Botches transplant or expectations WAY too high?

[TheHighGuy69]

Hey everyone! First, thanks for taking the time to read this, I desperately need your advice on how to proceed.

In August of 2014, or approximately 19 months ago, I had 1186 grafts transplanted to my front hairline via strip procedure in Miami with Dr. Nusbaum (www.miamihair.com/dr_nusbaum/). I had zero hair in the graft area before the transplant, so please keep that in mind. The idea was to create a front hairline and incorporate a hair system behind it. But 19 months later, the results are EXTREMELY underwhelming. Please take a moment to examine the attached pictures taken yesterday. The density is NO WHERE NEAR the amount I need to conceal a hair system behind it. Dr. Nusbaum now tells me that it will take a second and maybe third surgery to get the coverage I need. The problem is, I now do not trust him and am, in-fact, in the process of finding a medical malpractice attorney. But I want to make sure that I'm not tricking myself or had too high expectations. I'm going to consult with doctors in the coming month, but I want your opinions first: the opinions of people who have gone through this procedure before. Is this a botched hair transplant or were my expectation simply too high?

 

[Giiizmo]

Holy sh-t, that looks bad. Do you really need to ask? This is nowhere near what a ~1200 graft transplant is supposed to look like even with somewhat sparse density, especially using a strip procedure which should give the grafts a higher chance of survival.

From what I understand, hair systems are a hassle to maintain but you can have great results even when you reveal the hairline; there shouldn't really be any need for a transplant to cover it up.

I'm sorry you have to endure this, I hope you'll find a viable solution. Good luck.

 

[TheHighGuy69]

But the question is, it it something to do with me (I'm just not a good candidate for hair transplant Surgery) or is it due to my doctor?

 

[oye_rg]

Roughly, how many hair have you got in the transplant area now?

 

[buckthorn]

But the question is, it it something to do with me (I'm just not a good candidate for hair transplant Surgery) or is it due to my doctor?

Your doctor is a quack in my opinion. First off, he was trying to cover way too much area with only 1200 grafts. Secondly, It looks like he only transplanted a few hundred. I personally feel you need to expose this guy all over the internet and get your money back.

 

[oye_rg]

Roughly, how many hair have you got in the transplant area now?
Sorry but I estimate it was not botched because if you count your hair the percentage survival would come out decent enough for a FUT hair transplant.
It is a case of miscalculation and high expectations, everyone knows 1186 is too far away from what you need for anything worthwhile for a NW6/7. You have a deep coverage and full breadth, please use 2k+ grafts minimum for temples alone. Any more filling is several thousand grafts.
Having said that I would still term the surgeon poor because he should have advised you. A lay patient is not expected to know what's right or wrong with hair transplant. You shouldn't have to plan it he should plan what is best for you.

Btw, have you ever been on treatments, Minoxidil, Finasteride, before or after hair transplant?

 

[Giiizmo]

It's hard to say whether you were a poor candidate for hair transplant without knowing more about your health. It's true that the survival of grafts depend on your overall health and on specific contraindications (smoking, skin disease, etc.).

Regardless, 1200 grafts is not sufficient to cover the designated area at an acceptable density as to provide a good front for a hair system. I very much doubt that your results can be attributed to poor graft survival instead of a gross miscalculation on the surgeon's part.

Here's a handy calculator to get a (very) rough approximation: http://www.hairfear.com/hair-transplant/hair-transplant-graft-calculator.aspx

For instance, if you wanted only areas 2 and 3 on the Norwood-Hamilton scale to be covered, it takes between 1500 grafts for a low density (25 per cm2) and a little over 2000 grafts for a medium density (35 per cm2).

 

[TheHighGuy69]

You have a deep coverage and full breadth, please use 2k+ grafts minimum for temples alone. Any more filling is several thousand grafts.

Can you perhaps clarify that statement? Does this mean that I will, ostensibly, never have enough grafts for what I'm trying to achieve?

- - - Updated - - -

Here's a handy calculator to get a (very) rough approximation: http://www.hairfear.com/hair-transplant/hair-transplant-graft-calculator.aspx

.

First of all, thank you for that super handy calculator! So basically my doctor gave me areas 1, 2, and 3 when I really only needed 1 and 2.

If I go to another doctor and specify that I only want areas 1 and 2, wouldn't I have the "full" look according to the calculator (ramping it all the way to the right and stopping at 50)?

Also, no, I have not tried Minoxidil or Finasteride before or after a hair transplant.

 

[Giiizmo]

Do keep in mind that this calculator uses the average surface of a head to get its estimates. Of course, you would need more grafts if you have more surface to cover.

