PupDaddy

Thanks for providing this information regarding Dr. Rahal's current practices. I hope you won't mind if I ask some additional questions: 1. Do I understand correctly, then, that Dr. Rahal performs a maximum of 2 ht surgeries per day, one in the morning and the other in the afternoon? Could the two surgeries both be FUE, both FUT, or one of each? 2. If there are 2 FUE surgeries scheduled for the day, and each patient is assigned his or her own team of techs, what do the techs who worked the morning session do for the rest of the day? (I suppose they continue inserting grafts into the recipient sites until all the grafts have been placed, whereas Dr. Rahal has, by then, moved on to the afternoon surgery?) 3. Do your techs operate as set, distinct "teams" so the same techs always work together, or is it a mix-and-match situation? 4. How many techs comprise a team for an FUE surgery? For a strip/FUT surgery? 5. Are there separate, distinct tech teams for FUE procedures vs. FUT procedures? In other words, is there a team(s) that only assists with FUE surgeries and another team(s) that only assists with FUT surgeries? 6. Related to questions 4 and 5, do all techs perform graft strip dissection, FUE excisions-extractions, and graft insertions, or do certain techs specialize in one/some of these tasks to the exclusion of other tasks? 7. For FUE surgeries, is the division of labor: Dr. Rahal designs and marks the hairline & other recipient areas, and later makes the graft recipient incisions, whereas the techs are responsible for graft excisions-extractions and for inserting the grafts into the recipient sites made by Dr. Rahal? 8. How can an FUE patient be assured he is getting Dr. Rahal's "A team" for his or her surgery, if he is one of two FUE surgeries schedules for that day? I might have some follow-up questions, but thank you very much in advance for answering these. I really appreciate it.

Much wisdom and reason in this post

Congrats recedingazn! You chose a top notch FUE surgeon in Dr. Diep, and the hairline design looks great. Please keep us updated. Grow well!

I think both these cases reflect meticulous work, apparently good yield for the size of the procedure, and a good aesthetic by Dr. de Reys. If I were these patients, I would be very happy. Well done!

I'm with you, ready4Hair. I don't think that Dr. Diep gets his due when the best FUE work is discussed, considering that he has probably posted (on a popular video site) a greater number of cosmetically impressive matured FUE results with befores-afters than most anyone. I put him in my personal top 3-5 in a recent thread (and I happen also to agree with you about Dr. Lorenzo's hairlines, btw). As I recall, Dr. Diep does all the FUE extractions himself, manually, using a punch of his own design, and I believe he only operates on one patient per day. In his videos, he says he pays particular attention to design and placement of the hairline to aesthetically frame the face and compliment the shape of the patient's head, their features, and ethnicity, which I think is borne out by his results. I also think his hairline work has a good naturalness to it by virtue of him building in a healthy amount of micro irregularity. He responsibly maxes out at around 2,500 extractions per FUE transplant, doesn't perform consecutive day extractions, and seems to make cosmetically efficient use of the grafts and obtain consistently good yield. My one quibble would be with his preference for using needles to make graft recipient incisions (my vote is still for tiny custom cut blades), but his rationale is that needles for this task cause less trauma, and he does produce lovely results using them. A few things might account for why Dr. Diep isn't mentioned in the same breath as other top FUE docs here: He and his patients don't post here that often; when he was up for recommendation he posted only a small sampling of his FUE work (yet, as you noted, he has scores of results posted on the video site I referred to); his Vietnamese accent, personality, and cluttered personal office as seen on his videos can make him seem a bit, I don't know, quirky, although I personally find his manner sweet and refreshing compared to the slick environs and marketing of some other docs. But, yeah, I think he deserves to be mentioned among the best FUE docs.

Beautiful work here by Dr. Wesley. It would be helpful, though, to see a close up of the hairline with the hair combed up or back.

