Hairline - Pekiner or Freitas?

[Gatsby]

1 hour ago, Melvin- Moderator said:

It’s impossible for one person, not impossible for a team. As long as there’s a dedicated team doing one thing and one thing only, there’s no issue. The problem with technicians isn’t the technicians themselves. That’s not a good outlook.

There are very talented technicians that value their job. Hasson and Wong have technicians that have been with them for over 20 years. I would put those technicians against any surgeon who’s only been doing it a few years. 

The problem is having a revolving door of technicians with varying degrees of experience and skill. This affects consistency and the results. Hair transplants is all about reducing the variables.

If you have a team with a surgeon and the same technicians performing the same things day in and day out. I see very little difference between a surgeon doing everything themselves, and in fact I believe someone doing everything themselves has a higher chance of surgical fatigue and error. 

This ^ 👌

[ITA]

2 hours ago, Melvin- Moderator said:

It’s impossible for one person, not impossible for a team. As long as there’s a dedicated team doing one thing and one thing only, there’s no issue. The problem with technicians isn’t the technicians themselves. That’s not a good outlook.

There are very talented technicians that value their job. Hasson and Wong have technicians that have been with them for over 20 years. I would put those technicians against any surgeon who’s only been doing it a few years. 

The problem is having a revolving door of technicians with varying degrees of experience and skill. This affects consistency and the results. Hair transplants is all about reducing the variables.

If you have a team with a surgeon and the same technicians performing the same things day in and day out. I see very little difference between a surgeon doing everything themselves, and in fact I believe someone doing everything themselves has a higher chance of surgical fatigue and error. 

I think a patient can trust a surgeon who does all the surgery himself (like Pekiner), as much as a surgeon who has an experienced team of technicians who have been working with him for years (like most surgeons), in this In the last case the costs increase because the surgeon has to pay his technicians.

[PizzaWolf]

@Melvin- ModeratorI agree with what you're saying, but don't many of the benefits you're describing when it comes to having technicians, like reducing a doctor's workload and fatigue, end up being cancelled out if they opt to have multiple patients per day?

 

 

 

 

[Melvin- Admin]

3 hours ago, PizzaWolf said:

@Melvin- ModeratorI agree with what you're saying, but don't many of the benefits you're describing when it comes to having technicians, like reducing a doctor's workload and fatigue, end up being cancelled out if they opt to have multiple patients per day?

 

 

 

 

Yes and no. If one surgeon is overseeing multiple surgeries per day, then yes that adds to the variability. However, if there are multiple surgeons, then I don’t believe it makes a difference, as long as those other surgeons are as talented. For example, Lorenzo and Villa or Lorenzo and Ferreira. 

[Spring15]

On 12/9/2022 at 1:00 AM, RaymondMG said:

some years ago Freytas was supposed to be one of the best surgeons in Spain. Pekiner looks like is a bit choosy when taking new patients 

How do you mean Pekiner is choosy? What factors influence whether he accepts or declines a potential patient? 

[A Fue Good Men]

Technicians absolutely have a huge role in hair transplants and without them the surgery would be nearly impossible. However, doctors need to be performing the crucial parts of the surgery (extraction and at minimum the slits). Technicians should be supporting with sorting, splitting, storing, and placing grafts into openings.

 

If a doctor is outsourcing the extractions to the technicians, they are doing the patient a huge disservice. Extracting grafts is extremely technical and under the wrong hands can end disastrous

[deeznuts]

On 12/11/2022 at 12:24 PM, 5BetaReductase said:

Technicians absolutely have a huge role in hair transplants and without them the surgery would be nearly impossible. However, doctors need to be performing the crucial parts of the surgery (extraction and at minimum the slits). Technicians should be supporting with sorting, splitting, storing, and placing grafts into openings.

 

If a doctor is outsourcing the extractions to the technicians, they are doing the patient a huge disservice. Extracting grafts is extremely technical and under the wrong hands can end disastrous

It's not like having a medical degree from some top tier university makes you better at extracting a graft out of someone's scalp or even trains you in hair transplantation. You could have a doctor with parkinson's and have a MD from the best medical school in the world. Now that's not to say he'd be a bad doctor but I wouldn't trust someone with Parkinson's to do FUE on my head lol

Does typical doctor training ever teach you how to use a motorized FUE punch? A doctor or a tech can study as much as they like but at the end of the day, deftness and dexterity at a technical job like graft extraction is developed from repeating the motion thousands of times. It's like the world cup - study as much as you like, at the end of the day you have to step onto the field and practice kicking the ball and develop those neural pathways that allow you to be a master of your craft. And the tech has kicked the ball thousands of times more than the doctor. A technician who spent 8 hours a day, 5 days a week for the last 20 years will have more experience than a doctor who only did extractions a quarter of the time as they manage all other aspects of the surgery. 

What makes a person good at punching grafts out of the scalp is having a lot of experience and a career of using a manual or motorized FUE punch.

The question is more along the lines of - how good is the tech?

