2 1/2 years post operation, and i think something

[Rawkerboi]

Absolutely agree with Spanker!!!

the last doctor recommended was against the recommendation of the majority of the community., but then he was still recommended, WHY??

[FUE2014]

Blake, I feel like there should be a metric for approval honestly. Say, a board of doctors have a specific weight in percentage of approval and then members with over say, 200 posts, it something to that effect. Then it's a yes/no vote. Obviously, the last doctor recommended was against the recommendation of the majority of the community., but then he was still recommended, and the community was told that the majority WAS in favor of that physician being recommended, even though it was black and white that he was not. There is also at least one physician that is no longer at the standard of what a recommend physician, was called out (and fairly so) and he's still recommended. There is obviously work to do in recommendation process and I'm afraid we'll see more posts like these without done action being taken.

 

 

I agree with Spanker, especially in regard to Dr Quatela's recommendation, despite the disapproval of his results by the community here.

 

http://www.hairrestorationnetwork.com/eve/174416-8-months-post-op-7.html

 

http://www.hairrestorationnetwork.com/eve/170361-vito-c-quatela-md-2-988-graft-fut-59-year-old-patient.html

Edited March 1, 2015 by FUE2014

[KO]

I'm not too keen on putting a lot of weight in the community vote. There are too many problems with it, first of all small sample size, only a small number of people participate. Secondly, I don't feel their metrics are all that appropriate for judging AKA, Recommended does not imply he should be a superstar. Finally, I do not feel many are qualified to judge an HT doctor's work (I include myself in that group BTW). Hence, I believe there should be input, but it should not be the decider at all.

 

That said, I feel the last doctor recommended did pretty decent work and is at the level of this community IMO.

[KO]

We can perhaps fix the community review process by allowing only a certain number of knowledgeable posters, guys like Mickey85, Joe Tillman, etc to review a clinic.

[1966kph]

As I've said I think who ever has a input into the recommendation of a dr whether it be members or drs it should all be all done within the thread so all can see how the decision was made.

Transparency is I think fair and called for both for members and the dr who is up for recommendation.

I think a lot of us thought our input stood for nothing and was a waste of our time.

I think this is clearly evident here again with the responses.

Have a good day all

[JoeTillman]

I'm confused. Your post says you had 1350 grafts 2.5 years ago which would put your surgical date at roughly August, 2012. However, your first post to the forum, in December 2012, says you were nine months post-op and you had 1450 grafts. That would make your surgical date to be sometime in March, 2012 and with 100 more grafts than you stated in this thread.

 

http://www.hairrestorationnetwork.com/eve/168479-1450-grafts-9-months-later.html#post2327610

 

In addition, you have not talked about before photos or talked about your medical regimen to prevent further loss. I mention this because the photos you posted in your original post from December, 2012 show that you had more hair than you do in your most recent photos, particularly on the sides where I see significant retreat of your native hair. If you look under the red circles you outlined in your newest photos, there is significantly less hair below the red circles compared to the photos you posted in December, 2012. The temples inside the red circles have also expanded.

 

From this thread...

 

 

From the thread in December, 2012...

 

 

 

 

Playing devil's advocate, I don't see an absolute disaster here. I just see a low density transplant. The angles are, for the most part, acceptable (if not a bit to low) and all that is really needed is more hair (and the odd graft removal via FUE) but based on your before photos it was not enough work to begin with and it was doomed to failure from the start. Further, you had too few grafts into an area that is continuing to get larger which is the very definition of a surgical black hole. I would advise you to move forward very carefully and understand that several hundred more grafts will do little to remedy your situation. I don't know how many grafts this 3000.00 will get you but I'm pretty sure it won't be enough.

 

It is my opinion that to get a fuller appearance that is worthwhile you will need in excess of 3500 additional grafts minimum. Roughly 1000 grafts per temple, about 750 grafts per temple region below the red circles. The frontal hairline that has receded from your first post would need at least another 500 grafts so that would even take you up to 4000 grafts to get a frontal result with acceptable density. There are other options but to get the entire front up to par, and that will give a blend that naturally meshes with your existing native hair, you'll need a lot more hair moved than you've already had.

 

Again, tread VERY carefully with regards to additional work as you don't want to be stuck in a revolving door of surgeries, each designed to fix or add to the last.

[KO]

I don't see that the temple area has gotten larger. In his latest pics, for the right side he's sweeping hair away from the thin area, which he wasn't in the previous photo for the. For the left side, his hair is longer in the older photo, and he has flash on.

 

In either case though even if it is not a disaster, in terms of planning, I think you'll agree that the temples were placed too low.

