ASMED / Dr Erdogan - High number of FUE Grafts per HT

[Panamera13]

Hello All,

I have had 3 consults so far: H&W, Rahal and Bhatti (Darling Buds). All three docs suggested they can get 2500-3500 grafts.

Continuing with my research, came across ASMED in Turkey and he has HIGH number of cases (in the results section of his website) with 5000+ FUE Grafts. He also mentions use of custom blades and punches which are 0.6mm/0.7mm. Everyone else I have spoken to uses 0.8mm.

Ignoring price/location - is ASMED better than H&W for my case.Why is that ASMED has too many cases of 5000+ FUE while other docs barely have any (they do but exceptions).

I'm going to book a consult with ASMED but can you please guide me if it's worth going to ASMED. I'm tired of searching/re-searching since I just end up with more names and they all look good on paper.

So, for my case - High norwood diffused - Which is the best doc to go to leaving aside money/location? My expectations are realistic - get front face framed nicely and leave the crown.

 

 

Edited September 11, 2019 by Panamera13

[Melvin- Admin]

Are you sold on FUE? I would go strip first and then FUE to get max grafts. 

[Panamera13]

4 minutes ago, Melvin-Moderator said:

Are you sold on FUE? I would go strip first and then FUE to get max grafts. 

Yes Melvin; I'm scared of the scar and want to avoid it completely.

 

[Melvin- Admin]

Well, have you asked each of the clinics to provide you with examples of patients with similar hair loss? 

[CosmoKramer]

Hi

I would suggest you post some good clear photos  of your back and both sides of your donor area to better get honest opinions. It looks like you have a similar hair loss to what I had but how well your donor is is what’s important.

Edited September 11, 2019 by CosmoKramer

[thornbush]

I would not like a strip scar too. I am in conversation with ASMED.

They do quote large numbers. But nice results being showcased by the clinic.

This weekend is the last I have given myself for the research.

Will decide between India and Turkey. Saturday will be a busy day flying for consultations.

Bhatti/  Poswal are on my Indian list due to their largest repertoire of Caucasians in Asia.

[Panamera13]

Attached Donor pics

Edited September 11, 2019 by Panamera13

[Panamera13]

7 hours ago, CosmoKramer said:

Hi

I would suggest you post some good clear photos  of your back and both sides of your donor area to better get honest opinions. It looks like you have a similar hair loss to what I had but how well your donor is is what’s important.

Quote

Well, have you asked each of the clinics to provide you with examples of patients with similar hair loss? 

CosmoKramer -Can you share your thread link; would love to see your journey/pics. Thx

 

Melvin - Yes, I asked Rahal and they did share a similar pic; it wasn't exactly like mine though. H&W just said verbally and they barley spend anytime on the consult (5 min consult)

Edited September 11, 2019 by Panamera13

[CosmoKramer]

Sure!

Here is my microneedling + Minoxidil progress thread:

https://www.hairrestorationnetwork.com/topic/54717-microneedling-may-2019-progress/

[Panamera13]

32 minutes ago, CosmoKramer said:

Sure!

Here is my microneedling + Minoxidil progress thread:

https://www.hairrestorationnetwork.com/topic/54717-microneedling-may-2019-progress/

I do 1mm micro-needling too once per week, use Lipogaine Shampoo, Azelaic Acid in night and Lipogaine Minox in morning. I also have a laser cap....ALL this hasn't really done much so far. I stopped FIN because if side effects. PRP is one thing I have been thinking about. 

So, HT is the only way forward now I guess and I'm lost which one to chose for my pattern.

[CosmoKramer]

40 minutes ago, Panamera13 said:

I do 1mm micro-needling too once per week, use Lipogaine Shampoo, Azelaic Acid in night and Lipogaine Minox in morning. I also have a laser cap....ALL this hasn't really done much so far. I stopped FIN because if side effects. PRP is one thing I have been thinking about. 

