THE REALITY OF HAIR TRANSPLANTS

[Bill - Seemiller]

I appreciate everyone's input on this thread.

 

The reality is that Brian is hurting because of a bad experience. I hope that he will come back and enlighten us regarding the specifics so that we can do the best we can to support him, encourage him, and help him make an educated decision moving forward.

 

It is obvious that many of us can relate to his pain (which is why we are here). Maybe not because of a bad hair transplant experience (though some of us have), but simply because of the pain hair loss has caused us.

 

I think it's normal to lash out and pass blame when we are in a bad situation. Normal however, doesn't make it right. But we all have a tendency to do it.

 

This post and a few others have convinced me to write information on this thread: An important dose of reality on hair transplantation and this site's purpose. I encourage you to read all of the posts as many have already contributed valuable input.

 

I encourage you all to read it and add your thoughts.

 

Best wishes,

 

Bill

[NervousNelly]

This is a tough one for me to comment on because I truly do feel sorry for this poster. Unfortunately the first thought that came to mind for me was that he is correct. Now before everyone starts throwing online darts at me, you have to understand where I am coming from.

 

Firstly, there are many physicians out there that are only interested in the money and ofcourse the others that just need to pay the bills. I am sure that even the ethical ones have some difficult choices to make on the slow weeks.

 

I have stated on other threads that I personally don't believe that an individual that is a NW5+ or someone that could potentially become one should consider a HT unless they are willing to spend $20,0000 or more. Yes there are some that might be happy with a sparse look, but for the most part likely not.

 

There is a slight conflict of interest with this site and docs paying to be promoted, but hey how else do you do it? Better to have quality docs promoted than useless physicians.

 

I believe that you need to research the hell out of things and have realistic expectations as Bill stated. Don't just rely on this site.

 

This is a time when the bald look is cool. If you can swing it than go with the shaved look. Think about the poor bastards 20+ years ago that couldn't have shaved heads because you stood out as a Nazi or worse. You got more looks than someone with a bad HT.

 

Results now days are definitely improved but it is still a surgery and there are risks. Take the time to research and be absolutely sure you have full confidence in the doctor, your goals, your finances, etc.

 

I really am sad for Brian. Let's try to support him.

[YoungGuy]

Funny how BrianH isn't replying anymore.

[djdennis]

Brianh Where are you? You started this topic and I am curious if you did have a ht and which doctor did your work?????? If I had a bad experience I would post the mans name,so the caveat emptor was warned.

[Aquarius]

Maybe he is working with someone that he can relate to. What's funny yung goi?? Does suffering amuse you? Cuz I know where you can getsum.

[Time to do something]

It is possible that Brian is involved in the hair piece industry or selling a "hair tonic" and just came on to give hair transplants a bad name and scare people who might be considering it. I hope he is wrong because I am one of those people that is waiting for my results and his email made me think. However, I think there have been too many positive stories on here for him to be 100% accurate. If he did have a bad experience I encourage him to reply back because if anyone can guide him it is Bill and the people on this forum who have been through good and bad and come out ok.

[NervousNelly]

Ttds,

 

Gathering from all of your recent posts, you are definitely in the doubting stage. Hang in there and give it a year then we both can compare notes as I am roughly at the same stage as you.

[notgoing2gobald]

BeHappy,

 

man I really feel for you. You have shared your story (with pics) in private posts with me and I appreciate your input and honesty on this forum. Im completely sympathetic to your case in particular, because we typically think of a worst case scenario (from a ht) as having unnatural results. But, you ended up losing all of your grafts, all of your donor hair, AND were scarred. Your story on this thread REALLY makes it hit home. You missed weddings and funerals because hats couldn't be worn. Most people in our society really don't understand how balding can affect a man. Im still not bald, but sometimes I imagine if I were and didn't have a ht I would feel, for loss of a better analogy, "naked". You can't wear a hat every where you go. People in our society equate being a "man" with being strong and too care to much for your appearance is equated with being gay or something. But they don't realize how significantly balding can impact one's ego and overall image and reception by others. We all have protocols (or one's essence) for what we find attractive in others: Tall, Dark, Handsome...Young, Cute, and Blonde; or whatever it may be, I can assure you though it is not bald.

