TTDS -

Okay, I've caught myself up on most of your thread -

For 9 months, if you received 2500+ grafts, your results aren't good - especially if they were in the frontal 1/3 as you indicated.

I think you should talk personally with Dr. Epstein and see what he recommends. I've been away from the boards for a few months but in my tenure here have liked the work I've seen from him. I do wonder why you didn't get more grafts from your first session with your level of loss.

Anyway - boards are great for information but in this case I think you've heard enough to know that your results at this point aren't what they ought to be, so I'd start talking with your Doc ASAP!

Best of luck to you -

Hairbank, Thanks for your input. I have contacted Dr. Epstein and he says to wait for another month to see what happens. I'm willing to give that much more time but nothing beyond that. I believe I am also going to consult with a third party to get their input. The number of grafts I was given is what the doctor recommended and I didn't argue with him since this is his area of expertise not mine. Trust me I would have rather had it done in one session so I wouldn't have to go through this again. Now to think the first one may have been unsuccessful has left me numb. I can't say enough how everyone on this post has really made me feel like I'm not alone. I couldn't imagine going through this before the internet. People on this forum seem to be genuinely interested and concerned with my dilemma. Thanks

TTDS,

Good luck, I hope you get a spurt his month but I would be very concerned, you should document with hi res pics your progress. I really think 2500 grafts are a significant amount and should have made a real difference. Maybe it will in time.

ttds, after my first ht i new immediately something wasn't right so i went to dr.feller the next day and he confirmed my fears--i had been given mini and micro grafts and for what i paid received hardly any. so there i was, having just dropped $7k and knowing that the next year would produce pawltry results from my ht. i'm now 4 months post-op from ht#2 with feller and it was a long and expensive journey--my first ht doc did not stand behind his work. so, things could always be worse. but have faith that your hair will thicken up.worst case scenario you have a good base to start with for a 2nd procedure if needed.

Several of you have suggested I post more photos with different angles and higher resolution etc. That is a great idea. Since the site wouldn't take any of my photos until I reduced them down and I'm not so good at that task I don't have any more to post. However, I did send several different shots with different angles and high resolution to Dr. Epstein. He has my permission to post them as long as he leaves my face out. I'd like to retain what little dignity I have left. LOL!

TTDS,

If you need help posting photos, I'll be happy to edit them to hide your face and reduce them to the appropriate size without losing resolution.

Email me 2 pictures per email at help@hairtransplantnetwork.com and I'll be happy to edit them and send them back to you for posting.

I have sent a follow up email to Dr. Epstein yesterday and have requested that he post a public reply to this thread. I expect that we'll hear from him in the near future.

Regarding private messages, what is said in private is kept private. However, if there are members who are dissatisfied with a physician's work, I encourage them to create their own thread, share their experience, pictures, etc so we can help them.

Best wishes,

Falc

Falc, when I get home tonight I'll send you a couple of photos to post. I agree with you about the private messages I received. I'll attempt to see if that individual is willing to contact you or post something about his experience. He has posted on this thread but didn't mention who his doctor was. Of course it is up to him to remain anonymous if that is what he decides to do.

quote:

Originally posted by Time to do something:
The number of grafts I was given is what the doctor recommended and I didn't argue with him since this is his area of expertise not mine. Trust me I would have rather had it done in one session so I wouldn't have to go through this again.

I do feel for you and hope you can get this resolved. Be sure to keep us posted on your progress and how things go with Dr. Epstein.

If you were NW5 or more as you appear to be in the pic, IMO you needed as many grafts as safely could be harvested so I'm not sure why you only received 2500. You may have had laxity issues, sparse donor.............I'm not the doc but I believe average virgin scalp between 3000-4500 is pretty doable........just IMO and for others lurking out there who have excessive loss.

I received over 3800 grafts from Dr. Wong for HT #2 and believe if it would have been my first HT they could have harvested 500 additional easily.

I was told I am a NW5 and that I had enough donor hair for three procedures with ample donor hair and good laxity.

