hairweare

There are two, possibly four and several more if one stretches the criteria a bit that I am aware of.

There is no perfect technique or one that is free of faults but note that with the implanter device, the depth is consistent and controlled, the follicle is subjected to less traumatic force and handling than with forceps and the ischemic time is shortened by streamlining the implantation phase. Lorenzo for one, can implant at a far greater speed that even a "team" of technicians. There is reason that his nick name is the "Robot"!

At it's best FUE is the sum of it's parts and any weakness or failing there of will be reflected in the final result. When Lorenzo was in Manchester his fees were at a premium but one paid to have experienced hands control both vital aspects of the procedure. While still no guarantee for an" out of the park" result, one was a least receiving a quality standard demonstrated repeatedly based on posted videos which were performed in the same manner.

Any experienced physician who is exclusively dedicated to FUE, that takes his time, limits his case volume to one or at most two patients a day, performs both extractions and implantations would be on my preferred short list and the list is indeed a short one.

Scar5 beat be to it! Don't lose sight that success of a HT is always qualitative first and quantitive second. A diffusely thinned out donor region that blends better with the obligatory thinner recipient area should be preferable to an abrupt demarcation between donor and recipient area that only will look worse as one's hair loss progresses (and it most likely will regardless of your age or current perception of stability). Expertly performed FUE extractions do not leave a visible scar even with the hair cut very short and the adjacent hair pattern and directionality for the most part will have been left undisturbed. Contrast that with a widened ear to ear strip scar with hair and or wave patterns that no longer naturally match and the esthetic difference can be quite striking. Transection and wastage occur with both procedures and the element of operator/assistant skill or lack thereof can never be discounted. Qualitatively the yield on my first 1500 FUE scalp extractions from a scalp that had previously been over harvested by 3 earlier FUT procedures more than equaled that of my first strip HT which involved 3600 grafts to virgin scalp. Granted that leading FUT technology from NHI in 1993 is being compared to the state of the art FUE methods but my point is that even if one concedes that there is presently a modest quantitative edge to strip harvesting, the qualitative and ancillary advantages of FUE make it the better initial or secondary choice for the vast majority regardless of NW class.

The only limitation that affects the widespread adoption of FUE in my view is that with either FUE of FUT hair transplantation is a business and foremost an extremely lucrative one. In the US the inability of FUE surgeons to utilize and rely on techs to the same extent as they do for FUT will stand as an impediment to it's acceptance. For the rest of the world the over reliance on techs, and assembly line, multiple patient "mill" clinics will always have quality control issues and an unknown percentage of unsatisfactory results despite what is ideally the superior approach.

I recently had another procedure done in Madrid which was where I too first learned that techs were participating in the extraction phase. I do not know how long this has been the case and the information posted by others earlier this year suggesting the contrary may not have been entirely accurate. It appears now that at least one experienced tech and perhaps others as well have been doing some of the scalp and beard extractions prior to Dr. Lorenzo's one year one man production in Manchester. I always assumed that his colleague Dr. Vila has also done both extractions and implantations either together with him or independently by herself, but the participation of the techs is not something I knew much about.

From my personal experience, the scalp extractions that I had done in Madrid were done exclusively by Dr. Lorenzo but the tech subsequently extracted the beard grafts. It may indeed all turn out fine, but it honestly wasn't part of the my original plan nor did I have much of an opportunity to discuss this with Dr. Lorenzo until after the fact. I therefore will reserve my final opinion regarding the capabilities of this particular tech for several more months at which time the crown grafts should have started to grow.

To research this matter further which I do believe is important, I suggest going to both the Euro and Spanish fora where the clinic's work and reputation are much better documented.

If one chooses a clinic that does multiple procedures, mega sessions and has teams of techs, then unless you know specifically about the individual qualifications, experience and previous results from the actual techs that will be both extracting your follicles and later implanting them, you are merely rolling the dice and hoping for the best possible outcome. Of course you may or may not be lucky which I believe explains why some posters give raving reviews while others go away disappointed. We have no way of knowing how many other patients either with good or bad experiences are actually out there as I am sure only a small percentage from either group take the time to post their results in detail.

I therefore have come to the conclusion that while it is quite possible to get a state of the art fantastic HT at at any of the larger clinics that significantly utilize teams of techs during the procedures, this result should not be a forgone conclusion or unrealistic expectation. I think that choosing one of these clinics based on auxiliary factors such as price, scheduling, and location should ultimately be the deciding factor as to how best to decide which of them to select.

If one wants to take advantage of the highest level of quality control, then select one of the few rare physicians that exclusively does his own extractions and implantations. The next best option would be one that actually "cuts" the skin in both phases of the FUE procedure even if techs assist with the forceps removal and implantation parts. I think it goes without further need for explanation why selecting a clinic that confines their work to mainly one but no more that two patients a day is to the patient's advantage and should always be sought after. Lastly, I would avoid megasessions, as when it comes to FUE patience is a virtue!

Perhaps it is just me but I did not find their explanation of fees very clear. My recipient area was not shaved for either of my two procedures with Dr. Lorenzo and there was no additional charge nor was it ever really discussed. I expected a full shave particularly for the crown work but the Dr's brief explanation was that it was not necessary.

A poster on another forum mentioned that Dr. Reddy's rates were lower outside of the London clinic but apparently he no longer performs FUE there so that factor may now be moot.

Charging per hair instead of FU would certainly be disadvantageous to those lucky enough to have great donor density so I'm not sure that is a particularly equitable way to charge. Shacked first stated that the rates were per hair but then later claimed the actual rate he paid was 6GBP/graft.

Lorenzo's rates in Manchester were 6GBP for the first 1000 FUs then 4GBP thereafter. All extractions and graft implantations were performed by the doctor and the only time the techs handled the grafts was for sorting and loading of the implanter pens.

