johnto

What size punch did you use? 

On 5/18/2022 at 6:02 PM, Rahal Hair Transplant said:

Lowk,

As a four-time hair transplant patient, I can definitely relate to what you’re going through - especially the first time when I didn’t know that much about the procedure.  At first, I was pretty excited thinking about my new head of hair but then all the doubts creeped in. How do I know that the procedure really works? How do I know that the doctor I selected isn’t a quack? Why were technicians working on my scalp more than the doctor? Why were the technicians laughing and giggling about social endeavors rather than focusing on my scalp?  The more I thought about it, the more I became concerned and worried whether or not I made the biggest mistake of my life.  Then, my “depression“ became even worse when I started experiencing shock loss between 8 to 10 weeks postop.  

All that to say however, I was comforted when I began to see signs of new growth each and every month after the third month.  Of course, I was hoping for more after my first procedure but I really didn’t understand how many grafts I required until I really spent time researching the procedure and learning about what hair transplant surgery really can accomplish.  In hindsight, I wish I did all of my research prior to my first procedure as I very likely would have gone to a different doctor the first time around, not to say the first doctor didn’t do a good job but I simply need more and there were other doctors doing larger procedures even back in 2004 and still producing outstanding results.  Note that the first doctor I went to was a local doctor in Pennsylvania.  

But considering I had advanced degrees of balding, I realized that I needed to focus on the long-term and after four hair transplants, I am very satisfied with my results and my last hair transplant was literally 15 years ago. My results have held up wonderfully and now I have the privilege of helping and supporting others who are either considering the procedure or have gone through it.

All I can say is, if you’ve selected a surgeon with a proven track record of producing outstanding results, you should be just fine.  Without knowing much about your specific situation, just know that sometimes more than one hair transplant is required and hopefully you spoke to your surgeon about not only your short-term goals related to this past procedure but your long-term goals in terms of what to expect over the years especially if you lose more hair and how to meet your ultimate goals.

I hope this helps.

Rahal Hair Transplant

Can we see your hair? I'd love to se what 4 transplants looks like 

On 4/23/2022 at 4:11 PM, HugoX said:

Yes 👍

So I don't understand this.   Why take fin and min when basically all the hair you have is DHT resistant?

On 4/23/2022 at 4:11 PM, HugoX said:

Yes 👍

So I don't understand this.   Why take fin and min when basically all the hair you have is DHT resistant?

Question for team Rahal.  I'm sure this will be a home run result as you guys are very experienced and obviously know what you are doing...

My question is....if you look at the post op day 1 photos from the front and back sides, it looks like the grafts are very spread out.  Will this be an issue with density for the end result? 

Any  photos closer up???

Your only hope in my opinion is Tsvetalin Zarev in Bulgaria.

https://www.hairrestorationnetwork.com/topic/59913-dr-zarev-7070-3613-grafts/

I have wondered this myself.  I believe couto and zarev use implanters and they have some of the cleanest work I have ever seen.   I mean wouldn't slits cause more scarring?

Who did your original surgery (the small 2200 graft one?)

I would go to Dr. Zarev in Bulgaria 

So for donor scarring.  If you compare Zarev post op scarring vs Diep for example.....for Zarev you can't even see the FUE dot scars whereas for other surgeons you can clearly tell they are there.  What is it about his extraction technique that allows for this ?  

One example is if you look at Mr.  Rolandas on YouTube he had a video where he shaved his sides and you can see FUE dot scarring everywhere. But I feel like for Zarev this does not happen.   Does Zarev use a smaller punch size?

I'll never understand why clinics don't spread out their extraction sites more? I hate when they keep it in a confined area like that and you end up seeing a halo in the area. 

12 minutes ago, KKB said:

Dr.Zarev is an amazing surgeon!I did my first HT with hin in late 2015 about 1700 gr  infront only!I already knew that i am hedding to NW 6 or 7!5 months ago i did my second surgery 7400 grafts!And i still got about 1800 2000grafts left for 3rd surgery when i am ready! but he told me to wait so i could have resource for future balding!I am 36 y.o. !My point is that in 2015 cause i am one of his first patients i knew that he would be the best!He is the best and he is very honest doctor and simply a good person!Good choice Hugo!I mean there are very good surgeons out there but for high norwood he is the best out there!

Do you have any before and Afters???

Bro.....can you give us a wet hair slicked back photo under harsh lighting? Please bro we all need it lol 

16 hours ago, Curious25 said:

Well this was my point exactly - I find it very hard to believe Dr Zarev is just fortunate enough to encounter these types of patients. I don't understand why other recommended surgeons don't have examples of this type of restoration, unless;

a) they aren't able to execute the same level of restoration 
b) a higher volume of lower level restorative surgeries is more financially beneficial - so they choose to prioritise business first (which I'm not suggesting is wrong to do so, just don't publicly criticise other surgeons who are performing this type of surgery as not being a viable or safe method, because your clinic chooses to put profits first).  

