DavidEur

After my first transplant I had what appeared to be one large solid scab, so my fear would be that (as Sparky mentioned) only parts would come off at day 14. Non-shaved but with scabs would be less noticeable, or shaved but no scabs. But shaved and scabs would be. There's of course a large variation associated with individual healing factors and post-op routine. To be honest I've no idea how I'd have looked at 14 days but do know that scabs seem to sit relatively long on my skin. As I mentioned in an earlier post, I should have taken it up directly with Dr. Rahal and asked if there were alternatives.

Michael, it's great you had a very positive experience with Dr. Rahal and I understand your frustration with my post. Let's leave it at that please. Gattaca, thanks a lot for your angle on things, I agree with you the most important thing is getting a good result and as I've stated I'm sure Dr. Rahal would have delivered. It's not the scabs per se that bother me, the major factor is being able to return to work in 2 weeks post-procedure without scabs. I'm actually very positive that I'll get this sorted and grateful that I live in a day and age where I even have the luxury and opportunity of getting a natural looking hair transplant (if you choose the right doc). Best wishes to you

For the record I think Bill has handled this situation very well. He doesn't agree with everything I say and he doesn't have any financial interest in letting me have my say. He could have easily pulled the thread, removed me as a member, or both. Especially as he has years of dealings with Dr. Rahal, likes him, and I'm a relative 'nobody'. But he kept a calm head and chose not to. I never felt unfairly treated, on the contrary, he provided an excellent perspective on this situation, irrespective of whether we're in 100% agreement.

Thank you for all for your very reasoned responses, much appreciated. If my first post seemed unreasonable, then I am perhaps strongly influenced by my background. I've been the principal investigator on a number of small and larger public sector clinical trials over the last 17 years, and have taken post-doctoral education/exams in medical ethics and good clinical practice. For each trial I've led, I've had to write a patient consent form that basically informs the patient of the risks, their rights and responsibilites of participation in a trial. This is then sent for approval to an ethics committee to evaluate. I can say with 100% certainty that in this situation it would have been deemed unethical to not inform me of the post-op procedure as it would be considered as information that could influence my decision as to whether to go forward or not. You may argue "But this wasn't a clinical trial you were entering!". Very true, but the principle is the same (I could elaborate but choose not to become overly verbose). To argue "but this this the way we've always done things" simply doesn't cut it. It's irrelevant as to whether it's ethically correct or not. Saying "Dr. Rahal acted entirely within his rights" is 100% correct legally, but has nothing to do with ethics. Yes, I waited 10 days before cancelling, but I honestly felt locked in by the deposit (and by a strong instinctive desire to fix what is broken irrespective of consequences. I did, and still do believe, Dr. Rahal would have sorted it 100%). Eventually I decided I'd rather lose the money that come back to work with obvious scabbing. But yes, I waited too long. My point in telling you this is not to play the know-all, I only hope this will assist in an understanding of where my standpoint originates. In public health clinical medicine (where I've worked at least), it's entirely ok to be criticised or advised to perform something in another way for ethical reasons. I've never interpreted this as defamatory or interpreted it as being called an unethical person. That's two very different things. At the same time, I've never lived in a litigious society nor worked as a private physician, so I respect the fact that I don't understand how things work in North America and that I overstepped the line. I apologise for that. It's easy for me, in my work, to say "You have a fair point, this could have been done differently, I should have done that. We can change it so that in the future we do this". I'd lose neither money nor pride. I'd also like you to note that I never even mentioned the name of the surgeon who performed my first disastrous surgery when I posted my 10 month pic, so I'm not vindictive. I'd never go back to him. I would trust Dr. Rahal. But I simply wasn't 100% sure he was negligent and gave him the benefit of the doubt. I had zero fear of legal implications. Until I received the legal threat (sorry but being told my words were defamatory, that it's been discussed with lawyers and was considered actionable, and that I should retract my post immediately, should be considered as a threat), I was even trying to think how I could get 3 weeks off work so I could actually go to Dr. Rahal. So from my side there was nothing vindictive about my mail. It was simply a principle and perhaps a cultural difference. Dr. Rahal, I sincerely apologise for any offence caused, I hope you understand that was not my intention. However, I still believe your (and any other) hair transplant practice could be more ethical if patients were informed of post-op procedures before any financial transaction. I, in absolutely no-way whatsoever, think you are personally unethical. I could improve by ensuring I have all the relevant info. before any financial transaction takes places to avoid wasting the time of the physician, the clinic, and of course, money. Thanks again for everyone's thoughts, much appreciated.

Sincere apolgies. The mail has been sent.

