View Full Version : Why so many different survival rates for scar grafting?
03-22-2012, 05:24 PM
I have recently been looking into repairing the donor scar I have from strip surgery. It has not been an easy decision..... I have first looked into micropigmentation but thats not the look i'm looking for, and honestly you can still see the scar. I saw some impressive results from a couple MD's but wonder if that is the exception. I have spoken with 4 very well known MD's and I'm getting a huge success range:
Dr A ..... 30-50% :(
Dr B ..... 85-90% with RPR and Acell :D
Dr C ..... 70% :)
Dr D ..... 30% :mad:
Obviously it is hard to decide what to do with stats like that! :confused:
I'd love to hair (sorry about the lame pun) from a few experts and even patients who have done this.
03-23-2012, 12:19 AM
i would choose none of them. reason Ė low yield aside, when they try to repair an old scar, they just create losts of new scars therefore. they just spread the old problem, even when the procedure is successful
I ve had 1032 beard grafts , grafted into my strip scars, I have no marks or visible scars on my face ,from the extractions . The grafts are growing and so far at ten months post op the growth is as expected . As with all hair restoration procedures it depends on who is doing the procedure , My Dr is Dr Bisanga at BHR Brussells feel free to have a look at my thread
Dont believe the hype on acell and prp , unproven ,untested and no results
hope this helps
Are you refering to yield of grafts placed into scar?
I agree with Ejj - Acell has no proven results and on the contrary i've seen a few scars with "acell" and not impressed in my honest opinion. The guinea pigs found that out the hard way:(
03-23-2012, 07:17 PM
Ejj...... I just checked out your link. I have to say, those results look quite good. I'd say you got quite a great success rate. Sort of proves the 30% docs wrong....at least I'm hoping so anyway. I have to asume going in for another round would result in an even better outcome do to better vascular support? I'm hearing the number one problem with scar grafting is the lack of bloodflow or vascular support. If that is the case wouldn't you have a 0% success rate?
Spex..... can you explain why Acell is a waist of money? How did users find out the hard way? Does it do damage?
PM ej above and get his personal opinion.
acell = .. run for the hills ....
03-25-2012, 09:00 AM
acell = .. run for the hills ....
.... Please enlighten me! i wonder why some MD's swear by it and others don't.
probably because there is an economic downturn and they need to sell there procedure harder
03-25-2012, 09:03 PM
Does anyone have links to photos or examples of "Acell disasters"?
03-29-2012, 03:27 PM
FUE seems to be the way to go for adding hair grafts to an existing suture line scar instead of cutting out the old scar only to have a "wait and see" hopeful attitude. The nice thing about FUE to the scar area, you can always add more later if you want. Survival rate will vary on the quality of the grafts and the amount of scar tissue in the area.
John P. Cole, MD
03-29-2012, 06:57 PM
There are studies that show the benefit of Acell on the growth of beard hair and chest hair in strip scars. This data has been presented at more than one scientific meeting and it has been published in the Hair Transplant Forum. There are numerous physicians who rarely attend scientific meetings. They often do not think there is anything to learn so they just don’t go. Mean while scientific data continues to build and be presented.
There is scientific data to support the capacity of Acell to promote follicular regeneration in the donor area. To date we have seen as much as 54% follicular regeneration in FUE extraction sites.
Acell is not going to improve the width of strip scars. Jerry Cooley feels that Acell will make strip scars feel more like normal skin.
Acell can help FUE hypopigmentation appear smaller in diameter when follicles do not grow back. All of this has been presented more than once to a scientific body of physicians.
Acell is not available in Belgium. Therefore, do not expect anyone there to recommend it or offer it.
I have heard that some physicians think that Acell makes the strip scar appear more red. This is possible because it stimulates angiogenesis. That means healing. Still red is not something you want in a strip scar if you can help it because it makes it more noticeable.
PRP alone has been shown to stimulate increased hair coverage in some, but not everyone seems to respond. The response is quite variable it seems. Adding Acell may help patients respond better. On top of that, it is possible to vary the hematocrit and PRP concentration so we may find that there is an optimal concentration that has a more positive influence. We do know that PRP will stimulate stem cells, improve healing, and might influence hair diameter.
There is no procedure (FUE, Strip, body hair) that has not had an occasional poor result. There is no physician who has not had a poor result. It fortunately happens rarely, but it may occur. No physician is immune from it. Therefore, it would be ridiculous to suggest that on occasion Acell might make a strip scar more red. Maybe you saw the first two and they were bad. Maybe the next 50 would have been good. I know my first chest hair transplant back in 2003 was fantastic. Then the bad ones came and it turned out that body hair growth in general works well in only 50% of the patients. Beard hair is different, though. It is between the scalp and the rest of the body in terms of growth. For me, I recommend head hair first, beard hair second, and then the rest of the body.
All right. Here is the skinny on strip scars. Head hair grows great in them. The blood supply is fantastic in strip scars. High densities tend to grow well in them. Still, I recommend that you have a lower density placed in your strip scar because sometimes the growth is not as good in normal skin when you have a higher density placed. I’ve never seen poor growth in a strip scar with head hair, but that means it will happen to me one day. Body hair is a different animal. About ½ the time it grows well and then it is visible in only ½ the patients. That means it tends to work out well in about one in four patients. Beard hair works well at all times. Expect a 60% growth from beard hair. As I stated, we can push the yield up with Acell and PRP based on initial studies.
