Integrity of the HT Industry's Online Presence

[Follicle Death Row]

Now I'm mainly talking about other forums that showcase results pretty much exclusively before anyone goes off on me here.

Q. How many supposed patient cases are plants by the clinics?

Q. How many are done after the result has turned out great and then post op pics are put online for us to follow the progress over time with the idea in our minds that the HT had just been done last week?

Q. How many of the patients that do not update, do not do so because they are happy and not worried about hairloss, or because their HT failed and they've been silenced?

What do you think the true case success rate judged by the patient's themselves is for the IAHRS docs?

What do you guys think? I've seen mega results and I know HTs can be life changing but I can't help but feel that bar a handful of docs, we're only seeing the top results and not the typical average that you or I could expect.

For sure HT can create amazing results but damn it seems like a serious risk to me. Maybe I'm super conservative. I'd like to do it when I see some of these great results but I couldn't handle failure.

Of course much of what I've said doesn't apply to the creme de la creme but I honestly think I could count clinics of that calibre on one hand.

Thoughts?

[topcat]

Be thankful that you are conservative and that you ask questions that make sense. It puts you in a position to make a better decision regardless of what that decision happens to be. Too many in this industry rely on those whose desperation puts them in a position of never asking too many questions.

[Follicle Death Row]

Be thankful that you are conservative and that you ask questions that make sense. It puts you in a position to make a better decision regardless of what that decision happens to be. Too many in this industry rely on those whose desperation puts them in a position of never asking too many questions.

I have it rounded down to 3 clinics if I ever do go for it. To be honest, I think Spencer should be proactive (he probably is, I don't know what goes on behind the scenes) in getting all IAHRS members to commit to video documentation. Now it won't always be possible to do so, especially with out of town patients, but it should definitely be pushed for. Pictures tell lies big time, comb throughs in good lighting in high def videos give a more honest representation.

Also, while I'm not going to debate the safety of finasteride with anyone I have this sneaking suspicion that there may be a secondary reason to prescribe finasteride if you follow. I think Gillenator might know what I'm on about here.

[Thinning@30]

One thing to bear in mind is that many patients with failed HTs are going to be reluctant to badmouth their surgeon publicly, because if they do, the surgeon is unlikely to work with them toward any sort of resolution. Back when I did consultations with some doctors, they all told me things like "99.9% of my procedures are a success!" I feel like in their minds the procedure was not a failure if they got at least some of the transplanted grafts to grow.

Personally, I've heard so many negative stories about HTs that I'm very reluctant to get one. So many people have told me they regret it, and I've never met anyone who reported long term satisfaction with a procedure.

I agree with you on the video documentation.

[DepressedByHairLoss]

Thinning@30, I totally hear you. There are so many people on this message forum, as well as plenty of people on the internet, who say that having their hair transplant has been the worst mistake of their lives for whatever reason (a botched transplant, inability to stay on Propecia due to sides, or the existence of a permanent head scar). There are several people on here who say that they just wish they could shave their heads and move on with life, but now they can't because of the permanent head scarring. I think that once a person has a hair transplant, they are "stuck". They will likely have to have more than one hair transplant and will never be able to shave their head or buzz it too close ever again. I mean, I understand why people have HT's, because people cannot stand the thought of living life as a bald man. Hell, I don't know how I would be able to handle living life as a bald man, that's why I'm on this message forum in the first place. I'm just not at all impressed with the whole hair transplantation process to begin with. Actually, I can probably count on one hand the number of HT surgeons that I believe to deliver consistently great results (Hasson & Wong, Rahal). With regards to the others, the results bring a person from a bald/balding head of hair or a thinning head of hair and do not offer anything close to full coverage. That being said, I really think that Spencer offers a great service to hair loss sufferers by founding the IAHRS, especially since the ISHRS is such an unethical sham. At least I believe that the doctors within the IAHRS will not screw you over and are legitimate. I don't think a person will get butchered by an IAHRS doctor and Spencer's always been honest about what a hair transplant can and cannot achieve. I just think that the process of hair transplantation is so limited and offers setbacks that just don't make it worth it in some people's eyes, including mine. But as I said before, I understand why people do it; living a life with hair loss is just unbearable in many people's eyes, including mine. I just wish that there were much better options out there. For instance, if an HT could give a person anything close to a full head of hair, then I could gladly accept the head scarring and take Propecia til my dick falls off!!!

[Follicle Death Row]

One of the real problems is: If you're headed to an advanced stage of baldness down the line and you have one session that fails to yield well you're never going to have what looks like a nice head of hair (bar the mutants with ridiculous donor and laxity). You're f**ked more or less.

If you really want to go for it some of the guys you mentioned DepresssedByHairLoss will give you the best shot for sure.

