Newcomer Looking for Experiences

[Bill - Seemiller]

Godzluv69,

 

I took a look at your pictures, and I agree that your hair does not look good.

 

In looking back in your history, I see you posted back in June 2007 your experience and very similar photos. (Click here) for the original thread. In the original thread however, you claimed to have had 900 grafts, but here you only reference 800 grafts. Please clarify for us so we know how many grafts you actually had transplanted, where and when.

 

I see you were given a lot of advice to consult with a number of physicians. Did you follow anyone's advice? What was the outcome?

 

I also see that later in July, you asked forum member about financing an HT (found here).

 

Though it is clear that the donor area looks bad, without seeing before pictures, it's difficult to evaluate the success of the transplanted hair. In fact, your "patchy" hair loss pattern could indicate something else going on. Please describe in more detail your hair loss situation prior to hair transplant surgery, etc.

 

Please also provide adequate before/after photos so that we can see for comparision sake.

 

I am going to send an email to Dr. Bernstein also so that he can properly address your concerns. Please be sure to contact him and give him any necessary permissions that he might need to discuss your case publicly.

 

I do hope that Dr. Bernstein or another physician of your choice can address your concerns.

 

Best wishes,

 

Bill

[notgoing2gobald]

Godzluv,

 

I would *strongly* recommend you start your own thread as I am sure many people would like to take a look at your situation and gladly give you input which you can glean from *prior* to moving forward to remedy your situation. I am curious why in your initial thread you waited three years after the procedure though? It's not surprising that no one has responded to you, to the extent that it is on someone *else's* thread. Looking back at your original posting it is clear that people did respond and were *very* troubled that this was performed by a member of the Coalition. And Aussie I think that was extremely presumptuous of you, w/out even "connecting the dots" that this was someone else's thread. I think we would all be *MOST* interested in complaints pertaining to members of the Coalition.

 

That being said I think there are possibly a couple of different things going on here:

 

#1 Scar---

It does look *very* poor and I would NOT be happy w/that at all. Im really sorry that you have had to live w/that and hopefully it can be revised quickly and left looking naturally. However, I did notice on your original thread that Nervous Nelly pointed out that the scar looks like a "keloid formation" (scar tissue goes haywire) which he commented as being common in African American's. I had *never* heard of this prior to that thread. Did the doctor make you fully aware of this risk, and if so in terms of the likelihood of you experiencing this?

 

#2 Recipient Area---

 

I would *assume* the 800 grafts were used to rebuild the front of your hair line. If that *was* the case, then it certainly looks like substandard work which I would be *very* unhappy with. However, it is *very* difficult to get an accurate read on the situation having not seen your pre-op pics or where the grafts were placed. Another thing to consider is that it has been about three and a half years since your original procedure. Have you experienced additional hair loss? But, certainly you would know after the first 12 months if the transplanted hair grew or not, which you stated they did not. That does sound *very* troubling to me.

 

I think you should start your own thread where all of us can discuss this and it will be organized in one place for you and others.

[Bill - Seemiller]

Godsluv,

 

Please check your private messages.

 

I've been in touch with Dr. Bernstein and in order to address this publicly, he needs to 1) validate you are who he thinks you are and 2) obtain the necessary permissions from you to discuss your case publicly minus any personal information such as your name, etc.

 

Please contact Dr. Bernstein in order to discuss this further. His contact information can be found by clicking here.

 

Please also confirm the year/date of your surgery and any other details that would be helpful.

 

Best wishes,

 

Bill

[Godzluv69]

Thank you all for your concern. The reason l didn't post to my earlier tread of June 2007 was that what l was saying, l have said it earlier. l only contributed to the "new comer looking for experiences" inquries. l have put the hair transplant procedure behind me although, l would wish Dr. Bernstein would refund my money.

