1800 Grafts - Dr Maras at HDC - Does this look wonky/natural?

[WonkyHair]

After reading many positive reviews I took the plunge and had a HT by Dr Maras at HDC back in early December. As you might have guessed based on the title of this post, I’m really unhappy with how it’s gone!   I’ve tried to write the below without too much bias and focus on the facts that are visible from the photos so you can draw your own conclusion!

It’s only been 4 months and we all know that you need to wait longer than that to see the end result, but what you can see right from the outset is the shape of the new hairline.

Before the HT I was a very stable NW3 and just looking to subtly bring it back towards a NW2:

Dr Maras came up with a hairline design, I asked for it to be slightly higher as I only wanted a subtle improvement. I was a simple case, only needing 1800 grafts, and I trusted him to design a natural looking hairline.  

After the design, I went through to the operating room and lay face down for the extractions. After a short break it was time for the incisions to be made. I sat back in the chair, slightly uncomfortable as it’s a bit weird when you can’t feel the back of your head against the chair due to the anesthetic. Dr Maras stood behind me to start the incisions, he said that the hairline that had been drawn had smudged where I had been lying face down. Standing behind me he redrew the outline, he didn’t check it from any other angles before starting the incisions.

When the HT was complete, we went through to the other room for pictures to be taken. I vividly remember Dr Maras commenting that the anesthetic can cause things to look uneven and saying, “don’t worry we haven’t given you a wonky hairline!”

Here’s some pics from immediately after:

When I look at the picture taken from the front it’s immediately apparent that the right side is higher than the left. You might be tricked into thinking that my head is leaning/turned to the left however this is because the hairline has been skewed off-axis.  Whilst the picture is taken ever so slightly from my right side, if you line up other features such as my eyebrows and ears you can see that they are reasonably level:

The left side is what I’m most unhappy with, here’s how it looked at 2 months:

 

This is at 3 months, note the difference in symmetry between the right and left, the left slopes downwards at an unnatural angle:

I’m no expert when it comes to hairline design, but Dr Ron Shapiro has some pretty good material on the subject like this paper - https://shapiromedical.com/wp-content/uploads/2019/08/article_hairline-design.pdf

One thing he talks about in that paper is frontal-temporal angles:

·        Key points – “Do not flatten or totally fill in the frontal temporal angle”

·        “Slight temporal recession or weakness of the FTA is normal in the white male hairline. Therefore, flattening or densely filling in this recession is a mistake and would make the hairline look artificial”

Comparing his example of a bad hairline design with the hairline Dr Maras has created for me!

Now I’ve got 6 months of waiting for this to grow before I can get other doctors to review and decide what can be done to fix it. In my opinion the slope on the left side is unnatural and the temples will need to be punched out to try and create a natural look (which will result in scarring). This is really depressing situation to find myself in!

 

[MachoVato]

I think it's way too early to talk about repair work. Everything looks fine to me and on track for a successful transplant. I think it's a mistake to judge your results by Shapiro's design thesis. Surely you agreed to the hairline before proceeding. Truth is Maras does good work. Reserve your judgement until 10 months, at least. 

[WonkyHair]

It’s now been more than 6 months since my transplant by Dr Maras at HDC, here’s an update on how things have progressed.

If you saw my last post and didn’t think it looked wonky hopefully this video (taken at the 2-month mark) better shows the issue:

I’m really unhappy with the slope of the hairline on the left-hand side and the way the temples have been rounded off. I think you only see rounded temples on very juvenile hairlines. In the Bisanga case, mentioned in the post above, the patient’s hairline has been brought right back to a Norwood 1. Mine is still a Norwood 2, but with rounded off temples. You just won’t find a natural hairline that does that. This is another good video where Eugenix talk about the importance of not doing this - https://youtu.be/Sf9xwD3h2PM?t=201.

By the four month mark my native hair had regrown. On the left side, where my hairloss wasn’t as bad, the transplant had only covered a few mm below my hairline, then chopped off the temple angle in a completely unnatural way, the red skin you can see in this pic:

On the right side I had a bit of wispy new growth at the 4-month mark:

At the 6-month mark on the left-side I’ve resorted to shaving the rounded off temple, the redness has mostly faded so I can make this look more natural:

On the right side the wispy hairs have grown and thickened up a bit. The density is about half what it needs to be to give that “illusion of density”:

All the hairs are now a couple of inches long and I haven’t seen any new growth in weeks. I’m still holding out in hope of another batch of hairs bursting through but not optimistic.  I reckon the density is less than 20 grafts per square cm.

