Best transplant surgeon available...Umar or Bernstein?

[hairyandthehendersons]

Hi all,
This is my first post. Hoping to get some truthful responses off of this site.
Since my mid 20s I've tried all of the different things... Propecia, finasteride, rogaine, laser comb, supplements. All of it cost a lot and didn't do very much. I still use rogaine just out of habit I think at this point
I'm now in my mid thirties and buzz my hair. This has always been a better choice to me than to risk a scar on the back of my head or a bad transplant proceedure. Even if I get a ht now at some point it will thin out again and I'll buzz my head again so no scar is a huge issue for me. Until recently I pushed the idea out of my head. The last year or so I have been keeping an eye on two doctors that have actually made me feel these chances of scaring or a bad transplant is greatly diminished or almost no longer an issue. Those two are Dr Umar and Dr Bernstien.
I contacted both and Id like to see both in person before I make a decision. Umar got back to me promptly and gave a thorough response. His staff called when I showed interest in making an appointment. He did mention a possibility of using beard hair which is really scary to me. I'm in Pittsburgh so I would have to fly out to LA which is a little inconvenient but worth it if he is better. Dr Bernstien has been on the bald truth, has an incredible resume and seems like an honest man. When I sent him an email with pics I didn't get a response had to call a few times and when I got a response it was from a different doctor telling me to come in to the office in NYC for a consultation. I know dr Bernstien was out of town but this left me feeling a little disappointed.
Have any of you had experience with these surgeons?? I'm ready to start setting things up once I make my final decision. These guys are really expensive but I see way more value in this than say buying some flashy car
Thanks!

[JoeTillman]

Your choices seem a bit unusual to me in that there are few surgeons that could be further apart in style, approach, etc. than Dr. Bernstein and Dr. Umar. One is very conservative while the other is, considered by many, anything but. I highly recommend that you search with a bigger net to see what you come up with.

What is your NW level? Are you taking meds?

[hairyandthehendersons]

Thanks for the response Joe.
Originally I would have agreed with what you said about Umar. He was dealing with extreme cases and did some pretty aggressive procedures. Some that were from botched jobs and others where body hair just didn't look natural to me. However he seems to be showing off more of his "normal" procedures. Ones like he did with Benardo De Paula and a few others that are now in his photo gallery. His response gave me a fair selection from very conservative to very aggressive. I would probably start very conservative and progress from there based on results. My reasoning for selecting these two doctors is be cause the appear to be at the forefront of advancement. I think they will yield the best percentage of grafts that actually take and the least amount of scaring from the donor area.
Sorry this is getting long winded but obviously this is a major life decision so I am trying to be as careful as possible in my decision. here is the response from Umar.
1. We can create an expanded forelock the involves your front and middle to the exclusion of the crown with 1500 - 2000 head and nape derived grafts. The hairline would be very conservative at about the NW 3 position and the density is also conservative

2. Restore your front and middle to the exclusion of the crown with 3000 - 3500 head and nape derived grafts. The hairline would be conservative at about the NW 2 position.

3. Restore your front, middle and crown with 4500 - 5000 head, nape and beard derived grafts. The hairline would be conservative at about the NW 2 position. The crown is given a thinning look.

4. Restore your front, middle and crown with 5500 - 6500 head, nape, beard and other body area derived grafts. The hairline would be aggressive at about the NW 1 position. The crown is given a moderate density coverage.
If you would like options # 3 or 4,

[hairyandthehendersons]

I figure it's a good idea to try to post a couple pics to show how bad it is. I quite the meds a few years back. They didn't seem to do much for me

[JoeTillman]

The meds "did not seem to do much" how? By not bringing any hair back or did you have sides? I ask because I hear this issue a lot but what many do not realize is that by NOT seeing any differences the medication is in fact working. Why? Because the main ability of the medication is to do just that, prevent there being any differences, ie. continued hair loss. Just because it doesn't thicken your hair doesn't mean it's not working. If you are continuing to lose hair at the same rate, then that is a different story but that is where I would ask if you were using generic or name brand Proscar/Propecia. There is a difference.