Out of curiosity: was the "killing yourself contemplation" added for dramatic effect, or were you serious? How did you eventually come to grips with your situation?

 

I hope others can appreciate why someone such as BeHappy uses a lasercomb and tries other methods in hopes of an improvement to his situation.

[Al - Moderator]

Originally posted by notgoing2gobald:

Out of curiosity: was the "killing yourself contemplation" added for dramatic effect, or were you serious? How did you eventually come to grips with your situation?

 

I seriously wanted to kill myself for a lot of years. This was AFTER the HT, not because I was thinning. Sure I was depressed and worried about my hair loss just like anyone else who is losing their hair at a young age, but I didn't want to kill myself until AFTER what was done to me.

 

I took a year off of work to have my HT since they said it would take a total of 3 procedures and take 1 to 1.5 years to be fully grown out and completed, so I figured I'd just take a year off, so I wouldn't have to worry about anyone finding out, looking horrible during the healing, etc. All the things everyone else wonders about when they think about having a HT. One year out of work turned into 5.5 years of having 25 HT procedures. That's an average of about 1 procedure every 2.5 months for 5.5 years. So yes I was in such bad emotional shape at that point that I just wanted to die. No money, no job, and I looked like a freak.. and the worst is feeling that you have abosuletly no control over it. Whatever i did to try to fix it, it would just get worse. I would drive my car 100 mph down the road late at night and just want to slam into a tree or drive off the overpass. I'd grip the steering wheel so tight while trying to talk myself out of it trying to convince myself that the next procedure might work, another Dr might be better, etc. I had some really bad days when i would trash the whole house, rip down the wallpaper, smash the mirror, want to hang myself, etc etc.

 

How did I finally get past it? Well I can tell you what I didn't do. I didn't start drinking, I didn't use drugs, I wouldn't even see a psychiatrist when my mother tried to make appointments. I knew what my problem was. I didn't need another Dr trying to tell me. I had enough of the Drs. Putting me on pills wasn't going to solve my problem. It would have just kept me in that state for the rest of my life. I just kept trying to tell myself that this as the worst it could possibly ever get which means things can only get better, so I can manage to stick around another day and see what happens tomorrow. I had to keep telling myself that every day. It wasn't easy.

 

I eventually decided I wanted to live my life. I think just getting older made me a little more OK with it. It's not as bad at 35 to be bald as it is at 21. I decided one day to stop wearing a hat and have never worn one since. I started working. I actually have a job where I have to wear a suit and meet with new people every day. Yeah I look ugly, but I make good money, bought my own house, and do what I want to do. It still bothers me of course, but you can't let it run your life.

 

Now that I have money I decided to come back to the forums and see if there was anything new that could be done and here I am.

[Al - Moderator]

Thought I'd throw in another post. This looked like a good place for it. I'm sure you're all tired of my long postings.

 

I wore a hair system prior to the HT. I knew I was going to be a NW 7 in a few years because my hair was falling out very fast and I had the same pattern as my uncle who started losing his hair in his teens and had hardly any hair at all on the sides of his head by the time he was 40. I first went to a dermatologist and didn't really get an answer as to why my hair was falling out. He said the hair pull test indicated my hair wasn't falling out, so whatever condition I had was gone and I shouldn't worry about it and I'd have a lot of hair for years to come. He was obviously a complete moron, so I went to a "physician who specializes in hairloss" or so the company claimed (I found out several years later that the person handling my case wasn't a Dr., but he was the "Medical Director" and was the one you were sent to if you wanted to talk to the Dr.). As I said I was already wearing a hair system and knew I was really unlucky when it comes to hair, so I was hoping to at least get some real hair in front and maybe build up the sides, so I the hair system would look more realistic. I figured if that was the best I could get at least it was an improvement.

