Potential Recommendation of Dr. Pathuri Madhu of India

[Bill - Seemiller]

Dear Forum Members,

 

As many of you know, we gather as much information as possible about a physician, their staff, technique and track record before they are even considered for recommendation on the Hair Transplant Network. Part of our review process involves getting input from patients and the members of this forum community. To learn more about this review process, click here.

 

The search for a quality physician in India has been long and hard. However, after interviewing Dr. Madhu of India and seeing several examples of his surgical procedure and results, I believe that Dr. Madhu should be considered for potential recommendation by this community. At this time, Dr. Madhu is only being considered for recommendation, not the Coalition. To see our standards for recommendation, click here.

 

Dr. Madhu has a large and experienced staff of 12 surgical assistants and is dedicated to performing state of the art hair transplant surgery exclusively since 2005. He has the staff and ability to perform large ultra refined hair transplants exceeding 3000 follicular units when appropriate for the patient, the largest of which has been 4800.

 

Dr. Madhu is very hands-on and is involved in every step of the procedure from harvesting the donor strip to placing grafts in the crucial hairline and temporal areas. The hairline is reconstructed carefully using single hairs in most patients to most adequately mimic nature. Dr. Madhu may use the occasional 2 haired follicular unit in the hairline in patients with extremely fine hair characteristics. However, since most Indian patients produce hair with a thicker hair shaft diameter, he reports this is very rare.

 

Dr. Madhu uses a single blade to harvest the donor strip and employs the open method of dissection using the fork hooks method to minimize transection. By separating the edges of the wound, Dr. Madhu can easily see and avoid accidentally severing and damaging precious hair follicles. The wound is closed using the trichophytic closure technique with an external continues mattress suture and intermittent nylon stitches. Dr. Madhu believes this significantly reduces tension on the wound and minimizes the appearance of the scar. Follicular units and occasional multi-follicular units are dissected and trimmed under microscopes and carefully placed by Dr. Madhu and his staff into recipient sites to maximize growth yield. Multi-follicular units are used occasionally in those he believes are qualified candidates to increase the appearance of density.

 

Dr. Madhu customizes his approach for each patient using a combination of custom cut blades and needles to allow for a perfect fit of the grafts into the incisions. He uses tools as small as .7mm in order to minimize trauma to the scalp and reduce the risk of post-surgical telogen effluvium (shock loss). Parallel (sagital) incisions are employed for single hairs while perpendicular (coronal/lateral) incisions are reserved for multi-haired follicular units. While Dr. Madhu's use of sagital incisions for single hairs helps him and his staff in identifying slit sizes, he employs the lateral slit technique for multi-haired grafts because he feels it provides a greater illusion of density. Dr. Madhu can transplant up to 50 FU/cm2 into the balding area safely when appropriate for the patient.

 

Dr. Madhu is a member of the ISHRS and is the only physician in India board certified as an ABHRS diplomate. He also has a strong background in dermatology.

 

Given Dr. Madhu's experience and commitment to ultra refined follicular unit hair transplantation, I believe that he should be considered for recommendation. See our standards for recommendation.

 

View some of their patient and surgical photos below:

 

4450 Grafts in 2 Sessions with Dr. Madhu

 

3520 Grafts with Dr. Madhu

 

3250 Grafts with Dr. Madhu

 

3120 Grafts with Dr. Madhu

 

3200 Grafts with Dr. Madhu

 

2940 Grafts with Dr. Madhu

 

3140 Grafts with Dr. Madhu also with Post-ops

 

2420 Grafts with Dr. Madhu also with Post-ops

 

3180 Grafts with Dr. Madhu

 

Surgical Walkthrough Album

 

New:

 

Patient Received 3150 Grafts with Dr. Madhu and Additional Surgical Photos

 

I welcome input and comments from forum members regarding his potential recommendation.

[MikeTheDane]

I agree. So far Dr. Madhu has shown really good work and he deserves to be recommended.

[Maxxy]

I also agree. From what I've seen, Dr. Madhu seems to be producing consistent, impressive results.

[thanatopsis_awry]

I'm impressed by Dr. Madhu's work, but also his attitude. His response in other threads to curiosity, if not skepticism, was strong yet professional.

 

My one request, at least going forward, would be more close-up post-op photos, especially on cases where, admittedly, meds likely could be helping out in non-surgical areas.

 

But end-results and attitude are what matter the most, and he looks to deliver those in spades.

