Hello. I recently visited a very well known transplant surgeon. He’s all over the internet and on many of the blogs etc. I think you may have referred to his practice in some of your recent postings. The photos and testimonials on his website are almost too good to be true, I mean the results are consistently the best I have seen anywhere internet. I am a forty year old white male, with receding hairline at the temples, I’m currently a NW3. I’m mainly just concerned with filling in the temples.

Here’s the issue. This doctor recommended 2500 FUE’s to fill in the hairline, this sounds a bit high to me, but he assured me that I wouldn’t be happy with any fewer. Is it wise in your opinion to do 2500 in the frontal zone based on what I’ve stated, I’m surely bound to keep loosing hair. And, can this doctor’s results be REAL? Even if he was cherry picking his best patients, he has probably 75 patients on his website, most with unbelievable results. I’m wondering if it’s marketing hype or is it real? Maybe he’s only doing very young patients with results that look great today, but not in the future? In addition, since this clinic only offers the FUE procedure, it is extremely expensive and would require a loan for me to complete the transplant. Thanks for your time.

Getting a second opinion is a reasonable next step. Some doctors produce a terrific marketing image showing what patients they want you to see. We offer our Open House events every month where you can see patients up close, ask them about their surgery, and get comfortable with the physicians and staff. For example, in our Los Angeles open houses, we often have a dozen patients to show off, and many just show up to help educate our prospective patients. Maybe you should listen to your instincts and get another opinion.

I can not comment on the 2500 graft recommendation with FUE (in one session? hmmmm) for a frontal hairline without at least seeing a photo of your hairline. Send me a good picture or three and point out the area where the surgeon said he would move the hair to. Reference this post when sending.

Hello Dr.

I have a short but interesting question for you.

Is there a way to get a hair transplant which caters to a shaved head? what I mean is, since it’s less important to have such a packed in and natural look when you shave your head; is it easier or cheaper to get some sort of thinner coverage on your head which still looks natural when you shave it really short?

I really don’t know what your expectations are, but I think that the answer is a hair transplant will not add value to your bald areas in the front, top, or crown in very low densities and wide distributions. If you want the easiest and cheapest way to have a shaved head look, use a razor and just take off whatever hair you have left.

Otherwise, the follicular unit extraction (FUE) technique doesn’t leave any linear scar in the back of the head, but there are tiny pinhole size scars that could be visible upon close examination. I’m not sure how short “really short” is for hairstyles.

This is Part 2 of 2. If you missed Part 1 from yesterday, that can be found here.

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What is FUE2?

Ever since we announced the FUE2 technique a few months back, people have asked me how it is different from the traditional FUE procedure I invented and published in the medical journals back in 2002. The basic difference is the addition of a water jet for enhancing the dissection of the excised graft. The pressure of the water jet adds to creating a plane of dissection which produces clean grafts as good in most situations as strip harvested grafts (the golden standard for follicular unit transplants).

What is better, the strip or the FUE2? First lets assume that the FUE2 produces comparable quality grafts to the strip harvesting method. When the donor density is low, the missing follicular units from FUE2 become obvious when the hair is cut short. There can be a moth eaten look in these low density people. In high density people, the FUE does not show up so there is generally not a moth eaten appearance, but the many white dots created by the FUE scar can be seen and this will absolutely limit a shaved head. When a strip is performed and a good wide lower trichophytic closure is created, the scar is less in most patients than any scar from FUE. The problem is that most FUE doctors have created illusions around what they do and produce hype that will never be substantiated in most patients, particularly those with low to average densities and a high number of FUE grafts. I always tell the patient that I get 50% more $$$ for an FUE procedure (graft for graft), so if I recommend the strip as a viable alternative, it is clearly not a financial issue for me. The results of the evolution in my thinking is based upon following many patients (mine and other doctor’s patients) with regard to scarring.

THE FUE2 is a better procedure than the standard FUE, but not better with regard to strip harvesting in quantity and quality. FUE fails to grow at the 90% plus rate much of the time in most doctor’s hands, but strip grafts do not. I am afraid to tell you that honest doctors who do FUE are few and far between, but they do exist. With our FUE2 procedure, we clearly can do it better than most doctors. And as our survival rate following FUE2 is comparable to strip harvesting and significantly better than traditional FUE, the choice with us is clearly in the hands of the patient. I try to present a balanced approach in the analysis when patients come to my office and ask about FUE.