What % of docs are actually good?

[Rafael Manelli]

Title says it all really. I’m curious what proportion of clinics actually do a great job. 60%? 20%? 5%? 
 

If you had to guess? And what’s your reasoning based on?

[A_4_Archan]

No wild guesses frm my side 😅

[Gatsby]

If you were to really consider the amount of clinics out there the answer would lie in a figure of less than 1%. That is not just a reflection on the vast number of hair mills, cosmetic surgeons who are a Jack of all trades, etc. It's also on the consistently poor results.

[Fue3361]

Hm.  Maybe 2%.   

[NegativeNorwood]

I don't know the exact %, but the ones that post pictures taken with a camera (not phone, to avoid lens distortion) that show the hair slicked back (both dry and wet) and combing the hair, in addition of pics of the donor area before, inmediate post op and 1 year after are the truly good ones (and of course, the results presented must be good, one can take such detailed and honest pictures to show bad work too).

I can only judge properly if I see valid pictures that do not lie and let me make a proper judgement, if the clinic doesn't present it's pictures like described above, I assume it's mediocre at best because is hiding something on purpose, as a proper camera starts around 800$ new, and the notion that clinics that make 5 or even 6 figures per month can't buy one is ridiculous, they can but they don't want. Same with taking pictures with the hair combed down and at low resulotion...it's because they want to do it, not because they can't take honest, high quality pictures as described above.

To find an exact %, we should find the amount of clinics that present their work with honest, high quality pictures, then the complete number of hair transplant clinics in the entire world and do the math to get an exact %

At the moment I see Zarev, Dr Munib Ahmad (Fuegenix), Feriduni, Couto (FUExpert) and Konior meeting those standards. Probably with an extensive research here we can find another 4 or 5 hair clinics that present their work in the same way IMO. Idk how many hair transplant clinics exist in the world, but the % that meet such a simple standard could very well be around 0.00001% as a guess.

Edited February 7, 2023 by NegativeNorwood

[Rafael Manelli]

15 minutes ago, NegativeNorwood said:

I don't know the exact %, but the ones that post pictures taken with a camera (not phone, to avoid lens distortion) that show the hair slicked back (both dry and wet) and combing the hair, in addition of pics of the donor area before, inmediate post op and 1 year after are the truly good ones (and of course, the results presented must be good, one can take such detailed and honest pictures to show bad work too).

I can only judge properly if I see valid pictures that do not lie and let me make a proper judgement, if the clinic doesn't present it's pictures like described above, I assume it's mediocre at best because is hiding something on purpose, as a proper camera starts around 800$ new, and the notion that clinics that make 5 or even 6 figures per month can't buy one is ridiculous, they can but they don't want. Same with taking pictures with the hair combed down and at low resulotion...it's because they want to do it, not because they can't take honest, high quality pictures as described above.

To find an exact %, we should find the amount of clinics that present their work with honest, high quality pictures, then the complete number of hair transplant clinics in the entire world and do the math to get an exact %

At the moment I see Zarev, Dr Munib Ahmad (Fuegenix), Feriduni, Couto (FUExpert) and Konior meeting those standards. Probably with an extensive research here we can find another 4 or 5 hair clinics that present their work in the same way IMO. Idk how many hair transplant clinics exist in the world, but the % that meet such a simple standard could very well be around 0.00001% as a guess.

0.00001%? How many HT docs do you think there are exactly? 100 million? 😂

I think there are more bad clinics than good ones, but I do wonder if online forums trick themselves into thinking they're an exclusive club. Every clinic wants to say it's one of the few good ones after all. 

[NegativeNorwood]

28 minutes ago, Rafael Manelli said:

0.00001%? How many HT docs do you think there are exactly? 100 million? 😂

I think there are more bad clinics than good ones, but I do wonder if online forums trick themselves into thinking they're an exclusive club. Every clinic wants to say it's one of the few good ones after all. 

Yeah that probably was an exaggeration on my part.

I did a quick google search, and one site says: choose over 250 hair transplant clinics in Europe. Probably there are more that do not pay to be registered there, let's assume there are 300 in Europe.

ISHRS has 1000 members worlwide.

I think 1500-2000 hair transplant clinics around the world would be fair assumption.

If there are 2000 ht clinics in the world, and I could find 5 that meet those standards (assuming they are the only ones that do it), it would mean only 0.25% are top tier.

Edited February 7, 2023 by NegativeNorwood

[Rafael Manelli]

9 minutes ago, NegativeNorwood said:

Yeah that probably was an exaggeration on my part.

