JayLDD

Personally I wouldn't take anyone that puts Bicer or Demirsoy above ASMED seriously. Put simply, their eyes aren't functional or they certainly aren't using them.  Or put more socially acceptably, they lack good aesthetic judgement. Even off the sole basis of success rate. For hairlines Pekiner appears to do good work, although there's not a huge body of work to go off and as others have said he seems to have a larger than average track record of aborted cases (for better or worse) and there are a number of poor results. I would put Keser who he worked with at a clearly higher standard and Keser also has a broader track record to judge from.  HLC is a world class FUE clinic however they have a range of surgeons. 

For the OP, if you're looking for a megasession that covers the entire balding scalp (hairline/mid/vertex) and graft numbers that are potentially 3k+ I would absolutely consider ASMED primarily. If you're looking for mainly hairline refinement Keser and HLC have earned their strong reputations for this.

On 6/23/2021 at 7:35 PM, Spring15 said:

Hey all

I'm looking to go for my second transplant 

First is linked below

That was back in March 2017 I was quite happy with it, now I'm wanting to go for a second transplant add more density around the hairline & frontal midscalp

I've been trying to figure out who my best option is. Would be in Turkey or Europe I think , perhaps USA. Don't really have a budget just want the best chance at excellent results

I was thinking Dr Bisanga - Bit pricey but seems to have extremely consistent results & some good second transplant patients

                        Dr Keser - In Turkey, he also seems to have top notch results

                        Dr Demirsoy - Also in Turkey , he is cheaper. I'm not sure of his experience with second transplant patients however. But he has great results on here

 

Any other advice would be appreciated?

 

 

 

 

Damn dude I remember you from HLT years ago. 

I assume you're looking for more refined hairline work mostly, I am ultra-happy with my results from Erdogan although those were a while back now.  Would absolutely consider Keser for this kind of case, personally I think Freitas does among the worlds most aesthetic hairline work and his prices are fairly reasonable. I think his waiting list is fairly extensive but you're probably in a position to wait a bit.

This is largely my personal opinion, but I feel surgeons and patients alike tend to overshoot the mark when estimating grafts per unit area, being impressed by the stating of large numbers like 80. The largest density cases I have seen are from Dr. Hasson, some of which do appear to match or potentially even exceed native adult density however. Even among people without hairloss I'd estimate some are 55cm2 throughout their entire scalp, those on the other end of the spectrum being closer to 90. "Native density" is largely a generalisation and while it can be transplanted in small areas it very rarely occurs in single procedures. 

Outside of the hairline there are massively diminishing returns for density placed in the midscalp and crown, less often being more. 

It does appear some of the Spanish surgeons are just a cut above for whatever reason virtually 99% of other FUE clinics globally. This result as good as their clinic posted results, which themselves are spectacular by any sense of the word. Not a huge graft number for a fairly drastic change here too. 

15 hours ago, foor said:

What are some ways to combat fear typical before and during hair transplant procedures? Just before going to sleep at night I find myself with a heightened sense of fear arising from what I perceive as high potential for mistakes during a hair transplant procedure. My greatest fear is that my hair transplant will not work out and I will have wasted thousands of dollars if it doesnt pan out as I expected it. Out of constant worry I dont want to have to look in the mirror after several months post op to find no growth whatsoever.

This prospect is messing with my psyche. Nonetheless I've diligently researched the very best doctors in the field after reviewing photos and patient's experiences. I want a transplant but I dont want to experience subpar growth a year post up. What position do you guys believe I should take?

What surgeons are you considering? What are the specifics of your hairloss situation? 

Typically, for men under 40 the impact to looks and quality of life as a result of severe hairloss (NW3+) are going to massively outweigh the risks. Are you considering the impact of your current hair situation when worrying about the risks? Because that's the real calculation. 

If you've genuinely done proper research and have good aesthetic judgement to be able to choose between surgeons to begin with I have to question if your hairloss is even bad enough to worry like this about getting a procedure. I don't say this as an insult, but ideally you shouldn't be spending so much that you'd feel screwed if a procedure doesn't go the way you want. The reality is that most "poor" results with good surgeons can be corrected if you have the time and money + a reasonable donor. Plenty of people find themselves wanting a touchup,  that's not the scariest thing in the world, its just a factor you need to account for.  If you don't like hearing that then it goes back to my previous points, is your hair bad enough that you even need a hair transplant and do you have the money to comfortably go for a procedure? 

