Can you please let me know your opinion about my hair transplant, please? I have doubts...

[4chanhrn]

7 hours ago, Al - Moderator said:

The only person who posted in this thread and is paid by this site is me and that is for work I do as a moderator. I do not get paid by any Dr

Sir without going into merits of the argument, you get paid by a company which this clinic is a customer of. That automatically means you indirectly get paid by this clinic. Even if you claim to have best interests of patient at heart, this creates extremely high conflict of interest. And the patient should be aware of this relationship.

Because I'm just an anonymous poster, let's see what an industry experts Spencer Kobren and JT, who have more knowledge about HT transplant industry than me have to say about this. Watch this video from 1:13:00 onwards.

They call you(moderators) salespeople for clinic and say you should not be taking any part in or try to steer a discussion when your client is being talked about, and moreso when the result is poor. Spencer says that your job as a moderator is to keep sponsors happy and making sales. So I'm not the only person who thinks this is problematic.

Edited July 19 by 4chanhrn

[4chanhrn]

9 hours ago, sweveney said:

It was curious to me that I wasn't provided with a copy of the paperwork I signed with all the technical legalities. I do remember, though, it was pretty much self-serving and intended to preempt or forestall any feasible complain on my part. I also recall the paperwork did not offer any possible measure of correction in my benefit. It made sense to me that the guy was covering himself.

Things like this and coming after patients who write reviews with lawyers means this doc should be on a blacklist for any potential patient. If you're actually good, you shouldn't need to threaten to sue or make people sign legalese to cover yourself. Ask yourself this: Do any of the surgeons who are very good: Zarev, Pittella, Muresanu, Laorwong, Leal, Pekiner, Nader, Ahmad come after people with lawyers and make you sign legalase so that you can't talk about a poor result? Sure they have poor results like with any doctor, but I'm yet to see a case where they left patient in a bad spot.

9 hours ago, sweveney said:

It is the nature of the trade.

HT industry is all about managing reputation because things are very subjective and regulations are scant. Bad word is bad for business.

9 hours ago, sweveney said:

I believe I owed myself to ask to someone else an informed opinion about my H.T. and thanks to you all I have a better sense of what happened and what could have been done absolutely better than it was. Also, I owe to other guys like me to share my experience at this practice. I swear I was very enthusiastic about writing an essay detailing how wonderful it was. 

Everyone should be free to share their result and anyone should be allowed to call a result sh*t or give their opinion/criticise a doctor without lawyers and industry intermediaries telling you why you aren't allowed to do so. Sharing your experience as a patient helps others in making a more informed decision. I know it certainly did for me.

Edited July 19 by 4chanhrn

[wr1015]

1 hour ago, 4chanhrn said:

Things like this and coming after patients who write reviews with lawyers means this doc should be on a blacklist for any potential patient. If you're actually good, you shouldn't need to threaten to sue or make people sign legalese to cover yourself. Ask yourself this: Do any of the surgeons who are very good: Zarev, Pittella, Muresanu, Laorwong, Leal, Pekiner, Nader, Ahmad come after people with lawyers and make you sign legalase so that you can't talk about a poor result? Sure they have poor results like with any doctor, but I'm yet to see a case where they left patient in a bad spot.

HT industry is all about managing reputation because things are very subjective and regulations are scant. Bad word is bad for business.

Everyone should be free to share their result and anyone should be allowed to call a result sh*t or give their opinion/criticise a doctor without lawyers and industry intermediaries telling you why you aren't allowed to do so. Sharing your experience as a patient helps others in making a more informed decision. I know it certainly did for me.

Had surgery with Pekiner this week and signed nothing of the sort.. can’t speak for the others. I think there are two cases online of less than full growth but not much else.

[JoeD]

11 hours ago, sweveney said:

Hey man, let me answer all that you don't know, as stated in your post: "We don't know if OP was told he may not get a great result, and decided he wanted to go for it anyways because he was happy with his first HT.'"? That assertion, with all due respect, is ludicrous.  Why would I, or anyone, decide to have a second H.T. when told that I "may not get a great result," ? It doesn't make any sense.         "We don't know if OP had bad laxity" Well, I am pleased to inform that I have great laxity.    "and poor healing characteristics" I had a surgery sometime in my life and I healed very well. I don't make keloid and have non perceptible scars from all the times I scraped my skin playing when I was a kid.   I have never been told that I may have "poor healing characteristics".    Regarding "out of the doctors control"? I can say that the doctor has a very good control over his finances.     "We don't know if the patient paid for the HT before the doc could assess said laxity"? No I didn't. I paid $2,000 as requested in advance at Feller and Bloxham. Then I paid the balance the same day of my H.T; and even if Dr Bloxham didn't assess correctly in a timely and professional manner my laxity, that's on him. He had six months to do so.  "and went forward with a procedure without knowing his own laxity situation" Are you serious? do you take me for a fool? and again, even if I didn't know my own laxity situation, Feller and Bloxham failed, once again, in doing a professional assessment of my "own laxity situation" as you say. Your questions seem to imply that the poor outcome of my H.T., as my cohorts in this network opine, somehow is my fault  ???.   At the same time, your questions, put Dr Bloxham in a very precarious position, professionally and ethically.    Why would he move forward not knowing all those things? Finally, I have nothing against Feller and Bloxham other than the things that have been subjected to the opinion of my peers in this network. You sound very knowledgeable man, so allow me to ask: Do you think that I may lose my graphs?  Thank you. 

If there were no other anatomical, medical, laxity or other unique concerns, I just cannot understand why the second strip for the crown had so few grafts. Something is amiss. 

[kgoat]

OP, if you paid the $2,000 upfront and then paid on the day of the surgery, when would the doctor have had the chance to assess your laxity? Bloxham doesn't change for follow up consultations, so that 6 month timeframe seems like it would've been the time to do this. If you paid the doctor a deposit, I don't think its that ridiculous for him to just take your money without checking your laxity himself lol. I don't take you for a fool, but I do take you for someone who may not have been overly eager to gather all the possible information you could have before deciding to pursue a second surgery. Again, I get the frustration here, I would be pissed about this outcome too. 

I think Bloxham should have done a much better job communicating expectations here. As I said before, the most ethical decision for a patient like you would be to never do a surgery in the first place (this applies to all doctors). The fact that a second strip got only 1500 grafts means something was wrong (laxity, density, etc). Could that have been a mistake on the part of the doctor during the surgery? Sure, totally possible. But based on what you've told us, we have no evidence pointing to that. And a lot of evidence that it was due to factors that could have been known before the surgery. 

Ultimately I think there are two criticisms of doctors that I see. The first is that they perform subpar surgery, due to flaws in technique. The second is they don't set patient expectations properly. My point in commenting here is to help other researchers see the difference in these two criticisms. In this post, its clear the expectations were not set correctly. This is a genuine knock against the doctor. Again, the caveat being: if OP pursued this 2nd surgery without first having an in-person consultation with the doctor, then much of that "knock" is invalid in my mind (I'm a bit unclear on whether this happened based on OP's response. Just note that this is a REQUIREMENT if you want a good result, even if you've already had a good result with the same doc prior). 

But based on the evidence in this thread, this is almost certainly not a case of the first category criticism (subpar technique) applying. So what's the correct takeaway from this thread, for someone doing research? I think it's basically:

- Have a very good understanding of how many grafts you need to get coverage given your norwood level and hair type. Ask the doctor before you pay any money (deposit or otherwise) how many grafts they are going to try to take out. If this number is insufficient, reconsider the technique, doctor, or surgery altogether.

- Bloxham is a doctor who is willing to pursue surgery in candidates who probably should not have it. This should be obvious to anyone researching him (he states on youtube he doesn't require finasteride usage, which I personally think is ridiculous). In doing so, he creates expectations for patients that are mis-aligned with the reality of what they are going to get, either implicitly or explicitly. Based on my interactions with him, I'd guess these are more implicit expectations (i.e. he probably didn't look OP in the eyes and say "after this HT you will have a full head of hair that looks very dense and nobody will think you are balding", but I have no way of verifying this fact. Maybe he did. If so, that deserves to be condemned.)

- This post says effectively nothing about Bloxham's skills as a technician. I would even argue that OP got average to slightly above average results given that he is a NW 6, clearly thinned natively between surgeries, has very fine hair, and most importantly only had 3900 grafts implanted. The outcome here, which no doubt is not "ideal", does not speak to Bloxhams skills as a doctor whatsoever. Maybe those skills are indeed subpar. But this case is not evidence of that fact.