I use PRP and Acell on a regular basis. I’ve never seen an adverse event from them. Of course, I practice only FUE and I’ve practiced nearly all FUE for the past 10 years. The reason I use PRP and Acell is because they can improve results in some patients. In a few, they can make results awesome. I also use liposomal ATP with my patients. I supply energy to the cells in the Petri dish and then directly on the grafts prior to implantation. Why? Because it may matter to one of my patients. It may not affect nine out of ten, but it might benefit the 10th. It’s sort of like the guy who walks along the beach tossing starfish back into the water that washed up on shore. When asked why he bothers because he can’t toss back the thousands of star fish that washed up on shore the night before, he replies, “well, it matters to this one”.
No one ever knows who is going to be the patient who benefits from cold storage, liposomal ATP, advanced holding solutions, PRP, and Acell, but if it makes a difference for you, I’m sure that you are going to be happy. Bad outcomes do occasionally occur so the more things we can do to help prevent them, the better for our patients.
The bottom line is this. Most physicians do not add new technology to their practice until it has been around for 10 years. If it makes the 10 year mark, you might see more and more jump on board. Think about it. 10 years ago there were three physicians in North American including myself offering FUE. All the others said it was a bad procedure and that it would never work. Well it did and now it is here to stay. Acell, PRP, cold storage solutions such as hypothermosol, and liposomal ATP cost money. You are not going to find most physicians spending extra money until the patients begin to demand. That’s what happened with FUE. That is what is going to happen with advances in cell biology. Quite frankly, that is where the real jump is going to most likely happen in hair transplant surgery.
Yes, products like Acell and PRP need more research and objective data. The data is still in its infancy. Adding additional improvements such as liposomal ATP are simply one additional improvement because cells cannot manufacture ATP in sufficient quantities without oxygen and there is no oxygen supply to cells sitting in a Petri dish.
There is not such thing as an Acell disaster, quite honestly. There is plenty of cheap, however.
many times on this and other forums I have requested that Drs contribute to a repair fund , i believe that if 60 Drs threw in 1k per year to a repair fund then six patients could be helped out yearly , what matters is what help a patient receives when things go wrong ....
I am the victim of eight prior strip procedures , each time prior to a procedure papers are signed , I spoke to a person who informed me that a certain Dr in California is the most ` litigious` Dr he had ever come across , my view is that this ` may ` be standard practice across the industry and restricts information and ` may ` explain your comment re ` cheap talk ` as it ` may` appear that way due to restrictions on what can be said.
That said I applaud the fact that you only offer fue
03-30-2012, 03:24 AM
Nice post Dr. Cole. :cool:
ps Acell isnt approved for use on humans in the european union .
Is it really to much to ask for just `one ` set of photographs showing a strip scar ,half treated with acell the other without , and say 20 fue extractions again half with acell the other half without , also photographs showing the donor regeneration , photographs showing the extraction area post op then six months later showing shaved down hair growing out of the extraction sites ?
would be good if any patients could chime in with there results either good or bad as acell has been being used since 2009 now .
John P. Cole, MD
03-30-2012, 06:11 AM
ok, i'll put something up on Acell. What I did in the scar study was to take a patient with two scars. Donor scars are great for evaluating yields because they have no hair in them, usually. A trichophytic closure may leave some hair in the donor scar, but most of the hair that is supposed to be growing in the scar doesn't. One thing that has always baffled me is where does that hair go after chopping off the top of the follicles. i guess it just dies. Anyway, scars have not hair usually. When you do hair count studies on the balding scalp, you never know if the growing hair is preexisting hair that was in a resting phase or whether the growing hair is one of the grafts. With scars, you don't have that problem. They are a dessert without hair.
I put beard hair in one scar and added Acell and PRP. Scars have good circulation, but it is not as good as normal skin. PRP helps deliver more of the stuff needed for healing that will be in limited supply in areas where the circulation is not very good. This is why PRP on chronic wounds works so well. PRP brings the growth factors and proteins needed to repair injured skin. Scar tissue lacks some of this too, which i why i like PRP here.
Anyway, i expect a 60% yield with beard hair when i use it. I've done several hair yield studies with beard hair over the years and this is a pretty common yield in normal skin. I added PRP and ACell to one of the scars and planted 50 Beard hair. The yield was 92% in this scar. In the other scar I did not add PRP or Acell and the yield was ZERO. This was well below what i would expect. Then the patient came back. I added PRP and ACell again to this second scar and grafted it again with Chest hair. The yield this time was 100%. Chest hair is even less likely to have a high yield.
The one issue that concerned me with Acell from the beginning was how to deliver it. I think putting the powder directly in the extraction site is the best option, but it is impossible to remember which sites have been treated and which sites have not been treated. It is also impossible to deliver the Acell well because it has plenty of static charge and sticks to everything. When it is placed in a gel, it is much easier to deliver and make sure that every extraction site is treated.
I've not seen better than a 54% follicle regeneration rate yet. What i do is note the number of extractions I do from each of the 8 major donor regions and each of the 6 minor donor regions. Then I can go back and count the number of empty extraction sites with a pen that counts the number of times i touch the skin and place a mark on the empty sites.
Remember that Acell may not eliminate hypopigmentation. It will make hypopigmentation smaller though. Often times I still see hypopigmentation in extraction sites when regenerated follicles are growing through them. Acell seems to make them smaller, but not eliminate them entirely.
