Cristero

A really good outcome. Congratulations.

I agree with you. I think they should have aimed for a better density on the first 1 cm of the hairline and they gradually decrease density while going towards the mid. But as @Curious25said they covered a big area with few grafts and it seems the yield rate has been pretty good.

The only one missing on the Pekiner's section on the Italian forum is the Russian guy, who did a mess there as well and he has been kicked out. Other famous surgeons had cases removed (not only one) for patients misbehaviour or because they reached an agreement with the patients and they took it down.

That's interesting. Is that true @Melvin-Moderator? I keep hearing the story of people getting a discount for their report as an argument for Pekiner's bad ethic and I don't really get it. It actually shows the doctor is confident to deliver a high-end result and he's not afraid of people showing the outcome on forums. He's trying to build a name, like all the surgeons in the industry.

That's the case of the Russian guy we all know. I've been told the guy was far from being honest, but I won't say anything else, as I just know what I've been told.

Melvin, 2 clinics I have consulted before choosing rejected my case, saying I still had too many hairs (being a diffuse thinner) and there was no way to avoid shock loss or that I should be on medication, not having an HT performed. One was a clinic you recommend here. Pekiner on the other hand didn't have any issue with that and was confident implanting between native hairs and avoiding shock loss.

Same as above. I think you should go and translate the threads with Google translator to have a rough idea of what is written there. The moderator/rep never did anything to discredit the patients concerns or deleted any comments. There are 2 cases in particular that I remember: one young guy who lowered his hairline by far and everyone was saying that the doc was unethical etc etc. Then after 6 months the hairline was looking pluggy and everyone saying that was a bad case etc etc. Eventually it grew up really well at 12 months and result was great. No comment was deleted. The other one is a recent one with a guy that has been expressing his concerns for not growing well at the 6 months mark and everyone was telling him to wait until 12 months, but he was still saying his transplant wasn't successful. He changed his mind completely at 12 months. No comment has been deleted. There are also several other Pekiner's cases on a German forum and they are all good. Do you want to elaborate a conspiracy theory for that one as well?

I don't know if you understand Italian, but if you went through the post you could have clearly understood the threads were real because some patients expressed their concerns during the journey. Also they are updated month by month, it's not guys coming in and posting their before and after. Several of them were users of the forum since many years, sometimes had a transplant with other surgeons and went to Pekiner for a repair or second pass. So I don't really know how the fact that Pekiner's rep is a moderator on the forum could be relevant. He was a moderator on the forum since many years ago and got his first transplant with another surgeon, then went to Pekiner for a repair.

Ah let me add that I met Dr. Sethi from Eugenix in NYC and he gave me a really good impression. If I was a high NW, I would have gone to Eugenix or Dr. Zarev in Bulgaria, but for a refined job on the hairline, I decided Dr. Pekiner was the man.

I've had my transplant with Dr Pekiner 3 weeks ago and I can confirm the doctor ethics and skills. I had 5% of miniaturized hairs on my donor but the others were thick caliber and he used those for the hairlines and crown. I've never seen better and more natural hairlines done by anyone else, apart from Dr. Couto and Dr. De Freitas in Spain. You can see it by yourself in an Italian forum through real patients reports: This forum is a it biased negatively towards him due to the bad behaviour of his rep in one case. Then my HT could still be a failure, I'm in early stages, but I can tell you the doctor has been proven to be super professional and really human.

2 objections to your claims: - If you have found a revolutionary way/tool in your industry that brings you to the very top of it, why would you share it with your competitors? Do you think surgeons are doing their job for the sake of balding people mental health? If that was the case, you would have seen much different prices; - even if he wears a hairpiece, what does it have to do with his ability as a surgeon or his credibility? I'm not following your logic here.

Couldn't have said it better myself. Also, I'm not Bulgarian, but I need to point out that Bulgaria is the leading country in the CGI and VFX industry. Softwares that are used for Hollywood's high end VFX have been developed in Bulgaria by Bulgarian people. There are studios which did the whole special effects scenes for the main movies in the past years. So if they mastered that industry, I don't know why it's not possible for a Bulgarian talented doctor to be one of the best in the world.

Another thing that makes me think Dr. Zarev is legit is that got the endorsement from Dr. Rassman. Dr. Rassman added on a comment to a thread on Reddit: "To get 14000 grafts from the donor area without causing significant depletion and a see-through look, you would have to have a coarser hair with high density, a rare combination of metrics. I saw his presentation in Europe and the patients who had these high number of grafts has (1) very high donor densities and (2) he harvested outside of the permanent zone which means that some of these hairs are subject to apoptosis (death from genetics) something I do not do. There are some doctors who believe that since the Class 7 pattern is rare (about 7% of the population) most advanced balding men will end up as a Class 6 pattern. Under that assumption, harvesting the donor area of a Class 6 pattern of balding yields easily 60% more grafts. If the doctor is wrong, and these patients fall into that 7% group, then the 60% of the hairs that were transplanted will fall die and fall out. Being conservative, I don't go beyond the Class 7 donor area and that is why for advanced balding patients I generally recommend Strip (FUT) surgeries rather than FUE surgeries. By the way, I coined the term FUE and published it with the first paper ever on the subject which you can read here: https://newhair.com/wp-content/uploads/2018/11/mp-2002-fue.pdf William Rassman, M.D.” We can all agree that, even if the insane results are only 41 as it has been said, I never saw any clinic getting even closer to that. I'm just curious to see if there are patients reports online.

Those are the same areas where H&W are harvesting and a couple of us on this forum are trying to understand the reason for that, especially on patients that are not even in their 30s. So it's not just Dr. Zarev doing that.

Ha! Yeah sorry, I wrote it wrong. I agree completely with you on the money part. I chose Pekiner for the full manual FUE procedure he's experienced on and for the great patients report I've seen. Also my main target was the crown and I saw him doing an insane crown reconstruction that finally convinced me to choose him. We will see if I took the right decision. Good luck with your journey pal and hopefully you will have a great regrowth and be done with this cross.

With dr Peniker in Ankara. I will create a thread when I'll have the pictures from the clinic. Because DHT is just part of a bigger picture and oral finasteride just take care of a percentage of it in the scalp. You still have testosterone miniaturizing, along with the normal aging of all the follicles throughout the years. A good number of people still lose ground with finasteride. That's why I said a good European surgeon would have used less grafts, aiming at a better survival rate, making you save a good amount of money as well. In any case, it seems you did an educated choice, so I hope everything will go well for you and you won't head towards NW5 like your dad. Maybe you inherited some genes from your mom and that, along with medications, will preserve your hairs and donor.

How do you establish a "safe zone" for a 29 years old though? I guess the patient needs to provide a family history of AGA progression in his relatives or pictures. Is that correct?

I've already had my procedure done and I did a dense pack on the hairline (50 grafts per cm2) and rebuilt the crown with the swirl. Time will tell how the HT will turn out to be. What I was trying to say is that you can clearly see in your case (like in my case) that the whole NW6/7 area is being affected by miniaturization, with hairs being less dense and thinner than the rest. Hence why I was saying that they extracted too high in my opinion, in an area that isn't really safe. I truly really hope for you that finasteride is gonna maintain as you said for 20 years, but I highly doubt it. I'm not a big fan of any North American surgeon to be honest, as they do great FUT, but I never saw good FUE results, unless they use an unnecessary high amount of grafts. And I'm talking mostly about H&W. I know many will disagree with me, but that's my opinion. Without considering that you would pay at least the double of the price of an experienced FUE European surgeon. What's the history of AGA in your family?

Does anyone else think that some grafts were harvested too high? The OP is clearly a diffuse thinner like me, you can see the whole "horse shoe" being less dense than the occipital area and the sides. They went to extract right at the border of the thinner areas.

@Melvin-ModeratorYou know me since a while now, and you know I was looking for a surgeon and then eventually decided for Dr. Pekiner. I'm glad I did and I hope the results will turn out to be good. Time will tell. Thanks @Portugal25 for the encouraging words. Now it's all about patience and taking care in the post-op. Biggest challenge for now is to stay away from lifting heavy weights for a while. Feels like a torture :D.

Did you see any further progress with your HT btw @Portugal25?

Not sure @Portugal25, but this is what I got from @Melvin-Moderatorlast time I spoke with him privately. That Pekiner's patients report weren't allowed on this website anymore. @Melvin-Moderatoris that correct?

Just to chime in after coming back from Ankara, where I had my procedure with Dr. Pekiner. I will skip the report with him as per Melvin's policy, even if the doctor is truly amazing and I would advice him to anyone. I asked specifically about the topics we have been discussing here. His opinion about transplanted hairs is that they don't fall. What happens to some of them is that they get thinner with age and AGA and that's why I was having 5 % of them on donor that were miniaturized. But they remain full length, unlike what's happening on the recipient area. He told me that there are different opinions among surgeons though and this is just his opinion. So basically we don't know, but it seems that surgeons are moving away from the concept of so called immune hairs. Regarding the topic of treatments and beard grafts, he wanted to implant some beard grafts in the beginning, but when I told him that I'm under treatment with clascoterone and other topical anti-androgens, he changed his mind and we decided to leave the beard grafts for the future if needed. That means he is fully aware that hair loss treatments are counter productive for bears grafts, but he evaluates case by case.

You are getting all heated up for no reason and acting like a child. I didn't say your study is something to look over. I've actually been the first onn to say that new studies debunked the high prostate cancer link to 5-ar inhibitors, but I wans't too convinced of them yet. And the reason, once again, is that things are still up in the air, with a lot of may or might. What you are saying on the second link is something I've been talking about since a while with people obsessed about DHt serum levels and something Italians dermatologists know since a while. Some of them request a serum 3a- androstanediol value to understand enzymatic activity in tissues and even that is not giving you the whole picture. You would need a scalp DHT biopsy to understand what's going on. In any case, even if the latest studies didn't completely shed light, how can you categorically exclude it, when some doctors are still reluctant to prescribe 5-ar inhibitors? And most of all, what's your contribution to the topic? This is not a post about finasteride side-effects, rather a thread regerding the alleged usefulness of finasteride on the donor.

That's what we have been saying. The actual studies didn't figure it out yet and, as you can see, the conclusion is still to be found. I see a lot of "might". The jury is out there regarding the impact of 5-ar inhibitors in terms of prostate cancer, while you are clearly taking a side.