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  1. #21
    Moderator JoeTillman's Avatar
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    Quote Originally Posted by tedwuji View Post
    In general, what is the ideal age for a hair transplant?

    What is the age which ethical surgeons would unanimously agree it is "safe" to get a transplant assuming no donor thinning or any other abnormal occurences? I.e. a good transplant candidate.

    Just looking for maybe an average age for strip as everyone is different. I am guessing it is around 35 as Spencer Kobren said he doesnt recommend any guy get FUT under 35 on the radio show before. Thoughts?

    Obviously it is not 22. I am 33 and still concerned about the future loss.
    These are very tough questions to answer. In my experience, I think most doctors will at least say that 25 is a general threshold to consider but, as with anything, caveats exist. The idea is that FUE is "safer" so younger patients can be accepted but I've got mixed feelings about that. A bad result is still a bad result, regardless of the technique. One thing that I've learned is that the technique is irrelevant when you're talking to a patient that feels "butchered" and that includes FUE patients. The bad FUE results of today are no different, psychologically, than the bad plug patients of thirty years ago. I'm currently in regular contact with multiple patients that have had FUE and are in various states of depression due to unnatural results, over harvested donor zones, or a combination of effects.

    For strip, I think 30 is the threshold, especially now with the negative image it has in the market. Most patients considering strip now, in 2016/2017 are doing so only because they've really thought long and hard about what it involves and the side effects that are unique to strip alone.
    Joe Tillman
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  2. #22
    Moderator JoeTillman's Avatar
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    Completely ridiculous comment. No one cares about being bald or having a grafts at the front along with a bald top and crown when they're 45 years old.
    Over 1/4 of all hair transplant surgeries performed are on men between the ages of 40 and 49. I've had patients in their 70's and even their 80's come in for surgery. One never stops caring about how they look and this really is a naive statement.

    If you're a 20 year old balding guy, why not go for a transplant every few years and look like a guy with a beautiful mane?
    Because if he were to start off with your original suggestion of "4000 to 5000 grafts" to the front then he won't have enough hair to follow your plan.

    You shouldn't be sitting there suffering in your 20s because of hairloss, DO something about it and who cares about the future, in a decade there will probably be a cure.
    This has been said every year for the past thirty years. Doing anything on this level based on the assumption that something specific will happen to warrant and justify a glutenous approach regarding such a limited resource is extremely irresponsible and short sighted.

    In the mean time, saying someone should live their 20s as a balding man is outright stupid. Shame on you, the amount of mens mental health issues that could be solved with decent transplants are huge.
    Another naive statement. Dealing with hair loss is nothing compared to dealing with a bad hair transplant. Until you've had one you had no idea what you're talking about.

    And I say Turkey is better than the US because their procedures, densities, aesthetics and graft survival rate is much higher. A quarter of the price of the US, and twice as good quality wise. Anyone who says the US is a good place for a transplant is conning people.
    This is your opinion, but you are insulting the hundreds of thousands of patients that have had and will have surgery in the United States by saying their happiness is the result of being conned. It doesn't really make any sense.
    Joe Tillman
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  3. #23
    Moderator JoeTillman's Avatar
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    I also noticed Joe recommended to someone else that 3000 grafts for the front of the hairline is a reasonable number, despite making fun of me and criticising me for suggest EXACTLY THE SAME THING.
    For some people, 3000 makes sense, but you did not recommend the "exact same thing". You recommended for this 22 year old 4000 to 5000 grafts just for the hairline.

    PLEASE don't listen to Hairbrain and Joe who got badly done transplants decades ago and wasted their donor area, and now want to stop anyone else from getting better results and living a happy youth.
    My donor was hardly wasted. I've had 10,000 grafts successfully transplanted over the course of several procedures by Dr. Wong, the last of which was only six years ago, not over a decade ago. Regardless, I find it disturbing and ironic that I'm in the hair transplant industry with fifteen years of experience, having personally dealt with tens of thousands of people regarding this subject, and you are the one aggressively pushing this young man to have a hair transplant and to use 50% to 70% of his donor supply for his hairline. And I have no idea why you said I'm making fun of you. Please reference how I did.
    Joe Tillman
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  4. #24
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    Quote Originally Posted by JoeTillman View Post
    For some people, 3000 makes sense, but you did not recommend the "exact same thing". You recommended for this 22 year old 4000 to 5000 grafts just for the hairline.



