U.S. vs International - Quality and Cost

[elicash80]

Okay, so I have at least done the cost analysis side of many of the recommended HT international surgeons for this site. I made my own personal google doc. that basically breaks them down by cost per graft. I am 95% certain I am going to do FUT due to my lowish/average amount of donor supply.

 

I have just a few questions for anyone who has researched international surgeons before their procedure.

Right now I am down to these surgeons if I decide to go with someone outside the U.S. Dr. YV Rao, Dr. P. Madhu, and R. Palakurthi and T. Bhatti are the Indian surgeons I am considering. India defintely offers the best prices. As far as other international surgeons there is A. Karadeniz and H. Doganay in Turkey and J. Devroye in Belgium.

 

I know this is quite a few surgeons to compare, but has anyone else been through this process of considering international surgeons based on quality vs price? Can you share your experience? Also, of the surgeons above who would you consider the best or who has been putting out great results consistently with little or no complaints?

 

I hope this can help others who are looking to keep their HT below 10K. I would like to make a decision in the next month or so and maybe do a bit of vacation right before the procedure. Any info. on these docs. would be appreciated.

[Wwiizzkkiidd24]

Hi there, ive noticed youre also looking in belgium aswell and you could alsolook into dr de reys im currently considering him aswell along with some of the doctors you mentioned ie dr karadeniz and doganay and them two docs have produced some good steller work but coming back to dr de reys from what ive seen of his work and tbh there isnt that much in here but the work looks good quality and for the price you pay definitely in your price range as well..he has over 7 yrs experiance amd he envolved in the entire process with the help if one nurse that helps him put in the grafts but other then that he does evrything which you want for a procedure that your paying for.

 

Just thought id put my two cents in on the doctor if you havent heard of him

 

Have a good day and i hope you choose the right surgeon and all goes well for you.

[KO]

I would add Bisanga to the list as well.

[elicash80]

@WizKid Thanks for the response - I did not look into Dr. Reys because I did not see him on the recommended surgeons list for this site. I know there are probably great docs that are not on that list, but this saves me time and energy as the list docs have already been 'pre-screened' in a way. Also, if they are on the list, it is likely that members have open and honest posts about them, not just what their website might say. I just use it as another filter basically.

 

Also remember that I am aiming for cost vs quality. There are a lot of good docs out there, but I am trying to keep my cost per graft at $2.50 or below. This is why a few of the recommended European surgeons got bumped off my list.

 

@KO - Thanks for the input and while Bisanga does great work, he is roughly the same in cost as some amazing American surgeons in my area. If I do spend $4-$5 a graft I am going to stay in the U.S.

 

Anyone have experience with Indian surgeons? I am going to search the threads, but was wondering if someone who traveled internationally to India for their surgery could help. I know they are recommended, but I am just a bit concerned about quality of care before, during and after the procedure. Are these doctors on par, as far as medical care, with U.S. surgeons? Would you do it again?

[elicash80]

So I did my due diligence and did some more research on the 4 international surgeons I was looking at; Radha, Madhu, Karadeniz, and Bhatti. Out of the 3 Indian surgeons Radha, though not having years upon years of experience, seems to have some great results. On top of this she is very inexpensive and does only 1 client a day.

 

This means if I eliminate Bhatti and Madhu, then it comes down to Karadeniz or Radha. Can anyone speak on the difference between these 2 specific docs? I am going for a somewhat aggressive hairline, so it is important that the result not look pluggy.

 

Anyone who was in my situation (comparing international surgeons to save on cost and/or travel), what factor made you choose your surgeon? Can anyone speak on travel to India for a HT or a medical procedure? I am getting close to choosing and I don't want to make a mistake, I have been considering doing this for a long time and I appreciate all the advise I can get.

[scar5]

I am 95% certain I am going to do FUT due to my lowish/average amount of donor supply.

 

 

Personally, I think that you are making a bad decision.

 

You are falling hook, line and sinker for the strip bait - based on the rationale that you are in poor shape, so you need every graft you can get, and strip delivers.

 

Listen because this is really important.

All of us need every last little graft. There is never enough.