As an example, if you're say a 30 year old NW3 with the money for a hair transplant and an even an average donor area, worrying about a bad result is delusional when you compare it to the alternative. That's not to say that you have nothing to worry about, there are plenty of people that go to good surgeons and get poor results, however if you avoid surgery altogether you need to factor in the impact to your life of appearing to be heavily balding, which in 95% of circumstances is massively negative for younger guys who aren't married.  And to be clear, a poor result isn't an end to that path of choices there are options and issues to correct things beyond that too. 

Like most choices it boils down to a calculation of risk/reward. If you're on the fence then don't get a hair transplant. If you've done your research and can't stop worrying about your hair, then get a hair transplant. There are reasonably clear potential consequences and percentages in each case, vapidly worrying is a waste of your energy. You may as well be worrying about getting hit by a car, it serves about as much value. 

Sometimes when a person makes a negative comment on a surgeon, other posters then pick the issue up without actually considering if its true or cross referencing other cases and then make the same claim as if they are playing safety inspector. They seem to just follow the herd and regurgitate false information whether or not its true. Mentioning the "he uses techs" argument makes this blatantly clear, anyone with a functioning set of eyes can see that Freitas achieves among the most aesthetic hairline work of any surgeon on the planet and the yields appear to be consistent from what I've seen on other forums.  The comparison to the Dr Zarev cases also shows this as very obvious, to any rational person the cases are *totally* disanalagous as Melvin pointed out.  

Does it appear that these extraction zones go beyond the safe zones of these individual patients and their specific balding patterns? No it doesn't.  Not every patient is destined for a NW7 and typically competent surgeons will do a basic test for miniaturisation in the donor and at its edges. 

I do think that this is the best hair transplant I've ever seen, particularly because it was into almost completely bald scalp, involved front to back coverage and was a set of multiple procedures with high graft numbers. 

The thing I've never seen people mention in regards to Aftermath that I think is the major reason why he achieved and was able to get a result this good is the narrowness  of his balding area. Typically on a NW5 pattern there is SIGNIFICANTLY more exposed scalp, on Aftermath the sides extend much higher than usual and the width of midscalp and crown exposed by balding is small. Legitimately freakishly narrow compared to the average patient. 

So what it really comes down to is numbers involved and donor quality. His balding area is probably the narrowest NW5 I've ever seen, he crammed the highest number of grafts I've ever seen in an area that small into it , and did so with surgeon that is probably the most extreme in regards to dense packing, and one of the best in general. 

Agree with Melvin that this is unironically true natural density if not higher than the average non-balding person, at least in the frontal area,

Again, I think looking at his photos and particularly this one its very clear that he is not a normal patient in terms of his specific Norwood pattern, he doesn't fit neatly on the scale and clearly his overall balding area is miniscule compared to 99% of patients.  Its not a matter of luck or even just a good surgeon that he got this result, he's an ideal patient going to an ideal doctor for achieving extremely high graft numbers/dense packing. 

Imo on price and graft numbers this patient should consider a clinic like Eugenix who are competent with body hair work. Depending on laxity Hasson/Wong would be my other main consideration.  

If the goal is simply filling the current transplanted area I still wouldn't even consider 2500 grafts viable. To fill that full NW6 area that was a job for 8k+ grafts, even with the crown completely bare this case should have been 5000 grafts to begin with. To add to that, the growth was mediocre, pretty clear from the post-ops that not everything grew. Not terrible and likely straightforward to repair for the right clinic.

Personally, I just think the clinic chosen was the wrong one for this specific case. Anyone with that level of baldness should be looking to the obvious contenders like HnW, Eugenix, ASMED etc. 

For OP, I wouldn't be too concerned about risk of shock loss or damaging grafts etc with a second procedure, its a very normal process for people to undergo multiple surgeries. For your case it would be very much expected no matter the approach.

