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a.j.

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About a.j.

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  1. Whether the extraction tool is motorized or not isn't really the question. What determines the nature and extent of FUE scarring and donor damage are the punch sizes used, the extraction pattern and spacing within the donor, and the extractor's skill.
  2. By "manual," Dr. Diep means handheld. As in, non-robotic. He uses a motorized punch device with foot pedal control similar to a dentist's drill or Devroye's WAW. I think he rigged it up himself or had someone build it for him.
  3. Good point. As good as Dr. Lorenzo is with FUE, I personally find that the cosmetic results of his frontal zone/hairline work isn’t quite up to the level of other elite ht docs, such as Konior, Rahal, etc. I see the same thing with another excellent FUE doc, Dr. Doganay. My theory: Both these docs use implanter pens to make their recipient sites, which are essentially round needles. While these pens have their benefits for FUE procedures, what is lost is the enhanced shingling effect and refinement achievable with custom cut blades making lateral slits. Quite some time ago, I recall that Jotronic posted a video demonstrating differences between needle-made sites and sites made with blades.
  4. I’m so glad Spanker noted this (and that Loags79 seconded it). I thought maybe I was bonkers for thinking that Dr. Erdogan’s frontal hairline work, although usually impressively densely packed, can appear somewhat harsh/lacking in irregularity in a way that can say “transplant." I suppose it is just a different aesthetic, but I will say that my girlfriend, who is much less ht-photo saturated than I am, has noticed the same thing.
  5. If by “successful rate” you mean graft survival rate, I haven't seen that to be the case -- anecdotally or quantifiably -- when comparing the body of work posted here by top FUE docs and their patients.
  6. Wonderful, utterly natural result, cenkoa01! Great facial framing and a terrific distribution of grafts between hairline and crown. Based on consistency of yield and artistry, I’d have to say that my top pick today for a 3,000-4,000+ FUE transplant would be Dr. Hakan.
  7. Dr. Greco's PRP procedure protocol involves the use of a dermaroller/scalproller to "injure" the scalp on the theory that it serves to activate the platelet rich plasma or otherise enhance the effect of the procedure. You can see Dr. Robert Jones use such a roller in his self-administered PRP procedure on YouTube. Dr. Feller currently uses manual needle pricks in place of a the scalp roller. I don't know of hair restoration physicians who subscribe to the view that traumatizing the scalp with one of these rollers stimulates regrowth or enhanced growth on its own (absent the injection of platelet rich plasma beneath the epidermis) - but maybe some do? Esteemed physicians? a.j.
  8. Bill, Dr. Feller has the "before" photos, which I will ask him to post. In retrospect, I should have asked him to take more detailed photos of the top rear two-thirds of my head and rearward from there to the crown, and I should have asked him to take hair counts and to measure hair shaft diameters there. Those areas have only just begun to thin slightly, and are the areas I most want to bolster and maintain via PRP. While it would be nice to get some cosmetic benefit to the 1" deep, moderately miniaturized zone in front of that area and even to the 1" deep, markedly miniaturized and diffusely thinned zone in front of that (directly behind my old "mini" grafts), the primary objective is to bolster and maintain the top rear two-thirds and crown while they are still relatively robust. If I transplant the frontal third, I don't want to have to "chase" my hair loss with future transplants. Propecia is not an option for me because the two times I tried it I had adverse reactions sufficiently severe to cause me to stop taking it after a few days. Besides, Propecia seems to lose its efficacy for some users after a number of years. If PRP fails to reverse, or at least halt the early thinning of the top rear two-thirds and crown, I might well decide simply to have the 50 or so old "mini" grafts removed, maybe FUE into my three-inch-long scar, and start close-cropping the old noggin. To my way of thinking, that would be preferable to a lifetime of "system" wearing or stripping myself out to where my eyebrows are on top of my head and my ass is at my ears. That said, if PRP works for me (fingers crossed), I would go ahead with a transplant and be okay with repeating PRP every six months or so -- sort of like Botox for men. brentipold, I paid $800. As of today, the fifth day following PRP treatment, I have only two dime-sized spots of slight tenderness that I don't notice unless I press on them. For me, four days out was when residual tenderness/soreness became a non-issue. Grow well! a.j.
  9. So yesterday, I had my PRP treatment with Dr. Feller. The treatment itself is quick. It took about 45 minutes from start to finish. The whole thing was done with me sitting in a reclining 'dentist' chair. It commences with a tech drawing a large syringe of blood, which is taken to another room where it is put in a centrifuge that spins it to separate the platelet rich plasma from the other components of the blood. Dr. Feller then numbed the areas of my head we agreed to treat with PRP by injecting them with a numbing agent (probably Lidocaine, but I neglected to ask). This was the only uncomfortable part of the treatment. Those of you who have had a hair transplant will no doubt remember the numerous 'sticks' of these injections. Dr. Feller is adept at giving them and lets you know what to expect with each one ('a stick, and a little pressure'). As the area begins to numb up, the discomfort of successive injections is diminished. Each injection is accompanied by a little 'crunching' sound that is conducted from the site of the injection through the skull. Don't be alarmed. The tech returned with the syringe of my platelet rich plasma. Because the top of my head was numb, I wasn't entirely sure whether she was injecting the plasma beneath the scalp at various places, but I am pretty sure she was. Once the plasma was used up, she went over the entire area with a needle, making lots and lots of little pricks (which weren't felt because the area was still numb). My understanding is that this activates the platelets. Before the procedure, I asked Dr. Feller about his use of needle pricks versus a perforating wheel, such as the one I saw Dr. Robert Jones (Toronto) use in his video demonstration of his self-administered PRP treatment. Dr. Feller believes that the pricks (which are more labor intensive) should be more effective because they penetrate the scalp, whereas the wheel only irritates the scalp. Anyway, that was it. Done! Today, I have only a little soreness at a couple of small spots. As I mentioned elsewhere, I wanted to try a PRP treatment in anticipation of having a HT of my frontal third (more like frontal fourth), including the hairline. (I had a very small session of "mini" grafts placed just behind the hairline zone about 15 years ago, but have worn a hairpiece since.) I want to see if moderate miniaturization of hairs comprising about an inch-deep or so strip on top of my head can be stopped or reversed so as avoid having to transplant into that area. I also want to see whether the hair farther back on top of my head leading towards the crown, which has only recently started to miniaturize and thin a bit, can be bolstered and maintained without drugs. Dr. Feller and I also discussed 'turbo charging' my donor area with PRP a couple of weeks prior to transplant. Dr. Feller was up front about the nascency of using PRP to treat hair loss. At worst, he says, it will do no harm because it is your own blood. What I know of the science and the successful history of PRP for other medical purposes makes me optimistic that it could deliver cosmetically significant benefits for hair loss, but only time will tell. Dr. Feller took 'before' photos. I will be taking photo updates every few weeks or so over the next several months, which either I or Dr. Feller will probably post here. (Note to Dr. Feller: Feel free to post photos with my facial features masked.) Cheers, a.j.
