Hair Transplant with Dr. Meshkin

[TakingThePlunge]

Romeo,

 

I'm very sorry to see that your hair transplant growth was so poor. Despite covering a large area with a relatively low number of grafts, in looking over your hair loss website, it's clear that a substantial number of those grafts did not grow.

 

Have you been in touch with Dr. Meshkin again since your one year followup? What is his assessment? He has a long-standing record of producing very impressive results.

[KO]

Sorry to this...are you planning on having more work done? I think you deserve a refund. A year after surgery, nothing grew, and they tried to tell you it would grow? Highly unethical IMO.

[Blake Bloxham]

Romeo,

 

Are you using preventive medications (ie finasteride and/or minoxidil)?

 

Sorry to read about your experience. Dave and I will touch base with Dr. Meshkin's clinic and let him know about this thread. Hopefully, he - or Athena - can review the situation, leave and reply, and help fix the issue.

[Athena]

Hello Everyone,

 

At our office, We take care of our patients during the procedure and give instructions as to the post op care. We keep in touch with the patient during the first 10 days to make sure they are following instructions and we see them after two weeks for follow up care to make sure that it is done correctly and every thing is healed properly. If a client is from out of town and can not come in for 2 weeks follow up they send us pictures. Usually after six months and also one year we have them back for a follow up to see the progress of hair growth. We also encourage the patient to keep in touch and call us frequently if there are any questions or concerns.

 

In addition, We explain to the patient that hair loss is progressive and they need to stay on a medical regiment to reduce further hair loss or they may need additional treatments in the future specially in the crown area. We also review all the risks that may contribute to poor growth such as health issues. In general with any hair transplant procedure, it takes one year and sometimes even longer for all the hair to grow in. In this case, we are only guessing as to the identity of this client. This client has not contacted us or has never brought up any dissatisfactory comments or emails so we could properly take care of his concerns. He just has not contacted us.

 

It is not fair for someone to just come into this forum once a year and leave derogatory comments, without giving a chance for the doctor to properly evaluate the progression or cause of his concerns. It is also not fair to assume that we have not done any thing to satisfy this client, when we do not know what is going. If indeed this is the patient we are guessing he is, The patient was called many times to come in for a follow up with out any response. He did not email us or send us any pictures of his progress or brought up any concerns. We try our utmost to take care of our patients and make them happy. I suggest that he contacts us and or come in for a follow up visit so we can examine and evaluate his situation and take care of his concerns in a proper fashion.

[hadenough2014]

Romeo,

 

Are you using preventive medications (ie finasteride and/or minoxidil)?

 

Sorry to read about your experience. Dave and I will touch base with Dr. Meshkin's clinic and let him know about this thread. Hopefully, he - or Athena - can review the situation, leave and reply, and help fix the issue.

 

Help me understand how preventative meds have anything to do with this result? I see virtually no improvement from his before pictures. These grafts should have grown without any meds at all given the baldness of the recipient zone. If these photos are truly this patient's result, this is a scary result for prospective patients.

 

I don't disagree with Athena that is it is unfair to just drop in after a very long time and no contact with the Dr. office and post negative comments or results, so that makes me a little suspicious about the patient's recent postings as well, but for the sake of the industry someone should get to the bottom of this and provide an explanation.

[Blake Bloxham]

Hadenough,

 

More curiosity than anything.

 

I did ask, however, for one important reason: I've seen a few unfortunate cases where the appearance of no or poor growth of the grafts themselves could be explained by loss of the native hairs. Let me explain: say a patient has 500 native follicular units in a certain area of the scalp and undergoes transplantation with another 500 grafts in that region. The patient now has 500 native FUs and 500 transplanted FUGs for a total of 1,000 follicular units. Now, say the patient's androgenic alopecia progresses and he loses those 500 native units during the 12 months after the procedure (and permanent loss of weakened native hair, or "shock loss," can happen after transplantation). Even if all 500 transplanted grafts grew, the patient is left with the following mindset: I went into the procedure with 500 native follicular units, received 500 transplanted units, experienced a generalized shedding during the "ugly duckling" post-transplant phase, and 12 months later found myself with the same 500 units. Ergo, nothing grew and the transplant was a failure. The reality, however, could be that the transplanted grafts grew fine, but the native follicular units permanently shed. This generally doesn't happen with patients utilizing stabilizing medications.