I wouldn't risk the same mistake of ultra-conservative graft numbers for a second surgery.  You're basically completely bald beyond a few thousand transplanted grafts and there's no reason to be conservative when the goal is to fill that area to the highest degree possible. That area is huge and takes a lot of grafts, there's no getting around that. That doesn't mean it has to be 4-5000 grafts, but the reality is that the best result is going to be from those kinds of graft numbers. Whatever a clinic like HnW would deem to be the maximum number of grafts that can safely be taken I would advocate for. 

On 4/28/2021 at 2:41 AM, Melvin-Moderator said:

What intrigued me the most was his thoughts on crown hair restoration. He said before they said the crown was a black hole. But now, he doesn’t feel the same, based on his technique he can get good visible density with 1,500-3,000 grafts. He also confirmed that the reason why grafts yield low in the crown is the blood supply is poor. He has a technique for preserving blood vessels. Overall, I’m super intrigued and want to pay him a visit once the border opens up to here more about this technique. 

I've always felt this was the case simply off the basis of surgeons specifically like Wong himself, Konior and Lorenzo for example who seemed to prove that the opposite was true.  Coverage is much easier achieved in the crown by virtue of how the hair sits compared to how it does for an exposed hairline. My own is bordering on bald which is very apparent when wet but the placement makes it unnoticeable. Height of the hair is the only way someone can easily tell, which the average person is unable to. 

In the case that I do need to remedy further losses over the next few years though Wong and potentially FUT would be among first considerations. 

I don't mean to piss on anyones bonfire, but to pretend this result is a disaster is a bit delusional.

Marginally different lighting, but it was very clearly a seethrough, unnatural mess prior to the ASMED procedure. Post-op it looks natural, frames the face properly albeit a bit of thinning. You're also not on finasteride and I assume after the first surgery that not all of that hair is the result of the transplant, you almost certainly lost most hair over that time period. 

For reference, I think you should take a look at what 3500 grafts over that area can actually achieve. There are plenty of Hasson cases (albeit an extreme example) where he is using that number of grafts in an area a third of the size. Would I expect slightly more density? Yes to a small degree, but its pretty clear that there is a large improvement.

"Thanks, I honestly started to become delusional and try to believe the result is actually ok. When I saw this post below I wanted to create a topic because user's experience seemed similar to mine; https://www.hairrestorationnetwork.com/topic/56597-my-ht-at-asmed-and-dr-koray-erdogan-january-2017/?tab=comments#comment-538567"

The fact you question whether or not its ok and have to look at someone else's relentless complaints to decide whether your own is ok is in my opinion telling. Its an *ok* result overall.  Someone else's bad result with the same clinic doesn't make yours bad too. 

On the basis of the hairline prior to the surgery to after alone, I would say you've had a fairly significant success. Anyone looking at the former could see something was unnatural, in the second you look like a guy with thinning hair but a hairline that frames the face well. 

The photos where you spread the hair to show as much thinning as possible are pointless. There are photos of Melvin the moderator doing the same where it looks very thin, but his result when styled properly looks fantastic. In the 14 month photo the hair looks good to me. A little thin and the yield not perfect, but good. 

4 hours ago, FkdUpHairline said:

Thank you for the answer. I was pretty happy with the density on week 1 to be honest even if the hair was short, let's hope it grows to that. It was 2789 hairs total, they had planned 2200-2300 hairs but ended up extracting more. I like to wear my hair down anyways when it's grown so here's hoping it turns out good. I was also really happy with the graft direction, also.

I also added that the area was not completely bald, even tho the point that some grafts are placed far apart still stands.

My main worry really is the donor area right now. Fucking shockloss.

I have an additional question that some of you might be able to answer: They told me to stop min for 15 days, already started it again. Fin they told me to stop for 31 days but I'm not feeling it. In your experience, can I start before?

 

 

 

As far as I'm aware for both minoxidil and fin there isn't a good amount of data to draw conclusions on for your questions. Standard practice is no minox for a few weeks prior to the procedure to avoid excessive bleeding. I have also heard some clinics state to avoid for a short period after, but plenty of clinics don't say this. My assumption is that you'll be 100% fine starting up minox early, and for fin I've never heard clinics say to stop taking fin for that period, so I wouldn't worry about that at all.

