Will any surgeon give an honest answer?

Hair Transplant
1

This is a simple question. :confused:
All Ht surgeon surely have a failure rate. Certainly, we see surgeons taking on cases where patients have been to another clinic and the HT failed.

1: When transplanting into a non scared virgin area of the scalp using standard scalp hair by fue what percentage get back less than 70% of the transplanted hair.

2: When transplanting body hair into an unscared scalp what percentage get back less than 70% of the transplanted hair

3: When transplanting scalp hair by fue into a scalp that has been populated with some previous FUs what percentage will get back less than 70% of the new hair.

I will be pleasantly surprised if this post is not avoided but thanks in advance.

2

» This is a simple question. :confused:
» All Ht surgeon surely have a failure rate. Certainly, we see surgeons
» taking on cases where patients have been to another clinic and the HT
» failed.
»
» 1: When transplanting into a non scared virgin area of the scalp using
» standard scalp hair by fue what percentage get back less than 70% of the
» transplanted hair.
»
» 2: When transplanting body hair into an unscared scalp what percentage get
» back less than 70% of the transplanted hair
»
» 3: When transplanting scalp hair by fue into a scalp that has been
» populated with some previous FUs what percentage will get back less than
» 70% of the new hair.
»
»
» I will be pleasantly surprised if this post is not avoided but thanks in
» advance.

I would be surprised if anyone was really ABLE to answer honestly. I wonder if anyone has such data.
With the difficulty of hair counting, especially complicated by existing hair, previous grafting, etc, yields and survival rates are tough to calculate. Plus, it would need to be done by independent researchers to avoid even unconscious bias. HT docs are generally busy clinicians without the manpower and research funds of academic institutions.
And then there is the huge issue of “lost to follow-up”: in truth, most patients get on with their lives and don’t come around for checkups UNLESS they’re looking for more hair, or have a beef with the doc. It would be very nice to know, though, I agree. And they’ve been talking for years about the so-called “X-factor”, that inexplicable reason why some few people do not grow much hair after HT, when everything else goes “just right”. Few, but they are out there.
BTW, it’s “scarred”; O/W, it would be “afraid” rather than “containing or revealing scar tissue”. :wink:

3

»
» I would be surprised if anyone was really ABLE to answer honestly. I
» wonder if anyone has such data.
» With the difficulty of hair counting, especially complicated by existing
» hair, previous grafting, etc, yields and survival rates are tough to
» calculate. Plus, it would need to be done by independent researchers to
» avoid even unconscious bias.

Rubbish! :angry:

» It would be
» very nice to know, though, I agree. And they’ve been talking for years
» about the so-called “X-factor”, that inexplicable reason why some few
» people do not grow much hair after HT, when everything else goes “just
» right”. Few, but they are out there.

Verry true!:yes:

» BTW, it’s “scarred”; O/W, it would be “afraid” rather than “containing or
» revealing scar tissue”. :wink:

Are you making fun of my brain damage? :rotfl: :lookaround: :rotfl:

4

Dear Marco,
The questions raised by you and some of the explanations given by F2B are both correct.

However, even though this may seem to detract from your original questions, I wish to add my thoughts.
Standardisation and analysis of data has to be preceded by standardisation of training and techniques.

Analogy - I have textbooks on Retinal pathologies. I have attended a 2 day workshop on retinal surgeries and have a certificate of appreciation from them.
Will you let me operate on your eye?

No.

However, any physician, anywhere in the world, can start a hair transplant practise when he/she wishes.

If they have memberships of organizations or have attended some workshops/meetings, then all the more convincing.

None of the recognised branches of medicine offer any training for hair transplant surgery.
Still, I am often approached by doctors who wish me to train them for 2 weeks. For some reason, they feel, unlike other fields of medicine, hair transplants is something that does not require extensive training.
This shows what they feel for Hair transplant surgery and I have to politely refuse them.

Therefore, for me to say that we experience 95% success rates is not helpful to prospective patients. They will take the figure of 95% to apply to all doctors who decide to start HTs one fine day.

Start of a branch/subspeciality of medicine requires that there be a rigorous training program as well as recognition.

Hair transplant has to become a recognized branch in its own right with formal training and examinations.

Then only will there be standardization of techniques, peer reviews and data analysis.

