400+ and 2900 Grafts FUE with Feriduni

[Gasthoerer]

On 2/19/2020 at 2:05 AM, TrixGlendevon said:

I think going with Feriduni was by far the best option. He did you right the first time so why go into the unknown?

Even though the first result was great I normally would have preferred a surgeon who does more of the procedure himself. Also feriduni switched from CIT manual to the WAW system in between my surgeries, which made me a little nervous. Konior using the system himself gave me a better feeling in a way 😅

[Gasthoerer]

2 minutes ago, brickellmoto said:

yea thats what i meant. how long till the shocked native hair grew back?

Hard to tell, 80 to 90 % of my result came in between month 3.5 and 4.5. The remainder around 6 to 8. Hard to tell which was the native hair and which was the transplanted. 

But after 3.5 to 4 month I was looking better than before with month 3 being rock bottom. 

[Gasthoerer]

1 hour ago, transplantedphil said:

Sorry if i missed it, ...

I did not mention it yet as I did not wanted to spoiler 😉Gonna sent a PM. 

 

[bw77]

This thread is really helpful Gasthoerer. I'm planning a hairline repair and possible crown procedure with Dr Feriduni and I'd love to see your results. I'm thinking my graft needs will be similar as well. Any chance you could PM me with some pics? I've got a couple of additional questions if you have time.

[Gasthoerer]

Thanks for you interest in this ancient thread. Will sent a PM. 

[home1212]

On 2/20/2020 at 3:31 AM, Gasthoerer said:

Even though the first result was great I normally would have preferred a surgeon who does more of the procedure himself. Also feriduni switched from CIT manual to the WAW system in between my surgeries, which made me a little nervous. Konior using the system himself gave me a better feeling in a way 😅

I believe most doctors outside the US have built experienced technical teams do deal with the tedious and repetitive work involved with FUE in order to avoid fatigue - how does anyone expect to have a 3k graft FUE case done in a day without excellent techs that the doctor supervises and also performs overall quality control? I know in my case, the doctor was primarily involved with the recipient site incisions and design of the hairline, but he was intimately involved from the beginning to end checking up on his lead tech and also administering meds, checking up on me, etc. I think without this model, FUE could not be as efficient as it is today. Going in, I think doctors should be transparent about the entire process and how much they're involved vs. techs, etc. I do understand your concern.

Edited August 14, 2020 by home1212

[Gasthoerer]

A little earlier than planned (but I have some spare days now), please see the update about my 2^nd procedure. @Melvin-Moderator, maybe you can change the title into “400+ and 2900 Grafts FUE with Feriduni”?

I decided only to tackle the crown to be able to cover the treated area with my long hair at the front. It worked fairly well. Feriduni used some more grafts than originally planned some years ago. Maybe the situation has slightly worsened despite FIN. Diffuse thinning is very difficult to judge anyway.

Extraction sites were completely performed with WAV system (Motorized), while the first one was purely with CIT (Manual). I was very nervous about this fact and looked for other clinics despite my nice first result. But Konior also using WAV somehow calmed my mind^^

My judgement: WAV is much faster (entire surgery was finished around 2 pm, starting around 8.30 or 9 am). I had the feeling that the extraction was easier after WAV compared to CIT (less crunchy sound when ripping the grafts lose), I had less tingleling pain post surgery despite much more extracted grafts and my feeling is that there are less grafts kinky (injured) with WAV. If this is the combination of the motor and the trumpet punch or manual trumpet punch would be even better…who knows.

Wow, crown really takes longer. I never believed it until it happened to myself. Growth was ~1.5 month delayed compared to my hairline procedure and I was really nervous because of that. Feriduni also has no real explanation for it, when I asked him in the consultation. My theory is actually it is related to the multies in the crown. But it is just a theory of course.

I will have my final consultation with Feriduni sometime in March and plan a small surgery mid of 2021 for my left temple to finish my look for the next 10 years (fingers crossed).

Finally, I am very happy with the (preliminary) result. Keep in mind: Latest pics are only at month 8.5 and with a lot of pomade in the hair. Of course it is not natural density, but it further thickened in the last month. Such a great feeling, not to be afraid of wind, rain or someone standing behind you. And I do save 10+minutes a day styling my hair.