Thank you for your thoughts Bill. I agree 100% that pre-op and post-op care should be discussed with the physician you select prior to booking the procedure. I could elaborate, but the discussion regarding ethics and the provision of sufficient information to the patient by the physician has become a side-show, and the main interest here now seems to be the legal aspect. Since the validity of my claim regarding a legal threat sent to my private email address is being called into question, and in the interests of transparency, I'd like to ask Adrian if it's true: Have you or have you not sent me a mail asking me to remove my comments and that you've discussed the matter with your lawyers who have determined this is an actionable offence? Yes or no?

Adrian, if you'd just stuck to the post above I would have been fine retracting my comments. But your private threat of legal action changed my mind. Do your lawyers seriously think my post stating that I believe it was unethical to keep my deposit would win you a libel case in Norway? Your lawyers are clearly 100% clueless about the chances of winning a defamation of character lawsuit outside of North America. Unless of course they apply for extradition to Canada? Good luck with that one. Fortunately I live in a country where the individual can't be bullied by petty threats of legal action. But what I will do is this. I like Bill Falceros, the guy that runs this site. He seems like a very fair and decent guy. If he feels my post is out of line, then I'll respectfully remove it for him. Otherwise, bring on your lawyers. At least I'll have the pleasure of knowing that my deposit disappeared in legal fees and not to your clinic. Yours sincerely, David

Thanks a lot for your thoughts guys, very much appreciated. It's good to hear objective opinions, (I perhaps can't see so clearly as I saw hard earned money disappear into thin air). MusoInOz, RodG and Michael5577 agree 100%, I was too hasty, and deposit info is on website. However, I don't think I'm entirely to blame. My point is that the when I discussed the back to work issue, the patient coordinator might have said "Please also note that we require that you can't touch scabs for 14days so you'll most likely be going back to work with scabs still on your hairline". That's it. Then I could have made a more informed decision. I think losing 50% would have been more fair. HARIRI, thanks for good wishes, agree, a HT SHOULD only happen once (with my starting point) but I was unfortunate in my choice of doctor for the first. On a positive note, I'm 100% confident this can be resolved with another small procedure with a top doc. Thanks for info Sparky. The issue touched on by several of you regarding following post-protocol as advised is interesting. Either you believe the doctor who operated on your or not. In this instance, I'd have to say to Dr. Rahal "I've got no doubt you're fantastic at performing the operation, but I hope you don't mind if I rub the scabs off earlier than 14 days as other doctors think that's ok". Or going to another doctor and saying "I know you advised me to start gently washing and rubbing scabs off at day7 but Dr. Rahal says they should only have vitamin E dripped on until day 14 before touching and I have more faith in his protocol". Not sure how well that would go down (unless you decided not to mention it). In retrospect what I would have done is written to Dr. Rahal and asked "On this occasion can we please break protocol and (1) start removing scabs at 12 days and (2) removed stitches at 12 days and not 14?" I work in a small medical community and even finding someone 'anonymous' who could remove stitches at 14 days is not possible (and I wanted to do this discretely)

I recently documented my story on this forum regarding a failed HT with a former coalition doctor in the US. To add to the mess, I also then lost $2000 deposit after booking a late spot with Dr. Rahal only 20 days in advance of a procedure (to coincide with a trip to the the US from Europe) as I cancelled at 10 days pre-op due to concerns that I'd be unable to go back to work 14 days post-op looking presentable. I'm willing to take my share of the blame for being too hasty (and desperate after failure of first transplant). But I also feel I've been unfairly treated by Dr. Rahal's practice. To reiterate, I only had direct contact with the patient coordinator, never Dr. Rahal. When enquiring about the procedure, I said I hoped to be back at work in 14 days and was told I'd need to shave down. I specifically stated that this would be difficult. I was told they could make it stubble, instead of a zero guard. I thought ok, I'll deal with that. I paid the deposit. My grudge is this:-after I paid the deposit, I was then sent all the pre and post-op instructions stating I couldn't even touch the recipient area for 14 days, at which time scabs could begin to be gently removed. Shouldn't I have been told this before I paid a non-refundable deposit? (it wasn't stated it was non-refundable, it was assumed I'd checked the website). The patient coordinator knew well of my concerns, but he neglected to tell me. And the info is not on their website. Why not? I can't turn up to work with scabs all along my hairlines, out of the question given my line of work. Shouldn't there be some terms and conditions when paying up-front that the patient is made aware of? As I said, I messed up, but not to the tune of $2000. I think it's unethical. Am I wrong here? To be fair to them, they do state on their website that cancellations with less than 30 days notice lose 50% deposit, less than 14 days 100% irrespective of the reason. But this must apply to patients who book more than 30 days before, not patients who only book 20 days before? Who hasn't been given all the info needed? $2000 is a lot of cash. Isn't the point of a deposit to ensure the doctor doesn't lose business by booking a spot that might have been filled by someone else, that then falls through? Given that 14 days pre-op is the latest booking time (as the patient coordinator told me), that would mean that Dr. Rahal lost a potential customer between day 20 and day 14 pre-op. In the defence of Dr. Rahal, the coordinator said they could ask a local patient to take another day so I could get the procedure on the Monday. They rushed things to fit me in too (and I mean that in their defence). In addition I've no doubts Dr. Rahal is second to none in his skill, and by all accounts he sounds like a very decent guy. But in this instance I feel they've acted unethically by failing to accept that they have some responsibility for letting a prospective patient know what's ahead for him when they accept a considerable deposit. Again, I was too hasty and didn't perform due diligence but I never knew any doctor required that the recipient area can't be touched for 2 weeks. I believe it's highly unusual. I was offered $1000 discount if I re-booked with Dr. Rahal but I simply can't follow such a stringent protocol, I need discretion so will go to a coalition doctor that doesn't require shaving and actively encourages removal of scabs at an earlier time point (such as Shapiro). Why is there zero info on Dr. Rahal's extensive website about the stringent post-op protocol, including no exercise for 3 months? Apologise for the long whine, but this has left a bad taste in my mouth and I'd be very interested to hear if I'm out of line here :confused:

Thanks for your thoughts. It's too short to cover the recipient zone at the moment, although if I grew it longer it would, albeit with a contrived style (it spikes straight up naturally) if I attempted to cover everything. Given the eagle-eyed people I work with (and my girlfriend), I think I'd just have to accept it would be noticeable 2 weeks post-op if it's going to be done properly.

My frontal hairline was lowered by about 1.5 to 2cm, and the original hairline was thickened very slightly. I have pretty solid hair, it was just the hairline was a bit high. Ironically, before I had a solid, if higher, hairline and now I have a weak, but lower, hairline. The former looked better, and in decent lighting is actually looks like my hairline is still where is was, with 'stragglers' below. I never got any info on the break-up, singles, doubles etc, but it's at least done properly with only a couple of doubles on the hairline, so it doesn't look pluggy. And the sides seem to have grown without even shedding. So a mixed-bag, but ultimately, it's not ideal cosmetically.

Thanks a lot for your tips guys. Haircut, I understand your point, I should specify that the doc who performed the surgery is not recommended on here so I doubted his name would come up.

Hello, I'm seeking opinions on which course of action I should pursue after a disappointing 1700 graft transplant to my hairline performed by an IAHRS surgeon in the US (I flew from Europe to have it performed). I'd prefer not to name the surgeon as I don't like anyone, patients or doctors, using the internet as 'leverage' for personal gain or other dubious reasons (even if I lose respect for the other party). Most importantly I'd rather just focus on where next and avoid conflicts based on historical events, As you can see from the 10 month pic, the density is poor and doesn't match the hair behind. I'm a 42 yr old non-smoking male so not sure what happened. I voiced my concerns to the doc's patient co-ordinator on several occasions, and he promised they'd do a complementary touch up if there were problems, and that I should be patient. However, when I contacted again at 10 months (10th of January) re. possibility of a touch up, I was told my result was acceptable and that I had decent growth, so if I'd like a touch up, I could get a few hundred grafts for $1000 (reward for loyalty). More and it would be normal price. I wrote I'd just wait then, and see the results after 18 months or so. But I realised I was fooling myself, and that it wouldn't be the result I'd hoped for, even after 18 months. So I decided to contact a reputable IAHRS surgeon (also on the 10th of Jan). His coordinator showed him the pic, and said the doc thought he could help. But that shaving would be necessary. I expressed my concern about shaving, as I needed to be at work on 14th of Feb and wanted to be discreet (and am in new relationship). But I accepted shaving would be necessary. As I'd be back in the US at the end of Jan, they said they'd move a local patient to the next day to fit me in on the 31st of Jan if I paid a $2000 deposit. I paid on the 11th of January (in retrospect too hastily) and booked flights. After paying, I was then sent all the various payment & post-op forms, and realised the post-op care was vastly different from the last surgeon, and included not touching the recipient site for 2 weeks (in the first surgery the scabs were to be rubbed off at 7 days and I even was allowed to shave the recipient area). The thought of turning up at work with scabs on my head started to scare me and gradually I got cold feet and cancelled last Friday (on the 21st) and have been informed the $2000 is gone but that I'll get a $1000 reduction should I rebook. As anyone who's been through a bad surgery knows, the thought of hopping back into the doldrums is not a pleasant one. Anyway, it was my fault for being too hasty, to the tune of $2700 (with flights). So....now I'm in the situation where I've got a bad result, spent a lot of cash, and still need to get it fixed at some point. I'm thinking I (a) have to find a surgeon who won't shave down and risk getting a sub-par result or (b) get it done properly and accept that I'm going to come back to work at some point with a bizarre haircut and scabbing (I can't take more than 2 weeks off work) and be open about having had a HT. Not a pleasant thought. Any advice very much appreciated!