Is FUE extraction important? Does it have to be done by the doctor? Can you find a clinic that the doctor does the extraction in Turkey?

[wei2go]

Is FUE extraction important? Yes, it is definitely important. Follicular is very fragile. Many follicles died during the extraction before they are implanted. Poorly performed extractions wastes our money, our time, and our precious grafts.

 

Does it have to be done by the doctor? It should be. However, in Turkey’s HT industry, you almost cannot find a doctor who does both the graft extraction and the slit incision. During the last ten years, the competitive cost of HT in Turkey appealed to many people due to the cheap price. However, the surgeries in most of clinics were done by technicians and nurses. You just see doctors in the first personal consultation and he draws the hairline, then he is done. This is why a clinic can take many patients in one day. They never tell you the follicular extraction will be not done by the doctor before you come to Turkey. This was completely hidden. We recently saw on some clinics’ websites that they explicitly list their package details. Primarily they have two different packages. With the cheaper package, technicians do all the procedures and doctor is just a supervisor. Choosing the expensive package, the doctor does the slit incision (open channel), but the FUE extraction is still done by technicians. Giving patients the clear information is an improvement and it is good. However, the concerns still exist due to the extraction done by technicians. So far, I have not found any clinic who is able to convince me their technicians can do quality extractions. After I watched the video below, I was completely terrified. People in the video treat the follicles like treating a pile of alfalfa.

https://www.youtube.com/watch?v=qvSZSPGF2l4

 

I probably can understand why the doctors do not do the both extraction and incision. This could get the price way too high because a doctor might be able to take only one or two patients a day. It takes a lot of energy from the doctors. Based on this current circumstance of the business, you probably cannot expect it will change much in near future.

 

Can you find a clinic that the doctor does the extraction in Turkey? So far, I only see two clinics.

Dr. Ali Emre Karadeniz – Does he really do it like he promises on his website?

Dr. Civas extracts grafts for 1 hour before leaving the assistants to proceed with the rest of the extraction.

 

Does anyone have experience with them?

[Sean]

Yes, if you are paying a certain premium price to a doctor for his or her name, then that doctor needs to do all aspects of surgery.  Extracting is surgery.  Few clinics may bypass this in North America by using a robotic machine called Artas which get continued updates as it is not perfected 100%.  

The best likely experienced extractions are done by surgeons.  Techs may implant grafts into recipient sites created by doctors, but they should not extract as it is considered surgery as there is tissue that is scored.  In fact, a lot of areas consider this illegal.  

Some folks ended up as repair patients where techs may gave extracted.  Dr Karadenis is good I heard, but Dr Keser does his extractions completely manual and limits number of extractions per day. I do not think many doctors if any offer a dedicated one patient a day procedure where that same patient may come back each day until all grafts are inserted.  

 

Best of luck

[ctrlf]

I am at the stage of researching several doctors for my hair transplant and will post my outcome at a later time. This is a short summary what i have found out about Dr. Karadeniz which would on my shortlist

Dr. Karadeniz
patient reports and the AEK Clinics Website claim that Dr. Karedeniz is doing the extraction by himself, in person very sincere and ehtical 

Unfortunately i was told otherwise about extraction after getting in contact with the clinic:
"recipient incisions will be performed by Dr. Karadeniz, extraction and placement by his assistants."

Trying to get a reconfirmation from the clinic to see if something was lost in translation.

 

Edited July 28, 2018 by ctrlf

[Sean]

12 hours ago, ctrlf said:

I am at the stage of researching several doctors for my hair transplant and will post my outcome at a later time. This is a short summary what i have found out about Dr. Karadeniz which would on my shortlist

Dr. Karadeniz
patient reports and the AEK Clinics Website claim that Dr. Karedeniz is doing the extraction by himself, in person very sincere and ehtical 

Unfortunately i was told otherwise about extraction after getting in contact with the clinic:
"recipient incisions will be performed by Dr. Karadeniz, extraction and placement by his assistants."

Trying to get a reconfirmation from the clinic to see if something was lost in translation.

 

Really?  This is news to me.  Hopefully, it is just language lost in translation but last I read and even speaking with him via video conference a while back, he mentioned he does his own.  He seems like a really down to earth guy.  

[ctrlf]

2 hours ago, Sean said:

Really?  This is news to me.  Hopefully, it is just language lost in translation but last I read and even speaking with him via video conference a while back, he mentioned he does his own.  He seems like a really down to earth guy.  

I hope so as he would be my first choice. ?

 

 

 

[ctrlf]

His assistant just replied. Dr. Karadeniz still does the extractions but many patients don't want him to do it because of the price factor. So this service is only offered to those who ask for it. 

