Rafael Manelli

Good question. A sharp punch has a greater risk of transection, which is especially so for Afro hair because it splays under the skin, and especially for multi hair follicular units. FUE is a blind procedure and requires great skill to do properly, doubly so for those with curlier hair.

a dull punch will cause greater torsion on the graft. It stays in contact with the skin longer, and sort of “grabs” the graft. Therefore when the punch rotates the graft can be twisted and damaged. A good doc might minimise this by using careful oscillation instead of continuous rotation.

At the end of the day laymen can’t control what punches surgeons use. Many use hybrid punches these days. You are better off just looking for someone who produced good results on Afro patients, instead of fretting over which punch they use.

6 minutes ago, DrTBarghouthi said:

Just waiting on Verteporfin reaching them before finalising the date. 

This has to be one of the most exciting things in hair restoration, thank you for your work Dr Barghouthi.

3 hours ago, duckling said:

just save that money for future HT and years of meds (min, fin).

This.

Adding too many “treatments” is likely to reduce compliance. In other words people find it a hassle and give up or get lax with it. Better to take Propecia daily than wear a laser helmet, spend ten minutes a day rolling needles on your scalp, spraying miscellaneous lotions and potions, and miss out on Propecia a few times a week.

Keep it simple and stick to what we know works.

36 minutes ago, Sunset Dune said:

I personally would get an FUE for a number of reasons, my donor is excellent above average with over 14,000 grafts in reserve, my current hair loss hasn’t spread that badly, I can keep getting multiple transplants in the future and I just don’t like the idea of having a long scar around my head whereas with FUE the small dot scars are not noticeable at all 

If you have that many scalp grafts available without giving the donor a depleted appearance, you will be in an extremely lucky minority indeed. You have won the lottery.

7 minutes ago, Melvin- Moderator said:

The truth is that the FUT vs. FUE debate has been put to bed. FUT is fading each year. The statistics show 75% of men choose FUE over FUT. Shockingly enough, even women choose FUE over FUT. This debate may have been relevant in 2014, but definitely not today.
 

Funnily enough, I actually wrote this poll after reading that very ISHRS census data. It seems a great topic to review on the members of the forum in the current year. The people here may represent the average better educated patient.

There seems no contesting that FUE has gained popularity worldwide.

17 minutes ago, Ant763 said:

I guess because I seen results from some people it seems to look better. And even someone like Kanye west who seemed to do a small temple one himself. But I could look more into that drug. It was the ED side effect mostly for me

The problem with doing a transplant without meds is you’ll probably continue to lose hair and need more and more surgery just to keep pace 

5 minutes ago, A_4_Archan said:

Depends on situation ...if the donor is very average and if baldness is of higher grade with big head and if the patient is young and if there is a surety of futher loss and requirement of hts in future than fut can be considered in that situation ..and if the situation is not as such thn fue would be a better option ...so all that is depend on the situation and can't be predicted now...bt fue would be suitable for high percentage of people ...

The poll is asking you, for yourself 

If you’re scared of the risks of finasteride, why aren’t you scared of the risks of hair transplantation?

ED is a rare side effect.

ED that continues long after the drug is discontinued is much rarer.

Hair retention is the most common effect of finasteride and it may help to try the drug for a few months to see if it works for you. If you notice side effects, they will likely subside with continued use. If you stop taking the drug, side effects will likely dissipate also.

You have a good head of hair. It may be best to avoid transplanting yet unless it bothers you too much, because once you go down that route it’s hard to back out since you’ll have scars and hair growing on those temples indefinitely - even if the hair behind it continues to recede, which would look unnatural.

If you want  a transplant, consider finasteride first. As for recommendations, Couto is great. Fuegenix too. Dr Heitmann also. 

On 4/21/2023 at 6:53 PM, Melvin- Moderator said:

Why are all of these 15 year old threads being resurrected.

I find it interesting to look through old threads sometimes and see what has changed or if anything sticks out as relevant to the present day. It’s compelling to see how things compare. When this thread was created, Hasson and Wong were among the only doctors doing big megasessions. Now we have Eugenix, Dr Pitella, Zarev, Hattingen, Lorenzo… and more . One could say the industry has evolved a great deal.

And Dr Hasson’s comment made me laugh  

Interested in which procedure you would rather opt for today, if you were starting from scratch - so you needn’t worry about previous scars, donor damage, or anything like that which would influence your choice. 
 

What are the main factors that would go in to your decision?

21 minutes ago, Melvin- Moderator said:

Who else agrees?

It would be a good idea to maximise exposure

@DrMunibAhmad has some great results posted here recently 

11 minutes ago, refactor said:

I am loving the result 😀.

 

Thanks!




I have added a progress pic showing the donor area at month 7, for those that are interested.

Donor looks immaculate, but to be fair this is expected at this length of hair. However I suspect it would look excellent even with much shorter hair.

8 minutes ago, Gregory said:

I didn’t have enough grafted and implanted, so it was not a good result 

500 extracted, 500 implanted and 500 grew is a good result. A bad result would be if the yield was low, or if there was damage to the donor, or if it grew in an unnatural way.

if you grow it out, does it cover much area?

3 minutes ago, DrMunibAhmad said:

Although in some cases it can be safe, i leave them alone. There is no need to rob a bank with the risks involved, if someone else is giving away free money next to the bank. 😁

That’s what I expected. I love the analogy. The extraction looks exemplary. There is a reason your practice has become so popular these days.

11 minutes ago, DrMunibAhmad said:

Not at all. These kind of naevi are common for his skintype. 

In your view is it ever appropriate to extract hair from such naevi or are they best left alone? What is your reasoning behind this?

5 minutes ago, DrMunibAhmad said:

Photography on point 🫡. Result just like i had imagined when you were here for the consultation. It's going to get even better.

I notice he has some bumps and a scar on the back of his head. Did you find this affected the extraction process at all? 

Very natural

What was the result of your strip procedure 24 years ago?

I am rarely impressed by SMP, and photos don’t always tell the whole story, but this looks very impressive.

3 minutes ago, bigmistake said:

They used just 2000 scalp grafts. In some cases only 2000 grafts are used in the hairline.

Scalp grafts can contain anywhere from 1 to 5 hairs, occasionally more. The average is about 2.1. Do you know yours?

@A_4_Archan that I can agree with. Plenty of hair mills and bad doctors in the west too. The OP has plenty of time to get a satisfactory result, and any dissatisfaction with the way his operation was conducted on the way should hopefully be moot compared to a good final outcome. He is only a few months in after all.

Seems like a waste of time and money. There are vastly superior alternatives.

1 hour ago, duckling said:

what ? He says one line and then you come and add 9 other lines trying to explain things and also you added so much on turkey 😄 did you see him/others discussing on turkey being a HT hotbed ? 

From where did you bring these lines into context :

1) Your point about Turkey is valid and it’s true that Turkey has become an HT hotbed precisely because of the permissive regulations there.

2) It’s not as if you are saying that every surgeon in a developing country is worse quality, just that standards vary across the globe, as laws and customs differ.

He just used the "turkey card" to get a pass for him calling india a third world country. There was no made on turkey, Plain and simple. Think everyone got that until you came and added more words.

I’m not here to play “spokesperson” as you call it. I am merely stating that medical standards vary legally throughout the world. It seems you’re more offended that a country would be referred to as third world, than that third world countries are criticised for their medical standards. Fair enough. To some, it’s an offensive term. He could have chosen his words better.