Rafael Manelli

https://hairtransplantnetwork.com/best-hair-transplant-surgeons/New York

I would trust any of these doctors in New York.

4 hours ago, duckling said:

From south america i have heard of two names: 

1) luis nader

2) thiago bianco

I have to echo this, Nader.

Thiago Bianco Leal is great too but he is in Brazil.

You’re about a Norwood class 5 - high sides and a bridge. Medication should be priority 1. If you can hold on to that hair in the middle and on the lateral humps, preventing yourself from becoming a class 6 or 7, you will save the equivalent of perhaps 3000 grafts. Maybe even more. Finasteride or dutasteride might actually thicken up your native hairs somewhat.

After that, I think 5000 grafts sounds about right for respectable density and a conservative hairline placement. You could go to Hasson and Wong. You could go to Hattingen in Switzerland. They do large sessions. Or you can break it up into two surgeries.

On 4/22/2023 at 2:08 AM, Beamerboy said:

This is donor area post op day 2. Honestly I’m surprised it looks this way (in a good way)  compared to what I have seen others post. 

I am not surprised. Dr Konior is among the best in the world 

A lot of people say that ASMED tend to quote higher graft numbers.

On 4/20/2023 at 9:49 AM, aykay7 said:

Hello all, just wanted to write an update.

I requested a consultation from Erdogan/Asmed and HOI, just to see what they say out of curiosity. (I have decided no way I'm going back to Turkey this time around)

HOI - I sent the pictures via WhatsApp and they answered within 2 minutes quoting me 3500-4000 grafts at 6,000USD. It was their main WhatsApp number and the quotation was done within 1 minute of me sending the pictures, so I doubt a doctor actually saw, assessed, and quoted that.

Erdogan/Asmed - I sent the pictures and they say Mr. Erdogan has evaluated and says "the surgery should consist of 5,000 grafts"

 

I definitely didn't expect to be quoted that much 😮 I was thinking I'd need 1,000-,1,500 grafts max just to increase the density. What do you guys think?

I really hope they're just gauging the grafts to increase costs 😔

I would avoid HOI.

Your hair looks sparsest at the frontal tuft. The very front middle, where it needs the highest density, not the lowest. Then there seems to be a roughly triangular area of low density behind and especially to the left side. It’s not bald however. You maybe only need 50% more density there. To be conservative, you might need about 2000 grafts minimum. Your hair seems to have a good texture for coverage. Even just 200 grafts could make a huge difference to that frontal circle.

4 hours ago, duckling said:

The results are good no doubt. Donor also looks good.  Donor has fine hair so I don't know if he can get much in 2nd surgery.

Probably because of his fine hair even with 3200 grafts and a decent area of implantation , the density came out to be good and not great. 

The trouble with fine hair is you need more density to look thick, and that means you need more grafts in the recipient but it also means you can afford to take fewer grafts from the donor before it looks thin there. And it’s more expensive in terms of money, and the grafts are more delicate.

Result here looks very natural though, and seems to have a good density. Is there a reason grafts were not prepared with a microscope?

2 minutes ago, Pauly7719 said:

Thanks Rafael, I appreciate your input.  So wearing a cap is ok then and it won't impact my growth?

It should be fine. If you wear it incredibly tightly it can be bad. People get traction alopecia that way. But that would be very rare. If you’re just wearing a baseball cap normally, it should not cause issues.

Impressive. Do you have a photo of the scar?

Too early to tell. Don’t worry about it. Wearing a cap is fine.

25 minutes ago, BaldV said:

Basically everything that you mentioned, and I wouldnt describe the last part as a simple thing. 

I understand. I think you mistook my use of the word "just". I didn't mean to imply it was 'simple', but more that it's just kind of obvious. As in, it's just common sense. People don't want that done to them. They find it gruesome. 

24 minutes ago, BaldV said:

I would never do FUT

Fair enough. Why? Do you like very short haircuts? Are you scared of scar stretching or would even a good scar be unacceptable to you? Are you afraid of just getting a big slab of flesh cut from your head? 

56 minutes ago, Z-- said:

Konior, Nadimi, Hattengin, Shapiro, H&W. Personally, if you want the smallest scar, I’d opt for the first two only. The rest do larger sessions, but the trade-off is that you are more likely to get a wider scar. 

There are all top quality for sure. 

4 hours ago, MaximusEastwood said:

I got FUT for my first procedure give i'm relatively young (mid 30s) and a norwood 6, so I wanted to maximize grafts and reduce chance of transection. Luckily I was able to get a high graft count (close to 6k), but am still having slight buyers remorse due the possibility of a visible scar. If I were to get another procedure it would definitely be FUE at this point

Are you worried that you are "locked in" to having hair now, incase hair loss advances and you can't maintain an aesthetic result, but you can't shave your head either? 

1 hour ago, Bandit90 said:

For me I really wanted the  ability to wear a fade cut, therefore, a FUE/BHT combo was the only way forward for me.  This approach also felt less risk-adverse to me, as I went in the with mindset, it it failed I could just smp and shave (without fear of a linear scar). FUE/BHT  worked for me, but I had good beard to supplement. For someone who is comfortable with having there hair long on the back, there is no denying FUT is a great way to max scalp grafts. But I think FUT downfall in demand lies in that the majority of males in there 20s & 30s want the ability to have short hair on the back and sides.

I think this is pretty accurate. The only thing I would add is that FUE has risen not just due to consumer demand but also because it's far more accessible to physicians. Learning how to do strip takes a big investment, they need a large staff, and at the end of it you have to sell it to patients with education because average guy just doesn't want it and doesn't see the point. Especially young guys in their 20s and 30s. The other thing is learning FUE gives the doctor access to BHT as well. It's clearly worked out very well in your case. 

