Need advice for bad TP

[NervousNelly]

Rambler,

 

I agree with you but feel that they should pay for whatever number of grafts it will take to make things look cosmetically perfect. Are they offering 500 because this won't cost them much and will hide things? Hell they need to rectify this problem and I personally believe that it will take more than 500fu.

[Rambler]

I don't think cosmetically perfect is achievable.

 

In my first consul with Dr. Pak he examined me and then offered to do a procedure of 300 grafts, mostly single units to create a transition in front of the damaged area. He then sent me a follow up letter in which he said

You have good results from a prior surgery from us. However your frontal hair line consist of 2 and 3 hair grafts which makes it a bit harsh on close examination. Personally I am not pleased with the results and I recommend 200 to 300 single hair grafts to soften up your frontal hairline

 

These statements are not addressing the very reason I went in for the consultation. Yes, the frontal line could absolutely be fixed, but the pitting absolutely can not and he does not address this. Also in the interview, Dr. Pak would not admit that the pitting is a result from a bad procedure and that I risk the same thing in future procedures. This bother me on several levels.

 

Hence, another consul with Dr. Rassman. Dr. Rassman also did not contribute the pitting to a bad procedure. In this consul I indicated that if I were to undergo a repair procedure I would like to do an additional procedure for the area behind the area I had done before. I suggested these be done at the same time for obvious reasons. Less stress on the donor area, time restraints, less cost for everyone etc..

 

During the consul Dr. Rassman told me that he would put about 500 in the "affected" area to do the camouflage. So now I am confused. There is a big difference between 200-300 and 500. Am I to take from the paid portion of the procedure into the area for the cover up? I sure hope not but the fact that he indicated he would use 500 leads me to believe it will take at least that.

 

Like I said, I would rather be able to fix the problem and go back to a normal thinning scalp instead of having to cover up a bad procedure no matter the cost. Apparently this is not an option. But I do feel that they should own up to the bad procedure and feel that instead of me asking them what it will take to make me happy .. they should be asking me the same question. I am stuck with this for the rest of my life.

[TooThin]

Rambler

 

Take Janna's advice on the punch outs. I had similar "micrografting" in my hairline from a past doctor. My situation was worse than yours. I even had multi-haired grafts in the hairline. From your photos, it looks like your grafts are all single hairs.

 

I had two procedures with Dr. Ron Shapiro last year which involved punch outs of the old grafts and a strip to densify the frontal half. In my opinion, punch outs are the way to go with bad grafting at the frontal hairline. I think you will get a better result than just camouflaging the area with more grafts. Get a consult with Shapiro Medical Group. TooThin

[Bill - Seemiller]

Rambler,

 

I emailed Dr. Rassman today requesting his input on this thread so that we can not only obtain a proper understanding of your situation, but so that a resolution can be made to best help you.

 

Dr. Rassman is a stand-up physician and I trust he will do whatever he can to help you in this situation.

 

Best wishes,

 

Bill

[Rambler]

TooThin,

 

Thanks for the advice. Actually most, 80-90% of the grafts in the frontal hairline are 2-3 hairs. There are very few 1 hair graft units there.

 

I appreciate Janna's suggestion, but there are about 900 grafts, and they are all like this. It isn't like there are just a few.

 

Would you be willing to post some fotos of your results?

[Rambler]

Bill,

 

Well, I was going to contact Dr. Rassman again personally about this matter. My purpose here was to obtain advice from those with transplant experience and on my options etc...

 

As I stated before, I agree with you, aside from what has happened to me I do believe he is a stand up guy and surgeon. I have a lot of respect for him on many levels. That is why I went back to him instead of going somewhere else first.

[Janna]

Hi Rambler,

 

There have been many degrees of poor work that needed repairing. Some take multiple sessions of removing all the plugs that stand out like a sore thumb. But, there are techniques that can repair the unsightly hairs to turn them into positives rather than the negatives you're putting up with currently. Here is one example of repair of someone who had plugs too low, which I posted recently. While the resection is a delicate procedure that is not to be taken lightly, it's just one example of a technique that can transform bad work into something very natural looking. Good luck with your situation.

 

http://hair-restoration-info.com/eve/forums/a/tpc/f/256...771073453#7771073453

[Rambler]

Janna,

 

It's hard to tell the extent of the plugginess from that particular patient from the photos but it must have been pretty bad if he was wearing a hairpiece. The results, from the photos anyway, look excellent. I sure hope that is not the route I need to take. Thank you for the information, I appreciate your input.

[Bill - Seemiller]

Janna,

 

My best guess is that Rambler wouldn't have to go through this type of radical surgery however, it is clearly an option. In my opinion, removing the hairline as a strip should be the last possible resort for repair.

 

Rambler,

 

I have heard from Dr. Rassman today and he will be contacting you shortly to ask for your permission to discuss your case publicly (without revealing any confidential patient information of course).

 

I hope that you will allow him to give his professional input on this thread and that he can help you through this situation.

 

Best wishes,

 

Bill

[Janna]

Rambler,

 

I wasn't implying you would need to go through such measures in your situation, but you mentioned having to endure large grafts for the rest of your life. I just wanted to you to know that there are steps you can take to eliminate enough of those unsightly grafts for a more natural look. They may be punch outs, lasering, resectioning, and planting singles in and around the big grafts. Sorry for the confusion.

[Rambler]

Bill,

Yes of course I would allow that.

 

Janna,

I understand. You were just indicating that there are other options that can be considered.

