Senior Member mr_peanutbutter Posted February 23 Senior Member Share Posted February 23 dr.zarev does the best results on high norwoods and the reason is that he can extract an amazing high amount of grafts without letting the donor area left like it was destroyed. he stated several times this is mostly to a self constructed extraction device which he blurs in his videos as brilliant as dr.zarev is i dont think he has a degree in medical engineering so im wondering if that device is really that groundbeaking different from what others surgeons use and why no other surgeon has to tried to develop something similar? 1 Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted February 23 Senior Member Share Posted February 23 4 hours ago, mr_peanutbutter said: dr.zarev does the best results on high norwoods and the reason is that he can extract an amazing high amount of grafts without letting the donor area left like it was destroyed. he stated several times this is mostly to a self constructed extraction device which he blurs in his videos as brilliant as dr.zarev is i dont think he has a degree in medical engineering so im wondering if that device is really that groundbeaking different from what others surgeons use and why no other surgeon has to tried to develop something similar? The thing is, the device is only as good as the person using it. You cannot automate its usage like an ARTAS robot for example. How I understand it, it is gentle enough to dislodge the graft where a precise hand movement is then required to pluck it out without causing too much damage. Imagine pulling a carrot out of the ground for example. The tool will make the surrounding soil more loose, but you still have to pull out the carrot in the right manner without damaging the other nearby carrots. 2 Link to comment Share on other sites More sharing options...
Senior Member mr_peanutbutter Posted February 26 Author Senior Member Share Posted February 26 On 2/24/2024 at 6:21 AM, asterix0 said: The thing is, the device is only as good as the person using it. You cannot automate its usage like an ARTAS robot for example. How I understand it, it is gentle enough to dislodge the graft where a precise hand movement is then required to pluck it out without causing too much damage. Imagine pulling a carrot out of the ground for example. The tool will make the surrounding soil more loose, but you still have to pull out the carrot in the right manner without damaging the other nearby carrots. how can be the only providing such good results though i dont think he is one of a million regarding hand-eye controll Link to comment Share on other sites More sharing options...
Senior Member Rawkerboi Posted February 26 Senior Member Share Posted February 26 6 hours ago, mr_peanutbutter said: how can be the only providing such good results though i dont think he is one of a million regarding hand-eye controll May be is indeed on in a million with that kind of skill. Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted February 26 Senior Member Share Posted February 26 8 hours ago, mr_peanutbutter said: how can be the only providing such good results though i dont think he is one of a million regarding hand-eye controll Well, probably even you and I could do it a few times. The key is to have the stamina and focus to do it thousands and thousands of times in consecutive time intervals. This seems very hard to do. Link to comment Share on other sites More sharing options...
Moderators Al - Moderator Posted February 26 Moderators Share Posted February 26 I will say Zarev does the cleanest work I've ever seen. Immediately after the HT you can hardly tell the patient had work done. 1 Al Forum Moderator (formerly BeHappy) I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here. Link to comment Share on other sites More sharing options...
Regular Member MC117 Posted February 28 Regular Member Share Posted February 28 This is literally12 hours after 2k grafts extraction haha 😅 He developed the tool with a french start up, based on ava Fue but customized. Cleanest donors I've seen since I started browsing HT cases 8 years ago. 4 Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted February 28 Valued Contributor Share Posted February 28 What's even more amazing is that he is doing this without using stereoscopic microscopes. He has shared his mapping of the scalp which in itself is quite something however he still will not share anymore to the hair transplant industry about his surgical details. He reminds me a little of Dr Ray Woods here in Sydney twenty years ago. The results for Dr Zarev however speak for themselves. 👌 GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Regular Member ScottishGuy21 Posted February 28 Regular Member Share Posted February 28 From the limited info around on his device it’s much more like a suction tool. Which in his eyes causes less trauma and damage to both the follicle and surrounding tissue area. Something which the results above just hours after surgery strongly support. Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted February 28 Regular Member Share Posted February 28 (edited) Is there any reason to not choose Dr Zarev ? Presumably getting a consultation and booking surgery is now very challenging given his results Edited February 28 by BlueSkyDay Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted February 29 Senior Member Share Posted February 29 17 hours ago, BlueSkyDay said: Is there any reason to not choose Dr Zarev ? Presumably getting a consultation and booking surgery is now very challenging given his results years of waiting and for some people understandably the price is high. Link to comment Share on other sites More sharing options...