Till then, if I may put it very tactfully, all that you read and see is like the childhood game of playacting doctors. Yes, that applies to most of the current organizations too.

It is my ambition that by the time I retire, I formalize HT into a recognized and mandatory course that doctors wishing to enter the field must clear.
And no, :slight_smile: it does not have to be run nor named after me.
No Dr. A’s technique, training or tools.
These long term indoctrination/training courses should be carried out under supervision of good HT doctors around the world.
That will be the time when your questions will be confidently answered by so many doctors.
Regards,
Dr. A

5

I live in the Minneapolis area and stopped in to see one of Dr Ron Shapiro’s consultants. He was a former patient and actually looked pretty good. While I was there I ran into Dr Ron himself. Hell of a nice guy. But I asked him what he could do for me and after he gave my dome a good going over he said, “I could build you a nice frontal hairline but there is not enough to fill in the back
but if you don’t mind combing your hair straight back or wearing a piece to fill it in it wouldn’t look too bad.” Fair and honest answer.

I asked him about hair multiplication and he said “it seems so simple and there are a lot of people working on it, but they keep running into roadblocks. Someday it will happen but there is no telling when it will be available. Could be 5 years, could be 20.” Again a fair answer.

I saw Dr Manny Jaffe as well and he said the same thing per my hair and hair multiplication. In fact both doctors made it a point to say “you will never look 17 again.” So yes, some doctors are honest.

But I think 90% of the people that are not happy with their transplants either chose not to hear the part about “I can not give you a full head of hair” when the doctor warned them or they went with the cheapest medic they could find and they get butchered.

Sure there are times where even the best doctors have a procedure that didn’t work right
every human body/reaction is different. But if you want to go the transplant trail, find the best you can and pay the extra dough
they charge more because they are better. And keep in mind, they live off their reputation and they are not going to damage that rep and lose business just to make a few bucks off a hair transplant. They will tell you what they can and can not do for you
just make sure to listen.

Me, I used to do the comb-over and thought it looked pretty good, about weeks 3 through 5 between haircuts and when the wind wasn’t blowing. But then I saw a few pictures of myself from the side and said, “Who am I trying to kid.” So I shaved it off New Years day. I hate it but a few (including my wife) says it looks great.

I figure I will go through the summer, get my skull good and tan and see what it looks like by fall and if I still don’t like it I’ll grow it back.

6

» But I think 90% of the people that are not happy with their transplants
» either chose not to hear the part about “I can not give you a full head of
» hair” when the doctor warned them or they went with the cheapest medic they
» could find and they get butchered.

I live in the Minneapolis,are you sure you live there and not cloud cuckoo land!

I myself went for a consultation for frontal loss.I asked the question what happens if hair at back starts to fall out.I was told propecia stops that in its track.Which is a complete load of rubish,it may slow loss down.I found this out after a lot of research on the net.

If you look back on a lot of posts on old forum you would realise you are completely wrong in most cases.

I myself decided against having an hair transplant,after doing proper research,a lot of information scared the shit out of me.I feel sorry for those conned by some of the doctors out there.I do get the feeling that a FUE transplant by one of the top doctors,might work.HM might work in a few years,too.

The consultant I went to see,reminded me of a fly by night market trader,car sales person.That it self made me stop in my tracks.

I’m doing the waiting game to see.Hopefully HM will come out,wishful thinking perhaps.

My best option as been to shave hair all off and get a tan on it.Looks good,but hair would look better.It also grows to bloody fast,which means having to shave to often!

7

» 2: When transplanting body hair into an unscared scalp what percentage get
» back less than 70% of the transplanted hair

I don’t think I have ever seen bh that gives over 70% yield IMO. That’s almost a given that you get less than 70% for bh.

8

Do you mean St Cloud, land of collage hotties and shopping malls?
All I can say is, I went to 2 of the best hair transplant docs (Shapiro is known nation/world wide) and they both were honest. That’s 2 out of 2. Even Jaffe’s nurse/receptionist told me not to expect miracles over the phone when booking the appointment before I even saw him/her.

I have had numerous surgeries (to repair injuries) and have learned the hard way to ask the doctor ALL of the negatives that go along with the surgery he is suggesting. I went in for a minor 30 minute procedure to remove a bone spur from my shoulder. It turned into a 4œ hour rotator cuff repair.