DEAR FORUM MEMBERS- I AM IN TOTAL SHOCK- HOW MY REPUTATION OVER THE COURSE OF 5 PAGES HAS GONE FROM ONE OF THE 2 OR 3 TOP SURGEONS IN THIS SPECIALTY TO ONE WHO NEARLY EVERY POSTER IS QUESTIONING MY INTEGRITY, MY DEVOTION TO MY WORK, AND MY WORK. THIS IS TRULY A TRAVESTY.

I HELD OFF ON ENTERING PUBLICLY THIS FORUM AFTER REPLYING TO MY PATIENT IN THE PROPER WAY A PHYSICIAN SHOULD- PRIVATELY AND WITH DEEP SINCERITY. I REASSURED THIS PATIENT THAT I DID NOT KNOW THE CAUSE OF HIS LESS THAN EXPECTED HAIR GROWTH AT THIS TIME- BUT WAS CONSIDERING SEVERAL REASONS, THAT HE REPEATED- THE MAIN ONE BEING HIS CONTINUED WEARING OF THE HAIR PIECE. HOWEVER, THERE IS AN "X" FACTOR - THAT EVERY SINGLE COLLEAGUE OF MINE, EVERY ONE WHO IS PART OF THIS COALITION- HAS EXPERIENCED. THAT X FACTOR IS THE OCCASIONAL LOWER THAN EXPECTED RATE OF GROWTH THAT, DESPITE OUR BEST EFFORTS, OCCURS FOR AN UNKNOWN REASON- YES, PAT AND BILL ARE CORRECT IN THEORY- IT CAN BE DUE TO POOR GRAFT HANDLING OR DESSICATION (DRYING OUT).


HOWEVER, HERE IS MY POSITION.
I PERFORM 500 PROCEDURES EVERY YEAR- PERSONALLY, WITH THE SAME TEAM OF 15 ASSISTANTS I HAVE HAD WORKING WITH ME FOR YEARS- SEVERAL HAVE BEEN WITH ME FOR 10 TO 14 YEARS! THESE ARE THE SAME ASSISTANTS WHO WORKED ON JULY 4TH, 2007- ASSISTANTS WHO DO THEIR VERY BEST, UP TO THE VERY HIGHEST STANDARDS, EVERY SINGLE DAY. THERE WAS NO "I WISH I WAS SOMEWHERE ELSE?" THERE WAS NO "DRYING OUT OR MISHANDLING OF GRAFTS BY INEXPERIENCED ASSISTANTS" THERE WAS NO "DR. EPSTEIN IS COMPROMISING QUALITY".
AFTER ALMOST 15 YEARS OF PUTTING MY HEART AND SOUL INTO MY PRACTICE- TO WHERE PATIENTS KNOW THAT THEY WILL TREATED BY ONE OF THE BEST TRAINED, MOST DEMANDING SURGEONS IN THE FIELD- I HAVE EARNED MY PLACE AS ONE OF THE BUSIEST IN THE FIELD OF SURGICAL HAIR RESTORATION.
I INVITE YOU TO GO AHEAD AND ASK DRS. CHARLES, NUSBAUM, FELLER, SHAPIRO, BERNSTEIN, MEJIA, STOUGH, RASSMAN, HASSON, MCANDREWS, HABER, COOLEY, PARSLEY, KNUDSEN- EVERY ONE OF THEM, TO A TEE, KNOWS OF MY INTEGRITY AND THE QUALITY OF MY WORK.
I TRULY FEEL LIKE THIS THREAD HAS BECOME A WITCH HUNT- I THOUGHT THIS IS SOMETHING THAT ONLY HAPPENS IN POLITICS- AND I AM NOT A POLITICIAN, NOT "W' BUSH, NOT BILL CLINTON, NOT CHENEY, NOT OBAMA- RATHER A BOARD CERTIFIED FELLOWSHIP TRAINED FACIAL PLASTIC SURGEON, WHO SPECIALIZES IN THIS SPECIALTY PERFORMING 2 PROCEDURES EVERY DAY BECAUSE I AM PASSIONATE ABOUT MY WORK, LOVE MY PATIENTS, AND AM REALLY TALENTED AT IT.