Limiting the grafts to only areas 1 and 2 might be tricky but feasible in theory. Again, I simply can't fathom the poor outcome of your hair transplant, even with a sub-optimal proposed amount of grafts. I'd definitely shop around for better surgeons.

Look up the hair transplant network blog* to help you find good surgeons in your area and look and ask around this forum a bit. Just steer clear of the IAHRS (http://www.iahrs.org/) as they're promoted by the BTT which is notorious for giving glowing reviews to its affiliated surgeons and denigrate those who refuse to pay for a good review.


*To note: HairLossTalk.com censors the website address. /shrug

 

[shookwun]

Should never go for strip unless you plan on having a big procedure.. 2000+ ideal.

Literally looks like 100-200 grafts grew.


Seek an attorney and get your money back. This guy's a hack with poor medical back round and is advising you under false pretense.

A hairline without a Forelock in your case would literally take 3000- grafts if not a litthe bit more. I had over 2250 grafts on a NW2.5.....and I had a forelock

I wouldn't bother getting another procedure. A hair system with a translated hairline will not look good. Just wear a piece

 

[TheHighGuy69]

A hairline without a Forelock in your case would literally take 3000- grafts if not a litthe bit more. I had over 2250 grafts on a NW2.5.....and I had a forelock

I wouldn't bother getting another procedure. A hair system with a translated hairline will not look good. Just wear a piece

Whats a forelock?

Regardless, I've seen pictures of a procedure that was very similar and it turned out magnificent looking. Please observe the attached pictures. granted, his hairline is WAY less "wide" than what my doctor gave me. His is basically like a quarter inch wide, if that.

 

[shookwun]

oh.... a little strip of hair across?

Still, that's now where NEAR 1200. i can count the grafts.

 

[TheHighGuy69]

oh.... a little strip of hair across?

Still, that's now where NEAR 1200. i can count the grafts.

Well all I need is a wall of hair. it doesn't matter how "wide" the wall is. So...like a hair "fence"?

So then how many grafts for the hair fence?

 

[shookwun]

I can't you needing more then 500-750 grafts for a skinny wall of hair.

I don't think it's nessesary to have a transplant though. What happens when the hair system sheds at the hairline, and leaves a gap of transplant hair and system follicles?

i would just wear the system how it is. it's undetectable.... swiss lace. I wore one.

this hair wall is just a hassle.

 

[TheHighGuy69]

I tried to wear hair for year. I honestly gave it my best shot, and spent hundreds of dollars every few months trying different systems from a variety of vendors. The result was always the same. If I expose the hairline, I expose the system. But the "shedding" problem you mentioned would be a problem for regular wear as well. The way to solve it, in both cases, is to simply buy a new unit every 3 months or so.

The hair wall makes the system truly undetectable, because the damn thing doesn't even start at the hairline. Its your real hair, no crazy front hairline maintenance required.

As to needing 750-900 grafts for that kind of a hair wall, you have to realize, I need it as thick (maybe even thicker) than the guy in the picture. The catch is that I don't think you can fit all ~1000 grafts into such an area in a single operation.

Bottom line though, I'm calling three doctors on Monday to set up appointments to evaluate my doctors work. If I have to salvage this by getting that tiny hair wall and just shaving the transplanted hair behind it, I wouldn't mind. I just want my f**king hair back, and this whole ordeal has maybe been the most frustrating experience of my life. For example, I've had to do my first two semesters of law school while wearing a hat the entire time. You have no idea of my suffering...

 

[Pequod]

I would need to see the post op pictures to get a better idea of where the 1186 grafts were placed, but without that it appears he spread them out far too thin for what you needed. 19 months you should have seen excellent growth by now, and I would not use that doctor again obviously. I am also only guessing about 350 grafts survived, and since they were not properly placed it looks much worse.

As far as a lawsuit goes you have to read the contract you signed, it may spell out mediation. Since this was not a total failure it will be harder to show total negligence, but that is only my opinion.

For what you want, a simple hairline should be easily done. I would do another procedure and go with a proven doctor. They should have drawn on your scalp your new hairline and the boundaries for it prior to starting. On the downside you seem to have very thin hair, so it may take more grafts to get the coverage.

 

[TheHighGuy69]

He did draw on my scalp, he just implied that it would be the same thickness as in the picture I sent him. Now, I realize he meant "over several surgeries," and maybe not even then. I literally sent him this series of pictures from my last post with pictures and he said he could do it.

He probably didn't even look.

 

[hellouser]

Wow... that is criminal.

 

[shookwun]

you must be wearing an old school system because I wear a swiss lace and it's undetectable at the hairline.

Graduated hairline n everything.

 

[buckthorn]

If he's done this to you, chances are he has done it to many other people. He's obviously an unethical crook that shouldn't be allowed to practice.