Need Your Opinion - 1 Yr Results From Recommended Dr.

[Getting-Thin-68]

All -

 

I first want to say that I really appreciate this site. Just over a year ago I decided to "take the plunge" and I researched this site and learned a lot about the process. It also helped me select my surgeon as he has a solid reputation from those on this site that judge pre and post op pictures.

 

I would prefer not to reveal the surgeon's name at this time as I am looking for unbiased responses and I don't want to cause him any duress as I feel that we are both disappointed with the outcome.

 

My thoughts - I paid for 3,000 graphs and post op the doc said that we made it to 2915. A year later, I am very disappointed in the density/lack of coverage and am not sure if I am expecting too much. I would REALLY appreciate your views as to:

 

1.) Does this look like 3,000 graphs

2.) If I go back for a #2, should I use this Dr.

3.) How many more graphs do you think I need to thicken the front (I am not worried about the crown at this time)

 

Thanks in advance for your feedback.

 

All of this pics are also on my profile.

[KO]

Unfortunately, it does not look like 3k grafts, assuming average density (may or may not be the case).

[hadenough2014]

Your post op does not look like 2915 grafts. No way. I think you have received the growth relative to the grafts you actually received.

[Spanker]

How long post op are the immediate post ops? I agree it doesn't really look like that much, but some may have already shed?

[Getting-Thin-68]

Guys - Thanks for the comments.

 

Spanker - The post op pick is immediately after surgery. The other "after" pics are at the 1 yr mark.

[stinger99]

No way that's 3000 grafts. The growth u got looks on par to the amount of grafts u seem to ha e recieved . Seems like 1500-1700 grafts to me.

[Getting-Thin-68]

Guys -

 

Thanks for the replies. Consensus appears to be that I didn't get anywhere near 3,000 graphs. What a disappointment!

 

Any comments from the others?

[1966kph]

Hello getting thin.

On close inspection of the post op photo I would say that it does not look like 2915 grafts.

I think the resulting yield was not that good either even for the number of grafts you did receive.

I can understand your frustration but unfortunately we have to place our faith that the doc we choose is going to do the best for us and that they will be honest when it comes to graft count.

Even if it were 2915 single hair grafts with 90% + yield you would get a better result.

If I were you I would go with a different doctor next time around as there is no way you could prove you've been short changed with the number of grafts placed.

I along with anyone reading this would want to know who the doc is as your result from this doc would influence their decision as to whether to use him or not.

Better luck with your next procedure I honestly feel for you.

Have a nice day.

[BUSA]

lol why do ppl feel the need to hide the doctors name? so ridiculous! why a patient feels the need to protect a Dr.'s reputation after a HT doesn't go well is beyond me.

 

GREAT HT doctors sometimes have poor results. doesn't mean the Dr. screwed up. cud mean a dozen other things but for christs sake ppl stop hiding the doctors name like their gonna go out of business if u do.

 

ppl hide the doctors name cause ether feel embarrassed which is again ridiculous!

 

I'm sure u got 3000 grafts. doesn't mean they all took tho. but if those are ur immediately after pics then u definitely didn't get 3000 grafts but its hard to say cause ur photos are unclear. either way its not a gd result.

 

but going to a different Dr. isn't gonna guarantee anything. but remember being recommended here doesn't mean the Dr. is experienced in FUE.

 

there are plenty Dr's that started out FUT and then decided FUE was the future of HT's and then started to dabble in FUE. I'm assuming FUE cause u didn't mention a scar but maybe it is FUT but if so lets se the how the scar healed cause if he can't get the HT right then I have doubts on the scar healing properly.

 

I have brought this up before that Dr's shud be recommended for either FUT or FUE or BOTH if they have demonstrated skill in both not just a blanket recommendation cause they decided to try something new that they suck at!!!

 

so who is the Dr. so we can tell u to move on or maybe u got the "X" factor goin on and going to another Dr. will result in the same poor result.