Anyone want to discuss the elephant in the room that is finasteride (not the sides, its effect on hair)? If you search hard enough you'll find even a doctor mention that upon close examination of a number of patients over time, finasteride helps maintain the hair calibre or shaft thickness of transplanted hair. At first I was alarmed but I guess it makes sense. Now I'm not saying these were patients that had DUPA and were operated on but take a look around next time you're out and about; donor thinning is a real issue. So you might think that a norwood 6 has no use for finasteride but that may not be the case due to potential donor thinning uncovering the scar and loss of the calibre of transplanted hair and indeed of some of the transplanted hairs. While this isn't a worry for some it may well be for others. While FUE is fantastic for mild hairloss and guys in their 30s and 40s, trying to get the biggest number of grafts by FUE for large bald areas over time will give the DUPA appearance if donor thinning kicks in.

Also imagine your donor thins by 20%. I don't actually know what's the normal but I should imagine even 10% at least happens in us all over time. I'm going to go with 20% to illustrate my point; say a decline in donor density from 100FU/cm2 to 80FU/cm2. Let's say you have 3000 grafts transplanted at a density of 45FU/cm2. Now if the donor thins by 20% you're now potentially looking at a density up top in the transplanted area of 36FU/cm2. 45 down to 36! That's the appearance of fullness to a thin appearance.

So much to consider that's often overlooked by prospective patients.

[gillenator]

I have it rounded down to 3 clinics if I ever do go for it. To be honest, I think Spencer should be proactive (he probably is, I don't know what goes on behind the scenes) in getting all IAHRS members to commit to video documentation. Now it won't always be possible to do so, especially with out of town patients, but it should definitely be pushed for. Pictures tell lies big time, comb throughs in good lighting in high def videos give a more honest representation.

Also, while I'm not going to debate the safety of finasteride with anyone I have this sneaking suspicion that there may be a secondary reason to prescribe finasteride if you follow. I think Gillenator might know what I'm on about here.

FDR, could it be the money?

[gmonasco]

I can't help but feel that bar a handful of docs, we're only seeing the top results and not the typical average that you or I could expect.

Of course you are. The portfolio of anyone, in any profession, is only going to include the very best examples of that person's work; nobody puts average or substandard work in their portfolio for others to see. In the case of hair transplant surgeons, therefore, prospective patients see only pictures representing a handful of the best results and usually come away with the mistaken impression that those results are typical.

[gillenator]

Any clinic is going to show their best work, that's a given.

The truth of the matter is that most patients who surf these forums for information never join or get involved in posting. At any given time take a look at how many folks are online reading and how many are actively posting. It's a very small percent. It tells us that hairloss is a very personal and private matter to most people. It is also why we do not see more pics posted. Most patients don't want their photos put up happy or not. But those who are not happy especially will not come forth and say so.

And it is also true that once the patient is satisfied, they rarely come back to these online forums. They get on with life. And further true when some patients are not happy, they are too embarrassed to come back online and broadcast to the world that they are not happy. Many blame themselves.

Most of the patients that contact me never join these forums, they just read and get the information that is most important to them.

[Follicle Death Row]

Of course you are. The portfolio of anyone, in any profession, is only going to include the very best examples of that person's work; nobody puts average or substandard work in their portfolio for others to see. In the case of hair transplant surgeons, therefore, prospective patients see only pictures representing a handful of the best results and usually come away with the mistaken impression that those results are typical.

Oh for sure. That's exactly it. What can we really expect? I'm all too aware that they show there top stuff. That's a given. But just how much do the results vary I wonder.

[topcat]

It’s also true that many patients that have come back and tried to help and warn others about how this industry operates or write about their experience are attacked by those who work in the industry. Over the 14 years I have seen it happen over and over again. Those patients many who were very good posters eventually said to themselves F this shit let these prospective patients find out the hard way and I will admit having that feeling every now and then. Let these guys that think they know something but don't know shit find out the hard way.

Eventually you will have just the consultants and the doctors that post along with the guys that don't know shit, how convenient.

[gmonasco]

I'm all too aware that they show there top stuff. That's a given. But just how much do the results vary I wonder.

That's a key point, because it's really hard to get a handle on how representative the presented results are. Even granted that you're only seeing the best of any surgeon's results, how do you what percentage of his total patient base those results represent? 20%? 5%? 1%? 0.2%? There's no way to tell without a lot more information that prospective patients generally don't have access to.

[Follicle Death Row]

That's a key point, because it's really hard to get a handle on how representative the presented results are. Even granted that you're only seeing the best of any surgeon's results, how do you what percentage of his total patient base those results represent? 20%? 5%? 1%? 0.2%? There's no way to tell without a lot more information that prospective patients generally don't have access to.

That's exactly it. Are the results we're seeing representative of the top 5%, top 10%, top 20% or what I wonder.

[Follicle Death Row]

FDR, could it be the money?

Donor thinning and to help maintain the calibre of transplanted hair.

[Follicle Death Row]

I'm not saying HT's are not necessarily bad; they're not. Some are great, some are good, some are down right appalling. What I am saying is the industry is still by and large shady. Look around enough and you'll see it...But then again so is cosmetic surgery so really the only advice I can give is caveat emptor.