HGC (Hair Growth Centre) London, Maida Vale

[Bigmac]

I agree with your points you’ve listed above. Your hairs that are growing look to be normal calibre but you’d need your hair analysed to gain a true reading.

 

[JonathanLondon]

I agree with your points you’ve listed above. Your hairs that are growing look to be normal calibre but you’d need your hair analysed to gain a true reading.

Ask how many were placed in the crown, the side area and then the hairline.
It would be good if they send you your immediate post op pictures they have. This should provide a better understanding of how many grafts were placed in your hairline.
Measurement-wise, you could use a piece of string. Then measure from your existing hairline to the edge of the transplanted hairline to see how far they lowered it. They should be able to advise you of this too.

This Hairline education video by Dr Bisanga explains density.

Hi Bigmac
I have taken some measurements as best i can.
The distance from one temple to the other, as measured in this picture is 18.5cm. That's the length of the tape. Sorry if i've done this wrong, I know it looks ridiculous. The hairline is lowered 15mm-17mm at the centre, I would say.

 

[JonathanLondon]

Ask how many were placed in the crown, the side area and then the hairline.
It would be good if they send you your immediate post op pictures they have. This should provide a better understanding of how many grafts were placed in your hairline.
Measurement-wise, you could use a piece of string. Then measure from your existing hairline to the edge of the transplanted hairline to see how far they lowered it. They should be able to advise you of this too.

This Hairline education video by Dr Bisanga explains density.

I have received the following reply from the clinic.

"we implant approximately nineteen hundred to two thousand grafts into the hairline and side was about 150 and crown 150 to 200"

They won't send me their own photographs, which are for use in the clinic only unfortunately. Not sure if this picture helps which i may not have uploaded
previously.

 

[Bigmac]

As far as I’m aware, you have every right to request your medical data which includes all pictures taken by the clinic. As for your graft count/placement. You’ll enlarge your picture from your first post on here and count the grafts. They are quite big, it should not be too difficult to get a count that won’t be far off. See if its anywhere near 1900.

 

[JonathanLondon]

I'm struggling to accurately count the grafts. Partly because in some areas, they appear as a large solid scab, and I can't determine how many grafts are in those areas. And apart from that, I can't seem to count the grafts with any confidence. is there a more accurate, or scientific way of doing this?

 

[bullitnut]

Mark your picture squares and count… for blobs of scab you will have to guess by comparing the surrounding squares.

 

[bullitnut]

You can count your existing density by cutting out a 1cm square from a piece of card which is how this membdr counted his.
Counting hair grafts

 

[JonathanLondon]

Mark your picture squares and count… for blobs of scab you will have to guess by comparing the surrounding squares.

Thanks Bullitnut. Can you explain how to do picture squares?

 

[bullitnut]

Edit your picture on your computer… There should be an option for drawing such as the paint or using an iPad that has it.

 

[JonathanLondon]

Edit your picture on your computer… There should be an option for drawing such as the paint or using an iPad that has it.

Thanks, I will try to work out how to get that option.

 

[JonathanLondon]

Can anyone advise?
If I get a second FUE to add density to the hairline, afterwards when i go through the same shedding process that I did before, will all of the now established grafts that were implanted during the first FUE start to shed all over again? or will only the new grafts shed?
Thanks.

 

[Bigmac]

I don’t see any reason they won’t send you your own records/pictures.
You may get some hairs that will shed due to shock loss but they should recover quite quickly. The majority, if not all the transplanted hairs should continue to grow normally.

 

[Bigmac]

Hi Jonathan, how is your hairline looking now? Were you able to obtain your surgery data?

 

[JonathanLondon]

hi. Here are my post op pictures. What do they tell you about the implanted grafts?

The Dr is maintaining that he implanted a good amount of grafts, but I may have lost 20-30% of them. He doesn't know why exactly but apparently that can happen. He agrees that the density is low, and the outcome not good.
He has offered to provide a second FUE, using a sapphire blade (apparently not used as standard in that place).
He would charge only the costs of the clinic, but not for his time. A substantial discount from the usual price.
He said that they would do a few extra precautions to try to give the hair the best chance possible of surviving such as replacing the ice on the hair grafts every hour?
He suggests another 2,300-2500 grafts approximately, most of them in the front of the hairline but he would implant some all the way back a little past my original hair line to blend them in. He can remove the multi hairs in the hairline although it could leave a small mark.