 

I feel the thing is that a clinic can easily restore a norwood 2-3 all day every day and give consistent results.  For norwood 6+ its probably hit or miss.  Everything has to be in the patients favour (donor, hair thickness, graft survival) that it is too risky to do surgery on them. 

Also I believe clinics dont want to spend the time/energy training necessary to restore norwood 6s if the results are not predictable.  Remember that for this 1 surgery that may look amazing, there may be 2 others that dont come out as good. 

In that case its the clinics reputation on the line.  Its easier to say no at the beginning and take the easy cases than to change someones life for the worse and try to repair it after.  Once you have to repair for free you end having both an unhappy patient and you lose money on the case as well.

Now surgeons are regular people as well.  Some are motivated by money and others are motivated by being world renowned.  Ie they wan to be the best in the field worldwide.  Zarev may be one who wants above all else to make sure every single patient that walks into his office comes out as "perfect" as possible. 

24 minutes ago, SLA said:

I just don't understand how Dr. Zarev claims to be able to extract 60% of the donor without signs of depletion, where other surgeons might say not to extract more than 40%.

I think this depends on the patient.  He has said on his Instagram that it depends on donor capacity, hair thickness etc.  Not everyone can have these types of results.  Also I think he has said that you can extract 60% of donor area without "visible signs of depletion".  Ie. the donor becomes thinner but I believe because it becomes a bit thinner in  a homogeneous way its not perceptible.  Whereas if you extract in a more defined zone then if it thins you can tell (ie. halo effect).

I assume this would depend on type of hair.  Thick black slightly wavy hair Is better than thin blonde hair.  If you look at his giga sessions all patients seem to have similar type and quality of hair

If you compare Couto and Zarev to Dr. Diep for example you can see the post-op difference.  I assume Dr. Diep uses lateral slits and then they implant the FUE grafts with forceps? (ps. Im not bashing Diep I actually really love his results I think he produces world class results.  I am just comparing technique thats all).

I was hoping that someone would start a thread about Zarev.     I feel these "God" surgeons who treat high norwoods with amazing results usually are every meticulous about every step of the process.  when I look at the way grafts are implanted and how the steps to the process are planned Zarev and surgeons like Couto feel like their process and results look similar.

One of the things I have noticed is when they remove grafts from the donor zone they seem to spread the extraction sites equally around instead of removing them from a more localized area so if the donor gets thinner it does so equally so it is not as noticeable instead of creating a "halo effect" in the donor.

The second thing I notice is when they implant the grafts it looks so minimally invasive.  Almost no bleeding or trauma.  I guess this would be from the implanter pen they use and by being so meticulous with their pre-surgery consultations and quality control that they achieve the best results.

Finally for Couto and Zarev their patient pool is almost always European dark slightly wavy hair which helps make less grafts go a longer way.  

I mean look at the implantation from Zarev and Couto.  Its so clean and minimally invasive.  I assume they both use an implanter pen and not lateral slit technique which when I see this technique used always seems more bloody to me.

This has to be the most amazing transplant I have ever seen.  Really making me consider him for my transplant when I will need one.  

I think the unique thing here is because the OP is effectively bald on top and since all of the grafts are essentially evenly distributed, the texture/quality of the hair is all donor hair so it makes it all look homogeneous.   

Is something like this even possible on diffuse thinners?  I guess Zarev would just transplant amongst the native hairs?

How old were you when you got your procedure ?

18 minutes ago, JohnRoss said:

As a two time Dr Rahal patient (2006 and 2017) I can honestly say the guy has changed my life. People comment on how lucky I am to have a full head of hair: if only they saw what my hair was like in my mid-20s before I met Dr Rahal! The density that Dr Rahal achieved for me I honestly do not believe any other doctor could have achieved, anywhere in the world. Sure, not everyone heals as well for a variety of reasons. But all things being equal, I do not believe any other doctor comes close to Dr Rahal. I am just sad he will retire in a few years, before I need my third / final procedure. Dr Rahal, you are a living legend and I will be eternally thankful for what you did for me! 

Why do you day he is gonna retire ?? Also do you have a photo of your results? Im considering him for my fue transplant.  

Does Rahal use a motorized punch for fue? Also does anyone know if it's the WAW system or some other system?

Any before photos?

7 minutes ago, andrew11 said:

Ok no problem I understand! Ill try and post the measurements after !!

Thanks so much! Please let us know!

1 minute ago, andrew11 said:

I can do it for sure , but what information does this give besides knowing i have a big forehead 🤣 by the picture given it shows about 1-2 inches

Well it gives perspective on how high your hairline is.  Im considering using rahal and would like a similar height for my hairline.  But without knowing the centimeter height I don't know how much I would have to lower my own hairline and how many grafts I would need  to achieve similar results