[Gasthoerer]

I do not agree with this thread, because it is a simplification of a complicated topic.

A) Why is there such a focus on turkey? There are many countries in the world where transplants are performed.

B) Just from the back of my head I can name several clinics in turkey where the doc is doing the entire procedure:

      - HLC (actual several docs in a joint clinic)

      - Keser

      - Kaan (former HLC employee)

I guess there are more, and there are even more if you look outside of turkey say belgium, switzerland, greece....

C) There is not one typ of clinic for all type of situations: The "do it all" approach limits the amount of grafts per day (typical 500-800) and per session (1500 - 2000 as a rough value) which can be moved. It also leads to fatique to the person performing it. No one can fully concentrate for 8-12 h / day. Depending on the approach it can (!) also lead to longer "out of body times" of the grafts.

Edited July 29, 2018 by Gasthoerer

[Sean]

Absolutely, there are docs outside of Turkey that also do their own extractions via manual FUE.  Pricing may not be the same for most part, but there is.  

[wei2go]

On 7/28/2018 at 1:20 AM, Sean said:

Yes, if you are paying a certain premium price to a doctor for his or her name, then that doctor needs to do all aspects of surgery.  Extracting is surgery.  Few clinics may bypass this in North America by using a robotic machine called Artas which get continued updates as it is not perfected 100%.  

The best likely experienced extractions are done by surgeons.  Techs may implant grafts into recipient sites created by doctors, but they should not extract as it is considered surgery as there is tissue that is scored.  In fact, a lot of areas consider this illegal.  

Some folks ended up as repair patients where techs may gave extracted.  Dr Karadenis is good I heard, but Dr Keser does his extractions completely manual and limits number of extractions per day. I do not think many doctors if any offer a dedicated one patient a day procedure where that same patient may come back each day until all grafts are inserted.  

 

Best of luck

Thanks for sharing, Sean! Your journey of HT is quite impressive. I checked Dr Keser and cannot find any information about the cost. Some other folks in other websites say he charge 3 euro per graft. Not sure if he does the beard transplant as well since I want beard too.

[Sean]

3 minutes ago, wei2go said:

Thanks for sharing, Sean! Your journey of HT is quite impressive. I checked Dr Keser and cannot find any information about the cost. Some other folks in other websites say he charge 3 euro per graft. Not sure if he does the beard transplant as well since I want beard too.

Thanks Wei, 

Lets hope I can get my life back soon.  Journey has been exhausting and stressful.  Nobody wants to end up being a repair.  Not sure if Dr Keser does beard, but you may want to email him about that. If he charges 3 Euro, i don’t it is too high considering he does only you as the patient of the day and does limited graft extractions a day.  I think he paces his surgery which may be a reason of the higher yield aince your grafts are not out of body for so many hours.  The linger the grafts are outside of body, the likelihood the grafts may not survive.  

 

There are other surgeons though in usa that do manual fue too I believe.   Dr Vorhies, Dr Wong, Dr Konior etc

[wei2go]

3 hours ago, ctrlf said:

His assistant just replied. Dr. Karadeniz still does the extractions but many patients don't want him to do it because of the price factor. So this service is only offered to those who ask for it. 

This is interesting! Did they offer you a different price then?  If they have different options for the cost, I think it is ok to put that information in their website to make it more transparent. 

Are you going to choose him?

[ctrlf]

1 minute ago, wei2go said:

This is interesting! Did they offer you a different price then?  If they have different options for the cost, I think it is ok to put that information in their website to make it more transparent. 

 Are you going to choose him?

The price was about double - but still reasonable - for the doctor doing the extractions.

Not sure what to think, they advertise as a doctor-only clinic and then only offering that service after request. ?

[wei2go]

2 hours ago, ctrlf said:

The price was about double - but still reasonable - for the doctor doing the extractions.

Not sure what to think, they advertise as a doctor-only clinic and then only offering that service after request. ?

Umm, not sure it will pass my smell test. Thanks for letting us know.

[wei2go]

6 hours ago, Gasthoerer said:

I do not agree with this thread, because it is a simplification of a complicated topic.

A) Why is there such a focus on turkey? There are many countries in the world where transplants are performed.

B) Just from the back of my head I can name several clinics in turkey where the doc is doing the entire procedure:

      - HLC (actual several docs in a joint clinic)

      - Keser

      - Kaan (former HLC employee)

I guess there are more, and there are even more if you look outside of turkey say belgium, switzerland, greece....

C) There is not one typ of clinic for all type of situations: The "do it all" approach limits the amount of grafts per day (typical 500-800) and per session (1500 - 2000 as a rough value) which can be moved. It also leads to fatique to the person performing it. No one can fully concentrate for 8-12 h / day. Depending on the approach it can (!) also lead to longer "out of body times" of the grafts.