And because it was only supposed to be a simple procedure they sent me home with some strong oral meds rather than checking me into a room. By midnight when the Demerol wore off I was writhing in agony and even 4 oxys weren’t cutting the pain. I had to keep going back to the emergency room to get shots of morphine (love that pain train and the meds that go with it). And the next 6 weeks were pure hell
even with copious quantities of oxy. Then I had to wean myself off the narcs. No, always ask the doc the good and the bad before they get you on the rack.

To be honest, I will say Shapiro’s consultant was far more optimistic than Shapiro himself.

Of course keep in mind, the consultants are salesmen and only get paid when someone signs up so they have incentive to exaggerate
and maybe that’s what it is, people talk to the salesman who paints the rosy picture but never talk to the doctor. Then the doc comes in, picks up the blade and assumes the patient is aware of the facts
but by that time he doesn’t see a potentially bad transplant sitting in the chair, he sees that new boat or Porsche’ and the ethics go out the window.

And I will add, I did a few phone consultations with various consultants and they didn’t know what they were talking about. One I asked about scalp reductions and he said they didn’t do it. When I asked him why he started stammering and stuttering trying to come up with a reason and finally settled on, “because gravity will stretch your skin back out and you lose any gains you may have got.” Obviously this clown was a telemarketer that wasn’t well trained.

Talk to the doc himself BEFORE they get you in the chair and the greed takes over. And don’t be a teenager with selective hearing. But maybe Minneapolis is the only city that has a high percentage of honest doctors.

And one of the reasons I have shied away from getting a transplant is what happens if I get cancer and lose my hair from chemo. Then I’m sporting a huge scar. Also many of the transplants I’ve seen don’t look all that great
not much more than a good comb-over. Give us true multiplication that works.

9

» And one of the reasons I have shied away from getting a transplant is what
» happens if I get cancer and lose my hair from chemo. Then I’m sporting a
» huge scar. Also many of the transplants I’ve seen don’t look all that
» great
not much more than a good comb-over. Give us true multiplication
» that works.

Fair play.I also learnt via internet that the consultant I seen,was the owner of probally the worse Hair transplant specialist in the UK.I also learnt that the UK do not seem to have any top hair transplant doctors.

The US seems the best place to go,but as I’ve already stated I’m not going to have one anyway.

I do not know anyone who’s had a upto date hair transplant,or perhaps I do,maybe who knows.

I do know a older bloke who I noticed had a seventies HT,and that looked shit.I do wander if anyone else notices,or did I notice,due to the research I’ve done.I wish I hadn’t noticed,as everytime I talk to him I have to stop my eyes going up to his head,as him and his wife are very nice people.

Roll on Hair Multiplication.Intercytex have my number,so who knows!

10

Dr. A, Thanks for your reply. I empathise with your passion for wanting to apply some standards and standardisation to an industry that is virtually unrestrained.

I would add that in you scheme you would need to envisage a system of continued auditing of clinics after they or their surgeons have “qualified”. Of equal importance would be the need to enable ongoing research. This is important because, as you have seen in you BHT endeavors, there is no way that results can be predicted even involving a responsible surgeon when investigating uncharted territory. There would need to be the equivalent to an ethics committee. Actually, it is the process and need for stretching the boundaries that have been the surgeons biggest defence against external review auditing and control.

Anyway sorry to detract from your detraction but you still didn’t attempt to answer the question! Which ever way you slice it, you (and other surgeons) know what percentage of patients get unsatisfactory results. You know what I mean and you can answer it!

At least you had the courtesy to engage so thanks for that.

11

» » 2: When transplanting body hair into an unscared scalp what percentage
» get
» » back less than 70% of the transplanted hair
»
» I don’t think I have ever seen bh that gives over 70% yield IMO. That’s
» almost a given that you get less than 70% for bh.

No doc can give you a success rate, every patient is different and every clinic is different it would be impossible to predict this.

12

» No doc can give you a success rate,

Absolute Rubbish!

13

»
» No doc can give you a success rate, every patient is different and every
» clinic is different it would be impossible to predict this.