    My donor was hardly wasted. I've had 10,000 grafts successfully transplanted over the course of several procedures by Dr. Wong, the last of which was only six years ago, not over a decade ago. Regardless, I find it disturbing and ironic that I'm in the hair transplant industry with fifteen years of experience, having personally dealt with tens of thousands of people regarding this subject, and you are the one aggressively pushing this young man to have a hair transplant and to use 50% to 70% of his donor supply for his hairline. And I have no idea why you said I'm making fun of you. Please reference how I did.
    Firstly while I think your end result is no doubt very acceptable and you have better coverage than most men your age, I think that transplants of 2016 standards at a Turkish IAHRS surgeon clinic like that of Civas or Erdogan would grant a better result and most would be happy with. If you go to an IAHRS surgeon, there is a very, very low chance of needing multiple repairs like you experienced or complications arising. I've seen beautiful full head transplants at just over 7000 grafts with a few 1000 left spare.

    Don't get me wrong, I agree that it's a serious medical procedure and one should consider their future when going into it, find a short and medium term solution to stabilising loss such as minoxidil and finasteride and look around for IAHRS surgeons, however beyond that, I think that if you're sitting there day in day out wishing you had more coverage, then you should make a move, whether you're 20 or 40. The satisfaction rates with IAHRS surgeons over the last few years is through the roof. I have a number of friends who have undergone FUE in Turkey and India and the results are beautiful and it has been life changing for them. These people are all in there mid 20s.

    Telling people to sit there and be miserable for a decade waiting till they have a shiny bald head, no confidence and years of stress over an issue that could be fixed in a day is downright irresponsible, and just as irresponsible as telling someone to have a back alley Indian transplant with 7000 grafts in the front of there head. If they have stabilized their losses effectively, why in the world would you wait for another ten years? If you want a transplant and you have exhausted other means of growth and maintenance, then chances are that desire isn't going to change, whether you wait 1, 5, 10 or 15 years.

    In regards to the OP I strongly agree with you Joe that he shouldn't go through with it, however I think if he effectively plans for the future and is sensible with grafts he could use along with maintaining through fin and minox , then he should start planning ASAP.

  5. #25
    Moderator JoeTillman's Avatar
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    If you go to an IAHRS surgeon, there is a very, very low chance of needing multiple repairs like you experienced or complications arising. I've seen beautiful full head transplants at just over 7000 grafts with a few 1000 left spare.
    And this is one of the problems with your position. You're speaking from a consumer point of view, meaning, you don't know the real story. All clinics have more problem results than you have heard about, read about or seen. The degree of each problem result varies from no growth and visible donor scarring to not enough density thereby requiring the (legendary in it's simplicity) "touchup" procedure. Yes, you detected some sarcasm Are the chances low that a result will wind up being a repair? Yes. As low as you indicated? Not even close and this is considering better clinics, not no name mills.

    Don't get me wrong, I agree that it's a serious medical procedure and one should consider their future when going into it, find a short and medium term solution to stabilising loss such as minoxidil and finasteride ...
    This is another problem with your position. Medical treatment should be considered a long term solution because if they are halted in the medium term then any gains or maintenance they have provided will be rendered moot. In my opinion, most surgical cases are doomed for the long term if medical treatment is disregarded.

    Telling people to sit there and be miserable for a decade waiting till they have a shiny bald head, no confidence and years of stress over an issue that could be fixed in a day is downright irresponsible, and just as irresponsible as telling someone to have a back alley Indian transplant with 7000 grafts in the front of there head.
    Where did I say wait a decade or until the OP has a shiny bald head? How is recommending against surgery now compared to "just do it" and get "4000 to 5000" grafts into hairline considered to be irresponsible? I think you're confusing the issue. I told the OP that 4k to 5K in the front, as you suggested, was wrong and that he was too young. Nothing more. You're taking this into additional realms that I never addressed.

