Necrosis Update

[John R]

I would like to thank everyone for the support and encouragement you have given me.

As hard as it is for me, I attempted to temper my frustration here by not placing blame on the Doctor or practice. This is not the forum or venue to seek a resolution with them.

 

Worth noting is that PAI operates in St.Louis with an agreement (of some unknown type) with a hair restoration company called Hans Wiemann. They provide "hair systems" and other hair restoration products and services. While the hair transplant services are marketed full time at this facility, the actual procedures are performed only several days a month (the actual scheduling is unknown to me). This one doctor travels to various PAI locations as stated previously. Regrettably if complications occur, it is conceivable that this single physician will not be available.

 

I contacted the staff (nurse) by email with an attached picture and concerns on day 13. I went into the office that day and returned again on day 14 for suture removal. I did receive a call in this time period from my doctor who was at another location to check on me.

 

I think I posted here on day 15 and received treatment with Dr. Samules on day 19.

 

They (HT doctor) have offered to perform additional procedure(s) to correct/repair this. They have also offered me a hair piece to cover all of this in the interim.

 

My question to all of you, if you were the man in those pictures:

 

What would be your confidence level to return to this practice again?

Could you expect the same complications again, or perhaps worse?

 

I had a small procedure approximately 18 years ago at NHI. I was pleased with the results at that time. I started this journey again to just feel better about myself when I look in the mirror (as I expect most of us here do).

 

Thanks again

[NEWHAIRPLEASE]

John R

There is NO WAY I would consider going back to this place!!!!!!!!!!!!!!!!!!!!!!

NO WAY!

[dingdong12]

thankfully theres people like dr panine out there

[John R]

Stuart,

I would like to thank you and Dr. Panine for taking time to review my information, photographs and your generous offer.

I will send you an email.

Thank you both again,

John

[Blake Bloxham]

John,

 

I'm glad you're going to contact Stuart and Dr. Panine. I think this is a great first step. Please keep us updated and feel free to ask any additional questions.

[StaggerLee123]

Good man Dr. Panine. John I agree that seeing a hair doc who is a dermatologist is the way to go. Dr Panine obviously and Dr. Bernstein come to mind.

 

I would be very gun shy about returning to the clinic where this originally happened. First of all the fact that they are part time out of that office doesn't inspire a lot of confidence. It could very well be just "one of those things" that can happen in the course of surgery and you just happen to be the unlucky bloke that it happened to, but still it would be very difficult to roll the dice twice with them. I would want to know how likely it was the fault of the doc and/or their procedures and make a decision from there. I would most likely not return to them for any work.

 

To your extreme credit John you are handling this situation with class and dignity. Get expert opinions and come up with a gameplan on how to move forward.

[Spanker]

Jon,

 

I just saw this thread and wanted to tell you that I think you are handling this like a class act. My heart sank when I saw this thread. I hope the best for you and hope you are able to find some peace with your situation. There may be a time when donor is unlimited and you can get your hair back. I hope you are the first one standing in line. Days are still early and hopefully thins will pick up. Again, I am really sorry that you are going through this. Hang in there.

[HairPro1]

Thank you to everyone who posted regarding my necrosis.

I wanted to provide you with chronological documentation since my procedure.

I will spare all of you the "drama" I have been living with the past four months.

Right now just trying to heal (emotionally and physically).

Living with a bad mistake..... is for me the hardest part right now.

Thanks again,

J

 

Hello John,

 

I came across your history when researching Necrosis recently. I'm both shocked and disturbed by the trauma you've had to endure.

 

My reasons for researching Necrosis will become clear to you when you've read my blog. I I hope it will give you some sort of 'closure' by discovering the likely cause of your predicament.

 

Although my blog is directed against mega sessions, the opening comments from the gentleman I'm quoting apply to any size session.

 

 

My regards to you John. Good to see you're getting solid support from your fellow members.

 

**outside link removed by moderator**

 

 

Mal

Edited March 24, 2014 by Future_HT_Doc

[HairPro1]

Thank you to everyone who posted regarding my necrosis.

I wanted to provide you with chronological documentation since my procedure.

I will spare all of you the "drama" I have been living with the past four months.

Right now just trying to heal (emotionally and physically).

Living with a bad mistake..... is for me the hardest part right now.

Thanks again,

J

 

Hello John,

 

I came across your history when researching Necrosis recently. I'm both shocked and disturbed by the trauma you've had to endure.

 

My reasons for researching Necrosis will become clear to you when you've read my blog. I I hope it will give you some sort of 'closure' by discovering the likely cause of your predicament.

 

Although my blog is directed against mega sessions, the opening comments from the gentleman I'm quoting apply to any size session.

 

 

My regards to you John. Good to see you're getting solid support from your fellow members.

 

Mal

 

 

 

 

THINKING OF HAVING A HAIR TRANSPLANT?

 

ON YOUR HEAD BE IT!

 

 

 

I asked an old friend, a world renowned Hair Transplant surgeon his opinion on mega session procedures being offered on the Internet?

 

One clinic in particular were offering upwards of 10,000 grafts or more in 1 split 2 day session!

 

10,000 holes 'punched' into anyone's scalp in an extended session seemed extreme to me, so I emailed him for his views.

 

His response alarmed me. It brought 'flashbacks' of the bad old days. When Elton John and Russ Abbot were the 'unacceptable faces' of hair transplant surgery.

 

My friend cited a report in the 'Journal of Plastic & Aesthetic Surgery' .The article, sent to him for his comments concerned a serious case of Necrosis (cell death) from hair transplants.

