Please Help Me Choose A Strip Surgeon For First hair transplant On Virgin Scalp

[jcs87]

Hi all, I've been lurking on this forum for the past couple of months. Tremendous resource and I know so much more than I did just a few months ago.

I have decided that I am going to get a hair transplant to restore density to my hairline and fill in some of my temple angles - although I would be interested if folks here think I am doing this at too young of an age/stage of hair loss...

First the basics:

Age: 29
Location: Virginia, USA (East Coast / Mid-Atlantic area)
Age I started losing hair: Probably really started to notice it around 20 years old.
Past Surgeries: None
Treatment: Taken Propecia for the past 3 years. It definitely helped. I think it probably added some density in the crown and mid-scalp areas but the temples are still continuing to recede, albeit at a slower pace compared to when I wasn't on propecia.

I've used Rogaine on and off but I never felt like it was doing much and it would sometimes give me an itchy scalp so I haven't used it in about 12 months.

Ideally I'd like to get off Propecia because I don't like messing with my body's hormones like that and I've felt like the libido side effects have hit me at times (but never bad enough to stop taking the meds). But I am pretty sure that if I were ever to do that then my hair loss would come back with a vengeance...so I'm sort of on the fence about future propecia usage.

Most likely procedure: I'm leaning towards FUT Strip at this point

Based on a lot of research and consultations I've narrowed my list down to five top doctors (all prices have been converted to $USD so these prices will fluctuate a little bit with exchange rates). Also each doctor's treatment plan / pricing structure is slightly different but I assumed 2,500 grafts so that I could do an apples to apples comparison:

All Prices converted to $USD:

Dr. Pathomvanich in Thailand - $2.66 per graft for a total cost of $6,700
Drs. Hasson & Wong in Vancouver - $3.91 per graft. Total cost of $9,500 (this price factors in a $800 travel credit)
Dr Rahal in Canada - $3.88 per graft. Total cost of $9,700 (this price factors in a $1,000 travel credit and $1,500 in taxes)
Dr Alexander in Phoenix, AZ USA - $4 per graft = total cost of $10,000
Dr Gabel in Portland, OR USA - $4 per graft + $500 setup fee = total cost of $10,500

I'm basically looking to balance price with skill/quality. As far as I can tell all of these doctors are very skilled and widely respected. Dr Path is significantly cheaper than the other three (and I go to vacation in Thailand once a year so I was thinking I could kill two birds with one stone and do the surgery while I'm there anyways.) That being said, if the consensus is that one of the other three doctors is far and away a much better surgeon then perhaps I'd reconsider and spend the extra money...

I'm leaning towards Dr Path and just scheduled a surgery date for mid Feb'17 (I still have ~10 days to cancel without any penalty though). The price is right and he seems to be quite well respected but I have some concerns:

1. It sounds like his nurses do all of the graft placement - he only handles the strip removal and lateral slit incisions. I would prefer that my doctor is involved in every step of the process (even though I understand it would be impossible for him to plant every single graft)
2. I came across this very negative hair transplant experience that someone had on hair Restoration Network: http://www.**********************.co...way-him-3.html
3. In that same thread there are a number of people chiming in saying that Dr Path's results have gone downhill in the past year or two.
4. On the other hand, I have gone through countless threads posted by both patients and by Dr Path himself and the results seem good so I may be allowing a few negative experience to stress me out too much
5. Dr Path received very strong endorsements from Dr Wong (2006) and Dr Parsley (2002)

I'd love to get some feedback on (1) How appropriate a hair transplant would be for me at this point in time (2) Which doctor to go with.

Thanks everyone!

Also, a quick guide to the photos:

The ones with a buzzed head are from 2013 and 2014 - As you can see it looks like I'm destined to be a Norwood 6..but Propecia has been very helpful in halting and reversing some of this. Still, noticeable receding hairline and miniaturization of hairs in the front.

The one taken outdoors in a grey t shirt was done with pretty wet hair to fully showcase my hair loss

The ones outdoors/indoors in a brown jacket were taken at a BBQ so they are showing what the hair looks like in the wild when it is recently cut and styled (hair doesn't look nearly as bad in these angles). No concealers.

The selfie style with a sweater on (taken while I'm seated) is probably the best representation of what my hair looks like these days when it is dry and styled normally (no concealers or anything else were used in this photo). The mid-scalp and crown are perfectly acceptable but the front third, hairline, and temples, are what bother me at this point.

Lastly, the selfies with no shirt on are what the hair looks like when I comb the hair forward to illustrate the hair loss (I never style my hair like this though)

[Stevedawg18]

Hi,

I've had a procedure with Dr. Wong and can attest that I had a very positive result and the scar is not a problem for me at this point. However I'm looking at your photos and where it's shaved really close on the sides you could not pull off after FUT which is too bad because it looks really sharp. So if you want to keep that hair cut I wouldn't do a strip.

[gijedi]

I went to Dr. Alba Reyes Sajiv in Santo Domingo, Dominican Republic. Went after seeing two of friend's results. I went early 2015 and am very happy with results. Around 2,400 grafts. She doesn't charge by graft but by procedure. Around $4.5K or so. She has excellent results. From Virginia, that's a quick trip for you.

[rbkoreaus]

Hi all, I've been lurking on this forum for the past couple of months. Tremendous resource and I know so much more than I did just a few months ago.

I have decided that I am going to get a hair transplant to restore density to my hairline and fill in some of my temple angles - although I would be interested if folks here think I am doing this at too young of an age/stage of hair loss...

First the basics:

Age: 29
Location: Virginia, USA (East Coast / Mid-Atlantic area)
Age I started losing hair: Probably really started to notice it around 20 years old.
Past Surgeries: None
Treatment: Taken Propecia for the past 3 years. It definitely helped. I think it probably added some density in the crown and mid-scalp areas but the temples are still continuing to recede, albeit at a slower pace compared to when I wasn't on propecia.

I've used Rogaine on and off but I never felt like it was doing much and it would sometimes give me an itchy scalp so I haven't used it in about 12 months.

Ideally I'd like to get off Propecia because I don't like messing with my body's hormones like that and I've felt like the libido side effects have hit me at times (but never bad enough to stop taking the meds). But I am pretty sure that if I were ever to do that then my hair loss would come back with a vengeance...so I'm sort of on the fence about future propecia usage.

Most likely procedure: I'm leaning towards FUT Strip at this point

Based on a lot of research and consultations I've narrowed my list down to five top doctors (all prices have been converted to $USD so these prices will fluctuate a little bit with exchange rates). Also each doctor's treatment plan / pricing structure is slightly different but I assumed 2,500 grafts so that I could do an apples to apples comparison:

All Prices converted to $USD:

Dr. Pathomvanich in Thailand - $2.66 per graft for a total cost of $6,700
Drs. Hasson & Wong in Vancouver - $3.91 per graft. Total cost of $9,500 (this price factors in a $800 travel credit)
Dr Rahal in Canada - $3.88 per graft. Total cost of $9,700 (this price factors in a $1,000 travel credit and $1,500 in taxes)
Dr Alexander in Phoenix, AZ USA - $4 per graft = total cost of $10,000
Dr Gabel in Portland, OR USA - $4 per graft + $500 setup fee = total cost of $10,500

I'm basically looking to balance price with skill/quality. As far as I can tell all of these doctors are very skilled and widely respected. Dr Path is significantly cheaper than the other three (and I go to vacation in Thailand once a year so I was thinking I could kill two birds with one stone and do the surgery while I'm there anyways.) That being said, if the consensus is that one of the other three doctors is far and away a much better surgeon then perhaps I'd reconsider and spend the extra money...

I'm leaning towards Dr Path and just scheduled a surgery date for mid Feb'17 (I still have ~10 days to cancel without any penalty though). The price is right and he seems to be quite well respected but I have some concerns:

1. It sounds like his nurses do all of the graft placement - he only handles the strip removal and lateral slit incisions. I would prefer that my doctor is involved in every step of the process (even though I understand it would be impossible for him to plant every single graft)
2. I came across this very negative hair transplant experience that someone had on hair Restoration Network: http://www.**********************.co...way-him-3.html
3. In that same thread there are a number of people chiming in saying that Dr Path's results have gone downhill in the past year or two.
4. On the other hand, I have gone through countless threads posted by both patients and by Dr Path himself and the results seem good so I may be allowing a few negative experience to stress me out too much
5. Dr Path received very strong endorsements from Dr Wong (2006) and Dr Parsley (2002)

I'd love to get some feedback on (1) How appropriate a hair transplant would be for me at this point in time (2) Which doctor to go with.

Thanks everyone!

Also, a quick guide to the photos:

The ones with a buzzed head are from 2013 and 2014 - As you can see it looks like I'm destined to be a Norwood 6..but Propecia has been very helpful in halting and reversing some of this. Still, noticeable receding hairline and miniaturization of hairs in the front.

The one taken outdoors in a grey t shirt was done with pretty wet hair to fully showcase my hair loss

The ones outdoors/indoors in a brown jacket were taken at a BBQ so they are showing what the hair looks like in the wild when it is recently cut and styled (hair doesn't look nearly as bad in these angles). No concealers.

The selfie style with a sweater on (taken while I'm seated) is probably the best representation of what my hair looks like these days when it is dry and styled normally (no concealers or anything else were used in this photo). The mid-scalp and crown are perfectly acceptable but the front third, hairline, and temples, are what bother me at this point.

Lastly, the selfies with no shirt on are what the hair looks like when I comb the hair forward to illustrate the hair loss (I never style my hair like this though)

Have you considered or done a consult with Dr. Matt Huebner in Alexandria? I have a friend who got his HT with him and I thought the results were good. If I were you, I would also strongly consider how accessible your HT doctor is to you post-surgery. So perhaps try to consider consulting with more doctors within a day's drive of you.

Since price is such a factor from what you're saying, I would NOT even consider a HT if you're going to stop propecia altogether. If you do that, consider how many future HTs you may have to get that much sooner to offset all the hairs you had maintained with propecia.

[J_B_Davis]

All the surgeons you have mentioned show very consistently superior results. Personally, I think it's best to stick with those in the IAHRS, and I would not be to concerned about traveling within North America. Things get more complicated when when traveling outside of the U.S. and Canada. I've heard that IAHRS doctors will do followup with patients who go to other IAHRS doctors, like for staple or suture removal, exams and such, which is an important factor. I don't know much about Dr. Pathomvanich, but traveling that far for surgery with no local followup could be risky.

[KO1]

I think Gabel is really good at FUT.

[Sean]

Jc, tread carefully.

HW do great work for the most part. In the end it is upto you and be careful.

Good luck and best wishes. I did respond to you at another place and really hope you get what you seek.

[jcs87]

Hi,

I've had a procedure with Dr. Wong and can attest that I had a very positive result and the scar is not a problem for me at this point. However I'm looking at your photos and where it's shaved really close on the sides you could not pull off after FUT which is too bad because it looks really sharp. So if you want to keep that hair cut I wouldn't do a strip.

Thanks Stevedawg. That's good to know because I do like to keep my hair pretty short so based on feedback I'm actually reconsidering if FUE would be a better choice for me (I had previously been thinking strip for lower transection rates and significantly more affordable)

[jcs87]

Have you considered or done a consult with Dr. Matt Huebner in Alexandria? I have a friend who got his HT with him and I thought the results were good. If I were you, I would also strongly consider how accessible your HT doctor is to you post-surgery. So perhaps try to consider consulting with more doctors within a day's drive of you.

Since price is such a factor from what you're saying, I would NOT even consider a HT if you're going to stop propecia altogether. If you do that, consider how many future HTs you may have to get that much sooner to offset all the hairs you had maintained with propecia.

I hadn't heard of Huebner before. TBH, I just looked him up and wasn't too impressed with his results. I think if I'm going to do this I am only going to go with a surgeon that is considered elite and is well known on the forums.

I also think that's a fair point about the propecia, I was thinking along similar lines that maybe I should figure out what I want to do with Propecia before doing any surgeries.

All the surgeons you have mentioned show very consistently superior results. Personally, I think it's best to stick with those in the IAHRS, and I would not be to concerned about traveling within North America. Things get more complicated when when traveling outside of the U.S. and Canada. I've heard that IAHRS doctors will do followup with patients who go to other IAHRS doctors, like for staple or suture removal, exams and such, which is an important factor. I don't know much about Dr. Pathomvanich, but traveling that far for surgery with no local followup could be risky.

Thanks, is IAHRS considered the most elite membership organization for hair surgeons? As far as I can tell anyone can join ISHRS so membership there means nothing to me. Are there other organizations that only allow membership to elite surgeons?

I think Gabel is really good at FUT.

Thanks, as in he’s better than H&W and Rahal or just considered to be in the same league. It seems like H&W and Rahal are superstar surgeons and get a lot of name recognition whereas Gabel is very good but doesn’t have the same celebrity status.

Jc, tread carefully.

HW do great work for the most part. In the end it is upto you and be careful.

Good luck and best wishes. I did respond to you at another place and really hope you get what you seek.

Hi Sean! I’m very sorry I didn’t respond to your message on the other forum. I read it and appreciated the response but for some reason the messaging system is not allowing me to reply to any messages…I spent a while trying to respond to you but it kept giving me error messages!

I was going to send you a private message on this forum but it looks like that capability doesn’t exist here…I don’t want to publicly post my email here so could you shoot me another private message on the other forum with your email and I can reply to you that way.

[KO1]

I wouldn't get too focused on the celebrity status. Some doctors are better at marketing than others, and have developed vocal "fan bases" (That doesn't mean they are bad, just have more public following). I would add these to your list: Konior, Shapiro, and Cooley. Konior is my favorite, but he has a long wait list of a year. IMHO Path is ok, but I think for FUT, it may be best to stay in NA.

Also, please don't price shop or rank by price. Go with the clinic you are most comfortable with. The price difference will be negligible if you get a good result.

[jcs87]

I wouldn't get too focused on the celebrity status. Some doctors are better at marketing than others, and have developed vocal "fan bases" (That doesn't mean they are bad, just have more public following). I would add these to your list: Konior, Shapiro, and Cooley. Konior is my favorite, but he has a long wait list of a year. IMHO Path is ok, but I think for FUT, it may be best to stay in NA.

Also, please don't price shop or rank by price. Go with the clinic you are most comfortable with. The price difference will be negligible if you get a good result.

Thanks KO1. I agree with you on the whole celebrity thing - I didn't mean to imply that celeb status was a pre-requisite to make my short list.

I've already decided to add Shapiro to my list because you are one of many people to tell me to do so.

Konior is a name that has come up multiple times as well but it sounds like his wait list is crazy. Do you have any idea of his prices?

What's the deal with Cooley, I hadn't heard of him at all but you're now the second person to mention him.

Also, in regards to the whole price thing this is my mindset:

It seems like pretty much everyone agrees that the Shapiro's and H&W's are on a different level than Dr Path. But what I am trying to determine is just how much of a difference there is. I.E. if we took a 100 point scale and said Shapiro is a 99-100 then is Dr Path a 96? Because in that case perhaps there is an argument to be made to save $3000-$4000 and go with him. Or are we saying Dr Path is an 82, in which case it is most likely worth it to pay the extra money and get that big jump in quality.

I know that it's impossible to give each surgeon a score out of a 100 so I don't mean this in a literal sense...more so just trying to get a sense just how much of a difference there is in skill.

P.S. Based on feedback and further convos with some folks I think I was a bit premature in leaning so heavily towards FUT over FUE... so I have re-opened that avenue of research and Doctor Lupanzula is on my short list for high skill/reasonable prices. I followed your thread on another forum and may have some questions for you on your experience with him (if you don't mind)

[KO1]

Konior is probably the most expensive of the surgeons that are discussed on here, I think he is around $5/FUT and $8-$9/FUE. I think he might be slowing down a bit and reducing the number of patients. Cooley is also well respected at FUT, he's an innovator and very experienced. I understand what you're trying to do, but it's really not possible to rank clinics in the way you mentioned, and if you were to, it would simply be an opinion based on limited data. If money were no object, who would you go to?

Feel free to ask away on my thread. When it comes to FUT vs FUE, take everybody's opinion with a grain of salt, while the forums are great, they also lend themselves to passionate cheerleading from posters, both for surgeons as well as techniques, and posters get emotionally invested in clinics and techniques. There are good clinics for either technique these days....what are you more comfortable with? (recurring theme)

One thing I am concerned is that you already have an HT booked for next month while also being in the exploratory stage in terms of looking at clinics....

[Hairbrain]

I wouldn't get too focused on the celebrity status. Some doctors are better at marketing than others, and have developed vocal "fan bases" (That doesn't mean they are bad, just have more public following). I would add these to your list: Konior, Shapiro, and Cooley. Konior is my favorite, but he has a long wait list of a year. IMHO Path is ok, but I think for FUT, it may be best to stay in NA.

Also, please don't price shop or rank by price. Go with the clinic you are most comfortable with. The price difference will be negligible if you get a good result.

Good points. I think the Drs listed above are in an elite class even as far as IAHRS recommended surgeons are concerned. I had my last procedure with Dr. Wong (3200 grafts) who also in my opinion belongs in that class. I can not attest to my end result as of yet because I am just shy of my second month. I can tell you Dr. Wong was very involved in each step of the procedure. Certainly a Dr who cares about each and every graft as well as the desires and well being of the patient. I did have a strip so I'm sharing from my own perspective.
Just a couple of thoughts from a HT veteran, 1. DONT make your consderations based on price. An extra few grand will compare very little to your final result that you will forever live with. 2. Stick with IAHRS, the ISHRS from tbe consumers aspect is a joke in my opinion. They have no critical feed back of their members or any forum to provide patient feed back. They are self regulated and as long as you pay your dues, show up to a convention you get your badge. There are numerous complaints and very poor results from Drs. holding that moniker. Do enough internet searching you will see. 3. If your still on the fence about who to go to and why then there is no question in my mind you should cancel your upcomming appointment and take a deep breath. You are asking very important qustions you are unsure about very late in the game. Good Luck

[jcs87]

Konior is probably the most expensive of the surgeons that are discussed on here, I think he is around $5/FUT and $8-$9/FUE. I think he might be slowing down a bit and reducing the number of patients. Cooley is also well respected at FUT, he's an innovator and very experienced. I understand what you're trying to do, but it's really not possible to rank clinics in the way you mentioned, and if you were to, it would simply be an opinion based on limited data. If money were no object, who would you go to?

My initial starting point for getting this short list was to cross-reference the recommended surgeon lists from IAHRS, American Hair Loss Association, Hair Transplant Network, and Bald Truth Talk. I figured that doctors that kept showing up on all of those lists were worth looking into.

As far as I can tell Dr Konior is only recommended on this site, none of the others - so that's why I was not aware of him when putting together my list. Is there any back story to why he isn't recommended on the other sites (pretty much all of the other elite docs I'm considering are recommended on each site). You mentioned that he has a 1-year wait list so is he simply making so much money that he doesn't feel the need to 'play the game'?

If money were no object I'd probably go with H&W. If I went that route then the next question I would try to explore is whether to go w/ Hasson or Wong. I've heard a couple well respected ppl in the community say to go with Wong but I'd be interested to hear your thoughts.

Is Cooley considered to be in the same elite level as H&W, Shapiro, Etc.? I have seen his name come up a couple times now.

Feel free to ask away on my thread. When it comes to FUT vs FUE, take everybody's opinion with a grain of salt, while the forums are great, they also lend themselves to passionate cheerleading from posters, both for surgeons as well as techniques, and posters get emotionally invested in clinics and techniques. There are good clinics for either technique these days....what are you more comfortable with? (recurring theme)

Excellent advice, I will take this into account.

In my mind it would seem that the main advantages of FUT is that as a general rule of thumb you can get more grafts by doing FUT first and then FUE at a later point in time. And secondly, it's just cheaper - I simply can't afford to do $7-9 per graft for FUE. On the other hand w/ FUE you don't have the linear scar and I do like to keep my hair short at times so this is a big benefit. That's why I've opened up my search to FUE (clinics in Europe specifically since they seem to have more reasonable pricing)

One thing I am concerned is that you already have an HT booked for next month while also being in the exploratory stage in terms of looking at clinics....

Yeah it seems pretty clear to me that I jumped the gun and need more time to research further and continue the education process. I am 95% sure I am going to cancel the surgery - I still have a few days to do so within the free cancellation period.

[jcs87]

Good points. I think the Drs listed above are in an elite class even as far as IAHRS recommended surgeons are concerned. I had my last procedure with Dr. Wong (3200 grafts) who also in my opinion belongs in that class. I can not attest to my end result as of yet because I am just shy of my second month. I can tell you Dr. Wong was very involved in each step of the procedure. Certainly a Dr who cares about each and every graft as well as the desires and well being of the patient. I did have a strip so I'm sharing from my own perspective.
Just a couple of thoughts from a HT veteran, 1. DONT make your consderations based on price. An extra few grand will compare very little to your final result that you will forever live with. 2. Stick with IAHRS, the ISHRS from tbe consumers aspect is a joke in my opinion. They have no critical feed back of their members or any forum to provide patient feed back. They are self regulated and as long as you pay your dues, show up to a convention you get your badge. There are numerous complaints and very poor results from Drs. holding that moniker. Do enough internet searching you will see. 3. If your still on the fence about who to go to and why then there is no question in my mind you should cancel your upcomming appointment and take a deep breath. You are asking very important qustions you are unsure about very late in the game. Good Luck

Thx HairBrain

Would you say Cooley is considered to be in the same elite level as H&W, Shapiro, Etc.? I have seen his name come up a couple times now.

Why did you choose Dr Wong over Hasson?

Completely agree regarding ISHRS - I'm not factoring that into my decision at all.