How Many Grafts ? Consultation result with different Doctors

[tuja]

Posted in a different thread but now starting my own on advice of M&M.

 

I am currently in process of online consultation with various renowned surgeons for HT, some of them have sent how many grafts i will need after looking at my pictures:

Dr. Rahal's office: 3750 grafts

Dr. R.Bernstein : 2400 grafts

Dr. Hassan&Wong : 3500 grafts

Dr. Pathomvanich : 2500+ grafts

 

I had a meeting with Dr. Bishan Mahadevia yesterday where Arnolder had his transplant done, I found him reasonable, not selling anything, no pressure, he just told me that whenever I intend to take HT with him just inform 15 days before.

 

But the main thing which worries me is:

 

His estimation of graft requirement: 1850+

He calculated it using a scale(a small aluminium sheet with marking in cms) on my head

 

Also, he said you dont need grafts at the top because hairfall should be stable and it looks like either more hair will fall from the crown or you will get it considerably dense by medicines itself.

 

Kindly comment although M&M has already said a detailed discussion is required but here the difference is 50% and I have already discussed in detail with Dr. Bishan.

 

And yes one important thing, he said in 1 sq.cm. area, you should have not more than 30-35 grafts or at the max 40 because your average scalp at back has not more than 80/ sqcm(specific to me) of grafts, 50% of which is maximum you should transplant.

 

Please comment based upon your experience.

 

Please see more pictures in the subsequent posts, these are the same set of pictures I sent to different doctors and Dr. Mahadevia I have consulted in person.

 

You will appreciate that the cost will also fluctuate humungously with these kind of estimates and geographies.

Luckily I have got Arnolder and Dreamer to post about both the doctors I am contemplating to undergo HT with, will follow closely with you my friends. All the very best with your recovery.

 

AND here I add, Dr. A advised I need 4000-5000 grafts

 

Regards,

tuja

[tuja]

Adding images in the posts

[tuja]

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[M&M]

Tuja,

 

Good work creating a detailed summary of your research so far, along with posting some photos of your situation. Although they are a little dark, it does show the area of work needed. For the benefit of others, I'll repeat myself a bit here as to the range of grafts quoted by the Doctors.

 

Graft counts can vary widely depending upon some of the following information:

 

- Same photos shown to each doctor (I trust this was the case)

 

- Same description sent to each doctor about your thinning / balding, family history, age, etc.

 

- Description in detail provided to each doctor on your desired goals (ie. hairline only, hairline and crown together, hairline density with 'dusting' in the crown, etc.)

 

- Agreement by the Doctor on your goals (ie. if you are 21, ethical doctors may be less aggressive than you desire)

 

- Did either doctor show you with markings on your photos as to where they would restore your hairline, temple points, etc.? Some may bring it lower than others, some may keep it higher but more densely packed. Lots of choices here!

 

- Density -

 

- Doctor's ability - this is a huge one! Some of the top doctors can do session sizes of 5,000+ in one sitting. I'm pleased when I see the top two doctors (in my opinion) that you have received estimates from come very close (Dr. Rahal at 3750 and Dr. Hasson/Wong at 3500). These two (okay, three really) are so good at what they do and can do very large sessions, so if they thought you needed more, they would quote more. If they thought you needed less, they'd quote less, but they do prefer to minimize the number of passes. Based upon your photos, though, you may need one large procedure or two smaller procedures.

 

Now, on the other hand, some Doctors perhaps can only do 2500 in a single session and therefore, they are saying that is all you need... but then you'll require another procedure. To put it into perspective, I had 1662 grafts in my hairline - about the first inch only. There is no way that 1850 - 2500 is going to give you the density you require to cover all of that area. Did these doctors say that this was ALL you'd need... or that this was 'HT one' only.

 

Now, onto the next topic from Dr. Mahadevia, who I have honestly never heard of. Taking a conservative approach with the crown if you are new on the meds certainly makes sense. Is this something you've discussed with the others? Have you responded well to Propecia / Rogaine? Overall, this is good advice. But, when he says that 30-35 grafts per cm2 is the most you should ever get, I do disagree. Have you seen what that looks like? Typically, what Dr. H&W and Dr. Rahal will do is plant the hairline at a thicker density (say 50-60) and then taper back the density ensuring you have nice framing for the face, while not wasting any precious grafts (like some who receive 70-90 cm2 in the hairline).

 

I hope others chime in here as well, as I am certainly no expert!

 

M&M

[tuja]

No more replies (

[Leeson]

I've never been wowed by Berstein, due to his conservative approach. I think the most should be done at once. Your basically giving up a percentage of your life (down time) in addition to the cost of HT. One pass max vs. 2 passes? No thanks. I'd agree w/ the 3500-3750. Honestly I'd go w/ HW or Rahal, as these Madevia/Dr. A, I've never seen their work. Also, that 30-35 cm2 would give a thin look, unless you have great hair characteristics (wavy, course, dense donor)

[Dr. Ricardo Mejia]

Tuja:

You have hair already and you are not completely bald. Consequently there are different game plans.

