7 months on from a terrible transplant - Dr Rajan Bhojwani, RefineSurgical, Nottingham UK

[HappyMan2021]

I honestly hope OP sues, this goes to trial, the doctor is barred from future HTs, OP is is expensed the total cost of all repairs, and emotional compensation to boot. I am of course rooting for OP. 

But just objectively and impartially, I would be curious to see the language of any claims/release papers OP signed

Horrible, negligible, uncaring, irresponsible doctors and their clinics are usually still wise enough to have a lawyer on retainer and reduce their liability. 

I doubt OP is the first botched case from the clinic nor the first person to potentially pursue a legal route with them.

I am a botched repair patient myself, know plenty of other botched patients (a few who went the legal route) and all failed. 

I do think a lawyer MIGHT still be a good tactic to put added pressure on the clinic to give you a refund and then some. 

But from a textbook, in the weeds legal POV, even the worst doctors out there are smart enough to have legal defense in place before surgery. 

Edited March 11 by HappyMan2021

[Berba11]

10 minutes ago, Mike888888 said:

Hi all,

Thank you for taking the time to reply, I appreciate all input.

I agree with everything said - I don't think anyone thinks this work is good, but I could have avoided this with a little research. Just a few hours reading these forums makes clear that 678 grafts is not enough. If I knew that, this would never have happened. It was naïve of me to go in blind, I just thought it would be an "easy" procedure. Foolish.  

I am hoping that the surgeon refunds me in full. I can't see how he could be proud of this work.

As for further compensation, I am not holding out much hope. As one comment mentioned, I have signed some paperwork saying words to the effect of "results not guaranteed". I suppose the only argument would be that the graft count was so low to begin with, that there was very little chance of success in the first place.

On a scale of zero to 2500 grafts, who decides what point is acceptable and what is not? How do you define what is dense enough? If he had put 2500 in, the work would still be poor, but there would be density. But what if he had only put 250 grafts in? Or just 50 each side? Technically the transplant would be a success - is that still covered by the consent form "results not guaranteed"? What he has done to me is definitely unfair, and nobody will be rushing to get a hair transplant with him, but as for it being illegal... who knows?

For now I am waiting on the surgery to reply to my refund request.

After that, I will be looking for a repair once I am at 12 months.

Only then will I think about compensation.

Thanks again for all comments

M

 

 

I think what I would be doing if I were you is getting some consultations from 4 or 5 top surgeons and get a written assessment of the work as they see it to you via email. Having an assessment from multiple experts in writing would be a useful tool, even if it's only to help enforce a refund. If you decided to take matters further (such as them refusing a refund), then you'll want expert testimony in your favour going forward.

Quote

On a scale of zero to 2500 grafts, who decides what point is acceptable and what is not?

Deducing how many grafts are needed for an area is a straightforward combination of maths and "best practice". Hairline work will most typically start to look naturally dense at around 45 grafts per cm2, so if you were trying to make a legal argument, your position would be: total area to be covered in cm2 x [approx] 45 grafts = total amount of hair needed for the intended area. Your HT was doomed to fail from the start at only 600 grafts in total, not to mention the butchery of the work itself in terms of being nothing close to "best practice" (angles, directions, graft selection, and so on).

Be wary that if you manage to secure a refund, you might struggle to escalate further for compensation as legally you might be considered to have beeb "made good" by the clinic and the matter settled. I'm not a legal expert, so just thinking out loud on that.

[Bundles123]

This is incredibly poor work mate but like others have said it’s more than fixable tho. When I checked this guy out it kept coming up with eye surgeon??

[Buffaloboy]

2 hours ago, HappyMan2021 said:

I doubt you have an actual/true/legitimate legal claim that would hold up in a court of law. If you signed any sort of patient documents/claims prior to surgery, it pretty much kills your case. I'm certain it would have mentioned something along the lines of "this is a voluntary cosmetic surgery, results not guaranteed, etc."

I can tell you've never been to law school.

You can not perform a terrible medical procedure and then hide behind a clause in a pre-surgery document. It doesn't work that way. Nor are you only entitled to compensation if you are permanently disabled or disfigured. 

The mental anguish alone would find favor in many courts. As would the requirement to wear head covering to hide the the terrible angles that are going the wrong way. 

The reason that many surgeons get away with this is:

1) It's much more difficult to bring suit against a foreign doctor. 

2) Most people do not have the funds in order to pursue this long term. The clinic likely has an attorney on retainer to delay, motion, delay, motion, etc. This eats away at a plaintiffs funds and many simply drop the case as they run out of money. However, a plaintiff with deep pockets can pin a surgeon to the wall if they can wait until it eventually hits a court room. 

