1 euro per graft strip, 2 euro - fue

[linchpin]

Hello again Doc, nice to hear from you and thanks for those great photos. As I mentioned, everything has been super since I had my procedure with you 3 weeks ago (except that I'm still waiting for my shaven donor area to cover over fully with hair again, so I still have to wear a hat for a few more days!)

 

And in response to your post Happy, it's true that there really wasn't any pain to speak of, and the very next day after the operation I was more than comfortable with the idea of going on a sightseeing tour. And the swelling from the op really did vanish overnight.

 

Thanks again Doc. If I ever need any more transplanting done (and let's hope I don't), I wouldn't think twice about going anywhere else - I'll be straight on the plane to Georgia to see you again!

 

I might just have to visit anyway, to partake of some more of that lovely Georgian wine...

[linchpin]

Also a question for you Doc: I think Surfarosa has an interesting point above. As your methods are clearly more precise than most other clinics and as your assessments are based on actual data (instead of guesswork), in combination with lengthy discusions with the patient, do you think your clinic might consider leading the way in presenting each patient with a short report on your findings?

 

It would only have to be a small one-page assessment of the pre-op and post-op condition of the patient's scalp, and your recommendations for the future, based on current observations. As Surfarosa has said, this could be used by the patient as the basis for any further treatments needed.

 

I know you like to stay at least one step ahead of other clinics and I'm sure you already keep a file for each patient, so do you think this sort of thing would be possible, or indeed useful?

Edited September 6, 2010 by linchpin

[1966kph]

hello talizi,very informative posts above,could you please tell us more about your fue procedures,ie what size of tools do you use?, what ammount of grafts will you use in a session?, is the extraction by manual or mechanical means? is it two euro per fue no matter what size of a procedure it is or doe's the cost reduce after a certain number?have you determined what your your survival rate is with fue? i must admit your work looks very good are you intending to apply for recomendation here,?if so good luck to you,have a nice day....

[Happy]

also a big thank you from my side and for your contribution, talizi!

 

what i really do appreciate is, again, your clinic's transparent approach. i personally believe that this will be the next big step in ht, in particular when a clinic is able to provide a detailed report as surfarosa suggested.

 

now before i overload you with too many questions, let me just focus on the following one for the time being:

 

since the clinic's assistants provide detailed reports about the amount and size of grafts that were harvested - what, in your clinic's experience, is the average size per graft of your patients?

 

ps: i did a rough calculation of the picture with the hand written numbers that you provided. and the average was about 1.8 hairs per graft. and which is very low.

[Happy]

I have always thought that a telogen–anagen ratio or some other metric pertaining "rate of hair-loss" or "stability" is absolutely critical for this science to have any real credibility.

 

This should be an absolute in what Coalition doctors should be doing without exception. Stability is such a critical component (even though it can change for various reasons) even if it's a snapshot in time. If the technology is there it should be part of the gold standard for sure. Doctors could then say that you have become less stable than 3 years ago - we need to change your medications up etc etc ....

 

I also think full "standardized" reports should be given to patients before surgery and after 12 months.

 

i.e. you had this many FUs harvested successfully. They were placed in these regions at these densities. The survival rate was estimated at x %. You have xxx of FUs left in your donor area that could be used with a further xx via FUE.

 

Then you can take your report to another doctor if you decide to have further work done elsewhere (or you current doctor disappears) or to seek a second opinion. This would eliminate so much of the conjecture and subjective b/s that plagues this field of surgery. As you history is a critical indicator of you destination with this condition, how can we not demand this ?

 

I think this step forward as a standard would be awesome for us patients & would elevate this community. It would really make doctors have scientifically comparative results and elevate the bar beyond what really is just opinions about photos for most patients and potential patients.

 

What do others think ?

 

surfarosa,

 

i think your idea of a standardised report is a superb suggestion since this makes everything so much more predictable for a patient. and for that reason i would encourage you to start a new thread to discuss this idea more in depth and with as many forum members as possible.

 

in case you don't feel to start one, i am Happy to do it instead.

