Dr Zarev Vacuum Assisted Tecnique For Graft Extraction

werefckd

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There were big, explosive threads on other forums with certain FUT (mostly) surgeons claiming that FUE would never be able to get FUT yields. That FUT will always remain the gold standard.

These claims were only about 5 years ago too. Now, unless you have extremely fine caliber hair, exceptional scalp laxity, or are constrained by price, I think most people would agree that FUE is the way to go.

I think quite enough evidence is out that FUE yields have matched FUT, and that FUE (if done correctly) has less surgical risks. FUT scars can also widen over time, and the surrounding tissue can also be damaged thus making those grafts unharvestable for future procedures.
Yes but as far as I know, the evidence that FUE can yield the same as FUT came from studies done with very small sessions. One reason why Dr. Zarev is being able to deliver such impressive results could be that he is one of the few doctors truly getting a 90%+ yield with mega sessions and above.
 

werefckd

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Look how small are Zarev's punches compared to other doctors, I wonder if this results in less harm in the adjacent hairs.

This is a Zarev patient. You can barely see the roles, even when zooming in:

image.php?&mode=full&folder=11700Grafts&file=j8.jpg

image.php?&mode=full&folder=11700Grafts&file=j9.jpg



Now compare with the size of the roles of the other doctors:

Eugenix:
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********
FBE624.thumb.jpeg.b957cbce1b96e4a572cd626b43a93366.jpg


Hasson
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Pinto
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Edit: why is Bisang@s name censored in this forum?
 

Omega2327

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Zarev does not respond in any way whatsoever to emails sent over months which kills any enthusiasm in the potential patient, giving him time to realize that 4 eur per graft in a country like Bulgaria is absolutely nuts (this price is absolutely prohibitive to 99.9% of all bulgarian citizens), who else in Europe/Turkey uses these micro punch size tools like he does and does exctraction + implantation himself?
Just keep at it. Once you establish a line of communication, he’s actually very responsive. Be sure to include pictures of yourself, details about your situation, etc. You could also DM him on Instagram, that’s what did it for me.
 

Omega2327

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Look how small are Zarev's punches compared to other doctors, I wonder if this results in less harm in the adjacent hairs.

This is a Zarev patient. You can barely see the roles, even when zooming in:

View attachment 149949
View attachment 149950


Now compare with the size of the roles of the other doctors:

Eugenix:
View attachment 149951

********
View attachment 149952

Hasson
View attachment 149953

Pinto
View attachment 149954

Edit: why is Bisang@s name censored in this forum?
Yeah it’s insane.. such a big difference. I imagine it makes the scars less noticeable at the very least.
 

werefckd

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Just keep at it. Once you establish a line of communication, he’s actually very responsive. Be sure to include pictures of yourself, details about your situation, etc. You could also DM him on Instagram, that’s what did it for me.
I assume he is receiving mad amounts of e-mail and responds only the people that send multiple ones and don't quit in order to triage the people who really want to do a consultation vs dudes that are just curious and are going to waste his time
 

whatintheworld

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He is difficult to reach, I think due to the massive e-mail volume he gets per day. Give it a few weeks, try again like I did.

Include good pictures, in either bright sunlight or bathroom lighting.

I contacted Dr. Feirrera too in Portugal and he didn't respond to me and it's been over a month and a half, his patient representative told me they are simply overwhelmed with requests.
 

whatintheworld

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@werefckd when I was zooming in on the pictures I noticed the small punch size too. It appears to minimize the surrounding damage around the grafts, very impressive.

That may be why when you see the results on the donor on the patient website, it looks pretty pristine, due to the 50% density rule of thumb (that the human eye has difficulty noticing hair loss until less than 50% density is present).
 

kawnshawn

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Zarev does not respond in any way whatsoever to emails sent over months which kills any enthusiasm in the potential patient, giving him time to realize that 4 eur per graft in a country like Bulgaria is absolutely nuts (this price is absolutely prohibitive to 99.9% of all bulgarian citizens), who else in Europe/Turkey uses these micro punch size tools like he does and does exctraction + implantation himself?
If what he says is true that the grafts have a much higher survival rate compared to standard FUE grafts then the price is justified imo.
 

Jonnyyy

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Looked through all the pictures of his most successful results, didn’t see a single one with brown hair, I might’ve missed one but does that mean if you don’t have thick black/grayish hair and a Norwood 7 you’re probably not a good candidate?
 

whatintheworld

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Looked through all the pictures of his most successful results, didn’t see a single one with brown hair, I might’ve missed one but does that mean if you don’t have thick black/grayish hair and a Norwood 7 you’re probably not a good candidate?

I wouldn't think so. Those are just the best candidates for FUE, thick dark donor hair. Look at other elite doctors like Cuoto and Lorenzo and they typically showcase patients with those type of hair characteristics.
 

Omega2327

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Looked through all the pictures of his most successful results, didn’t see a single one with brown hair, I might’ve missed one but does that mean if you don’t have thick black/grayish hair and a Norwood 7 you’re probably not a good candidate?
Remember that over 90% of his patients are Bulgarian, and the vast majority of Bulgarians have dark hair. Blonde hair is not common there at all so I’m sure that’s also a big part of the reason why we see most patients in his gallery have darker hair.
 

