thanatopsis_awry

When Pat and Bill (maybe 3 months ago?) mandated clinics to do a required amount of documentation this was a key step of forward progress. Even though the quality of documentation and % of grown-out cases has to date been a bit lacking at times, IMO, we are still able to get a much better "flavor" for the respective clinics out there. I think PGP is absolutely right, and that this would be an ideal that serves the patients, the forum, *and* the doctors performing high-quality work. Frankly, I'm surprised more clinics haven't stepped up and gone into a mode of rigorous competition in doing their work justice. *also, IMO, when clinics like Bernstein's don't even allow for a mere *comment* or critique of their work by patients and prospective patients alike it is a slap in the face and serves to stymie the forward progress that Bill works so hard for, and that we all look forward to.

Umar's recco seems a bit high, though I'm not sure what he is basically saying that these #s are to achieve. For a totally full, slick looks -- prolly....but you can get much less and still get a much improved look. I wouldn't take True's word on you have 2k max in your donor as gospel. No disrespect to him, but to often I've seen some docs give very negative donor estimations only to be considerably trumped by others. e.g. Epstein turned one guy down for lack of donor; Feller yanked out 8k in 2 sessions. LondonLad was somewhat shunned for puny donor, he has had 11k+ from H+W. Just to name a couple that spring to mind. I agree w/ PGP to not do BHT until all other measures have been explored, and even then to research it cautiously and heavily.

PGP is like a black panther in the deep parts of a jungle pouncing on anti-patient livestock! For real, though, he has over 2k posts I believe...in addition to *countless* PMs and private conversations....much of which is directed on the important "red meat" of the HT world. As a result he tangles more with people, and *other* people tangle more with him -- and 99% of the time, even if he is wrong in the entire scope of his opinion, it results in positive benefit to the patient. This can't be discounted. The "insults" are really a minor component of a small portion of threads, over the backdrop of a very, very large # of posts/PMs/etc. IMO, it isn't appropriate and most importantly it isn't beneficial to patients to hyper-focus on this one aspect of him and jump on a bandwagon while giving him a stigma that would discredit the good he has done and most importantly could hinder the good he will do. I think he can ratchet up the intensity too much for the time and place and this should change, and I believe it will -- he'd be the first to admit it and if it had a negative effect on a patient's ability to be informed and make a decision he'd be the first to apologize. It's a two-way street, though, too. /3cents

The magnitude of the techs' importance adds an interesting -- if not dangerous/volatile -- dimension to the HT practice. The doctor can't just have consummate surgical skills, but also a keen eye for running a business w/ regard to finding, training, fostering and managing a team of "employees". I honestly don't know how top clinics are able to confidently assemble the initial team AND how they are able to confidently ensure that their consistent quality keeps up.

Interesting....with your hair/scalp contrast, and combined w/ your head shape...even as bald as you currently it really looks quite good shaved. How have you been *responding* to the fin? No side-effects and at the very least relative stabilization of loss? I don't doubt that H+W will give you a very appropriate HT and with enough grafts to give you a really full look. The only ? I have is that my first paragraph combined with the fact that even most "full" HTs have their drawbacks....keeping your buzzed look AND/OR doing FUE to fill in a sweet hairline and an illusion of coverage behind is an option I find fairly attractive.

Wow. You have come a VERY long way, dude. Your situation was actually quite similar to mine - perhaps, a bit more loss, though since my op I think I've thinned to where you were pre-op. You look radically different and at 8months you have more growth, thickening, and maturation. I think every HT has a couple of styles that work best for the given patient, too, and it takes some time and experimentation to find them. Another few months and I think the proverbial cherry will be atop your follicular-sundae! Enjoy how far you've come and how far you will go -- live it up, bro!

Well said! And I don't think a very spirited debate and mudslinging are mutually exclusive. Lengthy "grudge matches" simply end up obscuring the truth that debate has been gradually uncovering. This $%(@s everyone, especially patients....and the people who are right... I don't think it's possible to *always* remain *100%* tactful, especially in a lively debate that has merit where people have strong beliefs that have strong ramifications; but you can draw a line between being forceful and blunt w/o self-sabotaging your own pursuit of "winning the war" by allowing personal insults to obstruct from the valid, important points.

I agree. It's very sound reasoning, and I can't imagine it isn't Dr. Wong himself...? Besides the "J Wond MD" signature the entire post sounds verbatum like it is Dr. Wong himself speaking/typing...

There is an ulterior motive to actively want to love Epstein if you aren't concerned by his performance and patient-care at this point. And I find it very hard to believe you would answer the title of this thread with an Honest & Emphatic Yes and sign yourself up without any major concerns. I notice he dodges Bill's legitimate inquiry, once again, as well -- the 2nd or 3rd time that I can distinctly recall in recent memory.

