Dr. Rassman:
I’m a 32 y/o physician and have had a high temporal hairline for as long as I can remember. Unfortunately, over the course of the last few years it has gotten higher. I’m thinking about doing something about it but have concerns about transplantation. My concenrs include the durability of transplantation and the potential need for more and more procedures as time goes on. I also wonder about the variability in outcomes from physician to physician, even in your group. Do you keep track of graft yield/take statistics within your group, do you know who the best is as far as the above is concerned, and do you share this information? After deciding on proceeding with transplantation, can one ask that you specifically be the one to do it and, if so, do you charge more? Thanks.
Wow, that would require a long dissertation to answer it all. Yes, there are differences between medical groups in the survival of grafts and the yield of hair as it relates to different procedures. As you may know, there are many techniques being used today. The golden standard is Follicular Unit Transplantation, a process which we pioneered. See Follicular Transplantation: Patient Evaluation and Surgical Planning? and The Aesthetics of Follicular Transplantation for more.
Hair transplants, once grown out, are quite durable and they should last your lifetime. The issue you should be concerned about is the progressive nature of hair loss in the balding man. Propecia (finasteride 1mg) is a good way to address this problem and in most men with a good Master Plan, they (in conjunction with a good doctor) should be able to define what will happen to your hair situation over time. Good miniaturization studies are critical to the development of a Master Plan for hair loss and treatment.
The average clinical doctor does not keep records on graft survival, but the different doctors have learned over time that they must have graft survival if they are to survive in the competitive marketplace. So what they have done is modify what they can do effectively. Some doctors do not do Follicular Unit Transplants (FUT) and instead have developed modifications of this technique so that their survival will be high. But, in my opinion, the FUT standard is the Golden Standard and has been so since the day we first published the article on it 9 years ago. The reason that it is the golden standard is simply, it produces the best and most natural results possible.
Pricing does vary between medical groups and even within my medical group by doctor (my price being higher than the other doctor because of availability issues). I suspect that the quality of work in any one medical group should be consistent with doctors in that medical group. Dr. Pak, for example, does as fine work as I do as he uses the same staff and the exact same techniques. As you should realize, the crux of the quality of the work you get is tied to the staff as much as the medical group, something we proudly show off at our monthly open house events, where our patients come to meet with prospective patients.
For further reading, here are some past blog posts that I’d recommend:
Honestly… it looks painful. Its a roller with little spikes on it to open the scalp so that it can absorb minoxidil better. The site claims that it is pain-free though. I cannot really comment on how much of a benefit (if any) it has or if it really works, but the theory and concept seem valid.
I have heard some of my patients reporting that they lose hair during certain seasons. Humans have asynchronous hair cycling, which means that we generally shed uniformly over the entire hair cycle of about 36 months. We lose about 100 hairs per day and replace that number each and every day. Animals have synchronous hair loss, which means that they molt once a year, usually in the Spring when their hairs go into telogen (the sleep part of the cycle) and in the Autumn when they go into anagen (the growth part of the cycle). 
It is possible to damage your scalp and make your hair pay for it. We get reports all of the time by people who had hair stylists damage their hair with rough handling (like you) or as a result of dyes and chemicals. You need to be evaluated in-person by an expert to understand just what is happening. Maybe there is another cause of the thinning, and just maybe you are misjudging what you see.