Regular Member Fox243 Posted February 29 Regular Member Share Posted February 29 On 2/28/2024 at 12:39 AM, MC117 said: This is literally12 hours after 2k grafts extraction haha 😅 He developed the tool with a french start up, based on ava Fue but customized. Cleanest donors I've seen since I started browsing HT cases 8 years ago. I literally see no scars Link to comment Share on other sites More sharing options...
Regular Member LeonBlack Posted February 29 Regular Member Share Posted February 29 1 hour ago, Fox243 said: I literally see no scars That is really incredible. This is mine about 12 hours after 800 FUE. Link to comment Share on other sites More sharing options...
Senior Member mr_peanutbutter Posted March 1 Author Senior Member Share Posted March 1 On 2/28/2024 at 1:39 PM, MC117 said: This is literally12 hours after 2k grafts extraction haha 😅 He developed the tool with a french start up, based on ava Fue but customized. Cleanest donors I've seen since I started browsing HT cases 8 years ago. seee…why are no other doctors trying to get this? i feel like much doctors got way too comfortable and dont try to to search way of improvementa really…whether thats verteporfin or a new device Link to comment Share on other sites More sharing options...
Senior Member mr_peanutbutter Posted March 1 Author Senior Member Share Posted March 1 On 2/29/2024 at 5:03 AM, BlueSkyDay said: Is there any reason to not choose Dr Zarev ? Presumably getting a consultation and booking surgery is now very challenging given his results right now only @DrMunibAhmadcan challenge him but he doesnt has much high norwood cases as far as i know Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted March 23 Regular Member Share Posted March 23 (edited) So most doctors use motorised FUE. According to Dr Zarev - Extraction trauma from motorised FUE remains the same as in the case of manual technique, as the number of damaged grafts is likewise between 20% and 30 %. So every time you harvest 1000 grafts, 200 to 300 grafts are damaged. Are surgeons selling defective services, or is Dr Zarev mistaken. Dr Zarev states that he used to use manual and motorised punches but has moved to the advanced extraction method called AVA FUE (Automatic Vacuum assisted FUE). This method avoids damaging and extracting unnecessary tissue. So less tissue is extracted, meaning less damage, less scarring, less scabs, less recovery, more available grafts. The risk of damage to the extracted graft is reduced to a minimum. The quality of the grafts is Guaranteed. The graft survival rate is 95% to 98% (Source: Dr Zarev's web- site). So why keep buying sub-standard transplant services from surgeons. Dr Zarev has shone a light on the practices of all surgeons performing motorised and manual FUE. Dr Zarev is saying that the damage to grafts in reality between 20% and 30% - the patient will never really know how much damage the surgeon is doing anyway. Having spoken to 3 surgeons recently, the motorised FUE appears to be the standard extraction method, the manual FUE is too slow and if its used today will be used by techs instead of doctors. Donor management is critical, so it makes sense to avoid motorised FUE - (assuming the 20% to 30% damage asserted by Dr Zarev is correct) Edited March 24 by BlueSkyDay Clarity 1 Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted March 24 Regular Member Share Posted March 24 Vacuum power assisted FUE extracts individual follicular units without the use of foreceps. This reduces the trauma on the grafts while harvesting. 1 Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted March 24 Regular Member Share Posted March 24 Dr Robert Trevillini developed a vacuum assisted FUE device as well - Trevillini system ( similar to NEOGRAFT system). The traditional FUE method means the surgeon plays a game of chance with the patients donor area and the patient pays the surgeon to damage the donor area. Below is a quote from Dr Trevillini: We know that the angle of the hair changes as it emerges from the scalp because we are able to see it; it is tangible. However, what is beneath the epidermis is usually a puzzle for the FUE surgeon. In the three-dimensionality of a follicular unit, each hair usually has a different path from the bulb until its departure from the skin. The surgeon can only estimate this, since it is not visible. Axial movement applied to the punch by the surgeon’s hand during insertion undergoes changes of direction in its path as it penetrates the skin. This causes constant modification of the resulting force vectors in the dynamics of follicle extraction. Since the punch movement is unpredictable, its path and its geometrical shape are very irregular. Nevertheless, the surgeon’s hand movement is much better than the linear motion of the punch performed by a robotic arm. Given these realities, the advance of a punch blindly into the scalp almost becomes a game of chance in which there can only be a loser, the patient. We have developed a new device and technique for FUE that 1) improves the margin of safety in the extraction of the follicular unit, 2) provides better control of the punch movements into the scalp, and 3) facilitates safe removal of the follicular unit. Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted March 24 Regular Member Share Posted March 24 Dr Zarev uses AVA FUE. This appears to be very similar to NEOGRAFT FUE. NeoGraft® is a minimally-invasive follicular unit extraction (FUE) hair replacement method that safely harvests individual hair follicles and transplants them to areas affected by hair loss. This innovative hair transplant technology is the most advanced method on the market today. NeoGraft leaves behind no scars, includes a mere 48 hour recovery rate, and has a 92-98% success rate. my takeaway is that patients should avoid motorised and manual FUE- the surgeon or technician is playing a game of chance with you limited donor area. I will demand higher standards from my surgeon ensure your surgeon uses vacuum assisted FUE to avoid handling the grafts with forceps (traditional FUE uses forceps to pull out the grafts - this is another opportunity for the surgeon to damage your limited grafts) Link to comment Share on other sites More sharing options...
Senior Member mr_peanutbutter Posted March 24 Author Senior Member Share Posted March 24 (edited) 2 hours ago, BlueSkyDay said: Dr Zarev uses AVA FUE. This appears to be very similar to NEOGRAFT FUE. NeoGraft® is a minimally-invasive follicular unit extraction (FUE) hair replacement method that safely harvests individual hair follicles and transplants them to areas affected by hair loss. This innovative hair transplant technology is the most advanced method on the market today. NeoGraft leaves behind no scars, includes a mere 48 hour recovery rate, and has a 92-98% success rate. my takeaway is that patients should avoid motorised and manual FUE- the surgeon or technician is playing a game of chance with you limited donor area. I will demand higher standards from my surgeon ensure your surgeon uses vacuum assisted FUE to avoid handling the grafts with forceps (traditional FUE uses forceps to pull out the grafts - this is another opportunity for the surgeon to damage your limited grafts) is there a list of surgeons who uses neograft or ava fue? i wonder if dr ahmad from fuegenix uses vacum assisted fue as his result regarding the donor looks very similar Edited March 24 by mr_peanutbutter Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted March 24 Regular Member Share Posted March 24 I recommend reading "An Innovation in Suction Assisted FUE" by Roberto Trevillini. Best Practice today is Suction or Vacuum assisted FUE. The use of micro-engine punches is old technique. Patients are gambling with their remaining hair follicles if they Do not go the Suction Assisted FUE route. As Roberto says: “We know that the angle of the hair changes as it emerges from the scalp because we are able to see it; it is tangible. However, what is beneath the epidermis is usually a puzzle for the FUE surgeon. In the three-dimensionality of a follicular unit, each hair usually has a different path from the bulb until its departure from the skin. The surgeon can only estimate this, since it is not visible. Axial movement applied to the punch by the surgeon’s hand during insertion undergoes changes of direction in its path as it penetrates the skin. This causes constant modification of the resulting force vectors in the dynamics of follicle extraction. Since the punch movement is unpredictable, its path and its geometrical shape are very irregular. Nevertheless, the surgeon’s hand movement is much better than the linear motion of the punch performed by a robotic arm. Given these realities, the advance of a punch blindly into the scalp almost becomes a game of chance in which there can only be a loser, the patient. We have developed a new device and technique for FUE that 1) improves the margin of safety in the extraction of the follicular unit, 2) provides better control of the punch movements into the scalp, and 3) facilitates safe removal of the follicular unit.” Link to comment Share on other sites More sharing options...
