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In January of 2013, I had a hair transplant surgery with Dr. Sanusi Umar. The online photo consultation was utilized and all communication was conducted between Dr. Umar and myself via email in part to geographical constraints. Dr. Umar seems to be a man of few words, but in my opinion he is very terse, which is a conclusion I did not come to until afterwards. He advertises that he was a victim of a bad hair transplant in the past; therefore, I did not analyze his terse email replies in depth because in my opinion a person who advertises having been a victim of a bad hair transplant would never wish the same fate on another. Dr. Umar recommended the use of 3000 grafts to restore my hairline aggressively. We did not discuss exactly what this meant during our emails though. I was under the impression that the use of a high number of grafts would create a denser, natural looking hairline. I was required to sign a plethora of legal documents including an arbitration agreement that requires each party to select arbitrators and then select a third party arbitrator to prevent malpractice lawsuits. However, in California a patient’s ability to find representation for anything medical malpractice related is virtually impossible due to the Medical Injury Compensation Reform Act (MICRA). Under this law non-economic damages are capped at 250,000 USD, thus making a medical malpractice suit not financially worth it for attorneys to pursue. This coupled with the great difficulty of prosecuting medical malpractice cases, and the abundance of hours required of arbitrators, a patient in California seems to be at a disadvantage, and possibly financial loss if arbitration is pursued. Therefore, I am of the opinion that if someone wants to have elective or other medical procedures performed they should not do so in California. Due to time constraints I was not able to arrive in the morning of my day of surgery which the surgical staff had said was still acceptable, but arrived somewhere around lunchtime. I was rushed by the techs to re-sign more paperwork, and take photos in preparation for surgery. Upon changing out of my clothes I was given a small cup of pills, These pills were the following: Cephalexin 500mg x 2, Diazepam 10mg x 1, Mephyton 5mg x 2, Prednisone 10 mg, Triazolam 0,025 x 1 mg, and Tylenol with codeine x2. Additionally, I was given shots of Diphenhydramine, Midazolam, Butorphanol, and Lorazepam. Previously, I had been told that I would be awake for the procedure and only receive local numbing agents in the areas that are operated on. The use of the aforementioned medicines was not made known to me until right before the surgery. After ingesting the medications and waiting in the operating room while techs scurried around, Dr. Umar arrived. This was the first time I had ever seen him in person. I had been instructed by a tech to write down my final questions for Dr. Umar and that we would discuss these prior to starting the surgery, that never happened though. Yes, I wrote them down, and they are included in my medical record, but we never conversed about them like I was promised by the techs. He introduced himself, and asked me to draw where I thought I would want my hairline with a marker and a mirror. At this time my head was swimming from the medications and my recollection is drawing a line at my existing hairline. He said I was not much of an artist and instructed me to lay my head back, and that is the last thing that I remember, and that was the only time we ever spoke in person. 2350 Grafts were then subsequently placed. Since then in emails between the doctor and I, he has claimed that in the operating room that I collaborated and agreed to the hairline he designed in the operating room. However, as I have said before I was given a multitude of oral and intra muscular medications, which are listed above and transcribed from my medical record. Did I sign multiple pages of documents previously? Yes. Did I fully understand them? No. I was really anxious to ask my final questions in person because electronic communication can be misinterpreted, but never had the opportunity. In my opinion I was in no condition to collaborate on a surgical design in the operating room as Dr. Umar has said transpired due to the aforementioned medications. I did not realize the gravity of what had transpired until several months later when the transplanted hair grew in, and around the six-month mark I felt something was wrong. While this can be early in the twelve-month timeline for a hair transplant the other people who I have spoken with say you have a pretty good idea of what you’re going to end up with around this time frame. However, the greater issue for me was not the hair but the design itself. To me the transplant and hairline was pluggy, too low, and too straight. In my emails with Dr. Umar he echoed his sentiment that I would likely need another procedure to fill in some gaps where the hair was sparse, but insisted I keep waiting, even though I said I thought the hairline was too low. I then consulted another hair transplant surgeon. His opinion was that the hairline was too low and too straight, and recommended excising my forehead and scalp skin which would leave me with a large hairline / forehead scar. Other surgeons recommended a series of laser hair removal and laser resurfacing options. However, I have blonde hair, and there is no guarantee of hair removal for blondes. Laser hair removal is marketed as permanent hair reduction. In my opinion this is a marketing ploy. Yes, laser hair removal can remove some unwanted hair in some people, but it is not an exact science, and does not work on blonde hair. Essentially, what it does is attack the melanin in the follicle and damages the hair follicle, which may destroy its hair growing capacity. However, in my opinion what is more likely is that the hair in anagen (growing cycle) will be forced into telogen (resting cycle). This resting phase typically last anywhere from 2-4 months, but a safe bet from my research is 100 days on average. After that you can expect regrowth if not sooner. Therefore, unless you are committed to enduring laser hair treatments for the rest of your life there is nothing permanent about laser hair removal, that’s why the FDA forbids laser hair removal to be marketed as permanent hair removal. Eventually, I consulted a reputable surgeon. Once again his opinion was that the hairline was too low, too straight, temple point angles were incorrect, hair type used was incorrect, and it did look pluggy. One lady said I had been butchered! Interestingly enough there was another of Dr. Umars previous patients present that day consulting about getting repair work too. When my forehead was measured it was discovered that the hairline that had been artificially designed left a 5 cm forehead The average adult male hairline is typically 6-8 cm. Luckily, this surgeon is skilled in hair transplant repair and has begun the removal of the grafts to help me one day return to a normal life. He then went on to say, and this was again echoed from his staff that the two and three hair grafts that were placed in the frontal hairline and temples were inappropriate for the areas they were placed in. A staff member who is also a native Nigerian initially defended Dr. Umar by saying, “Sometimes people have a bad day,” only to come to the aforementioned conclusion that the wrong types of hair had been implanted in the hairline. The most egregious statement I heard from the hair transplant physician was the opinion that my hair transplant performed by Dr. Umar was reminiscent of a 1990’s hair transplant, and that with the state of the industry today there was no excuse for poor work like this in his opinion. I look forward to completing the graft removals, and to never having to wear a hat again. While I was not really self-conscious about my hair before the transplant I was inspired to have better hair, and to not go bald because a friend had experienced such great results from a surgeon on the East coast. I wish I had, had the same experience as he did, but that has not been my fate in my opinion. I have asked Dr. Umar for a refund, and he has never specifically responded to this request. I have asked Dr. Umar to contact my current physician, and he has refused to do so via his emails. I have consulted every attorney imaginable in California to no avail. In my opinion Dr. Umar is a pompous arrogant man, the consultation was insufficient, and the use of medications in the operating room were erroneous. Revision of unfavorable Hair Restoration: Hair Restoration: State of the Art: Revision of the Unfavorable Result in Hair Transplantation