27 Years Old NW3, ARTAS FUE to Frontal Areas Approximately 1500-2000 Grafts - Georgia, GA

Regarding my last comment (below for reference):

"He's not a diplomat of the ABHRS, which is suggested as a good thing to have (among many others that Anderson does have) by other prominent HT surgeons. This is sort of like saying "but he didn't go to Harvard" as ABHRS only has 200 HT surgeons right now to my knowledge. With that said, he's a fellow of the ISHRS, which shows he has some professional social proof among other HT surgeons."

I asked Anderson about this and his answer was pretty informative.

"[about fellowship at IHSRS] that's not really a social thing, but you have to earn that through presentations, publications, meeting attendance, delivering courses, and so forth over 5+ years. The board certificate is not really as significant, as it's just a test. I need to take that test, but simply have not gotten to it. Obviously I could take it with zero prep and pass, I've just been remiss in getting that done. Anyway, you mentioned the fellow status in a social context, but it really has nothing to do with that. It's about participation and a long track record of contributions and continuing medical education in the field. There are far fewer fellows of the ISHRS than ABHRS certificate holders."

What he said sounds accurate. According to the ABHRS website on certification:

"Certification of a Diplomate requires demonstration of training, evidence of post-training experience, and successful completion of Written and Oral Examinations on the entire scope of the specialty."

Anderson has been a HT surgeon since 2003 and more than meets the requirements for training and experience without me needing to know exactly what those requirements are. He just needs to apply and take the test to get the certification. The reason I mentioned ABHRS was a post by Bernstein medical on choosing a hair transplant surgeon where he said:

"Doctors to consider should be members of the International Society of Hair Restoration Surgery (ISHRS) and be Diplomats of the American Board of Hair Restoration Surgery (ABHRS)."

Anyway, Anderson is not just a member of the ISHRS but also a fellow. According to ishrs.org,

"In 2012, the designation of Fellow was established in order to recognize members who met its exceptional educational criteria. ... It is a great honor for a member to achieve the Fellow designation of the International Society of Hair Restoration Surgery (FISHRS). This recognizes the surgeon who strives for excellence in this specialized field. "

From the ISHRS website they have a list of fellows. I can count a little more than 100 physicians listed. (Ken's there, of course.) From the ABHRS website physician directory, I can find more than 4000 physicians listed, so I was incorrect in my earlier comment stating that there were 200 ABHRS diplomates. Looking into this, I got this original estimate from abhrs.org's article on "Why ABHRS certification matters":

"Approximately 200 hair restoration surgeons have completed the rigorous pathway to achieve the designation of DIPLOMATE OF THE AMERICAN BOARD OF HAIR RESTORATION SURGERY."

I think this is either a big typo (i.e. 2000 not 200) or really outdated info. As I mentioned, on the physician directory listing for certified doctors, there were >200 pages with 20 results per page, or more than 4000 doctors in this listing.

tldr; Anderson's a solid choice as a hair transplant surgeon.

Disclaimer: this is an ongoing review as it takes 3-12 months to see the net effect of the hair transplant. My surgery was early November, 2016.

I have more hair loss than is typical for my age and wanted to do something about it. My current regimen is 0.5 mg/day dutasteride, LLLT 3x/week, minoxidil foam, and ketaconazole 2% shampoo. I had consultations with Anderson and a separate prominent HT surgeon already knowing the procedure of interest (ARTAS FUE), wanting to know if I was a good candidate for HT surgery. In my consult with Dr. Anderson, he was initially a bit reserved about whether a HT right now was appropriate because being so young meant the progression of my hair loss was mostly unknown. With that said, he said he would be comfortable working on the frontal area, and advised against work on the crown at this point. The initial quote 17900 (the second quote was reduced to 15900) and I took some time off to evaluate if I was really stable. About 5 months later I came back, sent in some new photos, and got the updated price of 15900.

I am going to leave out details on the actual procedure, because (a) they are more-or-less what you would expect if you read about the latest standard protocol for ARTAS FUE and (b) I don't think recounting this adds much value.

The reason I chose Anderson over an even more prominent HT surgeon had a few factors
(a) There were no major differences among how the procedure would be performed
(b) Anderson was several thousand more expensive, but cost wasn't a primary concern
(c) Anderson focuses a lot on patient care, but that wasn't my primary concern
(d) I was able to speak with Anderson at the time of the consultation, which was not the case for the other surgeon (though I still spoke with a doctor who I could have chosen as my HT surgeon).
(e) Anderson has a background in the fine arts, and that could translate to good outcomes in the design of the hairline as well as placement of the hair grafts. A good sense of aesthetics is an important quality in a cosmetic surgeon.
(g) Anderson encouraged LLLT and minoxidil before the procedure to promote good vasculature in the scalp, and LLLT immediately after the procedure as LLLT has beneficial effects on the inflammatory phase of wound healing. This was the basis that made me pick Dr. Anderson. At the time, the Dr. I spoke to at the other clinic recommended against LLLT post-surgery to avoid putting pressure on the grafts. The best way to describe this is that the established protocol for HT evolves very slowly as lots of research needs to develop first. There are number of things that could improve HT outcomes which is supported by research but usually not on humans who have undergone a HT (e.g. the study might be on skin grafts). An example is wound-healing. A HT is effectively a skin graft, and it might make sense to look into research on promoting skin graft survival and apply that to a HT. Anderson is the kind of doctor who is thinking about a HT in a broader context and considering whether treatments for closely related conditions might make sense for a HT, and I felt it was a good cultural fit.

Pros:
- Lots of experience with ARTAS FUE, the procedure I was interested in
- Fellow of ISHRS
- Double board certified surgeon
- Contributes to research in hair science
- Background in academia - he's an assistant clinical professor at UCLA
- He has a background in art. (His undergrad degree was in the fine arts.) Cosmetic surgery is part art, part science, and I like the idea of someone with a good natural sense of aesthetics involved in the process. This is probably something that is increasingly important with the complexity of your procedure.
- You'll speak to him during your consultation. It's important to speak to the surgeon who will be operating on you.
- No pressure to pursue surgery. I had an initial consultation and decided to wait six months before deciding to go forward.
- He's focused on a long-term plan. In his words, "the goal is to look normal." Obviously, there are a finite number of donor grafts over a patient's lifetime and while the short-term goal is to have better hair from a cosmetic standpoint, the long-term goal is to still look normal as hair loss invariably progresses (albeit at a slower rate with treatment) and preserve your donor region.
- He's very much on the cutting edge of HT science. He's familiar with established hair science and wound healing as well as investigational treatments that are likely to merge with evidence-based medicine as more research is done. For example, he creates the extraction sites the day before the procedure and injects PRP/ACell, he uses ARTAS for FUE extraction, hypothermasol holding solution (the same stuff used in organ transplants), and ATP spray post-op. He keeps the wound moist post-op with shower caps (moist wounds heal better than dry wounds). He suggests taking minoxidil and LLLT for one month before the procedure to increase the vasculature of the scalp, which is likely to promote a better environment for healing. His post-op instructions include LLLT, which is significant because LLLT is not just associated with hair growth but faster wound healing and less inflammation. (Faster wound healing likely translates into better graft survival.)
- Performs one hair transplant per day even with ARTAS. I don't want any outside factors contributing to surgeon fatigue beyond his involvement in my procedure.
- He'll pull strings to make sure things go smoothly. I mentioned that I wanted to do post-operative hyperbaric oxygen therapy and he took care of all of the details on short notice.
- Good communication. He'll personally call you after the procedure to check in. His office will call about one week later to check in as well. I value good communication and think this is generally important, even though I didn't have any special needs or questions after the procedure was finished.
- Good pain management. The procedure involves numbing your entire scalp twice (the procedure is over two days generally), and obviously recovery after the procedure. He uses a vibrating device when injecting into the scalp, which surprisingly makes it hurt much less. The procedure itself is similar to a colonoscopy in that you remember right before the procedure, right after the procedure, and nothing in between, which was pretty interesting considering the procedure was all day long. After the procedure you'll have vicodin for pain if you need it as well as a sedative to help you sleep.
- Well reviewed and cares about his reputation. At the end of my procedure, he asked me if I would feel comfortable writing an anonymous review about my experiences and mentioned RealSelf as the platform to post the review if I write one. There were no incentives to write a review or even a positive one, which is good since it can introduce biases. He also said it's fine to mention parts of the procedure that went less smoothly, like the delay due to recalibrating the ARTAS machine. That's also a good sign since he's not introducing a bias for the reviews.

Cons:
- May be more expensive than other options, but not by a large margin. (note: a hair transplant is not something to decide on cost.) This expense is possibly due to him performing one hair transplant per day, which is costly on his end.

Misc:
- My procedure was delayed by 6 hours. Dr. Anderson called me 12 hours before the procedure to tell me that the machine was failing to calibrate, technicians were coming in to fix it, and the procedure might be delayed by several hours. It would be unfair to list this as a con because the reality is that machines sometimes need repair, possibly on short notice, and that the machine was fixed, calibrated, and retested very quickly. The communication from him and his office was very good. I got frequent updates on the status of the repair as it was ongoing the next morning.
- He's not a diplomat of the ABHRS, which is suggested as a good thing to have (among many others that Anderson does have) by other prominent HT surgeons. This is sort of like saying "but he didn't go to Harvard" as ABHRS only has 200 HT surgeons right now to my knowledge. With that said, he's a fellow of the ISHRS, which shows he has some professional social proof among other HT surgeons.