which dr?

[mil]

Help! On my consults- one dr said he does only 800 fu at a time since more can fight each other and fall out. The other will do 15-18000 and use staples, not stiches. He's also one of only 40 drs that are on the Board of Hair restoration in the country. He also uses a fu slicer and ultra refined fus.and he used a machine to shoe my hait units.

[Guest Cousin_It]

LOL, does he use a veg-a-matic too? Sounds like this guy is making a salad!

 

My advice to you is forget both of these guys and start from scratch. Research the doctors listed in this Coalition. Narrow things down by looking at thier work, there are hundreds of pictures on file, find ones that are similar to your hair loss and see how well they look after surgery, with this knowledge in hand, fill out the online consultation to the doctors you are interested in and then follow up with those that interest you the most and narrow it down further.

 

Where are you located, how much area are you trying to fill and how much density do you want. These are all key questions that you must address in your evaluation of surgeons. If possible let us know this type of info and perhaps a picture of your hair loss and maybe some members can make recommendations from personal experience. We are all here to help.

[Gorpy]

Hi Mil,

Forget the doctor who only does 800 fu's. He's way behind the times.

 

Forget Dr. Pistone that you mentioned in another thread. I believe he does mediocre work at best. See the posts by a user called dhuge67.

 

Click on the link at the top left of this page that list "Coalition Surgeons". Choose one of those and start some consultations with them.

[Bill - Seemiller]

Mil...here is my best advice:

 

1. Do some more research...there is a lot you should learn before considering a transplant.

 

2. Do at least 3 consultations (physical is best, but if not do a virtual consult) with a coalition doctor. Forget these other doctors....800 max is way behind the times as Gorpy said. Link below to the coalition docs:

 

http://www.hairlosslearningcenter.org/hair-loss-content...s/our_physicians.asp

 

3. Establish realistic goals...depending on your level of loss and where you are destined to be, and depending on your donor supply will all determine how much hair you will restore. You will NEVER be able to restore your high school hair again in terms of density, but you may be able to get some good restoration that looks natural and relatively dense.

 

3. If you are not on Finasteride, get on it right away to prevent further loss...unless of course you are already a NW7....but even still, you could try the medication to see if you regrow any hair. You might also want to try minoxodil (topical solution). I heard Rogaine foam doesn't irritate the scalp like the liquid does.

 

Do you have any photos you can post?

 

Bill

[mil]

Thanks for the responses! Iam a 46 yr old female with hair loss in the temples and crown (will get photos this week to post) Rogaine etc did not work for me. I went to Dr Carlson (bosley) for 1st consult but after reading the boards, forget it, 2nd was with Pistone's guy.He said he does refined fu and one of 40 dr on the board of Hair restoration, was shown photos of work and #'s to contact others. The price for 1800 fus was 6500 which I thought cheap. i have an appoint with Thomas Griffen who'll only do 800 at a time. He was recommended to me by 2 of my doctors who have sent many to him with great results. however, I don't want to have to go twice for operation! I am going to make an appoint with Dr True next. Please give me opinions ! Thanks so much!!!

[mishmash]

i just read your post--I am a woman who had 1600 ht last January with Dr. True--I had male pattern baldness in the temples and along my hairline. I am going back to Dr. True to fill in some areas in the hairline for a thicker look --this time 200 to 300. I think he is very good and honest.

 

It was traumatic to even need the procedure in the 1st place--I mean, this isn't supposed to happen to women is it? I just shut my eyes and went for it--I have told 3 people and no one has ever noticed. It is an ordeal, though. For the 1st month I stayed undercover --my head swelled up --I wore headbands and scarves. I tried to ignore it and not pay too much attention when it was growing in --and when i got disheartened I would think of the alternative and that always got me back on the right path. This time (from what I have read and from my consultation with Dr. True) it will be alot easier. It is all worth it, believe me. You just have to bite the bullet, get it done, endure some unpleasant side effects, try not to obsess and you will finally see the resuls and it is well worth it! Now, I see women everywhere who are losing their hair--and now I realize I was lucky--if this had to happen to me then it was better not to have diffuse thinning so i could be a candidate for this procedure.

[Gorpy]

Unfortunately being on "Boards of Whatever" means very little. Many doctors have VERY impressive credentials yet perform their work poorly. A frequent user here, dhuge67 was highly impressed by Dr. Pistone's credetials and he came recommended to him by others. Dhuge67 went ahead with his surgery despite this community's advice not to. Now dhuge67 is very dissappointed in his results.

 

We are a community of consumers with substantial experience at evaluating levels of Hair Transplant performance. Like I have said before, every doctor will tell you what you want to hear and claim to perform state of the art refined FU transplants. Only a select few will actually perform up to those standards.

[Guest Cousin_It]

Going to Dr. True is definitely a step in the right direction. He is a Coalition surgeon with impeccable credentials. It appears you are in the NYC area, have you considered Dr. Feller? He has done quite a few surgeries for women and is a expert at hairlines. He recently posted the results of his surgery on a woman with excellent results. I have included a link so you can review it yourself

 

http://hair-restoration-info.com/eve/forums/a/albumcomm...651032282#7651032282

[the B spot]

Yep, it is certainly time to check out other Docs!!!!

 

If Griffen or Pistone are your choices, imagine your relief and amazement at what can be done by Doc's in the Coalition!!!!!!

 

Please take some time and review and speak to several patients, look at photos, and see a couple of patients IN PERSON.

A well-established/Top Flight clinic will have several patients that are willing to speak/meet with you.

 

mishmash-- interesting, I must confess that Dr. True would not be my first choice for a female patient, but he is a very solid and ethical Doc by all accounts. I would hope that you could post some before and afters?

It is always a great benefit for me to be able to file away a tidbit of information concerning any Doc, especially concerning female patients.

 

Anyway, good luck and fast growth!!

[mil]

Thanks I made two appointments in Jan with Dr True and Dr epstein. Any opinions between the two?

[JohnS]

I did not like either of them, I had my surgery with Dr.Feller. Why dont you go to the best he is in the same area???

[Gorpy]

Mil, as you can see there are many varying opinions on this open forum. Understandibly, people tend to promote their own doctor. After all, they chose him based on the fact that they thought he was the best. In reality all of the coalition doctors perform consistenly good refined Hair Transplants. If they don't they'll be booted off quickly.

 

I agree that Dr. Feller does fantastic work. I have, however, seen great work done by True and Epstein. It all comes down to doing consultations, and getting a feel for what you are more comfortable with. If possible see some patients in person. It might be more difficult for you to find female patients.

 

Good luck.

[mil]

Thanks! I really appreciate this forum and will do my research.I'll let you know what I find out.

[nikkop23]

I agree that Feller does some great work, though I'm not always a big fan of his hairlines. Some look great, some really don't, as is the case with many other doctors. But I think you also need to consider that one of the reasons everybody says Feller, Feller, Feller every time New York comes up is b/c he maintains a more active presence on this forum than the other 2 doctors. And he has a paid showcase who posts here all the time as well. If True or Epstein were as aggressive about maintaining the same kind of presence, everybody would repeat their names all the time as well. But as Pat has pointed out many times, many surgeons are quietly doing comparable work with little fanfare, so you should make a decision based on comparisons of photos and patients that you've seen firsthand.

[mil]

Thanks for the info. My consults are Jan 26 so I'll let you know how it goes. another thing about my consult with Pistone's salesperson was he said I could get Hair Volume add ons ( like hair extensions) before or after my procedure. he agreed hair extentions were harmful but these were totally safe. I never heard of them.

[Bill - Seemiller]

Feller, True, or Epstein (though I've heard very little of Epstein - but he is on the coalition) are great choices as well as any of the coalition docs. I'd advise to stay away from Pistone, only because from my research over the last few years, I've seen only negative comments about him...no positive.

 

Bill

[Guest Paul M Straub MD FACS]

Greetings to all of the regular members. I, of course, am Dr. Straub from Torrance, California and I have been reading some of the past messages and I am very impressed by your knowledge. I plan to occasionally add my humble opinions but you people are already doing an excellent job advising people who are new to the field.

 

WHAT ARE THE REQUIREMENTS OF A GOOD HAIR RESTORATION SURGEON? First he must have the right attitude. He must ALWAYS have the best interest of the patient as the only goal. He must never put his interest ahead of the patients.

 

He must be able to do MEGA SESSIONS OF ULTRA REFINED MICROSCOPIC CUT FOLLICULAR UNITS. He must have sufficient experienced and motivated staff. And this is what he does when this is in the best interest of the patient.

 

However he must take every factor of the patient's welfare into consideration, his age, his family history of hair loss, the density and type of hair and what is in the BEST INTEREST OF THE PATIENT'S ECONOMICS.

 

First let me firmly state that the only acceptable result is TOTAL UNDETECTABILITY. If we take a given strip of donor hair and we perfectly cut it into exact follicular units we will have a given amount which, properly planted will result in an undetectable transplant. If we take a small amount of the strip and cut it under the microscope such that two follicular units are in each graft and plant them carefully mingled among the follicular units and we get a total undetectable transplant, we have done what is best for the patient. The patient has gotten the same result for a lower fee.

 

This judgment of when and in what ratio you can use multiunit grafts and follicular units requires a good bit of experience. If you push the ratio between the MUG's (multi unit grafts) and the follicular units too high you will not get a totally undetectable result. If you try to do this with straight black hair on the first session, you will not get a totally undetectable result. However you can usually get away with a high ratio of mug's to follicular units with a patient with white hair.

 

We all know that a well done ultra refined follicular unit mega session will be undetectable. But what if the surgeon cuts the follicular units into sub follicular unit pieces? The patient pays more but he probably grows less hair since sectioning a follicular unit has a chance of damaging a follicle enough that it does not grow.

 

For all of the above reasons I feel that it is not fair to the physician who recommended 800 grafts to come to the opinion that he is behind the times without knowing more about the patient. If he had white hair and a small amount of loss this could been an appropriate recommendation.

 

Thanks for letting me have my say.

[mil]

Thanks for the imput. The dr that will only do up to 800 never saw me. the nurse told me that is the amount he does for any patient.It's also in the literature that was sent to me.

[Gorpy]

Thank you Dr. Straub for your input. We as a community, look forward to and welcome your input. Hearing from a hair transplant doctor is always educational.

[Bill - Seemiller]

Great post Dr. Straub and thank you for your input.

 

I have been having some discussion with a few other doctors about multiunit grafts...which also seem to be called:

 

1. Double Follicular Unit Grafts (DFUs)

2. Multi Follicular Unit Grafts (MFUs)

 

It seems, however, different doctors have different philosophies on how these grafts are put together...some with a maximum size of 4 and others with a maximum size of 6.

 

It seems that you are now the second doctor to state that multiunit grafts work better with people with lighter hair, and it makes sense just as Dr. Paul Shapiro defined it in another post about how the light hits the scalp, etc.

 

Despite all the above, I disagree with your conclusion of your statement that a doctor who recommends 800 grafts as a max is not behind the times. I am not stating that there aren't times that 800 grafts are appropriate, but I quote from mil above, "one dr said he does only 800 fu at a time since more can fight each other and fall out." Doing a max of 800 grafts at a time isn't stating that he would only do 800 grafts on this patient because it's in his best interest...it's stating a limitation for the general public. It basically says "no matter who you are, I can only give you 800 grafts at best...though I can give you less".

 

I agree with your assessment above on what makes a good hair restoration surgeon. I'd also add to the mix that he/she must be able to perform consistent positive results over time.

 

Thanks again for sharing your expertise with us and we hope you continue to do so.

 

Bill

[Guest Paul M Straub MD FACS]

Oh, absolutely, the doctor who ALWAYS does only 800 as a maximum is behind the times.

 

I want to clearly distinguish what I mean by multiunit grafts. This means a graft which is carefully cut under the microscope to contain two complete follicular units. This is in contrast to the old minigrafts which were cut to size without respect to the follicular structure. When these grafts are cut under the micoscope they have the same spacing between the follicular units as the patient has on his own head. They are totally undetectable as a transplant if they are mixed in a field of follicular units.

 

I love to do megasessions of ultra refined follicular units and I have an excellent motivated staff to do them but I have a lot of patients who come to me because they can get an excellent result using mixed grafts at a very reasonable cost.

[Bill - Seemiller]

Dr. Straub,

 

I thought once you read that post again you'd agree with me that 800 FU as a MAX is behind the times .

 

Thanks for the clarification on how you define multiunit grafts. I believe that is also how Dr. Paul Shapiro defined a Double Follicular Unit (DFU) graft. I know, however, that he limits his DFUs to 6 hair DFUs, which I assume means he would never double up on two 4 hair follicular unit grafts, and keep it at the max of 2 3s. What is the maximum hair count of multiunit grafts that you will use? Would you use 2 4s (though I know 4s are rare anyway) or would you stick ot 2 3s or 2 2s, etc? I tend to agree with the philosophy that as long as these multiunit grafts are minimal that it could help create a further illusion of density if mixed well with FUs.

 

Bill

[mil]

why do some drs use both fus and mini/micro grafts on some patients?

Also do all drs gaurantee their grafts?

I'm referring to a brochure of Dr Griffen

Thanks!

[the B spot]

The best docs guarantee all of the grafts they transplant, period.

 

On the rare occasion that poor yield/no growth occurs, it is my understanding that all of the Coalition Docs will work through the issue by either retransplanting the area for free or refunding the cost of surgery.

 

I think this is common practice for any ethical clinic to be sure.

 

I think the use of follicular families or double follicular families is limited to specific areas of the scalp and are camoflouged by ultra refined grafts. The biggest use for these type of grafts is purely density (getting more bang for your buck)

 

You should only have 100-150 of these if you are a candidate for their use.

 

Dr. Griffin in Atlanta (Coalition Doc) does some fine work, but I have advised several prospective patients that he likes to do several smaller sessions, so a consult with Doc's that do larger sessions is in order, before you make a decision.

 

Hope this helps you out!

[mil]

I went for a consult today to dr Griffen in Pa.He said he does up to 800 grafts( which are FUs and he leaves the fat connected)and that produces approx 2000 hairs. He doesn't believe in dense packing because they have to strip off the fat pockets and use single hairs, which may not survive.He has one nurse only who implants the FUs. Ointment (antibiotics etc) are put on the area for 24 hrs and then removed.3-4 days later you can soak your head. Some stitches removed in 1 week, the rest in 3 weeks.

Please advise. I really appreciate your imputs!