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DrTBarghouthi

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  1. I agree with the previous answers. If a clinic you are considering has different service levels, then make sure you see the results. Although if you think about it, if you see results from the package that had minimal doc involvement, then how would you guarantee that the personnel involved are going to be the same? As a HT patient myself, a clinic offering different service levels (in terms of surgical involvement) is something that will make me reconsider. Having packages for accommodation or travel etc is fine, but not for surgical involvement. Thats only my personal take on it, with no disrespect to anyone’s business model.
  2. The standard practice is to shave the donor and recipient areas for both FUT and FUE. The shaved portion of the donor area for FUT is minimal and hair above usually covers the scar initially. The recipient area can be minimally shaved depending on the size that needs transplanting, the pattern of hair loss and your current style. Clients with longer hair and only minimal recessions or some crown work can hide this pretty well. Nonetheless, nothing is 100% hidden and redness and shedding will always occur. Now, more recently, a trend to do more “hidden” work has emerged. This is usually divided into two techniques: 1. Preview Long hair FUE as the name implies involves extracting long haired follicular units and transplanting while maintaining the long hair shaft. This is done by some clinics and gives you an immediate “preview” of what the end result will be and also avoids shaving the donor. The downside is that those hairs will shed in few weeks (might be more upsetting to some clients seeing that happen after seeing an almost fully grown set of hair), but also might be satisfying to some. The main downside is probably cost and the fact that the yield per session is smaller. It is a more time consuming process and probably yields 1000 grafts at most per session. 2. The other way to sort of avoid a full shave FUE is to have your hair long in the donor and to shave several strips of hair (similar to FUT shaving) and extracting those grafts from there. The hair over these strips will hide the areas being extracted quite well. Again, the yield is less per session and we usually plan the procedure in stages every 3-4 months so that you can extract from different areas every few months and make it look undetected. Usually 1000 grafts per session (depending on how long the hair is ofcourse). The longer the hair in the donor, the wider the shaved strips can be and hence a bit more per session can be done. This one works well in my opinion, but it’s important to have it well planned because you need to have a uniformly extracted donor by the end of the sessions. I hope this helps. Different clinics can name these techniques differently so I wont get into the different names that can be given to these procedures.
  3. It's a tough call at times to base the decision on photos. I think in such cases a live consultation is the best, where the donor area can be properly examined and also the areas of hairloss and then an appropriate plan can be drawn.
  4. It is completely normal to feel in such a way. The main thing is to feel ready, be a suitable candidate and to do your research as to who should be doing your procedure. It is also important in your case to commit to maintenance therapy to avoid a great deal of progression. Once you're happy with that, there is no reason to be worried or concerned. If getting bald bothers you, then fixing it right is one of the most rewarding/satisfying things ever. Best of luck to you!
  5. I agree with @spex that there is a lot going against you having an FUE. If you plan on having it buzzed then SMP is a more sensible approach.
  6. I do agree with you @Lennney that the actual technicalities are not a determining factor and perhaps shouldn’t be asked. I guess I put the list based on what I encounter daily and these came up along as some people who researched would usually ask about these. I don’t mind them asking about the broad differences in technology as it does show some level of research and knowledge of the procedure so I do answer and discuss why I use this over that. I think people generally have an innate tendency to question, show off their knowledge and are simply curious at times regarding techniques. The questions I mind would be the too “markety” ones such as specific device names etc as you rightly mentioned.
  7. Thanks. It is different ofcourse from area to area. I dont think there is a set protocol on how to proceed, but yes infection is one of the concerns after HT on Imuran and especially in a big FUT scar. It might be wise to do a small test area first and proceed from there. This way you can assess how your excision sites and recipient sites heal and also the overall hair growth success. I also quoted the link Melvin sent about consulting one of the recommended surgeons online.
  8. Hi aasyd, I just came across your question which I find worth discussing. Azathioprine is a medication considered to be a Disease modifying anti rheumatic drug/immuno suppressant. It goes by the brand name Imuran as it is most commonly known. I assume it is being used for some anti inflammatory condition that you may have such as crohns disease or other auto immune disease. With regards to HT, here are my thoughts on how it should be approached: 1. This medication can suppress blood counts including white blood cells and platelets, so it is important to check these levels before going forward as it can indicate whether there is a risk of excessive blood thinning or bleeding. Reduced white cells can also lead to more severe infections followong HT, especially if FUT is considered (wound infection) 2. In the early stage of taking this, hair loss related to the hair cycle abnormality can occur such as telogen effluvium or anagen effluvium. These are hair loss conditions un related to damage to the follicle but rather issues related with hair cycle disturbances, similar to what happens in shock loss or hair loss following chemotherapy. Because of these factors above, approaching a HT on this med in my opinion should be approached carefully. One should see how long a patient has been on it, the blood works, the fact that whether hair loss actually occured due to it or has stabalized following the treatment. There is no evidence that says that HT would fail using it, but I think it should be approached with good planning and on a case by case basis. I had one patient with a very limited genetic loss who has been on it for years. All his tests above were reasonable so we moved on with it and things are great. Where as if someone just started, has irregular bloods and possibly some non genetic hair loss due to it, then I would personally hold off and most likely proceed with an FUE once things are better.
  9. Yes it is quite unfortunate how penetrating those marketing “terms” have become. In certain regions and for certain individuals it seems like completely brain washing them. For most doctors it is unethical to claim something that doesn’t exist or to make false promises such as your donor will regrow itself!!! However, when several non medical practitioners get into a trade (which is the case in many tech only practices where non medical individuals actually perform procedures), then the ceiling for “selling” becomes quite high that they will provide you with false promises in order to close the deal. Extremely sad and unfortunate. In the HT business, a bad reputation driven by a bad clinic could affect many good practices unfortunately.
  10. Hi KIwi Guy, Interesting topic. I think your consultation should establish two main things: 1. A good understanding of your hairloss problem including your options for medical treatments, surgical hair restoration, number of grafts that you may need, the different pros and cons of medical maintenance therapy, a good scalp and hair analysis etc. So basically this is the part related to your condition, its diagnosis and your options going forward. Ofcourse you will need to get answers about the details of each procedure, what the scars look like, how long it takes etc, possible hairline designs..... 2. A good understanding of your surgeon: this will lead to questions such as: his or her experience doing hair transplants, what aspects of the procedure do they actively participate in? , how experienced is the team?, how many years have they been doing this?, do they do FUT only or FUE only or both? , do they use implanters or forceps?, what kind of extraction tools do they use?: manual or motorized, sharp or blunt? You probably need to know if they do one or multiple cases a day? how much do they charge? and you definitely need to see befores and afters similar to your case. I'm sure there is always something missing or something that comes up, but going through everything in both points 1 and 2 should get you through a one hour consultation easily.
  11. Well from what I see being advertised many clinics in Turkey (with no associated doctor) are advertising using choi implanters. I wouldnt be surprised as it could be easier /safer to train someone on implanters rather than forceps. Nonetheless, they advertise it heavily. Whether they are genuine or not I’m not sure. But it seems most of these are tech run clinics anyway.
  12. I totally agree that implanters (various types) are getting increasingly popular and produce nice results. However, it is a bit of generalization to assume that anyone using implanters will produce great results and anyone using forceps produces sub par results. There are many excellent clinics that are still producing amazing results with forceps and at the same time there are tech driven mills that are using implanters and producing bad results. I use both personally and at the end it comes to respecting the grafts from the moment its extracted to the moment it is implanted.
  13. This is a very nice study indeed. Nonetheless, it does not aim to compare forceps with implanters. Its objective was to assess the various injury levels of grafts placed using an implanter, which is quite slim. Remember that if a practice is used to one method, then they are likely to produce less damage using that method.
  14. I do think it all comes down with what works well within the team. It is not an easy thing to switch to a new implanting technique if the previous one is working well and the team is experienced in it. Implanters do have a faster learning curve though and can offer a safer option for new or less experienced techs. I personally like some implanters out there that offer the combined use of premade sites, an implanting device and the use of forceps at the same time. But again, each practice goes for what works for it.
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