1. Please identify a SINGLE contradictory statement I have ever made regarding The Maral Klink vs. any other doctor or clinic. Waiting . . . . 2. Please identify a SINGLE ht physician or clinic recommended here that allows technicians to cut the graft recipient sites ("channels") into the patient's scalp. Waiting . . . . 3. Please identify a SINGLE ht physician or clinic recommended here that uses a motorized drill to cut the graft recipient incisions ("channels") into the patient's scalp, let alone that allows technicians to use that tool to perform this task. Waiting . . . . 4. Please identify a SINGLE doctor or clinic posting here, other than The Maral Klinik, that lied about technicians performing hair transplants at their clinic and falsely assured us that the doctor personally performed every aspect of the hair transplant surgeries done at the clinic. Waiting . . . . I eagerly await your answers to these questions in light of your gratuitous assertion regarding my intellect and recall. I have posed these questions to you before, but each time you have evaded answering them, choosing instead to continue your campaign to drive unsuspecting newbies to The Maral Klinic technician ht mill. I suspect you will evade answering these questions yet again, but there is always hope, I suppose.

1. Please identify a SINGLE contradictory statement I have ever made regarding The Maral Klink vs. any other doctor or clinic. Waiting . . . . 2. Please identify a SINGLE ht physician or clinic recommended here that allows technicians to cut the graft recipient sites ("channels") into the patient's scalp. Waiting . . . . 3. Please identify a SINGLE ht physician or clinic recommended here that uses a motorized drill to cut the graft recipient incisions ("channels") into the patient's scalp, let alone that allows technicians to use that tool to perform this task. Waiting . . . . 4. Please identify a SINGLE doctor or clinic positing here, other than The Maral Klinik, that lied about technicians performing hair transplants at their clinic and falsely assured us that the doctor personally performed every aspect of the hair transplant surgeries done at the clinic. Waiting . . . . I eagerly await your answers to these questions in light of your gratuitous assertion regarding my intellect and recall. I have posed these questions to you before, but each time you have evaded answering them, choosing instead to continue your campaign to drive unsuspecting newbies to The Maral Klinic technician ht mill. I suspect you will evade answering these questions yet again, but there is always hope, I suppose.

My apologies, Pianist, for sidetracking your thread. I should have ignored 1966kph's attempt to provoke and scare you, as I knew that his buddy GraveD11ger would then join in the action. Let me explain what is going on: 1966kph and GraveD11ger have been actively promoting an illegally operating FUE clinic in Turkey called The Maral Klinic. You've probably seen the barrage of promotional threads started here by that clinic's online representative and various purported patients of the clinic (none of whom have documented matured, final results). This clinic has non-physician technicians performing every aspect of the hair transplant surgeries, without a physician present in the operating room. The doctor whose name is on the clinic has no hand in the transplant surgeries whatsoever. Instead, he leverages his technicians by letting them illegally perform FUE hair transplantation surgeries, and then passes the "savings" on to patients looking for cut-rate FUE. The technicians use motorized drills to make the graft recipient incisions ("channels") -- a tool that no hair restoration surgeon recommended here uses or would use, and a task that no physician or clinic recommended here allows a technician to perform. (By contrast, your repair surgeon, Dr. Karadeniz, who is a recommended ht surgeon here, uses tiny custom cut blades for this cosmetically and artistically critical task, to personally make mostly lateral slits, which is the ht gold standard.) Yet when this clinic's online representative started posting here, he lied about this and assured everyone that Dr. Maral performed every part of the hair transplant surgeries done at the clinic. This proved to be utterly false. At about this same time, Dr. Karadeniz was put up for recommendation here. In one of his posts, he discussed the ugly underbelly of the FUE trade in Turkey, which is populated by hundreds of clinics that offer cheap FUE by illegally having technicians perform hair transplantation surgeries -- clinics like The Maral Klinic, whose online representative acknowledge here that this practice is illegal in Turkey (at least while he was trying to mislead us into believing it wasn't occurring at his clinic). Dr. Karadeniz was subsequently approved for recommendation by this community. Since then, 1966kph and GraveD11gger have taken shots at Dr. Karadeniz and his patients at every opportunity. You got caught in the cross-fire, for which I apologize. I wish you great luck with your repair! Please keep us posted of your progress, and try to ignore the rantings of the shills for the clinic I mentioned.

