Payam
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Posts posted by Payam
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On 12/21/2018 at 8:51 PM, JeanLDD said:
I think you already know the growth was bad, and I think the only reason you’re asking the questions is so you can complain about the answers on here.
People take more notice dependent on tone, and I do think it’s obvious that you’re the type to just ignore things that are said more casually.
Youre better off consulting clinics that are to your liking and fixing the problem ASAP than complaining for over two years about an easily fixable problem like HT012 did. The questions you’re asking are below your intelligence level and are outright dumb, you’re clearly smart enough to know the yield was poor and can see it in the preops. It’s obvious the only reason you’re asking and continuing correspondence is so you can complain about the response here.
Maybe you’re happy asking dumb questions when you’ve already made up your mind about the clinic and your result, but I strongly doubt it and think you’d be a million times happier if you booked with a clinic more suited to your liking like Koniors with Nadimi and fixing the problem asap. Honestly your result isn’t even that bad, the density is poor but easily fixable.
You constantly sound like you’re freaking out and want help, being helpful isn’t patting you on the head and saying “who’s a good boy” like some people here want to, it’s telling you that complaining doesn’t fix a poor yield, but a touch up with a clinic that takes a more tailored and slower approach like Konior/nadimi, Keser, lupanzula, Baubac etc will help. You should consult clinics like these and make a booking rather than dwelling on a problem that is very, very small if you don’t have financial issues with more work.
You have it all backwards, usually adults will respond to an adult tone, when you write like a petulant child it's all the easier to ignore you.
I will keep posting my monthly updates obviously, at least until the two year mark, between those i will voice my opinions and concerns with the clinic, also I am of course having talks with several clinics and will start a new thread about my repair in due time so no worries there, that is unrelated to this thread though.
My observations have led me to the following conclusion, something I wish I knew before booking my surgery: Asmed regularly quotes guys far more grafts than other clinics, this is a well known fact. Now skim over some of the better results in this forum where an inordinate number of grafts were used (far more than any other clinic would have in the same area), and take note of how many patients speak about needing a touch up due to multigrafts in the hairline or that they have density issues. And if they do return they are once again quoted ludicrous graft counts. So even some of the better Asmed results have issues as stated by the patients themselves, despite the fact that Asmed uses far more grafts than any other surgeon in the world, how exactly does this add up? I know full well you sometimes need a second pass to achieve full coverage, but with these graft numbers?
On top of this you have obvious negligence shown in pretty much any given Asmed case with the doubles and triples placed in the first two rows of the hairline which the clinic can't seem to explain, coupled with the ridiculous claim that 2800 grafts wasn't enough for full coverage In my case is just, for lack of better words, shady as fuck.
If you have any doubts, look at what guys like lorenzo, de freitas, couto, konoir and even someone as new as Nadimi consistently achieve with FAR less graft numbers.
I mean not a single one of the other 3 guys who did surgery the same day as me are happy ranging from density issues to unnatural looking hairlines, this is what happens when you have the FUE factory approach Asmed uses.
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It looks like you have some early growth when comparing to the preop pics which is a great sign, looks like it's heading in the right direction
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It looks mazing and very dense, what is the density in fu/cm2, do you know? And how do they test for laxity?
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33 minutes ago, JeanLDD said:
In terms of these numbers you're giving now, from you on your first post:
Why did you say these numbers here then?
It's not like you want to go back to the clinic again anyway, no idea why you still bother to correspond (other than to bump this thread so people can see your complaints of course)
Not sure why you're more content on moaning on the forum when you supposedly have the money for a surgeon you actually want that runs their clinic the way you're comfortable with, you're FORCING yourself to be miserable and stressed at the moment, just as you did from the beginning as is obvious from reading your initial posts. No wonder you're consulting with Couto, with his waiting list he'll give you another 4 years to whine about your surgery rather than actually fixing what is unlikely to be a complicated fix, and you absolutely have the donor for. Seems to be your preference.
