duchaine

the treated area was about 35-40 cm2 but I can't see 45-50 FU/cm2.
I think you got at least 1/3 less.

40 minutes ago, shiba1985 said:

Ask Keser. He will tell you. Just so you know, telogen by definition is hair that is fallen out or about to fall out. If it has fallen out there is nothing to see there. EVEN under 100x magnifcation that telogen hair will not be "visible" cause it is not there.

 

 

Thanks GOD!
Wonder why people don't understand a such simple concept. Sometimes a double in first line just happens, because, when you had HT, the hair was not there!
You can increase the image 1000X, it doesn't matter, the hair is not there.
As I wrote above, A graft is 3-5 mm and about 0,5 large. that means that if you use magnificent glasses x 4, you see the graft 1,2/2 CM long and 2 mm large, so you can clearly see if it is a single, a double or a triple.

These are my graft. Maybe  pics can help: you see exactly the same number of hair if you use the cellular or a 126 inch monitor!:

8 hours ago, kutekay said:

Thank you for sharing your thoughts! I've had a tendency to experience dandruff over the years, so pinpointing if the topical minoxidil contributes to it is a bit challenging. I've been using Nizoral as a preemptive measure ever since I began the finasteride and minoxidil routine. Your suggestion to discontinue minoxidil and continue solely with finasteride and vitamin supplements seems like a reasonable approach. I appreciate your insight on this!"

Fina and Minox has two totally different functions..
Fina reduces the damage of HF while minoxidil increases anagen and, presumably, blood flow, that it is crucial after an HT, to have the maximum grafts survival (just think that some doctors prescribe oral minoxidil and Cialis tougher to increase nitric oxide and, thus, blood flow).
About the sides, I won't tell you that it doesn't have sides (I am one of that who had sides from galenic minoxidil (while I never had from Pfizer's) but the sides were a minor swelling around the eyes, maybe related to some excipients) but, according to the studies, they are overrated.
The typical dose for hair loss is about 10% of the dose used ad a therapeutic treatment for high pressure. 
There are several researches showing that oral minoxidil at 2,5-5 mg has no sides and improves hair thickness and hair density.


 

I think that both Keser and De freitas are great and they both are in my top 5 European surgeons.

The topic is "who is better for hairline?"
a) Hairline design:
both DF and K design great hairlines.
Df hairline are charmie and beautiful but, from an anatomical prospective, K's hairlines are close to perfection.
I studied a lot HL design and there are many ways to design CORRECTLY an hairline. 
HL is the frame of the face: from what I see, DF looks for an hairline that fits your face  while K looks for the anatomically perfect HL. 
DF's HL are flatter and wider and with an ottuse frontotemporal angle while K HL are more rounded and (this is the big difference) a norrower angle.
I see that this big difference is related to the (point b) fact that DF usually doesn't rebuild temples (he just makes the upper side) while K does.

b) temples and temporal peaks
K is one of the very few to rebuild the temporal hairline and the temporal peaks.
HL design is a bidimensional concept: the frontal HL and the temporal HL (that included the temporal peaks).
To lower the frontal HL you need to rebuild the temporal HL and, when needed, the temporal peaks. 
It the doctor doesn't rebuild the "sides", you don't have support for the frontal hairline (to have a clear idea, look the Norwood scale. You will see that the tuft and the temporal peaks recede almost at the same time).
If the doctor doesn't rebuilds the sided and tries to lower the hl, the coupe effect is almost guaranteed.
The doctors usually don't rebuild the sides because they are the most difficult part of an HT: the hair on the sides are perpendicular to the floor and have an angle of about 5°.
So, ythe doctor and his assistant need to be very skilled to work on that.
To make things harder, the temporal peaks are made of small hair, that are very hard to extract and tom implant.
The fact that K rebuilds the sided (included the temporal peaks), shows how skilled he is.