So, HT is the only way forward now I guess and I'm lost which one to chose for my pattern.

I use a derma pen with 12-needle cartridges and adjust the pen to 2mm on sessions I microneedling hard once every 7-9 days and apply Minoxidil foam an hour or two after, but I Also microneedle at 1mm every 3rd night gently and also apply Minoxidil foam an hour or so after.

 

[Raphael84]

@Panamera13

May I ask your age?

The comments thus far don’t seem to have picked up on your expectations. You say that you are looking to restore your frontal loss, reframing your face. This restoration would move somewhat into your mid scalp area.

Do you intend to have a subsequent procedure in the future to address your vertex?

Your expectations are realistic. Depending on your hairline placement and how far back you want to achieve growth into your mid scalp will dictate your graft count.

If you are content with a mature/conservative hairline, which I would suggest would be the appropriate approach, then naturally this would consume less grafts. If this is the case and you are not looking to graft too advanced in the mid scalp, I would suggest that 5000 grafts is excessive. But that appears somewhat typical of ASMED.

Keep us updated.

[thornbush]

On 9/11/2019 at 2:13 PM, CosmoKramer said:

Hi

I would suggest you post some good clear photos  of your back and both sides of your donor area to better get honest opinions. It looks like you have a similar hair loss to what I had but how well your donor is is what’s important.

Of all the people currently active on the forum, I find your comments balanced and to the point. The support and the positivity you exude is commendable. I thank you for it. A patient recovering from a procedure needs just that. Thanks for what you do.

[CosmoKramer]

6 hours ago, thornbush said:

Of all the people currently active on the forum, I find your comments balanced and to the point. The support and the positivity you exude is commendable. I thank you for it. A patient recovering from a procedure needs just that. Thanks for what you do.

Thank you for the kind words, much appreciated! 🙂

[CosmoKramer]

4 hours ago, transplantedphil said:

@CosmoKrameris awesome

Thanks Phil! Your sentiment is much appreciated! 🙂

[Raphael84]

10 hours ago, transplantedphil said:

I think some guys are happy wth the one and done approach, even if the medical literature supports more incremental conservative approaches around the 2000 graft mark to increase one's yield. 

You are absolutely right. I am also an advocate of this approach with the appropriate patient with the appropriate circumstances. My point was considering @Panamera13 desires of the framing of the face and not addressing the crown.

Loving the love for @CosmoKramer Well deserved!!!

[CosmoKramer]

8 minutes ago, Raphael84 said:

You are absolutely right. I am also an advocate of this approach with the appropriate patient with the appropriate circumstances. My point was considering @Panamera13 desires of the framing of the face and not addressing the crown.

Loving the love for @CosmoKramer Well deserved!!!

Thanks Raphael! 🙂

[Panamera13]

17 hours ago, Raphael84 said:

@Panamera13

May I ask your age?

The comments thus far don’t seem to have picked up on your expectations. You say that you are looking to restore your frontal loss, reframing your face. This restoration would move somewhat into your mid scalp area.

Do you intend to have a subsequent procedure in the future to address your vertex?

Your expectations are realistic. Depending on your hairline placement and how far back you want to achieve growth into your mid scalp will dictate your graft count.

If you are content with a mature/conservative hairline, which I would suggest would be the appropriate approach, then naturally this would consume less grafts. If this is the case and you are not looking to graft too advanced in the mid scalp, I would suggest that 5000 grafts is excessive. But that appears somewhat typical of ASMED.

Keep us updated.

I'm 40 now. I'm ok with having multiple procedures in future if needed and If I have donor left.

So, the question again - For my type of diffused + advanced hair loss - Which doc should I choose?

[harry_potter1]

23 hours ago, Panamera13 said:

I'm 40 now. I'm ok with having multiple procedures in future if needed and If I have donor left.

So, the question again - For my type of diffused + advanced hair loss - Which doc should I choose?

If you were considering FUT I would have said H&W is an easy answer. 