Edited December 28, 2014 by BUSA

[1978matt]

I know who the doctor is as anyone who has spent too much time here - me included - will recognise the background screen and markings.

 

I think it is conceivable that you did get close to 3000 grafts but I agree with BUSA that the photos just aren't clear enough.

 

One of the reasons for the disappointing outcome may be your donor density is below par. You should find out how many 'hairs' were moved. If this is below 4500 and you have fine hair then it won't be an amazing result for the area covered.

 

Knowing who the doctor is, I see no reason why he would rip you off.

 

A second pass would definitely improve the result for sure.

[Sean]

Does not look like 3000 grafts grew. That is poor yield. Doctor should have forcasted this base on your donor (if you had any donor issues) and advised you from the start this will be the way it looks when it is all grown. Usually, if you have terrible donor a doctor would state this at the beginning of transplantation and ask you to do more grafts. In this case, your transplant looks like it did not yield well and looks like the majority agree on that notion. As for a second pass, look your grafts are precious, what if it happens again with the same doc and what if another doctor you does repairs well can fill in density adequately? Your doc is probably going to only give you the option of a second pass and try to dissuade you from partial refund if any. I think you should move onto another doc and try to mitigate some of your losses based on percentage of grafts that didn't yield. It looks as if 50% did not grow. Again, if this was a donor density issue it should have been addressed during preop versus now, where there seems to be an issue with graft yield. Good luck to you.

[Cryingoutloud]

It ain't a poor yield; the doc didn't place 3,000 grafts - NO WAY.

 

I can understand the patient withholding the surgeon's name. It could be that he wants to bring the surgeon's attention to the thread and the opinions therein and using them to leverage some kind of recourse.

 

That could be another procedure at zero cost if he still has confidence in his surgeon

 

OR

 

it could be a refund of his costs if he doesn't.

 

Personally, I'd go elsewhere. The surgeon took a fee based on 3,000 grafts but delivered what looks like 1500. Why the hell would I trust him again?

 

PS Yes it's quite clear who the surgeon is but I respect what the patient's trying to do so my lips are sealed

[Chewy]

Definitely would go elsewhere to get feedback from at least one other surgeon on what has occurred and what can be done. I too would very much like to know who your surgeon was.

[1966kph]

Chewy look in the patients post history the answers there

[Chewy]

Got it, thank you

[Getting-Thin-68]

Guys -

 

Thanks for the feedback. I didn't want to reveal the doctor's name as I think he runs a quality practice. I also do not believe that be did anything to intentionally short change me. I forgot about my post history and therefore didn't realize some of the things you guys have discovered.....my bad.

 

The bottom-line is that I am disappointed in the results and could not see, based on the other results I have seen on this site, that I received 3000 graphs. I don't understand the "low yield" comments as my yield would need to have been 50% in order to get 3000 graphs and achieve my outcome. What I was looking for is an independent opinion as to my result. I think it is unanimous.....not a good outcome. I am also surprised about the comments of the picture quality.....I have digital, well-lit close-ups of the post-op. What additional pics can I post to assist with the assessment?

 

I plan to work with my HT surgeon to remedy the issue. I have confidence in his practice but just perplexed at my outcome and post-op graph count.

[Dr. Bernardino Arocha]

Gentlemen,

 

This is a good conversation, but the focus on the number of follicles transplanted is misplaced and one-dimensional. That’s understandable, since you don’t have necessary context on which to form your opinions. All of the following has previously been communicated to the patient, and prior to the procedure we carefully explained that the limited availability of donor follicles would require us to prioritize how we approached the transplant.

 

There are several contributing factors in this case:

 

1. The canvas is large. The larger the head size the more grafts needed for coverage and density.

 

2. Hair loss is chronic and progressive. A regimen of treatment with proven medication was recommended and it was not followed. Therefore, the hair on the area transplanted shown in the before photos has probably been lost or further thinned, diminishing the overall results of the transplant.

