G
Guest
Guest
Ok so after calling me to fix my next appointment and then calling me to invite me for a Open house session, I get another email from the hair transplant surgeon's office. Here is the contents. I have obviously omitted the names there....
Is this common ?? dunno what to make of this.... do you know any hair transplant surgeons recomminding hair transplant for a class 2 patient ? does it not make sense to have the patient go on propecia for a year before even recommending an hair transplant specially if the hairloss started less than a year back ??? ofcourse I am not going for an hair transplant. I only wanted to get the hairloss/thinning measured.
Dear XXXX
I enjoyed meeting with you. We covered a great deal of information, so this letter will help review what we discussed. I also suggest reading XXXX’s materials and publications because they highlight many of the issues you will want to consider when deciding to have a hair transplant. Our book, The Patient’s Guide to Hair Restoration, stresses the blend of “art and science†in the specialized field of surgical hair restoration, and our website, XXXXXX explains in detail the pioneering hair transplant procedures of the XXXX Institute. The site also gives you valuable information about our physicians, and the important educational programs we offer.
The XXXXX's Follicular Unit Transplantation is used exclusively in every hair restoration procedure we perform. Our publications emphasize different aspects of the hair restoration process and describe how new developments at XXXX will help make your procedure a better one. The field of hair restoration is evolving rapidly, and our writings reflect these changes. If inconsistencies are discovered while reading XXX literature, the most current document will be the most accurate.
I do not believe that the few hair relaxer treatments you have had are responsible for your hair loss since it is following a genetic pattern. Genetic balding is a life-long process; therefore, the initial surgical plan should consider future hair loss. It is important to consider any long-term change in the hair loss pattern and create a result that will continue to look as natural as possible if further loss should occur. To achieve the maximum cosmetic benefit from hair restoration surgery, a personalized "Master Plan" should combine the best information available today, with a realistic assessment of your projected future hair loss.
YOUR HAIR CHARACTERISTICS
Pattern of Loss
Age......................... 26
Present.................... Class 2 (All derms I visited put me between 1-2)
Possible…………... Class 6
Color
Hair......................... Black
Skin......................... Medium
Character
Wave....................... Slightly Wavy
Thickness................ Medium Fine
Density
Donor Site............... 80/cm2 (70 is average) (I wonder how she even measured it considering she ran that intrument on my hair for a few seconds and i didnt see her taking any readings :roll: )
Scalp Laxity................. Loose
Summary: Your hair loss pattern is presently a Class 2 with diffuse thinning through the frontal area, and may lead to a Class 6. You are a good candidate for this procedure because of the low contrast between your black hair and medium skin tones. Your slightly wavy hair will typically produce a bit more fullness than if it were straight, and its medium fine character gives more coverage value to each hair than if it were fine. Your donor density measured above average.
PROPECIA
You report that you are currently taking Propecia. I recommended continuing on Propecia for whatever benefits it may possibly provide in halting or slowing your hair loss and even strengthening your growth in the back area of your scalp. I have seen some wonderful results and am generally enthusiastic about this drug as part of a master plan for stabilizing hair loss (at a minimum). We reviewed the possible benefits as well as the potential side effects of this medication during our meeting. I also recommended using Rogaine in conjunction with the Propecia for maximum retention of your native hair.
ANTICIPATED SURGERY
Goal: You desire that we work to restore your frontal hairline and fill in the front and top areas of your scalp, and allowing Propecia to thicken up the crown area. Since expectations and actual results may vary from person to person, the ability to achieve your specific goals in one or more sessions cannot be accurately predicted. As your hair loss progresses, additional work may be needed.
Plan: A natural looking frontal hairline (for god's sake my frontalhairline is intact and even she adimitted it saying "people from your ethnicity have their hairline intact"... yeah right) can be produced by the delicate placement of single hairs, followed by two, three, and possibly four hair follicular units (depending upon your density and hair groupings). All of the hair will be harvested and implanted in naturally occurring groups for the best cosmetic result. I believe that 1500 to 2000 grafts would be appropriate for this procedure, but the actual number harvested could vary from this estimate. At the time of the surgery, the surgeon may find that he can move more hair safely, so if you elect to keep the size of the session open ended, then a higher number of grafts should be budgeted.