I did a quick google search, and one site says: choose over 250 hair transplant clinics in Europe. Probably there are more that do not pay to be registered there, let's assume there are 300 in Europe.

ISHRS has 1000 members worlwide.

I think 1500-2000 hair transplant clinics around the world would be fair assumption.

If there are 2000 ht clinics in the world, and I could find 5 that meet those standards (assuming they are the only ones that do it), it would mean only 0.25% are top tier.

Is Turkey considered part of Europe by this website? Does the website list 90% of all doctors who do HT (not even HT exclusive docs, but any doc who does HT)? Or is it more like 50%? Or 10%? I just don't have enough information to say. 

I could name maybe 5 surgeons in the UK. 4 in Belgium. I could name 2 in the whole of South America.  How many more are there? What proportion of them are members of ISHRS etc? I don't have a clue. I must confess my ignorance. 

I suspect maybe less than 10% are good quality. Maybe more. Maybe even less. Insane to think it's even less though. We're all incredibly lucky to be here if it's 1 or 2%, since that means we're dodging a 98% chance of going to a mediocre or poor clinic. 

What % of patients even go on forums? I've read that at least 700,000 HTs are done a year. I think that's from data collated by one of these big orgs like ISHRS. There are many docs who aren't affiliated with them so maybe the real number is a million. 

There are not a million active users of this forum. Are there a million lurkers who read but don't post? I don't know. 

But I find the subject interesting. 

[NegativeNorwood]

7 minutes ago, Rafael Manelli said:

Is Turkey considered part of Europe by this website? Does the website list 90% of all doctors who do HT (not even HT exclusive docs, but any doc who does HT)? Or is it more like 50%? Or 10%? I just don't have enough information to say. 

I could name maybe 5 surgeons in the UK. 4 in Belgium. I could name 2 in the whole of South America.  How many more are there? What proportion of them are members of ISHRS etc? I don't have a clue. I must confess my ignorance. 

I suspect maybe less than 10% are good quality. Maybe more. Maybe even less. Insane to think it's even less though. We're all incredibly lucky to be here if it's 1 or 2%, since that means we're dodging a 98% chance of going to a mediocre or poor clinic. 

What % of patients even go on forums? I've read that at least 700,000 HTs are done a year. I think that's from data collated by one of these big orgs like ISHRS. There are many docs who aren't affiliated with them so maybe the real number is a million. 

There are not a million active users of this forum. Are there a million lurkers who read but don't post? I don't know. 

But I find the subject interesting. 

 

Yes the website that said choose over clinics in Europe had turkish clinics.

There are a lot more surgeons out there with either no websites or that can't be bothered to pay a forum or even a specialized online platform, only relying in general doctor/health oriented websites, sharing space with dentists, plastic surgeons, etc.

I googled "hair transplant" in my city (in Spain) and found 3 doctors, one of them without a website and only a single case (very bad outcome) posted in Recuperatupelo (spanish forum). The city where I live has a 250k population, imagine how many of them are in a city like Madrid, Barcelona or even New York or Istanbul.

The subject itself is quite interesting, I still mantain that the number is less than 1% worlwide.

No related to hair, but I searched for a dentist (worldwide) 2 years for a very specific subject, and found 5 capable of doing what I'm interested in at high standards, 3 of them in Spain, one at a 50 km distance (imagine googling for years in english when the answer is practically next to you without any form of adverising). So searching for the best professional (in any field) can be full of surprises, I have no doubt about it.

I know for experience in other forums that the people that gets the most surgeries are the ones that already have the cash, take the time to lurk, dm users directly and don't even post. Probably less than 10% post their results IMO.

[mrmane85]

On 2/7/2023 at 9:30 PM, NegativeNorwood said:

I don't know the exact %, but the ones that post pictures taken with a camera (not phone, to avoid lens distortion) that show the hair slicked back (both dry and wet) and combing the hair, in addition of pics of the donor area before, inmediate post op and 1 year after are the truly good ones (and of course, the results presented must be good, one can take such detailed and honest pictures to show bad work too).

I can only judge properly if I see valid pictures that do not lie and let me make a proper judgement, if the clinic doesn't present it's pictures like described above, I assume it's mediocre at best because is hiding something on purpose, as a proper camera starts around 800$ new, and the notion that clinics that make 5 or even 6 figures per month can't buy one is ridiculous, they can but they don't want. Same with taking pictures with the hair combed down and at low resulotion...it's because they want to do it, not because they can't take honest, high quality pictures as described above.