The donor doesn't look great for those graft numbers but at the end of the day its incredibly common for it to take a 3-4 months for it to get back to relatively normal and even a full year sometimes. I'm more concerned with how the transplanted hairline will look when grown out than the donor. 

Part of the issue with the graft numbers is that its extremely clear looking at the photos that the density of the new hairline is lower than the hair behind it. Conventionally what is natural is highest density in the hairline with decreasing density behind this area.  Yes immediately post-op without it being grown out it might look reasonable, but its problematic when grown out. I'm just saying it as a warning from a (very) educated guess based on seeing tens of thousands of results. At a guess I think you will need a touch-up for it to look natural, potentially 6-800 grafts. It depends on your donor quality and the growth rate however. 

16 hours ago, FkdUpHairline said:

Yes mate, was a lurker before registering after HT.

I don't think it was stupid of me to want to preserve the donor area. I'm only 25. As much as a dense packed hairline was tempting., my hairline stabilized due to the meds, but it might've not forever. Being that FUT is out of the question, and I'm open to more FUE hair transplant in the future, I don't think I made the wrong decision, being that on average 4k FUE grafts is all you can give without being bald in the back. As you've said, it's healing nicely as expected except for the shock loss in the back.

Let's see how it goes, I'll keep my fingers crossed for my sake that it at least turns out to look decent.

Problem is you might end up with an unnatural result that looks worse than you did prior to a hair transplant. From your initial photos it’s somewhat hard to conclude but your hair looked decent already.

4K grafts before you look bald in the back from FUE is absolutely false as an average, even a NW6 will almost always achieve more than that number. For NW5s the average would be closer to 7k. 

if you were worried about your long term donor utilization you should have chosen a clinic that is taken seriously on a forum such as this one and probably gone with FUT.

In this case, if every last graft grows it might look fine, in regular circumstances it will look thin and overly see through. Unlikely to be natural. My personal opinion is that it’s highly likely you’ll be forced back into another surgery in the near future because of this, and therefore your point about saving donor is unfounded.

There are surgeons that make a small amount of grafts go a long way, at the end of the day though no surgeon can make 1250 grafts enough for that area appear fully natural (unless it’s just providing basic thin/wispy coverage) and it’s visibly thin in the post-op.

I assume this company has a variety of doctors working for them, but some of the results they achieve are good. If every graft grows like I said it might be passable.

This is a *terrible* result and anyone that says otherwise doesn't have a clue. Macro design is totally unnatural and as others have said the graft number looks overstated.

Probably not the worlds most difficult repair, but I guarantee most surgeons on this network would acknowledge that this is a poor result and whoever did the work is incompetent. 

OP, based on this post alone you absolutely do not have unrealistic expectations. There are plenty of surgeons on this network that would never put out a result like this.  Bad yield is one thing, below par density in placement and straight lines that border on feminine hairlines are another.

If you're happy with FUT these are arguably the best two clinics at it, Hasson in particular for larger megasessions. At the end of the day if you've come down to these two clinics I'd assume you already have a good sense for decision making, you really just have to look at their results yourself and decide who you think produces the best results to your eye consistently and in terms of aesthetics. On top of that the price, I'd also consider budgeting for a potential touch-up, not that you will absolutely have to but its worth considering in advance. Personally I do think Hasson produces more aesthetic hairlines, albeit at higher densities typically than Konior might. Konior however potentially marginally more consistent and better coverage per graft number.  My conclusion would basically be that if the 2k deposit for Konior is a meaningful amount of money for you I'd simply go with Hasson, on FUT prices one of the best valued surgeons in the world.

I'm not an American, but I do think just on the numbers that an end is *absolutely* in sight in regards to the border situation. That might mean 3-6months, but it it sounds like you've already endured the brunt of the wait regardless. For the period to extend another six months especially for those that have already been vaccinated it would mean a gargantuan failure of governance on behalf of both countries. 

15 minutes ago, AB2000 said:

When is it ever a good idea to go back to the same doctor for a no cost repair?  Donor hair is finite.

