mtb

On 9/20/2023 at 5:31 PM, Mr. Clean said:

Hi @mtb, you have great results like Hugox. Congratulations on waiting and having surgery with which I consider the best HT surgeon at this time!
I was reading your thread and in your earlier post, you mentioned that your brother was going to Dr. Pittella in a few months for his surgery… that post was back in February, did he already have his surgery? If so, did he post his results here? I want to have an HT done by Dr. Zarev but his waitlist is way to long, no thanks to you and @HugoX😆, I’m just kidding 😁… I’m thankful you guys posted your results for us to decide on who to choose. I’m also considering Dr. Pitella if his waitlist is not as long as Dr. Zarev. I am very interested in seeing your brother’s results since you guys probably have the same hair characteristics and skin tone. It would be an excellent example to compare your results from Dr. Zarev and his results from Dr. Pittella…

If I were you I’d look at going elsewhere besides Zarev. I believe he is the best but if I was looking at a 3-5 year wait I would go elsewhere. Very grateful I got in when I did.  

10 hours ago, hairman22 said:

@mtb are you going for your 2nd surgery soon or you will hold it off for now?

Yeah I’m doing it this month. ~2k in the crown and mid scalp. A little bit for the hairline. Would like to lower the hairline if possible. Just not sure it’s realistic given my remaining donor grafts and need to thicken the crown and midscalp. If I can’t lower it I’ll still be happy with where it is. Wont know for certain until he does his pre-op measurements. 

10 hours ago, Dieter987 said:

It is possible to pay more for consultation and operation to get an off-scheduled meeting. That's what it says on the website.

Oh really? I didn't know about that. I didn't see that on his website. But can't blame him. If the demand is there you can charge whatever you want. I see that he charges 500 euros for a consult now. Very glad I got in when I did.

10 hours ago, RobertoDeNiro said:

Hello @mtb  Your result is impressive. Maybe one of the best results I have seen in my life. 

Are you still going in October for those 2000 grafts you mention on the first posts? Maybe you can hold on that.

Congratulations! You look fabulous!

I've thought about holding off. The crown and mid scalp do need a bit more. He says that even with this 2k there will still be another 2k in reserve for years down the line. 

18 hours ago, Grouse said:

@mtb what was wearing a hair system like the years before this procedure? I'm considering one to tide me over for the 2 years it takes to get in and see Zarev (rather than go with another surgeon), but am concerned about the maintenance and having it weigh on me day to day.

@Grouse No easy answers unfortunately. Once I saw my head shaved bald before my Zarev procedure I thought, "hm, I don't look bad bald." Have you tried shaving your head first to see if you'd like it? If you want to do the hair system I'd find a reputable online company and a local stylist that has experience with systems. Then there is a thousand vids online of how to apply and maintain them. I did a few different glues and two sided tapes over the years. It's a commitment but if you have to do it you'll figure a way to make it work. The company I used is out-of-business now so I cannot recommend them anymore. If you would like a lot of details please dm me and I can share more. I don't even think about the hair system days anymore, feels fortunate to be where I am. 

While I think Zarev is the best surgeon but there are other phenomenal surgeons who have much shorter waitlists if you cannot wait the full 3 years to see Dr. Zarev. They would require an FUT/FUE combo or FUE with beard hair. Just a thought.

Thank you for sharing everything in your journey, Karl. You were one of the ones that showed that high norwood HT is possible and can look great. 

8 months update for Dr Zarev. Dry, styled, gym. 
 

25 minutes ago, Grouse said:

@mtb I'm starting to realize transplants may not be permanent for 20+ years, and with my poor donor I may need to shave slick bald in the future (maybe with SMP). Less visible scars is a huge plus if that's the case.

If I can get 5 - 10 years of decent coverage, then shave later without looking disfigured, that's a home run success in my books. 

@Grouse I haven’t heard about transplants not lasting. Are you speaking of the actual transplanted hair? Does that include with the taking of finasteride? Can you share any references for the education of the group, please?

