asterix0

24 minutes ago, Fox243 said:

Sure, I don’t think I properly clarified. Dr. Zarev is one of the few doctors who is willing to overharvest for a NW7 to get good coverage. My question is whether you could get more grafts as a nw7 via FUT + FUE and leaving hair long  or only FUE and overharvesting such that you have to leave your hair short.

Intuitively, an FUT cross section of a sparse donor area would not seem to yield good results. Also, keep in mind the scar stretches, which seems to happen more often than not, that is more potential donor that is compromised which could have been used to extract good FUE grafts.

I think in 2023 FUT really is an outdated procedure.

Pimples are normal, just do not deliberately go popping them and make sure your head stays clean so they don't get infected. 

1 hour ago, Fox243 said:

I’ve been doing some deep dive analysis with FUT vs FUE for NW7s and I’ve come to a crossroads.
 

Traditional wisdom said max out via FUT then do FUE in areas FUT can’t reach. You need to keep your hair long. At the same time, we’ve seen doctors like Zarev basically over harvest the donor such that you’re forced to keep your hair extremely short.
 

Ideally, we could combine the two but unfortunately, one will require you to keep your hair long and the other short.

 

Which technique will end up getting more grafts? 

You don't understand, Dr. Zarev will only over harvest the donor with the patients consent if he is a Norwood 7 with a below average donor area, if conventional wisdom to transplants is applied, to get adequate coverage.

He will never deliberately over harvest the donor. His surgical technique, surgical tools, and attention to detail allow him to obtain more grafts than other surgeons can. 

@GeneralNorwood if you are happy with your results do not listen to me, but my humble recommendation is to get a skin level fade for your temples or some electrolysis. They are too straight and the grafts are too thick in my opinion, something looks off even for a complete hair transplant layman or person on the street.

Also, brush your hair forward I think it looks better than the slick back style. 

See for example Beckham here:

His hairline has that natural softness in the front and unevenness. 

Yes, by 6-7 months particularly in the front and midscalp it will be pretty noticeable if you will have good growth or not.

Back part and crown around 9-10 months. 

@mustang I will let you know, when my mpb started I tried every single natural ingredient under the sun, with various levels of dosage strength.

I tried topical "natural" anti androgens much stronger than what you are trying and it did not help me.

Granted, I was in my early twenties and balding in a Norwood 6 pattern.

Thanks for documenting this, I will be following closely!

1 hour ago, Tscott said:

Good morning everyone, coming to see if I can get some info on some reputable transplant surgeons in the us for my hair transplant. No I do not want to go out if the states. If anyone has had a hair transplant with a U.S. doctor and has a review I’m all ears. Thanks!

In my opinion Dr. Konior and his apprentice Dr. Nadimi are some of the best US options. Also Dr. Shapiro. 

On 6/7/2023 at 5:22 PM, general-etwan said:

You guys can have a sleepover and indulge in your perspectives together, then!

Let me state clearly again, so no one feels compelled to use phrases like "regardless if he did or not" anymore: I have never used or purchased hair fibers and if I ever do, you'll all hear it straight from me right here. I am 100% transparent with everyone always and for GeneralNorwood to state a completely fabricated idea as a fact and then ask me condescendingly to confirm it as such...that is mal-intent or a serious personal-attitude problem.

GeneralNorwood seems like a fun guy to have a sleepover with but I think I'll pass 😃.

The point is, your thread has attracted a lot of attention because your case is very interesting, any hair transplant enthusiasts would be interested to see your result, which I think has been very good so far.

Sorry if you got offended by the insinuation of fiber use, I think from the discrepancy of the pictures it is not out of the realm of reasonability to wonder how there can be that much of a contrast in the various lighting conditions.

I do think the use of grafts for your temple points is interesting also, normally in such high Norwood cases it is preferred to use the grafts for the limited coverage on top. I am (was) a Norwood 6 before my transplant, so I understand this thinking. 

1 hour ago, GoliGoliGoli said:

To be fair, GeneralNorwood is kind of doing a community service here. Maybe he could have been less accusatory about it.  But if people are posting pictures of their results that give an overly optimistic portrayal of their results (Compared to reality) whether through using fibers or using flattering angles/lighting, that should be mentioned. You have a duty when posting results to portray them accurately for future forum members doing their research. You've been very honest and deliberate about doing that in your own case Melvin, and it's highly appreciated so people can get a realistic expectation. In my own thread I recently posted two 6 month result pictures and made a point to say "Here's one in harsh lighting and conditions and here's another in flattering lighting and conditions". 

This forum is a lot less useful as a tool if people are posting flattering pictures. I don't think Etwan was deliberately trying to mislead anyone as obviously he later posted less flattering pictures later on, but I do think this is something the community needs to be concerned with especially when it comes to very difficult cases. The standard should be posting pics in sunlight so that there is a general standard people adhere to. For clinic posted results, it should be stipulated that there must be a video with a comb through. I don't really trust any of the clinic posted results on here tbqh, and I'm starting to not really trust patient posted results either.

As far as Eugenix, I don't think they ever should have taken this case. I'm sorry to be brutally honest here, but I think it's worth saying. Not everyone is a candidate for HT surgery. The strategy for the 2nd surgery seems not great either because there aren't enough grafts to fill in the balding area. But even if there were Etwan's balding is going to continue and eventually there will be a disconnect again between the donor and the recipient. I think Etwan has a great option to solve this by sticking with his haircut from April 12th, but one way or another over the long term he's going to need very regular fades to achieve a natural result. 

I also didn't think GeneralNorwood had bad intentions. I thought the difference between that picture and where the lateral humps were barren were because he used fibers as well.

