Coalition Surgeons

unfortunateHT · #1 **Top** 03-21-2009, 07:43 PM

HT Date: 08/03/2006
2000+ grafts

Though this is my first post I am not new to this forum. My story goes like this...

---------------------PAST-------------------------------------------------------------------------------------------------------------------------------

After doing research in this forum, I had my HT done with Dr.Feller on Aug 03 2006. I was aware of the process through
this forum and everything went smooth with my HT session as expected. Dr.Feller said he has transplanted 2000+ grafts as
planned in pre-op consultation. Though I wanted to bring down my front hairline, bit aggressive than want Dr.Feller has suggested,
he convinced me why it is important for me to save the donor area for later bcoz of my family history's balding pattern (Norwood 6-7).

I agreed with him as my priority was density always. I was 23 and Norwood 3 at the time of my first HT.

Below are the images that Dr.Feller has taken before HT and 7 months after HT. I was not so satisfied with results esp. density.

I will be happy to see your comments/feedback of what you guys think about these pictures. Before I had long and thick hair in the middle.

-----------------PRESENT--------------------------------------------------------------------------------------------------------------------------------

I met few doctors recently for my second HT as my hairline receded in non HT area. Their opinion has added to my disappointment.
They said 2000+ grafts for front hair line for Norwood 3 could have got better results.

I met a Doctor in NJ and according to him density is around 20 grafts/ sq.cm in most areas and 25 grafts/ sq.cm in few areas and covered 70-80 sq.cm in total.
Another doctor said it is hardly 1200 grafts.

I have added my recent front hairline pics in closeup towards the end - 2.5yrs post HT.

Three things that I am looking for my second HT in the order of decreasing priority

1) Increase density in first HT area to 50-60 grafts/sq.cm

2) Cover the receded hair line

3) bring down my front hair line by very little (on the sides)

Dr.True suggested for 1700-1800 grafts for 2nd HT that would fulfill my objective for a decent price tag. Though he said he cannot get
50-60 grafts density through out my front hair line but definitely at most parts of front hair line which is important. He also said he will not touch crown, I lost few hair in the crown area too.

After reading the forum with recent posts, I felt Dr.Rahal would be my option for second HT but the fact that I am in NJ and have
other options nearby, currently I am in dilemma.

Given the reputation of Dr.Feller in this forum, I was timid to express my disappointment with my HT results until my recent consultations.

Do you guys suggest that I should meet with Dr.Feller and discuss what went wrong or may be something went wrong only with my case,
how it can be addressed going forward. I am optimistic about him only seeing his other works in this forum but personally I am not happy with my HT.

I am currently Norwood 5 and down the line I may go to 6/7. Given my objectives, limited resources and past experience whom should I be considering?

Dr.True vs. Dr.Rahal vs. re-visiting Dr.Feller.

Your opinion is much appreciated.

I am posting this to seek advise rather than making a complain.

*************Update on 03/26/2009*************

Scheduled second HT on 05/15/2009 with Dr.Feller

*************Update on 05/31/2009*************

Sorry for the delay guys, I had my second surgery on May 15th everything went smooth but not as excepted. As my scalp at donor area was tight Dr.Feller could extract only 1400 grafts and not 2000+ grafts that we have targeted earlier. As there were less grafts obtained from strip, Dr.Feller had dealt it tactfully and filled all 1400 grafts in left half as i usually comb from left to right. I will be filling in around 600+ grafts in the right half in two FUE sessions in near future.

These are my pics on surgery day, after surgery pics are not that clear because of those white little things on grafts. I got my staples removed on 26th May and also got a PRP injection on same day.

I will keep you updated with monthly progress and about my FUE sessions.

Opinions, comments and suggestions always welcome.

*************Update on 09/16/2009*************

Added FUE pics and 4 months post second HT

Dr. Alan Feller · #2 **Top** 03-21-2009, 09:10 PM

'Do you guys suggest that I should meet with Dr.Feller and discuss what went wrong or not, may be something went wrong only with my case,
how it can be addressed going forward. I am optimistic about him only seeing his other works in this forum but personally I am not happy with my HT.'

