11 months. 2100. Underwhelmed.

[hairthere]

dr. gencheff, why was aaron originally told 1k grafts? was this a misunderstanding on his part?

[aaron1234]

Here is a link to the thread I started the day before I had surgery last year. It contains the graft conversation.

 

http://hair-restoration-info.c...471011583#6471011583

 

Dr. Gencheff and his staff were professional in the consultation and the surgery. Yes, I was confused about the initial 1,000 graft estimate. But I figured it was a misunderstanding of terminology. I reasoned at the time that a graft must not have been the same thing as a follicular unit. I thought that he could have meant 1,000 different slits with 2,000 different units placed in each one. That's how I rationalized it at the time. I'm much more educated on the terminology now than I was a year ago... because of this site.

 

But I do not accuse Dr. Gencheff of being intentionally deceiving and sinister. If he was, I would have been in that transplant chair two years prior when I was verging on a NW 6, age 26, before I started the meds.

 

I simply expected more density. His explanation does make sense when you consider my scar. Though a little pink still, it is very thin and I am pleased with that. My hairline placement is appropriate. I just expected more density and thought I could abandon concealers for my frontal third. That is not the case as the density is thin enough to reveal recipient marks when I'm under florescent lights.

 

In one phone conversation, he mentioned that men of my complexion tend to take a little while longer to heal and grow. He called us "pinkies". And I think he's right. I can get sunburned in less than 10 minutes. So I understand that the process can take a little longer for someone like me. And as some of you have mentioned that it could take up to 14-15 months for the hair completely mature, I am holding on to that.

 

Again, I have not been butchered or taken advantage of. I just expected more density and I'm disappointed that I will have to use another surgery to address the same region.

[thanatopsis_awry]

Ahhh, now I remember your case, Aaron...ya, before even seeing your grown out results in this thread, my reaction was the same as before, pre-op, for the same reasons; ultimately, that 2k would still be a very conservative approach and not approximate the type of density it seemed you were after.

 

This is no fault of yours, and I wouldn't exactly fault Dr. Gencheff, either -- you simply weren't on the same page.

 

I see this problem a lot, especially with younger guys. We do some research, realize and are "OK" -- we "won't get our 15yr old hair back". We tell the forum, tell the doctor, tell whomever that we don't have outrageous expectations and that we aren't after a lion's mane. The problem is that while this is true, "we" often don't truly understand how difficult it is to even regain a semblence of the density we think we are compromising over.....this attitude leads to a radical under-appreciation for how many grafts really need to get moved (over the backdrop of our hair charachteristics); and that the language we speak of when we talk about wanting "modest density" or whatever, as HT-newbs and people of the general population means something else to the vast majority of hair transplantation docs out there.

[aaron1234]

You've hit it on the head Thana. 1,000 grafts sure sounds like alot to someone who doesn't completely understand how a HT works.

[TheEmperor]

Originally posted by the B spot:

Yeah, I think it is tragic when people like Aaron do not fully understand what getting HT #1 signs you up for........more hair transplants.

 

There is nothing wrong with getting a HT---but there is something wrong when a clinic misrepresents coverage or fails to acknowledge the warning signs of patients who have unrealistic expectations.

 

I have guys get really upset at me for telling them they are not candidates. Then they go find a clinic willing to take the cash.

 

Hair transplants is a HUGE commitment both financially, time wise and emotionally.

 

This is why younger guys are generally not good candidates because it is just so difficult to understand the lifelong commitment in your 20's

 

Anyway, all good points--tough to deal with this situation other than to add density to the front and hold out for propecia to continue to work.

 

Take Care,

Jason

 

I am happy to hear your honesty in this regard. However, I think everyone does the visual math. They see what (say) 4500 grafts does on one patient and thye expect the same on themself.

 

The reality is that either hair density or growth rates account for a fairly staggering difference in results. For as many home runs that we see, there have to be at least as many patients who are dissatisfied.

[TheEmperor]

Originally posted by aaron1234:

Here is a link to the thread I started the day before I had surgery last year. It contains the graft conversation.

 

http://hair-restoration-info.c...471011583#6471011583

 

Dr. Gencheff and his staff were professional in the consultation and the surgery. Yes, I was confused about the initial 1,000 graft estimate. But I figured it was a misunderstanding of terminology. I reasoned at the time that a graft must not have been the same thing as a follicular unit. I thought that he could have meant 1,000 different slits with 2,000 different units placed in each one. That's how I rationalized it at the time. I'm much more educated on the terminology now than I was a year ago... because of this site.

 

But I do not accuse Dr. Gencheff of being intentionally deceiving and sinister. If he was, I would have been in that transplant chair two years prior when I was verging on a NW 6, age 26, before I started the meds.

 

I simply expected more density. His explanation does make sense when you consider my scar. Though a little pink still, it is very thin and I am pleased with that. My hairline placement is appropriate. I just expected more density and thought I could abandon concealers for my frontal third. That is not the case as the density is thin enough to reveal recipient marks when I'm under florescent lights.

 

In one phone conversation, he mentioned that men of my complexion tend to take a little while longer to heal and grow. He called us "pinkies". And I think he's right. I can get sunburned in less than 10 minutes. So I understand that the process can take a little longer for someone like me. And as some of you have mentioned that it could take up to 14-15 months for the hair completely mature, I am holding on to that.

 

Again, I have not been butchered or taken advantage of. I just expected more density and I'm disappointed that I will have to use another surgery to address the same region.

 

If its any consolation, the roughness and incisions fade over time. I remember seeing them around 10-11 months and now I do not.

 

The fine hair just camoflages them less well I believe. I also received increasing density (mild) through 18 months, but then there seems to have been some thinning.

[hairthere]

aaron, thanks for clarifying. at least we know what happened now and that it was more of a misunderstanding than a deceptive doc.

 

i do wonder, however, what other ht surgeons would have recommended and if clinics like H&W, who are known for their (mega) megasessions, could have helped your achieve your goals in one surgery.

 

that being said, at this point i would continue on with your doc. the work looks clean, it just needs a second pass. i'm sure he will do the right thing by you with the price, too. best of luck!

[SharpTooth]

Yea, before any of my 2 HTs, all the numbers/stats I read were greek,. I understood everything in theory. But after my first HT, things were put into a little better perspective. After my 2nd, I had an even better understanding of stats/numbers.

[JohnS]

Any updates?

[aaron1234]

Not really. Just hoping to get some final thickening over these next few months. I also have $500 saved for my next surgery!

[MikeTheDane]

Hi Aaron.

 

Sorry to hear about your situation. As others have explained, sometimes your hair characteristics do not allow for a full look the first time around. I know, its damn irritating having to spend more money, pain and time for another session, but c'est la vie.

 

The good side though, is that the comb forward looks great on you - sure the temples look a little thin, but theyre natural and i wouldn't look twice at you in a negative way.

 

So just get in the chair again, 500-1000 for the crown, 1000-1500 for the front and you're probably set for the next 5-10 years mate.

 

Also, what concealers are you using?

[aaron1234]

Thanks Mike. I like those numbers. My goal is for next summer. We'll see if I can make it happen.

[TheEmperor]

Originally posted by aaron1234:

I knew full well that I would likely need more transplants in the future. However, I didn't know that I would have to go over the same transplanted region all over again just to get any kind of density.

 

 

Again, I don't think I was butchered. I just expected more density than this. And I had fairly reasonable expectations.

 

Yes, I feel EXACTLY the same way. The clinic said my hair was between medium and fine (found out after I called them back after in-person consult), and when we talked about some other patient results who were what I considered bad, I said I didnt want to move forward if that was all I was going to get. I was reassured that my characteristics are better, and that my loss not as extreme. This from a top-5 clinic.

 

The game plan was to do the front, then eventually get around to doing the crown. Either the yield was not 100%, or the grafts were spaced so much that coverage was not attained. It turns out now, that the recommendation is to go back in the front with more grafts, which means shaving down and another (almost unbearable socially) healing period. Just lame. This also means I wont be able to finish my crown...

 

I got 4500 in hopes that they would be placed to achieve the "illusion of density", but they were spread out a bit too far.

 

In the docs defense, he placed them in a way that is a "standalone" fashion. I dont HAVE to go back for the crown, but due to my dislike of the hairline design and some other elements, I will probably be back in the chair soon enough. The narrow hairline ends up looking like a bit feminine widows peak.

 

If he had put more density in front and given me more than a "spike" hairline, then he wouldnt have been able to go back as far. Then I would probably require another session. I also got a bit lower graft count than anticipated.

 

I think their consultant was a bit over zealous and hopeful for me and the doctor just did his standard routine for what he had to work with on surgery day, which didnt match the plans I had discussed extensively with them.

[thanatopsis_awry]

Emp, you're prolly being too hard on yourself...

 

But ya, Aaron, just make sure you go to the right clinic this time who will give you the *right* number of grafts! All the best, keep every1 posted -- I'm confident you'll get to where you wanna be!

[TheEmperor]

Originally posted by thanatopsis_awry:

Emp, you're prolly being too hard on yourself...

 

 

I look better than I did before the surgery, but it did not match my expectations in a number of ways, and I am just expressing WHY I belive that to be the case. I was not butchered. I think there was a disconnect between an over-zealous consultant and the work the doc did, that comprehended the material he had to work with, but did not meet my expectations.

 

It may be that I got the best HT in the world, that he eeked out as many grafts as possible and stretched them in a masterful balance of coverage and density, such that I dont have to go back for another procedure.

 

That said, I had never planned to shave down TWICE, nor make a choice between bolstering the front OR coverage in the crown.

 

I see guys with 5-5.5K grafts who get total coverage with my loss patttern, and think that had I got just a bit more grafts, I would be happy and not feel compelled for a #2.

 

 

TO the OP, yeah, 2K grafts is a drop in the bucket. Your hair looks pretty good, I think you can get creative with styling until you graduate, then you will have plenty of cash.

[Speegs]

Brother, considering your advanced hair loss i think you got about all you could expect from 2100 grafts, your front looks much improved. Frankly load up 2500 to 3000 in the frontal third and let nature take its course with the rest.

[thanatopsis_awry]

Bleh, ya, hear ya....I thought you were a ~NW6+ for some reason, but re-checked....the "disconnect" you mention is the #1 problem with (non-butcher job) HTs in my opinion....and it bit Aaron in the ass, too....it's only post-HT that it often becomes clear how many grafts are really needed to meet "expectations" (i.e., imo, a decent look of solid coverage and density).

[aaron1234]

Yeah, Emp. I hear what you are saying. I think I look better too now than before I did surgery but it no where resembles what I expected. And I thought I had reasonable expectations at the time. Just hope that after the 2nd round I will be much more satisfied.

 

Thanks Speegs. I am still hoping for some kind of coverage in the crown. Nothing high in density, just some hairs there and not slick bald.

 

My goal is ultimately to get off the concealers in the front and use them solely for the crown.

[lost my swagger]

----"Yes, I feel EXACTLY the same way. The clinic said my hair was between medium and fine (found out after I called them back after in-person consult), and when we talked about some other patient results who were what I considered bad, I said I didnt want to move forward if that was all I was going to get. I was reassured that my characteristics are better, and that my loss not as extreme. This from a top-5 clinic."-----

 

=======================================================

 

the quote above says alot IMO, when we tell people to "do LOTS of research" its posts like this that i hope their research leads them to.

 

 

 

i really believe that 'The Emperor' and 'aaron1234's' story is one that that is common with hair transplants......not butchered but not happy..... not lied to but not fully informed.....not the worst thing but not what i expected...

 

i believe ALOT of guys go into this thing with a gameplan only to find out that its not gonna happen like they had planned, for one reason or another.. and these are guys who DID their homework...

 

aaron- chose a recommended doc

 

the emperor- says he went to a top 5 clinic

[TheEmperor]

Originally posted by lost my swagger:

----

i believe ALOT of guys go into this thing with a gameplan only to find out that its not gonna happen like they had planned, for one reason or another.. and these are guys who DID their homework...

 

 

I did my homework for ten years, visited my first HT doc in the late 90s.