At this stage (9 months), if i push my hair right back, then it is clearly a low density hair line. However, I think that my hair looks ok if styled with a side parting and that this is an improvement on my original pre op hairline. - Far from ideal, I am aware.

 

[loui]

hi. Here are my post op pictures. What do they tell you about the implanted grafts?

The Dr is maintaining that he implanted a good amount of grafts, but I may have lost 20-30% of them. He doesn't know why exactly but apparently that can happen. He agrees that the density is low, and the outcome not good.
He has offered to provide a second FUE, using a sapphire blade (apparently not used as standard in that place).
He would charge only the costs of the clinic, but not for his time. A substantial discount from the usual price.
He said that they would do a few extra precautions to try to give the hair the best chance possible of surviving such as replacing the ice on the hair grafts every hour?
He suggests another 2,300-2500 grafts approximately, most of them in the front of the hairline but he would implant some all the way back a little past my original hair line to blend them in. He can remove the multi hairs in the hairline although it could leave a small mark.

At this stage (9 months), if i push my hair right back, then it is clearly a low density hair line. However, I think that my hair looks ok if styled with a side parting and that this is an improvement on my original pre op hairline. - Far from ideal, I am aware.

View attachment 32467View attachment 32468View attachment 32469View attachment 32470View attachment 32471View attachment 32472View attachment 32473View attachment 32474

Looks like gaps in the implantation, not just because of poor growth. Looks like bad work to be quite honest.

So he's saying if he does the hair transplant with sapphire blades, it would be better? How come he does not do it everytime? Do he not care about his patients?

Replacing the ice on the grafts every hour? If this was necessary, again he does not do it regularly? Only when someone gets botched and he need to fix it?

So he wants to remove multis in the hairline, my first question would be why did he put them there in the first place, if he's knowing what he's doing? And why would you trust him again?

If I could recommend something for you it would be to not punch out grafts in the front rows, because it can look awful.

I call bullshit on pretty much every thing he's saying, sorry if I came across a bit harsh, but this guy should be a salesman.

 

[Bigmac]

hi. Here are my post op pictures. What do they tell you about the implanted grafts?

The Dr is maintaining that he implanted a good amount of grafts, but I may have lost 20-30% of them. He doesn't know why exactly but apparently that can happen. He agrees that the density is low, and the outcome not good.
He has offered to provide a second FUE, using a sapphire blade (apparently not used as standard in that place).
He would charge only the costs of the clinic, but not for his time. A substantial discount from the usual price.
He said that they would do a few extra precautions to try to give the hair the best chance possible of surviving such as replacing the ice on the hair grafts every hour?
He suggests another 2,300-2500 grafts approximately, most of them in the front of the hairline but he would implant some all the way back a little past my original hair line to blend them in. He can remove the multi hairs in the hairline although it could leave a small mark.

At this stage (9 months), if i push my hair right back, then it is clearly a low density hair line. However, I think that my hair looks ok if styled with a side parting and that this is an improvement on my original pre op hairline. - Far from ideal, I am aware.

In your pre-op pictures it`s clear to see the density was not adequate. I’d say you got most of your growth. Louii raises valid points about why did they plant multi grafts in the hairline.
A sapphire blade will make no difference to a surgery. The tool is only as good as the person using it. Ask him why a sapphire blade will make a difference. See if it has special healing powers.
He will only charge the cost of the surgery room hire. That’s because he is working freelance, not an employee. They hire him and others to do surgery they book.
Storing grafts on ice blocks. While sorting grafts, each petri dish will have its own block. Depending on how they perform surgery protocol the sorted petri dishes should be stored in the fridge until they are ready to start placing. When placing begins, a new ice block is used for each Petri dish leaving the fridge.
If it’s a big surgery the ice blocks may need switching out if surgery takes a long time.
Another 2300-2500 grafts. Let’s say it’s the lower 2300, that will be 4800 grafts for your hairline and no guarantee it’ll be a success. I would have a consultation with another clinic, preferably one that is owned by a hair transplant doctor.
Combing your hair to the side is something you should not have to do.
I`m sorry this has happened to you. Please thanks the advice of a second opinion.