19 hours ago, Grouse said:

@mtb this result is just straight up insane!! 

If you ever get a bald fade on the sides, or otherwise shave, I'd appreciate a picture of the scars. If Zarev's scars are significantly less visible than other top surgeons, I may be down to wait the 3 - 4 years to see him. 

If you look at the pictures one or two pages back you can see the hair very short on the sides. No visible signs of scarring. Do you anticipate shaving the sides of your head after the transplant? Or what has you worried about the scarring?

17 minutes ago, hairman22 said:

Are you going to shave the recipient area or leave it longer how it is?

Dr. Zarev will want the entire recipient area shaved. The master artist needs a clean canvas. ha

18 hours ago, Melvin- Moderator said:

@mtb

Thought you’d be interested in checking out the podcast I did with Dr. Zarev. Hopefully, there a part two where we break down your case. 

 

Very interesting. Thank you for sharing. I'm not so surprised that my case wasn't shared because the cases he covered were more extreme than mine. A NW 6 anywhere else is a huge deal but for him it's just another uneventful case. He's showcasing deep NW 7's and repair cases. Quite frankly it's just unfortunate that other surgeons haven't caught up to him yet. Lots of guys definitely wanting his level of expertise.

Bout to shave my head in one month. Or, more accurately, Dr Zarev is going to be shaving it. Second procedure coming up. I’ll try to remember to post a pic then. 

On 8/18/2023 at 4:14 PM, hairman22 said:

Thats amazing. 

He done an amazing job on the lower part of the crown. Hairline is complete

You could definetly not get a 2nd surgery if you wanted

 

But looks like you plenty donor left

I would guess maybe even 6k left it you kept sides short.

 

 

Yeah he said 2k if I want to be able to west the slides longer, 4-5k if I keep it really short on the sides forever

On 8/18/2023 at 9:40 PM, Grouse said:

Bro staaahp you’re making me wanna wait 4+ years to get a surgery with Zarev, looks incredible! My hair won’t make it that long 😂

 

can you remind me - are you on any meds?

 

Topical min and topical .1% fin. It’s Zarev’s formula. Also, started taking oral fin on my own. 

On 8/19/2023 at 8:48 AM, Melvin- Moderator said:

I’m not joking when I say you’ve lost at least 20 years! Holy 🤯 

 

Im gonna be doing a podcast with Dr. Zarev, hopefully I can discuss your case with him.

Dr Z is a great doctor. 

On 8/20/2023 at 3:27 AM, Andreww said:

@mtb Hi, i'm from Romania also. Can you help get in contact with him?

I’m not from Romania. That was a joke. But I loved visiting Romania though. Just keep calling the main number. 

On 8/20/2023 at 10:35 PM, MaximusEastwood said:

Looks so good! Just curious - does the transplanted hair stick up naturally? Or is that from styling? I'm finding after about ~7months my transplanted hair is still kinda wispy and tends to stick up without any styling, so curious if that's the case for you as well 

Yeah. They stand up. Even without product. 

On 8/25/2023 at 7:23 AM, Mr. Clean said:

Hi @mtb, Congratulations on your surgery with DR. Zarev and for having an impressive result! Hugo and you have been very helpful to this forum for posting and sharing your experiences with us. 

In your previous comments,  you mentioned you're going to have the 2nd HT this coming October? Does he have an option to stay in his new clinic/hotel if you are not from Bulgaria? 

 

There is a little hotel room he will have upstairs but I’m not sure if it’s finished yet. There’s little hotels in the neighborhood that are a long walk or you can Uber for about $5. 

7 months

Some dry shots, some styled shots, some gym shots 

17 hours ago, Xanadu said:

second procedure for what? Please point us to the weak spots - they are hard to find

14 hours ago, MaximusEastwood said:

Looking great! Do you mind also sharing some photos with your head facing down, so we can see it from the top? 

I have to send Dr. Zarev my 7 month photos next week. I'll post those here as well.