To find an exact %, we should find the amount of clinics that present their work with honest, high quality pictures, then the complete number of hair transplant clinics in the entire world and do the math to get an exact %

At the moment I see Zarev, Dr Munib Ahmad (Fuegenix), Feriduni, Couto (FUExpert) and Konior meeting those standards. Probably with an extensive research here we can find another 4 or 5 hair clinics that present their work in the same way IMO. Idk how many hair transplant clinics exist in the world, but the % that meet such a simple standard could very well be around 0.00001% as a guess.

You can also add Freitas and Pinto.

Both present their work with high quality pictures and detail. 

For top surgeons this should be the standard and not the exception.

Edited March 3, 2023 by mrmane85

[NegativeNorwood]

11 minutes ago, mrmane85 said:

You can also add Freitas and Pinto.

Both present their work with high quality pictures and detail. 

For top surgeons this should be the standard and not the exception.

 

Agree, can't be a top clinic and not have detailed, honest pictures.

"Trust me bro, they have great reputation" doesn't cut it.

 

[Digs49]

@NegativeNorwood what about H&W and Pittella?

[ready4Hair]

Well to be honest, even the clinics that do show detailed pictures only do so for their superior results.  So the question goes even deeper; which clinics produce good verifiable results, and which do so on the majority of patients they see? We've seen enough anecdotes here where patients are either threatened with legal recriminations and/or bullied/bartered into taking their poor results down.

Curious where you would put Eugenix on this list?

[BackFromTheBrink]

15 minutes ago, ready4Hair said:

Well to be honest, even the clinics that do show detailed pictures only do so for their superior results.  So the question goes even deeper; which clinics produce good verifiable results, and which do so on the majority of patients they see? We've seen enough anecdotes here where patients are either threatened with legal recriminations and/or bullied/bartered into taking their poor results down.

Curious where you would put Eugenix on this list?

It's all completely subjective. That's both in how you assess the quality of a result and where you draw the line as to what is a 'top clinic'.

It's like asking what percentage of all musicians are actually good.

From NegativeNorwood's perspective we'd be able to rule out any that don't use extremely high fidelity recording equipment. 

Some are technically good (using metrics such as note and pitch accuracy, variation from perfect timing etc). I'd argue that is more data than we have for hair transplants since we cannot possibly tell the graft survival rate with any accuracy, the consistency of the extraction pattern etc. That's even if we could decide what factors constitute a good result. 

In both cases there's then the artistry, which cannot be measured scientifically.

In summary, the answer is 12.37%. Now prove me wrong 😉

 

 

Edited March 25, 2023 by BackFromTheBrink

[ready4Hair]

14 minutes ago, BackFromTheBrink said:

It's all completely subjective. That's both in how you assess the quality of a result and where you draw the line as to what is a 'top clinic'.

It's like asking what percentage of all musicians are actually good.

From NegativeNorwood's perspective we'd be able to rule out any that don't use extremely high fidelity recording equipment. 

Some are technically good (using metrics such as note and pitch accuracy, variation from perfect timing etc). I'd argue that is more data than we have for hair transplants since we cannot possibly tell the graft survival rate with any accuracy, the consistency of the extraction pattern etc. That's even if we could decide what factors constitute a good result. 

In both cases there's then the artistry, which cannot be measured scientifically.

In summary, the answer is 12.37%. Now prove me wrong 😉

 

 

I agree there is a certain level of subjectivity in terms of the 'look'. A lot of HTs came out well where I really do not like the look.

However there is certainly a level of objective metrics.

We can all see certain clinics/surgeons just turn out subpar results too often. Poor planning, poor survival rates etc.

I don't know if I rule out non high-fidelity photography clinics per se.

I tend to look at reviews here (patient results not doctors) the same way I do with anything online; I know there will be SOME unhappy customers (I always joke that if Heaven were on Amazon it wouldn't get more than a 4.8) but the key is finding if there are consistent complaints that.

With HTs I *immediatly* write off a doc when I see the patient experienced either pressure from the doc/rep to not report or they get some runaround (e.g. 'wait a year' when it is clear there is an issue). To me top of the list would be a doc/clinic that cares at least as much after the HT as they do when they are trying to get your business. That should be the fountainhead to the rest...

[BackFromTheBrink]

Looking at that way I'd say it'd be easiest to work out what percentage of clinics are bad, where one or more of the following are true:

- poor aftercare

- poor donor management 

- poor placement 

- poor planning 

- poor ethics 

- poor growth rates and resulting density 

- poor value

That way we wouldn't be trying to distinguish the elite from the good clinics.

With that criteria and considering the number of hair mills, I'd say there are probably 70% 'bad'.

