Is it common for morning of surgery, for the surgeon to give you a form stating that if they extract more grafts than quoted, I need to pay to have those implanted?

[HairRun]

This is something I always wondered about. For my first hair transplant, the morning of the procedure, the surgeon hands me a form. It says that if he extracts more grafts than quoted, I can have those implanted by paying the per graft fee. 

I didn't want any grafts to be thrown away, so I signed the form. It was a 1000 graft implant, but they ended up with 1400, so I had to pay 40% more than I had budgeted out for. 

Is this a common practice? I feel like if it is, it should be done while figuring out all the other financial stuff. I was in school at the time, and I had a really had time that semester dealing with the unexpected expense. With just the original procedure costs I was just barely getting through. 

Also, if I didn't sign the form, what would have happened to the extra grafts? Would they have been just thrown away?. 

 

 

Edited July 22, 2021 by HairRun

[Al - Moderator]

I suppose there are some real slimeball Drs who would throw away your grafts, but the idea of that form is so they know what you want to do in case they decide you need more grafts than they estimated.

 

For example. If during the consultation the Dr estimates that you need 2000 grafts. the form will basically say:

During the procedure if the Dr thinks you need more than 2000 grafts would you like to:

A. Stop at or as close to the 2000 graft mark as possible.

B. Do more grafts as the Dr thinks is necessary, but no more than a total of ____

C. Do as many grafts as the Dr feels is necessary.

 

This is so you don't get stuck paying for extra grafts that you didn't plan on and may not have the money for, but also allows you to do more if needed if you decide you do have the money to do it.

 

[Al - Moderator]

I will add that FUT is much harder to know how many grafts will be removed because with FUT they are removing an entire strip of hair and then dissecting the grafts, so you end up with however many grafts that strip contained. A good Dr who has been doing FUT transplants for a long time can get close to the number by knowing how wide and long a strip to cut, but it's impossible to know exactly how many there will be in a strip. With FUE they can basically count as they go, so it's much easier to stop at a certain number.

With FUT some Drs give a discount or not charge at all for the additional grafts that were harvested since you didn't agree to pay for them, but that varies by Dr/Clinic

 

Edited July 22, 2021 by BeHappy

[LaserCaps]

This is something every clinic deals with. And, if the doctor is ethical, he will consider these grafts as gold.  Remember, your donor is finite. All grafts will go in.  If the clinic is smart, they will say -at the end of the day- "the doctor gave you 400 extra grafts at no cost, That's $2800 of free work." That's an excellent way to develop intrinsic value and rapport with the patient.  Unfortunately, however, this is just something not readily being done.  

Others, and most commonly, will try to charge you for every graft.  If so, they better say something before the procedure starts.  Once you are under the local they can not talk to you about any of this.  (A case can be made - as you are not aware of anything at that point).

The opposite also happens.  If the doctor is short, they will go back to harvest more grafts.

We are all waiting for that hair-o-meter to be developed to give us a better idea of graft numbers.  Money does affect all of us and, unfortunately, it affects some more than others. In the end, it is the patient who ends up paying for the greed.  

At the time of the initial consultation, ask.  If there are more grafts at the end of the day, what happens?  What if you're short? Discussing this before hand is a good way to diffuse the whole subject.

[Melvin- Admin]

My surgeon gave me a form that essentially said he could try and go above the number quoted, if I agreed to pay for the additional grafts. I think that’s perfectly normal. I don’t see anything ethically wrong with that. Just like there’s nothing wrong with requesting a refund if you don’t get the number of promised grafts. Goes both ways.

[HairRun]

17 minutes ago, Melvin- Moderator said:

My surgeon gave me a form that essentially said he could try and go above the number quoted, if I agreed to pay for the additional grafts. I think that’s perfectly normal. I don’t see anything ethically wrong with that. Just like there’s nothing wrong with requesting a refund if you don’t get the number of promised grafts. Goes both ways.

This, and the other variations of this type of agreement posted above,  make sense to me; to get the results that were agreed upon in the consultation. I don't think it was quite the case for me, as he overshot by 40% and the extra grafts were used to create a hairline that was lower than what was agreed upon. Consulting with the surgeons on the list confirms that the placement is not ideal. I don't have a copy of the additional graft agreement, it wasn't disclosed to me until morning of the procedure, and I didn't get a copy. 

I has considering another place for my next transplant (not on list) and they disclosed a clause which is pretty similar to what I remember. It was better than it being disclosed morning of the procedure, but after paying a non-refundable deposit. 

" In the LSE harvesting of the donor strip, extra follicular grafts may be obtained from the donor strip. I agree that any grafts beyond what I have already paid for will be implanted into my scalp for an additional fee"