Please help me pick my surgeon - Belgium (Lupanzula, Bisanga) / Turkey (HLC, Bicer) / Switzerland (Hattingen)

[sulhcg]

Dear Forum!

I would like to kindly ask you for support in choosing my doctor. I have already done intensive research here and in other forums and have already had contact with the classic "top providers" in Europe ranging from Belgium, to Turkey and Switzerland.

Now I would like to go into the final selection round and ask for your input. A really "bad" doctor/clinic should hopefully no longer be there - but since there are partly massive differences between the doctors both in approach and price, I would be very happy about your comments! I am of course not looking for the cheapest provider but for an appropriate mix.

I have already asked in the German Forum for advice so there you'll also find the status from about a year ago (https://www.alopezie.de/foren/transplant/index.php/m/150008/#msg_150008)  (relatively stable I would say - but you are the professionals).

About my person:

• Age: 31-32
• Current hair status according to the Hamilton-Norwood scale: NW 3 "Vortex" by my estimation.
• Planned budget: Gladly under 12k EUR, but is not an absolutely hard criterion "if it must be".
• Hair status in family (parents/grandparents):
  • Paternal: father at about 55 yrs at NW 4+ (but semi-stable there), grandfather deceased at an early age.
    • Maternal: grandfather until death sufficient hair - towards the end with 80+ naturally thinned out
• Hairloss progression (fast/slow?): Difficult - I've been using Min/Fin since I was 20 (every now and then discontinued and restarted) - the hairloss has thus progressed gradually, but I would say it has progressed reasonably slowly (also due to Fin/Minox).
• Hairloss stopped?: From my point of view no - slowly progressing
• Medication (therapy attempts/successes/current medication):
  • 1x tgl. Minox 5% foam ("Regaine") - I will now increase to 2x tgl.
  • 1x tgl. 0,5MG FInasterid ( half a tablet Propecia) in the evening - if necessary I could increase the dose of course. Since family planning has not yet been completed (or started at all), it is also possible that I will have to discontinue it in a few years for the purpose of having children.
• Are there already certain hair surgeons/clinics on the shortlist?: Yes - see below at the end of the post.
• Previous hair transplants, if any (year? hair surgeon?): No
• Preferred treatment method (FUE/FUT?): The best possible treatment method is preferred - assume in my case that would be FUE.

About clinics / doctors:

As I said I am in contact with some good providers, I would almost go as far as to say "the usual suspects". I don't think any of the providers is a fundamental mistake, however, there are partly significant differences in approaches, methods and finally also in price. Specifically, I am looking for your opinions and would be very (really very!) happy for your encouragement and input.

• HLC (Hairline Clinic Ankara):
  • The estimate of FUs is: hairline about 2,200 - 2,600 FUs or for the crown/upper head 1,000 - 1,500 FUs.
  • Manual harvesting - FUE
• Lupanzula (Belgium):
  • The estimation of FUs is: hairline 2,000 - 2,300 FUs or crown/upper head: 1,000 - 1,200 FUs.
  • Partly manual/partly micromotor - FUE
• Bicer (TR):
  • Hairline 2,000 FUs or crown/upper head: 1,500.
  • Micromotor FUE
• Hattingen (CH):
  • Hairline: Here the initial information is not to do anything further (because hairline still intact and to leave reserves) and/or crown/upper head: 1,500 - 2,000 FUs.
• Feriduni (BE):
  • Hairline 1,800 - 2,400 FUs or crown/upper head: Dr. Feriduni does not want to do anything here to leave reserves.
  • By far the most expensive provider
• Bisanga (BE):
  • Hairline/GHEs: 2,000 - 2,300 FUs or crown/upper head: 2,000 FUs -
  • Very price intensive offer (expensive).

Initial impression:

Feriduni & Hattingen (although the highly professional contact and good impression) I would rather sort out because either hairline or top of head would not be treated, and that would make me in the long term I guess not really happy because I would always "complain" when I look in the mirror. 

My gut feeling currently goes in the direction of HLC (TR) or Lupanzula (BE) leaning ever so slightly to HLC - but as I said would be very happy to hear your opinion. Again, all the contacts have been super professional, friendly and re-assuring so nothing negative to mention here.

