14 years after my first procedure, I'm considering a second one...

[UMan64]

Back in 2010, I had a FUT procedure done with Dr. Dorin.  I was happy with the results, and the results have held up well.  However, I'm now over 40, and I'm at a point where, due to natural hair loss, it might make sense to do a second procedure.  (Also, my last procedure was more focused on the front of my hair, as opposed to the crown.  Whereas with this procedure we'd be able to reverse that and focus a little more on the crown, which is needed.)  I wanted to get folks' thoughts on some questions I have...

1) It sounds like my options this time are FUE, FUT using my existing scar, and FUT opening up a new scar.  And it sounds like the latter, i.e. FUT opening up a new scar, would be my best option if my desire is to yield the maximum number of grafts.  (Dr. Dorin believes he can get as many as 2,200.  He did about 2,500 back in 2010.)  What do folks think about this?  My initial mindset is that given that I already have one scar, having a second scar right beneath it shouldn't be that big of a deal.  And also that if I'm going to go through the trouble of doing a procedure again, I might as well get the most out of it.

2) There are a few "bio enhancements" that Dr. Dorin offers as part of the procedure: hylenex, liposomal ATP post-op spray, and PRP with surgery.  In total, these would add about $1,500 or about 12.5% to the overall cost.  He and his staff walked me through these, but I honestly don't remember much of what they're about, other than that at least one of them will help him maximize the number of grafts he's able to get, which sounds worthwhile.  What are the general opinions on these add-ons and are there any good explanations for what they are?

3) Is the general consensus on Dr. Dorin still positive?  As mentioned, I was happy with the work he did my first time around 14 years ago.  But just want to make sure there isn't anything that's changed in the time since then that I should be aware of.

Thanks in advance for any advice and thoughts that folks are able to share!

[Shadman]

@UMan64 hi, can you share few photos ?

[LaserCaps]

15 hours ago, UMan64 said:

Pls review the notes below,

 

Back in 2010, I had a FUT procedure done with Dr. Dorin.  I was happy with the results, and the results have held up well.  However, I'm now over 40, and I'm at a point where, due to natural hair loss, (There's no such thing as natural loss. If you've shown the propensity to lose, you'll continue losing.  What are you doing to mitigate the progressive nature of this condition)?

it might make sense to do a second procedure.  (Also, my last procedure was more focused on the front of my hair, as opposed to the crown.  Whereas with this procedure we'd be able to reverse that and focus a little more on the crown, which is needed.)  I wanted to get folks' thoughts on some questions I have... (Donor limitation often drives this industry, particularly when dealing with an advanced pattern.  There's typically not enough to allow for density throughout the entire head.  It's for this reason most ethical doctors will concentrate their efforts towards the front, at least initially.  It's the area you see when you look at yourself in the mirror, it's also the area others see when they interact with you.  So, when is the right time to work the crown?  When you're happy with the front and confirm the meds are doing their thing.  Why is this important?  In most basic terms, I'd like you to think of the crown as a circle.  You fill it.  You go on to lose all the native hair around the island worth of permanent hair, you'd be left with an island worth of hair and nothing around it.  An unnatural pattern to say the least).

1) It sounds like my options this time are FUE, FUT using my existing scar, and FUT opening up a new scar.  And it sounds like the latter, i.e. FUT opening up a new scar, would be my best option if my desire is to yield the maximum number of grafts.  (Dr. Dorin believes he can get as many as 2,200.  He did about 2,500 back in 2010.)  What do folks think about this?  My initial mindset is that given that I already have one scar, having a second scar right beneath it shouldn't be that big of a deal.  And also that if I'm going to go through the trouble of doing a procedure again, I might as well get the most out of it. (Since you already have a scar, why not just replace it with a new one?  You typically want to re-excise the original scar so you keep the area as clean as possible.  You'll likely be able to do this multiple times until the doctor confirms you have no elasticity left.  At that point you can do FUE.  This will allow you to take advantage of the entire donor area).

2) There are a few "bio enhancements" that Dr. Dorin offers as part of the procedure: hylenex, liposomal ATP post-op spray, and PRP with surgery.  In total, these would add about $1,500 or about 12.5% to the overall cost.  He and his staff walked me through these, but I honestly don't remember much of what they're about, other than that at least one of them will help him maximize the number of grafts he's able to get, which sounds worthwhile.  What are the general opinions on these add-ons and are there any good explanations for what they are?  (All modalities, whatever you do, are temporary.  Grafts are permanent, provided the hair is permanent in the donor.  Spend the money on grafts.  The more you do, the farther back the doctor can work so as to minimize the size of the crown).  

3) Is the general consensus on Dr. Dorin still positive?  As mentioned, I was happy with the work he did my first time around 14 years ago.  But just want to make sure there isn't anything that's changed in the time since then that I should be aware of.

Thanks in advance for any advice and thoughts that folks are able to share!

 

[Melvin- Admin]

@Al - Moderator has had several HTs with Dr. Dorin, he’s a great option in the tri state area. 

[translator]

@UMan64 Would you mind sharing some photos please? It would be interesting to see photos before and after the procedure and of course the current ones.

