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rhstoned

3rd HT deciding on next surgeon. Who would you guys recommend?

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1st time posting here.  i've been losing hair since i was 20, did my 1st HT FUT in 2013 for 1500 grafts, then 2nd FUE HT with a well known surgeon in Beverly hills for 2000 grafts in Dec 2018.  its been around 18 months since i had that 2nd procedure and id say i'm about 60% satisfied with the front.  I was told by that Dr. that i would need a 3rd procedure to fill the mid and crown which i planned to do.  However after seeing the results with this doctor, i'm not prepared to spend a ton of money for another 2000 grafts as he suggested that won't achieve my goals.  There appear to be areas like my right side hairline that are see through and right in the middle front where i feel like he didn't put any grafts or nothing grew.  After consulting with a few doctors, i was told i am a repair case.  I do want to note, i was advised to take FIN and i did not as i was scared of the sides and i did continue to lose more hair in the mid/crown.  I plan on starting FIN 1 mg a day or every other day. when i do my 3rd HT after talking to numerous people and doctors.  

I started looking at doctors in Turkey (Pekiner, HLC, Demirsoy, ASMED, Hair transplant of Istanbul,  then India (bhatti, Suneet Soni) and i also reached out to Couto, Lorenzo, Ferreira of Spain/Portugal.  Dr. Couto is unfortunately not accepting any consultations at the moment. I found some decent results on some Brazilian doctors, has anyone on hear have good experience with them?  I recently saw Thiago BIanco Leal and they look solid too.  

Turkish clinic i short listed was Pekiner who advised me 4000 grafts (2000 from BHT).  I wasn't expecting to take that many grafts from beard/chest at least in my 3rd HT. i know that yields on BHT is lower than scalp.

For India, Soni said i would also need 4000 grafts but max 2500 via FUE and 1500 grafts with FUT.  This was the first time i was introduced by a doctor of combining FUT+FUE.  I'm not looking to have a 2nd linear scar. Bhatti said i only have 2200-2500 grafts available and thats all i need for the crown. 

Dr. Ferreira's clinic gave me a detailed assessment/plan and Dr. Ferreira personally emailed me saying i would need 4000 grafts to fill my mid/crown and do another procedure 5 months from then to repair donor scar and touch up hairline as its a bit see through.  He mentioned my donor looks good for 4000 grafts, my previous doctor also mentioned that after my 2nd HT.  

 

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looks like you need another mega-session based on the balding area that needs to be restored, since you've already had an FUT procedure, I would look into that again to yield as many grafts as possible - Dr. Blake Bloxham, Konior, Shapiro, Hasson & Wong, Dr. Cooley, Dr. Gabel - just a few I would be researching and talking with

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Hi @rhstoned, I myself had 2 procedures, first one was a failed FUE in a Turkish "nice price" clinic, then I did my repair HT at HDC clinic in Cyprus, which I am very happy about!

Currently I am the representative of HDC clinic and Darling Buds of Dr. Bahatti in India, you are welcome to consult with me in private, your donor looks great 👍 

You can read on my procedures here:

Also there is a YouTube link on my signature.

 


Doron Harati - Hair transplet offical international representor of HDC (Cyprus), Darling Buds (India), HT procedures are done by MD Doctors with Microscope FUE.

Feel free to contact me: WhatsApp +9726542654\ Mail: Doronstar546@gmail.com

My own HT story: https://youtu.be/K4x1KLZhWS0

 

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7 hours ago, home1212 said:

looks like you need another mega-session based on the balding area that needs to be restored, since you've already had an FUT procedure, I would look into that again to yield as many grafts as possible - Dr. Blake Bloxham, Konior, Shapiro, Hasson & Wong, Dr. Cooley, Dr. Gabel - just a few I would be researching and talking with

@home1212 I've been told that FUE can yield same amount as FUT.   Is that not the case?  I'll take a look at those doctors.  When you mean mega session, do you think 4000 grafts won't be enough? 

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On 6/28/2020 at 5:53 AM, rhstoned said:

For India, Soni said i would also need 4000 grafts but max 2500 via FUE and 1500 grafts with FUT.  This was the first time i was introduced by a doctor of combining FUT+FUE.  I'm not looking to have a 2nd linear scar.

You wouldnt have a 2nd linear scar for FUT - they would go in through the first one. I personally dont get the point of doing both extraction methods at the same time as it seems more logical to exhaust FUT before pursuing FUE. If you were considering that clinic Id want to know the reasoning behind that.

