6 Month Update - 1800 Grafts w/ Dr. Sharon Keene

[sr0d]

Hi All. Here is my 6 month update. Overall I have to say I am not happy with my results but again will continue to wait and assess at my 1 year mark.

 

The things I am specifically unhappy with is first off my density which seems very sparse and uneven. As you can see in the pic there is clearly a high density area in my right side. I have heard that eventually this all evens out but at 6 months I would expect that the difference would not have been so dramatic. Also there seems to be very visibility places where there is no growth. Some areas that are probably about a centimeter. I am also going to send these pics to Dr. Keene who in my last visit told me that anything that will grow will have done so by the 6 month mark at which point the hair will just thicken up. Suffice it to say I am probably looking at doing a second transplant which I was hoping to avoid.

 

Right now I would say my look is worse then it was before. A completely bald head would have been better than a head of patchy and thin hair. It just looks very unnatural and freakish. I wish I could just go with the shaved look but I can't because I have a nasty scar across the back of my head which by the way isn't even straight because there is a 45 degree angle at a point where the doctor had to open me up again and cut out some more skin because someone didn't accurately get the right amount of hairs before she first closed me up.

 

I will continue to provide updates, however if you are looking at this forum to make a decision I would suggest you don't take the decision lightly. You can select a highly reputable doctor and still not achieve the results you would expect and may find yourself regretting the whole thing as I am now. I have been a long time lurker of this forum (probably reviewing results for about 4 years before going for it) and felt like the technology and advances pretty much assured a satisfactory result. I am proof that good results aren't always guaranteed.

 

- SROD

[Spanker]

That is a pretty bad result, but it is only 6 months. While some may, I won't sugar coat it and say you still may end up with an awesome result, but it will likely get better.

 

Hopefully, you end up at least more satisfied, it's still early days.

 

I am scheduled for the end this month and stuff like this scares me.

[gmonasco]

I'm no expert, but looking at your "before" pictures, I'd have thought you needed considerably more than 1,800 grafts to achieve a satisfactory result in a single pass. Were you led to believe otherwise?

[sr0d]

Appreciate the candidness and honesty. I spent many years researching and went back and forth on this decision. I felt that getting a subpar result was minimal given the advances of surgery. I had thought that as long as you pick a great doc then you should be ok. This goes to show you can still get poor results from a reputable doc. I also followed the instructions to a T. I used rogaine and hair vitamins. Saline solution early on. I babied the hell out of my head to give myself the best chances and this is what I got instead. There is no way to go back. Now I need to commit to follow up sessions just to get myself to not look freakish. The only concern is whether I will have poor results no matter what doc I pick. Am I just genetically inclined to have weak hair that doesn't transplant well? How much of this was doctor technique versus my hair predisposition?

[sr0d]

In my consult with Dr. Keene I didn't have any limitations on money. I actually wanted to do FUE at first but she recommended strip. She said I should be able to get the result i wanted with only 1800 grafts. I should have went to get a second opinion but there aren't a lot of options in Tucson. I figured I was lucky to have a coalition surgeon in Tucson so didn't think twice. In hindsight I wish I did maybe 2200 or more. Now I'll probably have to go under the knife again but maybe I can get 500 FUE grafts to fill it in where needed.

[zenmunk]

Sorry about your ordeal, sr0d. Your point is well-taken - there are no guarantees. You're already committed, so focus on an improvement with this procedure at month 12 and achieving your goals with the next. Best of luck.

[Spanker]

Yes, I would have said you need 2500 or more for a wow result, but it still looks low yield so far.

[sr0d]

Is a low yield the result of a poor transplant by the dr staff or can someone just have poor hair genetics tht don't transplant well? I ask because I am contemplating whether to continue with a second surgery or do I cut my losses and go with the buzz cut and get the tattoo pigment procedure (can't recall formal name).

[Spanker]

It all depends. Just another crap shoot IMO. I have seen people do well the second time and seen people do not so well. I don't thing it looks bad enough to have to shave. I would wait a year and see how dr Keene deals with it. It may worth your while search for another doc. I don't know a lot about that doctor but you shouldn't take traveling off the table to get the right doc.

[AdamAJ]

i have no idea why she would only told you 1800 would give you the results you desire...

[aaron1234]

sr0d,

 

I feel for you. My first procedure was with a doc recommended on this site and it was shoddy work at best. There is always a chance that a procedure will not grow out as hoped no matter who your doctor is. But let's face it, some docs on this site are better than others - a recommendation by the HTN does not guarantee equality in skill, talent, and technical support.

 

Now it is still early in the game. The only thing you can do right now is wait it out the full year. Your growth looks more like three or four months post-op rather than six. You could be a slow grower. However, you probably needed at least 3,000 grafts in the front to get respectable density. 1800 grafts simply won't cut it even if you end up achieving 100 percent yield. Stay in touch with your clinic throughout the remainder of the year, but if you are not happy with the results then go elsewhere (as I did) for round 2.

