Body hair for transplant? Which type is best?*

[John P. Cole, MD]

Payday, there are many fine FUE surgeons across the globe. Some have different philosophies, which you will not find in this particular forum unfortunately. While I’ve done over 8000 strip procedures I’d hardly classify myself as a great one any more simply because I don’t do many. I have done over 5000 FUE procedures, which probably ranks me tops in experience in the world. Experience does not make someone the best, but it sure is helpful. As Malcolm Gladwell noted in his book, Outliers, one does not become really, really good at anything until they have at least 10,000 hours of experience. So, based on experience and my results, I’d consider myself very good at what I do. That in no way implies that I’m the best. There are varying philosophies in FUE. Some have more practice at one, but less at another. This is where FUE becomes very technical and well beyond the scope of this predominate strip forum. Now, in regard to FUE I am an expert. I know what I’m talking about. While some would like to be led down the primrose path, others are grateful for the enlightenment so that they can avoid such mistakes. I take it that you were never disfigured by the unwise solutions offered in the past. I also suspect that you have no experience trying to hide your obvious hair transplant results. If you did, you would have a much clearer perspective of where I am coming from. If you were living under the veil of conspicuousness, you would have a completely different opinion of my perspective in my posts. Remember, I deal with the horrific results that you might consider professional every single day of my life. You may turn a blind eye to these gruesome stories and ruined lives, but I do not. You may consider it acceptable to turn your back on the atrocious work that still exists, but I do not. Exposing such terrible work does not make me the best. It simply puts me on an island by myself championing for better work across the board. I don’t want more work. I have plenty. What I want is for physicians to hold themselves to a higher standard of care. What I would like to see is far less repair work. I often cringe when I see the ghastly results I’m met with. I simply can’t imagine how someone could do that sort of work on another human being. Have you ever repaired a bad result? I doubt it. It's incredibly hard. Few can do it. It nearly breaks my neck to do it for a day. I'm sick of seeing it. I want it to end. While it is hard on me, all I can think of is how difficult it is for my patient to live through it, so i persevere.

Now, the optimal way for me to get this message across is not in a forum. It is to train more physicians to do the job right from the beginning. I can’t do it all. I don’t want to do it all. One can never make all patients happy with coverage. What we must avoid at all cost is making them look like they’ve had a hair transplant. That is much worse than thin or bald or inadequate coverage.

One may not recognize the limitations of the donor area. One may not recognize the greater difficulties with FUE procedures as a whole. One may consider it pathetic to bring to light those methods and physicians who perform suboptimal FUE. Well, good on you. You never had to live through a wasted donor area. You never had to live through a suboptimal result. You never had to live through a disfiguring result. Others have and I’ve had the heartbreak of living that experience with them.

I’m all about the patient and honesty. I don’t work for physicians who own a robot. I don't have to figure a way to promote physicians who don't have a clue how to do FUE so they buy a robot. I do make my own equipment, but my equipment will not make a bad doctor good. I don’t have to pretend that a robot is good just because I get paid to promote them. I don’t have to pretend that bad doctors are good and I don’t have to pretend that mediocre doctors are great. I guess that qualifies me as unprofessional. However, if that means that I don’t have to stand by the status quo in the hair restoration industry as a whole that has ruined lives for many years, I’ll take the unprofessional label with a degree of pride and encourage others to do so, as well.

Payday, I don't know your story, but I'd say you have a leg up on naive. Perhaps you are simply blissfully ignorant. i work for my patients. I don't work for complements from people who have no idea where the hair restoration industry started, where it went, where it redirected, or where it is headed. I work for the welfare of patients. Color me unprofessional if you like. I'll wear that badge with honor.

[topcat]

Patients learn more from open honest exchange and can make better decisions when those in the industry worry less about being politically correct. Being politically correct is what has been doing most of the harm to patients when it comes to these forums. One would need to ask why is anyone here if is not to help the actual patient make an informed decision with open honest information.

I love to see brutal honesty because it is good for the patient, it’s a breath a fresh air in a very polluted industry. I also agree it cannot be done alone and those that can should at least try.

The same goes for patients when you don't come back to help others most especially when things have gone wrong then you help perpetuate what has happened to you.