There’s a couple of areas where I don’t appear to have any growth:

The grafts, particularly on the right side, haven’t been implanted flush with my scalp so I’ve got some ugly tenting/cobblestoning. It looks worse on the hairline, coupled with the lack of density it’s not a good look:

Going back to the rounded off temples, I’m having to shave these to avoid an unnatural look, the red lines on the pics below show the actual hairline, the hairs I’ve shaved down will need punching out ☹

One last issue to add to the list, the zig-zags Dr Maras does on the hairline are too defined and don’t look very natural:

So, to sum up my feeling on how things are looking at 6.5 months:

-        Wonky unnatural hairline, punch outs will be needed at temples

-        Really poor density, hoping for more growth but I can’t see any new hairs coming through, some completely bare patches

-        Cobblestoning/tenting – think the best option will be to add some more grafts to camouflage it, not sure what else can be done

-        Un-natural zigzags - grafts will need to be scattered around them to make them look less defined.

I’m still a few months away from being able to get any ethical clinic to look at this so for now all I can do is adopt this Hollywood hairstyle and try not to let it get me down 😊

 

 

 

 

 

 

 

 

[nicoandgello]

1 hour ago, WonkyHair said:

It’s now been more than 6 months since my transplant by Dr Maras at HDC, here’s an update on how things have progressed.

If you saw my last post and didn’t think it looked wonky hopefully this video (taken at the 2-month mark) better shows the issue:

I’m really unhappy with the slope of the hairline on the left-hand side and the way the temples have been rounded off. I think you only see rounded temples on very juvenile hairlines. In the Bisanga case, mentioned in the post above, the patient’s hairline has been brought right back to a Norwood 1. Mine is still a Norwood 2, but with rounded off temples. You just won’t find a natural hairline that does that. This is another good video where Eugenix talk about the importance of not doing this - https://youtu.be/Sf9xwD3h2PM?t=201.

By the four month mark my native hair had regrown. On the left side, where my hairloss wasn’t as bad, the transplant had only covered a few mm below my hairline, then chopped off the temple angle in a completely unnatural way, the red skin you can see in this pic:

On the right side I had a bit of wispy new growth at the 4-month mark:

At the 6-month mark on the left-side I’ve resorted to shaving the rounded off temple, the redness has mostly faded so I can make this look more natural:

On the right side the wispy hairs have grown and thickened up a bit. The density is about half what it needs to be to give that “illusion of density”:

All the hairs are now a couple of inches long and I haven’t seen any new growth in weeks. I’m still holding out in hope of another batch of hairs bursting through but not optimistic.  I reckon the density is less than 20 grafts per square cm.

There’s a couple of areas where I don’t appear to have any growth:

The grafts, particularly on the right side, haven’t been implanted flush with my scalp so I’ve got some ugly tenting/cobblestoning. It looks worse on the hairline, coupled with the lack of density it’s not a good look:

Going back to the rounded off temples, I’m having to shave these to avoid an unnatural look, the red lines on the pics below show the actual hairline, the hairs I’ve shaved down will need punching out ☹

One last issue to add to the list, the zig-zags Dr Maras does on the hairline are too defined and don’t look very natural:

So, to sum up my feeling on how things are looking at 6.5 months:

-        Wonky unnatural hairline, punch outs will be needed at temples

-        Really poor density, hoping for more growth but I can’t see any new hairs coming through, some completely bare patches

-        Cobblestoning/tenting – think the best option will be to add some more grafts to camouflage it, not sure what else can be done

-        Un-natural zigzags - grafts will need to be scattered around them to make them look less defined.

I’m still a few months away from being able to get any ethical clinic to look at this so for now all I can do is adopt this Hollywood hairstyle and try not to let it get me down 😊

 

 

 

 

 

 

 

 

I see your concerns and I agree with you, dr Maras shouldnt have designed a hairline like that, it looks unnatural, but weirdly we can see other good doctors also using similar shapes. Its actually very hard to find a doctor that gives a patient a 100% personified hairline design. Ive myself send pictures to a decent doctor that said that my actual hairline I was born with is unnatural looking and I couldnt ever have it because its feminine. I know your frustration because its also hard for me to find a surgeon that will do a hairline design that acutally suits my face.

I hope you will get what you look for with diffrent doctor.