YOUR HAIR RESTORATION AT XXXX
We perform the Follicular Transplantation technique exclusively in all of our hair restoration surgery. Hair transplantation is purely cosmetic in nature and as such is not considered ‘medically necessary’. Alternatives to hair transplantation are 1) to do nothing, 2) drug therapy if appropriate, 3) hair systems (wigs), 4) other types of hair restoration surgery. At XXX, we do not recommend scalp reductions, flaps, or larger grafts because, in our opinion, the potential short- and long-term problems associated with these procedures outweigh their benefits. All physicians do not accept this view. The Patient’s Guide to Hair Restoration presents our opinion regarding the benefits and risks of these alternative surgeries.
It is the goal of XXX physicians to accomplish your hair restoration in as few sessions as possible. There are several important surgical advantages in minimizing the total number of procedures, as well as numerous social benefits. These include less disruption in your daily life, avoiding the short-term cosmetic problems of incomplete or partial procedures, and, most important, achieving your goals in a shorter time. We recommend that you take advantage of XXXX's vast experience in performing large transplant sessions to accomplish this, but, of course, each patient’s needs must be carefully evaluated on an individual basis.
The distribution of follicular units is dictated by the aesthetic considerations used to reach your goals and will take advantage of our extensive experience in order to maximize the benefit of your transplant. The safety and mechanical factors specific to your particular circumstances also impact this distribution. The fullness you will achieve will reflect the intrinsic characteristics of your hair. In other words, coarse hair gives better coverage than fine hair, curly hair often looks more full than straight hair, and hair that is similar in color to the skin produces a more covered appearance. Subsequent procedures may be planned to increase fullness in specific areas.
Some information, such as the exact donor density and scalp looseness, cannot be precisely determined until the procedure has begun. Therefore, for planning and safety reasons, I will use my judgment at the time of surgery as to the exact number of units available. The ‘Follicular Unit’ transplants that we perform reflect the natural hair groupings normally found in your scalp. Therefore, when these are used to increase the density of a thinning area, they may not be distinguishable from the surrounding hair.
We use exclusively follicular unit grafts placed into very small sites. Because of this there should be no significant visible scarring in the transplanted area. In addition, we use surgical techniques that significantly minimize scarring in the donor area. We carefully assess scalp laxity prior to removing the donor strips and rarely see scarring problems. Scarring is more likely to occur in the donor areas of individuals who have had multiple previous hair transplantation procedures, especially when those procedures have employed older techniques. Patients who have a history of developing significant widened or raised scars, may see their individual healing dynamics reflected in similar scarring after hair restoration, in spite of the surgeon’s best efforts to minimize this risk. Please be aware that there will be at least a fine line scar in the donor area. Complications such as poor growth or no growth can occur, fortunately, these are rare. Folliculitis and infection occur in a small number of patients and these conditions are treated with antibiotics.
All our procedures are performed under local anesthesia. Some patients experience discomfort during the initial round of injections, however, every effort is made to minimize this short-lived discomfort. In our California offices, we offer nitrous oxide (laughing gas) for the initial phase to reduce discomfort. For the first few days following the procedure, you may have some discomfort in the donor area. You will be given medication to relieve this pain.
THE GROWTH CYCLE AND PATIENT EXPECTATIONS
The normal growth cycle of hair is quite variable. The majority of patients will see their newly transplanted hair shed before the permanent hair grows in, although some may experience continued growth following their procedure. The transplanted hair follicle (or root) contains the center for future growth; therefore, when your hair stubble falls out after surgery (generally in two to eight weeks), you should not be concerned. The transplanted follicles enter a normal resting phase following the procedure that can last weeks to months. During this time, very little, if any, growth may be seen. New hair will gradually appear in waves, first as very fine hair, then increasing in both thickness and length. Some growth can usually be expected in the first three to five months, achieving combing length over the next several months, but this may vary considerably from patient to patient with new growth sometimes appearing as long as 18 months following surgery. Miniaturization (reduction in hair shaft size) in the donor area, present in virtually everyone, may lead eventually to some gradual thinning of the transplanted hair over ones lifetime. It is possible that you may experience shedding of your existing hair in the transplanted area following the surgery (a process called telogen effluvium). If this hair is at or near the end of its normal life span (miniaturized hair), it may not return.
The majority of patients will see most of the cosmetic benefit from their procedure within one year after surgery and have continued improvement for another year, so the final result of the transplant may not be appreciated for a full two years. Since there is great individual variability, it is important to be patient during this period. It is not uncommon to be anxious while awaiting the results of your procedure; therefore, your doctor will be available to answer any questions during this time. Your results are influenced by many factors. In some people, the results can be dramatic, achieving a full appearance in one session. In others, the results may be thinner and less full, requiring additional sessions. Because each person is different, it is one’s responsibility to thoroughly research the hair transplanting process. We strongly suggest that prospective patients attend seminars where a number of patients who have undergone the process can be observed and studied. Although balding patterns and hair qualities differ in everyone, you can gain insight into what you may eventually look like by comparing your hair characteristics to those of others.
Our general philosophy is to minimize the number of times one has a hair transplant. To accomplish this, we started the field of Mega Sessions and Dense Packing in 1992-3 and the world has followed us since. The following reflect my view of the value of my patient’s time with regard to multiple surgeries.
• Move the greatest amount of hair in each session. Safety and long-term scarring concerns have limited the size of donor strips and graft yields in the past. We recently had a breakthrough in our donor closure technique that we believe reduces the risk of stretching the donor scar. This allows us to expand your donor area, remove wider donor strips, and get more grafts per session. Now we can significantly increase the average number of grafts per session to total between three and five thousand grafts, based on your donor supply. Fewer surgeries will produce less damage to the donor area and will help you achieve your goals faster.
• Put in the highest density possible in each session. With a higher yield of grafts from your donor area, in those individuals who have smaller balding areas, we can now use very small needles to place more grafts closer together. Up to twice as many grafts can be placed into a small area when the grafts are properly trimmed and small needles are used. In addition, higher graft density produces higher hair density and greater fullness. We fully expect that densely packed grafts will have the same growth rate as those grafts transplanted in sparsely packed patterns.
WHAT TO DO NEXT
I suggest that you join us at a seminar that we hold once a month to meet patients with their work completed and to give you a further understanding of the hair transplant process. Enclosed please find a seminar schedule giving you the times and places of the next few meetings. If you need additional information or want to know about future meetings, please call.
We have changed our pricing for traditional strip surgery to produce better value for our patients. We are leveraging higher graft numbers with a discount that encourages our patients to take advantage of (1) more grafts per session and (2) higher densities when possible. The program is as follows:
Program Fees Cost Per Graft Additional Grafts
XXXX Fees $10/graft Above 1800 @ $4/graft
Standard Fees $6/graft Above 2500 @$3/ graft
Standby Fees $5/graft Above 2500 @ $2.50/ graft
Travel reimbursement and Open House coupons may be used provided that total fees do not drop below our $3,000.00 minimum surgical fee. We also offer financing to make it easier for you to achieve goals that are within your specific budget. You may call 1-800-639-2222 or 310-553-9113 and we will supply you with any additional information you may need. You may also call these numbers to schedule your procedure.
We ask our patients to have the following laboratory tests prior to surgery: HIV-1 Elisa, Hepatitis B Surface Antigen and Antibody, and CBC. Our supplies and instruments are either disposable or sterilized to prevent the transmission of HIV, Hepatitis, and other communicable diseases. Our office employs comprehensive infection control measures for rigorous adherence to all Occupational Safety and Health Act (OSHA) standards. I do not anticipate that your asthma will be a concern for the procedure.
We feel strongly that a trusting, supportive doctor-patient relationship is necessary in the hair restoration process which is why I was glad we were able to spend so much time going over this information together. If you have any questions about the above information, I would be happy to answer them by telephone or in person. You also have my personal email now (XXXXXXX) and should feel free to use it. I look forward to seeing you in the near future.