 

Am I saying this happened here? Absolutely not. I have no proof and wouldn't try to diminish the OP's situation by claiming "this wouldn't have occurred if you took finasteride." I am curious, however, as this could be a possible explanation.

 

I hope this makes sense.

[Athena]

Hadenough,

 

More curiosity than anything.

 

I did ask, however, for one important reason: I've seen a few unfortunate cases where the appearance of no or poor growth of the grafts themselves could be explained by loss of the native hairs. Let me explain: say a patient has 500 native follicular units in a certain area of the scalp and undergoes transplantation with another 500 grafts in that region. The patient now has 500 native FUs and 500 transplanted FUGs for a total of 1,000 follicular units. Now, say the patient's androgenic alopecia progresses and he loses those 500 native units during the 12 months after the procedure (and permanent loss of weakened native hair, or "shock loss," can happen after transplantation). Even if all 500 transplanted grafts grew, the patient is left with the following mindset: I went into the procedure with 500 native follicular units, received 500 transplanted units, experienced a generalized shedding during the "ugly duckling" post-transplant phase, and 12 months later found myself with the same 500 units. Ergo, nothing grew and the transplant was a failure. The reality, however, could be that the transplanted grafts grew fine, but the native follicular units permanently shed. This generally doesn't happen with patients utilizing stabilizing medications.

 

Am I saying this happened here? Absolutely not. I have no proof and wouldn't try to diminish the OP's situation by claiming "this wouldn't have occurred if you took finasteride." I am curious, however, as this could be a possible explanation.

 

I hope this makes sense.

 

That is also our suspicion as to what may have happened here. Of coarse there may be other factors involved, however this could very well be one of the contributing factors. That is why it is critical for this patient to be seen from close up to see if the hair that is in the recipient area is the transplanted hair or not and how much more native hair he has lost in the past three years. We always explain to all of our clients during the initial consultation and also on the day of the procedure that they may lose their remaining native hair and their degree of hair loss will progress. They have a choice to go on a medical regiment or expect to do a second procedure when the native hair is lost. The pictures that are produced in this thread does not say when they were taken, they are not clear enough to tell if they are transplanted hair, and also it does not show if his own degree of hair loss has progressed. That is why it is critical to do an in person follow up to examine and evaluate the situation

Edited November 20, 2014 by Athena

[hadenough2014]

Well, I would not accept that as an explanation in this case. I understand the math, but there is no way his 3000 grafts grew if those recent photos are real. I would say something between 0-10% grew. He had very little hair in the recipient area before the HT. He probably had a few hundred bad and thinning native hairs in the recipient zone before the HT and he received 3000 grafts. This is not a 1:1 ratio discussion.

 

I agree an in person meeting is necessary. If the patient is not representing this properly, I would suggest the site pulls the thread down. If it is reasonably represented, I'll be interested to hear what may have happened.

[Loags79]

This case caught my attention. After reviewing the post op photos, it doesn't surprise me why romeo09 had little growth. There is a lot of bleeding and the graft appear quite pluggy and raised. I suspect that there was a lot of trauma to the grafts or the recipient area hence the bleeding. I wouldn't classify this as refined work. Something went wrong here, sad

[hairweare]

I agree that even if the pt had shed his scant remaining native hair in the recipient region it would not explain the resultant poor growth. I don't think the visible blood is necessarily an issue as good blow flow is a necessity for the grafts to take. I do concur than despite the less than dense packing there appears to be considerable popping. Unusual scalp characteristics or fibrosis from previous surgery could account for that. Yes the post op pictures are very concerning.

