2124 grafts @ AEK with DR Karadeniz (28/10/16)

chris39 · November 23, 2016

Yea on reflection I was possibly probably being unfair , to be honest I think dr karedeniz is a good doctor who fell foul of the trolls on here . I think His completion is too much for him in turkey as he's a 1 patient per day surgery where he performs all the important parts of the surgery himself , trouble is for him he charges the same if not less than some of the 10 patient per day hair mills .... I honestly feel he would do better back in the uk where he studied , there is a definite gap in the market especially in the north of the uk !

The competition in Turkey , especially Istanbul ,is intense . His price at 1.50 euros per graft , as it was , is far more expensive than the tech' mills charge . I'm guessing he's just trying to be more competitive in a fierce market .

I thought the same as you about him setting up in the UK . Price wise , he'd blow the competition away , but he'd have to increase his prices also to run a similar set up .

Dumpling · November 23, 2016

Yeah, that's the problem in setting up a high end clinic in a low end market. UK or another Euro country would be great. That said Demirsoy is doing something similar.

wibbles180 · November 23, 2016

Agreed , I'm pretty sure he would blow the likes of Farjos and dr reddy clean out of the water , especially with him offering fut fue and repair work , reddy is something silly like 20 grand fir 2500 grafts and Farjo charge 7 pound per graft for a female doctor who has been performing fue for a very limited time and with virtually no result to see .... come on dr K open a small boutique clinic here in the uk !

HairsGone · November 23, 2016

When I had my surgery with Dr K I was charged by the old rate of 1.5 Euros per graft, as I had booked it months before. He mentioned to me that he changed his pricing structure to 0.6 Euros per hair as he feels this is fairer to the patient.

Initially I also thought this was odd but it does make sense and this is how he discussed it with me - although everyone talks about grafts it is actually the number of hairs which overall provides the density. Surgeons can manipulate the number of grafts they eventually transplant by breaking up larger grafts they extract into more smaller numbered grafts and implanting those, this way they can implant more grafts but each with fewer hairs on average.

In my 2 surgeries, the 1st surgeon gave me an average of 1.87 hairs per graft. Dr K gave me an average of 2.27 hairs per graft. To me this shows Dr K was ethical and fair as he could have implanted more grafts with the same number of hairs he used in the end to bring the average down, and so he could have made more money this way.

If I was charged by his new pricing structure I would have actually saved money! (by a few hundred pounds).

It would be interesting to hear comments from other clinics on this.

chris39 · November 23, 2016

Surgeons can manipulate the number of grafts they eventually transplant by breaking up larger grafts they extract into more smaller numbered grafts and implanting those, this way they can implant more grafts but each with fewer hairs on average.

Hairsgone - I agree that I would have also had a cheaper procedure had the new pricing structure been in place ,.

However , where I have a different take on this is on what constitutes a graft . Strictly speaking , a graft is a follicular unit normally comprising 1 to 4 hairs per unit . If a surgeon decides to play games ( to put it nicely ) and splits a follicular unit to create supposedly more units , then it's not an additional follicular unit - it's jus a split unit .

I've read elsewhere about surgeons supposedly splitting grafts , and as far as I'm concerned it's a pure con job . The no. of follicular units ( grafts ) can't be changed just because someone cuts it up .

Having said all that , maybe a cost per hair would be a fairer way to cost a HT procedure , but it goes against the status quo at the moment where no other surgeon is assessing on that basis , because they can't . It's only after the units are extracted that a cost could be determined .

At this moment in time , where people need to know an approximate . but fairly accurate cost , a per graft cost works . Maybe this will change in time .

That's my take on it anyway . Interested in others opinions,

chris39 · November 23, 2016

Apologies to Baldydude for derailing your thread !

**Pete-from-Farjo** · November 27, 2016

Agreed , I'm pretty sure he would blow the likes of Farjos and dr reddy clean out of the water , especially with him offering fut fue and repair work , reddy is something silly like 20 grand fir 2500 grafts and Farjo charge 7 pound per graft for a female doctor who has been performing fue for a very limited time and with virtually no result to see .... come on dr K open a small boutique clinic here in the uk !

To clarify, Dr. Kay has been performing fue for a few years now and and charges nowhere near seven pounds a graft. It's closer to half that.

wibbles180 · November 27, 2016

My apologies Pete , I've just re read they message you sent me her prices you sent me were between 4 -6 pounds per graft for the first 1000 and she has been working with the Farjo clinic since 2015 ??did she train in fue elsewhere ? Wasn't dr Lorenzo briefly associated with your clinic in 2013?

