Kira, I understand your point regarding propecia not doing much to improve the frontal third since it generally does not work great in that area. The area where there is no hair pre op stage primarily the temples have been transplanted which shows a lower than expected yield for a strip procedure and this cannot be attributed to native hair continuing to thin.

Im sorry to say this but it is not the kind of result one would expect from 3600 grafts via strip.

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2968 FUE Dr Feriduni 20/21 October 2011
My HT story: http://www.hairrestorationnetwork.co...-feriduni.html

Looks like a very poor result really, He shouldn't have to wait until 18 months for the end result, he should be 98% of the way there by 12 months, so if it isn't looking good at 12 months, pretty sure it's not going to change much by 18 months.

The pics that you posted unfortunately don't look very natural, it looks like an HT.

Why would he suddenly of lost hair at the exact same time as having an HT, and why was someone in their early 20's operated on in the first place anyway?

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My Hair Loss Website

I agree with the above coments,and also the patients own assessment and views!! With respect kira I think what you have said is incorrect and to be blunt a poor excuse,the amount of hair he had before seems to have stayed and the transplanted hair doesn't appear to have grown!! Could you provide photos of just after the survey so we can actually see where the hair was planted,and I would advise the patient to now style his hair in the same style used in the pre op photos and post them in! Because to be fair it appears his hair was combed at ubfavourable angles pre op and combed back from the middle of his head to expose the problem areas,then in the post op photo it just appears the his original hair has been styled to cover those area up!! I would imagine had you styled his hair in the same manor as post op before his surgery ther would be very little difference to his post op results! Also I think that the patients comment about poor yield is correct and he must be disappointed with the results especially considering the amount of grafts used!!! I initially didn't want to comment on these results as didnt want to say the results were poor as I felt it might upset the patient and he may have been happy with them,which is the main thing,however since reading his post,I thought it should be mentioned!! What are your plans for this patient?? As I would hope that you would look at the results and agree they were way below par and offer a solution for him,although with hair restoration there are no guarantees I think the difference between physicians is when results are below par they take a honest and professional view and hold there hands up and say, you know what,they are below what should be achieved,but don't worry we will look into why and address the situation for you and try to put that right!!! I hope at 12 months if his situation hasn't greatly improved this will happen as that makes a huge difference as to what makes a great surgeon stand out from the average/below par one!!!

In a strange way, it somehow helps to know that others agree I've had a poor outcome. I'm coming up on 11 months now and it looks pretty much the same as 10 months, so I really don't expect much improvement.

I'll try to keep a positive mind about all this, but I'm also a realist. As others have said, this is not the kind of result I should have expected for this size/type of procedure. I'll be the first to admit this is clearly below expectations, and with all due respect Kira, I would rather you and Dr. Arocha just be honest and tell me there isn't going to be much improvement rather than try to sugar coat it and tell me it could still get better. There will likely not be enough of a difference in the next 4-5 months to warrant a change in opinion, but like I said, I'll try to remain positive about all this as the extra stress doesn't exactly help.

Sparky hit the nail on the head. I should be at essentially full growth. I understand the concept that some patients grow more quickly than others, but it's a little extreme to say that could still apply to someone at 11 months. I've seen patients at 5 months have better results than I have at 10-11. I would also agree the result does not look natural, hence why I feel it's necessary to wear concealer to avoid further embarassment.

To address Sparky's concern about operating at such a young age (which I completely understand - that was a big factor for me); I consulted with two other recommended surgeons on this forum, and they both also agreed to move forward with the procedure if I had decided to go with them. I guess they had come to the same conclusion that I was still a good candidate, regardless of my young age. As pointed out by Cant decide (by the way, excellent result, Rahal does amazing work), I was also under the impression that I had above average donor hair. However, as it stands, I am aware it was risky to operate at such a young age. I don't entirely believe that would be the main cause for the poor yield though - if anything I would think the donor hair would have a greater chance of success being in a younger state that someone who is 40+ years old.

As I said, I'll try to keep a positive outlook on this situation and give it the benefit of the doubt in waiting the full 18 months, but I won't get my hopes up. I hope I haven't come off as rash or unreasonable, but I'm sure there are plenty of members on this forum who could imagine the frustration of going through this entire procedure with a recommended surgeon, only to have a result that not only is way below expectations, but also looks fairly obvious at the same time. Not to mention the large expense of such an operation...

I will have to reassess my situation at 18 months. If there isn't much improvement by then, hopefully an agreement can be met between the clinic and myself that will please both parties. I know Arocha wants the best for his patients and for them to be happy, but at this point that is unfortunately not the case for me.

Good luck texag! Really hope it works out for you!!! Although your growth wasn't great on a plus point your hair doesn't look bad as it wasn't that bad before,just not the change you would of hoped for or expected!! Fingers crossed for you!!!

