Crown 1126 grafts

[nobuzz4me]

Charlie,

 

I agree with the numbers not adding up. Using the numbers you would have had around 2000 hairs moved before adding in the missing 30%.

 

If that missing 30% were 4 hairs, you would have ended up with well over 3000 hairs moved. There must be some mistake.

 

It is not the incision type or size in question, just the layout in rows. That is what we want the DR. to explain.

[charlieb]

I think my estimation off 2000 hairs previously was incorrect, ill check and post back , hopefully its over 3000 hairs.

 

As for the layout all i can say is my hair is in her theories...hope they are right..ill post a day 3 pic now..

[nobuzz4me]

Sounds good Charlie, I hope you did get what you paid for.

Look forward to your pics.

[Bill - Seemiller]

Moderator Note

 

I wanted to give everyone an update on this.

 

Pat and I have been in touch with Dr. Martinick regarding this case and her continued recommendation on our network.

 

Dr. Martinick has presented a compelling case for her methodology in this hair transplant patient's case despite the fact that it goes against what we know today as the "gold" standard as ultra refined follicular unit hair transplantation.

 

I admit however, that I have reservations about this approach.

 

In my opinion, this patient's hair transplant should not be fully evaluated until the results come in. Basing a suspension of membership solely upon immediately postoperative photos doesn't seem fair.

 

However, in order to continue Dr. Martinick's recommendation on our network, she is required to present compelling evidence of her recent work in our hair transplant photo album forum.

 

We have already received an email from Dr. Martinick's associate, Sarah, who will most likely be posting photos in our gallery soon.

 

I ask everyone to reserve final judgement on this hair transplant patient's case until 12 months - after the results come in.

 

In the meantime, her continued recommendation is dependent upon her providing compelling results in our photo section.

 

Thanks,

 

Bill

[NervousNelly]

Bill,

 

I have always believed you to be a fair and honest individual and I understand your concern about suspending a doctors membership based on post-op photos. I personally believe that Charlieb will look better in a years time if he maintains his current level of hair, but this unorthodox methodology in no way mimics nature and if all native hair is lost it will look strange. Most of us believe this and are unlikely to alter our stance irregardless of any explanation. I have seen enough bad results to know that it can be devastating to an individual and I for one lean heavily towards "stand alone" Ht's and this is obviously not one of them.

 

I definitely don't need to wait a year to decide on things. I don't like what I see relative to work performed by other physicians. Most of us know this to be a against the norm. Why have no other physicians on this site chimed in as a defense of this technique? She may have her reasoning and ofcourse she has to defend her case, but I will not endorse her work as I want to know that I can be confident in my referal and with what I just have been witness to, it's not going to happen.

 

NN

[nobuzz4me]

I agree with NN.

 

I see no reason for us to wait a year to get an straight explanation on this "technique" irregardless if the result comes out OK in a year.

 

I think most of us here who contribute on this forum know this pattern looks strange. Is this some new technique??

 

I am surprised this seems to be getting brushed under the rug with a wait a year approach. Can we get a straight explanation on the reason for this weird pattern?

[Bill - Seemiller]

NN and nobuzz,

 

I am in agreement with both of you. Despite the evidence in support of her technique, I am 100% skeptical and do not believe it mimics nature.

 

Please understand that this is in no way is this getting "brushed under the rug".

 

Pat and I are discussing. Please give it some time for us to make a decision based on the evidence before us. Recognize that the decision we make will be what we believe is best for our community.

 

Thanks for providing your feedback.

 

Bill

[mphoenixaz]

charlieb,

 

1126 grafts doesn't seem alot, I think we have a similar case.

However, I just received 2300 grafts from Dr. Alexander

Here are my pics.

 

 

I've had previous surgeries. As you can see, there are hairs growing on my crown and kind of scattered and some are thicker. That was from a previous surgery.

 

I had my 3rd one and this is where I got my grafts.

 

 

and then Dr. alexander fixed my hairline because I had some obvious hair transplant in the front from previous surgeries.

 

Dr. placed the grafts to cover and fix them.