Well, this was part of my point in my first post in response to Marco’s query: I personally do not believe that HT docs are holdiing on to some definitive data that they have, in order to delude patients. For the reasons I suggested, and more, the data does not exist at this time.

One of the biggest reasons in the “lost to follow-up” problem. The patients go away, get on with their lives, and it is then impossible to evaluate their growth and yield. MOST patients do not come back unless they want another procedure; even locals (a small percentage) often are “too busy” to come in for follow-up.

I think some of Dr. A’s comments were very germaine, in that there is not really any standardization of training and of techniques. Until HT becomes a specialty in and of itself, this will not happen. People learn through “fellowships” (clinical time spent under the tutelage of other docs), or, God help us, from intro courses and seminars.

14

» »
» » No doc can give you a success rate, every patient is different and
» every
» » clinic is different it would be impossible to predict this.
»
» Well, this was part of my point in my first post in response to Marco’s
» query: I personally do not believe that HT docs are holdiing on to some
» definitive data that they have, in order to delude patients. For the
» reasons I suggested, and more, the data does not exist at this time.
»
» One of the biggest reasons in the “lost to follow-up” problem. The
» patients go away, get on with their lives, and it is then impossible to
» evaluate their growth and yield. MOST patients do not come back unless
» they want another procedure; even locals (a small percentage) often are
» “too busy” to come in for follow-up.
»
» I think some of Dr. A’s comments were very germaine, in that there is not
» really any standardization of training and of techniques. Until HT becomes
» a specialty in and of itself, this will not happen. People learn through
» “fellowships” (clinical time spent under the tutelage of other docs), or,
» God help us, from intro courses and seminars.

O.K, but here’s the thing. If a patient has a poor result then he will talk to the doctor about it before he disappears. The surgeon knows how many patients he treats so the maths are simple. You can see from my replies that I just think it insults our intelligence to think that, although we all see the butchered patient on this board from the old days and also bellow par results from recent times, the surgeons themselves have no idea about this. I am just not going to buy that. What has sparked this is that i recently met with patients of two well known surgeons who had poor results and and the surgeons are not volunteering this because the patient has not publicised the issue. I have seen on this board various cases of patients going from surgeons known on the board to other surgeons know on the board because the results were not good. You and your fellow anti-conspiracists are suggesting that the original surgeons know nothing of this.

I can’t believe that anyone has a sympathetic word or an excuse to make on behalf of any of them in this respect and here’s another icon for you:no:

15

» It is my ambition that by the time I retire, I formalize HT into a
» recognized and mandatory course that doctors wishing to enter the field
» must clear.

The more you type the more I am impressed by you.This is a very noble gesture & I believe your sincerity but how could you possibly implement this vision in a field of anarchy?You are one man,the butchers are many.
Sadly,I am one of many victims who has lost his life thanks to a butcher.I regret the very day I ever tried to restore my hair.
I truly hope you are able to implement your ideas because this industry desperately needs to be overhauled.You cannot help me,but I hope your vision may one day be able to save others from suffering the same fate as me.

16

» » It is my ambition that by the time I retire, I formalize HT into a
» » recognized and mandatory course that doctors wishing to enter the field
» » must clear.
»
»
» The more you type the more I am impressed by you.This is a very noble
» gesture & I believe your sincerity but how could you possibly implement
» this vision in a field of anarchy?You are one man,the butchers are many.
» Sadly,I am one of many victims who has lost his life thanks to a
» butcher.I regret the very day I ever tried to restore my hair.
» I truly hope you are able to implement your ideas because this industry
» desperately needs to be overhauled.You cannot help me,but I hope your
» vision may one day be able to save others from suffering the same fate as
» me.

good grief - personally i think the good doctors skill set is a bit restricted by cutting himself off from the rest of the world.

how can you possibly be taken seriously when you don’t even belong to the ishrs.

17

There are not many growth studies out there. On these forums we see that Dr. “Y” has a 90% growth rate and Dr. “X” has a 95% growth rate. These sorts of claims are either wild guesses OR they may be based on a patient (or a small subset of patients) that submitted to a hair count study. Kernels of anecdotal data should not masquerade as scientific information for the sake of marketing. IMO, most Drs do not have great scientific data on their procedures.