Edited July 7, 2012 by aaron1234

[TakingThePlunge]

sr0d,

 

I'm sorry to hear that your results are not meeting your expectations at this point. In looking at what's been said so far, I first want to say (speaking from experience) it's really best to reserve judgement until one full year has passed. At only 6 months you should be seeing roughly 50% of your final result.

 

Take a look at my own 6 month results after 2500 grafts. At one year, it was still pretty thing but I do believe it continued to thicken up to four months after. Even still, I needed a second procedure to get the results I wanted and I ended up with over 4000 grafts. I do think that your procedure should have been bigger from the start.

 

Have you forwarded your photos to Dr. Keene yet or discussed your concerns? She is truly top notch and genuinely cares about her patients. I'm sure she will work with you to ensure that you get the head of hair you deserve.

[Hairtechnician]

Dear sr0d,

 

I checked with Dr. Keene regarding your concerns. As David pointed out, it is too soon to assess your final results or success of your surgery at 6 months post operatively. Though Dr. Keene generally advises patients that it will take 6 months for the grafts to erupt, this is not a hard and fast rule, as each patient is different in their growth rates. In addition to varying genetic rates of the hair growth cycle, there are other things, such as medical and environmental factors, that may impact hair growth in general, including things like smoking, exposure to sunlight, stress, any direct trauma—and many other factors that can influence and sometimes slow the rates of growth. It is this reason why patients are advised not to anticipate the final results to be evident before a year after surgery, and this advice is part of the postoperative instructions you received. Your full period of maturation could be even longer than a year depending on these factors. Therefore, the amount of growth at 6 months is unique from patient to patient, with some patients having a lot of growth at that time, and some who have much more to come.

 

You were interested in FUE as a less invasive procedure because of wound healing concerns. However, Dr. Keene felt that almost two thousand open round holes in the scalp, left exposed to the environment at the end of surgery, was not less invasive in terms of wound healing compared to an incision sutured closed immediately at the time of surgery. The amount of open wounding at the conclusion of surgery is greater with FUE compared to strip surgery, which was why she advised you to have a strip procedure. Dr. Keene will be happy to see you for a follow up appointment, to help address any concerns specific to your clinical circumstances, and she may also have some additional suggestions to see if your graft growth can be accelerated, as well as to take care of any cosmetic concerns in the interim. Please call the office to schedule a follow up appointment.

[MAGNUMpi]

hey Srod, sorry to hear about the poor results. I hope it works out for you in the end. To be honest this is my nightmare. I haven't had a HT yet (still researching) and am really quiet afraid of getting results/scars that I cant turn back from. I really hope you get more growth over the next few months. Please keep us posted. Its important for all of us to have as much honest information as possible. Thanks.

[sr0d]

Thanks for the response hair technician. I appreciate the professionalism of Dr. Keene and her staff and have an appointment scheduled to discuss. My concern really springs from a slight linear area right above my left hairline. In this area, there is a very noticable lack of hair growth that even my wife has pointed out as looking strange. I agree and understand that seeing the full results of the transplant will not be seen until at least a year so I am remaining optimistic.

 

I am not in disagreement about Dr. Keene's choice in going FUT vs FUE. After having a good discussion with her on this we were in agreement that this was the best choice. My only regret was that we didn't go a little more agressive on the graft count. I was in no way under a budget so I would have been open for more graft if she felt that would accomplish my goals. Now as it stands I probably will most likely need a second procedure which I really wanted to avoid. In this second procedure I will probably want to go FUE because I do not want to put my scalp under additional trauma of a scar.

 

I am sure we will discuss this further in my appointment.

 

Thank you.

[sr0d]

Hi all...quick update. I met with Dr. Keene last week and she offered to do 100 FUD grafts to fill in some areas above the hairline. I think I might ask her if I can do 200 and I will pay for the additional 100. I figure if I am going to do it I might as well go for more.

 

Anyone have experiences with mini FUE sessions?

[AdamAJ]

Hi all...quick update. I met with Dr. Keene last week and she offered to do 100 FUD grafts to fill in some areas above the hairline. I think I might ask her if I can do 200 and I will pay for the additional 100. I figure if I am going to do it I might as well go for more.

 

Anyone have experiences with mini FUE sessions?

you should get how many grafts as it takes for optimal density in this next surgery...don't hold back

[Spanker]

100???

Wow...somebody call the National Board of Philanthropic Surgeons.

 

I would not even think about getting cut open for 100 grafts. It is still early and I hope you get better yield, but it really seems like poor planning to do 1800 on that area, but it should look much better, and it may get better.

 

Sorry for your experience so far.

[sr0d]

Thanks for the reply. Just to be clear she was going to do FUE and not strip. I agree and would never get cut open for only 100. With that said, I know everyone said to give it more time but there are clearly places in my transplant that are noticeably lacking in growth that Dr Keene even recognized and thus she offered up the 100 FUEs. I do see myself getting another major transplant sometime down the road but for now to make my transplant look presentable I think the 100 to 200 grafts would help. Does anyone have a similar experience? Would doing a small number of grafts abrupt growth for the other transplanted hairs?