    In regards to the OP I strongly agree with you Joe that he shouldn't go through with it, however I think if he effectively plans for the future and is sensible with grafts he could use along with maintaining through fin and minox , then he should start planning ASAP.
    There is nothing wrong with planning but a 22 year old has no idea how finasteride is going to maintain his hair for the long term. The benefit to this particular case is that he's been on the medication for a few years but the fact that he had to even consider going on finasteride while still a teenager (at 19 years) spells potential long term disaster with regards to potential future loss and long term donor management.
    Joe Tillman
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  6. #26
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    Quote Originally Posted by Hairbrain View Post
    I have personally met Joe and have spent time with him. There is specific reason he had 9 transplants aside from the first two. Some were for repairing bad work from a different era and others for research and experimentation of various methods . He has helped move this field forward in multitudinous ways in which I have no time to even begin to list. I can tell you I probably have more experience picking out and critiquing transplants than just about anyone, and to have met Joe I would have never guessed that he ever had any work done. As far as I know Joe never brags about anything (well aside from maybe how hot is wife is ) To advise a 22 year old who is experiencing aggresive MPB to run to Turkey, or anywhere for that matter, to get his entire head coverd with 4000 grafts in what could very easily be a NW6 + case is just pure ignorance. I will not go through the whole litney why that is a bad idea, but let me just propose at least one. In reality 4000 grafts into a NW6 is no where near enough grafts to even give an illusion of a decent head of hair without at a minimum say leaving the crown. So what happens after possibly getting into his 40s and becoming a NW6 if not before and you have 4000 sporadically placed grats based on a prior pattern or an assumed future pattern? Chances are great you will have an unatural appearance or one seriously diffused head of hair. So many NW6 cases are fortunate to get 6000 grafts. Even if he's lucky theres a good chance an additonal 2000 grafts would not fix this type of poorly planned consequence. God forbid a retro thinning of the donor that was used for the first 4000, then it is certainly game over. Then what? This is only one of many things that could go wrong. Aside from a couple of known Turkish IAHRS recommened surgeons why do you say Turkey is a better place than the US? Price? Price may be a factor however there are so many other factors that go into getting a hair transplant that involves serious considerations and its highly advisable to talk to more than just a single doctor or advocate for that matter. Saving a potential few grand doesn't mean shit to someone who ends up f'n up his life.
    With all due respect and I mean this sincerely please, do yourself and everyone on this site a favor and dont just claim someone is an encyclopedia of bad decisions when that individual has given back to this community in ways you can not begin to account for. You posted in an unrelated thread and advised another individual in order to slow down or stop his hair loss he should try pumpkin seed oil and limiting his masturbation. If you believe that works for you then that's fine but try to understand individuals come to this site primarily for proven methods, help and advice that works. That usually means searching out EMPERICAL data and getting advice from qualified doctors or from those who have been there done that. I hope in the future you will expand your knowledge by doing more reading here than advising.
    Joe, What is the best way to predict your "future pattern" ? I think this is really important to know when coming up with what Dr. Rassman called a "Master Plan" in his office when i saw him (future plan to account for final pattern and graft distribution).

    Do you support the idea of using minaturization mapping and the HairCheck tool aka bulk analysis (something that compares density of permanent zone to top of scalp?)

    Are there other ways to predict your final pattern besides these and of course family history?>
    Anytihng I am leaving out?

  7. #27
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    Quote Originally Posted by JoeTillman View Post
    And this is one of the problems with your position. You're speaking from a consumer point of view, meaning, you don't know the real story. All clinics have more problem results than you have heard about, read about or seen. The degree of each problem result varies from no growth and visible donor scarring to not enough density thereby requiring the (legendary in it's simplicity) "touchup" procedure. Yes, you detected some sarcasm Are the chances low that a result will wind up being a repair? Yes. As low as you indicated? Not even close and this is considering better clinics, not no name mills.



    This is another problem with your position. Medical treatment should be considered a long term solution because if they are halted in the medium term then any gains or maintenance they have provided will be rendered moot. In my opinion, most surgical cases are doomed for the long term if medical treatment is disregarded.



    Where did I say wait a decade or until the OP has a shiny bald head? How is recommending against surgery now compared to "just do it" and get "4000 to 5000" grafts into hairline considered to be irresponsible? I think you're confusing the issue. I told the OP that 4k to 5K in the front, as you suggested, was wrong and that he was too young. Nothing more. You're taking this into additional realms that I never addressed.



    There is nothing wrong with planning but a 22 year old has no idea how finasteride is going to maintain his hair for the long term. The benefit to this particular case is that he's been on the medication for a few years but the fact that he had to even consider going on finasteride while still a teenager (at 19 years) spells potential long term disaster with regards to potential future loss and long term donor management.
    Among IAHRS surgeons, what would you consider to be the satisfaction rate with procedures? What % of procedures among these surgeons are botched or have a substantially lower than expected graft survival rate? I would expect these numbers to be substantially lower than those with fin sides, particularly in 2016.

  8. #28
    Senior Member Hairbrain's Avatar
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    Quote Originally Posted by JeanlucBergman View Post
    I would also recommend to look solely at IAHRS surgeons.
    Most all IAHRS are American doctors. Per your above posts there are many young hairtransplant victims who regularly call in to TheBaldTruth weekly program who have had horrible FUE experiences within the last few years. Some badly planned who started agreesivley loosing more hair. If you knew enough about transplants you would also know that no matter how much donor you have it is impossible to aquire original density. Its the physics of making the recipient sites. Hairtransplants offer many a good illusion of having full denisty but it is an illusion. Funny you state to only consider IAHRS surgeons but the fact is collectivley they would disagree with practically every post you've made here and on this forum. I have personally spoken and met numerours IAHRS surgeons and for the most part know that they concur on most matters in regarding who and when individuals should or should not get transplants and how conservative one must be when starting down that road. FUT or FUE. There are no perfect or scarless surgeries. All doctors including IAHRS doctors have patients that are not satisfied. Its just the facts. If your going to try and give advice on the forums you need to educate yourself a little better about hair transplantation. I would suggest listening to the weekly BaldTruth podcast in which some IAHRS doctors will chime in from time to time. Feel free to be critical of me anytime. I always tell people to always get multiple opinions from qualified doctors before ever making any desicion regarding hair transplants. I guarantee you by criticizing Joe Tillman, who is constantly inside the clinics and knows the ins and outs of every technique, and by advising others on this site to slow down or stop their hair loss to stop masturbating and take pumpkin seed oil no one here is ever going to take you seriously. Anyone who needs proof of that can just search your previous posts.

