Please Help Me Decide, Artas Vs Smartgraft?

[Dion.M]

Hi Folks, I am new to the forum. I am in my 50s and started losing my hair about 3-4 years ago, it is thinning on the top, I attached 2 photos. I did a PRP procedure by Dr. Yaker 12 months ago followed by the 2nd PRP 11 months ago. It didn’t do much, I saw some growth after a few months, but then they went away and I am back to square one. I am interested in FUE transplant.

I saw Dr. Arocha last week, he said I had about 1,500-2,000 donor grafts and he recommended manual FUE instead of ARTAS. I then saw Dr. Bishara and he said I had about 4,500 to 5,000 donor grafts and recommended about 1,000 grafts transplant, I showed him a picture (3rd attached photo) and indicated I would like fuller hair and less receding line, he then suggested about 2,000 grafts using ARTAS. I believe he has done more ARTAS procedures than most surgeons in USA.

Dr. Yaker uses SmartGraft and I am schedule to see him in 2 days.

I have a few questions:

1- Is anyone here familiar with these doctors?

2- Any opinion on ARTAS vs SmartGraft?

 

[buckthorn]

they want to transplant into all that existing hair? when you're not maintaining on any treatments?? You go through with this, then you can kiss your native hair goodbye, guaranteed. I wish I could tell off these f*cking doctors.

 

[Dion.M]

they want to transplant into all that existing hair? when you're not maintaining on any treatments?? You go through with this, then you can kiss your native hair goodbye, guaranteed. I wish I could tell off these f*cking doctors.

Thanks for the reply Buckthorn. Dr Bishara recommended I use Rogain, laser hat and Propecia after the procedure.

Why do you think I would lose my current hair?

 

[buckthorn]

Thanks for the reply Buckthorn. Dr Bishara recommended I use Rogain, laser hat and Propecia after the procedure.

Why do you think I would lose my current hair?

they would be transplanting into a lot of native hair. It is likely you will get Telogen Effluvium (which they will call "shock loss" to not scare you) or experience transection. Either way, It is very reckless of any doctor to suggest transplanting through that without any preventative medication. They are recommending laser cap because they are the ones selling it. Laser caps are complete garbage. I would get on minoxidil and finasteride right now and see how you do.

 

[buckthorn]

I hope other experienced members can comment on this?? this is a very interesting case and important to this forum. @Swoop @Dench57 @Wolf Pack

 

[kj6723]

The recommendation of laser therapy should be an immediate red flag imo...I wouldn't want anyone who advocates that treatment touching my follicles, let alone my precious donor hair

 

[DoctorHouse]

Hi Folks, I am new to the forum. I am in my 50s and started losing my hair about 3-4 years ago, it is thinning on the top, I attached 2 photos. I did a PRP procedure by Dr. Yaker 12 months ago followed by the 2nd PRP 11 months ago. It didn’t do much, I saw some growth after a few months, but then they went away and I am back to square one. I am interested in FUE transplant.

I saw Dr. Arocha last week, he said I had about 1,500-2,000 donor grafts and he recommended manual FUE instead of ARTAS. I then saw Dr. Bishara and he said I had about 4,500 to 5,000 donor grafts and recommended about 1,000 grafts transplant, I showed him a picture (3rd attached photo) and indicated I would like fuller hair and less receding line, he then suggested about 2,000 grafts using ARTAS. I believe he has done more ARTAS procedures than most surgeons in USA.

Dr. Yaker uses SmartGraft and I am schedule to see him in 2 days.

I have a few questions:

1- Is anyone here familiar with these doctors?

2- Any opinion on ARTAS vs SmartGraft?

I am very confused with the amount of donor you were told you have left. Did you have a transplant in the past? Your hair loss is rather diffuse but you still have alot of hair left for your age. I would think you would have at least (the average most people with your pattern loss) have 5,000-6,000 donor grafts still considering your case is not major. And if you have not started on Propecia yet, you need to before your even consider a hair transplant. You could regain some of your hair back since you claim your hair loss is very recent. And as buckthorn said, you are going to have to transplant between native hairs so without Propecia for at least one year under your belt, your risk for shock loss is greater. You need to spend the next 6 months researching hair transplant surgery and at the same time take some Propecia to see how you do.

 

[Dion.M]

I am very confused with the amount of donor you were told you have left. Did you have a transplant in the past? Your hair loss is rather diffuse but you still have alot of hair left for your age. I would think you would have at least (the average most people with your pattern loss) have 5,000-6,000 donor grafts still considering your case is not major. And if you have not started on Propecia yet, you need to before your even consider a hair transplant.