Unfortunate,
I am truly sorry that you are not satisfied with your result, it can and does happen, and I know that you are hurting because of it. You want answers, accountability, re-assurance, and most importantly-guidance moving forward. I am always available to offer all of that, but you have to at least identify yourself first in order for me to have the chance.

From those photos and text you posted I can assure you that nothing 'went wrong'. It's glaringly obvious from your recent photos that you experienced a HUGE amount of continued hairloss since your procedure which denied the transplants the 'back up' hair it needed to give a satisfying illusion of fullness. Look at the hair BEHIND the transplants in the before and after photos you posted - you clearly lost at least another 4 inches of native hair since your procedure. This is not shock loss, but aggressive recession.

From the snippets of conversation you said we had back before your surgery in 2006 this was a possibility I was verbally concerned about and explains why I didn't bring the hairline lower as you requested, nor did a super large case. Since you haven't identified yourself to me nor made a complaint directly to me before coming on a public forum I don't have your file which may provide us with some very important information about your particular case.

The harsh reality of hair transplantation is that it is PHYSIOLOGY dependent. This is something I preach online, in all my consultations, and make patients acknowledge in writing before every procedure. Because no two people have identical physiologies, the same exact procedure can be performed on ten different people with ten different results ranging from 'unimpressive' to 'miracle'. Here is a patient presentation I put up on this site only yesterday. He had the same exact surgery as you in terms of density and technique, but look at the difference in results:
http://hair-restoration-info.c...21087683/m/276104781

The fact that you were only 23 years old at the time of your visit compounds that reality because I will invariably be more conservative with patients in your age group.

I agree with the assessment that 2,000+ grafts could have produced a better cosmetic result. But I personally guarantee to you that none of the doctors who told you this would guarantee that they would have had better results in your particular case and that they never had a case where the growth yield was sub par despite their best efforts.

If I knew who you were and had your permission I would post your immediate post op pictures that show the placement of each and every graft and would leave it to the community members and the doctors you consulted with to publicly state if they see any difference between the procedure I performed on you and that which I've performed on thousands of others with higher growth yields.

I am not heartless and I am not un-empathetic to your situation, but if you had come to me personally you would have found that I would have offered you a significant discount on a second procedure. I would have done so not because I felt I did anything wrong, I know for a fact that I haven't; but because I know what it's like to be 25 years old, to be losing my hair, and to be tight on money; it would be my pleasure to see that my 'boys' get the very best I can offer.

I think it's inappropriate to have this exchange online in a public forum, but you chose the venue, not I. As I've always said, I have no problem if a 24/7 live broadcast were made from my office covering all my consultations and surgeries. Transparency is a point of pride for me and there is nothing I would tell you in private that I wouldn't tell you in front of the entire HT community.

Going forward I would recommend that you do not lower your hairline. I echo the same concern you said I made to you 2.5 years ago in that you probably will not have enough hair to insure a proper balance of coverage throughout your head if you choose to 'frontload'. I know 25 year olds want as much density as possible, but that ALWAYS comes at the cost of coverage; and with your very aggressive hair loss that's a trade off you should not be making.

Also realize that if you had lower than average yield from your first surgery, then it is highly likely that such will be the case for future surgeries. If you are just looking to thicken up the area I already transplanted, then that's a slam dunk and would be something I would push for, followed by a fill in of the newly bald scalp just behind.

The lines of communication to my office are always open and it is my fervent hope that you will identify yourself and make an appointment to speak to me face to face.

Best wishes
Dr. Feller

kaounis · #3 **Top** 03-21-2009, 09:40 PM

My advice to you unfortunate, would be to personally contact Dr. Feller and work out a solution. I firmly beleive that all surgeons should finish what thwy started. Dr. Feller is a stand up guy. I'm sure he can bring you closer to your goal. He knows what he has transplanted, has pictures, and can probably improve your density better than anyone else....IMHO...By the way, don't think that what another surgeon tells you, whoever he is, has your best intrest, it's still a business, and with the economy what it is, everybody thinks they are better than the other guy! Stick with Dr. Feller...Thats my advice...

Just a thought from the peanut gallery....

MikeTheDane · #4 **Top** 03-22-2009, 04:47 AM

Sorry to hear about this.