 

They told me I was crazy for only wanting to hide the problem rather than fix it. He said people are bald because they don't have surgery to correct their hairloss. I still had enough hair that he could save mine, but if I waited much longer I wouldn't have enough for him to be able to help me. He said it was like going to a dentist. If you have a cavity you can go to a dentist and get a filling. If you wait until it starts to hurt, you may be able to have a root canal and still save the tooth, but if you wait too long, your tooth will be totally rotted out and it will fall out or need to be pulled. Don't do that with your hair. Save it while you can. It's not something that will kill you if you don't have this surgery, but once it's gone you can never get it back. Why let that happen? You wouldn't let all your teeth fall out.

 

That was the sales pitch. After I asked a bunch of questions and said I wanted to make sure the sides don't get thin he said they can do an extra procedure during each HT session that "doubles the amount of hair in your donor area" (that quote is even in their literature believe it or not) and guarantees I would never run out of hair. They charged me an extra $150 per HT procedure for that. This is no joke. It's even marked on their billing notes for each procedure as an additional $150 charge for this.

 

 

 

Now I'm going to get into another point:

I am totally against having consultants who are not licensed Drs do consultations on patients. I know some of you on this forum are consultants and nothing against you guys personally because I don't know you, but don't you realize that some people, especially the younger guys, are coming to hair transplant clinics because they are looking to go to a Dr to find out why they are losing their hair and what they can do about it? They think they are talking to a Dr. When/if you recommend surgery to them some of them are NOT going to know that they don't have to do it. I'm saying these things from personal experience, so I know it happens. This isn't a theory.

 

I also totally disagree with techs placing the grafts. This is surgery. It's a transplant. Would you want a tech putting in your transplanted liver, kidney, heart, whatever? I sure wouldn't. Now you can say it's no where near as comlex as that and you're right, but isn't it still tissue transplanting? Doesn't anyone think there are some ethical issues here? Both with having a non Dr consult with potential patients and having non Drs performing parts of the surgery.

[MrJobi]

Be happy

 

I can understand about being skeptical about techs placing grafts. However, this is standard for most coalition surgeons and quite common. These people are specialists and are quite experienced.The tech who did my surgeries has been working there over 10 years . Look at the result on the web, they are speak for themselves. You just need to be carful to select a good surgical team. A doctor can deliver poor results as well.

[Agio]

I am totally against having consultants who are not licensed Drs do consultations on patients. I know some of you on this forum are consultants and nothing against you guys personally because I don't know you, but don't you realize that some people, especially the younger guys, are coming to hair transplant clinics because they are looking to go to a Dr to find out why they are losing their hair and what they can do about it? They think they are talking to a Dr. When/if you recommend surgery to them some of them are NOT going to know that they don't have to do it. I'm saying these things from personal experience, so I know it happens. This isn't a theory.

 

I also totally disagree with techs placing the grafts. This is surgery. It's a transplant. Would you want a tech putting in your transplanted liver, kidney, heart, whatever? I sure wouldn't. Now you can say it's no where near as comlex as that and you're right, but isn't it still tissue transplanting? Doesn't anyone think there are some ethical issues here? Both with having a non Dr consult with potential patients and having non Drs performing parts of the surgery.

 

Hi BH

I totally agree with your 1st point. There is absolutely no way that I would have this done without speaking to the Doctor. None, zero and zip. I had an appointment a couple of years back with a Dr. and when the consultant showed up and not the Doctor I left. That's not a slag on any consultant but they aren't the ones doing the surgery.

 

However in respect to the technicians I think they are under-estimated in many ways. In my discussions prior to the surgery with several top notch Doctors what became apparent was how rare truly expert planters are and it seems most of the best surgeons treat them like gold. So in this area I don't share the concern you have.

I guess one of the purposes of this site and others like it is to help people make informed decisions and encourage due dilligence prior to having surgery done. And it is surgery so to me the idea of trusting a consultant without the Doctors input is entirely out of the question.

[Bill - Seemiller]

BeHappy,

 

I eventually decided I wanted to live my life

 

You have certainly been through the ringer but I am glad you decided that you wanted to live life. THAT is the most important thing!

 

Regarding placement of the grafts, I know that some patients feel more comfortable with the physician doing this however, many top physicians have fully qualified and trained technicians placing the grafts and hair growth yield is high. In my opinion, it would be way too much for one physician to transplant all the grafts which is why a team is needed. Keep in mind too that technicians cut the grafts from the strip. Clearly there is way too much work for the physician to do alone.