 

3. The brush is small. The smaller caliber of the transplanted hair renders a thinner wash effect. This may thicken over the next year, as studies have shown that there can be further maturation of the hair shaft from 1-2 years post-op.

 

4. The patient has low density follicular units. The average density of the follicular units ranges between 2.1 and 2.5. The patient’s came in at 1.96 hairs/FU.

 

5. Another factor contributing to low density with this patient was the low number of hairs per FU. Most Caucasians have two and three hairs per FU, the patient had mostly one and two hairs per FU;

 

6. In consideration of the preceding, I elected to use 500 DFU in the frontal core area and behind the hairline, the remaining single follicular units were transplanted into the hairline and frontal areas. This had the greatest positive impact on the look of the hairline.

 

As I said, I think this is a valuable discussion, because managing patient expectations is a big part of hair restoration. Some are focused on the number of follicles transplanted – and for good reason, since that’s the way the costs of procedures are typically calculated – but the strategy for how and where those follicles are placed can be more important. And, of course, if you don’t follow your doctor’s recommendations for medical treatment, you jeopardize achieving the maximal result or improvement.

 

As I assured the patient, I will assure the rest of the community here: we transplanted the promised number of follicles. The total number was 2915 FU, however, 250 DFUs were placed in central forelock, 125 DFUs were placed behind the left and right hairlines. That is a total of 500 DFU employed to decrease see-through effect when viewing the hairline from front and sides.

 

 

Hair loss is a formidable foe. It is progressive and unrelenting. It has no scruples or conscience. It is also cruel in the sense that patients with the most hair loss have the least donor follicles. Our focus is entirely on hair restoration surgery, we strive to produce the best possible outcome for all our patients. Remember that the outcome of this procedure is entirely dependent on many factors including hair characteristics, genetic pattern inherited, compliance with medical regimen and of course, and the skill of the surgical team (doctor and surgical assistants). Most of these factors are individual dependent , that is they are unique to the patient. It is not possible to generalize 3000 FU procedure results since these factors can and do vary. A 2500 FU transplant with fine hair will not produce as full a result as a 2500 FU with coarser hair (please see the hair characteristics slideshare presentation.) Most results can be improved by a second session to work between the frame-work of the prior transplant.

[KO]

Thanks for the response, Dr. A, do you have recorded the patient's hair caliber in microns?

[ArochaInfo]

KO,

 

Please view the photo below to view the caliber of the patient's hair.

 

 

[Number47]

Gentlemen,

 

This is a good conversation, but the focus on the number of follicles transplanted is misplaced and one-dimensional. That’s understandable, since you don’t have necessary context on which to form your opinions. All of the following has previously been communicated to the patient, and prior to the procedure we carefully explained that the limited availability of donor follicles would require us to prioritize how we approached the transplant.

 

There are several contributing factors in this case:

 

1. The canvas is large. The larger the head size the more grafts needed for coverage and density.

 

2. Hair loss is chronic and progressive. A regimen of treatment with proven medication was recommended and it was not followed. Therefore, the hair on the area transplanted shown in the before photos has probably been lost or further thinned, diminishing the overall results of the transplant.

 

3. The brush is small. The smaller caliber of the transplanted hair renders a thinner wash effect. This may thicken over the next year, as studies have shown that there can be further maturation of the hair shaft from 1-2 years post-op.

 

4. The patient has low density follicular units. The average density of the follicular units ranges between 2.1 and 2.5. The patient’s came in at 1.96 hairs/FU.

 

5. Another factor contributing to low density with this patient was the low number of hairs per FU. Most Caucasians have two and three hairs per FU, the patient had mostly one and two hairs per FU;

 

6. In consideration of the preceding, I elected to use 500 DFU in the frontal core area and behind the hairline, the remaining single follicular units were transplanted into the hairline and frontal areas. This had the greatest positive impact on the look of the hairline.

