JohnBob

On 12/24/2020 at 4:48 PM, Melvin-Moderator said:

You’re absolutely right in your thinking, I too was fooled by my hairline. For the longest time I would say I was a Norwood 2, but the reality was a diffuse Norwood 6. 

Now, are we a lost cause? No, but you either have to be committed to medicine, or lose most of your hair before you consider having surgery.

I would easily prefer be a NW6 diffuse thinner with a NW1 hairline like you were than to be a slick bald NW6 obviously.

Meds seems to work much better in diffuse thinners in comparison to totally bald scalps. (btw have you tried meds Melvin?)

Also, you would still good ok from the front because you still have a hairline and most people will never look at your scalp from the above angle, so most of your hair loss would be unnoticed. 

And if the person decides to go for an HT, the hair left on top, if at least main tended, will help to make the end result look more dense. 

I think the only bad scenario for a diffuse thinners are if they are thinning all over the scalp - even in the "safe zone" areas. In those cases you are not eligible for a HT and if the meds don't work you are royally screwed. 

• Dr. Lorzenzo (example: 10,377 Grafts https://www.youtube.com/watch?v=iXSg1yeiulg)

• Dr. Zarev (example: 12,890 Grafts https://www.youtube.com/watch?v=QylaivmGvbg)

Any other doctors?

double post

2 hours ago, mustang said:

This is absolutely untrue

9k to 12k is done by many top european doctors, their cases are all over.

Other than Zarev and Lorenzo, who are the other doctors performing 9K+ scalp graft FUE restorations? I would love to know. 

3 hours ago, aaron1234 said:

I'd take C-section scars for a NW 0 any day of the week.  Show off! 😜

FUE in a scar is not a sure thing because of the scar tissue, but you're only talking 300 grafts so there's not that much at stake here.  I'd go the FUE route for sure.

Me too, easily!

1 hour ago, Yolando said:

Thanks much appreciated. 
The doctor as recommended going with FUE for the second pass. 
The scar is great but slightly noticeable when my hair are cut very short, see pictures below :

 

The scar looks very minimal even when the hair is cut short. Impressive. 

Thanks for documenting the back of your head as well! Makes me a little less scared of FUT.

So I came across this thread on another forum (thanks to @SLA) showing a guy having 16,500 grafts implanted with 4 sessions over the span of 2.5 years. 12k grafts were BHT! And the end result is amazing!

The guy must had crazy quality chest hair, all the implanted follicles in his head looks like normal scalp hair. But also what a great job the people at Eugenix have done. They have lots of well documented cases where BHT hairs were used, they must be the kings in that type of procedure. 

Bravo guys!

And also important: while most (if not all) FUE doctors won't extract more of 6k grafts TOPS from the scalp of a patient, Dr. Zarev can go double that and still show a good looking donor area post op. How is that possible?

I have a guess, but I would love to read the opinion of the other forum members first. 

I researched all the cases @Melvin-Moderator posted and all were FUT and bellow 9K grafts (couldn't get very accutare info on Antonio Conte but he had at lease one FUT). 

@SLA thanks a lot for posting that 16,500 grafts case from Eugenix. That is insane, those guys are beasts and that case deserves its own thread. In total, only 2,500 grafts from scalp were used. Even though Eugenix have done a lot of big restorations, after glancing at all the videos from their YT channel I didn't see any case where more than 6,000 grafts or so were taken from the scalp. 

What I mentioned above goes to show how unusual is what Dr. Zarev is achieving, because: 

1 - 12k graft restorations are very very rare

2 - 12k graft purely from scalp donor like he is doing is even more rare

3 - 12k graft from scalp donor AND performed 100% via FUE (a method they say is not well suited for large restorations) is EVEN more rare. Maybe it's just Zarev going that far with FUE? If you guys know any other doctor doing that please let me know (maybe Lorenzo?)

4 - On top of doing 12k restorations with only scalp hair and 100% FUE, he also shows the post op donor area of his patients looking surprisingly good.

This leads me to believe he must have one of the lowest transections rate in the business. It's one thing to mask a bad transection rate with 4k FUE extractions well spread all over the safe zone of a patient. It's a totally different story to mask it on 12k extractions, no matter how good your donor originally was.

So if Zarev is doing such large FUE restorations and showing very detailed post of photographs of good looking donors, I will assume he is very masterful in extracting those grafts, and only a very few of them are being lost due transection. And since the end result on the recipient area is also excellent on the cases he showed, I will assume his growth yield is also good. 

Will Zarev be able to perform a 12k restoration on my if my donor is not good? No. But even if my donor only allows half of that amount to be used, I still will want a surgeon with low transection rates and high growth yield. And because of I mentioned earlier it seems like Zarev has both. 

