Help needed to choose a surgeon from shortlist "HLC,Bicer,Erdogan ,keser,Pekiner"

[H.K]

I Made another thread earlier and i got great help from members to nominate some of the good surgeons for FUE HT .. i made consultation with these doctors and reviewed their work , but i find it really hard to make the final choice 😭 , my goal of the procedure is basically to restore original hairline not lower than that , and increase density in front/mid areas .. i attached an old pic just to show my  original hairline , as per my calc. , hairline need 0.5 to 1 cm to be restored , area with low density in front/mid area is 6-7 cm . 

I have some diffused thinning/shedding in front area , don't intend to use finasteride .

Below is my thoughts and consultation results , appreciate if you can share and elaborate your thoughts  , as i understand that all of these surgeons are top surgeons 

- Erdogan : Advised 3500 grafts .. he do very good and dense hairlines but in my opinion he work with large number of grafts which can be explained by density of hairlines he creates 

i intend to choose package where dr himself do surgery .. on downside , i  saw some complains lately on this forum regarding some inconsistent results from asmed lately , also i'm afraid that not using finasteride to be used as an excuse in case that HT didn't go well . 

- Kesser : Advised 2000-2400 , then after reviewing pics in sunlight and drawing hairline i want  on a pic  , estimation was modified to 1500-2000 "with higher probability towards 1500 range " , operation to be done in 3-4 days , manual extraction , i believe taking enough time to implant grafts carefully between native hair ,  using less Anesthesia and implanting few grafts per day can lower possibility for permeant shock loss .. also dr kesser do very good hairline , he do much with few grafts which is good for a conservative 1st hair transplant as i don't know how hair loss will progress . 

- Bicer : Advised 2600-2800 grafts "can be changed upon live consultation and hairline design" , she's a very genuine person with great care and dedications towards patients and do very good work   .. if working with micromotor operation will be done in one day , if manual , price will be double , and operation to be done on two days , not sure which option i will proceed with due to Controversy of manual vs micromotor .. 

- HLC : advised 2000-2400 grafts .. communication is a bit of issue , but this can be tolerated , hairline design and density are good , operation is done on 2 days with manual extraction .   

- Pekiner : recommended 3000 grafts "2600 grafts + 400 for crown" .. i believe he use large number of grafts , but create dense hairline with nice design in return .

Thanks in advance .. 

[Melvin- Admin]

How old are yo? Can you share top down photos?

[H.K]

@Melvin- Moderator Hi Melvin , i'm 36 , hair thinning started in mid-twenties "with no noticeable shed/no bald spots , no recession , just thinner hair" possibly hair loss started and progressed slowly at that stage .

hair shed and recession started at 31/32 , now shedding is noticeably  less , but didn't stop completely , possibly may proceed within following years ,, hopefully breezula will be out soon with good efficacy/safety profile  😆

that's why i want to have a moderately conservative HT as hair is impossible to style now  , not sure yet what my donor capacity can provide .

Lastly , i prefer a surgeon who can work within native hair "as/if required" without causing un-reversible shock loss . 

 

[Melvin- Admin]

2 minutes ago, H.K said:

@Melvin- Moderator Hi Melvin , i'm 36 , hair thinning started in mid-twenties "with no noticeable shed/no bald spots , no recession , just thinner hair" possibly hair loss started and progressed slowly at that stage .

hair shed and recession started at 31/32 , now shedding is noticeably  less , but didn't stop completely , possibly may proceed within following years ,, hopefully breezula will be out soon with good efficacy/safety profile  😆

that's why i want to have a moderately conservative HT as hair is impossible to style now  , not sure yet what my donor capacity can provide .

Lastly , i prefer a surgeon who can work within native hair "as/if required" without causing un-reversible shock loss . 

 

I’m concerned about possible shock loss are you on finasteride? 

[H.K]

@Melvin- Moderatorno , i'm not .. i'm not intending to risk the side effects .. 

i'm using stemoxydine which seem to stabilize shed , but on product web page it's advised to use it for  3 months .. when i stop using it , shed begin slowly to increase , will try using adenosine and share my feedback . 

on the other hand , i was thinking to lower hairline a little bit "0.5-1 cm"  "just to avoid working much between native hairs" , but that can impose risk of consuming more follicles , also as you can see from pics , hair line recession as well as density in front area is not symmetrical .. not sure how surgeon can handle this 😏 , will he need to graft follicles asymmetrically as well ..

[Melvin- Admin]

28 minutes ago, H.K said:

@Melvin- Moderatorno , i'm not .. i'm not intending to risk the side effects .. 

i'm using stemoxydine which seem to stabilize shed , but on product web page it's advised to use it for  3 months .. when i stop using it , shed begin slowly to increase , will try using adenosine and share my feedback . 

on the other hand , i was thinking to lower hairline a little bit "0.5-1 cm"  "just to avoid working much between native hairs" , but that can impose risk of consuming more follicles , also as you can see from pics , hair line recession as well as density in front area is not symmetrical .. not sure how surgeon can handle this 😏 , will he need to graft follicles asymmetrically as well ..

I’d be very careful going in between hairs. Have you considered Dr. Sethi? He has a lot of work with diffuse hair loss.

[H.K]

@Melvin- Moderator no didn't check sethi , i will do a consultation and share feedback .. but not sure if it's even allowed to travel to India with covid situation there .

I agree i want to avoid working between natives as possible , but not sure how surgeon can correct my situation without doing so . 

So what re your thought about choosing between the surgeons i mentioned .

i just need to add that i sent a pic with hair line i want only to dr keser when he asked to .. so i believe most of other surgeon gave high graft count as they assume i need to lower hair line by 2 cm or so "as per my estimation for  pics they sent for the proposed hair line"  .. i had video call with dr bicer , graft count provided based on lowering hairline by around 1.5 cm ... 

 

[Melvin- Admin]

I think you should ask for examples of diffuse hair loss. Bicer is very good, Keser doesn’t use microscopes. For that alone, I’d rule him out. 

[H.K]

..

 

Edited June 25, 2021 by H.K

[H.K]

@Melvin- Moderator

That's a pretty sad news 😐 ..  keser is one of my top choices as he have the ability to give great result , nice hl  with fewer graft no. which is ideal for a conservative 1st procedure .

In youtube link below , dr sethi show importance of using magnification in diffuse thinning 

https://youtu.be/w385SyvaJlQ

I'm not sure if dr keser use microscopes or not , are you sure about this info. ? ... 

also it's not clear from link below if he use microscopes or not . 

https://hairsite.com/ankara-turkey/dr-keser-fue-hair-transplant/

regarding dr bicer , my only concern that if doing procedure on one day , that may cause more trauma and using more Anesthesia for longer period can lower blood flow and increase risk of shock loss , i was considering proceeding with manual extraction instead of micromotor with her even if that cost me double the cost of the procedure , the thing is she don't recommend one method over the other .

what is your thoughts about rest of short list , how do you compare them to bicer/keser for my particular case ..

[Melvin- Admin]

25 minutes ago, H.K said:

@Melvin- Moderator

That's a pretty sad news 😐 ..  keser is one of my top choices as he have the ability to give great result , nice hl  with fewer graft no. which is ideal for a conservative 1st procedure .

In youtube link below , dr sethi show importance of using magnification in diffuse thinning 

https://youtu.be/w385SyvaJlQ

I'm not sure if dr keser use microscopes or not , are you sure about this info. ? ... 

also it's not clear from link below if he use microscopes or not . 

https://hairsite.com/ankara-turkey/dr-keser-fue-hair-transplant/

regarding dr bicer , my only concern that if doing procedure on one day , that may cause more trauma and using more Anesthesia for longer period can lower blood flow and increase risk of shock loss , i was considering proceeding with manual extraction instead of micromotor with her even if that cost me double the cost of the procedure , the thing is she don't recommend one method over the other .

what is your thoughts about rest of short list , how do you compare them to bicer/keser for my particular case ..

I’m pretty sure he does not

[H.K]

@Melvin- Moderator thanks melvin , any comments on the other points in my last post ?

[BDK081522]

It's baffling to me that people will try all of these experimental, unregulated, not FDA approved medications before even trying finasteride. You never know if you'll experience side effects unless you try. Finasteride is the gold standard and quite simply it works. Why pay all this money for transplants without even trying finasteride because you're scared you might be in the 2% that have sides. Oh and by the way we use adenosine to literally stop patients hearts when they're in supraventricular tachycardia. So, yea I'd be a little careful with that one. 

[H.K]

4 minutes ago, BDK081522 said:

It's baffling to me that people will try all of these experimental, unregulated, not FDA approved medications before even trying finasteride. You never know if you'll experience side effects unless you try. Finasteride is the gold standard and quite simply it works. Why pay all this money for transplants without even trying finasteride because you're scared you might be in the 2% that have sides. Oh and by the way we use adenosine to literally stop patients hearts when they're in supraventricular tachycardia. So, yea I'd be a little careful with that one. 

thanks alot for the advise regarding adenosine , yes it's not regulated by FDA , although there's some published research about it , although it's a small group , but i assume they won't do it if it have high risk factor , i will consult a dr before administering it of course . 

https://pubmed.ncbi.nlm.nih.gov/24183218/

being one of the 2%-4% mentioned in the researches  is scary for me specially when some of that percentage don't recover , or recover in very long period , also i saw multiple cases for  people who tried finasteride without having bias against it   and stop after a while .. 

[Gatsby]

Without the ability to use finasteride and be able to stay on the drug you have to assume that you will eventually become a Norwood 6. Any reputable surgeon will inform you of the progression of MPB.

[H.K]

that's disappointing to hear 😂 , but you are correct i have to assume MPB may progress further although i believe that region 4,5 look solid , i'm more afraid about region 1 to 3 + 5v .. i'm 36 now as mentioned earlier .

hopefully breezula will be out soon with good efficacy , better safety profile .

I really can't blame anyone who use or avoid using finasteride because both sides have valid points .

but i like to focus more on this thread on the best options i have available for the surgery while  eliminating finasteride from medication plan while accounting for the diffused thinning/low density in frontal area that   i'm blessed with 🤪 

 

[mxm56]

I think all these doctors are good. I also think you should consider using Finasteride as soon as possibile. I was in the same exact situation of you a few months ago, i did regain a lot of density all across the scalp and now i may not even need a transplant, at least in the imminent future. It seemed to be an emergency but not anymore now that i can get a good haircut again.