6 hours ago, mr_peanutbutter said:

you dont need a second procedure

hairloss is officially cured for people who are not norwood 7 and can afford to go to dr.zarev

It'll be for density. Under intense direct light, like my barber's chair or the sun, it is thinner through the hairline. Also, the crown will need a little bit. First procedure was 8,300 grafts. This one will only be 2k-ish

6 hours ago, mr_peanutbutter said:

other surgeons need to step up … i really wonder what dr zarev and@DrMunibAhmad are doing different and why others cant replicate it (yet)

I'm feeling that way myself. Not sure why other surgeons aren't able to replicate.

4 hours ago, UKLad81 said:

Unbelievable result! Zarev is definitely top notch and has done wonders with your case. Well done in selecting and also getting a date with him! Lol! Guys wait list is crazy. I managed to get in touch with his office and his current wait time for a consult is 2026 eek. 

My first contact to in-person consult was May '21-Dec '21, so 7 months. Then consult to procedure was Dec '21-Jan '23, so 13 months. 3 years til consult is just crazy. I feel very fortunate.

Just had my first real hair cut. My stylist of 10 years was stunned. She ran out and grabbed her colleague to show him. Feeling fortunate. Don’t want to sound ungrateful but I barely even think about it anymore.
 

Maybe it’s too long to notice if there’s scarring but I don’t see any scarring. Two months of this and then time for my second procedure. 

6.5 months. At the gym. 
 

After about 15 days it's started to fall out but it took up to 45 days for it to all fall out.

On 7/2/2023 at 1:04 AM, consequence said:

Wowza. There's almost no part of your scalp that was untouched, either to extract or to place. Almost amoebic in scope.

Do you have any pics in outdoor lighting of both recipient and donor?

Just those ones in the gym a page back. I can post some with in-door lighting in my house next month.

2 hours ago, Spring15 said:

What have the reactions of your friends/family etc been? Going from NW7 to a near full head so quick would be a shock

Have you noticed more attention from the ladies as well? 

I did a hair system for the last 13 years. Then the first four months after procedure I just wore a hat all the time. Now when people see it they ask if I got a hair cut or if I have colored my hair. No one guesses hair transplant.

8 minutes ago, GeneralNorwood said:

 

Did you make this photos with flash? Lighting is very shiny. 

Yes. Dr. Zarev requests flash in the monthly update photos that I send him. 

6 months. This old boy needs a hair trim. Prob gonna do a skin fade to see what the scarring looks like. 
 

17 hours ago, Gatsby said:

Density is incredible for only 5.5 months! 💯👌

Thank you. You're journey was helpful for me as I was making the decision. Thank you for your contributions, @Gatsby

17 hours ago, BRITA-XL said:

Lighting enhancement or not this is progressing very well indeed !

Thank you, sir. I was at the gym with my friend and I just kept looking in the mirror laughing. It's just surreal. Honestly though I'd be a head-shave or hairpiece guy for life. 

7 hours ago, mr_peanutbutter said:

zarev is officially the goat; keep in mind op didnt has super coarse mediterranean hair

zarev is unachieved

Yeah, he said my characteristics were pretty average in total

2 hours ago, Nelly said:

This is just unbelievable. Great surgeon donor is pretty much as good as it can get after that many grafts. 
 

hiw much did he charge

I was grandfathered in at 4 euros per graft. 

1 hour ago, ITA said:

Surely in the end it will be a great result and you can already be satisfied now, but the pics  in the mirror cannot be judged.

Ok, boomer.

5 minutes ago, Melvin- Moderator said:

Looks excellent 👏🏼

Thank you. Excited for the future.

5.5 months. At the gym again. The lighting makes it looks great. 
 

On 5/31/2023 at 4:36 AM, Gatsby said:

That's an incredible result. If the patient had his temple points restored slightly it would be quite literally a 'perfect' result! 🙌 I know I will get flamed for saying this but my only concern with Dr Zarev is that I haven't seen the number of results that other high Norwood 7 surgeons (and their patients) show such as Dr Pittella and Dr Sethi. Both these surgeons have shown lots and lots of videos of how they go about the areas of a Norwood 7 scalp in detail and how they will (and do) address the areas that need addressing. I've never seen this with Dr Zarev. Having said that Dr Zarev is incredible from the few results that I have seen.

