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Dr. Kaan Pekiner FUE+BHT 3895 (2007 FUE + 1888 BHT) 28/12/2019


Portugal25

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  • 4 weeks later...
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This is actually yielding pretty well.  My scalp didnt have much loss i had beard body hairs in crown too, mine ruined scalp more and shocked it more with the doc i had.  You are definitely coming along well for 4 months with the doctor you went with.  I cant wait to see the final result.    Lookin good so far!  

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@guestY thank you for the reminder!

I just hit the 5 month mark and I finally got my first haircut.

Things seem to be getting better but still a lot of ground that needs covering.

I know the 120cm2 recipient area needed 6000 grafts to achieve the density I wanted of 50fu/cm2 and the 3895 grafts I had implanted with almost half comprised of single beard grafts will probably not even achieve 30fu/cm2 density so I’m not sure if the end result will provide a sufficient level of density (but I’m hoping it will).

Looking forward to everyone’s comments. 

Thanks

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Edited by Portugal25
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5 hours ago, guestY said:

congrats! Significant improvement from before.

Yes indeed and now that I look at how I was 5 months ago and the fact that I only had 3895 grafts Implanted into 120cm2, I have to say that I can’t complain (but really hope it gets a lot better before the end of the growth cycle).

 

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@HTHope I’m using Sebamed ever since my HT and minoxidil every night.

Considering starting to use Nizoral twice a week but that’s really powerful stuff and I’m affraid it might do more harm than good. 

Luckily at age 37 I still haven’t had to worry much about grey hairs. 

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1 minute ago, Portugal25 said:

@HTHope I’m using Sebamed ever since my HT and minoxidil every night.

Considering starting to use Nizoral twice a week but that’s really powerful stuff and I’m affraid it might do more harm than good. 

Luckily at age 37 I still haven’t had to worry much about grey hairs. 

Thanks does sebamed work for dandruff? Do you use it daily?

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@HTHope I ‘ve been using Sebamed Ultrasoft for sensitive hair every day since I started washing my hair and it’s great.

Nizoral should be your best bet to remove dandruff and promote growth.

Edited by Portugal25
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@Portugal25  That's a significant improvement my man!  I've been considering demirsoy but after seeing Pekiner's results and following your story, I can say he is a great HT surgeon to consider!  Do you know how many patients Dr Pekiner sees in a day? Look forward to seeing your continued progress.

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@Portugal25 Congratulations very nice progress to date.   You are very early on your journey especially as it takes longer for the crown area to show the illusion of density , you are doing really well,  and you have a plenty of time yet. Continued good growth.

Paddy

 

 

Edited by paddyirishman
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@rhstoned Pekiner only does 1 patient per day just like HLC (where he used to work) and Demirsoy.

However, you can’t compare Demirsoy with Pekiner or HLC because it’s two totally different techniques. 

Demirsoy is able to do up to 4000 grafts per day because he does motorized extraction which is faster, then does pre-made slits/holes and has the technicians implant the grafts into the 4000 holes he opened.
Slits/holes immediately start to close after being opened so if you have opened holes for hours before being implanted with grafts it means the holes need to be wider and the recovery more painful.
I’m not a fan of pre-made slits or surgeries where the technicians are responsable for part of the surgery. 
For me It’s Doctors doing the whole with nurses or techs providing assistance. 

HLC (2.5€/graft) and Pekiner (2.25€/graft) do manual extraction that takes longer and then implant using stick&place which means the Doctor opens 1 hole/slit and immediately implant the graft.
Because it’s the Doctor doing the whole procedure with a more precise technique the maximum grafts per day are just 1500.

So Demirsoy (1.25€/graft) can charge half the price of Pekiner or HLC and still make more money per day because he can implant more than double the grafts per day. 

I only recommend two options in Turkey: HLC and Pekiner (only if you don’t have miniaturized hair because he aborts surgeries if he finds miniaturized hairs).

The best option right now is @Dr. Bruno Ferreira he does motorized extraction with a smaller punch than Pekiner or HLC (easier recovery) and implants with the most recent technique - DHI - meaning he places each graft inside a implator pen and this  pen will open open the slit/hole and implant the graft at the same time.
This technique is limited to 2000 grafts per day and Dr. BF doesn’t go beyond 2 day surgeries (Pekiner and HLC go up to 3 days but they do less grafts per day).
Dr. BF also operates on just 1 patient per day and has his clinic in Porto where he charges 2.5€/graft, he also works in Madrid with one of the best FUE Doctors in the world - Dr. Lorenzo. 

Final note: it’s the Doctor that matters when doing a surgery because a bad doctor using the best technique in the world will still get you a bad result. 

Wish you all the best!

