Doctor and hair transplant comparison question

[Recession1]

Why is it that top doctors out of the US have have such better results as far as density and more aggressive hairlines that the most renown surgeons in the United States? Based off of pictures of top doctors in the US such as Robert Leonard, Rasmussen, Bernstein all of their before and after pictures seem like they lack density and aren’t aggressive with creating solid hairlines. Some of these clinics overseas with prominent doctors almost seem like they take patients with extensive hair loss and make them look like they haven’t even lost hair. Does anybody else agree with this? 

[duckling]

There are many factors which contribute to this (just my opinions):

1) in US, surgeons probably stuck to FUT as the gold standard and didn't move fast towards FUE when time was right.

• FUE opened new opportunities like harvesting out of the claimed "safe donor zone". this way surgeons could harvest more areas of scalp and now you see dr zarev taking out 10k + grafts from scalp itself. by taking out grafts in pattern such that donor doesnt look depleted.
• FUE enabled beard hair transplant and also hair transplant from other parts of body were later introduced. This enabled clinics like eugenix , pittella to give patients 11k+ lifetime grafts in some cases. this way scalp donor didnt look depleted.
• with FUT , you cannot do multiple seating so close and there is risk of too many big scars with multiple FUT. other parts of world combined FUT and FUE early. when they didnt have experience doing lot of FUE grafts a day

2)when US surgeons moved to FUE , some used ARTAS which ended up as a failure. when they thought it would be successful in future.

3)main thing is that cost was so high even with FUT technique in US, that the patients went to other parts of world and when you have huge number of cases which ultimately means more experience and more chance of bringing new innovative tweaks by surgeons to either their tool or their technique as they keep doing thousands of cases. 

although i think in US they dont overharvest(mostly) at cost of high density when doing FUE now and they stick to safe zone with FUT. so its not a bad thing as they are saving your donor but it does come at cost of lower satisfaction with density.

[A_4_Archan]

I would agree with @duckling in this plus US surgeons and specially some renowned one takes more conservative approach and some follow the surgical guidelines very strictly..for eg

- There is a chance of damaging the native hairs if you put grafts very near to the existing ones

- There is a chance of not geting enough blood supply to the transplanted hairs if you densely pack it

- There is a high chance that the hairloss progression would continue and the patient will need more surgeries in future so they use less grafts at one go comparatively 

- Some try to achieve age appropriate results and go conservative 

- Strictly harvesting from and remaining in safe donor

- Creating an illusion of density and not the real density as normal person without hairloss issue would have

This things makes a huge difference and for some this is a good approach and for some this is not...This is a subjective issue and people will have different views ...