Gentlemen,

No one is saying that this is the best result in terms of density. Quite frankly, I am expecting more to come in the next month or two. I am concerned about it. We are not trying to hide this case why in the world would we post it on an internet forum. We do not want to rush prematurely when there is the possibility that more may grow in only 1-2 months.
We pray that there is no underlying physiological reason why this transplant has strayed from the more usual course. We always stand behind our work. We would like to meet with the patient privately to clarify the plan.

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Dr. Bernardino Arocha is a member of the Coalition of Independent Hair Restoration Physicians

Tex, I do hope you get a nice growth spurt over the next few months. It has happened before. Don't give up hope yet as you went with a top doctor who I'm sure will stand behind you.

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HT #1: Karamikian Unknown # of grafts Sept.2006

HT#2 Nov.23rd, 2007
Dr.Feller
Almost 3200 grafts via strip

HT#3 April 2010
Fue 200/side into temple points

HT#4 February 2011

My Hair Loss Website - Hair Transplant with Dr. Feller

Hey Tex,

The reason is can be risky to ht a young patient is not because the grafts might not grow (they don't grow better as you get older) but, rather, because a young patient's baldness pattern might not be developed sufficiently to know what they will be facing in middle age and later in terms of hair loss. That is why using up lots of donor at a young age and/or doing an aggressive frontal restoration on a young patient can be risky.

Anyway, I hope you get some better growth and density in the next couple of months, and if not, your doctor has said that he stands behind his work and will take care of you.

Best of luck!

Thanks to everyone who posted their valuable input on this topic. After viewing the results and other member's comments, I wanted to add my feedback as well.

In looking strictly at the before/after photos, I can see why members might expect a denser result. And while I can't comment on whether or not all 3600 plus grafts have grown, there are several variables worth discussing.

For starters, I wholeheartedly disagree with Sparky that TexAg's results don't look natural. While they may not be as dense as the patient wants, the results show a rather subtle but natural improvement in both the hairline and temple areas.

Secondly, while TexAg still possessed a lot of natural hair prior to surgery, it's very common for a young man in their 20's to continue losing hair. Furthermore, trauma to the scalp during hair transplant surgery can permanently "shock" miniaturizing hair. While DHT resistant / non-miniaturized hair has a very good chance of surviving trauma and regrowing, hairs in the process of dying may not grow back. Thus, if TexAg possessed a lot of miniaturizing hairs in the frontal core, it's quite possible that these hairs may have died a bit prematurely. The good news however, is that they were placed by permanent DHT resistant hairs and will not fall out.

Moreover, while it's true that many patients see the vast majority of growth by 12 months, studies performed by world class hair transplant surgeons have clearly demonstrated that hair growth can continue after 12 months and continue up to 18 and even 24 months. I often see some of the same members dismiss this reality during controversy, which is highly unfortunate, especially since it often stirs the pot instead of providing real information and encouragement to the patient.

Another important point to note is that we haven't seen any postoperative photos or interim photos showing the scalp 1 to 9 months after hair transplant surgery. Thus, if either Dr. Arocha's clinic and/or the patient have photos of his scalp immediately afer surgery or sometime before now, I suggest posting them.

I also want to point out that Dr. Arocha has an outstanding reputation for producing excellent results and standing behind his patients. While we encourage members to share their genuine opinions, I suggest that patient members of this community and expert physicians work together and not pass blame back and forth. At the end of the day, we all want to help patients get the results they ultimately deserve.

Thus, I strongly suggest that TexAg meet with Dr. Arocha if possible for an in-person consultation and evaluation of his growth yield and collaborate on a long term hair restoration plan that takes into consideration his current and future goals as hair loss continues.

TexAg,

As a young guy, I can certainly understand why you'd want more density. The good news however, is that your results do show a subtle but natural improvement. Furthermore, your hair does appear more dense and miniaturizing hairs were replaced with permanent DHT resistant hair.

If you would like to discuss your experience and/or concerns with another patient who understands the procedure and all the feelings involved, I'd be happy to speak with you on the phone and/or privately via email. Feel free to email me at help@hairtransplantnetwork.com with your phone number and I'll be happy to call you.

Best wishes,

Bill

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Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

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To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Here is my take on it. This was a miss. Not sure if the patient chose the hairline or the doc chose it, it seems too aggressive. Further hair loss is a mute point as far as the corners go because they were slick anyway. The temple points do not look good quite yet. I think they take longer and there is a high probability in my mind that temple points end up course looking like this. This pt is in his early 20's and never should have even considered dropping his hairline. He has a high chance of ending up an advanced Norwood. He has already spent a lot of grafts and needs to think about being conservative about his remaining grafts. Hopefully he gets some maturity in the next few months.

Good luck to the pt and the doctor on this one.

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2110 FUT grafts by DR. Raymond Konior on July 30th, 2012

Best HT advice I have ever heard: "Find a doctor that you need more than they need you." Author Unknown

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