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Sunil Vaghela

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    • 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. 
    • Which method do you guys think results in less damage to the donor area like less scaring and lower transection rates? I think this is the most import aspect of this for me and remember someone saying manual fue was better in this regard. What's the consensus on this? 
    • Future patients of our clinic know that in case something goes wrong about the regrowth, we offer a free touch up as it was offered to you. You showed concern in all the potential side effects of the medicines you were prescribed. Finasteride (depression after only 2 weeks of usage is inconsistent with the drug mechanism of action). In addition not only you just lasted 2 weeks taking Finasteride, you also stopped Minoxidil once and for good after you had been taking it for 6 months before surgery, losing all benefits you gained thanks to the medicine. You lamented side effects even from a mild saw palmetto supplement. You behaved so bizarrely that dr. Pekiner started to have strong doubts about you following the other post operative instructions. While we are sure you did not take the prescribed drugs. Long message of his team only started to appear after you began to shoot bad words at the clinic in public forums trying to blacken dr. Pekiner's reputation and frighten potential patients. The facts are that the patients treated just before and just after your first and second surgery are all doing or have done perfectly fine. I just published two of them: Something went wrong only in your surgeries and we don't know exactly what happened. We are sure you did not take the prescribed drugs to fight androgenetic alopecia (Finasteride and Minoxidil) and dr. Pekiner has heavy suspects you did not follow the post operative instructions either.  You are sure instead it was all dr. Pekiner's fault, but the 4 patients treated just before and after you, show that the problem is in your case only. Do you have proofs dr. Pekiner performed something wrong? You don't have still you keep on shooting at him. I am repeating myself, a successful surgery requires collaboration and trust between the patient and the doctor, following the post operative instructions is fundamental. It is also possible there is something wrong in your physiology but it is impossible to determine exactly.   There is not an official guidance but it is commonly accepted in the hair restoration world that around 50 grafts per cm2 is the threshold between medium/high density and dense packing, even if that is just a conventional term, because it also depends on graft size. Mostly about taking care of the recipient area, taking the prescribed medicines, not doing heavy activities and not wearing a helmet for 1 month etc. Every clinic provides a list of how to behave after surgery, more or less things are the same for all. I cannot list them all and explain why every point is important here it would take hours. Grafts are anchored way before 7 days post op, but this doesn't mean you can treat them like normal hairs, not at all. Well then you have been badly informed, nowdays most of the top notch clinics implant at 50 grafts per cm2 and more in every case in which a norwood 1 to 4 must rebuild the frontal part and the existing hair behind is at native density. Same story for crown reconstructions. I have never seen a clinic asking a patient to come twice to implant 30 grafts per cm2 square in the first surgery and then 20 grafts in the second one on the same area. Following this principle, clinics who perform mainly frontal reconstructions at high density (lets say Keser's DermaPlast since we spoke about him before) should simply not exist, since they perform only dense packing (50 to 65 grafts per cm2) on daily bases. We perform dense packing in around 50% of our cases. What you say is logical in special cases like transplanting hair on burn scar or damaged tissue, where you have to re-vascularize the area and try to soften the tissue. There is no clinical reason to limit implantations at 35 grafts per cm2 on healthy skin. ...how come, because this is basically a vindictive topic even if it is disguised as an informative one.     Yes, finasteride would help. Dupa and retrograde alopecia are nothing but just having DHT sensitive hair follicles inside the donor area and sparse around the occipital sides (that is why it is called DUPA) and/or above and beneath the donor area and on the periauricular area. You can see patients with initial miniaturization on donor while at norwood 2/3 level, and patients at norwood 5 level with perfect donor. DUPA can begin at a early baldnes stage or not be present at all, there is not a rule. This why Finasteride is ofter considered an assurance for long term maintainance. Example: This one is a doctor Pekiner's patient, norwood 5 level, donor is perfect   This is a norwood 2 patient, he has diffuse miniaturization on all donor and surgery had to be postponed after deciding to raise finasteride dosage.  
    • I am getting HT in a few weeks and wonder what doctors have guys to cove their heads immediately after surgery. I have seen videos in which Dr. Nader has guys wear paper surgical caps home with instructions to remove it upon arrival. My guess is that he allows guys to put on on to go out. This guy wore a beanie over the surgical cap and looked completely presentable. Comments?
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