14 Months Post Op Dr. Siporin

[Cole]

I had the procedure performed with approximately 1700 grafts in the crown and the hairline. Dr. Siporin was very accommodating and even offered to meet me on the Sunday prior to the procedure but my flight was delayed. He set my expectations from the onset that I may require another procedure to increase the density. It is now 14 months post op and I am really concerned with my hairline, crown area and the scar (He used the trichophytic method to close the wound) . I shared my concerns with Dr. Siporin and he indicated that I may need another 1500 grafts. I also consulted with Dr. Rahal and Dr. Cam Simmons (Recent member of the coalition) and they all averaged 1500 grafts. Dr. Simmons also mentioned that he can also perform scar reduction. I am in the process of scheduling another procedure as I have exhausted all my excuses in the office for wearing a HAT! This second procedure must be perfect as my financing would be exhausted and I would NOT be in a position to afford a third go-around.

 

 

 

[Cole]

I am posting here because I need guidance with regards to my next procedure. I would really appreciate any recommendations and advice from you guys. Dr. Siporin indicated that he is willing to offer a follow up procedure at a reduced cost. His professionalism and attention to detail was outstanding however I did not expect this result. I must also mention that the cost factored (Limited Funds) in the number of grafts I received but I honestly didn't expect this. I am open to any suggestions. Please share your thoughts.

Many thanks... .

 

Please see link below for photos.....

 

http://hair-restoration-info.c...66060861/m/153103645

[Bill - Seemiller]

Cole,

 

I'm sorry to hear and see that the results you received are not what was expected. Did Dr. Siporin provide a reason as to why he thinks you've had less than optimal growth?

 

I'm pleased that Dr. Siporin is willing to stand behind you and help you meet your goals at a reasonable cost. Ultimately, I would like to see you give him the chance to help you get the results you deserve. However, you are the one who ultimately has to be comfortable with your decision.

 

If there's anything else I can help you with, don't hestitate to reply here or contact me privately.

 

Best wishes,

 

Bill

[Blake Bloxham]

Cole,

Like Bill said, very disappointed that the result didn't meet your expectations. Rest assured that you did the right thing seeking out a doctor recommended from this site. I think that if you felt comfortable with Dr Siporin, and if you have previously reviewed his positive results on this site, it would be okay to have him do the follow up procedure. In my very, very limited opinion, I think this result had the potential to be dynamite. The hairline was lowered, fairly aggressively plus temporal reconstruction and vertex placement was done. If it would have grown to plan, I think the design and the characteristics of your hair, would have created a nice result. Like Bill said, I would be curious to know if Dr Siporin had a theory about the growth? It appears that you may have suffered a bit of continued loss and some shock loss at the scar, but I don't think either of these factors really account for the poor growth in the hairline. You could always consult with a dermatologist in the meantime to see if there is an underlying condition. Regardless, I think that having a consultation with a recommended surgeon to assess what happened and planing a revision procedure would be a wise choice. If you trust Dr Siporin and he is offering the procedure at a reduced price, I think this is even better. I truly wish you the best of luck!

[Cole]

I spoke with Adrian from Dr. Rahal's office and he should be setting up a phone consultation later this week. I have already discussed my condition with Dr. Simmons and he was very thorough and identified what is required to increase the density and reduce the scar. I tried to contact Dr. Siporin late last week however I was unsuccessful and that is due to NO fault of his own but I know that he performs surgeries all over the world and he may not have been not in state at the time. Future_HT_Doc, Dr. Siporin is a recommended surgeon and I have discussed my poor growth with him. He advised that I contact him around 14 months post op. Hopefully I can have that discussion this week. That being said and in addition to Dr. Siporin's initial assessment that I may need another procedure to increase the density, I am terribly disappointed with the results. Hence the reason I am posting here to get opinions and recommendations going forward. If you guys were in my position, what would you do to fix this?

[justgrow]

Cole,

 

I feel that you ARE on the right track consulting with Rahal.

Don't mess around. Rahal's Scars are excellent and the results he consistently achieves are matched by few.

[dakota3]

If you guys were in my position, what would you do to fix this?

 

Im really sorry to see you have less than optimal results. I have been in your shoes. I think you first need to determine whether this is physiology or physician. I am not 100% sure how you would go about doing that ,but maybe start with a dermatologist. I would hazzard a guess that a result of this magnitude may be a future predictor of proceeding surgeries if it is indeed physiology.

 

2nd I dont know much about Dr. Siporin, but from what I've seen of his work is steller so if he is indeed offering a discounted or free repair your financial situation might lean you that way. I MUST STRESS though that you should never let finances or location determine which surgeon you choose. Good luck Cole!!