Edited by Portugal25
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4 minutes ago, paddyirishman said:

@Portugal25 Congratulations very nice progress to date.   You are very early on your journey especially as it takes longer for the crown area to show the illusion of density , so you have a plenty of time yet. Continued good growth.

Paddy

 

 

Thank you @paddyirishman for the kind words really means a lot!

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45 minutes ago, Portugal25 said:

@rhstoned Pekiner only does 1 patient per day just like HLC (where he used to work) and Demirsoy.

However, you can’t compare Demirsoy with Pekiner or HLC because it’s two totally different techniques. 

Demirsoy is able to do up to 4000 grafts per day because he does motorized extraction which is faster, then does pre-made slits/holes and has the technicians implant the grafts into the 4000 holes he opened.
Slits/holes immediately start to close after being opened so if you have opened holes for hours before being implanted with grafts it means the holes need to be wider and the recovery more painful.
I’m not a fan of pre-made slits or surgeries where the technicians are responsable for part of the surgery. 
For me It’s Doctors doing the whole with nurses or techs providing assistance. 

HLC (2.5€/graft) and Pekiner (2.25€/graft) do manual extraction that takes longer and then implant using stick&place which means the Doctor opens 1 hole/slit and immediately implant the graft.
Because it’s the Doctor doing the whole procedure with a more precise technique the maximum grafts per day are just 1500.

So Demirsoy (1.25€/graft) can charge half the price of Pekiner or HLC and still make more money per day because he can implant more than double the grafts per day. 

The only options I recommend in Turkey are HLC and Pekiner (only if you don’t have miniaturized hair because he aborts surgeries if he finds miniaturized hairs).

If you can spend a bit more money go to @Dr. Bruno Ferreira he does motorized extraction with a smaller punch than Pekiner or HLC (easier recovery) and implants with the most advanced technique - DHI - meaning he places each graft inside a implator pen and this  pen will open open the slit/hole and implant the graft at the same time.
This technique is limited to 2000 grafts per day and Dr. BF doesn’t go beyond 2 day surgeries (Pekiner and HLC go up to 3 days but they do less grafts per day).
Dr. BF also operates on just 1 patient per day and has his clinic in Porto where he charges 2.5€/graft, he also works in Madrid with one of the best FUE Doctors in the world - Dr. Lorenzo. 

Final note: it’s the Doctor that matters when doing a surgery because a bad doctor using the best technique in the world will still get you a bad result. 

Wish you all the best!

@Portugal25 I saw on demirsoys website he does manual extractions too, does he not do that anymore?  I have yet to consult with his office.  My concern with motorized extraction is due to overharvesting, especially if done in a single day. 

Is the stick&place method considered FUE still or is it DHI?  Is this a new method or has this been done for years with consistent results?   I agree that i'd also prefer to have surgeon doing most of the work than the techs.  Aren't most FUE procedures done with pre slit method where the dr does incisions and techs do 100% implantation? 

I will check out HLC and Ferreira.  I've had 2 HT's (1 fut and 1 fue) and my head looks exactly like yours did pre op with Pekiner.   I'm looking to fill top and crown and have short listed demirsoy, my previous HT in US although expensive, and pekiner.  I did consider Bhatti but his results lately don't seem that great.   

any risk of overharvesting with dr Ferreira's method?  I have to see his results.

Thanks for the help!

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@rhstoned, stick&place and DHI are two FUE techniques. DHI is the newest technique and I consider it to be a evolution of stick&place. 

The most profitable technique is having the doctor do pre-made slits and then have techs do the implanting because it allows for more grafts to be implanted in 1 day and for the Doctor to have more than 1 patient per day. This is why this technique is common but I would never chose it for myself. 

Overharvesting has nothing to do with motorized extraction but rather with clinics using technicians with little experience to extract grats (you have cases of overharvesting here at HRN from ASMED for just this reason). 

Dr. BF does both manual and motorized extraction depending on the graft he is extracting and if you check @Rolandas results thread you will confirm that @Dr. Bruno Ferreira produces the cleanest donor area you will ever see.

 

Edited by Portugal25
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@83mjs you should check with your Doctor on how many days post surgery does he recommend starting Nizoral.

It’s not a delicate neutral ph 5.5 shampoo like Sebamed.

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5 hours ago, Portugal25 said:

stick&place and DHI are two FUE techniques. DHI is the newest technique and I consider it to be a evolution of stick&place. 

I really think you contribute a lot to this forum and I appreciate your knowledge, but in this we have disagreed before and we still do.

It is not as simple as you make it:

- DHI with implanter pen has also counter arguments (these are given to me by several surgeons I have spoken too):

  Loading the graft into the implanter puts stress on the grafts.

