Hi, I have read all the information here and other boards about both doctors, but some input would still be nice.

I'm 25, NW4ish with a pretty strong hairline and some temple recession, areas 3 and 4 are really bad.

Rahal said he would only do 3000 grafts for now, while Armani said 4000 is fine. Both estimated around 7-8 thousand donor supply. My lineage isn't that bad, mom's side males are fine, dad and one brother have also bad areas 3 and 4 with an ok hairline and temple recession.

Of course, Armani's ethical standards have been called into question almost everywhere online, but it seems to be more for hairline packing, which doesn't apply to me as they agreed my hairline is fine for now.

Both doctors want to put about 1000 grafts in Zone 2 as the middle area of that part is bad. Rahal wants to keep going and stop at the crown pretty much for now and hold off from using any more grafts.

Armani wants to keep going and close off the crown right away.

At this point I'm a little confused to be honest. From the research I've done I don't know if it's really necessary to be as conservative as Rahal wants to be considering my genetics etc.

But also, Armani's team/the whole situation there is pretty annoying, I've felt sales-pitched from the moment going in there, which is just ridiculous considering this is a situation where people are going with open wallets saying in not so many words "please help me now", and the consultants job is simply to sit there be nice and make people comfortable...apparently Armani's consultants think they're selling used cars...anyway, that's just my opinion...

I felt comfortable with Rahal and Adrian. Although I don't know if it's necessary to be that conservative, I want the best possible surgery I can get now considering my donor supply, and think that can be more then 3000.

Also, Armani's clinic is here in Toronto which also makes things easier. I know there are tons of reservations about Armani with hairline etc but again that just doesn't apply to me. If I can get 4000 done now and even have only 3000 left for the future, with the hairline not having been touched and the crown and top filled in then why not. My dad is a NW5 at most and I do not have any genetic propensity for complete baldness where its just the sides and the back.

I made it very clear to both that the only factor I want influencing the extent of my surgery was future consideration. Sure Armani could be being more aggressive for money, but Rahal could also be more conservative for money and spread out over a few surgeries what can reasonably be done in 2. Again, my dad is in his late fifties and he will never go completely bald on top...

I would like to have my mind made up soon however as I do have a booking with Armani somewhat soon. The fact that I don't get to speak to him or see him right away, and who knows where he is at any point in time doesn't sit well with me either, but, Rahal is far from me too so not that much different.

Armani of course is also a little more expensive but also 30 minutes away from me.

I'd say I'm probably leaning more towards Armani now.

What do you guys think?

Should also mention that Armani's 4000 graft recommendation is at 20-40/cm2.

Ethics (regarding densepacking and aggressiveness) would be the least of my concerns if I were you; I would be more concerned with who is the most candid, and thus proven, and can virtually guarantee you a world-class result....grafts actually growing included...Results > Ethics ------ Rahal > Armani. IMO, of course.

I'm sure you are aware that Armani is only doing fue now and Rahal is strip. So, obviously two different procedures. Armani's strip work was undoubtedly very good as far as yields and design is concerned. I'm not that confidant in his fue yields even though they stand behind their work. Even though Rahal is further, I feel these guys are more personable than Armani and seem to be doing good work. They are also much cheaper than Armani. They always say don't let distance be a factor

quote:

Ethics (regarding densepacking and aggressiveness) would be the least of my concerns if I were you; I would be more concerned with who is the most candid, and thus proven, and can virtually guarantee you a world-class result....grafts actually growing included...Results > Ethics ------ Rahal > Armani. IMO, of course.

Perhaps I'm misunderstanding but there seems to be an inconsistency in what you're saying.

You're saying results are greater then ethics and so therefore rahal is greater then armani...although...rahal is the more ethical one in general....

Also, I can take then from your comment that you're saying rahal has more proven world class results....does armani not as well?...

quote:

I'm sure you are aware that Armani is only doing fue now and Rahal is strip. So, obviously two different procedures. Armani's strip work was undoubtedly very good as far as yields and design is concerned. I'm not that confidant in his fue yields even though they stand behind their work. Even though Rahal is further, I feel these guys are more personable than Armani and seem to be doing good work. They are also much cheaper than Armani. They always say don't let distance be a factor

Rahal is not strip, both are FUE...

Right distance shouldn't be much of a factor, but it's slightly considered when assessing post-op factors, in this case neither doc will be "next door" so it's cancelled out.

Interesting...I've never heard/seen of a Rahal FUE of such a size....

Anyways, I was just saying that results *are* more important than the ethics of a "too bold a hairline" variety; and you should be more concerned with consistency of results, growth being a primary tenent. But ya, I also do believe that Rahal's results AND ethics are generally better than Armani's.

Armani had lots of impressive strip work, and the only real dig into him was that he was hyper-aggressive in working on very young patients, with limited balding, and giving very dense, bold hairlines; he also had some dubious claims. But, his results were quite transparent and you could go to him and know what you were getting (into...ethics included). Since abandoning strip in favor of the more marketable -- and expensive -- FUE, his results....marketing...and general transparency have gone down in quality, while complaints and questioning have risen (regarding growth, bizarre quoting w/ regard to his past strip quotes, e.g.).

