Jamie_Finndust

17 hours ago, mr_peanutbutter said:

sometimes thinning and miniaturizing isnt that visible in pictures. to get a full picture  need a clear eye and sometimes even a microscope.

another example would be signs of lichen planopilaris which basically rule out any form of hairtransplant but not necessarily can be seen in pictures 

 

pictures can never replace a in person consultation - so yes, if the clinic hasnt said that, it was miscommunication 

 

 

 

True; but I think you’ve missed the point.

Being, that after going through this process I still have no idea what type of outcome I would have seen from Laorwong; and I dont feel confident he knew what I would have been satisfied with. Again, my feeling is he thought my requirements were higher than what they actually were. So who (least of all you) can say that I should be glad the procedure didn’t go ahead when in fact; there’s a pretty good chance I would have been satisfied with the outcome? This is probably the most frustrating part of the whole experience.

1 hour ago, mr_peanutbutter said:

as a norwood 7 you should mostly go with

dr.pitella

eugenix

 

bodyhair will be needed.

be glad the dr. didnt go through with surgery, no you can reconsider and get surgery with another doctor

 

i personally think the behavior of the doctor was ethical

Why exactly should I be glad the Dr didn’t proceed with surgery?

Also, the point of this thread is to stress the importance of communication; not one about ethics. If you want to discuss ethics; feel feee to start another thread and I’ll happily contribute to that. Although one thing I will say on that is, its clearly unethical to flat out lie about the requirement for a liability waiver, which Dr Laorwong did, in writing.

As most people have guessed. My planned surgery was with Dr Kongkiat Laorwong. 

Probably best using him for low Norwoods. For high NW or complicated procedures; if you use him; do so only if you are confident you can brake through the communication barrier.

On 10/29/2023 at 11:40 AM, Fabio said:

Without you saying the name of the doctor, I can tell who it is. While I agree the communication could be better, it’s difficult to provide an accurate analysis based on photos when consulting over email. When it comes to the pre-consultation in-person, I agree, it happens very quickly and more questions should be asked by the doctor. While this doctor is extremely talented, if he/she wants to truly manage expectations with their clients, there needs to be more asked during that process. With that said, no doctor will be perfect and sometimes the clients have to engage the conversation to truly convey what it is exactly what they want. Without any pictures, it’s tough to say how much better of a job the doctor could have estimated this ahead of time. 
 

On another note, do you still expect to get a HT? Even with an estimate of 7k, that’s a lot of grafts. Since I trust the doctor in questions estimations, I don’t think any other doctor will be able to achieve the density you want with the grafts you have available. 

I’m also left not knowing what to believe. Would I have been happy with the surgery; or as the surgeon said; would I be dissatisfied?

I did my best to research HT and communicate with the surgeon.

I dont think I could put myself through that process again.

On 10/28/2023 at 8:02 PM, TorontoMan said:

Just curious, they told you you were nw7 at the clinic, what was your estimation for your Norwood before getting there ?

During the video call consultation/ review of photos I was told NW6. Another clinic also gave me the same advice. The day of the surgery at the clinic, was told NW7. 

Im not quite at NW7 but you can clearly tell that I am heading that way due to my thinning patterns.

I think it’s worth remembering that between the first face to face meeting; and the time of surgery; which was the very next day; the advice changed from; you need 7k of grafts to achieve your goals, to; you need 10-12k, but thats not available to you due to insufficient donor

58 minutes ago, Berba11 said:

I think it would be useful.

It's not clear to me that this surgeon did anything wrong or that you did anything wrong. I think it shows the limitations of not getting an in-person consultation prior to the booking of a surgery, and it shows how communication can breakdown a bit when travelling abroad. These are important realities that you've shared, which is a useful contribution for others looking to go abroad.

As for the Dr's name - if you did share it might at least help others considering the same surgeon to know that a) that surgeon would be willing to pull the plug last minute (which isn't a bad thing by any means), and b) to have an understanding in advance that communication might be tricky and to plan accordingly.

I did have an in person consultation the day before surgery. Unfortunately there was inadequate communication during that session. Otherwise we wouldn’t have had changing advice the day of surgery, with regards to how many grafts I would need.

I tried. They tried as well Im sure; but ultimately, it missed the mark.

My point really is, do you want to choose a surgeon who can’t effectively communicate with their patients? For straight forward cases, it may (arguably) be less important. For high Norwood/ complicated cases, it is very important.

8 hours ago, Chrisno said:

I understand OP is let down.

However, although some communication errors have been made, this sounds like an ethical doctor to me in that the surgery is cancelled when he understands that patient expectations cannot be met. If there had been more surgeons like that, many 'disaster cases' where patients are highly dissatisfied could have been avoided.

