Do NOT Have a Hair Transplant!!!

[JoeTillman]

As I mentioned in another thread, I'm starting a new series on my Youtube channel to focus on hair loss and hair transplant education.


Class has started! This is episode #001

[JSmyth]

Hey Joe. I was wondering if you could shed some light on how to minimize these risks you mention. I have been consulting with Dr. Rahal for a FUE procedure. I am on the younger age spectrum (27 years old), but my loss isn't too bad. I have been recommended 1500 grafts.

[pafc66]

Your Dr is an idiot. Your hair is fine.

[JSmyth]

Your Dr is an idiot. Your hair is fine.

Why do you say that?

[Cheke1979]

that is a great question at the end of video first of all I don't think doctors should be transplanting hair on most patients under the age of 40 most people 40 or older are looking for a conservative approach and at 50 I'm sure they think even more conservative when a doctor wants to transplant 5000 grafts in one session that's scary! to much trauma, a good doctor will work with you to make a plan. small procedures over a period of 5 to 10 years sounds like less trauma no need to hurry as long you achieve your goal at the end. its surgery test the water before you jump in it and wait!!!

[JoeTillman]

Hey Joe. I was wondering if you could shed some light on how to minimize these risks you mention. I have been consulting with Dr. Rahal for a FUE procedure. I am on the younger age spectrum (27 years old), but my loss isn't too bad. I have been recommended 1500 grafts.

Minimizing risk involves some of the following considerations.

1. Don't go just by photos and video. Do everything you can to meet patients face to face. This could require travel but a couple of days and the cost of a plane ticket and hotel is well worth the investment and is peanuts next to the cost of a surgery.

2. Make sure the doctor has a reputation worth considering. This is obvious but you still owe it to yourself to dig deep.

3. Consider what you will do if you are unhappy with the result for any reason. Will you be content trying to "fix" whatever the potential problem may be or will you accept the chance of dissatisfaction and move on? Are you even sure you want to fix something that you just said isn't a big deal to begin with? Is it worth the risk to you?


These are but a few of the questions that anyone should be asking themselves before a procedure. What may seem to be a minor problem to fix can turn into a giant problem to fix again, and again.

[JoeTillman]

that is a great question at the end of video first of all I don't think doctors should be transplanting hair on most patients under the age of 40 most people 40 or older are looking for a conservative approach and at 50 I'm sure they think even more conservative when a doctor wants to transplant 5000 grafts in one session that's scary! to much trauma, a good doctor will work with you to make a plan. small procedures over a period of 5 to 10 years sounds like less trauma no need to hurry as long you achieve your goal at the end. its surgery test the water before you jump in it and wait!!!

I agree that 5000 grafts is too much but I've seen too many men aged 40 and 50 want the same aggressive hairlines that younger patients want. It's all about education and getting people to understand two things. 1. They don't have to have surgery. 2. If they have surgery they don't have to look like they're a teenager again. The wrinkles don't look good with a Justin Bieber hairdo.

Funny thing you said, making a plan over the course of several years. This is exactly what I did but it wasn't so much of a plan as it was just the way things turned out. I used to be the posterboy for super megasessions yet I never once had a procedure over 2500 grafts

[PayDay]

This is a great video, it highlights the importance of doing research and knowing what you're getting into before you have surgery. I also enjoy watching you on Spencer's show Joe. You guys are doing God's work. I mean it! TBT has literally saved my life, it's been my therapy for many years and think you have been a really good addition to the show. I only wish it was on more often. Twice a week would be great! For a while Spencer was doing two shows a week, see if you can talk him into doing that again, will you?

[ClideChamberland]

Your Dr is an idiot. Your hair is fine.

not idiot. he must be bald. want to see him bald too

[Cheke1979]

in my opinion if somebody waits until there 40 or 50 and does small procedures over a period of time there going to know what there getting into and what there going to expect now if a person does a big mega session there expecting a nice result but if something goes wrong that will be major setback especially on young people trust me what somebody wants at age 25 is not what they going to want at age 50 higher hairline less density looks more natural when someone is older and this can be done with smaller procedures!! most hair doctors (not all) take advantage of young people all the time if everybody would wait most of these doctors would be out of buisness and only the old school doctors would remain

[Driver]

Joe,
Nicely done. A lot of hard truths that people need to hear. I suspect that most who want HT will find their way to it one way or another, but this helps make the risks very clear to potential HT patients.

Sorta like the black box on tobacco, "Smoking may be harmful to your health."

