When did Hair Transplants get better?

[sausage]

I understand hair transplants have not always been as good as they are today....

but when did they start getting better?

I remember going to Turkey a year ago once and a random Turkish guy told me I should get a hair transplant (the B*stard), he said he had one done 10 years ago and said they were much better these days......

his hair had that ridiculously sparse look to it. Like it has 2 hairs per square cm.

I have also been browsing the his hair website (smp tattoo) and found someone on there who had a HT 7 years ago with the same ridiculously sparse looking hair.

What improvements have been made and when were they made to get the thicker more realistic looking results we have today?

[baldymcgee]

It's a complicated question, on the one hand they really haven't gotten much better.

Basically, they'd tell you anything to get you believe that HTs are "reliable" and "undetectable".

So ... what *has* changed:
- More patients, so docs can pick and choose those few patients who end up looking great and feature them on this site and their website.
- FUE is a real option now, it wasn't before
- Microscopic graft dissection (if you're naive/brave enough for FUT)
- ARTAS
- Finasteride (I'm convinced that half the "great" results from "top docs" are in-part due to their patients responding well to propecia)
- Better surgical techniques (scar closures)

I'd really like docs to publish:
- yield rates from *all* their patients
- complication rates from *all* their patients
- satisfaction rates from *all* their patients

Try asking a doc or their rep for these numbers and you'll get vague answers ("complications are very rare", etc). This is a science and should be treated as such.

[sausage]

So is FUT something to avoid at all costs?

[baldymcgee]

So is FUT something to avoid at all costs?

Not at all -- if you're one of the lucky few who gets a great FUT result then it will have been the best thing in the world.

Problem is that most people aren't "the lucky few" ... if you're a high norwood then you'll have a decent combover that looks pretty unnatural but that you won't be able cut short on account of a scar.

It's up to to you -- do you feel like rolling the dice?

[sausage]

Not at all -- if you're one of the lucky few who gets a great FUT result then it will have been the best thing in the world.

Problem is that most people aren't "the lucky few" ... if you're a high norwood then you'll have a decent combover that looks pretty unnatural but that you won't be able cut short on account of a scar.

It's up to to you -- do you feel like rolling the dice?

hmmm it's tough...

with various surgeries I think I am close to something then a door is slapped in my face........

thing is, in my case, there are issues with all hair procedures that are out there.

I really don't want a massive chunk of flesh cut out my head but I was thinking it was my only real option.....now I am thinking about just playing it safe with FUE but just getting the front area done, frame my face and keep it short as I'll still have the bald spot........or possibly in the future to get Gho to sprinkle some hair in my bald spot for me....

[ryan555]

It's a complicated question, on the one hand they really haven't gotten much better.

Basically, they'd tell you anything to get you believe that HTs are "reliable" and "undetectable".

So ... what *has* changed:
- More patients, so docs can pick and choose those few patients who end up looking great and feature them on this site and their website.
- FUE is a real option now, it wasn't before
- Microscopic graft dissection (if you're naive/brave enough for FUT)
- ARTAS
- Finasteride (I'm convinced that half the "great" results from "top docs" are in-part due to their patients responding well to propecia)
- Better surgical techniques (scar closures)

I'd really like docs to publish:
- yield rates from *all* their patients
- complication rates from *all* their patients
- satisfaction rates from *all* their patients

Try asking a doc or their rep for these numbers and you'll get vague answers ("complications are very rare", etc). This is a science and should be treated as such.

First off, stop spreading misinformation about FUT. The good docs who do it can produce only a tiny scar and they get better density, better yield, and less graft transaction that just about any modern FUE. In fact, all of the top docs perform both types of procedure, but they continue to do FUT because the results are generally just plain better. I wonder when this obsession with the hair in the donor region began to supersede the hair on the top of the head.

Now then, the really great doctors like Rahal, Shapiro, Feller, Cole, H and W, etc, have consistently excellent results and you will be hard stretched to find many patients anywhere who regret having surgery with them. They will not operate on young guys, on men whose hair loss is too extensive or on men with insufficient donor because to do so is unethical. And when the conditions and expectations are correct, the success rate is extremely high. And honestly, a lot of the unhappy patients right now are a direct result of the ridiculous hysteria over propecia leading to all these young guys wanting a HT without stabilizing their hair loss. Of course, there is always an unscrupulous doc who is willing to take there money.

[baldymcgee]

have consistently excellent results and you will be hard stretched to find many patients anywhere who regret having surgery with them

Nice to see the apologist brigade out!

I'm not saying that these docs (and others) don't have outstanding results, but until they publish success/failure rates then we have *no* idea how typical the results are.

There are people, on these and other forums, who have had bad results with the docs you list. Even on this forum, note that that "complaints" section is private.

In order to know how good a procedure is, we cannot just look at the successes -- we need to see the successes and the failures and we need to know the probabilities of each.

Until this information is completely transparent, my advice is simply to assume the worst from the clinics.

Edit: As bad as FUT is, I think FUE is better. It's still a risk, but it's lower risk.