9 hours ago, asterix0 said:

To note, it is a bit of a red herring to post another clinic and claim some sort of equivalency when:

1) Those other clinics do not show detailed comb through videos of the hair, to avoid any camera lighting tricks. 

2) They do not post high resolution pictures of the donor with the hair cut short from all angles.

3) They do not post top views with the hair cut short or from other angles. All are slick back "combover" style hair cuts where the actual yield is masked as much as possible. 

3) They do not post immediate post-op pictures of the donor and recipient, where-as Dr. Zarev does. His transparency far exceeds these other clinics.

Like it has already been stated, the patient accounts are the only missing piece, and hopefully this will be rectified soon enough when people go and start documenting their results here and on other forums.

 

To add on top of that, the other cases posted were all FUTs, while FUE (the method Zarev uses) is supposedly harder to do right on large restorations like he is doing. 

And good point on his documentation. His pre and post op pictures are the most detailed and consistent I have ever seen. Lot's of pictures from different areas and angles but with almost exact lighting before/after. Very easy to compare and inspect. 

His videos are also very good. No sound, animations or basically any marketing stuff. Just the head documentation. 

17 hours ago, Curious25 said:

Agree 100% 

And I think that is what is being misinterpreted by a few on here - it's not 'hype', its intrigued posters who have seen astonishing results, and want to learn more about said surgeon. 

No matter how good a patient presents himself to be as a hair transplant candidate, to achieve the end results Zarevs clinic showcase with the graft numbers given, the team are clearly doing an excellent job. 



 

Exactly. I don't want to hype anyone. I'm doing my research, trying decide which doctors I'm going to have a consultation and eventually have a procedure done. And as I'm discovering new things I share with other people here. 

7 minutes ago, Melvin-Moderator said:

Not necessarily, you may assume they have a great donor, but that may not be reality. Hair density can only be seen really with high magnification, that’s when you see doubles, triples quadruples. 

Plus, the number of grafts is irrelevant to the number of hairs per graft.  Add to that, the thickness of the hair, which is the most important.

For example, one patient gets 12,000 grafts with lets say 1.5 hairs per graft. Conversely, another patient gets 8,000 grafts with 2.8 hairs per graft, who gets more hair? I’ll spare you the math 18,000 vs 22,400 hairs.

On paper, the 12,000 looks impressive, but the truth is in the numbers. You should tune in to the Bisanga post, he explained it perfectly.

Again, you’re looking at things from tunnel vision. Just because a clinic is good at mega sessions doesn’t mean they will be best for your situation. Also doesn’t mean you’ll look like their star patients. There are surgeons best for different situations. 

That Bisanga post was one of the first I read here, very informative and opened my mind on how I should view the whole game plan for my future hair transplants. That quantitative approach is now something I look for with every doctor I consider making a consultation. 

To be clear why I'm interested in doctors producing outlier results -- as I said that is an ability that I think it is correlated with top skill. (of course consistency is another aspect I'm looking at, but it goes beyong the point here).

A doctor that has the ability to maximize the results of a patient with a great donor area will have a higher chance of maximizing the results of a patient with a average donor too (while not destroying it) compared to a ordinary doctor, IMO. 

For example, I believe a doctor can only can perform 10k+ FUE restorations if his transaction rate is very low, no matter how good your donor area is.

If your donor area is average or bellow average, you will still be benefited from a low transaction rate, so it makes sense to consider that doctor for a restoration.

6 minutes ago, Gatsby said:

Eugenix have performed a case of over 16,500 grafts. Everything that I have to chime in in this thread will mirror everything that Melvin has already previously stated.

Wow, do you have a link for that? Was it all FUE and scalp hairs?

I believe there is a positive correlation between the ability to produce outlier results (given the right patient) and skill. It's no surprising Eugenix is very well regarded. 

6 minutes ago, Melvin-Moderator said:

The number of grafts is dependent on the patient, not the surgeon. Dr. Umar has cases of up to 20,000 grafts. Fairly certain Eugenix has some cases in the 10-11k range as well. Again, just because you see a case like these, doesn’t mean you’re gonna get the same results.

That’s why it’s so important to see how regular everyday patients with average to below average donors look. There’s no secret tool or formula that will multiply hair in the donor. You’re given a certain supply and that’s what you have to work with for life.

"The number of grafts is dependent on the patient, not the surgeon."

Isn't both necessary? If you have great donor but the doctor doesn't have the skills, you won't be able to use a lot of grafts without looking depleted. I've seen guys with good donors looking depleted with as little as 4K grafts extracted via FUE.