This is not so much about ethics. They acted ethically by providing advice which aligned with their understanding of the situation.

In saying that, I did ask in advance for a copy of any contracts/ liability release forms to review; and was told there weren’t any. Then, the day before surgery I was asked to sign something… 
 

Anyway, this topic is more about the surgeon’s abilities to communicate with their patient whats possible and have the tools and competencies to extract the patient requirements and understand what they’d be happy with.

On 8/30/2023 at 6:32 PM, Jamie_Finndust said:

thanks guys,

 

i did get a response. ive been told there are no contracts to sign

 

seems sooo blasé!

Went in for surgery recently (it was aborted on the day - see my other post

Turned out that yes indeed; despite asking for these in advance and being told in writing that there would not be any; I was in fact asked to sign a liablilty release the day before my planned procedure.

42 minutes ago, jjalay said:

Who was your surgeon if you dont mind telling?

Im not totally comfortable posting his name publicly right now. If people on the forum think it’s important that I share; I’ll reconsider.

I flew half way around the world only to have my surgery aborted at the 11th hour. Understandably, Im very disappointed right now.

I’m writing this as a lesson to others of the importance of choosing a surgeon who can clearly communicate to their patient, what the likely outcome of surgery will be; and have the tools and capabilities to accurately determine patient requirements.

My story:

Ive been following this forum and others for years. This year I had the funds to go ahead with surgery. I had online consultations with two respected clinics and decided to go with the second; as the surgeon there does most of the work. This story only relates to the second clinic.

After sending an email with my current photos, I had an initial video call consultation with the surgeon regarding having a hair transplant procedure undertaken with them. We discussed my expectations and what would be possible. I was told I was a Norwood 6 and that we could have a good outcome with 6000-6500 grafts over two procedures. I was happy and excited with the way things were sounding, so booked the appointment. 

Over the next couple of months, I emailed the surgeon a few times with other questions that had come up with me. I received slow; short responses, or none at all. It was apparent that as people on the hair transplant forums had said previously; this was ‘a person of few words’.

The time came for my surgery so I took two weeks off work and spent 17 hours in transit to fly to the surgeons country/city.

I had my pre-surgery appointment which I thought went ok. We determined that I was still receding and that I would need medication to save the remaining DHT receptive hair. It was decided that we’d achieve an even density of 40-45/cm across my whole head (slightly higher across the hairline), now using 7000 grafts over 2 procedures spaced 12 months apart; the first 4000 grafts being performed the following day. Up until this point, I thought we were both on the same page regarding the expected outcome.

That night a couple of questions came up for me concerning possible hair styles and density/ ‘illusion of density’. I was able to talk with the surgeon about these topics the next morning while being prepared for surgery. This ultimately turned into a one hour (approx) conversation (with both of us dressed in surgical scrubs), where we seemed to go in circles trying to respectfully understand each other’s expectations.

I trust and respect that this surgeon aimed to achieve the best possible outcome and that their expectations are the closest (but still only an estimation) one could get to understanding the reality of the final outcome. 

Therefore the way I see it, the challenge to the surgeon is to ascertain patient requirements; communicate what outcomes are possible; and understand / communicate if patient requirements can be met. 

Once the patient understands what is possible with that surgeon and knows if this meets their personal requirements, surgery can commence. Simple right?

My main requirement was that I was able to grow my hair out and style it in a way that created an illusion of density without looking like an obvious 70’s comb over. I didn’t want to go through this entire process only to still end up looking bald/ very badly thining and then having to just continue to shave my head (albeit with scars). There needed to be at least an illusion of density. From what I had read online and heard from the surgeon previously, 40-45 /cm seemed to achieve this. 

Throughout the course of our conversation during surgery preparation I was now told that I was a Norwood 7; and based on the surgeon’s understanding of my requirements; that I would now need 3000 - 6000 additional grafts (10-12k in total) to achieve my desired look; but, that unfortunately I did not have that amount of donor hair available. I was quickly shown examples of very dense results that I said I would be very happy with; to only then be told that these weren’t available to me. I was not shown examples of results that looked similar to what the surgeon was suggesting. It was actually very unclear what visual outcome the surgeon was proposing.

Again; actual surgery and logistics aside, I see the hardest challenge as communicating surgeon and patient’s expectations to one another. 

I feel this is where my HT experience flopped. The surgeon was unable to communicate what outcome I might expect; I do not feel confident that the surgeon understood the outcome that I would have been satisfied with; and I believe they more than likely assumed my expectations were higher than what they actually were.

Furthermore; it took until the actual time of surgery for the surgeon to make a decision for themselves regarding their patient’s expectations; only to then state that a significant amount of unavailable grafts would be required to achieve this.