c) miscroscope
I don't know if Df uses miscroscope but I see people criticizing K because he doesn't.
First of all, people make a lot of confusion between magnificent lens and microscope.
It is important to understand the difference because sometimes I read people (that do not have clear the difference) saying that Keser works on naked eye. Hell no!
The magnificent lens are usually x6 glasses (sometimes x4, others x8) while a microscope is an iHT nstrument to increase the imagine 20-40X.
Dr Keser and his team use magnificent lens. In the link you can see him in the op room using the glasses.
https://www.youtube.com/watch?v=rlAudYZBvM4
He doesn't use microscope.
From my prospective, microscope is a marketing tool. Do you need microscope to select the graft? Or the magnificent glasses are more than enough?
I suppose that who says that a microscope is "mandatory" or "necessary" to select grafts never saw a graft in his life.
For sure he doesn't know what he iw talking about.
A graft is 3-5 mm and about 0,5 large. that means that if you use magnificent glasses x 4, you see the graft 1,2/2 CM long and 2 mm large, so you can clearly see if it is a single, a double or a triple.
By the other way, the microscope has a big DISAVANTAGE: TIME!
selecting the grafts with miscroscope requires time.
Now, we know that after 3 minutes the surviving rate goes down (from 100% to 95% and so on as time goes).
Does it make sense spending time with a microscope (risking grafts death) while you can have a clear picture of the graft using magnificent glasses?
Everybody is free to choose the doc he trusts, but blaming K because he doesn't use miscroscope is BS.

My end result:
I think they are both great. 
DF has more an "artistic sense".
K is more skilled and anatomically perfect.

 

On 5/22/2022 at 11:47 PM, MachoVato said:

As perfect of a hairline as you can get. He was my very first choice for a transplant, but the pandemic changed all that.

 

Did you change because the pandemic or because the doc had family issues?

On 5/19/2023 at 1:46 PM, mr_peanutbutter said:

is it even worth it to get ht for 1 cm?

yes! If someone has a smaller recession, it makes a HUGE difference.
Sometimes, in aesthetic medicine, the smaller procedures are that making the biggest difference.

On 6/10/2023 at 7:57 AM, mr_peanutbutter said:

isnt he 3.5 eur per graft? isnt defreitas s better option at that price? 

don't think so. 

46 minutes ago, Kashnw7hope said:

HLC is a hair mill now, ruined my scarce donor and not for a great yield. Stay away, much better Docs to choose from. 

do you have a report?
 

When you lose great amount of hair all at once, it is simply a telogen effluvium.
It can be a natural process that simply occurs (life sucks!) or it can be induced from your therapy because, to allow a new growth, you need to remove sleeping hair (hair in castagne and telogen).

My suggestion, in any case, it: take your pics with artificial, replicable  lightings and use always the same camera and the same angles.
From what I see, in the first set of pics, someone took that or you, in the seconds, you took by yourself.
To me, the lightings appear different too.
Sometimes, just a little difference in lightings, make a huge difference in pic.
To show you, I attach 2 pics of mine, taken 2 seconds apart.
In one I look bald, in the other, I look "normal".
Surprise surprise, the more lightings I had, the less bald I appeared.
In fact, in the bald pic, I have pic only from the back, in other I had lights from the back + light from the front.

1 hour ago, gillenator said:

 no I have not seen any other clinic take this same approach to substantiate a plan for the recipient area.

Because you have more experience than me, can you explain me please how other clinics calculate the number of grafts that need to be used?
I suppose that, after the doctor sees me and say "ok, you need hair in this area", he will "analyze" my hair and will say "guy, you have medium caliber hair, to get a good coverage effect you need X amount of FU/cm2". After this, what happens?

@gillenator @Gatsby

If agree with you but what you said is not relevant to my topic.
I am talking about my case, where I paid for 2050 FU.
I have some doubts that I really got 2050 FU.
First of all, they said that the recipient area was 41, while il was 36.
Second, they said that the recipient area was going to receive 50 FU cm2 but, considering that the area was smaller than they said and part of that area was covered of hair, in the "bold area" I should have get 70+ FU/cm2.
I don't think I got so much FU...

Mecroneedeling is a safe and inexpensive procedure DIY.
"Dermal papilla (DP) is the site of expression of various hair growth related genes. Various researches have demonstrated the underlying importance of Wnt proteins and wound growth factors in stimulating DP associated stem cells. Microneedling works by stimulation of stem cells and inducing activation of growth factors".
While it can be discussed to use MN as a mokotheraphy (but the question is: why should someone use MN only?) there is no doubt about its efficacy, showing a synergistic effect at least in conjunction with minoxidil.
I just quote a study "While the current evidence does not allow one to conclude superiority of microneedling over existing standard therapies for hair loss, microneedling shows some promise in improving hair growth, especially in combination with existing techniques".
I've read dozen of researches about this topic and all the researches show an improvement.
At the moment, is you are looking for safety, the best way is MN 2/week, 0,75 mm.
Studies has shown that higher frequency, shorter needles is better than lower frequency/higher needle, while other showed that an higher intensity and lower frequency is better (tI suppose that the efficacy of this kind of therapy is age related, as I discussed with a very smart guy on this board).

