Heres a idea regarding technician led fue clinics

[1966kph]

With all the controversy that seems to surround nearly every post regarding the Maral clinic it just dawned on me.

That if there are fue clinics that provide the answer to a hair loss sufferer by producing consistently good results that the patient is happy with is this forum not doing hair loss suffers a injustice by not recommending such clinics just because they are done by a team of technicians?

I thought the whole point of this forum was to protect patients by steering them in the direction of a clinic that can be trusted to help them get the result they wish for.

 

I do not know if this would be possible but could there not be another category for pre screened technician led clinics recommenced?

NOTE i only mean for FUE as with strip surgery i think it imperative that the physician do the strip removal and closure.

A happy patient in my mind = a good result and is this not the goal our happiness?

 

But one thing i dont know is how many technician led clinics there are.

 

All have a good day

[KO]

Problem with your idea is that there are no technician driven clinics that are producing "consistently good results".

 

I have another idea - We not allow technician driven clinics to be recommended. There is no rule that every clinic has to be recommended on here.

[1966kph]

Why? How very constructive

As usual not thinking of others but yourself i wouldn't of expected anything different from you.

But you have a good day anyway.

[KO]

I am precisely thinking of others when I urge technician clinics to not be recommended. It is for the benefit of patients.

[1966kph]

so your basically saying that all marals satisfied customers shouldn't be and bill does not know a good result is that right.

Obviously it is!

Maybe one day all of us will succumb to your knowledge and wisdom.

Your argument that maral is not achieving the goal of all hair transplants customer satisfaction just does not stack up.when there are numerous of them here stating so.

I do not know what your problem is but its major.

Why not leave marals threads to other viewers to comment on as impartiality is not something you possess.

Of course your going to ignore what I've just said because you know better obviously.

Have a good day and i think a trip to the shrink might be of benefit.

[KO]

I'm afraid that you are thinking primarily about what's best for Maral Klinik.

 

This isn't about "satisfied customers" but about clinic meeting standards. Given that you cannot handle a rational criticism and have to turn to personal attacks, perhaps you can visit the shrink.

[Spanker]

I was surprised to learn that there were clinics that technicians do the extractions. I have seen done good work by said clinics, my worry is that this reduces consistency and there is less to lose without your name attached to each case. I'd have to say that personally I would feel more at ease with a doctor that has proven results doing it.

[1966kph]

KO Its all about the satisfied customers are you for real?

You can have the highest of standards but results are what matter and especially to the patient.

Theres no rational in what your saying you are full of contradictions.

So you go to a clinic of the highest standards and you would be happy with a poor or mediocre result?

Of course you wouldn't because its the result that matters.

Educate yourself before trying to educate others.

Like i said previously you will stop posting on marals threads even though we all know that you will not say anything constructive.

Some people just cannot take a hint that their useless input is neither justified,appreciated and unwanted.

I think your hair loss may have damaged your moral compass if you cannot see that your unfounded negativity is a annoyance and that you need to take a long hard look at yourself and what .you are all about.

You have a nice day

[1966kph]

Hello spanker at last rationality has entered the topic.

If a clinic has a reputation built over years with consistently good results with the same technicians doing the procedures over many years why would you have any reservation in following previous satisfied customers through the door?

Most if not all HT patients have reservations even when going to the best of doctors and they come here for reassurance,support and to show the rest of us what they have had done.

Never would i suggest to anyone they go to a strip procedure without a doctor doing the strip and closure but Fue is along way off Fut.

Pat the publisher and bill had this to say on the matter

 

Recently, I spoke with our publisher Patrick Hennessey regarding physician involvement and whether or not a physician should perform any of the operating procedure in order to be considered for recommendation. This is an important topic since many patients prefer the lead physician to be directly involved in operating on them.

 

What we've concluded is that hair transplantation is a team effort and cannot be completed by the surgeon himself/herself. Some physicians choose to be very hands-on while other surgeons choose to step back into more of a supervisory role. That said, I agree with Pat when he said:

 

"Ultimately the end results and their consistency are the most important measure. If the physician is supervising and maintaining the quality, then who's hands are on the tool is very secondary in my opinion".

 

Now, some patients may prefer a physician who is more hands-on. However, I don't see anything wrong with a physician supervising a procedure as long as the end results and consistency is the same.

 

That said, I do have concerns about clinics who operate without a physician at all where technicians and nurses are the only ones performing procedures. In my opinion, a qualified physician should always be involved and at the very least, directly oversee the procedure and the outcome.

 

Best wishes,

 

Bill

 

Have a good day spanker

[KO]

Some people just cannot take a hint that their useless input is neither justified,appreciated and unwanted.