The consensus opinion on this board looking at my situation was that l should raise enough money to get as much as 3000 graft. The less than a 1000 graft wouldn't make much impact. l have save cash which l think is reason amount to get as much as 3000 graft and l am now shopping for a Dr. who can do repair job for me.

thanatopsis_awry:to respond to your question, that was not my first HT. l had about 1300 grafts all together with Dr. Rassman who actually trained Dr. Bernstein and was the owner of New Hair Institute which Dr. Bernstein managed for him for many years before he set out his own outfit. Dr. Bernstein told me on the day of the surgery that NHI will give me "this on the house" as PR of the procedure Dr. Rassman did in 1992 when he first open his New York Office and Dr. Bernstein said as such l should only pay $1000 which is the cost of the facilty.

Bill To answer your question, when l said it was 900 grafts it was long after the surgey(years)so l forgot the exact number. l ran into the surgical paper rencently and l notice it was precisely 799 grafts. Like l already explain, l took the advice members of this forum gave me and l seek financing l wasn't lucky so l took a second job and l have being saving agressively and l think l am ready to go for as much as 3000 grafts right now. l just need to know where to go to avoid a repeat of this mess.

notgoing2gobald:l waited 3 or more years because l didn't know of the existence of this board until June 2007.

Bill: l just send Dr. Bernstein an e-mail authorizing him to discuss my situation.

[notgoing2gobald]

Godsluv,

 

what about your scar w/respect to keloid scarring and it's more common occurence among African American's? Did Bernstein inform you of this and what the likelihood of you experiencing it would be?

[Bill - Seemiller]

Godzluv69,

 

I'm confused.

 

How many surgeries have you had altogether and how many grafts?

 

From what I'm gathering so far, you've had 1300 grafts with Dr. Rassman. Was this before or after your surgery with Dr. Bernstein? How many surgeries did you have with Dr. Rassman? This was back in 1992? So your surgery with Dr. Rassman was 16 years ago?

 

When was your surgery with Dr. Bernstein and how many surgeries did you have with him? Was this/these surgeries performed back in the 90s also?

 

Do you have a picture progression you can show us?

 

Example:

 

1. Before any surgery

2. After pictures with Dr. Rassman (for how many surgeries you've had with him)

3. After pictures with Dr. Bernstein (for how many surgeries you've had with him)

 

Thanks,

 

Bill

[Godzluv69]

Dr Bernstein never talked about keloid scarring with me. The only thing he talked about was that he was going to work in the front not the sides.

l only had ONE surgery with the Dr. Bernstein and before that Dr. Rassman.

[Dewayne]

I doubt anyone was doing decent ht's back in the early 90's.

[Bill - Seemiller]

Godzluv69,

 

Please continue to work with Dr. Bernstein in order to give him the necessary permissions to discuss your entire case openly and publicly.

 

I know that you sent me and Dr. Bernstein an email giving him permission to discuss this particular hair transplant however, in order to discuss your case in proper context, he will have to go beyond the scope of your most recent hair transplant procedure with him and discuss what he knows about your medical history including previous procedures. I believe he also has copies of correspondence and photos that he will need permission to reference / post. Your identify of course, will be protected.

 

I believe Dr. Bernstein has been very helpful in this case and hope that you will give him the permissions he needs to share his side of the story.

 

In the meantime, I hope you are also consulting with other physicians to get a second opinion as suggested.

 

Best wishes,

 

Bill

[Bernstein Medical]

Forum readers, sorry I didn't address this thread sooner, but it just came to my attention.

 

Dear Godzluv69,

Thank you for giving me permission to discuss your case on this forum. To give the readers a bit of background, prior to seeing me you had two hair restoration procedures by another doctor to address your hair loss at the hair line and a few small patches of hair loss at the temples. The frontal hair loss was characteristic of androgenetic alopecia and the patchy hair loss was felt to be due to MPB, or possibly old lesions of alopecia areata.

