Thanks for clearing that up. 
Our feelings towards Dany26 have and will not change, he was and is our patient and we stand by that, and are prepared to always have an open door to him with a helping hand and open arms.
Although no proof is apparent and only past events mould to the conclusion that maybe one reason besides Dany26 unhappiness was to discredit a Dr, as it has been suggested but with no direct relation on another forum of which escar used to post, and subsequently was banned for aggressive behaviour and unsubstantiated attacks towards a Dr, among other different issues; then we only feel sadness.
The purpose of the forum is to help patientâs work through their problems and hopefully guide them to a happy conclusion, whatever that maybe, to do a h/t or not.
If the HDC advisor has personal or if he feel legal issues with any current member of BHR it is suggested he directs his remarks directly rather than posting unsubstantiated comments here or on other forums; truth and spin can lie in the same bed but are poles apart. If as he says he has a high moral standing then I am sure he will understand this and that there is no purpose other than to cause hurt and damage without having to substantiate a thing.
We are happy to address Dany26 concerns and have been in email contact with him trying to maintain a cordial and beneficial relationship with him. We feel that we have said all we can say on comments from HDC, their rep or their cohorts, we are happy to talk to them if they have a concern, but canât see any point in continuing here, which is ultimately the thread of a patient, not ours or HDCâs.
Guys, you screwed up!
It should not take a member of the public or a forum poster to say this.
A surgeon is in a unique position just as is a lawyer or a physician from another speciality.
When a patient is under your care then the patient is vulnerable beyond their own comprehension. They are putting their body or future in your hands and within an arena that they / we do not fully understand. This often brings out a quality that obeys orders even in the face of what would normally be rejected because the patient accepts that they have to submit to a higher understanding of the circumstance for their own good. Of cause this wares off after the event!!!
If you operate in the middle of the night under unexpected / perceived unprofessional circumstances and surrounding that would obviously be perceived as unprofessional then you are asking for trouble and if there is the slightest impression that things have gone wrong then as the patient looks back in the cold light of day then this will come back to haunt you.
You screwed up. Regardless of the result, you would be as well to give the price of the 1000 grafts back (done out of office hours), admit the error make a clean slate and ask that no more is said. None of this relates to the quality of your future work.
wow what a mess! But then again Marco, there 's no law that says the doctor cannot do surgery in the middle of the night.
What is your next plan of action?
This seems like dany26 was slightly coerced into stepping forward. He even stated that he was given an option not to do the surgery at night. Ultimately it was his decision and all things considered he seemed to get a natural looking transplant.
This is truly the most important aspect.
He seems to have buyers remorse and would rather have a time machine than his $ back. Whats done is done and his result does look natural. If it is 70per/cm2 is up to debate, but looks close.
This seems to be turning into a tift between different clinics over pts.
I understand dany26âs concerns and it looks as if BHR is trying to make good. These forums are designed so members can help one another to avoid getting butcherd as well as moral support.
Petty rivalries should be kept personal and private.
It is trueâŠwho says a Doc cant do surgery at night?
» This seems like dany26 was slightly coerced into stepping forward. He even
» stated that he was given an option not to do the surgery at night.
» Ultimately it was his decision and all things considered he seemed to get
» a natural looking transplant.
» This is truly the most important aspect.
» He seems to have buyers remorse and would rather have a time machine than
» his $ back. Whats done is done and his result does look natural. If it is
» 70per/cm2 is up to debate, but looks close.
» This seems to be turning into a tift between different clinics over pts.
» I understand dany26âs concerns and it looks as if BHR is trying to make
» good. These forums are designed so members can help one another to avoid
» getting butcherd as well as moral support.
» Petty rivalries should be kept personal and private.
» It is trueâŠwho says a Doc cant do surgery at night?
Hello, âvehementâ, It seems clear to me that you have a direct relation with the BHR clinic so I want to request you to refrain to post here or in other place hidden your real identity and with the objective of hurt, damage, injury and discredit, it is completely unacceptable and it is not the first time that I request you to stop your game.
Here you can see the poster vehement taking direct part in a discussion related to BHR Clinic, with only one post published in this one and in the other forum I believe that there are more than reasonable doubts to think that somebody is being hidden behind false names to create favorable currents to his company. Could the administrator of the forum check the IP to unmask the user vehement?
http://stophairlossnow.ipbhost.com/index.php?showtopic=1582&hl=
You would have to put a signature in your posts.
Dr
I have seen bad results from Doctors before and this is not one of them
this patient to me is looney nuts unrealistic expectations
he would not have been happy unless you also gave him a million dollars
âIf it is 70per/cm2 is up to debate, but looks closeâ
I donât know what planet you are from but this is nowhere near 70 grafts per /cm2. His hair looks fine but get real, this is not 70 per /cm2.