[Legend007]

That doctor is an idiot, you have thick hair, in ur mid n forelock n stuff., he actually tried to match what you already had with 650+ grafts. I don’t need a doctor degree to know the math is off by a few thousand. 

[Legend007]

And no he ain’t winning any lawsuits because someone was bad at their job. Unless he got brain damaged or something or severely injured, not being happy about a hair transplant is the same as not being happy with a construction worker promising not tiling your bathhub to your liking, with big gaps in the tiles or the and color was off, wasnt what he promised prior to treatment.. 

so what, thats a matter of opinion in the court of law. Work was provided and staff and equipment and time were used. Doctor wanted a good result,  but beauty is  subjective and could look good to him

Edited March 11 by Legend007

[HappyMan2021]

1 hour ago, Buffaloboy said:

Most people do not have the funds in order to pursue this long term.

 

so you're saying a lawyer wouldn't take this on contingency? I wonder why not....

[Buffaloboy]

20 minutes ago, HappyMan2021 said:

 

so you're saying a lawyer wouldn't take this on contingency? I wonder why not....

Real life is not the movies. Most attorneys don't work on contingency. PI is really the only branch where you see it at more than 30% of the occurrence, and that is typically 300k+ cases.

In addition to this, the winning would be too small. Let's say he wins $25,000. That's a refund for services, plus 8x punitive/emotional damage. The attorney would take home less than 3k after taxes and fees. 

Of course, this is common sense for anyone who has worked in law.

[HappyMan2021]

50 minutes ago, Buffaloboy said:

PI is really the only branch where you see it at more than 30% of the occurrence, and that is typically 300k+ cases.

i'm honestly just curious since you are a lawyer - would this not be considered personal injury? I'm not sure what other lawyer this would go to. Isn't medical malpractice considered personal injury?

 

52 minutes ago, Buffaloboy said:

In addition to this, the winning would be too small. Let's say he wins $25,000. That's a refund for services, plus 8x punitive/emotional damage. The attorney would take home less than 3k after taxes and fees. 

 

can you explain this more? I don't know much about the law so just curious. So OP is expected to take home 225,000 euros for his 2500 euro surgery?

3k contingency fee/225000 euros = 1.3% contingency fee. 

It is common for contingency fees to be this low?

thanks. 

[Melvin- Admin]

On 3/10/2024 at 2:41 PM, Mike888888 said:

My story (long):

7 months ago I had a transplant with Dr Rajan Bhojwani at Refine Surgical in Nottinghamshire, UK.

I decided that I wanted to fill in my hairline, so I Googled "hair transplant near me" and this clinic popped up. They had 5 star reviews on Google and Trustpilot, they had a "Good" CQC rating, they had photos on their Facebook page of Dr Bhojwani standing with Dr Basinga, Dr Farjo and Dr. Shahmalak and others at the 2023 BAHRS conference.

I paid for a consultation with the doctor. He said all the right things - about how he would avoid the "pluggy" look, place singles in the hairline, angle the hairs to create a natural look, manage the donor area for future requirements etc.. All the things I expected to hear. He even showed me some poor results from Turkish clinics to warn me what a bad transplant could look like. He explained about the shedding phase, the hair life cycle, recommended finasteride and minoxidil. Basically, he said all the right things and seemed very genuine. Based on this original consultation, I booked in for the operation with no worries at all, thinking I had got a great doctor.

I paid a fixed price for the day i.e. unlimited grafts for £2,500. He told me that 500 grafts would be enough to cover the area, but ended up putting in c.678. I didn't know at the time how inadequate this would be.

The operation was a lot longer than I expected. I had a "funny turn" in the morning after laying face down for approximately 3 hours for the extractions (the doctor suspected a reaction to the anaesthetic), so I took over an hour for lunch to recover. The implantation stage took approx 7 hours, from around 1.30 to 8.30. The anaesthetic kept wearing off towards the end so it was quite painful at times. The extractions were done by Dr Bhojwani, as were the incisions. Implantation was by the doctor and a technician. After surgery, my wife picked me up and drove me home where I fell straight asleep.

 

The next morning when I woke up I felt physically fine, but when I looked in the mirror there was heavy scabbing over the grafts and a big gap to my existing hairline that had literally nothing in it. The hairline was not neat, nor defined (I wouldn't even call it a hairline), nor did the rest of the work look dense. I emailed the surgery with my concerns and they told me:

"some grafts would have been feathered in and many grafts aren't always visible as blood does not represent where all the surgery have taken place".

I took him at his word. I didn't know any different.

On day 10, after taking the scabs off, I could see a clearer picture. There were gaps. Lots of gaps. I made a post on Reddit (link removed) and it was brutal. I was hoping for reassurance but got quite the opposite. Every single comment was shocked with the work. One comment asked if I'd had it done in an alleyway. Another asked if I'd done it myself at home. My favourite (worst?) comment was "My brudda in christ please and name and shame the spawn of satan who did this to you". After the first 10 or so comments I couldn't bring myself to read or reply to any more, I just deleted the account. I was really down and just didn't want to hear it.

I emailed the doctor the next day with my concerns. He told me:

"Please don't worry in this early period - if there is a gap it will be covered as it grows as the hair is styled, and as with all our patients - we want you to have the best results, so if you need any adjustments in the future to fill in areas that are deficient we will do this for you without charge."

 

This improved my mood. I decided to bury my head in the sand and wait it out - maybe it would turn out ok? Maybe this doctor knew something that I (and the Reddit community) didn't? Perhaps it would look ok when it grew in? Either way, there was nothing I could do about it now, other than wait for it to grow and see what it looked like. I convinced myself that even if it was not very dense, or the hairline was lacking, then at least a free top would correct it.

I saw the doctor again at 5 months. I had a little bit of growth coming through, but not much. He again said that it would grow through and that 5 months was still very early.

He said that as I still had redness in the scalp, this indicated that more hair was still to grow through. Again, I took him at his word, buried my head in the sand again and convinced myself it would thicken up. And if not, a free top up would sort me out, right?

I am now at 7 months and the pictures speak for themselves. I cannot bury my head any longer. The density (or rather, lack of) is no longer my biggest concern. I am more concerned about the non-existent hairline, the excessive use of multi grafts, and the poor angulation, all of which have only become apparent to me as it has started growing.

This is not a good result. Far from it. This is an awful result. Everything is wrong.

• There were simply nowhere near enough grafts put in for the area covered, so the density is non existent
• There is still a gap all around the edge to my old hairline. It is basically 2 triangles of hair stuck on my forehead
• I cannot see a new hairline - there are hardly any grafts, and the grafts that are in the hairline that have now grown in are mostly thick hair and multi grafts. (No hair was taken from the sides of my head)
• The transplanted areas are still red - I think I may have permanent damage

It is, quite simply, a disaster. The only good thing I can take from this is that he only took ~650 grafts. Everything else is just terrible.

I have now started to reach out to repair clinics.

Unsurprisingly, they all unanimously agree that this work is terrible (one surgeon told me that in 14 years he thought he had seen it all, but this changed his mind). I have to wait a few more months until anyone will take me on as a patient, so at this time I am just booking in for consultations. I have done my research and am hoping to be taken on by one of the following doctors:

Dr Reddy / Dr Mittal / Dr Bisanga / Dr Moussa / Dr Bicer / Dr Turan / Dr Bek / Dr Aygin

I have written to Dr Bhojwani to request my money back for his original surgery. I am awaiting his reply which is due within the next five days.

I am also considering taking legal action, but I am not sure how successful that would be, or if it is even worth the effort. I guess technically I have hair where I didn't before, so one could argue it was successful. It is undoubtedly a poor job, but there is some hair there, so it could technically be classed as a success (if you ignore the fact it grows in the wrong direction, is full of multi grafts and is more scalp than hair!).

I am hoping that a reputable surgeon can just fill in the gaps, but I have been advised by some of the clinics that I have contacted that to repair this will require at least 2 surgery sessions; one to punch out the grafts he has placed, and a second to basically start again. If this is the case with all doctors, then I will be considering trying to reclaim this cost through Dr Bohjwani. I am unsure how realistic this would be.

I am scheduled to meet him again at month 10, but I don't see the point. I suspect he will argue that final results take 12 months. I have not had a reply to my complaint and refund request as yet, but I really don't see any way in which he could claim this to be a good result. Nobody that I have spoken to so far sees anything other than a mess. I am hoping he does the right thing and offers a full refund.

One thing is for certain - there is no way I will be letting him perform another surgery on me.

So, in conclusion, to those who have read this far, my advice to you:

There is no substitute for real verified reviews.

Do not rely on Google / Trustpilot / Facebook.

Ask to see examples of previous work.

Don't make the mistakes I have made, or you will end up worse off a year down the line.

I will update again when I have a repair surgeon booked.

Im sorry to hear about your situation. It’s indeed poor work. I think at this point, the only thing you should be focusing on is getting it repaired. Have you consulted with any surgeons?

In terms of legal action. Think about the time and money this will incur, talk to @Al - formerly BeHappy he gave some excellent insight on what attorneys would ask in cross examination which can be very damaging for a patient. 