Please identify the statement(s) in my post that contend is/are false. For each such statement you identify, please provide the facts and evidence to support your contention. Blake has publicly obliterated your conspiracy theories and paranoid accusations regarding those of us who disapprove of the practices of the budget clinic that you and 1966kph support. Are you now accusing the original poster here (pianist) of doing something untoward? Dr. Karadeniz appears to have done an excellent, state-of-the-art job of repairing atrocious work done by another clinic. He explained his repair plan and approach and reasons for them on p. 1 of this thread. 1966kph, who has demonstrated antagonism towards Dr. K since this doctor pointed out the illegality of the technician-performed hair transplantation being sold by a certain Turkish clinic that you and 1966kph support, chose to ignore Dr. K's post and call into question the repair plan and work, accompanied by wild, uninformed suggestions that electrolysis would have resolved the issue and that punching out the misplaced grafts was somehow an inappropriate use of fue/punch extraction technique. The tone of 1966kph's "questions" expressed incredulity that Dr. Karadeniz punched out the poorly place grafts: E.g. "Did you not discuss with Dr. K . . . . laser or electrolysis hair removal?," and misleadingly suggested that there were better options for repairing a grossly low transplanted hairline populated by outrageously angled and directed grafts (there were not). These were not questions, they were agenda-driven assertions -- and they unfairly called into question the surgeon's wisdom, competence, advice, and expertise. Doing so was, as I said, cruel to the patient and misinformed.

As others have said, this is gorgeous, natural hairline work. Well done!

Holy smokes! Looks fantastic. And the linear scar is undetectable even with your hair cut quite short at the sides and back. Congrats to you and to Dr. Hasson.

Your bias against Dr. Karadeniz for calling out the illegal Turkish technician-performed ht clinic you promote is showing. Dr. Karadeniz answered these "questions" in the first paragraph of his post on page 1 of this thread. Laser or electrolysis does not work, functionally or cosmetically, to eradicate poorly placed grafts. The only options available for repairing poor hairline work are punching out the old grafts or trying to camouflage them by transplanting lots of new grafts around and in front of them. The second approach wasn't an option in this patient's case because the transplanted hairline was placed so unnaturally low and the grafts were placed at poor angles and direction -- as Dr. Karadeniz explained. He used the tiniest punches available to extract the old grafts (as he also explained), which should leave nearly undetectable, or completely undetectable, scarring. This is the surgical gold standard for repairing this kind of shoddy work. Your implication that Dr. K somehow did this patient a disservice with this very challenging repair is both cruel to the patient and misinformed.

At the moment, for significant FUE cases, with hairline work that best mimics nature, and a willingness to fill temple points and peaks, my personal top 3 would be: Diep Maras Bisanga Honorable mention: Rahal (if you could get him on a single-op or two-op day when he can pay full attention to your case, and if you could be sure to get his A team of techs) For smaller FUE cases and/or less aggressive hairline and temple work, but still with natural-looking results: Reddy Wesley Shapiro Feriduni I am eager to see more FUE cases from Konior and Gabel. My guess is that both will end up cracking my top 3.

Lovely, refined work as usual from Dr. Paul. Looking good at only 6.5 months and especially considering the patient's low donor hairs-to-graft ratio.

Many docs now offer virtual consultations where you email them photos, which they assess and then email you back a proposed restoration plan, including proposed graft numbers and pricing. If the doc offers both FUT and FUE, they can give you proposals for both (FUE is usually more expensive). A number of docs also offer Skype consultations after you email in your photos, which is a great opportunity to talk to the doctors, ask questions, compare their approaches, and see who you're comfortable with, without having to travel about. Or you might find that you can narrow things down via virtual consults to two or three docs and then follow up with in-person consults with the two or three docs on your short list. Good luck!