I think you might be mistaken, itsabouttime...

Unless something has changed very recently, there are many patients of Dr. Rahal on this forum that have had recent strip procedures.

Also, according to Dr. Rahal's website as of today:

"Follicular unit extraction: Dr Rahal is one of the few physicians worldwide that performs both the strip surgery as well as the recently introduced follicular unit extraction (FUE)."

quote:

Originally posted by HLBD:
I think you might be mistaken, itsabouttime...

Unless something has changed very recently, there are many patients of Dr. Rahal on this forum that have had recent strip procedures.

Also, according to Dr. Rahal's website as of today:

"Follicular unit extraction: Dr Rahal is one of the few physicians worldwide that performs both the strip surgery as well as the recently introduced follicular unit extraction (FUE)."

Right, he does FUE and that is what I discussed with him...? Perhaps I'm missing something here?

Armani and Rahal have acheived beautiful strip results . Armanis fue sucks in my opinion and Rahal is too new .Ive never seen a fue result from Rahal. You sure he even does it ? Of those two I would choose Rahal and then Rahal again

Itsabouttime,

I *think* the point that was trying to be made was that Rahal does BOTH FUE and Strip; and by implication, perhaps people are wondering if *all* of the results you are seeing are indeed FUE *only* and not strip patients as well? I don't know, there's too much quoting and re-quoting on this therad...

A couple of points which haven't been addressed yet, and especially viewing them in the context of your age:

GENETICS:

you have stated repeatedly (at least 3-4X) that your 'balding-lineage' isn't that bad. Family history at *best* serves merely as a *very* GENERAL and VAGUE *idea* of where one 'might' end up...it is by NO means a definite that you will not end up a NW6+ just because no one you can find in your family has not; and family history should not in any circumstances be viewed as conclusive evidence as to your final balding pattern.

CROWN:

you questioned why there is a discrepancy among the two docs, and specifically why Rahal would suggest or even deny you work on your crown. I have read from several docs, that foraying into the crown of a relatively young man can be a complete nightmare.

This is the case, because while most docs will address the top/and hairline of a young man in their twenties, leaving that area fairly secure even in the event of future loss; the same can NOT be said of the crown...If you end up w/a LARGE BALD CROWN, w/extensive loss and the doc had elected to begin addressing this area years prior when the loss was not that severe, the patient will end up w/a 'halo' of hair w/bald skin below it, looking completely unnatural. The crown (if it ends up in a state of extensive baldness) is by *far* the biggest consumer of grafts of any single area on the head. In addition, due to the angle of the crown, it is the most difficult to give the 'illusion' of density when compared to any other area of the scalp.

Rahal's plan of attack for you, seems only consistent w/what all ethical doc's would suggest especially on a guy of your relatively young age.

The idea that Rahal is attempting to give you less grafts now, so he can get you back for a second surgery, thereby starting your graft count (cost wise) back at base one in a master plan to charge you more over the course of two procedures is tantamount to a conspiracy theory...seriously, this guy is NOT lacking for biz, and is probably booked out for a couple months in advance. I really doubt he is "banking" on the notion that you will be coming back to him in a couple year's time, but rather he is looking out for you best interest as not addressing the crown on someone of your age is consistent w/other docs; whereas Armani is notorious for over estimating grafts AND having little to no regard for the patients *future* state...

according to a post on hlh, rahal stopped doing fue. I'm not sure how true it is. Rahal has pretty good strip work. I haven't seen any grown out case of fue from him for that matter any patients who had fue at all. I'm going to have to ask Adrian about it. Or maybe he can chime in

Firstly, yes I was wrong, Rahal would be a strip procedure, I apologize.

Thanks for all the responses.

notgoing2gobald, your response addresses my concerns really well and sheds some nice light, thank you.

I am realizing how emotional I am getting about this whole thing and it's clouding my judgement. Deep down it's obvious I am trying to convince myself that I can restore all now and everything will be okay, it might...but as much as I feel I'm willing to make choices now on "maybes", I probably won't have the same mindset 20 years down the road.

Perhaps this whole Armani situation is jumping the gun. I walked out of there thinking wow I was just told what I wanted to hear, what do these guys think I'm a sucker, and yet, it still manifests in my decision-making.

Regardless, I have some thinking to do, but, it does seem to be a common theme in hair restoration in all boards etc that it's not a good idea to throw too much into the crown...

Now, I do have one question however.

In my situation, looking at my head, if, 4000 grafts is enough to cover all of this, then, I fail to see how 3-4000 more is not enough to cover other hair loss...that would mean I would have to lose an amount equal to or greater then the balding areas now, which just based on the size of my head seems unplausable.

I can't help but look at it like that...

quote:

I am realizing how emotional I am getting about this whole thing and it's clouding my judgement

dude, we can *all* relate to you on this one, trust me!! The good news is it sounds as though your leaning to error on the side of *caution*/conservatism; which is by far the wisest way to error and you will no doubt thank yourself for it in 10+ years time.