 

 

I could say the same to you.

[1966kph]

Unlike you I have a open mind and do not come with the mindset of being as negative as you.

And a response such as this to my previous post would not be out off place if posted by a 10 year old.That's your replie ? And you think that is constructive?

I know I am wasting my time but try and break the habit of a lifetime and be constructive.

And just to be clear I am not just talking about marals clinic but any technician led clinic that wishes to be considered for recommendation and is prepared to go through a pre screening procedure.Bill should step in and have a word regarding unproductive posts that serve no purpose other than annoying people who are actually here to try and do something positive..

Have a nice day

[Blake Bloxham]

1966,

 

Stop with the personal attacks. It's only hurting your arguments and detracting from the thread.

 

I see no reason why we should start a recommendation process for technician-run clinics. Promoting an environment where surgery is being performed by non-medical personnel with absolutely no malpractice insurance, no certifications, no board-recognized education, and complete deniability when/if a procedure goes south isn't something we should be supporting.

 

I understand your arguments to the contrary, but it absolutely is dangerous to patients. You say that strip should only be performed by a physician because of the more invasive nature. On what grounds do you make this claim? Do you have any medical training to conclusively state that one surgical procedure should be performed by a surgeon and another a technician? Are the rates of lidocaine toxicity any lower? What about decreasing risk of peri-operative infection? How about recognizing important co-morbidites like cardiac conditions, propensity for stroke, or underlying seizure disorders? How is it different if a superficial artery is punctured while making incision sites in an area like the temporal triangles? Did you learn about the arterial vessel anatomy in these regions during your graduate-level anatomy courses? Did you learn about the appropriate timing for this type of bled to stop? Is it possible to "bleed out" from a scalp laceration of this manner? What happens if you are told the patient is on some sort of anticoagulant during this bleed? Is the agent reversible? Do you know how to reverse it? Are these medications on site? Tick, tock, tick, tock.

 

These are the things physicians are trained - repeatedly - to recognize, comprehend, and manage. I can't tell you the number of times I've heard/seen situations where non-medical individuals see or do something a number of times and feel confident in their ability to manage. 99 times out of 100, there are no issues. However, it's that 1 out of every 100 situation where crap hits the fan and you absolutely 100% need someone with medical/surgical training to step in and prevent disaster. I've personally witnessed the most benign situations become scary FAST, and I can tell you first hand that you have no way of knowing when it will occur. This is why saying things like "strip needs a surgeon, but FUE doesn't" is incorrect. It's also the reason why recommending technician-driven clinics isn't something I feel comfortable with.

 

If my loved fell into a bad legal situation, I would want them to go to court with a lawyer, not a paralegal; If I had to go to war, I'd want to go with the trained solders, not the guy who works the front desk at the military base; If I'm recommending a medical and or surgical procedure to someone, it will be with a doctor, not a technician.

 

Argue as you will, but I don't think you will sway opinion. What's more, clinics like this are actually illegal in most regions around the world. In the US, a doctor would lose his/her license for running a technician-driven clinic. This is another reason why I don't support this practice and I wouldn't advocate for recommending technicians or technician-only clinics.

 

I hope this makes sense.

[1966kph]

Thank you for your input future it is much appreciated.

To answer the majority of the questions you put forward I have no medical training.knowledge or expertise.

But then again I did not state that the clinic should be carrying out the procedure without a Dr being present during the procedure to be called on if need be.

I'm not saying that a so called clinic that are run purely by technicians should be even considered for recommendation.l don't even know of any technician led clinic other than the maral clinic.

At the moment how many of the recommended doc's hear perform all the extractions,incisions and placements during a procedure?

I don't know and I'm positive you know better than me.

As regards to the personal attacks KO consistantly comes to threads and adds no relevant points but pours scorn on peoples opinions.

But fair enough I will adhere to not making personal comments.

I know you are obviously very knowledgeable about HT surgery and know far more than I ever will being as how it will be your chosen profession but as I have said to you in another thread.

Can you be impartial on a matter like this ?

I mean no disrespect in saying this and I hope non is taken.

Your input is much appreciated .

Have a nice day

[1966kph]

Also Future whilst I will Agee to try my best not to insult or offend anyone I would appreciate you doing the same.

The sarcasm (did you learn this during your graduate level anatomy training) wasn't appreciated.

Thanks and have a nice day

[Blake Bloxham]

1966,

 

I don't think it's being impartial; I made the same comments about lawyers, soldiers, et cetera. I've never understood the desire to take the trained professional out of the equation in any respect. It's actually something I notice occurring more frequently in general, and it always boggles my mind.