 

I think it's a good idea that you keep using your laser comb, rogaine and propecia. I'm going to do the same.

 

I also changed my food habit. I eliminated a lot of food that might cause hairloss and started eating food that promotes hair growth.

 

 

Since I don't eat meat, protein is very important for healthy hair. I eat alot of protein rich foods such edaname, tofu, soy, seeds, beans and nuts.

 

I cook a lot, so I always include lots of biotin rich foods as brewer's yeast and soybeans in my food and lots of Vitamin B rich vegetables such as kelp, bananas, sunflower seeds, almonds, lots of green veggies.

I don't like fatty foods and if I crave chips, I usually cook my own using olive oil. My favorite is Kale, it's a green vegetable that is rich in vitamin A, C, B6 and manganese. I usually roast it with almonds and it's really good.

[NervousNelly]

Bill,

 

Thanks for the clarification. Officially maybe she has not been removed, but unofficially there aren't too many of us that will ever make a recommendation to see her based on what we just saw. I know you well enough to know that you understand fully where I am coming from with that statement.

 

I am willing to overlook a poor yield, scar, or occasional unnatural result as some of these issues are out of the doctors control; however, to create a pattern as obvious as to the "corn row" we all try to avoid is not acceptable.

 

At this point the only thing that might possibly change my mind is for some of Dr. Martenicks peers (regular posters) and talented physicians on this site such as Dr. Feller or Dr. Alexander for example to chime in with an explanation.

 

I do understand the difficulties for you and Pat when faced with something like this as it is very concerning and there should always be a standard protocol to follow. I'm certain that you will make a decision that is ultimately best for the community.

 

NN

[L'Anonyme]

I, too, applaud Bill's consistent fairness and the need for an appearance of open-mindedness to be maintained in this case, but I fail to understand how Martinick's defense of this work could be considered "compelling" if Bill still maintains "100% skepticism". I can't imagine any other doctor coming to the defense of the placement of these recipient sites. And on an unrelated note, I think it must be said again, mrphoenix, that there are no foods that "cause hair loss" or promote hair growth. Unless severe malnourishment is the case, diet has nothing to do with hair loss....

[Bill - Seemiller]

Sorry if it sounds like I contradicted myself.

 

I'll explain briefly.

 

Something can still be compelling even if one is not compelled to buy into it.

 

I can understand why Dr. Martinick may group follicular units into 3 haired grafts (due to gradual central density) however, in my opinion, doing this in a case like this where there is very little native hair could create a "pluggy" appearance.

 

I also cannot buy into the placement of the grafts. It seems to me that groups of six 3 haired grafts spaced this far apart will create a "patchy" and unnatural look.

 

So few grafts were used in such a large area, that even if placed more "appropriately", it would most likely not create a huge cosmetic difference in appearance.

 

I suppose the use of the word "compelling" made it sound like I am compelled. At this point, I am not a believer in this approach.

 

Pat and I have asked Dr. Martinick for evidence. Sarah from Dr. Martinick's office has asked how to post photos and we have sent her information.

 

Regarding her continued recommendation on our network, Pat and I are still discussing the matter. Like all of you, I don't enjoy unresolved matters, but we have to be thorough before we jump the gun. I promise however, that a resolution is around the corner.

 

Bill

[Guest]

Bill,

my opinion previously was that I should look abroad to the US/Canada in finding the right HT Doctor. This thread has confirmed my opinion. The number of quality of HT Docs in Australia is limited at most. When the only Doc in Oz that is recommended here is producing results that clearly look like that - it is time to hit the stop button. I appreciate your position on this matter. There is absolutely no doubt that I will be heading overseas for my HT. The risk to stay local is just not worth it.

Bundy

[hairthere]

After seeing dozens of quality Ht examples I'd have to say this approach looks ancient by comparison. I'd like to give her the benefit of showing comparison photos, but if this were all I had to go on there's no way I'd let this doc touch me....

[el guapo]

Im no expert and I've enever had a HT myself but that result looks awful by any standard.