100% co-sign. Arguments -- even very lively ones -- have a very appropriate place; the problem is when the arguments spawn so much *personal* insulting that it begins to detract from the very debate taking place and the *truth* that gets exposed through the debate begins to go into hiding. Bill indeed has done an excellent job while threading a fine line (though I think what LMS said before may have been taken more harsh than LMS sincerely intended it to be). I see what Dewayne is saying, except Drew hasn't yet gone to Wong and hasn't yet gotten a result to beat his chest over, let alone had the result long enough to truly speak with un-tamable confidence like he has. In that respect, I think it's very good that his viewpoint was opposed, even opposed strongly. Even if he ultimately disagrees with the opposition -- and he has -- he is all the better for it, and going forward his decision will be all the more informed and he'll live with it for better or worse.

The 800pound gorilla in the forum is that Drew understands all of the "detracting" points of view as far as I can tell; it seems he simply disagrees, as a matter of personal choice. Yes, there are risks in getting a HT....there are also risks in inaction and *not* getting a HT...usually, the latter is a much more sure-thing, too... Perhaps, Drew is willing to accept the long-term potentiality of a doomsday scenario because the doomsday to him is the **very present**? Drew isn't going to get 20k BHT or 5k packed into his hairline by Armani (etc.)...this is much more a matter of personal preference and tolerance for risk, and it isn't an outrageously defined line. He's been informed and seen dissent, and it's good that he has.

Depends on the doc...also, note that being a NW "4-5", 2k grafts isn't a terribly large chunk of change....so, getting impeccable yield would be all the more vital, which is the primary drawback of FUE....

No doctor should "focus on the youth". In theory -- and practice -- there is right and wrong when it comes to HTs, and it's a decision that is a blend of surgical competence and gameplan combined with the patients expectations and general outlook. What Dewayne said is vital -- you need to temper looking good now with looking good later....thankfully, this doesn't have to be mutually exclusive! IMO, there are doctors who *won't* work on "the youth", when another would and it would be sound....or, doctors who will, but will provide a relative disservice with a smallish session that much of the time simply won't meet the expectations of the said "youth". Again, this is why education on the patients' part is paramount -- knowing what the result will legitimately likely look like, e.g. -- and it needs to be combined with a gameplan that works with what the doctor is comfortable with!

Nanogen > Toppik > HairCubed. Consensus -- HairCubed SUCKS.

Fairly recently I began a process of laser hair removal. Oh, the irony! Anyways, I did my research and found one of the only joints I'd go to in the U.S. Part of the treatment is for what they loosely call "the neck". Basically, the area they zap goes right up into the zone of where your barber might go during a haircut when cleaning up your "neck's hairline". It just hit me that I could be plundering some potentially sweet donor, especially that of "nape hair"...? I'm not sure if nape hair constitutes hair that a barber might shave off when neatening up your neck, or if it's really just the hair that would exist right above that area following a haircut...? I just have this re-occurring nightmare after laser hair removal that I'm destroying hundreds of fine grafts that could someday be used to refine my hairline..

Fairly recently I began a process of laser hair removal. Oh, the irony! Anyways, I did my research and found one of the only joints I'd go to in the U.S. Part of the treatment is for what they loosely call "the neck". Basically, the area they zap goes right up into the zone of where your barber might go during a haircut when cleaning up your "neck's hairline". It just hit me that I could be plundering some potentially sweet donor, especially that of "nape hair"...? I'm not sure if nape hair constitutes hair that a barber might shave off when neatening up your neck, or if it's really just the hair that would exist right above that area following a haircut...? I just have this re-occurring nightmare after laser hair removal that I'm destroying hundreds of fine grafts that could someday be used to refine my hairline..

GL HJ, look forward to the pics and write-up! I'm curious to hear what Dr. Umar says about nape hair on you -- I've always been intrigued by it!

Yer making a great decision, bro! You've researched well, your expectations are sound, and you're in a solid spot to get a robust HT that will transform you. I actually don't even like the word "transform" by itself -- it's really more of a "reclamation", or a transformative-reclamation. The # of grafts to the recipient looks good, and even if you have finer hair the scalp-color contrast works in your favor. Based off of everything you've said (thoughts on bic'ing, realism about multiple HTs, meds, goals, etc.) I have little doubt that this will be awesome for you! I'd only add to look into either furthering an existing hobby or picking up a new one (ideally something physical, IMO, but not necessarily so). I've talked about this in detail in the past, but I believe it has multiple benefits, some obvious (taking mind off the HT process) and some not-as obvious (optimizing the process that occurs as our end-results begin impacting our self-view and outward confidence in a level, realistic, long-term manner). In a sense, our negative view of hair is aggrandized and (unfairly) disproportionate; likewise, IMO, it's best to not allow ourselves to slip swiftly into a *positive* view of hair that *in turn* is an aggrandizement and unrealistically *favorable*. The more hairloss smites you the more likely it is to fall into this rough sketch of a "trap" once you do have hair.

It absolutely should from everything I know. Start your research and do some consults with clinics! Keep us posted.