 

So you do not think the Maral clinic should be considered for recommendation? I'm confused? I thought this entire thread was about recommending the Maral clinic and/or clinics where the technicians are performing the surgical procedures?

 

I know of a few practices were the doctors take a large role and participate heavily in all aspects of the procedure. I also know of a few FUE clinics that use implanter pens and, in this respect, the physicians are doing the extraction, site creation, and graft implantation.

 

I really wasn't trying to be sarcastic. If it was taken as such, I apologize as well. But yes, I have taken these courses and I think it's why I feel this way; I know what it takes to perform surgical procedures, I know what can go wrong, and I've seen the consequences. Based upon this experience, I will never advocate for less physician involvement in any medical/surgical scenario.

[scar5]

First up, the only way this forum and other forums like it recommend any clinic is to the forum owners receive $$$$$$$ from the clinic.

Everything else is secondary.

 

That doesn't mean any one is recommended, of course, but no ideas or good proposals - and there are so many - will go anywhere if it cuts into the $$$$ the forum owners make, and I completely agree with them and wouldn't do it any other way myself. Bravo to HTN.

 

So would this idea cut into the potential income stream?

That HTN could recommend clinics on the basis that they would prominently display a few key parameters such as;

 

Tools and Techniques employed.

Degree of doctor involvement in procedure.

Technician responsibilities and credentials.

 

??

 

Of course it would. Clinics don't like doing that if they don't have to, and for good reason. Major disincentive to join and sign up on the HTN payroll.

 

My choice would be that clinics are not recommended at all, and that HTN is sponsored by garden tools or something unrelated except in the demographic of balding men. Perhaps technology, our cookies and the way Google spies on us and sells our info could make it happen like that one day. But for now, we gotta deal with it the best way we can, by playing cat and mouse, risking your reputation by 'telling on' clinics in a thread like this.

 

Of course, I'd love to see some kind of classification for clinics which told us all about their protocols. I was absolutely stunned when I was told at a leading clinic techs would be extracting FUE outta my head in 2012.

The hair grew fairly well. The design, which the doc DID do, isn't all that great.

I think techs should be able to do extractions but only if we, as punters already rolling the dice anyway, are made aware of it and the credentials of the tech. But that 'aint gonna happen.

[1966kph]

Thank you Future and yes it was taken as sarcasm.

To answer your questions

[.So you do not think the Maral clinic should be considered for recommendation? I'm confused? I thought this entire thread was about recommending the Maral clinic and/or clinics where the technicians are performing the surgical procedures? ]

 

Yes i think if the maral clinic or any other clinic were the technicians are doing the work under the supervision of a doctor and are willing to be pre screened and their work practices,technician expertise and medical qualifications scrutinized then that is what i am saying.I do not see any reason for the confusion.

I also know there are fue surgeons such as dr kesser who do the whole procedure apart from the trimming of units but my question was.

At the moment how many of the recommended doc's hear perform all the extractions,incisions and placements during a procedure?

Another question you put was

[You say that strip should only be performed by a physician because of the more invasive nature. On what grounds do you make this claim? ]

This is the first time i have heard any one say that the two procedures are as equally as invasive if this in fact what you are saying?

 

quote from bill in the sticky why fue has become increasingly popular?

[ Whether it’s the less invasive nature, lack of the linear scar associated with the traditional follicular unit hair transplant (FUT) procedure, or potentially faster healing time, demand and popularity of FUE has increased greatly over the last several years ]

 

Now obviously you will know and i am just presuming this but by invasive nature do you mean that both fue and fut carry the same amount of potential medical complications?

Or does one carry more risk than the other and if so would you please elaborate more on this?

 

I find it admirable your stance in defense of what will be your chosen profession and i in no way intend to belittle in any way or cause offence to any dr but i think you may be belittling the role the technicians play in modern ht surgery.

As to your statement

[i see no reason why we should start a recommendation process for technician-run clinics. Promoting an environment where surgery is being performed by non-medical personnel with absolutely no malpractice insurance, no certifications, no board-recognized education, and complete deniability when/if a procedure goes south isn't something we should be supporting.].

 

Is this above statement based on your knowledge of the requirements to lawfully perform surgery in turkey or any other country? i do not know whether this is the case or not but maybe one of the recommended turkish doctors here could clarify exactly what is needed to perform ht surgery in turkey.

As always i appreciate your educated input and if you could please be so kind as to answer each of the points i make above for clarity it would be much appreciated.

You have a nice day.

Edited November 5, 2014 by 1966kph

[1966kph]

Scar5 thank you for your input there are to few people on this thread at the moment and the more the better.