» âIf it is 70per/cm2 is up to debate, but looks closeâ
»
» I donât know what planet you are from but this is nowhere near 70 grafts
» per /cm2. His hair looks fine but get real, this is not 70 per /cm2.
You know, I read a lot of guys talking about densities and punch sizes and such measurements.
I do not know how ANYONE can look at a picture and say âthis is or is not ____ per cm2â or look at a donor area picture and say âthis looks like it was about a ___mm tool for the extractionsâ.
Iâve been around for a long time and I cannot do this, nor can I do it with the patient in the room with me (without the proper equipment and lighting and magnification).
The appearance of 70 (or 50, or 30) grafts in a given area depends on a lot on other factors, like the size of the grafts, the caliber of the hair, etc.
There seems to be an obsession with density without regard to hair characteristics, (and likewise an obsession with extraction tool size with little regard for the potential for transection).
» There seems to be an obsession with density without regard to hair
» characteristics, (and likewise an obsession with extraction tool size with
» little regard for the potential for transection).
I think there is an absolute awareness on the board relating to the influence of hair characteristics and a number of discussions in this area. Transection along with a number of other factors is relevant because of its influence on yield and most if not all members of the board are absolutely interested and aware of yield. There have also been a host of discussions about the effect of extraction tool size on yield.
If I had the amount of hair you had before the procedure I would even think about getting a transplant.
BTW the hairline looks VERY good to me. Really natural.
The story related to the office used for the procedure is scary thoughâŠ
» I think there is an absolute awareness on the board relating to the
» influence of hair characteristics and a number of discussions in this
» area. Transection along with a number of other factors is relevant because
» of its influence on yield and most if not all members of the board are
» absolutely interested and aware of yield. There have also been a host of
» discussions about the effect of extraction tool size on yield.
Hmmm⊠this may be, and perhaps Iâve not been around long enough to see it equal out. `My main reference (as in the remainder of my post) was to the common conceit that one can âeyeballâ photos on the forum and then make judgements about the perceived density, tool size, etc. I see THIS quite frequently.
» Hmmm⊠this may be, and perhaps Iâve not been around long enough to see
» it equal out. `My main reference (as in the remainder of my post) was to
» the common conceit that one can âeyeballâ photos on the forum and then
» make judgements about the perceived density, tool size, etc. I see THIS
» quite frequently.
Well, I think you need to respect that if a poster suggests a density then they may be taking onto consideration the various hair characteristics. Many of us have been around for a while too As far as tool size is concerned, I recently commented on this myself. As one looks through the evidence, there is a tendency for the wound from larger tools to be closed by secondary rather than primary intention or that the primary intention takes longer to effectively close (hours rather than minutes). You simply cannot assume that if you have not worked it out then everyone else must be wrong!
» Well, I think you need to respect that if a poster suggests a density then
» they may be taking onto consideration the various hair characteristics.
» Many of us have been around for a while too As far as tool size is
» concerned, I recently commented on this myself. As one looks through the
» evidence, there is a tendency for the wound from larger tools to be closed
» by secondary rather than primary intention or that the primary intention
» takes longer to effectively close (hours rather than minutes). You simply
» cannot assume that if you have not worked it out then everyone else must
» be wrong!
I donât really get your response; itâs not about whether someone is taking characteristics or whatever into account, itâs the declarations that this is or is not a certain density that gets me. I just donât think it possible and I doubt that any HT surgeon worth his salt would claim that ability either.
As far as the punch healing, they ALL heal by secondary intention, by definition. Primary intention refers to clean surgical incisions only; when a hole is cored out and tissue removed, it will be secondary, that is, granulation tissue forms on the open surfaces, and the hole fills in from the bottom and sides up.
I donât assume every one is wrong here, Marco, but I think itâs lazy to give people a pass when they say things like âhmmm, that looks like about a 0.9 punch to meâ, or "no way that is close to x grafts per cm2!"
Anyway, I always appreciate your responses regardless, they make me think!
» As far as the punch healing, they ALL heal by secondary intention, by
» definition. Primary intention refers to clean surgical incisions only;
» when a hole is cored out and tissue removed, it will be secondary, that
» is, granulation tissue forms on the open surfaces, and the hole fills in
» from the bottom and sides up.
Actually there was a protracted discussion initiated by Dr.A about this issue. I donât know if anyone has the link. Is the tissue loss is small or the area around the wound is flexible to the extent that it can breach the gap then the wound can close by primary intention. Personally I feel that this is quite noticeable soon after the operation and looks quite different to a kind the gap left by a larger punch but I may be wrong. If the wound is larger or the tissue is not flexible then the wound must heal by secondary intention leaving a small white dot of scar tissue or hypopigmented dermis and epidermis. Dr.A used to deal with this by covering the wound with epidermal cells to get rid of the dots.
There have been a lot of changes and with both BHT and scalp HT it seems that most Dr. are moving to a smaller punch so that the dots are not evident and with smaller procedures the wound os sealed by primary intention. From what I am seeing, I think that the hair viability due to the smaller punches, is being compramised now especially with BHT.
