THE TRUTH

Tsvetalin Zarev and Kevin Mann are the 2 GOATs in the hairloss community. I wish more young men with balding knew about these 2 guys... That would save countless tears, an incredible amount of blood, hair, overharvested donor areas, potential Norwood 7, emotionnal trauma, stress, psychiatric disorders etc etc... Some people make the world better. Zarev is definitely one of them.

Ow my Dear Lord this is literally the best result I have ever EVER EVER seen. This is like finally seeing the light of God. At first, Zarev looked to me like he was too good to be true...I was thinking his results must be a ton of hair fibers or a wig... But honestly he keeps impressing me every time... Listen Hugo, your result is better than the best result I have ever seen from Dr. Umar Sanusi that many considered the best in the old days, Eugenix, Konior or Hasson & Wong... I don't know what to say except Zarev might well be the GOAT of hair transplantation. Following the Holy Gospel of our Prophet and absolute GOAT Kevin Mann and getting your surgery performed by Dr. Zarev may well be the Ultimate Redemption from the evolutionnary curse in permanent Male Pattern Baldness aka ANDROGENIC ALOPECIA. Congrats champ. Your case gives me hope and faith in Humanity. 🙏

Well I will try to be as objective as I can. Your donor area doesn't look too bad bro. I would say it's slightly overharvested yes but not too badly overharvested. I have seen much much worse coming from terrible hairmills such as AsliTarcan, Arenamed, Sanantur or even some bad spanish surgeons like Eduardo Lopez Bran.... Now, your donor area is in bad shape considering the fact you said you went to a reputable clinic...This is definitely not how it should look like with this particular length of hair...Looks like poor extracting skills...Especially for such a low number of grafts....I hope they offered refund so you can go to a better place for donor repair with beard grafts for example or get SMP. How many grafts so you have left anf could you go for a second surgery ? I cannot answer that question. You would need some of the best HT surgeons in the world to examine you in person in order to determine that. You could probably go for a second round but extremely carefully with a repair expert.

Your result reminds me of Matej Kacvinsky's who has a youtube channel under the name of 'Matt Dominance". He went to Balwi for his first hair transplant and got the exact same type of result. Nice improvement, frames your face nicely but it has that signature missing density... Consider yourself lucky bro because I have seen really bad work from Elithair. I am talking about overharvested donor areas etc... Your result is pretty good for Elithair. I've seen some outstanding results from Elithair such as Damien Ferry, Michael the British guy on youtube but also disasters. But I guess just like Dr. Cinik, most of their results turn out like yours.

Topical finasteride and Dutasteride are the only options that work although they are a lot more expensive and far less convinient to use than the oral version....Just do your research and make sure you are getting them from a reputable place. Not some shady websites. Dutasteride mesotherapy is also often used by spanish doctors. Other than that you can experiment with Topilitamide (Fluridil 2% Eucapil) that is derived from Flutamide, a potent anti androgen that was used to treat prostate cancer in men back in the day. Other options include RU58841 that Derek swears by but honestly it is still pretty obscure and even if you buy from Kaneshop or Anageninc you never know what you get. It could be gone bad or a scam. It could be flour 😂 CB0301 aka Winlevi/Breezula. Works but very expensive... Alfatrafiol (Pantostin/El Cranell) also has some evidence and is over the counter in Germany but probably too weak as a standalone. Oral spiro is great for women and trans but the topical version is crap. I don't see any other viable substitutes for oral 5AR inhibitors.

Sorry but I have to disagree with you about this particular issue. While it is very important to be PATIENT and calm during the post transplant process, it is also very important to be realistic and objective. At the 3 months mark most people don't see any improvement at all. That is perfectly normal and expected. Their recipient area looks the same way it looked before surgery. So the fact that your hair looks bad at 3 months is nothing you should be worried about. Stay patient and if you've done your due diligence and chosen a great clinic then trust the process like Melvin Lopez says. However, the 3 months mark is also the time when hairs are actually supposed to start growing. In over 95% of cases, the decider happens between the 3rd month and the 6th month. We have to be realistic here, your result at 6 month is VERY indicative of the final fully matured result you will have at 8-12 months. I have never seen a miracle happening between month 6 and month 12. If it looks bad at the 6 months, then there is still some room for slight marginal improvement of course (mostly in hair thickness and not so much in number of hairs that have popped). There are some "late bloomers" obviously. I have seen it happen over the years but this is extremely rare. Actually it as rare as people who do not shed the transplanted hairs post surgery.... Some doctors like Hasson & Wong and Feller & Bloxham actually report patients having additionnal maturation in hair thickness between month 12 and even month 18. So yes it does take time. But again being a late bloomer means having SOME noticeable growth already around the 5-6 months mark. It doesn't mean miracle growth coming out of nowhere at the 11th month mark on a result that looks like crap...That won't happen. I remember Dr. Lorenzo saying that 75% of patients in his practice get early growth around the 5th month mark and he's got plenty of documented cases on his channel. Also browse through this forum. There are thousands of results posted. Judge by yourself, in most cases the 6 months result is often very close to the final result... Now of course, be patient, try to think about something else and don't lose hope. 3.5 months is nothing. It is still considered very early and don't jump to conclusions. Try to focus on something else in life and reassess your situation at the 6 months mark.