Sincerely yours,
BTW, The hair transplant surgeon in question entered hair transplant business in 2004.
Is this common ?? dunno what to make of this.... do you know any hair transplant surgeons recomminding hair transplant for a class 2 patient ? does it not make sense to have the patient go on propecia for a year before even recommending an hair transplant specially if the hairloss started less than a year back ??? ofcourse I am not going for an hair transplant. I only wanted to get the hairloss/thinning measured.
Dear XXXX
I enjoyed meeting with you. We covered a great deal of information, so this letter will help review what we discussed. I also suggest reading XXXX’s materials and publications because they highlight many of the issues you will want to consider when deciding to have a hair transplant. Our book, The Patient’s Guide to Hair Restoration, stresses the blend of “art and science†in the specialized field of surgical hair restoration, and our website, XXXXXX explains in detail the pioneering hair transplant procedures of the XXXX Institute. The site also gives you valuable information about our physicians, and the important educational programs we offer.
The XXXXX's Follicular Unit Transplantation is used exclusively in every hair restoration procedure we perform. Our publications emphasize different aspects of the hair restoration process and describe how new developments at XXXX will help make your procedure a better one. The field of hair restoration is evolving rapidly, and our writings reflect these changes. If inconsistencies are discovered while reading XXX literature, the most current document will be the most accurate.
I do not believe that the few hair relaxer treatments you have had are responsible for your hair loss since it is following a genetic pattern. Genetic balding is a life-long process; therefore, the initial surgical plan should consider future hair loss. It is important to consider any long-term change in the hair loss pattern and create a result that will continue to look as natural as possible if further loss should occur. To achieve the maximum cosmetic benefit from hair restoration surgery, a personalized "Master Plan" should combine the best information available today, with a realistic assessment of your projected future hair loss.
YOUR HAIR CHARACTERISTICS
Pattern of Loss
Age......................... 26
Present.................... Class 2 (All derms I visited put me between 1-2)
Possible…………... Class 6
Color
Hair......................... Black
Skin......................... Medium
Character
Wave....................... Slightly Wavy
Thickness................ Medium Fine
Density
Donor Site............... 80/cm2 (70 is average) (I wonder how she even measured it considering she ran that intrument on my hair for a few seconds and i didnt see her taking any readings :roll: )
Scalp Laxity................. Loose
Summary: Your hair loss pattern is presently a Class 2 with diffuse thinning through the frontal area, and may lead to a Class 6. You are a good candidate for this procedure because of the low contrast between your black hair and medium skin tones. Your slightly wavy hair will typically produce a bit more fullness than if it were straight, and its medium fine character gives more coverage value to each hair than if it were fine. Your donor density measured above average.
PROPECIA
You report that you are currently taking Propecia. I recommended continuing on Propecia for whatever benefits it may possibly provide in halting or slowing your hair loss and even strengthening your growth in the back area of your scalp. I have seen some wonderful results and am generally enthusiastic about this drug as part of a master plan for stabilizing hair loss (at a minimum). We reviewed the possible benefits as well as the potential side effects of this medication during our meeting. I also recommended using Rogaine in conjunction with the Propecia for maximum retention of your native hair.
ANTICIPATED SURGERY
Goal: You desire that we work to restore your frontal hairline and fill in the front and top areas of your scalp, and allowing Propecia to thicken up the crown area. Since expectations and actual results may vary from person to person, the ability to achieve your specific goals in one or more sessions cannot be accurately predicted. As your hair loss progresses, additional work may be needed.
Plan: A natural looking frontal hairline (for god's sake my frontalhairline is intact and even she adimitted it saying "people from your ethnicity have their hairline intact"... yeah right) can be produced by the delicate placement of single hairs, followed by two, three, and possibly four hair follicular units (depending upon your density and hair groupings). All of the hair will be harvested and implanted in naturally occurring groups for the best cosmetic result. I believe that 1500 to 2000 grafts would be appropriate for this procedure, but the actual number harvested could vary from this estimate. At the time of the surgery, the surgeon may find that he can move more hair safely, so if you elect to keep the size of the session open ended, then a higher number of grafts should be budgeted.