If he or others have the money to go to a surgeon that uses stick and place as well as being more meticulously hands on in general like Konior or Keser for example, then absolutely I'd recommend going elsewhere. In reality unless he has the money to do this its probably the best option to go back with Ferreira. I don't consider Ferreira at the absolute top end for hair transplant surgeons, but he's no clown. I would give him the benefit of the doubt.

Also has been said, I think he's likely to get some further improvement that leaves a position where a touch-up will achieve a good result. 

23 minutes ago, Ittiaz1 said:

Thanks for the reply. It definitely doesn't look a home run and to be honest I can't see it getting better. Again, as I mentioned to someone else, would I go back somewhere which hasn't left me happy the first time? I don't know.  

And yes his responses so show he cares.

If this does fail then I would like to know why. It would bug me all the time, not knowing why. Paying alot of money to suffer a failure,  I don't know anyone else but I would like to know the reason why 

There's no means to find out why unless you have some kind of specific physiological condition. Other surgeons who didn't take part in the surgery would almost certainly be lying if they try to give you specific reasons. The surgeon who conducted the surgery to begin with might have theories as they're the one that conducted it but even they are unlikely to have anything close to concrete answers.

Its worth taking it out of your head completely because there's no means of getting concrete answers here. I understand in an ideal world that you would know, but that's not reality.

Realistically I think its unlikely that the growth will ever be a home run if this is the situation at six months, however its definitely possible it can improve reasonably substantially over the next three months or so. 

As Bono said,  the responses from Ferriera are well above average for patient aftercare, and the fact that he is he supporting of potentially remedying the situation at twelve months if still not satisfied is as close to as good as you will get anywhere in the industry. 

"One thing I will do if after 10 months my hair transplant has failed ( and yes i am jumping the gun here) is to find out why it failed otherwise it would bug me forever."

One can safely say you will never, and should try to find out why a transplant failed, because no one in the world will be able to tell you (unless its related to some rare physiological condition). No other surgeon is likely to be able to even get a rough idea either. Any surgeon or any person who can claims exact reasons in a case like this lying or being misleading. If it fails you have to move on and the best option in your case would likely be to have Ferreira attempt to remedy through a touch-up. 

7 minutes ago, Icyraindrops said:

Thanks for all of the additional information again guys, it's clear that Turkey and now Thailand with Dr Path are the way to go, only issue with Turkey is their covid cases are thru the roof still and while it's still some way off, it maybe be a long time before we'll get there while we may get an Asian travel bubble. Dr Paths results on their site look fantastic, does anyone know what he charges roughly? 

If Dr Bicer is only behind Dr Erdogan in terms of marketing, I can manage I think as price will be a bigger factor there.

Budget isn't super constricted since I was ready to do it locally but would still like to not be super expensive, have been quoted about 1000 grafts for the hairline and anywhere between another 1-2000 for the crown (one place even said the crown wasn't thing enough to work with yet). 

When I say their marketing is a redflag, I'm saying that even the cases they're advertising often look unnatural.  If the cases they're advertising don't look good, then the average case they're not advertising is unlikely to look even baseline level. 

I have no idea how you drew that conclusion from what I wrote but ok. 

I don't know the full reason why (bad vibes?) but Spex was always one of the most unlikeable people I've ever come across on an online forum or hair related environment. I think he is the type of person to think he can simultaneously help people through directing people to decent clinics while making a buck doing it (which is partially true and he's probably a net benefit to the industry) but ultimately I don't think he's all that bright, weak ethically and certainly lacking levels of each enough to be a great patient advocator.

Probably also I'm just a little jealous of him making money in a role I feel I could do a significantly better job of. Not to toot his horn too hard but Melvin gives a signficiantly better name to the role of patient advocator than Spex. 

Ultimately, for anyone looking for guidance in the industry your own eyes and interpretation of data needs to be the primary guider of decisions and opinions. 

On 3/31/2021 at 10:50 PM, Icyraindrops said:

Does that include Erdogan? I found out the others were mills (though apparently the better mills) and thought he was different, at least judging from his price and some of the info online.

Just looked up Dr Bicer and this is Ozlem Bicer right? Her prices seem cheaper than most of the reputable ones there from memory, I've never heard of this clinic before but will definitely look some more into it, what other info have you got on this clinic mate?

