A 1990 Hair Transplant Horror Story That I Had To Tell Which May Yet Have a Happy Ending
Can you imagine that you go see a doctor because you are losing your hair. You are young and you believe in modern medicine and in doctors. You take the courageous step to improve your look and get your hair back to look younger. You have already lost too much hair and fear that you will lose it all. Then you go to the doctor’s office who advertised with the strong suggestion that one can get their hair back by having a hair transplant. Then he sees pictures in the newspapers, even a few ads on TV and in magazines. He went to one of those advertised doctors and met a man in a white coat that he thought was the doctor, but he quickly finds out that he is not a doctor. The man tells him that he came to the right place. “Dr. T can give you back all of your ‘luxurious’ hair and you will never have to worry about it again” says the man. The year is 1990, before Propecia was available (which means that his hair loss would continue even more rapidly after the transplant). This man in the white coat introduces him to the doctor and he seemed personable enough. After all, with his white coat and his name clearly displaying ‘Herbert T, M.D.’ he clearly presents with authority. He recommends hair transplants and a series of simple surgeries called scalp reductions (removing the bald spot from the back of his head).
Then he starts the process and after one surgery he starts doubting that this is going to work out so he go back to Dr. T three weeks from the date of surgery and he tells him how nicely he are doing and the scabs on his head will disappear in a few weeks. He then tells him that he scheduled you for your first scalp reduction surgery, two months later that while he is waiting for the hair to grow out which normally takes 8 months. “After all, he only transplanted the front of his head and had to deal with the top and crown area”, said the doctor. At this new scalp reduction surgery, the removed part of the bald area in the top and back of his head. That simple surgery is not quite as simple as the doctor said and he has a lot of pain following the surgery. He got to a mirror and saw the scar down the middle of his head and now became more concerned than ever. So again, he goes to visit Dr. T. This time 4 1/2 months following his transplant surgery, the doctor tells him that he is doing fine but that there was still more bald scalp that had to be removed, so the doctor schedules him again for another scalp reduction surgery. He agrees. Then after 2 more months, he noticed a red scar down the middle of his head that seems to have stretched, so he goes back to Dr. T again and he tells him that he still needs a third surgery to remove the rest of the bald area along with scar that formed. After that third scalp reduction, he is now starting to get concerned. Four surgeries (one hair transplant and 3 scalp reductions). Now he waits anxiously until 8 months later when the hair starts growing. At first he gets excited, but then the pluggy nature of his dark brown hair grafts start showing. So again, he goes back to Dr. T who then tells him that it will take two to four more hair transplant surgeries to fill in between the brown hair plugs so it does not look so pluggy. Now he is not trusting the doctor anymore because he never told him that he would look pluggy and needed more surgeries. Where was that luxurious hair that was represented? So he gets a second opinion and he meets Dr. Fredrick W who confirms that he needs at least 4 more surgeries to makes the original work look normal.
Between the terrible plugs of the early 90s, and the three scalp reductions, he had a pluggy look created by his dark brown hair spaced by bare white scalp skin, like a corn field. The scalp reduction scar ran down the middle of his head, the scar stretched and anyone could see it. Over and over again, he repeats this process with Dr. Y and then Dr. Z and a few other doctors until he reached 13 surgeries in 4 years. Imagine 13 surgeries and having to wear a hat to hide the deformities on his head. Can you believe that his faith in doctors allowed him to go down the garden path created by immoral doctors who took his money and cared nothing about him? I am ashamed of those doctor who were nver honest with him and continued to rip him off for money and worse, continue the deforming surgeries repeatedly over and over again, making promises they could never meet. No one ever told him where reality was.
I asked him why he had so many doctors and why he put up with failures upon failures. He said there was no internet in those days and each time he saw a new doctor and they looked at him, they told him that they could fix him because other doctors messed him up. Just another false start here and there. He even flew to Chicago to see another ‘experienced’ doctor. He found that during the surgery a doctor doing his first hair transplant procedure did the surgery, supposedly supervised by the senior doctor at the Chicago office who never came into the surgery room.
If I were him, I would have sued all of the doctor, everyone of them, but the statue of limitations had expired and he was left to live his life under a hat. It impacted him in every social setting one can imagine. He couldn’t go swimming because he would have to take his hat off. He felt shame, but it was the doctors who should have felt shame. It must have cost him a fortune as his doctors made off like bandits. Patients like this just don’t sue their doctor because they feel so much shame and going before a jury of his peers would make them feel even more shame.
Now with that said, last week we put together a plan on how to fix him. The plan was simple. I told him what I wanted to do but there was a risk that I could not implement the plan I wanted because his donor hair was very depleted. The goal was to try to rebuild a normal hairline and put hair into and around the scar and also place it to the sides of the scar if we got out enough hair to accomplish this goal. It was risky and we both knew it. But he agreed to take the risk. Then, after the surgery, with great surprise, we succeed beyond what I had expected and harvested 1550 grafts, enough to produce a normal hairline with enough hair left over to sparsely cover the scar area going down the center of his head (from the three scalp reduction).
Over the past 24 years that I have been in this business, I have had well over 1000 patients like this man. I was able to fix many of them (see: https://newhair.com/photos/patient-ul/ and https://newhair.com/photos/patient-vi/) but not all of them. In eight months, I am planning to perform scalp micropigmentation on him to hide all of the scars and give him a good base for a totally new look. Scalp micropigmentation (see: https://scalpmicropigmentation.com) gives me a tool that I have never had before so now I am more confident than ever that I can help him achieve a normal look with only some minimal styling modifications. I am anticipating that for the first time in 25 years, he will take off his hat and even go for a swim if he want to. In 10 months, I anticipate that I will post his before and after pictures here on Baldingblog.com along with a reference to this post and a statement from him (which he indicated he would make about his view of his result).
Ironically, the experience of the patient above – now considered
poor care – was regarded as “standard of care” practice pre-FUE.
It essentially echoes my experience – with fewer surgeries – in 1979
at a Los Angles mill considered the “state-of-the art” center back
then. Initially, I also initially met with a non-medical customer rep
who had his shirt open to navel, gold chains around neck, and multiple
gaudy rings (even then I thought it would make a good Saturday Night
Live skit). He could not answer any significant medical questions but
ensured me that I am a quality candidate at age 29. This would
followed by meeting a charming charismatic physician who was a few
years out of specialty training and who instilled confidence by
outlining a plan for several scalp reductions – and transplant (with
large plugs) to hairline, which was the only area with significant
thinning. No discussion of highly likely future balding and risk of
depleted donor source. Many years later, when FUE became available, I
obtained a satisfactory look with repair work from additional
transplants (including using non-heard hair). The all-too-common
problem that the above patient’s story emphasizes is that once you
go down the path of “correctable” surgeries that, in fact, make
things worse – it’s hard not to chase and chase poorer outcomes in
the hopes of improvement. Medical malpractice occurs when a
health-care provider deviates from the recognized “standard of
care” in the treatment of a patient and “standard of care” is
defined as what a reasonably prudent medical provider would or would
not have done under the same or similar circumstances. As a physician,
I’m sad to say that both my and the above experience of the patient
Dr Rassman is posting about would have been considered
“state-of-the-art” back then, although in retrospect years later I
recognize that profit and marketing seemed the most compelling (if not
only) interests of the group in my case.