Not really happy with my HT......please take a look

[MrJobi]

That's a shame

 

I have heard great things about Dr. Rose on here.. Let's remember though, surgery is not a perfect thing. I have heard a questionable comment about (almost) every doc on here including a couple from mine.. That still doesn't discount the fact that coalition docs are consistently delivering good results..

 

A questionable issue is bound to come up .. Just the nature of the biz

[mm]

Guys, my only objective coming on here was to get a credible independent viewpoint relating to my concerns. I think I was being very fair by waiting as long as possible (18 months post op) to ensure that I was not jumping the gun. Now, I have that credible viewpoint and I can take it from here. Thanks for your help.

[Bill - Seemiller]

MM,

 

Unless I missed something...

 

Did someone give you the impression that you are not entitled to post your experience and questions?

 

Let me assure you that you are welcome and encouraged to share your experience and ask any question you would like.

 

We welcome all shared experiences whether positive or negative which is one of the beauties of this community.

 

Likewise, Dr. Rose and theHairlosscure are entitled and encouraged to state their point of view in this matter as well (without revealing any specifics of your case or your identity).

 

Best wishes,

 

Bill

[TheHairLossCure]

Hello all. I let Dr. Rose know about this particular thread. Nobody is ignoring the concerns stated here. The doctor will address these shortly. Thanks.

[MrJobi]

MM , You are always able to speak your opinion on here..

 

We encourage this unless it is offensive.

 

I'm sure Dr. Rose would be more than happy to speak with you.

[Dr. Paul Rose]

I recently read the post from MM. I am disappointed that he is not satisfied with his result. Since the first time that he related to me his concerns more than a year ago, I have tried to do everything in my power to accommodate him. I have not pushed him away nor have I dismissed or ignored his concerns.

 

As he pointed out after he had his first session with me we both agreed that he had a superb result and I thought he should consider stopping at that point at least for the time being. As MM pointed out he wanted more grafts to increase the density.

 

I do not believe that my ego has gotten in the way and feel that I would be the first to admit if I thought something had gone awry. I feel that objectively if one were to meet MM in person that a reasonable observer would find the result to show excellent growth naturalness.

 

As I understand the situation, MM is not saying that he did not have good growth; rather he is concerned about density in some areas.

 

I have suggested that he visit with other doctors and let them evaluate his results. I have offered to speak with any and all of the doctors he has seen to assess if there is a problem.

 

I have offered to send his pictures to an email group of doctors that I communicate with and let them examine the pictures to see if there is a problem they can discern. MM did not want his photos sent out or brought to a hair transplant meeting to be seen by other physicians that I know.

 

Members of my staff have seen him and spoken with MM one on one without me being nearby. While one could assume a bias on their part I think they try to be objective. Their impression was that the results were excellent as well. Some may feel that the staff cannot provide a valid opinion but members of my staff have worked for me for many years. I have respect for the skills and experience they bring to the table.

 

In meeting with MM I have tried to understand his concerns. What I think may be occurring is that he may be noticing a difference based on ongoing hair loss and the difference in density from the back of the head to the frontal area. If this is the case then I suggested adding some grafts to the area of concern. When I raised this possibility MM disagreed with the analysis.

 

Similarly in the temple area my feeling is that he is noticing more recession in the area from his own natural hair loss. I suggested adding grafts to refine this if he desired. MM apparently MM feels he has not lost more hair in the temples.

 

 

Again objectively I truly do not think he looks worse. I take great pride in my work and I try to be responsive to my patient's concerns. I personally remain disappointed that MM is not satisfied with the work. I have repeatedly offered to do whatever he wants (within the context of what I think is reasonable)

[Bill - Seemiller]

I am glad to see that Dr. Rose has taken the time to post on this thread. From what I see, he is doing well to accomodate MM and help him in the best way that he can. His commitment to patient excellence and genuine concern for his patients show in this post.

 

I admit however, that it is very difficult to make an evaluation of the hair transplant based solely on these pictures - especially without any immediately post op photos.

 

In all honesty, I agree with MM that the photos do not do justice to the surgery. Based on these photos alone, I too would be disappointed if this was my final result. The question remains as to whether there was poor growth yield or whether MM experienced additional native hair loss.

 

I would like MM or Dr. Rose (with MM's permission of course) to post any additional photos that might shed more light to this situation. Of course, one can only determine so much even from the very best of photos which is why Dr. Rose's idea of getting a second opinion in person from another leading hair restoration physician is a viable suggestion in my opinion(though whomever makes the evaluation should see all the photos that were taken before/progressive/after).

 

If there is anything I can do to assist this matter, feel free to PM me.