 

He told me that this very topic was high on the agenda to be discussed by the members of 'Forum'. The monthly journal issued to their thousands of members by I.S.H.R.S(The International Society of Hair Restoration Surgery).

 

He was concerned that the problems induced by high volume transplants would cause the industry damage and stated the reasons why.

 

I asked him if I could publish his words and he agreed, albeit anonymously.

 

His opening comments refer to a case history of Necrosis (cell death) from hair transplant surgery he was viewing after being asked to comment on it.

 

The case history first published in Turkey 2009 and republished by the Journal of Plastic & Aesthetic Cosmetic Surgery in 2010.

 

As the procedure was performed by a Plastic Surgery Clinic and reported in that industries journal, the problem has taken some considerable time to surface. Only recently becoming apparent to the hierarchy of hair transplant surgeons.

 

I cannot show the photos my colleague reviewed nor identify the clinic concerned for legal reasons. Let alone risk them being linked to my site.

 

However you can Google 'Necrosis after hair transplant surgery' to see other examples of Necrosis from hair transplant surgery.

 

 

 

ON YOUR HEAD, BE IT!

 

 

 

 

SCALP NECROSIS

THE DANGERS OF HAIR TRANSPLANT MEGA SESSIONS

 

 

 

''The doctors concerned seem a bit mystified about why they got the necrosis?"

 

Our I.S.H.R.S. experts say that although the donor density was acceptable, 970 FUs from a donor area of 120 sq. cm, the donor holes were probably cut too deep and damaged the underlying arteries. The operating doctors do not really understand what has happened.

 

It is only the collection of guys in our Internet group - all with over 20 years experience and some like me with 35-40 years who can make an educated guess at what really happened.

 

It is clearly a case of poor harvesting technique and it is now happening more often as less experienced surgeons try to copy the "masters" like Harris and do 4000 grafts in a sitting. They have a gentle "touch" that allows them to get away with such a risky procedure.

 

Many others will not be so lucky and we will have a repeat of the "Cowboy Clinics" fiasco of the 1980s . It did not affect Australia or the USA but hit Hair Transplants in the UK for a decade or more.

 

It is coming fast, courtesy of the new Robotic devices which promise to allow Plastic Surgeons to do Hair Transplants with the aid of an expensive computer controlled machine and lowly paid assistants but with minimal personal training or experience required by the surgeon.

 

It is a recipe for disaster and we all know it but don't know what we can do about it. The Plastic Surgeons have the legal qualifications and can do whatever they like.

 

Several of our guys report seeing similar cases already in the USA and many more will come over the next 12 months. None of this has been published and I am surprised that the clinic reported their own case. Such a degree of honesty would be unknown in the litigation-prone West these days.

 

Anything more than 3000 grafts involves a helluva lot of holes in the scalp and sooner or later you are going to have problems. New and inexperienced scalp surgeons seem to think that they can go on pushing up the numbers forever. The fact is that you cannot.!!

 

Every scalp has its own limit where the damage to the blood supply by all the holes in the side, back top and front will result in a failure of blood supply and death of patches of scalp tissue at the side , top ( or both). I have already heard and seen reports of such cases and there must be many others not reported because there would be serious litigation involved.

 

Now it is not just a matter of numbers of holes but the depth of holes or size of recipient slips and holes that are important as well. Really deep donor holes can damage the arteries supplying blood to the scalp. The age and thickness of the scalp and amount of sun damage are important as well as is previous scalp surgery or burns.

 

Once you get to numbers greater than 2000 you have to consider a lot of safety factors.. We saw it all in past decades with big plugs with laser holes and scalp flaps, even mini grafts in large numbers. Nothing has changed except the type of procedure. Once you pushed any of these procedure past a certain point you are likely to have catastrophic problems and litigation.

 

If people want to push their luck and undergo these outrageous numbers of grafts in one session then warn them and let them go. "On your head be it' sounds an appropriate comment.

 

I would split 5000 grafts into two sessions several months apart. I am sure that there will be some discussion about this in FORUM soon as reports of problems are coming in to our "Masters" discussion group but no-one has enough experience or the full facts to write about it yet. The other thing is that once it is published in I.S.H.R.S. ''FORUM' and the newspapers get onto it, it will cause bad publicity for all''.

 

SUMMARY:

What concerns me is by the time the hair transplant 'establishment' has acknowledged and published their findings and people become aware of the practice,such catastrophic cases will continue to appear?

 

Whether it be at the hands of a 'part-time' cosmetic surgeons performing the occasional hair transplants and again I quote ''the donor holes were probably cut too deep and damaged the underlying arteries''. Or be it a plastic surgeon offering super low prices while training low paid assistants to assist with mega sessions, the consequences are only now becoming clear.

 

Either way, the heartache and trauma it can cause people needs to be acted on. People have the right to know. My colleague suggested I warn people. Hopefully I'm doing just that.

 

As my blog 'F.U.E. or HOOEY'? blog states, there are 2 ways of performing F.U.E. hair transplants. The right way and the wrong way. Now it appears with super mega sessions we have a third.contender, 'Risky', bordering on 'Dangerous'!

 

CONCLUSION:

At HDHT we limit our session to up to 3000 grafts. A session that can take 6/8 hours depending on the patients donor/ density.

 

At HDHT we use the 'selection process', locating the higher content grafts to give our patients optimum density/volume.

 

HDHT are members of and use techniques recognised by the I.S,H.R.S. ( International Society of Hair Restoration Surgery).

 

Our surgeon, Dr. Fotis Tsounis is member of the GMC (General Medical Council).

Dr. Tsounis has been performing Hair Transplants for 20 years.

 

 

Mal Mendelsohn 22/03/2014

 

 

 

High Density Hair Transplants

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