[Maorizio]

This is the worst hair transplant in history, but at least no donor damage and it can be fixed with no problems.

[HappyMan2021]

19 minutes ago, Maorizio said:

This is the worst hair transplant in history

it's really not. 

Some hairmills may basically use up an entire patient's donor all in one surgery, get no growth, and leave a bunch of scars and other permanent scalp disfigurements. 

In situations like this, repair is not even an option, and the patient is condemned to wearing a hat or wig for life or some other drastic measure. 

OP has a long road ahead of him, but it is not the worst hair transplant ever solely due to the fact that this is repairable. 

 

Edited March 11 by HappyMan2021

[Buffaloboy]

1 hour ago, HappyMan2021 said:

can you explain this more? I don't know much about the law so just curious. So OP is expected to take home 225,000 euros for his 2500 euro surgery?

3k contingency fee/225000 euros = 1.3% contingency fee. 

It is common for contingency fees to be this low?

thanks. 

30(ish)% is common.

$25,000 * 30% = $7,500.

Then there is all the filing fees, court fees, documents, paralegal pay, etc, etc, etc. These add up really, really, really fast. Plus 40% tax.

The attorney would be lucky to walk away with 3k. Whch, if they spent even 1 month on your case, would be under $20 per hour pay. Which is why even most PI attorneys wont take a contingency case that is expected to be less than a 300k judgement.

Edited to say: I’m talking about firms. Maybe some local private attorney with a single shingle may take a contingency with lesser amount but no reputable firm would.

Edited March 11 by Buffaloboy

[Gatsby]

Elective cosmetic surgery is sadly, where the surgeon has stated that he 'did his best,' is very hard to prosecute. Think of how many bad results have been challenged legally over the years and how many have actually been successful. It's incredibly costly financially for the patient even just to send a letter of demand. However I would be going full guns on a full refund. I've personally been involved in two law suits as the plaintiff and they are very taxing not just financially but more so psychologically and emotionally. Trust me when I say that a lawyer's first duty is to be paid first. Unless you have been through it their are just so many variables. As a butchered patient as a teenager myself I wish this was not the case.

[HappyMan2021]

Very telling in this thread how the actual botched patients are saying the legal route is near impossible, whereas people who have never been in this situation make it seem like a 6 figure payday is all but guaranteed 🤣

Edited March 12 by HappyMan2021

[asterix0]

9 hours ago, Buffaloboy said:

I can tell you've never been to law school.

You can not perform a terrible medical procedure and then hide behind a clause in a pre-surgery document. It doesn't work that way. Nor are you only entitled to compensation if you are permanently disabled or disfigured. 

The mental anguish alone would find favor in many courts. As would the requirement to wear head covering to hide the the terrible angles that are going the wrong way. 

The reason that many surgeons get away with this is:

1) It's much more difficult to bring suit against a foreign doctor. 

2) Most people do not have the funds in order to pursue this long term. The clinic likely has an attorney on retainer to delay, motion, delay, motion, etc. This eats away at a plaintiffs funds and many simply drop the case as they run out of money. However, a plaintiff with deep pockets can pin a surgeon to the wall if they can wait until it eventually hits a court room. 

Yes sadly this should be in the risk calculus for patients before they decide to take the plunge. Everybody thinks they can beat the odds. Truly there is nothing that can be done because even if everyone on these forums stood on their roofs and warned against hair mills and scams, you would still have people go and roll the dice, probably enough to keep business rolling for quite a long time.  

 

[Al - Moderator]

Lawsuits like this are extremely hard to win. Lawyers don't even want to take the case because it's elective surgery. It's something that wasn't necessary, but the person wanted to try it. We can all sit here saying how bad it looks, but in the courtroom and in real life most people are going to think he looked just fine before he did anything, so doing something when nothing was wrong is on the patient, not the Dr. You can think the Dr shouldn't have done anything then, but that's what cosmetic surgery is. Unless the patient is left with other issues besides the hair then he is going to have a major uphill battle with a case like this. There are two sides. As I said, we can say all day long how bad it looks, but the Drs lawyers are going to point out that the patient didn't like how it looked before either, so just because he doesn't like it afterwards that doesn't mean it's the Drs fault... and as I said, most people are going to say he looked normal before, which you may think helps his case, but it doesn't because if everyone thinks it looked normal before then it's on the patient to explain why it didn't and he felt the need for surgery. You won't get much sympathy with that from most people unless you had extreme hair loss and very young. That's the only time most people will feel bad for you. Otherwise everyone thinks its normal for men to lose hair and these days they will tell you that you should have just shaved it off.

[Al - Moderator]

6 hours ago, Maorizio said:

This is the worst hair transplant in history, but at least no donor damage and it can be fixed with no problems.

 

I can 100% tell you that that is not even close to true.

 

[Al - Moderator]

10 hours ago, Buffaloboy said:

You can not perform a terrible medical procedure and then hide behind a clause in a pre-surgery document. It doesn't work that way. Nor are you only entitled to compensation if you are permanently disabled or disfigured. 

 

That is only the case with medically necessary procedures. It's very different for elective procedures. Drs don't need any special training or surgical background to performa a hair transplant. Any dermatologist, general practitioner, or any Dr in any field can start performing hair transplants tomorrow without any training. That's how low the bar is for this type of elective procedure. There's a completely different level of training required for procedures that are deemed medically necessary.

 

10 hours ago, Buffaloboy said:

The mental anguish alone would find favor in many courts. As would the requirement to wear head covering to hide the the terrible angles that are going the wrong way. 

 

That would pretty much be everyone who goes through a hair transplant. Even all the ones that come out great, the patient usually goes through mental anguish and has to cover his head for months. That's not going to be a determining factor in court.

 

 

[Buffaloboy]

1 hour ago, Al - Moderator said:

That is only the case with medically necessary procedures. It's very different for elective procedures.

No, it’s not only the case with medically necessary procedures. Not only was I personally involved in a case with a young woman who had cosmetic surgery on her eyelid (zero medical necessity) and obtained first hand knowledge of the intricacies of these cases, but I also have precedent from other cases I can show. It’s 2am and I am on my phone but I can post them tomorrow. Unfortunately I am not allowed to give the outcome of the eyelid case but use your imagination.

I could show cause a million different ways with cosmetic surgery. Everything from §6530 which defines professional misconduct to include practicing with incompetence on a single occasion or on multiple occasions, gross negligence, gross incompetence, and negligence on multiple occasions in practicing a profession.

Or I could go to § 2805 and argue lack of informed consent. As OP said, “I didn't know any different“. The provider did not provide the patient with enough information (and at times provided the patient with FALSE INFORMATION) about his skills, the risks, benefits, and alternatives to a procedure that a reasonable person would want to know to make an informed decision. Of course, even if he had informed consent, state supreme courts have ruled that malpractice rises above this and makes it inadmissible.

etc

 

[Buffaloboy]

1 hour ago, Al - Moderator said:

That would pretty much be everyone who goes through a hair transplant. Even all the ones that come out great, the patient usually goes through mental anguish and has to cover his head for months.

Certainly you understand the distinction between normal post-surgery recovery issues (which is expected), and the mental anguish and suffering due to negligent care leading to semi-permanent harm (which is generally addressed through compensable damages).

Know what one of the top malpractice insurance policies are? Breast augmentation. Know why? Because they’re sued all the time. Nearly 35% of all claims for PS.

[Buffaloboy]

3 hours ago, asterix0 said:

Yes sadly this should be in the risk calculus for patients before they decide to take the plunge. Everybody thinks they can beat the odds. Truly there is nothing that can be done because even if everyone on these forums stood on their roofs and warned against hair mills and scams, you would still have people go and roll the dice, probably enough to keep business rolling for quite a long time.  

 

Absolutely. Which is why I am such an advocate on these matters.

 

[Buffaloboy]

2 hours ago, Al - Moderator said:

Lawsuits like this are extremely hard to win.

Uh, these hardly ever go to court because they are typically settled with the insurance company before trial.

Of course they try to delay and motion away the case first.

The cases that make it to court are the ones in which they (the surgeon side) believe they have an excellent chance at winning. And they STILL lose close to 40% of the time. 

[Marko7t4]

The UK seems to be getting almost as bad as Turkey for crap hair mills/surgeons. There seems to now be a transplant clinic popping up in every city, offering unlimited grafts for a cheap price. Even some of our allegedly better surgeons aren’t actually that good, giving consistently poor results and having a handbook of excuses as to why (usually the patient’s fault for one reason or another). This is why decent research is so important. These clinics have to bombard Facebook/Instagram, etc, for a reason. Hope you get sorted mate

[BackFromTheBrink]

6 hours ago, Buffaloboy said:

Uh, these hardly ever go to court because they are typically settled with the insurance company before trial.

Of course they try to delay and motion away the case first.

The cases that make it to court are the ones in which they (the surgeon side) believe they have an excellent chance at winning. And they STILL lose close to 40% of the time. 

Are you basing your recommendations or US or UK law, or don't you think the differences would be important in such a case?