FUE HLC Ankara | NW 5/6 | 5762 Grafts | November 2022

[Drew-83]

6 hours ago, BaldGuy said:

I agree..the result is pretty good for this huge area and the graft survival is fine.

As you said the hairs are not combed in the same direction to give the illusion of density. Generally in hair transplants you need to comb your hair in the same direction in order to have a good illusion of density...

Also his hairs are pretty short, which doesnt help with the illusion too...

Sorry but doesn't understand...do the grafts have to be done in the same direction as the hair? as you can see they are all combed down by me and the length is enough to understand the result of this transplant...

[jjalay]

1 hour ago, Turkhair said:

Couto is a great surgeon but you’re doing apples and oranges comparison. 

First two videos - Great donor. All scalp hair grafts. The donor is so great in these cases, they had 4-5s multi hairs grafts by hundreds!.  Comparing that to body hairs or weak donor with single/double grafts isn’t really a comparison, is it? 
 

Last video is a much fairer comparison. But look at how high the hairline is and how small the area covered is. His lateral humps are untouched and all grafts went into front + midscalp.

 

I feel like a lot of OP’s grafts were wasted on his lateral humps, and his hairline is lower than it should’ve been for his level of loss. His midscalp didn’t get much love and is obviously thin. Look how Couto planned the last patient. Very very conservative hairline, lateral humps untouched. If HLC had gone with the same plan with OP, he would be ecstatic with his density.

But I think this shows perfectly how to be a great clinic, it’s not just about getting good survival rate, it’s also about perfect planning according to each patients hairloss and managing expectations. How couto has executed the HT with last patient shows why he is so highly regarded. 

I don´t think i am comparing oranges with apples here. In the first two cases the thickness of the donor hair is medium, the donor density is at 80 FUs/cm not so great. In the first case from 4766 grafts 225 were singles, in the second case from 3070 grafts 158 were singles. In the case from OP from 5762 grafts around 430 grafts were singles, the rest were doubles and mainly multiple grafts which is a great amound of multis in order to achieve great density.

They used beard hair too but as the moderator said in the previous post this is really thick hair and it provides great coverage on the midscalp mixed with scalp hair always.

Comparing with the last case, the hairline in the case of the OP is preety conservative and high in my opinion too, which is right were it should be. This result was achieved with 3288 grafts, almost half the grafts that HLC has used in this case.

If you read the report from OPs thread the density they have implanted the grafts is at 50 FU/cm on the hairline and 40 FU/cm on the midscalp, there is no difference to the density between the midscalp and the lateral humps that you are referring. The difference is in the growth rate, which in my opinion is preety low in the whole area.

[Turkhair]

7 hours ago, jjalay said:

They used beard hair too but as the moderator said in the previous post this is really thick hair and it provides great coverage on the midscalp mixed with scalp hair always.

I want to show you something funny 😂

You see those hairs sticking out growing upwards and in directions of their own? They are beard hairs. My head was shaved completely at the same length yet look how they are behaving growing at different rates and with a mind of their own. A lot of them are also sleeping unfortunately. 

They are not helping with illusion of density 😂 They are also single hair grafts and not really great like multi hair grafts are. I mean they are helping when styled/tamed (with gels) but if those beard hairs were multi hair grafts or if they were in really large numbers, the illusion would’ve been better. 

[jjalay]

5 hours ago, Turkhair said:

I want to show you something funny 😂

You see those hairs sticking out growing upwards and in directions of their own? They are beard hairs. My head was shaved completely at the same length yet look how they are behaving growing at different rates and with a mind of their own. A lot of them are also sleeping unfortunately. 

They are not helping with illusion of density 😂 They are also single hair grafts and not really great like multi hair grafts are. I mean they are helping when styled/tamed (with gels) but if those beard hairs were multi hair grafts or if they were in really large numbers, the illusion would’ve been better. 

All i see is around 30 hairs sticking up in 90 degrees. There is no debate in that, beard hair is thick hair and provides great coverage for the midscalp and crown for people who have exhausted their donor area. But you have to know how to extract these grafts and how to use them properly. It is not that everybody can do it and if the grafts don`t grow its your beard to blame.

[Melvin- Admin]

On 9/2/2023 at 10:23 AM, jjalay said:

Impossible to get full density with one surgery and 5K grafts? Check out these cases from couto:

 

These are most definitely “illusions” not true density. 

