Dr cole for my hairline?

[Ziggyz123]

Anyone have any thoughts on dr cole for hairline work? Was going to use Rahal, but I think I pissed off the patient advisor about being indecisive lol.

I
Really don't want a "see through hairline"

[BiqqieSmalls]

Can you post any pictures?

[JoeTillman]

Hi Ziggy,

I dont think it's possible to piss Chad off, if that is the patient adviser you are talking about He's too much of a laid back guy. Regardless, always look in the gallery of the doctor you're considering to see if what you want is there. Speak to patients and you'll have a good idea of what that doctor may be able to do for you but ultimately, you'll never know if he'll even try unless you send in your photos and talk to the doctor on the phone. Dr. Cole makes natural hairlines, no question about it, but he and Dr. Rahal have two different styles so give him a call and see what he says.

[Spex]

Really don't want a "see through hairline"

I would advise keeping your expectations in check and realistic when it come to HT hairline.

[Ziggyz123]

Joe! I actually consulted with Robert at Rahal via email. I sent pictures and all, but ultimately decided on fue over strip because of age (24). After juggling funds, I got the money together, but did a lot more research about doc's in turkey, mainly Dr. Koray, and also doctors on the east coast where I'm located. I was ultimately trying to do about 1800-2000 but my financial situation limits me to only $10,000..

Btw, can't wait for your travels and how you document them! Really exciting breaking this barrier and showing what its is all about.

Spex! I'm totally realistic, but I really need to be confident that I'm making the right choice with the right doctor. I don't want a pluggy look or it will all be for nothing and I'll be out a lot of moola. This is why I looked into Dr. Rahal because I know he does a good sense hairline, however I don't want to waste all my grafts.


If pictures would help, would you both be able to possibly look and tell me if I am being realistic? I drew on a few to show what I'd like done... I know, I'm weird..

Thanks again!

[John P. Cole, MD]

Yes, Joe, I would say that Dr. Rahal and I have two different styles. Dr. Rahal has nurses that extract grafts and I extract my own grafts. I have never let a nurse extract a graft. That's a huge difference. I would never go to a dentist that let the hygienist drill on my teeth anymore than I would go to a doctor that lets nurses or assistants with minimal or no formal medical training to drill on my head. I also don't own an ARTAS and he does.

Ziggy, I have many patients from a diverse economic background. Some are the most wealthy men in the world. They are very discriminating and could go anywhere they want. They come to me because I have more FUE experience than anyone in the world. Obviously, they are not going to allow their photos to be published. However, I also have patients with very limited budgets. If a patient is a good guy and he has limited funds, I never let this stand in the way of working for him. I am very fast with my hands and I have the best equipment. You see, when I started doing FUE in 2002, there was no equipment to do the procedure. Therefore, I made my own and it is the best in the world. Now the entire world buys my equipment. All of these advantages I have allow me to offer my skills to patients from many different walks of life.
Not only this, I partner with great clinics because we want to offer the best possible procedure to patients all over the world. I do not work with clinics that employ nurses to cut grafts. That's why we started a hair transplant training facility only for physicians in Ankara, Turkey where we are in the process of training 95 physicians from around the world. We want to stamp out this black market hair transplant surgery because it is nothing more than a cancer to the hair restoration field. It is unethical and highly illegal, but clinics are getting away with it probably because the regulatory bodies have never seen anything like it in the world so they have no idea how to deal with it. Imagine going in for a heart bypass surgery. The doctor leaves the OR for coffee and doughnuts while the nurse takes over to do the surgery. If a nurse sees a procedure enough times, the nurse might possibly do the procedure, but as the doctor stuffs himself with doughnuts his skills atrophy. Then one day the nurse gets a better job offer from another doctor who who also prefers doughnuts to surgery. Now your heart surgeon who has not done a bypass in 2 years has to do a procedure in which he may well have forgotten some intricate details. Hair surgery is no different with the exception that many physicians offering FUE today have no idea how to extract the grafts. Thus, if you show up on the unlucky day where the experienced nurse leaves for a more lucrative offer with another physician, you are stuck with a novice nurse and an incompetent physician. If you understand it, I think you would say no thanks. That's why I'll match or find a way to match any offer you have so that you do not find yourself in the unfortunate position of having to trust the appearance you will carry for the rest of your life to a clinic that employs nurses or assistants with little or no formal medical training to extract grafts.

[Ziggyz123]

Well, I must say that this was a surprise for me. Not once has a doctor that I have extreme interest in replied to a thread I've posted.

Dr. Cole,
Thank you so much for this reply. I would like to say that when researching which doctor to chose, my searches kept leading me to results telling of the professional manner in which you operate. This totally proves every thing I've read about you. I did have issues with traveling to another country for a transplant and getting duped ito thinking one thing and getting something totally different.

This is an extremely vulnerable time for me and I'm sure that anyone reading this will agree with that. All I want is complete trust and an actual relationship between myself and the doctor that is helping me regain not only my hair, but my life. I've actually watched videos of you extracting grafts and speaking on things such as PRP.. This has sort of become my obsession, but even more, you seem to share that obsession with me and that's what I am looking for.

This has truly helped me and I want to thank you again for that reply. Just showing interest and saying, "chose me!", would have made me feel a little better haha. But, you took what seems to be a lot of time into that post and that's great!

I'll be in contact with you soon
Thank you again, it means a great deal to me !

[JoeTillman]

Joe! I actually consulted with Robert at Rahal via email. I sent pictures and all, but ultimately decided on fue over strip because of age (24). After juggling funds, I got the money together, but did a lot more research about doc's in turkey, mainly Dr. Koray, and also doctors on the east coast where I'm located. I was ultimately trying to do about 1800-2000 but my financial situation limits me to only $10,000..

Btw, can't wait for your travels and how you document them! Really exciting breaking this barrier and showing what its is all about.

Well, I've never met Robert so I have no comment on that I'm sure if you called him he'd tell you that you didn't make him mad. I'm excited about my trip too and I've got some gear to help me with the recording process. I think the toughest part will be stitching everything together once I get home.

John P. Cole, MD
Yes, Joe, I would say that Dr. Rahal and I have two different styles. Dr. Rahal has nurses that extract grafts and I extract my own grafts. I have never let a nurse extract a graft. That's a huge difference. I would never go to a dentist that let the hygienist drill on my teeth anymore than I would go to a doctor that lets nurses or assistants with minimal or no formal medical training to drill on my head. I also don't own an ARTAS and he does.

Dr. Cole,
When I was at Dr. Rahal's office he was using a technician and a doctor was working with this technician side by side.I get and understand your position but I was not referring to the extraction differences, I was referring to the design differences.

The technician only clinics in Turkey are an abomination to the field which is why I am working with a doctor in Turkey that also does all the work himself save for actual placement. Dr. Karadeniz performs all the FUE extractions and he makes all of the incisions. He has a relatively safe and sensible approach to hair restoration surgery with only one procedure performed per day. Since you are now apparently involved in the Turkish market you obviously know that the vast majority of clinics do indeed operate as "technician clinics" and I feel this is wrong.

The problem is that the majority of people don't know this until it is too late and part of the reason why is because of the middle men booking agencies that have set up shop in France, Germany and the UK. They misrepresent the procedure, whom it is that is performing the procedure, and the overall graft numbers to be moved. In many cases they wind up taking up to 30% of the total surgical fee for themselves as their booking commission. If these operations were shut down or at the very least severely restrained then you'd see the Turkish market transform into something completely different in an extremely short period of time similar to what happened when the Turkish governent required all clinics to cease and desist the use of cheap two storey apartment flats for surgery just a year or two ago.

I'd like to know more about this training program going on. Is there a link that you can share?

[JoeTillman]

Hi Joe, Cole Instruments have the hair restoration training program page: http://www.coleinstruments.com/hair-...aining-program
were doctors can apply for the program, i will post a link to more information about the training in Turkey once it will be up online.

Thanks, Forhair. I look forward to learning more.

[John P. Cole, MD]

No problem, Ziggy. Happy to help out. We are in the care for people industry. My philosophy is that God gave me a great opportunity in life to help others. God did not do this so that I could help only those with massive bank accounts. I try to help anyone as long as they have realistic expectations and they psychologically understand what is possible and what is not. Like it or not, the quality of the donor area and the degree of hair loss always control the final result. One cannot turn straw into gold and one cannot turn a poor candidate into Elvis Presley. One also cannot help one who does not have hair loss, but they believe that they do.

Joe, Dr. Rahal does allow technicians to extract grafts. I don't agree with this practice. However, I don't think it is the place of the ISHRS to dictate how physicians operate their practice. It's up to regulatory agencies to control how physicians manage their practice. I believe that surgery should be in the hands of trained physicians and not technicians.

I'll take my design because it plans for the next 20 to 40 years rather than for the next 5 years. If you are too aggressive in a young patient, it looks great when they are young or when they don't loose more hair. However, 10 to 20 years down the road, it looks like a transplant or something fake. My philosophy is to make a man look natural for life rather than buy him a few good years followed by a lifetime of misery wishing he had never had the procedure in the first place.

The big change in FUE in the past five years is donor area management. Not everyone understand this. This comes from experience and an persistent drive to produce better results.

Two story flats are not the problem in Turkey and neither is the problem limited to middle men. There are ridiculous laws in Turkey such as the height of the surgery room must be a minimum and if it is 1 cm less, it is not allowed to function as a surgery room. There is nothing wrong with doing a quality procedure in a two story flat without sedation. However, in Turkey, the surgery must legally be done in a hospital. Thus, everyone is moving to hospitals and often the rooms are just rented for the surgery. This just moves the problem from one address to another address. There is no need for this. The problem in Turkey is that a single physician hires multiple technicians to perform the extractions and often the recipient sites for a very low cost. The physician generally does not want to train other physicians how to perform the surgery because they are afraid the physician will move across the street, take some technicians, assistants, front office people, salesmen, and nurses and open a competing clinic. With technicians doing the surgery, the physician (owner) can do 4 surgeries simultaneously at a savings to the patient. Technicians can often do the surgery better than the doctor because doctors do not all have great hands just as not all people can draw beautiful pictures. However, assistants are prone to move for a better opportunity with another physician and again, you can get stuck on the most important day of your hair transformation day with someone who is a novice. Another glaring problem, is that clinics in Turkey often over estimate the number of grafts required to treat hair loss. If you recommend 4000 grafts when 2000 grafts would be fine, you just turned a 2.5 euro a graft procedure into a 5 euro a graft procedure. Finally, clinics in Turkey are notorious for billing patients for grafts that were not done. They might do 2000 grafts and bill you for 4000 grafts. Again, they turn 2.5 euros a graft into 5 euros a graft through fraud. You have no legal recourse. Big clinics do their own marketing and they have their own traveling sales team. Stoping middle men from taking a 30% fee is not something that with negatively impact these clinics.

I have trained many physicians in the world including Drs. Bisanga, Mwamba, and Devroye, as well as others. All trained as assistants, watching me, and later I helped Drs. Bisanga and Mwamba open their practices. Unfortunately, I have had assistants who were not physicians watch me work and then go to work for other physicians doing surgery. I've seen assistants come to work after a long weekend of debauchery where we had to tell them to go home. Assistants are not under the control of any licensing body so if they show up still high from the weekend, they don't get in trouble. Physicians on the other hand loose their license. There is a moral code that goes along with being a physician that does not exist for assistants, who do surgery. If your moral code allows assistants to do surgery illegally, I wonder if their moral code will allow assistants who are clearly hung over to go on doing surgery.

In that I enjoy training physicians I sought to take this training beyond observation at a live surgery workshop. Live surgery workshops are great for a limited exposure. However, the physician often practices in an environment that is not his own. Often he does not have the equipment he uses day to day. The procedures are typically limited to a small number of grafts due to time constraints. There is limited exposure to the consultation, hairline design, and complications. Thus, I partnered with Dr. Ozgur Ozkan to offer a more extensive training fellowship lasting from one day to one month including consultation, patient assessment, determination of candidacy for surgery, hairline design, setting up for a procedure, observation of the procedure, meggassesions, complications, micro pigmentation (SMP), along with donor area management, etc. I set up the office with my own equipment so that physicians would get exposure to all of this along with a variety of other instruments. It is designed to be a comprehensive training program with exposure to a wide variety of surgical situations. One goal is to get enough physicians in the market place so that we eliminate assistant performed surgery. Another goal is to make hair transplant physicians better trained so that they can deliver the highest quality of service to patients. We have already trained 10 physicians.

It sounds like a good option for patients that you are working with, Joe. I wish you luck.