Can you guys please answer a few questions for me?

[Goosesausage]

Hi, I'm a 38-year-old male located in the Washington, D.C. area, and I have a few questions and concerns related to hair replacement surgery.

1) Which surgeons do you recommend in my area?

I really don't know how to find good surgeons, and so I simply typed "best hair surgeons near me" into Google and a hair clinic called Natural Transplants was the highest rated by far.

Here's their website:

Removed link

I called a couple of years ago, and a doctor named David Kurzman got back to me and told me that he was a patient advisor. He asked me to take a few pictures of my scalp - which I did. He then had me do a free virtual consultation with Dr. Kevin Blumenthal - who would be the actual surgeon doing my transplant. They were very polite and helpful, and at the end of the conservation they gave me a quote of $10,000.

Here's his profile:

Removed link

Is he good surgeon? And is that a fair price?

Ultimately, we both agreed that it would be a good idea to delay the surgery since I was also in the process of getting double jaw surgery - which is a very serious operation. They wanted me to focus on taking care of that first and then get back in contact with them after I was healed. Getting double jaw surgery took much longer than expected due to Covid, my insurance taking forever to give pre-approval, and waiting for space in an operating room. But I finally got the surgery about 2 months ago and I now feel well enough to get a hair transplant.

2) One of my other complications related to getting hair transplant surgery is that I have a chronic skin condition on the back of my scalp called gram-negative folliculitis. Basically, I've been suffering from chronic bumps and sores on the back of my scalp for over 15 years. And my previous dermatologist overprescribed me antibiotics - which made my skin conditions even worse. He had me taking oral antibiotics like Tetracycline, Doxycycline, and Minocycline every single day for over 10 years. He also had me apply a topical antibiotic called Clindamycin to my face and scalp every single day for over 10 years. And that caused me to develop antibiotic resistant super bacteria on the back of my scalp. After going to several different dermatologists looking for answers, I finally learned that I'd have to take low-dose Accutane for the rest of my life since that's the only solution that works. And that created all sorts of issues for me since you're not supposed to do any sort of procedure to your skin while on Accutane because it can give you really nasty permanent scars. You have to stop taking Accutane for a full 6 months before doing any sort of procedure to your skin. And even though both my oral surgeons and my dermatologist told me that Accutane wouldn't affect internal surgeries like double jaw surgery, I still stopped taking Accutane 1 month prior to my double jaw surgery just to make extra sure that it wouldn't affect my surgery and recovery in any way. And so I stopped taking Accutane back on December 24th, 2022 - which was a little over 3 months ago. And I'm now trying to schedule hair replacement surgery in about 3 months from now because then it will be 6 months since I last took Accutane.    

My questions related to this are A) is it safe to get hair replacement surgery with my skin condition? I'm worried that transferring hair from the screwed up lower part of my rear scalp to the front of my scalp will just spread my skin condition to the rest of my head. In my own mind I've reasoned that it will hopefully be safe because Accutane has been effective at controlling my gram-negative folliculitis on the back of my scalp. And so if the surgery does cause it to spread to the front of my scalp, then hopefully Accutane will keep it in remission once I get back on that medication. And B) do you think that my on-again off-again use of Accutane will somehow affect my results, even if I take a long break both before and after my transplant?

3) Do you have to take oral medications like Finasteride and Minoxidil in order for your hair transplant to be successful long-term? I tried taking oral Finasteride back in 2017 for hair loss, and I had severe sexual side effects after only 5 weeks of use. At first my sex drive was through the roof for the first 4 weeks of being on Finasteride, but then I woke up one morning about 5 weeks into taking it with almost zero blood flow to my penis. My penis shrunk to less than half its normal size and was cold to the touch. I couldn't get an erection to save my life. And my testicles shrunk too and tucked close into my body as if I just jumped into ice water. This lasted for an entire year and gradually got better over the next 5 years. I went to several different urologists, and nobody had any answers. Most of them had never even heard of this happening before. Only 1 urologist did, but he didn't have any solutions. And so they all just basically gave me prescriptions for generic Viagra and Cialis and sent me on my way. And so there's no way in hell that I'm ever taking Finasteride again. But I heard that oral Minoxidil worked pretty well, and my dermatologist gave me a prescription for it. I got it filled, but I haven't taken it yet because I don't know if you're supposed to take it or not if you're getting a hair transplant. And so what do you guys recommend when it comes to oral Minoxidil? Should I take it before my transplant? Should I wait? Is it necessary to take for the rest of my life in order to have good results with my transplant surgery long-term? 

