Graft count vs actual grafts.

[LasVegas2Orangecounty]

:confused:I just started a hair blog.....documenting my journey to a fuller head of hair.

 

But wanted to share something with community for feedback.

I recently had hair transplant surgery completed on FEB 10,2014 at 2:30pm

Follow the instructions 1 day post surgery. FEB 11,2014. Return to the surgery for post op pic and changing of the dressing

Today is FEB 12,2013. I decided to take some post op pictures...

 

 

Initially I requested 1500-2000 graft via the online consult..

When I met the provider, I decided to go with1500 FUE. I was informed of the pro and con. "50% survival rate for FUE".

Provider recommended that I do FUT. Better yield. I was hesitant. I decided to go with half FUE and half FUT.

1500 graft. Provider verbalize understanding.

 

 

Well, looking at the post op pictures..it doesn't appear 1500 grafts were performed. More like 650-ish.

I've sent and message to office. Waiting for their response.

 

 

I am not naming the providers name yet, but he was found on this website on the recommended list...Southern California. He had great reviews.

I based my decision on the cases that he has done...and on this site.

 

Now I am having second thoughts... .

 

Here are the pictures. Please chime in and let me know what you think.

Do you believe 1500 grafts place?

 

Thanks

Edited February 13, 2014 by LasVegas2Orangecounty

[Spanker]

Really hard to say at a glance. But I'd never go to a doctor that was talking about a 50 percent survival rate, and have a hard time believing any recommended surgeon that any recommended surgeon would do fue and only offer a 50 percent survival rate.

[LasVegas2Orangecounty]

Really hard to say at a glance. But I'd never go to a doctor that was talking about a 50 percent survival rate, and have a hard time believing any recommended surgeon that any recommended surgeon would do fue and only offer a 50 percent survival rate.

 

 

The guy was listed on the recommended list. Not a coalition member though....

 

Some of his cases yield good results.. I guess they were are FUT... Now that I am thinking about, this provider shouldnt even offer or perform FUE....if the survival rate is 50%.....

 

 

50% was what he mention to me. He even wrote on the worked up sheet. I'll scan it and post it after I get reply back from clinic regarding actual grafts place.

 

1500 graft should not look like 650-ish....even with splitting FU.....

[Blake Bloxham]

A 50% survival rate for FUE grafts sounds quite low. While FUE yield was lower than strip surgery in the past (and likely still exists in certain instances today), I don't think I've ever heard of a gap that large.

[greatjob]

If a recommended doctor is claiming 50% graft survival from FUE, they should either not be performing FUE, or they should not be recommended here.

[Britanium]

1500 Grafts or not i really think you needed more. The area your covering with 1500 does not seem enough to make a decent improvement.

Considering your donor area looks good im suprised it wasnt all FUE. Shame to get a FUT scar for such a low number of grafts,

[Britanium]

As far as im aware there is no difference these days in the survival rate of FUT or FUE ! if there is its very little.

[LasVegas2Orangecounty]

1500 Grafts or not i really think you needed more. The area your covering with 1500 does not seem enough to make a decent improvement.

Considering your donor area looks good im suprised it wasnt all FUE. Shame to get a FUT scar for such a low number of grafts,

 

Thats what i was thinking. If i had more coverage in the mid scalp...then it wouldnt be an issue. which lead me to believe 1500 graft was not deliver.....not remotely close. i will be speaking with the provider tonight.. To have a scar for this little graft is not acceptable.

[LasVegas2Orangecounty]

A 50% survival rate for FUE grafts sounds quite low. While FUE yield was lower than strip surgery in the past (and likely still exists in certain instances today), I don't think I've ever heard of a gap that large.

 

This provider informed me the 50 percent success rate is the norm. Still have worksheet with that written on it. Future HT...you have given positive reviews on this provider as well. Nevertheless..i will everyone updated when i talk with him tonight.

 

most likely i will need another session in 11-12 months...for mid scalp..... and hiding the fut scar.

[Paulygon]

Dude.. Relax!

