Saul Goodman

On 7/5/2023 at 8:17 PM, disTressedHairline said:

Thank you for posting again, I had seen your previous posts here and on Reddit and had wondered what the outcome was. I had no idea you were overharvested, that's just terrible. 
 

Agree that Nader is a good choice.

 

Edit: removed my recommendation for Arocha, and sorry again about your work with McGrath. Thanks for your post!

 

Planning on scheduling something for the new year. 
 

I have some concerns about going to Mexico for the transplant. I’ve been contemplating scheduling a consultation with Dr. Arocha. Could you explain why you removed your recommendation for him? I appreciate the advice! 

Hello,

I posted my situation with Dr. McGrath back in 2021. The thread is in the link below. 
 

To summarize where I’m at now, I sent McGrath my 1 year update in Jan 2022 and explained I was dissatisfied by the obvious gap on the right side, as well as clear over harvesting on the back right side. In the email, he acknowledged that he had messed up, was very apologetic, and asked me to come in ASAP for a repair job.
 

It was very difficult for me to set aside time with work & my social life to have a noticeable procedure done like an FUE HT, and I didn’t feel like going through it for the second year in a row, so I did not respond to his offer to repair my botched job. Further, although it would be a lot cheaper to have McGrath do the repair, I feel like going back to the same surgeon who I was unhappy with previously is a mistake given my limited donor hair. 
 

We’re now 2.5 years down the road and I am contemplating getting the situation fixed. The gap is quite noticeable and while there’s likely been some additional hair loss, I feel like a HT is obvious given the gap that was left. Multiple barbers have asked when I got my procedure done, so it’s clearly noticeable to some…

Which leads me to my question. My apologies if this is not proper etiquette on this forum, but considering I wished I had found this place before choosing a doctor last time, I wonder if any of you have Austin surgeons you’d recommend. The closest on the “forum recommended surgeons” list is in Houston and that’s less ideal, but I would be willing to travel some. 
 

I really appreciate all the advice!

Day 133 (4 months & 13 days)

It seems to be about right for the timeframe, but I’m curious to hear what you all think. Sorry for missing a month or two with posting. I recently moved and it’s been a hectic time. 
 

You can still see the gap on the right side that I previously complained about from an aerial view. I chose the 2 pics where it was most apparent. Hoping it blends soon as there’s nothing I can do at this time. What do y’all think?

34 minutes ago, JohnAC71 said:

Looks perfectly normal for the 2 month point. It’s not going to Improve that much in 3 weeks to be honest. 

Haha I know. I’m pretty realistic about everything and have looked at so many progression threads that I know it won’t be great in 3 weeks. Not too worried about it either way. 

8th Week Update 

- Things are going pretty well. Each week looks a little bit better than the last.

- Starting to be a little concerned about the right side being over harvested. Still pretty thin and red on that side of the donor.

- I’m going to a wedding in 3 weeks, and I’m hoping I’ll have some decent improvement before then. I bought DermMatch because hair fibers are very noticeable at this stage. Only tried the DermMatch once and it’s not a great color match, but I may still use it for the wedding. 

- I had to go to Chicago for work, so I had the sides trimmed to a 2” a week and a half ago. Nothing off the front.

- Every day I get 2-3 of the little pimples (in the pic below) on my donor area. Is this normal? Any recommendations on how to treat this? I’m waiting on a folliculitis treatment to arrive from Amazon that I ordered yesterday. 

How do y’all think this looks for the 2 month mark?

Just now, RandoBrando517 said:

I hope it works out for you, has he offered to add grafts there? Seems like that would be the logical thing to do. 

When I complained about it, he said we would add grafts there, but that he thinks it will turn out good and not be necessary. Nevertheless, it clearly could've used a few hundred more grafts on the right side that I gladly would've paid for. I will say, the gap was not very evident when I was fully shaved and the donor area was drawn. 

4 minutes ago, RandoBrando517 said:

Why would the doctor leave that gap?

Your guess is as good as mine. Thankfully, the gap is less noticeable in the photos I just posted. It still bothers the hell out of me though.

13 minutes ago, JohnAC71 said:

Looks on track. But you wont see any real growth until at least about 3.5/4 months approx. Month 1 to 3 is the worst part. Known as the ugly ducking stage. 

Oh, I know. I’m just hoping it’ll look better in early March than now. Some of my native hair will hopefully be back and I’ll at least be able to cover it up with Toppik. 

1 month update — 

These photos are under very harsh lighting and look worse than usual. The redness isn’t as noticeable in person, but I am continuing to wear a hat at work until it looks quasi normal. 
 

The right side is a little more bare than the left, but I’m starting to see some new hairs sprout. I had a lot of shedding between day 12 and day 24, but it has slowed down since then, with only a few hairs noticed after shampooing. the right side of the donor area is also more noticeable than the left, but hopefully recovering. 

A couple questions — when is it okay to start using minoxidil on the recipient area? Generally, when do you think I’ll be able to use hair fibers without it being noticeable?

Everything looks about right for the 1 month mark, and I’m hoping to see big gains in the next month. What do y’all think?

19 hours ago, DenverBuff1989 said:

@Saul Goodman any update on your plan of action? Are you just going to wait and see what happens?

Yeah, that's the plan. I figure there isn't much I can do right now anyway. The gap is starting to fill in a little bit, and while I'm obviously still not happy about it, I'm thankful for that.

I figure I will wait until the real growth starts (month 3-6) before planning something to fix the issue, if that is even necessary.

The aftermath of the FUE has been very difficult with work, so I desperately don't want to go through this again any time soon. I also didn't have any big social event until late March this year, so the date of my FUE was ideal to get this done. I don't know if I'll have that much time in between events to do this all again. I'm hopeful it will turn out okay.

3 weeks - day 21 update 

I have been shedding in the shower every morning since day 12 and I believe it’s getting worse. The gap is still pretty noticeable on my right side, behind the recipient area. The right side of my donor area looks a little rough still too. What do y’all think?

Is 2 weeks too soon to use aloe vera on the recipient area to help reduce the redness?

16 hours ago, Style22 said:

Totally see what your talking about. Did you talk with Dr. McGrath about it?

I emailed him last night and he immediately responded. He believes I have nothing to worry about. He said it's still very early and that the native hair and transplanted hair will melt together as it continues to grow. He wants to have a call today to talk about it. I will say, he has been very responsive and reassuring throughout this entire process, but it doesn't change that I believe we should've gone further back on the right side. 

3 hours ago, DrTBarghouthi said:

First of all congratulations on wrapping up a rather exciting milestone. I do understand your anxiety regarding the post op care and anticipated results especially with identifying a gap in the right temple area. While I do agree that there is an obvious empty area, I must first of all point out that anything related to density or empty spots is usually the best of both evils when it comes to recovery. It is nothing that cant be fixed and certainly not irreversible. Not ideal I agree, but certainly not on the top of the list of things that could have gone wrong. Yes it may be shock loss, but I think it is an empty area that could've been filled and is easily filled in the future. It can happen in certain cases where the numbers are under estimated and we need to go back and extract more which is the ideal way to do it. In fact we have recently switched to making all sites first and then extracting the numbers in an attempt to eliminate any surprises. What matters now is that I dont think it will be a noticeable thing once hair grows and in case it needs filling up, then it will hopefully be a very limited and small job. Best of luck. 

Thank you for taking the time to respond to my issue, doctor. Ideally it'll blend decently and I won't have to go back for another procedure. I don't need incredible hair, I just didn't want to be so bald at 28. Taking the plunge that is getting a HT is a huge decision and I would've loved to not have this issue, but I suppose there's nothing I can do now.

The gap is not a completely bald area. It is just much thinner than the native hair behind it, so like you said, I imagine it will blend and be much less noticeable once the hair is grown out. It's just upsetting to spend $10K+ and go through something that is socially and internally tolling, only to have an issue that could've easily been fixed during surgery. I suppose I should be happy that it's not a larger issue but I'm certainly not pleased at this point. It seems like common sense to make all of the sites before extracting like you do, but I guess that's what I get for not finding this site sooner and being more diligent with my research prior to my procedure.

Thanks again for your thoughts.

36 minutes ago, DenverBuff1989 said:

@Saul Goodman in my own experience, my gap was evident right after surgery. The doctor had underestimated the graft count, and instead of ethically putting more grafts in during surgery as needed (I would have been completely fine paying for these extra grafts), apparently decided to only put in the grafts I had paid for beforehand, even if it meant her own work would be subpar. She even said to me as surgery wrapped up "your front could use more grafts in another procedure, but I think it will blend in well as is". What a lie...

It was my first HT and I was not knowledgeable about HTs at all and was very naive, so I thought this gap was "shock loss" and thats what the doctor kept telling me. In the end it was all fixable, I "just" needed another surgery to fill in the gap. 

I don't mean to be biased with my own personal experience, but IMO you clearly have a gap in the right temple area and in the mid-scalp, and because it seems like you have had this since the surgery, this is not shock loss and hair will not grow there. If I were in your shoes I would definitely reach out for a 2nd opinion from a different, elite hair doctor. It's hard to know if the operating surgeon will be honest with you, especially if they have made an obvious error. They very well may pull the "shock loss" excuse on you

Your gap(s) are not as significant as mine were, so as @Melvin-Moderator said, perhaps the hair will cover it and blend in well. However, this does not make it right at all, and its not what you paid for. You may be very limited in hairstyles you can do. Furthermore, if you have further hair loss, the gap areas will just get bigger and it will turn into a huge mess. The pessimistic scenario is that these gap(s) will not blend in well as in the current state. In either case, I assume you would want a repair surgery. You did not go down the HT journey expecting unnatural gaps in your hair. 

I sincerely hope I am wrong and am just blinded by my own experience, that's just my 2 cents. In my own situation it was all fixable in the end. 