One interesting thing about hypopigmented sites is that they are larger than the punch that is used. They are usually about 1.79 mm in diameter regardless of punch size. With Acell they are much smaller.
I will put up some photos when i get some time.
I've heard a variety of reasons why Acell is not available in Europe. One reason is that the company does not have enough product to supply the world at this time. Maybe I'll call the company to find out what is going on with Acell abroad. I suspect it will not benefit every patient, but again, if you are the patient that it benefits, you are going to be happy. With FUE, I've used it on over 1000 cases and I've never seen a single patient have an adverse reaction to it.
With PRP my only concern is that it can increase frontal swelling. There are different concentrations of PRP and there are different cell components in PRP. I have a new machine where i can specify the exact concentration of the various whole blood components and mix different types of PRP. In other words, I can make a 1 to 1 concentration of PRP with a low hematocrit to treat my wounds (recipient sites and donor area extraction sites) and a higher concentration of Platelets to treat the grafted area and native hair. Before, i could mix a high concentration of Platelets, but it also had a high concentration of granulocytes. Granulocytes are fine for fighting infection, but they also induce inflammation. Patients don't want or necessarily need this and it is not going to necessarily help hair grow. Therefore, I love the new equipment where I can dial the hematocrit way back and eliminate the cells I don't need for cell growth. This is one of the things i'm talking about with regard to the advances in cell biology.
There are several phases of a transplant where things can go poorly. One is the harvesting phase. If you harvest poorly, you damage hair coming out. It is much easier to remove follicles in a strip procedure than with FUE. We are seeing more and more physicians offer FUE, but sadly, they are often not getting good training and performing poorly. My suggestion is to find a physician who specializes in FUE if you want FUE and if a physician specializes in strip harvesting, go with him for the strip. If the physician offers both, he is more than likely not a master of one of them. The next phase we are concerned about is graft production ,which is required in strip surgery, but unnecessary in FUE. Unfortunately, lay individuals do the graft production with strip surgery so physicians don't control this aspect of the procedure. Then there is graft storage where we want to minimize injury due to a lack of oxygen, cold storage, warm storage, and time out of body. Next is the re-implantation phase. This is where i think most of the damage occurs to cells, when it occurs. Replacing cells into the recipient area exposes them to oxygen and this leads to the production of free radicals including hydrogen peroxide, super oxide, and the hydroxyl radical, the most lethal of them all. Some damage may occur from dense packing and some due to problems with revascularization. We don't know all the pathways to destruction yet. What i do know is that strip grafts have adipose on them and this may protect them from the damaging affects of re-implantation to some degree. With FUE grafts there is generally no adipose so the follicles are more exposed to the dangers of repercussion. I think this is one reason to limit temperature, use free radical scavengers, and add energy sources to FUE grafts.
John P. Cole, MD
03-30-2012, 06:24 AM
on the subject of repair work, there is a thing called operation restore. This is a fund that helps patients get repair work. It is an off shoot of the ISHRS and they are quite proud of themselves for setting it up.
I donated 4500.00 to it last year. A number of physicians also contribute up to 2000.00 to this fund. There are physicians who do the repair work for patients in operation restore. I think the fund pays for your hotel and travel, while many of the doctors donate their time in exchange for the right to market your photos. i'm personally not involved because I do the work for free many times and did it for free before there was an operation restore. Also, i have no desire to use patient misfortune to promote operation restore, the ISHRS, or myself. This is how the fund got off the ground. One doctor treated a child that was a burn victim and then posted the child's photos all over the place. I was happy to see the youngster get a more normal look, but hated to see the child become the poster boy for hair restoration surgery even if done under the banner of a non-profit organization.
What bothers me about repair work and patient cost is that the repair work is much more costly than doing it right the first time. If someone needs repair work and they are worried about cost, it is best to find a physician who will work with them inside their budget. That is what i've always tried to do.
Of course, repair work can be challenging. It is not always easy to do this. It often takes many procedures. Goals can sometimes not be achieved because one is often limited to sources that do not have high yields. This includes body hair. I once had a patient who needed quite a bit of work and he had 500 beard hair and 500 scalp hair grafts. He needed much more. He spent his budget getting the first bit of work and then he was demoralized because he was out of money. That is where the physician just needs to kick in and do more work on the house to help the patient get over the hump.
I gave about 80,000.00 to charity last year. Making money to give to charity is not always the easiest thing to do, but giving one's time is easy.
Dr Cole ,
Thank you for taking the time to reply, with such a detailed account , its very much appreciated .
I myself am undergoing repair using beard hair grafted into strip scars , so its of huge interest personally .
Am unsure re operation restore as i thought it was solely for accident victims , and not applicable to hair transplant failures/ repairs , please feel free to correct me if im mistaken .
Again thanks for the reply , all the very best
John P. Cole, MD
03-30-2012, 12:30 PM
I'm not sure if operation restore is only for "accident victims". I'll do some snooping. I can't imagine why they would not consider repair work part of operation restore, but I would guess that perhaps the hierarchy at the ISHRS might consider bad ideas and bad work acceptable results. In other words, I've heard them say for years, what are you patients complaining about? It's just plugs, mini-grafts, pitted grafts, ridging and strip scars so why are you upset about them?