Regular Member BlueSkyDay Posted March 24 Regular Member Share Posted March 24 (edited) I want to thank the poster of this topic. It caused me to do further research on FUE techniques. I read Dr Zarev's web-page covering the 3 FUE techniques : (1) The Latest AVA FUE (2) Previous : Motorised FUE (not vacuum assisted) (3) Original Manual FUE. Dr Zarev makes it clear that there is only 1 winner : Vacuum assisted FUE. He believes the other 2 technqiues are not in the Patients best Interests because the damage to the donor area and grafts is unacceptably high. He states 20% to 30% of grafts are damaged. Unnecessary tissue is extracted causing additional / avoidable scarring, more trauma, longer recovery. It is absolutely outrageous that the IAHRS allows its members to continue using the old FUE techniques. As a result of this thread and the research it led me to do, I have cancelled my surgery for 2 April. The Gold Standard today is Vacuum Assisted FUE (AVA / Neograft / Trevillini) performed by an IAHRS surgeon, with all the memberships, qualifications and results to back up. These Vacuum assisted FUE devices have (1) improved graft quality, (2) reduced transections, and (3) make it easier to remove the grafts without trauma If the surgeon does not post after surgery photos of the donor area then be suspicious. I noticed this problem with the surgeon I was dealing with. Be very careful out there - Its an absolute minefield out there! Edited March 24 by BlueSkyDay Clarity 1 Link to comment Share on other sites More sharing options...
Regular Member Gennox Posted March 24 Regular Member Share Posted March 24 But a lot of famous and reknown surgeons use manual punch, right? Like the Belgian surgeons, Dr Konior, Dr Nadimi. Please correct me if I am wrong. Link to comment Share on other sites More sharing options...
Senior Member hairman22 Posted March 24 Senior Member Share Posted March 24 26 minutes ago, BlueSkyDay said: I want to thank the poster of this topic. It caused me to do further research on FUE techniques. I read Dr Zarev's web-page covering the 3 FUE techniques : (1) The Latest AVA FUE (2) Previous : Motorised FUE (not vacuum assisted) (3) Original Manual FUE. Dr Zarev makes it clear that there is only 1 winner : Vacuum assisted FUE. He believes the other 2 technqiues are not in the Patients best Interests because the damage to the donor area and grafts is unacceptably high. He states 20% to 30% of grafts are damaged. Unnecessary tissue is extracted causing additional / avoidable scarring, more trauma, longer recovery. It is absolutely outrageous that the IAHRS allows its members to continue using the old FUE techniques. As a result of this thread and the research it led me to do, I have cancelled my surgery for 2 April. The Gold Standard today is Vacuum Assisted FUE (AVA / Neograft / Trevillini) performed by an IAHRS surgeon, with all the memberships, qualifications and results to back up. These Vacuum assisted FUE devices have (1) improved graft quality, (2) reduced transections, and (3) make it easier to remove the grafts without trauma If the surgeon does not post after surgery photos of the donor area then be suspicious. I noticed this problem with the surgeon I was dealing with. Be very careful out there - Its an absolute minefield out there! Great Post Other surgeons need to step up there game in regards to the extraction of grafts No doubt about it Link to comment Share on other sites More sharing options...
Valued Contributor Berba11 Posted March 24 Valued Contributor Share Posted March 24 59 minutes ago, BlueSkyDay said: It is absolutely outrageous that the IAHRS allows its members to continue using the old FUE techniques. Given that virtually no one is doing what Zarev is doing with donor areas, but many clinics are able to adequately transform their patient's hair loss troubles, this statement is plainly ludicrous. Is a technique like the one Zarev deploys better than the others? Maybe. That doesn't mean the other techniques are suddenly bad. Some of the best results we've ever seen pass through these forums are from motorized FUE extractions, and have left perfectly good donor areas at the same time. 1 Link to comment Share on other sites More sharing options...
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