Yield refers to two things: a) the percentage of transplanted follicular units that grow, and b) the percentage of transplanted follicular units that grow the same number of hairs that comprised them before they were extracted. If you've done a good bit of research, you will recall that modern day hair transplantation involves extracting and transplanting naturally occurring follicular units, each comprised of either 1 hair, 2 hairs, 3 hairs, or, occasionally, 4 hairs (the 1-hair follicular units are placed in the very front of the hairline). These days, when practiced by skilled and experienced physicians with excellent technicians, FUT yield usually is very high in both respects -- a very high percentage of the transplanted follicular units grow, and a very high percentage of them produce the same number of hairs they originally had. This is because the follicular units are dissected from the extracted strip under high magnification microscopes, using very thin, very sharp blades (razor blades, essentially). Because the technicians can see what they are doing, and can see where to cut between the follicular units, there is minimal "transection" of follicular units during the dissection process (transection means cutting into or across the bulb of a follicular unit). In dissecting out the follicular units from the strip, the technicians are also able to maintain a healthy amount of fat and tissue that surrounds each follicular unit and protects it during handling and implantation. FUT dissection produces what the industry terms "chubby" grafts, which is a good thing. Also, some docs have their techs purposely dissect some double or even triple follicular units from the strip for strategic placement in regions behind the hairline for added density. (This can't be done with FUE because the punch would have to be too large and leave too large a round scar.) FUE poses challenges to graft extraction not faced by FUT graft dissection. The doctor or technician is punching "blind" into the scalp, hoping that the bulb of the follicular unit beneath the surface of the scalp is in line with the angle of the hairs the exit the scalp. This isn't always the case, particularly for patients with wave or curl to their hair. This can -- and usually does -- result in the bulbs of more follicular units being transected than with FUT strip dissection. The challenge is exacerbated by the small punches being used in today's FUE to try to minimize the appearance of the punctate scarring (the "white dots") in the donor area from thousands of punch excisions. The smaller the punch, the greater the chance of damaging or transecting a follicular unit, and the less protective surrounding tissue is able to be extracted with the follicular unit. It is said in the industry that FUE produces "skinny" grafts or "skeletal" grafts, which can compromise their survival. A further challenge to FUE graft survival is that some grafts require some pulling/torsion with forceps to fully free them after they have been punched. Each of the challenges disused above can negatively effect yield from FUE compared to yield from FUT, in both respects mentioned: percentage of transplanted grafts that grow, and percentage of grafts that grow the same number of hairs they originally had (e.g., a 3-hair follicular unit that was partially transected during punching or that was damaged by torsion or during handling and implantation could grow, but it might produce only 2 hairs or 1 hair). All that said, the best FUE docs and clinics appear to be producing better and better yields than in the past. There have been some efforts to quantify FUE yields vs. FUT yields, but I don't know of any current reliable studies or estimates. Some docs claims that their FUE yields rival, or are at least in the same ballpark, as FUT yields. I hope that helps. There are many, many threads and posts on this site about this topic, so use the search function and dig around.

It's all about the linear scar, Bardlebee. Some ht candidates are inalterably opposed to being left with the FUT linear scar. There are legitimate cosmetic reasons for this aversion: Some people plan to wear their hair very short on the sides and back as a matter of style, e.g., shaved down to a #1 or #2 blade. Other people are concerned about the distant future when their hair thins. The "safe zone" isn't immune from the effects of DHT, it's just more resistant to it and for a longer time. Most men's donor hair thins somewhat as they reach more advanced age, which also means that the hair transplanted from the donor will eventually thin somewhat as well. Plus, whatever native hair that had left on top likely will miniaturize or disappear over the very long haul. So they want the option to shave their hair down close in their later years without worrying that the linear scar will show. Another scar-related FUT concern is if the transplant "fails" or the result isn't what the patient had hoped, and now they have a linear scar to deal with, which can limit their options to shave things down. However, if the FUT linear scar were to become an issue in any of these situations, many men could have the linear scar fairly well camouflaged via FUE, pilofucus (Dr. Wesley's emerging scarless extraction technique) and/or SMP. Really, the scar's the thing. An increasingly large percentage of ht candidates are willing to accept the generally lower yield of FUE and the lower numbers of available transplantable follicular units compared to FUT (per session and in total) for the sake of avoiding the FUT linear scar.

FUEAsianHairline, I would second FUE2014's suggestion that you consult with Dr. Diep in California. He is a recommended hair restoration surgeon here, and his has posted numerous video examples of his FUE work on YouTube. Good luck!