The surgeons advice now was that they felt I would be unsatisfied with the outcome and as such, they were uncomfortable performing the surgery. After hearing this, I felt that my power to make my own decision had been taken away from me and that I had no choice but to respect their advice. At this point, the surgery was canceled, along with my hopes and dreams of hair restoration.

Although the surgeon in question appears to be highly regarded for their technical abilities, I do not believe they have the skills to accurately understand and relay back patient expectations, be able to communicate to the patient what possible outcomes can be achieved, or do this within a time appropriate manner. While the responsibility of this is shared between both parties, I believe that the surgeon, given that this is their trade; should have available to them tools and capabilities to aid this process to a satisfactory end. The importance of a surgeon to be able to do these things is the lesson I want to pass on today. 

I’m happy to answer any questions or reply to comments.

47 minutes ago, Gatsby said:

If you have any doubts about keeping your hair and shaving it then I strongly recommend you reconsider having 6k punctuated wounds all over your scalp. Perhaps shave your head now and see how you like rocking that look. All the best.

Thanks, I appreciate everyone's comments. I shave my head currently. In my mind, HT is a risk with unknown outcomes. As impossible as this is, Im here to try and get a better understanding of likely outcomes and possible mitigation measures, in the advent that Im not not satisfied with the outcome. Thanks again everyone for your opinions, keep it coming

28 minutes ago, Jamie_Finndust said:

@BaldV Thanks for posting. I don't have insta - if its not too much to ask, could you please post screenshots of the photos?

 

@BaldV and others, these were the best photos I could find on those two people, and honestly, I cant see any scaring (Im assuming these were taken post surgery?). They look fine to me

I have similar skin and hair colour to these people

Volken

Menaja - Not really a good enough photo to tell if scaring is visible, and again, dont know if this was taken post surgery

16 hours ago, BaldV said:

Check this guy 

 

https://www.instagram.com/nemanjamilovic/

 

he had an ht on a NW6 area and then shaved it all off

 

This guy did the same

 

https://www.instagram.com/volkan_oezdemir/

@BaldV Thanks for posting. I don't have insta - if its not too much to ask, could you please post screenshots of the photos?

i just read @hairman22’s post.

I guess this is what I could expect. Turkhair, I agree with you in that it is visible. If it looks bad… well that’s subjective.

Interested to hear if others shave/ buzz their hair after FUE or if the community generally thinks its a bad idea or not.

@hairman22 Would you feel comfortable shaving your head now? Is this something you’ve ever done?

On 9/18/2023 at 1:24 PM, Turkhair said:

Should I be honest or be nice?

edited: just noticed my post has been answered already

Thanks for your response. Is this the case even with FUE?

In case I don't like the outcome of my surgery (most likely due to lack of density - or not being able to find a hair style that I like), can it look ok to then just go with buzz cuts?

I'm currently Norwood 6 (40+ yeas old - have been balding for almost 20 years - no meds). Have been advised I need 6,000 grafts over two procedures. Im booked in for the first procedure focusing on the front and mid areas. Will get the second for the crown. as soon as advisable.

Will it look weird to buzz cut without getting the crown procedure done?

Thanks guys

Hey everyone,

Can anyone advise a beneficial scalp care routine for the lead up to surgery which might improve the conditions required for the grafts to grow?

Ive got my 1st procedure booked in 10 weeks.

44yo. Norwood 6. Dont currently use any meds (not to keen about fin). I generally look after myself. Decent diet; no junkfood/sugar. Non smoker, minimal alcohol. Moderate weekly exercise. Not overweight. No health issues.
 

Im curious about Specific vitamins? Derma punching/rolling? Minoxidil?

Thanks!

thanks guys,

i did get a response. ive been told there are no contracts to sign

seems sooo blasé!

Ive twice asked my surgeon for copies of any legal documentation in advance and they have both times ignored/ dismissed my request

It all seems very informal so far. No invoice, no formal receipt of the deposit and no contracts. Everything has just been communicated via email messages.

Doesn't seem right to me.

Hey all;

Ive just booked for my first procedure. 

Q: Is it common to sign legal contracts before the surgery?

Thanks

Hi Jamos; 

Your result looks great. Id be happy with that if I was you.

Question: Based on your experience with Dr Laorwong, do you have any advice for others getting surgery with him?

Perhaps questions you wished you’d asked, general communication, or anything to do with the hairline design?

ok no worries. what im hearing is that there’s no immediate concern with taking donor hair from outside of the areas indicated in that diagram

Regarding safe zones; how concerned would you all be to be told that its not a consideration for someone my age with a Norwood 6; even given the fact that i might not be on meds long term?

I was under the impression that you could assume a generic safe zone for estimation purposes as per this diagram 

My hair loss is like the first photo on the sides and the second photo on top: