Thoughts on clinics where techs do the work

[fullheadofhair]

Hi, I have began consulting with clinics for my first FUE procedure and have narrowed my search to a handful of surgeons.

 

My surgeon of choice is arguably the best in Turkey and from my understanding he performs 3 - 4 surgeries per day. Given the multiple surgeries per day, his technicians perform the extractions and implanting, with the surgeon solely performing the incisions without the help of the technicians (which I have been told is the most crucial part of the surgery).

 

Given the heavy involvement of the technicians in the procedure (for extraction and implanting), should this be a concern? I have been told the technicians all have a minimum of 6 years of experience. If the skill and experience of the technicians is there, would it really matter if the surgeon isn't the one performing the extractions and implanting?

[Sean]

It doesnt matter how many years they have been with the doc. It is heresay. Techs change and quit and move on get replaced. A surgeon went to a special school to become a doctor and that takes years and then on top of that they have many years doing surgery. That surpasses the 6 year so called skill part.

 

I definitely think the surgeon should do all surgical aspects of surgery which includes extractions. There are classy surgeons in Turkey that do all the work. The fear factor of Turkish clinics are all tech extraction clinics is a lie. Not all are that way. Take a look at Dr Keser. You just have to ask the clinics hey do you do extractions or do technicians or nurses do it.

 

Problem is that some folks are marketing and agenda driven and they may make It seem that Turkey is only a technician or a nurse only surgery country when there are plenty of clinics that have docs do work themselves. The cost factor. Ondoubt is much less if youbare willing tontravel over there. You just have to search for those that do quality work and donit themselves.

 

There are surgeons even in North Amerca that had techs or nurses do work and obviously it is detrimental to some folks and the results that needed repairs afterwards.

 

 

Be safe and definitely look for a doctor and not a hair mill. Good luck.

[Vainism]

I understand where your coming from but it comes down to this question.

 

Would you rather a team of 4 individuals rotating who are trained specifically for there job?

Or an individual surgeon to do 8 hours of intense labour which could lead to major fatigue?

 

Trust me you don't want any fatigue when your implanting the grafts, plus his keep method practically guarantees that the follicle is implanted effectively. We could debate these subjects for weeks, but at the end of the day, regardless of certifications and methods being used, Erdogan gets the results. I still to this day haven't seen a negative review about ASMED. Plus at 2.50 euro is a bargain compared to what western coalitions charge.

[KO]

While I prefer the doctor to be maximally involved, some of the best surgeons believe that the graft site creation is the core of HT surgery and more complicated. In Europe Feriduni and Lorenzo have this type of system and here Hasson & Wong do the same. If techs are trained and experienced, I think it can be OK in my opinion.

 

I assume your OP is about Erdogan. It seems like he's building an assembly-line type of system (I don't mean this in a derogatory way) with less "key man risk" where each person has a different role and that allows them to produce a lot of of good results at high volume.

 

What are you more comfortable with? A boutique type clinic where a doctor does most of the work, or an institutionalized system where a team operates on you? There are clinics doing good work in both ways.

[Sean]

I also think its wise the surgeon maximizes yield by limiting out of body extracted graft time. This is done when surgeons split procedures up into two separate days. Maybe by doing 1000-1500 grafts a day max. This way tgey also avoid fatigue if doing the procedure themselves. It also means they are dedicating you to be tgeir patient of the day versus having multiple patients which also itself adds lots of fatigue. Research carefully and good luck.

[fullheadofhair]

Vainism, KO - Thanks, both of your views was my consideration i.e. having an experienced team operate on me, as opposed to the surgeon performing a long procedure suffering from fatigue. It's good to know that other world class clinics (Feriduni, Lorenzo and H&W) are set up in a similar way

 

Sean - point noted. Point taken on fatigue playing a part if the surgeon performs multiple surgeries per day. Based on this I will request to be the first patient on my scheduled day.

[Ernie]

Rahal's lead tech (mike) has been with him over a decade and does the manual FUE extractions. I've met Mike and he's a nice guy -- this means nothing of course, but what does mean a lot are Rahal's FUE results since he started doing manual extractions quite awhile back. I'm not sure but the number "13 years" keeps popping into my head when trying to think how long he's been there

[Transhair]

If they're a bunch of no name techs that come and go than I'd prefer not to.