 

Best wishes,

 

Bill

[mm]

Ugh.........I knew should have not agreed to say the doctor's name. I never said or implied that Dr Rose was not listening to me or ignoring me, or that I had not met with him to review my results. My only intention was to get feedback on how my HT looked because what my doctor thinks of it and what I think of it is different. It was a bit of a relief to receive plenty of emails that validated my concerns, generally speaking.......thats all I was looking for from a "peace of mind" standpoint.............end of story.

 

That being said, just for the record, I need to clarify Dr Rose's statement "I thought he should consider stopping at that point". I met with Dr Rose in Sept/Oct of 2005 and we both agreed that I could use another approximately 1500 grafts to fill in some areas after my first HT. I subsequently arranged for a surgery in Feb 2008 for a 2000 graft session (the additional 500 grafts were my idea). When I arrived at Dr Rose's office the morning of the surgery, the very first thing he said to me was that I did not need another HT. That statement really flustered me at that point. (While I appreciated his honesty, after prepping for surgery for 2+ weeks, no alcohol, no meds/vitamins, taking time off of work, waking up at 3 AM and driving 2 1/2 hours, etc., I was ready to go for the surgery and could not turn back at that point.) From there, I continued to be flustered and rushed things and the communication was not the best, which is probably the main factor on how I got to where I am today. We were just never on the same page that day, as far as my goals were concerned.........major regret.

[mm]

Correction: the surgery was in February 2006.

[Bill - Seemiller]

mm,

 

Don't be frustrated. The members of this communtiy are on your side and I believe Dr. Rose is also.

 

I understand that you are only trying to receive objective feedback from forum members based on your photos, but I feel it is better for all of the information to be layed out (from you and Dr. Rose) so that you can receive proper help and advice.

 

It appears that you have received the confirmation that you wanted - that there does not appear to be a cosmetic improvement based on your photos.

 

But in reality, nobody can discern why. Is it because of poor growth yield or is it because of additional native hair loss? What is your opinion?

 

If you are willing, I'd still like to see some immediately post op pictures from your second surgery and some pictures before any surgery.

 

Bill

[Mark McFarland]

I recently had 2300 grafts in 2006 and i'm not happy with the results. the hairs that did come in and stayed in..are thin and whispy..and you can clearly see "through" them to my scalp-both in the front and crown area. I am going to meet with my surgeon for a second procedure..to increase density/thickness. I am going to aggressively recommend that he add multiple hair grafts to help me with my density-and should he honestly state that he has not done many of those types of grafts..i will faster than fast..seek another opinion from a more experienced clinician. It moved me when i read that you have ALREADY had 2 surgical procedures. You MUST get another opinion from another team of ht specialists. I agree..you look the same, if not worse, and it hurts me to have to honestly admit that to you.

[notgoing2gobald]

Mark Mcfarland: who was your doc?

[MrJobi]

MM

 

Are you taking Propecia to stabilize the loss? You might have mentioned but don't recall.If not ( or even if you do) progressive loss can impact the overall result. It is like climbing up a greasy pole. You climb but still slip and don't gain ground.

 

I can tell you with my first two HT's I thought I would have more of an impact ( not that I wasnt happy but I thought it would cover more) . My expectations fo 2800 were too high so I went for a 3rd.. NOW I have the result I want and at 6 months post op , I would be happy if it stayed at this level ( but it will only get better)

[mm]

Mrjb, as I stated in my initial statement, I am taking propecia. I have had 2 HT's totaling 4500 grafts in the frontal/mid section of my scalp. Also as I have previously said, its not coverage that is the problem, it is the placement of the grafts (insufficient grafts placed in the temple areas proportionally to the top area). From the front, density appearance is sufficient...........from the sides, it looks too thin.

[TheEmperor]

Originally posted by TheEmperor:

Originally posted by mm:

Ugh.........I knew should have not agreed to say the doctor's name. I never said or implied that Dr Rose was not listening to me or ignoring me, or that I had not met with him to review my results. My only intention was to get feedback on how my HT looked because what my doctor thinks of it and what I think of it is different. It was a bit of a relief to receive plenty of emails that validated my concerns, generally speaking.......thats all I was looking for from a "peace of mind" standpoint.............end of story.

 

That being said, just for the record, I need to clarify Dr Rose's statement "I thought he should consider stopping at that point". I met with Dr Rose in Sept/Oct of 2005 and we both agreed that I could use another approximately 1500 grafts to fill in some areas after my first HT. I subsequently arranged for a surgery in Feb 2008 for a 2000 graft session (the additional 500 grafts were my idea). When I arrived at Dr Rose's office the morning of the surgery, the very first thing he said to me was that I did not need another HT. That statement really flustered me at that point. (While I appreciated his honesty, after prepping for surgery for 2+ weeks, no alcohol, no meds/vitamins, taking time off of work, waking up at 3 AM and driving 2 1/2 hours, etc., I was ready to go for the surgery and could not turn back at that point.) From there, I continued to be flustered and rushed things and the communication was not the best, which is probably the main factor on how I got to where I am today. We were just never on the same page that day, as far as my goals were concerned.........major regret.