 

My recomendation for anyone is to develop a good repoire with the doctor -- speak with the doctor -- take what the consultants way with a grain of salt. While they may be charismatic, maybe not working on comission, it is their goal to fill the appointment books.

 

When you are researching HTs, you will probably have MANY questions. The consultants exist to field these questions, because the doctors are busy in surgery. Their opinion of what is possible for you is just an opinion. And plans you work out with them, maynot get communicated to the doctor.

 

It became obvisou to me that despite all the "planning" that you do with a consultant, on surgery day, the doctor is faced with the actual reality of how many grafts he can get (which may also be influenced by how many staff call in sick that day. . .), the quality of your hair, and the extent of your loss.

 

Given these constraints, the doctor then "improvises" within his judgement and wisdom to give the best possible result.

 

In my case, I repeatedly communicated the need for a symmetrical hairline. Even on the morning of surgery, it was if the doctors hand could not draw one.

 

That is one of the things I do not like about the "hairline". Inspecting other patients of this doc, it is clear that this is a pattern he uses on almost all his patients. The center of the hairline is offset to the side, with one side rounder than the other. This may achieve several things 1) Ecomonmy of grafts 2) A sloppy hairline perhaps less detectable as man made 3) More styling options.

 

I see that he does this with most of his patients, so it was not an accident, but it contributes to what I see as a "harsh" or incorrect look to my forehead. And since I asked for symmetry, I am disappointed with it, even though it may support the physicians goal of stretching the grafts out.

 

Also, the scar, I measures is between 3-4mm throughout the length. This may not sound like much, and is within the advertized range of scar width, but requirs I keep the hair on the sides at 1.5 inches to cover it. I am sure it may shows under circumstances of wind. So the possibility of an even worse scar has caused me to be really cautious about a second surgery. If I get another 2500 grafts in #2, it wont make _that_ much of a differnce in looks, and if the scarstretches, it will be a HUGE step backwards. Thus my trepidation about moving forward with another surgery. A lot can go wrong -- maybe I should just live with what I have.

 

So based on a hairline shape I do not like, the fact that I will not be able to get the planned coverage, and the prospects of an already bad scar getting worse, my plans have changed a good bit.

 

With careful styling, I can make what I have look pretty good, and I look better than before the surger, but the reality is that there are quite a few things that did not turn out as I had planned. If the scar was pencil thin, I would have alrady had #2 and probably be raving about my new look right about now. As it is, I am happy that I am not bald, but realize I am not finished and recognize that taking any more steps could make things worse.

[MrJobi]

2100 is not going to give you that much coverage with your Norwood regardless of which doctor performs the surgery .

 

Few people get away with one procedure for a full restoration

[aaron1234]

You are totally right Jobi. I really wish I knew that before going in. But now I do.

[HairHope]

Aaron,

 

I think your hair is a tremendous improvement over your baseline. Almost everyone, except for the FEW here that are very low norwoods, need a second pass. Even the Megasessions you have seen online (e.g., Nic-Nitro) needed a pass...

 

Take some time off - enjoy the summer, and then go back in for another 2000+ you will come out just find.

 

Keep the faith bro.

[thanatopsis_awry]

Re: graft #'s --> "(which may also be influenced by how many staff call in sick that day. . .)"

 

Do you have legit reason to believe that your doctor would actually waste grafts due to a vagary in staffing, while pulling the wool over the patient's head? Not accusing this of not being true, but it's a pretty bold claim with scary implications.

[MrJobi]

One of the key points to keep in mind when getting a HT is "setting realistic expectations". It's easy to get caught up in all of the great pics on this site and to let your imagination go wild!! I must compliment Dr.True in educating me on the facts and directly telling me it would be a gradual process needing more than one surgery based on my goals.

 

I myself fell into this trap (even though I knew it would take time). I think this is also due to hair greed!! The graft calculator is a great way to get an estimate of what you will need to achieve your goal . it was very close in my case.

 

The good news is every sugery brings you 1 step closer ( assuming it is a qualified doctor). 3 surgeries later all of the blood , sweat, and tears are no longer relavant!!

 

I have a great head of hair and it was worth the wait!