 

I am merely encouraging everyone to be a good Bayesian when updating their priors on the doctor here. This advice applies to all other posts on this forum, this post just happens to be a great example of how reading reviews from strangers on the internet has the propensity to create a unique form of cognitive bias.

 

 

Edited July 19 by kgoat

[GibGob]

I'm a former patient of Bloxham. I am strongly suspecting that the variation in patients' results are due to the skill of his TECHNICIANS. He has techs that have been with him for many years, however there always seem to be a few that he uses that are relatively novice.

And, what is most questionable is WHERE and HOW he is sourcing these "elite" technicians he likes to brand them as. How much involvement these novice techs have handling grafts is anyone's guess. 

How much training do these new techs even go through and how well are they being supervised without Dr. Bloxham turning a blind eye to it all?

Quite factually, it is the humanistic qualities of utmost skill,motivation, and care techs must have in order to not damage precious grafts.

During my procedure I found some techs to be very questionable in their behavior and dialogue between each other. 

All the doctor does is cut the strip from your head and poke the holes. Then he hands your strip off to his techs and crosses his fingers and says a prayer they don't fumble the grafts. Who does the graft prep?....You guessed it...the TECHS! And it is for that reason it's the most logical reason why some patients have poor results and others good results

Now of course you're going to have people says it's the physiology, scarring, lack of blood flow etc. But the reality is no one can prove exactly why. The probability and most logical reasoning points towards human error i.e. technicians fault

The lack of blood flow reasoning I find to be the most hilarious. When you're having surgery the scalp is literally a bloody mess no matter where an incision is made for crying out loud! Poke a hole in the crown, front, midscalp, anywhere and what comes out? A steady stream of blood!! So, very low probability of that being the cause of poor growth. What's the higher probability of poor growth...you guessed it...human error i.e. the TECHNICIANS!

Edited July 25 by GibGob

[sweveney]

On 7/19/2024 at 2:24 PM, kgoat said:

OP, if you paid the $2,000 upfront and then paid on the day of the surgery, when would the doctor have had the chance to assess your laxity? Bloxham doesn't change for follow up consultations, so that 6 month timeframe seems like it would've been the time to do this. If you paid the doctor a deposit, I don't think its that ridiculous for him to just take your money without checking your laxity himself lol. I don't take you for a fool, but I do take you for someone who may not have been overly eager to gather all the possible information you could have before deciding to pursue a second surgery. Again, I get the frustration here, I would be pissed about this outcome too. 

I think Bloxham should have done a much better job communicating expectations here. As I said before, the most ethical decision for a patient like you would be to never do a surgery in the first place (this applies to all doctors). The fact that a second strip got only 1500 grafts means something was wrong (laxity, density, etc). Could that have been a mistake on the part of the doctor during the surgery? Sure, totally possible. But based on what you've told us, we have no evidence pointing to that. And a lot of evidence that it was due to factors that could have been known before the surgery. 

Ultimately I think there are two criticisms of doctors that I see. The first is that they perform subpar surgery, due to flaws in technique. The second is they don't set patient expectations properly. My point in commenting here is to help other researchers see the difference in these two criticisms. In this post, its clear the expectations were not set correctly. This is a genuine knock against the doctor. Again, the caveat being: if OP pursued this 2nd surgery without first having an in-person consultation with the doctor, then much of that "knock" is invalid in my mind (I'm a bit unclear on whether this happened based on OP's response. Just note that this is a REQUIREMENT if you want a good result, even if you've already had a good result with the same doc prior). 

But based on the evidence in this thread, this is almost certainly not a case of the first category criticism (subpar technique) applying. So what's the correct takeaway from this thread, for someone doing research? I think it's basically:

- Have a very good understanding of how many grafts you need to get coverage given your norwood level and hair type. Ask the doctor before you pay any money (deposit or otherwise) how many grafts they are going to try to take out. If this number is insufficient, reconsider the technique, doctor, or surgery altogether.