YOUR HAIR RESTORATION AT XXXX
We perform the Follicular Transplantation technique exclusively in all of our hair restoration surgery. Hair transplantation is purely cosmetic in nature and as such is not considered ‘medically necessary’. Alternatives to hair transplantation are 1) to do nothing, 2) drug therapy if appropriate, 3) hair systems (wigs), 4) other types of hair restoration surgery. At XXX, we do not recommend scalp reductions, flaps, or larger grafts because, in our opinion, the potential short- and long-term problems associated with these procedures outweigh their benefits. All physicians do not accept this view. The Patient’s Guide to Hair Restoration presents our opinion regarding the benefits and risks of these alternative surgeries.
It is the goal of XXX physicians to accomplish your hair restoration in as few sessions as possible. There are several important surgical advantages in minimizing the total number of procedures, as well as numerous social benefits. These include less disruption in your daily life, avoiding the short-term cosmetic problems of incomplete or partial procedures, and, most important, achieving your goals in a shorter time. We recommend that you take advantage of XXXX's vast experience in performing large transplant sessions to accomplish this, but, of course, each patient’s needs must be carefully evaluated on an individual basis.
The distribution of follicular units is dictated by the aesthetic considerations used to reach your goals and will take advantage of our extensive experience in order to maximize the benefit of your transplant. The safety and mechanical factors specific to your particular circumstances also impact this distribution. The fullness you will achieve will reflect the intrinsic characteristics of your hair. In other words, coarse hair gives better coverage than fine hair, curly hair often looks more full than straight hair, and hair that is similar in color to the skin produces a more covered appearance. Subsequent procedures may be planned to increase fullness in specific areas.
Some information, such as the exact donor density and scalp looseness, cannot be precisely determined until the procedure has begun. Therefore, for planning and safety reasons, I will use my judgment at the time of surgery as to the exact number of units available. The ‘Follicular Unit’ transplants that we perform reflect the natural hair groupings normally found in your scalp. Therefore, when these are used to increase the density of a thinning area, they may not be distinguishable from the surrounding hair.
We use exclusively follicular unit grafts placed into very small sites. Because of this there should be no significant visible scarring in the transplanted area. In addition, we use surgical techniques that significantly minimize scarring in the donor area. We carefully assess scalp laxity prior to removing the donor strips and rarely see scarring problems. Scarring is more likely to occur in the donor areas of individuals who have had multiple previous hair transplantation procedures, especially when those procedures have employed older techniques. Patients who have a history of developing significant widened or raised scars, may see their individual healing dynamics reflected in similar scarring after hair restoration, in spite of the surgeon’s best efforts to minimize this risk. Please be aware that there will be at least a fine line scar in the donor area. Complications such as poor growth or no growth can occur, fortunately, these are rare. Folliculitis and infection occur in a small number of patients and these conditions are treated with antibiotics.
All our procedures are performed under local anesthesia. Some patients experience discomfort during the initial round of injections, however, every effort is made to minimize this short-lived discomfort. In our California offices, we offer nitrous oxide (laughing gas) for the initial phase to reduce discomfort. For the first few days following the procedure, you may have some discomfort in the donor area. You will be given medication to relieve this pain.
THE GROWTH CYCLE AND PATIENT EXPECTATIONS
The normal growth cycle of hair is quite variable. The majority of patients will see their newly transplanted hair shed before the permanent hair grows in, although some may experience continued growth following their procedure. The transplanted hair follicle (or root) contains the center for future growth; therefore, when your hair stubble falls out after surgery (generally in two to eight weeks), you should not be concerned. The transplanted follicles enter a normal resting phase following the procedure that can last weeks to months. During this time, very little, if any, growth may be seen. New hair will gradually appear in waves, first as very fine hair, then increasing in both thickness and length. Some growth can usually be expected in the first three to five months, achieving combing length over the next several months, but this may vary considerably from patient to patient with new growth sometimes appearing as long as 18 months following surgery. Miniaturization (reduction in hair shaft size) in the donor area, present in virtually everyone, may lead eventually to some gradual thinning of the transplanted hair over ones lifetime. It is possible that you may experience shedding of your existing hair in the transplanted area following the surgery (a process called telogen effluvium). If this hair is at or near the end of its normal life span (miniaturized hair), it may not return.