 

mm,

 

I have read this whole thread and I believe I understand what you are trying to communicate.

 

You are a diffuse thinner and dont appear to have much recession. I remember when I was at this stage of hairloss. (There was actually a point where I lost some more hair which allowed me to style it differntly which made it look better.)

 

I believe what you are saying is that the transplanted hair built up the central density but the temple areas were either a) not transplanted with the same density b) not transplanted at all or c) didnt get the desired yield.

 

Because the density in the middle is much greater (and probably growing differntly than the native hair, it is probably more difficult to style everything in a cohesive way. So while the grafts were placed and grew you feel that they have a negative effect on your overall look.

 

I have been reading the forums for a while and the large majority of people who express dissatisfaction had a good ammount of hair to begin with. I believe in your case, it looks like the existing hair in your temples is lower than where most doctors will transplant. You will notice that most docs plant behind the original hairline.

 

If he built the temples to the same density as the middle area, that would probably require a large number of grafts and risk your long term result.

 

So my guess is that the doc chose a responsible conservative placement pattern for the transplant hairs, and the net result is that the density is uneven and this makes it difficult to style. Because you were not bald to begin with and he was planting in the existing hair, you did not see a huge density increase -- which is par for the course.

 

Seems like youve got a couple options. You could a) go to an agressive temple closer doc and put more grafts in front b) Wait for the temples to recede more and the density to even out c) remove thin temple hairs.

 

Seems like there was some miscommunication here. I dont think the doctors suggestion to see other docs who are his peers would really help because thye may not understand your concerns and may evaluate the result based solely on growth.

 

 

Hope you can get this worked out. My opinion is that the docs who routinely do _large_ sessions are also good at lon term planning and planting within existing hair.

 

I hear your concerns and I believe they are valid. I also think you are trying to communicate fairly although some of the problem may be expectations. I'm curious how many docs would have touched you (your before pics look like you have a good bit of hair) Good luck.

[MrJobi]

Hi

 

This is tough. I realize the results are not where you want them to be . As far as the crown, it is indeed an improvement as the bald spot is smaller. The other area's I would agree it could be better. However, taking into the consideration of donor quality ( your hair looks very fine & straight) , head size ( do not know), and Norwood scale, 4000 or so grafts may not be enough..in addition, we do not know if your hairloss is stabilized as Propecia is not a guarantee. Placement is one thing but density is another. When I look at other peoples HT's I have much better coverage than many other who have 2000 grafts more than me.. it is not by any means a perfect science. I must admit, in the beginning, I thought 2 HT's would be enough but that wasn't the case.

 

in the end, working with your doc is important. Dr. Rose has responded accordingly and seems quite open. You can always go to a different surgeon as many on here have done..

 

I know it is tough but sometimes, a situation is not cut and dry. I am eager to see the outcome.

[Poitrmx]

Hmm. Looks the same. Certainly not worse.

[mm]

Emporor, while I do not agree with everything you say, I am impressed by many keen observations that you have made. Thanks for taking the time to thoroughly review my situation. While I learned a lot from this experience, one thing that I definitely learned from this experience, and that I can not over-state, is that pre-op patient/physician communication is extremely important.

[Guest]

Originally posted by mm:

Bill, my doc was Dr Paul Rose. He did my first HT and everything went well. I really believe I have had new growth, but the placement has been the problem as I previously discussed. Not sure what else to do at this point.

 

I agree with your doctor. The angles are wrong. They dont really show everything.

 

As Dr. Voldemort says, flash is bad when taking pictures. Try take some in good daylight. Or, use the video function and run a brush thru your hair. Honestly, that gives a really better idea than your current pictures.

[mm]

Jolly, no one else had a problem with the photos.

[Rockwell]

I agree, It does not look worse. It looks the same before the TP was done.

[Dr. Ricardo Mejia]

It is difficult to interpret photos and expectations on the website especially if they do not show before and after photos from the same position and lighting. However, I can see from the thinning areas of the crown a significant tendency for ongoing hair loss which may not necessarily be improved with Propecia and or Rogaine. I personally know Dr. Rose and have the highest regard for his work. The temple areas can receded with time irregardless of propecia. As a physician we are always trying to make sure we are on the same page with the patient and even when we think we are, somehow we are not. Close communication and follow-up with Dr. Rose will always lead to a successful result.

[MrJobi]

No doc can predict future loss or final result. This is not a perfect science. if you are not happy it is important to sit down with the doc to review why and see if there is a decision or agreement you can come to.