hair transplant repair

[Murphys_Law]

I like to consider all possibilities on everything, including the worst ones. So if I had a hair transplant and say something came out wrong like

1) grafts didn't grow
2) shock loss
3) bumpiness where the grafts where placed
4) larger than normal scar

Would I be able to have it repaired? Could I look normal, even if still balding, but normal ?

It is hard to know what doctor to go to and who to trust. Even the best doctor in the world could have had a late night out or something and what if I was the patient the next day. What if, what if.

I have a bit of bad luck so this is all concerning since this involves surgery, so that is why I ask about hair transplant repair even before booking a surgery date with a doctor.

thanks.

[Jotronic]

I think this is a valid concern and the answers greatly rely on whom you choose for your procedure. So you know, neither Dr. Hasson or Dr. Wong drink so you have no hangovers to worry about

Regarding;

1) grafts didn't grow

This can be remedied by additional grafts or in rare cases removal of old grafts. I see more of the latter with patients that had plug work years ago but it is becoming less common nowadays.

2) shock loss

This depends because there are two types of shock. Permanent and temporary. Temporary usually starts to regrow about the same time that your grafts start to come through (three to five months). Permanent, well, never comes back. Now both of these can happen in either the donor or the recipient area. Permanent shock in the donor will not come back so there is not much you can do. Thankfully, we don't really see this issue nor permanent shock in the recipient area either but if it were to occur in the recipient area then more graft work would be necessary.

3) bumpiness where the grafts where placed

Thankfully this does not really happen with us either because of the flat blades we use via the lateral slit technique. Bumpiness usually is caused by incisions being made too deep that can lead to pitting or too much tissue attached to the grafts which can cause ridging. There are other reasons but these are among the most common. The solution is not so clear cut. I have heard of some patients (online) speaking of fraxel (spelling?) laser to resurface the area. It is a long and expensive process to undertake just to regain the appearance of normalcy.

4) larger than normal scar

Scar revision is king for this issue and we deal with large scars all the time with our repair paitents. Repair makes up about 30% to 35% of our total patient base.

Hope this helps.

[SpencerKobren]

Well written Joe! I would also add that there are some people who are just not emotionally equipped to deal with a less than perfect outcome. All cosmetic surgery carries with it the risk of complications, and no matter how small that risk might be, a prospective patient has to be able to cope if the worst case scenario does arise.

The good news is that most complications can be relatively easily addressed and rectified, but for some this can take a heavy emotional toll.

[Murphys_Law]

Jotronic:

Well thats good to know that Drs. Hasson and Wong are not drinkers

Thanks so much for providing so much detail to my question, it does help to know that some things can be done to remedy an unsuccessful hair transplant procedure. I guess the key is not to be messed up in the first place. I think the scariest most unpredicatable thing is the shock loss, but I guess if you are gonna go through with the procedure you just have to accept that it is a possibility and then hope for the best.

Spencer:

I am equipped to deal with an average outcome, something better than where I am at, I just don't want to be worse off. Thank you for sharing your thoughts on this as well. You are right, you really do have to be ready to cope with that worst case scenario, especially if you are me. Bad luck follows me around. Where is the "Are You Mentally Equipped To Be a Candidate For Hair Restoration" List?
I'll start it off:

1) Do You Suffer From Obsessive Compulsive Disorder?
2) If Not All The Grafts Grew Would You:
a) Be happy with the ones that did grow and move on and be happy with what you had?
b) Be happy with the ones that did grow and get another hair transplant
c) Sulk For a Week
d) Sulk For Two Weeks
e) Sulk forever
d) Paste a photo of the doctor on the dart board, drink, throw darts and sulk forever ?
-----
Anyone want to add anything?

[gillenator]

Originally Posted by Murphys_Law

I like to consider all possibilities on everything, including the worst ones. So if I had a hair transplant and say something came out wrong like

1) grafts didn't grow
2) shock loss
3) bumpiness where the grafts where placed
4) larger than normal scar

Would I be able to have it repaired? Could I look normal, even if still balding, but normal ?

It is hard to know what doctor to go to and who to trust. Even the best doctor in the world could have had a late night out or something and what if I was the patient the next day. What if, what if.

I have a bit of bad luck so this is all concerning since this involves surgery, so that is why I ask about hair transplant repair even before booking a surgery date with a doctor.

thanks.

Well the first thing you may want to consider is changing your handle to "Great Expectations"!

Obviously you have done some homework and discovered some of the well known risks of HT surgery. And that in itself is a good thing because how else can a potential patient make a sound decision if they are not aware of the potential risks along with the potential benefits?

Here's some additional thoughts which I hope will help you along the process:

1) If the grafts did not grow then either the place you went to completely whacked your procedure by damaging/transecting them, OR another reason to have no or very little yield from a HT procedure would be something related to your current medical condition and/or one's physiological makeup. In addition, a patient may be on certain medications for other medicial conditions which could potentially affect the re-growth. That's why it's so important for the doctor and patient to review that patient's medicial history and current and prior medications BEFORE any decisions are made about moving forward with the procedure.

2) Shockloss is unpredictable, PERIOD! Yes some of the instrumentation which create the recipient sites have been greatly improved and subsequently less invasive to the recipient area, yet a ceratin level of trauma is caused by ANY incision and what we cannot predict is how any patient's scalp will respond to that trauma. I will say this. From my endless observations since the advent of using much smaller custom-sized blades, shockloss has not been as extensive as it was years ago. And I attribute that to the improvement of the tooling and the types of incisions used by the best docs today. Not all HT docs use the most improvised tooling and methods so that's something to be to asking in the consultation, "Which type of incisions will you be doing and what instruments do you use to create them?" See what I mean?

3) Bumpiness, pitting, ridging, etc, etc, are usually the result of being treated by an imcompetent HT doctor. Notice I said usually, not always. Do your research on docs, look for patient examples trying to see as many in person as possible. Obviously most HT docs are only going to preview the best pics they put up at their websites. Nothing can match seeing the patient in person.

4) This should not happen UNLESS you do not have the scalp elasticity to accomodate a strip excision and the doctor decides to do the strip anyway for the money. Believe it or not, many docs still never test scalp laxity for strip. You have no idea on how many guys with wide scars have told me over the years that their doc never tested for laxity, nor even discussed it! IMHO, every doctor should discuss with EVERY poposed patient "how they heal" from cuts, wounds, lacerations. And especially cuts above the neckline. Some patients heal with wider scars, but is the exception, never the rule. If the doc is reputable and competent, the scar should come out fine IF the proper closing method was utilized for that particular patient, AND they have no issues with healing. Worst case, if the patient does not have the laxity to accomodate a strip, then FUE is the best path to take from there.

Wishing the best in your research!

[gillenator]

One other thing about your first item, grafts not growing. In those times where regrowth has not occurred favorably, most docs first response is to "ADD MORE GRAFTS!" Trust me, much more evaluation including a potential scalp biopsy must be done before throwing the unhappy patient back into the OR room!

And unless it can be established with a high amount of certainty that it was a case of the patient's medical condition or physiological makeup, going back to the same doc would be TRAGIC! You do not want to roll the dice again with the same doc when we have very limited donor to draw from.