It's way too soon to be doubting the results of your HT procedure. You will drive yourself crazy if you analyze it everyday.. Just continue your life and let the hair grafts do their thing.

 

You posed some interesting questions, nevertheless, that for a second got me curious and paranoid- as I am looking into getting some FUE work done to target/augment 1 or 2 areas on my scalp; and I am in the same region as you (Orange County / Los Angeles). I had a consult with my physician today and brought up the issues you pointed out. My HT surgeon is Parsa Mohebi and he has done a strip (FUT) procedure for me in the past.

 

1) My surgeon feels that 50% is way too low (based on his experience and skill level).

That being said, I have seen sites on the next saying that for certain types of hair (ie. very curly, African American, as low as 50% is possible)- yours does not seem to fit that category. Maybe your physician was making sure to give you the worst possible outcome? In that case, I totally respect what he said.

 

2) Dr Mohebi also confirmed something from my experience post-transplant, which is that you (the patient) cannot guess the # of grafts the surgeon has implanted based on looking at the red scabs on your head after a transplant. Or for that matter, neither can we (the viewers who are looking at the pics you've uploaded). This is because not every transplanted graft has the scabs or dried blood on it.

 

3) Finally, and something I never thought of, is Dr Mohebi said that surgeons sometimes double up on grafts. For example, if the number of singles are more than what is needed for building a hairline, then they double them up to have more density.

 

4) Don't you need to get staples removed? Make sure to ask your dr if you have any concerns. Keep up updated. If your doctor was recommended on HTN, I'm sure you can be confident in his abilities. Did your doc's office ever get back to you - what did they say?

 

Also, in case you are interested in further reading , David (TakingThePlunge) had written (in 2009) a nice article regarding that 50% survival rate for certain FUE cases:

Is Graft Survival Lower with FUE Hair Transplants? | Hair Loss Q & A

[scar5]

You are in "no-mans land" at the moment (time-line wise), my reading is you are looking for a bit of feedback and support. You are in a good place to get support here. In your case here, I would have been appalled beyond words just a few years back that they hacked your head open - a virgin scalp none the less - for the sake of so few grafts. But as an observer of this industry since 1988 you just get used to it, the casualty rate is so high. The good thing is that it looks like a short stumpy scar. These are far less a problem psychologically and technically later on; they don't look like traditional HT scars curving up over the ears. You might get away with it and you have tons of donor left

 

Well, the final consultation is always such a dangerous place to be.

All the research you have done, all the emails, the calls, the late-night doubts, the scenarios you have played out in your head dozens of times just preparing for the various possible problems and nosey antagonists that might come your way. Finally, in the very last consultation you hear the doctor use the "bait-and-switch" tactic that HT docs/clinics are famous for.

 

In your case, it looks like they got you into a strip frame of mind and watered it down by throwing in the FUE with it. Well done doc! and rep!! Take a bow!!

 

Just as a warning to others; In the final consultation *and Im not even sure our guy went down this way, be aware of the following (and more)

 

Likely list of bait-and-switch tactics docs use at the last curtain call;

 

1) I won't be dong your procedure today. Dr. (fill-in blank) will do it. He is excellent.

2) No, the extractions will be performed by the techs today. They are better than me! (said with smile and exclamation mark eyebrows.

3) After taking a good look at your situation, I think strip will be a better choice in the long run

4) No, I won't touch the crown today. You'll likely lose a lot of hair if we do. (Pateint, "But you said shock loss is not usually permanent") Would you like pizza? Or curry? How about curry for lunch?

[Paulygon]

this is why i love these forums-- different viewpoints from experienced people...

 

also, i agree, your scar is pretty small.. mine is of the curved-to-ear type that 'scar5' mentioned (2710 grafts from it).

 

and i also think you have a ton of donor left.

 

 

You are in "no-mans land" at the moment (time-line wise), my reading is you are looking for a bit of feedback and support. You are in a good place to get support here. In your case here, I would have been appalled beyond words just a few years back that they hacked your head open - a virgin scalp none the less - for the sake of so few grafts. But as an observer of this industry since 1988 you just get used to it, the casualty rate is so high. The good thing is that it looks like a short stumpy scar. These are far less a problem psychologically and technically later on; they don't look like traditional HT scars curving up over the ears. You might get away with it and you have tons of donor left

 

Well, the final consultation is always such a dangerous place to be.