[JoeTillman]

I know what you're talking about, KO, but I'm positive he's had more loss. It's logical for one and its obvious to me in the photos. When I have time I'll make a better comparison where I'll point it out specifically in the photos.

 

I think you'll agree that the temples were placed too low.

 

I already did:)

 

The angles are, for the most part, acceptable (if not a bit to low)

 

The thing about the temples is that we don't know how far "too low" is because each photo is overhead and not on the same plane as the hairline. Regardless, it definitely could be a lot better, there's not argument there, but I think that all issues should be addressed for a more clear and definitive picture of what's going on and what happened to begin with.

Edited March 2, 2015 by JoeTillman

[PupDaddy]

I'm confused. Your post says you had 1350 grafts 2.5 years ago which would put your surgical date at roughly August, 2012. However, your first post to the forum, in December 2012, says you were nine months post-op and you had 1450 grafts. That would make your surgical date to be sometime in March, 2012 and with 100 more grafts than you stated in this thread.

 

http://www.hairrestorationnetwork.com/eve/168479-1450-grafts-9-months-later.html#post2327610

 

In addition, you have not talked about before photos or talked about your medical regimen to prevent further loss. I mention this because the photos you posted in your original post from December, 2012 show that you had more hair than you do in your most recent photos, particularly on the sides where I see significant retreat of your native hair.

 

Good catch, Joe, and good questions. I think you're right that this appears to have been a low density transplant, and that in the 3 years since it was done the patient has lost more native hair. Without pre-op photos it is really difficult to judge, but based on his 2012 9-month post-op photos, the OP appears to have gotten about what would be expected for the number of grafts that were transplanted, which amounted to only 675/725 grafts per side. I question why such a low density transplant was done (although the wave/curl in his hair at the longer length he was wearing it at the time did aid cosmetically), and like you, I'd be interested to know whether the OP was advised to take Fin and has done so.

[KO]

Even if we accept that he continually lost native hair, which is possible, it doesn't mean that the original transplant was successful. The transplanted areas do not show density. Whether it is poor yield or poor hairline placement, it doesn't reflect good work IMO.

[Blake Bloxham]

1966,

 

I disagree with this statement:

 

The only people that didn't know that maral was not hands on were the ones who had not read the information thats been on this forum since 2013.

 

As several members pointed out, the doctor's ex-rep initially claimed he performed the procedure. After this was questioned, he changed position and said the procedures are completely run by technicians, but supervised by a physician. In the end, it came to light that there is frequently no physician on site.

 

I'm not sure if it was KO or Pup or someone else who really pushed and obtained this information, but I, unfortunately, don't have time to dig through everything and find it.

[Blake Bloxham]

KO,

 

I agree; the result is underwhelming and I don't want to sweep this under the rug. The patient may have been a good FUE candidate as well - it's a bit difficult to tell from the details we have here.

 

I also want to get to the bottom of it and help FBO out. If he sends me details about the doctor - or posts them publicly, we can figure out what happened and help him get it fixed.

[Sean]

If the notion is he may have lost more native hair then this transplant was poorly executed. People go for substantial defferences, not to be told the result didnt pull well due to loss of native hairs a year or two later,otherwise, what is tge point of a doc doing the restoration? To screw someone over financially or what?. The way this procedure was performed, to the number of grafts, to placement, it is safe to say it was not adequate and goals were not met. Otherwise, the patient would not be dissatisfied in a short amount of time. It is not like he came back 15 years later to question this?

[Blake Bloxham]

RE: Recommendation standards and Dr. Dua

 

Again, I'm sorry to hear some member take issue with our recommendation standards or some of our recently inducted physicians. It's honestly pretty difficult to walk that thin line between screening and recommending doctors we think are performing quality surgery, allowing member's to pick and endorse the doctors they think deserve recognition, and keeping the community up and running (IE "keeping the lights on").

 

What's more, there is a lot that goes into the recommendation process before it reaches the community. We get and send requests all the time. When we do make a connection, Bill spends a TON of time emailing back-and-forth and obtaining general information about the practice. He then asks for some results to review and sends the practice an extensive questionnaire. After he's comfortable with their practices and results, he discusses it with me and Dave (and Pat if he hasn't already). If this goes well, we start formalizing the process by contacting our other physicians and then sharing everything with the community.

 

We've had the process halt at each step in the process. What's more, we do weigh and consider each step. However, if you think about it, the community's opinion is one step in a very long process. Bill looks at it this way: if you have 5 different "checks and balances" involved in the recommendation process and 4 out of 5 go well, we should likely give the physician a chance. We've revoked recommendation after a clinic "blew their chance" in the past, and we wouldn't hesitate to do it again in the future. In the case of the most recent recommendation, he felt like everything was a "go," and the community feed back was mixed. Based on this, he felt comfortable giving the doctor a chance. He's developed an extremely keen sense for this process, and I tend to trust his judgment.

 

However, I realize this sometimes raises eyebrows or questions about the legitimacy of the recommendation process. All I can say is that the member's opinion counts. Sometimes one aspect of the recommendation process, including the community's opinion, is overshadowed by the majority opinion of the other pieces. This is never ideal, but it happens.

 

But if members feel like their voice isn't being heard, maybe we should make changes. I'm honestly open to suggestions. Please, message me with them! What's more, email me names of physicians you guys think should be re-reviewed. Bill, Dave, and I have done this in the past. Remember though, this can go either way. We've reviewed doctor's before and thought they still met our recommendation standards.

 

I hope this clears a few things up! I think you guys know we work hard to run a legit community here, and we are always open to suggestions for improvement.

[Spanker]

I'm not too keen on putting a lot of weight in the community vote. There are too many problems with it, first of all small sample size, only a small number of people participate. Secondly, I don't feel their metrics are all that appropriate for judging AKA, Recommended does not imply he should be a superstar. Finally, I do not feel many are qualified to judge an HT doctor's work (I include myself in that group BTW). Hence, I believe there should be input, but it should not be the decider at all.

 

That said, I feel the last doctor recommended did pretty decent work and is at the level of this community IMO.

 

Yeah, I remember you had a dissenting opinion against the majority of people who expressed their opinions on the case, so I can understand why you'd feel that way.

 

No system Is perfect, I understand, but I think using a metric voting system up or down could be beneficial, but I could be wrong.

[FBO]

Hi, you are correct its been almost 3 years. As for the Grafts, I was told by the doctor that i need 800-1000, but i insisted on 1200. At the start of the procedure, a staff member asked me if i was willing to pay $400 more, so that if there are more grafts then 1200 in the strip, they would just simply plug them in instead of throwing them away. So i figured why not, ill pay the 400 so they do not throw them away, this way i will get all of the grafts that are in the strip. That being said, i was told that i received couple hundred more grafts, when asked how many? 1350-1450 was the reply. So, my first post i wrote 1450, this time 1350 and honestly i do not know the exact amount that was put in.

Also, the pics from the first post my hair was long at that time. What i have to do is, bring the hair from the back area to cover up the section of the HT.I posted these pics when i cut my hair short, eighter way, long hair or short hair it looked bad from the start and it looks bad now, and the Dod's., reply was i can fix it for 3k. From the start it showed that one side is a lot worse then other side. My concern, and it was mentioned first is the results, the two different results. my right side always had more than my left side. Believe me, i am not looking to get a refund or anything for free. I posted to get all your guys opinions and i appreciate everyone of them. I do know that i need a lot more grafts, its just concerns me to get another surgery and get bad results again.

[FBO]

Yes procedure happened just as you described, to give credit to the Doctor, he did come in couple of times and asked if everything was okay?

My only concern, since day one has been that the right side looked no where near left side, and i firmly believe that is because of two sets of hands working on me. It also irritates me that an underpaid $11 an hour person was doing the work, when on youtube the doctor says in his videos that he is the one doing all the procedures.

[JoeTillman]

KO,

 

Even if we accept that he continually lost native hair, which is possible, it doesn't mean that the original transplant was successful. The transplanted areas do not show density.

 

Without proper before photos it doesn't mean that the result was unsuccessful either. See what I mean?

 

Sean,

If the notion is he may have lost more native hair then this transplant was poorly executed. People go for substantial defferences, not to be told the result didnt pull well due to loss of native hairs a year or two later,otherwise, what is tge point of a doc doing the restoration? To screw someone over financially or what?.

 

How does future hair loss dictate if a procedure was executed poorly or not? If this is true then the majority of hair transplants are poorly executed because everyone will lose more hair afterward. It's called male patterned hair loss and it's progressive nature dictates additional loss is imminent, to a lesser degree for some, to a greater degree for others.

 

I think you're missing the point of my position on this. Of course people go for substantial differences but the problem is that sometimes they do indeed have to be told that the result didn't pan out due to loss of native hairs a year or two later. Doctors can't prevent further loss, only patients can, because they are ones that make the decision to do something about it or not and surgical hair restoration only addresses what is lost, not what WILL be lost. It's like trying to fill an already full glass of water to prevent evaporation. It can't be done. This is why I was asking about preventive medications and if there are any before photos to see where he started.

[FBO]

The pictures from my initial post, which proves i has a concern about my right side being different than my left side. My hair was long at that time, and i'm sure if i let my hair grow for next few months and post pics, it will be the same as my pictures from the first post.

I understand that i need more grafts, and i understand that i may have lost native hair. But, lets not forget that i use my native hair when letting my hair grow to cover the HT site, and even then the right side looks horrible, and as it did 6-9 months post operation.

I will pay 4/5 thousand dollars to get it fixed, but i will not pay it to someone that has $11 an hour tech's doing the work, and when a patient has a concern the Doc., says "Oh, i can fix that for additional 3k)

I myself have a business, and i know how things work. Even now i do not mention the Doctors name, as i know he does good work, which is obvious from all his youtube videos, and i accept the fact that i got poor results, and i firmly believe that is because two different ppl worked on me. If my right side looked as good as my left side, three years ago, two years ago, and even today, then i would be more then happy.

Thank you all for your input, i really appreciate it!

[KO]

I'm surprised to learn this doctor would throw away precious donor grafts that were harvested if you did not pay the $400. Is this standard procedure?

[Spanker]

I'm surprised to learn this doctor would throw away precious donor grafts that were harvested if you did not pay the $400. Is this standard procedure?

 

No. What's standard is for the pt to know way ahead of time if there is not a fixed cost. The clinic should have NEVER said that they would throw grafts away.

 

I don't see a reason that he can't get more grafts and end up with a good result. It'll likely be more than $5k if he is getting with done in North America or western Europe. On a case this small and without the proper photos, there isn't a way to know if there was a yield issue.

[FBO]

I wish i had photos of before, but i don't. The pictures from my first post are the ones i have, right after the HT and till this day, my ONLY concern was the difference in the right temple and left. Believe me, it looks a lot worse in person, and it is noticeable. This is why i wear a cap all day, couple of my friends were going to get their HT done at this clinic, but decided not to after they saw my results. Not saying the Doc. or clinic are not trustworthy, or do not know what they are doing, but my experience was simply bad. Thanks again for all your opinions!

[wadenwa]

FBO?

How come you've never mentioned the name of this doc to this forum?

[Garageland]

I think this underlines the need for EVERY patient to take clear consistent and regular photos of their hair before surgery and during the first year and more to monitor growth and potential loss of native hair.

 

I think it makes sense to do this to monitor how stable you are before considering surgery. Being able to see in photos how much hair you have or have not lost over a period of a year is essential.

 

FBO- I wish you all the best with what you do next I would suggest some in person consults to work out the best approach.

[PupDaddy]

I will pay 4/5 thousand dollars to get it fixed, but i will not pay it to someone that has $11 an hour tech's doing the work, and when a patient has a concern the Doc., says "Oh, i can fix that for additional 3k)

 

i accept the fact that i got poor results, and i firmly believe that is because two different ppl worked on me. If my right side looked as good as my left side, three years ago, two years ago, and even today, then i would be more then happy!

 

FBO,

 

I'm still confused by what you mean when you say that two different people (presumably technicians) "worked on me" and that you don't want to pay repair costs to "someone that has $11 an hour tech's doing the work." Can you clarify what "work" the technicians did? I ask because it sounds like they performed the tasks that technicians typically perform for strip procedures: 1) dissect the strip into grafts, and 2) insert/place/seat the grafts into the recipient incisions that have been cut by the surgeon.

 

Often a clinic's technicians are divided into teams, each with their own specialty: one team dissects strips into grafts (using high powered microscopes), and another team inserts/places/seats grafts into the surgeon's pre-cut recipient incisions.

 

This is pretty much the standard protocol for all clinics that perform strip procedures, so you might have to live with what you've got if you're unwilling to pay a surgeon and clinic to repair you that follows this protocol. You MIGHT could get Dr. Konior to personally place/insert/seat some of the grafts for you in the frontmost areas of the temples/hairline (he is about the only ht doc of note that still does this to my knowledge), but I think you'll find that all hit docs have their techs place/seat/insert grafts in the surgeon-cut recipient sites.

 

If this puts you off, you might consider an FUE consultation with Dr. Vories. He uses implanter pens for the grafts, which are used to simultaneously cut the recipient hole and implant a graft in it. However, even with this procedure, the technicians handle all the extracted grafts because their task is to load the implanter pens with the grafts, one graft per pen on a rotating basis -- a delicate procedure itself due to the relatively fragile nature of FUE grafts. The techs will also be involved with "pulling" the grafts out of your donor area with surgical tweezers after the doctor has punched each of them with a punch.

 

Good luck!