[hair_care]

I am very glad to hear Dr Madhu being recommended. Finally all Indian patients will have a good doctor, close to home. I hope he continues displaying examples of his work on this forum.

[rpachigo]

I absolutely concur with his recommendation. His results have been extremely good thus far. One very slight concern of mine would be his donor closure technique - if you are using a continual horizontal mattress stitch, there should be no need for these intermittent nylon sutures. Two external stitch closures are superfluous and possibly a little asphyxiating. I would presume that he places a subdermal absorbable layer before skin closure.

[Forrest Gump]

I totally agree.

 

As others have pointed out, not only are Dr Madhu's results very impressive, his demeanor on this forum has been very professional and courteous, when it came to responding to some posters' skepticism.

 

So, good results + good attitude = potential recommendation.

 

I hope that in the future, he would continue to post pictures, including some immediate post-ops.

[aaron1234]

I like what I see from this guy. Some great illusion of density. I do echo Thana.. need some immediate post-op pics. But love the final results.

[riz]

Yes, I agree. See my results from Dr.Madhu.

http://hair-restoration-info.c...=121107783#121107783

[Bill - Seemiller]

Guys,

 

Thanks for your excellent feedback on Dr. Madhu's potential recommendation so far.

 

For those of you wanting to see some post-op photos, in case you missed them, 3 albums I linked to above do contain surgical examples.

 

Riz,

 

It's nice to see a satisfied Dr. Madhu patient posting results. I encourage you to create a patient website to share your experience and detailed before, surgical, and after photos. Then, you can link your website in your forum signature so that every time you post, our members and guests can read all about your experience and see your results. For instructions on creating a patient website and linking it to your forum signature, click here.

 

All the Best,

 

Bill

[HaiRisWhere]

Good to finally c a doctor from india being considered for a recommendation on this site.its been a really long time.his results seem to b really good..but!!! its just too good to be true..i wud like to c a lot more of immediate post-op pictures from him

[subbu]

HAI PALS

IAM FROM INDIA , ANDHRAPRADESH ,THE SAME STATE WHERE THIS DOCTOR MADHU BELONGS TO. IAM THIS FORUM MEMBER FOR THE PAST 1.5 YEARS.I AM A PERSON WITH NW5 BALDNESS AND IS PLANNING FOR A HT. CAN ANY OF THIS DOCTORS PATIENTS VOLUNTEER TO MEET ME. I WILL COME AND MEET YOU AT THE PLACE AND TIME CONVENIENT TO YOU .I WILL BE VERY THANKFUL FOR THAT.IT WILL BE VERY MUCH HELPFUL TO ME. I THINK IT WILL ADD TRUST TO THIS DOCTOR BEFORE GETTING RECOMMENDED.

[us]

Dear Bill

 

It is a matter of great honour that Dr Madhu is being presented on HTN for recommendation. The results in pictures also seen very good but it will be appreciated if the transplanted hair are not mixedup with the left side original hair to show density. through pictures it is quite obvious that the left side hair are combed in with transplanted hair thus hidding the original effect of procedure, plus the hair line is also very clearly prominent in 2 cases. I would suggest here that the scar marks should also be shown in all pictures. needs here more clear pics with pure results, otherwise anybody can send these types of pics to get recommendation on HTN. I appreciate HTN for doing a detailed analysis of a Dr before recomending, and welcome opinion from public. It is strange that everybody has appreciated the DRs work through pics but nobody noticed the flaws.

There are so many Drs. who are doing good surgeries but their results can not be compared with the world class Drs. like DR. Ron Shapiro,Dr. Seler, Dr Hassan & Wong etc. Same is the case with Dr. Madhu as well. Apart from the technical tools being used in these surgeries his results are quite ordinary and such results can be produced after 1 or 2 years practice i dont mind your recommending Dr Madhu in India as there should one from India as well but i am sorry to say that your this recommendation is not up to the HTN standard.

[Bill - Seemiller]

HaiRisWhere,

 

I appreciate your feedback,

 

One thing to understand is how hair characteristics can strongly influence the appearance of density. Though you say his results appear "too good to be true", given that most Indian men have thicker, wavier hair with minimal hair to scalp color contrast ratio, their hair can appear quite dense with a smaller amount of grafts.

 

I strongly recommend reading Coalition member Dr. Arocha's article on How Hair Characteristics Impact Hair Transplant Results which I believe strongly applies here.