I INVITE EVERY ONE OF THE POSTERS ON THIS THREAD TO COME VISIT MY OFFICE. PAT HAS. TO SEE HOW I AND MY TEAM OF ASSISTANTS ALL WORK ON ONE PROCEDURE AT A TIME, EVERY ASSISTANT WITH 3 ICED PETRI DISHES INTO WHICH THEY PLACE EACH INDIVIDUAL 1, 2, AND 3 HAIR GRAFTS. HOW MY 6 "PLANTER" ASSISTANTS- EVERY ONE WHO HAS BEEN WORKING WITH ME FOR A MINIMUM OF 4 YEARS, 5 OF WHOM HAVE BEEN WORKING IN THIS SPECIALTY FOR 7 TO 14 YEARS- PLACE EACH SINGLE GRAFT INTO THE SMALLEST POSSIBLE RECIPIENT SITES, SIZED 0.6 TO 0.8, OCCASIONALLY 0.9 MM IN SIZE, EVERY ONE THAT I PERSONALLY MAKE.

I AM TRULY CONCERNED ABOUT THE RESULTS THIS PATIENT HAS RECEIEVED, AND I TOLD HIM THAT. I ALSO TOLD HIM THAT, IN THOSE FEW CASES IN WHICH THIS HAPPENS, I WILL REPLACE THOSE GRAFTS THAT DO NOT GROW, AT NO CHARGE.
DO YOU REALIZE THE ILLOGICAL NATURE OF THE COMMENTS MADE HERE- SOME POSTERS ARE SAYING THAT 2500 GRAFTS IS TOO SMALL- INSINUATING THAT ONLY A FEW DOCTORS ARE CAPABLE OF PERFORMING THESE STATE OF THE ART PROCEDURES. I HAVE IN FACT PERFORMED PROCEDURES OF AS LARGE AS 4300 GRAFTS- BUT FOR THE OVERWHELMING MAJORITY OF PATIENTS, 2400 TO 2800 GRAFTS SEEMS TO BE THE IDEAL NUMBER. NOT PLACING ENOUGH GRAFTS WAS NOT THE CAUSE OF THIS PATIENT'S RELATIVELY DISAPPOINTING COVERAGE AT THIS 9 MONTH MARK- RATHER, HE HAS EXPERIENCED A LOWER PERCENTAGE OF GROWTH THAN EXPECTED.
JUST YESTERDAY I PERFORMED A SECOND PROCEDURE ON A MAN FROM SARASOTA- FIRST PROCEDURE I PERFORMED IN MID-SEPTEMBER, 2400 GRAFTS- AND AT 3 1/2 MONTHS HE HAD OUTSTANDING COVERAGE, AND YESTERDAY AT THE 7 MONTH MARK I DID A LITTLE FILLING IN UP FRONT WITH THE MAJORITY OF THE WORK PLACED INTO THE MID SCALP AND CROWN REGION.
DID I DO ANYTHING DIFFERENT ON THIS PATIENT? NO.

I INVITE EVERY ONE OF YOU TO GO THROUGH MY WEBSITE- SEE THE LITERALLY HUNDREDS OF PATIENTS' BEFORE AND AFTER PHOTOS. LOOK CLOSELY AT THE HAIRLINES, THE DENSITY, AND READ THE COMMENTS THAT MANY OF THESE PATIENTS HAVE MAILED INTO ME UNSOLICITED.

