38 year old patient who was requesting added density to the frontal 2/3 of thinning area.

I guess assuming he had full growth he must have very poor hair characteristics because it barely looks any better in the after pctures, espeically as the lighting is much darker in those.

I agree....this guy looks barely any better than before. I respect you dr. charles, and I know you used to work with dr shapiro who might be the best in the biz, but this result is in my opinion, terrible.

The top-down, on a diffuse thinner especially, really tells the tale; here, I dunno, it looks closer to 2k than 4+ IMHO. He def looks better to me, but it just doesn't seem like full growth.

What happens alot in surgery is the new hair replaces the existing hair.
If he wasnt on propecia and the hair was already weak then it was more then likely permanently shocked out.
You would be surprised how many results on here looked like this if the clinic showed a topdown shot.
Dr Meija ,Rassman , and many more is good at avoiding those shots as they dont want the true story told .
I at least give credit to this doc for showing us this shot from above.
Also a doc who once worked with or for another doctor will not guarantee the same type of results.
Its the techs that make or break a surgery.
Sharon Keene also worked with Shapiro and shes fantastic .
I believe Charles works with Epstein now

Any plans by this patient to correct the rest of the top?

Doesn't look like 4k? Another 3k might be enough (staying out of the crown)

I doesn't like this resullt, poor HT.

Τhis must be the result of the first session, I'm guessing not more than 2000. Dr Charles can you clarify?

Sorry Dr. Charles but for 4000 plus grafts this is not very impressive.

My Bad guys. This was the result after the first procedure. This case was not supposed to be entered until results of second procedure were obtained.

Dr Charles ,Do you use the same techs as Eppy?

No please, Dr. Charles is an independent doctor, why do they keep comparing him to Eppy? Dr.Eppy is done.kaputz. Give Dr.Charles a break. He is a good guy. You guys are funny.Dr.Eppy was even taken out of here. Dr.Charles is in.What happened to Eppy?

PGP,

Can you clarify your statement that it is the techs that make or break a surgery?

Thanks,

M1A,

Ultimately, it takes a staff of experienced and skilled people (surgeon and technicains) to make a hair transplant successful. The technicians play a major role in the procedure. While the surgeon harvests the strip, closes the wound, and makes all the recipient incisions - the technicians sliver and trim follicular units under microscopes and place all the grafts into recipient sites. The mishandling of grafts is the number one cause of less than optimal growth. Since all members of the team handle grafts, it's critical that all team players are on their game.

I hope this helps.

Bill (Falc)

Bill,

Thanks. I guess than the traveling techs that go from one suregon to the other would be inferior in consistent performance and thus, they would have no continuity or experience in working with each other or the surgeon. In terms of probability of positive outcome, the loser would be the patient and the winner would be the doctor due to on time management of labor cost. No? What do you think Bill?

Again thanks Bill.

Hey PGP, what's your take? Am I off base here.

Thanks,

M1a1,

I couldn't have said it better myself...

In my opinion, using traveling technicians puts hair transplant patients at unnecessary risk. Traveling technicians are usually part timers who are usually far less experienced with no allegiance to one particular hair restoration surgeon. They also can't be held accountable in the event of a problem because they disappear just as fast as they come.

Ultimately, it takes a staff of experienced and skilled people working together as a team to ensure the success of a hair transplant. Thus in my opinion, adding a less experienced part time technician with no experience with a particular surgeon or staff could break the necessary cohesiveness it takes to ensure patients get the best results. A lack of teamwork can put patients at unnecessary risk of potential problems.

Ultimately, if one cog in the wheel isn't functioning properly, the whole mechanism can break down.

Just to be clear, I'm not suggesting that physicians who use traveling technicians can't do quality work. However, I believe it creates additional and unnecessary risks that as a patient, I wouldn't be comfortable with. Thus, in my opinion, the only real benefit to using traveling technicians is the reduced costs the clinic incurs while performing the procedure.

Just my two cents...