I had one yesterday. He was 19 when the largest TV advertiser got ahold of him. He had absolutely no hair loss what so ever and still doesn't. What he did have was grafts in his temple recessions like woman though. I took out about 300 grafts. Of course they told him they'd done 2400, but he did not have more than 300. I rotated them all to his strip scar. The chief medical officer of this group told me that he should not be blamed for what happened in his group prior to his arrival in 2001. Of course, this one happened under his watch so next time I see him, i'll let him know that it does not appear that much has changed with the group. At least they are working on hair multiplication. Maybe that will make up for their prior sins.
Dr. Bisanga started in the hair transplant field in my office, and I set him up in his first clinic. He is capable. You should be in good hands ejj. He eats a little too much, but he is a good hair transplant surgeon. You'll be fine.
03-30-2012, 01:01 PM
FUE seems to be the way to go for adding hair grafts to an existing suture line scar instead of cutting out the old scar only to have a "wait and see" hopeful attitude. The nice thing about FUE to the scar area, you can always add more later if you want. Survival rate will vary on the quality of the grafts and the amount of scar tissue in the area.
From what I have observed, that really depends on the individual patient. If the wider strip scar was more attributed to incompetence, and the patient has the scalp elasticity to "reclose" then removing some of the scar tissue and then utilizing Acell, PRP, etc, can make a dramatic improvement. Not on all, but some..
The problem with scar revisions is yes sometimes the wider scar is due to a healing issue and not incompetence. Cutting again can potentially make the new scar worse than the first one. And also, the blood flow is compromised everytime more cuts into the tissue are done. The less blood flow, the more scarring is left which any way you look at it will compromise yield.
Hopefully scar revisions are being done with closer scrutiny verses a wait and see what happens approach.
03-30-2012, 05:48 PM
Since I am a patient of Dr. Bisanga I would describe him as more than capable. In my opinion he stands out as the best but of course I am a patient so many others will debate this statement. What I can tell you about him through my own experience is that he is a very soft spoken, down to earth, and a kind hearted person. This is also evident in everyone that works at BHR. He seems to employ those that are similar to himself and those same traits in those that work there are what make it a complete clinic as one person alone does not make a clinic.
Actually I was a little shocked at how down to earth he happened to be. I have worked for years in customer service and hospitality. When someone ever asked me what occupational group represented the worst in customers without a doubt it was always doctors. They were the most arrogant, the cheapest and always treated the service staff like shit.
As far as Acell is concerned the debate will end when substantial photographic evidence is presented. At this point is simply does not exist.
03-30-2012, 06:07 PM
Thanks Dr Cole for the detailed information I was looking for. It helps quite a bit and hopefully this information has helped others who had similar questions. I think we are all looking forward to seeing those photos. Being someone ready to pull the trigger on my strip scars, this information has eased my mind quite a bit. Obviously, I don't want to waist 800 grafts if only 30% grow. Especially when I could use them else ware.
In regards to strip scar revisions, I like the Idea a Physician has brought to my attention about revising only small sections at a time. If a scar was 16cm in length.... a 4cm section would be revised and 6 months or so allowed to pass before revising another section. Obviously this allows the existing and old scaring to minimize the tension to the revised area. I was told this does not completely prevent stretch-back but does decrease it substantially. Hell, a 3mm scar is a hell of a lot better than a 6mm scar. Dr Cole, have you had any experience with this?
.... I see the horrible scarring issue that ejj is dealing with and I wonder why there isn't some sort of guideline or test designed to spot patients who are prone to scarring issues like his. Obviously if a "test" area was done and he knew the pending results, he never would have gone down this road. I doubt any of us would have gone down this road..... Strip harvesting anyway. ejj your results so far look great, your obviously in the right hands. best of continued luck with your scar grafting.
04-16-2012, 11:58 AM
Anyone who feels the way that you do about Dr. Bisanga many times state that they feel their doc is "the best". I would wholeheartedly agree that he is one of the best and also have always agreed that talent is not enough. Ethical characther is vitally important especially in this field.
04-16-2012, 12:09 PM
It's in the preliminary consultation with "every patient" that the doctor review that patient's medical history which IMHO, should always include the area of healing from past and present wounds/lacerations. It's in the physical examination that the doctor can potentially look through the individual's scalp, test laxity, etc. That does not imply that this will prevent scarring but should the doctor discover something that could compound the healing process or discover then that the patient has past issues with healing including keloiding, other decisions in the patient's best interest can be made. This includes a change to FUE or even "no surgery".
They also can review current and past medical conditions, past surgery, medications, etc.
To this day I still hear about patients undergoing HT surgery and never asked about their medications or medical history. :rolleyes:
04-16-2012, 03:39 PM
Gillenator I think every time I state my opinion people take it a little too personal. Regardless of what many think I ended up at BHR because I knew they were the best from my own research. Over the years I have personally told some doctors that I would never consider them in fact one doctor on this site’s list I let know that I would not use if they were the last clinic on earth. I have been around too long and I’m too mature to be desperate. I’m also too honest and principled to come to these forums and simple make shit up.
Dr. Bisanga does what most will not and cannot do. He works long hours extracting FUE’s with very small hand punches. The is very tedious work but he has conditioned both his hands and his mind to be able to do it day in and day out while achieving exceptionally high yields along with beautiful end results.
