Dr. Arocha - 3600+ FUT Procedure, 10 Month Results

[ArochaInfo]

This patient was in his early 20's when he came to Dr. Arocha. He wanted a procedure to restore his hairline and frontal third. Dr. Arocha performed a 3640 FUT procedure. The after photos are taken 10 months post-op.

 

Click HERE for the complete album.

 

 

[makem32]

Nowhere near as impressive as other results i have seen Dr Arocha.

[hairtodaygonetmrw2]

an improved result but it appears to be poor yield

[Davis91]

Kira--could you comment on what appears to be a relatively poor outcome? Will the patient be getting a touch up? Kudos to you for putting this out there.

[Cant decide]

This patient appears to have great qualty donor hair. Therefore, this result, while certainly a nice improvement is what I would have expected with 2000 grafts and not 3600. I do have great respect for Dr. Arocha's work in general however.

[irishsailor]

Still a big improvement from where he started, He could just be a late bloomer, hes still only at 8 months.

[TexAg]

That's me in the photos. I was worried I might have had unrealistic expectations going into this procedure, but it appears I'm not the only one who thinks I had poor yield. I guess that makes me feel a little better.

 

Kira--could you comment on what appears to be a relatively poor outcome? Will the patient be getting a touch up? Kudos to you for putting this out there.

 

I wasn't planning on having any touch-ups any time soon, hence why I opted for such a large procedure. I might not have a choice though - my hair doesn't exactly look natural at this point. I was really hoping to be off Toppik at 10-11 months, but still don't feel comfortable without it. It's very see-through even in moderate lighting. However, I agree about putting these photos out for the forum to see - I'm sure future candidates will appreciate documentation that not all procedures turn out excellent.

 

I really don't expect much improvement in the next few months or so. It's looked more or less the same from months 6-10. It's a shame because I feel that I made a good choice in my surgeon.

 

Finally, for those wondering - been on Propecia for 1.5 years now (every day). I really don't understand the poor yield. I followed all of the post-op directions, have been taking medication, eat a healthy diet and excercise almost every day. Just goes to show not all results will turn out as expected, I suppose.

[ArochaInfo]

Thank you for viewing and commenting on our post. There are a few things we would like to address. While most of our patients have more robust and early results, remember, that occasionally some patients take a bit longer to grow in. We have had patients who continue to see improvements well beyond one year. So at 10 months there may still be some further improvement to come.

 

In regards to “poor yield,” I would like to clarify. Poor yield refers to a transplant that does not yield a significant amount of growth within an adequate amount of time. Considering that there was no re-growth in the frontal third in 11/2 years of taking Propecia, and with a significant amount of miniaturization in the area one can surmise that Propecia might not be helping and that the native hair could have continue to miniaturize in the ensuing 10 months post-surgery. So the question is where would he be without the benefits of the transplant. Dr. Arocha takes hair loss very seriously and of course he wants the very best for his patients. The prudent course is to continue to maximize the treatment and give it the tincture of time!

 

~Kira

[Sparky]

Looks like a very poor result really, He shouldn't have to wait until 18 months for the end result, he should be 98% of the way there by 12 months, so if it isn't looking good at 12 months, pretty sure it's not going to change much by 18 months.

 

The pics that you posted unfortunately don't look very natural, it looks like an HT.

 

Why would he suddenly of lost hair at the exact same time as having an HT, and why was someone in their early 20's operated on in the first place anyway?

[hairshopeing]