Dr. Feller is one of the most respected doctors on this site, and rightfully so, i trust that you and him will find a reasonable sollution to your situation - which is probably a second procedure to thicken the areas lost by your receeding hairloss at a discount.

either way, good luck.

mgem · #5 **Top** 03-22-2009, 06:45 AM

Hi you should speak to or go and see Dr Feller in private to resolve this situation. All the best mgem

Bill - Managing Publisher · #6 **Top** 03-22-2009, 06:49 AM

unfortunateHT,

I too am sorry that you are disappointed with your hair transplant.

Though all patients are welcome to share their epxerience and photos online (good or bad), we always recommend patients contact their doctors privately first to resolve any disputes.

Additionally, we believe in allowing both the patient and the doctor to share their side of the story upon request. Unfortunately for doctors, the anonymity of the forum prevent doctors from knowing who the patient is without getting their identity privately and HIPAA laws prevent them from discussing their case without the necessary permission. Your name and contact information will be kept off of our forum to protect your anonymity.

Whereas we are concerned here about protecting the rights of patients and allowing to share their genuine concerns online, we also want to be fair to doctors who deserve the right to properly reply.

Please contact Dr. Feller (or me via private message if you are more comfortable) privately and give him your full name and date of surgery so he may discuss the specifics of your case and present your postoperative pictures.

To learn more about how we create a fair and safe environment for both patients and physicians, click here.

In my opinion, give Dr. Feller the chance to evaluate you in person and give you the head of hair you want. In my opinion, his opinion is honest and forthright - if he believes there was poor growth, I trust he'll make it right.

Whereas the moderators of this discussion forum are not the ultimate arbitrators of truth, we believe that in order for anyone to draw an educated conclusion, both sides should have a chance to present all the information they have. In my opinion, let's reserve judgement until Dr. Feller has a chance to present additional information and photos.

Best wishes,

Bill

hopefull · #7 **Top** 03-22-2009, 07:04 AM

this is very sad...but its the reality of transplants when they are not supported my native hair and when hairloss drugs dont work properly.

you went in young with an agressive case of MPB, when propably should never have a transplant.

Feller is straight forward and tells many truths about transplants, that is to be respected, though maybe young guys with agressive hairloss should be evaluated more carefully before the transplant if they are such a high risk case.

I dont see anything wrong with the patient going online, if doctors had it their way we would never know anything about dissatisfied patients and we couldnt see the other side of transplants.

Thank you for posting your result and i wish all the best

P.S. Since we are an online community we must keep the same standars when we see dissatiafied patients of doctors. We cannot scream to some doctor bad results and silence on other doctrs so i will say what bothered me...

1.A discount on the second procedure???i would like to hear we will fix it for free since there is low growth.
2.the case was high risk?dont take it on
3.finally...do doctors speak the language of refund when there is a bad result??

djjr1 · #8 **Top** 03-22-2009, 07:14 AM

GO to dr. Feller he is the best guy,an he allready offer you huge discount.

Dr. Alan Feller · #9 **Top** 03-22-2009, 08:09 AM

Hopeful,
Most doctors wouldn't come within ten keyboard lengths of responding to a thread like this one, much less a hyper critical post like the one you just wrote.

But I have no problem because "unfortunates" situation may be educational to current and potential HT patients; and I pride myself on being concsiencious of every decision I make regarding all my patients- including this one. If you don't know this about me by now, then you obviously don't read many of my posts.

If ANY doctor wants to chime in on this thread and critique what I've done for this patient, please do. No doctor bats a thousand, and I doubt any doctor who would come onto this thread has either.

"Unfortunate" is not my first patient with a lower yield result, and likely not the last, that is the simple reality of hair transplantation for ALL doctors and their patients. And all patients must understand this and sign off on this disclosure IN WRITING before I accept them for surgery. I believe "Unfortunate" will confirm this himself. If not, I'm sure I have his signature on such a disclosure in his file if he will identify himself.

Hopeful, who told you he was such a "high risk" case? I didn't write that, and neither did he. There was nothing in his posted case history that indicated that he was "high risk".

If you are referring to the fact that he had progressive hairloss, that has nothing to do with risk at all. I anticipate ALL patients in his age catagory will loss ALL of their hair in the future and plan my surgery around that extreme possiblility. That's why I kept his hairline HIGHER than he requested. Had his hairline been lower, then I would have done something demonstrably wrong. But I did not because I spend alot of time planning each and every surgery and looking into the future for all the possibilities-including lower yield growth.