JUST 2 WEEKS AGO, IN SOUTH FLORIDA, AN 18 YEAR OLD TEEN HAVING A BREAST AUGMENTATION DIED ON THE OPERATING ROOM TABLE. ANESTHESIA COMPLICATION. HAPPENS ONE IN EVERY 10,000 CASES. RESPECTED PLASTIC SURGEON- DID ABSOLUTELY NOTHING WRONG FROM EVERYTHING I CAN TELL, YET HERE THIS YOUNG GIRL DIED.
THIS IS MEDICINE. YOU, AS A PROSPECTIVE PATIENT, CAN ONLY DO YOUR HOMEWORK, AND FIND THE MOST RESPECTED, DILIGENT, HARD WORKING, HONEST, ARTISTIC, DEVOTED SURGEON - AND THEN AFTER THAT, THERE IS SOMETHING CALLED INDIVIDUAL VARIATION. I HAVE ABSOLUTELY NO CONTROL, UNFORTUNATELY, AS TO THE RATE AND SPEED OF GROWTH OF TRANSPLANTED HAIRS, PROVIDED THAT I PERFORM THESE PROCEDURES UP TO THE VERY HIGHEST STANDARDS. THAT IS WHY THERE CAN NEVER BE A "GUARANTEE" AS TO THE OUTCOME. I CAN TELL PROSPECTIVE PATIENTS THAT IN OVER 90% OF MY PATIENTS, THERE WILL BE SOME NICE EARLY GROWTH AT THE 3 TO 4 MONTH MARK, AND THAT AT 9 MONTHS THERE SHOULD BE 70 TO 80% OF THE FINAL RESULT- BUT THERE IS INDIVIDUAL VARIATION. I CAN ALSO TELL PATIENTS THAT I CAN ASSURE THEM THAT THEIR WORK WILL BE PERFORMED TO THE VERY HIGHEST STANDARDS, AND THAT THEIR RESULTS WILL BE NATURAL IN APPEARANCE.
LOOK AT WHAT I CAN CONTROL:
1. ARTISTRY OF THE HAIRLINE- I INVITE EVERY ONE OF YOU TO GO THROUGH MY WEBSITE PHOTOS AND SEE THE AESTHETICS OF MY HAIRLINES. THERE MUST BE AT LEAST 400 HAIRLINES THAT I SHOW CLOSE UP.
2. FINENESS OF THE DONOR SITE SCAR- ALTHOUGH THERE ARE PATIENT VARIABLES IN THIS AS WELL, BUT GO AHEAD AND LOOK AT THE 50 TO 70 OR SO DONOR SITE SCARS THAT I SHOW ON MY WEBSITE.
3. EDUCATING AND CHOOSING OF PATIENTS- JUST LAST WEEK, I CANCELLED A PROCEDURE ON AN IRAQI WAR VET, A 28 YEAR OLD, WHO HAD UNREALISTIC EXPECTATIONS OF THE SURGERY, AND WHOM I THOUGHT LOOKED QUITE GOOD WITH HIS HEAD SHAVED. HE HAD PAID 100% OF HIS SURGICAL FEE- WHICH I RETURNED, AND LEFT ME WITH A HALF DAY OF 15 PAID ASSISTANTS WITH NO WORK TO DO. NOT EVEN AN ISSUE AS TO WHAT WAS THE PROPER THING TO DO. I FELT HE WAS BEST OFF NOT HAVING A PROCEDURE, AT LEAST FOR THE NEXT YEAR OR SO, UNTIL HE FIGURES SOME THINGS OUT AND UNDERSTANDS THE LIMITATIONS OF THE PROCEDURE.
4. MY REPUTATION- I CAN ONLY LOOK EVERY PATIENT IN THE EYE AND TELL THEM THAT I STAND BY MY WORK, WILL ALWAYS DO THE VERY BEST I CAN, AND WILL NEVER RIP OFF A PATIENT.

I DO NOT HAVE INFORMERCIALS. I DO NOT HAVE A YELLOW PAGE AD. I DO NOT DO PRINT, RADIO, OR TV ADVERTISING. NOTHING OTHER THAN WORD OF MOUTH- BY OVER 5000 HAPPY AND HAIRIER PATIENTS, AND BY A NUMBER OF MY PHYSICIAN COLLEAGUES.