That was the original plan, the plan was for 1000 in the crown (reduced from 1400) and 2600 in the front, but apparently they changed it on the second day for whatever reason and added 200 in the front somewhere and 800 in crown (Esen told me a couple months ago).
Of course I will correspond with the clinic, I have questions I want them to answer which they are extremely reluctant to, and when they do the answers leave a lot to be desired, like the example above. How can 2800 grafts in that are have been too low, would you accept that explanation?
Really think you should keep a better tone man, not at all necessary to write the way you do
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Need some opinions here as they are claiming the low density is because I reduced the number of grafts planned from 4000 to 3600, which Is true, I did reduce the number of grafts he planned to use IN MY CROWN from 1400 to 1000, eventually they ended up placing 800 in my crown and 2800 in the front.. But now he means 2800 grafts in the area implanted and with my hair calibre wasn't enough and I would have needed more to get full coverage, whatever that means? I can't believe this as 2800 grafts is a huge amount and should at the very least have given me a decent result, as the density should be over 40fu/cm2 with 2800 grafts, what do you guys think?
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On 12/16/2018 at 2:35 PM, 1978matt said:
Not sure if he does the really big sessions any more, you would have to ask him. Pretty sure he will still do over 3000 for FUT but maybe not 4000+. He's in his mid 60s now and can't be working 18 hour days!
Man I didn't know he was in his 60's, this might sound horrible but the thought of this guy retiring before having the chance to get a surgery with him is horrible lol.. how long was the wait time for your surgeries? And why didn't you FUT it? Did you have an in person consult with him before your first surgery to determine If you were a viable patient?
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No offense but this thread is pointless without pics man, people have wildly different standards for what is acceptable on this forum(and in real life) so please put up some pics and let people judge for themselves
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21 minutes ago, Gasthoerer said:
Personally, I think the scar tissue thing is overblown in general and especially in your case. Million of patients get a second surgery / touch up with good results, why should it be an issue in your case? I believe this new clinic (Which one?) only wants to lower your expectations.
I don't know man, I don't mind them being blunt with me and not promising the world, they don't really know what my expectations are (pretty damn low at this point), and it is most definitively harder to transplant into compromised scalp rather than virgin scalp. They say that they can't know for sure unless I do an in person consultation and have my recipient examined in detail under magnification and with blood tests, this all makes perfect sense to me and I'm actually very happy with this response. Problem is though they are really far away for just a consultation so I am really looking to have my recipient examined by a EU doc for now, leaning towards Lupanzula, I also have a consultation with Cuoto next year, I need a EU doc who is meticulous and personal, I have heard Lorenzo, De Freitas and Bisanga despite their monster results see several patients a day which is not for me.
I will pm you the clinic
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On 12/13/2018 at 12:09 PM, Mikey1970 said:
Pretty alarming to read this post & feel the impact it has had on you! Im a bit surprised as based on many previous posts on this forum I had considered Asmed to be amongst the best FUE team in the world. Maybe they are taking on too many clients/surgeries in the one day and it is beginning to impact their results?
Dr Couto is the red hot surgeon atm but his wait times are apparently insane/years!
I have been on the receiving end of the good, the bad & the average from this industry myself so can genuinely empathise with you pal. What doesn't break us does make us stronger but we do need our smarts, complete dr integrity & a bit of luck to end up happy in this game.
Best.
He's not even the best in Turkey. I'm sorry to hear about your bad experiences man, do you have a thread detailing your journey? I've never been this angry and disappointed over something in my life, the pictures really don't do it justice. It looks beyond awful in natural light and I really am left with no choice but to conceal my hairline.
