Category: Hair Transplantation

hello dr

lets say if the new drug came to the market and it can regrow the hair completely, then what what happened for who had hair transplant over 8000 grafts like me, they will have too much hair, i mean their hair back and the transplanted. will that make the hair to not look natural ?? or is that dangerous? thanks

Fun with hypotheticals!

I have never heard a person tell me that they have too much hair. Actually, the typical hair transplant rarely exceeds 35% of the original density, so getting all of your old natural hair will only add to your density. And, it should look absolutely natural if it was done correctly in the first place.

Hello Doc,

I had my first hair transplant 6 months ago in Texas and I received 1613 hair follicles in the frontal region (That’s what my Doctor claims 1500 + courtesy grafts). I lost all the transplanted follicles within first 2 months and I see few hair follicles growing in the sides.

From the day one I had doubt that I didn’t receive the number of follicles I paid for (1500). I felt I received only 1000-1100 grafts, My buddy did count the number of incisions made 2 days after the surgery. I also went to a hair transplant surgeon to get a second opinion but the surgeon refused to do the counting as he felt it was unethical thing to do. However he convinced me that I would have received the number of Grafts I paid for. He also told me the incisions are microscopic and I cannot count it accurately. As the days went by scabs started to form and I did my research by comparing the photos of people who received same number of grafts as me in the frontal region.

After all the research I’m still convinced that I didn’t receive what I paid for and I feel cheated. It took me great pain and sacrifice to get that surgery and I feel its not even worth it. I have decided to wait for few more months to see, how may hair follicles will grow and how far it covers my bald spot.

My question to you is

1) Is it normal to feel what i’m going through
2) Can someone count the number of incision/grafts accurately after the hair transplant ?
3) Lets say if I get a HT from you, How Am I insured that I receive what I paid for ?
4) Do HT surgeons really cheat ? or Am I just being paranoid ?
5) Lastly In case im really cheated , What Can I do ??

I don’t mean disrespect you or the HT surgeons community But I’m very disappointed with my situation. Please answer all my questions and relieve me from this confusion.

Thanks in advance.

I don’t know if it’s “normal” to necessarily worry about getting cheated, but I suppose that depends on your level of trust with the doctor.

On occasion, I have been requested to count the grafts for someone that wasn’t my surgical patient. I had one of my patients feel that he was cheated and took a professional photograph of his head the very next day. He had a large photo printed and placed pins in the wounds that he could see (in the photo, of course) and found that only 50% of the wounds were pinned after the analysis was done. So I managed it by showing him: (a) the count sheets of the 5 individual technicians who did the cutting of the grafts from the strip and we added them up together, (b) I had him come in to watch a surgery on his second day to see if he could identify the wounds in all lighting conditions with good photographs (he could not), and yet he watched us place the grafts to know that the counting process is intricate. He saw that there were two counts that were done simultaneously — one by me audited by an assistant working next to me as the sites were made, and one by the staff cutting up the hairs and grafts from the strip. I invested a great deal of time to address his concerns. I am not sure, to this day, if all of my efforts were successful.

In three people that came to see me to count their hairs and grafts on the 3rd-6th day after surgery, in two of them I found that the counts did not match up. One was off by over half of the amount claimed, one had 90% of what was paid for… and the third was on target.

On another patient, I counted the grafts and the hairs that grew 8+ months after the surgery (the man was relatively bald in the front and top where the grafts were placed) and found that many of the grafts did not grow to the numbers transplanted (about 2000 grafts out of 7600 graft he paid for), and the hairs in each graft had low hair counts. This was done under the assumption that everything on his head in the transplanted area were grafts. I had inside information on this last patient from one of the doctor’s technicians who claimed that this was far more common in that particular doctor’s practice than he could stomach, so he quit working for there.

There is little recourse for the patient if he feels that something improper has occurred, as an investigation would be difficult. I think that most doctors are honest and try to do their best when they deliver a service like a hair transplant or, for that matter, any cosmetic procedure. This, of course as I have said many times before, is a buyer beware issue, and each and every prospective patient should do their research before making a final doctor selection.

I sport a buzzcut and am considering MHT/SMP to disguise my norwood 3/4 hairline. I was just wondering, would a hair transplant surgeon be open to the idea of densely packing grafts into a mohican hairstyle and then filling in the rest with SMP?