I mention this only as a point for comparison, I do not know what role techs play in Dr. Reddy's 3G technique and of course Dr. Lorenzo no longer practices in Manchester so his policies, techniques in addition to his rates are obviously different in Madrid.

It might be helpful if someone could clarify the reported discrepancy in rates. An earlier poster(Shacked) reportedly paid 6GBP/graft whereas this poster claims to have paid only 4GBP/graft. That is quite a spread so I am sure all prospective patients would want to know what the fees actually are.

The problem is that he is at 7.5 not 6 months out and considering the pattern and amount of hair that he had pre-op, I would not consider this one of the better examples of a stellar result from this clinic.

CJD, thanks for that comprehensive review however I disagree with your statement that due to finasterides short half life it must be taken daily in order to be efficacious. Considering that the drug's inhibition of 5aRll is irreversible, Unless the inhibited enzyme is replaced at rate that returns levels to baseline within 48 hours, taking it every other day would still from a pharmokinetic standpoint provide net inhibition of the enzyme and decrease circulating DHT.

Hi and congratulations on your procedure. Looking at your pre-op photos and data, I think that the ultimate outcome of your HT will more than meet your expectations and look fantastic. Based on age, hair loss pattern, donor density and characteristics you are pretty much the perfect candidate for a very successful HT that many here would be envious of. In terms of cost even if you had flown first class and stayed at a 5 star resort you would have still saved a substantial amount of money. As a point of reference an experienced and well respected FUE surgeon within 20 miles from you charges $7-8/graft but I doubt your sojourn to Turkey even factoring in the peripheral costs came out any where close to $35K!

The most important thing to keep in mind is the final outcome as the road leading there may have it's twists and turns. While it's good to feel satisfied with your experience at 2 weeks, the real test comes after the 6th month when the true yield and density pattern of your HT will be more apparent.

As it is said with stock investments, past performance does not guarantee future results ( the underwhelming 7.5 months photos of another current Erdogan poster will attest to this), but for the reasons stated above you have every reason to remain optimistic.

If you are trying to match your prospective results with pictures on a webpage or video you need to know specifically who did the work. Techs may all be competent but as humans we all have different abilities. For example MLB players are all great athletes but some hit for higher averages than others. The final result of an FUE is the sum of many parts. The more you can isolated those variables the better you can predict how your individual result may turn out.

Busa, what are the names of the techs who you would actually recommend to perform the extractions?

Do you have enough personal experience with all of them to know which ones are the best?

This would be very useful information to share with prospective patients.

Thirty-seven hundred

How can consistency be achieved when different hands some more experienced or talented than others are introduced into the equation?

Realistically the only one who benefits from extractions performed by techs and multi-patient procedures in the same day is the doc who exponentially increases profits, not the individual patient.

I don't believe that there is any exception to this logical concept.

I would also trust that Dr. Vila is well qualified to perform extractions but I have doubts that all techs have equal experience and abilities. I agree that prospective patients should be informed as to whom will be performing the extractions before the deposit is requested and that the web page clearly needs to be amended to reflect this significant change in the clinics's philosophy and practice.

Is this contest and film an educational public service or a shameless publicity stunt?

I think the number one reason a person would want a free hair transplant is because it is free!

Am I missing something here?

I am somewhat more skeptical. The other tech assisted FUE docs with the exception of one that I can recall have all had less than stellar results documented here within the past year. Lorenzo's posted cases up to this point on the other hand have all been home runs. Only time will tell, but I do not see this as a favorable development for those who seek the pinnacle state of the art FUE procedure irrespective of price or location.

I assumed Dr. Vila was assisting him in Madrid for the mega cases. Do you know for sure that techs were doing extractions there prior to the year he was at Farjo?

To be fair his rates are now well within the range of the other European clinics. When he was in Manchester, they were clearly at a premium but to my knowledge he was doing only one case a day and doing the entire procedure other than loading the implanter pen by himself.

From his website:

"The procedure is performed exclusively by surgeons. Auxiliary staff or nurses DO NOT participate in any phase of the procedure, only assisting the surgeon which is very important when it comes to quality control"

But apparently that was then but not now. Does anyone know how much hands on experience these techs have? Grace was working at Farjo up until this fall so I doubt that she would have much extraction experience. An optimally successful FUE procedure depends on the sum of it's variable parts, but I view the extraction process as the the most important.

Based on the first hand information gleaned from this network Dr De Reys is the only physician doing manual extractions and slit implantations primarily by himself. He states that exhaustion and excessive grafts exposure time is facilitated by having his nurse(wife) assist in the simultaneous forceps removal of the scored grafts and that sessions are limited to under a 1000 a day and divided over 2-3 days if necessary. I find this approach most desirable and would like to see more examples of his work and hear from actual patients who post their experiences. It goes without saying that he limits his cases to a single one a day but his rates are surprisingly modest considering the obligatory labor expended and the loss of economic benefit by performing multiple cases.

Look at the post today from Klkiss as he had similar frontal zone work done with 2000 grafts. It is quite a stark comparison however.

Wow! the density achieved for your hairline and frontal zone appears to match your native hair seamlessly. Most HT patients can only dream of having your donor density and the likely incredible result that awaits you in 6 months.

A NW6 that is possibly going to an eventual 7 does not have the luxury of using up 1500 or more grafts to address the temples especially during the first procedure. 7 month f/u pictures will likely show a very dramatic transformation. I think the hairline is just fine.

I agree with Dr Emre's assessment. It is probably too late to try a more aggressive anticoagulant such as Lovenox or Eliquis. I doubt that the aspirin will be of much benefit at this point but it will do no harm. Please adhere to your doctors instructions and make sure to follow up in person when advised to do so.

Sounds like you should be good to grow.