I show what the illusion of density is and how it can make your hair look good. But a certain length is necessary to provide a layering effect. As you can see with all of these patients, there hair is combed in a way that layers over the scalp. 

This is the reality with surgery as a Norwood 6/7. You can’t expect to have true density unless you get 12-13k grafts. It’s simple math really. A Norwood 6 has lost around 20-25k grafts. 6k grafts is a fraction. 

[jjalay]

5 hours ago, Melvin- Moderator said:

These are most definitely “illusions” not true density. 

I show what the illusion of density is and how it can make your hair look good. But a certain length is necessary to provide a layering effect. As you can see with all of these patients, there hair is combed in a way that layers over the scalp. 

This is the reality with surgery as a Norwood 6/7. You can’t expect to have true density unless you get 12-13k grafts. It’s simple math really. A Norwood 6 has lost around 20-25k grafts. 6k grafts is a fraction. 

We are not talking about native density here, nobody wants or better said expects to achive native density after a hair transplant. I think its good to separate the illusion of density that you are talking about from lack of density after a poor result. About the number of grafts needed according to the scale of baldness of every patient you can also read this article from Bernstein medical:

https://www.bernsteinmedical.com/hair-transplant/basics/graft-numbers/

It says nowhere that you need 12-13 k grafts to restore your hair as a NW VI-VII patient.

The length of the hair is important and it adds more volume and coverage if you leave your hair long after a hair transplant. This is the same for people without hairloss too.  Most of the patient after a hair transplant also want to leave their hairs long and be able to style it in different ways.

But i don´t believe that after a hair transplant you are not allowed to  cut your hair short. If you need to leave your hair at 7 cm long after a HT in order to cover bald patches on your head then something is gone terribly wrong.

Edited September 5, 2023 by jjalay

[Melvin- Admin]

7 hours ago, jjalay said:

We are not talking about native density here, nobody wants or better said expects to achive native density after a hair transplant. I think its good to separate the illusion of density that you are talking about from lack of density after a poor result. About the number of grafts needed according to the scale of baldness of every patient you can also read this article from Bernstein medical:

https://www.bernsteinmedical.com/hair-transplant/basics/graft-numbers/

It says nowhere that you need 12-13 k grafts to restore your hair as a NW VI-VII patient.

The length of the hair is important and it adds more volume and coverage if you leave your hair long after a hair transplant. This is the same for people without hairloss too.  Most of the patient after a hair transplant also want to leave their hairs long and be able to style it in different ways.

But i don´t believe that after a hair transplant you are not allowed to  cut your hair short. If you need to leave your hair at 7 cm long after a HT in order to cover bald patches on your head then something is gone terribly wrong.

You’re free to believe what you want. I’ve had 4 hair transplants, and I’m also a Norwood 6. I’m speaking from actual experience. You cannot achieve visible density leaving your hair short after getting 5,700 grafts. It’s not possible. 

You’re allowed to cut your hair however you want after an HT. But if you want to achieve the best possible appearance, you will HAVE to leave it long enough to layer, and also style it in a way that maximizes the appearance of density. I gain nothing from telling you how it is, if you can’t accept these facts, don’t get an HT. Getting a hair transplant as a Norwood 6 is a multi-step process that requires multiple procedures over the same areas.

Every result posted from clinics are results posted in the best situation, ideal lighting, hair styling and on the best patients. No two people are the same, head size, hair thickness, and donor density is different for every patient.

So two patients could look vastly different after receiving 5,700 grafts from the same surgeon for the reasons stated above. But regardless, every Norwood 6 will have the “illusion” of density with 5,700 grafts. I’ve had 9k grafts and it’s still not perfect. My hair still looks thin if it’s wet, its not because I was botched. It’s just the reality of the limitations with surgery. If you cannot accept these limitations, don’t get surgery.

 

[Nw7HPE]

On 9/1/2023 at 9:11 AM, Melvin- Moderator said:

While I can understand your frustration. I don’t believe name calling is warranted. HLC has produced some good results. Looks like they’ve missed the mark in managing expectations here. I think it’s natural to question the reason why this may have occurred. Questioning the reason why, isn’t a defense. 