"Hair transplants may be harmful to your head (and psyche!)."

[JoeTillman]

This is great. I wish we had more open discussant about approaches to minimize risk as opposed to all the mega session talk One complaint we often get from patients is why we are not more aggressive or do larger cases and the truth is we want to minimize the patient risk(even though the patients do not want to hear that and even though larger case = more profit) people are just in to much of a rush.

Thank you, Dr. Rashid. The issue with smaller sessions can also backfire in a discussion because multiple smaller surgeries are a bigger profit maker than bigger surgeries. For instance, look at the following scenario.

Clinic A charges 5.00 per graft for the first 2000 grafts then charges 3.00 per graft for everything over 2000. The patient gets a procedure of 4000 grafts and pays 16,000.00 before tax.

Clinic B charges the same rate, 5 then 3, and the patient gets two procedures of 2000 grafts each time. Same number of grafts, same result, but clinic A made 4000.00 less than clinic B. The reason is because the fee resets back to 5.00 for every new surgery.

Not to mention there is an argument to be made for larger single sessions vs. smaller multiple sessions as the law of averages dictates that the odds of failure go up with each subsequent procedure.

I personally believe that there should be a balance. Not too much but just enough to address any single area properly before moving on to the next area of the scalp.

[Mountinvan]

Joe wrote "Not to mention there is an argument to be made for larger single sessions vs. smaller multiple sessions as the law of averages dictates that the odds of failure go up with each subsequent procedure. " I thought smaller sessions cause less head trauma---why do subsequent procedures then increase odds of failure? Does FUE after FUT reduce those odds of failure?

[JoeTillman]

Joe wrote "Not to mention there is an argument to be made for larger single sessions vs. smaller multiple sessions as the law of averages dictates that the odds of failure go up with each subsequent procedure. " I thought smaller sessions cause less head trauma---why do subsequent procedures then increase odds of failure? Does FUE after FUT reduce those odds of failure?

Hi Mountinvan,

The issue is one of balance. Think of it like this. To understand my "balance comment" look at the life of a tightrope walker. With every successful step the odds increase of the next step not being so successful. With surgery it can be expected that with each successful outcome of a procedure, the more often you perform that same procedure on the same patient the odds go up that a failure (to some degree) will occur.

Smaller sessions DO cause less trauma, on two fronts. The donor and the recipient. The fewer holes you have made in your head the less trauma your body experiences. This goes for both the recipient and the donor areas but you have to have a certain degree of trauma (extractions/ donor strip size, number of incisions) to deem a procedure to be worthwhile. For instance, if you're a NW4 (see image below) it can be said that you'll need roughly (+/- a few hundred) 5000 grafts.



This will be to allow for enough density in the front and acceptable coverage for the back. I personally don't like these sized sessions anymore because there is no guarantee that it will work out. When they don't, and many times they have not, you've just wasted the majority of your donor hair. At the same time, you don't want to go through the procedure with an ineffective amount of hair because it will just leave you looking thin and in need of more work. Working on the front of a NW4 with 1500 grafts is a waste of time. Therefore, I believe that cases like this should be broken down to their components. Do enough for the front and evaluate. Maybe do 3000 or 3500 for the front. If the work is good then the 2nd surgery can be done to take care of the back with 1500 to 2000 grafts. You're still doing enough to address specific areas but you're not doing a super mega session to take care of everything at once. Any increase in the amount of scarring from two sessions vs. one is negligible and doesn't negatively factor into the approach. It's when you get into four and five or more surgeries that you can see diminishing returns. Stretchback becomes more likely because of the increasing complexities of the donor tension and with FUE the threshold of cosmetic density depletion in the donor zone becomes more and more difficult to gauge.

There are many ways of looking at this but my position is that smaller is better but not too much smaller else it's a waste of time. It's like this idea that one should have 500 grafts at a time to test things out. This means it would take you ten years to get your 5000 grafts due to the time it takes to see the result.

[Cheke1979]

back in the late 90's 2500 grafts was considered mega sessions so 2500 grafts is a mega session for some strange reasons doctors recommended by the hairloss association all have different opinions some are doing only fue others say fut is better others say artas is better while others say manual and others neograft its crazy all this confusion creates a lot of doubt of whos right or wrong its hard to know wich approach to take to have a positive outcome I have also seen doctors websites recommended from the association they have pictures of patients that received 3000 grafts for hairline in two separate sessions I'm guessing 1500 each session and they look good so 1500 graft session sounds like something that could be done with less trauma compared to 3000 or more grafts in a single session