 

If you are already in bad shape, the last thing you need is an ear-to-ear strip scar.

 

You should, IMO, aim to;

1) redistribute your hair carefully and conservatively via FUE.

2) Avoid US clinics if you are limited in funds

3) Avoid reading or listening to people/ reps/ docs trying to tell you that strip is your best option. (Strip is THEIR best option)

4) Maintain meds

5) Screen your overseas FUE options very carefully. They are not restricted by law like in the States and Canada. (Techs can't extract in America - know this and reflect on how the economics and legal implications of this trickles down into the lips of those white coats telling you that you need a strip scar.

 

Best of luck

Edited February 21, 2015 by scar5
of, and missing

[BUSA]

quality is better and cost is less in Europe. there is really no comparison.

[BUSA]

Personally, I think that you are making a bad decision.

 

 

cud not agree more.

[tootall]

quality is better and cost is less in Europe. there is really no comparison.

 

I agree with cost and quality is great. But, would you agree that Ron Shapiro and Konior are on par with Docs from Turkey/Europe?

[BUSA]

 

I agree with cost and quality is great. But, would you agree that Ron Shapiro and Konior are on par with Docs from Turkey/Europe?

yea I definitely wud for sure.

[scar5]

I agree with cost and quality is great. But, would you agree that Ron Shapiro and Konior are on par with Docs from Turkey/Europe?

 

Tootall,

 

How could we say yeh or ney? (Seriously, as regular guys?)

 

I hope Busa responds to your question, and I hope he/she/they (lol) does, but in the meantime, as a guy who has been through the mill, I gotta say, i wouldn't care if Shapiro and Konior have more x, y, and z than doctors in Europe/Asia. The key point is - laws prosecuted in their juristriction (and lawyers ready for action) , comparative economic advantage, hype/momentum.

 

I think there is no way in the world, any of us could judge a doctor versus another doctor on any index that requires expertise knowledge.

 

We have no yardstick except our crude interpretation of the protocols they seem to employ/use and those protocols could be blatant and obvious or completely random/ arbitrary factors beyond our awareness.

 

And then there is their capability versus the probability that economic and legal pragmatism dictate.

 

And even if we could calculate it down to the last follicle...

 

....we could never take anything for granted. The perceived risk factor viz-a-viz legal situations can change, as can the economic opportunities etc. Cracks and opportunities emerge. A doc could be doing manual extraction in May having interviewed potential extraction techs in April. Meanwhile a rep who is on his way out is briefing an incoming newbie all about us, these boards, the kinds of nutcases and casualties that inhabit them.

 

I suppose those docs (a.b,c) are great.

Why? Because I've heard a lot about them on these networks - more so Shapiro.

 

Once upon a time a guy with an Italian name ran up a bunch of great strip results, went all FUE, built an empire then collapsed. Perhaps he has re-emerged in another guise, but his name and his chain was turned to mud in the world of these forums. He was the poster boy for the 'unscrupulous FUE hype' - the kind that the strip guys like (fill in the blank) etc. really needed to provide a bulwark for the progress of FUE. His reps were terrible, reeling off impossible numbers - it should serve as a caution to anyone that thinks that the FUE people are 'the good guys'. Nevertheless, it was part of inexorable trend that started. Strip - Manual FUE - Mechanical FUE- ???

 

???- where does that end? Another famous doc in India, was a big early FUE star, but he has since reversed into strip - why? Economics. He is more experienced. So easy for him to say now, "Well, after a good deal of experience in FUE, I realised strip was better yield."

 

But despite all this, I still think it is a fair question.

There is no doubt that Shapiro and Konior operate in a libel trigger friendly environment and that they have their hands tied by laws that prohibit tech-harvesting? Does that make them better?

[hairweare]

Brilliant post!

[hiddenmovement]

Elicash 80, can I have a look at the spreadsheet/word.doc that you've made up? I live in Australia and was quoted 8000$ for just 600 grafts earlier this year, and I'm interested in travelling to the US this year anyway so I'd love to have a look at your research to see if it's worth me getting a procedure done in the states.

 

I'm only looking for a conservative fill in of the temples, have very thick donor area, so 8000$ for about a square inch of hair seems silly.

