Did I get over charged?

[HTX832]

I had a consultation with Dr Arocha for a hairline repair in the temporal region where he recommended 2000 grafts. I decided to have the procedure. Following the harvesting process he explained he only extracted 1500 grafts. When I got home and looked more closely (and counted) there was only about 700 actual grafts.

 

I was under the impression that a graft was counted as a single unit of 1, 2, 3, or 4 hairs. So if I paid for 1500 grafts there should be approximately 1500 units transplanted into my hairline, right?

 

Or do I have this wrong? Is it counted by the number of hairs? So 1500 hairs in groupings of 1, 2, 3, or 4 hairs would equate to roughly 700 units transplanted?

 

I'm confused. Please help.

Edited December 9, 2016 by HTX832

[HTX832]

Thanks for the reply Spex. I have since re-counted several times and I feel like it is quite clear where each unit was placed because there is a dark, red scab. My hair is also very coarse and black so each unit stands out quite well.

 

I am waiting on a call back from my Dr but I wanted to see what other people's experiences were.

Edited December 9, 2016 by HTX832

[HTX832]

I also want to make it clear that I'm not trying to get an accurate count. If it was close, like I counted 1200 and I paid for 1500 that would be one thing. But I'm counting roughly half of what I paid for and it seems quite obvious that there aren't anywhere close to 1500 units. That's why I was wondering if the number is based on units or the actual number of hairs.

Edited December 9, 2016 by HTX832

[gillenator]

This is certainly not the first time I have heard of this, not that I am implying you were taken or shorted.

 

You could certainly have another person take a rough count and yes for every graft placed, there should be an obvious scab or by now, a crust that has developed and easily seen by the naked eye. Using a scope that can be connected to a monitor will blow up the recipient area and make the counting that much more accurate.

 

And just to confirm, a graft is a FU that can be a single hair bearing, double, triple, etc. Sometimes multiple hair bearing FUs are dissected into singles when needed such as building a new hair line where only singles are appropriate.

 

So the true type of follicular unit grafting is supposed to involve grafting FUs in their natural occurring state as they grow in the donor area where they are harvested.

[Shampoo]

It is my understanding that when you are told 1500 follicle grafts were transplanted, that does not mean 1500 hairs, it means 1500 follicle grafts that contain various amounts of 1 hair, 2 hair, 3 hairs follicles. I have met Dr. Arocha and he seems like a very good surgeon that I am sure would be happy to discuss this with you. You need to feel right about this, so don't postpone getting an explanation from the doctor.

[ArochaHair]

HTX832,

 

We thank you for choosing Dr. Bernard Arocha for your hair restoration. I think that some clarification must be made regarding your case.

 

According to Dr. Arocha your donor hair had a significant percentage of single hair follicular units and this was discussed with you prior to the procedure. In fact, Dr. Arocha was hesitant to perform a procedure for you without your agreeing to adopting a regular and consistent medical regimen to keep your hair in the best possible shape. Dr. Arocha estimated that 2000 grafts would be sufficient for your needs but after the procedure commenced and the donor area was more visible with the scope it was determined that the harvesting should be reduced. Dr. Arocha determined that to attempt the full 2000 grafts would be unwise due to the visible miniaturization that some of your donor hair exhibited. Dr. Arocha actually harvested more than 1500 grafts (1591) but did not charge you for the additional grafts. During the examination and trimming of the grafts via microscopic dissection, none of the grafts were "sub-divided". They remained in their natural bundles, which happened to be mostly singles and then doubles.

 

The confusion may lie in the fact that many of your single hair grafts were placed into incisions with other grafts. This is done at most clinics as doing so helps to counteract the see through effect that too many singles will create. By "doubling up" Dr. Arocha used the same number of hairs in a way that will give you a thicker result than had he simply placed all single hair grafts next to each other. Dense packing is one thing but the density achieved with multi-hair grafts placed closely together is much more desireable compared to dense packing with single hair grafts. In this case, and many others, some of the singles were turned into multi-hair grafts to simulate this effect. This is why the incision count does not match the graft count. Also, about a third of the grafts were placed into your native hair so counting them, regardless of the scabs you can find, is normally quite difficult.

 

Dr. Arocha has built a solid reputation for being an outstanding hair restoration specialist but also for being an ethical and caring man. We understand your concerns but rest assured, they are misplaced. You are welcome to call or visit the clinic any time and Dr. Arocha will be more than happy to explain matters further.

[HTX832]

Thank you everyone for all the replies. I did speak with Dr. Arocha and he reiterated what was stated above. I admit, I panicked when the number of grafts weren't matching what I was seeing on my head. My apologies to Dr. Arocha for second guessing him! My doubts and fears were definitely misplaced.

[aWidowsPeek]

Hmmmmmm

[options]

Was there a process during the extraction which enabled you to know what was happening? In my operation every time a graft was taken a little click happened and a counter increased by 1. This has to take place because whoever is doing the extraction isn't obviously expected to mentally count.

[gillenator]

Was there a process during the extraction which enabled you to know what was happening? In my operation every time a graft was taken a little click happened and a counter increased by 1. This has to take place because whoever is doing the extraction isn't obviously expected to mentally count.

 

Definitely like that system of counting and then those aggregate numbers need to be documented in the patient's chart by graft size and number.

[ArochaHair]

Was there a process during the extraction which enabled you to know what was happening? In my operation every time a graft was taken a little click happened and a counter increased by 1. This has to take place because whoever is doing the extraction isn't obviously expected to mentally count.

 

1291 of the grafts taken during this procedure were scored by the ARTAS robotic FUE system. We have a flat screen display on the wall that documents each graft. Dr. Arocha then turned to his hand held FUE system to remove another 300 grafts of which all were documented in the patient's chart. Dr. Arocha was not only honest and transparent with the graft count as would be expected he also undercharged the patient as 91 grafts were given at no extra charge.

 

Dr. Arocha and the patient (as already mentioned) discussed the procedure and the details. Dr. Arocha strives to go above and beyond for his patients and will personally reach out to any of his patients that is thought to have additional questions.

[gillenator]

Encouraging to hear...