Should I Have To Wait a Year to Receive My Refund?

[Michael Vories, MD]

I wanted to take the opportunity to respond to recent posts. Our clinic performed a 1200 graft procedure on an African American patient in August of 2012.

 

This patient has stated that he posted photos of his results at 9 months post-op. I believe these photos are accurate and show poor graft survival on his right hairline and frontal forelock, with acceptable growth on his left hairline and frontal forelock.

 

The procedure was performed by my Physician Assistant (not an unlicensed technician), and I personally supervised the procedure while I was performing a second procedure that was occurring that day.

 

While I agree with posts that describe the result as poor and not representative of a recommended clinic on this forum, I would like to reassure this online community that this is not the result we see consistently in my clinic.

 

In November of last year, my PA left our clinic due to family health concerns, and since her departure, I have extracted and placed all grafts for all of our surgical patients. I do use surgical technicians to count and collate grafts during extraction, and to load the Hans Implanter pens for graft placement. I also perform all administration of local anesthesia for patients. I would like to make clear that myself, Michael Vories, MD takes full responsibility for all outcomes, good or bad, that occurs in my clinic.

 

Regarding the recent posts- I believe the poor result is not due to poor hairline design or graft density. We perform many African American surgeries, and densities that would be unacceptable in Caucasian patients do well with African American patients, who normally have a lower absolute hair density. (Unger 5th Edition). I do not believe the result is due to poor hair exit angle- African American patients have a random acute exit angle, with hair follicles that vary from relatively straight to a sharp C or even an S curl. See the below video for a recent example of another African American patient.

 

 

 

The above shows another African American patient one month after surgery. Note that some of the transplanted hair has already shed.

 

I believe TygerD's result is due to poor graft survival. I also believe that poor graft survival is most often a result of a breakdown during the intra-operative period.

 

Transection, desiccation, and placing trauma are all well-known reasons for poor graft survival, and I believe one or all of these occurred during this case. That is unacceptable for our clinic regardless of who is performing the procedure.

 

However, we have seen results like this before, and there is no reason to believe we will never see results like this in the future. The best human hands (and I suppose robotic hands) and human minds can do is reduce these known factors as much as possible, and by doing so obtaining a typical result that is good to excellent. That is the goal for my clinic and myself, and I look forward to posting results that continue to prove myself to this forum.

 

Dr. Vories

[Bill - Seemiller]

While I don't think the way TygerD approached this topic was fair, after speaking with him privately, I don't think his intentions were malicious. Thus, now that Dr. Vories has had a chance to respond to the topic, I've re-opened the topic for additional feedback.

 

Ultimately, like everyone else, I agree that TygerP's results are poor and hope he gets the best possible outcome moving forward. However, I don't feel that TygerP's results are indicative of the kind of work and results Dr. Vories is regularly producing. All physicians have cases of poor results and ultimately, it's how a patient's concerns are handled that matter most in these circumstances. Dr. Vories appears to be taking full responsibility for the outcome of this procedure and has offered him a free procedure and/or some kind of refund in 3 months after the hair transplant has had a chance to full mature.

 

I'd still encourage TygerD to give Dr. Vories an opportunity to make things right for him via another procedure. However, it's ultimately his decision how to proceed.

 

I wish him all the best in getting his concerns resolved.

 

Best wishes,

 

Bill

[hairthere]

Dr. Vories,

Firstly, thank you for coming on the forum to offer an explanation.

 

What I don't understand is how a good result could have been expected after viewing the patient immediate post-op. The graft placement looks extremely poor in terms of the density, angles, and design. What exact density were those grafts placed at?

 

Also, you say "I personally supervised the procedure while I was performing a second procedure that was occurring that day." But how could you have supervised the surgery while performing another surgery? Does your clinic still perform more than 1 surgery per day?

 

"Transection, desiccation, and placing trauma are all well-known reasons for poor graft survival, and I believe one or all of these occurred during this case. That is unacceptable for our clinic regardless of who is performing the procedure."

 

So if that is the case, what should Tyger expect in terms of a refund? I must agree he should not have to wait a full year for compensation.

 

I do think you have displayed some very nice results, and I understand not every case is going to be a success. However, I do feel if certain standards were upheld this would not have happened in Tyger's case.

[Michael Vories, MD]

To clarify- we did perform two procedures on the day in question. Both myself and my PA switched off on cases in both extraction and placement. My suspicion is that there was a too high transection rate when my PA was extracting (Not her fault- the surgical techs are responsible for graft inspection) and that resulted in unilateral poor graft survival. Tyger and I have worked out an agreement to put this issue to bed.

[Mickey85]

I personally do not see the benefit or point of having to wait a full 12 months for a refund, I think the ship had sailed for a late blossoming of growth. However a late refund is better than no refund and if no negotiation can occur, I would say just wait it out and research who your next FUE surgeon will be in the meantime.

[GNX1]

 

What I don't understand is how a good result could have been expected after viewing the patient immediate post-op. The graft placement looks extremely poor in terms of the density, angles, and design. What exact density were those grafts placed at?

 

 

I would have to agree with this Dr. Vories. the graft placement is really poor and spaced way too far apart. it looks like 1st generation plugs. it really is some of the worst FUE work I have seen in many years by any clinic.

 

can you explain why the grafts were placed so far apart from each other in the hairline? I get it if it was back towards the top of the head and you or whoever was doing the placement might want to conserve grafts if they were limited but the hairline is not the place for that to occur.

 

or do you find that black patients grafts are placed further apart then ur average white patient for some reason? im just trying to find some reason how you could look at that patients head after it was done and be satisfied and essentially put ur name it as the patient walks out the door.

 

everyone understands that not every patient is going to have grafts that grow for a number of reasons but the inital placement of being so far away from each other would only serve to HELP the grafts grow not hurt the grafts grow.

 

and if someone is coming to you to have a HT the patient should expect YOU to perform the placement of grafts and not ur assistant. we all get that tech's and others perform some of the other procedures not necessarily vital to the outcome but graft placement should be done by YOU and YOU only unless the patient is aware and agrees to have someone else place them.

 

can you elaborate on this?

[TygerD]

Thank you Bill for allowing further discussion, and Dr Vories for his explanation as well. However I would like to point out there are some haft thruth's to his story. The first being the assistant's involvement. She performed my surgery 100%, extracting via the Neograft machine and making incisions, and then placing the grafts via the hans implanter. I even recall asking her "are those the hans implanters I saw on one of the youtube videos" or something to that effect. There is no question about it and do not know why The Dr will not come clean about this. I was wide awake throughout watching a Bob Marley documentary on the clinic's flat screen and occasionally exchanging words with the physician. She would ask me my comfort level, move this way, lean that way, things of that nature.

 

I put my faith and trust in Dr Vories. I had never flown prior to my surgery. This really meant a lot to me that I was willing to go the extra mile to get this done. With him being an IAHRS member and having practiced hair surgery for close to a decade I thought I would be in good hands. I had a good discussion with him prior to surgery on video chat and was under the impression he would be performing the surgery. I know techs are part of hair transplant surgeries however if I was informed prior that Dr Vories would not be performing my surgery and a physician's assistant would, I would have never flown out from Buffalo, NY to Charlotte. On the day of the surgery the young lady pops up and introduced herself to me and told me she would be performing the surgery on me today.

 

I find it disheartening that Dr Vories is not taking responsibility for the cosmetic result and is just viewing my result through the single lens of growth. Even the waiver formed I signed notes that this is a "cosmetic" procedure just as much as it is about growth, graft survival, etc. Although Dr Vories has offered to do regrafting there is nothing in terms of photographic evidence of good to great results with African American men coming out of his clinic. There are certain complexities to ethnic hairline and graft placement that must be taking into consideration. My grafts are placed sporadically and do not hug the skin as the rest of my native hairs. Dr Vories only involvement in my procedure was drawing the hairline. He took no measurements, and just eyeballed it and drew a high arching caucasian hairline that widened from the center point at about 20 degree angle and there were no connecting temple points. Just think of a wide shaped letter "M".For 1200 grafts, and the thickness, curliness of my hair I felt that was entirely wrong nor was this type of hair line appropriate for my ethnicity. Dr Vories then later lowered the hairline and cautioned me about future "density" issues.

 

I want to reiterate that I followed this Dr's post op instructions to a tee. These grafts were my little babies. No exercise, no sun, no fish oil, no showering, etc. In fact I may have been overly cautious for the first 10 days but I didn't want to jeopardize my procedure in any manner. As it relates to a refund. If I were receiving a full refund then I'd just have to bite the bullet as frustrating as it is, and just wait out the three months, However for a 50% discount which is what the Dr offered me, I guess which equates to a vast portion of one side growing that is all I entitled too. Most of the grafts just didn't grow. My hair type masks that even on the side that grew. But if that is what Dr Vories sees fit that all to which I am entitled to then I can live with that. My only gripe was having to essentially wait another 3 months for a mere formality to validate itself and sought the opinion of fellow forum members about the efficacy of that. I wish at 9 months I could be more hopeful, but my hope has been on E for quite some time and the tank has just ran empty. Hair "matures" not bald patches of skin. Dr Vories has basically admitted that this is a bad result and future growth is unlikely but apparently policy takes precedent over patient.

[Michael Vories, MD]

During the time I had a PA it was explained, both during the consult and in writing, that both myself and the PA would be doing the work. Presently, I do all the extracting and placing on all patients, and have done so since November 2012.

[Bill - Seemiller]

TygerD,

 

I have removed your last post under the account TygerD1 due to duplicate content. You do have permission to post under your TygerD account, so please continue using that account.

