PupDaddy

First, thanks for the link to the hysterical SNL sendup of B*sl*y (ironically, the "after" shots aren't that far off from some of the body hair transplant work we've seen). Second, I don't work for any doctor or clinic. If you search my posts, I think you'll find that they are mostly positive and supportive. In this case, however, I am irked by a dishonest campaign to promote a cut-rate FUE clinic where, it turns out, the "doctor" whose name is on the door doesn't actually perform any part of the hair transplant surgeries he sells. In fact, no physician works on the patients who go to this clinic for a hair transplant. Getting to the true state of affairs at "The Maral Klinik" has been like pulling teeth, both from the clinic's online rep and from its purported patients who began deluging this site with photos of immediate post-op work labeled as "results," supposedly executed "by Dr. Maral." When questions arose about who had actually performed the work, we were assured that Dr. Maral personally performed every aspect of the transplant procedure on the clinic's hair transplant patients. After all, the story went, only licensed aesthetic surgeons are permitted to perform hair transplants in Turkey. Then we were told that Dr. Maral's role was actually more supervisory but that another physician performed the most critical parts of the transplant surgeries. That assertion was then "corrected," and it was admitted that no physician is involved in the hair transplant surgeries at this clinic, only non-physician technicians. Despite that, we were told to rest assured that Dr. Maral was there to supervise the FUE transplant surgeries every step of the way. Now we learn that even that isn't true. Ash1975 tells us that Dr. Maral leaves the clinic to go home while the procedure is still underway and the patient is still in the chair. (We still don't know, by the way, whether Dr. Maral himself has any substantial experience performing hair restoration surgery.) If a doctor is going to promote himself on this site in order to recruit hair restoration patients and possibly even seek "recommended" status, I think it behooves the doctor (and benefits the membership and visitors) to provide accurate, forthright information about himself and his clinic. That's all.

So Dr. Maral is not even on the premises while his technicians complete hair restoration surgeries!?!? First we learn that Dr. Maral "supervises" all aspects of the FUE surgery, which his technicians perform from start to finish. Now we learn that the good doctor heads home for dinner while his (hourly rate) technicians are still operating on patients. Some supervision! And, apparently, the doctor's parting words to the techs as he heads out the door are "finish up quick," so he won't have to pay them for additional hours of work. The shady practices of this clinic become more and more alarming.

I am undecided on this one as well. Difficult to tell whether this fellow's old style comb-over is by design or by necessity.

Beautiful, natural work by Dr. Wesley with a conservative number of grafts. Excellent!

Welcome back, Sean! Very, very best luck with the growth and outcome of your touch-up/repair session!! This go around, were there differences you noticed from last time in the FUE procedure/protocol/approach/tools used/method/extraction personnel/etc. at Dr. Rahal's clinic?

While I agree that FUE clinics should be transparent about the role that technicians will play in the procedure, you should know that this case was FUT/strip, not FUE (H&W doesn't offer FUE), and that contrary to the misimpression created by the patient that started this thread, Dr. Wong personally performed the surgery, not his technicians. Dr. Wong surgically extracted the strip, sutured or surgically stapled the wound closed, and, using custom cut and sized blades, made all of the recipient sites for the grafts to be seated in. The technicians' role was limited to the routine, technical tasks of dissecting the strip into follicular units and then seating the grafts into the graft recipient sites that had been cut by Dr. Wong. Just thought you should know, as it may have been difficult to determine this given the length of the thread and the various tangents it has taken.

I recall Joe Tillman telling us that your clinic was using a method to remove the punched follicular units from the donor that is supposed to be less traumatic on the grafts than other methods (e.g., forceps). Joe was going to fill us in about it but I believe that he and your clinic have since parted ways. Assuming that I am remembering correctly, do you have information about this graft removal method you can share?

Looking REALLY good at 4 months, jkm3! Love how the hairline is shaping up. Looks like Dr. Diep did you and himself proud. As you know, not only will more hairs sprout as the months go on, but as the transplanted hairs cycle through their growth stages, they will mature, fatten up, and become better "trained" to the angles and directions they were implanted. Please continue to update us.

You are missing one of the main points here: The clinic in question isn't just having techs do all the extractions and seating of the grafts in recipient sites. It is even having technicians create all the recipient sites!! The creation of the recipient sites is the heart-and-soul of ultra refined hair restoration surgery. We have NEVER read of this and we have NEVER read of ANY clinic -- and certainly have not recommended one -- that removes the surgeon from the procedure entirely and allows non-physician technicians to perform the entire hair restoration surgery, from start to finish. In fact, from what I can gather, the physician who owns the clinic in question has no experience performing hair restoration surgeries at all and merely hired a team of technicians to perform hair transplants as a second profit center. This is the kind of clinic that we should recommend to members or even grant Coalition status to?

The quality of abcd's self-taken photos are so poor that I am unable to tell anything about his 10-month progress other than he appears to have some hair on top of his head. His crown and vertex are obviously thin, judging from the single relatively clear photo of that area. The rest is unknown. There are no clear, properly lit, close-up photos of the hairline work or of the top, temples, or sides. It is impossible to tell whether this single case is quality work, comparable to that of the body of work posted by recommended clinics and their patients. One thing is for certain: no ht physician or clinic has been recommended here based on a single case, and if the poor, blurry photos of this lone 10-month result is the best that can be offered on behalf of the FUE work being turned out by the technicians working for the Maral Klinic, I would say that your idea of a separate recommendation status for technician-only FUE clinics is moot anyway.