Dr. Umar seems to rely heavily on "nape" hairs in your assessment. Problem is, nape hairs are not necessarily permanent as they can be affected by DHT quite often just like the hair on the top of your head. I've never liked the use of nape hairs save for special circumstances. Being a virgin scalp you should exhaust your scalp donor before moving on to alternative sources such as beard hair or hair from other parts of the body. Head hair is king, period. Everything else is a distant second, or third. In fact, I still consider anything other than scalp hair to be experimental because in the grand scheme of things, there aren't that many cases of wholly positive results with BHT.

You said something interesting about why you chose both doctors for consideration. You said "My reasoning for selecting these two doctors is because they appear to be at the forefront of advancement. " I can understand this logic but in my experience you should choose a surgeon that has consistent results. I'm not knocking your reasoning but rather I'm giving you something to consider that I think is more important. Being one that is at the forefront of advancement is fine because the field should move forward, faster than it is, but being at the forefront doesn't always equate to getting the best growth or the most aesthetically pleasing results. "Tried and true" is the way to go in my opinion. If I may, I'd suggest that you find a list of clinics that have a large and consistent body of outstanding work then work your way backward from there by eliminating the clinics that may not be using the technique you prefer or have other undesireable traits that you'd like to avoid. These may or may not include the degree of doctor involvement, the type of procedure (FUT or FUE), if FUE then the type of extraction (ARTAS, Neograft, manual or motorized extraction) and so on. You should also consider if you wish to be aggressive with coverage or if you wish to take the slow road and address each section of your scalp in separate procedures. There are merits to both approaches.

I hope this helps. If you have more questions feel free to ask.

[wylie]

I have had over 5000 beard hair grafts from Dr. Umar, and it saved my appearance. I can tell you, without a doubt, that beard hair works. But I don't think that it works nearly as well as scalp hair, and the success rate of beard hair is quite possibly less than that of scalp hair. I personally believe I would have more hair had that same number of grafts been scalp hair, and not beard hair. I'm speculating that Dr. Umar is only considering using beard as a 'filler" for you anyway, and certainly not as a primary source. It works excellent for that. When I saw Dr. Umar over 4 surgeries, I used my precious remaining scalp hair (less than 1500 grafts) to rebuild my hairline. Dr. Umar also softened it with the use of nape hair. I'm as pleased as one can be with my hairline, because, quite honestly, I don't think there is much you can improve on the result.

As far as the scalp itself, damaged over years of botched surgeries, I've come very far with the beard hair, but it is still not as far as someone who got purely scalp hair. I have a lot of disadvantages, they being the frontal half of my scalp covered in "mini-grafts", which are smaller plugs, as well as very fine hair and a lot of contrast between dark hair and pale skin. I'm not comfortable under bright lighting to this day as a result, but if I have to, I can pull it off (without the use of concealers) If my crown was not bald I would (possibly) apply a concealer every day and never worry again, but having a bald crown makes using a concealer tricky and unpredictable. So I don't use them.

I wouldn't worry about using beard hair if you are considering it, it works great at adding coverage and it also adds volume, which was a huge bonus for me, considering how fine my hair was. My numerous strip scars had around 1500 beard grafts added to them, and after temporary SMP I shave to a #1 guard in back.

Dr. Umar is expert at blending a variety of different sources into a totally natural looking result. He's expensive, but in my case, was literally the only doctor (other than Dr. Woods) who could have gotten the result he did on me. Three other highly touted doctors looked at me and could only sympathize with me. None of them could do anything, it was beyond their scope. It was beyond anyones scope other than these two doctors. And his scalp and nape hair hairline rebuild I'm still amazed by, even 4 years later.