I tend to agree with you Gatsby. For me, and really everyone on this forum who has consulted with Zarev, it was the in-person that sold me. He's very detailed in discussing the approach. Then he shows you a dozen or so cases that resemble your own. I also happened to see a former patient while I was there. Dr. Zarev is just not a big media and social media guy. I would say it's to his detriment but being booked out for five years probably indicates to him that he doesn't need to change anything. I would tell any prospective patient to do an in-person consult with any surgeon before making the big decision.

On 6/1/2023 at 3:24 PM, duckling said:

I loved those videos (and was wowed too ) and admire him for doing this for community but I am skeptical too for below reasons.

1)I think those big cases were only on people with extraordinary donors. Not all his cases will be that high grafts ( all from scalp). surely we will see beard and body grafts used just like others.

2)I think there is huge risk that lot of those grafts he put there will not survive without DHT meds because he literraly took non DHT resistant hairs. Once the patient gets sides from meds or something happens like trying for a baby then they have to get off meds. All those hair are falling out for sure. and even in best case that they take meds for life , meds can only slow it down. Can't stop it.

3)Once his number of cases increase so will the bad cases of shock loss and if they get it then there will be no hair on back and sides as already he took majority which were the good ones. 

his videos did great marketing for him as it got him booked completely and i am happy for him but until lots of result with long term results come i cant say that his method is better than others. 

On 6/22/2023 at 1:25 AM, BeHappy said:

Any HT Dr can take as many grafts as Zarev does. They don't because they try to stay in the safe zone. It used to be considered a major mistake to take grafts from outside what is considered a safe zone. Now, for some reason, it's considered a great thing and is hailed as the best way to do a hair transplant. This makes no sense. If you really want to know if Dr Zarev is doing HTs better than other Drs then wait 5 to 10 years and see what happens to his patients hair. My guess is there will be a large percentage of them who have lost a lot of grafts by then.

 

Yeah, it is a risk going outside the "safe zone". But one I was okay with. My reasons were as follows:

- My balding has been fairly stable for 10 years so lower risk of my NW getting all the way to 7, of course not guaranteed

- No one in my family is a NW7, of course that's only a slight indicator and not a guarantee that I won't go there

- NW7 is only achieved by 7% of the population so lower probability that I'll get there

- I can tolerate oral finasteride and respond well to it which will greatly slow down my possible progression to NW7, of course not guaranteed (talk of sides and permanent sides are greatly overblown)

- I still have 4k grafts in reserve from my scalp for FUE with Dr. Zarev if I start to head toward a NW7

- Even further, Dr. Zarev says in extreme cases he can take up to 70%-80% of scalp grafts for very advanced Norwoods (so an additional 1.5k to 2k grafts for me), however this does require the patient to keep donor areas very short (nearly skin fade) which I saw as an acceptable option but a last option

- I have a pretty thick beard and can likely get 2k-3k grafts from it if there is big-time thinning in the recipient area

- I'm also okay with SMP to add the illusion of coverage/density

-I'm comfortable with an FUT procedure as a possibility down the road if recipient areas thin 

-Or in the case that nothing above works and I'm thinning greatly in the transplanted region I'm okay to shave my head and I chose Dr. Zarev because the scarring from his procedure is almost indiscernible

Just my my through process when making my decision. There are many things to consider and additional treatments if needed. I don't feel it's likely that it'll come to that for me. If you're not comfortable with the possibility of thinning recipient area don't get a procedure at all. However, I knew the risks and the ways to mitigate and made my decision comfortably. 

Strip with the right surgeon is a great procedure. FUE with the right surgeon is a great procedure as well. So much depends on your personal characteristics. 

