My hair transplant with Dr. Pathomvanich in Thailand

[Dr. Damkerng Pathomvanich]

The patient was seen on December 22, 2008. He has 1 session at the clinic in Bangkok but unhappy with the result and wanted to add more density. I looked at the record,his bald area that need to be transplanted measured 48 cm2. Since he has 1st session at Yosakarn clinic (cosmetic clinic,not a full time hair).He also was informed about incorrect direction and angle that were transplanted previously.He said he had 1000 grafts from the first session and based on 48 cm2 of the balding area, to achieve adequate cosmetic improvement he will need (50%) 2400 grafts.So 2400-1000=1400 grafts.The strip is roughly 13x1 cm2 but not include the tail on both side that will be closed to 15 cm2. His grafts was break down as follows 601 single hair grafts,830 two hairs grafts,63 three hairs grafts with a total of 1494 grafts. We cannot use the old scar since the old scar is big. This is only close to 50% density to achieve cosmetic improvement ,for higher density he might need to add more depend on his expectations at the time of consultation. From my experience, celebrity always required higher density as in his case as a model. Another point is the grafts survival is 90 % on average that need to be put into consideration. Over crowded grafts on subsequent session will result in poor growth from vascular impairment.Too dense the hair line will look like hair piece and future hair loss need to be cosidered.

I need him to send me the pictures of the donor scar from my surgery on the right side to compare with the first session.

The 1000 grafts in addition base on the calculation is to give him 72% density.It is just the rough estimation.If he wants to add on 500 grafts he will get 61% density.If he add only 200 grafts will give him 55 % density and his eye can not detect the small change and will result in unhappiness.

 

nawoak,hair transplant is the art and science,we work on the living cell it's not the merchandize that you can count exactly.There are many factors involved he need to wait another 3- 4 months to complete one year to see the final result before he makes a decision since 9 months is still premature for complete evaluation of the final result.

 

I like to post his comment on 9/08/09 to me

 

From: (email removed)

Sent: Tue 9/08/09 5:01 AM

To: path_d@hotmail.com

 

Hello,

this is (name removed) the French from Tokyo. I had an operation with you on last Dec. I m happy with the result, but I still need a 3rd operation to adjust and fill up the front line and hide the back previous scare.

 

My guess would be around 500 FU.

 

I m thinking about going around mid Oct. if I have time and money then.

 

Are you busy on that time?

 

Also I have been promoting you on Internet in a French forum. It seems that a French guy from Singapore was supposed to visite you end of August. Did he come?

 

Regards,

(name removed)

[youngsuccess]

I understand where you're coming from. The appearance of the front of your hairline has improved greatly; however, the right side looks a bit artificial to me:

 

 

A little sparse and grafty in the corner temporal region, and the orientation of the hairs is too straight (or maybe just too sparse) near the temple point. Just needs to be softened a bit. Other than that, you look good.

[nawoak]

glad that the subject has been more opened freely on Internet thanks to Bill, even more than I expected, so we can have feedbacks from different sides then.

Putting this thread I didnt aim to criticize and turn badly Dr. Path s reputation but I was aiming to get opinion from people who share the same experience as mine and get advises. At least it seems working well, I get lots of attention...

I dont want keeping argue too much but just justify myself.

I guess most people get happy and excited with the result of a transplant operation on the first few months, especially when it s really important to people s life and feelings.

As for me I think the result of the operation is good but the density is still really too low and makes some areas very light.

I promoted Dr. Path on a French site. Indeed I had a bad experience with the first clinic where I went about 2 years ago. so I got really happy to get "the number 1 dr. of Thailand and maybe Asia" to finally get was I dreamed about...

This month I started to do my research for my next operation (that I was not expecting to undergo) and I have sent my fotos to different doctors. The answers stroke me. It varies from doctors to doctors. Some of them say that I d need around 700 grafts, some went up to 2000 grafts needed. Basically the number that came back the most would be around 1000 to 1500 grafts, which is nearly the same that I had last Dec...

I m doing modeling jobs in Tokyo and I need my face and my hair to work well. When I do job I still can hardly comb my hair straight up and I always have to put them a bit more down to hide the light areas. It gives lots of work to the make up artist then lol...

 

anyway I was pretty excited and happy with my new hair growing up but I figure out lately that it was not yet finished and I would have to go again for a 3rd operation for the same problem that I m trying to solve for nearly 2 years.

That s why I said I wasnt very happy.

I guess the main problem and the lesson we should consider out that story is that the communication is the key word. Since I have been surfing the Internet for few years, I have seen too many contradictions and it makes me not confident about the reality and keeps me on the defensive unfortunately.

Sorry Dr. Path, I didnt mean to darken your reputation but I was looking for people s opinion. I still think your work is considerably good and your technique is certainly one of the best.

Criticizing is also a good way to help people to continue to improve.

Bertrand

[Bill - Seemiller]

Dr. Pathomvanich,

 

Thanks for your detailed reply of this patient's case and reasons for your approach. I very strongly agree that future hair loss has to be considered, especially since this patient appears young.