Drs can be truthful about other more subjective questions, such as “Do you feel I am a good candidate?” “Have you recently had any unhappy patients?” “Why do you feel growth is less than optimal in some cases?”

Personally, I would be suspicious of a clinic that can quote their “overall growth rate” to patients. The data would need to be fudged or fabricated, and this could only be for the sake of getting patients in the door.

Marco, you make the point that surely patients with bad results will address the issue with the doc. Many times unhappy patients do, but you rule out the self-deception factor with the DOCTORS. Some drs see a bad work and do not feel accountable. I’m not singling any one physician out here, but sadly it happens.

18

O.K, I give up. I may go to a good surgeon and and no one here can tell me or has any idea wether I have a 2 or 3 or 1 or 5 out of 10 chance that I will have a bad result / be unhappy / get poorer than expected growth or whatever. It must be one of the top questions in most patients minds. what a pathetic industry!!!

19

after lurking on the forum for two years I have learned it is very possible to get great transplants nowadays, natural hairlines good densities, there are more than a few docs that can do this, out there

the problem is the future and the future hair loss, nobody worries about this as much as they should

lets say you get 7000 grafts on top and your receding temples and your balding crown now look fantastic from one of the best docs in the word
you were a NW3 coming in and now you hardly look like you have lost any hair

now 20 yrs down the road you go to a NW7 status
you in no way have enough grafts anywhere on your head to fill in the newly bald areas, even if you had never had a transplant

trouble is now you have unusually dense areas that were transplanted years ago with the 7000 grafts, the hair continued to bald and now you have a RING of baldness around all your previous great hair
that you CANNOT FIX because you dont have the grafts
even if that bald area could be fixed it could only be fixed with a VERY LOW DENSITY, which would in no way match the thick density of the previous work

in short you look like a freak and there is nothing you can do except hope your body hair is there in enough supply and hope you have an extra 100,000 dollars laying around to fix this mess

this scenario could very easily happen to a lot of guys who over harvest their donor area at a young age
then what do you do

» » And one of the reasons I have shied away from getting a transplant is
» what
» » happens if I get cancer and lose my hair from chemo. Then I’m sporting
» a
» » huge scar. Also many of the transplants I’ve seen don’t look all that
» » great
not much more than a good comb-over. Give us true multiplication
» » that works.
»
» Fair play.I also learnt via internet that the consultant I seen,was the
» owner of probally the worse Hair transplant specialist in the UK.I also
» learnt that the UK do not seem to have any top hair transplant doctors.
»
» The US seems the best place to go,but as I’ve already stated I’m not going
» to have one anyway.
»
» I do not know anyone who’s had a upto date hair transplant,or perhaps I
» do,maybe who knows.
»
» I do know a older bloke who I noticed had a seventies HT,and that looked
» shit.I do wander if anyone else notices,or did I notice,due to the
» research I’ve done.I wish I hadn’t noticed,as everytime I talk to him I
» have to stop my eyes going up to his head,as him and his wife are very
» nice people.
»
» Roll on Hair Multiplication.Intercytex have my number,so who knows!

20

» » »
» »

Marco,

I believe your premise is flawed. There are many patients who have poor results and NEVER mention it to the surgeon who did the surgery. It happens a lot. Maybe a combination of shame at being duped, and depression, who knows. Ask any cop that does the scam artist circuit. They will tell you, people would rather be anonymous (and broke) than admit they were duped, it’s very common.
Most docs are not going to get on the horn and call another doc and say, “hey I saw Mr.X that you did, and his results sucked”.
So if you combine this with the number of good results that never show up again, you have no way of knowing what the percentages are, much less the yields in individual patients. It goes both ways, good results and bad. Believe me, we would LOVE to get a lot of those good ones and post them on the sites, but we can’t.
One of our patients posted about this yesterday, that even though he lives within walking distance of our clinic, he couldn’t even get in here for a hair length check. Imagine the guys in the Middle East, or Europe, or Australia that we do. Not gonna get any idea. You would not believe the number of guys I’ve called to follow0up after surgery, and they don’t cal back. Then they show up 3 years later, and it’s just, “oh, I was busy”. Those are just the ones that DO show up.
So you can’t take a few cases, good or bad, and extrapolate the results to a much larger cohort.
If there’s was a “sorry” icon, I’d put it up for you, mate :wink: