Thinking of a hair transplant? Avoid Dr Sharon Keene (Physician's Hair Institute of Tucson)

[throwawayht111]

I started balding at around 19 (23 now). As I’m sure a lot of you can sympathize, I panicked and started looking into ways to prevent it. At 20, I decided to consult a surgeon about a hair transplant and stumbled on Sharon Keene. Dr. Keene was local, and apparently one of the best surgeons in the area. After a couple months on finasteride, she assured me that I was done receding and would be an excellent candidate for a transplant. She had zero concerns about my age.

 

I underwent the FUT procedure (1800 grafts), as she heavily advocated for it. The first few weeks after the surgery I experienced heavy shock-loss around the areas Dr. Keene operated. Up until this point, I did not know this was a potential side-effect of a hair transplant. Dr. Keene failed to mention the potential for shock loss at any point during our meetings. The possibility was only briefly referenced in the waver I had signed days before the surgery. Dr. Keene did not seem concerned when I brought this up and stated that permanent shock-loss was impossible.

 

The placement of the grafts was also a concern. Prior to the surgery Dr. Keene outlined where grafts would be placed (primarily on the top of my head and parietal ridges, where I had receded). I’ve attached pictures of these outlines to this review. After the surgery, it was apparent that grafts were placed well beyond what I had agreed upon. About an extra inch of hair was added to my lower temples, making my hairline jut-out beyond its natural proportions. Dr. Keene assured me that it would look great, and I trusted her judgement.

 

After about a year I noticed the transplant was not filling in as promised. The shock loss had not grown back. Transplanted hairs were unnaturally thicker than the other hairs around it and filled in at a much lower density than what would look normal. On one side of my head, the grafts grew in different directions than my natural hair. The “extra” hair placed near my temples ended up looking completely unnatural and did not blend in well. You could very easily see where I was receding, and it now looked like someone essentially glued a bunch of scraggly hairs to my temples. I was assured that this was normal for a first procedure. I was desperate for her to fix this, and got a second transplant.

 

The second transplant (200 grafts) left an even larger linear scar due to my “scalp laxity" (again, something that I was not warned of before the procedure). It was now obvious that I had a scar on the back of my head. The new grafts were again poorly placed and looked terrible. More shock loss.

 

About 12 months ago I went back to Dr. Keene for a third transplant. I figured it couldn’t get worse, and I couldn’t afford to go anywhere else (the clinic offers large discounts to repeat customers). I was assured that the last two operations were works in progress, and that I just needed another procedure to fill in the gaps. 

 

This transplant was another failure. I went in to have 1300 grafts done and to have the scar reduced. Instead, the scar was made about twice the original size and is now clearly visible with any haircut under 2.5 inches. She operated more extensively on the right side of my head, causing a disproportionate amount of shock loss in that area. As a result, one side of my head has a disproportionately patchy appearance, leaving the transplanted hair completely exposed.

I recently confronted Dr. Keene about these concerns and my poor results. In her eyes, the scar was improved. Everything looked great. My expectations were too high. I explained that I was particularly concerned with the large gaps of scalp on the right side of my head.

 

In her notes on our meeting Dr. Keene wrote the following: "Patient states "no change"... in reference to bare scalp. Notably this area is no longer visible. Efforts to point out and show my [positive] opinion were ineffective. Patient asserting that his poor results were not a matter of opinion—it was fact... concerned for state of mind as cosmetic results do not mirror self criticism." 

 

Apparently Dr. Keene would rather presume that I've lost my mind than recognize her own poor work. Clearly, the scar had expanded considerably and the gaps of scalp on the right side of my head have not vanished. It's fairly obvious that the transplanted hairs look abnormal. I have visited multiple other HT professionals and posted my results in several forums. Not a single person has seen these results as anything short of poor.

 

Over the last three years I've spent over $10,000 on what is essentially a large scar on the back of my head. I have much less hair now than before the surgery, primarily due to shock loss. Grafts were placed poorly, and in areas not agreed upon. A couple months ago I formally requested a refund. This was flatly denied. Dr. Keene stated that she “complied with the standard of care”, and stood by her opinion that “permanent shock loss does not occur in hair transplant cases”.