[AdamAJ]

I think I have heard most people say to wait at least 8 or 9 months before getting worked on again but could be wrong.

[sr0d]

It will be 8 months in September and I trust that Dr Keene wouldn't do it if she thinks it could harm the existing graphs. Eventhough, I might wait to do it in October to ensure the risk is minimal.

[PupDaddy]

srOd,

 

Several things concern me about your case. First, your doctor advertises on her web site that she offeres FUE as an alternative to FUT (the only proviso being that you might not get as many 2-3 hair grafts, which can effect density). Yet is seems apparent that your doc doesn't really do FUE in a serious way and, instead, steers every patient towards FUT, just as she talked you out of FUE. This smacks of something of a bait-and-switch. Get 'em in the door by advertising FUE, then steer them to FUT.

 

Second, when you posted that you originally requested FUE and weren't happy thus far with your FUT results, your doc's representative responded with the old, misleading scare tactics used for years by FUT shops that didn't or couldn't adapt to FUE: You end up with more scarring with FUE than FUT because of the hundreds or thousands of "open holes" on the back of your head resulting from FUE. No one forced your doc to advertise FUE as an alternative to FUT, but if she is going to do so then she should actually offer it, believe in it, and be competent to perform substantial FUE sessions. Your doc is not the only ht doc I've seen do this but that doesn't make it right or acceptable. Plus, the way her representative responded, by trashing FUE in general, after the fact, with misleading scare tactics, stuck in my craw. It would have been one thing to say you weren't a good FUE candidate for specific reasons (e.g., curly hair, "spongy" donor scalp that would make extraction of the excised grafts difficult, etc.), but instead your doc, through her rep, implies that any significant FUE procedure is dangerous, risky ("open holes"), and results in unsightly scarring far worse than any FUT strip scar.

 

Third, for your doc to suggest that 100 FUE's would fix you right up in your current situtation is, well, ludicrous. (The same could be said for 200 FUE's, I'm sorry to say.) Personally, I would cut my losses and move on to a doc more comfortable and experienced with FUE to add some much-needed density. Even if you ultimately decide to go FUT again, I would try someone else based on the results you obtained the first time and what appear to be some shady marketing tactics of your current doc.

[s2thoudriver]

Have to agree with pupdaddy here, sounds like the surgeon isn't experienced in FUE so sent you down the strip route.

 

As youa re only 8 months, i would wait a couple more months to see if there is any late growth, then if not, go to an experienced FUE surgeon and have a good number of FUE to get the density you want, probably go for 1,500 +

 

Fue 'scars' are closed within days due to each being so small, so don't believe the 'danger' story you were fed.

[Hairtechnician]

Dr. Keene has performed megasessions with FUE, this number of grafts was just offered to address a targeted area of concern, because our patient didn't want another strip operation, and had not yet reached full maturity of his grafts.

 

pupdaddy,

We do not do bait and switch marketing, that is offensive as Dr. Keene is forth right and has a reputation for honesty, you clearly don't know her to make that comment--we do offer both FUE and FUT and do provide patients with information so they can make an informed decision. Dr. Keene has been very vocal about promoting competency amongst all hair restoration surgeons in both techniques of donor harvesting, among her peers, because only when surgeons are capable of offering both strip and FUE donor harvesting can they reliably offer the most appropriate procedure for a given patient.

 

There were circumstances particular to this patient's medical history that were reviewed, and Dr. Keene's recommendations were based on that, as she does for all patients when providing her recommendations. The limited number of FUE grafts were also based on those factors. We are continuing to follow up with Sr0d.

[Bill - Seemiller]

Pup Daddy,

 

Given your posting history, I'm sure you mean well in your response to SR0D. However, Dr. Keene is a highly reputable physician member of the Coalition of Independent Hair Restoration Physicians and has an outstanding reputation for producing excellent results. She is also one of the most honest, passionate and ethical hair restoration physicians I've had the pleasure of knowing and working with. Thus, I feel confident that she's not falsely advertising her services.

 

You have to understand that FUE, while it can be an alternative to FUT is not suitable for all patients. There are also mixed reviews on whether or not everyone is a candidate, growth yield, scarring, etc. Each patient is unique and their physiology and goals vary. This will affect which procedure is better suited for the patient.

 

To learn more about what physicians around the world are saying about FUE today, view our recently published article "Highlights from the Annual 2012 ISHRS (International Society of Hair Restoration Surgery) in the Bahamas".

 

Dr. Keene informed me today that she saw SR0D today and plans on posting her own photos showing his results. She also informed me that he is mostly happy with his results and that growth, density and naturalness is optimal. But I'll let SR0D and Dr. Keene provide the details.

 

Best wishes,

 

Bill