I agree with the above coments,and also the patients own assessment and views!! With respect kira I think what you have said is incorrect and to be blunt a poor excuse,the amount of hair he had before seems to have stayed and the transplanted hair doesn't appear to have grown!! Could you provide photos of just after the survey so we can actually see where the hair was planted,and I would advise the patient to now style his hair in the same style used in the pre op photos and post them in! Because to be fair it appears his hair was combed at ubfavourable angles pre op and combed back from the middle of his head to expose the problem areas,then in the post op photo it just appears the his original hair has been styled to cover those area up!! I would imagine had you styled his hair in the same manor as post op before his surgery ther would be very little difference to his post op results! Also I think that the patients comment about poor yield is correct and he must be disappointed with the results especially considering the amount of grafts used!!! I initially didn't want to comment on these results as didnt want to say the results were poor as I felt it might upset the patient and he may have been happy with them,which is the main thing,however since reading his post,I thought it should be mentioned!! What are your plans for this patient?? As I would hope that you would look at the results and agree they were way below par and offer a solution for him,although with hair restoration there are no guarantees I think the difference between physicians is when results are below par they take a honest and professional view and hold there hands up and say, you know what,they are below what should be achieved,but don't worry we will look into why and address the situation for you and try to put that right!!! I hope at 12 months if his situation hasn't greatly improved this will happen as that makes a huge difference as to what makes a great surgeon stand out from the average/below par one!!!

[TexAg]

In a strange way, it somehow helps to know that others agree I've had a poor outcome. I'm coming up on 11 months now and it looks pretty much the same as 10 months, so I really don't expect much improvement.

 

I'll try to keep a positive mind about all this, but I'm also a realist. As others have said, this is not the kind of result I should have expected for this size/type of procedure. I'll be the first to admit this is clearly below expectations, and with all due respect Kira, I would rather you and Dr. Arocha just be honest and tell me there isn't going to be much improvement rather than try to sugar coat it and tell me it could still get better. There will likely not be enough of a difference in the next 4-5 months to warrant a change in opinion, but like I said, I'll try to remain positive about all this as the extra stress doesn't exactly help.

 

Looks like a very poor result really, He shouldn't have to wait until 18 months for the end result, he should be 98% of the way there by 12 months, so if it isn't looking good at 12 months, pretty sure it's not going to change much by 18 months.

 

The pics that you posted unfortunately don't look very natural, it looks like an HT.

 

Why would he suddenly of lost hair at the exact same time as having an HT, and why was someone in their early 20's operated on in the first place anyway?

 

Sparky hit the nail on the head. I should be at essentially full growth. I understand the concept that some patients grow more quickly than others, but it's a little extreme to say that could still apply to someone at 11 months. I've seen patients at 5 months have better results than I have at 10-11. I would also agree the result does not look natural, hence why I feel it's necessary to wear concealer to avoid further embarassment.

 

To address Sparky's concern about operating at such a young age (which I completely understand - that was a big factor for me); I consulted with two other recommended surgeons on this forum, and they both also agreed to move forward with the procedure if I had decided to go with them. I guess they had come to the same conclusion that I was still a good candidate, regardless of my young age. As pointed out by Cant decide (by the way, excellent result, Rahal does amazing work), I was also under the impression that I had above average donor hair. However, as it stands, I am aware it was risky to operate at such a young age. I don't entirely believe that would be the main cause for the poor yield though - if anything I would think the donor hair would have a greater chance of success being in a younger state that someone who is 40+ years old.

 

As I said, I'll try to keep a positive outlook on this situation and give it the benefit of the doubt in waiting the full 18 months, but I won't get my hopes up. I hope I haven't come off as rash or unreasonable, but I'm sure there are plenty of members on this forum who could imagine the frustration of going through this entire procedure with a recommended surgeon, only to have a result that not only is way below expectations, but also looks fairly obvious at the same time. Not to mention the large expense of such an operation...

 

I will have to reassess my situation at 18 months. If there isn't much improvement by then, hopefully an agreement can be met between the clinic and myself that will please both parties. I know Arocha wants the best for his patients and for them to be happy, but at this point that is unfortunately not the case for me.

[hairshopeing]

Good luck texag! Really hope it works out for you!!! Although your growth wasn't great on a plus point your hair doesn't look bad as it wasn't that bad before,just not the change you would of hoped for or expected!! Fingers crossed for you!!!

[Dr. Bernardino Arocha]

Gentlemen,

 

No one is saying that this is the best result in terms of density. Quite frankly, I am expecting more to come in the next month or two. I am concerned about it. We are not trying to hide this case why in the world would we post it on an internet forum. We do not want to rush prematurely when there is the possibility that more may grow in only 1-2 months.

