This is the latest episode of The Bald Truth (air date January 12, 2016) and I wanted to share it with you because it touches on an important subject. With the way that hair restoration (surgical and non-surgical) has taken off in the past few years the landscape is getting more and more competitive. With this increase in competition there seems to me to be less emphasis on education and more emphasis on marketing. There was never a danger of there being too much education but in the past it was easier for patients to go online and find at least some legitimate information without having to dig very deep. The advent of FUE has made this even more difficult because the only real thing that needs to be pushed is that the patient won't be left with a linear donor scar and that us usually all it takes for many people to sign on the dotted line. The sale is made and the patient is still completely unaware of what they are getting involved in.
A recent poster on Baldtruthtalk.com made an announcement that he was going to Turkey to have a 5000 graft FUE case. Actually, he started a thread saying he found my website and he was asking me what I thought of his plan. I looked at his photos and read his back story and I felt I needed to field a few questions to him to see if he had really thought his decision through. As I continued to ask him questions the reality of his decision started to reveal itself to me and I think it started to sink in with him. The following were the first questions I asked him to answer;
1. What happens if this surgery fails?
2. Will I still be able to shave?
3. Will I still have an acceptable appearance?
4. Will I have enough donor hair to correct any failures from the previous failed procedure?
The first question is one that I don't think people spend too much time contemplating. Why? Because I think that with all of the positive stories and reviews it is easy to get swept up in the excitement and as patients we focus on the details of what kind of hairline we want or what kind of density we should ask for. What happens if the result looks like shit? This is a real possibility and happens more often than clinics would like you to realize. Even if you get some growth you've still put yourself in a position that demands more surgery to fill in the gaps and holes that should have grown well in the first place and when you've used 5000 grafts in one shot you don't have much more to get the job done.
The second question is one that should be asked of any FUE doctor that is worth considering. Why? Because for years this was the #1 "benefit" to FUE in that you can "just shave your head" if you don't like the result. In reality, this is not the truth for everyone and to "shave" is relative. To some it means having the hair cut so short that there is no real hair visible on the scalp except for dots. For others, a shave means to have a hair cut with a #1 clipper or shorter. Regardless of what the definition may be from one person to another the idea that one can just shave their head if they want to is not always true with regards to seeing donor scarring in the form of dots.
Number 3 has a little bit to do with number 1 but not entirely. If the result fails then it is unpredictable what a patient will look like but even if it grows perfectly what will the result look like? Will you be stuck with certain hair styles? Will you still be able to have close haircuts? I call this the "celebrity syndrome" where patients look at other results and think they'll wind up having the same appearance even if they have the same size and type of procedure. No two patients have the same final result just like you don't have the same appearance as Brad Pitt because you bought the same jacket he wears.
Finally, when you're dealing with 5000 grafts, via FUE or FUSS, that is a lot of hair. It can make a phenomenal difference if distributed properly but it is also a lot of hair taken from the donor zone and in almost every case it is way more than half of the total amount of donor hair that a patient has available in their lifetime. Essentially, if someone gets a hair transplant for 5000 grafts they are essentially putting all of their eggs in one basket and if that basket gets crushed, it's game over. I've seen it happen and it breaks my heart. 5000 graft sessions work well but when they don't the patient has few options so that is why I do not endorse such sized sessions.
There were more questions and answers back and forth but ultimately the poster said he made it to the airport and even got past security but after standing at the terminal for 20 minutes looking at his plane as it arrived he decided he was not unhappy with his current appearance. He then turned around, left the airport and went to work. During the episode shared above the poster actually called in to talk about our discussion and what was going through his mind. You don't want to miss this so watch the video.
Joe