**Pete-from-Farjo** · November 28, 2016

Wibbles,

Dr. Kay has been with us for a good two to three years now I believe. She shadowed Dr. Lorenzo for several months (Dr. Lorenzo worked with us for a year during 2013-2014), and she also trained extensively with Dr. Farjo. She has performed many fue procedures, sometimes on her own and sometimes working alongside Dr. Farjo.

chris39 · December 12, 2016

I recently received updated pricing information from Dr K and his reasons for doing so . There have been a few comments on various threads recently about pricing , so hopefully this will clarify the situation :

I have always been looking for a fair way of pricing hair transplants.

The per graft pricing isn’t fully to the patients benefit, therefore it has never been appealing to me for the following reasons:

1. The per graft pricing gives the clinic the incentive to sell more grafts which is frequently against the patients benefit.

2. Patients get coverage from hairs, not grafts.

3. In strip surgery, clinics prepare more grafts from the same strip to charge more. The patients not only pay more for a strip that has a fixed number of hairs, but also gets more recipient site incisions for the same number of hairs. I don’t believe in the theory that distributing more single and double haired grafts gives a more natural result. It is also proven that chubby grafts have a higher chance of survival compared to skinny grafts. Single haired grafts are at a much higher risk of drying out. It is not fully proven yet, but sub follicular unit dissection to create more grafts may also lead to poorer survival rates due to the disruption of the follicular units natural structure.

4. In FUE, the per graft graft pricing is even worse. This causes at least two more harmful things. The surgeon usually tends to over harvest for more grafts. A smaller surgical punch is used to make punch holes and get more grafts. This causes a significant increase in the transection rate. I don’t believe in the theory that doing more punches with a smaller punch causes less scarring than a punch that removes the whole follicular unit without damage and needing less punch holes. This may sound controversial at first but, we should be trying to get the most hairs out of the fewest possible grafts, which is exactly the opposite of what happens when there is a per graft pricing.

5. I am in a very unfavourable market where 99% of the market is dominated by cheap technician clinics. The typical surgical approach in Turkish technician clinics is to over harvest by doing 6000-7000 punching attempts, waste 50-70% of the donor hairs, get only 5000-6000 hairs from these attempts and tell the patients that they got 4000-5000 grafts for a very cheap price like 2000 Euro. When we charge per graft in Turkey we look as if we are much more expensive than these technician clinics. But when you consider the wasted donor hair and amount of healthy hairs that you get in these clinics, we are actually much cheaper. This has led to me trying to find a pricing that points out this reality.

At the beginning of 2015 I tried a fixed pricing for certain price ranges. I was charging a fixed amount between 2000-2999 grafts and 3000-3999 grafts. This was intended to get the patients mind off the grafts number issue; but it didn’t. Very soon, I realised that patients that received a graft number close to the top of the range would leave without any comments, but ones that received a number at the lower end started complaining. So I was only causing dissatisfaction. I even got a patient on the forum complaining about this as asking for a refund. Bill from HTN advised me to start using ‘a more conventional pricing structure’, so I started using the 1.5 Euro per graft.

The per graft pricing quickly started causing the above-mentioned problem. When I quoted patients they could have up to 4000 grafts, they would quickly make the maths 4000x1.5=6000 Euro and run to a cheaper clinic that offered 5000 grafts for 2000 Euro. I had to start thinking again on how to make a pricing that both educated patients on the 'graft number controversy’ and made it more affordable for them to choose us. I then thought about the per hair pricing and started using it about 6 months ago.

The advantages of the per hair pricing are as follows:

1. The patient pays for coverage, not for pieces of tissues that may have very different coverage potential.

2. It takes away the incentive for over-cutting in strip surgeries and over-harvesting in FUE.

3. It distinguishes quality FUE from unprofessional FUE; the main determinant of this is the hair per graft rate. Quality FUE is the fewest possible grafts for a given hair number.

4. I consider a hair per graft rate below 2 to be poor both for FUSS and FUE. It is certainly is very poor for FUE where multi-haired grafts are cherry-picked. Hair per graft rate between 2-2,5 is good and above 2,5 is exceptionally good.

5. By charging 0,6 Euro per hair, I have actually reduced my price, because it will only cost more if I get a hair per graft rate above 2,5.

6. In FUE I charge 3000 Euro for 5000 hairs which should be an excellent offer. Considering the quality of grafts with no donor damage, my price is very close to technician clinic prices.

To be able to survive in such an unfavourable market one has to be very creative about things you would not have to think about in a developed country.

I hope my explanation has been useful.

Baldydude89 · December 30, 2016

Hi guys so time to update my month and 2 months photos . Everything has been fine pretty much only isssue was some spots and pimples on the recipient area which seems to have died down now . You will see the spots I talk about in the 1 month photos. Not really going to comment too much on the price, so far I am happy with the price I paid for the service I received although my final result really is all that matters. Thanks for everyone's nice comments and a good debate.

1 month post op