PupDaddy

Spectacular FUE result! And one of the largest single FUE transplants (2 days) I've seen. Very good to see another successful large FUE session, achieved through excellent planning, punch selection, and execution on Dr. Devroye's part, taking into account the patient's particular follicular and hair characteristics and donor laxity and density. One more pass for the crown and this advanced NW patient is good to go, with a result that appears to rival the best of FUT.

Wow, wow, wow, Spanker! That is one seriously great looking hairline. Dr. Konior hit it out of the park for you. May the gods of mpb now be intimidated into leaving you alone.

Hi Hairybadger, From your recent photos, it appears that your recipient area ended up with lots of scarring and little growth. The recipient area also appears to still be rather inflamed, which would be unusual at this stage. You really ought to consider consulting with one or more of this site's Coalition docs or Recommended docs who practice FUE for a second opinion before letting the doc who performed this procedure have a second go at you. Key questions to ask include: Was the result due to some physiological anomaly that makes you a poor candidate for further ht work? Or, rather, was the (what appears to be) excessive scarring and poor yield caused by faulty technique or practice of your ht surgeon? Can your apparently unsuccessful transplant be repaired, either via FUE or FUT? How many grafts would a repair require? Can you expect acceptable yield of grafts implanted into your scar tissue? Best of luck!

From freakish to distinguished. Dr. Umar never shies away from a challenge, and what a challenge this was. Good for Boomboom!

Bangs' case shows that with a world class ht surgeon, a transplant can make a world of cosmetic difference even for someone with very fine caliber hair and significant loss. Congrats!

That is refined, feathery, natural frontal hairline work. Looks great for only 6 months post op. Nice!

I agree with what others here have said. You look to have gotten the appropriate result for the number of grafts that were transplanted to the real estate there was to cover. The work itself looks solid and already you have achieved a significant cosmetic improvement, which should get even better as the transplanted hairs mature. Can I ask: Was the number of grafts transplanted a function of budget or was it a matter of your donor laxity and/or density, or a matter of your doctor wanting to be conservative with how many grafts he took at your age, or something else? As Spanker said, for the amount and pattern of your hair loss, a session in the neighborhood of 3,500 grafts might have been ideal, all things being equal.

Yes, indeed!

Really nice start to this patient's restoration! He could even stop now and be okay. Beautiful FUE work, Dr. Feriduni.

Very pleased for you, ej! Dr. B's staged approach seems really to be paying off. Already things are tremendously improved cosmetically. Another beard hair FUE pass (or two?) and you should be in excellent shape.

What cueball35 said. Deposits for cosmetic procedures, including hair transplants, are usually non-refundable as a matter of policy and are stated as such on the paperwork provided to patients and often signed by them. There is nothing disreputable about it. For a cosmetic surgery practice, the deposit is intended to insure that the clinic doesn't set aside a full-day surgery date for the patient and turn other patients away for that date, only to have the patient then cancel. The clinic would then have to scramble to slot in another patient who is willing to schedule a procedure at the last minute, which often can't be done, resulting in an idle operating day for the doctor and his team of techs. (Some cosmetic surgery practices retain the deposit in the event of cancellation WITHOUT applying it to a future surgery.) I question whether Dr. Williams' people would have guaranteed that you could get private financing, not knowing your credit score, income, liabilities, etc., and not being loan officers. More likely, they would have said something along that lines that it shouldn't be a problem to get financing for a hair transplant, as many of their patients do. It is unfortunate that your personal situation kept you from obtaining financing, but unless the paperwork expressly made the clinic's retention of your deposit contingent on you obtaining financing (like some real estate transactions), I am with the clinic on this one.

FUEsday, I hate to break it to you, but a manual punch is unlikely to resolve your FUE transection issue caused by wavy/curly hair. Be it a motorized punch or a manual punch, it is still a straight cylindrical cutting tool. Unless an extremely large punch is used (again, motorized or manual doesn't matter -- both are straight), the curvature of the hair beneath the surface means it is likely that the terminating follicle, which is non-aligned with visible surface hair where it exits the scalp, will be transected when a straight, cylindrical cutting tool placed around the surface hair is plunged downward. That is my understanding, at any rate. It may well be that you are simply a better candidate for FUT.

That is beautiful, refined FUE work, Dr. Doganay, especially for a patient with high hair color-to-skin contrast and what appears to be relatively course hair. Your FUE work continues to impress!

I think you must have misread Dr. Konior's profile. It says that "He carefully creates all the incisions for these refined grafts using very tiny custom cut blades. By carefully controlling the angle, direction and depth of these incisions he creates a very natural pattern and direction for the new hair, even in the temples and sides." Possibly you were confused by the preceding paragraph of the profile where it says: "He prides himself in personally placing the majority of the grafts and not leaving the surgical room until the procedure is completed." As I read these sentences, Dr. Konior makes all the incisions himself and even places the majority of the grafts into the incisions. It is the second task -- placing grafts into the incisions -- that most, if not all top ht docs share with their trained techs, with some relying more on their techs for this task and others less.

Also, Lotsofhair, I don't know of any docs recommended on this site who don't make all the recipient incisions themselves, regardless whether the incisions are pre-made en mass or stick & place is being done. To the best of my knowledge, all the HTN Coalition and recommend docs make all the recipient incisions for the hair transplant, be it FUT or FUE.

I think maybe you have a different understanding of what "stick & place" means than I do. To my understanding, it is not an alternative to the lateral slit technique. Rather, stick & place refers only to whether a graft is placed into a recipient incision immediately after that incision is made (stick & place) or whether a number of incisions are made after which grafts are placed in them (not stick & place). Laterally oriented recipient incisions (lateral slits) or sagitally oriented recipient incisions (sagital slits) can be executed with either implantation procedure. I would imagine that most top docs with sufficient numbers of techs mostly use pre-prepared incisions quickly followed by implantation of grafts into them and reserve individual stick & place for tweaks and refinements to the overall work or for specialized, smaller areas of implantation . . . but I could be completely wrong. I would also imagine that docs might sometimes make the pre-prepared incisions in zones, such that the doc makes the incisions for a particular zone or area, grafts are implanted in those incisions, then the doc makes the incisions for another zone or area, etc. But I am sure that Janna can better address your question as it pertains to how SMG does it.

As others have said, Dr. Gabel, Wow! This fellow's hair and scar (what scar?) already look amazing, yet he's only 6 month post-op. I don't know how you managed to recreate a hairline and temple angles and densify the hair behind them using only 2200 grafts, but it looks great and should only look better six months from now. Beautiful work.

In the FUE section, Janna of SMG has posted close-up photos of an ARTAS patient's donor area immediately post-op and 1-week post-op. She says that their ARTAS is about to be outfitted with a new .9mm punch. Check it out: http://www.hairrestorationnetwork.com/eve/168562-artas-safe-system-donor-extractions-healing.html

Thank you for that, Janna. That is a fascinating and informative visual comparison of ARTAS-made and SAFE-made extraction sites immediate post-op and 1 week post op. To me, the ARTAS extraction sites look slightly cleaner and more consistent than those made with the SAFE, which, I suppose, stands to reason given the ARTAS's touted computerized mapping/site selection and robotically replicated excisions. In the immediate post-op, extreme close-up photos, I do detect the slight difference in size as between the .9mm SAFE punch extraction sites and those of the 1.0mm ARTAS punch, but speaking personally, I'd be thrilled if my donor looked that good with extremely short hair only one week post-op. Still, knowing that your ARTAS will soon be outfitted with a .9mm punch is excellent news. Anyway, we (if I may speak for others) really appreciate SMG's transparency regarding this new technology. Please do keep us posted on this patient's progress and of your future ARTAS patient's experiences and results. In terms of transaction rates and yield, the proof will be in the pudding, but it definitely will be exciting to see what sorts of FUE results docs of the Shapiro brothers' caliber can achieve with this new extraction technology in their arsenal.

Dr. Harris, Am I correct that this is a frontal restoration only, i.e., reconstructed hairline and frontal third/half, but the crown wasn't treated? The hairline looks excellent. Like others here, I'd like to see some shots from above and from additional angles to get a better sense of the restoration, as well as some post-op and current shots of the donor area. Thank you!

Wowsa Spankster! That is excellent early growth you've got going on. You mentioned in another thread that you're considering minoxidil for your crown. Have you been using it on your transplanted grafts?

You're right, Hariri. Turkey seems to be a hot-bed for exceptional FUE work these days. One clarification, though: While Dr. Doganay uses the same tool to make the recipient incisions and implant the grafts that Dr. Lorenzo uses (a Choi Implanter Pen), Dr. Doganay uses a motorized punch (a micro-motor) to excise the grafts in the donor whereas Dr. Lorenzo uses manual punches. Both docs appear to be getting excellent FUE yield and cosmetic results.

You might also want to check out Dr. Doganay in Antalya, Turkey, another FUE specialist who recently started posting some his results here. He does multi-day FUE sessions for larger cases and has posted several 3,000+ FUE cases, including a 3900 graft case.

Hmm. I feel somewhat responsible for this debate, seeing as how I started a thread about Dr. Diep’s FUE work. I have a confession to make: When I took a glance at Dr. Diep’s site and then mentioned it here, I was under the impression that all of his work was FUE. As I recall, I found Dr. Diep’s work while looking at some FUE results of another ht doc on YouTube. I now understand that his site shows both FUT and FUE cases, the majority being FUT. Having looked at the cases submitted by Dr. Diep here and having taken a closer look at his site, I admit to some ambivalence regarding his recommendation. For what they are worth, these are my thoughts: 1. Dr. Diep has submitted eight cases for consideration: 6 FUT cases and 2 FUE cases. The 2 FUE cases are of 1 asian male and 1 black male, both of which I would categorize as specialty cases, and both are relatively small graft counts: 1500 and 1295 respectively. 2. Of the 6 FUT cases submitted, 1 is a black female and 1 is a black male, which, again, I would categorize as specialty cases. The 4 remaining FUT cases consist of what I would describe as 1 mega session case (5,000 grafts), 1 large session case (3,500 grafts), 2 moderate session cases (2,000 grafts each), and 1 double-session case (his “home run” 2-session, 8,000 graft case) 3. So I think what we effectively have to go on are 2 modest-sized FUE cases, both being specialty cases in terms of ethnicity, and 4 "non-specialty" FUT cases. I am just not sure that is a sufficiently large and representative sample to judge this doctor’s work. I recall that Dr. Diep says that he has been specializing in ht surgery for five years, with an emphasis on FUE. I would think he would have more cases to show us, both FUT and, especially, FUE. 4. I would describe the 4 “non-speciality” FUT cases as ranging from average to excellent, but with the proviso that the somewhat poor lighting and limited viewing angles make it difficult to judge some of the cases completely. 5. The 1,500 FUE case on the asian male looks solid, but as I said, it gives me pause that this case and the 1295 FUE case on the black male are all the FUE cases Dr. Diep has to share with us, especially considering his purported emphasis on FUE for low to moderate Norwood patients. 6. I appreciate Dr. Diep’s study and appreciation for differences in hairline height and shape among different ethnic groups. At the same time, I have some reservations about some of the rounded temple work he does. I read somewhere that good ht docs can often spot transplant work of lesser docs by rounded temple work because (according to what I read) that does not occur in nature. When I see the temple work of the top docs on here, including their pre-op drawings of the hairline and sides to be restored, the hairline and sides meet at an acute angle. 7. I share the concerns voiced by others about hair1978’s FUE case, especially considering that Dr. Diep has only submitted two FUE cases for consideration, both being of somewhat limited value by which to judge this doctor’s FUE work for the reasons I mentioned. I do question the judgment of a doctor agreeing to transplant 2,000 grafts over such a large area, even with a proviso that another session might be needed for better density. Even with 100% yield, this patient would seem to require much more than 4,000 grafts for a cosmetically acceptable result, and the doctor knowing how a patient with this amount of hair loss would look for a year or more with only 2,000 grafts gives me some pause. I appreciate that the patient says his expectations were met, but the photos do not paint a pretty picture, nor should a responsible and experienced ht doc expect them to. 8. I am a bit put off by the doctor’s self-descriptions of his artistic abilities and skills and by his (or whoever writes up the case descriptions, if not the doctor) use of adjectives to describe the results. I know that probably doesn’t mean anything and might just reflect a lack of familiarity with protocol, but the top docs let their work speak for itself and leave the accolades to others. I suppose I am saying that I'd like to see more "non-specialty" cases by Dr. Diep, especially more FUE cases but also some additional FUT cases. Ideally, I'd like to see better lighting and more viewing angles to get a better idea of what we are looking at. I'd also like to see more scar and FUE donor area photos.

Dr. Doganay, Thank you for your informative response. Were the 3900 grafts extracted and implanted in a single day? Over multiple days? In two hair transplant sessions separated by some number of months? This appears to be impressive yield for a large FUE case, which is why I ask.