 

Your first hair transplant was performed on 8/14/1993 where 220 minigrafts were added to your frontal hairline and temples. In the second procedure, performed on 7/14/1995 an additional 94 grafts were added to these same areas.

 

I first evaluated you for surgery on 9/21/2001. At that time you had additional frontal hair loss that bothered you considerably. You wanted me to transplant as large a session as possible, but I had concerns that you had low density (1.5 even before your first procedure) and not a lot of scalp laxity. I expressed that before considering another hair transplant you should keep in mind that you had a raised scar after your first procedure that would likely occur again and also reminded you that you were somewhat dissatisfied with the growth from your first procedure (although the session was very small) and that I could not be sure you would get good growth in a subsequent session. Although the frontal hair loss appeared to be typical androgenetic alopeica (see pre-op photo), I reminded you that a diagnosis of alopeica had been considered as contributing to hair loss on the temples. Lastly you expressed that you had financial concerns and I said that I would do the procedure for just a deposit fee.

 

I summarized our conversation in a letter written on 9-21-2001. The body of the text read as follows, I quote:

 

As we discussed, before we proceed, there are a number of important issues that we need to discuss. First, you have a raise donor scar that is not uncommon in the black races. There is a significant chance that this will occur again in your next procedure. Second, the poor growth from your past procedure may have been due to alopecia areata. There is no guarantee that you will get good growth with another session.

 

Because of those concerns, I suggest a conservative session with the placement of approximately 600 follicular units to your frontal hairline and the front of your scalp. As a courtesy, you will be responsible for the $1,000.00 deposit only. I have enclosed a new lab prescription.

 

I next heard from you via a letter on 5/29/2004 where you stated that the hair loss was "socially professionally unacceptable" and it was making you "miserable." You said that you had saved up additional money for the procedure but I said that I would honor my offer to perform the surgery for the deposit fee.

 

I performed the follicular unit transplant on 7/2/2004. Because of your low density a strip of 15.8 x 0.9 cm yielded only 699 follicular unit grafts (150-1s, 417-2s 126-3s and 6-4s). The procedure was uneventful except for that the donor area was slightly tight on the right side, the area of old scarring (and the area that you showed in the photo). We handled the post-op course by phone since you were in Baltimore.

 

On 6/23/2007 you returned for an additional procedure. At that time I explained that your donor area was tight and, because your yield was so low from your last procedure, due to your low density, I would not recommend further surgery. I also expressed a concern that you again did not get satisfactory growth from your procedure. I suggested that you increase your finasteride to 1/2 of a five mg tab, but to not have another hair transplant.

 

From your posting and our conversation yesterday, I understand that you are extremely frustrated that you have not gotten a satisfactory result from your hair restoration procedures. As I had mentioned in your last consult, it is reasonable to get other opinions, but in my best judgment I would advise you against further surgery, as I don't feel that you have enough movable donor hair to make another procedure worthwhile and you would run the risk of a more visible donor scar. I would caution that if you were to contemplate additional surgery, first have a biopsy to see if there is any other process going on that may be affecting growth. As we discussed on the phone, I would be happy to do this for you.

 

Sincerely,

Dr. Bernstein

[the B spot]

Hi Godluv---I am sorry you are experiencing these issues.

 

African American patients are very, very diffcult due to scarring issues and the shape of the grafts.

 

I have to tell you that Dr. Bernstien is an honorable man who stands behind his work--- he is considered to be a conservative doctor, but that is no knock on his work whatsoever.

 

For your situation I would recommend a trip to Dr. Harris in Colorado who does FUE on A.A patients with success.

 

Doing FUE will help you in two ways: You can place some grafts into your scar in order to help cover it and you can proceed with small sessions to help ensure growth.

 

Additionally, one of the great characteristics of AA hair is the great coverage each graft gives.

 

I don't presume to know your situation as Dr. Bernstein does, nor am I discounting his recommendation of no strip surgery.