BurningCoals

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If Zarev can turn a NW6 into a NW1-2, wouldn't it then be possible for him to turn a NW7 into a NW3-4? I mean I suppose it wouldn't be ideal but it would still be way better than NW7.
 

coolio

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I just skipped through this whole thread for the first time.

Thoughts:

- Zarev is raiding outside the 'safe zone'. That helps to make the huge graft counts possible. I hope he is scattering those hairs carefully or else the patients might end up losing big patches of transplanted hair with advancing hair loss in the future.

- His technique/tool does seem to allow smaller punch sizes with good graft survival rates. I agree that most "good" FUE docs are probably getting lower survival rates than they claim. I also suspect that big-punch FUE extractions in the donor may be killing more surrounding follicles than the FUE docs are admitting to. Everyone scrutinizes the recipient after each transplant, but the donor areas don't get scrutinized that much until it is becoming a problem. So Zarev may have made a legit step forward here.

- If Zarev has been in business for a decade then he's had time to cherry-pick his best results to show off. It's never smart to believe your results will be as good as the showoff pics. Never, not from any Doctor. Personally, I would not expect to get any more than 2/3rds of the results of the showoff cases. And that's from the best docs. It's better to start off being realistic than to end up disappointed.
 

werefckd

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I just skipped through this whole thread for the first time.

Thoughts:

- Zarev is raiding outside the 'safe zone'. That helps to make the huge graft counts possible. I hope he is scattering those hairs carefully or else the patients might end up losing big patches of transplanted hair with advancing hair loss in the future.

- His technique/tool does seem to allow smaller punch sizes with good graft survival rates. I agree that most "good" FUE docs are probably getting lower survival rates than they claim. I also suspect that big-punch FUE extractions in the donor may be killing more surrounding follicles than the FUE docs are admitting to. Everyone scrutinizes the recipient after each transplant, but the donor areas don't get scrutinized that much until it is becoming a problem. So Zarev may have made a legit step forward here.

- If Zarev has been in business for a decade then he's had time to cherry-pick his best results to show off. It's never smart to believe your results will be as good as the showoff pics. Never, not from any Doctor. Personally, I would not expect to get any more than 2/3rds of the results of the showoff cases. And that's from the best docs. It's better to start off being realistic than to end up disappointed.
Excellent analysis. It's hard but the people that goes to Dr. Zarev should not expect those kind of results as they are probably the hand picked the best hair transplants ever made, the result of great donor, patient response and of course a great doctor.

Dr. Zarev seems to be very scientific in how he evaluates the donor areas. So I believe one should get a good notion of what's possible after that first assessment. Also, his "gigassessions" are really two procedures performed months a part. After the first one it would be possible to get a good idea already of how far it would be possible to get in the end.

Nevertheless, seems like Dr. Zarev the guy to maximise the results of whatever the donor you have.
 

the smoking baby

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What do you think is the smallest punch size possible that will remove the minimal amount of surrounding tissue of the FU needed for survival? What is the current smallest punch size used by a hair transplant surgeon in anybody's experience?
 

coolio

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Excellent analysis. It's hard but the people that goes to Dr. Zarev should not expect those kind of results as they are probably the hand picked the best hair transplants ever made, the result of great donor, patient response and of course a great doctor.

Dr. Zarev seems to be very scientific in how he evaluates the donor areas. So I believe one should get a good notion of what's possible after that first assessment. Also, his "gigassessions" are really two procedures performed months a part. After the first one it would be possible to get a good idea already of how far it would be possible to get in the end.

Nevertheless, seems like Dr. Zarev the guy to maximise the results of whatever the donor you have.

Thanks. I agree, this guy appears to be getting more bang-for-the-donor than anyone else in the business. At least that I have seen.

I've thought for years that FUE (and for that matter, FUT) docs are probably losing a higher percentage of grafts than anyone is admitting to.

As for raiding outside the safe zone, I'm cautiously on board with that - assuming that the "endangered" grafts are not reimplanted in a pattern that would cause unnatural results when they fade. Very important caveat.

Large sessions always scare me. More grafts at once = more grafts lost if that Doctor didn't do a great job. And if more grafts are dense-packed together at once, there is more danger of reduced survival rate. Or even skin necrosis.

Particularly with shiny bald skin. I would NEVER want to get a ton of grafts dense-packed into a shiny bald area in a single session. It's just not worth the risks. Shiny bald skin is different from hair-bearing skin. It takes time for the skin to revert to hair-bearing condition. Don't flood it with too much density at once. Nature never designed your skin to cope with anything like that.

One more thing that is rarely talked about - hair cycling. If you transplant your whole head in one big session, all those hairs will get their cycles synchronized. Several years later you may be in for a sudden "bad hair season" when a lot of them cycle over again at the same time. It may take a few cycles (like 10+ years) for them to get out of lockstep with each other. It's one more reason why I would rather get a lot of grafts done in 2-3 separate sessions.
 
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