 

As I said, I think this is a valuable discussion, because managing patient expectations is a big part of hair restoration. Some are focused on the number of follicles transplanted – and for good reason, since that’s the way the costs of procedures are typically calculated – but the strategy for how and where those follicles are placed can be more important. And, of course, if you don’t follow your doctor’s recommendations for medical treatment, you jeopardize achieving the maximal result or improvement.

 

As I assured the patient, I will assure the rest of the community here: we transplanted the promised number of follicles. The total number was 2915 FU, however, 250 DFUs were placed in central forelock, 125 DFUs were placed behind the left and right hairlines. That is a total of 500 DFU employed to decrease see-through effect when viewing the hairline from front and sides.

 

 

Hair loss is a formidable foe. It is progressive and unrelenting. It has no scruples or conscience. It is also cruel in the sense that patients with the most hair loss have the least donor follicles. Our focus is entirely on hair restoration surgery, we strive to produce the best possible outcome for all our patients. Remember that the outcome of this procedure is entirely dependent on many factors including hair characteristics, genetic pattern inherited, compliance with medical regimen and of course, and the skill of the surgical team (doctor and surgical assistants). Most of these factors are individual dependent , that is they are unique to the patient. It is not possible to generalize 3000 FU procedure results since these factors can and do vary. A 2500 FU transplant with fine hair will not produce as full a result as a 2500 FU with coarser hair (please see the hair characteristics slideshare presentation.) Most results can be improved by a second session to work between the frame-work of the prior transplant.

 

thats all understandable, he was clearly a very bad candidate... but did you tell him all this before the surgery?

[Getting-Thin-68]

Thanks to Dr. Arocha and others that have commented. While I am very disappointed in the density, we were able to improve my situation. I had lost a lot of hair so the coverage area was large.

 

I will pursue a second HT to improve density with Dr. Arocha. He has a great reputation on this forum and has produced great outcomes re-establishing hairlines and doesn't require the patient to shave (a non-starter for me).

[Questionmark]

http://img3.fotos-hochladen.net/uploads/postopfromto52hwtgxi13.jpg

 

Each color field represents 100 grafts. As the picture quality is not the best, I was very generous in my interpretation: Oftentimes, I made dots when there was the slightest interpretational possibility; when there were blood spots, I took the highest amount of grafts possible in such an area, even though it would exceed the normal and average placing density and pattern. Especially in the middle hairline area marked in green and yellow, I rather made wildly generous assumptions. If I would have only marked the grafts identifiable as such, the areas may as well have almost double size (in tendency, this would apply to the other areas as well). What most probably are just freckles, I counted as grafts (please have a look at the patients forehead and his general skin structure). In the middle front area, the picture quality is too bad as to count the grafts, and the sight gets blocked by hairs, so one could only make assumptions in the area imo. But even if assuming the same density as in the hairline zone, and even assuming some grafts I overlooked at the temples, under hair and so on, after extrapolating, it`s hard to reach the claimed number of nearly 3 k. To me, realistically, it`s rather 1700 - 2000. Again, I was very generous, please compare the photoshopped pic with the original one.

 

This is not to attack Dr. Arocha, he imo is one of the most credible and likable docs, so I`d welcome any feedback as to why this just doesn`t look like 3 k.

[Questionmark]

As said in two other threads, I`m leaving this site. Have fun everybody

[Sean]

Oh my. This is a curve after someone took time to analyze graft placement. Speechless. FTC please review this possibly future locked thread.

[1978matt]

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This is not to attack Dr. Arocha, he imo is one of the most credible and likable docs, so I`d welcome any feedback as to why this just doesn`t look like 3 k.

 

The photo does not appear to be an immediate post-op photo. It could be as much as 7-10 days post op. Hairs have shed which is why you can't count 3000 grafts.

 

I wouldn't mind betting that the photo was taken on suture removal day.