Almost 9 months out with no noticeable growth

[Bill - Seemiller]

Hariri,

 

Speculating as to who performed Strong's hair transplant isn't helpful. Besides, your assessment of "very bad" shows a lack of understanding as to how hair transplant procedures work.

 

For starters, you simply can't get a "wow" result when transplanting 2200 grafts over a large bald area. It's impossibe! This is true no matter who performed the surgery.

 

An educated question would be why Strong only received 2200 grafts Having had hair transplant surgery before, perhaps his donor area was limited. Or perhaps it was a financial issue.

 

Another educated question would be regarding the reason for placement. For instance, he could have used the grafts to focus on the frontal area and then return for another procedure or two to tackle the crown and mid-section. However, if he was a repair patient, this approach may have been better in order to preserve the vascularity in the recipient area which otherwise, may hinder growth.

 

Based on the last set of photos, I disagree with your assessment and feel that Strong has had adequate growth for only 2200 grafts over a large bald area.

 

Best Regards,

 

Bill

[strong887]

Bill,

I value your opinion and am encouraged by your comments. I was disheartened by Haririr's comment as a would view a "very bad" HT as one that does not appear natural. I think my results of my most recent procedure is quite natural actually - just not as transformational as most others I've seen on this board. It was not a financial issue as I told the Doc to get as many as pssible and would gladly play! He got 2247... He had to deal with scar tissue from prior mid 1990 strip surgery. He mentioned on my way out of door that there is more in reserve. Perhaps he can get more on the next session but I don't think I have nearly enough for another 7k grafts. I am OK with having general thinness in the crown area (a little toppik helps greatly there) or just deal with it as I age into my 40's...

 

I have a follow up next month and have also scheduled an appt with another coalition Dr. For a 2nd opinion.

[hairthere]

Strong, Bill is right on the money with his assessment. 2200 grafts in someone with your hairloss will generally rebuild a hairline and give some light coverage in the front. Also, working on a repair patient is totally different than dealing with a virgin head. There are variables like scar tissue, perhaps a bad strip scar, etc. I do not think your HT looks unnatural, however I can understand wanting more density and coverage. I also think a second opinion is a fine idea as another doc may have a different approach. Keep us up to date.

Edited January 16, 2012 by hairthere

[bonkerstonker]

I have to agree with bill too, that amount of grafts in such a big space with hardly any existing hairs was never gonna do much. sorry but it's just obvious!

[Blake Bloxham]

I must say, I agree with Bill as well. For the amount of grafts placed in the balding scalp, it's definitely not a "failed" hair transplant procedure.

 

However, because you are currently less than satisfied, I do highly recommend researching additional options (preventive medications, a secondary procedure, etc). Please, feel free to send me a private message if you'd like any assistance researching any physicians.

 

Good luck.

[strong887]

I am absolutely resigned to the fact that another procedure is necessary.... The question I had was whether the 2200 grafts were strategically placed by the surgeon so that it could "stand alone" or if I would have been better served with denser packing up front and not doing anything in the crown... I guess that is a question for my surgeon.

[Bill - Seemiller]

Hariri,

 

I want to say one more thing. Both True and Dorin Medical Group and Dr. Bernstein are highly esteemed members of the Coalition and perform world renowned hair transplant procedures.

 

Stating that Strong's "bad HT" may have been performed by one of them implies they do less than optimal work. While you're certainly entitled to your opinion and specific tastes, given all 3 physician's proven ability to produce excellent results, this statement is false and inappropriate.

 

Additionally, your misguided comments were very discouraging to the OP. Thus, I expect that you'll start being more responsible and educate yourself more before posting.

 

Best Regards,

 

Bill

[HARIRI]

Bill.. Strong 887 stated that his surgery was performed by a coalition Doc from New York...

 

In Post 1, he said "I went back to my very prominent NYC surgeon a few weeks ago to take a look as I do not notice anything growing. He said it is still too early to tell and was not concerned."

 

In Post 20, he said "This work was absolutely from a Coalition surgeon"

 

 

So common sense, it should be one of these three,

 

Hair Transplant Clinics in New York

 

1) Feller , 2) True and Dorin , 3) Bernstein

 

Im not bringing names from my mind. I was just wishing for Strong887 to mention the name of his Doc so then we hear the reply of his doc stating the reasons and his future obligation. Nothing much really??? Its a forum for patients discussing their problems. Dont take it personal, I have nothing against these doctors, I just stated the names of the coaliton docs from New York. This is it !!!

 

About my opinion of his results, Its freedom of speech, I just said i didnt like it, not only me also Hair There said in post #10 "Well, it does look like you had some growth, but to be honest with you, I don't love this HT work. The grafts appear to be spaced far apart and don't look like dense packing.".

 

Mr. Bill it doesnt mean if someone shared his opinion about a bad job that been performed by coalition doc is a prohibited thing or a red line! Thus thats my last post in this thread, Im not looking for problems. Thanks.