5 month mark

Here’s some top shots from this weekend. The bottom one is where I started. Almost 5 month mark. Dr Z says the top takes longer than the hairline and the crown comes last, maybe 4 more months until it’s meant to look great. Will post the Dr Zarev yellow background update pics this weekend. 

5 minutes ago, Turkhair said:

Or maybe I am already booked and trying to dissuade others from going there 😅😀

It's all good man. Gotta do what you feel comfortable with. 

3 minutes ago, Melvin- Moderator said:

Guys,

This is really de-railing the purpose of this thread, which is to follow @mtb progress.

Thanks for keeping us on track. And to your comment, I will post some top and crown pics from real life when I do my 5 month update in a couple weeks. 

On 6/4/2023 at 10:33 AM, Joseph James said:

How is this even possible?

 

He uses a much wider donor area than most surgeons. On page 3(?) of this thread I commented on why I was okay with this. It's not going to be right for everyone. Everyone needs to make their own informed decision.

On 6/4/2023 at 11:50 AM, HugoX said:

Just the begging, you haven't seen anything yet..On top of that... One more surgery to go. 

I still have to look at my old pictures just to remember what I used to look like and pinch myself 

I'm pleasantly surprised. I no longer where hats. Maybe once or twice a week I use toppik. But even getting to the point where I don't care for it. 

On 6/4/2023 at 1:24 PM, asterix0 said:

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

Yeah, he wants to get a med student rather than someone from the industry who already had bad habits.

On 6/4/2023 at 2:16 PM, Fox243 said:

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

It's rough, man. I totally understand. You could shave it down or glue a wig to your head. Or just go to Pitella, H&W, or Eugenix. For me it was worth the wait but I only had to wait 20months from first contact to procedure. 

On 6/5/2023 at 4:13 AM, asterix0 said:

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. 

If you're a full blown slick NW6 Zarev is the man for the job. 

22 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.

I have no idea how anyone can accurately estimated the survival rate. What is the methodology?

19 hours ago, johnto said:

If you watch some of his youtube videos you can see how he can do what he does.  Below are two videos which show his surgical technique and how he can accomplish transpants with such high graft counts.  The main points of his technique are as follows

• At your consultation he develops a long term plan on how many grafts you need to cover your area of balding.  
• So lets say if you are a norwood 6 he will make measurements on your head on where to place your hairline and then develop a calculation of the number of grafts you need for full coverage.  If he determines you need 10000 fue grafts to cover the entire norwood 6 area he will see if your donor zone has this capacity
• so if your donor area has "20000 total remaining folliucar units in the entire donor" he will recommend extracting 50% of the donor in a "homogenous" way which depletes the donor equally allowing him to remove such high graft counts without the donor looking moth eaten or depleted.  It does deplete but its equally across the whole donor.  So to the naked eye the donor looks the same after surgery
• I believe the vacuum assisted FUE machine he uses allows him to use a tiny punch size which minimizes scarring but "sucks up" the fue graft dislodging it (it doesnt suck it into a tube).  This allows him to then easily remove the graft with tweezers and not harm adjacent follicular units allowing him to extract more grafts without damaging neighboring follicles.
• when he places the fue grafts into the recipient area he does so in a homogeneous way and in a way to optimize graft survival.  So because each FUE graft needs blood flow to survive he doesnt "dense pack" but distributes the grafts equally ensuring survival and getting full homogeneous coverage.  Density is then added in subsequent surgeries over time as needed.  This is why his patients he performs surgeries on with high norwoods are booked for a 2 day session then a follow up session 10 months later to add density (like HugoX)
• He does not do 10000 fue grafts in one sitting.  He will do 3-4000 fue grafts in one 11 hour surgical day and then a second surgery the next day for 8000 fue grafts over 2 days.  A final follow up density surgery is booked for 10mo later to finish the case completely.
• He doesn't use microscopes to separate follicular units.  During his micro camera analysis of your donor zone he maps out different parts of your donor.  There are areas in the donor zone that apparently only have singles, other areas doubles, others triple fue units, so when he extracts grafts the separates them based on the location of the donor he got the grafts from.  I assume this just results in less handling of the grafts preventing damage to them and increasing survival rates
• Grafts are implanted with a choi implanter pen.  He does not use lateral slit or scalpels for preparing recipient sites so when he works on a patient it appears there is less trauma to the recipient area which may help with graft survival.  His surgical field is clean.  He is very meticulous 
• Finally every step of the procedure is completed by him.  Apparently no one else touches a patients head other than Zarev.  It allows for consistency in results