I am happy with a buzzcut but having the option of growing a thick mohawk seems great to me. I know it’d look very odd if I left my hair to completely grow out, but so would SMP alone.

You need to establish a doctor-patient relationship, then ask that doctor if he would go along with your request. I am open to any reasonable ideas and plans, but I look for realistic expectations and will not produce a “fad” that will fix you to an unusual look for the rest of your life.

I am considering an eyebrow transplant due to having lost a good portion of my eyebrows as I have aged. (I am in my mid-40s). Can you discuss the relative merits between using leg hair and scalp hair for eyebrow transplant procedures? I have heard some doctors prefer leg hair for this procedure.

Leg hairs do look similar to eyebrow hairs and can grow to about the same length, so it may be an option. The major problem with leg hair is the length of the telogen portion of the hair growth cycle. The telogen component (the period where the hairs are not growing above the skin and are in a rest period below the skin) is about 60-70% of the total cycle. That means that for every ten hairs that are transplanted, only about 3 will be growing above the skin to see at any one time. With scalp hair, the telogen component of the hair growth cycle runs about 3 months and the growth phase runs about 3 years. Better value!

In general, we have traditionally transplanted scalp hair to eyebrow, because we have the most experience with scalp hair and know how it behaves (its growth cycle is predictable).

Hi Doc,
Could you be able to post some photos in HT on younger men (30-40) with advanced balding patterns (class 6 or higher) in your blog or at NHI site. I am 32 years old south asian considering HT with NHI, but I havent been able to find how younger patients fare with HT.
Thanks for this great blog.

Take a look at our patient photo galleries on the NHI site. There’s over 300 patients shown there with thousands of pictures. There are many young men on the site that fit what you’re asking for. I used the search box and found these to get you started: Patient LT, Patient EE, Patient XG, and Patient MU.

If you come to one of our Open House events, you will actually meet some men in their late 20s or early 30s who have been transplanted.

I’m sure you’ve heard the saying, “You get what you pay for.” With offerings in the dollar store, are you getting real value? Those who purchased cheap toothpaste at bargain stores a few years back obviously didn’t know that it was toxic with lead or antifreeze, or those that bought imported pet food filled with chemicals to make plastics had no idea they could potentially be killing their pet… but fortunately the FDA came to our rescue. For those that buy cheap hair transplants, there is no FDA, medical board, or attorney general to tell you if you are getting what you are going to pay for. Even if the doctors had a better than 90% failure of the transplants, what is your recourse? You can ask for your money back, but it’s doubtful you’ll get it. I just read a recent post on a hair forum from one poor fellow that had an almost complete failure of the transplants and was refused any money back.

Recently I met with two men. One had 2000 grafts done about 8 months ago by a Los Angeles doctor with a survival rate of the grafts at about 20% (my estimate). That means that his $2/graft pricing really was $10/graft based upon survival of the grafts. Not only did the grafts that survived cost more, but there was significant damage to the donor area with 1600 graft with at least 3000 hair equivalents lost from his donor bank. What was the negative value of that loss? Incalculable in my humble opinion, as these hairs are gone forever.

The second man was an old hair transplant patient of mine from about 13 years ago. He had terrific results and loved his transplanted hair, which lasted to the present time. A friend of his wanted a procedure done and found a doctor willing to do it for $2.50/graft. My patient referred his friend to me, but wanted to know if I would match this price point. It just so happened that the doctor offering this cheap rate was the same doctor that had the 20% survival on the other patient! [note – It’s our policy to not speak unfavorably about doctors by name on this site, so please do not ask me to reveal his name (do your research and you can probably figure it out though)]

I told him to look over our Selecting a Hair Transplant Doctor guide, and invited him to our next open house event. We had 6 of our former patients come to that event to show off quality results. That other doctor never showed off the quality of work he does. Does that mean that he has no patients worth showing? The only way you can really get an idea of what is going to happen to you is to see results first-hand. We wrote the how-to guide on selecting a doctor, because we want you to become smarter shoppers. This is surgery on your scalp! I fail to understand why someone would risk having this procedure look completely fake or risk the loss of valuable donor hair. Ask yourself, do you really want a discount store hair transplant?