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Nebulosity

How to undo a hair transplant ASAP

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What a shitty situation this doctor put you into. I really feel for you and hope you can get things worked out. I agree that going to a top doctor like Dr. Cooley is your best bet and tell him your wishes and concerns and let him advise you on what to do. Keep your head up. You are not the first person who jumped into a bad decision. I think that with the technology/techniques that top doctors are able to perform, you will look fine down the road because you still have good hair behind your transplanted area. Good luck!

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15 hours ago, Triple7 said:

What a shitty situation this doctor put you into. I really feel for you and hope you can get things worked out. I agree that going to a top doctor like Dr. Cooley is your best bet and tell him your wishes and concerns and let him advise you on what to do. Keep your head up. You are not the first person who jumped into a bad decision. I think that with the technology/techniques that top doctors are able to perform, you will look fine down the road because you still have good hair behind your transplanted area. Good luck!

Thank you and I agree, I still have donor supply and enough money to pay for all the work it will take to fix this. I am becoming less confident in the work the more I observe. I’ll post some details below.

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EDIT: Ok so I think this is just crusting. I didn’t know that it could be fleshy colored. I applied water pressure and the skin is smooth.

In my next post I’ll outline some quesions I asked the surgeon. Before we get to that, I want to ask you guys if this looks normal for 10 days after the procedure.

I see some raised bumps. It is really worrying me, because I do not want cobblestoning.

I asked a patient advisor and they said it’s normal and that it would be ok after the crust falls off. But I haven’t been well informed during or after the procedure by anyone, so here I am asking you guys. I can imagine everyone telling me “just wait, be patient” as the weeks go on so I want to ask now, is this normal? I haven’t seen this in any other images of peoples’ transplants.

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Edited by Nebulosity

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Here are some close up images of the transplant. I apologize that you need to see the crusts, as they are in the process of falling off.

Anyway, you'll notice that, along the hairline, the first row is almost exclusively 2's and 3's. In fact, I'm not sure there is a 1 in the first row in that image. The other two images show one square cm containing 29 grafts, and another that contains 22. I doubt a single square cm contains more than 35 grafts.

Although the hairs are thick, I think at this point I should prepare myself for having a large area of thin hair. Let me know if I'm wrong.

There are supposed to be 2469 implanted grafts, since 100 of the 2's were supposedly split for use as 1's, making a total of 258 1's implanted. I haven't gone through my images to do a count, but 2469 seems unrealistic. I mentioned this to the doctor, and he became defensive. I didn't accuse him of lying or cheating, but he insisted that they didn't lie or cheat. I was merely looking for an explanation for the apparent discrepancy, but received none. It's in the realm of possibility that there really are 2469 implanted grafts. I expected the doctor to keenly explain the graft positioning, density requirements, etc. Anyway, it would probably be good for me if fewer were extracted.

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Anyone who has spent a fair bit of time here will know the surgeon.  This is the type of 'work' he is renowned for.

It probably wont be a disaster but at the same time I'd put some money aside in a year's time as it may end up lacking a bit of density here or there and need some refinement.

Just set it aside for now. 

I don't believe it to be cobblestoning.  It's just dead skin that will eventually fall off.

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4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

My HT results thread from 1st procedure.

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58 singles says it all really. i doubt this doctor spent extra time splitting the multis up to make more singles. Doctor should be named and shamed. When the result grows out its going to looks ruff and abrubt. Good styling and hair product will help you!

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Nebulosity I am not sure if it is practical for you, but for a few weeks post-op I very gently applied Vitamin E oil to my scalp to help with the crusting and itching associated with crusting. I would apply it lightly in the evening around dinner at home and have to sit around the house with a towel around my neck and then sleep with a towel around my pillows. It reduced itching. Another trick I used to help with relatively intense itching was I would buy aloe tissues or cool touch tissues and gently wave the tissue over touching by waving the itch area. It would 100% relieve the itching but do zero damage to the grafts.

Amazon - Vitamin E Oil

Amazon - Cool Touch Kleenex

Edited by Shampoo

Dr. Dow Stough - 1000 Grafts - 1996

Dr. Jerry Wong - 4352 Grafts - August 2012

Dr. Jerry Wong - 2708 Grafts - May 2016

 

Remember a hair transplant turns back the clock,

but it doesn't stop the clock.

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4 hours ago, 1978matt said:

Anyone who has spent a fair bit of time here will know the surgeon.  This is the type of 'work' he is renowned for.

It probably wont be a disaster but at the same time I'd put some money aside in a year's time as it may end up lacking a bit of density here or there and need some refinement.

Just set it aside for now. 

I don't believe it to be cobblestoning.  It's just dead skin that will eventually fall off.

My current understanding is that I’ll need electrolysis, and a repair transplant of around 1000 grafts. I’m not just setting aside money just in case. I am planning to completely fix it.

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14 hours ago, HT0416 said:

58 singles says it all really. i doubt this doctor spent extra time splitting the multis up to make more singles. Doctor should be named and shamed. When the result grows out its going to looks ruff and abrubt. Good styling and hair product will help you!

Yea, it’s sort of amusing. During the procedure the doctor mentioned that he only got 58 singles, and he mentioned splitting some grafts to one of his technicians. Then he told me clearly that they would split some grafts to produce more skngle hair grafts. After the procedure was completed, I read the discharge notes, and there was no mention of any splitting. I approached the doctor and asked him how many single hair grafts were implanted, including the ones resulting from splitting, and he said “I think there were two hundred something.” When I asked by email later, he said that there were 200 single hair grafts produced by splitting double hair grafts, making a total of 258 single hair grafts implanted. I had to ask very directly and confrontationally, by the way, and every time I asked him questions by email he was defensive and seemed incredulous that I had not asked everything before. He said the single hair grafts went into the first few rows (without being specific about what proportion of the first row grafts should have been singles), and the rest were distributed randomly. Actually, during the procedure he said something similar, but I didn’t take note of his exact grammar. I understood him to mean that the first row would entirely consist of singles. Looking at images of my result, it looks like singles were just randomly distributed across my transplanted area, except that the first few rows of my temple points (but no other areas) were indeed singles. It doesn’t seem like there is any excuse for that. It just seems sloppy. Believe me, I want to name and shame. But I want more info, and I would like compensation, however unlikely that is.

Edited by Nebulosity

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Lots of doubles and triples along the hairline. Very sloppy work. 

Its also time to give your scalp a thorough and vigorous clean to get rid of those scabs. 

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7 hours ago, Nebulosity said:

Yea, it’s sort of amusing. During the procedure the doctor mentioned that he only got 58 singles, and he mentioned splitting some grafts to one of his technicians. Then he told me clearly that they would split some grafts to produce more skngle hair grafts. After the procedure was completed, I read the discharge notes, and there was no mention of any splitting. I approached the doctor and asked him how many single hair grafts were implanted, including the ones resulting from splitting, and he said “I think there were two hundred something.” When I asked by email later, he said that there were 200 single hair grafts produced by splitting double hair grafts, making a total of 258 single hair grafts implanted. I had to ask very directly and confrontationally, by the way, and every time I asked him questions by email he was defensive and seemed incredulous that I had not asked everything before. He said the single hair grafts went into the first few rows (without being specific about what proportion of the first row grafts should have been singles), and the rest were distributed randomly. Actually, during the procedure he said something similar, but I didn’t take note of his exact grammar. I understood him to mean that the first row would entirely consist of singles. Looking at images of my result, it looks like singles were just randomly distributed across my transplanted area, except that the first few rows of my temple points (but no other areas) were indeed singles. It doesn’t seem like there is any excuse for that. It just seems sloppy. Believe me, I want to name and shame. But I want more info, and I would like compensation, however unlikely that is.

I had similar frontal work on my first HT.  There were 1355 singles used and yet you had...258...WTF.

Probably best not to mention the doctor.  I would keep records of everything and start by logging your concerns with Bill on this forum and the "guy who runs the IAHRS"  (not sure if he is allowed to be mentioned). 

Both will say you need to wait 12 months, which is fair enough, but if it turns out as pluggy as we expect I think you would have good grounds for at least a partial refund.

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4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

My HT results thread from 1st procedure.

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Was this performed by one of our surgeons? If yes, please send me a private message. 


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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Update. Now I am getting worried about irregularities that may be caused in the skim due to this transplant. Please help by taking a look. The bloody pics are from the same day as the procedure. The clean pics are from right now - most of the scabs washed off with a few hours of pouring water over my head and gentle dabbing.

What I am most concerned about is that in the bloody pics the follicles seem to be protruding from the right temple. And in the clean pics you can see there are lumps where the grafts went. I am really worried by this. Someone who knows what they’re doing, please help. I don’t know what the ____ to do because I wouldn’t trust the surgeon to fess up to a botched procedure.

Please help.

 

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15 hours ago, 1978matt said:

I had similar frontal work on my first HT.  There were 1355 singles used and yet you had...258...WTF.

Probably best not to mention the doctor.  I would keep records of everything and start by logging your concerns with Bill on this forum and the "guy who runs the IAHRS"  (not sure if he is allowed to be mentioned). 

Both will say you need to wait 12 months, which is fair enough, but if it turns out as pluggy as we expect I think you would have good grounds for at least a partial refund.

Why not mention the Dr's name? This isn't a case of slander or anything untoward. Nebulosity has simply provided the community with pictures and information of his surgery. I don't see the problem with asking, "Dr x did this transplant. Here are the pictures and my experience. What are your opinions?". That is just what I did for mine. Indeed, this is the whole point of the forum. The community can decide for themselves the quality of the work and make their own decision in the future. It would also give the doctor the opportunity to walk us through your case and provide explanations for his actions. In fact, an ethical doctor will have no problem standing by his/her work in an open forum for all to see. Taking this approach should have no bearing on whether you get a refund or something else.  

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I think this hairline design looks just fine

the density is low and a bit pluggy but you have a decent first ground work, then having one more FUE in a year to increase density will give you excellent results in the end, and no one will notice the multi hair grafts with added density

 

Hard to get perfect dense and wide results in one pass, given the limits in blood supply

 

 

Edited by elduterino
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1 hour ago, elduterino said:

I think this hairline design looks just fine

the density is low and a bit pluggy but you have a decent first ground work, then having one more FUE in a year to increase density will give you excellent results in the end, and no one will notice the multi hair grafts with added density

 

Hard to get perfect dense and wide results in one pass, given the limits in blood supply

 

 

I am glad to hear that. I am still tempted to electrolysis some of it off to raise it slightly. In case I do that, I guess I won’t need to add as many additional grafts, due to there being a smaller area, and that maybe a lower volume makes sense for a slightly higher hairline. Before I do anything, I’ll consider the opinions of top surgeons and informed individuals such as yourself. I appreciate your perspective on the hairline, and I will consider it in my planning. It also makes me feel better about my situation.

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3 hours ago, Baldrick101 said:

 

Why not mention the Dr's name? This isn't a case of slander or anything untoward. Nebulosity has simply provided the community with pictures and information of his surgery. I don't see the problem with asking, "Dr x did this transplant. Here are the pictures and my experience. What are your opinions?". That is just what I did for mine. Indeed, this is the whole point of the forum. The community can decide for themselves the quality of the work and make their own decision in the future. It would also give the doctor the opportunity to walk us through your case and provide explanations for his actions. In fact, an ethical doctor will have no problem standing by his/her work in an open forum for all to see. Taking this approach should have no bearing on whether you get a refund or something else.  

Eventually I will do a full report including doctor identity, results after a few months, etc. I am worried that by sharing his name now, I will have fewer options for recourse, due to the sparse and less than forthcoming replies he has given to my emails.

I wouldn’t be here ranting if he had provided reasons behind the decisions he made during the procedure, specifically the density, the distribution of the grafts (density), the number of singles, etc. I’ll even accept blame for agreeing to a low hairline.

I don’t want to make this into a gossip session, so lets give the doctor a while longer to reply to my questions in more detail, before I post a full report on my experience.

Edited by Nebulosity
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Honestly,  

I don’t see anything alarming, it’s impossible to tell at this point. I suggest taking a deep breath and not thinking about it for 6 months then re-evaluate.


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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It does look like you have a large number of multiple hair grafts throughout the entire area, so it may not turn out very thin looking once it grows in.

 

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Thank you BeHappy.

Questions for anyone: As it grows in, is there any harm in keeping much of the recipient area shaved? How soon is it safe to shave it in this stage? I imagine that it’s better to leave it undisturbed for some more weeks, right? I’m at 2 weeks now.

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32 minutes ago, Nebulosity said:

Thank you BeHappy.

Questions for anyone: As it grows in, is there any harm in keeping much of the recipient area shaved? How soon is it safe to shave it in this stage? I imagine that it’s better to leave it undisturbed for some more weeks, right? I’m at 2 weeks now.

The grafts should all be falling out now anyway, so you may not need to shave it for a few months when they start growing in. However if some of them don't fall out, I'd say you can start shaving them after the 3 week point.

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What is the cause of the dramatic thinness of my donor area? Overharvesting? Shockloss?