In regards to yield differences I remember reading something by Bloxham where he put the difference somewhere as high as up to 20% (ill try and find it if i can), but ofc that number is ultimately going to come down to surgeon skills. For top surgeons the difference is probably negligible. 

Stay away from Bhatti - hes not even recommended here after a number of bad incidents with patients (including blackmail).

Pekiner likes using beard grafts - idk why. Most docs like exhausting scalp hair first as beard hair doesnt have the same characteristics as scalp hair. I believe there are even different growth rates between the two.

4000 grafts seems a reasonable number to get good coverage of that area. 


 

 

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7 hours ago, Doron Harati said:

Hi @rhstoned, I myself had 2 procedures, first one was a failed FUE in a Turkish "nice price" clinic, then I did my repair HT at HDC clinic in Cyprus, which I am very happy about!

Currently I am the representative of HDC clinic and Darling Buds of Dr. Bahatti in India, you are welcome to consult with me in private, your donor looks great 👍 

You can read on my procedures here:

Also there is a YouTube link on my signature.

 

@Doron Harati  Wow what a huge turnaround for you man! I'll definitely take a look into Dr. Maras.  Congrats on the improvement!

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4 hours ago, transplantedphil said:

You wouldnt have a 2nd linear scar for FUT - they would go in through the first one. I personally dont get the point of doing both extraction methods at the same time as it seems more logical to exhaust FUT before pursuing FUE. If you were considering that clinic Id want to know the reasoning behind that.

In regards to yield differences I remember reading something by Bloxham where he put the difference somewhere as high as up to 20% (ill try and find it if i can), but ofc that number is ultimately going to come down to surgeon skills. For top surgeons the difference is probably negligible. 

Stay away from Bhatti - hes not even recommended here after a number of bad incidents with patients (including blackmail).

Pekiner likes using beard grafts - idk why. Most docs like exhausting scalp hair first as beard hair doesnt have the same characteristics as scalp hair. I believe there are even different growth rates between the two.

4000 grafts seems a reasonable number to get good coverage of that area. 

 @transplantedphil I passed on bhatti after i found out he uses motor extraction and i saw some bad cases of donor areas out of his clinic.  

My concern with a 2nd FUT is if the linear scar becomes even more noticeable as its a little thick on my right side.  I figured if the yield is the same as FUE with a talented surgeon, it may be better?  Especially if its DHI method with direct implantation.  

@Silent1234 Appreciate it man.  I've been coming across hasson and dr wong on here lately.  I'll check them out 

 

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@rhstoned feel free to contact me, DR. Maras uses manual FUE, will show you my donor compare to what Arenamed in Turkey did to me.

Dr. Maras took most of my grafts from the sides of my head, where Arenamed did't touch.

But I must tell that using motorized punch isn't a bad thing necessarily, even HDC use it sometimes, there are kinds of motorized punches and pro level clinics use them for very thick hair like 0.9-1.0 mm depends on other elements too, manual punch is mostly commonly use.

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Doron Harati - Hair transplet offical international representor of HDC (Cyprus), Darling Buds (India), HT procedures are done by MD Doctors with Microscope FUE.

Feel free to contact me: WhatsApp +9726542654\ Mail: Doronstar546@gmail.com

My own HT story: https://youtu.be/K4x1KLZhWS0

 

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IMO strip is the way to go, you have a large area and you’re gonna need as many grafts as possible. 


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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You should definately stick with FUT as there's a lot of real estate to cover, unless there is a contra-indication like a tight scalp.


4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg Mon/Wed/Fri.

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@Melvin-Moderator  @1978matt

I didn't even consider doing FUT again but I got 4 guys on here recommending FUT for my case.   I'm hearing that DHI / stick and place provides greater yield because grafts aren't sitting outside as long and the incisions won't remain open for long.  Wouldn't that method provide better yield than FUT due to that? Also, isn't there a limit to how many grafts a doctor can take during an FUT session?  

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4 hours ago, rhstoned said:

@Melvin-Moderator  @1978matt

I'm hearing that DHI / stick and place provides greater yield because grafts aren't sitting outside as long and the incisions won't remain open for long.  Wouldn't that method provide better yield than FUT due to that?

That's marketing spin.  FUT was studied in the early 90s as to graft survival and was found to still be very good even after 6-8 hours out of the body.  That was even before more novel holding solutions were developed which likely increase it further.