 

[JonathanLondon]

In your pre-op pictures it`s clear to see the density was not adequate. I’d say you got most of your growth. Louii raises valid points about why did they plant multi grafts in the hairline.
A sapphire blade will make no difference to a surgery. The tool is only as good as the person using it. Ask him why a sapphire blade will make a difference. See if it has special healing powers.
He will only charge the cost of the surgery room hire. That’s because he is working freelance, not an employee. They hire him and others to do surgery they book.
Storing grafts on ice blocks. While sorting grafts, each petri dish will have its own block. Depending on how they perform surgery protocol the sorted petri dishes should be stored in the fridge until they are ready to start placing. When placing begins, a new ice block is used for each Petri dish leaving the fridge.
If it’s a big surgery the ice blocks may need switching out if surgery takes a long time.
Another 2300-2500 grafts. Let’s say it’s the lower 2300, that will be 4800 grafts for your hairline and no guarantee it’ll be a success. I would have a consultation with another clinic, preferably one that is owned by a hair transplant doctor.
Combing your hair to the side is something you should not have to do.
I`m sorry this has happened to you. Please thanks the advice of a second opinion.

Thanks Bigmac and louii.
In a way, that's good if you think I got the growth, but bad that the surgeon didn't implant enough grafts. I am trying to work out if that means that he didn't actually implant the number of grafts he claimed (around 2300 total), or if my hair is very fine as he claims and gives the impression of low density therefore i need more grafts that average?

Perhaps he doesn't want to incriminate his work, and therefore cannot accept that he didn't implant enough hair. If that's the case, I can sort of understand that perspective, although it's dishonest of him.

He did lower my hairline (as you have observed previously). Therefore, maybe he didn't allow for enough grafts to cover that area and didn't plan the surgery well enough.

I am considering these possibilities because if i can establish the reason I am where i am will help me decide whether to go back to him to add that density, or to avoid him at all costs.

He explained that the saphire blade enabled finer work, smaller incisions and higher density when compared with the other option.
(stainless steel i think).
On the question of the multi hairs in the hairline, he said it's unfortunate - and is a mistake. i don't know what can cause such a mistake, but it's happened.

If I try to get him to acknowledge that he didn't implant enough grafts, it may not help my situation, even though it seems that was the case. Is it possible for you to indicate in the picture where it looks clear the density is low, or there are gaps? I struggle to recognise it.

Going somewhere else for corrective surgery would obviously be the expensive option. If i were to try to make a claim against HGC (as i may have to do), then I would have to prove that the density they implanted was inadequate, and i don't know how to go about that.

 

[Bigmac]

Thanks Bigmac and louii.
In a way, that's good if you think I got the growth, but bad that the surgeon didn't implant enough grafts. I am trying to work out if that means that he didn't actually implant the number of grafts he claimed (around 2300 total), or if my hair is very fine as he claims and gives the impression of low density therefore i need more grafts that average?

You will have to take your post-op picture, enlarge it, mark it into grids and count the grafts. It won’t be precise but will provide a rough estimate.
You could have a consult with another clinic and have them check the density and graft numbers in the transplanted area. This will probably have to be paid for but will give you an accurate assessment.

Perhaps he doesn't want to incriminate his work, and therefore cannot accept that he didn't implant enough hair. If that's the case, I can sort of understand that perspective, although it's dishonest of him.

He did lower my hairline (as you have observed previously). Therefore, maybe he didn't allow for enough grafts to cover that area and didn't plan the surgery well enough.

Ask what density he placed the grafts. How many grafts were placed in the hairline? How many along the lateral hump and crown?

I am considering these possibilities because if i can establish the reason I am where i am will help me decide whether to go back to him to add that density, or to avoid him at all costs.

I would seek a second opinion from a different clinic.

He explained that the saphire blade enabled finer work, smaller incisions and higher density when compared with the other option.