[Al - Moderator]

Since you already had a FUT then I'd do another FUT since it's the cheaper option and you already have a scar. You shouldn't be creating a 2nd scar though. The Dr should just excise the old scar and make a new one in the same place, so you still have one scar in the same location it is now. You can probably get more grafts if he creates a 2nd scar, but then you have 2 scars. Id prefer to go with less grafts and not create any new scars.

 

[Al - Moderator]

29 minutes ago, Melvin- Admin said:

@Al - Moderator has had several HTs with Dr. Dorin, he’s a great option in the tri state area. 

 

Dr Dorin moved out of Manhattan in January 2023 when Dr True retired. His new location is in Garden City, NY. I've been to both locations. The Garden City office is larger, but there are really only 2 hotel choices nearby if you are staying over. The La Quinta Inn and Suites is on the same street just a few steps away (there's just one building in between the hotel and the medical offices), so that's the most convenient, but it's not the best of hotels (although I haven't stayed there. Just going by reviews). The other is the Residence Inn which is much newer, only 3 or 4 years old I think, and is very nice. It's in a corner of the Roosevelt Field Mall. The mall is a few blocks away from Dr Dorin's office, but I was able to walk it.

The mall is nice and was more crowded than I thought it would be as most malls aren't so full anymore, at least not where I live, so that was nice, but I do miss going to Manhattan as there was much more going on there. Where it is now, my girlfriend can still spend a day shopping in the mall while I'm in surgery and she feels a lot safer in the mall than in Manhattan, so that's a plus.

 

EDIT: I just looked on a map. There are 2 buildings between La Quinta and the medical office building, not 1, bit still a very short walk of less than a block.

 

[UMan64]

12 hours ago, Al - Moderator said:

Since you already had a FUT then I'd do another FUT since it's the cheaper option and you already have a scar. You shouldn't be creating a 2nd scar though. The Dr should just excise the old scar and make a new one in the same place, so you still have one scar in the same location it is now. You can probably get more grafts if he creates a 2nd scar, but then you have 2 scars. Id prefer to go with less grafts and not create any new scars.

Thanks, @Al - Moderator.  Is "excising" the old scar the same as opening up the old scar?  Because he said the number of grafts we'd get by opening up the old scar would be significantly fewer than the number of grafts we'd get by doing a second scar.

Edited June 1 by UMan64

[UMan64]

Thanks, @LaserCaps.  Is "excising" the old scar the same as opening up the old scar?  Because he said the number of grafts we'd get by opening up the old scar would be significantly fewer than the number of grafts we'd get by doing a second scar.

[LeonBlack]

This is interesting. Its actually the first time I have ever heard of making a second distinct linear scar.  Most typically 2nd FUT would start either directly above or directly below the old scar and cut out a new strip that includes hair and the old scar.  
 

Presumably, if you heal really well, have good laxity, and don’t mind keeping the hair a little longer to cover it all…. I guess it could be a good idea to get more grafts. Perhaps there is also something distinct with your anatomy and the old strip area, where it is not ideal to do the traditional way after the doctor evaluated it.

that said, I would potentially ask about a variation of a more traditional approach, taking a new strip that includes the old scar and if more grafts are needed, doing some FUE as well. That is what was done with my second FUT.  ~3800 on first FUT, ~2800 on 2nd, plus about 800 FUE.

Edited June 1 by LeonBlack

[Al - Moderator]

10 hours ago, UMan64 said:

Thanks, @Al - Moderator.  Is "excising" the old scar the same as opening up the old scar?  Because he said the number of grafts we'd get by opening up the old scar would be significantly fewer than the number of grafts we'd get by doing a second scar.

 

Yes. That is what he is talking about. You will get less grafts because of the width of the scar that will be taken out. You won't have any grafts from that section, so the width of hair bearing grafts will be less. However I would still opt for doing that rather than creating another scar. It may not be a huge issue to you now, but the problem comes in later if you need another transplant. You'll now have 2 scars and may not have the option to excise one of those scars for a new FUT because there won't be enough room between them. You'd end up trying to take a wide strip to remove both scars and end up with very little grafts and possibly a wide. stretched scar. If you opted to go with a 3rd scar then you're creating scars all over your donor which will start getting hard to cover and it may be too high or too low in the donor area. I'd stick with using the same scar line even if you get less grafts. You won't have any more scarring than you already have. You could also ask about doing some FUE along with it as @LeonBlack suggested.

 

[LaserCaps]

On 5/31/2024 at 11:38 PM, UMan64 said:

Thanks, @LaserCaps.  Is "excising" the old scar the same as opening up the old scar?  Because he said the number of grafts we'd get by opening up the old scar would be significantly fewer than the number of grafts we'd get by doing a second scar.

True, scar tissue has no hair.  Hopefully the scar you have is not wide at all so you'll get a greater yield.  How many grafts did you do the first time?  If not many, the doctor could extend the length - ear to ear, to maximize results.  

[UMan64]

2 hours ago, LaserCaps said:

True, scar tissue has no hair.  Hopefully the scar you have is not wide at all so you'll get a greater yield.  How many grafts did you do the first time?  If not many, the doctor could extend the length - ear to ear, to maximize results.  

Thanks!  The first time was around 2,500.