Looking GREAT, turtle! One of the best I've seen at only 4 months.

How would one conclude that "high standards" are the "paramount concern" of a surgeon, be it Dr. Maral or another surgeon, who would turn a cosmetic surgery over to a group of non-physician technicians while the surgeon is doing god knows what and whose only involvement is an occasional walk-by to ask if everything is going okay? It seems to me that if high standards were the paramount concern, either the surgeon would dedicate himself/herself to learning and perfecting top-notch hair transplantation and/or hire the finest hair transplant surgeon available to perform these procedures for the clinic. At the very least, the surgeon should assist in putting the purportedly talented head technician through medical school. Oh, wait -- if any of these steps were taken, the surgeon couldn't leverage cheap, non-physician labor into a veritable hair transplant factory. You keep referring to "results [Dr. Maral's] team are producing" being of a "high standard." What results are you talking about? Immediate post-op is not a "result." I have yet to see a single result (12-18 months post op, or even 8-12 months post op) of this clinic, let alone a body of results that would allow an assessment of the consistency and quality of the work being turned out. Even if acceptable results could eventually be provided, I still would oppose the recommendation of any clinic where hair restoration surgeries are preformed entirely by non-physician technicians.

Then why does Dr. Maral not directly participate in the clinic's FUE hair transplant surgeries? Has Dr. Maral ever performed FUE hair transplant surgeries? For how long? How many? When did the Maral Klinic start offering FUE hair transplant surgeries performed entirely by technicians? Where did these technicians come from? Who trained them? What is their experience?

I've already commented on this great result by Dr. Cooley, but let me say again: this is what the art of hair transplantation is all about. Kudos!

Ha! Adding my applause both for the terrific result and for equally terrific video presentation (great soundtrack, good humor). Good job on both fronts!

Everything Blake said, x 10. Hair transplantation is a cosmetic surgery, be it FUE or FUT. Removing the surgeon entirely from hands-on involvement in the surgery is a bad, bad idea -- on many levels, a number of which Blake already touched on. Bottom-basement pricing for technician-performed FUE hair transplantation might "benefit" some patients in the short run and only in the sense of immediate cost, but the long term consequences and costs (financial and otherwise) are potentially disastrous and devastating. Something else being given short shrift here is that with Turkish FUE mills like the Maral Klinic, not only do non-physisian technicians do all the fu extractions and fu implantations/seatings, THE TECHNICIANS ALSO CREATE/CUT ALL THE RECIPIENT INCISIONS FOR THE EXTRACTED FU'S!! To make this cosmetically critical task "easier" and "faster" for the tech, the clinic provides the tech with a motorized drillI to make the recipient sites!! I have NEVER heard of this being done anywhere, and, as KO noted, this assembly line, techs-only approach to hair transplantation is taking things to an absurd level. It seems apparent that clinics such as the Maral Klinic have started offering FUE hair transplantation as a second profit center to the physician's cosmetic surgery practice. While the surgeon busies himself with rhinoplasties and facelifts, a group of techs churn out hair transplantations at cut-rate prices made possible by this business model. Patients are then encouraged by the clinic to post their "results" here, but the only results we see aren't results at all, but rather are immediate post-op pics only showing that a transplant recently occurred -- indicating that the clinic only recently started offering these technician-performed FUE transplants such that actual grown-in, matured results are as yet non-existent, or that such results have proven to be deficient. I can't conceive that this forum would put up such an outfit for recommendation, let alone that recommendation would be granted.

FueSoon, None of the Coalition physicians or recommended physicians on this forum use the Neograft machine to extract graphs, and two who purchased an ARTAS machine for this task no longer use it. Why? Because the top, experienced FUE physicians have learned that there are no "robotic" shortcuts to the tedious process of individually punching out (excising and extracting) follicular units without damaging them. Both the Neograft and ARTAS have proven deficient in yielding viable graphs compared to hand punching by skilled practitioners. The top FUE docs and/or their technicians punch out and extract the graphs by hand, using either manual punches or one of a variety of hand-held motorized punch systems. Keep researching, and if at all possible, don't limit your choice of surgeon to your immediate locale. People routinely travel great distances, or even fly around the world, to be worked on by the best hair transplant physicians. A poor transplant can have lifelong negative consequences. We only have a precious, finite supply of donor graphs. Don't risk squandering them with an inexperienced local physician who has purchased an FUE robot as an "easy" entry into hair transplantation. Good luck!

Understood, doc. I will be on the lookout for postings of your work if you seek recommendation and Bill decides to propose you to the community for recommendation.

Hey Spanker, Can you fill us in on Dr. Konior's current FUE protocols? For example, for this patient do you know whether all of the 2320 graphs were extracted and transplanted in one day? Did Dr. K do all the extractions himself? Did he use manual punches? Dr. Cole's PCID? Thanks very much.

Congrats, afgaliday! I like what I've seen of Dr. Demisroy's work. Grow well. Notes to self: (1) Don't work out for a year prior to FUE. (2) See if the clinic will perform the procedure on the plane, on the tarmac, ready to take off when the final graph is placed.

tk, I was just looking at some of Dr. Civas's work online. What I saw looks really, really good. Please keep us updated in the coming months. Grow well!

Hi willguy, Lots of people using Minoxidil/Rogaine report getting dark circles under their eyes and experiencing negative changes to their skin and complexion. I did, so I stopped using it. I do take propecia/fin, though.

That's some really nice, refined work, Dr. Haber!

Perfectly said, hairweare. Very clean work, and responsible harvesting of the patient's donor.