JUVIDA UK - My surgeon wouldn't put hair where existing hair was. Is this common?

[Tismo]

I went to Juvida as its where i felt most comfortable. They are very ethical and honest. Since i have posted photos on another forum a lot of people are questioning the procedure, asking why have i only had such a small area done. This is what i was told i could have done and what was best for the "long game" to get the best results. The surgery does not put donor hair where is already existing hair. Is this best practise? So i have had the front filled in and the back i will have PRP, thats what was suggested as the best way to go for me. Does anyone with any knowledge have any opinions on this? Im happy with the work but i do know the  middle and back does been seeing to as well, so im hoping PRP does its job. Also the surgery never spoke to me about how many grafts i was having as they dont work in that way.  Looking forward to hearing peoples responses, good or bad. 

[RTC]

I actually saw your post on reddit but didn't realise the middle part at the front was so thin.. not sure why they wouldn't bolster that at least

[mafpe]

can't tell how your donor or recipient is, too far, and the creams veils the donor condition.

your surgeon might be worried about cutting through existing native hair or that there would be shock loss?

i can't really understand the graft count issue though. if you ask they should be willing to answer. if not, then its somewhat of a flag. then again you might not have asked?

[NARMAK]

OP, are you currently taking any medication like Finasteride? 

Also, i appreciate you felt they are ethical and honest, but it doesn't look like they're very good at doing a proper evaluation of placing grafts within areas that could do with reinforcement. 

What's done is done. Just concentrate on healing right now and seeing how things shake out but if you aren't on medication like Finasteride, i am sorry to say but your results aren't going to meet expectations and your hair loss looks set to progress quite a bit further based on the top down scalp image. 

 

[Tismo]

22 minutes ago, Aslitarcan sucks said:

I actually saw your post on reddit but didn't realise the middle part at the front was so thin.. not sure why they wouldn't bolster that at least

Yeah this is something ive thought afterwards. You just think you're getting the best advice from the surgeon. 

[Tismo]

14 minutes ago, mafpe said:

can't tell how your donor or recipient is, too far, and the creams veils the donor condition.

your surgeon might be worried about cutting through existing native hair or that there would be shock loss?

i can't really understand the graft count issue though. if you ask they should be willing to answer. if not, then its somewhat of a flag. then again you might not have asked?

he was counting while he was doing it so im sure if i asked, and i will, im sure they would answer the graft amount. Yes they dont put hair where there is already existing hair due to risk if damaging native hair 

[Tismo]

5 minutes ago, NARMAK said:

OP, are you currently taking any medication like Finasteride? 

Also, i appreciate you felt they are ethical and honest, but it doesn't look like they're very good at doing a proper evaluation of placing grafts within areas that could do with reinforcement. 

What's done is done. Just concentrate on healing right now and seeing how things shake out but if you aren't on medication like Finasteride, i am sorry to say but your results aren't going to meet expectations and your hair loss looks set to progress quite a bit further based on the top down scalp image. 

 

i start fin/min in two weeks and with prp they said best results will come in 12 months. they wont put any grafts where there is native hair. 

[NARMAK]

37 minutes ago, Tismo said:

i start fin/min in two weeks and with prp they said best results will come in 12 months. they wont put any grafts where there is native hair. 

Yeah, i think the fact they won't put hair in the areas where there are native hair is a warning sign imo but like i said, what is done is done. 

Finasteride and Minoxidil are fine. You can honestly leave the PRP if it's for anything other than the hairline that got transplanted unless it's being given for free. It's a con.. 

Good luck with your healing and don't worry about things from here. It's going to be a long 12 month journey and about patience for both the hair transplant growth and the medication results. You will initially shed quite a lot on Finasteride and Minoxidil. That's completely normal. Ride it out till the 12 month mark. 

I would urge you to add in Microneedling once a week with a derma pen at 1mm to 1.5mm once a week. It has shown to boost results than just using Minoxodil alone and you get the skip Minoxodil application in that day

[RTC]

1 hour ago, mafpe said:

can't tell how your donor or recipient is, too far, and the creams veils the donor condition.

your surgeon might be worried about cutting through existing native hair or that there would be shock loss?

i can't really understand the graft count issue though. if you ask they should be willing to answer. if not, then its somewhat of a flag. then again you might not have asked?

yeah seconded regarding the shock loss - but then yes, patient should have been advise on ways to strengthen existing hair

[mafpe]

i was wondering why it's a warning sign as narmak said.

now that i think about it as narmak and ali said about existing hair...

it is possible that they are rather inexperienced, thus are scared of damaging the native hair... and then, if you have strong side hairline, when the front tuft recedes... it's going to be weird as heck... and unless the transplanted hair have the same or less density as native, having a thick temple and weak front tuff and scalp/crown is... pretty telling...

still, you've undergone the procedure, let's hope for the best, perhaps with meds, and dermarolling, it could turn out great!

[BaldDude]

yes as the transplanted hair will compete with old hair for blood supply, which may cause old hair to fall out.

[Ryan Daniel]

He didn't put hair where there is existing hair because the clinic doesn't have advanced microscopes 

[Tismo]

3 minutes ago, Ryan Daniel said:

He didn't put hair where there is existing hair because the clinic doesn't have advanced microscopes 

So you dont think its a fully functioning clinic compared to others?

[Ryan Daniel]

Just now, Tismo said:

So you dont think its a fully functioning clinic compared to others?

There is a very delicate limit to how close you can implant grafts next to native hair. It is very normal especially when increasing density on scalp and temple points

[Berba11]

2 hours ago, Tismo said:

So you dont think its a fully functioning clinic compared to others?

This isn't a well regarded clinic I'm afraid. Most UK HT clinic's are at best bang average, with only a couple being pretty good.

Putting transplanted hair too close to native hair is and can be a problem, but looking at your level of loss, I'd expect a good clinic to be able to cover more of the areas of baldness fairly easily. Also, PRP isn't going to do much; it certainly won't make hair that has already been lost magically reappear.

Lastly, you need to get a proper graft count from the surgery. To not be told how many grafts you've had extracted and implanted is poor form by the clinic. Hopefully it's just an oversight and they can give you those details easily and quickly. If not... big red flag. Please keep us updated!

Also, do you not have higher resolution photos that the clinic will have taken pre & post op? They would be a better indicator of the work.

[Tismo]

3 minutes ago, Berba11 said:

This isn't a well regarded clinic I'm afraid. Most UK HT clinic's are at best bang average, with only a couple being pretty good.

Putting transplanted hair too close to native hair is and can be a problem, but looking at your level of loss, I'd expect a good clinic to be able to cover more of the areas of baldness fairly easily. Also, PRP isn't going to do much; it certainly won't make hair that has already been lost magically reappear.

Lastly, you need to get a proper graft count from the surgery. To not be told how many grafts you've had extracted and implanted is poor form by the clinic. Hopefully it's just an oversight and they can give you those details easily and quickly. If not... big red flag. Please keep us updated!

Also, do you not have higher resolution photos that the clinic will have taken pre & post op? They would be a better indicator of the work.

And what determines that it's not a well regarded clinic? apart from info i have given you. The total graft count was 1263. I asked this afternoon and got a email back almost immediately. They probably have photos i can ask for, and will. 

[NARMAK]

13 minutes ago, Tismo said:

And what determines that it's not a well regarded clinic? apart from info i have given you. The total graft count was 1263. I asked this afternoon and got a email back almost immediately. They probably have photos i can ask for, and will. 

I think he meant in regards to having a lot of independent patient posted reviews and results online rather than just via Google, Yelp etc. which are usually and easily manipulated to say 5* etc. 

I personally think there's few clinics in the UK that are highly praised and have been consistent over time in their results but the main factor for me is also pricing. For what the UK clinics charge if they're not giving hair mill pricing and services, then the better options are usually a short flight away in Europe. Spain, Belgium etc. 

[Berba11]

2 hours ago, Tismo said:

And what determines that it's not a well regarded clinic? 

