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Dr. Robert Haber

Elite Coalition Physician
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Posts posted by Dr. Robert Haber

  1. 1200 grafts placed into an area of about 100cm2 would give only 12 grafts per cm2. Hardly enough to make a lot of difference, but enough to satisfy someone with modest expectations. I wouldn't place only 200 grafts. I would add 200 complimentary grafts to a second session, if he chose to have another procedure. I agree that the results are subtle at the present time, but I generally see additional density appear between 9 and 15 months.

  2. That would depend on my assessment of his growth. If his growth was excellent but he was still not satisfied, I'd probably offer 100-200 complimentary grafts. Again, not because anything went wrong, but because its better to have a happy patient.

     

    I shared this case because its too easy to always show great results and happy patients. I wanted to share a case of an unhappy patient as a learning experience for all of us.

  3. Thanks for all the comments. I conduct all consultations myself, and never proceed with surgery unless I am comfortable that the patient will be happy with the results I can provide. When a patient can't afford a large enough session to give benefit, I suggest putting money aside until the funds are sufficient to undergo a larger procedure. In this case, as the patient was an older gentleman and voiced very reasonable expectations during the consult, I thought 1200 grafts would make him happy. At 9 months, the growth is incomplete, and I remain confident that several months from now he will be happier. What if he's still unhappy in a few months? As its in my best interest to have happy patients, under such circumstance I will generally offer an appropriate number of complimentary grafts during a subsequent session.

  4. 62 year old man 9 months after small HT due to limited finances to enhance frontal density. Fewer than 1200 grafts used in the frontal region, and at his return visit recently, he was very angry about the "complete failure" of the surgery. The photos demonstrate increased density consistent with the size of the session, but the patient refused to believe me, or that further growth and improvement was likely. I'm hopeful he will return in a few months with a better outlook!

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