Most doctors that have tried it have said to themselves screw this shit. I’m certainly not going to be busting my ass doing this day in and day out so they go back to doing strip and just rely on bullshit when asked by their patients. Oh FUE that results in low yield, white dotting, blah, blah blah. They leave out the important fact that it only applies to them. While others try to achieve the same yield with a basterized version of FUE using drills, in my opinion it is not the same and they end up giving FUE a bad name.
So yes I do give Dr. Bisanga a lot of credit for sticking with something that is very hard to do and not caving in while others around him make more money working less. And to top it all off he is a good man.
John P. Cole, MD
04-16-2012, 07:07 PM
Yes, i agree. Dr. Bisanga is very capable. He did not invent FUE or sit down and figure it out. He learned it from me in 2003. FUE has evolved significantly since then. Since then Dr. Bisanga has been quite critical of FUE. I really don't think you can be pro-Strip and anti-FUE, which is what DR. Bisanga is. Dr. Bisanga worked in my office from 1999 to 2003. He was a very good surgery assistant during that time. I gave him his first opportunity to do surgery in 2003 working in our office in Cyprus. Dr. Bisanga subsequently took staff and patients from this clinic to open his own office. In short, he was nothing short of dishonest. Personally, I could care less, but he has no right to market himself as someone who developed FUE or someone who figured out hair transplant surgery as is suggested. Dr. Bisanga is very capable, but he has not advanced a single aspect of hair transplant surgery. What he is does is limited to what he learned by 2003. Beyond then he is simply stuck in the mud, which is common to most hair transplant surgeons In other words, he learned some good techniques, but he has not grown beyond those. If he has, i'd love to know what they are. Still 2003 technology is better than 1958.
I have a freind who is self employed , he has a manager who worked for him for over ten years , the manager left to set himself up in buisness , the same buisness , its interesting to hear the points of view of both , my freind states he left him to set up on his own and took clients with him , the guy who left states that he wanted to go on his own as he had fresh ideas and felt restrained within the company , naturally his clients developed over time wanted to follow , i think this is what happens in buisness generally and all to often people forget hair transplantation is just that ..... buisness ..
Being a victim of over eight procedures ranging from .4mm plugs in 1990 with Drs who were ` stuck ` in the mud , i often wonder how any Dr can swear an oath , treat ill people in hospital , experience illness even death during there career and still ... think that 120 4.mm plugs cored into a twenty year olds ever so slightly receding hairline can possibly ever look good is beyond me !
Going forward i experienced ` mini grafts` ` choi ` implanter , even bizzarre methods of multiplication ,plucking , regeneration etc before having a procedure with Dr Bisanga of 1032 beard grafts into my horrific scarring , so I have growth and there is improvement so i think Dr Bisanga has advanced the area of repair with beard hair significantly , i think there are only a handful of Drs who can do this ( Dr Cole included )
That said i like the fact Dr Cole is fue only and has some outstanding results
04-17-2012, 03:18 AM
Where exactly have you read it posted that someone else has taken credit for inventing FUE other than Dr. Woods. I have been around for a very, very long time and I know who has stated what. Everyone starts somewhere does MHR ring a bell. Some become better than those that have helped in their training that is just a fact of life. I am very familiar with the history of this industry and who has worked where. Who has become better and moved on as we all can relate to working for employers that are not the ideal. You seem to be a bitter and angry and it comes out in your posting. I have spoken to many people over the years including employees and many patients from the various clinics so I think I might know just a little bit. Many of these doctors are extremely arrogant and that is why they have such a hard time attracting and keeping quality people to make up their team. Humbleness is something that most often cannot be learned but is a human trait one develops at a very early age.
It is very well known that Dr. Woods invented FUE and most doctors with any integrity still call the procedure what it is FUE and not some new acronym to call it their own. Here is some posting history but it is only a taste. The history of this industry cannot be erased.
(2003 patient consultant)
If I were Woods, I would put away my paranoia and make a sincere effort to work with the best strip docs out there. They all acknowledge the benefits of FUE but these are some damn smart guys and they don't need to shell out the cost of a couple of years of medical school to learn one procedure. The biggest thing that Woods has to offer is his experience, not the technique, as there is more than one way to skin a cat and these guys are smart enough to figure it out on their own. It's already being done by Feller, Jones, Cole, and soon enough Hasson & Wong. These guys are working together to advance the field.
All Woods has to do is say, "Hey, let's put the past behind us. You strip docs that are the best of the best recognize what I've done, now let's work together to truly bring about real change in this industry. If we lead the way, then the rest will have to follow". Then, he needs to cut the price of his mentoring to maybe 50K tops. Actually, that may still be too much but you get the idea. If he were to have a healthy attitude like this then he would have LOADS of docs just lining up to learn. Not to mention he could learn a thing or two from the other docs. I think that Dr. Woods is a very paranoid individual and he should not let the experiences of the past dictate the future.
(2002 from Dr. Woods)
Dear Dr ,
As you know, we accepted your invitation some months ago to address the ISHRS on October 12th. However there were "problems" as you well know and the invitation was not followed through. Perhaps it is better that you give a public explanation regarding this matter.
We were very disappointed with this missed opportunity, but have since made other arrangements.
Message to the forum
Dr Campbell and I will be holding an introductory seminar on October 12th. (this date was put aside after the original invitation). We are looking for expressions of interest from doctors interested in joining a "woods technique" training program.
From the very start it was our intention to end strip excision and other forms of harmful surgery worldwide. However, simply having a vastly superior procedure guarentees nothing.
We are directly challenging a multibillion dollar industry. People who run it do not always act in the public interest.
It was our strategy to create worldwide interest . We needed a critical mass and overwhelming public opinion to force a change. We are not there yet and still need support.
However , we have come so far because we have proved the undeniable superiority of our technique and offered future hope to millions. We have not played into the hands of those who would relegate our technique to obscurity. Revealing our technique too soon and to the wrong people would be like revealing a "water engine" to an oil company.
Now, the time is drawing near. We need people to become active. If you know a doctor who you think could be a woods technique surgeon, tell them about the seminar. We need good people. NO PRIOR HT EXPERIENCE NECCESSARY(LOL).
We expect there will be those who will see one procedure and then self proclaim they are "expert pioneers" offering an "improved" version. If done incorrectly, the damage to the donor area will be the same as strip. We intend to protect the public from these unscrupulous opportunists.
We thank you all for you support.
( I liked the Julius Caesar invited to the forum analogy (LOL) )
Dr Woods and Dr Campbell
Reply from Drs Woods and Campbell
From our own experience and from the word of clients and from Farrel and Spencer it was clear that the hair transplantation industry did not want the changes we were proposing. I am on record for saying to journalists as early as 1996 and to Spencer Kobran 2 years ago that we wanted to make strip excision surgery obsolete and that the individual removal of follicles via 1mm microsurgical incisions would replace it.
Doctors in this industry have tried to misrepresent and discredit us. We decided not to reveal our technique to doctors who were hostile to our commitment to changes in this industry because we felt that they would further misrepresent our cause.
We believed that doctors would say, "yes we have seen and are familiar with the Woods technique and it is inferior"
We have been accused of being paranoid but we have been right, as doctors who have never seen our technique have made similar comments.
As I made clear to Farrel and Spencer our intention was to create a frenzy of interest. To advertise in American magazines and create a "pressure cooker" effect......the public would be convinced by living indisputable truth and evidence, that our approach was the end point in hair transplantation surgery.
It is our belief that this would not come from the doctors in this industry. However once the public became aware of the truth they would force a change.
We thank all our clients who have told of their experiences and spread the word. We thank all the posters who have not actually seen us but have the ability to do thorough research. Your intelligent clear thinking has maintained a high level of debate and prevented the hijacking of our achievement, future hopes and principles.
We hope to establish an international clinic and training facility based on the following unshakeable foundation principles-
1. That everyone is a candidate for the WoodsTechnique and strip excision is definitely not done
No Biopsy or test procedure is required.
2. The entire procedure is to be preformed only by a doctor fully trained and accredited in our technique by Doctors Woods and Campbell
No one else touches the patientís head
Absolutely no assistants
3. The entire procedure adheres strictly to microsurgical cosmetic principles, which defines our technique.
4. There will be no routine legal disclaimer or waiver.
5. The doctor must be responsible for the removal of and the placement of each and every follicle,ensuring a virtually perfect result each and every time.
To my knowledge Dr Campbell and myself are the only cosmetic surgeons in the world who operate without routine legal disclaimers and waivers
For all the people out there who want to make a difference. We ask that you be vocal and spread the word and be part of this fight.
We want everyone to know that it was through the journalistic integrity and courage of Farrel Manne that the truth is told. Farrel had the 'sheer guts' to present us on his website despite opposition.
As far as Spencer is concerned. Approximately 2 years ago we contacted Spencer Kobran and told him of our achievement - He appeared to be fascinated and told us that we would be on his radio programme. With great excitement our entire staff was informed and we anxiously waited to tell of our achievement and our vision for change to the American public. However within a week Spencer called me to state that it would be impossible to interview me on his radio programme . We have never since been asked to be on Spencerís radio programme. We gladly would have done so at any time.
We offered to fly to New York to show him hundreds of case studies never before seen by anyone else - I even offered for him to come to Australia to observe a procedure. Spencer told us not to come to New York and he declined our invitation to come to Australia. Our American patients have actively pursued trying to go on to Spencers show. It was due to Spencer himself that he refused to have our patients on his show.
Three days ago was the FIRST TIME we were ever asked to write a statement for Spencers website.
We are now very pleased to provide the above statement to Spencer .
Dr Ray Woods and Dr Angela Campbell
04-17-2012, 05:12 AM
The problem with many in this industry is that they forget history. They have become blinded by money and boosting their own egos. These young guys that come to these forums don’t know jack shit about what is going on. They refuse to research the past and prefer to look at all the pretty pictures of present day. So if you wonder why I have been posting for 14 years, you now have your answer.
I have had my share of time working for a-holes and when employees get together they talk about how the boss is such an a-hole. It’s not unusual for them to often leave in groups as people tend to view social proof when making their own decisions. Get a clue already.
So I know very well to not only research the doctor but know who is working for him and how happy they are in their line of work. People that treat their employees like shit often treat others like shit, it's not rocket science people it's common sense.
04-17-2012, 02:36 PM
Do you recognize this quote from 2002 that was posted to another forum under the name Dr. Cole. Either way it doesnít matter to you see yourself and your arrogance?
