The Best Transplant Results I have ever seen, is this legit?

[asterix0]

There was still some native hair, and without finasteride maybe it was lost...the 4 month photos seemed pretty promising at least. 

Maybe even without finasteride the transplanted hair was lost. There seem to be more and more patient accounts of transplanted hair thinning in the recipient area unfortunately. That's why I think a transplant without finasteride, especially for aggressive male pattern baldness sufferers, is quite risky. 

[UnbaldEagle]

I think his most "suspicious" too-good-to-be-true result is this:

https://www.hairtransplantation.bg/index.php/en/results/event/results/6050FUEChestGrafts

I remember reading somewhere that BHT is very challenging and time consuming, as the level of transection could be much larger and only about 100 follicular units can be extracted in an hour. Also, chest grafts rarely contain more than one hair and are much finer, thinner in diameter. 

How on earth was he able to extract 3000 FUs in 2 days, was he working overnight or what? Also, body hair being thinner and mostly singular, provides less coverage even if it's a high density transplant.

I may be a poor judge of this, but the guy is hairy alright, however not on a chewbacca/wolfman level, so I'm not sure if there were 6000 grafts to be extracted there. 

If it is true however, he seems to make the most out of BHT too, I've never seen anything like this, not even from Umar.

[JohnBob]

9 hours ago, UnbaldEagle said:

I think his most "suspicious" too-good-to-be-true result is this:

https://www.hairtransplantation.bg/index.php/en/results/event/results/6050FUEChestGrafts

 

I agree that result is maybe the most puzzling of them all. 

Quote

 

I remember reading somewhere that BHT is very challenging and time consuming, as the level of transection could be much larger and only about 100 follicular units can be extracted in an hour. Also, chest grafts rarely contain more than one hair and are much finer, thinner in diameter. 

How on earth was he able to extract 3000 FUs in 2 days, was he working overnight or what?

 

Maybe the answer is in his "AVA" technique (vacuum assisted and all). He seems to have a higher productivity than other doctors with regular scalp transplants as well. 

What I find the most strange part is that the implanted hair doesn't look like chest hairs at all. They look like normal hairs pretty much. All the other chest implants I saw looked almost like pubes in the scalp - very noticeable. How come this guy got perfectly looking normal hair? Maybe he has the best chest hair ever? I don't now haha. 

[JohnBob]

Someone posted in another website this picture up close of the donor of a Dr. Zarev patient after the total extraction of around 12k grafts (in 3 procedures).

Notice how smooth it is. You can't spot any "gap areas" which is usually the case when the donor gets ultra harvested. The density must have decreased very evenly and it still looks very natural. That's an indication of a very refined technique. 

 

[Curious25]

Looks fantastic. No doubt the patient probably had favourable donor characteristics before starting out, but never the less, like you mentioned - the evenly spread out extractions of the 12,000 grafts have played the main role in the patients donor presenting like this, and that is testimony to a very refined surgical technique. 

 

Edited November 22, 2020 by Curious25

[JohnBob]

1 hour ago, Curious25 said:

Looks fantastic. No doubt the patient probably had favourable donor characteristics before starting out, but never the less, like you mentioned - the evenly spread out extractions of the 12,000 grafts have played the main role in the patients donor presenting like this, and that is testimony to a very refined surgical technique. 

 

Exactly. You have doctors stating that with a donor with 80 FUs/cm2 the most they can extract is 4000 grafts. Then you have Dr. Zarev extracting 3x that (with a donor with smililar density) and the donor still looking good. I'm starting to believe he really made a significant improvement on the standard FUE technique and is one step ahead the whole industry in that regard. 

[whattheFUE]

Generally a good rule of thumb to ignore all cases posted by the clinics themselves.

[JohnBob]

4 hours ago, whattheFUE said:

Generally a good rule of thumb to ignore all cases posted by the clinics themselves.

True, eat least the cases his clinic shows are pretty well documented

 

 

I still find it hard to believe how you can extract 12K grafts via FUE and the donor still look that good under intense lighting conditions. The result on the recipient area is top notch too, you can't even point where is the division between original and implanted hairs - very refined work.

Those results are so ahead of the curve compared to other docs there must be an explanation.

Edited November 23, 2020 by JohnBob

[giegnosiganoe]

Somewhat interesting video to get another peak at Dr. Zarev taling about his work, although 6 years old: 

 

One thing I found very odd is that he said manual FUE causes 20-30% of grafts to die, whereas with his technique it's only 2-5%.

[Curious25]

Have you tried contacting him or his clinic @JohnBob? 

[JohnBob]

7 hours ago, Curious25 said:

Have you tried contacting him or his clinic @JohnBob? 

Not yet, I'm thinking about flying to Bulgaria to do a in person consultation once this covid mess is over. 

[aaron1234]

52 minutes ago, JohnBob said:

Not yet, I'm thinking about flying to Bulgaria to do a in person consultation once this covid mess is over. 

That'd be great!  Would love to see a patient review of Dr. Zarev. 

9 hours ago, giegnosiganoe said:

Somewhat interesting video to get another peak at Dr. Zarev taling about his work, although 6 years old: 

One thing I found very odd is that he said manual FUE causes 20-30% of grafts to die, whereas with his technique it's only 2-5%.

Yeah, definitely outdated numbers there on the transection rate.  Most docs would say about 2-5% now for FUE.

[JohnBob]

3 hours ago, aaron1234 said:

That'd be great!  Would love to see a patient review of Dr. Zarev. 

