This week I saw a man who claimed that he had 3000 grafts (he said his doctors told him that his grafts had about 9,000 hairs) placed on his head about a year ago. I could not see much hair from the hair transplant and because of his dark skin and diffuse hair loss, it was difficult to see detail well without a good light. The patient was not sure what benefit he had and came in for another 3000 grafts, this time from me.
I did my usual analysis. His family came from India so I was immediately alerted that he probably had a density in the 1.6 hairs/square mm range (average for an Indian from India). When I measured it, his average density was 1.5 hairs hairs/square mm. To have received 3000 grafts containing 9000 hairs, his density would have to be at least double what I measured. People who can get 3000 grafts averaging 3 hairs per graft, are very, very rare and it was clear that his 3 hair count per graft was not possible based upon my assessment of his donor area density. Putting aside this way of analysis, I would take it a step further. The size of the strip for 9000 hairs would have been huge. I would doubt that he had a strip of that size. My conclusion was that what he thought he received a year ago almost certainly did not happen. I believe that he had to have been duped by his surgeon.
I asked him about his doctor. He liked his doctor’s personality and his prices, but did not want to go back to him because he did not see much in terms of the results he expected. When I asked him what he paid, he told me that he paid $3/graft and selected the doctor after extensive shopping. This was the one doctor he felt that he could afford. When he looked into this doctor’s reputation, he did not find anything bad about the doctor (I did not probe what he meant by looking into the doctor’s reputation). When I suggested that he might not have received 9,000 hairs in 3,000 grafts, he said that he wouldn’t know, since he trusted that the doctor sold him what he paid for.
So here’s my analysis and the reason for writing this…
This patient was fleeced by his doctor. He was robbed. Not only did he not pay $3/graft (because the graft count was highly inflated), but he did not get what he wanted or needed and his results reflected that. What transplants he did get, seemed to be very few by my estimate (less than 500 grafts had grown). Assuming the 500 graft figure, one could calculate that he paid far more than the $3/graft. It angers me when patients get screwed over like this and I’ve been very open about my feelings in the past (see here, here, here, and here for examples).
I personally believe that his experience, although extreme, unfortunately does reflect some doctors’ practices where the doctors manage their way out of the recession in the US economy by taking advantage of the patient who believes in and trusts them. Doctors are like many professionals on Wall Street, where the bottom line is money and not the welfare of their clients. Scummy doctors unfortunately give the honest doctors out there a bad name and the good doctors really can’t compete with price claims of $3/graft (that actually reflect higher fees). My analysis was reached by my knowledge of the field and the science of hair density calculations which I have defined in the literature. I’m not trying to scare you away from having surgery if you are a candidate thinking about doing it, but I’m hoping this serves as a warning to do some extensive research and learn about what you’re buying… and above all be careful about your research. Some of the references here give more specific advice.
Traction alopecia reflects pulling on the hair. Long hair under a turban would do that, so as you are keeping your hair outside the turban, then that hair will not be pulled and the insult that is causing the hair loss will have been obviated. Shaving your head might keep the traction off your scalp, but as your hair regrows, the problem will reappear. A ponytail can also lead to the same fate, depending on the tightness and how much pulling is going on. Really, your only option to prevent this is to not produce traction on your hair.