The MOST important fact to remember!!!!

[Tracy C]

It's just that I always get very suspect of someone who mentions one doctor and presents him as the only right choice?

Hi gillenator,

Look at it this way - just as an example. I only have personal experience with one doctor and I think the world of him. He is a knight in shining armor as far as I am concerned. I'm sure other doctors are also great and have patients who feel a similar way as I do about my doctor - but I don't know those doctors.

Do you see what I mean?

[topcat]

Gillenator I understand what you are saying and there are other doctors that I think are very good and would consider including Woods and Mawamba. But I say this with complete honesty I think Dr. Bisanga is the absolute best in every area and have been told exactly the same by those that actually work in this industry without mentioning names as they work for other clinics.

I think for the most part I don’t cheerlead as I don’t care for those that hop onto threads that are posted by a clinic in which they are a patient and then rave nonstop. You can look at my posting history on any of the forums over the years and I think it speaks for itself.

Sometimes on occasion it is hard for me to just hold it inside. It’s like going to see someone that is at the absolute top of his/her game whether it be entertainment, sports or whatever. You get this feeling inside that you want to tell everyone how great that person happened to be just out of excitement. I will tone it down and I do honestly believe that everyone should do their own research. Too many people out there who are actually in this business and why should anyone believe any particular person.

I guess my main point is that just because someone is on a list doesn’t exactly mean that there is not someone who is actually better but chooses to let their body of work speak for itself without having to pay for a reccomendation.

25 going on 65 I would love to hear about your own experience as you sound like someone with something valuable to say.

[25 going on 65]

25 going on 65 I would love to hear about your own experience as you sound like someone with something valuable to say.

I personally have never had any kind of hair restoration surgery, sorry if I gave that impression. I'm just relatively familiar with the awful history of that business (which for some reason the US government has barely ever regulated), and of the hair loss industry in general. I don't know if I've ever seen good results from any procedure done before the mid 90's, but I can think of plenty of terrible results. That's to say nothing of the utter false advertising that came out of hair restoration clinics for decades (I imagine some still do it).

I am fortunate to be a relatively new hair loss sufferer who found good online resources, including Bald Truth, to help me treat my condition. People from the 1950's through the 1990's didn't have these kinds of options, and many were taken in by false advertising and then basically butchered by incompetent doctors and sloppy techniques.

I'm not considering surgery right now. Whether I ever do depends on how long I can keep my hair with meds, and how long it takes for newer treatments to come out.

[chrisis]

topcat, I have to be honest, having checked the galleries for Dr. Bisanga in comparison with Dr Rahal and Dr Feller, I don't think his work exceeds theirs.

What I'm looking for in a surgeon is one who can create a natural hairline in a relatively young guy. Dr Bisanga doesn't seem to have too many example of this.

Any thoughts on this?

[topcat]

Chirisis I can’t speak for the clinic as I am only a patient but I do feel they have the highest ethics and I do know that they regularly turn away patients other clinics are happy to get into the chair. I doubt very much they are going to give a low dense hairline from one’s youth to a patient because that is what the patient wants. They are in a position of greater knowledge and they know very well that performing that type of work is short term gain and long term pain for the patient.

Anyone who has done an ounce of research knows very well that the clinics that do give the patient want they want often need to sue that same patient in order to silence them years later because the patient now finds out that they look like a complete freak with a prepubescent hairline and nothing left to fill in the areas of further loss. And I’m not necessarily referring to the clinics you have mentioned but I suggest you research the history on all the forums and go back 10 years or so. Find out who is suing who and why they are suing.

What I think you will find with BHR are the most natural looking hairlines out there that are planned with the patients best interest in mind but then this is my opinion. I'm not impressed with the thick model type hairline on young guys in fact when I see it I say to myself, holy shit this guy is fu*ked.

BTW I think Jotronic did a very good thing here as I like visuals and hopefully it wakes up some to the fact that your donor is very limited and it must be used wisely. In fact I would go as far to say that all patients should have to sign a statement acknowledging that they understand the limitations of donor availability and if they decide to have a low dense hairline then they should bear full responsibility. At least this will take the burden off the clinics as long as they are honest and open about the consequences.

[UK_]

exactly.
Wait for Histogen and Replicel to announce their results first....

Hi 2020, you stated on another thread that Histogen plan to release their PH2 data by December 2012 - have you a link/source to this info? Did you email them?

[25 going on 65]

Here is an example of why realistic expectations and understanding the limits of donor supply are paramount for anyone seeking an HT:

http://www.baldtruthtalk.com/album.php?albumid=359&pictureid=2986

http://www.baldtruthtalk.com/album.php?albumid=359&pictureid=2983

Please note I'm not saying anything disparaging about the patient or doctor in this case. This is just to illustrate how even in the hands of a skilled surgeon, people with extensive loss can only expect so much coverage.
I brought this up because I recall someone in a different thread suggesting that guys should have enough donor hair for full coverage if they're willing to get enough grafts. For the NW6's and 7's out there, this is clearly not the case (although the album describes this patient as having "decreased donor laxity).

[Jotronic]

I purposely left this thread untouched to see where it would go and to see how many people would "get it" with just the one image. Sadly, it has spiraled into multiple directions, all of which are completely off topic and not only irrelevant but counter-productive. This thread is independent of any single clinic so please, keep the "who's best" posts where they belong.

The visual analogy I presented is not only for strip. I used the strip analogy because it is the most powerful visual tool I could devise but the point is the same if you are considering FUE. 4800 grafts taken out via FUE would only cover an area of the size of this strip if the grafts were planted at full density. To get true full density throughout the balding area this area would have to be multiplied by a factor of 8, at least, thus requiring in the neighborhood of 45,000 to 50,000 follicular units.