I agree the world is driven by greed and people try to protect what they have or even kill to get what they want from the poorest in society to countries going to war.

Is the world a better place for it i think not.

Is pressure going to be put on the forum owners by the current recommended doctors to dismiss potential recommendation of clinics doing fue were the technicians do the work under the supervision of a doctor at a 10th of their prices?Again i do not know.

Do HT doctors get into HT surgery to help vulnerable people suffering hair loss or for the financial gain? Again i do not know but i would guess is that the majority of HT doctors no matter what country they are practicing in are classed by the working class people as wealthy

.

As long as a clinic operates under certain criteria and is pre screened by bill or pat and found to meet a good standard what is the problem with recommending such clinics ?

 

All have a good day.

[KO]

Why are you so persistent in wanting technician clinics to be "recommended" here? What do they add that does not exist at other clinics? When we should be finding good clinics that have high standards to broaden our portfolio, you are trying to do the exact opposite. If anything, people running technician clinics are the ones that are greedy....opening a clinic, handing all the work to others while you drop in to "make sure everything is ok" from time to time. I'm against technicians doing extractions, as extraction is pretty much the core difference between strip and Follicular Unit Extraction, but this is taking it to a ridiculous level.

[Blake Bloxham]

1966,

 

First, let me apologize if I came off rude or condescending at all in this thread. It wasn't my purpose. Like I said, I'm very passionate about this field; sometimes, I suppose passion can be interpreted the wrong way.

 

Technicians play a crucial role in the hair transplant process. The procedure absolutely could not exist without them. I have nothing but the utmost respect for technicians and what they do. However, I still think they are one aspect of a team; a team which, I believe, should be run by a physician. And not only a physician who is checking in from time-to-time or involved more in an investment role, but one who is in the procedural suite, removing grafts, making incisions, and actively supervising techs.

 

I hope this clears a few things up "right off the bat." I frequently remind members to remain civil, and I need to remember that these rules apply to moderators as well!

 

Let me see what I can do to address the rest of your questions:

 

First, let me explain why I became involved in this field - as you asked "if doctors become involved to help vulnerable patients or to profit:" when I was a pre-medical student in college, my grandmother was diagnosed with breast cancer. She was cared for by the best oncologists and they were confident in her recovery. However, her treatment involved a chemotherapy agent with a known side effect of hair loss. She wasn't confident enough to share her concerns about the hair loss with the oncologists, so she started to ask me questions. I wasn't sure of the answers, so I turned to the web. One of the first places I found solid answers was HTN and HRN. I became fascinated with the field, and here I am 6 years later!

 

I'm glad we clarified the issue with your views on Maral's recommendation. Furthermore, both Bill and Pat discussed it and feel okay presenting clinics with supervising physicians for recommendation. However, Bill did openly comment that he has reservations. I feel like it's going to be more difficult for these clinics to win over the community, but we did decide to consider these types of clinics. Again, I don't feel comfortable with this model for a variety of reasons, and I'll share these when it becomes necessary in the future.

 

I don't know exactly how many doctors perform all aspects of the procedure. I know of several who use the more traditional incision and placement process who place grafts, and even more who use implanter pens and, in doing so, perform the entire procedure.

 

Strip is more invasive. That wasn't exactly the point I was trying to make. You stated earlier that strip required a surgeon whereas FUE did not - and could be performed by technicians - and I disagreed and still believe this isn't a decision someone who is not a physician/surgeon should make.

 

From what I understand, this type of practice is legal in Turkey. I accept this and it helps clarify why this type of clinic is becoming popular there. However, it's definitely not the case in the states. Where I'm from, for example, it's illegal for anyone besides a physician (and likely a PA or maybe NP) to break the skin with essentially anything larger than a needle for injections. A doctor would lose his license allowing technicians to perform FUE on his patients in this situation.

 

Thanks.

[MikroFUE]

Sorry, just a quick note:

 

1966,

This is another reason why I don't support this practice and I wouldn't advocate for recommending technicians or technician-only clinics. .

 

We share Future_Doc's opinions and comments on that matter and Dr. Maral agree with this opinion totally.

 

Please take this note into your consideration when you discuss on that matter anymore.

 

Maral is surname of Dr. Tugrul Maral, Associate Professor of Aesthetic Plastic and Reconstructive Surgery.

 

Maral Klinik is totally surgeon/physician led hair transplant clinic.