  10. As I mentioned earlier in this thread, I am having a PRP treatment with Dr. Feller tomorrow (Monday). My situation is this: I started wearing a frontal hair piece about 18 years ago after my hairline started receding. About 15 years ago, I had a very small trial ht session. I had less than 100 'mini' grafts placed just behind what would be my hairline zone. (The hairline zone itself is completely barren.) I ultimately decided to wait for improvements in ht technology and technique before going whole hog with a transplant. So I kept wearing a hair 'system.' Since then, my recession has progressed, although not dramatically. I am probably around a Norwood 2A, maybe getting to a 3. The hair directly behind where the mini-grafts were placed has markedly miniaturized and thinned, the hair directly behind that less so, and the hair on the coronal hump and back towards the crown is still pretty robust. I have decided to get a transplant to my frontal third. Before I do, however, I want to see whether PRP treatment(s) can sufficiently shore up and fill in some of my miniaturized swaths of hair to possibly make it unnecessary to transplant into them, or at least allow for minimal transplantation into those zones. (We've got to preserve our precious donor hairs.) I also want to determine whether PRP can keep my relatively robust hair in good stead and maybe even give it a bit of an 'umph' without using drugs. And, finally, I want to see whether PRP can 'turbo charge' my donor area in anticipation of a transplant. I was thinking about starting a new thread to diary my procedure and progress, if there is sufficient interest. Or I can just add to this thread. Members? Moderator? Tomorrow should be interesting! A.J.
  11. I will be having a PRP treatment with Dr. Feller this coming Monday, August 3rd. I'll see if I can get some before pics to post and then post updated pics as things progress.
  12. john36, If I could give offer some friendly advice? Based on your description, you could very well have received substandard care in connection with your hair transplant. The problem is, though, you have been making appointments with other transplant physicians under false pretenses. Rather than telling them up front that your primary purpose in seeking a consultation is to obtain a medical affidavit for use in your lawsuit, you are leading them to believe that you are consulting them for repair work. No one likes to be sand bagged. By trying to "catch" them evaluating your prior work negatively and then springing an attorney letter on them, you are all but guaranteeing that they will decline to provide you with the medical affidavit you seek. If you or your attorney would be honest at the outset, it might well improve your chances of obtaining the affidavit required to pursue your lawsuit. A phone call, letter, or email from your attorney to several respected transplant physicians saying that his client (you) wishes to schedule a consultation to evaluate the work that was done by your transplant physician and to obtain an affidavit of his or her medical opinion, might well bear fruit and, at the very least, would save you wasting your time and physicians' time with futile "consultations." You should be prepared to pay for the evaluation since the purpose of the consultation is not for possible treatment. Your attorney could consider dangling the carrot of the physician doing repair work for you. However, that could call into question the credibility of the physician's opinion if it were to be challenged by the lawyers representing the doctor you are accusing of medical negligence. Just a thought. Good luck.
  13. Thank you, Lorenzo. The thing is, I WANT to be persuaded that Dr. De Reys can achieve as consistently exceptional results with his particular FUE technique as Coalition Physicians achieve with strip. But it doesn't help my confidence that Prohair Clinic would engage in what I consider to be dodgy marketing tactics. Why not just be up front and clear that Bart co-owns the clinic? Remember the Remington Electric Razor spokesman, who also happened to be its CEO? "I was so impressed, I bought the company!" And why not be clear and up front that Bart's FUE transplant(s) was/were not performed by Dr. De Reys but by another/other clinics? Why not just say (if it is true) that I (Bart) got these results from other physicians using techniques that were state-of-the-art at the time, but FUE in Dr. De Reys' hands has eclipsed even those techniques and produces consistently great results? Then back it up with plenty of before-and-after photos, graft counts, and hair counts of patients whose FUE transplants were actually performed by Dr. De Reys. My guess is that Prohair Clinic is a relatively recent creation and that it will take some time for Dr. De Reys to stockpile significant numbers of results photos. Still, I think they hurt their case by being less than forthright about Bart's transplant history and his ownership interest in the clinic. This is not a knock against Bart. I don't know him. I am only speaking as a consumer who might seriously consider Dr. De Reys but for the (in my opinion) less than candid marketing of his services. a.j.