[ready4Hair]

I would recommend Dr. Erdogan. Turkey, $2.5 per graft FUE. He is going to recommend way more than 2500 for you probably closer to 4k. His yield and hairline are fantastic and his clinic is second to none. He offers PRP ($250 extra) and offers (additional fee) recovery rooms in his private clinic/hospital.

[fortune11]

Those living in the US/Canada and thinking about HT abroad , especially in locales where patients rights don't amount to much should also consider the following --

 

What happens if there are complications during or immediately after surgery ?

 

What about post op care once you have flown back home and need urgent follow up ?

 

If this was not a cosmetic surgery , would you still be itching to fly to Europe or India ?

 

Ultimately this is an invasive procedure (FUT or FUE) and should be treated with some seriousness. During my three HTs , I have needed post op care and every time the surgeons have been extremely helpful whether it be multiple post op visits to the clinic , personal follow up over the phone, calling in a prescription within minutes when I needed one while traveling , etc.

 

I understand everyone has their own preference and others who have traveled abroad and had a good experience will vehemently disagree with my post here. But the quality and skill of top tier US HT specialists (and other cosmetic surgeons) is second to none and I personally cannot see my self ever traveling abroad for any such procedure.

[Sean]

Those living in the US/Canada and thinking about HT abroad , especially in locales where patients rights don't amount to much should also consider the following --

 

What happens if there are complications during or immediately after surgery ?

 

What about post op care once you have flown back home and need urgent follow up ?

 

If this was not a cosmetic surgery , would you still be itching to fly to Europe or India ?

 

Ultimately this is an invasive procedure (FUT or FUE) and should be treated with some seriousness. During my three HTs , I have needed post op care and every time the surgeons have been extremely helpful whether it be multiple post op visits to the clinic , personal follow up over the phone, calling in a prescription within minutes when I needed one while traveling , etc.

 

I understand everyone has their own preference and others who have traveled abroad and had a good experience will vehemently disagree with my post here. But the quality and skill of top tier US HT specialists (and other cosmetic surgeons) is second to none and I personally cannot see my self ever traveling abroad for any such procedure.

 

People travel from NJ to California for procedures all the time. It would be a similar scenario if going overseas or to any country. It is wise to stay at least a week or two, wherever you go, in case of post op concerns. There are recommended surgeons in US, Europe, and Turkey. Recommendations showcase such quality surgeons. Each has their own special way of doing a procedure. Most of the time, if there is a concern, patients are told to wait it out and return after a year. Thank goodness for, skype and orher means to communicate. This helps when it comes to post op questions.

[elicash80]

Thanks for all the posts. I am going to try and address all that are relevant to this thread.

 

@Sean Yes, I am concerned about post-op care quite a bit, but you are right, these surgeons are screened and then recommended. I wonder how much of the screening process for recommendations is based on results compared to other parts of the practice such as post op care. I know people travel for medical tourism often and a doc. recommended by this forum understands the implications if a member gets something like a staph infection after a procedure.

 

@Fortune You make a good point. If the cost was close AND I heard a few horror stories about these international doc's (maybe I am just not digging enough) post op care, I would continue to save and wait. With that said, many of the European docs. are quite reasonable and some of the recommended Indian docs. have been doing this a long time and are members of the IAHRS, such as Dr. Bhatti.

 

@ready4 That is actually 2.5 Euros which equals $2.80 per graft. At the $3-$4 range I could go to a top tier US surgeon a few hours from where I live. I am looking in the $1-$2 range.

 

@Hidden - Do you have a gmail account? I would be glad to share.

 

@Scar5 - Amazing post. Yes this all seems like trying to compare the beauty of a woman or the artistry of a painting. It can be somewhat objective, but a lot of it is subjective and there are a ton of factors we simply can not know. Personally if I can have a doc. remove and insert all the grafts himself/herself for a low price, I would rather go that option. Yes there are probably some techs out there who are better than doctors (more things we will never know or can not quantify), but it gives me a bit more piece of mind, even if it is an illusion. I am looking for the same things the mods look for when they recommend a doc. the only difference being is that cost is a factor for me.

 

@Scar5 - This FUT vs FUE business is exhausting some times for a newbie not knowing which way to go. I hear quite a bit that FUT yields more and if you start with FUT, you can get more grafts in the long run. I wish there was a definitive answer to this (and yes this is even too subjective to put an answer on because so many factors are involved). Dr. Cooley does both procedures and his rep. who has been doing this a long time said strip is typically a higher yield. She could have tried to sell me on the more expensive procedure, but she did not. Also Dr. Vories, who does FUE, said that he can only promise a 80% yield* *(This is because there are so many smokers in the south which lead to lower yield, but still this is just not a good number to me coming from the doc. himself). If I had above average density I might take that 80% or higher gamble, but with limited hair I like the 95-98% yield I have been reading about with strip. I do not want to pour gasoline on the FUT vs FUE war, my main concern right now is inexpensive recommended docs that have consistent results with little to no complaints. Good point you made - I am going to do a lot more screening on the actual procedure when I get it narrowed down to 3 docs. I am going to look into Demirsoy and do a little more research on Bhatti. I want to lean towards Radha, but she is so new.*

 

* Yes, I know Demirsoy is not recommended, his name is popping up for quality in Europe for a reasonable price.

[ready4Hair]

The 80% yield quote for FUE is nonsense many top FUE surgeons get yield as good as Fut eg Feriduni, Erdogan etc. One thing you are missing is the ability to cherry pick with FUE which is probably even more critical with your limited donor. One thing that sparked my move fro. FUE to FUE (I was scheduled for a fut before reconsidering and doing more research). This mean being able to get a better hair per follicle yield. A 2000 fut can yield as low as 3500 hairs while surgeons such as dr. Reddy routinely get 5600 from the same # of grafts.

 

I do not think you will find a $3 surgeon in the uss remotely as good das Dr. Erdogan.

 

Lastly I would reconsider your price emphasis.nyeah I get you want to make this possible to yourself but when you start saying things like Dr X is 2.5 Eurex and I only want to spend 2.5 US you are making a bad decision. I don't mean you have to choose Dr Erdogan by any means just that if you decide against the right Dr. Because he is 10% more than your budget you are asking for a bad result. If you cannot afford to do this right do NOT do it until you can. If you can't accomodate a long trip vs a short one do not do it until you can. If you think US surgeons means higher quality vs Euri ones thing again, IMHO ALL of the top ht surgeons are US (and maybe Canada if you. Consider Dr Rahal).

 

My hair is not close to you thinnes donor wise and I realized myself that fut was a bad path. A bad of ineffective ht can leave you with that and a scar you will be very hard pressed to hide and few options for styling or further HTs.

[ready4Hair]

Those living in the US/Canada and thinking about HT abroad , especially in locales where patients rights don't amount to much should also consider the following --

 

What happens if there are complications during or immediately after surgery ?

 

What about post op care once you have flown back home and need urgent follow up ?

 

If this was not a cosmetic surgery , would you still be itching to fly to Europe or India ?

 

Ultimately this is an invasive procedure (FUT or FUE) and should be treated with some seriousness. During my three HTs , I have needed post op care and every time the surgeons have been extremely helpful whether it be multiple post op visits to the clinic , personal follow up over the phone, calling in a prescription within minutes when I needed one while traveling , etc.

 

I understand everyone has their own preference and others who have traveled abroad and had a good experience will vehemently disagree with my post here. But the quality and skill of top tier US HT specialists (and other cosmetic surgeons) is second to none and I personally cannot see my self ever traveling abroad for any such procedure.

 

Um the quality of US surgeons Is not second to none; it is second to Euro and Canadian Drs and by a long shot. uS surgeons are way behind on FUE ( one reason they do things like promise only 80% yield) and the ones who are (purportedly) not charge 5x more rhan their euro counterparts. The fact you can get an actual master like Dr Feriduni for $4 or Dr Erdogan for less than $3 vs US drs whose skill, yield and patient interaction doesn hold a candle to either of those drs is a case in point

 

Lastly, people travel overseas all the time for operations. Just do the smart thing and stay 2-3 weeks. Will it add some time and money, sure. But if you are trying to skimp on the cost or time you are ask g for trouble and let me tell you the money you save on say Dr. Erdogan vs Dr. Shapiro for a 4k FUE you could stay in a nice hotel room nearby for a year.