Myself and the others are thinking more in terms of your lifetime number of grafts available.  I have had around 8000 hairs from strip and 5000 from FUE.  I can noticeably see my donor density has decreased from the FUE.  I'm not convinced I could have got 13000 hairs from FUE alone, without seriously compromoising the donor area.

As things stand, I still probably have another 3000 or so left in the bank.  Perhaps even more if i went FUT again, then a small FUE.

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4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg Mon/Wed/Fri.

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7 hours ago, rhstoned said:

@Melvin-Moderator  @1978matt

I didn't even consider doing FUT again but I got 4 guys on here recommending FUT for my case.   I'm hearing that DHI / stick and place provides greater yield because grafts aren't sitting outside as long and the incisions won't remain open for long.  Wouldn't that method provide better yield than FUT due to that? Also, isn't there a limit to how many grafts a doctor can take during an FUT session?  

You need A LOT of grafts moved in one single setting, the best way to do this is with FUT hands down. If you needed a small touch up then FUE would be the way to go. 

Don’t pay too much attention to graft placement techniques, what you should concern yourself is the quality of the results. I’ve seen some black market FUE clinics pride themselves on providing DHI but their results are garbage. 


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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@1978matt Got it.  So you would do FUT because you can take more grafts in a single session without compromising the donor.  You got 8000 grafts out in a single session?  What is the most you can take out from a single FUT session?   How does your donor look after that many grafts taken out and multiple FUTs?  I get that the Dr can use the same scar but could the scar become more noticeable?  Any FUT Doctors you can recommend in Europe? 

@Melvin-Moderator How many grafts do you think i would need?  Dr Ferreira said he can do 4000 grafts for me with FUE then touch up 5 months later and repair donor.  

I also heard back from Dr. Pekiner i would need 4000 grafts but 2000 from BHT.  Not looking to do BHT for my next HT unless if i really needed. 

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i reached out to H&W to see what they would consider and they told me that i should consider FUT for 5000 grafts with them since i have a lot to cover but when i showed them my laxity video, they said i need to do stretching exercises for a few months  as my scalp isn't stretchy enough for FUT at this time. They didn't get back to me when i asked if i can do FUE.   I feel like i'm ruled out of doing FUT from my conversation with David at Dr. Wong's office.  

Dr Pekiner said 4000 grafts (2000 from BHT though)

Dr. Ferreira said he would do up to 4000 grafts doing FUE all from scalp but would be as gentle as possible he said to avoid risk of over harvesting.  he thinks he can take up to 3600 on 1st procedure. 

What would you guys do if you were in my position?  

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I would have thought your previous two transplants of 3500 total grafts would have given you more density.

Did you talk to your surgeons to find out what they think the yield was? I hesitate to say the transplants were a failure, but unfortunately that may have happened.

In your situation, I would come to peace with having a semi bald head that is buzzed, and I would go the FUE route with maybe some SMP. If your hairline stays in tact then I think it will be a good look. However, maybe a surgeon like Konior or Lorenzo would be able to get a top result given your circumstances.

Dr. Ferreira's opinion on your case seems reasonable to me, but 4000 grafts is quite a lot. I would maybe break that up into two sessions, one 2500 and then another 1.5k later once you see how the yield is. 

 

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Posted (edited)

@asterix0 Dr Ferreira said the same thing.  He doesn't think i got 3500 grafts on my front. i think my 1st FUT for 1500 grafts wasn't successful so i went for my 2nd HT via FUE with Dr. Mohebi.  You can see the before and after below.  I think he improved my hairline but yes i feel like i should have more density for 3500.  I'm hoping my 3rd HT would help address my mid scalp and some crown.  

Dr Lorenzo wouldn't take me as a patient as he thinks my donor isn't enough but Dr Ferreira who works with him said he would be able to make significant improvement on my head.  He's the only doctor that has been in constant contact with me via email and spoke to him for 45 mins by phone.  I can't say I've had this much professionalism with any doctor I've contacted so far.  

 

@JohnAC71 Have you heard of anyone being able to improve laxity with doing exercises?  i'm scared if it would be to tight after another FUT.  Also, my concern is the strip won't have as much grafts since i've done FUE before, any thoughts on that?  

 

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Edited by rhstoned
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Did you mention to H&W you had some FUE already? And yes over the years I have known members that increased the laxity by doing scalp exercises. More successful than not. 
 