To respond to the points that bothered you:
1. In the hands of an experienced and proven clinic, low growth is a function of patient physiology, not negligence or incompetence of the clinic.

If you can find one qualified and credibile doctor to come on here and state otherwise THEN I will do his next surgery for FREE and give him a steak dinner as well. You can even join us for that steak, on me, if you identify yourself.

If Dr. True, one of the doctors he consulted with, will come on here publicly and articulate how anything I did for this patient was inconsistant with the way I've performed surgery on any of my other thousands of patients, or even just the ones I've posted on this site over the years, then I will give a free surgery. Of course, this assumes that Dr. True has no patients of his own who have experienced lower than expected growth yields. If Dr. True can come onto this thread and make that assertion, then "unfortunate" gets his freebie. But don't hold your breath. No credibile doctor would ever make that claim. To do so would be professional suicide. Again, that's the stark reality of ANY and ALL surgery.

There is nothing to "fix" because nothing was broken. His result are what they are, and he can EASILY thicken up by doing a second surgery. He's not the first, and he's not the last. That is the truth of all HT surgery no matter the patient or the doctor. We do the very best we can for each patient and we MASSIVELY document the procedure throughout. If the patient identified himself I could look up his pictures and post them for all to see. He was just a poor grower. Simple as that. There is no "blame" to cast, no one at whom a finger can or should be pointed.

2. This case was not "high risk" as you wrote. The possibility of losing hair does not make a patient a bad candidate for HT, in fact it is very often a strong criteria FOR a transplant.

3. I don't give refunds when the result is "bad" or just perceived as bad. Sometimes I perform surgery for a steep discount or even for free when I feel it is waranted, but I never feel compelled to do it, and I can guarantee I won't do so simply because a dissatisfied patient went public to vent his disappointment before even bothering contacting me.

This post is injurious to my reputation because very often a doctor's reputation is only as good as his last patient's post. I've always been aware of that which is why I participate so much and post so many results that range from "eh" to "awesome". But perhaps a post like this every now and then is a good thing because it keeps it "real" and prevents expectations from getting too extreme.

If any of you people out there reading this are thinking of a hair transplant, look very closely at this patient's case and realize that while I belive the chances of receiving such a low yeild result is less than 2%, it CAN and DOES happen. It is almost impossible to know who the unlucky ones are going to be.

No doctor will come on here and state publicly that they don't have a few patients every year with yields like this one. But almost always a second procedure is done with far more satisfying results, and it's usually these results that make it to the internet.

unfortunateHT · #10 **Top** 03-22-2009, 08:30 AM

Thanks all for your sincere opinion. As suggested by all I will discuss this with Dr.Feller.

Flac,

I have just hidden my name but not the surgery date, I think Dr.Feller would have got my details by now, if not also i would contact him to schedule an appointment and discuss.

There were few reasons why I posted my results:

1) I have seen idealistic results in this forum 100% success by all the best doctors in the discussion board. Is it true that there is not even 1% (or less than 1%) unhappy results, I am not saying worst results. I want to see more realistic results in the forum than idealistic. I want to know what happened with them and how did they resolve it. I know few who lost hope on HT and never fixed it.

2) I have faith in HT by seeing thousands of happy patients in the forum, I want to take my case as a challenge and help patients like me to be confident and to educate them that this can be resolved. I want to make this happen.

3) I wanted to hear from patients like me and their opinion.

I am not saying Doctor(s) did wrong, when the fact is that results could be poor in some patients, then why I haven't seen them on this forum especially patients of renowned doctors of this forum and then getting fixed by themselves in later sessions.

I am here to see similar cases with success at the end, i am here to fix my hairline but not to blame anyone.

I ask everyone to think in direction of helping this to fix rather than blaming. I have faith in doctors of this forum.

Dr Feller,

To correct one of your statement, Dr.True did just gave the stats of density and the area covered in his opinion and he said 2000+ grafts might be justified "in low tone". He never said results are inconsistent.

I will be more than happy to consult you in person and discuss.

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