Dr. Bicer isn't in the league of ASMED. Their marketing and instagram are approaching trash tier. 

https://www.instagram.com/p/CLUTFJHDv3t/

Sorry to the people recommending on this thread, but this looks terribly unnatural in every way. An Instagram should be the place for the clinics deemed top results. This is nowhere near par. Sometimes I feel like I'm too hostile in my critiques but recommendation of Bicer just reminds me that indeed a lot of people just lack any level of aesthetic judgement. 

It sounds like your budget isn't endless, in terms of the mentioned clinics ASMED would easily be my choice (being biased in that I went there myself). I think Keser in Turkey would be a fantastic option for your hairline, at a slightly higher cost and with a more doctor driven procedure. However your crown is probably better off with a few thousand grafts and in my case Erdogan did a very impressive job at giving crown the appearance of good coverage and density without huge graft numbers. If you opt for them I would go for the package with Erdogan doing the incisions. If you only want hairline work (and its probably at very most 1500 grafts) Keser would be a good choice, if you want crown and hairline I'd go ASMED.

Interesting all the Melbournites here (myself included). 

I would add to the consensus that Australia is subpar in regards to hair transplants and should be avoided entirely. Quite frankly, the standards for the price are a disgrace.  

43 minutes ago, Curious25 said:

Still looks excellent, congrats. 

What are your plans and goals going forward - do you have any indication as to how many grafts you have remaining? Have you considered any other treatments to help maintain? 

Would go for FUT in the case of a future procedure. Assume at worst I'd be able to get 3k grafts to cover lost midscalp and crown that is still native hair. Probably closer to 4k, 1000 of which to perfect density in frontal third. For FUE, I think if I really pushed it I could get another 2000, but I don't think that's the best choice, especially considering any potential donor thinning over the next 30 years. 

In the meantime things are fine, crown placement from ASMED was good enough that it still appears to have very good coverage despite being very thin in reality. 

No interest in current treatments for maintenance. Perhaps something new will come along, if it doesn't not a big issue. 

Close to 3 years post second op.

Realistically, in terms of how bad the situation was at 21 ASMED did a very good job. No matter how much more I spent or any other doctor globally I doubt I could have got a result from 2 surgeries even 10% better. 
 

Gone from looking like a 35 year old at 21 to looking probably the best I ever have and even regularly getting compliments on my hair. 

6 hours ago, EvoXOhio said:

I’m curious why she didn’t bring your new hairline down to where your existing hairline currently ends? Your pre-surgery hairline is asymmetric. On the left (left on pictures, may be right side on you) your existing hairline comes down below the new hairline she created. This is going to result in a clump of existing hairs residing below your new hairline. 
 

is the intention to shave those hairs? Laser removal? Assume they may fall out on their own one day?

I recall seeing something similar on another post, but the extra hair was right in the middle, not off to one side. 

Hairs will fall out and relatively soon unless you believe in voodoo or think this guy had some hairs fall out because of diet.  Slightly asymmetric hairlines are also totally normal. Plenty of options like shaving it off in the short term and letting nature take its course. Or simply leaving it in which case it also isn’t likely to be especially noticeable at his original length.

What matters is that she placed into existing hairline, so over time it’s not going to end up looking weird.

He has the benefit of working with patients who often have incredible donor hair and perhaps that is also a result of his selection process, but he is undeniably one of the best FUE surgeons in the world on consistency. Arguably *the* best in terms of hairline aesthetics although that is to some degree preference. . Naturalness is a relatively low bar to cover, these go well beyond that and largely are the equivalent of designer hairlines. Last I saw his prices aren't even that high either. 

Easy recommendation. 

54 minutes ago, giegnosiganoe said:

I'm skeptical too. I appreciate the new pic, but it still kind of hides a lot of your hair.

I'm also surprised how much loss you have in your pre op pics given that you were on finasteride for 20+ years since the age of 17-18?

The case seems totally legit imo but I wouldn't conclude that they're are a particularly proficient surgeon because of it. It doesn't tell a lot. 

Their hair characteristics massively work in their favour and even in these mediocre photos it clearly isn't a high density, but the coverage is very good. It seems like low placement density with a high growth rate and very good donor quality and curl. A good result but for most patients they would require a very different approach.