1000% agree. One of the worst hairmill traps out there. Don't fall into his trap of new technology, robots, big modern clinic and Koray's "coverage value" theories etc etc...It's all BS... His 25 year-old nurses do everything. They have minimal training. He takes your money, draws your hairline. No refund no free touch-ups in case of disaster. Koray is basically an expensive version of Emrah Çinik and Serkan Aygin 😂😂😂 Actually I feel like other hairmills like Cinik, Serkan, NowHairTime have somewhat improved and they're producing better and more consistent results than Koray these days... I've checked a few results on the international hairloss forum recently and I feel like ASMED has dropped in quality even more...

Hasson & Wong are considered a worldclass clinic on this forum. Many still consider them to be the best in the world. They've been around forever and they're one of the rare clinics that has stood the test of time. I have seen outstanding worldclass results from both Victor Hasson and also from Jerry Wong. Antonio Conte and The Hair Transplant Mentor are probably the 2 most famous. Hasson & Wong litterally made them come back from the dead. I gotta say I've also seen many average ones. And sadly I did see a few bad ones over the years. Not many though. It was more like very poor growth cases....Never seen a disaster. Again if you are lucky, if you have good donor hair, if the doctor is 100% focused on that particular day IF IF IF all the odds are in your favour you may get an outstanding result from them. But I feel like most of their real results (those that are published by independant patients) are "average +" and you should never expect what you see online... Just like from any other clinic. That said, Dr. Hasson is certainly one of the world's most experienced surgeons especially for FUT. Hardly anyone in the world will be able to perform a better strip than him. Maybe Konior, Shapiro, Muresanu etc...are on the same level for FUT. I think Hasson is great but you just may not get what you see online. Hair transplant is always a lottery even with the best surgeons in the world. You never know. Also one thing I don't really like about Hasson and Wong is the heavy use of techs and doing 4-5 surgeries per day. The real question is: is Dr. Hasson still worth the money ? I belive he was definitely worth the money in the early 2000's. Hardly anyone else in the world at the time could match his skills. Nowadays you can probably find the same level of quality but twice cheaper with the few best clinics in Europe. Not Turkey. At least for FUE. For strip surgery, he is still amongst top 5 in the world.

Couto is an amazing surgeon but don't get fooled by his youtube videos... He is overhyped in my opinion. He has around 30-40 youtube videos that are all cherry picked cases. How many patients has he treated during the last 15 years since he's been practicing ? Probably a few thousands. What is 30-40 out of thousands ? Nothing. I have nothing against Dr. Couto. I would actually recommend him. He is good for sure and he seems much more involved than Dr. Lorenzo, the other surgeon from Madrid who outsources his work to young technician with questionable training...I heard Couto is involved and cares about patients, offers free touch-ups etc... But just like any other clinic, I have seen a few average to subpar cases from Fuexpert on recuperartupelo and belicapelli. Not bad by any means but average. I think he doesn't do all the steps himself. I heard he uses a tech for implantation or extraction. Can't remember exactly. Just because you see these few outstanding results on youtube doesn't mean you gonna get the exact same. If you think so then you're setting yourself up for huge disappointment. Zarev seems like the most "capable" guy in the world but again there is not enough independant reviews to draw conclusions... Konior is very solid and highly involved. He is also sponsoring this forum. That said, he is legit for sure and seems like a great guy. But he is extremely expensive. One of the most expensive surgeons out there.

Left side came in pretty good. Right side didn't grew in as well and I agree it's quite thin. You will most likely need a touch-up.

Rassman is retired. He is one of the pioneers of hair transplants in the US who has trained quite a few big names in the industry (Shapiro, Mohebi, Bernstein etc...). He attends conferences and he still answers some questions on Tressless reddit and Real Self. I think Dr. Jae Pak has taken over Dr. Rassman's practice. Dr. John Diep is very solid. He is a good choice but you can find the same quality ( if not better) for half the price in Europe with Freitas, Pinto, Ximena etc... Diep actually did Melvin's 2nd and 3rd hair transplant and he gave him a much better result than Behnam on the first one... Also there was another guy whose username was baldlivesmatter. He had a failed hair transplant by Dr. James Harris in Denver (the doc who did Kevin Mann's hair tranplant) but then this wame guy went to Dr. Diep for a repair and got a great result. Diep is sometimes criticized for his donor area management. And just like any other doctor, he has some subpar cases although statistically minimal.

