BackFromTheBrink

Agree with the above. In terms of graft numbers I was NW5 and much more progressed than you and 3200 grafts made a significant difference in my first surgery. Without any medical induced recovery of existing hairs, I'd have said you need in the region of 4k grafts but it does depend on your hair thickness and the average number of hairs per follicle. That would be 2000 for the front and 1000 each for midscalp and crown, give or take. Whichever you choose, those grafts will be transplanted. 4500 isn't ridiculous but the 3500 surgery could use a bigger punch or have better survival rate and therefore yield the same result.

Well, that's quite the mic drop. Plenty of time to seek a consult with Dr jjalay to validate Dr Zarev's cursory glance at your head. 😉 In all seriousness, you've seen the world's best and will put yourself in the best possible position for a great outcome. I'll follow with great interest - if I'm not mistaken you'll be the first Zarev repair case documented on here.

Definitely looks different. We were comparing the other surgery from fuegenix posted above. Zarev uses much smaller punches that the .9 used in my surgery. I'd agree that Zarev is the best in the world at donor management. Sadly, most of us missed the window when he was affordable. He was 4euro not long ago and it seems he's 9euro now to all intents and purposes. A €100,000 surgery is surely mostly for elite business people and celebrities.

Agreed. Here’s my head 24 hours after surgery (and not by zarev or fugenix). Standard 0.9 punch.

Then let me ask a question which cannot be misinterpreted. Given the same skill of surgeon, what % of grafts will survive on average with; 1) motorised punch and the suction technique you are advocating as ‘state of the art’. 2) traditional FUE where grafts are handled by motorised/manually punching them and extraction with forceps? I’ve no idea how you think the method of handling grafts will influence the naturalness of the result, but I’m sure you can enlighten us….

I went to Dr Michalis in Cyprus to add density to my hairline. He performs partial shave surgery and uses a manual punch. I would highly recommend him.

That's interesting, but I can't see how it relates to my comment.

I don't think 70-75 percent survival rate is accurate for traditional FUE. I'd say it was closer to 90% for accomplished surgeons. Zarev is brilliant at planning surgery. His attention to detail in examining and mapping the donor area is second to none. Combined with a highly efficient extraction technique he gets great results. However, to say it's all down to the method he uses for extracting punched grafts is a massive stretch, IMHO.

Their website mentions that: 1) they can/do use the robotic transplant method alongside traditional FUE 2) their is a primary physician, singular 3) they perform 2-3 surgeries per day, alongside free consultations and PRP sessions 4) their fixed fee is for up to 5000 grafts in one day. Their publicised 'best' results looks somewhat average to me. The hairlines are very straight and not that dense. It basically reads like there is some doctor involvement and up to 5 techs. In some of the videos the techs are seemingly marking out the various areas for extraction and implantation. Is that planning, or just marking? They may be ok, but I'd suggest they're closer to a hairmill than many would like.

Probably the $22k he mentioned in his post. OP your head still looks fairly red in the 10 months shots. Is that just the camera, or can you see it in person too? Sadly I suspect it will need a second pass, but I'd want to make sure there's nothing else going on with your scalp before going through surgery again.

Because they implanted more than one extracted follicle in some of the incisions.

It's not really three strips though, its one strip lengthened twice to get the number of grafts needed. Looking at it the other way, the OP claims 1700 grafts. What FUT strip of that length would contain as few as that, and why go back for two more areas if you're planning to short change the patient by that amount? To me it looks like the OP has 3 options - go back to the surgery and speak to him as he suggested or go and see another surgeon for a second opinion, or wait. The area covered would be very sparse with only 1700 grafts, so it'll be obvious if he has in fact had 2700.

In his letter he identified 3 roles - supervising doctor (him and Dr Feller), technician (seemingly with some more senior/responsible for providing updates) and observing doctor. He doesn't mention who does what as part of the actual surgical work, so it's open to interpretation.

I don't think his letter is unreasonable. It does, however, lack specifics on your case and instead talks generally. The only think I can see that is definitive is that he extracted and implanted 2700 grafts. However, since that is the main concern you have, I'd say he has addressed that. The implication is that you had less than 2700 incisions since he uses multiple singles in one incision 'almost every day'. Similarly, he presumes there was only one surgery taking place at the time of your surgery. If I were to guess, it would be that you have not been given specifics about your surgery because he doesn't have them (such as a record of the hair to follicle ratio of the 3 strips). He also may be concerned about you using his words as part of a legal case against him - e.g he could have checked to confirm how many patients were booked on the same day as you, but chose not to do, or not to disclose that for fear of you finding further fault. While not directly stating it, he also seems to say that there are only 2 senior doctors. Others may be 'shadowing' but would not have interfered with the surgery. It'd be useful to have a definitive statement that only he and Dr. Feller operated on you, but he chose not to take the opportunity to clarify that. From reading his letter, the only way you'll know for sure is to take him up on his offer of a consultation to ask him the questions you listed above. I don't think that will help you, other than to perhaps set your mind at rest. You have paid for the surgery, he believes he's delivered what you paid and you were in no way short changed. While it may not be what your want to hear, nothing is going to change what did or didn't happen in the surgery. You've really just got to decide whether the outcome is worth the cost (monetarily and in donor grafts), the rest is really largely just noise.

11k beard grafts will be slightly over 1 hair per follicle, so about half as many as using scalp as a donor source. 6k scalp grafts wouldn't cover the area entirely, so I'm not expecting a miracle here, but do expect/hope for very effective use of grafts to give a good illusion of density.

According to Google; On average, hair tends to grow between 0.5 and 1.7 centimeters per month. This is equivalent to around 0.2–0.7 inches. At just under 4 months-ish you're around 0.4 inches a month, so well within the normal range. Given your scalp has been undergone significant trauma i would say that's perfectly normal.

Thank you 😊 Sure, feel free to drop me a message. This was the day after my surgery.

Here is growth after 6 weeks. You can see the implanted grants have shed in the hairline so it's looking thin, but the donor is looking relatively normal. Makes a good comparison to today, with wet hair, after the 750 hairline grafts have grown back.

I think it depends on the size of the surgery. I had a little shock loss on the donor area, but I suspect many wouldn't notice. I agree though - if you cut your hair short (with scissors) with clippered sides beforehand, noone would notice after a month.

What was strange (and great) was that I regained all sensation on my head within a fortnight and the redness only lasted probably 7 or 8 days. I think all the scabs had gone by about a week too.

It was brilliant. After about 10 days there were no real visible signs of surgery, except the perculiar haircut. This was 10 days post hairline and 9 days post crown.

Dr Michalis' work is always very clean. My donor looked pretty tidy on the plane home after surgery. This was day 5.

Are you basing your recommendations or US or UK law, or don't you think the differences would be important in such a case?

They even mention it in Jackie Brown. Google it, he was very open about getting a hair transplant.

This case is troubling. There are multiple concerns here, raised by the OP. However, there are 2 that seem to be the most important, and that the surgeon appears to be in a position to help address. 1) the surgeon has already stated that 2700 grafts were extracted in an earlier post. I believe the OP wants to know how many incisions were made to accommodate those grafts, and confirmation that all 2700 were implanted. 2) The OP believes another doctor was involved in his procedure. The surgeon could help clarify how many people were in the room and what part they played in the surgery to set his mind at rest. moderators: Do you not see it that way? Do you agree the surgeon should help to answer the questions since it’s what is troubling their patient?