 

1. Fill in the density between existing hairs to augment what you already have. In this scenario, graft counts can range in the lower numbers and above as you experienced without trying to push the limit. In this scenario, many surgeons would not necessitate shaving your head completely and 2400 grafts can be accomplished without shaving

 

2. Maximize the graft density count per square cm. In this scenario, it is alot easier to dense pack with a totally shaven scalp.

 

The differences may lie in what the objectives are for each physician, the desire to maximize the graft count per cm squared and the area in which they intended to place the grafts and the hairline locations as noted above. Can you comment if any of the physicians said you did not have your head shaven?

[tuja]

Nobody asked me to have shaved head for surgery....

Thanks for feedback Leeson and Dr. Mejia.

 

I need to ask the doctors a little more questions to move further. Doctors in the west are anyways almost 4 times more expensive and are not affordable. Would either go with Dr. Pathomvanich or with Dr. Mahadevia as I am seeing some results from his patients as well on this website.

[Take a chance]

Dr Pathomvanich is a great Doctor. I had my HT done with him. Its still to early to see my results but I was very happy with his service and price.

Cant comment on Dr Mahadevia, never heard of him.

[tuja]

"Take a Chance",

 

Could you please put some of your pictures, pre-op and post-op, also how many grafts you got ?

 

Awaiting your reply.

Dr. Mahadevia is in India, and currently only person I have come across on this forum and nothing bad written about him but he is not recommended on this forum as well so not completely confident......

That's why seeking Dr. Pathomvanich's services but they are also quite costly......could you kindly upload your details. It will help a lot.

 

Thanks,

Tuja

[hairthere]

You should also consult dr. feller. he is a great doc when it comes to balancing an aggressive approach while being cautious and planning ahead.

[riz]

Tuja, Did you consulted Dr. Pathuri Madhu? I have done my HT with him on May 2 2009.

[HairHope]

This is the correct advice.

 

Originally posted by Leeson:

I think the most should be done at once. Your basically giving up a percentage of your life (down time) in addition to the cost of HT. One pass max vs. 2 passes? No thanks. I'd agree w/ the 3500-3750. Honestly I'd go w/ HW or Rahal, as these Madevia/Dr. A, I've never seen their work. Also, that 30-35 cm2 would give a thin look, unless you have great hair characteristics (wavy, course, dense donor)

[arnolder]

Tuja,

 

Only go to Dr mahadevia if my results come out good. Dr. Pathomvanich is a good choice for you to have ur HT done as he is close to india.

[tuja]

Yes Arnolder, I have consulted him as well but just when you move out of India cost increase manifold.......and thts a big constraint for me, so researching my best.....have sent a pm to u. If possible, reply.

[tuja]

Originally posted by riz:

Tuja, Did you consulted Dr. Pathuri Madhu? I have done my HT with him on May 2 2009.

 

Hi riz, can you upload your pre-op and post-op pics, it may help finding a well skilled doctor with proven results in India, lot of people are looking for a great doctor in India for HT but unable to find one.....

[tuja]

Originally posted by riz:

Tuja, Did you consulted Dr. Pathuri Madhu? I have done my HT with him on May 2 2009.

 

Kindly post how to contact this doctor, cant find his/her coordinates on internet. thanx.

[aska]

I trully recommend you to do this HT with some Doctor that uses needles instead blades. Cause you have so much hair and it can be damaged by the blades.

[Bill - Seemiller]

Aska,

 

Your last statement about the superiority of using needles over blades is a fallacy. There are many topics on this issue, so I'll simply link to some of them. The bottom line is, some leading surgeons in the field use blades with much success while others use needles just as successfully.

 

Does using Blades or Needles Cause More Scalp Trauma?

 

Needles or Blades?

 

More on Needles Verses Blades: Redness

 

Best wishes,

 

Bill

[riz]

Tuja,

 

Vsit my thread at http://hair-restoration-info.c...=633101182#633101182

I have uploaded my post op pic here. Dr. Madhu is in Hydrabad. as per his claim he uses ultra refined HT and he creates good density. Evaluate the pic I have atached and decide. For me everything went fine and I am happy so for.

You can contact him at 918832460064.

[aska]

Oh ok, i'm sry Bill, just my opinion.

[Bill - Seemiller]

Aska,

 

There's no need to apologize. If you have legitimate information on why you feel needles are superior, but all means, share it. I've read a lot on this topic, even more recently, and value all opinions on the matter. It's just that "blanket" statements without any evidence are dangerous and I feel the need to comment on this when I see it.

 

By all means, share any information you have that would facilitate good discussion on this. However, since doing so would take the topic off track, I'd either recommend creating a new thread on the topic or replying to one of the topics I linked to above.

 

Best wishes,

 

Bill

[Franklin]

If you have legitimate information on why you feel needles are superior, but all means, share it. I've read a lot on this topic, even more recently, and value all opinions on the matter. It's just that "blanket" statements without any evidence are dangerous and I feel the need to comment on this when I see it.

I agree with Bill on people making blanket satements. I think both do a great job in the right hands. I had small gauge needles from my last ht and my work was great. I have also seen presentations online from both proponents of small custom blades and needles along with results first hand from quality docs. So if you like the work you see in person from a doctor from past patients do you really care what he uses?