Armani---yeah, that's why he's so successful, especially among the relatively younger crowd; like a late night money-making info-mercial, he preys on individual's desires and telling them what they want to hear, even though *everyone* has a gut instinct telling them it is just "too good to be true"...not *everyone* will heed that instinct.

One's *Final* Balding Pattern:

no doubt, this is everyone's biggest concern/apprehension, for it is both the unknown variable in the equation, but it is aslo (and more importantly) the predicate of our proposition at hand -AND-our final product; that is---'what is our *final* supply & demand scenario (?); and how do we allocate my supply to demand BOTH now, in my current condition, AND w/respect to my foreseeable future loss?"....


It's the single biggest question which effects all of us, hence the less than ideal Armani ethics which always enters the discussion when his name is dropped.

" if, 4000 grafts is enough to cover all of this, then, I fail to see how 3-4000 more is not enough to cover other hair loss...that would mean I would have to lose an amount equal to or greater then the balding areas now, which just based on the size of my head seems unplausable"...

that sounds very plausible, as we have seen many NW5, 6+'s who have 7 & 8K moved and end up w/great coverage:
http://www.hairlosshelp.com/websites/Bobman/
http://www.hairtransplantmentor.com/
http://www.hairlosshelp.com/websites/london_lad/

So the fact that both docs estimate you have a total donor supply of 7-8K puts you in a pretty good position; although I wouldn't put much stock in Armani's estimate.

How bad is your crown loss currently? Care to share a pic? On any meds?


Also, after re-reading the begining of your initial post, it *sounds* as though you are not addressing the hair line at *all* in this procedure, correct?

One thing you might want to consider, even though your hair line is currently intact and strong, is that this is by far the single most important area of concern for virtually everyone; not only does it frame the face, but further *most* guys front-load the grafts (placing a disproportionate amount of grafts into the frontal third) to aid in the illusion of density. If you currently do not have loss in the hair line AND are not going to address this area in this procedure, then you might want to give some serious thought as to how many grafts your saving in the bank and how your allocating the one's your currently using...

In light of that, I would *def* not want to get too deep and heavy into my crown in the first procedure...

Itsabouttime,

When you wrote that you had a booking with Armani sometime soon, did you mean you have booked an ht with him? If so did you put down a deposit? If you did and decide you want to cancel the procedure now, I can assure you that you have lost some coin. In my opinion I have no problem with Armani himself, however, he has to hire someone to manage his office in Toronto that actually does not treat people like they are buying a bedroom suite at LEONS. This is a big decision and short consultations are just not acceptable, especially when you are dealing with some kid sales rep whom is barely out of his teens.

Read the posts regarding Dr Rahal.He stands by his work and offers personal attention both pre and post-op. Just my 2 cents worth for you to ponder.

Good luck and keep your head clear.

NG2GB, Those pics you are showing him are from strip. There is no way he is going to get that amount of coverage from the same amount of FUE grafts.


How much did Armani quote you per graft ? Armani claims most men have an average of 12-15K donor for FUE so your donor hair must not be very good if you only have 8K. I would check the coverage he is getting from the many 3K FUE patients around the internet and you will see that 3K FUE from Armani isn't covering much.

You are very bald for 25 and there is no way you can accurately predict future hair loss.

Are you on Propecia/ Rogaine Foam ?

quote:

Hide Post
NG2GB, Those pics you are showing him are from strip. There is no way he is going to get that amount of coverage from the same amount of FUE grafts.

Quote itsabouttime----
"Firstly, yes I was wrong, Rahal would be a strip procedure, I apologize"..............

sounds like strip is still on the table, as he is considering against Armani.

Is Armani the one with the gay looking commercial on his website? Something about art, etc.?

I did book with Armani but have not left a deposit...yes I agree about his consultant, I'd think more fondly of Armani if I did not discuss anything with that kid...Armani's only hurting his practice with that individual...anyway.

Been on prop 3 months now, was on minoxidil for a bit, going back on soon.

What's the graft limit of the strip procedure in one sitting?

How about FUE?

Here's the pic.
Making this decision really comes down to trusting that the grafts left over aren't enough to cover the rest of the potential balding and leaving the crown alone for now. Still seems inconsistent that 4000 grafts can cover all this, and 3 or 4000 more isnt enough to cover what could also be lost in the future.
http://hair-restoration-info.com/eve/forums/a/ga/ul/9461029853/top.jpg

[quot Still seems inconsistent that 4000 grafts can cover all this, and 3 or 4000 more isnt enough to cover what could also be lost in the future.pg[/quote]
No one is saying you won't be able to *cover* future loss w/a total of 8K grafts. In my last post to you, shows several examples to prove otherwise.

Also, to "cover" your final balding pattern is so relative. Some guys use almost 5K grafts JUST in their frontal third *alone* which is the most important area (to most) and which I believe your not addressing at all in this procedure.


Graft Limit for Strip:
totally relative. H&W have moved over 7K on several patients in but a single session.
FUE:
I don't think ANY doc has consistintly demonstrated moving more than 3K in a single session...