 

This is contrary to statements made by numerous clinics and AHLA/ IAHRS certified resources (some links provided). Permanent shock loss is less common, but can occur due to follicle transection during the procedure. Permanent shock loss can also occur in areas genetically pre-dispositioned to hair loss. The Chicago Hair Institute states that “this is the reason that hair restoration is performed when patients are older and have experienced most of the balding and hair thinning that they are likely to have as a result of the aging process”.

 

In an online Q&A, Dr. Keene herself states “one thing that shock loss can do is accelerate a pattern that would have occurred anyway (without treatment), by putting the hair into its rest phase (telogen) in response to an inciting event (stress, surgery, etc)”.

 

Still, Dr. Keene had no concerns with operating on a 20-year-old before it could be known that hair-loss had stabilized. Instead, her analysis on whether or not my hair loss had stagnated consisted of a quick look at my dad’s hairline and guessing that we would have the same pattern. As explained to me by Dr. Keene, my ongoing treatment with finasteride and Minoxidil should have been enough to prevent this “accelerated” (permanent, HT-associated) hair-loss. Apparently this was not the case. None of my shock-loss has grown back at this point. Dr. Keene's explanation is a Catch 22: Permanent shock loss is impossible, but if its not, you were going to lose that hair anyways.

 

I’ve recently consulted with several other surgeons to determine whether the damage caused by these initial hair transplants can be repaired. It will cost me thousands of dollars and several surgeries involving scar excision, FUE placement, and MP tattooing to repair the scar alone. I plan on buzzing my hair once the scar is reduced.

 

IMGUR link to pics

 

Links regarding permanent shock-loss

http://www.regrowhair.com/hair-transplant-surgery/what-is-shock-loss-from-hair-transplant-surgery/

https://www.hairtransplantmentor.com/shock-loss/

http://www.hairtransplant.org/shock-loss-after-hair-replacement/

https://www.rahalhairtransplant.com/how-to-prevent-hair-transplant-shock-loss/

https://drtyngtansg.wordpress.com/2013/07/26/serious-shock-loss-after-hair-transplant-how-long/

http://www.spexhair.com/post-operative-course-what-to-do-what-to-expect-by-spencer-stevenson/

https://www.iahrs.org/q-a/female-hair-transplant-shock-loss

https://www.chicagohairinstitute.com/blog/2015/10/16/understanding-the-risk-of-shock-163737

Edited July 19, 2018 by throwawayht111

[Jacks0n]

You should be admired for posting this information considering the sad state of affairs you have been through. I hope you can get it sorted, age is on your side. On a side note to others, homework homework and some more homework. The bad practices exist because some people do not do their homework. Good luck in your quest.

[Bill - Seemiller]

@throwawayht111,

 I’m terribly sorry to hear of your disappointing hair transplant experiences, all three of them apparently. This is quite shocking to me in particular because Dr. Keene is one of our recommended hair transplant surgeons and a member of the Coalition of Indepemdent Hair Restoration Physicians.  

While  even the best hair transplant surgeons have cases of less than stellar results, the photos you have shown are highly concerning. 

 In order to help you and in order to keep this for unfair and safe for both patients and physicians, I ask that you send me a private message with your full name and all three dates of your procedures.   I will then contact Dr. Keene to let her know that you have publicly posted your concerns and photos and ask her to reply with her side of the story. Please be sure you give her permission to do so as this is required to keep our community fair and safe to all.

I will be looking for your private message But in the meantime, I will  be contacting Dr. Keene to give her heads up about this topic so she can at least offer an initial reply until you give her full permission. 

Best wishes,

Bill

[Melvin- Admin]

I’m sorry to hear that you have had a less than stellar experience. As Bill has already mentioned, we would like to gather some information from you, so that Dr. Keene can confirm you as a patient. Please feel free to send this information to me or Bill and we will relay this information to Dr. Keene, we will not disclose any of your personal information and anything you provide us is confidential and only used to verify you as a patient thank you. 

Warmest regards- Melvin

[Bill - Seemiller]

I have just received a response from Dr. Keene.  It seems as if there may be a lot more going on behind the scenes then we are being made aware of here. As a result, I am currently walking this topic until I can obtain more information and I can be sure that the patient gives Dr. Keene  all of the necessary permission to share her side of the story. 

I will keep you all posted. 

Bill

[Bill - Seemiller]

Dear members and guests, 

 Our fair forum policy enables Patients to share their genuine experiences and opinions on this forum. However, in cases where results are less than optimal, patients may be required to privately identify themselves to their clinic and give them the necessary permission to share their side of the story. 

 Moreover, patients are expected to attempt to work out genuine concerns with their physician in order to come to an amicable resolution. Likewise, surgeons recommended by this community are expected to work with and stand behind their patients  in order to give them the best service and results. 

After investigating this particular situation And speaking both to the patient and Dr. Keene,   It has come to my attention that there are some  legal issues going on behind the scenes that extend beyond the scope of this community and what we allow.   Moreover, because of those legal matters, Dr. Keene cannot share everything she wants to  what she would under normal circumstances where legal issues don’t exist. 

 In this case, I do not feel it is appropriate to continue allowing discussion when the doctor cannot share everything that she needs to in order to publicly defend yourself and share her side of the story. However, she did send me what she can post at this point and as a result, I am sharing it below.  

After a few days and when enough people have had a chance to view Dr. Keene’s response,  we will be archiving this topic out of public view.   In the event something changes and Dr. Keene  becomes able to share her side of the story completely, we will move the topic back into public view and reopen the discussion.  

 We understand that some people may feel this is unfair, but you have to realize that the only way this community can offer a fair platform is if both patients and physicians can share their full side of the story without any possible legal ramifications.   Frankly, once lawyers are involved, there’s really no  advantage to hosting a discussion about a case that can’t be fully discussed by both parties.  

That said, below is Dr. Keene’s response. 

———————

I am disappointed to read the narrative posted by a patient who I operated on in good faith, educating he and his father about the various medical and surgical options to treat hair loss, the donor harvesting methods including pros and cons of each (my notes indicated the patient went back and forth between the two before a final meeting to decide for FUT), and also advising them of the advantages of waiting to see if the FDA approved medical therapy would be effective at stabilization—especially because of this patients age.   I do not operate on every patient I meet, age is a consideration, and so is a patients intellectual capacity to understand the risks and benefits of surgery, as well as their goals.  I was impressed that both father and son were capable of understanding the information provided to them, asked relevant questions, and did not attempt to jump into surgery, but spent time to deliberate on what would be best option for this patients goals and self esteem.   I review the risks and benefits of hair restoration surgery with every patient, regardless of age—but do provide age related advice, based on my extensive experience and knowledge of the field of hair loss.  The caveats to proceeding with surgery are outlined in the notes that were not posted— accelerated hair loss, as well as progressive hair loss from AGA are among them.  I provided a service based on my impression of a father’s earnest request to help his son, and my desire to do the same—as well as a young patient who seemed intellectually capable of making an informed decision . During my last visit I did my best to address the patients concerns, and particularly the claim that his most recent grafts hadn’t grown—although at 6 months in my view they were already improving the appearance of density,  I knew and reminded the patient from his previous experience they had not matured to their ultimate benefit which should make them more apparent to him. The various options to improve the scar which widened early in the postop period from exercise, I attempted to review with him again-- as had been done preoperatively.  Because I personally want my patients to be satisfied with their results,  I provide SMP into surgery scars for a minimal charge and provide a scar revision at no charge.  Since the patient has unfortunately not returned for the usual scheduled follow up visits at 8 and 12 months postop, I was unable to provide a final assessment or do more to address his concerns.  I would share before and after photos from the first surgery which I believe document successful growth, and a  very natural,cosmetic appearance, as well as a flattering frame to his face-- However, because the patient attempted to demand quadruple the amount of money from me that he paid for all of the surgery, and did so 6 months before the final growth was expected—I am legally advised to limit further public discussion at this time.

———————

We will give members and anyone interested a few days to read both Dr. Keene’s and my response on this topic and then we will archive this topic out of public view. 

Onwards and Upwards,

Bill