[Melvin- Admin]

2 minutes ago, deeznuts said:

It's not like having a medical degree from some top tier university makes you better at extracting a graft out of someone's scalp or even trains you in hair transplantation. You could have a doctor with parkinson's and have a MD from the best medical school in the world. Now that's not to say he'd be a bad doctor but I wouldn't trust someone with Parkinson's to do FUE on my head lol

Does typical doctor training ever teach you how to use a motorized FUE punch? A doctor or a tech can study as much as they like but at the end of the day, deftness and dexterity at a technical job like graft extraction is developed from repeating the motion thousands of times. It's like the world cup - study as much as you like, at the end of the day you have to step onto the field and practice kicking the ball and develop those neural pathways that allow you to be a master of your craft. And the tech has kicked the ball thousands of times more than the doctor. A technician who spent 8 hours a day, 5 days a week for the last 20 years will have more experience than a doctor who only did extractions a quarter of the time as they manage all other aspects of the surgery. 

What makes a person good at punching grafts out of the scalp is having a lot of experience and a career of using a manual or motorized FUE punch.

The question is more along the lines of - how good is the tech?

I agree. Extracting is a motor skill, I guarantee there are some technicians out there that can extract a better graft then 90% of the top surgeons. The issue isn’t technicians, it’s their skill and level of experience. 

The biggest issue I see is when there are revolving teams of technicians with varying levels of skill and experience, as is the case at hair mills. There’s no doubt some talented techs at hair mills, which is why they can have  some successful procedures.

But it’s unlikely those hair mills will retain these technicians, and impossible for the patient to know whether they’ll get these talented techs to work on them. We shouldn’t be looking at things as dogma. I remember when the forum used to say “motorized” punches were trash and you should only go manual. 

Well, fast forward 8 years, now we know that’s nonsense. The tool doesn’t matter, the hand using it matters. Now, I see the same dogmatic views on technicians. There are a handful of doctors that do most of the work themselves and get excellent results. But it’s not because they do it all themselves, it’s because they have a system put into place that works for them and their practice. 

In the 80s and 90s, most surgeons did everything themselves. That’s why they would only do a couple hundred grafts at a time. Some of the worst work ever done was done during that time. Just because the surgeon did it all, didn’t guarantee success. Let’s not lose sight of that, its the surgeon’s portfolio, results, and most importantly independent reviews that matter most. 

[A Fue Good Men]

11 hours ago, deeznuts said:

It's not like having a medical degree from some top tier university makes you better at extracting a graft out of someone's scalp or even trains you in hair transplantation. You could have a doctor with parkinson's and have a MD from the best medical school in the world. Now that's not to say he'd be a bad doctor but I wouldn't trust someone with Parkinson's to do FUE on my head lol

Does typical doctor training ever teach you how to use a motorized FUE punch? A doctor or a tech can study as much as they like but at the end of the day, deftness and dexterity at a technical job like graft extraction is developed from repeating the motion thousands of times. It's like the world cup - study as much as you like, at the end of the day you have to step onto the field and practice kicking the ball and develop those neural pathways that allow you to be a master of your craft. And the tech has kicked the ball thousands of times more than the doctor. A technician who spent 8 hours a day, 5 days a week for the last 20 years will have more experience than a doctor who only did extractions a quarter of the time as they manage all other aspects of the surgery. 

What makes a person good at punching grafts out of the scalp is having a lot of experience and a career of using a manual or motorized FUE punch.

The question is more along the lines of - how good is the tech?

We can throw around anecdotes all day. But the bottom line is the technicians are trained by the doctors. That means the doctors themselves must be extremely skilled at extraction in order to teach their technicians correctly.

 

There are a bunch of questions one should ask in terms of why the doctor isn’t performing the extractions or AT LEAST just punching the grafts:

1) are they juggling more than one patient per day to maximize their profits?

2) do they have some type of physical impairment? If so, are they even fit to do incisions or other parts of the surgery?

3) is their eyesight that bad? (Default to #2)

4) do they not really care and just want to sit in their office and edit YouTube videos and do online consultations?

5) do they not prioritize patient care during a surgical procedure?

 

Most technicians don’t have formal education and aren’t trained in surgery. All their learning is done through practice on patients. Who wants to be the training cadaver for a new tech?

 

Punching and extracting grafts is not easy. It requires proper spacing between grafts, adjusting a tiny tool to the exact angle and depth of the graft, using traction and torsion techniques to safely remove the graft without trauma or damage.

 

Its not a lot to ask for a physician to just punch the grafts and be present while technicians remove and store the follicular units. This would totally limit the BS excuse of “fatigue.”

I’ve been to both types of clinics, and I know who I would choose every.single.time.

coming from someone that went to a well known clinic where a “very skilled“ technician with years of experience decimated my donor and destroyed my grafts, i can confidently speak from experience.

[RaymondMG]

On 12/11/2022 at 6:59 PM, Spring15 said:

How do you mean Pekiner is choosy? What factors influence whether he accepts or declines a potential patient? 

I sent to his assistant multiple pictures of my scalp etc etc showing a very good donor area etc etc...,,, she asked me about finasteride I said I stopped taking it years ago and just after this answer she ghosted

 

On 12/11/2022 at 6:59 PM, Spring15 said:

How do you mean Pekiner is choosy? What factors influence whether he accepts or declines a potential patient? 

 

[Spring15]

16 hours ago, RaymondMG said:

I sent to his assistant multiple pictures of my scalp etc etc showing a very good donor area etc etc...,,, she asked me about finasteride I said I stopped taking it years ago and just after this answer she ghosted

 

 

What norwood are you?