Melvin , I understand your point but the thing is that HLC of 2023 is not HLC of 2015 . They have many unknown Drs doing surgeries left and right (Factory Assembly line) now which may have not been the case a decade ago .They increased their volume so expectedly quality dropped and a lot of us trusted that they are one of the best based on their past results not what they became now. As you know we have very limited donor and limited ability to scar the donor tissue   . In my case , I had both my scalp and immediate high quality post-op pictures analyzed by two surgeons and they confirmed that HLC misrepresented the grafts amount implanted per sq cm . There is no gray area here . In my case I paid 15k USD and others who paid tens of thousands just to get what a Serkan or Emrah would provide them in Istanbul for one tenth of the price on top of their donor scarred . It s a bit painful when people attack us as if we did not do our research and had unreasonable expectations . 

[BaldGuy]

The result looks pretty good for such a huge area. Also 1250 beard grafts were used which are single hairs and they dont give good coverage as scalp hairs which are multi grafts. Also beard hairs do not behave like scalp hairs, which affects the coverage too.
You cant expect high density and full coverage in a higher norwood like this with only 4500 scalp grafts, especially with short hair.

Dr Zarev implants about 13.000 scalp grafts on simillar cases like this one in order to achieve good density, as you can see below...
 

 

Edited September 5, 2023 by BaldGuy

[jjalay]

1 hour ago, BaldGuy said:

The result looks pretty good for such a huge area. Also 1250 beard grafts were used which are single hairs and they dont give good coverage as scalp hairs which are multi grafts. Also beard hairs do not behave like scalp hairs, which affects the coverage too.
You cant expect high density and full coverage in a higher norwood like this with only 4500 scalp grafts, especially with short hair.

Dr Zarev implants about 13.000 scalp grafts on simillar cases like this one in order to achieve good density, as you can see below...
 

 

You really can`t compare these two cases. This is a NW-7 patient and these 13.000 grafts were uses not only for the front but to cover the front, midscalp and a huge crown. If we had the total breakdown of the grafts i am preety sure that the number of grafts used from Dr. Zarev to cover the front and midscalp were about 6000 grafts.

Also we don`t know how many from these 13000 grafts were bodyhair and how many from the scalp grafts were splitted in order to create more grafts.

[BackFromTheBrink]

27 minutes ago, jjalay said:

 

Also we don`t know how many from these 13000 grafts were bodyhair and how many from the scalp grafts were splitted in order to create more grafts.

Zarev rarely used body hair. There are several Norwood 6/7 cases where he extracted 10k plus scalp follicles.

[Turkhair]

6 hours ago, Kashnw7hope said:

Melvin , I understand your point but the thing is that HLC of 2023 is not HLC of 2015 . They have many unknown Drs doing surgeries left and right (Factory Assembly line) now which may have not been the case a decade ago .They increased their volume so expectedly quality dropped and a lot of us trusted that they are one of the best based on their past results not what they became now. As you know we have very limited donor and limited ability to scar the donor tissue   . In my case , I had both my scalp and immediate high quality post-op pictures analyzed by two surgeons and they confirmed that HLC misrepresented the grafts amount implanted per sq cm . There is no gray area here . In my case I paid 15k USD and others who paid tens of thousands just to get what a Serkan or Emrah would provide them in Istanbul for one tenth of the price on top of their donor scarred . It s a bit painful when people attack us as if we did not do our research and had unreasonable expectations . 

Your density is amazing and clearly you had great graft survival. Your lateral humps had been reinforced too. 

You haven’t shown how your hairs behave when fully grown out and styled.

 

[jjalay]

57 minutes ago, Turkhair said:

Your density is amazing and clearly you had great graft survival. Your lateral humps had been reinforced too. 

You haven’t shown how your hairs behave when fully grown out and styled.

 

If this is amazing density with great survival rate, well i don`t want this, better stay bald.

I don"t know how the patient is looking now because the photo is at 7 months postop.. But if it stayed like this its not only that it will look as poor growth but it will look weird too. Kashnw7hope sorry for my words, i don`t mean to offend you in anyway.

[Melvin- Admin]

1 hour ago, jjalay said:

If this is amazing density with great survival rate, well i don`t want this, better stay bald.

I don"t know how the patient is looking now because the photo is at 7 months postop.. But if it stayed like this its not only that it will look as poor growth but it will look weird too. Kashnw7hope sorry for my words, i don`t mean to offend you in anyway.