I have not had any transplant yet. When I saw Dr. Yaker a year ago, he told me I am fortunate to have so many donor hair, so when Dr. Arocha told me I only have 1,500-2,000 donor grafts, I was confused too. Dr. Yaker put me on Propecia, but it had negative sexual effect, so I stopped after a month.

Guys, I just want to say I really appreciate all of your inputs!

 

[DoctorHouse]

I have not had any transplant yet. When I saw Dr. Yaker a year ago, he told me I am fortunate to have so many donor hair, so when Dr. Arocha told me I only have 1,500-2,000 donor grafts, I was confused too. Dr. Yaker put me on Propecia, but it had negative sexual effect, so I stopped after a month.

Guys, I just want to say I really appreciate all of your inputs!

My advice is to try to get some topical finasteride and try that because you are going to keep thinning as you age and you will not be able to keep your hair looking thick with hair transplants with such a limited donor supply. The good news is you have a situation where you can sprinkle toppik and get by with a full head of hair. Honestly looking at your hair situation you might have been diffusely thinning even earlier than you thought. Otherwise, you need to go to someone like Erdogan who is very experienced in transplanting between native hairs.

 

[Wolf Pack]

My opinion: a little bit similar to DoctorHouse

1) Prevention is best but you say you can't take finasteride. Look into topical RU or something. Minoxdil can grow a lot of hair too.
2) You look to be thinning in the "A" pattern. Loss is mainly at the front and mid scalp with the crown being pretty well preserved even in later stages.
3) Big risk of shock loss especially as no Propecia. But no doubt this hair may go in few years. I think the reason it doesn't look as bad as it perhaps is, is due to your thick hair.

Given your age, unable to take finasteride, I would have two hair transplant sessions if it's not possible to do in one. Provided you have the funds. Yes you will get shock loss but this hair is going to go anyway unless you get on preventative medication. Even then it might go but at a much slower rate hopefully. Also you need to assess again your donor capacity.

A long term plan needs to be made with a good surgeon basically if you go down this route first without meds. Also I have heard of some bad cases concerning this ARTAS robot. I would opt for FUE in the hands of a good surgeon. You may need a combination of FUE/FUT to make use of your donor hair and that's no bad thing.

 

[buckthorn]

You have to treat your native hair as if it's not permanent, especially if you're considering an hair transplant right through it. Then, what happens if the crown starts to go and you've exhausted your donor supply? This is the major caveat with hair transplantation. You will always be playing catch up. The BEST candidates are those with distinct loss in specific regions of the scalp, that have completely maintained their hair elswhere. For example - those with receding hair lines that have maintained in the crown and midscalp with propecia, getting their hair lines filled in. With diffuse loss like yours (and mine), and no preventive medications, you're pretty much screwed.

That being said, I have diffuse loss, like yours, but "reversed". My loss is primarily concentrated in the crown and midscalp, with the frontal region a little bit thicker. finasteride / dutasteride do NOT work for me. They speed up my male pattern baldness 100 times. The ONLY option I would have for an hair transplant would be 6-7k grafts right THROUGH everything, on the entire top. I would then settle for a diffused head of hair, knowing that it is at least permanent.

 

[Dion.M]

My opinion: a little bit similar to DoctorHouse

1) Prevention is best but you say you can't take finasteride. Look into topical RU or something. Minoxdil can grow a lot of hair too.
.

I looked for topical finasteride, but can't find much in USA. Do you know where I can get it?

looks like Dr. Bauman in FL offers topical finasteride mixed with Minoxidil. He calls it Formula 82F “Finoxidil” .

Wondering if anyone has any experience with the 2 combined as a topical solution..

 

[DoctorHouse]

I looked for topical finasteride, but can't find much in USA. Do you know where I can get it?

looks like Dr. Bauman in FL offers topical finasteride mixed with Minoxidil. He calls it Formula 82F “Finoxidil” .

Wondering if anyone has any experience with the 2 combined as a topical solution..

On another thread, someone claims Dr Carlos Wesley is offering topical finasteride now.

 

[Wolf Pack]

You have to treat your native hair as if it's not permanent, especially if you're considering an hair transplant right through it. Then, what happens if the crown starts to go and you've exhausted your donor supply? This is the major caveat with hair transplantation. You will always be playing catch up. The BEST candidates are those with distinct loss in specific regions of the scalp, that have completely maintained their hair elswhere. For example - those with receding hair lines that have maintained in the crown and midscalp with propecia, getting their hair lines filled in. With diffuse loss like yours (and mine), and no preventive medications, you're pretty much screwed.

