Rambler

Bill, I absolutely welcome Dr. Rassmans input on this thread. He did send me a consent form to fill out but I do disagree with it as it is written. It did in fact indicate my photos would be used, amongst allowing any info on my medical history to be posted as well. I myself do not know what info any Dr. has about me, but consenting for it to be posted allows any of it to be posted even if irrelevant. I'm sure as a physician he has legal reasons for the consent, but there must be a way to allow him to respond without agreeing to this. I came to this forum seeking advice from others that have had experience with hair restorations. When I joined I didn't know the forum was visited by physicians as well, let alone Dr. Rassman. I really just wanted advice. I stated my situation, posted the pics as suggested, gave my opinions, and asked for advice of what to do. I think I have done that fairly and maturely and thanked everyone that posted. Now I am being asked that my medical records ( whatever they may be, and not knowing what they are ) be posted online? I don't think so. I had no expectation of this being such an ongoing thread. However, all being the case of events and fairness, I want to allow Dr, Rassman to input here and speak openly and freely about the situation and voice his opinion on my input as well. I will contact Dr. Rassman by telephone tomorrow and see what can be worked out regarding this. Rambler

Fair enough... That said I guess it's moot point ... .

I wonder about those of you that have had out of town procedures. I agree there are many reasons to choose this but it begs to wonder... Follow up consultations, one of which is that is required ( suture removal ), after a procedure could really be inconvenient and as well expensive. Flight, hotel, time off work. I wonder if those that have done this considered this beforehand and how it has turned out after an actual procedure. It's not like you can just schedule a quickie appt. for a concern you have afterwards etc... Was this more of an inconvenience and/or expense than you expected? Rambler

Bill, Yes of course I would allow that. Janna, I understand. You were just indicating that there are other options that can be considered. btw, I never mentioned having to endure large grafts. It is the pitting nature of the transplant that I am concerned with.

Janna, It's hard to tell the extent of the plugginess from that particular patient from the photos but it must have been pretty bad if he was wearing a hairpiece. The results, from the photos anyway, look excellent. I sure hope that is not the route I need to take. Thank you for the information, I appreciate your input.

Bill, Well, I was going to contact Dr. Rassman again personally about this matter. My purpose here was to obtain advice from those with transplant experience and on my options etc... As I stated before, I agree with you, aside from what has happened to me I do believe he is a stand up guy and surgeon. I have a lot of respect for him on many levels. That is why I went back to him instead of going somewhere else first.

TooThin, Thanks for the advice. Actually most, 80-90% of the grafts in the frontal hairline are 2-3 hairs. There are very few 1 hair graft units there. I appreciate Janna's suggestion, but there are about 900 grafts, and they are all like this. It isn't like there are just a few. Would you be willing to post some fotos of your results?

I don't think cosmetically perfect is achievable. In my first consul with Dr. Pak he examined me and then offered to do a procedure of 300 grafts, mostly single units to create a transition in front of the damaged area. He then sent me a follow up letter in which he said These statements are not addressing the very reason I went in for the consultation. Yes, the frontal line could absolutely be fixed, but the pitting absolutely can not and he does not address this. Also in the interview, Dr. Pak would not admit that the pitting is a result from a bad procedure and that I risk the same thing in future procedures. This bother me on several levels. Hence, another consul with Dr. Rassman. Dr. Rassman also did not contribute the pitting to a bad procedure. In this consul I indicated that if I were to undergo a repair procedure I would like to do an additional procedure for the area behind the area I had done before. I suggested these be done at the same time for obvious reasons. Less stress on the donor area, time restraints, less cost for everyone etc.. During the consul Dr. Rassman told me that he would put about 500 in the "affected" area to do the camouflage. So now I am confused. There is a big difference between 200-300 and 500. Am I to take from the paid portion of the procedure into the area for the cover up? I sure hope not but the fact that he indicated he would use 500 leads me to believe it will take at least that. Like I said, I would rather be able to fix the problem and go back to a normal thinning scalp instead of having to cover up a bad procedure no matter the cost. Apparently this is not an option. But I do feel that they should own up to the bad procedure and feel that instead of me asking them what it will take to make me happy .. they should be asking me the same question. I am stuck with this for the rest of my life.

Is Dr. Siporin considered one of the elites on this forum? I will read through the forum, but who is considered to be of the elites these days in So. California?