Some clinics, like Shapiro medical have techs with lots of experience in the industry and I'd be fine if they assisted with the graft planting or possibly even extractions.

[Al - Moderator]

I also think its wise the surgeon maximizes yield by limiting out of body extracted graft time. This is done when surgeons split procedures up into two separate days. Maybe by doing 1000-1500 grafts a day max. This way tgey also avoid fatigue if doing the procedure themselves. It also means they are dedicating you to be tgeir patient of the day versus having multiple patients which also itself adds lots of fatigue. Research carefully and good luck.

 

I often wonder why there are no Drs anywhere who remove say 500 grafts and plant those, then remove another 500 and plant those, etc in order to reduce the time out of body for the grafts. Wouldn't it make sense to do that? It also gives him a break from removing grafts as far as the fatigue issue.

[hsrp10]

Realistically in terms of the mechanics of the procedure and keeping the costs to the patient down, having techs involved is a practical operational decision for most clinics.

Bisanga, H&W, Rahal etc. get the results while using techs in the HT procedure. But some of the odd mistakes I've seen with doubles being placed in the hairline and in the temple points etc also are made by techs so there are both pros & cons.

 

If you've ever undergone a procedure with the likes of Dr. Konior, where he not only gets results but also limits your downtime by minimal trauma to the scalp and eliminates lingering post-op redness through his meticulous refined work I don't think you'd ever go back to a tech-focused clinic, unless you couldn't get a booking with him.

Also, I personally feel that you cannot beat the "stick and place" technique when it's required to transplant in between existing hair. You will never get that type of elaborate graft per graft placement at tech-focused operations.

 

As far as I know the only ones out there who do everything are Konior, Dr. Keser, and Dr. Couto (if I'm wrong on Couto correct me). And that's a very elite class of surgeons there.

 

But each case and each patient's needs and budget are different.

[aWidowsPeek]

Isn't it true that even a Dentist can legally perform a hair transplant?

[KO]

Do needles and implanter pens reduce recipient site trauma?

[KO]

I think there's a few other docs out there that do the whole procedure. I don't think this is necessarily the most efficient way but a few others out there - Karadeniz, Vories, Gabel?

[Yaz89]

There is also Dr Zekeriya Kul of Istanbul, Turkey who does all the surgery himself. From extraction to implantation. He uses the stick and place method. I seen some videos of his work in youtube demonstrating this technique; very impressive. His work can also be found in the Italian forum. There are plenty of excellent surgeons scattered through the world. Researching can be quite difficult finding these kind of surgeons but they are out there

[hsrp10]

Do needles and implanter pens reduce recipient site trauma?

 

I asked Dr. Konior the same exact question recently about needles vs blades, he gave a longer text book explanation but he said in summary it (using needles) would be like trying to cut your arm with a butter knife, so actually instead the trauma in some cases could be even greater with needles.

 

However he also mentioned that different parts of the scalp have different skin "textures," and for example the sites he transplanted into my temple points were softer so he used needles.

I think for transplanting in between hairs sharper small blades are better for reduced trauma.

[hsrp10]

I think there's a few other docs out there that do the whole procedure. I don't think this is necessarily the most efficient way but a few others out there - Karadeniz, Vories, Gabel?

 

I asked Dr. K about Gabel and he said he thought he used a hybrid type, where he did a lot of the work himself but not all of it.

OtherSyde or other Gabel patients can maybe elaborate more.

 

It depends on the doctor of course, and what the patient is seeking.

Certainly not best in all cases.

 

There is also Dr Zekeriya Kul of Istanbul, Turkey who does all the surgery himself. From extraction to implantation. He uses the stick and place method. I seen some videos of his work in youtube demonstrating this technique; very impressive. His work can also be found in the Italian forum. There are plenty of excellent surgeons scattered through the world. Researching can be quite difficult finding these kind of surgeons but they are out there

 

Hey Yaz, how's it going?

I had heard of Dr. Kul but didn't know his techniques or much about his reputation, interesting.

 

Really are a lot of options out there these days.

[Yaz89]

Hey Yaz, how's it going?

I had heard of Dr. Kul but didn't know his techniques or much about his reputation, interesting.