Thanks for sharing. Do you have recommended doctor in HLC? Trying to find more work they did for beard transplant.

I think extraction and incision are two important procedures to me. I am ok with assistant doing the graft implantation. So I am not looking for "do it all".

[2941grafts]

Hi

There are HT clinics in India (Bhatti)  and Thailand (Kongkiat Laorwong) have what your looking for.

[wei2go]

On 7/29/2018 at 5:10 PM, 2941grafts said:

Hi

There are HT clinics in India (Bhatti)  and Thailand (Kongkiat Laorwong) have what your looking for.

Thanks a lot, 2491! Dr. Laorwong did amazing jobs. Thailand is too far to travel but I will think again. 

[Payam]

On 8/1/2018 at 6:27 AM, wei2go said:

Thanks a lot, 2491! Dr. Laorwong did amazing jobs. Thailand is too far to travel but I will think again. 

I would honestly not go for a clinic where the techs do the extraction, you may get good results, but there are too many unknown factors involved, with Erdogan we don't even know the names of the people making thousands of small holes in your head. Go with a doctor that does the extractions themselves.

[Gasthoerer]

On ‎7‎/‎29‎/‎2018 at 9:41 PM, wei2go said:

Thanks for sharing. Do you have recommended doctor in HLC? Trying to find more work they did for beard transplant.

I think they split the tasks at HLC. One is specialised for body and beard. Otherones for head donor. Before I mix up the names of the docs better you contact them yourself.

[Gasthoerer]

4 minutes ago, John Baris said:

Actually, you can easily find them, if they have ABHRS and ISHRS membership and certificates, these doctors are the ones you are looking for. The reason for that is, these two doctor boards are very hard to be a member of, and they inspect strictly their doctors. They have a little more than 200 doctors as members in the world, so Turkey or not, try to find them.

That is simply not true. There are a lot of clinic ISHRS members who do use techs for most of the procedure and there are actually quite a lot bad clinics (independently if the use techs or not). Also, a lot of great clinics are missing at the ISHRS site.

There is other way, but to look at the results in forums like this or others if you want to find great clinics.

Turkey has maybe a handfull of great clinics and maybe thousands of horrible ones.  

[wei2go]

On 8/9/2018 at 4:48 PM, John Baris said:

Hello there, i have seen your topic and willing to help you. In Turkey, i have seen that many people are confused because of what doctors websites and themselves say, and what is actually done after. I want to clarify this for you. 

I am a Turkish hotelier in Toronto and know many doctors in Turkey, and actually am trying to protect Turkey's integrity as well as those honest doctors. Doctors in Turkey mostly have assistants they teach, and let them do the procedure. The reason is, because price is very competitive, there is a lot of people going to Turkey for the procedure, and because of the demand, doctors not willing to lose these patients, do some of the procedure and then let the assistants take over. 

There are a few doctors i would recommend, because they do the procedure themselves. Ethically, not doing the entire surgery is not acceptable. I know for a fact that some of these doctors people mention a lot were expelled from their communities because of their way of operating this not from a medical perspective, but rather a business perspective.

If you are spending all of that money for such a thing very important to you, please try to find doctors who does the entire procedure themselves, and are ethical about their profession. Actually, you can easily find them, if they have ABHRS and ISHRS membership and certificates, these doctors are the ones you are looking for. The reason for that is, these two doctor boards are very hard to be a member of, and they inspect strictly their doctors. They have a little more than 200 doctors as members in the world, so Turkey or not, try to find them. Because they are inspected strictly, they can not do half procedure, they are not even allowed to have anyone else other than an assistant just helping the doctor while he operates. They are expelled immediately if they don't follow rules. 

Anywhere you consider, find one of those doctors, so you know for sure that they will follow the highest standards because of the discipline of their boards, if not because they are ethical people. If you need help with Turkish market, feel free to ask me, i represent no clinics or doctors, so i can give you information for what to look at rather than where.

 

Cheers!

Thanks John! I agree with you. I do see some ethical doctors in Turkey and they do great work. Currently, I've narrowed it down to three clinics:  HLC, Dr. Kaan, and Dr. Laorwong. What I need to decide is going with manual harvest or motorized. Do you have any suggestions or other doctors to recommend? 

 

[Gasthoerer]

36 minutes ago, wei2go said:

What I need to decide is going with manual harvest or motorized. Do you have any suggestions or other doctors to recommend? 

 

That is a simple one. Go manual. The only clinic I trust who us a kinf of motorized punch is Devroye.