Thank you for the thorough response, even though it isn't exactly what I want to hear. I was quoted at 2000 grafts upon inspection of my head pre-op and like you, I would have gladly paid for more for proper coverage. I received 2263 during the procedure, which is great to get those extra 263, but it appears I needed more. I was slightly balder on the right side and my recipient area is symmetrical rather than being heavier on the balder side. I part my hair to the right, so I imagine it'll look decent once it's full grown, but it's just bullshit I wish I didn't need to deal with. Dealing with the social aspect of a HT is enough to not want to go through it again, let alone the fact it's a pretty invasive procedure. Do you have photos you could share with me from your first procedure that show the gap? 

Does this forum have a list of reputable doctors who would be willing to give me their opinion on the topic? I have yet to bring it up with my doctor although I probably will tonight when I get home from work. 

Here’s what I’m talking about. These photos are from yesterday (day 11). 

1 hour ago, Curious25 said:

1) Yes 

 

2) Potentially. It ultimately boils down to your bodies physiology and growth rate of hair. 
 

I’d just like to add I hope I didn’t cause you any anxieties with my previous comment - it’s a shame you found this forum after you pulled the trigger, however I think you’ll be fine in the sense that you’ve not gone to an outright bad doctor or clinic, maybe more so just not the best option you could have gone for. 
Like I said, the work looked good in the post ops, just make sure to look after yourself during the recovery period, and give yourself the best opportunity you can to grow it in. 
 

As has also been mentioned - you have a lot of donor remaining for future ops, if needed 😊 

Thank you for the reassurance. It wasn't so much what you said as it was what I read using the search feature. I saw some positive things too though, and I think it looks decent to this point, so I'm still hopeful it turns out okay. My only gripe is that I don't believe they went back far enough on the right side. I would've gladly used a few hundred more grafts to cover that area. The morning of the operation, we drew the area on pretty lazily and I wish I would've examined it more before the procedure. I think it should look fine once my hair is grown out, but it makes the transplant much more noticeable in the interim.

I began shedding today in the shower (day 12), which is sooner than I expected. A couple questions for the experts on the forum -

1. Day 12 is somewhat normal to begin shedding, right?

2. If you begin shedding sooner, does that mean you’ll get through the ugly duckling stage sooner?

It seems to follow logically that the sooner it falls out, the sooner it’ll grow back but I don’t know if that’s true. I’m trying to find a positive. Haha

48 minutes ago, JohnAC71 said:

All you can do is wait for the 12 months and reassess? Keep updating here on a monthly basis if possible. 
 

Will do. Thanks for the words of encouragement!

13 minutes ago, JohnAC71 said:

I can totally understand what your feeling. I too only stumbled on the forum after my 1st HT (+10 years ago) and then I really started to learn who to go to, and how little I knew about the process.

I think you will be fine, is he a elite dr ? No, will you get a good result ? Yes in all likelihood you will. 
 

IF going forward you need to get another Ht then you would be much better informed and could chose better. 

The good news is that I only used 2263 grafts, so if I need to go again with another doctor, I should have donor hair left. It sounds like Arocha is the board's favorite as far as Texas docs go, but I would do much more research here if that time came. I REALLY hope I don't have to do another one, at least any time soon, because this has been a difficult process as all of you know.

I will say, my concern about not going far enough back on the right side seems more valid now. I definitely didn't do myself any favors by using the search feature here retroactively. haha 

I only found this forum after my HT. I had seen a couple other forums with much less activity and had browsed Reddit, but just recently stumbled across HRN.

I wish I had done so sooner because I now have a lot of anxiety about my FUE after reading some negative things on here about McGrath. Not much I can do at this point but hope for the best. I guess it's promising things look normal to this point.

You're in your own head bro. Your hair doesn't just look good, it looks great. No sign of HT and if I saw you on the street, I'd be jealous of your hair. 

On 1/14/2021 at 10:54 AM, UnbaldEagle said:

At least you're maintaining though, you've got a fair amount of native hair. Are you still using topical minoxidil too?

I haven't used it since my surgery -- I'm not sure when I can start using it again, but I will. Prior to the surgery I used topical minoxidil foam twice a day. It generally allowed me to somewhat style my hair and was easy, so I figured "why not" despite not seeing much in the way of results. It supposedly only works in the crown anyway, right? It's not a large expense and it's easy, so I will continue my regimen of minoxidil & the fin combo pill. I may switch back to the generic fin at some point because it was super cheap in comparison, but I haven't thought about it much.

4 hours ago, UnbaldEagle said:

- Prescribes a combination of finasteride, oral minoxidil and biotin that he compounds himself to his patients. 

I switched over to this in November of '19 from generic fin. I didn't notice much of a difference, but the photos at the 1 year mark may have shown a little improvement. 

5 minutes ago, TorontoMan said:

Lol I actually think your head looks good buzzed. 

2 minutes ago, caricatura said:

Was going to say the same.

Thanks guys. Maybe I'll try it out once I have a decent hairline!