8 minutes ago, Melvin- Moderator said:

No, I’m saying when I went to the clinic I had a clear plan of where I wanted grafts. I didn’t go in with the plan of only doing my hairline and temples. I think Eugenix can be too accommodating to a fault. If a patient is unable to accept the reality of their hair loss they should be denied. No matter what, the patient can complain. We see complaints all the time _surgeon rejected me. It’s a no-win situation for the clinic. But best to not proceed with surgery, especially if a patient is trying to dictate the surgery and tell surgeons how and where to place hairlines and grafts.

My point is that results at 4 months should never be judged, regardless of the clinic. Even if a patient goes to the worst hair mill on earth, there’s a chance they could end up happy. 4 months is way too early to form any judgement. Judging a result this early sets a dangerous precedent on the forum. 

Judging an HT at 4 months is like judging a crop harvest at 4 months. It’s simply far too early.

I took a look at the topic where he used the term, that is what I mean. I was just looking for context. But I understand your position and I see how it was fairly criticised as derogatory.

I’m trying to give the benefit of the doubt.

Just now, Melvin- Moderator said:

If its past a year old, there’s no reason to bump it. If it’s a relevant topic you want to discuss, create a new topic. 

Okay. That is fine by me. I made a mistake in thinking it would be better to bump an old thread than start a new one of a similar topic. I am sorry.

14 minutes ago, Melvin- Moderator said:

That’s a very condescending and patronizing comment. It’s shocking that a doctor would use that on a public forum. It was shocking to the entire community.

Fair enough. I believe Dr Feller was simply using it to distinguish between physicians and laymen. But I see your point that it came across offensively.

4 hours ago, Melvin- Moderator said:

Please stop bumping old threads.

Okay. I apologise. I thought a blast from the past would sometimes be appreciated, and I thought the topic was still relevant. I guess I’ve done it too often recently. 
 

May I ask how old is too old? I figured 4 or 5 months would be fine, or a year or two. Does it depend? Is asking for updates on results okay? Once again I am sorry for reviving this old topic and the one that was last updated in late November. I didn’t know it was a problem.

3 minutes ago, GeneralNorwood said:

Yes, you were better educated when you had surgery at Eugenix, i can't deny this. Remember that they graded me Norwood 3V, which reasured my false belief.  You can blame me for being delusional that i was 3V, but what about the clinic? Clinic is not some random dude, who read some information about balding on the internet, Eugenix did thousands of procedures and they are well educated in subject of hairloss and hairtransplants. And they still graded me 3V, so think about that. 

So basicaly you are saying that if you don't have solid plan by yourself and you are not educated correctly about your baldness, don't count on Eugenix that they will make solid plan for you. 

 

I don’t think a patient should be blamed for putting his trust in a clinic when they tell him he is a class 3V. Laymen are expected to put a level of trust in experts, especially if they are going to be cutting their scalp open. Your head is literally in their hands.

“Peanut gallery” is not a phrase with offensive and negative connotations in my book. Perhaps it varies country by country. It simply refers to the audience. We’re all peanuts sometimes.

7 minutes ago, HairEnthusiast101 said:

Oh I was viewing it as fut first than fue compared to just fue. But who knows maybe it wouldn’t matter. Big fue cases are taking hair outside of the safe zone too though while a good fut is usually in the safe zone. But yes multiple strips leads to big scars should rarely do more than 2 

It’s mostly just a laxity thing. Some people have enough for 5 strips. Some only have enough for one.

8 minutes ago, BRITA-XL said:

Hindsight is a wonderful thing but yes, I would not have chosen Dr Z and i would have done much better research and not be led by marketing. However this was 2010

I was scratching my head reading this because I couldn’t think of Ziering and the only Dr Z that came to mind was Zarev 😅

6 minutes ago, Z-- said:

My estimate is that FUE only for 85% of men is best. If you’re Norwood 4 or below, I don’t see why you’d ever bother with FUT. 

FUT is best for younger men (sub 35) who may lose more future hair and need to maximize graft count (to get 1-2k additional lifetime grafts). This is probably generally going to be diffuse thinners, esp those not on meds. 

Even then, only 5 or so doctors worldwide are worth going to for the FUT scar. Personally I still feel FUT was the right call for me (it helps I can hide there scar at a 2.5 or so fade) but I think FUE is best for the vast majority. 

Interesting. Who are the 5 or so doctors you have in mind?

5 minutes ago, BRITA-XL said:

True, i remember a lot of FUT/FUE debates back around a decade ago, Dr Feller was always very pro FUT. They both still have their place, but in 2023 those patients are becoming fewer and fewer. Not many Drs are actually performing it on a regular basis.

If I started over I would absolutely be choosing FUE/BHT even as a NW6. After 2 FUTs and subsequent revision it’s still not good, and that is with trichophytic closure.

Do you think your result would be better if it had been done as an FUE?

That sounds like a plan. Just make sure you go to a proper good clinic AND the doctor is a good one.

4 minutes ago, mr_peanutbutter said:

i wished more clinics would post that angle, its definitely the least forgiving angle

 

 

excellent work

Great point about the photo angles.

24 minutes ago, Sunset Dune said:

Per Dr. Victor Hasson he told me I have way above average donor and 14,000 grafts in reserve. He even told me I can keep getting transplants if I chose not to use medication, I’m considering that because I really don’t think the side effects are worth it

You are set for life.