Bill, Thanks for correcting me about Dr. Rassmans special rate. I wasn't aware of that. Thanks for your opinion as well. I will definitely do some more research and reading on other doctors. Considering having a small cover up procedure, I was thinking it best to cover it all in a single procedure and do the additional (1200 graft ) at the same time. Less stress on the scalp and donor area etc.. but will have to consider everything else as well. Thanks again, to all who have posted. Rambler

Thanks, I agree with you completely. Yes, Dr. Rassman was in charge at the time I had my transplant and was as well doing procedures in the Los Angeles office. I actually consuled with him then as well prior ( and regarding ) to my first surgery. That is when he assigned Dr. Andrews to me for my procedure. Well, There are now only 2 surgeons at NHI in Los Angeles. Dr. Rassman and Dr. Pak. Dr. Pak has been there for about 9 years. He is also Associate Medical Director as Dr. Rassman is the Medical Director. This lends me to believe that Dr. Rassman has a lot of faith in him. Still, I would prefer that Dr. Rassman do anything I do from here on out.

Bill, My first consul was with Dr. Pak. He is the one that offered 300 grafts. I then consulted with Dr. Rassman separately. I discussed the additionl procedure I wanted and later in the consul he stated he would put 500 grafts total in the area to be covered up. This leads me to believe it will take 500 to do the job effectively as in addition to the transition area there also needs to be some one hair grafts placed in the affected area as well. By Dr. Paks estimation of 300, and the additional procedure done at the same time, I would actually be paying for the extra 200. Hardly sounds fair. Dr. Rassmans fees are actually a bit more than you quoted. He charges $10 per graft so at 300 that would be $3000. Dr. Paks rate is $6 and on standby it is $5 a graft. Dr. Rassman doesn't have a standby rate, it is always $10. Both have concessions for larger sessions. You use the words "$2400 value". True, the value of the cover up does have a per unit price, but considering the nature of the procedure, a repair of previous bad work, I don't think a monetary value can be factored in here. The cost of the repair is insignificant to me and I do not consider it a value at any per unit price. I am asking you guys as to what you think about my proposed request to NHI ( below ) I think it is fair but wonder what all and any of your opinions are ...

dhoose75, Thnkas for the suggestion about the finasteride. My hair loss is fairly minimal, just minr thinning on the top sides and receding hairline. I just can't bring myself to be a slave to drugs. Propecia etc.. are not for me. Interestingly though, Dr. Pak suggested I try a product called Toppik. It's a granular fiber powder sprinkled in the hair to beef it up. I don't like these kinds of maintenance products but decided to give it a try. The result was that the powder got inside of the pits making them stand out even more. Horrible.

Thanks Bill, I wouldn't feel comfortable with removing existing grafts as I believe they would leave behind scarring, possibly worse than the pitting. I do wonder what you think of my proposed request to Dr. Rassman I posted above.

thanatopsis_awry, I have done very much research on this and it appears that there is no way to actually repair the damage done. Dr. Rassman and Dr. Pak both have told me personally the same. No dermatologic procedure, laser treatment etc.. will repair it. I have not actually consulted with any other doctors. A lot of people would never return to a place where such bad results were obtained, however I am confident that it was not the technology, nor the company per say, rather the competence or quality control of the actual surgeon that is the cause. I think I have successfully nailed the cause of this. Say a person said, NHI does bad transplants, so this person then goes to Bosely because heh, they must be better. Well, Dr. Andrews is now at Bosely so what's the difference? I do know that I would never use Dr. Andrews again for obvious reasons. I do have confidence in Dr. Rassman as a surgeon. I wish that I would have paid the extra for him in the first place. I'm just asking what you all think is fair before I approach him once more with my request of what I expect to be the fair and ethical way to proceed with me. I think my requests are the fair and ethical thing to do. Like I said, I have to accept that what is done is done and I have to move on towards the best possible outcome.

I am convinced that the results I have are due to a poor quality procedure, be it surgeon/assistant error. At this point I do have to accept what is .. is and it can't be undone. However, I do feel like Dr. Rassman owes me a bit more than just a cover up procedure. NHI has told me that Dr. Pak would be the one to do the cover up procedure. All due respect to Dr. Pak, I do not feel comfortable with this. I could use another procedure of 1200 grafts or so behind the area that was done. Do you all think it is fair and ethical to ask that not only does NHI do the offered cover up procedure, but that Dr. Rassman himself perform the surgery? If I were CEO of an industry such as this and had a legitimately unhappy client I would want to take care of the matter personally. I also want to request of Dr. Rassman that he do the second procedure at a fair discount. I would do it for free if it were me but I do not know the business/ethical side of Dr. Rassman. I suppose the end result will tell but from what I have resarched he is a stand up guy. To make my point a little clearer, do you think Dr. Rassman would feel confident if I were an actual patient at an open house and have potential clients looking at my result? I am an actual NHI patient. If I saw me I wouldn't be impressed. What are your opinions on this whole matter? Should I accept the offer of the cover up procedure? Should I insist that Dr. Rassman do it himself? Do you feel that they owe me something for a procedure that I paid plenty for and that is not what I was told it would be, and now needs to be covered up? I am a fair person. That is why I am seeking advice from others before I contact NHI again.