[Surfarosa]

Hi Happy - already started it but no response yet. Feel free to be the first to get it going !

[Talizi]

surfarosa,

 

i think your idea of a standardised report is a superb suggestion since this makes everything so much more predictable for a patient.

 

We make such reports for every our patient and keep it in our database, so if the patient comes for the next hair transplant surgery we can see improvements and changes on his head. If patient requests this report we provide it.

Edited September 7, 2010 by Talizi

[Talizi]

Could you please tell us more about your fue procedures, ie what size of tools do you use?

For FUE we use titanium covered punches from Ellis Instruments: for 1–2 hair grafts – 0,75 mm

punches and for 3–4 hair grafts – 1,0 mm punches.

 

what amount of grafts will you use in a session?

In case of FUE per session (up to 8 hours) we use 2000–2500 follicular units (4000–5000 hairs).

 

is the extraction by manual or mechanical means?

We use special machine for FUE. It is used by surgeon only for rotating titanium covered punches

(0,75–1,0 mm), which are used only for initial incisions. Graft extraction is always done manually. Watch our videos about FUE on site or YouTube (and a new one with more details is coming soon).

 

is it two euro per fue no matter what size of a procedure it is or doe's the cost reduce after a certain number?

The price for FUE in our hair transplant center is 2.5 Euros per graft now. The price was 2 euros per graft in 2009. The price per graft is fixed no matter of the scale of the surgery. Unless any discount is provided. Discounts take place often in Talizi.

 

have you determined what your survival rate is with fue?.

Our survival rate in case of FUE is the same as in case of strip surgery – 90–92%.

 

since the clinic's assistants provide detailed reports about the amount and size of grafts that were harvested – what, in your clinic's experience, is the average size per graft of your patients?

By our experience, average hair quantity per graft is – 2 hairs per graft.

 

i did a rough calculation of the picture with the hand written numbers that you provided. and the average was about 1.8 hairs per graft. and which is very low.

Hair/graft ratio varies 1,7–2,3 hair per graft and depends on patient's skin feature.

Edited September 7, 2010 by Talizi
Grammar corrections

[Happy]

We make such reports for every our patient and keep it in our database, so if the patient comes for the next hair transplant surgery we can see improvements and changes on his head. If patient requests this report we provide it.

 

this sounds great.

 

would you be able to provide a real-life example how such reports look, eg. from a patient who had more than one surgery done with your clinic.

[Happy]

 

We use special machine for FUE. It is used by surgeon only for rotating titanium covered punches

(0,75–1,0 mm), which are used only for initial incisions. Graft extraction is always done manually. Watch our videos about FUE on site or YouTube (and a new one with more details is coming soon).

 

 

 

 

in other words, your doctor uses a power driven tool for creating the punches. as far as i know all the world renowned fue surgeons only make the punches manually as this seems to create less transected grafts. for example, the prohair clinic guarantees that less than 1% of the extracted grafts get lost due to damage.

 

what is your surgeon's opinion on that?

[1966kph]

hello talizi,thankyou for provideing the answers to the questions i asked you,as happy states above and from my own conversations with fue surgeons,they have tryed the mechanical punch but prefare and only use a manual punch even though it makes it slower and less profitable for the clinic,thankyou and have a nice day...

[Talizi]

in other words, your doctor uses a power driven tool for creating the punches. as far as i know all the world renowned fue surgeons only make the punches manually as this seems to create less transected grafts. for example, the prohair clinic guarantees that less than 1% of the extracted grafts get lost due to damage.

 

what is your surgeon's opinion on that?

 

Akaki Tsilosani says: "Some hair transplant surgeons assert, that their transection rate during FUE procedures is below 5% as a result of their big experience and exclusive instrument use. Transection less than 1% is impossible. So, it`s difficult for us to believe. In our practice, follicle transection percentage during FUE is 10–15%.This is truth, but transected follicles will grow back in the donor area because the root of the hair remains there.

 

That`s why we consider rechecking harvested grafts under microscopes to be important. Each grafts transection is checked and only good ones are counted and transplanted.