That's just my experience, you can take it for what it's worth. If you choose Dr. Umar, consider whether or not you wish to aggressively confront your hairloss, or wish to take it slow. You can discuss this with Dr. Umar. When you've done what he has done with so many patients over the years, being "cautious" and "slow" is just not his style. If it was, people like myself would still be hiding under ball caps everywhere they went. He is aggressive and supremely confident in his abilities. Whomever you choose, best of luck in your search and with your result.

[hairyandthehendersons]

Thank both of you so much for the responses! This to me will be the biggest decision of my life. I have been battling this for alomst ten years so being able to put it behind me with a (relatively) lasting solution would be great. I am extremely active, surf, mountain bike, etc. so even though with a buzz cut i can get Topix to look pretty darn good, its a PIA to do every day and it doesnt work in those activities I said...although some how manages to stay on for other activities where i sweat a ton.
Wylie I am very happy to hear Dr Umar was able to help you. Luckily I have not had any surgeries in the past and have a good donor supply. So I am thinking it may be best for me to start slow with someone like Bernstein and move forward if im not satisfied to more aggressive techniques that Umar can help with.
Joe I was not aware nape hair was not a proven permanent replacement. I have so much of it that it would be a great source for me! Your insight has made me think things over more. Even though Berstien charges alot ($200) for just a consultation, I think I will go and see what he can do. The robotic ARTAS process looks good to me.
As for the propecia, I was on that for years and then switched to finasteride. It probably did really slow down my hairloss but it didnt regrow it. At that time I figured its expensive to keep up and as soon as I stop Ill lose it all anyways. Also I am concerned with side affects. Often with medication the bad side affects arent known for a long time after so I dont like the risk. I may consult a pharmacist about my rapid hairloss of lately. I am on medication for other reasons and it has been pretty dramatic hairloss lately..although my job has been incredibly stressful as well so maybe that is a factor. I have lots and lots of little micro hairs. I am trying to get pics up so you guys can get a better idea of what im dealing with.

[hairyandthehendersons]

https://drive.google.com/file/d/0B4D9ZmfCbwajZUd0Tm9Qd3VwekE/view?usp=sharing

https://drive.google.com/file/d/0B4D9ZmfCbwajMnFrYUFNSFc4MXc/view?usp=sharing

https://drive.google.com/file/d/0B4D9ZmfCbwajNGtONXdJOGRQcFU/view?usp=sharing

https://drive.google.com/file/d/0B4D9ZmfCbwajNVNBbkZ0YVlqams/view?usp=sharing

And this is what it looks like when i fix it all up with product. If I can achieve this with an HT Id be extremely happy

https://drive.google.com/file/d/0B4D9ZmfCbwajMDdxQkx6c1FSdXM/view?usp=sharing

[gillenator]

Dr. Umar is basically known for FUE and Dr. Bernstein more so for FUHT. IMHO, they are worlds apart in both philosophy and methodology.

From my knowledge, Dr. Bernstein offers both FUHT and FUE while Dr. Umar is totally committed to FUE including the use of BH.

Dr. Umar has been known to have performed large BH sessions and I don't believe Dr. Bernstein would consider performing mega-sessions of BH.

IMHO, they are at opposite ends of the spectrum.

[wylie]

I think you need to do more research, personally. If you choices are only narrowed down to Dr. Umar and Dr. Bernstein then you have not done enough research. It can never be stressed enough that you NEVER let travel decide what doctor you choose, you always choose the best doctor that your budget will allow, travel be damned.

Two things I would recommend, above all else:

1) Go with a conservative hairline. Start at the front and worry about your crown later. Use your scalp grafts to create a conservative hairline and back fill behind it to mid scalp. Your crown will go bald, so you can decide later if you need to utilize beard to fill it in.

2) Don't go with a strip. I highly recommend you go with FUE and avoid a strip scar at all costs. In 15 years we will be looking back at FUT like we look back at "scalp reduction" surgery today.

But keep asking questions, you've gotten a lot of good advice on this thread but you need to do more homework.