[Guest wanthairs]

Doing another surgery at a reduced cost is not what I call standing behind the client. I think that is a poor way of standing behind ones work. I think either Dr. Siporin should do it free or give a 100% refund of the money. This is the modern age of service and there is much competition.

 

Cole, my first transplant was a screw up, and I had Dr. Hasson fix it up successfully....

 

You may want to consider Hasson and Wong for your repair job. I am sorry what has happened to you and I understand too well how you feel. I hope whatever you do, you have a successful outcome

[aaron1234]

Cole,

 

I'm sorry to say that you received a horrible result. Your before pictures look MUCH better than your 14 month post-op pics. You deserve nothing less than a full refund. It's a shame you spent thousands of dollars to look worse off.

 

Look at Coalition Clinics for this repair. Not just recommended docs. Docs like Rahal and Simmons are a great start. But also look into Shapiro Medical Group, Hasson & Wong, and Feller.

 

Sometimes there is a bit of grey area as to whether one needs a finishing job or a repair job. You need a repair job, especially in the donor region .

[Anouar]

1700 graft distributed through the hairline and crown is not enough considering your hairline looks to be lowered 3/4 of an inch. You would never get the density need to be esthetically pleasing. I think this was reckless planning on your doctor's part. I would def not go back to this doc. if you can get your money back go with someone else such as Hasson and Wong or Rahal

[Cole]

Anouar:

 

I must take blame for the aggressive lowering of my hairline as Dr. Siporin cautioned against this but I asked him to see how best he can accommodate my desires. Are you saying that none of the coalition members can perform a followup procedure where it is esthetically pleasing and my hairline looks natural seeing that I have only had 1700 grafts? I have seen cases here where people have had 4000+ grafts and as many as 8500+ ! I really hope that my scar can be reduced significantly though.

[Blake Bloxham]

what would you do to fix this?

 

Personally,

 

1. I would consult with a dermatologist to make sure that there wasn't some sort of underlying condition that will results in another, less the optimal surgery.

 

2. I'd do exactly what you are now ... consulting with top doctors on the site.

 

3. I'd decide if you did want to go through another procedure with the original doctor (only because he is recommended and has produced refined results in the past), and if not, see if you can maybe get some sort of compensation for the repair with another doctor.

 

4. Have a strip procedure with a doctor that will remove the scar as part of the strip, work on the hairline, and do a world class closure on the removal (this is assuming that the doctor doesn't think you'll suffer such bad shock loss again).

 

Good luck, and to answer another question you asked ... yes, there are definitely doctors here that can handle your touch-up and give you a aesthetically pleasing result.

[TheEmperor]

Your hair characteristics are good and will provide great coverage.

 

Do not go back to the original doc. The problem may have been with his cutting or placing. Throwing good money after bad is never a good idea.

 

Check out rahal, hasson and wong, feller, shapiro.

 

You should get a good look with 1500 grafts to redo your hairline.

[Anouar]

Cole, you shouldn't take blame for anything. An aggressive hairline like that would require much more grafts. Something along the lines of 3000 to 3500. I think the doc should have refused to go that aggressive with the minimum graft count and give you the reason. Sometimes clients go in naive not knowing how many grafts are need to achieve desirable results. I think its up to good docs to educate newbies who have no understanding of the # grafts that it takes to cover a certain area of baldness. You are not to blame

[Bill - Seemiller]

Guys,

 

I have contacted Dr. Siporin regarding Cole's case and I expect he will post a reply soon.

 

Dr. Siporin is recommended on the Hair Transplant Network and I have full confidence in his ability to provide state of the art results. That said, it's clear that these results turned out poorly for some reason we're not yet aware of at this time. Hopefully when Dr. Siporin replies, he will be able to give us a little insight into why and what he proposes to do to help Cole. It will then ultimately be up to Cole as to whether or not he wants to go back to Dr. Siporin or choose another physician.

 

All the Best,

 

Bill

[phil mascallpen]

Originally posted by Cole:

 

I must take blame for the aggressive lowering of my hairline as Dr. Siporin cautioned against this but I asked him to see how best he can accommodate my desires.

 

It's the doctor's job to tell you no. If he agrees to your desired hairline then he should use the appropriate number of grafts. You are not to blame for the failure of your HT in planning, growth or poor donor scar and deserve a full refund.

 

Best of luck Cole.

[Guest wanthairs]

Cole,

 

I must commend you on how reserved and respectfully you still speak about your surgeon. I know I didnt when this happend to me.

