Horrible results

[LasVegas2Orangecounty]

Had the OP had prior work done or was this virgin scalp? I think this matters.

 

Gram,

This was my first and only Hair restoration procedure. Virgin scalp.

[Gram]

That's unfortunate to say the least. Ok, I can't think of a plausible explanation in that case although in reality my knowledge base is limited short of being a forum spectator. Hang in there man, in the HT world things could be a whole lot worse. You can be fixed and likely even achieve your original goal from what I can tell from your pics and have seen on here. Stay positive, which I know is easier said than done. Very much looking forward to hearing from your doc and how he plans to rectify your situation.

[LasVegas2Orangecounty]

I requested FUE. He mention (which he wrote on my paperwork) FUE has only a 50% success rate. He recommended FUT. He saw i was hesitant about FUT..so he recommended FUT/FUT for a higher success rate.

1500 graft per provider.

 

Just got off the phone with Dr Meshkin. Relay my concerns. We discuss my medical hx. SH. Family HX.

He provided two options: full Refund or another session.

 

I elected the full refund. I may do another session, FUE only, in the future....or just live with what I have..

Yes, I now have a FUT and FUE scar.....so that's a risk with all elective procedure.

 

We both reach an agreement. Full refund. Which is fair thing to do.

 

I appreciate the support from all the members.

 

Thanks again

[KO]

50%? *facepalm* surely my advocacy of Dua does not look so bad now!

[Sean]

I requested FUE. He mention (which he wrote on my paperwork) FUE has only a 50% success rate. He recommended FUT. He saw i was hesitant about FUT..so he recommended FUT/FUT for a higher success rate.

1500 graft per provider.

 

Just got off the phone with Dr Meshkin. Relay my concerns. We discuss my medical hx. SH. Family HX.

He provided two options: full Refund or another session.

 

I elected the full refund. I may do another session, FUE only, in the future....or just live with what I have..

Yes, I now have a FUT and FUE scar.....so that's a risk with all elective procedure.

 

We both reach an agreement. Full refund. Which is fair thing to do.

 

I appreciate the support from all the members.

 

Thanks again

 

i commend the Doctor for offering you both options as recourse. most surgeons just rely on touchups and never mention a full refund. they even make you long periods in order to see if you have further growth up to 18-24 months and waste your time. This makes you bound to them for their services for repair. very rarely do you see a full refund. i can not recall when a recommended or coalition doctor has given a full refund to a patient on this forum. in some cases when patients asked for refund, they were blamed for not getting a repair done as recourse and told they were not willing to work with a doctor as refund was not even a mentioned option.

 

i am glad you got some closure. when are you expected to have the refund by? do you have to wait too long or is it like within a week?

 

i hope you do have the scar and restoration issues resolved if and when you decide to have another procedure. best of luck to you.

[Dr. Michael Meshkin]

Thank you David for bringing this patient’s concerns to my attention. It is interesting that when we post great results there is not much comment, but everyone jumps to conclusions before hearing from both sides. I will try my best to answer all the questions regarding this patient as much as possible and elaborate on the use of combination of FUE and FUT procedure on the patient. I am also attaching immediate before photos of the patient on the day of the procedure which looks much thinner than the one patient used for before picture.

 

The skull comes in different shapes and contours, the elements that a physician can asses to determine whether a patient is a good candidate for a certain procedure in hair restoration includes: the patient’s age, the patient’s general state of health, the degree of hair loss, donor size, donor density, hair characteristics, the contrast between the patient’s hair and skin color, whether or not previous grafting procedures have been done, the progression of future hair loss and the family history of the patient. Treatment options are customized for each patient.

 

I have been doing hair transplant surgeries for twenty four years; I have seen the patients who had the old plugs done in the past. In cases where the plugs were removed from too superior or too inferior of the safe donor area, two major problems were commonly seen years after their hair transplant procedure. The first was that once the hair of the superior fringe (in the donor area) were depleted, the area was left with pluggy scars which lead to a cosmetic concerns. Second, the transplanted hair plugs were lost a few years after the procedure. This is well documented by some of the pioneers in this field especially by Dr. W.p. Unger, the Author of Hair Transplantation textbook. He has described this in details in the article “history repeats itself” in hair transplant forum International. In order to avoid the mistakes of the past one has to be short-sighted or uninformed to not know that the hair loss is progressive and the bald areas were bound to get larger and the fringe narrower with the passage of time. This is especially true in a young patient with family history of hair loss and early signs of thinning in the crown area.