Edited January 17, 2012 by HARIRI

[Bill - Seemiller]

Hariri,

 

You are entitled to your opinion. But there's a difference between stating your opinion and posting false information. You might not like that the grafts were spaced far apart, but this is a legitimate approach used in many situations. What would make this a "bad HT" would be poor growth, bad scarring and/or an unnatural appearance. Since none of these conditions are true, what you posted was completely incorrect and false.

 

The problem with your post is that it either shows your lack of education, or intent to stir controversy.

 

Furthermore, you "guessed" Strong's hair transplant was administered by True and Dorin or Dr. Bernstein. You did not mention Dr. Feller. Obviously, it's one of these 4 doctors and thus, there's no need to "guess" unless you intended to imply the ones you mentioned do subpar work. So either you posted haphazardly or you intended to imply all the Coalition doctors in New York with the exception of Dr. Feller do poor work. Get it?

 

Once again, please be more responsible with your posts and base your opinions on facts.

 

Regards,

 

Bill

 

P.S. Hairthere's post was acceptable because he stated and backed up his opinion. Your comments were baseless and false.

[N-6]

Hariri/Bill, I understand the concern that Hariri initially mentioned 3 NY docs and then narrowed that list down to 2 NY docs whom he assumed performed this "very bad HT". I don't know why he pointed out those 2 docs out of the 3 as potentially responsible. Hariri never explained why he assumed it was either T&D or Bernstein out of the initial 3. Maybe he doesn't like their work but I think he's entitled to share that opinion even if they are coalition doctors.

 

Also, isnt it his right to say that this was a poor HT especially given the reason this thread was created, ie to get opinions about whether the patient received adequate growth, and the differing opinions in this thread on whether he received appropriate growth?

[StaggerLee123]

Strong as others have said it is difficult to judge your results because in your before pics you have your hair combed forward and to the sides. It looks as if the hair you did have in the front was rather long and you combed it back for coverage. Do you have any before pics with your hair combed back as you normally wear it? That would provide a more accurate starting point for comparison to your after pics.

 

The good news is that your hair does look natural and I wouldn't pick you out of a lineup as a guy with a bad hair transplant!! If you weren't happy with your doc the first time around, in terms of graft placement and results, I think it's smart to look to another clinic for your second go around. 2200 grafts was obviously not enough and even if they simply concentrated them into your frontal third you still probably would need another procedure. Usually the hairline and frontal third is the first priority for most patients and docs but some guys just want overall coverage even if it is a bit thin. Make sure you discuss a specific plan of attack that is to your liking for your next procedure with whatever doc you chose.

 

I see there is some bickering about who your doc was, is there any reason you don't want to say who it was? It's your choice and if you don't want to that's fine. One of the reasons this forum is so valuable is because when results are presented honestly it helps the poster get honest feedback and also helps others to make decisions about their own procedures and choice of docs.

 

Good luck, I'll be following your progress!!

[orlhair1]

I agree with Bill's assessment. With another pass, assuming you have sufficient donor you can get a really nice result. With the area covered by the number of grafts you got, the outcome would be expected. While thin, it looks natural. Adding more grafts will thicken it up in the front substantially if you use your grafts strategically getting thinner as you go back to the crown. Good luck and keep us posted.

[bonkerstonker]

This is the problem when patients ask for big areas doing but can only afford a small amount of grafts or don't have the donor. The surgeon can either turn them down or transplant them sparsely at the end of the day it's just common sense!

[hairthere]

In a HT patient with this level of loss and limited number of grafts there are two different plans of attack. You can either dense pack one area (i.e., hairline) or spread the grafts out to cover more area. Obviously the latter will give far less density, as is evidenced in Strong's case. The main problem with this patient is that the plan of attack didn't seem clear between doctor and patient, and it's not clear who is at fault. The good news is that if the donor grafts are available, Strong can have a follow-up session to add more density. My suggestion would be to return to the doctor who performed the HT and discuss this with him. The patient can also visit with other coalition docs if he is uncomfortable returning for whatever reason.

 

Hairir, You are correct, I did state that I do not love this HT work, but not because I think he had poor growth or because of surgeon/tech error; I personally prefer the approach of dense packing one area(s) at a time, and if there's a surplus of grafts, dusting the remaining thinning/bald spots.

Edited January 18, 2012 by hairthere

[England]

This is the problem when patients ask for big areas doing but can only afford a small amount of grafts or don't have the donor. The surgeon can either turn them down or transplant them sparsely at the end of the day it's just common sense!

 

In fairness, I think the original poster did clarify he told the doctor money was not an issue, and that the doctor told him he has more grafts available.

 

It all seems to beg the question to me: why were so few grafts used? I'm sure there are legitimate reasons, but it would be good to know them.

 

The bigger question, for me, is why the patient wasn't informed that he would be getting a low density with those numbers, to have realistic expectations. I think the biggest issue here is the gap between the expected outcome for the patient and what was actually achieved.

 

I would also be very interested to find out the name of the doctor, not necessarily as a witch hunt - but I believe it's right to name the doctors whether the outcome is excellent or not, and to potentially hear their reasoning behind the number of grafts.