 

When I went for my 2nd corrective procedure, Dr. Hasson did tell me I had physiological factors that could affect growth. Firstly my hair shafts were some of the longest and also some of the most fragile ones they usually encounter. He said this is soimetimes common with people of my ethnicity (middle eastern). He said he had to make much deeper incisions than normally done, and that the grafts had to be handled and inserted extra carefully . He pulled out a few of my old grafts and showed me how the incisions were not deep enough in some cases and also how the technicians must have pushed them in too hard ........I remembered how the technicians spent all their time yapping with each other about office gossip and seemed to not pay enough attention to me...

 

the end result is that as far as I can see I have an extremely high growth yield with Dr. Hassons procedure.. He observed and told me things about my physiology my first doc did not tell me and then took all of this into account........

 

I hope that you get a full refund----and you can definately get this all repaired and taken care of, just like I did.

 

Good luck---your future is bright....

[Guest wanthairs]

just to correct any misunderstandings---it was not Dr. Hassons techs who yapped constantly during the procedure. That happend at the first clinic I went to.

[Bleachcola12]

Cole, Go to Dr. Rahal. I feel like this thread needs more attention, and Pat needs to be notified Bill

[Bill - Seemiller]

Bleach,

 

I send Pat information on all pertinent topics each and every week (which includes this one) however, as the managing publisher of this community, I am more than able to handle this.

 

I've already notified Dr. Siporin and he and the patient have already collaborated on a game plan moving forward. He also intends to post a public reply to this thread. Moreover, I've been speaking to the patient privately regarding his concerns.

 

I just called into the clinic to find out when Dr. Siporin plans to respond. As it turns out, he's been really sick the last few days. That said, he plans on posting a public reply and collaborating with the patient soon.

 

These results are highly unfortunate. But let's not forget that Dr. Siporin has been producing excellent work as demonstrated by his postings every month and the accoldates he's received from dozens of his own patients on this community.

 

Nobody likes to be the one in a hundred or so patients with poor growth. Unfortunately, this can and does happen in the hands of even the best surgeons. I trust Dr. Siporin will do all that he can to discern why and do what he can to help this patient.

 

Ultimately, I encourage Cole to keep us all posted on his conversations with Dr. Siporin and his decision and outcome moving forward.

 

Best wishes,

 

Bill

[thanatopsis_awry]

Very unfortunate result, but I hope and trust Dr. Siporin will fully stand by his patient, much like Dr. Harris recently did, e.g.

 

The silver lining, Cole, is that you've handled this, truly, like a man, and your resiliancy is really commendable. MPB itself has the power to break a lot of us, and to go through with a HT that, for whatever reasons, ends up with such an unfortunate and unlikely end, is not an easy thing to deal with.

 

Going forward I trust you will only improve and move closer towards your goals.

[Forrest Gump]

Cole, first of all, you have acted like a perfect gentleman and shown exemplary temperament in handling this horrible outcome.

 

Although you might have asked for a lower hairline, the doctor, being the bigger expert in the room, should not have gone for it, with the specified amounts of grafts. For example, when I went for my HT, I asked my doctor to lower my hairline, but he did some facial measurments and told me that a lower hairline won't suit my face. So he turned down my suggestion for a lower hairline.

 

I hope you get this resolved positively, because right now, it looks pretty messed up. Not only is the transplanted area bad, the donor area is worse.

[Cam Simmons MD ABHRS]

Originally posted by Cole:

I had the procedure performed with approximately 1700 grafts in the crown and the hairline ... Dr. Siporin ... set my expectations from the onset that I may require another procedure to increase the density. ... I also consulted with Dr. Rahal and Dr. Cam Simmons (Recent member of the coalition) and they all averaged 1500 grafts. Dr. Simmons also mentioned that he can also perform scar reduction. ... This second procedure must be perfect as my financing would be exhausted and I would NOT be in a position to afford a third go-around.

 

Hi Cole

 

We have consulted by email and by phone but not in person. I have looked very closely at your "blown-up" photos again.

 

As before, I suspect that the main reason for your current result is that a large area was covered with a small number of grafts. In your before photos, you appear to have AGA (male pattern baldness) and I don't see signs of scarring or other conditions. As you can see in your natural hair on the sides of your head, your hair is quite curly and tends to clump into tufts.

 

The uneven appearance may be due at least in part to:

 

1. a low density hair transplant that is weighted more toward the front of the hairline.

 

2. clumping of your curly hair

 

3. some loss of existing hair in the back of the transplanted area and in your temples

 

To assess how well your transplanted hair grew or didn't grow would require direct inspection. My best guess is that this is more of a planning issue than a physiology or growth issue. I think it is reasonable to assume that further hair transplantation has a good chance of success. My recommendation would be to revise your scar and get as many grafts as safely possible to add to your frontal hairline. You should be able to get at least 1500 grafts with this approach and possibly many more.