That being said, I have diffuse loss, like yours, but "reversed". My loss is primarily concentrated in the crown and midscalp, with the frontal region a little bit thicker. finasteride / dutasteride do NOT work for me. They speed up my male pattern baldness 100 times. The ONLY option I would have for an hair transplant would be 6-7k grafts right THROUGH everything, on the entire top. I would then settle for a diffused head of hair, knowing that it is at least permanent.

Agree with you, like in my case. The hair transplant virtually gives a full head of hair. As you say, you still gotta be on Propecia though.

 

[Dion.M]

Guys, thank you for all of your valuable input!

I had a consult with Dr. Joseph Yaker today; he did the original PRP on me a year ago. He said I have well over 5,000 donor grafts and suggested 2,000 FUE graft using SmartGraft mostly in front for phase one and additional transplant in 6 months to focus on the back/crown . He also said since oral finasteride caused sexual downside for me, I should start using “Formula 82F” which is topical finasteride 0.25% and minoxidil 5%. I think it is available from MasterPharm, LLC in NY. Cost is about $100/month.

I am also considering consulting with Dr. Jae Pak in LA, he has 78 reviews on realself.com all 5 stars, very Impressive! I think he used to be an Engineer first and 2 of his patents were used in developing ARTAS. He is more expensive than the rest, about $8/graft using ARTAS, but cost is the least of my worries. I just don’t want to do something, regret it and have to live with it for the rest of my life.

 

[kj6723]

He also said since oral finasteride caused sexual downside for me, I should start using “Formula 82F” which is topical finasteride 0.25% and minoxidil 5%. I think it is available from MasterPharm, LLC in NY. Cost is about $100/month.

$100 a month? Isn't topical finasteride fairly unproven? So you'd potentially be paying $100 a month just for minoxidil....dude I would think twice before purchasing this product

 

[DoctorHouse]

Guys, thank you for all of your valuable input!

I had a consult with Dr. Joseph Yaker today; he did the original PRP on me a year ago. He said I have well over 5,000 donor grafts and suggested 2,000 FUE graft using SmartGraft mostly in front for phase one and additional transplant in 6 months to focus on the back/crown . He also said since oral finasteride caused sexual downside for me, I should start using “Formula 82F” which is topical finasteride 0.25% and minoxidil 5%. I think it is available from MasterPharm, LLC in NY. Cost is about $100/month.

I am also considering consulting with Dr. Jae Pak in LA, he has 78 reviews on realself.com all 5 stars, very Impressive! I think he used to be an Engineer first and 2 of his patents were used in developing ARTAS. He is more expensive than the rest, about $8/graft using ARTAS, but cost is the least of my worries. I just don’t want to do something, regret it and have to live with it for the rest of my life.

If cost does not worry you then go with Dr Rahal. He is the best for hairlines.

 

[shookwun]

I would go with arocha. Rest of the doctors are surgeons I have never heard of.


Arocha is know around the transplant industry

 

[Dion.M]

I did an email consult with Dr. Jae Pak in LA. I sent him my photos and he replied: “you have general thinning and hair transplant likely will NOT give you a cosmetic improvement”. Based on his excellent review on realself.com, I trust his assessment and decided against FUE transplant.

With finasteride negative side effect, my options are Minoxidil and laser hat. I just bought the Theradome and will give it 6-month try before I start the Minoxidil. I thought if I start both at the same time, it would be difficult to determine what may work for me and if LLHT doesn’t work, I certainly don’t want to wear a silly hat 2-3 times/week.

I know there are many folks on the forum who don’t believe in LLHT, but I figure for $900, I don’t have much to lose, I blew $2,900 last year on 2 PRP procedures with absolutely no result. I also just started on DHT blocker shampoo and oral supplements. I am desperate!

DoctorHouse, if I am not mistaken, on another thread, you commented that you use LLHT, what is your opinion of laser hats?

 

[Pequod]

A few things, I have had a couple of hair transplants and I am currently on finasteride which is generic Propecia.

-The PRP was a waste of money and we could have told you that.
-It is normal to have some side effects with finastreride-propecia. The key is to start with a smaller dose and see if you can stand that, and then increase dosage. So let's say you took the 1 mg and it was too much. Try going down to 0.25 by splitting a pill into 4 pieces and taking only one piece a day. I split mine.
-The doctor that said you had only 1500 donor grafts must be nuts. I wouldn't use him as you have that many on you sides alone.
-I agree with the doctor that said don't do a hair transplant. I would not try minoxidil but give Propecia another chance and accept that either you have to keep your hair with some sides or loss it. Minoxidil does not stop hair loss. It only forces some follicles that are naturally hibernating (about 10% are) into growth. But the follicles that are being damaged stay damaged and you will still lose your hair.