I have received some response from other clinics at least but the consensus based on the pictures I sent is that due to the scare tissue in my recipient there is a likelihood I will never get good results. I already knew this but hearing a professional say it and calling me a repair job due to the multitude of issues is too depressing, I'm glad they are honest and ethical though. I will have to get my recipient scar tissue examined under magnification, but the clinic is half way around the world so looking at options in the EU for now, at least to examine the scar tissue to see if a second surgery would be inadvisable
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On 12/9/2018 at 7:18 PM, JeanLDD said:
That also clearly show and state that there is significant scabbing and gaps of hair missing, but whatever you say.
But you can see the doubles and triples at the very front of the hairline there or very close to it, why would they place those triples there?
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Hey man, best of luck on this one. I have to ask, do you have any pictures of your previous surgery? Did Erdogan investigate your recipient scar tissue before the surgery?
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On 12/9/2018 at 12:05 AM, delancey said:
Hi Payam,
Covering the doubles and triples with singles would of course save you a lot of time. If everything went as expected, you would be done with the repair within a year. This is definitely a major benefit, as I can tell this is something that bothers you a great deal. There is of course the consideration of whether this is something that you have focus on to such an extent that it has become an obsession for you. In that case, it may always bother you that your hairline still has doubles and triples in in (albeit less noticeable), even after the hairline has been filled in with singles. This is a personal decision that only you can make after having consulted with an excellent HT Doctor about what each solution entails.
The second option, as you said, would be to extract the multi grafts in the hairline, allow the area to heal first, and then go back for another hair transplant. Perhaps the extracted grafts from the repair could be reused in an area behind the hairline that is still thin. This option would however generate scar tissue in the recipient zone where grafts were extracted. The risks associated here would be a great question to ask the Drs who you consult with. My understanding is that the scar tissue may have an impact on growth to a certain degree of any future hair transplant, but please verify this with your Doctor.
If I were in your shoes, I would consult with a few reputable clinics in your area. That way you will gain a better understanding of the benefits and risks associated with each option. I think you are in a good position to get this resolved so try to be calm about it and focus on finding a good clinic that you have full confidence in. Good luck.
Thank you my friend, unfortunately there are no good clinics in my area. My problems are the density as well which is about half of the implanted density and adds to the unnatural appearance.
I received a reply from one of the clinics I sent my pics to and they were very worried about my scar tissue in the recipient might not allow for more growth there, I would have to do a consult in person to determine if a touch up is even a viable, they are on the other side of the world though so I am looking to see of there is anyone in the EU that could examine my scar tissue to see if another transplant would be too risky. I am realizing that maybe it would be safer to let it be and that I will never have good density because of the scar tissue, Asmed has let me down in more ways than one during this process.
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1 hour ago, DEB1982 said:
I disagree. I think from his starting point and the area that has been covered he has had a huge cosmetic improvement. 3000 grafts across a large area which isn't solely focused on just the hairline isn't going to provide a dense hairline.
I agree about the cosmetic Improvement, however my point was that 3000 grafts over 90cm^2 is 33fu/cm^2 if uniformly Implanted, in this case it was spaced out and his hairline is more densely implanted so probably closer to 40fu/cm^2 if not higher in the hairline, which by all means should give a denser looking result unless I am missing something here, perhaps op has very thin hair
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8 hours ago, Fozzie said:
Think it's a good result based on where you were pre HT and made a big cosmetic difference overall. From the pictures, frontal area does show up scalp and maybe lacking some density but some of the pictures do appear be taken under harsh lighting by the looks of it.
Regarding the hairline....when you had the HT done was the clinic aware you would be taking finasteride? I maybe wrong but from your write up it appears the decision to take fin was made after the HT and the clinic were under the impression you wouldn't be taking it? If that's the case, I can see why a conservative approach with the hairline was taken because as you are in your 20s, it wouldn't be a great move to go with an aggressive hair line at your age without being on medication imo.
You can see the sparseness in his last picture though which is not under direct light, I would have expected more for 3000 grafts considering how dense his frontal third was implanted at.
Op what diameter is your hair?
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Thank you guys, I agree with you both, I think some added density and a row of singles would make a world of difference, mostly worried about depleting my donor now but will wait and see what my consults give, perhaps It's possible to put 1000 grafts in the frontal third while maintaining enough donor supply for a future FUT but... Erdogan estimated I had 7600 grafts, we know his estimates are on the higher side compared to other surgeon's so I really fear that the only recommendation by surgeons from this point on would be an FUT, which I had planned for already but not for another 10-15 years. Ideal scenario would of course be if I could get 1000 grafts by FUE now and 4000 or so with FUT later, mixed with body hair I think I would be relatively future proof
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My hairline is filled with doubles and triples after my surgery with Asmed, what can I do about this? Would it be better to move them or try to cover them with singles?
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1 hour ago, Melvin-Moderator said:
There is no transection of native hairs, it just looks like you're losing more hair. Hair transplants do not prevent or stop hair loss. Are you on finasteride or minoxidil?
No that can't be, my hairline has been very slowly receding since I was 20 and my hair loss effectively stopped almost completely when I started on fin earlier this year which is the one good thing to come out of this
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1 hour ago, Spaceman said:
Yes, unfortunately that’s what happened in this case. There were obvious doubles and triples up front.
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1 hour ago, JeanLDD said:
Typically I do not like the idea of a test procedure for various reasons and wouldn’t recommend it, but although I didn’t think of it initially this might be a reasonable option to consider. The only issue I have with it is perhaps your grafts are very sensitive to time out of the body, and although a short test procedure may go well one that is multiple hours subsequent to a test may still fail. Also perhaps with a small number of grafts you wouldn’t have the same healing issues as with a mega session situation as you had, or even for a subsequent say 1500 graft procedure. Personally I tend to think the issue was related to the flu like symptoms you had after procedure.
But in general I’m skeptical of test procedures and the posibility of it giving a false reading because it is fundamentally different to having a significant amount of grafts extracted. Obviously my thoughts on this are not based on a medical degree, but objectively speaking there are ample variables being altered drastically as compared to a full session. Interested what the perspective of a variety of top surgeons on this might be.
there are likely a variety of opinions on a best option, but I probably would consider an FUT with Konior perhaps or a slower approach of work as Keser does by FUE to minimize graft time out of the body. Looking at your latest result I do see genuine improvement and although the growth is poor it is enough that your next procedure won’t require a huge number of grafts which is good. Also I see a few multis but a new line placed in front would easily fix it, overall I don’t think this is a huge issue to address especially if further density with singles was added I guarantee no one would notice.
I guess you are right on the altered variables during a real surgery, i will have to see what the surgeons say regarding a test run, perhaps just extracting a couple of grafts could tell them something about my overall situation. I don't know what a test run would give me at this point since i clearly have had growth which is mostly uniform, why is it uniform?
How many grafts do you think I need to make it look ok while still allowing me to have a FUT in 10 years if necessary? I am extremely apprehensive about doing an FUT now as I will concede the possibility that this wasn't due to the flu or techs mishandling my grafts but some other physiological issue, even though the clinic has said from the start that my blood circulation was good. Doing a FUT that fails is a nightmare scenario I don't want to imagine. This is also why I'm leaning towards a small FUE, maybe 500 grafts stick and place in the right side and the front to add some density and singles to make it look natural, that way I can slick my hair to cover the bad side. It won't be perfect but I can live with that for now and then do a FUT down the line in several years to fix any remaining issues What do you think?
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11 hours ago, Melvin-Moderator said:
To be honest, it’s not bad, but not good either. For the number of grafts I wouod expect a little more at this point. However, you’ve been improving slowly each month. It’s possible it looks a lot better by 12 months even though 18 months.
Thanks for posting full pictures that give us a better understanding of your results. I will say that it looks natural and doesn’t appear like a hair transplant.
What do you think about my native hairs looking worse on the left side? Why would my native hair have become transected like this?
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10 minutes ago, Gasthoerer said:
What do you mean?
1. Is just simple geometry, and also shown in multiple discussions. Just look at the shape of the multis.
2. Well, this is what the protocol of good clinics is: They inspect the grafts. Why do they have microscopes in the first place? My clinic even sent me pictures from that process.
3. Well, some clinics refused to do a small test case on me and the one which offered it, asked for higher price/ graft. As some of the costs are not graft dependent (medicine, consultation, after care, hairline design, …) this is logical too.
Sorry man i meant, at with which clinic did you get the graft test run done? Which surgeons are willing to perform such a test? Perhaps i can contact them..
I don't know how many grafts i realistically have in the bank, i hope i can fix this with a FUE and still have enough grafts left for a FUT in the future =(
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6 minutes ago, Gasthoerer said:
1. Yes, small singles might be more sensitive but bigger ones are not more sensitive to mishandling than multis. Why should they be?. Anyway, you are talking about transection nit mishandling: Multis are much more (!) prone to transection (or: Only a single is surviving of a previous multi). That is one reason why I think you point regarding transection rate is not a good one.
2. Typically, grafts are inspected after extraction. Transection should be detected during this process. If the implant transected grafts and/or continue to extract grafts with such high extraction rates, this would be borderline criminal. That is another reason why I do not buy you theory.
3. Test runs are not typically loved by clinics and per graft they are very expensive. I did it nevertheless. But maybe I am overly cautious.
Where did you get that if you don't mind me asking?
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24 minutes ago, Gasthoerer said:
BY the way: Yes it appears (!) you lost some of your native hair. Hard to tell what is the reason for that:
Progression of the hair loss
Shock loss which was permanent as hair was already weak
Transection of the native hair
You can remove progression of hair loss, my hairloss has basically stopped since i started taking fin, just like the last time i started taking fin. It must be transection of native hairs, why did this happen? I have seen cases where Erdogan transplanted into native hairs with good results..
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6 minutes ago, Gasthoerer said:
We are going in circles and Jean answered most of this questions but I have one good reason to write one more post:
1. I have seen a lot of bad results from Feriduni, Bisanga and Lupanzula, but much less than from ASMED. I have seen non of Konior and Cuoto. BUT: Like Jean said, this is about statistics. There are only very few patients cases online of all clinics mentioned besides from ASMED.
2. No, your guess is not as good as mine, as you will make your next steps based on … on what actually? What did you read? Why do you think this is a transection issue? Do you really think they transected > 50 % of the grafts and did not even recognize it at the inspection? IF that is the case, this clinic should be banished from this forum. BUT: Why did the doubles and triples survive if the small punch is the reason for the transection? There should not be any doubles/triples cause they all should be transected even more than the singles.
Side points: Actually you could not even blame the young techs anymore if the reason was the small punch, cause I guess that Erdogan choses the punch size. If transection was the biggest issue of FUE than there would not be million of bad FUT results around.
3. I said several times: Thick grafts or multis in the hairline are typically bad work from the clinic if it is more than a few outlayers. Typically bad work by the techs sorting/implanting the grafts (and not a matter of microscopes). Only apology for the clinic: The singles in front of the doubles did not grow. DO you have close ups directly after the transplant? Can you see multis in the first row (in know some could have been dormant), but it could be a hint. Bad angles and wrong bending are always the fault of the clinic: Typically poor slides by the surgeon and wrong rotation by the techs.
Summary: Transection is unlikely to be the major reason for your results. Could be that this was the issue but it could also be:
- Your grafts are sensitive to the stress during HT
- You are a bad healer or the infection played a role
- The grafts were mishandled after extraction
- The grafts dried out (the small punch size could play a role here)
- Many unkown other reasons...
WHY DO I WRITE THIS. If it is an issue of your body, you have to be very careful about your next step. If the main reason is your recipient does not produce blood vessels fast enough or sth like that, than another transplant especially an FUT would make things much worse. I would recommend to make a small test FUE. Test strip is unfortunately difficult outside of the mFUE from Feller.
By the way: I never thought of going to ASMED, cause I did not have financial pressure and I like a more personal approach with my clinic. I am not trying to defend the clinic, I just want to say that there are many possible reasons and (!) you have to be very careful about the next steps.
Hey mate, thank you for the well thought out and lengthy post, i really appreciate it. From my understanding singles are more sensitive to mishandling than multigraft follicles though which could explain why more doubles and tripples survived. Im confused by your point on transection though, the techs would not have seen that the grafts were transected or damaged during extraction and would have implanted them anyway to my understanding.
I agree i have to be careful, i am not sure what to do though, is there any surgeon that will do a "test" run to see if there is growth?
3600 Grafts - Dr Koray Erdogan 13th March 2018
in Hair Transplant Reviews
Posted · Edited by Payam
Alright i'll bite, i know you don't have the reading comprehension of a middle schooler so the only conclusion i can draw from some of your posts is that you are deliberately misrepresenting what i write for the sake of discrediting me, or maybe you are just trolling for the sake of it, either way i bolded the important part for you;
I have never once PM'd anyone saying they shouldn't go to Asmed, i discouraged someone in this thread of going to Asmed a single time and removed my post quickly after, that's it, and even though i sometimes use harsh language (yes i have used the word "butchered"), i am yet to explicitly tell anyone not to go with Asmed save for that one time.
You keep diverting attention to the facts that techs do the extrations, but one of my main criticisms of this clinic has been the fact that they do FOUR parallel surgeries a day, this is not something they will tell you anywhere and infact you can check out Stephens video where he also talks about how shocked he was about this, and how rushed the surgery was. https://www.youtube.com/watch?v=433AmFqzG6E And even though Stephen decided to go back, you cannot disregard his first shitty experience.
I'm not going to comment on the statistics you keep pulling from thin air, but for anyone that cares Dr Baubac has nearly the same number of clinic posted results as Asmed from 2017-2018, strange that, considering Asmed supposedly churns out 4 times the number of surgeries a day. Maybe Asmed patients don't own cameras to send their updates to the clinic, or maybe the fact of the matter is that a large number of of Asmed results are average AT BEST and the clinic has no intention of posting them online, your guess is as good as mine.
And I won't comment on the naturalness of the case above out of respect for the patient but i will say this as i feel it illustrates my point perfectly: who looks at this and says, "yeah you probably need another 1200 grafts in the frontal third" when his mid scalp is obviously thinning, really? This guy needed 1200 grafts for what? You and me both know any other clinic would have AT MOST quoted half of that to soften the hairline and add some density, in fact there is a H&W case on this very forum where exactly that happened. It's cheaper for the clinic in the long run to cram as many grafts in there as possible now so they don't have to deal with this guy in the future, because they know fully well that their yields leave a lot to be desired. A rushed and tech heavy clinic with 4 patients a day will have worse yields than a meticulous one-patient-a-day clinic. Mind-boggling i know.
And lastly you keep claiming that my case is a simple fix, but i obviously don't want to blow 90% of my remaining grafts in the frontal third to fix a sub par result, not to mention the scar tissue from the first surgery making my case even more difficult, as well as now having to plan around the multihair-grafts placed in the very front of my hairline. I will have to consult several clinics and then think long and hard about how to approach this problem as any sane person would do in my situation, keeping my future hair loss in mind, this is not at all a quick and easy fix.
As for being vindictive, i'm really not, even though i have cause to be based on my experience and the clinics response to it. I recognize that this is largely my own fault for going with this clinic in the first place when their approach was completely wrong for my case. I don't believe anything i have written about the clinic so far to be false in any respect, other than posting one update a week too early which i owned up to.
And please stop talking about legal action, legal action over online criticism is something people threaten each other with in the youtube comment section, it's absolutely laughable that any top 50 clinic would attempt anything of the sort as they know fully well they have no recourse.