 

I don't know Dr. Siporin personally but he seems to have a very good reputation here. I hope that he offers you a good solution.

 

I don't think that you can get a perfect result in one more session but I hope that you will see a big improvement.

 

Best wishes,

[Guest Kenneth Siporin]

Originally posted by Cole:

I had the procedure performed with approximately 1700 grafts in the crown and the hairline. Dr. Siporin was very accommodating and even offered to meet me on the Sunday prior to the procedure but my flight was delayed. He set my expectations from the onset that I may require another procedure to increase the density. It is now 14 months post op and I am really concerned with my hairline, crown area and the scar (He used the trichophytic method to close the wound) . I shared my concerns with Dr. Siporin and he indicated that I may need another 1500 grafts. I also consulted with Dr. Rahal and Dr. Cam Simmons (Recent member of the coalition) and they all averaged 1500 grafts. Dr. Simmons also mentioned that he can also perform scar reduction. I am in the process of scheduling another procedure as I have exhausted all my excuses in the office for wearing a HAT! This second procedure must be perfect as my financing would be exhausted and I would NOT be in a position to afford a third go-around.

 

This is Jennifer from Dr. Siporin's office. I just wanted to quickly post to let everyone know that Dr. Siporin has been away on business. He will be back in the office later this week and will comment then. He is aware of "Cole's" posting and is looking forward to addressing his concerns.

[Guest Kenneth Siporin]

To Cole, and any other interested members of the Forum.

I am very interested in each patients experience and satisfaction with each procedure, and I remain confident that you will receive a nice final result. I am sorry that you have experienced what you are going through which includes a donor scar which is not the best it can be, and density in the hair line, which is also not quite what you expected.

In some ways we are at a disadvantage, because you live a great distant, and I have been unable to examine you in person.

I have a couple of comments.

In regards to the density: I think the greatest single factor affecting the outcome, was your desire to aggressivley lower your hair line. I remember the day of surgery we spent a great deal of time designing your hair line, and in discussing the ramifications of lowering the hair line aggressivley, as you desired, the greatest risk being, a desire for a second procedure. I do think we got good growth from your procedure, but certainly not 100%. If pressed for an exact figure, depending on photos alone, I would say we got a good 70% growth, which is a conservative estimate, and it could be greater. However, it is my policy to error on the side of the patient when determining this, and therefore compensat the patient for growth under 80%. There is no guarantee in this business, and a patient pays for a procedure, not a result, but I do feel that patients who get less than expected growth should be compensated in some way, even though there are many variables involved in that result, many of which are out of the control of the physician and his team. So despite the fact that there is no guarantee, I really try to be a patient advocate, and when expectations are not met, I will do my best to make the second procedure discounted, even if I do not feel personally responsible for the result. In your particular case, I remember pointing out that your goals to aggressively lower the hair line did carry some ramifications, and I think we are dealing with those ramifications now. I always take it upon myself to explain these details, and if I somehow failed in delivering that message, I apologize, but I feel as I spent a great deal of time reviewing this with you, so in some ways, I am not surprised by your desire for a second procedure.

Having said all that, I am confident the second procedure would achieve your goals, and enable you to take that hat off.

 

In regards to the scar:

Unfortunatley, once again, there just is no guarantee in this business, in rerards to scars. Much has been written on the use of tricophytic closures, and in my own practice I have looked at my results, as well as the published reports of scars, and I find the use of tricophytic closures as somewhat controversial

I am a board certified plastic surgeon, who takes great time and care in all of my closures. In fact, my team thinks I am too slow and too detail oriented, but I think each patient deserves that.

Without seeing your scar in person, I cannot comment completely, but most likely there is a combination of hypertrophic scarring, and some widening, which can happen in any case, unrelated to surgeon skills or deliberateness, and the result of healing characteristics of the patient, which are out of the control of the surgeon. I have seen this before in dark skinned individuals, and I have been able to improve the situation by a combination of techniques, including surgical scar revision, corticosteroid injections, and massage.

I have seen good results with both trichophytic and regular closures, and I decide on an indiviual basis, and after discussion with each patient, on which technique to employ.

 

I remain confident and undeterred, even if you do not, so my best advise is to try to remain positive and patient, and just know, almost assuredly, relief from your phyical and emotional pain, is not far away.

As always,

Respectfully yours,

Kenneth Siporin, M.D., F.A.C.S.