Zarev appears to be active on another hair transplant forum He just posted another case there. See the below videos for his technique

https://bellicapelli.forumfree.it/?t=79701174

 

Very thorough review. Agreed. 

13 hours ago, ScottishGuy21 said:

It’s a tricky one trusting someone 100% to carry your reputation especially if you barely know that person. Maybe Zarev isn’t at that stage right now where he is willing to go down this path. We’ve also seen countless surgeons try to expand their business and suffer reputation damage due to poorer results. So in that respect it’s understandable.

I agree with the attention to detail, nobody comes close from what I hear. 3+ hours just for an initial consultation alone!
 

 

I was the one who told about the 3 hour consultation. I wouldn't anticipate that are there were some circumstances that were specific to me. That said, you'll leave the consult feeling 100% confident. 

10 hours 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

It's not just going outside the traditional safe donor. It's also his extraction technique. For sure it's thinner overall than full native dense scalp but it's totally fine for me. Never understood wanting to have super thick hair on the sides of my head. 

10 hours ago, Spring15 said:

OP has great density on the side of his head where half the grafts were taken from, as seen in his recent pics. Pretty sure Zarev's donor results looks similar to all other top surgeons

Yeah, his donor management his excellent considering how many grafts he can extract. 

6 hours ago, asterix0 said:

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

Yes, not everyone goes full 7. See my comments on the matter on page 2 or 3 of this thread .

On 5/16/2023 at 12:07 PM, HugoX said:

When that hairline thickens and grows you won't think of it as high as you do now and as you say, you are 40 now, this is the hairline that you will keep as 50, 60, 70..

You’re right. 

On 5/16/2023 at 12:45 PM, hairman22 said:

@mtb looks amazing for 4 months crown which takes longer growing well too

donor looking very good too.

4-6 month mark is when you experience most growth from my experience

 

Crown getting thicker by the week. 

On 5/19/2023 at 4:56 AM, Wally West said:

Wow the crown looks great for only 4 months, amazing growth so early on!

I agree about the hairline - it will suit you right into your 70s and with a bit of length it’ll look way better imo. Its a little high but not super high. Zarev had done a really nice natural design. Also, I would wait and see how the crown density looks once it has fully grown in as that area can eat up so many grafts.

That said, if you can lower it a little without sacrificing the density of the mid scalp and crown too much, then why not. Do what you think is best.

Yeah the problem is there remaining donor grafts should be used for density rather than lowering the hairline. We’ll see. I’m pretty happy with things. 

On 5/19/2023 at 9:28 AM, GeneralNorwood said:

I called to Dr. Zarev's clinic. Current dates of consultations are... 2026 January. 

Pitella, H&W, and Eugenix are great options with shorter wait times. No other doc can gets as many scalp only FUE grafts however. Grateful I found Dr Zarev when I did. 

On 5/19/2023 at 2:42 PM, botchedguy95 said:

Hey mate, did you use flash when taking these photos?

Yes, sir. 

On 5/19/2023 at 2:57 PM, HappyMan2021 said:

wow, 2.5 yr wait time for a consult, so 3.5 yrs until surgery I'm guessing?

Just think.....if someone did 3.5 years worth of intense psychotherapy, they could learn to accept and embrace baldness and no longer have any need for hair transplants 🤣

ha ha. For real. 
 

Attached are some pics from the gym this week. Didn’t put up the Dr Zarev yellow paper at the gym. Ha. It’s getting thicker by the week