We pray that there is no underlying physiological reason why this transplant has strayed from the more usual course. We always stand behind our work. We would like to meet with the patient privately to clarify the plan.

[hairthere]

Tex, I do hope you get a nice growth spurt over the next few months. It has happened before. Don't give up hope yet as you went with a top doctor who I'm sure will stand behind you.

[PupDaddy]

I am aware it was risky to operate at such a young age. I don't entirely believe that would be the main cause for the poor yield though - if anything I would think the donor hair would have a greater chance of success being in a younger state that someone who is 40+ years old.

 

Hey Tex,

 

The reason is can be risky to ht a young patient is not because the grafts might not grow (they don't grow better as you get older) but, rather, because a young patient's baldness pattern might not be developed sufficiently to know what they will be facing in middle age and later in terms of hair loss. That is why using up lots of donor at a young age and/or doing an aggressive frontal restoration on a young patient can be risky.

 

Anyway, I hope you get some better growth and density in the next couple of months, and if not, your doctor has said that he stands behind his work and will take care of you.

 

Best of luck!

[Bill - Seemiller]

Thanks to everyone who posted their valuable input on this topic. After viewing the results and other member's comments, I wanted to add my feedback as well.

 

In looking strictly at the before/after photos, I can see why members might expect a denser result. And while I can't comment on whether or not all 3600 plus grafts have grown, there are several variables worth discussing.

 

For starters, I wholeheartedly disagree with Sparky that TexAg's results don't look natural. While they may not be as dense as the patient wants, the results show a rather subtle but natural improvement in both the hairline and temple areas.

 

Secondly, while TexAg still possessed a lot of natural hair prior to surgery, it's very common for a young man in their 20's to continue losing hair. Furthermore, trauma to the scalp during hair transplant surgery can permanently "shock" miniaturizing hair. While DHT resistant / non-miniaturized hair has a very good chance of surviving trauma and regrowing, hairs in the process of dying may not grow back. Thus, if TexAg possessed a lot of miniaturizing hairs in the frontal core, it's quite possible that these hairs may have died a bit prematurely. The good news however, is that they were placed by permanent DHT resistant hairs and will not fall out.

 

Moreover, while it's true that many patients see the vast majority of growth by 12 months, studies performed by world class hair transplant surgeons have clearly demonstrated that hair growth can continue after 12 months and continue up to 18 and even 24 months. I often see some of the same members dismiss this reality during controversy, which is highly unfortunate, especially since it often stirs the pot instead of providing real information and encouragement to the patient.

 

Another important point to note is that we haven't seen any postoperative photos or interim photos showing the scalp 1 to 9 months after hair transplant surgery. Thus, if either Dr. Arocha's clinic and/or the patient have photos of his scalp immediately afer surgery or sometime before now, I suggest posting them.

 

I also want to point out that Dr. Arocha has an outstanding reputation for producing excellent results and standing behind his patients. While we encourage members to share their genuine opinions, I suggest that patient members of this community and expert physicians work together and not pass blame back and forth. At the end of the day, we all want to help patients get the results they ultimately deserve.

 

Thus, I strongly suggest that TexAg meet with Dr. Arocha if possible for an in-person consultation and evaluation of his growth yield and collaborate on a long term hair restoration plan that takes into consideration his current and future goals as hair loss continues.

 

TexAg,

 

As a young guy, I can certainly understand why you'd want more density. The good news however, is that your results do show a subtle but natural improvement. Furthermore, your hair does appear more dense and miniaturizing hairs were replaced with permanent DHT resistant hair.

 

If you would like to discuss your experience and/or concerns with another patient who understands the procedure and all the feelings involved, I'd be happy to speak with you on the phone and/or privately via email. Feel free to email me at help@hairtransplantnetwork.com with your phone number and I'll be happy to call you.