Regardless if he did or not, I think using fibers in that area would be a good plan, and the other grafts can then be used to fortify the hairline and other areas that people will directly interact with/see. 

I think OP has already come a long way from where he started and he should be over the moon with his results. I'm personally happy for him that things look to have turned out brilliantly, he looks a lot better and younger.

15 hours ago, general-etwan said:

That is true but it's not like survival rate of grafts of other top surgeons lags far behind. It's already in the 90%+ and so Zarev isn't relatively that much higher. You can only get to 99%.

I think Zarev simply harvests from the entire head, way outside the traditional safe donor zone, and does so in a very calculated and proper way in terms of density distribution, so that when it all grows back, there are no obvious areas that stand out as having been over-depleted.

Not everyone goes to Norwood 7. The Norwood 6 zone is perfectly harvestable for many patients, see @Melvin- Moderator

26 minutes ago, Turkhair said:

He’s good but there’s nothing extraordinary going on here. 

Good donors and he seems to deplete the donor area completely to give coverage to the front. I don’t know how I feel about that having seen a person with a balding donor area and balding at the front too. It’s not a pretty look, even worse than frontal balding, donor area balding looks much worse. The frontal hairs then look like a toupee.

He does extract in a good way which makes the area look thin all over instead of in certain places.

I think the guy in the bellicapelli forum should have instead used body hairs. Once his donor area thins further, it’s going to look super weird balding at the back and having hair in front. He’s doomed to use finasteride forever

Good that you aren't a fan...one less person to go on the long waiting list 😀

13 hours ago, Fox243 said:

ugh we need this so bad -- i can't wait almost 5 years to get a surgery done.

I know I understand your frustration. There are some doctors that get close though, but are very expensive. Dr. Konior in the USA for instance, if you do not need a gigasession. 

23 minutes ago, mr_peanutbutter said:

he needs to train other surgeons; everything else would be almost unethical 

He has said he wants to but has found it hard to find medical students who are good enough I think. 

2 hours ago, mr_peanutbutter said:

holy smoke

 

so how is he doing it? and why cant other replicate it? maybe fuegenix is close but they havent done such results on high norwoods…

A combination of extreme surgical skill, innovative technology he uses in his practice, and he is simply a genius. 

@general-etwan There is no reason to stop finasteride prior to your procedure, or after. You can (and I believe should) continuously use it, unless you experience side effects. 

Always consult with multiple doctors, preferably top clinics.

You can also do some estimates yourself. Take a tape measure and find the square cm area you want to implant. When you consider a transplanted density of about 40 grafts per cm^2, you can approximate how many you'll need. 

If I were you, I would consider getting on a DHT blocker either topical or oral to protect your transplanted hair. You have weaknesses in your donor area unfortunately that indicate your recipient may thin over time. 

22 minutes ago, Big Rome said:

even if you only shave the recipient and not the whole head you may be able to conceal the recipient area with the remaining hair, that’s what I did anyway 

If I shave the recipient how can I conceal it?

Shaving the donor is a must so that I know I would have to do.

1 hour ago, Gatsby said:

The best thing to do before surgery is to shave your head a couple of months before the date of surgery. That way you colleagues/friends will be used to seeing you like this. When it comes to a no shave hair transplant personally my opinion is that anything that makes it more difficult for the surgeon/techs is not in your favor. You want all the stars to align in your favor. Also you will be surprised how happy your friends, colleagues will be for you if they knew you were having a hair transplant. I went back to work and the only people who knew was my friend and boss who were in my corner about doing this. All the best. 👍

Already had one bigger 4k+ graft session where I shaved so I know how the whole rodeo goes. This is more of a touch up procedure, but was hoping to just conceal it a bit more...but what's a bit with a buzzcut in the long run, not a big deal I suppose...

32 minutes ago, Z-- said:

Bro, just shave. IMO not worth the extended surgery duration + higher risk transection (which some doctors seemingly cite and others are less worried about). Just maintain a buzzcut for a few months. 

Even if co-workers see, don't worry about it. Jobs and co-workers are temporary; most people don't last more than 3 years before changing things up. A transplant is meant to last you a long time, and that's what you are going to see in the mirror day in day out.

I've already had one transplant where I shaved my head so I know how it goes...but fortunately I worked from home during the ugly duckling stage so no one saw me haha.

This will be a little trickier, but I don't look terrible with a shaved head either way. I was hoping to just conceal it better. 

I have an upcoming FUE procedure where I was told in theory that not shaving the recipient area will not affect my yield, it will just make the surgery last longer.

I anticipate it will be something in the 1500-2000 graft range.

My question is, since I recently changed jobs I really did not want to shave my recipient area and sort of hide what was done as much as possible. What I am concerned with is keeping my head clean post op, and that having longer recipient hair will make it more difficult to follow proper post op care.

Is this concern valid? 

Also, I will take a week+ off from work, so when I come back it will look like a buzzcut mostly. The main issue is the ugly duckling stage when all the grafts fall out, where then it will be obvious and my appearance won't able to be fixed even with fibers, since the hair length wont be long enough.

To add, I will just be adding density to the hairline and midscale, not lowering the hairline. 

Yes you did, unfortunately you are going to Norwood 7 now, sorry this is common knowledge. 

It is a two way street to be a well informed patient and communicate to the doctor what you want as clearly as possible. If this is the guy who went to Dr. Konior earlier, he does seem to have issues of not quite understanding what the possibilities and limitations of hair transplantation are.

Nevertheless, I do agree that the clinic should be able to respond to the claims before any judgement is cast.

If what he said is true, it is a disappointing result indeed and I understand his frustration. 

Watch this video from Eugenix to get an idea about transplanted long term maintenance:

https://youtu.be/rJctY_jvd6U