Specifically, then:

• Am I doing something wrong with named vendors?
• Am I specifically doing something wrong with HLC, Lupanzula or Bicer? 
• Manual (HLC) vs. micromotor (Lupanzula / Bicer) - quo vadis?
• How do you evaluate the statements of Feriduni / Hattingen, which recommend to do only GHE or crown (interestingly, the other way around)?
• How would you judge the donor area based on the picture? How many FUs does it approx. give from your opinion?
• Which of the doctors would you choose?

Initial information from De Reyes and Ferreira will follow - de Freitas unfortunately needs more than 2 months for initial feedback.

Thanks a lot!

 

Edited August 26, 2021 by sulhcg

[baalloss]

Hi @sulhcg, have a read of my experiences, all the way to the last post, and this may show how things can go wrong even with a "top provider"  clinic:

 

 

 

Edited August 26, 2021 by baalloss

[sulhcg]

Just now, baalloss said:

Hi @sulhcg, have a read of my experiences, all the way to the last post, and this may help you decide which clinic to avoid :

 

 

 

Appreciate your feedback - however, although i feel very very bad for you, I think it is not fair to disregard a renowned surgeon because of one bad case.

Again I deeply feel sorry for you!

[MachoVato]

My only experience is with HLC and Bisanga. For harvesting, HLC uses manual punches and Bisanga uses motorized. I used to believe that manual extraction was better than motorized, but I don't share that opinion anymore. I have no preference now. For recipient area, HLC does stick and place. Bisanga uses pre-made incisions. My preference is for stick and place. Mainly because it is slower and a little less painful. 

Looking at your photos, I think HLC is a great option. They are very pro high-density, so they like to use more grafts. Your donor and beard looks strong so no worries there. As you probably know, HLC has about 5 doctors on site and they select the doctors during the hairline design/planning session. You can expect 2 different doctors to rotate on you over the 2 days. It's worth mentioning that HLC partners with Dr. Cole with a FUE Training Center (https://www.hairtransplant-trainingcenter.com/).

Before selecting Bisanga, I requested a quote from De Freitas. This was 2 months ago and I still don't have an answer. My procedure with Bisanga was 2 weeks ago! haha

Good luck!

[Melvin- Admin]

Out of all those names I feel Bisanga, Feriduni and De Freitas would be my top list. 

[ITA]

Hi @sulhcg

I agree with @Melvin- Moderator, also for me, Bisanga, Feriduni and De Freitas are to be considered in the top list.

[Britanium]

11 hours ago, sulhcg said:

Appreciate your feedback - however, although i feel very very bad for you, I think it is not fair to disregard a renowned surgeon because of one bad case.

Again I deeply feel sorry for you!

Agreed we can’t start to rule out every Dr because of a poor result. We can find a poor result for every single Dr/Clinic worldwide. I feel for the guy also.

Your research is excellent and you are narrowing it down to some really good choices. Looking at all of the quotes I would say that Bisanga and Feriduni seem to stand out to me, both with very good graft counts/plans. 

[sulhcg]

On 8/26/2021 at 10:57 PM, MachoVato said:

My only experience is with HLC and Bisanga. For harvesting, HLC uses manual punches and Bisanga uses motorized. I used to believe that manual extraction was better than motorized, but I don't share that opinion anymore. I have no preference now. For recipient area, HLC does stick and place. Bisanga uses pre-made incisions. My preference is for stick and place. Mainly because it is slower and a little less painful. 

Looking at your photos, I think HLC is a great option. They are very pro high-density, so they like to use more grafts. Your donor and beard looks strong so no worries there. As you probably know, HLC has about 5 doctors on site and they select the doctors during the hairline design/planning session. You can expect 2 different doctors to rotate on you over the 2 days. It's worth mentioning that HLC partners with Dr. Cole with a FUE Training Center (https://www.hairtransplant-trainingcenter.com/).

Before selecting Bisanga, I requested a quote from De Freitas. This was 2 months ago and I still don't have an answer. My procedure with Bisanga was 2 weeks ago! haha

Good luck!

Hi @MachoVato - Thank you very much for taking the time to answer! HLC is indeed currently one of my shortlisted clinics due to their rave reviews and fair offering. I am just a tad bit reluctant as I somehow get the feeling that they are not mentioned in the same breath with Bisanga/Feriduni/et al. 

May I ask what:

1. Drove your decision towards HLC in the first place as well as 
2. What made you choose Bisanga for the 2nd time (and not for example again HLC or other Belgium options like Lupanzula)?

 

On 8/27/2021 at 12:43 AM, Melvin- Moderator said:

Out of all those names I feel Bisanga, Feriduni and De Freitas would be my top list. 