Yeah, definitely outdated numbers there on the transection rate.  Most docs would say about 2-5% now for FUE.

I'm afraid it's not that simple. These docs can be getting a 2-5% loss with FUE but with small sessions, say 1000 grafts. But FUE is a complex procedure and as the session gets bigger the challenges grows exponentially. So the same doctor could have 50% grafts to die if he tried to perform a 5,000 grafts session like Zarev. Most doctors avoid doing mega sessions with FUE and prefer to keep them small actually - and that may be one of the main reasons. 

[aaron1234]

Doctors in the US are required by law to do the extractions.  Clinics outside the US have multiple techs do the extractions.  That's why you see bigger graft counts abroad with FUE, it's far less laborious for the surgeon.  

[JohnBob]

On 10/27/2020 at 1:24 AM, giegnosiganoe said:

Found a post on here from 6 years ago of a guy who went to Zarev, but he never updated the final result. Also looks like all of the photos were taken in Zarev's clinic.

 

Let's be honest, comparing pics it is obvious a lot of grafts ended up not growing. Maybe his scalp has some sort of a condition and should have been checked by a dermatologist - would explain the redness of the skin.

10th day post op:

Almost 4 months post op:

[JohnBob]

I'm considering going to Dr. Zarev for a HT but it worries me that we only have one case documented by a patient of him on the whole internet and it went bad. 

[champybaby]

(disregard)

Edited December 7, 2020 by champybaby

[JohnBob]

13 minutes ago, champybaby said:

(disregard)

You are a seasoned patient that got home run results, your feedback is important man

[champybaby]

6 minutes ago, JohnBob said:

You are a seasoned patient that got home run results, your feedback is important man

I just asked for a link, but found it in the previous comments 🙂

[Melvin- Admin]

17 hours ago, JohnBob said:

I'm considering going to Dr. Zarev for a HT but it worries me that we only have one case documented by a patient of him on the whole internet and it went bad. 

If you’re in contact with him, you should ask him to have some of his patients post their results here. 

[JohnBob]

Guys, thanks to the WayBackMachine I found out that Dr. Zarev used to have a picture of the device behind his "AVA" FUE method in his website (text was originally in Bulgarian - I used google translate to convert it to english):

 

The device is called Punch Matic and it is manufactured by a french company named Medicamat.

Here is an Youtube video showing the device being used

 

Basically, the use of suction allows the surgeon so use a smaller punch and to not go as deep in the skin. This results in less transections compared to regular FUE because you don't need get the angle perfectly right, and less scarring because the punch don't go as deep:

During the video you can see the extractions happening very up close - you can actually see the grafts being sucked into the device.  It's definitely worth to watch it.

I know that there are people that believes that the suction damages the FU but let me ask if that was the case would Dr. Zarev be able to show such successful cases of huge restorations performed?

Edited December 18, 2020 by JohnBob

[Melvin- Admin]

@JohnBob

To answer your question can good results happen with suction? Yes, but only on individuals with thick hair, where the roots are sturdy. Fine hair would get damaged, no question about it. 

Tools should be tailored to the individual, to quote the great Konior: “do you go to a shoe store that says ‘we only sell size 9s.” 

Overall, I think suction isn’t good for grafts. FUE by nature makes grafts more skeletonized and fragile, adding suction to that is even worse. So, I have no idea if this is the only tool this doctor uses, but this whole thread is borderline a hype job. 
 

He’s hardly the first surgeon to post really incredible results, but you guys have to remember these are outliers. It’s like seeing a beauty pageant and saying “wow North Carolina has the most beautiful women in the world.” Obviously, these are cherry picked. Hasson and Wong has been presenting cases like that for over 20 years.

 

[JohnBob]

11 minutes ago, Melvin-Moderator said:

@JohnBob

To answer your question can good results happen with suction? Yes, but only on individuals with thick hair, where the roots are sturdy. Fine hair would get damaged, no question about it. 

Tools should be tailored to the individual, to quote the great Konior: “do you go to a shoe store that says ‘we only sell size 9s.” 

Overall, I think suction isn’t good for grafts. FUE by nature makes grafts more skeletonized and fragile, adding suction to that is even worse. So, I have no idea if this is the only tool this doctor uses, but this whole thread is borderline a hype job. 

I agree with everything you said, even the hype job part. That's why I'm researching about this doctor, trying to dig up more info and understand his methods. Because you can't dispute that his best cases stand out even when compared to the best cases of the other doctors (outliers vs outliers). There are patients with more than 12000 grafts extracted and the donor looks barely untouched, it's ridiculous.

Edited December 18, 2020 by JohnBob

[JohnBob]

@Melvin-ModeratorThose are great results, but I assume FUT was used to achieve that?

I'm not an expert in HT history, but I believe Zarev is the first doctor to perform 12000+ grafts restorations with FUE alone (and without destroying the donor)?

I know his results are total outliers but I'm not using them to gauge my expectations (well, at least not 100%). What is interesting is that he is achieving a level of results that were thought to be not possible with FUE alone until the recent past?

Edited December 18, 2020 by JohnBob

[Melvin- Admin]

There’s no doubt this surgeon is talented, but there have been plenty of equally impressive results. My point is you shouldn’t swayed by cherry picked results.

Here’s an analogy you join a gym and you see a guy who looks like this 

would it be reasonable to say, ‘hey, he goes to the same gym, I’m gonna look like that.”

Antonio Conte, probably one of the best hair transplants ever! He went to the Canadian clinic I posted.