 

However, preferences are preferences.

 

At one point or another, in my opinion, a consultation with the physician is needed, even if it is right before surgery. The problem is, the physician is really the only one who can really determine with the most accuracy, the number of available donor grafts and transplanting needs. Therefore, if at all possible, I'd recommend consulting with the physician before surgery at some point.

 

Best wishes,

 

Bill

[thanatopsis_awry]

I'd much rather have a team of experienced, patient women, laboriously inserting my grafts than one, "thick-fingered" man -- no offense to Dr. Feller, or any other doc, as I have no idea of the relative thickness of any of your fingers.

 

The consistently excellent results of top clinics, who follow this route, speak for themselves. At the end of the day we all just want the best results, and the best consistency.

[Al - Moderator]

Ok wait. I didn't mean to be bashing any techs. In fact the techs who were working on me seemed to care about me more than the Dr/person in charge and they were probably better at placing grafts too.

 

But I think when you have a good experience you tend not to give much thought to how it got done as long as it came out right. When you have a terrible experience you think about it for years.

 

So follow me a bit here. So far you all agree that techs can place grafts.

 

What about taking grafts out if it's FUE? Legally it's not considered surgery because the incision is small enough and requires no stitches (same reasons a tech can place grafts). That's how they can get away with calling it a non surgical and no touch.

 

So if a tech can remove grafts and place grafts, all you need is a nurse anesthetist and there you go. No doctor needed to perform hair transplants. Can't you see that coming real soon?

 

And it's not just hair transplants. What about all these new laser (oh I hate to even say that word now LOL) surgeries. Liposuction by laser that burns the fat that's underneath the skin, laser brain surgery, etc. My girlfriend last year had a fibroid tumor on her uterus and was looking into having it removed with a laser.

 

with all of those things there's no cutting involved. I'm sure real soon some money hungry crooks will realize that and start some clinics where there's no Drs involved. They won't need malpractice insurance because they aren't Drs. You can't sue them for malpractice because they aren't Drs. They can't lose their licence because they never had one and don't need one. Can't you see this coming?

[Bill - Seemiller]

BeHappy,

 

You make some valid points.

 

I for one am quite comfortable with experienced nurses/technicians cutting and placing my grafts however, I would not be comfortable with them making incisions or excising the donor strip (or extracting grafts via FUE).

 

Perhaps my level of comfort with the one and not the other has to do with the fact that the former is the norm and the latter isn't. Perhaps it has to do with the fact that I am only comfortable with a surgeon performing surgery.

 

In my opinion, the physician should perform all surgical aspects of hair transplant surgery and also oversee/supervise his/her entire team of technicians.

 

Bill

[Janna]

Behappy,

 

As a tech, I don't personally take any offense at your remarks. I understand where you're coming from. But there are couple points I'd like to touch upon.

 

I don't consider fue to be non surgical just because it doesn't require stitches or even that it's touchless. You still need to administer local anesthetic, remove tissue and plant them in another area. It's still surgery. Yes, techs can assist with just about every aspect of surgery, but with direct supervision of a DOCTOR. Someone could open up a clinic, but they'd still need to hire a doctor as they will need a medical license--or they will go to jail.

 

As far as planting grafts by doctors only...let's say a very experienced doctor can plant efficiently, they can probably plant at 300-350 grafts per hour on a good day as long as there are no complications. Complications such as low pain tolerance, above average bleeding, patients who can't sit still can prolong a ht session. This is after taking couple hours to make the incisions. How long do you think a relatively small session of 2500 grafts will take? Even the doctors who plant everyday have techs who will have other techs helping them plant on the other side or relieve them when their backs start breaking. With the mega sessions, you pretty much need 3 people planting at one time (at least for awhile) to get the all grafts planted. I don't know any clinics employing three doctors to do the planting. The price of ht would have to be tripled. The planting phase is a delicate matter. Finding techs who can plant efficently is more difficult than most patients realize. I know because I've been hiring and training techs for years. Not everyone has the physical or mental capabilities to be a good planter. I think most clinics do have an employee who is a standout and treat like "gold". It would be nice to have 5-10 techs with the same high skill level, but it just doesn't happen. There are different skill and experience levels of techs with every clinic. So it doesn't really matter how many techs a clinic employees if they are all relatively inexperienced or not really skilled to perform all tasks involved.