Hi @Melvin- Moderator!

Thank you for taking the time to reply! You put me in a hard spot here as I´d like to discard Feriduni (although his expertise is not questioned) due to the fact that he only wants to do the hairline and not hairline+crown in  his initial estimate. I feel I would not feel happy and good with the result if not both of my problems are taken care of.

De Freitas takes more than 2 mths for an initial estimate - therefore I unfortunately also have to rule him out.

That leaves Bisanga from your list and this is also tricky as Bisanga is significantly more expensive compared to HLC and also significantly more expensive than Lupanzula and the likes.

May I therefore ask you some follow-up questions:

1. How would you rate HLC and Lupanzula?
2. Do you think Bisanga - again not at all questioning his expertise - is significantly better in my situation compared to virtually anybody on the list (as again he is quite expensive but also renowned)

I am obviously not looking for a "price breaker" in a meat-shop - this is hopefully also underlined by my initial due dilligence. However as there are significant differences in terms of prices I just want to assess this properly.

On 8/27/2021 at 1:00 AM, Egy said:

Hi @sulhcg

I agree with @Melvin- Moderator, also for me, Bisanga, Feriduni and De Freitas are to be considered in the top list.

Hi @Egy! Also thank you very very much for your feedback! Then I would kindly like to ask you the same follow-ups as Melvin

Thank you all - really helpful so far!

Edited August 28, 2021 by sulhcg

[Melvin- Admin]

On 8/27/2021 at 1:58 AM, sulhcg said:

Hi @MachoVato - Thank you very much for taking the time to answer! HLC is indeed currently one of my shortlisted clinics due to their rave reviews and fair offering. I am just a tad bit reluctant as I somehow get the feeling that they are not mentioned in the same breath with Bisanga/Feriduni/et al. 

May I ask what:

1. Drove your decision towards HLC in the first place as well as 
2. What made you choose Bisanga for the 2nd time (and not for example again HLC or other Belgium options like Lupanzula)?

 

Hi @Melvin- Moderator!

Thank you for taking the time to reply! You put me in a hard spot here as I´d like to discard Feriduni (although his expertise is not questioned) due to the fact that he only wants to do the hairline and not hairline+crown in  his initial estimate. I feel I would not feel happy and good with the result if not both of my problems are taken care of.

De Freitas takes more than 2 mths for an initial estimate - therefore I unfortunately also have to rule him out.

That leaves Bisanga from your list and this is also tricky as Bisanga is significantly more expensive compared to HLC and also significantly more expensive than Lupanzula and the likes.

May I therefore ask you some follow-up questions:

1. How would you rate HLC and Lupanzula?
2. Do you think Bisanga - again not at all questioning his expertise - is significantly better in my situation compared to virtually anybody on the list (as again he is quite expensive but also renowned)

I am obviously not looking for a "price breaker" in a meat-shop - this is hopefully also underlined by my initial due dilligence. However as there are significant differences in terms of prices I just want to assess this properly.

Hi @Egy! Also thank you very very much for your feedback! Then I would kindly like to ask you the same follow-ups as Melvin

Thank you all - really helpful so far!

Let me tag @De Freitas Clinic Ignacio has been excellent helping our members. I’m not sure if you used our link, but our members have a much shorter time.

[sulhcg]

41 minutes ago, Melvin- Moderator said:

Let me tag @De Freitas Clinic Ignacio has been excellent helping our members. I’m not sure if you used our link, but our members have a much shorter time.

Thanks - would obviously much appreciated to also get their perspective:)

what do you guys think about donor quality as such? Reason: in another forum there are strong voices to just go for crown or Hairline in order to leave reserves. Personally however I would very much like to strike both as otherwise this would feel incomplete to me.

[ITA]

On 8/27/2021 at 10:58 AM, sulhcg said:

Hi @Egy! Also thank you very very much for your feedback! Then I would kindly like to ask you the same follow-ups as Melvin

Thank you all - really helpful so far!

I have seen many Pekiner transplants  of patients that started from the same situation as you, I consider him an ethical doctor, he does the whole procedure by himself, his prices are: 2.5 Euros per graft for ordinary FUE with complete shaving, 2.7 Euros per graft for BHT (Body Hair Transplant) (FUE with extractions from beard, chest, limbs, back, abdomen etc.),
 3 Euro per graft for long hair FUE.  The only thing I don't like about him is his consultant who I don't think is a crystalline person, because if he is a consultant, I don't think he should also be the moderator of a forum, it's not ethical in my opinion, but he's just mine opinion, and as a member of HRN maintains, a surgeon, even a good one, cannot be ruled out just because his consultant does not behave as he should, so I Pekiner would choose him, maybe I would try to bypass his consultant, but then again, I would choose him with eyes closed.

Edited August 28, 2021 by Egy

[MachoVato]

On 8/27/2021 at 3:58 AM, sulhcg said:

Hi @MachoVato - Thank you very much for taking the time to answer! HLC is indeed currently one of my shortlisted clinics due to their rave reviews and fair offering. I am just a tad bit reluctant as I somehow get the feeling that they are not mentioned in the same breath with Bisanga/Feriduni/et al. 

May I ask what:

1. Drove your decision towards HLC in the first place as well as 
2. What made you choose Bisanga for the 2nd time (and not for example again HLC or other Belgium options like Lupanzula)?

My very first choice was Dr. Keser (a former HLC doctor) but covid cancelled it. Then I was trying to book with Pekiner (also a former HLC doctor), but again, covid caused problems. I was in deep talks with Ferreira but Portugal was not accepting flights. Then last October, things started to open up and I reached out to Keser, Pekiner and HLC. HLC had an opening in 3 weeks due to a cancellation so I booked it. 

At the time, I was stuck on the doctor doing all the work. I wanted manual punches (not motorized) for extraction. And I preferred stick and place for insertion. HLC wasn't my *first* choice for the silly reason that you don't get to pick your doctor(s). HLC is kinda unique this way and didn't have a lot of cases on this board, but there are many more on BelliCapelli (Italian forum). There is a real consistency with these doctors. I can spot HLC post-operative work every time. Keser/Pekiner/HLC hairlines are all excellent. The videos on HLC YouTube channel really sold me.

Keser @ 3.5, Pekiner @ 2.5, and HLC @ 2.7 are the most expensive clinics in the country (Keser is high because he limits himself to 700 grafts per day). They are not bargain clinics, they are the elite options in Turkey. They don't get a lot of love on this board because they are in Turkey and aren't on the preferred list.

I chose Bisanga because I was looking for crown, temples and donor management. HLC could do it, sure, but I was really impressed with Bisanga's approach to donor management (he has a few videos on this) and I found some really nice temple work of his. Since I was only needing 1500 grafts, Bisanga is more affordable (he costs 4.85/grafts after VAT). In total I had almost 5800 grafts. That would have been over $33k USD with Bisanga. But I saved almost $12k by going to HLC first. 

Without question, Bisanga is top 25 in the world. I would have been equally happy to go to De Freitas, but he doesn't give quotes easily. If I ever get a third procedure, I would try to get De Freitas, his work is among the best I've ever seen. Maybe Lorenzo (because I love Spain) or Mwamba (because he offers procedures in Atlanta). But I won't go back to Bisanga or HLC, there are too many good options. Look at @mustang's list of clinics. He's been to like 7 or 8 different ones! 🤣

This forum does have a bias. The Italian and German forums have very different "best of" lists. Even Cuoto doesn't get a lot of love here, and his work is mind blowing. Just do your research. Look at real patient cases here and on other forums. Instagram is no good for research, but YouTube has been helpful. Just don't get caught up in indecision limbo. Pick a place and book it. And stick to it! haha

[mustang]

Having been to both HLC and Keser I would recommend HLC blindly. 

Another option is Lupanzula (4 EUR per graft) and Mwamba (2.5 EUR per graft) in Belgium. These are on the same level of not higher than HLC and Belgium is much nicer to visit than Ankara.

I went to Ferreira as well, very nice surgeon and excellent skills! 

[sulhcg]

14 hours ago, mustang said:

Having been to both HLC and Keser I would recommend HLC blindly. 

Another option is Lupanzula (4 EUR per graft) and Mwamba (2.5 EUR per graft) in Belgium. These are on the same level of not higher than HLC and Belgium is much nicer to visit than Ankara.

I went to Ferreira as well, very nice surgeon and excellent skills! 

Hi Mustang!
I was really hoping for you to get involved in the discussion as you´ve also been to HLC.

If you´d have to decide between HLC, Lupanzula and Ferreira (still waiting for the initial feedback - also express option seems to be out of stock) - what would be your pick?

Thank you in advance!