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Judging from your pictures, yes your hairline was improved by the second procedure, but in my opinion Dr. Mohebi did not utilize your grafts wisely. Considering you had a larger area to cover, he should have been more judicious in adding more coverage to the midscalp area.

I think Dr. Wong or Dr. Konior will also be good alternatives, but they are quite expensive. If price is not a limiting factor I would ask to consult with them and see what they think.

Dr. Ferreira from what I have seen is an ethical and reliable doctor. The results from this patient, in my opinion, are quite good: https://www.hairrestorationnetwork.com/topic/56111-dr-bruno-ferreira-3659-grafts-28th-29th-of-january-2020/

Also, I would do a consultation with Eugenix as well, they seem to specialize in high Norwood repair cases and have produced some great results. It wouldn't hurt to inquire what their opinion is. 

If you have decent beard donor and maybe chest as well, Eugenix is particularly good at incorporating those into the crown, which can make a significant cosmetic difference. 

I would go for FUE though because I think it will be hard to get full coverage with your next transplant. I would aim to go with a buzzcut look that at least frames your face, with decent coverage on the rest of your top. Because your hairline is good I think you can pull this look off and be pretty satisfied with your results, maybe adding some light SMP between some gaps to just add a hint more illusion of coverage. 

 

Edited by asterix0
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2 hours ago, JohnAC71 said:

Did you mention to H&W you had some FUE already? And yes over the years I have known members that increased the laxity by doing scalp exercises. More successful than not. 
 

Yes i mentioned to them my last procedure was an FUE with Mohebi.  Good to know those exercises work. its just i want to get my procedure soon as we're in quarantine and want to take advantage of the work from home.   

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2 hours ago, asterix0 said:

Judging from your pictures, yes your hairline was improved by the second procedure, but in my opinion Dr. Mohebi did not utilize your grafts wisely. Considering you had a larger area to cover, he should have been more judicious in adding more coverage to the midscalp area.

I think Dr. Wong or Dr. Konior will also be good alternatives, but they are quite expensive. If price is not a limiting factor I would ask to consult with them and see what they think.

Dr. Ferreira from what I have seen is an ethical and reliable doctor. The results from this patient, in my opinion, are quite good: https://www.hairrestorationnetwork.com/topic/56111-dr-bruno-ferreira-3659-grafts-28th-29th-of-january-2020/

Also, I would do a consultation with Eugenix as well, they seem to specialize in high Norwood repair cases and have produced some great results. It wouldn't hurt to inquire what their opinion is. 

If you have decent beard donor and maybe chest as well, Eugenix is particularly good at incorporating those into the crown, which can make a significant cosmetic difference. 

I would go for FUE though because I think it will be hard to get full coverage with your next transplant. I would aim to go with a buzzcut look that at least frames your face, with decent coverage on the rest of your top. Because your hairline is good I think you can pull this look off and be pretty satisfied with your results, maybe adding some light SMP between some gaps to just add a hint more illusion of coverage. 

 

I agree.  i felt my mid scalp was neglected.  That is why researching more for my 3rd doctor.  

Dr Wong so far only is suggesting FUT but 5000 grafts and i have heard no update yet what an FUE option would be with him.  Dr Konior's work looks amazing but i hear he charges $8.50 per graft....i would need to drop a lot considering the amount of grafts i need if i were to go to him. 

I heard about eugenix but thought i would go for BHT on my 4th procedure if needed.  I'll check them out too.  Would you consider Dr Ferreira a higher quality surgeon than dr. bansal though?

I've been in contact with Rolandas and been following his story.  He's the reason why i started consulting with Dr. Ferreira.  I wish more of his patients shared their results but also considering he works at Dr. Lorenzo's clinic also reflects his skill and talent.  Thank you for your suggestions.  

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2 hours ago, rhstoned said:

I heard about eugenix but thought i would go for BHT on my 4th procedure if needed.  I'll check them out too.  Would you consider Dr Ferreira a higher quality surgeon than dr. bansal though?

I've been in contact with Rolandas and been following his story.  He's the reason why i started consulting with Dr. Ferreira.  I wish more of his patients shared their results but also considering he works at Dr. Lorenzo's clinic also reflects his skill and talent.  Thank you for your suggestions.  

I believe the only thing that reflects a HT surgeon's skill and talent are his visible final results. Dr. Ferreira barely has any final results shown anywhere. I think that's pretty concerning, especially since there are people claiming he's "world class." How would they know?

Edited by PizzaWolf
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