[hairthere]

"It all seems to beg the question to me: why were so few grafts used? I'm sure there are legitimate reasons, but it would be good to know them."

 

England, Strong stated he had previous work done in the 90s which could have limited the number of grafts for various reasons. As far as naming the doctor, I feel that it is totally up to the poster and he should not be badgered for the info if he is not comfortable revealing it for whatever reason.

 

"The bigger question, for me, is why the patient wasn't informed that he would be getting a low density with those numbers, to have realistic expectations"

 

Agreed.

[England]

Yeah, he also stated that the doctor said more grafts were available.

 

Absolutely agree that it's up to the poster to decide if he reveals the doctors name - I would definitely be interested to hear.

[bonkerstonker]

Well if that is the case where donor and funds are available and i'm not saying this is the case because we haven't heard both sides of the story but if it is then it must surely be a density miss calculation by the doctor, i don't believe a coalition doctor would make a basic mistake like that when most of us here have spotted it.

 

I would like to hear what the doctor has to say here especially if he is a coalition doctor who has been narrowed down to 3 names. It's a little unfair to all 3 doctors!

[Bill - Seemiller]

Guys,

 

I think most of us agree that based on the number of grafts transplanted in such a large balding area that the procedure was a success. As to why the physician went for coverage versus density, I've asked Strong to contact his physician to discuss this and report back to us.

 

Going for coverage instead of density however, is a very legitimate approach and is used all the time. There are advantages and disadvantages of both approaches (going for density or going for coverage) that we can certainly discuss here. But ultimately, the question is why Strong doesn't seem to be aware of the reasons. Was it communicated but Strong somehow forgot? Or was this never properly communicated? Since there's no way to know for sure what was discussed behind the scenes, I don't think it's fair to speculate.

 

Also, there's a difference between "having more grafts available" and having more grafts available for a particular session. I had 9600 grafts over 4 procedures but they were not all available to the physician in a single procedure. Scalp elasticity can only handle so much and then must heal and return over time. Without splitting hairs (no pun intended), I suggest the physician may have been referring to the long haul. Thus, strong may have more donor hair available for transplanting in subsequent sessions and the surgeon took as much donor hair as he could safely in a single session.

 

I do hope that Strong discusses these things with his physician and then reports back to us so we can get a better understanding of his physician's approach and reasons.

 

Best wishes,

 

Bill

[Bill - Seemiller]

P.S. There are 4 Coalition physicians in New York, not 3. Hariri is the one who "guessed" it was one of 3 doctors when there are actually 4.

 

But ultimately, it's up to Strong as to whether or not he wants to name the physician. If he does however, he must be willing to let his physician share his input on this topic. But regardless, in the interest of fairness, if Strong doesn't want to mention his doctor, I ask that he discuss the above concerns with his doctor and then report what he learns back to the community.

[hairthere]

England, As Bill pointed out, we all have a certain number of grafts in the bank, but they are not all available in one session. That is determined by a number of variables such as patient laxity, donor density, and of course the skill of the surgeon and the size/skill of his team. If you go to a coalition doctor your chances of the latter two working in your favor increase tremendously.

 

Regarding the doctor's name, since Strong has not revealed it thus far I think it's safe to say he is not comfortable doing so.

[England]

Thanks guys for your responses.

 

I agree with what you say Bill. As I already said, I'm sure there are legitimate reasons for selecting a low graft amount (for example grafts not all being available in one session) - but we shouldn't assume that this applies to this case. If the intended solution was to spread the transplant over multiple procedures, I think Strong would (or should) know about it.

 

Lets wait to hear back from Strong who should be able to clarify the answer to my original question.

[England]

i note you were not shaved down either pre op.. This can lead to shock loss of native hair.

 

This is something I had not considered, and very interesting. Is it possible to reduce the shock loss of a hair transplant by having the hair shaved?

 

If so I may decide to have my hair shaved before my FT.

[bonkerstonker]

This is something I had not considered, and very interesting. Is it possible to reduce the shock loss of a hair transplant by having the hair shaved?

 

If so I may decide to have my hair shaved before my FT.

 

Are we talking about temporary shockloss or permamant shockloss?

 

shaving in the recipient area will definitely help your doctor not to hit and transect any native hairs causing permanent shockloss but i can't see it helping with temporary shockloss in the recipent area. I shaved to a blade 0 and got approx 90% temporary shockloss that grew back eventually over the months.

Edited January 19, 2012 by bonkerstonker

[strong887]

Had my (almost) 1 year follow up with the doctor the other day - he felt that i had good yield of grafts and wants to focus 1000-1200 grafts into the hairline on a subsequent procedure. If he can get more grafts out of the strip he will then work back into the crown (200-300 more). He felt that due to my several previous plug HTs that camouflaging in the vertex and distributing throughout the balding area(s) was an important 1st session to establish. Next he will concentrate on building up the hairline...

 

Here are some current photos under different lighting conditions....

 

One of the photos (top down view) has some Toppik in the crown.