Again, this is a COMPLETELY reasonable 7 month result for 5,200 grafts on the treated surface area. To achieve the “illusion” of density you need at least 45 grafts per cm2. The top of the balding area is around 175-200 cm2, excluding the central and posterior crown (changes based on head size/shape). For this patient the anterior crown wasn’t restored, so the area treated was less at 123 cm2. 

45 grafts is the minimum for the “illusion of density. However, with short hair you’ll need around 60 grafts per cm2 to have visual density. This is because you cannot get away with the “illusion” of density when you’re unable to layer your hair over your scalp. Which means he would have needed 7,380 grafts in that area to achieve visual density. 

For 7 months and for the number of grafts- this is not a bad result. Hair transplants are not perfect. Please consider abandoning the idea of getting a hair transplant if this is unacceptable.

[jjalay]

32 minutes ago, Melvin- Moderator said:

Again, this is a COMPLETELY reasonable 7 month result for 5,200 grafts on the treated surface area. To achieve the “illusion” of density you need at least 45 grafts per cm2. The top of the balding area is around 175-200 cm2, excluding the central and posterior crown (changes based on head size/shape). For this patient the anterior crown wasn’t restored, so the area treated was less at 123 cm2. 

45 grafts is the minimum for the “illusion of density. However, with short hair you’ll need around 60 grafts per cm2 to have visual density. This is because you cannot get away with the “illusion” of density when you’re unable to layer your hair over your scalp. Which means he would have needed 7,380 grafts in that area to achieve visual density. 

For 7 months and for the number of grafts- this is not a bad result. Hair transplants are not perfect. Please consider abandoning the idea of getting a hair transplant if this is unacceptable.

In this case you say 5200 grafts are not enough to achieve visual density and this bas result is reasonable. In this case:

you say 4000 grafts were to many to cover the hairline and the midscalp and you are not impressed. This behaviour doesnt make any sense to me. I think i ve proved everything i have said about the number of grafts needed in higher nordwoods and acceptable results with facts and articles from elite doctors, not with my personal experience.

I dont want to put this thread off tract. You have a reason for what you are saying and i am ok with that. At the end people can see results and judge from themselves.

[BaldGuy]

9 hours ago, jjalay said:

You really can`t compare these two cases. This is a NW-7 patient and these 13.000 grafts were uses not only for the front but to cover the front, midscalp and a huge crown. If we had the total breakdown of the grafts i am preety sure that the number of grafts used from Dr. Zarev to cover the front and midscalp were about 6000 grafts.

Also we don`t know how many from these 13000 grafts were bodyhair and how many from the scalp grafts were splitted in order to create more grafts.

They are similar cases with similar low lateral humps. if the op would use 13 k grafts then he would have high density. With 4500 scalp grafts he cant expect miracles and high densities...beard hairs do not give good ceverage like scalp hairs and they dont behave like scalp hairs( for example you cant comb the beard hairs easily in one direction etc..). Also Beard hairs have a shorter anagen phase and may be in a catagen phase, which means less hairs on the scalp every time.
Also in the Zarev's example all 13.000 grafts were scalp hairs, no beard hairs as he says on the video.

So definitely the op's result is pretty good considering his large area and his low lateral humps.

Edited September 6, 2023 by BaldGuy

[jjalay]

25 minutes ago, BaldGuy said:

They are similar cases with similar low lateral humps. if the op would use 13 k grafts then he would have high density. With 4500 scalp grafts he cant expect miracles and high densities...beard hairs do not give good ceverage like scalp hairs and they dont behave like scalp hairs( for example you cant comb the beard hairs easily in one direction etc..). Also Beard hairs have a shorter anagen phase and may be in a catagen phase, which means less hairs on the scalp every time.
Also in the Zarev's example all 13.000 grafts were scalp hairs, no beard hairs as he says on the video.

So definitely the op's result is pretty good considering his large area and his low lateral humps.

Again as i said to you before, let people see the pictures and judge from their own. You can say black is white and white is black for whatever reason you have but i am not willing to believe you.

[BaldGuy]

8 minutes ago, jjalay said:

Again as i said to you before, let people see the pictures and judge from their own. You can say black is white and white is black for whatever reason you have but i am not willing to believe you.

Yes people can judge i agree...I am not willing to believe you either, you can say whatever makes you happy for your own reasons.