 

 

 

Edited March 25, 2023 by BackFromTheBrink

[ready4Hair]

56 minutes ago, BackFromTheBrink said:

Looking at that way I'd say it'd be easiest to work out what percentage of clinics are bad, where one or more of the following are true:

- poor aftercare

- poor donor management 

- poor placement 

- poor planning 

- poor ethics 

- poor growth rates and resulting density 

- poor value

That way we wouldn't be trying to distinguish the elite from the good clinics.

With that criteria and considering the number of hair mills, I'd say there are probably 70% 'bad'.

 

 

 

I think that is a much better place to start.

Poor Planning probably also encompasses:

- Managing Patient expectations

- Accurately assessing donor (density, caliber, groupings) prior to surgery

- Taking into account age, miniaturization, donor area

Value would be a tough one. For instance Dr. Basal is quoting around $24k for 4800 grafts, Dr. Freitas as far as I know (and Dr. Bisanga) would be considerably lower. Eugenix is in India meaning this is premium cost, approaching even Dr. Hasson. So how do we determine value? It isn't just final cost right? Value would be some formula of cost / donor management + esthetic placement + graft survival rate. In my case, for now, I lean towards Dr. Basal (since she seems to do temples as a matter of course vs Dr. Freitas who does great hairlines but so far I see few examples of temples) so "estethic placement" goes up even though cost does.

It gets complex for sure, I'm guessing however there are at the end of the day truly only a handful of clinics or more to the point surgeons that can consistently pull off good and lasting results with the remaining being at least acceptable growth, with few to no failures and where there are less than stellar results amazing aftercare. compassion and when needed touch-up work. A handful as in... 8-24 clinics worldwide IMHO.

[BackFromTheBrink]

By value I was trying to make sure we weren't expecting the same from a $10 surgeon as a $2 dollar one. Both can be good clinics, and not everyone can afford the top tier.

Would Dr Gur get on your good list, for example? He would mine, especially when taking value into consideration. Would I expect as efficient use of grafts as Dr C-o-l-e? Probably not.

Edited March 25, 2023 by BackFromTheBrink

[ready4Hair]

1 hour ago, BackFromTheBrink said:

By value I was trying to make sure we weren't expecting the same from a $10 surgeon as a $2 dollar one. Both can be good clinics, and not everyone can afford the top tier.

Would Dr Gur get on your good list, for example? He would mine, especially when taking value into consideration. Would I expect as efficient use of grafts as Dr C-o-l-e? Probably not.

I don't know Dr. Gur.

From my recent research AFAIK Dr. Couta would be far and away the best. Dr. Freitas, Dr. Ferudini.  So far Eugenix with Dr. Basal or Dr. Sethi seems a good bet and every single review  I read lauds the cleanliness and efficiency of the facility and the care/after-care. But they can range from under $2 a graft to over $5 and I'm not sure yet how to discern the difference in care/results w/o a deep dive.

I seem to remembe Dr. Vorhies here in US had some good results but I don't see him mentioned.

Also as you know, at least with Turkish clinics, the low prices and demand turn even great clinics into Mills as everyone flocks there (see Asmed).

 

[BackFromTheBrink]

Eugenix do seen to be the darling of the forum, but usually at the top of their offerings. Dr Couta is a similar price ($6).

I believe there are 'good' doctors at $2-3 also, but I wouldn't choose one if could afford $10.

[ready4Hair]

Dr freitas us IMHO a far better cost benefit

[ready4Hair]

As it stands now I'd only do Dr basal Dr sethi Dr freitas Dr feriduni. Dr Coutas 3 year wait makes him out of reach for me

[Judelaw]

On 3/3/2023 at 3:45 PM, NegativeNorwood said:

Agree, can't be a top clinic and not have detailed, honest pictures.

The demand for transplants is so high that it literally doesn’t matter for elite surgeons. It’s like selling a new iPhone on eBay, you can take one picture of it on the toilet and it will sell immediately if priced $1 too cheap. 

What does a clinic with a constant wait list gain from hiring a team to promote results? 

[ready4Hair]

7 minutes ago, Judelaw said:

The demand for transplants is so high that it literally doesn’t matter for elite surgeons. It’s like selling a new iPhone on eBay, you can take one picture of it on the toilet and it will sell immediately if priced $1 too cheap. 

What does a clinic with a constant wait list gain from hiring a team to promote results? 

Ask Asmed...

 

[Judelaw]

18 minutes ago, ready4Hair said:

Ask Asmed...

 

That’s a perfect example, Asmed spent huge money on marketing, grew way too fast, and the quality of work deteriorated.

Growing too fast is the most dangerous thing for a business and I guarantee there are world-class surgeons who would cringe at the thought of a 3-year waitlist.