 

btw, I never mentioned having to endure large grafts. It is the pitting nature of the transplant that I am concerned with.

[Janna]

As long as the pitting is not all over the head, if it's in an area like right at the hairline, they can most likely be removed during the punch outs.

[Al - Moderator]

Janna,

Have you ever had to turn away a prospective repair patient because there was nothing you could do for them? What can you do if the person has no donor hair remaining?

[Janna]

There's aways something you can do for repair patients. Simply doing a scar revision or removing punches and recycling some of the bigger plugs can make for a more natural appearance. There are patients who have had previous punch work done at other clinics and by the time they get to us for repair, the donor is very limited, but we have always been able to do something to improve. The repair may not produce as many hairs as we like, but it's still an improvement.

[Bill - Seemiller]

Hello everyone,

 

In the interest of fairness, I have contacted Dr. Rassman about this particular thread so he could obtain the necessary permissions needed to discuss this patient's case publicly.

 

At this time, the patient (Rambler) has refused to give that permission.

 

Rambler, I recognize that you posted on this thread to obtain forum member advice. But given the information presented, it is only fair that Dr. Rassman be allowed to offer his input.

 

Therefore, I'm requesting that you give Dr. Rassman the necessary permissions that he requires to discuss your case publicly.

 

Without this permission, I cannot allow this unbalanced discussion to continue.

 

Please be aware that your identity nor your photos will be used, only the necessary medical information to discuss your situation.

 

Dr. Rassman has informed me that he will make another attempt to contact you regarding this.

 

Thanks,

 

Bill

[thanatopsis_awry]

I took it when Rambler said: "Bill, yes of course I would allow that", he was giving that consent. (?)

[Rambler]

Bill,

 

I absolutely welcome Dr. Rassmans input on this thread. He did send me a consent form to fill out but I do disagree with it as it is written. It did in fact indicate my photos would be used, amongst allowing any info on my medical history to be posted as well. I myself do not know what info any Dr. has about me, but consenting for it to be posted allows any of it to be posted even if irrelevant.

 

I'm sure as a physician he has legal reasons for the consent, but there must be a way to allow him to respond without agreeing to this.

 

I came to this forum seeking advice from others that have had experience with hair restorations. When I joined I didn't know the forum was visited by physicians as well, let alone Dr. Rassman. I really just wanted advice. I stated my situation, posted the pics as suggested, gave my opinions, and asked for advice of what to do. I think I have done that fairly and maturely and thanked everyone that posted. Now I am being asked that my medical records ( whatever they may be, and not knowing what they are ) be posted online? I don't think so. I had no expectation of this being such an ongoing thread.

 

However, all being the case of events and fairness, I want to allow Dr, Rassman to input here and speak openly and freely about the situation and voice his opinion on my input as well.

 

I will contact Dr. Rassman by telephone tomorrow and see what can be worked out regarding this.

 

Rambler

[Bill - Seemiller]

Rambler,

 

Thank you for your reply.

 

Please work out with Dr. Rassman privately as to what you will and will not allow. This may involve the signing of a release form with or without any necessary addendums as to what you will and will not allow. Please call his office to discuss.

 

Thanks,

 

Bill

[Rambler]

I sent Dr. Rassman an email on 1/21 inviting him to call me. Not receiving a response I called the office Thursday 1/24. He was not in at the moment, so I left a message for him to call back. Still no contact from him. It's been almost a week with no correspondence.

 

I'm doing what I can to reach resolution with this but don't seem to be getting any cooperation. I would think a the very least a telephone call to discuss this with me would have been an appropriate first step towards an end, in addition, it would show me that some level of concern towards my situation and options are even important to them. I gotta tell you, I am really disappointed with how this is being handled by NHI and its staff.

 

Rambler

[NervousNelly]

Rambler,

 

Although I agree with you that it should be a priority of theirs to make contact with you to resolve the issue, 1 week really is not that long. I am certain that Dr. Rassman is extremely busy and possibly even out of town as they do many seminars. Give it a little more time and I am sure he will make contact. Good luck.

[Bill - Seemiller]

Ramber,

 

Thank you for sharing your concerns. The last day I was in touch with Dr. Rassman about this was on 1/23/2008 and he stated that he would contact you at his earliest convenience.

 

I agree with Nervous Nelly that a few days is not a long time to wait.

 

I know that Dr. Rassman expressed great concern over this and I trust he will make this a priority at his earliest convenience.

 

Best wishes,

 

Bill

[MrJobi]

10 years is a very long time as well..

 

Why did you wait this long?

[Rambler]

Hi Jobi,

 

Read the very first post in this thread. It is explained there. I never noticed it because the pittedness of the damaged scalp is only visible from the sides and top, above my level of view but in plain sight of others. I posted pictures of this in this thread showing this with the different views.

 

The rough hairline I could see. I have several 5's and 6's right up front. That's one thing, but permanent pits are another.

 

If that wasn't bad enough the really disturbing thing is that Dr. Rassman denies there any pits at all and the follow up letter indicates that I had a "great" result. I would gladly post my follow up letters. Go back and take a look at the pics I posted and tell me if there is any way possible that these are not pitted and if the result is "great".

 

This is why I stated in another thread that I question his ethics. Even though he did not do the surgery himself, he is not providing an honest assessment of it. If you don't have honesty from your doc, no matter how painful it may be to hear, there's really no where to go from there. How could you trust anything said from that point on?

 

Also, If you notice, I did try to resolve this directly with the doctor first before posting here. I had 2 consultations with Dr. Dassman before coming to this forum seeking advice.