline too low, doing a hairtransplant on a young patient, etc.

 

Any agressive approach must be weighed against future hair loss, along with many factors specific to each patient.

 

To say Dr "A" is better or worse than Dr "B" because one "closes temples" and one doesn't is too general a statement.

[NC30]

Bob C....I'm not sure which post your quote about Dr A and Dr B is directed towards, so I'll clarify one thing about my post.

 

I'm not saying that closing temples should never be done in any situation. I'm sure there are a number of circumstances where that would be an acceptable procedure.

[HairBoy]

Usually, I can figure the terminology posters use by its context.

 

However, I'm not certain what is meant by "closing temples". Does "closing temples" mean that instead of hair angling back on the sides until it meets the top that it would go straight up or curve forward as the hair does on a boy?

 

I'd appreciate it if someone could define "closing temples" for me.

 

Thanks.

[Rugger]

I always thought that "closing the temples" is what they do in Iraq if a temple is caught holding Bingo games without a permit...i could be wrong on this...but not likely

[Big1]

To perform a procedure which you know down the road will be most likely a regrettable surgery on someone as long as they're "informed" and their check doesn't bounce.....well....to me that's unethical.

 

Thank god you're not a doctor. How do you "know" that a procedure will be regrettable. It may be exactly what the patient needs.

 

And using Michael Jackson as an example is weak. Are you talking about skin bleaching? I don't think that he regrets that. Or are you talking about his nose jobs. Do you also "know" that a nose job is regrettable?

 

Sometimes doctors are unethical. But many people need to be more careful with such a destructive word.

[Bob C]

NC30,

 

My comments were in response to the original post. I agree with you -- "closing the temples" or squaring off the hairline is not automatically a bad thing.

 

But a lot of young guys think that anyone who advises taking caution when considering aggresive work is "old fashioned", standing in the way of progress or fostering a "controversy". This is nonsense.

[arfy]

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>I'm not certain what is meant by "closing temples". Does "closing temples" mean that instead of hair angling back on the sides until it meets the top that it would go straight up or curve forward as the hair does on a boy?

Some people call the temples "alleys" or "power alleys". If you look at Jack Nicholson, he has mega mega Power Alleys.

 

The original post is really way too vague. EVERY TRANSPLANT "closes the temples". How could a transplant not close the temples? When you connect the hairline to the sides -BINGO- you've closed the temples. The issue is HOW the temples are closed.

 

What most doctors warn against is "squaring" the temples, especially in very young patients. This means restoring an adolescent hairline. If the patient has Male Pattern Baldness and continues to lose hair, he could wind up in big trouble as he gets older. When talking about squared temples, you have to discuss the age of the patient, and the risk of extensive future hair loss in the context of a limited donor supply.

 

Moving a hairline back can be one of the harder repair surgeries, in some cases. You can wind up with scarring where the moved grafts used to be, and it's right out in the open. Not to discourage the guys who may have this problem, but it's something that should be avoided from the beginning, if possible.

[Big1]

"Squaring" the temples is what I should have written.

 

Arfy wrote:

"If the patient has Male Pattern Baldness and continues to lose hair, he could wind up in big trouble as he gets older."

 

The same thing may be said about high density transplants; if a transplant is too densely packed it may prevent adequate coverage over the rest of the patient's head. No doctor is "warning" patients about avoiding high density though. If they did, then obviously, THEY would be the ones to go out of business. No, doctors indeed provide the density that is sought after by the patient. Squaring of the temples should not be faux pa (is that how you spell it?).

 

 

"When talking about squared temples, you have to discuss the age of the patient, and the risk of extensive future hair loss in the context of a limited donor supply."

 

I agree. It should be discussed and shouldn't be dismissed wholesale.

 

 

"Moving a hairline back can be one of the harder repair surgeries, in some cases."

 

Yes, but why would anyone want to nove it back? We move hair to look younger. I assume that I will look good in 25 years and would not want to mess with a good thing.

[arfy]

You might want to move your hairline back if it started to look strange as you got older. You also may decide that you need those grafts more in another place.

 

Think about how much your face changes over a period of 20 years. Your hairline may look unnatural if it's at adolescent levels, when you are in your 50s.

 

This topic has been beaten to death, but if your point is that there are "IF'S" attached to warnings about temples, I agree. The younger guys are the ones who need to be the most careful.

 

As far as the doctors' role, they are supposed to be the expert in the patient-doctor relationship. The patient is paying them to use good judgement. Doctors should not just be a "surgery machine" that you insert money into, to have them do whatever you want.

 

What if a guy walked into a plastic surgeon's office, and asked the doc to attach his ears backwards, and the guy was holding a stack of cash. Should an ethical doctor do it? I say "no".

[Big1]

arfy said:

"You might want to move your hairline back if it started to look strange as you got older."

 

Doubtful. I have seen some strange looking hair transplants but none that looked "strange" by virtue of the fact that it was "youthful".

 

"Think about how much your face changes over a period of 20 years. Your hairline may look unnatural if it's at adolescent levels, when you are in your 50s."

 

Fine, proceed with caution.

