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Dr. Elliott

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  1. Pat ??“ This is in response to your recent remarks. I have located the patient (Sure 34)'s chart and will address that shortly. As you know, I have not been a fan of your internet marketing and have refused to go to your learning center level. My only purpose in being listed on internet sites is to allow patients to find my address and phone number when they are looking for it, since many of them are not in the local Beverly Hills/Brentwood, Newport Beach, or San Francisco phone book areas. It is nice that you post a few pictures of patients on the internet, but the pictures are not of good quality. When patients come to my office for a consultation, we show them vast numbers of before and after photos, taken from various angles, and shot on film so the quality is extremely good. I don't believe people can make an adequate judgment about what they are seeing on internet photos. We also have one or more actual patients who work in the office, so real results can be examined in person. My practice is a referral practice, and virtually all patients come from referrals from other patients, other physicians, or from various hair salons who have our patients as clients. It is not important for me to "garner internet patients", as you suggest. It is good that you take feedback from patients very seriously. However, unfortunately you are not a physician and cannot possibly evaluate a patient for that reason, and also because you do not have access to the patient's chart, know the history, and have the before and after pictures. I would like you to visit our offices in California when you come in October, to see how we do these surgeries. However, I have no interest in being listed on your internet sites in the future. Your outrageous assertion that there is something wrong with my surgical results is beyond imagination. You may recall that I have done the most hair transplant surgeries of anyone in the world over the last 30 years, and our offices were achieving superb results even in the days of plug transplants. In fact, in those days, I had special plugs developed of 1-mm and 1.5-mm diameter, with which we extracted single follicles for transplanting hairlines. Today this is known as the follicular unit extraction technique and is used by several individuals including ourselves, in certain cases where the donor requires it. I attach a photograph of my longtime 15-year patient coordinator, Mr. John Peters, where you can see the section of his hairline transplanted 15 years ago with 1-mm single hair plugs (green), and the other section transplanted in recent years using modern techniques (blue). I believe you can appreciate that there is very little difference, although the modern technique is better. The reason for that is that in the old days, we used a 1-mm round hole to receive the 1-mm round plug, rather than the micro blade incision that is currently used. You have suggested that I ought to encourage some patients to get on line and post their experiences with photos. I have for the first time read your suggestions for that being done, but I am unclear as to the part about photos. Is a patient required to reveal their individual name or can they use some sort of web alias? Is the patient to send his photos in the same way that you suggest for physicians, namely to your man in Washington? Please advise specifically how patients are to proceed in sending their narrative and photos and to where. I will ask a few of my physician patients to do that, but only if their individual names and facial features can be protected. As mentioned, about one-fourth of my patients are physicians, so that is a very common type of patient for us, and also a type of patient who probably understands, in greater detail, all aspects of any surgery. Incidentally, your assertion that you have many times in the past emailed me instructions to invite patients to post on your forum is incorrect. I have never seen this information before. Perhaps you were emailing this to one of my employees. The patient known as Sure34, and of course we cannot discuss his real identity, initially presented to us on 3/31/00, at which time he was a student. He stated, "I've got a big scar on my head and it has become increasingly visible as my hair has thinned. I want to see if hair can be transplanted to cover the scar." The scar was apparently the result of an accident. In fact, there were three scars in a stellate pattern. The three scars connected at a point about 8-10 cm behind the patient's hairline in the center of the head. From that, one scar ran towards the hairline, intersecting at about the midpoint; one scar ran to left of the center of the hairline; and the third ran to the right, intersecting the hairline in the temporal corner. All three intersected the hairline. As the patient requested, we transplanted his existing hairline in order to hide these scars. Initially we did only 718 grafts to fill in the area of the three scars and fill in his hairline. Obviously, it was necessary to fill in his hairline in order to hide the scars since they intersected the hairline at three points. We did not lower his hairline. We charged at the student rate of $4.00 per graft for 500 grafts, but actually did 718 grafts. This was done in January 2001, because we had asked the patient to wait until the previous year's scars had fully matured, before transplanting, for six months. This was also to wait and see if there was any hair shock related to the accident that would grow back. The patient continued to lose more hair from male pattern hair loss and, so, required an additional transplant on 9/13/02, one year and eight months after his initial transplant. At that procedure, we did about 778 grafts, and we again charged him at the student rate of $4.00 per graft. Note that the patient was 21 years old at the time of the second procedure and 19 at the time of the first procedure. There is nothing wrong with beginning to transplant a person with scars on his head at age 19. It was my judgment that no amount of drug therapy could solve the problem with the scars. We spent plenty of time with this patient and carefully explained everything, including the fact that he would need several transplants over several years because he had male pattern baldness superimposed on his scars from the accident. My initial impression at the time of consultation was that he was likely to go to a 3V. His father was a 3V pattern , although both grandfathers and uncles were both 2s. There was no substantial and severe hair loss anywhere in the family. Based on the information on the internet, it would appear that this patient has gone into a depression, although it is not likely related to his hair loss. We have photographs dated in 2004, showing a very effective hair transplant with only a total of 2900 grafts used so far. It looks like his pattern will go to a 4 or 5, but there is still a vast amount of donor hair available. Originally we estimated about 7000 grafts available in his donor area, so there is no shortage of donor to finish whatever he requires. Obviously, the patient should not part his hair in the middle until all transplanting is done. His unusual natural hair direction fans out in the center of the hairline. In February 2004, the patient re-presented to the office with further male pattern hair loss, and we did a third transplant of about 1800 grafts. This has grown out nicely, although I have not seen pictures in 2006. It is likely that he has had additional hair loss since 2004, and needs probably one more large transplant to all areas. Pat, you should not be playing on a young man's depressed situation. You are not a physician or a psychologist, and your only role here should be to refer the patient back to his physician for additional treatment. The classic description of a depressed man is a rich man who, when depressed, feels he is poor. As we do occasionally in cases of depression, since our main objective as physicians is to make people look and feel good, we will be pleased to finish this case on a pro bono basis. Kindly refer the patient back to us for evaluation at this point in time. We will attempt to get his depression treated. Incidentally, the hairline on this patient is no lower than my 57-year-old hairline is, which you can easily see on my website at elliotthair.com. We never do hairlines that are too low, but in California, we probably tend to put hairlines at a little more youthful level than is done in the eastern United States. This is because people in California like to look good, and a well-framed face is what makes men have a handsome appearance. There is nothing more distracting than an elevated hairline from the front. It has always been my opinion that it is better to properly transplant the front of the head and, if necessary, leave a spot in the back. However, with modern micro technology, there is usually enough hair to transplant the front well and at least a medium coat in the crown, which looks great when the hair is combed back. California patients generally don't want a completely bald spot in the back of their head, although I understand in the East, this is frequently acceptable. Finally, Pat, your assertion that we do not have a consistent and proven tract record of excellent results may well end us in court. This is absolutely ridiculous. Of the more than 30,000 patients that I have done, there have only been a handful who were not completely satisfied, and each of those individuals was a revision case that had initially been transplanted somewhere else. Sometimes there is not enough donor hair left to get to the level we want. However, 100's of times I have gotten more donor out of people who had previously been decimated in their donor by another clinic. In our office, we never give up on these types of cases, we never surrender.
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