If a HT looks like that it defeats the purpose of having one done in the first place. There is nothing natural looking about it it at all. In fact it looks pretty much exactly like those doll hair results from the 80s.

[Pat - Community Publisher]

Thanks to all the members of this community for their input and patience.

 

Before making a decision on whether or not to discontinue Dr. Martinick's recommendation on the Hair Transplant Network, I sought Dr. Martinick's explanation as well as input from leading physicians who I respect.

 

While the patient, Charlieb, may be comfortable with his immediate post op results and surgical plan, I have reservations about the crown restoration technique used on this patient. While I do agree with the use of coronal incisions (also known as "lateral" or perpendicular) to maximize the optical coverage of the scalp with the shingling/splaying of larger grafts on the surface of the scalp, I'm highly skeptical of the placement and low number of grafts (1126) used on such an extensive balding area.

 

I have included Dr. Martinick's justification of her approach to this patient and other crown restoration cases below. While I believe Dr. Martinick genuinely believes her technique is optimal, I must respectfully disagree with her approach to crown restoration with this patient in particular. Dr. Martinick's credentials and enthusiasm for hair restoration are very impressive. But this community's #1, 2 and 3 most important criteria are ??“ results, results and results.

 

I hope that in time Charlieb's results do grow in with impressive coverage and naturalness and that my concerns prove to be unfounded. But until compelling photographic evidence of Dr. Martinick's procedure and its success in the crown in particular can be presented to me and this forum community I can't justify her continued recommendation on the Hair Transplant Network.

 

I regret that at this point in time I do not have the confidence to recommend any physicians in Australia at this time. I hope that this will change in time so that our hair loss comrades in Australia will have a compelling option in their own nation.

 

Best regards to all, Pat

 

Dr. Martinick's reply to me regarding Charlieb's 1,126 graft crown restoration:

 

Dear Pat

 

Thank you for your interest in vertex reconstruction.

 

As you know hair direction in the vertex is extremely individual, spiraling through 360 degrees. Certain factors you may not be aware of are that in a study that I presented in Las Vegas last month 12 young men with a full head of hair had up to 66% 3 hairs or greater groupings in the vertex, whereas the occipital/donor area has significantly less. Hence to create the natural density in the vertex it is essential to combine follicles to create a cosmetically acceptable result.

 

For example I frequently have to use 1500 to 2000 follicles from the donor area to create 1000 grafts when treating the vertex. These are placed in coronal slits, that is, in groups of 3 or 4 at right angles to the direction of growth. This by the way is exactly what nature does. Imagine 3 or 4 of your fingers lying flat on the scalp compared with the covering ability of 3 or 4 fingers piled on top of each other, the latter giving a stripy/tufty appearance.

 

If you look very closely at a scalp which is shaved, you will notice a triangular distribution of the follicles. (I explain it to patients as the pattern your feet would make when walking along a curved footpath.) This triangular distribution is something I have lectured on for the last 3 years and it makes sense because if you put a whole lot of oranges in a box, they too take up a triangular distribution so as to create the least pressure on each other. In the skin, the follicles do the same thing so as to create the least pressure on each other thereby allowing blood and lymphatic drainage to and from the area to occur most easily.

 

Hence in the picture that you referred me to on the internet, you will find that the recipient sites are not in straight lines but curved and have been placed with extreme care with the same angle, orientation and direction as the existing hairs so as to complement them.

 

I think you will be astounded with the outcome with regards to density and total naturalness when it grows through in 6 to 12 months.

 

If this is the patient I think it is, he already has 1200 sagitally placed follicles or hairs done by another Doctor and quite frankly, do not make a visual difference. However on close inspection I was able to see them as scattered and vertically angled.

 

Again if it is the same patient, I combined a 2 hair follicle with a 1 hair follicle to create all 3 hair grafts, so as to mimic the natural groupings in his vertex. (These hair groupings are quite obvious on close inspection but they are heavily miniaturized and as I am sure you know a hair that has lost 50% of its diameter has lost 75% of its volume due to ???‚¬ R 2.)

 

So, in closing, hair transplantation has to be individualized for each patient, as they are individuals.