[WonkyHair]

So it's now 8 months since I made the terrible decision to trust Dr. Maras at HDC with my HT 😢. I'm just praying there's an ethical doctor out there who can do something to repair this mess! I don't think there's much that can be done about the cobblestoning but I'm hoping that they can at least improve the density and make the hairline look something close to natural. 🙏

[Parasol]

Have you been in contact with HDC at all regarding your concerns? 

[Britanium]

2 minutes ago, Parasol said:

Have you been in contact with HDC at all regarding your concerns? 

Maybe @Doron Haraticould comment also. 

[ITA]

@WonkyHairCan I ask you if you don't pull your hair back (also because when you go around, you don't go with your hand on your head to pull your hair back) how does your hairline look?

[WonkyHair]

1 hour ago, Parasol said:

Have you been in contact with HDC at all regarding your concerns? 

I was in the first few months but have had no contact since about the 4 month mark. Before it even started to grow I was obviously concerned that the hairline looked wonky and had an unnatural shape. The responses I got were carefully worded to avoid mentioning the "wonkyness". I felt they were just trying to avoid saying anything that would admit any fault on their side.  To be honest I'm astounded at just how bad my result is:
-       Wonky unnatural hairline, punch outs will be needed at temples
-       Really poor density (as I'm only at 8 months this could still improve a little but it would have to double to even look passable)
-        Cobblestoning/tenting
-        Un-natural zigzags
There's just too many really basic mistakes, it's been a really shitty 8 months and I'd never trust HDC to get me out of the mess they've got me into!
 

[WonkyHair]

1 hour ago, Egy said:

@WonkyHairCan I ask you if you don't pull your hair back (also because when you go around, you don't go with your hand on your head to pull your hair back) how does your hairline look?

Hi @Egy, just took this pic of the same part of the hairline without me pulling my hair back:

[Britanium]

2 minutes ago, WonkyHair said:

I was in the first few months but have had no contact since about the 4 month mark. Before it even started to grow I was obviously concerned that the hairline looked wonky and had an unnatural shape. The responses I got were carefully worded to avoid mentioning the "wonkyness". I felt they were just trying to avoid saying anything that would admit any fault on their side.  To be honest I'm astounded at just how bad my result is:
-       Wonky unnatural hairline, punch outs will be needed at temples
-       Really poor density (as I'm only at 8 months this could still improve a little but it would have to double to even look passable)
-        Cobblestoning/tenting
-        Un-natural zigzags
There's just too many really basic mistakes, it's been a really shitty 8 months and I'd never trust HDC to get me out of the mess they've got me into!
 

Have you got someone in mind for your next procedure? Someone like Dr Bisanga could be a really good choice. 

[WonkyHair]

10 minutes ago, JohnAC71 said:

Have you got someone in mind for your next procedure? Someone like Dr Bisanga could be a really good choice. 

Hi @JohnAC71, I haven't really started investigating yet. Most ethical clinics wouldn't see me until the full result of my last procedure could be evaluated so I've had to bide my time.  Also travel has only just started to open up again so that could still limit my options.
This experience has left my very cautious so I'd want to have a face-to-face consultation with any potential Doctors before making any decisions. I'm in the UK so would be looking at places that aren't too far away (i.e. not the US). Dr Bisanga and another very well known Belgium doc would be on my list.   I think I might need to have 2 procedures, the first one to remove some of the grafts in the wonky section of the hairline, wait for that to heal, then go back for a 2nd transplant to make the hairline a natural shape, add some density and hopefully camouflage the cobblestoning.  

[ITA]

I advise you to wait a few more months to see if the situation improves, in the meantime I would hear the clinic (and here @Doron Haraticould intervene to let us know what the clinic would do for you), then you could actually start taking a look to other high-level surgeons such as Bisanga, Feriduni or De Freitas.  I sincerely wish you that the situation improves.  🤞

[Britanium]

4 minutes ago, WonkyHair said:

Hi @JohnAC71, I haven't really started investigating yet. Most ethical clinics wouldn't see me until the full result of my last procedure could be evaluated so I've had to bide my time.  Also travel has only just started to open up again so that could still limit my options.
This experience has left my very cautious so I'd want to have a face-to-face consultation with any potential Doctors before making any decisions. I'm in the UK so would be looking at places that aren't too far away (i.e. not the US). Dr Bisanga and another very well known Belgium doc would be on my list.   I think I might need to have 2 procedures, the first one to remove some of the grafts in the wonky section of the hairline, wait for that to heal, then go back for a 2nd transplant to make the hairline a natural shape, add some density and hopefully camouflage the cobblestoning.  