 

 

"This topic has been beaten to death, but if your point is that there are "IF'S" attached to warnings about temples, I agree."

 

Thats only part of my point. You agree that in some cases squaring temples might not be such a travesty. Well, that being the case, it follows that it is actually irresponsible of POSTERS!!! to accuse a doctor of being unethical for

providing this cosmetic service. It makes my stomach turn.

 

We're not talking about cutting off ears here, and the mere fact that you tacitly allege that squaring temples is comparable to such a procedure acutely reveals that this topic has not been beaten to death -- contrary to your (the high priest of hair restoration's) opinion.

 

 

"The younger guys are the ones who need to be the most careful."

 

Agreed.

[Mr T]

Big1,

 

I am struggling with understanding how you really feel. ;-)

 

I would agree that "Squaring temples might not be such a travesty", if the patient understands what may occur down the road and where that may leave him given his squared temples.

 

If the doctor squares the temples without informing the patient of the long-term consequences, then I could consider this unethical as the doctor may be doing it to guarantee additional business from this patient in the future. At a minimum, I would consider the doctor to be violating the Hippocratic Oath that says they will "do no harm...".

 

My two cents,

 

Mr. T

[NC30]

Big1...

 

You state..."Thank god you're not a doctor. How do you "know" that a procedure will be regrettable. It may be exactly what the patient needs. "

 

Are you saying that a doctor couldn't possibly predict that any procedure is regrettable? So let's say a patient comes in at 18, every man in his family was an NW7 by the age of 25, he's already got diffuse thinning throughout, etc....and the guy wants to restore his temples completely to where he was a few years ago using as many grafts as possible. Are you saying that a doctor can't look at the kid and figure that such a procedure would be a horrible decision for him? That 15 years down the road this kid is probably going to look absolutely hideous with some thick filled in temples and nowhere near enough donor hair left to cover the rest of his bald head? According to your statement, you're telling me that the patient knows best and the doctor is just there to give me my surgery the way I want it. Thank god you're not a doctor because with that kind of mentality I'm sure any hair mill would have another doctor willing to be part of their staff.

[arfy]

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>arfy said:

"You might want to move your hairline back if it started to look strange as you got older."

 

Big1 said: Doubtful. I have seen some strange looking hair transplants but none that looked "strange" by virtue of the fact that it was "youthful".

Well wow. I guess Big1 has seen so many hair transplants, that he's actually "seen it all"? Hard to believe. However, the doctors who have been doing hair transplants for a long time (including corrective hair transplants) almost all warn young patients to not square their temples. I'm just repeating the conventional wisdom on this issue, that was developed over several decades of doctors doing trial-and-error and making mistakes with things like squared temples.

 

Big1 also suggests this argument against square hairlines is 'bullsh#t" because in some cases (older guys) it can be okay.

 

Every thread complaining about doctors who do square temples (that I remember) has also factored in the age of the patient. There have been patients who have posted their photos with square temples, and nobody peeped...because they were OLDER patients.

 

Most everybody seems to understand very well by now that transplanting square temples is a risk in the young patient, except maybe you (Big1), because you're bringing it up again. I don't know why we need to hammer this out over and over again.<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>We're not talking about cutting off ears here, and the mere fact that you tacitly allege that squaring temples is comparable to such a procedure acutely reveals that this topic has not been beaten to death -- contrary to your (the high priest of hair restoration's) opinion.

If you have so much common sense, then why didn't you grasp that during these 'controversial" threads we've been talking about the risks to young patients all along?

 

One more thing: Lower hairlines = more grafts in the long term = more profitable for the doctor.

[parable]

"One more thing: Lower hairlines = more grafts in the long term = more profitable for the doctor."

 

ArFY~ I HEard tHAt one befOre....!!

 

WooD's TOld u THat Aye???.....

 

 

~pAraBLE~

[arfy]

Actually Dr. Woods did say that to me. It's true, the bigger the area you 'stake out' with grafts, the bigger your financial committment.

 

Really, that is just a minor point though. Some guys have plenty of dough and won't care. The bigger issues in this discussion are about looking correct as you get older, and not running out of donor hair before you've accomplished your goals.

 

If you have a problem in either of those areas, it doesn't matter how much money you have, or how much you've already spent, you are still in trouble.

[Big1]

I have never said that I've seen it all. My compunction isn't whether or not squaring temples is performed but is instead the remarks made about a doctor who does square temples.

 

"One more thing: Lower hairlines = more grafts in the long term = more profitable for the doctor."

 

More density also = more grafts. Many doctors who were accused of being unethical will provide fue if the grafts don't grow. FUE costs a lot more than strip. If it is only about making money, then why offer such a guarantee. The hair mills generally don't offer any guarantees.

 

I should have been more clear. Let me rephrase. I think squaring temples does not automatically mean an absence of ethics. What is bullshit is saying a doctor doesn't have ethics or principles -- simply because he gives patients what they want -- when they actually do.

[arfy]

Well we'll have to agree to disagree then. I think transplanting square temples on very young guys is unethical. And there's no such thing as being "ethical part-time", you are either ethical or not.