 

Dr. Madhu recently posted another album for review. This album includes one patient who received 3150 grafts and toward the end of the album, posted a few examples of additional patients immediately after surgery.

 

See Patient Received 3150 Grafts with Dr. Madhu and Additional Surgical Photos.

 

All the Best,

 

Bill

[Forrest Gump]

Bill, thanks for posting the link to the new set of pics with the immediate post-op pics. Looks like neat and clean work.

 

Somehow I missed this album before, and hence expressed interest in seeing results of immediate post-ops.

[Blake Bloxham]

Dr Madhu's immediate post-op pictures demonstrated very refined, professional work and I think this dedication backed up the impressive 'after' results. I think, with the addition of the post-op photos, he is definitely worthy of recommendation, and it will be nice to have a recommended surgeon in India!!

[Dr. William Parsley]

His work is very impressive. I would vote to recommend him.

Bill Parsley

[Raphael84]

His work seems very solid, consistant and impressive. As has been mentioned, that with the Indian male, the hair colour and skin tone ratio is minimal. Instead of using this as a negative against the Drs results, it should be used as a positive. Dr Madhu uses this as an absolute advantage, making the most of this characteristic, assisting in such impressive final results. This only makes sense to myself. I think what it all comes down to ultimately, is patient satisfaction. I dont belive that any of the patients whos cases have been supplied here, will feel anything other than satisfaction!

 

Having said that, I would be most interested in viewing any possible procedures that have been undergone on white caucasian males. Is this at all possible?

[Pratik]

wowwwwwwww its good to see finally doctor from india got recommendation from forum.Good News guys

Thanks a Lot Bill for your analysis about Dr.Madhu.

-Pratik

[drmstx]

I had 2 consults with Dr. Madhu in India in February '09. I was very very impressed with the patient results that he had shown me then. Though the doctor was not very forthcoming about certain information about some of those results, I managed to extract some info and remember that patients who underwent the surgery at least twice had some pretty cool results compared to the ones who had the surgery just once (we all know this, but the point is that the doctor was trying not to reveal the number of grafts and number of sessions for some reason).

 

For about 50 cents per graft, this is the only financially viable option for many Indians suffering from MPB.

 

I would no doubt recommend this doctor on this forum. But I do have a few concerns.

 

Procedures:

 

Bill, that info that you posted about Dr. Madhu's surgical procedures (trichophytic closures, single blades etc); Are they based on what he told you or did you personally go witness a procedure in India with the Dr.?

 

Number of Grafts:

 

This is true with any surgeon I guess. Some of the patients I spoke to said they received ~3000 grafts. We all have to take the surgeon's word for this, but I have a feeling the doctor plays with the graft numbers a little.

 

Information about the medications:

 

This was the thing that ticked me off the most and argued about it with both the Dr. and his patient counselors. They blatantly tell you that Finasteride (Propecia here in the US and Finpecia in India) has no side effects AT ALL !!!. I believe the patients should be educated properly about the medications before prescribing. My guess is that those counselors have no idea or information about the drugs and the Dr. does not bother to correct them.

 

And as with any other health-care/medical institution in South Asia, you cannot really expect any privacy in the clinic. When I went to meet the Doctor, I saw at least 3 patients who came out of the surgery room (with fresh sutures etc) being paraded openly in front of the others waiting for their consults. there should have been a back door kinda thing for these patients to leave the clinic after their surgery.

 

This Doctor is hugely popular in that part of South India, you can tell that by the number of consults he does every day. He performs at least 3 procedures every day (~15-20 per week including on weekends).

 

If you guys remember, this was the same doctor whom people on this forum wrote off too soon because of his inability to write and respond to emails. When I asked him about this, he told me the story of a guy from London who had emailed Dr. Madhu with some clumsy pictures and asked him to estimate the number of grafts he needs and the costs etc.,. Imagine getting like ~200 of those emails everyday. Given the number of patients Dr. Madhu sees every day, this exercise of responding to emails with crappy photographs and pointless questions is definitely not worth the time or the effort. And I could understand the doctor's situation there.

 

Purely from the viewpoint of his results, Dr. Madhu can certainly be recommended on this forum. I am not sure if the issues that I have mentioned above are parameters that affect recommendations, but it sure would be a good idea to for Dr. Madhu to address those issues in the near future. Hope this helps.

 

~R

[thanatopsis_awry]

drmstx,

 

Could you clarify what you mean by "I have a feeling the doctor plays with the graft numbers a little."?

 

Also, are you sure that Dr. Madhu performs 3 --if not more -- surgeries in a given day?

[Blake Bloxham]

Hmm, that '3 plus surgeries a day' comment is a little disheartening. Bill, would you mind trying to contact the doctor and ask some questions about the number of surgeries he does per day?

[Bill - Seemiller]

drmstx,

 

I appreciate your concerns and I'll do my best to address them.

 

I've done extensive interviewing with Dr. Madhu via email, phone, and through photos. If you take a look at his surgical walkthrough album, much of what he told me can be validated including his use of a single blade to harvest the donor area, the fork hooks method, microscopic dissection, etc. In fact, the reason we require a surgical album for surgeons being considered for recommendation is to verify what we're being told.

 

Regarding, performing 3 hair transplants a day, what you don't understand is that while his clinic performs 2 or 3 daily, there are 4 physicians, several junior physicians, and 12 surgical assistants. It is not unusual for clinics with multiple physicians and a large staff to do this many procedures a day.

 

While in person visitations and observing clinics in person certainly can verify what we've come to learn, it isn't always feasible in a timely manner. Pat Hennessey, publisher of the Hair Transplant Network may be traveling to the eastern part of the world in the coming months and I know he would like to meet with and observe Dr. Madhu in live surgery.

 

Given all the excellent work we've seen from Dr. Madhu over the last several weeks and his prompt responsiveness to member's concerns, I think we ought to trust our eyes and instinct on this.

 

Best wishes,

 

Bill

[Dr. Pathuri Madhu]

Hello guys,

 

I am very happy to see the comment made by Dr. Bill Parsley.

 

Reg. no. of surgeries: We have big team of 12 surgical assistants and 4 doctors who are ISHRS members, and a cosmetic dermatologist and 3 more junior docs. We also have 3 surgical theatres. Performing 3 surgeries is not a difficult task for us. It entirely depends upon the case, if they are bigger sessions, we adhere to 2 cases and if smaller sessions, we go even upto 4 cases. The other 3 ISHRS doctors are also, even though we are not projecting them, doing a great job. They are also upgrading themselves by attending many international workshops and conferences. They participate to a great extent in dealing with the surgery. This you can appreciate if can click this link.

 

http://www.hairhospi.com/aboutourteam.html

 

Reg. counting of grafts: As far as i know, we have one of the most transparent systems in counting the grafts in hair transplantation procedure . Actually we arrange 20 grafts per tray which were shown even in the surgical album. It is much easier to count the no. of trays and multiplied by 20 gives you the total no. of grafts and we arrange the one haired, two haired and multi haired units in different colored trays to make it very easy to count and transparent. We even encourage the patient's attendants to count and we have instances where some of the patient's attendants counted to their satisfaction. You can witness the same from the link given below or from the surgical album which we posted earlier.

 

http://www.hairhospi.com/Counting.html

 

Regarding privacy: During the month of Feb'09, we were establishing in Hyderabad. Only half of the premises (2500 sq. ft) out of a total 5200 sq. ft had been used for the purpose. But now, we are fully open and we have a separate consultation wing no way related to surgical wing. Now we have junior doctors to counsel who are fully trained. This can be appreciated by visiting our web site through this link.

 

http://www.hairhospi.com/aboutourcentre.html

 

And even I am fortunate enough to have a good no. of my patients who are qualified doctors (15-20%).

 

Thanks & regards,

Dr. Madhu.

[drmstx]

Thana,

 

What I meant was that there is a possibility the doctor might exaggerate number of grafts than what he had transplanted. For a couple of patients, I could not believe they were transplanted with ~3000 grafts. It looked more like ~2000-2500. But I see the doctor himself has clarified the issue for us, so no more concerns in that regard.

 

Bill,

 

I apologize I forgot to mention this before: I am pretty sure the clinic does 3+ surgeries a day, but yes, it includes work by the other physicians and assistants as well. His wife is also one of the physicians (apart from many other doctors) who works there in the clinic. Again, the doctor himself has responded to most of the issues (privacy, # of grafts etc)here so no more concerns.

 

Dr. Madhu

 

We really appreciate you taking out time to respond on this forum more frequently. Your recommendation on this forum only means that there is hope for balding Indian guys for whom an expensive transplant surgery abroad is still a distant reality. Thanks again for the great work and we hope to see these consistently good results in the future as well.