I HOPE THAT EVERY ONE OF YOU, BEFORE YOU BECOME JURY, JUDGE, AND EXECUTIONER TO MY REPUTATION ALL AT ONCE, CHOOSE TO TAKE A MOMENT TO EDUCATE YOURSELVES, AND PROCEED INTELLIGENTLY AND APPROPRIATELY. THESE POSTINGS HAVE DONE LITTLE OTHER THAN TO UNDERMINE THE PHYSICAN-PATIENT RELATIONSHIP.
I AM ONE OF THE DOCTORS WHO HAS ALWAYS WANTED THIS SITE TO TAKE THE HIGH ROAD. HAVE ARGUED AGAINST PAID CONSULTANTS POSTING COMMENTS ON THIS SITE OTHER THAN PROVIDING NON-BIASED EDUCATIONAL INFORMATION. HAVE PUBLICLY COME OUT IN THE JOURNALS AGAINST SURGEONS PAYING HAIRDRESSERS AND OTHER HAIR PROFESSIONALS FOR PATIENT REFERRALS BECAUSE THEY ARE UNETHICAL. GO AHEAD AND READ THE TENS, IF NOT HUNDREDS, OF POSTS ABOUT ME ON THIS SITE. GO AHEAD AND READ JUST A FEW OF THE HUNDREDS OF PATIENT LETTERS I POST ON MY WEBSITE. COME TO MY OFFICE AND ASK TO SEE THE 4 VOLUMES OF COLLECTED EMAILS AND LETTERS FROM HAPPY PATIENTS.
I WISH TO CONTINUE PARTICIPATING IN THIS SITE AS A POSTER AND EXPERT- BUT WILL NOT STAND BY WHILE MY REPUTATION GETS HACKED AWAY AT. I AM SORRY THAT THIS PATIENT HAS NOT HAD THE GROWTH I WOULD HAVE EXPECTED AT 9 MONTHS. HE IS NOT THE FIRST. HE AND PERHAPS 3 OR 4 OF THE 500 PATIENTS ON WHOM I PERFORMED A PROCEDURE ON IN 2007 I WILL NEED TO BRING BACK TO THE PROCEDURE ROOM AND PERFORM A TOUCH UP OR WHATEVER IS NEEDED, DUE TO A LOWER THAN EXPECTED RATE OF GROWTH. BUT AT 9 MONTHS, IT IS FAR TO EARLY TO DETERMINE THIS.

RESPECTFULLY,
JEFFREY EPSTEIN, MD, FACS
WWW.FOUNDHAIR.COM
MIAMI AND NYC

Hi Dr. Epstein

I appreciate your post as i'm sure others do too. It is a shame that people opinions can really questions a doctors integrity.. No doubt all Coalition ( or ethical) doctors will eventually get questioned on results and/or their abilities.. Just the nature of the business and law of averages.. If you look hard enough, you can find at least one issue with any doc on here whether justified or not..

I certainly wouldn't want to have anyone looking over my shoulder to question everything I did , especially considering the nature of people in 2008 and their tendency to lash out at the drop of the hat..

With all of this in mind I have repeatly stated over and over on the site for close to 3 years that ALL patients must hold judgement until at least 12 months. In addition, they must do plenty of research, have realistic expectations, and BE PATIENT. We see over and over people not following this mindset and making assumptions based on lack of information or irrational emotional feelings ( or horror stories through word of mouth).

Everyone needs to be proactive on this site in realizing the power of their posts and the claims made. No doubt there are risks involved in any surgery and results sometimes are not achieved as planned. HOWEVER, one must allow the proper amount of healing and recovery process to pass until judging both the doctor and the overall result.

If not, there is no objectivity and accurate measurement of the procedure. If there are indeed any descrepancies, one must give the doctor a chance to examine the outcome and the possible factors causing displeasure ( including a patients mindset)

This is the specific reason I posted my 12 month "feeling" timeline as I myself ( having 3 HT's) experienced these irrational feelings and wanted to share my experiences with others to offer a voice of reason.. Luckily, I kept my comments to myself and was even a bit surprised after 2 HT's as my expectations were not up to par with reality.. Now, 3 years and 3 HT's later I AM HAPPY as my doctors abilities & my expectations have aligned in addition to a hell of a lot of waiting ( i.e. healing).

This is the recipe for a successful HT!

thank you for that spirited response Dr. Epstein. I hope for the most part that the posters here know of the dedication you have and the best practices you use in your office.
conjecture began to take hold as to graft handling etc, so it is so comforting to hear that your same staff is still in place and this is something that can be ruled out, and knowing the quality control you have should not have been doubted in the first place.

do you feel that in most patients taking too much tissue for the mega sessions can cause more harm than good? would like to know your take on that if you happen to read the follow up posts to yours.

Dr. Epstein,

Thanks for taking the time for such a well thought out and heart felt response. It is very evident of your passion for what you do. Personally I have always respected your work and sorry that you had to experience this. Forums such as these can at times get a little out of control unfortunately. Hopefully this will quell any further innapropriate comments.