 

Bill

[hairthere]

Dr. Vories, do you continue to perform more than 1 surgery per day?

[Mickey85]

Hmmm if 50% of the refund is all Vories will give, he must realize that he will probably lose much more than that in lost patients and could possibly mitigate that by a full refund that would be in good faith and show potential patients that that will be looked after. Just my opinion.

[JohnnyDrama]

Dr, is it true that the first time this patient found out that you wouldn't be operating on him was in fact when he was in the clinic on the day of the procedure?

 

If so, why?

[Bill - Seemiller]

Tyger,

 

I appreciate you sharing more details regarding your experience. And while I understand you are frustrated and should have gotten much better results, you said -

 

I find it disheartening that Dr Vories is not taking responsibility for the cosmetic result and is just viewing my result through the single lens of growth.

 

However, Dr. Vories said -

 

I would like to make clear that myself, Michael Vories, MD takes full responsibility for all outcomes, good or bad, that occurs in my clinic

 

How is that not taking full responsibility for your procedure and result?

 

I just spoke with Dr. Vories and he told me that you already privately agreed to and were satisfied with a 50% refund for the one side that didn't grow. He also agreed to give it to you immediately so that you didn't have to wait an additional 3 months. This sounds more than reasonable to me, especially when most physicians don't give refunds and require patients to come into the office for an in-person consult to view their results in person before even considering a refund.

 

But if Dr.Vories is providing you this refund immediately, why are you still saying you have to wait 3 months?

 

Perhaps there is some kind of communication issue, but I suggest calling Dr. Vories to make sure you're both on the same page. But if you and he already agreed to an immediate 50% refund for the only side that didn't grow, then I trust your concerns are resolved and you can move forward.

 

Best wishes,

 

Bill

[Bill - Seemiller]

Hairthere,

 

The physician's assistant is no longer at Dr. Vories clinic (as of November 2012 I believe) and he now only operates on one patient per day.

 

Johnny and GNX,

 

There seems to be some disagreement regarding Dr. Vories involvement in Tyger's procedure. However, the vast majority of physicians have technicians, nurses or assitants do a large part (if not the majority) of the procedure (whether FUE or Strip harvesting). Most physicians don't tell patients that their technicians/assistants do the vast majority of the hair transplant, so it wouldn't surprise me if Tyger didn't know ahead of time. Admittedly however, I think physicians should sit down and explain how the procedure works at their clinic with each prospective patient so there is no confusion. But in all 4 hair transplants I had, no physician told me that technicians were going to be cutting and placing all the grafts. Of course, I knew from experience and research.

 

That said, the physician is still responsible for the procedure and the outcome as they are responsible for their staff.

 

Best wishes,

 

Bill

[Bill - Seemiller]

Mickey,

 

Dr. Vories stated that Tyger has already agreed to and was satisfied with a 50% refund due to the fact that he was only concerned with one side. Most physicians don't give refunds at all (whether you agree with that or not is a separate issue).

 

If the patient is satisfied, that's all that matters. If he's no longer satisfied with it only a couple hours later, then he should discuss this with the physician, not post his dissatisfaction with it on this topic which is then used as pressure on the doctor to do more than what originally satisfied him.

 

Best wishes,

 

Bill

[Michael Vories, MD]

I have made attempts to contact this patient, and if things are as they appear, to make good on what seems to be a substandard surgery outcome. Thanks for everyone's input.

[cueball35]

Doctor, This doesnt seem to be a substandard surgery outcome, it is a disaster, not a 50% disaster, a 100% disaster from the start. How was the guy supposed to get a decent outcome by implanting 1200 Grafts into the area marked out, its a huge area to be covered, frankly im appalled that you could leave this guy out of your clinic looking like that.

[Bill - Seemiller]

Guys,

 

While there seems to be some disagreement about some of the details surrounding the surgery, everyone agrees (including Dr. Vories) that the results are poor. While I agree this case turned out poorly, I don't believe this case is indicative of his usual work and results. Furthermore, the physician's assistant (not that I'm blaming him/her) is no longer working there and Dr. Vories now only operates on one patient per day.

 

At this point, both the patient and the physician had several opportunities to share their side of the story and details surrounding this case and members have been given the opportunity to provide their input.

 

Dr. Vories and TygerD have already talked and agreed to what appears to be a very reasonable solution. Thus, I encourage them to continue working together to resolve this patient's concerns.

 

While I understand that it's not a popular decision to lock topics, I don't see anything else that's constructive coming out of continuing this discussion.

 

It's now time to move on. This topic is now closed.

 

If anyone would like to discuss this further, they are welcome to send me a private message. However, we will not be hosting any additional discussions about this case on our public forum.

 

Thanks for your understanding.

 

Onwards and Upwards,

 

Bill