asterix0

Congrats on your latest procedure and a great outcome on the way, will follow this 🫡

It can take several months. 

The only way you can fix this is going to another surgery and repairing it. 

Awesome I'll be keen to try this out. 

Dude congrats I think your result looks good.

But I just want to comment to any prospective newbies viewing this thread, indoor car selfies are the absolute most favorable lighting to take a picture. There is no down light going down through the top of the head like on a sunny day outside.

Keep that in mind when evaluating any result, and taking the plunge with thousands of dollars, all the time, energy and effort, only to be confused why the result looks much different potentially in the mirror or in natural sunlight walking outside.

do you have any tips how to apply your styling product? Does it still hold your hair well on a windy day? @Melvin- Admin also chime in if you haven't made a video/tutorial on this already. 

The pictures are unclear, I do not see much of a difference. 

22 minutes ago, FormerFutureKrillin said:

This is confusing the issue - they are saying they often place two, separate, 1-hair grafts into a single channel to “create” a double (or perhaps a 1-hair graft with a 2-hair graft to make a triple etc.). So multiple grafts in one incision, which would mean two 1-hair grafts in a single incision would appear to the software as a single graft with 2 hairs. Thus, the software would be undercounting the total grafts that were extracted. The amount of undercounting would depend on how many grafts were combined this way.

This is all the more reason the graft breakdown should be provided asap. The graft breakdown would likely go a long way in clearing this up, which is why it’s so odd it hasn’t been provided. The longer it isn’t provided, the more it seems like Dr. Bloxham just doesn’t have it.

For what it’s worth, my graft breakdown from my surgery with Bloxham was also never provided to me, but in fairness, I didn’t ever ask. I would be interested to see if other Bloxham patients on the forum were ever provided with that information.

Interesting, I didn't know that was possible. Why would a surgeon prefer to do that, intuitively it would seem to compromise graft survivability? 

4 hours ago, BackFromTheBrink said:

Because they implanted more than one extracted follicle in some of the incisions.

Well, there can certainly be more than 1 follicle in a graft, that is the whole point of there being single, double, triple follicles in a graft.

We are talking about grafts though, not hair follicles. 

A graft is clearly identifiable, it doesn't matter if it's a single, double, or triple, all we have is a binary classification of graft or no graft. If we are talking about hairs then that is a different story. 

Can anyone help me understand, with the pictures OP provided, using software to count the grafts since they were transplanted on bare scalp, how we cannot get the accurate number of grafts from that?

Why speculate on strip width and all these things instead of just counting the grafts?

14 hours ago, deep7 said:

I don't have strong opinions about microneedling, but all controlled studies I came across suggest that micro-needling works (at least works with minoxidil better than minoxidil alone) and is safe if done correctly. Also, most of the best regrowth cases I came across from NW6/7 included micro-needling in their regimen, was it because of the addition of microneedling? Hard to know with certainty.

At the end of the day, the fundamentals of hair loss are currently not well understood, and forums are full of varying points of view, so whatever I do, there's some probability that I'm wrong, for the moment I decided to keep microneedling until I come across compelling reasons to stop.

I strongly suspect it is due to just increased minoxidil absorption, oral minoxidil could achieve the same effects. 

How old are you? I have seen this happen more frequently but it may just be coincidence with genetics, or the increased stress theory like people here have said. 

1 hour ago, jjalay said:

This is an example from ireland:

https://www.irishtimes.com/news/man-wins-70-000-damages-over-botched-hair-transplant-1.699720

The patient sued the clinic and won the trial and 70K compensation for the damage this doctor has caused him. If you search the internet you will find many cases like this one.

Yes this is interesting, the problem is really how much is the juice worth the squeeze. The legal system is very drawn out and inefficient, a bit too coincidental isn't it that the mode of billing is billable hours. 

For OP's case, such an outcome is probably unlikely but if he has the fire in his belly to do so perhaps formulation of the case along with requisite paper trails with communication from the clinic, expressing his concern and dissatisfaction and how it is affecting his life, with their responses, would greatly aid such an endeavor. 

9 hours ago, Buffaloboy said:

I can tell you've never been to law school.

You can not perform a terrible medical procedure and then hide behind a clause in a pre-surgery document. It doesn't work that way. Nor are you only entitled to compensation if you are permanently disabled or disfigured. 

The mental anguish alone would find favor in many courts. As would the requirement to wear head covering to hide the the terrible angles that are going the wrong way. 

The reason that many surgeons get away with this is:

1) It's much more difficult to bring suit against a foreign doctor. 

2) Most people do not have the funds in order to pursue this long term. The clinic likely has an attorney on retainer to delay, motion, delay, motion, etc. This eats away at a plaintiffs funds and many simply drop the case as they run out of money. However, a plaintiff with deep pockets can pin a surgeon to the wall if they can wait until it eventually hits a court room. 

