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26 minutes ago, Guy73 said:

For anyone that doubts fue For mega hairloss should take a look at this fue European conference. 

 

I’ve seen of all his work, and I wonder why he isn’t talked about as much as other doctors 🧐. But these giga sessions are crazy 

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I came across Dr Zarev after seeing a few fellow surgeons talk about his work at conferences and workshops online, and his FUE transformations are with out a doubt unbelievable. 
 

He has apparently developed his own harvesting method that allows such high number depletion - I admittedly didn’t look too hard, but I didn’t come across any patient posted results or testimonies - would love to see some though! 

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14K grafts sounds amazing, but we shouldn't get carried away into sensational headlines. In reality, most of us don't have half that amount. Dr. Lorenzo made a very good video on coverage value, and it really showed how different patients could achieve different results with different graft numbers, whilst being around the same hair loss level.


I do not provide medical advice, recommendations, all responses are my opinion.

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Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

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2 hours ago, Melvin-Moderator said:

14K grafts sounds amazing, but we shouldn't get carried away into sensational headlines. In reality, most of us don't have half that amount. Dr. Lorenzo made a very good video on coverage value, and it really showed how different patients could achieve different results with different graft numbers, whilst being around the same hair loss level.

Could you share the link ? 

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16 hours ago, TorontoMan said:

Could you share the link ? 

I believe its on YouTube just look up coverage value Dr. Lorenzo. 


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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This is the video I know. I is very easy to re-engineer the excel. If you have some INFOS of your own hair status (density, diameter,...) your can make some calculations for yourself.

With a conservative approach I came up with 12 k grafts for myself, which matches the Feedback of the three clinics which I visited. They used an even simpler approach and all came up with 10+ k grafts. 

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Very interesting video.  FUE has come a long way regarding graft numbers since my mega session of 5,125 grafts back in 2012.


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I am not a medical professional and my opinions should not be taken as medical advice.

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Posted (edited)

I think I just noticed Dr. Pradeep Sethi from Eugenix sitting amongst the audience at timestamp 11:05 (https://youtu.be/XASvPhbsRO4?t=665) 
Maybe if this technique is realistic and works well in practice it would be great to see other clinics adopting it.

Edited by tressful11

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I was fortunate enough to attend this particular conference in Manchester last year and it was very interesting to watch Dr Zarevs presentation and understand his approach.

As to be expected, many surgeons continued to discuss his patients considerably high graft counts after his presentation and whilst some were extremely interested and had further questions, others less so.

Dr Zarev was very transparent with surgical information and approach.

To try and better understand the two patient examples that were presented -

a) It is said that most individuals will lose up to 50% of native hair density before it being visually obvious to the naked eye that hair loss has occurred.

b) An average donor density on an average patient is understood to be around 70cm2/FU

c) Each hair follicle has unique hair groupings. Generally between 1 - 4 hairs per follicle. In an average hair restoration procedure, the average hair count per follicular unit is around 2.2 hairs.
When individuals speak of transplanted density, to be speak of this alone is very misleading and confusing. Apart from areas that receive grafts containing only single hairs, such as the first few mm of the hairline, transplanted density should be discussed alongside hair groupings.
It is generally understood that the higher the transplanted density, the "fuller" the illusion of hair. This is only true to an extent.
Density of 50 cm2 using follicles containing one hairs = 50 hairs
Density of 30 cm2 using follicles containing two hairs = 60 hairs
60 hairs will appear "fuller" than 50 hairs despite using less grafts and placing at a lower density.

d) Another presentation from a different doctor listed 10 leading surgeons, and their "average" safe donor zone. The area of scalp that they felt in most cases did not lose hair to male pattern baldness. The differences were very interesting and quite eye opening. I tried to find it to post, but unfortunately couldn't. Naturally the larger the area, the higher the follicle count. The higher the follicle count, the more grafts that each doctor would be able to harvest from the area they have deemed the safe zone. 
It is safe to say that Dr Zarev had one of the most aggressive and larger "safe donor zones".

The two examples in the above video -


The first patient -
was deemed to have a donor area of 336cm2, that contained a total of 25,520 follicles.
12,620 follicles were taken from this area, meaning more than 49% of the donor density.
Remember the above point a) where a up to 50% of density can be lost (in this case extracted) before seeing a visible decline in density to the naked eye.
Occiptal Density - 84cm2 (Above the average density in point b)) with an average of 3.1 FU/cm2 (Very impressive considering the average of 2.2 as explained in point c).
Temporal  Density - Measured in 2 areas as 68cm2 and 56cm2 for an average of 62cm2. It is common to have a lower density in the temporal region but still with 2.4/2.5 FU/cm2.

Therefore this patient had donor characteristics much more favourable than the average patient.

The second patient-
was deemed to have a donor area of 330cm2, that contained a total of 27,050 follicles.
11,370 follicles were taken from this area, meaning 42% of the donor density.
Remember the above point a) where a up to 50% of density can be lost (in this case extracted) before seeing a visible decline in density to the naked eye.
Occiptal Density - 99cm2 (Significantly above the average density in point b)) with an average of 3.2 FU/cm2 (Very impressive considering the average of 2.2 as explained in point c).
Temporal  Density - Measured in 2 areas as 68cm2 and 56cm2 for an average of 62cm2. It is common to have a lower density in the temporal region but still with 3.1/2.5 FU/cm2 at an average of 2.8 F/cm2.

Again, very favourable donor characteristics, even more so than the first patient.

Some of the concerns that fellow doctors were discussing were -

Understanding that hair loss is progressive and even with hair loss preventative medication, hair loss in most will continue. The debate is, having used such a large/aggressive donor surface area (safe zone) as mentioned in point d), if these areas were to experience loss with dropping of the lateral humps (sides) and the lower crown, the transplanted hair taken from these areas would also be lost, and the transplanted recipient area may become disconnected from the sides/back.

In every individual, the ageing process over time means a drop in overall hair density. This includes the donor area. If a patient has already had 50% of his donor density extracted, with further thinning in the donor through natural ageing, this would push the decline in density above 50% meaning that it may well now become visibly thinned to the naked eye.

Dr Zarevs results are phenomenal. There is no denying that such restorations are very impressive and such graft counts eye opening. I believe that he will be a name that will attract interest in the future. I very much hope that these patients results stand the test of time. He is a very clever and innovate surgeon. Other doctors concerns are understandable based on some key concepts of hair loss and hair restoration.

Time will tell.

Every single patient is completely unique in every aspect. Donor density, hair characteristics, follicular groupings, hair texture, measurements of head, measurements between facial features, race, skin tone, hair colour, objectives etc..
Comparing an average patient to such high graft counts would be very inaccurate.

I was very interested and intrigued by Dr Zarev and will continue to look out for his results and see his evolution. It was one of the more interesting presentations of the event.

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