Edited August 30, 2021 by sulhcg

[sulhcg]

On 8/28/2021 at 8:55 PM, MachoVato said:

My very first choice was Dr. Keser (a former HLC doctor) but covid cancelled it. Then I was trying to book with Pekiner (also a former HLC doctor), but again, covid caused problems. I was in deep talks with Ferreira but Portugal was not accepting flights. Then last October, things started to open up and I reached out to Keser, Pekiner and HLC. HLC had an opening in 3 weeks due to a cancellation so I booked it. 

At the time, I was stuck on the doctor doing all the work. I wanted manual punches (not motorized) for extraction. And I preferred stick and place for insertion. HLC wasn't my *first* choice for the silly reason that you don't get to pick your doctor(s). HLC is kinda unique this way and didn't have a lot of cases on this board, but there are many more on BelliCapelli (Italian forum). There is a real consistency with these doctors. I can spot HLC post-operative work every time. Keser/Pekiner/HLC hairlines are all excellent. The videos on HLC YouTube channel really sold me.

Keser @ 3.5, Pekiner @ 2.5, and HLC @ 2.7 are the most expensive clinics in the country (Keser is high because he limits himself to 700 grafts per day). They are not bargain clinics, they are the elite options in Turkey. They don't get a lot of love on this board because they are in Turkey and aren't on the preferred list.

I chose Bisanga because I was looking for crown, temples and donor management. HLC could do it, sure, but I was really impressed with Bisanga's approach to donor management (he has a few videos on this) and I found some really nice temple work of his. Since I was only needing 1500 grafts, Bisanga is more affordable (he costs 4.85/grafts after VAT). In total I had almost 5800 grafts. That would have been over $33k USD with Bisanga. But I saved almost $12k by going to HLC first. 

Without question, Bisanga is top 25 in the world. I would have been equally happy to go to De Freitas, but he doesn't give quotes easily. If I ever get a third procedure, I would try to get De Freitas, his work is among the best I've ever seen. Maybe Lorenzo (because I love Spain) or Mwamba (because he offers procedures in Atlanta). But I won't go back to Bisanga or HLC, there are too many good options. Look at @mustang's list of clinics. He's been to like 7 or 8 different ones! 🤣

This forum does have a bias. The Italian and German forums have very different "best of" lists. Even Cuoto doesn't get a lot of love here, and his work is mind blowing. Just do your research. Look at real patient cases here and on other forums. Instagram is no good for research, but YouTube has been helpful. Just don't get caught up in indecision limbo. Pick a place and book it. And stick to it! haha

Wow - so helpful! Thank you so much!

I am still waiting for feedback from Mwamba, De Freitas and Ferreira so let´s see what they reply and when they have availability as I am set on finalizing it in Q4 this year.

[De Freitas Clinic]

On 8/28/2021 at 6:55 PM, Melvin- Moderator said:

Let me tag @De Freitas Clinic Ignacio has been excellent helping our members. I’m not sure if you used our link, but our members have a much shorter time.

Thank you, Melvin, for your recommendation. It would be a pleasure responding any request of the forum members.

Best regards.

[Melvin- Admin]

On 8/28/2021 at 10:37 AM, sulhcg said:

Thanks - would obviously much appreciated to also get their perspective:)

what do you guys think about donor quality as such? Reason: in another forum there are strong voices to just go for crown or Hairline in order to leave reserves. Personally however I would very much like to strike both as otherwise this would feel incomplete to me.

I wouldn’t touch the crown, you don’t have enough hair loss, and you could potentially end up with net gain if you lose more hair. Definitely address the hairline first. The crown maybe in a few years. 

[mustang]

14 hours ago, sulhcg said:

Hi Mustang!
I was really hoping for you to get involved in the discussion as you´ve also been to HLC.

If you´d have to decide between HLC, Lupanzula and Ferreira (still waiting for the initial feedback - also express option seems to be out of stock) - what would be your pick?

Thank you in advance!

In this order

Ferreira

HLC

Lupanzula

This said, you are going to the best in their field, you will have above 95% growth with any. 

[TommyLucchese]

On 8/30/2021 at 4:26 PM, Melvin- Moderator said:

I wouldn’t touch the crown, you don’t have enough hair loss, and you could potentially end up with net gain if you lose more hair. Definitely address the hairline first. The crown maybe in a few years. 

I agree. Plenty of recession when the hairline is pulled back to justify 2,000 grafts. You could easily get by another 5 or 10 years with concealer on that fairly minimal crown and re-evaluate down the line. It looks like it's more mid scalp too which will be easier to hide.