All the research you have done, all the emails, the calls, the late-night doubts, the scenarios you have played out in your head dozens of times just preparing for the various possible problems and nosey antagonists that might come your way. Finally, in the very last consultation you hear the doctor use the "bait-and-switch" tactic that HT docs/clinics are famous for.

 

In your case, it looks like they got you into a strip frame of mind and watered it down by throwing in the FUE with it. Well done doc! and rep!! Take a bow!!

 

Just as a warning to others; In the final consultation *and Im not even sure our guy went down this way, be aware of the following (and more)

 

Likely list of bait-and-switch tactics docs use at the last curtain call;

 

1) I won't be dong your procedure today. Dr. (fill-in blank) will do it. He is excellent.

2) No, the extractions will be performed by the techs today. They are better than me! (said with smile and exclamation mark eyebrows.

3) After taking a good look at your situation, I think strip will be a better choice in the long run

4) No, I won't touch the crown today. You'll likely lose a lot of hair if we do. (Pateint, "But you said shock loss is not usually permanent") Would you like pizza? Or curry? How about curry for lunch?

[LasVegas2Orangecounty]

Dude.. Relax!

It's way too soon to be doubting the results of your HT procedure. You will drive yourself crazy if you analyze it everyday.. Just continue your life and let the hair grafts do their thing.

 

You posed some interesting questions, nevertheless, that for a second got me curious and paranoid- as I am looking into getting some FUE work done to target/augment 1 or 2 areas on my scalp; and I am in the same region as you (Orange County / Los Angeles). I had a consult with my physician today and brought up the issues you pointed out. My HT surgeon is Parsa Mohebi and he has done a strip (FUT) procedure for me in the past.

 

1) My surgeon feels that 50% is way too low (based on his experience and skill level).

That being said, I have seen sites on the next saying that for certain types of hair (ie. very curly, African American, as low as 50% is possible)- yours does not seem to fit that category. Maybe your physician was making sure to give you the worst possible outcome? In that case, I totally respect what he said.

 

2) Dr Mohebi also confirmed something from my experience post-transplant, which is that you (the patient) cannot guess the # of grafts the surgeon has implanted based on looking at the red scabs on your head after a transplant. Or for that matter, neither can we (the viewers who are looking at the pics you've uploaded). This is because not every transplanted graft has the scabs or dried blood on it.

 

3) Finally, and something I never thought of, is Dr Mohebi said that surgeons sometimes double up on grafts. For example, if the number of singles are more than what is needed for building a hairline, then they double them up to have more density.

 

4) Don't you need to get staples removed? Make sure to ask your dr if you have any concerns. Keep up updated. If your doctor was recommended on HTN, I'm sure you can be confident in his abilities. Did your doc's office ever get back to you - what did they say?

 

Also, in case you are interested in further reading , David (TakingThePlunge) had written (in 2009) a nice article regarding that 50% survival rate for certain FUE cases:

Is Graft Survival Lower with FUE Hair Transplants? | Hair Loss Q & A

 

 

 

 

Thanks for the link Paulygon:

 

You are correct that scab does correlate to the number of grafts place. Some of the scab could have washed away or gotten stuck to the initial pressure dressing.

Nevertheless, the number of scab does provide a semi accurate count of the number of grafts place.

For example, if only 1400 graft place instead of the 1500, its not an issue. If 1300 graft place...not an issue. Factoring in loss FU and transected FU units.. NO biggies.

But when the number is half place, then I have an issue.

 

I know some provider have a FUE machine that does actually provide a visual read out of the number of graft taken/place.

 

 

I factoring in the doubling which brings the number up to 775-800 grafts. Thats being generous.

 

 

 

 

 

I've sent him high resolution pics to show the FUE donor site. Counted each scab. Came out to only 175-200 FUE... when the agreed upon number was suppose to be 750-ish...

 

Counted the recipient site as well. High resolution pics.

 

I can understand some scabs washing away, to have 700 scabs wash away or 700 disappear in a certain area is alittle suspicious.

 

 

 

 

I dont have an issue with the quality (I'll know in 12 months)...just the agree upon number of graft. No difference than going to a dentist to have work done...and your insurance company gets bill for WORK NOT DONE.

 

 

So the take home message For EVERYONE READING THIS:"

 

1.Can the provider provide you with an accurate number of grafts placed?

 

2.Is there a second assistant in the room recording the number of donor removed and the number of graft placed.

 

3.Is there a machine that provide visual read out of the graft?

 

4.Take a POST OP PICTURE IMMEDIATE AFTER THE COMPLETION OF THE PROCEDURE BEFORE THE DRESSING IS APPLIED.

 

 

These are question I will ask when I have the next procedure in 12 months.

 

 

It unethical to bill for "X" numbers of graft and received "Y" numbers graft.

I know it's almost impossible to have 100% accurate count.. but you gotta be in the ballpark. Receiving 1850-1900 graft instead of 2000 is fine.

 

I WANT TRANSPARENCY!!!!!!!!

I spoke with the provider. He informed me that my concerns are valid.

I mention and confirm that the majority of the placement was in the anterior frontal region.. and some in the mid scalp. He could not give me an accurate number. (I FIGURE ONLY SOME IN MID SCALP...as it's pretty evident in the pics)

The Provider agree to refund the difference with my calculation. No hassle. Did not argue with me or anything. Very professional when I brought the issue up.

[LasVegas2Orangecounty]

You are in "no-mans land" at the moment (time-line wise), my reading is you are looking for a bit of feedback and support. You are in a good place to get support here. In your case here, I would have been appalled beyond words just a few years back that they hacked your head open - a virgin scalp none the less - for the sake of so few grafts. But as an observer of this industry since 1988 you just get used to it, the casualty rate is so high. The good thing is that it looks like a short stumpy scar. These are far less a problem psychologically and technically later on; they don't look like traditional HT scars curving up over the ears. You might get away with it and you have tons of donor left

 

Well, the final consultation is always such a dangerous place to be.

All the research you have done, all the emails, the calls, the late-night doubts, the scenarios you have played out in your head dozens of times just preparing for the various possible problems and nosey antagonists that might come your way. Finally, in the very last consultation you hear the doctor use the "bait-and-switch" tactic that HT docs/clinics are famous for.

 

In your case, it looks like they got you into a strip frame of mind and watered it down by throwing in the FUE with it. Well done doc! and rep!! Take a bow!!

 

Just as a warning to others; In the final consultation *and Im not even sure our guy went down this way, be aware of the following (and more)

 

Likely list of bait-and-switch tactics docs use at the last curtain call;

 

1) I won't be dong your procedure today. Dr. (fill-in blank) will do it. He is excellent.

2) No, the extractions will be performed by the techs today. They are better than me! (said with smile and exclamation mark eyebrows.

3) After taking a good look at your situation, I think strip will be a better choice in the long run

4) No, I won't touch the crown today. You'll likely lose a lot of hair if we do. (Pateint, "But you said shock loss is not usually permanent") Would you like pizza? Or curry? How about curry for lunch?

 

 

 

SCAR5!

 

You nailed it!

I initially had plan the FUE...even in my email, I mention FUE.

Convince me of the FUT...by saying FUE success rate is only "50%"

Or do both FUT and FUE... I should have been more firmed.

 

 

Good thing it's a shorter scar.

Nevertheless, i have 2 other scars on my head, oblique and vertical.....due to a skateboarding accident when I was 12 years old.... hahah..

So my head is not sooo perfect.

 

 

Next procedure, I am going to be firm. Anyone mention FUT..I am getting up and leaving.FUE only from now on.. I may try Drs. Rassman and Pak next..

[Blake Bloxham]

Vegas,

 

Because you said I recommended this physician, can you please send me a private message with the doctor's name? I don't recall having this conversation, and I would like to make sure we're on the same page.