I know this was really long, and so I just want to thank anyone who actually took the time to read it all and give me some helpful advice.

[Berik]

As far as your first question about the hair transplant clinic, I just looked it up and it appears to be a chain that has several locations, similar to Bosley. You should avoid these types of clinics at all costs 99% of the time. They won't provide great results and typically prey on the uninformed. 

My suggestion to you is not to pay attention to any recommended list, and instead search forums for patient reviews of doctors. Preferably people that have a similar hair loss level and hair type as you. It will take a while, but eventually you will be able to see the forest from the trees. 

#2 and #3 are questions that should only be answered by a doctor, in-person tbh. No, finasteride is not always necessary to take for a transplant but you should know that hair loss is unpredictable, and even more so when it is not stabilized by finasteride. This means that you could have a hair transplant, but the hair around the transplant will continue to thin, meaning you will have to keep chasing that hair with more surgeries which is unsustainable. 

 

[Melvin- Admin]

This clinic does not perform follicular unit grafting, they use an outdated technique called “minigrafting.” 

Lists are only starting points for research. This forum has a list of recommended surgeons, but remember it’s not a definitive list. The most important thing is looking at independent reviews. 

Hair transplants do not cure hair loss, you need to take medication to stop further hair loss. Getting a hair transplant without stabilizing your hair loss is a bad idea. If you took oral finasteride with side effects you can try a topical. In mu opinion, topical dutasteride is the best topical. Oral minoxidil is better than topical minoxidil, but be sure to speak with your doctor first. 

 

 
https://hairtransplantnetwork.com/best-hair-transplant-surgeons

https://www.hairrestorationnetwork.com/forum/24-hair-transplant-experiences-and-surgeon-reviews/

[Goosesausage]

23 hours ago, Berik said:

As far as your first question about the hair transplant clinic, I just looked it up and it appears to be a chain that has several locations, similar to Bosley. You should avoid these types of clinics at all costs 99% of the time. They won't provide great results and typically prey on the uninformed. 

My suggestion to you is not to pay attention to any recommended list, and instead search forums for patient reviews of doctors. Preferably people that have a similar hair loss level and hair type as you. It will take a while, but eventually you will be able to see the forest from the trees. 

#2 and #3 are questions that should only be answered by a doctor, in-person tbh. No, finasteride is not always necessary to take for a transplant but you should know that hair loss is unpredictable, and even more so when it is not stabilized by finasteride. This means that you could have a hair transplant, but the hair around the transplant will continue to thin, meaning you will have to keep chasing that hair with more surgeries which is unsustainable. 

 

Wow. That's so disappointing. How did they manage to get so many good reviews?

12 hours ago, Melvin- Moderator said:

This clinic does not perform follicular unit grafting, they use an outdated technique called “minigrafting.” 

Lists are only starting points for research. This forum has a list of recommended surgeons, but remember it’s not a definitive list. The most important thing is looking at independent reviews. 

Hair transplants do not cure hair loss, you need to take medication to stop further hair loss. Getting a hair transplant without stabilizing your hair loss is a bad idea. If you took oral finasteride with side effects you can try a topical. In mu opinion, topical dutasteride is the best topical. Oral minoxidil is better than topical minoxidil, but be sure to speak with your doctor first. 