 

Transplantation of 2000 grafts by FUE during 1 session with manual and small punches is simply impossible. Only 600–800 grafts may be transplanted.

 

We have 10% transection, others 1%??? So, you choose..."

Edited October 7, 2010 by Talizi

[linchpin]

Thanks again Talizi. This is something I mentioned earlier, that it's nice to have a surgeon who will tell you the truth and not try to make claims that aren't supported by the evidence.

 

It's important to have an honest relationship with your surgeon so that you can trust his advice and guidance in what could otherwise be a very stressful situation, and that's something I found to be very helpful when I had my procedure with you. There was never any attempt to evade any of the questions I asked, and the answers I received were always straightforward and explained properly to me.

 

I have seen material from some clinics where they claim to have virtually 100% success rates with FUE follicles but common sense dictates that with this kind of procedure there will always have to be a certain amount of transection, so I think I would take it with a very large pinch of salt if my surgeon told me he could achieve a loss of only 1%.

 

As a final note, I have been thinking about the FUE procedure I just had. There's no way I can claim to be any sort of expert, but I would have to say the FUE extraction method used seemed very precise and involved the minimum amount of disturbance to my scalp.

 

It strikes me that a surgeon using a well-designed powered instrument should be able to make incisions that are at least as delicate and precise as someone who has to manually force the punch into the scalp at the same time as aiming it properly at the target follicle!

Edited September 13, 2010 by linchpin

[Happy]

many thanks again for your contribution also including tsilosani's response. as for his statements, however, i am not quite sure whether other docs and patients will agree with him.

 

Akaki Tsilosani says: "Some hair transplant surgeons assert, that their transection rate during FUE procedures is below 5% as a result of their big experience and exclusive instrument use. Transection less than 1% is impossible. So, it`s difficult for us to believe. In our practice, follicle transection percentage during FUE is 10–15%.This is truth.

"

 

have a read through what another fue clinic, prohair clinic is saying on their website about damaged grafts during extraction process:

 

"...an inexperienced team who does not carry out or know the FUE technique properly will damage 5-10% of the grafts.

 

However, team Prohairclinic work exclusively using the FUE version, in which damage to the hair root scarcely ever occurs. This is why we guarantee that less than 1% of grafts are lost during the extraction process. This is far fewer than in other commonly used hair transplant techniques."

 

 

Transplantation of 2000 grafts by FUE during 1 session with manual and small punches is simply impossible. Only 600–800 grafts may be transplanted.

 

We have 10% transection, others 1%??? So, you choose..."

 

"Currently we are able to transplant up to 2000-2500 grafts (follicular units, sometimes also known as grafts) per day on the same patient. This means that we can transplant up to 4000 grafts on 2 successive days. This is much more than an average strip/FUT procedure."

 

as far as i know the prohair clinic doesn't use any power driven tools at all exactly for the reason to keep the transection rate that low.

[Happy]

For FUE we use titanium covered punches from Ellis Instruments: for 1–2 hair grafts – 0,75 mm

punches and for 3–4 hair grafts – 1,0 mm punches.

 

 

i hope, not to come across as being too critical, but i am a bit concerned about the size that your clinic uses for the 3-4 hair grafts.

 

from what i have learned in my research is that if the size of the punch is too big (i.e. 1mm inner diameter), the chances are very high that this will result in miniaturisation of the neighbouring grafts in the donor area.

 

in order to minimise this risk, punches with a maximum diameter of 0.85mm for the 3-4 hair grafts are being used, ideally 0.8mm.

[Happy]

 

It's important to have an honest relationship with your surgeon so that you can trust his advice and guidance in what could otherwise be a very stressful situation, and that's something I found to be very helpful when I had my procedure with you. There was never any attempt to evade any of the questions I asked, and the answers I received were always straightforward and explained properly to me.

 

 

i fully agree! and this is why i do love surgeons and clinics who are 100% transparent whilst always providing honest answers.

 

that's how you build relationships in any area, of course also including our private life ;-)

 

I have seen material from some clinics where they claim to have virtually 100% success rates with FUE follicles but common sense dictates that with this kind of procedure there will always have to be a certain amount of transection, so I think I would be a fool to expect that kind of result if my surgeon told me he could achieve it.