  14. good bhoy - My reservations regarding Prohair Clinic are: 1. The web site fails to disclose that "Bart," whose patient photos, bio, and web blogs are front and center in the "Patients Pictures" and "Patients Weblogs" sections, is the co-owner of Prohair Clinic. In fact, in one of Bart's two weblogs linked from the web site, he says, "My intention of publishing this web site is to document my personal experience for those that still have a lot of questions about hairtransplantation using FUE." His other linked weblog, which links back to Prohair Clinic, proclaims that "FUE rules!" I would think that visitors to the Prohair Cinic web site and to Bart's two linked weblogs would want to know that another "intention" of Bart is to promote FUE and Prohair Clinic for Bart's personal financial gain. 2. The web site buries the fact that Dr. De Reys did not perform Bart's FUE transplant(s), and makes inconsistent claims as to who actually did perform Bart's FUE transplant(s). One of Bart's two linked "Patients weblogs," with photos showing 3 - 11 month results of his FUE transplant, proclaims, "FUE Hair transplant Prohairclinic dr. Ilter: Another FUE hairtransplant, this time by Dr. Ilter at Prohairclinic in Belgium." THAT weblog suggests that Dr. Ilter did Bart's FUE transplant and is a Prohair Clinic physician (he is not, so far as one can tell from the web site, which only identifies Dr. De Reys as its hair transplant physician). Yet, Bart's other linked "Patient weblog" claims that his FUE transplant was performed by "Dr. Jones in Oakville Canada." Similarly, the bio accompanying Bart's "Patient photos" makes passing mention of the fact that Bart's FUE transplant was done by a "dr. Jones," but without making it clear that the physician who did the work on display is not Dr. De Reys and is not affiliated with Prohair Clinic. 3. For many, many months, the web site has displayed the same half dozen or so patient results (not counting Bart's), including some with small thumbnail photos that cannot be enlarged for a thorough viewing. 4. The web site states that the "FUE-plus" technique used by Dr. De Reys is a "refinement" of the FUE technique that decreases the transection rate to between 0% and 1%, but does not describe the so-called refinement or provide any studies or evidence to support the claimed transcection rate. 5. The web site misstates the nature of the "lateral slit" technique pioneered by Dr. Wong, which Prohair Clinic purports to use. The lateral slit technique is not only the use of small blades to make the recipient sites, as the web site suggests, but a different orientation of the sites than has traditionally been used. 6. The web site claims that, "Today it has been generally accepted that a well executed FUE hair transplantation will lead to equal, or even better survival rates compared to other techniques." Based on what I know, that claim is not accurate, and the web site fails to provide any surveys, studies, or other evidence to support such a consensus among top hair transplant physicians. 7. The patient photos show what appear to be some pretty good results, but taken as a whole they do not, to my eye, indicate consistently excellent results for the number of grafts transplanted compared with the body of work displayed by other physicians using strip. Having said all the above, I was quite impressed by two YouTube videos of Dr. De Reys performing FUE that Bart put up. Dr. De Reys seems to have a very deft hand and technique, which appeared to require NO PULLING, TWISTING, TORSION, OR TRACTION of the follicle to remove it from the donor hole after it had been punched. Dr. De Reys' punch technique looks to incorporate a rapid "twiddle" of the punch between his thumb and index finger as the punch descends into the scalp. He also appears to have a sure stopping point, which might not be quite so deep as other practitioners of FUE. Whatever he is doing, it seems to free the follicle completely upon removal of the punch. On the videos, it appears that the detached follicles are merely lifted out of their holes with a set of tweezers, without any pulling or twisting. In other words, at least for the case(s) depicted in the videos, the follicles seem almost to "pop out" with no resistance. The few demonstrations of FUE I've seen haven't used the rapid "twiddle" during the downward punch, and the follicles put up noticeable resistance when it comes time to remove them. I could see how Dr. De Reys' technique could do less damage to the follicles, assuming they are not transected by the punch. My guess is that by using very small punches and very carefully placing the punch over an appropriately sized follicular unit, Dr. De Reys keeps transection rates to a minimum for the FUE method. Personally, I would like to see more before-and-after photos from Dr. De Reys instead of the same handful that appear on the web site and that Bart keeps posting on this and other forums. I would also like to see the concerns enumerated above addressed with modifications to the web site. a.j.
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