OrioleFan's - Profile page One year post HT

Posted :1/14/2012

I have reached the one-year mark.  If this was the "final result" I would be disappointed; the hair density and evenness of growth is poor, indicating many of the transplanted grafts have not grown, particularly those behind the hairline.  Dr. Bernstein confirmed this assessment at the annual check-up.  At one year there is virtually no hairline and there are two almost bare spots near the temples.
My assessment of the result would be as follows.Hairline:
The hairline is apparent but porous (particularly on my left
side) and slightly asymmetric.  Density is greatest here, but still not particularly dense.Temporal region: The area
around the temples (behind the hairline) is extremely thin.  From atop it looks virtually bare.  I estimate density is <10 hairs per square centimeter in this area.

Mid/rear-scalp: The mid/rear-scalp area
is harder to judge as I had a reasonable amount of native hair.  This area is not a major concern for me at present -- though I do worry about it as I age and the native hair eventually falls out due to male pattern baldness.
Scar: The scar feels and looks good; I am aware of the scar when pressure is applied to the scalp near the scar, but overall I am happy with the scar healing.I am not sure exactly why I experienced such a poor result, but I can think of a couple reasons:1. Folliculitis/acne: About three weeks post surgery I experienced a fairly bad bout of folliculitis.  Dr. Bernstein initially did not diagnose accurately the type of bacteria causing the folliculitis (eventually it was determined to be acne bacteria), which delayed effective treatment by 3-4 weeks.  Dr. Bernstein indicated this could cause me to "lose a few grafts" -- this is a vague term, and I would hope ~50% of grafts is not "a few", but nevertheless this strikes me as the most likely reason for the lost grafts2. Poor graft placement: During the surgery one of the technicians continually corrected another (apparently new) technician about placing the grafts too deep into the scalp.  I noted that the area they were working on was behind the scalp and on the left side, where density has turned out to be poor.  I do not know whether deep placement is a major issue, and I was surprised the one technician was correcting the other while I was awake, alert and listening (I suppose I am glad the corrective guidance was given), but I surmise poor execution could play a role in the outcome.
Dr. Bernstein advised me to wait six more months before conceding that the first transplant produced a mixed result at best, and I plan to give him the benefit of the doubt.  However, if there is no material growth in the next six months, I will expect Dr. Bernstein to stand behind his work and address the shortcomings.  I paid absolute top-dollar for my procedure, and while money brings no guarantee of success, I expect this level of fee comes with an implicit guarantee that the doctor will allocate their time and resources to address adverse outcomes to the greatest extent possible, particularly those that could have been mitigated by better care.