I will say that there are many things occurring in Europe that do not occur in the USA due to more stringent control by the state medical boards in the USA and due to legal requirements. I know that Dr. Bisanga is doing hair transplant surgery. I also know that in the USA he was not a licensed physician and therefore did not practice hair transplant surgery. He never designed a hair line, he never made the recipient area, he never planned a donor extraction, and he never harvested from a donor area. He cut and placed grafts. He cut them the way he was instructed to cut them and he placed them where and how he was instructed to place them. He did not design any of my hairlines as Lee suggests he did and he did not control the result. He was a technician. Nothing more.
04-17-2012, 07:15 PM
I have worked in the Healthcare field since 95. I have worked directly with MD's for most of all of it. Some doctors are liked, some are not. It's that simple. Their personality, for my sake is not a number one requirement. Or as we call it Bedside manner. To be honest, most that have great bedside manor are making up for weakness in other vital requirements. I worked at a facility that employed a neurointerventionalist that was highly recruited by most of the major hospitals in Boston. He was the best and he knew it. He was not known for being a friendly guy. Often treated his staff like crap. To be honest, he was extremely difficult to understand..........However, if I ever had an inoperable Brain aneurism, please take me to him.
.... My point, although it would be nice to be buddies and share a few laughs with the Physician doing my transplant....my number one priority is the outcome. Plain and simple. All the other stuff to me is fluff. I want the best available to do it and I don't think we need to travel overseas to have that done. Dr. Shapiro, Dr Cole, Dr Rahal, Dr Hasson......Hell it's like comparing Sandy Koufax and Bob Gibson for Christ sake. I'd be happy with either. I do have issues with other aspects of the industry. But that is for another day.
04-18-2012, 02:17 AM
NE guy everyone has to choose what and who is best for them. But to see statements being made by those that work in the industry that are untrue and posted to a forum where others rely on research cannot simply go unanswered because someone thinks no one is looking or doesnít know the truth. Donít mistake education for intelligence.
I disagree completely with what you have written. My life experience has given me the opportunity to know differently. These traits you describe as weakness are in fact just the opposite they are signs of strength, because a man that treats others well is a man that has confidence in his own ability. I have worked in the night club industry for over 25 years and I have been around gyms even longer where some pretty tough fighters train. Confident men do not need to treat others like shit only men that are weak have this need and its always interesting to observe. I have very little respect for such weak men and I have made the same observation in both the field of HT and other industries.
But as I wrote everyone needs to choose who they believe is best by doing their own research. Iím an avid reader and tend to hold on to important concepts I believe to be true. I read this excerpt back in 1995 from the book Emotional Intelligence and I believe it to be very true. Everyone needs to understand that a HT procedure is a team effort and if you don't then you best not have a procedure.
In his book, Goleman relates the story of Melburn McBroom, who was a domineering leader, with a bad temper. The problem with this combination of emotional deficiencies was that he also happened to be an airline pilot. In 1978 as McBroomís plane was approaching Portland, Oregon to land, he noticed a problem with the landing gear. He decided to maintain a holding pattern as he obsessed about the landing gear. His co-pilots watched as the fuel gauges approached empty, but they were so fearful of their leaderís wrath that they said nothing. The plane crashed, killing ten people. This story is told in training courses to enforce the need for teamwork, open communication, cooperation, listening, which leaders with high emotional intelligence foster.
04-18-2012, 06:18 PM
Topcat, we can always rely on you to throw in your two cents :) We are all well aware everyone needs to choose who is best for them. Each of us is quite aware of that freedom.
You've completely mistaken the context of my post. The general respect one has or should have for another person is not at all what my comment was about.... Iím not referring to the everyday Tom, Dick, and Harry. Iím referring to those we are attempting to choose that will ultimately change a major part of our physical appearance.
My 25 years of experience in a gym with the exception of pain has taught me very little.... gaining life experience was never my top reason for going. Also, I do not have 25 years experience in a night club. What I do have is 17 years of direct experience working with doctors. The last 7 in some very gut wrenching procedures. I can assure you, my life experience in regards to the correlation between personality traits and the skill set of doctors might carry a little more weight than yours. And I get the feeling that might be hard to accept. There are very few Doctors who are the whole package. That is the unfortunate truth. For the most part, they are extremely personable and quite average or rough around the edges, or maybe a bit quirky, but they are second to none. But in general, most are decent people trying to do good. Do I think education and skill alone is a true measure of a person? Hell no, I completely agree. Does the average person need to treat people like shit to feel confident? Of course not. Most of us including you would never have the need to. But when it comes to those who are considered the elite in medicine, it is extremely common. I witness it every day for the last 17 years. Confidence has nothing to do with it either. They are all confident. If they weren't, they wouldn't be Doctors. That is especially true in the HT industry. Who in their right mind would ever allow someone to alter their appearance if they felt the Doctor wasn't confident He or she couldn't do it? Do we get mislead, guided, or misinformed?Ö..Thatís a whole other issue.
I have exhausted the last 2 months on a daily basis to find the right HT Doctor to repair and finish the mistake I made 19 years ago. E-mailing aside, I have requested a phone conversation with at least 7 of the top FUE doctors discussed on these boards. With the exception of one (kudos to Dr Charles), none of them made any attempt to call me in person. I've just accepted the industry is what it is and my goal was to focus on who had the most experience and skill set to meet my goals. Who gave me the best opportunity to put this chapter of my life to rest and to move on with the rest of it. That is my personal objective. That is how I decided who was best for me. I can assure you, personality as long as they werenít a downright prick, wasn't a major factor. Like I said, Itís the skill of their hands and experience Iím going to see them forÖ.itís that alone that will produce to final result I walk around with for the rest of my life. Not their smile. It's about priorities for me.