But while they are solid in FUE without doubt, they aren't above anyone else like they almost do with FUT. That said between all 3 they would be my choice (think Dr.Wong also is a tad better than Hasson in FUE, but don't take my word for it)

ASMED produced some amazing results for some comparable cases, some other solid cases. But they also have underwhelming results too. 

Rahal is great, but there have been some recent complains IIRC.

Are those your only options? I think if you can afford H&W FUE you might consider someone like Dr.Diep? I do really like his FUE work with high norwood patients.

 

Edited September 14, 2019 by harry_potter1

[Panamera13]

57 minutes ago, harry_potter1 said:

Are those your only options? I think if you can afford H&W FUE you might consider someone like Dr.Diep? I do really like his FUE work with high norwood patients.

Thx a lot!

That's exactly my question for this forum - please give me names of doc who are excellent for high norwood/diffused FUE. I'll lookup Dr Diep, I believe @Melvin-Moderator went to him as well for one of his procedures.

[Panamera13]

I have to rule out Diep after seeing this hairline design. Forget about density, hair placement etc....the basic hairline design is pretty bad like it's designed by a 4 year old. I feel bad for FrontalHT12. I can go to India and Turkey and get a better one for 4K USD.

Any other suggestions for my hair loss pattern other than H&W/Rahal?

 

 

[Panamera13]

Bump; please comment.

H&W - Not too much communication; no way to contact doc directly.

Rahal - Does the harline design and incisions only, everything else done my techs.

Asmed - Too many grafts, not sure how to think of it, does to "over-harvest"? Any prior patients who can comment.

Diep - Didn't like his hair line design.

What other surgeons should I be looking at?

[CosmoKramer]

Other than the surgeons/clinics you listed maybe look into Dr Lorenzo, Dr Pinto, Dr Villa, Dr Couto (but fully booked for a few years).

[Dr. Bruno Ferreira]

Hi Panamera13,

 

I see from the comments that I’m risking an unpopular opinion here, but I think Dr. Erdogan’s 5000 grafts was the best estimate. 

Maybe I’m unsure of your objectives, but I assume you’re looking for full coverage and a new hairline.

Looking at your photos, I estimate you’d have a recipient area of about 150cm2 (depending on where you place the hairline). With 5000 grafts you’d get an average density of less than 35 units per square centimeter. Now, the photos aren’t good enough to judge your current coverage, but from the top view you posted, it looks like you don’t have much coverage and you have a lot of miniaturization. So, the ~35 grafts/cm2 together with the hair you have now would be *just* enough to get you close to full coverage.

Of course, I can’t say how good your donor area is, how thick your hair is, how many average hairs per folicular unit you have, but from the macro shots it looks okay, even though I haven’t seen your temporal-parietal areas. (CosmoKramer very correctly suggested you post those photos.)

That being said, I’d still first put you on finasteride first at a lower dosage, so you can stabilize your alopecia and keep that hair you have there, whilst also lowering the chances of shock loss when it’s time for surgery. At 40 years old, standard dosage would also be an option, to see if you can get some improvement before surgery. (Edit: Just saw you complained of side effects. So it would be of interest to clear that up.)

I’d do it in two surgeries though. 

So, with the info I have currently available, that’s what I’d plan for you. (All would be subject to confirmation in a live consultation, of course.)

Also risking sounding biased since we work together (and only because CosmoKramer mentioned him), I’d also suggest Dr. Lorenzo. We do advanced alopecias on a daily basis, so I know he’s very experienced in cases like yours.

Quite a few great options and talented doctors were mentioned here though, so I think you’ll be fine with more than one of the choices given.

 

Best of luck!

 

 

#IMO (I should just go ahead and point out that this is just an opinion and not a medical consultation, since it could never be one.)

Edited September 16, 2019 by Dr. Bruno Ferreira

[Melvin- Admin]

Sounds like you’ve essentially ruled out your entire list. Try and look at the patient results section for inspiration.