[Karlton]

If you are continuing to lose hair at the same rate, then that is a different story but that is where I would ask if you were using generic or name brand Proscar/Propecia. There is a difference.

I was just curious what the difference between a legitimate U.S. generic , and brand name Propecia would be. Obviously there are questionable generic versions of every drug, but are you saying there is something special about Propecia that makes it work better than other legitimate finasteride?

[caphead]

I think I can make the decison relatively easy for you-Dr. Umar

https://www.baldtruthtalk.com/showthread.php?6533-Scar-Repair-1032-beard-hair-grafts-Dr-Bisanga/page20

Take a look at the caphead post and you can also go to Dr. Umar's website and see the video.

Before my repair, I consulted many noted hair restoration Dr's. I even contacted the firm Joe, I believe, is with. I was told that they could do nothing for me.

I think you will see that the repairs I needed were because of the strip procedures.

Now my hair's repaired and restored by Dr. Umar. How nice to have it back again. I really can't thank Dr. Umar enough. He told me that I had little margin for error. Heed this warning and have Dr. Umar restore your hair the first time.

Regards, BBC

[JoeTillman]

Karlton,

I really don't know what the differences are from one generic to the next. However, not all generics are made with the same additional ingredients as the name brand, only the "active" ingredient. I know that if for example there are numerous patents on a medication the generic "equivalents" do not have to have the identical number of formerly patented ingredients to be labeled as equivalents. What is special about Propecia (and Proscar) is that they are the original of which all generics are measured against so the originals are the gold standard.

[JoeTillman]

https://www.baldtruthtalk.com/showth...Bisanga/page20

Take a look at the caphead post and you can also go to Dr. Umar's website and see the video.

Before my repair, I consulted many noted hair restoration Dr's. I even contacted the firm Joe, I believe, is with. I was told that they could do nothing for me.

I think you will see that the repairs I needed were because of the strip procedures.

Now my hair's repaired and restored by Dr. Umar. How nice to have it back again. I really can't thank Dr. Umar enough. He told me that I had little margin for error. Heed this warning and have Dr. Umar restore your hair the first time.

Regards, BBC

Which clinic was I at when you submitted? H&W or Rahal? Regardless, I'm glad for your repair but with all due respect your experience and needs are vastly different than that of the OP. He is looking at the differences between the two doctors mentioned and was told about the prospect of nape hair. I countered with the fact that nape hair is in many cases DHT sensitive. Dr. Umar does a lot of repair cases and there is no question that many are better off for it but your case and that of the OP are too different to compare.

[caphead]

I can only speak as to first hand experience and thus resulting expertise of Dr. Umar

Which clinic was I at when you submitted? H&W or Rahal? Regardless, I'm glad for your repair but with all due respect your experience and needs are vastly different than that of the OP. He is looking at the differences between the two doctors mentioned and was told about the prospect of nape hair. I countered with the fact that nape hair is in many cases DHT sensitive. Dr. Umar does a lot of repair cases and there is no question that many are better off for it but your case and that of the OP are too different to compare.

Hi Joe,

I sent photos to you while you were at H&W. I consulted many well known hair restoration Dr.'s regarding my desire for repair work. And I'm thankful for your forthright response that H&W could not help me.

With regard to the question at hand. I have no first hand knowledge of Dr. Bernstein. I can only speak as to Dr. Umar -the person that did the repair restoration on me. Again, if I had to do it all over again, I would not hesitate to use Dr. Umar at the outset. And if I had to do it all over again and FUE was available, I also would only and solely do FUE. In addition, the soon to be patient looks to have much work needed to be done if he wants a complete solution including crown. Donor of course, will be critical. The donor need could well be beyond the comfort zone of head only and/or Dr. Bernstein-again if the prospective patient wishes to have a complete solution. Someone thoroughly familiar with the use of and placement of all head, body, and beard hair could be most useful to establish most prudent use of precious graphs for the complete solution.

Thanks again for your prior help Joe-you are most thoughtful.

Regards, bbc ch