...for the record, I'm going with Sandy Koufax :eek:
04-18-2012, 07:12 PM
NEguy I respect you right to state your opinion but I disagree regardless of your experience of working with doctors. People are people and what I worte applies regardless of their occupation.
I do not settle and I do not do business with someone that does not meet my own criteria as my standards are very high. I have not been desperate for the last 14 years and that is why I was able to wait.
I have not only spoken to many of the employees of these clinics but I have spoken to countless patients over years. Many of them have regrets and many seem to recollect how they were treated like shit on top of it.
I could care less who goes to what clinic as that is not my reason for posting all these years. I post to help the industry change itself. This doctor made a statement that was not only derogatory but untrue it needed to be addressed otherwise all the lies on these forums become truth over time.
04-19-2012, 05:58 AM
My research has been quite different it was very long watching the forums and reading day in and day out year after year. Speaking with former patients and listening to their own personal experiences and what they knew about the industry. It also included contacting those that worked in the industry not doctors but employees and asking them their thoughts about the industry in general and about specific doctors and clinics.
You simply cannot come on to these forums for a couple of years and know what is really going on. It doesn’t mean you will not make a good choice but it’s too easy to make a mistake.
My suggestion to everyone has always been, speak to as many people as possible both patients and those that work in the industry. Use the forums but use that search button which many are too lazy to do because it’s too much work. They think they can just post their question to the forums and have it all figured out in a few months.
I could have easily given examples using the medical industry but I chose not to as my point is that character matters regardless. Most of those that visit the forums are desperate and I can relate as I was desperate in trying to fix all this when I was younger. Desperate people are willing to overlook the obvious because they are in fact desperate. Will they admit this no as it is a sign of weakness. Those that work in this industry see this desperation day in and day out and for too many it works to their advantage.
If someone is going to try and convince me that doing business with anyone that treats those around them like shit is a good idea it’s not going to happen. Maybe for some this is acceptable and that is your choice and it could very well turn out to be a good choice. I can guarantee you the doctors that treat those that work for them like shit also place blame on those same employees when things go wrong. They are also more likely to blame the patient and treat them the same. Just as they treat their family members and everyone they come into contact with in their life. This is who they are as people and that was the point of sharing some of my own experiences outside of the HT world. If anyone thinks this makes for a good choice then you should make that choice and share your own experience after you get out of the chair. If your experience is bad don’t be surprised if many of the forums delete your posts as that is the way it works. Its either that or you will be hounded off the forums by the reps with their incessant attacks as if your experience never happened and I am not speaking about myself but others that I have seen this happen to over the years.
When you see patients or just customers in general of any business take the time to put together hundred page blogs filled with hate these are all clues.
I try to help people see what I have seen but many will just ignore it and that is their choice but also what makes the forums helpful. People can read the various opinions and make up their own minds.
I have posted my thoughts about some of these forums and quite a few are dishonest and rotten to the core, regularly deleting information that the consumer needs to know. How this is all legal with the doctors advertising and commenting at the same time is beyond me.
One final example would be contrasting 2 different forums outside of this one. Both have been around for a very long time. You can go back and read the posts from the moderator on one well over ten years and his statements have always been consistent and relevant posts are never deleted nor are posters that contribute banned. The other forum regularly bans posters that are not in line with their agenda and their advertising base. The first forum moderator has spoken very naturally about his family and children as it is something that matters to him. The second forum moderator posts his homemade fetish porn on the Internet. Who do you think makes more money and where do you think all the desperate young balding guys flock to, that’s right the second forum. Them along with many of the doctors in this industry. Try to make sense out of this. A person either does the right thing or they don't and it matters. I prefer to choose someone that does the right thing.
Like I wrote too many here just eat this shit up and you are completely clueless but I sincerely hope that you do nothing and keep waiting and learning.
04-19-2012, 04:18 PM
Had an Uncle just like you.....He was the only person who knew everything 100% of the time.
We should all wait at least 10 years before pulling the trigger. Maybe we can earn a PhD in Hair transplant research. I look forward to being completely unhappy for the next decade when there are completely competent and talented surgeons available to help. At least then I won't be clueless.
Next time you need major surgery with high risks I'd seriously like to know if you choose the guy who buys lunch for his staff and holds your hand or the guy who has a 99% cure rate with a less than 1% complication rate. Crunch time.
I'm done with this ridiculous banter.....This thread was about survival rates for scar grafting. If someone has constructive information on that subject it is obviously welcome.
04-19-2012, 05:00 PM
.....I obviously hope no one is ever in such a position to have to make that decision. It was a rhetorical question. apologies if it came across the wrong way.
04-19-2012, 05:32 PM
NEguy the answer has already been given to you, it was “use the search button”. There are at least 4 well known forums plus a few more, this question has been asked dozens and dozens of times as many patients are stuck with hideous strip scars. You will find at a minimum at least 100 responses to your question. You can then try and contact a particular clinic or poster that interests you and follow up by speaking in person or on the phone.
I believe links don't show up well here, you have to do it on your own.
I have not been to a doctor outside of HT in about 25 years and I do whatever I can to keep it that way. I will take that risk when I know I am going to die and even then I would think twice :)
And I'm not offended.