  The round implanter creates wounds which for many skin types lead to more scaring than a clean slit with a small knife

  Side note: You whole argument by pre made slits and techs doing the work is valid for DHI as well. Many DHI clinics use the techs to implant with the implanter, than the tech even controls the angulation which is normally given by the surgeon with the slid.

- Stick and place has the advantage for smaller slits but:

  It is much more difficult to create an overall hairline on bald skin or a whirl in the crown if you create every slit by itself. 

  Some clinics claim that the healing process in the pre-made slits helps graft survival (There was a discussion about it once here, but cannot find it anymore).

I think there is only the right technique for a particular case. 

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@Gasthoerer any technique used by unskilled Doctors (or even worse unskilled technicians) will not provide good results and damage the donor area that’s why the most important thing is choosing a good Doctor. 
I will never endorse tech run surgeries (full or partly run by techs) unless it’s clinics where any amazing tech would kill to work at like H&W. 

If you check the donor area @Dr. Bruno Ferreira gave @Rolandas you can confirm it’s one of the cleanest on HRN.  

I do know many clinics have the Doctor doing pre-made slits and then the techs implant using implantor pens because it’s more dummy proof than having them do it manually with forceps but this is ridiculous because the point for using DHI is for Doctors to avoid making pre-made slits. 

Pekiner designed my crown swirl on my bald crown and implanted doing stick&place. I agree with you that this is pretty hard to do this with this technique but I think it looks great (chosing a good Doctor goes a long way). 

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14 hours ago, rhstoned said:

@Portugal25 I saw on demirsoys website he does manual extractions too, does he not do that anymore?  I have yet to consult with his office.  My concern with motorized extraction is due to overharvesting, especially if done in a single day. 

Is the stick&place method considered FUE still or is it DHI?  Is this a new method or has this been done for years with consistent results?   I agree that i'd also prefer to have surgeon doing most of the work than the techs.  Aren't most FUE procedures done with pre slit method where the dr does incisions and techs do 100% implantation? 

I will check out HLC and Ferreira.  I've had 2 HT's (1 fut and 1 fue) and my head looks exactly like yours did pre op with Pekiner.   I'm looking to fill top and crown and have short listed demirsoy, my previous HT in US although expensive, and pekiner.  I did consider Bhatti but his results lately don't seem that great.   

any risk of overharvesting with dr Ferreira's method?  I have to see his results.

Thanks for the help!

I remember choosing my surgeon and Dr. Demirsoy was on my short list. He states on his website that he is doing manual extractions as well, however seems like he simply didn't update his website for a while now. His rep told me Dr. Demirsoy doesn't do manual anymore (it was almost a year ago!).

After my own experience I can 100% confirm extractions method (motorised or manual) doesn't really matter in a professional hands. Like Portugal said already, I've got extremely clean donor, at 1 month mark I shave it do 1mm and it was undetectable already! It all depends on extraction pattern and what punch size is being used. If extractions are done too close to each other, you will have chance for permanent shock loss for surrounding grafts. 
If you look closer at my post extraction pictures you will notice that extraction pattern is extremely good, quite enough space in between them.
Also worth mentioning that Dr. Ferreira is doing around 1500 extractions/day even with motorised. If you have faster tool, doesn't mean you have to rush. That was one of the main reasons I was put off from Dr. Demirsoy in the first place as he proposed 4000 grafts in 1 sitting for me. Imagine my donor after that... 100% would be overharvested to some degree.

In conclusion i believe donor is as important if not more than recipient area, as if something goes wrong with implanted grafts and they won't grow, if extractions were done correctly, you will still have lots of donor available to fix it. Again, looking at my case, I feel like i never had anything done, although I had 3659 grafts extracted, which is quite a lot.

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1st FUE28/01/2020 - 3659 grafts - Dr. Bruno Ferreira
2nd FUE - 03/06/2021 - 2881 grafts - Dr. Bruno Ferreira

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I'm not a medical professional, thus any information given by me is my own observation and should not be treated as professional advice.

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Looking good, 5 months is the tip of the iceberg.

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3 hours ago, Melvin-Moderator said:

Looking good, 5 months is the tip of the iceberg.

Thanks Melvin!
Was hoping to have better coverage by now but I read somewhere that the crown takes 18 months to get to 100% so I’m hoping I will get a lot more growth in the next months.

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Is there any study or physiological explanation why the crown takes longer than the hairline?

The grafts are the same (from the same donor area) and typically even more robust ones (thick multies) are planted. Do this multies grow slower than finer hair? Or is it just more difficult to create the illusion due to the whirl etc.? Or is it the lower density than in the hairline which requires the hair in each graft need to reach its full diameter and all hairs of the graft to grow to achieve the illusion? 

Blood supply is often mentioned but it this explanation does not sound logical to me. If there is not sufficient supply the grafts just would not survive to begin with. 

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