»
» Actually there was a protracted discussion initiated by Dr.A about this
» issue. I donât know if anyone has the link. Is the tissue loss is small or
» the area around the wound is flexible to the extent that it can breach the
» gap then the wound can close by primary intention. Personally I feel that
» this is quite noticeable soon after the operation and looks quite
» different to a kind the gap left by a larger punch but I may be wrong. If
» the wound is larger or the tissue is not flexible then the wound must heal
» by secondary intention leaving a small white dot of scar tissue or
» hypopigmented dermis and epidermis. Dr.A used to deal with this by
» covering the wound with epidermal cells to get rid of the dots.
»
» There have been a lot of changes and with both BHT and scalp HT it seems
» that most Dr. are moving to a smaller punch so that the dots are not
» evident and with smaller procedures the wound os sealed by primary
» intention. From what I am seeing, I think that the hair viability due to
» the smaller punches, is being compramised now especially with BHT.
Yes, I think it is still unknown exactly what the âthresholdâ is for primary intention with âholesâ healing.
We have tried everything under the sun to convert holes into slits, if you will (compression, elastic, sutures, staplesâŠ) We still do that when we are FIT-ing out FUâs from old plugs in the recipient area, for instance. I personally think you have to get pretty small (probably more than is feasible) to have approximation across a dead space to mimic incisional primary intention healing.
You may well be right about punch size compromising viability. I keep forgetting to post those pix of âsheathingâ etc, but I WILL do it!
BTW, I remember mention of preserving the epithelium for âpluggingâ the holes; does he still do it? Or was that approach abandoned?
» BTW, I remember mention of preserving the epithelium for âpluggingâ the
» holes; does he still do it? Or was that approach abandoned?
I donât think that Dr. A would describe his clinic as âabandoningâ the approach since it was successful. As far as I understand it, he has reduced the need for it by adopting other strategies in extraction that minimise its need due to an increase in closure by primary intention. Having said this, Dr. Umar who studied with him was opposed to its use and sees its harvesting and problems as outweighing the benefits. Dr. Woods has suffered a number of neuroleptic attacks at even the mention of âdonor sealingâ. All in all, it was a successful experiment but developments have placed it as an evolutionary dead end for now.
some of you guys are unbelievable.
1.the rsult for me is total crap i dont see any difference i just see some hair standing out that even look wiry and unmanageable if you try to style it. but this is something that happens with transplants sometimes.
2.If he has a full head of hair and you fix his hairline the guy came in for density!!!its obvious he is a typical high hopes patient with high expectations to regain his original hairline 1000 grafts will never do that and that is something that should be explained to himâŠITS GOING TO LOOK THIN ARE YOU SURE?I know thatâŠthe doctor does not???
3.they put the poor guy in a basement and they operate on him as if you are going for an abortion in Saudi Arabia!!!
4.The clinics fight with each other at the same time they standby to eachother against the patient. The Dr. steals patients,well not exactly stealing because the patient will also save money, all these weird things take away credibility from these clinics and the way they operate.
I see these jokes posts he is trying to discredit them and he has a personal agenda and blah blah blah.Helloooooo he is not happy with his procedure he is angry and he should be and he shares the story.What you prefer that these people dont speak?Are you trying to silent them so we know half the story always?
Escar thanx so much for the story it was really helpfull to know all these things. and i am sorry for the doctor but if he did not want for this to happen he should not treat the patient like that operating him in cellars. And as for the clinics with one hand you are petting him and with the other you are stabbing him DISGUSTING.Next time dont put the âwe have the right to post your picturesâ hidden in the contract where people usually sign with initials.we have all signed these forms and usually we dont even bother reading them.You might think you are smart with this tricks but we are not stupid either.
» » BTW, I remember mention of preserving the epithelium for âpluggingâ the
» » holes; does he still do it? Or was that approach abandoned?
»
» I donât think that Dr. A would describe his clinic as âabandoningâ the
» approach since it was successful. As far as I understand it, he has
» reduced the need for it by adopting other strategies in extraction that
» minimise its need due to an increase in closure by primary intention.
» Having said this, Dr. Umar who studied with him was opposed to its use and
» sees its harvesting and problems as outweighing the benefits. Dr. Woods has
» suffered a number of neuroleptic attacks at even the mention of âdonor
» sealingâ. All in all, it was a successful experiment but developments have
» placed it as an evolutionary dead end for now.
Marco,
You know any specifics about these âstrategiesâ for increasing primary closure? We found after a long time that there seemed to be no difference whether we tried to turn the holes in to slits, so to speak, or left them alone.
As to whether they âabandonedâ it or just âquit doingâ it, same end result
BTW, did they publish anything on donor sealing? I would like to read it if they did, or any links you know of. thanks.