Just some of my thoughts on your concerns.

[flyby]

Hi Janna,

 

Perfectly said! It would be rare for anyone to want to pay 4 doctors to place grafts :-) let alone finding 4 doctors that would want to do it.

 

I am very curious as to how newbie techs are trained in graft disection and placement. Who's head do they do their first graft placements on? Are there any types of training tools, animal cadavers :-O or what. If it's on a patient are they informed about the training going on. It seems like an aware patient would notice. I've also always wondered how often accidents happen with the trays that the grafts are kept in until placement. Seems like it would be easy for someone to trip or fumble one of those trays and all those precious litte fellas in saline would be all over the ground :-(

 

Thanks

a

[Janna]

Thanks flyby.

 

In regards to how we train: We take the training very seriously, therefore, we train in stages. First of all, we do not begin training techs until they are skilled with every other aspects of ht surgery, so technically, we are not training newbie techs to plant. They must first master cutting and slivering and assisting with surgery. They are by now familiar with handling grafts. With limited space and time being of the essence for planting, the tech in training will simply observe planting for a while followed by the "buddy" system. This is where the doctor or I (Dr. Ron always starts this portion and I will take over after several training sessions) will open the incision and the tech will plant the graft into the incision. Then the role is reversed until they are comfortable with the grafts and knowing the angle of each incision. They are allowed ?? hour each day when time and space permits. They then move onto planting a small area by themselves and that area is checked. Once they can efficiently plant an area, they are on their own, but technically, we go over the whole head with every patient to make sure there are not any missed incisions whether it's an experienced tech or not so experienced tech is planting. We have one tech in training for planting at a time as it's a timely process. Techs goes through the "planting training" for approximately 3-6 months, but they are then limited to one hour of planting time as it takes them longer to accomplish what another experience tech can in the same amount of time until they have the same speed as other planting techs. Since the techs are under heavy supervision while learning, the patients are never leery of a new tech "practicing" on them. Some patients are notified, especially during the buddy system process, but so far all patients have been very gracious and trusting of our ability to handle it with the best interest of the patient in mind. Plus they feel secure knowing the doctor is right there to make sure each graft is planted correctly.

 

We're fortunate to not have had any accident with the grafts (knock on wood).

[Al - Moderator]

Originally posted by Janna:

I don't consider fue to be non surgical just because it doesn't require stitches or even that it's touchless. You still need to administer local anesthetic, remove tissue and plant them in another area. It's still surgery.

 

I agree with you Janna, but my opinion and your opinion don't matter if the laws and medical licensing boards say otherwise.

 

Yes, techs can assist with just about every aspect of surgery, but with direct supervision of a DOCTOR. Someone could open up a clinic, but they'd still need to hire a doctor as they will need a medical license--or they will go to jail.

 

Hahaha. I have to laugh at that. Sorry. I'm sure you really do think that stuff is true. I have to ask you, what do you consider direct supervision? Recently there was a thread about Dr Cole ethics. There was a link to someone who had some bad FUE procedures. here's the link:

http://hairtransplantcons.blogspot.com/2008/01/its-neve...mba-its-patrick.html

It's hard to decipher with all his cursing and ranting, but it sounds to me like he's going through the same kinds of things I did. The just call me Patrick thing is something that happened to me. It's a planned thing the way they do it. In my case it was something like "This is your lucky day. You won't have just any Dr working on you today. You'll have the Medical Director". Then he comes in and says "Hi. Dr is so formal. You can call me Stephen". Now in my case there was a Dr who came in, put some novacain in where Stephen marked the area to be worked on and the Dr cut out the strip that was already marked where to cut. Once he was done that he would leave the building and drive back to his General Practice office 20 miles away.