 

Really are a lot of options out there these days.

 

All is well brother, you?

 

Yeah, only recently he hit my radar; a few months ago. He be worth researching. The internet has really developed to be an excellent source. I can remember the days surgeons were being recommended to me via mouth.

[wibbles180]

This dr kul yaz ?? http://www.hairrestorationnetwork.com/eve/180317-dr-kul-7-month-after-2000grafts.html?highlight=Kul

[Yaz89]

It is Wibbles. I know what you are thinking...7 months for that poster maturation of the hairs wasn't complete.

[MrGio-WHTCClinic]

Hi, I have began consulting with clinics for my first FUE procedure and have narrowed my search to a handful of surgeons.

 

My surgeon of choice is arguably the best in Turkey and from my understanding he performs 3 - 4 surgeries per day. Given the multiple surgeries per day, his technicians perform the extractions and implanting, with the surgeon solely performing the incisions without the help of the technicians (which I have been told is the most crucial part of the surgery).

 

Given the heavy involvement of the technicians in the procedure (for extraction and implanting), should this be a concern? I have been told the technicians all have a minimum of 6 years of experience. If the skill and experience of the technicians is there, would it really matter if the surgeon isn't the one performing the extractions and implanting?

 

It should matter for the surgeon to train and educate all medical assistants so that results aren't compromised.

[hsrp10]

I really like this thread, some real good discussion here.

 

Most posts recently 100 people make 100 different comments but there's not much real direct discussion and interaction like there used be with lengthy posts going over many pages in the past.

Guess we're all busy though.

[KO]

I asked Dr. K about Gabel and he said he thought he used a hybrid type, where he did a lot of the work himself but not all of it.

OtherSyde or other Gabel patients can maybe elaborate more.

 

 

 

When you say "all of it", do you include placing grafts into recipient sites? If so yeah, there's very few who do that, Konior and whoever uses implanter pens and harvests own grafts.

[fullheadofhair]

Just to close out this thread - After serious thought I am heavily leaning towards not going ahead with the Turkish clinic.

 

I don't mind a team of techs being used for the procedure, but the fact the clinic runs 4 procedures in parallel and that the physician will only be in the room now and then to check up on me is something I can't get comfortable with.

[jcs87]

I often wonder why there are no Drs anywhere who remove say 500 grafts and plant those, then remove another 500 and plant those, etc in order to reduce the time out of body for the grafts. Wouldn't it make sense to do that? It also gives him a break from removing grafts as far as the fatigue issue.

 

I believe this is exactly what Keser does so I certainly wouldn't say that "no doctors do this". Here's the link: Why Choose Dr. Keser?

 

If the mods remove the link then just go to Keser's page and click why choose Dr Keser.

 

He says "Dr Keser doesn’t do mega sessions, he divides a hairtransplantation surgery into a few days depending on the number of grafts planned to be harvested, which is just in order not to force patient’s body resistance too much. For instance, for 2000 grafts the surgery lasts three or four days. 500-700 grafts per day is the optimum option according to Dr Keser’s experience. By this means, the patient feels almost no weakness during the operation. He has enough resting time to feel good between the divided sessions."

 

 

I asked Dr. K about Gabel and he said he thought he used a hybrid type, where he did a lot of the work himself but not all of it.

OtherSyde or other Gabel patients can maybe elaborate more.

 

It depends on the doctor of course, and what the patient is seeking.

Certainly not best in all cases.

 

Hey Yaz, how's it going?

I had heard of Dr. Kul but didn't know his techniques or much about his reputation, interesting.

 

Really are a lot of options out there these days.

 

I had a consult with Dr Gabel and he said something along the lines of "I like to do some of the graft placements myself" Implication being that he does participate but techs are also gonna be involved in this stage of the surgery

Edited January 25, 2017 by jcs87

[milo12]

After serious thought I am heavily leaning towards not going ahead with the Turkish clinic.

 

I don't mind a team of techs being used for the procedure, but the fact the clinic runs 4 procedures in parallel and that the physician will only be in the room now and then to check up on me is something I can't get comfortable with.

 

I can respect that. But unfortunately given the large demand for these clinics the doctors have no choice but to hire a team of trained techs to do their work for them. I do agree with you wholeheartedly. It is the nature of the business now.