 

Nawoak,

 

Thanks for allowing open discussion about your case.

 

I apologize if you've already stated this, but how old are you? Overall, I'd say you have good results though I understand why you'd want a little more density. I imagine the follicles from the first procedure pointing the wrong direction made the second procedure a bit more difficult as well.

 

All in all, I'm confident that Dr. Pathomvanich will stand right by you. Just be cautious to reserve plenty of donor hair for the possibility of needed subsequent procedures if you need more hair.

 

All the Best,

 

Bill

[kaounis]

I think you looked better before...Hope you never lose the whats behind the HT or you will look ridiculous...I think you have hair greed...Just being brutally honest..

 

Just a thought from the peanut gallery...

[nawoak]

at first I d like to apologize to Dr. Path for doubting him about the number of grafts implanted. Indeed he would have no interest to lie about it, so I was wrong.

secondly I d like to apologize to him for putting the thread on the forum before getting his complet answer about my case, that was not fair.

Folceros: I m 28 y old and here are some info that would answer future questions:

I m taking finasteride for about 2 years to prevent further loss and preserve my back hair area.

In my family, my father (62 y.o) and brother (29 y.o) have beautiful and full hair (I m the 1 not lucky, I guess...), only some of my oncles lost the front hair. Nobody got completely bold. My hair is pretty thick and density is good according to the doctors. I guess probably I will continue to lose more hair in the next years, but I wont get completely bold....

Kaounis: I put my fotos in another forum, and someone ask me the same question (that a feel a bit dumb though...)

Hair loss is a progressive problem which needs to be treated progressively. I dont need to wait to be more bold at the age of 30 or 35 to start an operation. If as you said "I lose the whats behind the HT", there are 2 options:

1)look ridiculous and shave the front

2)make another operation of 2000 or 3000 grafts depending on the need.

As for me, the front is the most visible and important part, I wont need as much density in the upper part.

 

I guess everybody would choose option 2)

and if the donor area gets too poor, there are still FUE and beard or body hair implant to supply donor grafts.

It makes sense to me, please let me know if I wrong, I ll consider.

By the way are you sure you prefer the foto before operation? I put them both to compare...

[nawoak]

septembre 2009

[kaounis]

Don't get me wrong, I'm neither insulting or am I judging your decisions, that's not my place or business...I think in your before pictures you had a mature and age appropriate hairline, being european myself, I like a widows peak! But that is my prefrence and obviously not yours, fair enough...By the way, body and beard hair is only a "last" resort and I beleive for extreme repair only....Beard hair on the head will look just like beard hair on the head!!!Nothing more...I don't think you want to consider going that route...It doesn't look pretty....Shaving the front might not be an option either my freind...There will always be scars...no matter how small....2000,3000,4000, holes in your head will show once you shave...My advice to you would be to stay on meds to slow down your hairloss, and be happy with what you have....Peace..

 

Just a thought from the peanut gallery...

[AutoPilot]

i think Kaounis's point is that at 28yrs, you're already planning for a 3rd HT, you could maybe slow down a little, have a good re-think about a long term strategy. Hair is just as important in your 30s and 40s.

[Bill - Seemiller]

Nawoak,

 

I still stand by what I said before. I think your hair looks great as is and doesn't require anything additional at this time.

 

Though the density of the hair transplant may not match your natural hair, this is typical. Honestly, trying to match your natural density at your young age would be irresponsible since your future hair loss is unknown.

 

Honestly, I'd say this is a pretty good looking result.

 

 

Best wishes,

 

Bill

[nawoak]

Also I think it looks good especially looking from the front, but on both side it s still pretty light. My goal for the next operation would be to fill up only the first 1 to 2cm front line with more density. Hopefully like way I wont need that many grafts, and can keep them for future HT

here are fotos of the sides:

[nawoak]

left side

[shanti]

Very similar to my problem after my HT with Dr Jones a while back.

 

Maybe it's the way you've styled your hair but your left side doesn't appear to have the grafts standing as vertical from the scalp as the right side. The angle of the grafts on the left provides more coverage as they are sweeping backwards.

 

Will the hairs on the right side not do this or is this just your hairstyle?

[Am0986]

I only wish I could complain about having hair like this........ I am calling this one hair greed.

 

sry I think it looks great.

[nawoak]

Shanti,

the way my hair styles cannot be changed. my hair naturally is thick and not so easy to style. I guess this is the way it goes.

I ll wait few more months, until april before to do anything new, and see how they grow.

thanks for your comment.

Shanti, did you correct and add more grafts on your temples?

[Bill - Seemiller]

Since Nawoak's tone about his procedure with Dr. Pathomvanich has changed significantly and he recognizes the complications of the first surgery with another doctor and boundaries Dr. Pathomvanich had to work around, I've removed the "NOT VERY HAPPY" from the title of this thread.

 

This removes the negative bias members will have as they read through the thread. Those who read through the thread can draw their own educated conclusions based on all the information found within.

 

Thanks for understanding.

 

Bill

[nawoak]

I agree with you. the title would not be appropriate anymore.