Run a search for various Armani threads. This will include in depth discussion and light shown on lawsuits, shills, wretched growth, (laughable) technique, extraordinary deception and deceitful lies, and shady patient aftercare. If you still feel that he can deliver you the best result with the best consistency by all means go. Being a betting man, however, I'd still bet the house that you'd be paying a premium to get an inferior result.

Man, once again, the work looks *phenomenal*; really beautiful overhead shots in your latest update!!! You gotta be giddy looking at those babies (I know I'm already imagining your big growth update showing off a veritable lion's mane)! It will be sweet as you document your journey over the course of 09'. Like you, I couldn't stay away from the gym, either -- day 7 and I started to ease my way back in action. I wonder if there are indeed some positive benefits of adopting relatively early -- but prudent -- exercise, by way of facilitating overall healing through better blood flow and general body functioning. Btw, give TheEmp another 48hours or ship that prize to...I dunno....whoever....guessed the highest....

Man, I get bogged down with work and I miss this juicy behemoth of a thread.... My instincts have me tending to side with PGP's points of contention. Plus, it's obvious beyond doubt that he is passionate for patients above all else -- and even if he is wrong from time to time, it is good that even some "misplaced passion" forces docs to step it up some and keep on their truthful-toes. Gotta keep it as civil as possible, of course. Anyways, H&Ws results with super-large # cases are totally remarkable by the facts themselves. PGP himself has said as much, and it's not like he's a pitbull out to destroy them -- I think if he was it would be pretty obvious to most of us! Drew makes an interesting theory, and it's something I've previously considered and think might have some real validity. Is splitting actually advantageous, especially on those upper NWs....? If so, H&W's "stats" might get a quasi-artificial boost but one in the same their results get a very pure boost to the benefit of the patient. This is rote speculation; but, I'd love to hear some Dr's/reps' opinions on whether having a disproportionate # of 1s and 2s could theoretically be to a patient's best interest.... Pat has famously remarked on hairs vs. grafts with his pizza-pie analogy. Let's take a quintessential H&W case -- say, 5k-6k grafts -- and let's assume that 3s and 4s were indeed reduced and split to inflate the ~5500 grafts number. What would this be comparable to? The result of this hypothetical case, unless I'm mistaken, should be equivocal to a Rahal, SMG, Feller, Cooley, et al. of a lesser graft # where such splitting did not go on, and the actual amount of hair being moved would be roughly if not exactly equal. The results should then stack up rather equitably, no? I have yet to see a grown out ~5500+ graft case from anyone aside from H&W -- if this is in fact a result of some form of splitting on their part, there should nonetheless be cases out there by other clinics (on the larger side still, of course) that should approximate the coverage/density given due to # of hairs being moved while the actual graft tally should be smaller. I don't have any actual cases in mind to fill this "experimentation", but they exist and I'm sure they'd be fairly accessible. Ultimately, with the aforesaid assumptions, if we properly compare a "quintessential H&W" case to a number of other clinics the results given, filtered through their respective # of grafts, should tell us something quite telling.....my brain is fried from work and heavy deadlifts so my logic here might be totally off and the said "experiment" could carry little to no weight.....(?!?)

Every time a patient complaint has arisen I recollect Epstein's arrogance and self-righteousness above all else. It doesn't surprise me in the least to hear that he's an alright guy until he isn't getting patted on the back. Even if we were seeing consistently good if not excellent results shown from him (and we aren't) this type of behavior demands accountability. I could be wrong -- and I'll 2x check later -- but I believe recently Bill inquired to Epstein about further explanation on his patient care and protocol....and it was met with silence.

The people I know of (including patients themselves) who have inquired about methodology and extraction were given non-answers and the usual cloak of secrecy. I believe Abedogg himself said as much in his write-up. Anyways, just be aware of the +s and -s with nape hair. It can create an especially "soft" look, boosting "naturalness"; it can also be especially susceptible to MPB and be lost down the road. I kinda like the idea of using nape hair, though I think it's a (small) gamble and I really haven't researched the downsides enough -- but other than $ and the bitch of it possibly falling out at some point it seems like a pretty sweet thing to utilize.

I was about to say exactly what LMS said...except I would definitely at the very least consider Shapiro because of his price, ethics, skill-set, and that he strikes me as the type who wouldn't charge a dollar for something if he wasn't utterly confident in his ability to do the patient right. Umar intrigues me and I've said many times how much promise I think he represents. But, my reservations with him revolve around shills, hype (not FUE so much as BHT), super-secrecy over methodology and tools, and I simply haven't seen many cases documented that I trust on the level of other clinics. All of that can be 100% true and he can still be a 100% amazing surgeon, though, and deliver results that I'd love to experience myself. That said, to counter such red flags I'd want to be blown the hell away by the power of his skills and ability to deliver high-yield, consistent results in whatever graft range I'd be up for. IMO, the combo of Feller's latest FUE advancement and Shapiro's immersion into FUE would make me hold off on a FUE session for a bit longer to see where the dust settles and how the landscape gets impacted.