[ryan555]

Nice to see the apologist brigade out!

I'm not saying that these docs (and others) don't have outstanding results, but until they publish success/failure rates then we have *no* idea how typical the results are.

There are people, on these and other forums, who have had bad results with the docs you list. Even on this forum, note that that "complaints" section is private.

In order to know how good a procedure is, we cannot just look at the successes -- we need to see the successes and the failures and we need to know the probabilities of each.

Until this information is completely transparent, my advice is simply to assume the worst from the clinics. Especially since, as I said, several of the so-called "top docs" used to be butchers on par with Bosley.

Edit: As bad as FUT is (and it can be butchery), I think FUE is better. It's still a risk, but it's lower risk.

Why don't you provide some links to complaints about the docs I mentioned? Unhappy patients tend to be quite vocal so I'm sure you can dig up a ton of them. Speaking of "failure rates," whatever you are referring to, I had one of the docs I mentioned say that he had no had a case of poor yield in almost 5 years. I'm not sure where or how you would like them to "publish" this information, but they are all very open about it if you ask them.

Ps - I am not "apologist" and have no skin in this game. I do think I know a bit more about the industry, though, than someone who calls these guys "butchers."

[baldymcgee]

Why don't you provide some links to complaints about the docs I mentioned? Unhappy patients tend to be quite vocal so I'm sure you can dig up a ton of them. Speaking of "failure rates," whatever you are referring to, I had one of the docs I mentioned say that he had no had a case of poor yield in almost 5 years. I'm not sure where or how you would like them to "publish" this information, but they are all very open about it if you ask them.

Ps - I am not "apologist" and have no skin in this game. I do think I know a bit more about the industry, though, than someone who calls these guys "butchers."

With 30 seconds of googling:

Rahal:
http://www.*************/hair-loss/b...ategory-2.html

There's another complaint about H&W -- the fellow had very thin and sparse results.

And that's, like I said, with a quick google search.

I think you're utterly wrong about unhappy patients being vocal -- who speaks up after already being sensitive about their hair/appearance and then having it get worse? Most people just silently suffer further.

Lastly, where could docs publish this information? Are you being serious? On their website? On the IAHRS website? Any number of professional publications. Seriously?

I'm glad the docs told you that they haven't had any failures ... but until there are metrics for defining failure, that's a meaningless comment. Docs need to track:
- HT yield
- Hair caliber before/after transplant
- number of hairs per FU before/after transplant
- scar thickness
- scar coloration
- permanent shock loss rates
and so on

[ryan555]

With 30 seconds of googling:

Rahal:
http://www.*************/hair-loss/b...ategory-2.html

There's another complaint about H&W -- the fellow had very thin and sparse results. H&W had to be dragged kicking and screaming before offering to do another procedure on the guy.

And that's, like I said, with a quick google search.

I think you're utterly wrong about unhappy patients being vocal -- who speaks up after already being sensitive about their hair/appearance and then having it get worse? Most people just silently suffer further.

Lastly, where could docs publish this information? Are you being serious? On their website? On the IAHRS website? Any number of professional publications. Seriously?

I'm glad the docs told you that they haven't had any failures ... but until there are metrics for defining failure, that's a meaningless comment. Docs need to track:
- HT yield
- Hair caliber before/after transplant
- number of hairs per FU before/after transplant
- scar thickness
- scar coloration
- permanent shock loss rates
and so on

I realize its possible to publish results, but I don't know many businesses of any type that publically publish this type of stuff. Do you?

I do appreciate your scientific approach. I'll bow out of this one. I promised myself I would never be a guy who spends part of their Saturday arguing about hair transplants on the Internet.

[baldymcgee]

Surgeons past / moderators

Apparently some of my comments have been edited by mods and I'm fine with that.

But the reason for the edits need to be discussed. I implied that certain doctors (without naming names) were, in their past practices ... less than entirely ethical.

This is not my opinion but is actually something I only realized after listening to a great comment by Spencer Kobren:

"There were doctors who were doing, you know, archaic and gruesome procedures that I can't even believe. You know there are doctors that are still in the business who are kind-of world renowned hair transplant surgeons, and they've definitely evolved over the years but they became who they are because of all the, in my view, the damage that they did early on in their careers"

https://www.youtube.com/watch?v=H5dpuU4BFDA

(Jump to about 34:10).

[Winston]

Apparently some of my comments have been edited by mods and I'm fine with that.

But the reason for the edits need to be discussed. I implied that certain doctors (without naming names) were, in their past practices ... less than entirely ethical.

This is not my opinion but is actually something I only realized after listening to a great comment by Spencer Kobren:

"There were doctors who were doing, you know, archaic and gruesome procedures that I can't even believe. You know there are doctors that are still in the business who are kind-of world renowned hair transplant surgeons, and they've definitely evolved over the years but they became who they are because of all the, in my view, the damage that they did early on in their careers"

https://www.youtube.com/watch?v=H5dpuU4BFDA

(Jump to about 34:10).

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