The majority of patients will see most of the cosmetic benefit from their procedure within one year after surgery and have continued improvement for another year, so the final result of the transplant may not be appreciated for a full two years. Since there is great individual variability, it is important to be patient during this period. It is not uncommon to be anxious while awaiting the results of your procedure; therefore, your doctor will be available to answer any questions during this time. Your results are influenced by many factors. In some people, the results can be dramatic, achieving a full appearance in one session. In others, the results may be thinner and less full, requiring additional sessions. Because each person is different, it is one’s responsibility to thoroughly research the hair transplanting process. We strongly suggest that prospective patients attend seminars where a number of patients who have undergone the process can be observed and studied. Although balding patterns and hair qualities differ in everyone, you can gain insight into what you may eventually look like by comparing your hair characteristics to those of others.
Our general philosophy is to minimize the number of times one has a hair transplant. To accomplish this, we started the field of Mega Sessions and Dense Packing in 1992-3 and the world has followed us since. The following reflect my view of the value of my patient’s time with regard to multiple surgeries.
• Move the greatest amount of hair in each session. Safety and long-term scarring concerns have limited the size of donor strips and graft yields in the past. We recently had a breakthrough in our donor closure technique that we believe reduces the risk of stretching the donor scar. This allows us to expand your donor area, remove wider donor strips, and get more grafts per session. Now we can significantly increase the average number of grafts per session to total between three and five thousand grafts, based on your donor supply. Fewer surgeries will produce less damage to the donor area and will help you achieve your goals faster.
• Put in the highest density possible in each session. With a higher yield of grafts from your donor area, in those individuals who have smaller balding areas, we can now use very small needles to place more grafts closer together. Up to twice as many grafts can be placed into a small area when the grafts are properly trimmed and small needles are used. In addition, higher graft density produces higher hair density and greater fullness. We fully expect that densely packed grafts will have the same growth rate as those grafts transplanted in sparsely packed patterns.
WHAT TO DO NEXT
I suggest that you join us at a seminar that we hold once a month to meet patients with their work completed and to give you a further understanding of the hair transplant process. Enclosed please find a seminar schedule giving you the times and places of the next few meetings. If you need additional information or want to know about future meetings, please call.
We have changed our pricing for traditional strip surgery to produce better value for our patients. We are leveraging higher graft numbers with a discount that encourages our patients to take advantage of (1) more grafts per session and (2) higher densities when possible. The program is as follows:
Program Fees Cost Per Graft Additional Grafts
XXXX Fees $10/graft Above 1800 @ $4/graft
Standard Fees $6/graft Above 2500 @$3/ graft
Standby Fees $5/graft Above 2500 @ $2.50/ graft
Travel reimbursement and Open House coupons may be used provided that total fees do not drop below our $3,000.00 minimum surgical fee. We also offer financing to make it easier for you to achieve goals that are within your specific budget. You may call 1-800-639-2222 or 310-553-9113 and we will supply you with any additional information you may need. You may also call these numbers to schedule your procedure.
We ask our patients to have the following laboratory tests prior to surgery: HIV-1 Elisa, Hepatitis B Surface Antigen and Antibody, and CBC. Our supplies and instruments are either disposable or sterilized to prevent the transmission of HIV, Hepatitis, and other communicable diseases. Our office employs comprehensive infection control measures for rigorous adherence to all Occupational Safety and Health Act (OSHA) standards. I do not anticipate that your asthma will be a concern for the procedure.
We feel strongly that a trusting, supportive doctor-patient relationship is necessary in the hair restoration process which is why I was glad we were able to spend so much time going over this information together. If you have any questions about the above information, I would be happy to answer them by telephone or in person. You also have my personal email now (XXXXXXX) and should feel free to use it. I look forward to seeing you in the near future.
Sincerely yours,
BTW, The hair transplant surgeon in question entered hair transplant business in 2004.