[PupDaddy]

Everything Blake said, x 10. Hair transplantation is a cosmetic surgery, be it FUE or FUT. Removing the surgeon entirely from hands-on involvement in the surgery is a bad, bad idea -- on many levels, a number of which Blake already touched on. Bottom-basement pricing for technician-performed FUE hair transplantation might "benefit" some patients in the short run and only in the sense of immediate cost, but the long term consequences and costs (financial and otherwise) are potentially disastrous and devastating.

 

Something else being given short shrift here is that with Turkish FUE mills like the Maral Klinic, not only do non-physisian technicians do all the fu extractions and fu implantations/seatings, THE TECHNICIANS ALSO CREATE/CUT ALL THE RECIPIENT INCISIONS FOR THE EXTRACTED FU'S!! To make this cosmetically critical task "easier" and "faster" for the tech, the clinic provides the tech with a motorized drillI to make the recipient sites!! I have NEVER heard of this being done anywhere, and, as KO noted, this assembly line, techs-only approach to hair transplantation is taking things to an absurd level.

 

It seems apparent that clinics such as the Maral Klinic have started offering FUE hair transplantation as a second profit center to the physician's cosmetic surgery practice. While the surgeon busies himself with rhinoplasties and facelifts, a group of techs churn out hair transplantations at cut-rate prices made possible by this business model. Patients are then encouraged by the clinic to post their "results" here, but the only results we see aren't results at all, but rather are immediate post-op pics only showing that a transplant recently occurred -- indicating that the clinic only recently started offering these technician-performed FUE transplants such that actual grown-in, matured results are as yet non-existent, or that such results have proven to be deficient.

 

I can't conceive that this forum would put up such an outfit for recommendation, let alone that recommendation would be granted.

Edited November 5, 2014 by PupDaddy
typo

[MikroFUE]

Pup,

 

10X what you said, especially for your first paragraph.

 

Just a quick note: Maral Klinik is expensive (lets say cost-effective) here in Turkey, just we are honest giving the same pricing to our Turkish and international patients; considering also the fact that patients from abroad have some travelling costs.

 

And, Dr. Maral performs his aesthetic surgery operations at other times when there are no HT operations or after they finish. I informed you about that before but I see now you missed it. Or you tend to be neglect it??

 

There are millions of hair loss sufferers all over the world mostly derived from low-income levels. We just provide high quality service and cost-effective treatment for them. And, you can be sure that if Gates or Buffets apply for HT to Maral Klinik, the pricing will be all the same for them, just they may prefer to accomodate in some luxury hotels with 7 star, but who knows??

 

This is my last note in this thread for some time. Dr. Maral is in contact with Bill to discuss on those matters , we will wait to see the judgement/decision respectfully.

 

I think Bill and Pat will consider your valuable comments /opinions, because you are Jack Russel.

[1966kph]

Thank you once again future for your contributions to this thread.

Firstly thank you for your apology for appearing condescending and it was rather but I'm a adult and can handle it but the most important thing is that the issues get addressed.

I sincerely hope your grandmother is now in good health and thank you for letting me know how you ended up here debateing these issues with me.

OK I will just run a scenario by you for your input if you would please?

 

Dr Koray erdogan decides he wants to step back and just have a supervising role during procedures.

He trains his technicians personally and feels 100% confident in their capabilities.

They carry on with this setup and produce results that both Dr erdogan and his patients are very happy with should he have his recommendation revoked here?

 

I think that whether Dr maral has sufficient experience personally performing HT surgery and that he feels that the training,experience and results his team are producing are of a high standard.are of paramount concern and he obviously thinks they are.

I think the main purpose of this site is to educate,inform and ultimately protect vulnerable hair loss sufferers. And even though we are adults the over whelming desire for a better situation does make us vulnerable.

People may say that they can appreciate that hair loss has a dramatic impact unless you have suffered hair loss you cannot fully comprehend how sufferers feel.

The horror stories that most of us have seen were there has been total disregard for another human being astounds me.

The point in starting this thread was never to promote one clinic or another but to make sufferers aware of a possible avenue they could go down safely to achieve their objective nothing more nothing less.An achievable objective for people with very limited financies.

Just as I would advise someone to avoid going with a clinic they nothing about I would also want them to be made aware that they can get satisfaction hopefully without have to make massive sacrifices just for hair on their head.

Do you send your child to university or get some hair I think this is a appauling situation brought about by the cost of hair transplant surgery and is wrong.

Vulnerable people deserve the right for help and if the network Denys them all the possibilities I feel they would be doing hair loss sufferers a injustice.

Once again future thank you for your input.

And yes it is blatantly obvious you are passionate about hair loss

As am I .

You have a nice day

[KO]

Could you please answer my question on why you are so adamant on technician clinics being recommended?