 

Best wishes,

 

Bill

[Spanker]

Here is my take on it. This was a miss. Not sure if the patient chose the hairline or the doc chose it, it seems too aggressive. Further hair loss is a mute point as far as the corners go because they were slick anyway. The temple points do not look good quite yet. I think they take longer and there is a high probability in my mind that temple points end up course looking like this. This pt is in his early 20's and never should have even considered dropping his hairline. He has a high chance of ending up an advanced Norwood. He has already spent a lot of grafts and needs to think about being conservative about his remaining grafts. Hopefully he gets some maturity in the next few months.

 

Good luck to the pt and the doctor on this one.

[SADbutTRUE]

hang in there , and try to stay positive,how is the scar, hopefully the hairs will mature and give you more coverage,

[TexAg]

Thanks for the comments everyone. I really do appreciate y'all's opinion, even if it is very blunt and to the point haha. I can respect that. Since Bill took the time to write out such an elaborate response, I figured the least I can do is address some of his points:

 

For starters, let me say that I'm not claiming there isn't any growth. I know there is, and I think it's a marginal improvement, but there is no way this is the result of 3640 grafts. It appears as though half of that actually grew, which is what I'm truly worried about. That, and the fact that my donor hair supply has now been cut in half.

 

For starters, I wholeheartedly disagree with Sparky that TexAg's results don't look natural. While they may not be as dense as the patient wants, the results show a rather subtle but natural improvement in both the hairline and temple areas.

 

Eh. With all due respect, if I wanted subtle I wouldn't have opted for such a large procedure. I was planning to restore my hairline as reasonably as possible, and felt that 3640 grafts should have done so. Also, to address Spanker's concern, I wouldn't say it's a super aggressive hairline. If Kira can provide the post-op pics, I think you would see that it's pretty conservative.

 

However, I would have to respectfully disagree with Bill that it looks natural. You don't even have to zoom in on these photos to clearly see the individual hairs along the hairline in both the front and 3/4 view. In the temple area, I can literally count the grafts under any variety of lighting. The same can be said about the temple points. That's not natural.

 

Secondly' date=' while TexAg still possessed a lot of natural hair prior to surgery, it's very common for a young man in their 20's to continue losing hair. Furthermore, trauma to the scalp during hair transplant surgery can permanently "shock" miniaturizing hair. While DHT resistant / non-miniaturized hair has a very good chance of surviving trauma and regrowing, hairs in the process of dying may not grow back. Thus, if TexAg possessed a lot of miniaturizing hairs in the frontal core, it's quite possible that these hairs may have died a bit prematurely. The good news however, is that they were placed by permanent DHT resistant hairs and will not fall out.[/quote']

 

I understand your point, but that doesn't explain the poor yield and lack of growth in the temple areas where there was no (visibly) existing miniaturizing hair that could have died as result of the surgery.

 

Moreover' date=' while it's true that many patients see the vast majority of growth by 12 months, studies performed by world class hair transplant surgeons have clearly demonstrated that hair growth can continue after 12 months and continue up to 18 and even 24 months. I often see some of the same members dismiss this reality during controversy, which is highly unfortunate, especially since it often stirs the pot instead of providing real information and encouragement to the patient.[/quote']

 

Considerable growth? Or maybe ~5-10% growth with continued maturing? I honestly think I would need another 40-50% growth before I considered this a success. I can't see that happening over the next year...

 

Another important point to note is that we haven't seen any postoperative photos or interim photos showing the scalp 1 to 9 months after hair transplant surgery. Thus' date=' if either Dr. Arocha's clinic and/or the patient have photos of his scalp immediately afer surgery or sometime before now, I suggest posting them.[/quote']

 

If Kira reads this, hopefully she will be able to provide those. I took photos every month and stored them on my laptop, but unfortunately it crashed and my photos were lost.

 

I apologize if my post has come off as negative or that I was in any way neglecting your encouragement. I really do appreciate it, but at the same time I'm a realist and I know that at this point things are not likely going to improve drastically. I might experience a little growth and maturing here and there, but based off my research, it seems that the MAJORITY of growth should have happened by now.

 

Thanks again for the concern everyone. I'll be going back into Arocha's office in a few weeks for a full one year update.