Ideally this is a question you'd be asking before the surgery and not after, but it's a few things;

1. Is there a body of independent results available to view and follow online from a particular clinic?

2. Do the results show that the clinic has a good grasp of naturalness in their restorative surgery?

2a. Has the patient taken the time to understand what constitutes 'naturalness' with regards to hair transplants (graft type, direction, angles, irregularities, whorl reconstruction for crowns etc) and has the clinic themselves discussed/educated their patients on this? Do they have publicly available educational content that showcase their knowledge in these areas?

2b. Do they have the tools necessary to best create naturalness, such as the use of microscopes, the ability to dissect multi-hair grafts into singles where necessary, to select the juiciest & best grafts from the donor area?

3. How good is their donor area management? What evidence is available (relates to point 1).

4. Do they demonstrate or have expertise in more challenging areas of hair transplant surgery such as repair work, use of beard or chest hair as a resource, temple point work, ability to perform both FUE/FUT, mega sessions, high Norwood speciality, have any published papers in the literature or have pioneered any tools or techniques?

5. Who is the lead surgeon, what are their credentials, how much of the work do they perform themselves, how many patients are they seeing per day etc...?

6. Aftercare & ethics (ie, what is a given clinics protocol when assisting a patient whose results aren't as expected)?

A combination of these factors is what separates the best regarded clinics from rest. I'd be genuinely keen to know how Juvida measure up against those points above in your experience? You'll know more about them than I do of course!

[Berba11]

2 hours ago, Tismo said:

And what determines that it's not a well regarded clinic? apart from info i have given you. The total graft count was 1263. I asked this afternoon and got a email back almost immediately. They probably have photos i can ask for, and will. 

Sorry forgot to address the graft bit of your reply! Great that they knew and responded quickly. That suggests their comms are good which should be reassuring! I know from recent experience that the post-operative phase can be daunting and full of worry and what ifs...!

The good news with lower graft counts like yours is that it should mean your donor area is healthy assuming the extraction pattern was sufficiently well spread out. The total number of grafts for your level of loss does seem on the low side to me, though the high res close ups post op will reveal a little more.

[HappyMan2021]

IMO a good surgeon will put grafts in and around the non-balding border zone if it is likely this area will begin to bald/miniaturize in the years after surgery. 

A good surgeon should be able to safely navigate around existing hairs. 

While shock loss can be a very real phenomenon, be very careful about blindly accepting this reason from a doctor. Shock loss has been co-adopted by quite a few bad doctors as an excuse for all types of poor work. 

In one of my previous HT's, my surgeon clung to the "shock loss" defense when really I was just given a shocking undercount of grafts. 

TLDR: Shock loss can be a real thing, but don't accept that from a surgeon unless the evidence actually backs that up. 

[John1991]

Is the donor area destroyed or bad?  No.  Is the hairline design (outside of the fact that the frontal tuft should've been filled in) appropriate?  Yes.  Is 1200+ grafts enough to achieve a very significant cosmetic change to this patient?  No.  

[TommyLucchese]

This clinic is getting some UK press today with X Factor's Matt Cardle promoting his results with them, first time I heard of them so did a search on here 

[Gatsby]

I've never heard of this clinic. I've also never heard of a good clinic stating that they will not tell you the number of grafts to be used because they don't work that way? 😟 It's sounds like heavy marketing I'm sorry to say. Especially claiming that PRP can fill in the mid section and rear section (crown?). I would make contact with the surgeon and ask for a break down of the number of grafts extracted and placed. All the best!

[Adier]

Your mid scalp can definitely thicken with minoxidil and finasteride and if you respond well you might even not need a transplant there in future. As for the surgeon not putting grafts in between the hairs i am not sure he might be planning in a long term way hoping medications can probably thicken them. But your crown needs a future transplant because i honestly don't think medications can do much there at this point. As others have advised try Microneedling as well. The depth of the needle can be anywhere between 0.5mm to 1.5 mm depending on your pain tolerance.

Edited June 20, 2022 by Adier

[DrMunibAhmad]

If that part is so much miniaturised, they should've put grafts also in that area. 

 

The approach they took is a very short term. They should've thought for the long run.

Can't make anything better then this tbh. 

 

It's good that they didn't use many grafts.