Look for a derma pen or a dermoroller. You will find a lot on amazon.

I see people speak without any cognition of the topic.
If you want to do your own researches, these are good starting points:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/
https://pubmed.ncbi.nlm.nih.gov/29194786/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064188/

masterpiece!

I will tell you my experience about grafts counting and I will share with you my perplexities about the real amount of graft that I got.
NOTE: I can't say if all the doctors and all the clinics calculate grafts in the same way.


1) hairline design and area measurement 

The doc designed the hairline.
Then he put a plastic transparent sheet on my head and retraced the hairline on the head.
The sheet had squares on it. Every square was 1x1cm, so 1 cm2.
In my case, he calculated 41 cm2 (the doc wrote the number on my head)

2) follicular units calculation

After the doc calculated the area, he decided the density
In my case, he said that I needed 50 FU/cm2, so he concluded that I needed 2050 FH

My perplexities

1) wrong measurement of the recipient area.

If the design barely touched one square, the doc calculated) 1 cm2.To show you what I mean, I attach a pic.
In the pic that I attached, I calculated the area as the doctor calculated the area for me.
So, using their method (if the line barely touches the square, is considered 1), the end result is 19 cm2.
But, if you see the image, you understand that the area is smaller, because some squares are not completely filled.
So, if the squares were not completely filled, the recipient area was obviously smaller than they said.
To see if I was right, I tried to calculate the trasnplanted area by myself.
It is not an easy operation, because all the surfaces are elliptical. I won't bother you with the calculations I made but my  friend (an engineer)  said they are ok.
The real treated area was 36 cm2
Making the math, 2050:36=56,94 FU/cm2.


2) bogus follicular unit calculation
If you see my pic, you will see that most of the recipient area still had hair.
I suppose that an area that has hair is not able (and in any case, has no need) to receive 50FU. Usually, from my readings, I see that the area should receive something between 30-40 FU/Cm2.
Because I am doing the math in good faith, let say 40.
Considering that half of the area was covered by by hair, that means 18X40=720 FU. Ok, we say 750 to be fair.

CONCLUSIONS:

If the clinic really extracted 2050 FU, according the the previous calculation, we have some really bogus number for hairless area.
According to that calculations, the hairless area got 1300 (2050-750=1300)
We said that the hairless area was 18 cm2
Now, 1300:18= 72 FU/Cm2.
That is not what I got and, for sure, is not the density I have.


 

On 11/23/2023 at 2:54 PM, Den said:

Hey everyone,

I want to share my hair transplant experience with Dr. Keser in Ankara.

I am 33 years old and I have had hair loss for 10+ years.

Upon my arrival at the clinic, a very friendly and professional team welcomed me.

Right after I arrived, Dr. Keser started examining my hair. We discussed the ideal hairline, and he took pictures to document the process.

The operation spanned 4 days, with a breakdown of 650 + 650 + 650 + 600 grafts per day.

Dr. Keser was involved throughout the entire procedure, including the dressing part as well.

My observation about Dr. Keser is that he is very meticulous. He has his own standards, and until he reaches them, he is never satisfied. He never rushes things and he ensures that everything is perfect and aligns with his standards. I could feel that he really gave great care to each graft while extracting and implanting.

Regarding the nurses, Mrs. Senem has been working with Dr Keser from the beginning (since Dr Keser started doing hair transplants), and she has 20+ years of experience in this field. Mrs. Funda has been working with Dr. Keser for 10+ years and also has a lot of experience in this field. I mean, they really know what they are doing. Thanks to their help and guidance, I was calm and informed during the operation.

Overall, my experience with Dr. Keser and his team was very good. I truly felt like I was in good hands throughout the entire process.

I am sharing my photos below. We will see the final result together.

Spettacolare!!!!

You said that Keser took 4 days for 2400 FU.
Can you elaborate?
Why did he take so much time?
Does he male "mini" HT on several patients for several days?
 

On 11/30/2023 at 11:28 PM, toon_toon said:

I saw Konior really mess up a patients hairline recently. (Too dense and misangeled) And seems like he doesn’t take criticism about this too well 

I am not a big fun of Konior and I don't know very much about his works but a single case can happen to every doc on the planet.

Does Konior always try to reach that density? I read a long post from the patient and if I well remember, it was like a "case study".
 

19 minutes ago, jjalay said:

I never offended you and never cutted your statement, i just quoted the points that doesnt make any sense at all.

Talking with you is like talking with a 4 years old baby with the mouth dirty of chocolate. 
"Did you eat the chocolate?" 
"mmm...no, I didn't!".
The big difference is you are an adult man that should be responsible for his words..

42 minutes ago, jjalay said:

 

Trying to show that I was was contradicting myself,

8 hours ago, jjalay said:

Direct quote from you once again:
"As an old HLC patient looking for a second HT, I can say I won't go there and I won't consider turkey in any case.
The post op care was very poor and, just like you, I waited months to receive my pics."
And couple days after:
"I'm an ex patient of HLC. My experience was good, the end result was very good but I do not hesitate to say that the clinic has some flaws."

So sad that my whole statement was:

9 hours ago, duchaine said:

I'm an ex patient of HLC. My experience was good, the end result was very good but I do not hesitate to say that the clinic has some flaws: a) they over use grafts; b) I don't like the attitude that some doctors have with the patient; c) they after care is very poor.

Never saw such stupidity and "intellectual" dishonesty at once.

46 minutes ago, jjalay said:

I wont comment any further in this thread 

Once in a while, I support you.

24 minutes ago, duchaine said:

You are spending your whole day searching and quoting my old post and than you pretend to talk about my " state of mind". Really?
You are such a pathetic character that I would not waste my time with you. But you really crossed the line.
Did you really try to cut my statement to say that I'm contradicting myself? A statement that is just above your post and everybody can read?
What a poor man. Your dishonesty  is second only to your stupidity.


"I'm an ex patient of HLC. My experience was good, the end result was very good but I do not hesitate to say that the clinic has some flaws: a) they over use grafts; b) I don't like the attitude that some doctors have with the patient; c) they after care is very poor."

Get a life.
 

6 hours ago, jjalay said:

Direct quote from you once again:

"As an old HLC patient looking for a second HT, I can say I won't go there and I won't consider turkey in any case.
The post op care was very poor and, just like you, I waited months to receive my pics."

And couple days after:

"I'm an ex patient of HLC. My experience was good, the end result was very good but I do not hesitate to say that the clinic has some flaws."

 

 

You are spending your whole day searching and quoting my post and than you pretend to talk about my "the state of mind". Really?
You are such a pathetic character that I would not waste my time with you. But you really crossed the line.
Did you really try to cut my statement to say that I'm contradicting myself?
What a poor man. Your ethic is second only to your stupidity.


"I'm an ex patient of HLC. My experience was good, the end result was very good but I do not hesitate to say that the clinic has some flaws: a) they over use grafts; b) I don't like the attitude that some doctors have with the patient; c) they after care is very poor."

Get a life.
 

6 hours ago, Jlee said:

Thanks buddy yes I’m fortunate to have a good head of hair and my hair type is very thick so it helps with coverage, 

keto/low carb definitely is a massive factor when I’m eating low carb high fat let’s say only a few bananas per day everything else is protein and fat alot of coconut cream my hair looks night and day different skin as well, 

about the surgery il think very carefully and make a good decision I don’t think im going to be in trouble with either decision because going off my hair loss since the HT in 2017 it’s pretty slow, and im got a decent donor and very thick beard still so I can use these to make my top better 

I was talking about ketokonzaole...not keto diet!

in 60-70% of cases, rebuilding temples is crucial for creating a natural hairline.
Temples are the foundation of the frontal hairline. If you dont't have and you try to lower the hairline, the hairpiece effect is guaranteed. 

@jjalay

risum abundat in ore stultorum.
Get a life.

in my humble opinion, you don't need another HT.
If you don't like the HL, you could look for a small procedure with Ferreira, couto or de freitas.

On 10/28/2023 at 3:54 PM, FaganBecker said:

May I ask how you can tell? I had to get quite close up to notice that. Is that something that is quite obvious/ damages the result to the more trained eye? 

So far I am quite satisfied with how it's going and am reasonably optimistic about what it might look like 3+ months from now. Should I be more concerned about the multis? I was told HLC was basically the crème de la crème of HT places in Turkey. Is this many multis not necessarily a sign of sloppy work?

 

Ah sorry, when I asked about minoxidil's skin impact, I was referring to managing the extent to which it ages skin. I have a few friends using it, all of whom similarly look exhausted the whole time. Dark bags under their eyes and oddly unhealthy complexions. They all attribute it to minoxidil! 

It could be true for oral minoxidil (and it is not) but is almost impossible for topical, because the very low systemic absorption.
About your HL: I can see just one double in first line but maybe a couple of new single are implanted in front of it and are still hidden under the skin.

I really like portelli's work.
It would be nice to see more of them