[wylie]

Lastly, I met with Dr. Mike Vories right outside of Charlotte. I literally drove from Dr. Cooley's to his location. I was able to meet with him personally for the whole consultation. He practices FUE exclusively and no longer, from what he stated to me, practices NeoGraft. The reason being in that his efficiency is such now that he no longer needs the machine, therefor hand placing of the grafts is typically ideal, but usually less efficient. His speed now has let him eliminate the NeoGraft.

 

He recommended the same number, roughly 2000, as the first two surgeons as said that my donor density was definitely adequate for FUE. He punches, typically a 0.8 punch if I recall correctly, and places the grafts all himself. He does only one patient a day as with every other consultation I spoke with. He let me ask away, like all other consultations and was frank and honest with his responses.

 

The cost for this was quite competitive considering this is FUE and not FUT. If I was to come out with a high survival density and acceptable aesthetic look a year later, this would definitely rate as the best value if you consider FUE is typically more expensive. Not the lowest cost though.. HRS was the lowest estimate. Dr. Vories guaranteed me an 85% graft survival density and said that this is not actually a great number, but that the very high number of smokers in the south force him to be in this range. If he dealt with only non-smokers, he could guarantee a higher number. I do not smoke and apparently this lowers your typical graft survival rate.

 

One thing is that he does not practice PRP or other added solutions such as Dr. Cooley due to, what he feels is lack of empirical evidence. I will have to do more research and see what the advantages/disadvantages and evidence are for PRP and whether it could be a deciding factor in selecting a surgeon.

 

The only red flag I see here is guaranteeing an 85% survival rate. While many doctors makes similar claims, the truth is none of them can do this approaching any measurable level of accuracy. They can make estimates, and results vary as to how accurate they ultimately will be.

 

However, from the rest of this experience you documented, this is exactly the kind of doctor that gives the best results. One who does not hand off all the work to techs, one who does not work on multiple patients in the same day. These are very important considerations. He clearly stands out from the other three mentioned, IMO.

 

However, if he recently transitioned from the Neograft (which many doctors are presently doing) than you need to more closely research his body of work, and make sure you find his patient results to your liking. 2000 grafts is a fairly typical amount of work, graft wise, and it should not too heavily stress your donor (without pics. I can't tell)

 

As scar5 mentioned in his excellent advice to you, a strip scar is NOT what you need. In 10 years, strip scars will be looked on like we once looked at mini grafts, it will be an outdated procedure. Don't burden yourself with a scar, it not necessary if you choose the right FUE doctor.

 

And keep researching. You are going about getting a HT in the right way, and it certainly increases the likelihood of a great result. And don't forget, do NOT let cost be the final arbiter of your decision. Let doctor competency and trust in their ability be the final arbiter in your decision.

[Brently]

Thanks for all the posts.

 

How did this story end? Which did you choose?

[elicash80]

Due to my medical condition I have chosen to stay inside the U.S. I was willing to travel outside of the U.S. as I assumed international doctors may have previously worked on someone with an organ transplant (kidney), but they all refused treatment because of it.

 

I have instead chosen to go with Dr. Mike Vories in Charlotte. I traveled to a handful of other docs around Tennessee, but Dr. Vories (locked in a great price on FUE before 2016) was the best combination of value and what I am looking for.

 

The surgery is in May and I will be making a new thread before and after the surgery. I have just been extremely busy lately. 2016 is my year to accomplish many things I put off for a long time and while it is going great, it does not give me a lot of time to get on here.

 

Please drop me a line if you went to Dr. Vories with any pointers. He seems like a great doc, I guess I'll see.

[Brockstar]

I also chose dr. Vories! I scheduled in 2015 and go in for surgery on 1/28. 2500 grafts

[elicash80]

Brockstar that's great. Please let me know how it goes. It would be great for me and a help to the community if you could do a detailed report with pics. If this is unfeasible, at least respond in this thread after the surgery. Good Luck!