[KO]

Yes....the work does look pluggy, not very clean.

[hadenough2014]

I agree with the previous 3 posts. Something post-op just does not look normal compared to so many photos we see on this site of good post ops. Perhaps a doc can explain it better.

[Athena]

As explain before the post op care is very important and it is one of the essential parts of the procedure specially for the first two weeks. We explain this to the patient both in the morning before the procedure and also review it after wards. We clean the transplanted areas throughly before we put the bandage on for the first night. We provide special post op care package, show the clients how to clean the recipient and the donor site, give them paper instructions and give our nurse and Doctors phone numbers in case they have questions. We also make appointments for the patient to come in for a follow up in one day, 10 days and two weeks to make sure this is done correctly, and if they live at a distance we keep in touch via email, phone calls or Skype. Dr. Meshkin calls all of his patients and reviews the instructions with them personally over the phone and asks them to contact him if they have any questions. However, once the client leaves the office we have no control over the post op care. Again we do not know the identity of this client and he has not contacted us, but if our guess is correct he came in once for a follow up visit two months after the procedure. If the client does not follow up with the doctor, does not show up at the scheduled post op visits and does not call, we have no idea of telling how this post op care was done. We take care of our patients from our end and expect the client to follow instructions and do the same when they leave the office. In this case it seems from the pictures that perhaps it was not done properly.

[KO]

Hadenough,

 

More curiosity than anything.

 

I did ask, however, for one important reason: I've seen a few unfortunate cases where the appearance of no or poor growth of the grafts themselves could be explained by loss of the native hairs. Let me explain: say a patient has 500 native follicular units in a certain area of the scalp and undergoes transplantation with another 500 grafts in that region. The patient now has 500 native FUs and 500 transplanted FUGs for a total of 1,000 follicular units. Now, say the patient's androgenic alopecia progresses and he loses those 500 native units during the 12 months after the procedure (and permanent loss of weakened native hair, or "shock loss," can happen after transplantation). Even if all 500 transplanted grafts grew, the patient is left with the following mindset: I went into the procedure with 500 native follicular units, received 500 transplanted units, experienced a generalized shedding during the "ugly duckling" post-transplant phase, and 12 months later found myself with the same 500 units. Ergo, nothing grew and the transplant was a failure. The reality, however, could be that the transplanted grafts grew fine, but the native follicular units permanently shed. This generally doesn't happen with patients utilizing stabilizing medications.

 

 

While your statement may be true in a general sense, in this case, I strongly doubt this would explain this case. The transplanted area was significantly depopulated with very miniaturized hair. Loss of those miniaturized hairs would not be cosmetically damaging.

 

Before:

http://www.hairrestorationnetwork.com/eve/attachment.php?attachmentid=20684&d=1315167664

 

During:

http://www.hairrestorationnetwork.com/eve/attachment.php?attachmentid=20683&d=1315167315

 

After:

http://www.hairrestorationnetwork.com/eve/attachment.php?attachmentid=70154&d=1416292842

[Blake Bloxham]

KO,

 

I agree. It's less likely here. However, I was just curious and wanted to explain my rationale to hadenough.

[hadenough2014]

I also find it incredibly odd and even suspicious that this pt is basically saying "Oh well, it didn't work for me even though I gave a shot. Guess I'll move on with life."

 

I don't want to diminish his possible anguish due to a failed ht, but that is not the typical response of a pt in this situation.

[KO]

KO,

 

I agree. It's less likely here. However, I was just curious and wanted to explain my rationale to hadenough.

 

I understand, however, I was also keeping in mind the clinic response below.

 

That is exactly our suspicion as to what has happened here. That is why it is critical for this patient to be seen from close up to see if the hair that is in the recipient area is the transplanted hair or not and how much more native hair he has lost in the past three years. We always explain to all of our clients during the initial consultation and also on the day of the procedure that they may lose their remaining native hair and their degree of hair loss will progress.

[Bill - Seemiller]

In my opinion, Romeo09 should give Dr. Meshkin the chance to evaluate the work/results in person and if it's determined that he's had poor growth, I'd encourage Romeo09 to give Dr. Meshkin the chance to make things right. The pictures the patient recently provided do seem to indicate poor growth. However, I also find it strange that he waited almost 3 years to post an update and doesn't seem to want to try to get his concerns resolved?

 

Romeo09, what's your thinking on this? Also, what was the exact date of your surgery? I'm guessing by your patient website it was 9/2/2011?

 

Thanks,

 

Bill

[Bill - Seemiller]

Romeo09,

 

Please see and respond to my private message ASAP. Dr. Meshkin is having trouble identifying you and would like the ability to respond to your concerns publicly. In addition, he would like to stand behind you and help make things right in the event that you've had less than optimal growth. However, he needs to evaluate your results in person. He also told me that the last time he saw you (assuming he has the right person because he is a bit unsure) was only 3 months post-op which is when he told you that you have to wait for your results to grow in.

 

Thanks,

 

Bill

[Sean]

Hey Romeo, I remember you. Hope you get a satisfactory outcome, after all of this. Good luck.

[romeo09]

I am really really sorry to respond this late. I have been out of the country for personal reasons & didnt get a chance to login to the website.

 

First of all I did go through all follow up visits with Dr. Meshkin & then I met him once after 6months after the surgery which he said he'll be evaluating me after 1year & he suggested I needed a second HT to be done which I was not convinced as I didn't wanted to pay again for the poor result (at least in my opinion).

Yes I have been on medications (FIN & Propecia) till last year i.e till Dec 2014, but stopped Propecia & I am still continuing Rogaine.

 

I will be active now & please feel free to answer any of the questions & I would be glad to answer all of those. Anything that will help you guys I am glad to answer.

 

Thank you & really sorry for posting this late but will be active now. Just had some personal reasons and had to be out of the country for past 6 months.

[romeo09]

In my opinion, Romeo09 should give Dr. Meshkin the chance to evaluate the work/results in person and if it's determined that he's had poor growth, I'd encourage Romeo09 to give Dr. Meshkin the chance to make things right. The pictures the patient recently provided do seem to indicate poor growth. However, I also find it strange that he waited almost 3 years to post an update and doesn't seem to want to try to get his concerns resolved?

 

Romeo09, what's your thinking on this? Also, what was the exact date of your surgery? I'm guessing by your patient website it was 9/2/2011?

 

Thanks,

 

Bill

 

Hello Bill

 

Thanks for your message. Yes Sept 2, 2011 was my surgery date. I gave myself one more year to see how my transplant will be but it went worse I lost pretty much all the hair & since I had a couple of friends on this website I wanted to check how their status was & saw so many responses on my post so thought of updating with my pictures & like user @ hadenough2014 said yes that was my feeling "I gave a shot & it didn't work out for me well"

 

I didnt have much options.

 

So sorry for the late reply but I really appreciate you messaging me.

Thank you

[romeo09]

Once again I really want to apologize to everyone in this post as I had some personal issues.

I will be active from today & will be responding to every question you guys have.

 

Thank you so much for all your support.

[nervousguy]

Hello Romeo, it is great to finally hear back from you. I'm sorry to hear about your results...are you back in contact with Dr. Meshkin to fix this? I hope things work out.

 

It has been 10 months since I had my hair transplant with Dr. Meshkin. I have not had any hair fall out and I hope it stays that way. When did you first start losing your transplanted hair?

[romeo09]

Hello Romeo, it is great to finally hear back from you. I'm sorry to hear about your results...are you back in contact with Dr. Meshkin to fix this? I hope things work out.

 

It has been 10 months since I had my hair transplant with Dr. Meshkin. I have not had any hair fall out and I hope it stays that way. When did you first start losing your transplanted hair?

 

GLad to hear that...be positive & hope it turns out really good

 

No i didnt contact the doctor.