(stainless steel i think).

This is incorrect. Unless he is using large incision blades. Incision blades or needles are various sizes. A smaller blade or needle will be used to make incisions for single hair grafts, slightly bigger for larger groupings. Same will apply for a sapphire blade, they come in different sizes.

On the question of the multi hairs in the hairline, he said it's unfortunate - and is a mistake. i don't know what can cause such a mistake, but it's happened.

Not being very good, not using magnification, not knowing how to perform hairline surgery, inexperienced staff, no microscopes, lack of care are a few reasons why something like this may happen. I`m not suggesting the above are what happenned but to simply say I don`t know the cause to me would suggest he would benefit from more educational training from someone who knows how to create hairlines.

If I try to get him to acknowledge that he didn't implant enough grafts, it may not help my situation, even though it seems that was the case. Is it possible for you to indicate in the picture where it looks clear the density is low, or there are gaps? I struggle to recognise it.

Counting the grafts and having a separate consult is the way to go.

Going somewhere else for corrective surgery would obviously be the expensive option. If i were to try to make a claim against HGC (as i may have to do), then I would have to prove that the density they implanted was inadequate, and i don't know how to go about that.

As above.
Your donor grafts are not unlimited. Only so much you can take. If they did extract 2300 and then say another 2500, then that’s a sizeable chunk of your donor gone. Average donor is around 6000 grafts. You will have used most of this up unless you have a higher than normal donor density.

You had your hairline and crown implanted with 2300 grafts. He thinks 20-30% did not grow. I’ll use the 30% figure.

Originally 2000 grafts were sufficient for your hairline as I’m guessing 300 were used in the crown and lateral hump when looking at your pictures.

30% of 2000 is 600 grafts not surviving which leaves 1400 that grew.

Now he wants to add 2500 to your hairline with some used behind into the native hair. I’ll be generous here. 2000 placed in hairline with 500 behind.

2000 plus1400 that survived gives a total of 3400 grafts for your hairline. This is substantially higher than the 2000 that were used to create your hairline. If 1400 grafts survived, then surely by his calculations another 600 grafts are what is required to get you to the density of the initial surgery. Maybe an extra 1-200 for his blending in that he has suggested. So you have to ask yourself, why 2500 grafts for a second surgery?

These figures may vary depending on how many they plan to use in both areas for a second surgery.

Do you need any grafts placed in the native hair behind the transplanted area? Did he place grafts in the transition zone first time round? Is this area thinning? This is why a second opinion will help.

Once you have your correct surgery data with graft number distribution a better analysis can be made.

 

[loui]

Hi Bigmac.

The doctor didn’t state a density that would be over packing the grafts, but in an email previously he said the following at that time when I emailed him with some concerns raised on this thread.

“We aim to provide a density of between 40-60 grafts per cm2 however this can vary depending on the size of your individual grafts and how many hairs per graft you have. You had on average around 2.2 hairs per graft.

We transplanted approx 2300 grafts with focus given on your hairline.”

He didn’t give a reason for what might affect my graft survival nor did he mention any issues during surgery.

In the appointment he said that in a second surgery, he would aim to place 1000-1200 grafts in the front most area along the hairline, approx 4mm wide. This is to fill the front area to give the perception of full density when looking at me so you cannot see through the hair. And then place more behind but at a lower density than at the front.

In measuring from temple to temple, do you mean using a straight measure like a ruler in front of my head, or by taking a string and placing over my head and measuring the exact length to the temples?

yes the clinic did take pictures and I will request them.

If I would guesstimate this, I would say they did approx 1300 grafts. 500 for each side approx in the front, approx 300 in the weird planting towards the back of your head.

If you want me to be truthful, the work looks terrible with gaps all over.

He's saying 2300 grafts, there is no way it is 2300 grafts in there, maybe he meant the grafts he extracted? Then he threw the other 1000 grafts in the dumpster.

 

[JonathanLondon]

Can anyone recommend who i could go to for a consultation and get an official assessment of the work i had done?
this would have to be in or around London / South West England.

i don't know how to do that grid thing with the image - any pointers would be appreciated.
Thanks.