- Bloxham is a doctor who is willing to pursue surgery in candidates who probably should not have it. This should be obvious to anyone researching him (he states on youtube he doesn't require finasteride usage, which I personally think is ridiculous). In doing so, he creates expectations for patients that are mis-aligned with the reality of what they are going to get, either implicitly or explicitly. Based on my interactions with him, I'd guess these are more implicit expectations (i.e. he probably didn't look OP in the eyes and say "after this HT you will have a full head of hair that looks very dense and nobody will think you are balding", but I have no way of verifying this fact. Maybe he did. If so, that deserves to be condemned.)

- This post says effectively nothing about Bloxham's skills as a technician. I would even argue that OP got average to slightly above average results given that he is a NW 6, clearly thinned natively between surgeries, has very fine hair, and most importantly only had 3900 grafts implanted. The outcome here, which no doubt is not "ideal", does not speak to Bloxhams skills as a doctor whatsoever. Maybe those skills are indeed subpar. But this case is not evidence of that fact.

 

I am merely encouraging everyone to be a good Bayesian when updating their priors on the doctor here. This advice applies to all other posts on this forum, this post just happens to be a great example of how reading reviews from strangers on the internet has the propensity to create a unique form of cognitive bias.

 

 

Thank you for taking the time to write your opinion. Clearly, you lean towards blaming the patient.  You read very much like someone who has personal stakes in the business.

All your assumptions about me, my donor area, and hair type are plainly wrong. However, I don’t have the time, nor do I want or feel that I must defend myself in any capacity.

As I stated before, I was positively impressed by my first surgery. I didn’t have any better criteria to qualify any other hair transplant doctor. The bottom line is that I was a prime client that trusted a person who did not deliver for my second procedure.

Can you please share your doctor’s name and your Norwood? Without that, I would really prefer if you could kindly stop contributing to my post. 

 

Edited July 25 by sweveney

[sweveney]

17 hours ago, GibGob said:

I'm a former patient of Bloxham. I am strongly suspecting that the variation in patients' results are due to the skill of his TECHNICIANS. He has techs that have been with him for many years, however there always seem to be a few that he uses that are relatively novice.

And, what is most questionable is WHERE and HOW he is sourcing these "elite" technicians he likes to brand them as. How much involvement these novice techs have handling grafts is anyone's guess. 

How much training do these new techs even go through and how well are they being supervised without Dr. Bloxham turning a blind eye to it all?

Quite factually, it is the humanistic qualities of utmost skill,motivation, and care techs must have in order to not damage precious grafts.

During my procedure I found some techs to be very questionable in their behavior and dialogue between each other. 

All the doctor does is cut the strip from your head and poke the holes. Then he hands your strip off to his techs and crosses his fingers and says a prayer they don't fumble the grafts. Who does the graft prep?....You guessed it...the TECHS! And it is for that reason it's the most logical reason why some patients have poor results and others good results

Now of course you're going to have people says it's the physiology, scarring, lack of blood flow etc. But the reality is no one can prove exactly why. The probability and most logical reasoning points towards human error i.e. technicians fault

The lack of blood flow reasoning I find to be the most hilarious. When you're having surgery the scalp is literally a bloody mess no matter where an incision is made for crying out loud! Poke a hole in the crown, front, midscalp, anywhere and what comes out? A steady stream of blood!! So, very low probability of that being the cause of poor growth. What's the higher probability of poor growth...you guessed it...human error i.e. the TECHNICIANS!

Thank you, my friend. You got your point across. I strongly believe that poor planning and direction was a definitive factor that led to my outcome. 

Edited July 25 by sweveney

[sweveney]

Some final thoughts and closure

Hi everyone! Thank you for taking the time to share your opinions about my hair transplants.

After careful consideration and research, both within and outside this network, I can appreciate the effort, professionalism, and expertise that this doctor and his team put into my first surgery. Would I recommend this doctor? Yes, IF the client is looking to gain or improve their hairline.

I love my new hairline and believe it was well done. However, after reading all the responses to this post, the consensus here appreciates that the result of my second hair transplant (H.T.) was poor and a very lazy job. There is no way around this.

I did everything right in the aftercare of my first and second H.T. and continue to do so today. Thus, to any professional reading this: Critiquing the client is low! It adds stress to injury. I understand that this might be difficult to read; However, I’m being constructive and don’t mean to undermine your expertise or anyone else’s. I believe it’s important for professionals, in general, to acknowledge and take responsibility when things don’t go as they should, as it shows integrity and a commitment to improvement.

Writing this, my hope is to help to the best possible outcome for other clients who come to this practice, as well as wishing this doctor and his team success in the future.

Many thanks to all who contributed to this post. Good luck guys!

Edited July 27 by sweveney
Grammar

[Berba11]

On 7/19/2024 at 7:24 PM, kgoat said:

OP, if you paid the $2,000 upfront and then paid on the day of the surgery, when would the doctor have had the chance to assess your laxity?

 

If you paid the doctor a deposit, I don't think its that ridiculous for him to just take your money without checking your laxity himself lol.

These might just be the two stupidest sentences I’ve seen written on this forum. 
 

OP… I don’t know what Dr Bloxham thought he was doing in only giving you so few grafts across each surgery, let along what the hell that second surgery was supposed to achieve. The planning & strategy is mind bogglingly amateurish.
 

If the issue was laxity on the second surgery then a) the surgeon should have recognised this when testing the laxity b) should have informed you and c) suggested an alternative plan of action to get the appropriate number of grafts needed to do the job, such as combining a smaller FUT with FUE. You’re a high NW that needs a high number of grafts moving. Any plan that doesn’t involve moving enough grafts in a aesthetically strategic way is a bad plan and it’s not remotely clear what the plan was hear other than to do the absolute minimum (and even then, in a shoddy way) and pocket your money in the process. 
 

I also think any measures that clinics take to silence, intimidate or moderate what their patients can or can’t say via legal threats or otherwise is beyond despicable. 

[sweveney]

On 7/15/2024 at 1:02 PM, sweveney said:

Hi guys, once again thank you for sharing your straightforward thoughts about my hair transplant Journey. It is in fact Dr Bloxham and his team who performed both my first and second H.T.

Let me correct the dates. My first H.T. was in 2022 (two years ago today) and the second one 2023 (a year and 4 months since). I have waited two years since my first procedure and one year since my second to see the outcome. I am underwhelmed with the result and concerned about the quality of both procedures. I don’t see baby hair popping up as if I am in a permanent telogen phase. Does this mean that I can lose again all my hair? Should I start finasteride?

I was satisfied with the first procedure. My hairline looks natural enough (I believe) and my bang had good hair density. So, I proceeded to have my second H.T. with Dr Bloxham. But, the very same day of my second transplant I felt that the time they spent in the procedure was less than the time spent on the first one.

Before I say anything else I want to make clear that I had a wonderful, strong, healthy and abundant donor area.

For my first hair transplant I paid for 2,500-2,700 graphs, and for my second transplant I paid for 1,100-1250, (for a total of 3,600 – 3,950 hair graphs) , which now I understand means that I received more grafts the first time than the second, and at that moment I though it didn’t make much sense. I made clear to Dr Bloxham and his secretary that I was willing to pay as much as needed in my second transplant to achieve a successful and satisfying overall outcome.

In fairness to Dr Bloxham, he explains somewhere in his website another of his client’s outcome, stating that “Physicians and their teams tailor procedures to maximize the available donor area”. Not my case. My donor area was and perhaps still is optimal. He continues saying that:

Case Example: The patient in the “Before” photo had a large, round bald crown. Due to a suboptimal donor area, the team used grafts strategically to minimize the baldness.

Improvement: The “After” photo shows a less obvious bald crown, even though the density is lower than typical results.

Options: The patient can either undergo another surgery to thicken the crown or keep the grafts for potential future use”.

Having in mind that I had two hair transplants for a total of 3,600 – 3,950 hair graphs, is his former statement something that resonates with any of you guys? Is this a rule of thumb? Am I being unrealistic? What’s your take on this? I want to be fair before I continue to share my experience. Also, I have seen the results of different doctors and their patients who resemble my case, and they did achieve perfect coverage of their crown.

Maybe Dr Bloxham is good at creating a new hairline (check pic below please let me know) but in general could do much better with the crown?

What should I do now guys? I have zero hope that talking with Dr Bloxham would be in any capacity productive, as I have read his communications with the other two clients. Also, according to the paperwork I signed I am legally bound to endure without complaining about the results. Am I at risk of losing my hair (and money again)? Can anyone advise me what doctor I can go to for a revision?

Correction: First hair transplant 2022. Second 2023.