 

 
https://hairtransplantnetwork.com/best-hair-transplant-surgeons

https://www.hairrestorationnetwork.com/forum/24-hair-transplant-experiences-and-surgeon-reviews/

So follicular unit grafting is the latest and greatest? What makes it better than minigrafting? If I look for a clinic that offers follicular unit grafting, will it be way more expensive?

I'm very, very hesitant to take Finasteride in any form since I had such a severe reaction to taking the oral version. And so I'm going to start taking oral Minoxidil based on your advice and see how I react to it, since what you said makes sense about stabilizing my hair loss since there's no point in getting a hair transplant if the areas around it continue to fall out.

Speaking of which, I have been experiencing an absolutely insane amount of hair loss over the last 3 or so months, more so than I've ever experienced before by far, and it's freaking me out a bit. I'm finding several loose hairs on my face after I shower and several more on my hands after I apply moisturizer, new loose hairs on my dressers and bathroom counters every day, et cetera. I think it's because I stopped taking creatine in preparation for my jaw surgery, since I wanted to take as few supplements as possible just to make sure that they wouldn't somehow negatively interfere with my surgery and recovery. I don't know why stopping creatine would cause my hair to shed like crazy, since I've heard that the reverse can sometimes happen, but it's the only culprit that I can really think of. I also started and stopped Gabapentin around that same time, but I've never heard that being linked to hair loss. I also been using Selsun Blue anti-dandruff shampoo daily over the last year or so, and I heard that can cause hair loss as well.

[Al - Moderator]

4 hours ago, Goosesausage said:

Wow. That's so disappointing. How did they manage to get so many good reviews?

and this:

On 4/1/2023 at 7:40 PM, Goosesausage said:

I really don't know how to find good surgeons, and so I simply typed "best hair surgeons near me" into Google and a hair clinic called Natural Transplants was the highest rated by far.

 

What do you mean by good reviews and the highest rated? If you type in best xxxx near me or top 10 xxxx near me you will always get paid ads for whatever you are searching for. The highest rated are simply the ones who are either paying for premium ad space or they could simply be in a rotation, so that next week someone else will be higher on the list. So the "highest rated" is simply some company paying to advertise on search engines. It's amazing to me how many people don't realize this concept.

 

[Goosesausage]

9 hours ago, BeHappy said:

and this:

 

What do you mean by good reviews and the highest rated? If you type in best xxxx near me or top 10 xxxx near me you will always get paid ads for whatever you are searching for. The highest rated are simply the ones who are either paying for premium ad space or they could simply be in a rotation, so that next week someone else will be higher on the list. So the "highest rated" is simply some company paying to advertise on search engines. It's amazing to me how many people don't realize this concept.

 

I wasn't looking at some sort of ranked tier list where Natural Transplants was at the top. I'm simply going off of ratings and reviews. What I look for is not only close to a perfect 5 star review record (like 4.9 stars out of 5 or something like that), but lots of reviews in total (e.g., 100+) because that reduces the chances of the reviews being paid for or coming from friends, relatives, and business partners or something like that. I also look at the written reviews on Google to make sure that they aren't paid bots or whatever. So I still don't understand how this clinic managed to get so many good reviews if it's as scammy as a poster above me claimed. 

[AlexMeister21]

1 hour ago, Goosesausage said:

I wasn't looking at some sort of ranked tier list where Natural Transplants was at the top. I'm simply going off of ratings and reviews. What I look for is not only close to a perfect 5 star review record (like 4.9 stars out of 5 or something like that), but lots of reviews in total (e.g., 100+) because that reduces the chances of the reviews being paid for or coming from friends, relatives, and business partners or something like that. I also look at the written reviews on Google to make sure that they aren't paid bots or whatever. So I still don't understand how this clinic managed to get so many good reviews if it's as scammy as a poster above me claimed. 

It's hard to trust Google reviews and Yelp sometimes. Last I checked, most of the reviews for Natural Transplants were left by patients like 1 or 2 days after they had their procedure and they were writing things like "went so smooth. They even bought me pizza." Dr. Diep is also rated like 4.8/5 on Google, but he's probably the most unethical surgeon in the United States. Got to look at patients actually documenting their experience on places like HRN.