Okay great. I agree. The Norwood Reaper is the worst thing that can happen to a man or woman aesthethically speaking. I also hate it. Worst thing is even when you take a razor and shave everything off, you can still see the balding pattern...🤪😵 So you need some crazy painful scalp waxing or laser removal to become fully bald like Alopecia Universalis on your head. Or the other options would be to get SMP every year to conceal the shadow. Balding is such a nightmare. Yeah looks very solid on these pictures. No signs of thinning under this particular lighting. But I totally understand that you would have prefered a slightly lower hairline especially considering the fact that you are on MTF HRT. But given the demand/supply issue in hair transplants, this is probably the lowest you could go. Will your 2nd procedure with HLC be a touch-up on the hairline ? Or a new procedure on the midscalp ? Will Hattingen be performing the scar revision for free ? Btw who performed your strip extraction at Hattingen ? I guess it Dr. Sever & Dr. Laura did the strip and incisions while the techs finished with implantation, right ? Last question: how much estradiol do you take daily ? 10mg ? Good luck on your remaining procedures Jan. 🙏 All the best for the future and keep us updated. 👍

Fair enough and totally understandable. I feel the exact same way. We should have all started Finasteride/Dutasteride a long ass time ago but now it's too late and we have to spend tens of thousands of dollars on multiple surgeries. I think your crown and hairline are very solid now Jan. Midscalp still has some "weakness" going on but it is only noticeable under harsh light. I would would give Estrogen & cyproterone a bit more time. Chances are they will avoid you a 3rd surgery. I have seen outstanding transformations with Estrogen & direct Anti Androgens on reddit's page Transtimelines. In case you end up needing a 3rd surgery then I think 1000-1500 will probably will sufficient. All the best

Unfortunately the truth is you cannot really stay away from meds if you decide to go for a transplant because of the following reasons. You risk permanent shock loss of native miniaturized hairs on the recipient area. You risk further progression of balding which means additionnal surgeries may be required while your donor area is limited... You are Norwood 5 already so if your crown drops lower for example you will not have enough grafts left to fill in everything. You may have DUPA which is androgen caused thining in the donor area too. That means your transplanted hairs will start thinning too after a few years. I would at least consider Finasteride 1mg. Minoxidil works by stimulating dermal papilla cells through potassium channels but it does not tackle the underlying rootcause of hairloss in men: genetic sensitivity of hair follicles to DHT. Good luck and all the best

Hard to say....You look like you are around Norwood 5 already. I would say at least 5000 grafts. Probably more. And when I say 5000 grafts that would be just to provide some baseline "illusion of density" coverage and make you look less than bald in appereance. That wouldn't give you real density. However you wanna stay away from clinics that do giga sessions in Turkey...They often fail because they have very poor survival rate. You should get on medication first before attempting anything. Try the following stack for at least 6 months and see how it goes. Dutasteride 0.5mg daily Oral minoxidil 2.5mg daily Fluridil or RU58841 once daily topically You need to see if you can improve some of the existing miniaturized hairs as well as strengthen them enough to avoid potential permanenent shock loss in case you decide to get a transplant further down the road. Pekiner is solid although he has a controversial reputation on this forum. So far I've seen only 2 bad cases from him. His results are okay for the most part. Bicer and Gur are both good options if you are on a budget. They are not elite but so far I've seen solid work from both. HLC is good too but not comparable to the best clinics in Europe such as Couto, Freitas, Bisanga. They have quite a few subpar results on this forum... Keser seems highly involved but Freitas or even Ferreira are probably a lot better for the same price. I'd stay away from Yaman. That's pretty much it. Even if you choose a good doctor I would do a small test surgery first to see how well you respond to it. Don't go all at once please. Never do like 5000 grafts in one session. You run the risk of losing your limited grafts forever. Some doctors like Zarev, Pitella or Hattingen for FUT have mastered mega sessions but you'd have to increase your budget.

Allright well, fair enough ! However no bitching but this is a really really small number of participants... We need the same poll on a much larger number of participants before drawing any conclusions and consider it as being representative of the majority of the population. I still don't believe the majority of hair transplant patients in the world are totally satisfied... That wouldn't make sense based on what I see on a daily basis. But maybe I'm wrong. We will see

Sure shaving your head would be the best solution if there wasn't the "shadow" variable... The shadow is the dealbreaker and your balding pattern is still gonna be visible therefore shaving is not a "solution". I guess it has to be combined with either SMP to conceal the shadow or perhaps scalp laser removal to get the clean shadow-free look. Ultimately, it takes a lot more than a simple headshave.