Edited September 6, 2023 by BaldGuy

[Drew-83]

I'm back on my thread and reply to those who say that you have to keep your hair long to simulate density... maybe it's not my case because that practically empty area is less known to short hair as you can see from the picture

And in any case I just heard from the consultant at the clinic who told me that hairs probably didn't grow back there or they were very thin, offering me a touch up. I am convinced that, as shown in the post-op photo, something is missing there, it is not just a matter of density.

 

[Turkhair]

11 hours ago, jjalay said:

If this is amazing density with great survival rate, well i don`t want this, better stay bald.

I don"t know how the patient is looking now because the photo is at 7 months postop.. But if it stayed like this its not only that it will look as poor growth but it will look weird too. Kashnw7hope sorry for my words, i don`t mean to offend you in anyway.

If this is unacceptable to you yeah stay bald. 

 

Edited September 6, 2023 by Turkhair

[Melvin- Admin]

8 hours ago, jjalay said:

In this case you say 5200 grafts are not enough to achieve visual density and this bas result is reasonable. In this case:

you say 4000 grafts were to many to cover the hairline and the midscalp and you are not impressed. This behaviour doesnt make any sense to me. I think i ve proved everything i have said about the number of grafts needed in higher nordwoods and acceptable results with facts and articles from elite doctors, not with my personal experience.

I dont want to put this thread off tract. You have a reason for what you are saying and i am ok with that. At the end people can see results and judge from themselves.

This will be my last reply. We’ve de-railed this thread enough.

First of all, I never said the results were bad. I said they’re okay, which they are, okay means satisfactory. Not amazing like this patient claimed. You’re comparing someone who already has a lot of native hair in the same area. 

Secondly, you’re comparing someone who was bald, to someone who had a lot of native hair. Look at the comparison, there’s no way these two patients require the same number of grafts. Not the same comparison at all.

Thirdly, this patient has long hair and is combing his hair forward creating an “illusion” of density. Again, not a fair comparison because this patient would look much different, if he was buzzing his hair and didn’t have the layering effect by combing forward. 

Lastly, this patient took finasteride right before his procedure. So, it’s hard to distinguish how much of his result is the hair transplant, and how much is from medication thickening the rest of the the thinning zones that had a lot of hair, but were miniaturized.

@Drew-83 I think your results are reasonable/okay. They’re definitely not amazing or fantastic. But if the clinic has offered a free touch-up, that shows they’re ethical in my opinion. They certainly didn’t have to offer one.

[GeneralNorwood]

For me this matter is simple. Although the treated area was big and OP needed second procedure for the crown, HLC promised him uniform result in the first surgery. And they didn't deliver uniform result. 

Now HLC admitts that something went wrong and they offer a touch up. However, midscalp doesn't need a" touch up", but far more, 1000 grafts i would say. 

 

My advice. Don't go back to HLC, find a new clinic that will make you tailored plan. 

[Stewie]

But surely HLC have planned to hit the key areas, hairline and humps to reinforce the illusion and get a good style to run with? I have looked through all the thread and am struggling to see what the problem is? he has great density around the hairline and humps and like GN pointed out the mid scalp was not really touched, but reading through I agree maybe the clinic should of stated their intentions! This is not a failed HT and there is nothing wrong with the final result

My hair is super thin and now after my third surgery and more bald than this have had around 10500 and only just started growing it 7 months into my third surgery and now with 1.5 inches in length I am really surprised how well the thin hair on top is hidden and how good it looks

And I totally agree that if the intention is to keep the hair short then your never going to look in the mirror and think this looks natively thick, it just can't happen?

HLC for me have always had quite stand out results and I don't think they have done a bad job here at all

[GeneralNorwood]

20 minutes ago, Stewie said:

HLC for me have always had quite stand out results and I don't think they have done a bad job here at all

Well, they didn't botched him, but it is easy to understand why OP is dissapointed. They surely didn't tell him before operation, that they are going to implant less grafts on the midscalp. And now they can only pitch him excuses. 

[Stewie]

30 minutes ago, GeneralNorwood said:

Well, they didn't botched him, but it is easy to understand why OP is dissapointed. They surely didn't tell him before operation, that they are going to implant less grafts on the midscalp. And now they can only pitch him excuses. 

Surely there was some sort of conversation about the approach? But saying that I asked Eugenix to solely just give me density across my whole head and they choose to load the hairline, yeah it looks good but tbh it was not what I asked for or wanted, but I am where I am

This is not a bad result and can be easily sorted for sure?