We have seen TTDS before and after pics.. have we seen the pics of others who claim their HT with dr E was dissapointing..

I would like to see that.. there was gal of complaining of poor growth.. anyone seen the before/after pics.. are they genunine posts...

i still feel dr. Epstein is great doc based on the photos on his website..

Dr. Epstein,

You have a long proven record of consistent and quality results and have always stood by your patients, which is highly commendable. Your ultra refined results and level of patient care is what makes you worthy of the Coalition.

As I have stated numerous times in this thread, 9 months is not the time to fully evaluate the surgery, but I can understand his cause for concerns.

What we haven't seen are before and immediately postoperative pictures and these would be extremely helpful in evaluating the current situation and end result in a few months. If you have these pictures and obtain permission from the patient, I encourage you to post them. I don't believe he has these pictures, only pictures of his current condition.

If immediately postoperative pictures aren't available, a detailed description of the placement of the grafts and location on the scalp would be helpful. Where were the grafts placed? How far back? What was the approximate density of the packing in grafts per sq/cm?

I know this situation is emotionally upsetting for everyone involved, and everyone here is pulling for TTDS to have amazing growth in the next few months. Let's remember that we are all working together for the same purpose and reserve final judgement for a few more months.

Best wishes,

Falc

I can understand both parties desire to express themselves on this *heated* thread:

the patient:
made a tough decision, spent all his savings, underwent the procedure, has waited nine months w/little to show for it other than a scar. Now the doctor has sited two possible reasons of explanation (gray hair & the piece) for this AFTER the surgery and AFTER nine months, which is especially concerning for the hair piece.


doctor:
feels as though his very reputation is being boiled down to one single thread on the forum after years of work and hundreds (thousands) of successful ht's.

us (forum members):
I for one *never* questioned the "intentions" of Dr. E only the results. I don't appreciate the comments by some that make it sound as though we're making a big to do over NOTHING, turning a mountain out of a mole hill, in some wacky cyber space consperacy theory fashion...*that* is certainly not the case.

There have been about 4 or 5 patients who have recently (w/in the past 4 weeks *alone*) had some very serious, legit, concerns about their results from this doc. So we're discussing them. That's what we do here. I don't view any of that as innapropriate or jumping to conclusions.

Well said NG,

I for one care more about a patients scalp than any doctor's reputation. This patient feels bad enough as it is with the poor HT result (so far), and should he now feel guilty for damaging a reputation? I cerainly hope not.

"I AM SORRY THAT THIS PATIENT HAS NOT HAD THE GROWTH I WOULD HAVE EXPECTED AT 9 MONTHS. HE IS NOT THE FIRST. HE AND PERHAPS 3 OR 4 OF THE 500 PATIENTS ON WHOM I PERFORMED A PROCEDURE ON IN 2007 I WILL NEED TO BRING BACK TO THE PROCEDURE ROOM AND PERFORM A TOUCH UP OR WHATEVER IS NEEDED, DUE TO A LOWER THAN EXPECTED RATE OF GROWTH."


Don't you guys think that 3 or 4 patients every year is a little too many. I know I would not want to go to the surgeon who knows every year perhaps 3 or 4 of his procudures are going to fail. What if I end up being one of them? Just my thought....

quote:

Don't you guys think that 3 or 4 patients every year is a little too many. I know I would not want to go to the surgeon who knows every year perhaps 3 or 4 of his procudures are going to fail. What if I end up being one of them? Just my thought....

I just want to say again for the record that none of these patients are at full maturation and though I completely understand the concerns being made, I don't think it's fair to make a final judgment at this point, nor call them "results".

9 months is pretty far into the process however, I still think we need to give it another 3 months in the event he is a real late bloomer. The other patients who have expressed concern were at 6 and 7 months - still way too early to make a final evaluation.

Please don't consider the above as a "brush off" because it is concerning the number of patients coming forward at the same time. But I think we have to be fair and remember "hair transplantation 101" which includes key phrases like:

1. Patience
2. A watched pot never boils
3. Gradual process
4. Late bloomer

There is still a good chance that in a few short months each patient who has come forward (some in earlier stages than others) will get a positive result. I encourage these patients to keep us posted on their progress while we wait to see how things progress for them.

Falc