No one asked me if I had a HT (not even my parents at Christmas), all just said that they like my new hairstyle (and if my hair is getting grey). Only one women commented that it appears that I have “more hair”^^

Thanks to @Melvin-Moderator for this forum and to the users who supported me @JayLDD, @1978matt, @qui bono, @bw77 and for those who were an inspiration like@Aftermath.

Edited December 31, 2020 by Gasthoerer

[Gasthoerer]

Pre-Surgery (2nd) 

 

[Gasthoerer]

Immediately Post surgery - The Monk^^ - Very Interesting that a small area of the donor is left out on purpose (was marked before by Feriduni). 

Edited December 31, 2020 by Gasthoerer

[Gasthoerer]

11 days post surgery (post washing at the clinic). Donor and recipient looking great IMO. Styled to understand the look I chose the hide the procedure (sorry, PIC is very blurry). 

 

 

 

Edited December 31, 2020 by Gasthoerer

[Gasthoerer]

6 month and 1 week post OP with flash and slightly damped hair. At this time I might have reached baseline. 1.5 at least behind my frontal procedure. Before I was looking like sh.t. Much worse than before which made me very anxious. 

Edited December 31, 2020 by Gasthoerer

[Gasthoerer]

8.5 month consulation at Feriduni. Hair styled with pomade. With a comb over it is looking great. Splitting the hair, it looks very natural but the hairs are still thin. My feeling it has improved further since. Do not use any concealer since month 6.5 any more (what a relief). EDIT: Found another recipient pic under worst conditions: Split apart, lots of pomade and with bright light. 

 

 

Edited December 31, 2020 by Gasthoerer

[Gasthoerer]

I think I am not running out of donor soon. Actually I wear my hair in the back now much shorter than ever before (much shorter than on this picture). 

Donor after 3300 FU FUE. 

 

Edited January 1, 2021 by Gasthoerer

[Gasthoerer]

Finally, the area which I am going to treat next year. If I find a clinic, as Feriduni was not keen on the procedure as he thinks it is high risk/low reward.

Anyway, then I am hopefully done for the next 10 years (until my bridge and right temple have thinned even more) or maybe even for ever...who knows. 

[Aftermath]

Looking great bro! 

[Gasthoerer]

1 hour ago, Aftermath said:

Looking great bro! 

Thanks, if this is coming from the HT Goat it is even more of a compliment 😂

[PizzaWolf]

2 hours ago, Gasthoerer said:

Finally, the area which I am going to treat next year. If I find a clinic, as Feriduni was not keen on the procedure as he thinks it is high risk/low reward.

Anyway, then I am hopefully done for the next 10 years (until my bridge and right temple have thinned even more) or maybe even for ever...who knows.

Your hair looks great and completely natural.

Why did Dr. Feriduni think that area on your temple was "high risk/low reward"? I've seen cases from Feriduni where he lowered or altered hairlines on people who weren't even balding. Why is your little touchup a big deal? Seriously asking as I'm no expert and want to have a better understanding of these issues. Thanks.

[giegnosiganoe]

10 hours ago, Gasthoerer said:

Extraction sites were completely performed with WAV system (Motorized), while the first one was purely with CIT (Manual). I was very nervous about this fact and looked for other clinics despite my nice first result. But Konior also using WAV somehow calmed my mind^^

My judgement: WAV is much faster (entire surgery was finished around 2 pm, starting around 8.30 or 9 am). I had the feeling that the extraction was easier after WAV compared to CIT (less crunchy sound when ripping the grafts lose), I had less tingleling pain post surgery despite much more extracted grafts and my feeling is that there are less grafts kinky (injured) with WAV. If this is the combination of the motor and the trumpet punch or manual trumpet punch would be even better…who knows.

Congrats on the result!

I had some questions.

When you say the "entire surgery", does that include implantation? 5.5 hours seems quite short for 2900 grafts. How does it compare in time with your 400 manual FUE procedure?

Why exactly did Feriduni switch from manual to motorized for your case? Was it just because it's the only way to do 2900 grafts in a single day?