 

from what i have learned i also fully agree in this respect. anybody making these claims needs to be treated with suspicion.

 

 

 

 

As a final note, I have been thinking about the FUE procedure I just had. There's no way I can claim to be any sort of expert, but I would have to say the FUE extraction method used seemed very precise and involved the minimum amount of disturbance to my scalp.

 

It strikes me that a surgeon using a well-designed powered instrument should be able to make incisions that are at least as delicate and precise as someone who has to manually force the punch into the scalp at the same time as aiming it properly at the target follicle!

 

like you, i can't claim to be an expert either in the ht industry. and from what i have seen and read from tsisolani so far, he seems to be an outstanding ht surgeon with a passion to excel.

 

as for his current fue technique and by just looking at the bare figures and his used punches, however, i get the impression that there is still room for him to improve compared to other, outstanding fue surgeons.

[Happy]

for today i would like to ask your doc hopefully 2 easy questions:

 

1. do you sometimes split grafts into smaller units? (eg. a 4-hairs graft into 2-hairs grafts or a 3-hairs graft into a single-hair graft and double-hair graft)

 

2. on your website i noticed that it mentions a range of publications with quite groundbreaking topics - eg.:

 

- conditions/advantages of large-scale surgeries with 4000+ fu's

- measures to reduce the impact of post-op scarring with the strip method

 

unfortunately, no content has been provided yet. would you be able to maybe summarise the most important information that the relevant publications contain?

[mattj]

From what I've heard from other FUE surgeons, it's not always possible to tell if a graft has been damaged during extraction.

 

When you consider that there have been numerous FUE cases where very poor yield was achieved, it seems unlikely that in those cases almost every graft that passed under the technician's microscope had visible damage.

[Blake Bloxham]

Talzi,

 

While I appreciate the fact that you provided some information and cleared up any earlier misconceptions regarding your clinic, this thread has essentially become an ongoing advertisement and consultation center for the practice. Until a clinic has been proven that they meet our high recommendation standards for hair restoration, they are not free to self promote on our forum.

 

If you would like the clinic to be considered for recommendation, please contact Bill at help@hairtransplantnetwork.com and discuss the screening process.

 

Thank you for understanding.

[Happy]

how is it then possible for him or the surgeon to answer questions "correctly" ?:confused:

[Blake Bloxham]

how is it then possible for him or the surgeon to answer questions "correctly" ?:confused:

 

Happy,

 

I would recommend contacting the clinic directly or exchanging emails (ie: any sort of communication that does not involve promotional content on the forums). I do apologize for any sort of inconvenience, but our terms of service are quite clear when it comes to promotional content and these rules help keep the boards efficient and patient oriented. If you have any concerns, feel free to send me a private message and we can discuss it. Thanks!

[Happy]

 

our terms of service are quite clear when it comes to promotional content

 

 

i had a read through your terms of service again, but can't find anything. hopefully, you can help. thanks

[Blake Bloxham]

i had a read through your terms of service again, but can't find anything. hopefully, you can help. thanks

 

Terms of Service:

 

Posting Rules:

 

Any decisions as to whether any User Submissions violate any Posting Rule will be made by the Web Sites in their sole discretion and after they have actual notice of such posting. When you provide User Submissions, you agree to the following Posting Rules:

 

2. contains links or references to websites or resources of a promotional nature that are outside our network of websites and resources.

 

As I stated before, the nature of this thread had turned promotional, and this is a strict violation of our terms of service.

 

I hope this helps!

[ukbloke]

What an interesting thread I stumbled accross on this very pleasant Autumnal morning here in the UK. Has the situation regarding this clinic being recommended developed any further?

[Blake Bloxham]

Ukbloke,

 

At this time, the clinic is not recommended by our community. Feel free to review clinics that have been reviewed by both the website publishers and the community at large, and have met and surpassed our high endorsement standards: recommended hair restoration physicians.

 

Please feel free to send me a private message regarding any specific clinic/physician. I hope this helps!