 

Legally that was all OK because a Dr did every part that was legally required and was available by phone if they needed anything, so they could claim he was overseeing the process. In fact the company was run by several Dr's who were active in the business, so they technically were supervising/overseeing all of their 5 or 6 clinics in NJ, NY, and PA. There were several class action lawsuits and several individual suits, but nobody ever went to jail, nobody lost their license, nobody even got a fine. They are still in business today.

 

 

Moving on with that, I think the reason that FUE guy can't get anywhere is because that Patrick person didn't have to be a Dr, so there's no recourse. Even though it's clearly in the literature that he was a Dr (same thing happened to me) it doesn't matter because he doesn't have to be one. It would only matter if he performed duties that required him to be a licensed Dr.

 

So my question is what's stopping a Dr from opening several clinics and hiring consultants and techs to do everything while claiming the place is run by a Dr which it is... he's just not there during your HT, but he does run the business and is available if they need him. This was harder to do before because you actually did need a Dr to come in and take out the strip, but now you don't need that if you do FUE, so I'm thinking there's a chance the HT industry as a whole might soon be going backwards a bit to when there were a lot of butchers in the industry.

[Aquarius]

yeah there is another guy that had 1,000 of those bttch bangers instalated.

Observation ; He has a simpsons avitar and is a commie

An synonym for pest is ferrel. do the math and try not to ..smile.

[its752]

Janna, I was just reading your post about the training of your new techs and my appreciation for you and the techs who worked on me a few months started to reappear. Being a tech is a huge responsibility to have, and is why a good transplant looks so good!!!! I wish I could have given each tech a new car that worked on me!!

[Janna]

Behappy,

 

I call "direct supervision" to be when a doctor is on site at all times and is participating or watching over the process. Being a phone call away is NOT. I should have said it's unethical and should go to jail. You are right, what we think and feel doesn't matter if people can get around the system with loop holes. And I'm aware it does happen everyday. Not just in this field but every other aspect of life.

 

In a perfect world there wouldn't be liars, cheater or "butchers" who have no regard for others. I do work in a environment with ethical doctors and we are proud of the work we produce, so I tend to have a more "rosy" outlook. I'm sorry for your experience. It negatively effects not only you and your life but everyone else in this industry. Best regards to you.

 

 

Thanks very much Its752, I really appreciate your words. I'll pass your comments to the other techs today.

[NervousNelly]

Aquarius-- I never know what you are saying but it always makes me smile.

 

Behappy--Behappy!!

[phillyboy]

A few observations and comments....

 

There are conferences and professional groups for Hair Restoration and you can see who attends them and/or who is a member of the group. To me, this helps a little bit to put my mind at ease as you can see they care and are putting forth the effort and care about their craft. Not only that, the education, standards and quality of work all improve. I think in the future there will be classes for the techs (akin to what we've seen computer programming and a host of IT functions evolve in to through the years).

 

My 1st HT Doc was a member on this forum and then was dropped, and coincidentally, he did not attend many conferences. Bill and I talked about this before.

 

My 2nd HT Doc was Dr. Shapiro and Janna has worked on me. What I noticed in both my HT's is that the doc will usually do the more visible/critical work (i.e. the front) and the techs fill in in less critical areas. I know most of the time there were a combination of folks working on me, but that Dr. Shapiro was periodically checking the progress when he wasn't working on me (which he did a good deal himself). I had a high confidence level that he was focused and cared about me and my results.

 

Even with all that, I was still nervous! But I came back for a few days straight and everyone was so nice and took their time with me - which is why the forum is paramount - to get these details.

 

It's why less than a year out I feel it looks pretty good and will get better (I hope). It's why I would consider having another surgery with SMG. I am glad I found this forum, it helped me make a decision on what I was going to do and who I was going to do it with. That said, don't think I didn't run Dr. Shapiro's name through any database/board/BBB I could to find any problems. This forum ENCOURAGES you do that!

 

Lastly, when I pulled out the picture that triggered me in to HT action and showed it to a friend - they couldn't believe it! Their exact words; "HOLY SH!T!, what a difference." They stared at me all night and it didn't bother me, because I know while my hair will never be like it was - it is very good/improved and makes me feel better all around. I am lucky to have had two procedures to improve my quality of life.