Certainly good to start thinking ahead about your options. Sounds like you have already got some excellent names in mind. You will get this improved upon later rather than sooner. 

[WonkyHair]

2 minutes ago, Egy said:

I advise you to wait a few more months to see if the situation improves, in the meantime I would hear the clinic (and here @Doron Haraticould intervene to let us know what the clinic would do for you), then you could actually start taking a look to other high-level surgeons such as Bisanga, Feriduni or De Freitas.  I sincerely wish you that the situation improves.  🤞

Thanks @Egy for the good advice and kind words 🙂. There's a part of me that wants to get something done to fix this mess ASAP but I know that I could end up making a bad situation worse! I plan to give it another month or two before I start contacting places, I know most of the top clinics have waiting lists a few months long so realistically it's probably going to be next year before I undergo a repair.

[Doron Harati]

Hi @WonkyHair, we're never been introduced, but as international coordinator of HDC I'll be happy to assist you, I myself had a repair by Dr.Maras and guided members of this forum with the clinic, you're more than welcome to pm or even better contact my WhatsApp +972526542654

 

[pkipling]

I'm glad to see that you're getting pointed in the right direction, and also that your concerns are being validated. I agree with your assessment that the work doesn't seem to be up to par with what we've come to expect from high quality surgeons, and I think you're well within reason to be unsatisfied. I'm glad you seem to have a positive outlook on all of this, as that's going to make navigating a repair way easier on yourself. It's not ideal, but the work isn't so bad that it couldn't be properly addressed by a different surgeon. High hopes! 

It also may be worth reaching out to the original clinic and discussing this with them. I'm not familiar with the surgeon, but even the best surgeons in the world can miss the mark - and there could be any number of factors at play, particularly when it comes to how the patient's body heals. Perhaps they'll acknowledge that the work isn't up to par and can provide some sort of explanation or compensation. It wouldn't hurt to ask. 

[WonkyHair]

11 hours ago, Doron Harati said:

Hi @WonkyHair, we're never been introduced, but as international coordinator of HDC I'll be happy to assist you, I myself had a repair by Dr.Maras and guided members of this forum with the clinic, you're more than welcome to pm or even better contact my WhatsApp +972526542654

 

Thanks Doran, I will PM you

[WonkyHair]

11 hours ago, pkipling said:

I'm glad to see that you're getting pointed in the right direction, and also that your concerns are being validated. I agree with your assessment that the work doesn't seem to be up to par with what we've come to expect from high quality surgeons, and I think you're well within reason to be unsatisfied. I'm glad you seem to have a positive outlook on all of this, as that's going to make navigating a repair way easier on yourself. It's not ideal, but the work isn't so bad that it couldn't be properly addressed by a different surgeon. High hopes! 

It also may be worth reaching out to the original clinic and discussing this with them. I'm not familiar with the surgeon, but even the best surgeons in the world can miss the mark - and there could be any number of factors at play, particularly when it comes to how the patient's body heals. Perhaps they'll acknowledge that the work isn't up to par and can provide some sort of explanation or compensation. It wouldn't hurt to ask. 

Thanks @pkipling, I've been doing my best to have a positive but realistic outlook when it comes to repair options. I have to admit that the last few months have been a horrible struggle for me!  I find myself hating my reflection every time I glance at a mirror and spending ages trying to hide this mess before going out.  It would be a big understatement to say that it really isn't good for my self-esteem!

I think every clinic has patients whose results don't match their expectations, but in my opinion, there's just too many mistakes here that are really basic. There always seems to be the odd patient that has poor growth but a wonky hairline and cobblestoning just shouldn't happen at a respectable clinic. I've been trying to focus on moving forward but will go back to HDC to see what they say about my case......

[George_HDC]

Hi, my name is George. I am the patient coordinator of wonkyhair, and I have been in touch with the patient regarding the issues mentioned above.

I expressed my sympathy for his concerns, and I explained that whatever happens, HDC always stands behind its results and we will do anything possible to make the result look better and hopefully make the patient satisfied.

Close up, magnified photos which could be over exposed to light, do not constitute the best way to evaluate a hair transplant result.