Yes sadly this should be in the risk calculus for patients before they decide to take the plunge. Everybody thinks they can beat the odds. Truly there is nothing that can be done because even if everyone on these forums stood on their roofs and warned against hair mills and scams, you would still have people go and roll the dice, probably enough to keep business rolling for quite a long time.  

1 hour ago, HappyMan2021 said:

A court of law is not going to get as granular as bad angles, multi grafts, etc. 

The court's litmus test is going to be "did OP get disabled from this surgery. Has OP lost wages, etc."

Also, consider we are on a hair transplant forum so naturally there is going to be an exaggerated amount ton of sympathy, support, understanding, etc. Op is preaching to the choir here lol. 

In a court of law its going to be a much less sympathetic, much more black and white litmus test

If OP had a legit claim, why isnt every botched patient suing their doctors?

OP is hardly the first botched patient to consider the legal route

Mental health is getting more sympathy in the courts. OP could claim bad psychological impairment which affected his work performance, well being, medical expenses for therapy, etc. 

You came a long way, this was a tough repair case.

I don't know how it works generally, but when I had my FUE, the doctor was counting the grafts while the extractions were taking place, and I was awake during the whole procedure so I knew I was getting what was claimed. The same for when they were being implanted, they were counted and I was conscious to follow along. 

2 hours ago, bluebird00 said:

It is in the report.

1676 total FU's
Average Width = (1.6 cm + 1.8 cm )/ 2 = 1.7 cm
Total Area (Length x Width) = 29 cm x 1.7 cm = 49.3 cm
Total FU's (area x FU/cm2) = 49.3 CM * 34 FU/CM2 = 1676 FU's

 

edit: this is for the initial strip. Two additional strips were harvested. This also assumes 34 FU from 1676 grafts. I don't think that's accurate. Should be more like 54 FU. 

Ok, I misunderstood I thought that meant for the 3 strips combined.

Nevertheless it seems astounding to have taken 3 strips during 1 procedure. I suppose I "could" understand another one if the first one didn't yield enough grafts, but why induce even more scarring with a third and not take the necessary number in the second?

Everything is perplexing in your case, I am sorry you are going through this.

I will say though since you have fine hair, a second pass would probably have been necessary anyway to achieve the required density on your hairline. It is common for patients with finer hair transplanting on bald areas. Still though, the discrepancy in counted grafts vs what was claimed to have been implanted is worrisome. 

"49.3 sq cm with a follicular unit density of 34 FU/cm²"

OP that math indicates 1700 grafts, this is the report that Dr. Bloxham provided to you?

@Portugal did you by any chance measure DHT levels before and after you started TRT? 

It is part of the tradeoff some of us unfortunately have to deal with.

Try topical finasteride or dutasteride maybe that will help if you can't tolerate oral. 

It will be interesting to see how this turns out. Perhaps a relatively short haircut with the beard grafts will look good.

I don't know how old this patient is, nor what his motivation is to do this now. I am assuming he is pretty old. One would think at this point considering the quality of the donor area, it would be better just to accept the situation and move on. 

10 hours ago, deep7 said:

Where can I find more info about this claim? The assertion appears dubious to me, given that microneedling's primary goal is to provoke a healing response from the body, possibly increasing collagen production during the process. The tissue is not meant to stay permanently damaged, so I don't see how that tissue would become unsuitable for transplanted hair.

Not trying to be combative, merely trying to find the truth before considering dropping microneedling

If you try micro needling by itself you will see almost no hair regrowth. I have looked at many, many cases across the internet and it is only in conjunction with minoxidil that it does anything. 

The science may show that in theory it is supposed to do something, but we can say the same thing for saw palmetto or pumpkin seen oil as an alternative to finasteride, yet everyone knows that those treatments are pointless.

I spoke to several hair transplant doctors prior to my transplant and asked about micro needling and they recommended that I discontinue it, but continue to use minoxidil and finasteride.

Really what is just happening is greater permeability of the minoxidil through the wounds on your head. However, these wounds if not taken care of properly can also lead to infection, particularly if you don't sanitize the needle cartridge before and after each session. I would hope people are using new ones after each session.

I tried micro needling myself 1x a week and did not see any significant improvements vs my prior just finasteride and minoxidil regimen.

Also, consider the mere scientific fact that our cells cannot regenerate an infinite amount of times. The number of times is actually preprogrammed. Think if you were to continuously injure any other part of your body, it would not be conducive to making it strong and healthy as it would constantly be in a healing stage.

I think that the whole micro needling effect is more useful science but not very useful for male pattern baldness, when you could probably get the same benefits by just taking a more potent oral minoxidil dosage rather than doing micro needling + topical minoxidil.  It perhaps does have other applications though. 

Drop the microneedling, if you decide to get a transplant in that area your existing tissue may be damaged and not have it suitable as a foundation for the grafts.