3 days after procedure:

44E2CDAF-9D62-4BB5-AA64-BE47943CA90C.thumb.jpeg.fb8fdc741f1206251018c6c974b4f2ce.jpeg

 

6 days after procedure:

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Today, 15 days after procedure:

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BFA94061-32CF-4DAA-88B2-AF6E49CA0C25.thumb.jpeg.0389426693dd3f88bc26c425768f0a60.jpeg

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Unfortunately extractions were not spread out enough. 

For someone aged 40 and with mostly frontal loss, the doctor could have afforded to use a wider area.


4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

My HT results thread from 1st procedure.

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44 minutes ago, 1978matt said:

Unfortunately extractions were not spread out enough. 

For someone aged 40 and with mostly frontal loss, the doctor could have afforded to use a wider area.

That is what I think. It is like the doctor over estimated the donor density and over harvested from a narrow region. Also, the very middle is especially thin, which seems like exactly what not to do. If it was shock loss, it shouldn’t have been so apparent from the third day, right? I was hoping that when everything is settled after 6 months, I could buzz it to a number 2. It doesn’t appear that way at all now. It looks like overharvesting to my untrained eye.

Edited by Nebulosity

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Quite obsessing. That's what you are doing weather it seems rational or not to you. To us here who are not emotionally invested in it or looking at a strange look on our head this is what I see.  Your hairline, the transplanted area anyhow is about twice as deep as it should have been give your age, facial structure, feelings and Density. Had they make it half as deep and by default, twice as dense, you would have had a really nice transplant.  You are correct that the density is not natural and won't look good when fully grown in. If you want that hairline you will fully twice the density you have now. I will tell you something you may not want to hear. The implanted area on many many people doesn't heal as flawlessly as nothing even happened. Maybe you will get lucky and heel so flawlessly your forehead skin in the transplanted area looks virgin. But there is a very good chance it will be slightly different looking. Works fine even if there is think hair covering it. But it is surgery and not completely scarless often times. I don't see terrible work here from a functional point of view. You ultimately decided on your own hairline and that is more on you than the Dr. But he should have pushed you to go for a higher hairline. None of us were there so we will never know what actually transpired when that was decided. But what is done is done and you don't have a bad hairline now. You truly don't.  Just not an ideal one considering all the factors. Moving forward;

 

1) Let it grow for 7-8 months. You really have no option there for at least a few months as the skin heels. Maybe after a while you can shave it. But if you wear your hair pushed forward the surgery you got will look fine and even with thin density won't look like a comb over. If that's a look you can dig, you are all set and take a year to digest what to do next. 

2)Have hairline moved back. You would have to have a few .7mm punch tests done by a good doc to see if removing the hairs on your forehead is feasible. If after a few months there is ZERO scarring maybe you can have the first 1.5cm of hair removed and re-implanted farther back. I think this is unlikely. You would need perfect healing from this surgery to have a flawless forehead and then have no scaring with the graft removal.  Other options are just killing the follicles by laser, electric or plucking for ages.  

3)Have a 2nd transplant and fill in this new hairline to a respectable density. The most sure bet I think in having a good result. You don't need to fill right up to the front edge. With it low, a gentle transition from front edge to thicker would be appropriate and best. Maybe 1800 grafts would suffice. Then you would possibly still have enough in reserve to fill if you loose more hair. And that is the real risk here! Your new hairline is OK. Not unnatural, though you are not used to it yet. But it isn't unnatural. I just posted on someone here who had a HT with an already forward hairine and went way too low...looked awful and unnatural. You don't have that at all. You just need to get used to it and PRAY you don't loose a lot of hair over the next lifetime. 

 

At the end of the day what is is what is.. You decided on this hairline, you may very well have some minor scarring that might look odd if you try and remove all the new hair. You are not seeing your new hairline from a unemotional point of view. It really isn't bad, even if not 100% ideal.  Best bet is to leave it for a year. Then fill in starting back about 1cm  from the new hairline till it blends in with the old hairline on the top. Temple points look okay density wise. Yeah, it sucks....had the doc and you decided to do this less aggressive with that same number of grafts you would be in a great place as the workmanship is passable, but the artistry is not too good. 

 

As for the back. Yeah, he took too much from a small area with pretty specific boundaries. But again, wouldn't stress about it as I think when your hair get's to about 1/2 long back there it will be impossible to see. Overall it isn't anything to panic over. Some guys would love your hairline and be super excited..and looking forward to the 2nd fill in.  You know what you want. But as a outisider who has never see your face before. You are just a guy who got a little to aggressive hairline, but not awful. The more aggressive side of acceptable in fact. No human being would look at your hair and think the low hairline looked weird. But it will need more grafts to look natural. 

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