Keep in mind, this is to achieve "true" full density. Full coverage however is independent of full density and requires far fewer grafts. For instance, the image below on the left is the original depiction of me with my hair gone and only a full density strip placed on my scalp. To the right is me after my second procedure of which both procedures netted a total of 4825 grafts (25 more than the example shown). The example is to show that although full density is not possible the notion of full coverage is not so far fetched. "Full" is subjective and some people consider both terms, "full coverage" and "full density", to be one and the same. They are not as evidenced by my own result after two procedures.

Hair color to scalp color contrast ratios, hair caliber, hair type, etc. have extremely important roles to play in how your own result will turn out but ultimately, the biggest contributor, is your expectation because with anything in this life, perception eventually becomes reality, so the more you actually understand the happier you will ultimately be.

[Follicle Death Row]

Surely when you say 45,000-50,000 FUs you mean hairs Joe? A norwood 6 will have lost about 20,000-22,000 FUs or 45,000-50,000 hairs. With 10,000 FUs norwood 5s and some 6s can achieve 50% pre mpb density. Not everyone has 10,000 but some do.

With 2000 more FUs Joe you'll be at about 50% pre mpb density all over or very close too. 1500 more in the crown and 500 in the middle third. Not that you need them.

[ulanude]

Hi 2020, you stated on another thread that Histogen plan to release their PH2 data by December 2012 - have you a link/source to this info? Did you email them?

2020 any news on this. also would be interested in the sources of this..

[Jotronic]

FDR, yes. I meant follicles but this varies widely.

Ulanude, please keep the discussion on subject. Histogen has nothing to do with this so if you have questions please start your own thread.

[topcat]

Every clinic should be required to have their patients sign off on a sheet stating that they have read what the numbers mean. Although it’s basic math and simple geometry too many don’t seem to get it. They should not only have to read it but it should also be explained to them thoroughly. Then if they want to complain later they are on they own and have no one to blame but themselves when they have that really cool looking thick low hair line just like all the young guys but now they look like a middle aged circus clown without the makeup.

Too many clinics just fail to explain the numbers. If you lose 50% of your hair how can anyone reasonably expect to take 50% of the remaining 50% which would represent 25% of the original density of where the hair loss has occurred and think somehow they are going to have the original density.

Bottom line as it stands now if a patient complains that they did not achieve the density they expected then they were not fully educated by the clinic and the clinic bears the responsibility and I’m not saying all clinics do not educate their patients.

[Follicle Death Row]

Every clinic should be required to have their patients sign off on a sheet stating that they have read what the numbers mean. Although it’s basic math and simple geometry too many don’t seem to get it. They should not only have to read it but it should also be explained to them thoroughly. Then if they want to complain later they are on they own and have no one to blame but themselves when they have that really cool looking thick low hair line just like all the young guys but now they look like a middle aged circus clown without the makeup.

Too many clinics just fail to explain the numbers. If you lose 50% of your hair how can anyone reasonably expect to take 50% of the remaining 50% which would represent 25% of the original density of where the hair loss has occurred and think somehow they are going to have the original density.

Bottom line as it stands now if a patient complains that they did not achieve the density they expected then they were not fully educated by the clinic and the clinic bears the responsibility and I’m not saying all clinics do not educate their patients.

Great point. So many people just don't get it. If you take 50% of the donor (prob need both FUT and FUe to get it) you're looking at 10,000 ish and planting into an area where you've probably lost 20,000-22,000 if you're a norwood 6.

So close to 50% density can be achieved but the problem is some norwood 6s go in and the doc tell them they have amazing laxity, nice donor and they can get 5000 in one strip, at which type the patient's are thinking wow, 5000FUs, I'm going to have a rockstar head of hair result. Not so.

I like that though. It would be a good part of the patient education required.

[gillenator]

Adequate visual density is the proper term when relating to one's individual goal. And it is indeed very subjective without knowing each patient's goal and their individual hair characteristics. What is visually adequate for one person may look naked to another.

When "dense packing" was the buzzword not that many years ago, I was always mused by all of the newbies and even guys who supposedly had done enough research would all jump on the bandwagon once they saw so and so's pics denoting a 50 FU per cm density procedure. Yet no one would ask anything about his hair characterisitcs or how much virgin density was there to begin with. Or comments about achieving as much as 75 FU per cm2 without ever considering the two facts that a) they don't have the donor to accomplish that and b) they don't need that level of density to look like they do!

No one and I repeat no one needs true density or native density if the surgeon is competent and the patient has the candidacy to achieve his/her individual goal.

Patients need to be informed that achieving true density has never been the goal of ethical surgical hair restoration. Quite the opposite. It is the magic of getting native hair caliber back in place, not native hair density (hair count).

I have said this before and I will state it again. "It is the degree of hair shaft diameter (hair caliber) that determines the level or degree of visual coverage".

[Follicle Death Row]

Yep. There are a few tricks that the surgeons can do to maximise each follicle. As I've said before, while it is a numbers game by and large, so many people overlook hair characteristics such as hair shaft diameter, texture (straight or curly) and colour. These go a long way to the effect. NicNitro's hair looks like native density not just because he has had tonnes of grafts but also because his hair calibre is really thick.

For some it is possible to go to 60FU/cm2 in the hairline, 50 in a band behind, 45 in the density zone with loads of 2s, 40 in the midscalp and then 30-35 in the crown. I've actually seen examples of Dr. Feriduni's work where if he's taking a really big strip, he'll try and use up as many of the 3s as he can in the crown as the swirl tends to reduce the shingling effect so more multi haired FUs are required to splay out over each other.

So not just massive numbers of grafts but also good hair characteristics and skillful placement.