  9. #29
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    Quote Originally Posted by Hairbrain View Post
    Most all IAHRS are American doctors. Per your above posts there are many young hairtransplant victims who regularly call in to TheBaldTruth weekly program who have had horrible FUE experiences within the last few years. Some badly planned who started agreesivley loosing more hair. If you knew enough about transplants you would also know that no matter how much donor you have it is impossible to aquire original density. Its the physics of making the recipient sites. Hairtransplants offer many a good illusion of having full denisty but it is an illusion. Funny you state to only consider IAHRS surgeons but the fact is collectivley they would disagree with practically every post you've made here and on this forum. I have personally spoken and met numerours IAHRS surgeons and for the most part know that they concur on most matters in regarding who and when individuals should or should not get transplants and how conservative one must be when starting down that road. FUT or FUE. There are no perfect or scarless surgeries. All doctors including IAHRS doctors have patients that are not satisfied. Its just the facts. If your going to try and give advice on the forums you need to educate yourself a little better about hair transplantation. I would suggest listening to the weekly BaldTruth podcast in which some IAHRS doctors will chime in from time to time. Feel free to be critical of me anytime. I always tell people to always get multiple opinions from qualified doctors before ever making any desicion regarding hair transplants. I guarantee you by criticizing Joe Tillman, who is constantly inside the clinics and knows the ins and outs of every technique, and by advising others on this site to slow down or stop their hair loss to stop masturbating and take pumpkin seed oil no one here is ever going to take you seriously. Anyone who needs proof of that can just search your previous posts.
    There are plenty of studies that show ejaculation causes testosterone conversion to DHT. I never said this would save hairloss, I simply presented a fact. Either you accept the studies, or you don't.

    How many people who have had SUCCESS vs those who haven't call into the podcast? Most people with success are out living their lives. The % with results they are unhappy with would be less than those who get fin sides.

    I've seen HUNDREDS of examples of norwood 2s getting 2000-3000 grafts for their temples and aren't even on fin. You can find this with plenty of IAHRS doctors too. 95% of doctors do what the patient asks if they have the money. Get real.

  10. #30
    Senior Member Hairbrain's Avatar
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    Orignially Posted by JeanlucBergman
    There are plenty of studies that show ejaculation causes testosterone conversion to DHT. I never said this would save hairloss, I simply presented a fact. Either you accept the studies, or you don't.
    You presented a fact based on what? Of course I don't accept it. You did advise on a previous post that masturbation could help slow down or stop hair loss. And then posted a link to some unscrupulous study from 1976? Really? I am assuming that study is much older than you.

    How many people who have had SUCCESS vs those who haven't call into the podcast? Most people with success are out living their lives. The % with results they are unhappy with would be less than those who get fin sides.
    I will let Joe chime in on this one. But from my years of listening to the show I would say 50/50. There are individuals who call in constantly confirming how hair transplantation changed their life. Some who just say they are "satisfied". And others who have been devastated. This is true of results past, present, FUT or FUE.
    Not to say it doesn't happen, but as we've discussed before the number of people who experience actual sides with fin are very low.

    I've seen HUNDREDS of examples of norwood 2s getting 2000-3000 grafts for their temples and aren't even on fin. You can find this with plenty of IAHRS doctors too. 95% of doctors do what the patient asks if they have the money. Get real.
    So I will take issue with IAHRS doctors taking the money and just doing what ever the patient asks. Absolutely disagree with this. Many if not most IAHRS doctors are booked even up to 12 months in advance. Do you really think they need the business or would risk their reputation here, elsewhere, or their IAHRS recommendation on making poor decisions that will cost them MUCH MUCH more in the long run?....Simply not true. These doctors know and deal with the prospect of being called out for practically every head they touch. Probably one of the last persons any doctor would want to be called out by is Joe. And I've seen and heard him do it. Why? Because at the end of the day his real interest is in the patient.
    At the same time we all know there certainly are thousands of other doctors and so called clinics out there that do and will take every dime you have and run. That's why these forums and patient advocates exist.

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