Edited April 3, 2023 by AlexMeister21

[Melvin- Admin]

15 hours ago, Goosesausage said:

Wow. That's so disappointing. How did they manage to get so many good reviews?

So follicular unit grafting is the latest and greatest? What makes it better than minigrafting? If I look for a clinic that offers follicular unit grafting, will it be way more expensive?

 

Folllicular unit grafting is essentially transplanting hair as it naturally grows on your head. Refined follicular unit grafting makes a transplant look indistinguishable from your native hair. Minigrafting is an outdated technique that hasn’t been performed industry-wide since the 90s. 

Think of it like VHS vs. 4K streaming. 

[Britanium]

Yelp/Google reviews are falsified all the time, it’s so common that it’s become impossible to use when looking for a hair transplant. You could pick any random Clinic and you will notice they are all highly rated, even the worst chain clinics and Hair Mils, some of the most notorious ones such as Bosley, ASMED, HOI, Asli Tarcan and Cinik have equally great reviews everywhere!

The reviews will mostly read the same and most likely left at the start, it’s fully matured results you want to see, and not just what’s written but full journeys including pics. Definitely not cherry picked clinic results.

Forums such as this are great places to look for patient posted journeys, don’t rely on any one particular list, or anyone’s personal opinion, look for yourself and see who’s doing good work.

You will see the same names crop up on who’s doing good work. Look at as many sources as possible, you will notice that even the best Drs/Clinics have the occasional miss, no escaping that, even the worlds “elite” . You can definitely increase you’re chances of getting the best chance of a successful result by going to the more experienced/consistent and well known Drs. 

Edited April 3, 2023 by BRITA-XL

[Gatsby]

44 minutes ago, BRITA-XL said:

Yelp/Google reviews are falsified all the time, it’s so common that it’s become impossible to use when looking for a hair transplant. You could pick any random Clinic and you will notice they are all highly rated, even the worst chain clinics and Hair Mils, some of the most notorious ones such as Bosley, ASMED, HOI, Asli Tarcan and Cinik have equally great reviews everywhere!

The reviews will mostly read the same and most likely left at the start, it’s fully matured results you want to see, and not just what’s written but full journeys including pics. Definitely not cherry picked clinic results.

Forums such as this are great places to look for patient posted journeys, don’t rely on any one particular list, or anyone’s personal opinion, look for yourself and see who’s doing good work.

You will see the same names crop up on who’s doing good work. Look at as many sources as possible, you will notice that even the best Drs/Clinics have the occasional miss, no escaping that, even the worlds “elite” . You can definitely increase you’re chances of getting the best chance of a successful result by going to the more experienced/consistent and well known Drs. 

This ^

[Goosesausage]

I appreciate all of the replies. I know you guys want me to lurk around the forums some more and do my own research, but I'd really appreciate it if any of you have a top 5 list for surgeons/clinics within the USA. If they were within a few hours drive of Washington, D.C., that would be great, but not a deal-breaker. I'm willing to fly to a clinic (within America) to get my surgery done since the cost of a plane ticket and hotel room won't mean a whole lot to me in the grand scheme of things. I really just want the best chance of my results looking good.

[Melvin- Admin]

50 minutes ago, Goosesausage said:

I appreciate all of the replies. I know you guys want me to lurk around the forums some more and do my own research, but I'd really appreciate it if any of you have a top 5 list for surgeons/clinics within the USA. If they were within a few hours drive of Washington, D.C., that would be great, but not a deal-breaker. I'm willing to fly to a clinic (within America) to get my surgery done since the cost of a plane ticket and hotel room won't mean a whole lot to me in the grand scheme of things. I really just want the best chance of my results looking good.

We have compiled a list of surgeons approved by our community. You could use this as a starting point, but you should still research these names here

https://hairtransplantnetwork.com/best-hair-transplant-surgeons