 

I am trying to steer you to a Doctor who may be able to help you out, without a strip session.

 

Take Care,

 

Jason

[Godzluv69]

Thank you the B Spot the advised is well taken.

Do you know how l can get in touch with Dr. Harris in Colorado?

[the B spot]

http://www.hsccolorado.com/fue.asp

 

Dr. Harris has photos of caucasion grafts and A.A. grafts to illustrate the difference between the two.

 

I hope this helps you out!

 

Jason

[Bill - Seemiller]

Dr. Bernstein,

 

Thank you for providing a detailed account of this members hair transplant history and medical situation. Given the circumstances of his hair loss condition, poor growth due to possible Alopecia Areata, and tight donor, I can understand why you would be reluctant to operate on him again.

 

Thanks for being diligent and working with this patient to ensure he is able to make the best of his situation. Thanks also for addressing the questions and concerns of this forum and for proving that you stand behind your patients.

 

Godsluv69,

 

We all understand you are frustrated with your hair loss condition and clearly want the best for you. I think taking Dr. Bernstein up on his offer for a scalp biopsy would be smart. This will help rule out any other reasons for poor hair growth of the transplanted hair.

 

I recommend getting this done before pursuing any additional surgery, including FUE.

 

B Spot,

 

I agree that FUE may be something to look into, considering his tight donor area for strip however, this does not address the poor hair growth issue from his previous hair transplants.

 

I feel that he needs to have this addressed first before he wastes money on anymore surgery that could potentially lead to zero or little growth.

 

Bill

[Franklin]

I would just like to add. Every doc get's complaints. I have been on hairloss boards for years. Just all the facts have to be posted so we know if it is legit or not. Good job Bill for asking for all information to be posted. Also I would like to know why wasn't Fue offered when he went to Dr. Bernstein? I remember back in 2002 talking to Dr. Rassman that Fue was ideal for those with tight scalps. Anyway good luck on your repair. Quest.

[Dr. Alan Feller]

My guess is that even a great FUE session won't make much of a dent. Believe it or not, probably the best thing to do is to punch out 3mm plugs from the donor area then refine them under the microscope to minigrafts and then implant into the alopectic area of the donor and the top. This patient needs VOLUME. Thankfully he has very curly hair which will cover the plug donor sites AND provide him with the serious volume he needs.

 

Ironically, if his surrounding hair were thinner, then FUE might be useful, but the contrast in density would make FUE pointless, not to mention very expensive.

 

Dr. Bernstein is probably the world leader in punching out old plug work so he is the number one main for this job as this experience will serve him well in performing the old syle plug work this patient needs.

 

This would be a VERY RARE approach, but probably the best one:

My approach would be to punch out as many plugs as possible from the donor area with as much space between them as possible. Then I would suture or staple each wound closed. That will minimize the visible scarring. Then refine the grafts (on purpose) only down to minigrafts, NOT FUs. Then implant in both areas. That gets around the non-stretch skin problem AND allows for maximum yield. Sometimes you have to look to old techniques to get around rare problems. Dr. Bernstein would probably be the best in the world for this approach in my opinion. His results should then be posted on the web for all to see.

[Bernstein Medical]

Thanks for the suggestions. I did consider FUE, however the limitation he has is not only the donor scarring, but the very low donor density. I don't feel that FUE would offer any significant improvement in volume because of this and would just leave additional scarring. Although punch harvesting is an interesting suggestion, I am concerned that punch excision of the donor area would also leave unacceptable scarring. If you could examine him it would be apparent.

 

The grafts that Dr. Rassman placed were quite small. In his note, he said the maximum was 4-hairs and the patient does not look pluggy, rather the hair loss is patchy ??“ so graft excision with re-implantation would offer little. A main concern was the poor growth from each procedure, which is why I am reluctant to do additional surgery. A diagnostic biopsy would be a reasonable next step, but the other issues remain. It is a very difficult problem.