What would an ethical Dr do in this case?

[sonnya34]

I had a HT with a top surgeon often recommended on this site, he is known as one of the best, the work was on the hairline only on the only bare area( i was close to norwood3) of around 1500 grafts, I was happy with the result for 2 years (fyi I am on finasteride and have been for years).

After a couple of years only the transplanted hairs, almost all of them , fell suddenly, the regrew and keep falling, every few months going through the same until they stopped growing, this has been going on for close to 3 years, so I'm literally like pre surgery now.

Dr suggested blood tests and scalp biopsy which show that I am clean and healthy(no crazy stress or bad habits) and this is not due to a strange autoimmune hair loss condition, which makes it a during surgery issue.

Point is through my research and other Dr's have mentioned that during the surgery they could have made damage to the stem cell of the follicle or something of the sort which makes the hair unable to survive through time but often does during the first few years of the first cycle of growth.

My question is 1500 grafts have been wasted and the last years being a bitch regarding the instability of the now failed HT; so I have to go through pretty much the same exact surgery again covering the same area in the same way with another 1500 grafts or so, if I choose the same Dr to basically repair the whole thing and perform the same surgery, what would an ethical Dr do and offer?

80% discount? Free surgery?

[BurnieBurns]

The interesting point here is that they did grow fine for a while then, have and issue. Personally I don't see how it could be a surgical error if they did initially grow fine. Where from the donor was it extracted? are there any other hairs there miniaturising? 

[sonnya34]

No, great hair everywhere except the transplanted area

If transplanted hair that lasts a couple of years for no cause of the patients health or conditions is a successful one we have a different definition of successful surgery

Look into it

Back to the question, 80% discount, free surgery?

[StillAlive]

There is no 'official rulebook' here and your unique predicament makes it extremely hard to make a call on this. There certainly is no precedent that I'm aware of. I recommend discussing it with the surgeon to see what options they present you with. 

[ITA]

The surgeon has suggested a wise thing, blood tests and scalp biopsy if everything is fine and you do not have any autoimmune disease, if the tests you do do not show any problems, then you can agree with the surgeon what to do, as he says @BurnieBurnsI don't think it's the surgeon's fault that your hair has been fine for two years.

[BurnieBurns]

1 hour ago, sonnya34 said:

No, great hair everywhere except the transplanted area

If transplanted hair that lasts a couple of years for no cause of the patients health or conditions is a successful one we have a different definition of successful surgery

Look into it

Back to the question, 80% discount, free surgery?

I understand the situation fine. Having seen countless stories of unsuccessful surgeries, I've never heard of the grafts growing for two years then stopping. 

A much clearer cut situation would be if the grafts didn't grow at all, or shock loss of the surrounding native hair.

I imagine it must also be very frustrating and sorry you're experiencing this, but there's no official playbook. Unfortunately with no direct proof of surgical error, it is ultimately up to the surgeons. discretion. By all means you could suggest these solutions to them, but there's no guarantees they'd feel obligated. 

[sonnya34]

21 minutes ago, BurnieBurns said:

I understand the situation fine. Having seen countless stories of unsuccessful surgeries, I've never heard of the grafts growing for two years then stopping. 

A much clearer cut situation would be if the grafts didn't grow at all, or shock loss of the surrounding native hair.

I imagine it must also be very frustrating and sorry you're experiencing this, but there's no official playbook. Unfortunately with no direct proof of surgical error, it is ultimately up to the surgeons. discretion. By all means you could suggest these solutions to them, but there's no guarantees they'd feel obligated. 

Yeah the situation sucks and it is certainly very rare and is not one of those obvious right after the surgery clear cut cases

What is established is that the HT has been a total failure, the obscure theory of the damage during managing the follicles during surgery and it failing after the first growth cycle o first couple of years was discussed by Dr Couto(he is not the Dr or Clinic that performed my surgery) but the guy knows his stuff better than most

We'll see what we work with the Dr, he is known to be a good ethical Dr so we'll see what we work out, I'll be surprised if he doesn't offer a very fair deal after this disaster

[HappyMan2021]

Surgeon name???

[BaldReaper]

Thats very weird, I dont think there is an explanation for ht hair falling years after the procedure anywhere. I only remember an example of a person here who's hair thinned significantly 10 years after his ht .

[sonnya34]

It is rare and not often talked about but there are many cases buddy, I spent years researching it, and Dr Couto himself gave an explanation of one of the reasons why such situations happen 

[ITA]

I is the first time I hear about it, instead I hear a lot about autoimmune diseases and scalp pathologies (which the patient does not know he has, nor the surgeon notices during the procedure, because they are invisible to the naked eye), they are now always more frequent.

[asterix0]

Would you mind sharing some pictures?

[shiba1985]

Surgeons not gonna give u anything for free., there is no surgical error other than taking grafts out of safe donor zone that allows them to grow for two years and then go dormant. 

[Melvin- Admin]

Can your share pictures? 

[mrmane85]

It would help if you could share pics of pre-op, post-op and now.

Particularly post op would give us an understanding of the extraction

[mavigo]

Do you have before procedure photos, post-procedure photos and photos of when this condition began? 

 

[Gatsby]

This is why the relationship you have with the doctor you finally choose is imperative and a question you should always ask in consultations is what is your policy if things go pear shaped? But if we could see the pics we will be able to give much more accurate advice. All the best!

[sonnya34]

I appreciate it

Let’s see what we work with the Dr before I’d consider showing pics or naming the Clinic, if they offer a fair deal, it won’t be necessary

[ITA]

Seems like blackmail to me.  The surgeon was right to tell you to check up.

[sonnya34]

lol not at all, it's the way you interpret it, he's been very collaborative and ethical so far, just heard back from them and  looks like we'll work it out although is soon to say

[Bb111]

This is definitely an unique case. I am glad to hear your surgeon is working with you. I hope the best for you in your journey and if you do have a 2nd hair transplant that it is more successful.

 

I also think it would benefit everyone if you could share some pictures. I understand if you don't want to name the clinic yet but any pictures would be helpful to future HT patients. Maybe there are pictures you took yourself that don't have the clinic background. Anyway thanks for considering and good luck.

 

 

Edited November 23, 2022 by Bb111

[BaldReaper]

21 hours ago, sonnya34 said:

It is rare and not often talked about but there are many cases buddy, I spent years researching it, and Dr Couto himself gave an explanation of one of the reasons why such situations happen 

What was his explanation?

[sonnya34]

1 hour ago, BaldV said:

What was his explanation?

In a nutshell, it happens sometimes in cases where the ht grows initially but falls a few years later(not due to any condition of the patient) is that the graft is not removed intact during the extraction and part of the stem cells that are surrounding the bulb are lost.

This damages the graft obviously and while it might seem that the extracted units are good, they aren’t, they grow on the first growth cycle but don’t have the potential to survive long term and hence why they fall a couple of years or a few more after the surgery and don’t grow again

[BaldReaper]

39 minutes ago, sonnya34 said:

In a nutshell, it happens sometimes in cases where the ht grows initially but falls a few years later(not due to any condition of the patient) is that the graft is not removed intact during the extraction and part of the stem cells that are surrounding the bulb are lost.

This damages the graft obviously and while it might seem that the extracted units are good, they aren’t, they grow on the first growth cycle but don’t have the potential to survive long term and hence why they fall a couple of years or a few more after the surgery and don’t grow again

Sounds plausible 

[Henry]

Wow what a weird case. I'm a very anxious person and these kinds of stuff really make me go crazy when researching about hair transplants. It makes me question if i should even do it. Lol. I hope we can see some pictures. Anyway, hope you're mentally strong in dealing with your case.