JM, no I didn't alter these photos in any way except to crop out the specific area. Here are a couple more ( sorry they're a bit large in weight ) that shows it in natural light and from a normal "face view" where it isn't so bad. Natural Light Normal face view Normal face view 2 I know the pittedness is more pronounced when pulling the hair back or in incandescent lighting .. and up close of course. thanatopsis_awry, You say the problem is "solveable". Ok so maybe a cover up procedure will camouflage it a bit but I will still be stuck with the pitted ones and forever. Maybe a lot of guys are just thrilled to have hair in an area where it wasn't before but I expect better results than this. I will never again be comfortable with a woman up close. I would rather have a balding "normal scalp". Dr. Rassman brought in an employee in my recent consul with absolutely perfect results, and Dr. Pak has had 2 very excellent procedures, and they were done at about the same time I had mine. Seeing these didn't make me feel better, it made me even more pissed off. I paid the same as everyone else and did not get the same results.

Thanks for the replies. I think the pic I posted shows pretty clearly what the problem is, but I have uploaded a couple more. This is just one side, but both sides are the same. Pic 1 Pic 2

Hi fellow bretherin, I had a transplant of 900 grafts about 10 years ago at NHI with Dr. Andrews. He no longer works there and has moved on to Bosely. Anyway, at first I was stoked just to see the hair grow in etc.. After a year I just stopped looking close at it. Had a girlfriend during the last 8 years, she knew and no bggie. Having being single for almost a year now I have been noticing the women looking strangely at me, and in more intimate situations, really inspecting me. Very humiliating. I finally did look closer with double mirrors etc.. and to my amazement the transplant really looks blotched when looking down on it from an upper angle which I never had without double mirroring. All of the implants are pitted, almost like pluggines but reversed. Standard face level it looks ok more or less. I went back to NHI and consulted with Dr. Pak and then separately with Dr. Rassman. They didn't seem too bothered with the results but did offer me a procedure of 300 grafts at no charge to "camouflage" in front of it, and maybe put a few of those in the affected area as well. They wouldn't admit that this is the cause of a bad procedure, rather attributed it to the way I heal. Baloney! I've read up on this, even through Bernstein/Rassmans papers and found the reasons for this are bad preparation of the folicule ( leaving too much epithelium on the folicule, and/or placing it too deep in the scalp ) Either way, the surgeon should have been more diligent about quality control. I am not convinced it will do the trick, especially with the up-close inspections. Since I have noticed this, I'm extremely self concious and paraniod. I've researched and there is no way to "fix" this. It will be this way forever. Do you guys have any advice for me as how to proceed with this? I don't know what to do. I really don't want to go legal with this, or if I even can, but I have just recently "discovered" this and I'm kinda freaking out here. All this time everyone else could see it but I couldn't. I have attached an image of the result here.

Hi fellow bretherin, I had a transplant of 900 grafts about 10 years ago at NHI with Dr. Andrews. He no longer works there and has moved on to Bosely. Anyway, at first I was stoked just to see the hair grow in etc.. After a year I just stopped looking close at it. Had a girlfriend during the last 8 years, she knew and no bggie. Having being single for almost a year now I have been noticing the women looking strangely at me, and in more intimate situations, really inspecting me. Very humiliating. I finally did look closer with double mirrors etc.. and to my amazement the transplant really looks blotched when looking down on it from an upper angle which I never had without double mirroring. All of the implants are pitted, almost like pluggines but reversed. Standard face level it looks ok more or less. I went back to NHI and consulted with Dr. Pak and then separately with Dr. Rassman. They didn't seem too bothered with the results but did offer me a procedure of 300 grafts at no charge to "camouflage" in front of it, and maybe put a few of those in the affected area as well. They wouldn't admit that this is the cause of a bad procedure, rather attributed it to the way I heal. Baloney! I've read up on this, even through Bernstein/Rassmans papers and found the reasons for this are bad preparation of the folicule ( leaving too much epithelium on the folicule, and/or placing it too deep in the scalp ) Either way, the surgeon should have been more diligent about quality control. I am not convinced it will do the trick, especially with the up-close inspections. Since I have noticed this, I'm extremely self concious and paraniod. I've researched and there is no way to "fix" this. It will be this way forever. Do you guys have any advice for me as how to proceed with this? I don't know what to do. I really don't want to go legal with this, or if I even can, but I have just recently "discovered" this and I'm kinda freaking out here. All this time everyone else could see it but I couldn't. I have attached an image of the result here.