Please do not misquote me or put words in my mouth, GraveD11gger. The Maral Klinic has dug itself a deep enough credibility hole here without you taking up the shovel and digging even deeper. You can laugh at my responses to your comment and questions all you want, but we would all be better served by FACTS to refute the points I made.

I made a lengthy response to your questions, GraveD11gger, but it got caught for moderator review. I hope the moderators review it and post it soon.

No, NOT "all the same." Neither Dr. Bhatti, nor any other ht physician recommended here, relegates the "art" of hair transplantation -- the creation of the thousands of recipient incisions for the transplanted grafts -- to technicians. Not only is it ILLEGAL in Turkey (and every other country, so far as I know), it is an abdication of the physician's duty of care to his patient so he can pocket additional dollars running a hair transplant mill as a sideline. If Dr. Maral wants to offer hair transplantation but doesn't want to, or isn't able to perform these surgeries himself, he should hire or partner with a top-notch hair transplant physician. If he did so, everyone would win: The Maral Klinic could legitimately offer hair transplantation, a licensed hair transplant physician would be operating on patients and bringing both his or her skill and artistry to the table, and The Maral Klinic's prices would remain because, as MikroFUE claims, The Maral Klinic's cut-rate pricing is unrelated to the clinic having technicians performing hair transplants. "But, here agresiveness is just for Maral, why?" See above. PLUS -- When The Maral Klinic showed up and started promoting itself here, its online representative first evaded questions about who, exactly, was performing the clinic's hair transplants, and then, after questions persisted, and apparently recognizing that this community would look askance at a doctor and clinic offering hair transplants performed entirely by technicians, Maral's representative made these misrepresentations to throw us off the scent: 1. "Dr. Maral is an aesthetic plastic surgeon with academic career (he is an associate professor) and only plastic surgeons and dermatologic surgeons have a licence to do hair transplant operations with their professional teams in Turkey." 2. "Dr. Maral has whole responsibilities of his patients against medicolegal issues after the procedures have been completed. So you may accept that he does all steps of the HT operations on his own patients." (From MikroFUE's post of 10/28/2014.) When these representations proved to be utterly false, Maral's representative changed course and instead claimed that Dr. Maral "supervised" the hair transplants. Even that turned out not to be true, as one of the clinic's patients told us. During his hair transplant, Dr. Maral left the premises to go home early while the clinic's technicians completed the patient's surgery. Some supervision. So what we have is an illegally operating clinic, with technicians performing hair transplants under the auspices of a physician's name, promoting itself on this site, and lying about what it is doing. If you wonder about some members' "aggressiveness" towards this clinic, this might explain it. "Just because he does not open the channels? -His partner with 10 years of experience open channels all the time as mentioned by clinic representative, and they proved that she can open 5000-5500 channels in one setting." See above. And, what you blithely dismiss as merely not "open[ing] the channels" (a term I've never heard for creating the recipient incisions for the transplanted grafts) is the very heart and soul of the artistry of hair restoration surgery. It is what distinguishes and differentiates Konior's work from Rahal's work from Hasson's work from Wong's work from Gabel's work from Lorenzo's work from Diep's work from Maras's work from Paul Shapiro's work from Ron Shapiro's work, etc., etc. Hair restoration surgery is a cosmetic surgery. It is about more than merely having grafts survive being moved from one place to another, it is about the surgeon's hard-earned reputation, experience, and artistry, both from a medical standpoint and from an aesthetic standpoint. More than anything, the artistry of hair restoration surgery is manifested in the surgeon's creation of the graft recipient incisions, as Dr. Bhatti reminded us. And not for nothing, but NONE of the hair restoration surgeons mentioned above or recommended here use motorized drills to "open the channels" for the grafts to be implanted. The gold standard tools for cosmetic results that most closely mimic nature is custom cut blades to make mostly lateral slits, or sometimes needles, or sometimes implanter pens (although I personally think that the cosmetic result in the hairline region is compromised, somewhat, by the use of implanter pens). The only reason I can think of to use a motorized drill to make graft recipient sites would be if a non-physician was being allowed to perform this aesthetically critical task and needed a "fast" and "easy" tool to do it. Oh. Yeah. I forgot, that's exactly the situation at The Maral Klinic. Hell, I could "open 5,000-5,500 channel at one sitting" with one of these drills. Should I? Absolutely not. Why not? I am not a hair restoration surgeon. Besides, no self-respecting hair restoration surgeon truly concerned with providing patients with the best possible cosmetic result would ever use such a tool to make the graft recipient site incisions, let alone turn a technician loose on a patient with one of these drills. "PUPDADDY, , prove your authority as a senior member, Here are 2 examples of channels by lateral slit technique, which one is correct and why?? (I received both pictures from the forum)" Oy. I've responded to this red herring before, but I will try again. First, please re-read everything I wrote above in my response to your questions about this clinic. Second, absent some glaringly obvious mess or instantly apparent problem, a photograph of a recipient area immediately post-op won't reveal much of anything to the naked eye in terms of ultimate yield or matured cosmetic result. I've yet to see a matured result from The Maral Klinic that compares favorably with the best work out there or that I would want on my head, but even if the technicians who perform these surgeries manage to hit on a decent cosmetic result now and again, I still could not in good conscience recommend that anyone go there for all the reasons I articulated above.

JimHal, If you're still following your thread, please don't be misled by the likes of GraveD11ger. There are no surgeons or clinics recommended here, in Turkey or elsewhere, where the hair transplants are performed entirely by technicians. In particular, no surgeons or clinics recommended here permit technicians, rather than a licensed physician, to perform the artistically and cosmetically critical task of cutting the graft recipient incisions (slits or holes, sometimes called "channels") into the patient's scalp. As Dr. Bhatti, a HRN recommended physician from India, stated here just yesterday: “Where harvesting is a skill, slit making is an art.” The Maral Klinic has technicians perform this task as well (along with all other parts of the hair transplant operation), which is why it can charge such low prices. The doctor whose name is on the clinic has no hand in the hair transplant procedures. He performs face lifts, nose jobs, and other cosmetic procedures, not hair transplants. His technicians do the hair transplant operations. Buyer beware.

Where do you get your information, GraveD11ger? Are you seriously contending that Dr. Lorenzo's technicians make the graft recipient incisions on his patients? Do you not know that Dr. Lorenzo makes each and every graft recipient incision and does all the graft implantations himself? Do you not know that he does this using implanter pens (hollow needles with an injector mechanism)? His technicians load these pens with the grafts that were previously excised and extracted from the donor. Dr. Lorenzo then meticulously makes each and every graft recipient incision with these injector pens and simultaneously inserts the graft into the hole he just made. Dr. Lorenzo used to even do all the donor graft excisions himself, but he has lately had his technicians assist with this task. But he continues to make all the graft recipient incisions himself, AS DOES EVERY HAIR RESTORATION SURGEON RECOMMENDED BY HRN. As Dr. Bhatti stated just yesterday: “Where harvesting is a skill, slit making is an art.” I CHALLENGE YOU TO NAME A SINGE HAIR RESTORATION SURGEON RECOMMENDED HERE WHO ALLOWS HIS OR HER TECHNICIANS TO CUT THE GRAFT RECIPIENT SLITS OR HOLES INTO THEIR PATIENT'S SCALPS. Go ahead. Waiting . . . . Contrast this with Dr. Maral, who performs NO PART of the surgery whatsoever. The hair transplants are performed entirely by non-physician technicians, from start to finish, including the cutting of all the graft recipient incisions (using a motorized drill, no less). Dr. Maral's "supervision" is limited to stopping by the operating room every now and again to ask how things are going, although as one patient told us, Dr. Maral is not adverse to leaving the premises to go home early while the patient is still in the chair being operated on by his technicians. Your understanding of Turkish medical law is contradicted by Dr. K and even by The Maral Klinic's online representative, both of whom state that technicians are NOT permitted to cut into patients' scalps or otherwise perform surgical tasks or procedures.

My pleasure, JimHal. Good luck!