 

In this particular case, following close examination of this patient’s scalp, I noticed the signs of superior thinning in his donor and crown area. You can see this in the attached photo of the donor area.

With my many years of experience following examination of this patient, I came to conclusion that if we do a large number of FUE’s we had to remove the FUs from too superior and too inferior of the safe donor area; therefore he would have exact the same problems that we are discussing here. I offered to perform the strip harvesting method on him because of his donor condition, because I generally believe the yield is much higher in FUT than in FUE. Since the patient really wanted to do FUEs, I offered to combine the FUE with shorter and less width of a strip harvesting in order to minimize the risk of low yield from FUEs and minimize scar formation from the strip by minimizing the tension. This would leave a good amount of untouched donor area in case he needed future hair transplantation and he will benefit in the long term. This was discussed in details with the patient, and he confirmed that he agreed.

 

I have performed thousands of procedures over the past twenty four years, we try to provide the best possible results for our patients and I get consistently good results as you can see in my patient files. I get compliments all the time for achieving good density with low number of grafts. I get patients from other clinics who had a procedure done elsewhere either after FUE or strip method for corrections of their problems or for their second surgeries.

 

As far as this patient is concerned, there are many known and unknown contributing factors that can affect the outcome of the results. In some cases, it takes up to two years for all the hair to come in and the patient needs to be patient. As you can see from the immediate before picture I am attaching and patients progress picture, there is considerable amount of hair growth for such a large area. However, As a good faith, I have contacted this patient to resolve this issue.

Edited February 11, 2015 by Dr. Mike Meshkin

[kt4l]

the before pictures supplied by the OP are different to the before pictures supplied by the doctor.

[Dr. Michael Meshkin]

the before pictures supplied by the OP are different to the before pictures supplied by the doctor.

 

Exactly, that is why we take photos of patients immediately before the procedure. The patients

Before picture doesnot show his true degree of hair loss before the procedure , and his scalp condition, which would give people the false impression. Furthermore, I have asked the patient to come for follow up but he lives in Vegas, so I have not seen the patient after the procedure to follow his progress and take pictures, so I have to assume what he is providing is correct.

Edited February 11, 2015 by Dr. Mike Meshkin

[KO]

Did you tell him before surgery that he was a poor candidate?

[Dr. Michael Meshkin]

Yes I told him that because of all the reasons I explained in the above statement that he is a poor candidate for FUE. All of these are documented in his chart and was signed by him.

[KO]

Thanks, did you feel he was a good candidate for FUT?

[Dr. Michael Meshkin]

Yes as you can see in the picture of the donor I provided, he has good hair in the safe donor zone, but he is already thinning in the area superior to the fringe of the safe zone. This limits the number of FUE taken because if extraction is taken from that area he would lose the hair in the future. If you notice many clinics extract outside of the safe donor zone and even extract all the way into the crown. In a young patient whose hair loss is progressive, those hairs will most likely be lost in the future. An experienced and knowledgable hair transplant physician with integrity should explain this fact to the patient, which I did and had the patient sign it as it is documented in his file. I can release these documents if necessary.

Edited February 11, 2015 by Dr. Mike Meshkin

[BUSA]

ur such a hero! wat wud this forum do without u?

 

LasVegas, what a dreadful, stressful ordeal for you. Your surgeon deserves to be lined up and shot for that baffling combination of techniques alone.

 

I don't know why you won't name the surgeon but if it's because you intend to show him this forum discussion and the weight of opinion in order to get a refund, I think you're doing the right thing. Good luck with it.

 

PS If anyone but a moderator asks you for those surgeons details by personal message (PM), tell them to piss off. There are one or two douchebags out there who can't respect people's wishes to keep personal information private.

[LasVegas2Orangecounty]

the before pictures supplied by the OP are different to the before pictures supplied by the doctor.

 

 

The picture that Dr Meshkin post was the day of surgery. I had just cut my hair short...anticipating FUE procedure. Haircut completely 7-10 days prior. I went with 1/2 guard....in pictures

 

The picture(two pictures on the bottom row) I posted in the original post was about 7-8 weeks of hair growing prior to surgery.

When the hair is long..it tends to conceal and receding area.

 

Dr Meshkin pictures are accurate. My are accurate as well.

Edited February 12, 2015 by LasVegas2Orangecounty

[Sean]

Also note, the clearer the photo quality the better it is to get an idea of the state of hair both pre and post transplant. When photos are blurry or pixelated, it can add an artificial density like effect to a photo, making the situation look better than it is in reality. This can confuse a person when comparing. High flash may also make things look more dense in some cases. Thanks for posting photos again for comparison.

[Sean]

Are there more pre surgery pics by the clinic? As well as, What about right after surgery (post) pics,showing extracted, donor , and grafted recipient areas?

[LasVegas2Orangecounty]

Dr Meshkin mention that FUT would yield more growth.

Dr Meshkin mention that FUE would have a 50% success rate in my case.

Decided on FUT/FUE for 1500 grafts. He did mention about the safe-donor area as well. Future hairloss possible

 

After looking at Post op surgery pictures, I felt less than 1500 grafts were placed. Somewhere around 700-800 grafts. I calculate the number of FUE scabs minus the total of implanted scabs. I arrived at number of FUT and FUE implanted with some simple calculation. Accuracy---Very Accurate.

Dr Meshkin's office refunded the difference. 65-70% from FUT and 30-35% from FUE from my calculation.

 

So Dr Meshkin charged me for the 800 grafts.. (combination of FUT/FUE).....but insist 1500 were placed.

 

Informed Consent provided? Yes. Risk and benefit discussed. Yes.

I proceeded forward with all information provided. But if the risk outweights the benefit, should the surgeon even performed the procedure?

 

 

Fast Forward 1 year later:

After reviewing the pictures, was there some growth? Sure.

How many of the FUT/FUE survived? Not much as you can see from the pictures. Out of the 1500 (according to the provider), what you see is probably in the range of 100-150 grafts maybe. It's not worth evening counting.

 

Even if we did FUT completely, would the results in my case be any different? Probably not... Remember, the original 65-70% was FUT.

 

So I have to correct myself, and say there was some growth. Compare pre and post pic.

 

Nevertheless, Dr Meshkin did his best in my case. Dr Meshkin has achieved fantastic results in with other patients. I'm not here to crucify anyone. Just presenting the facts. FULL Transparency. Someone coming across this thread, will have something to think about.

 

I have friends that are ENT, Plastic, OMFS, etc...etc.. They have all experience cases that just didnt turn out right. Does it make them a horrible surgeon? Absolutely not. Every provider has different philosophy regarding treatment.

 

With that said, here some final pictures. I will stop by Dr Meshkin office when I'm back in the area..for him to take look.

 

In closing, my case could have been the extreme outlier. Given that other patient's have had stellar results with Dr Meshkin... One should only look at my case and understand that even with the best surgeon, the end result may not be desirable. The only thing to do is to refund the patient's money, let another provider manage this patient (which Dr Meshkin has done). One case with less-than-desirable result does NOT make the surgeon a bad surgeon. Multiple patients with the same outcome, THEN YES. So far, I am the only patient with sub-par results with this provider on this forum. I hope the next patient that sees Dr Meshkin for surgery will post pictures of fantastic results that will trump my case.....and it will demonstrate his ability as surgeon.

 

For the future HT candidate, use this post to educate yourself...before you take the plunge for surgery. It has definitely been a learning experience for me.

 

I wish you the best Dr Meshkin. Thank you for reviewing my case...and taking the appropriate course of action.

 

Thanks to all the members and moderators for taking the time to read my post!

[KO]

Honestly I'm not sure why you are a good candidate for FUT. Your donor scalp is visible even at that length.