 

Given the fact that if you shaved the head of the hairiest person you know you would find that their scalp surface is made up of over 90% skin. That is, much less than 10% surface area is actually hair.

 

I have lectured for some years now on how essential it is for doctors to slavishly follow nature's angles, orientation, direction, groupings, hair curl and triangular patterns to maximize the cosmetic outcome and I am pleased to say at last a few senior international colleagues are starting to understand the merit of these factors.

 

Jennifer Martinick, MBBS, FACCS

 

Perth, Sydney, Melbourne

[L'Anonyme]

"So, in closing, hair transplantation has to be individualized for each patient, as they are individuals."

 

Doesn't exactly inspire confidence, does it.... And she's not even sure which patient is being referred to? Even with artificially constructed 3-hair grafts, I'm afraid you'll still be able to, as Dr. Feller once put it, drive a truck through the spaces between those recipient sites.

[Bill - Seemiller]

Pat,

 

Thank you for providing the information we discussed and for taking your time to gain an accurate understanding of this approach.

 

As I've already stated, I am also highly skeptical of the placement of the grafts and the low number spaced out over such a large area.

 

I hope that in time, Dr. Martinick will provide compelling evidence that they still perform state of the art hair transplantation.

 

I also hope that CharlieB ends up with a quality hair transplant result.

 

Best wishes to all,

 

Bill

[TheEmperor]

This is peculiar.

 

The only potential advantage I can think of this is that if there shock loss or permanent death of weak hairs, it will be limited to the areas in which she grafted, which looks to be 30-50% of area.

 

It may also be that strong clumps of hair impart clusters of density which may be more manageable in styling or have some other benefit.

 

Other possibility is that it should be easier for her to do another session because it will be clear which are the permanent hairs and she can plant between them.

 

 

 

Her explanation doesnt make sense tho.

[NervousNelly]

Pat,

 

I think that this was a good move on your part to no longer recommend Dr. Martinick on this site. It is always possible that this was a one time thing and she had an out of body experience but for this site to have legitimacy she had to get ousted. It would not be right for those docs doing awesome work regularly and too much of a risk for potential patients. Her reputation was/is on the line and she didn't seem to even know or research who the patient was.

 

I am curious as to what other docs said that you consulted with. Obviously they want to probably keep a low profile but you could still mention their thoughts. No doubt they didn't have good things to say if you opted to no longer recommend her. What has been her reaction to not being recommended?

 

NN

[Byehair]

maybe 1,126 grafts was all CharlieB could afford and the doctor had to do the best she could with what little she had to work with.

Scattering 1,126 all over the whole crown wold have provided very insignificant coverage. Maybe her approach is the best option for so few grafts. In a year, all the naysayers may be looking like fools.

 

Byehair

 

Forum Oddball Associate Ahole

[hairthere]

Byehair, common sense, plus seeing tons of other patient results, dictates otherwise. also, while a surgeon should do his/her best to make the customer happy, they must also give the patient realistic expectations, and if a cosmetic improvement isn't possible due to lack of funds, must either let the patient know or refuse to perform the work.

[Byehair]

hairthere,

 

I agree with you completely. The outcome so far does not look good.

My first thought upon seeing the photos was that I was looking at some type of theater seating plan. Like when you get to pick your seats for a concert or sporting event.

 

I guess time will tell. Poor CharlieB, he must be feeling pretty low by now.

[Bill - Seemiller]

There is hope for CharlieB so let's not get him too down.

 

We already know at best this case will produce low density - however, with the use of only 1100 grafts, he should have a plentiful donor supply to have a follow up hair transplant surgery with a different hair transplant surgeon.

 

Bill

[hairthere]

i hear ya byehair. charlie, i hope we're all wrong and that everything works out. if not, though, do not go back to the same doc, even if she offers more suregery for free....

[Guest wanthairs]

i have to say.....I had been readin quite alot of negative things about martinick for a while on a different site.....

 

On the bright side, we all (who have alot of loss) will need several procedures so Charlies donor will be there to use wisely next time