Nope. I disagree about that Melvin. The majority of hair transplant patients are not satisfied or not entirely satisfied. FACT Even those who do their research. That said, I do agree with you that it does depend on your goal. If you are a Norwood 6-7 just looking to get "some" hair on the hairline for example then yes sure you will be happy with the minimum. 👍 But hey we all know what is the goal of most young or younger patients is....Achieve a normal/decent or at least the illusion of normal head of hair. Yourself included... So your analogy of "why go to the gym if you are not going to look like Arnold" is nonsense in this particular context.

Agree. Norwood 3 is probably the limit.

100% agree. 🙏 At the end of the day, transplants are crap.... I've been reseraching hair transplants extensively for the last couple years. 90% of the cases I've seen (and trust me I've seen hundreds...) were either failed or unhappy, missing density or "unreaslitic expectations" etc etc.... Very few are the cases where the patient was happy with full density after only 1 procedure. Especially when someone is beyond Nw 3... And like you said, genetic hairloss is progressive... Even if you are on Finasteride/Dutasteride you will continue to lose hair albeit at a drastically slower rate... The standard doses of these only lower scalp DHT by around 40-60%. You can never stop genetic hairloss completely... Even with surgical castration you still have some residual androgen production in the adrenal glands... You got scenile alopecia later in life too that cause some aditionnal degree of inevitable thinning, DUPA can affect the donor in some people etc.... Now if you are Norwood 2 or 3 maximum with minimal loss and you get let's say 2 sucessful surgeries with a great doctor then yes you can delay/postpone the need of additionnal surgeries for a good decade or so, possibly even more provided that you use a very strong pharmaceutical stack (5AR inhibitors in combo with anti androgens and oral minoxidil). But starting off as a Nw 4-5, it is a lot more complicated and you run the risk of depleting the donor area with poor results on the recipient area... I'd try to save for a great surgeon instead of playing russian roulette with Cinik, Yaman, Serkan, AsliTarcan etc... Otherwise I'd just get SMP every 1-2 years. You got a good headshape.

Forget about Turkey please. Turkey is the perfect place to ruin your life forever. I've seen too many bad results even from the most expensive clinics in Turkey... It is impossible to undo a bad hair transplant. Repairs are crap even with the best surgeons. You have already pretty advanced loss (Norwood 4-5). You would need at least 2 large surgeries. Probably even 3. I would look into scalp micropigmentation at this stage. Chasing transplants is a waste of time, money and energy at this point. Look at Didu's case. He had similar level of hairloss to yours and got 7500 grafts with 2 expensive and recommended clinics and still has a thin midscalp.... Unless you can afford someone like Zarev, Couto, Freitas I'd stay away from hair transplants. A bad hair transplant can ruin your life. Chasing multiple hair transplants and spending tens of thousands of dollars and still being bald because of the "illusion of density" variable that they imply can be devastating too....Keep that mind please. Even if you get 3 hair transplants your hair will still look like it's thinning and it'll NEVER look like it used to before your started experiencing the curse of Androgenic Alopecia. That is sad but that is the bald TRUTH. Look at Melvin's case, look at JT look at Matt Dominance, David DiMuzio etc... They all got multiple hair transplants and spent tens of thousands of dollars (between 3 and 10) and they all still look pretty bald or thinning... Unless you have minimal hairloss like Kevin Mann or the Hair Chemist (less than Norwood 3) and IF you start Finasteride early enough, IF you are lucky, IF you choose the right doctor, IF you get 2 surgeries IF IF IF you could get the illusion of full head of hair.... Have you tried some hardcore pharmaceuticals ? Dutasteride, oral minoxidil, topical anti-androgens etc ?

I feel you bro. Your crown looks solid even under harsh lighting though. 👍 Was your midscalp transplanted during your 2nd surgery ? And if so, how many grafts ?

Combover

We all know Pekiner is pretty controversial on this forum but when we compare him and Yaman then this is day and night... Pekiner does have a few poor results. One was when he used to work under HLC back in the day. Check Erfahrungbericht nicht zufrieden mit HLC 2× on alopeziede. And also another one here on this forum on a russian patient. It was a long drama 😂 Both cases I'm refering to were good looking donor area but poor survival rate... But Pekiner came a long way. Now most of his results are solid and pretty natural. He would definitely not be my number 1 choice but if I strictly had to choose someone in Turkey then it would be Bicer Pekiner or Gur/Turan. That' it. Yaman is russian roulette. I've seen decent results from him so far but also disasters and permanently damaged donor areas etc.... I watched couple of his interviews, he seems like a nice guy but hey don't be fooled. He outsources most of his work to his techs... Often has botched jobs etc.... Pekiner all day.

You mean Rob English ? I think Rob English is a knowledgable and well spoken guy but he (just like Hairguard) want to push the Galea Aponeurotica scalp tension theory just to sell their scalp massages etc... I think the Mann did a great job debunking all this.