I wrote this ages ago but never posted it at the time, as the topic has come up it seems appropriate.
Why are not all h/t patient 100% happy with their result; big question that opens up many questions and answers. If we assume that the surgery has been carried out well and not butchered because that assumes the doc is bad and then we are talking about something very different. To say 100% happy doesn t mean it was a bad h/t but only means that the person may have been expecting more or less or something a little different; human expectations cannot be measured that easily or due to medical complications not every aspect was able to be treated to the persons satisfaction.
Firstly it must be understood that be it a first/second procedure or a repair surgery a hair transplant is not a miracle cure, it does not hold the answers to hair loss, it cannot give you back the exact hair you have lost and may not meet your expectations because of medical boundaries and the simple fact that perfection is not a reality. Then there is the care taken by the patient and the patient s natural healing attributes, two aspects that are not liked to be discussed because it is felt removes blame from the doctor, but none the less it is a factor that has to be considered; medicine is not an exact science and many parameters go into a result, and each member has a part to play, the doctor to ensure he does his job technically, medically and cosmetically to a high standard and the patient to ensure he cares for the healing as much as possible.
As with any hair transplant there needs to be an honest and open dialogue between doctor and patient so both understand and agree the goals and the patient is aware that limitations can apply to what can be achieved. This is very important because a natural result can be achieved but if the patient s expectations were greater they still will see themselves as flawed without understanding why the procedure only went so far. On occasions it may be necessary for the doctor to override the wishes of the patient and only agree to proceed if the patient can dramatically re-evaluate their goals because they are too high, unachievable or will not resolve aspects of the look. This is not going to be easy for the patient to do obviously and a disappointment, but better that than go through more trauma later and potentially end up in a worse situation.
No quality doctor goes out of his way to have a bad day and will do everything he can to do the best technical procedure possible, but medicine is medicine and no one can 100% predict how the body will react. Certainly a virgin scalp is easier to predict than a previously worked on scalp or a repair case; then everything can change, medically and psychologically for the patient. Once the scalp has been impaired in the donor and recipient then future procedures take on a different meaning. Sometimes a repair cannot be 100% treated in one procedure and there must be areas that have greater priority rather than trying to do everything 50% and achieving nothing significant. Also the desire of the repair patient to be fixed is high and so are expectations many times, this is understandable but can be dangerous when educating because they may have had 2 bad procedures that may need three repairs to put right, but they want to do it all in one! Scalp healing and replacing in areas already treated, examples like pitting and ridging may impair the growth of newly placed hair yield, the donor may have extensive scarring, Keloid growth or fibrosis and this could impair the healing of a newly excised scar.
Going back to 100% happy, there are many good doctors out there, not all have the same principles of what a good hair transplant looks like but may all be technically proficient at what they do. Then happiness can be down to the choice you make as a person and on the doctor. You may like a low rounded hair line or a conservative approach to density and choosing your doctor that mirrors your likes or dislikes is important. If you narrow down your choice and are happy say with four docs that are good then choose the one whose work basically reflects your goals; don t necessarily go for one because of reputation but whose results are nothing like you are looking to achieve. You will be starting from very different fundamentals to each other and the chances of you reaching 100% happiness will be reduced. It is very personal and although pictures and meeting people can tell you a great deal, always best when possible to meet the doctor and see if your goals are reflected in his eyes, may sound simple but much can be found out from a personal meeting.
Then there is the case of just not happy and unwilling to except reality, this may be true or not of course. It is impossible to make everyone happy all the time, and even when you do your upmost to address the situation you may not appease some. Like I said, a good doctor is not knowingly going to have a bad day, and something s are out of their hands; but there is the other side that given the opportunity to assess the result what is then the outcome; as happiness can be on many levels and not purely the cosmetic result, but general well-being.