[FearTheLoss]

Payday, there are many fine FUE surgeons across the globe. Some have different philosophies, which you will not find in this particular forum unfortunately. While I’ve done over 8000 strip procedures I’d hardly classify myself as a great one any more simply because I don’t do many. I have done over 5000 FUE procedures, which probably ranks me tops in experience in the world. Experience does not make someone the best, but it sure is helpful. As Malcolm Gladwell noted in his book, Outliers, one does not become really, really good at anything until they have at least 10,000 hours of experience. So, based on experience and my results, I’d consider myself very good at what I do. That in no way implies that I’m the best. There are varying philosophies in FUE. Some have more practice at one, but less at another. This is where FUE becomes very technical and well beyond the scope of this predominate strip forum. Now, in regard to FUE I am an expert. I know what I’m talking about. While some would like to be led down the primrose path, others are grateful for the enlightenment so that they can avoid such mistakes. I take it that you were never disfigured by the unwise solutions offered in the past. I also suspect that you have no experience trying to hide your obvious hair transplant results. If you did, you would have a much clearer perspective of where I am coming from. If you were living under the veil of conspicuousness, you would have a completely different opinion of my perspective in my posts. Remember, I deal with the horrific results that you might consider professional every single day of my life. You may turn a blind eye to these gruesome stories and ruined lives, but I do not. You may consider it acceptable to turn your back on the atrocious work that still exists, but I do not. Exposing such terrible work does not make me the best. It simply puts me on an island by myself championing for better work across the board. I don’t want more work. I have plenty. What I want is for physicians to hold themselves to a higher standard of care. What I would like to see is far less repair work. I often cringe when I see the ghastly results I’m met with. I simply can’t imagine how someone could do that sort of work on another human being. Have you ever repaired a bad result? I doubt it. It's incredibly hard. Few can do it. It nearly breaks my neck to do it for a day. I'm sick of seeing it. I want it to end. While it is hard on me, all I can think of is how difficult it is for my patient to live through it, so i persevere.

Now, the optimal way for me to get this message across is not in a forum. It is to train more physicians to do the job right from the beginning. I can’t do it all. I don’t want to do it all. One can never make all patients happy with coverage. What we must avoid at all cost is making them look like they’ve had a hair transplant. That is much worse than thin or bald or inadequate coverage.

One may not recognize the limitations of the donor area. One may not recognize the greater difficulties with FUE procedures as a whole. One may consider it pathetic to bring to light those methods and physicians who perform suboptimal FUE. Well, good on you. You never had to live through a wasted donor area. You never had to live through a suboptimal result. You never had to live through a disfiguring result. Others have and I’ve had the heartbreak of living that experience with them.

I’m all about the patient and honesty. I don’t work for physicians who own a robot. I don't have to figure a way to promote physicians who don't have a clue how to do FUE so they buy a robot. I do make my own equipment, but my equipment will not make a bad doctor good. I don’t have to pretend that a robot is good just because I get paid to promote them. I don’t have to pretend that bad doctors are good and I don’t have to pretend that mediocre doctors are great. I guess that qualifies me as unprofessional. However, if that means that I don’t have to stand by the status quo in the hair restoration industry as a whole that has ruined lives for many years, I’ll take the unprofessional label with a degree of pride and encourage others to do so, as well.

Payday, I don't know your story, but I'd say you have a leg up on naive. Perhaps you are simply blissfully ignorant. i work for my patients. I don't work for complements from people who have no idea where the hair restoration industry started, where it went, where it redirected, or where it is headed. I work for the welfare of patients. Color me unprofessional if you like. I'll wear that badge with honor.

I just want to say thank you for this, we need more doctors/people like you in this world.

..and I'm very excited to hear about your meeting with Dr. Nigam.

[gillenator]

Ohhhh Dr. Cole. Please forgive me. Let me be more specific. I was not discrediting the work that you did on me. In fact, I failed to point out that you did all of the recipient sites and also harvested my donor strip. And although it's true that both Drs Mwamba and Bisanga were in fact surgery techs and not yet licensed physicians in the US, still they were both licensed physicians in their native country Belgium where they both practice today. I always showed them that respect by addressing them as doctors. I think most would agree with me even though they were not licensed in the US.

What I meant was that they cut my grafts and placed them for the most part. Francine also assisted in the microscopic dissection of my strip. I also remember you coming in at the end and you re-positioned some of my grafts. But in all honesty, you had several other procedures going on concurrently with mine which was MHRs protocol.

Doc, I remember the time when we first started working together and I had stubbed my big toenail sooo bad the prior evening that you got down on your hands and knees to examine my toe. You prescribed me an antibiotic, gave me instruction and advice how to care for it. Throughout the next week you kept asking me to remove my shoe and sock so you could have another look for any possible infections, etc. You did not have to do that but you cared about my pain and recovery as I limped around for a week. I know that I thanked you then but I also wanted to thank you publicly.

I am also skeptical of the claims made by Dr. Nigam however at least you are going to see for yourself and trust you will give us the clinical findings and whether there are any clinical substantiations to support them.

BTW, I still say that Dr. Shapiro gave me awesome hairline work "twice". You can still feel otherwise as you are entitled to your opinion. Also, any other HT doctors that looked at Dr. Shapiro's work on me said it was outstanding. So did Drs Mwamba and Bisanga. The other doctor that worked on me was a very small procedure from Dr. Brad Kurgis in California who also was a MHR doctor at the time. That was horrible work that I believe you are referring to yet Dr. Shapiro and you both were the majority of my surgical restoration.

Thanks again John and have a safe trip there and back.

[35YrsAfter]

I just want to say thank you for this, we need more doctors/people like you in this world.

..and I'm very excited to hear about your meeting with Dr. Nigam.

I posted photos in another forum illustrating the healing benefits of ACell. The progress photo was taken 3 months after surgery. We generally check for follicle regeneration at 10-12 months post op. My photo alignment was a little off, but my purpose of showing these three month mark photos was to illustrate the absence of donor scarring. A few weeks earlier, our patient came in and Dr. Cole examined the donor with loops and lighting for follicle regeneration. At that point, Dr. Cole could barely find the extraction points even with magnification. He didn't know, but I videotaped him with my Samsung Galaxy S3 for six minutes locating the extraction sites. Below are screen grabs from the video where he marked extraction sites that were regenerating follicles.

Dr. Nigam saw my post in the other forum, and responded:
"I admire dr cole for his work..and would be more than glad to share my work..and i am ready to be tested/scrutinized by any tight control methods..
would gladly welcome an email from your end..dr.rahul1970@gmail.com
convey my best wishes to dr cole..for his innovative and pioneering work since many years.."

35YrsAfter also posts as CITNews and works at Dr. Cole's office

https://www.forhair.com

Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions. Ask for Chuck

[FearTheLoss]

I posted photos in another forum illustrating the healing benefits of ACell. The progress photo was taken 3 months after surgery. We generally check for follicle regeneration at 10-12 months post op. My photo alignment was a little off, but my purpose of showing these three month mark photos was to illustrate the absence of donor scarring. A few weeks earlier, our patient came in and Dr. Cole examined the donor with loops and lighting for follicle regeneration. At that point, Dr. Cole could barely find the extraction points even with magnification. He didn't know, but I videotaped him with my Samsung Galaxy S3 for six minutes locating the extraction sites. Below are screen grabs from the video where he marked extraction sites that were regenerating follicles.

Dr. Nigam saw my post in the other forum, and responded:
"I admire dr cole for his work..and would be more than glad to share my work..and i am ready to be tested/scrutinized by any tight control methods..
would gladly welcome an email from your end..dr.rahul1970@gmail.com
convey my best wishes to dr cole..for his innovative and pioneering work since many years.."

35YrsAfter also posts as CITNews and works at Dr. Cole's office

https://www.forhair.com

Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions. Ask for Chuck

Yes, 35Yrs..I did see that post and was impressed with it. I really appreciate the advances Dr. Cole and Dr. Nigam are both hopefully making and I wish them both the best of luck. I think these two meeting could potentially bring a new era to the field of hair restoration. I hope Dr. Nigam can back up his claims, I don't know why he would be so willing to have a doctor, with the status that Dr. Cole has, come over to see his work first hand if he wasn't sure that he could back them up....so let's hope for the best of this.

I'm thankful for both of these doctors. Dr. Cole, I wish and pray for a safe trip to and from for you.

Best, FTL.

[sausage]

my beard hair is thick, dark and coarse whereas my head hair is not as thick and dark....

My leg and arse hair is more like my head hair.

[didi]

Patients learn more from open honest exchange and can make better decisions when those in the industry worry less about being politically correct. Being politically correct is what has been doing most of the harm to patients when it comes to these forums. One would need to ask why is anyone here if is not to help the actual patient make an informed decision with open honest information.

I love to see brutal honesty because it is good for the patient, it’s a breath a fresh air in a very polluted industry. I also agree it cannot be done alone and those that can should at least try.

The same goes for patients when you don't come back to help others most especially when things have gone wrong then you help perpetuate what has happened to you.

Topcat
I agree with you, we need more brutal honesty and less political correctness.
Also you need to understand when patients disappear you cant always blame them, when someone have bad result they tend to hide and suffer in silence, its not easy to come out on public forum and show your miserable results.
Another thing is forums are censored, sponsoring doctors have control of information,
also there are legal issues, I know that HT doctors threaten legal action(defamation, etc) if you say something bad about them.

what we see on forums is pretty much what Drs want us to see, when something goes wron its laways patient who had unrealistic expectations..even though only half of grafts grew like it the case with dr woods patient.
yet they always guarantee 97%+ growth rate.

[35YrsAfter]

Topcat
I agree with you, we need more brutal honesty and less political correctness.

Political correctness is always lopsided and is basically a philosophy of accepting standardized and homogenized opinions into one's heart as a kind of "religion". The reality is, political correctness is simply an intolerance of non-standardized opinions. The standardized opinions are in my view the result of media social engineering promoted by control freaks who see a need to regulate society and free thought.


35YrsAfter also posts as CITNews and works at Dr. Cole's office

https://www.forhair.com

Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions. Ask for Chuck

[John P. Cole, MD]

Dear Gillenator,

Thanks for mentioning Francine. She is not a PA (Physicians Assistant) with child and doing quite well. That was an all star bunch we had back in those days. I have a pretty good crew now, as well. A physician is only as good as his team, but his team is only as good as the physician demands. Everything in life takes the path of least resistance. It does not matter if it's dog training or people training. You have to set the standard and keep insisting on that standard every day. If you don't, it all fall apart. And no! I'm not suggesting that assistants are dogs. I train hunting retrievers and I love all of them to death. I would take a bullet for them. I'm simply implying that if you want anyone to perform at their best every day, you have to set the standard every day and maintain it. I see everything in my office and the second one slight mistake is made I'm on top of it. This way the standard never drops. If you let your standard down with your dogs, they get sloppy too.

I never discredit the work of Dr. Shapiro. He does great work. I'd just prefer he did not allow a layman to cut his FUE and you know how I feel about the robot, at least at this point. Maybe they will surprise me with that gadget and we will all be getting one some day. Who knows. For now, I really don't like the thing. He knows how I feel. I've told him. Still, he's a great physician and a great guy too. Anyway, I'm pretty sure the bad grafts you had were the handy work of another doctor. There are only two ways to conceal a bad hair line. One is to take it out and build a new one. The other is to build a better one in front. sometimes you can't go lower so you have to take out first. Then again, sometimes it takes a combination of both. Don't get me wrong. Your hairline was not terrible. It was a near miss. Frankly, I'm surprised you needed a top off because you were looking pretty good last time I saw you, but perhaps you lost a bit and also I'm sure that Dr. Shapiro complemented your hairline in follow up. He is damn good in my opinion.

At a meeting someone gets up and says something. Most of us sit in the back of the room and we scratch our heads in disbelief. Nobody says anything and so the whole crazy notion begins to take on a life of it's own. Then before long we all start to believe it simply because no one had the resolve to stand up and ask the tough questions. I ask the tough questions usually when I see something that just does not properly mix. I did not when I was younger, but I do now mainly because no one else will and it matters. This sort of thing never makes you the most popular guy in the room. That does not matter really at this point in my life. I will go out with some colleagues loving me and some hating me. I focus on doing what is right and getting to the bottom of something that does not seem valid. Sure, I make mistakes, but I make them with one perspective in life. That is to make certain I deliver the best possible outcome for my patients and I steer them clear of things that are not in their best interest. Sometimes it sounds possible so you have no choice other than to say that something sounds promising, yet I would not really recommend that you be the first guy to give it a shot.

Anyway, nice to chat with you. I hope we get an opportunity to spend some time together in the near future.

[John P. Cole, MD]

Didi, if you get 97% of BHT to grow you just plain got lucky. I've had some 100% growth with beard and chest when i injected Acell, but i'm not convinced the Acell was the reason. With my humbling experience on BHT, I'd say that luck very well may have played the predominate role. I'm pretty uptight about this BHT issue because the last thing we need to be passing along to patients is a heightened sense of confidence in BHT. Some times it just does not grow at all. Then again, beard grows good, but I've has tests of 10 beard hair grafts in a strip scar that grew their accustomed 60%, but the patients hated the appearance of the beard hair. They wanted nothing more to do with them. Some love the beard hair and some hate it. If Dr. Woods told this patient that 97% of his body hair would grow, then he was vastly exaggerating and perhaps delusional. I know that Dr. Umar wrote a paper where he said that 87% of leg hair grew for him across the board. I happened to be the moderator on a panel where he presented this. Now as a moderator, it's pretty tough to be critical, but I did ask him how he got 87% when I sometimes get zero percent and never more than 60%. His response was graft selection. Now having done enough leg hair to know that graft selection such as anagen hair makes a difference, but there is no way to pick out the 87% that will grow. It was just rubbish. I asked him to be more descriptive of how he chose the ones that will grow and the best response he could give was the same response again.

Don't go into body hair thinking it will grow. Go in expecting it not to grow and if it does grow, well you are just plain lucky.

[wylie]

And those of us who have character do not make grandiose statements that they are the best at this and that, nor do they take pot shots at their colleagues as you do repeatedly. You were rightfully called out on that too by another forum member remember?

You see a true professional does not have to disrespect others in order to make a point. The very best are humble individuals. They do not have to repeatedly come on a public forum insulting their colleagues and others in order to gain market share.

True dat.

[John P. Cole, MD]

I don't see it that way Wylie. The true professionals never said a word about plugs, scalp reductions, mini grafts, or strip scarring. How did that benefit the hair restoration patient or the field?

While the potential is much better for an aesthetic result today, procedures like FUE are much harder. Doctors and patients can get into a whole lot of trouble quick.

I don't mean to be disrespectful to you. if everyone sticks their head in the mud, sees no evil and speaks no evil, then you hear no evil. Then you wind up without progressive thought. Remember there are alot of guys trolling these forums who work for doctors that promote procedures and equipment that create the most potential problems. I don't know whether they get behind these methods and instruments because they are paid to get behind them or whether they just don't know any better. I do know, however, and I suspect you recognize that I'm not bashful about expressing my opinion, when something bad might happen if I don't. Now if you want to have a strip, which is done in perhaps 60% of all hair restoration surgery procedures, I'd be happy to steer anyone in a direction that I think is best. I personally don't do strips any longer so I would be one of your worst choices and I'd tell you that. Now if you want FUE, I happen to be an expert in that. I know there are all sorts of guys trying to do FUE these days because it is popular. That does not mean you will get a great result. In fact, just as I would not recommend that you have a strip with me, I would expect the physician who does very little FUE to recommend the same to their patient - go somewhere where they do a lot of FUE. I'd also recommend you steer clear of any robots because those docs have no idea what the robot is doing.

Any way, I hear you. I simply don't in any way agree with you.

Just curious, why Joe Biden for your Avatar? He is a NW 7. From the side or rear it's obvious something is not right. From the top down he is totally thin too. Guys like that are not good candidates for a HT because the results can look as unusual as his result appears. Now, Joe had plugs and it was obvious he had plugs. Then over time his hair began to thin and he had a bit of corrective work. Now the hairline look ok due to thinning and corrective work, but it's still pretty obvious that it's a hair transplant from the back, sides, and top. Joe is a guy who could have benefited from someone saying, "don't do it, Joe". Boy was it obvious during the VP debate. Wasn't he also the guy who was telling folks that they (Mitt Romney and Republicans) want to put you back in chains? Wasn't it is some southern evangelical delivery? Now that's something that didn't seem right to me regardless of political affiliation. Well come to think of it, it seems most politicians are misleading at times. Hmmm. Seems many doctors are too.

What we do in the hair restoration surgery field affects the lives of people from the first day forward. We need truth and honesty in this industry. My comments are not political. My comments are flat in your face fact.

I'm glad you had a positive experience with beard hair. It can be a real life saver for many. Thanks for sharing those comments. Just remember that not all like the appearance of beard hair. Some hate it.

[didi]

'I WARMLY WELCOME... Dr.Cole's announcement, that he would visit my DOUBLING/HM CLINIC.

I firmly believe, only by sharing and scientifically debating..we can decode the puzzle of MPB cure.

In 2013,
First constructive visit, was from the Berlin team of, dr gerd,dr umax..who visited me and we both were benefited by the visit.

Next was the my visit to WCHR,edinburgh,

where jahoda,stenn,phillipot,raus,randell and others ..really shared each others experience like a selfless and true scientist..whose goal is not just to make money..but a bigger goal TO BE A PART OF CURE..
Like a game of soccer..no individual alone can win the game.

Nature does not love monopoly...

I firmly believe..

A HARMONIUS COORDINATION AMONG MINDS ..FOR A CHIEF DEFINITE GOAL...IS THE WAY..TO ACCESS THE INFINITE INTELLIGENCE OF THE UNIVERSE..

SOLUTIONS EXISTS IN THE UNIVERSE..WE NEED TO DISCOVER THEM...'-Dr Nigam

[sausage]

arghhh website i tried to post won't work.