One of the photos we discussed on the 4-month stage was mainly concerning the angle on the temples as shown below:

 

We would like to invite and host wonkyhair at the Clinic to discuss his situation in person, in order to reach a mutually agreeable solution.

It seems that a good possibility is to remove the angles that wonkyhair does not like and add density in any areas if needed when the result is competed.

The idea of Dr Maras about this design was to achieve a similar result as the below one that would maintain the existing shape of the hairline.

 

Obviously, this shape proved not to be to wonkyhair’s liking.

Regarding the zIg zag and the angles, if viewed from a normal distance could look like the result below which we published before in this forum.

 

Conclusively, our aim is our patient’s satisfaction and we are willing to make what is necessary to achieve that. We also believe that HDC is the best option to alter the result in order to meet wonkyhair’s preferences.

I will make a personal contact with the patient I trust we will resolve the issue.

Edited August 13, 2021 by George_HDC

[Melvin- Admin]

I hope you can reach a resolution with Dr. Maras, I trust he can fix any issues. That said, I do feel it’s important to give it the full 12 months before making a final decision.

[ITA]

I am happy for @WonkyHairto read the write  of @George_HDC, I am sure that dr Maras will be able to solve this problem, this is what we would like all clinics to do for patients who are not satisfied with their transplants.

[Britanium]

Good to see some interaction happening with @George_HDChope this can be worked out. 🙏

[Gasthoerer]

My 50 cent:

- A HT which does not have the desired outcome is really devastating for any patient. Such a long time, researching, consulting, the surgery, the waiting and even more waiting...looking like shit for month...there is almost no one who does not get frustrated by this. It drove myself crazy last time. 

- I truly believe that the amount of below average results is much (!) higher than most clinics wants us to believe and also most patients wants (!) to believe themselves. 

- One rule always mentioned is, not to decide by distance...this is certainly true but it also requires double effort as I believe: NO ONE should have to decide for his hairline on the day of the surgery. Visit some of your target clinics, have them draw you a hairline, discuss your case, have pictures, look at them at home and THEN decide for the clinic and the surgery. Everyone is nervous on the day of surgery and no one should decide in a few minutes under the pressure of the surgeon and the team (who are eager to start) about his hairline. And there is this pressure, even if the clinic does not want to pressure you ... just by the team waiting this pressure is generated. 

- Having said this: I do not think that this hairline is "technically" wrong (of course more pics are required for a final judgement). I see quite a lot "conservative" hairlines with such round corners/temples. This is also not a contradiction to the "shapiro paper" as this describes another (more aggressive) type of hairline. Actually, I think the clinic followed the remaining, receded natural hairline and lowered it. Even if the design is not to the TO liking, I think it can be tweaked without punching out any grafts, by just rounding the middle section of the hairline (but again: more pics would be required for a final judgement). 

[WonkyHair]

Thanks to all those that have replied @Melvin- Moderator, @Egy, @JohnAC71, @Gasthoerer 🙂.

Agree that it would be wise to wait a few 12 months, I do continue to see some slight improvement but I think this is more down to the hair maturing and becoming less wirey. However I haven't see any new hairs for at least the last couple of months and there are some areas where there are big gaps. As per my pics above you can see that the density is really poor at the moment, particularly on the right hand side. Density is far from my only issue, the unnatural shape of the hairline and cobblestoning aren't going to go away in the next few months.

@Gasthoerer - you mentioned that  "I think the clinic followed the remaining, receded natural hairline and lowered it", I don't feel that's the case. if you look at my original hairline I had a real widows peak:
 

 

Following the initial shape would've been something like this:

However if you look at my pic post op (where a good chunk of my natural hair had been shaved close to the recipient area), you can just make out the lowest point of my existing hairline was about a cm below where the HT starts:

 

I do think I will need punch outs, particularly on my left temple, I've been shaving this area to try and make it look more natural:

 

In regards to @George_HDCcomments about the zig-zags, of my list of issues this is definitely the most minor one (and should be an easy fix scattering in a few grafts).  around them). When my hair isn't pulled back they're not as obvious.

 

I really have to question the logic behind this zig-zag method. I get that you don't want a dead straight hairline so micro-irregularities should be part of the design as depicted here:

 However 3 identically spaced and sized triangles of hair at the front of the hairline isn't a micro-irregularity. I'd describe it more as a symmetrical micro-regularity, a good HT should mimic nature, and I don't think you don't see that pattern in natural hairlines.