Also do you have any shaved pre-surgery pictures? And do you know what was the implanted density? And the hair count per graft? Thanks.

Edited January 1, 2021 by giegnosiganoe

[Gasthoerer]

4 hours ago, giegnosiganoe said:

5.5 hours seems quite short for 2900 grafts. How does it compare in time with your 400 manual FUE procedure? ... 

Why exactly did Feriduni switch from manual to motorized for your case? Was it just because it's the only way to do 2900 grafts in a single day? ...

Also do you have any shaved pre-surgery pictures? And do you know what was the implanted density? And the hair count per graft? Thanks. ...

Thank you for your kind words and very good points!

Yes, surgery was very fast. I am talking complete surgery. I left the clinic just before 3 pm after a small lunch, washing and final discussion with Feriduni. The 2900 FU was just 2 hours longer than the 400 FU. Partly because WAV was used for the 2900 FU, but also the amount of staff used was higher. The first surgery was just one tech doing extraction and implantation. The second had 2 techs extracting and 2-3 techs implanting. 

The switch from CIT to WAV was not for my case, but a general switch of the clinic. The transition phase was just around my first surgery. At this time CIT was used for most hairline cases and WAV (due to the trumpet punch) for crown cases with more multi-grafts. Nowadays, it is 90+% WAV according to Feriduni. He claims the results are better with WAV (grafts are more healthy) and the time saving is just a side effect (what else should he say^^). There is a thread from the clinic in here, giving the exact timeline of the switch and some background info. I will try to find it. 

I do not exactly know the implanted density, but from the measurements the diameter of the crown area was around 9 cm. Which leads to 64 cm2 of treated area. This would lead to 46 FU/cm2. My natural density of the donor was between 90+ and 110+ FU/cm2. 

HGI was around 2.45 (I have to look it up to know it precisely). 

[Gasthoerer]

7 hours ago, PizzaWolf said:

Your hair looks great and completely natural.

Why did Dr. Feriduni think that area on your temple was "high risk/low reward"?

Thank you. Natural look is the most important IMO. More important than pure density.

I had a long discussion with Feriduni about my hairline. His exact words were:

- It is much easier to completely (re)built a hairline from scratch than "to fill in certain parts of the hairline

- My hair(line) is even more difficult than the average hairline as my grafts grow in very "unusual and varying" directions

- The cosmetical benefit of the center of the hairline is higher than the benefit on the sides

- Most people tend to thin further over time on the sides of the hairline than in the center  (which means you need further surgery if you do work on sides or it will look unnatural) 

- Every surgery is a risk and he thinks the possible gain is small in my case 

- Business case is poor for the clinic (less €/hour with more/similar risk for complaints) - we talked very open about this

Think about it: Feriduni agreed with me that 400 FU for the center of my hairline gives a huge benefit and is worth the risk. 2 other top clinics rejected me and did not want to perform such a small surgery in the first place. But they would have lowered/rebuilt my entire hairline. 

[bw77]

Outstanding result!! Well done mate. I think your crown is a home run.

[Gasthoerer]

Thanks, I know you have critical eyes, so your feedback is even more valuable. 

[Gasthoerer]

Last but not least, another topic which is often overlooked. While density or better "coverage" is often discussed, HEIGHT and VOLUME are often overlooked. 

I have a very flat headshape, which makes a buzzcut not an option, but with my thinning crown this was also a big issue. Actually, my "flat" profile (amplified by the thick hair in the front) was an bigger issue to me than the missing coverage in the crown which was actually "age appropriate". Sorry, for the lack or better words. 

 

[Gasthoerer]

Flat crown at the day 11 pic is very obvious (as is the implanted density :-)) but also on the second pic which was pre-surgery. 

[Gasthoerer]

Comparing the pictures above to the new profile pics clearly shows the difference IMO. Even though the styling is slightly better, I could never achieve such a nice shape before the crown surgery.

Feriduni spotted this immediately at my first consultation, while none of the other clinics did. One clinic even mentioned that they would not recommend to "work on the crown". 

I guess this is it. Thanks again for the forum to support me, making not only a great clinic choice but also giving me motivation to finally go for it. 

 

Edited January 3, 2021 by Gasthoerer