Bill (Falc)

Hello, In reference to the Independent Hair Transplant Technicians. We are not mill tech's (large company's who move tech's state to state with low pay, poor wages, and poor travel conditions. Which does makes for poor job performance. These technicians and doctors are not monitored for quality control.) Please qualify whom you are referring to. I have over 20 years experience, trained by top doctors in the Hair Transplant Field and also have the privilege to still be working with them when needed. As far as creating risks we are at the top of the field in technology and skill, along with cost we are far more expensive. Only a doctor who's concern for the patient is number 1 and needs more staff will employ an Independent Hair Transplant Technician. Local staff with less experience are much more cost effective, if your doctor is only looking at the bottom line. Thank you.

Mindy,

My above post was a general precaution and the additional risks that come along with using traveling technicians. Nowhere did I say anything about specific people nor did I say that surgeons using traveling technicians can't produce optimal work. I made this clear by the above statement that I posted below for your reference:

"Just to be clear, I'm not suggesting that physicians who use traveling technicians can't do quality work."

I do however, believe it's more risky and takes additional quality control methods. Even if you and other traveling technicians work full time and are just as skilled as full time technicians working under a single surgeon, building teamwork and cohesiveness sometimes takes time. Thus, putting new people into the mix can confuse the process without additional quality control practices.

I do however, disagree with this statement:

"As far as creating risks we are at the top of the field in technology and skill, along with cost we are far more expensive. Only a doctor who's concern for the patient is number 1 and needs more staff will employ an Independent Hair Transplant Technician."

This is far too broad and makes it sound like doctors who've hired a full time staff does inferior work to those who employ traveling technicians as needed. Most leading surgeons employ a full time staff to promote cohesive teamwork and familiarity. The trust built betwee physician and technician takes time, but once developed, allows a concerned physician to breathe easier knowing qualified and experienced hands are carefully handling the grafts. Full time regular technicians promote a streamlines process that works like a well oiled machine.

You may very well be highly skilled and experience. But are you seriously suggesting I’m incorrect in saying that physicians need to employ additional quality control practices to ensure optimal results? You don’t think adding new people into the mix all the time (skilled or not) can’t possibly confuse things?

Your very words in the email you sent me earlier today prove my point about adding additional quality control practices.

"I was recently at Dr. Cooleys office in Charlotte, the staff was more attentive to my work to assure their standards were being meet." Dr. Cooley and his staff employed additional quality control practices to ensure you (his traveling technician) was doing work up to their standards. Now imagine how much additional work a physician would have if he used all traveling technicians all the time?

Again, I'm not saying physicians who employ traveling technicians do inferior work. Nor am I suggesting that all traveling technicians are inexperienced and inferior. However, in my opinion, there are additional risks of using traveling technicians and quality physicians utilizing them must be prepared to add additional quality control practices to ensure the patient gets optimal results.

All the Best,

Bill (Falc)

Hello, The statement concerning Dr. Cooley referred to your words saying our work is not monitored. My work was reviewed by the surgeon at the start. I have letters of reference that are go before me. We are hired as an addition to the hair transplant doctors team. To help with additional case's, team members not available. You continue to insinuate that we are not part of the team. There is a trust built between (ps-this is how you spell between, these are the details, we don't miss) the doctors and staff. We are all like family. I'm not quite sure where your spin is coming from. We are always a welcomed addition when we are called, because of our skill we are part of that well oiled machine. Have you had any surgical room experience? I mean no insult but your putting out miss information.

Thank you,
Mindy Gilbert

Mindy,

You said, "Hello, The statement concerning Dr. Cooley referred to your words saying our work is not monitored".

If you're going to make accusations, please back them up with proof. Where did I say that the work of traveling technicians is not monitored? Are you even reading my words or are you seeing what you want to see to start an argument?

You are being far too defensive and aren't reading my words carefully and objectively. Like everyone else, I am entitled to my opinion on the matter. Go back and re-read what I wrote and try to be objective. Then we can talk.

As for my experience, I'm a 4 time knowledgable and researched hair transplant patient, the Associate Publisher and moderator of this community, have discussed various procedures and philosophies with dozens of leading hair transplant clinics, and observed surgeries in person and via video.

You are making this a black and white issue Mindy whereas I'm not. My opinion is and remains that additional risks exist using traveling technicians. As long as these risks are understood and properly handled, I believe patients can still have optimal results.

Best regards,

Bill (Falc)