I might be wrong but I've never seen Eugenix go beyond 7K FUE with scalp hairs alone. 

Edit: you already asked it in the previous comment.

@Melvin-ModeratorThose are great results, but I assume FUT was used to achieve that?

I'm not an expert in HT history, but I believe Zarev is the first doctor to perform 12000+ grafts restorations with FUE alone (and without destroying the donor)?

I know his results are total outliers but I'm not using them to gauge my expectations (well, at least not 100%). What is interesting is that he is achieving a level of results that were thought to be not possible with FUE alone until the recent past?

11 minutes ago, Melvin-Moderator said:

@JohnBob

To answer your question can good results happen with suction? Yes, but only on individuals with thick hair, where the roots are sturdy. Fine hair would get damaged, no question about it. 

Tools should be tailored to the individual, to quote the great Konior: “do you go to a shoe store that says ‘we only sell size 9s.” 

Overall, I think suction isn’t good for grafts. FUE by nature makes grafts more skeletonized and fragile, adding suction to that is even worse. So, I have no idea if this is the only tool this doctor uses, but this whole thread is borderline a hype job. 

I agree with everything you said, even the hype job part. That's why I'm researching about this doctor, trying to dig up more info and understand his methods. Because you can't dispute that his best cases stand out even when compared to the best cases of the other doctors (outliers vs outliers). There are patients with more than 12000 grafts extracted and the donor looks barely untouched, it's ridiculous.

Guys, thanks to the WayBackMachine I found out that Dr. Zarev used to have a picture of the device behind his "AVA" FUE method in his website (text was originally in Bulgarian - I used google translate to convert it to english):

The device is called Punch Matic and it is manufactured by a french company named Medicamat.

Here is an Youtube video showing the device being used

Basically, the use of suction allows the surgeon so use a smaller punch and to not go as deep in the skin. This results in less transections compared to regular FUE because you don't need get the angle perfectly right, and less scarring because the punch don't go as deep:

During the video you can see the extractions happening very up close - you can actually see the grafts being sucked into the device.  It's definitely worth to watch it.

I know that there are people that believes that the suction damages the FU but let me ask if that was the case would Dr. Zarev be able to show such successful cases of huge restorations performed?

@Melvin-Moderator your hair looked perfect and ultra dense during that session. Were you using any concealer or appearance improving products?

You're right. Just sent you a PM.

40 minutes ago, wilkinte said:

For me, I inject .6 ml per week, so that's 140 mg.  It's prescribed by my doc since I was very low.  Been about 4 years.  I don't think the transplanted hairs are affected by the T.  Dr Nader and I talked about test (and other drugs I take) and he didn't have concerns.  That being said I'm sure I've wiped out my native hairs in my crown/front from it.  

Feeling good versus looking good.  And trying to balance it.  You'll have to figure it out.  I would recommend picking a HT surgeon and then talk it out with them. 

I'm guessing you don't have low T.  If you were suffering from the brain fog, lack of energy/drive, depression, etc. losing a few hairs wouldn't be a concern.

Makes sense. May I ask what kind of test are you taking what were your levels before starting TRT?

Also what is your the daily dosage of finasteride?

On 2/22/2020 at 4:32 AM, Annijoy31 said:

 

So I have completed 150 days after the procedure and here are my updates. I hope you all find a takeaway from this. Do comment if you have any questions for more information.

 

 

 

 

Woa look at those kind of results in only 5 months!

People say don't get anxious wait until 10-12 months to expect results but let's be frank in most cases by month 5 or 6 you can already tell with a good confidence if the procedure is going to be a home run or not.

I've never seen someone with low growth at month 5 or 6 that ended up with spectacular results later on. Maybe it could happen but I assume those are the rarest cases.  

Look at his post history, he stoped posting after that only to post one more time this year (6 years later). He basically said his results were meh and didn't want to post any more pictures so I guess things didn't improve much after those 4 months post op pics. 

Do you think it's normal for the skin to be that red in the recipient area 4 months after the procedure? I don't think so, not at all. I'm not an expert but that indicates some inflammation/auto immune response from his body, which ended up rejecting the grafts implanted in the crown area. 

Also, very interesting that you are doing TRT and your test levels are at 1000! That's some aggressive teenager test levels man, I like it. 

How long have you been doing TRT? Do you think your transplanted hair is dealing all right with such high levels? May I ask with kind of test and how much you are taking weekly? Did you have to increase the normal dosage of 1mg of fina per day because of that?

Sorry for this amount of questions, it's because I'm thinking of having a HT in the future too AND also think about TRT but I would be afraid that extra test would be too much even for the transplanted hairs.