Successes After Hair Transplant Challenges
Episode Synopsis: In this episode, Dr. Danyo shares his personal experience working with clients who sought out his expertise after a failed hair procedure. He also discusses the common ways he fixes the hair restoration mishaps so his clients’ self-esteem and confidence can be restored.
Dr. Danyo: You know, I have a lot of people that have had strip scars, that have really large scars that wish they hadn’t done a strip and wish they had found me earlier, but, you know, that’s in the past. We can put grafts in strip scars. We can do micro-pigmentation, you know, to conceal strip scars. There’s a lot of things that we can do to really correct this and just kind of move past.
Clark: That was the voice of Daniel A. Danyo, MD, founder, and physician at North Atlanta Hair restoration, a boutique medical practice solely dedicated to the diagnosis and treatment of male and female hair loss. And you’re listening to “Hair Restoration with Dr. Daniel A. Danyo.” I’m your host, Clark, and all season long, we’re speaking with Dr. Danyo about how he and his team at North Atlanta Hair restoration are helping his patients transform their everyday lives for the better. In this episode, Dr. Danyo shares about his personal experience working with patients who sought out his expertise after a failed hair procedure elsewhere. He also discusses the common ways he fixes the hair procedure mishaps so his clients’ self-esteem and confidence can be restored. There’s so much to talk about. So let’s dive right in. Dr. Danyo, welcome back. How are you doing?
Dr. Danyo: I’m doing great, Clark. How about you?
Clark: I’m great. Hey, another great conversation up ahead. This podcast is really fun. It brings me a lot of joy. I always love connecting with you. We always have fun conversations before, during, and after these sessions. And actually right before we started, you were telling me that today you had a patient in who was previously a podcast listener.
Dr. Danyo: Yes. Listen to every podcast.
Clark: That is so awesome. And that’s not the first time though that you’ve heard that feedback where, you know, someone [inaudible 00:01:57] they’re trying to find the right solution for them and they find the show. They listen along and you help them determine, hey, you know, this can be confusing kind of an overwhelming journey, but, you know, there’s plenty of people who you’ve helped and that need help.
Dr. Danyo: Well, I think, you know, the key with the podcast is messaging, and in this world of restoration, there’s so much, you know, salesy stuff and different techniques and what works and what doesn’t. And so when you, you know, message to somebody and then somebody actually becomes comfortable with my message, it’s actually their message. And, you know, our whys meet, you know, we’ve talked about what is your why and why you do it. And so if somebody’s why is why they wanna choose somebody like me, if that meets then, you know, it’s great…it really sets a way for people to get to know me before they actually even meet me. Because a lot of my out-of-town guests, like the patient I told you today came in from Michigan, he said, you know, “I feel like I know you,” which is great. And it’s a testament to you. Everybody’s always asking me about you, what’s…
Clark: Oh, man. I wanna come visit. I know.
Dr. Danyo: I know.
Clark: I wanna come visit. I’ve got family not far from you. And I would love to do that soon. That would be a blast.
Dr. Danyo: Yeah.
Clark: I appreciate that. Thank you. That means a lot. And it’s probably also gotta be nice because you’ve also told me that many of the patients you’re working with because this takes several hours and you are the person from start to finish working with them. And that leaves some potentially interesting conversations for you to have with your patients, all sorts of things.
Dr. Danyo: Yeah, yeah. Incredible conversations, really. And, you know, I like to learn and, you know, constantly listen to books or podcasts. And so, you know, I like to kind of delve in, get to know people, and it’s amazing just the incredible things that my patients do, or are working on, or hobbies that they do, or aspirations. You know, we’ve had some great talks about the future. I love leadership-type things. In fact, I’ll give a call out, I’m actually gonna be hosting a new podcast.
Clark: You heard it here first, folks.
Dr. Danyo: Yes. Which actually will be starting in the next month or so. It’s gonna be “Leadership Talk with Dr. Danyo.” So I’m gonna be talking with leaders mainly in medicine, but, you know, possibly outside of medicine that have some kind of leadership connection, and it’s gonna be a positive message for the patients, and particularly for the doctors. You know, right now, medicine, it’s tough out there for a lot of doctors. You know, COVID has complicated things, but you look at insurance and just, you know, capitated fees and decreased reimbursement, so much paperwork. You know, there are a lot of doctors that almost feel hopeless. So I’d like to hopefully be a positive light in kind of a negative world for medicine and, you know, hopefully, ignite some flames.
Clark: That’s great. I love it. Well, a moment ago, we were just talking about, you know, kind of the difference that you bring and, you know, you are someone working from start to finish with every single one of your patients. Of course, that creates a lot of great conversations, you know, during the curative relationship with everybody that you meet with. And that goes on with the follow-up, you know, six months or a year later. And, you know, we’ve talked in the past right here on the show of just sort of those experiences of the high fives and hugs and hearing how the results are.
Now, the topic for today, though, is clients and patients that you’ve worked with that came to you after a failed procedure at another practice.
Dr. Danyo: Yes.
Clark: And I understand you might have maybe a couple of examples or a couple of stories here, and I feel like this is the…man, this is like the nightmare of what someone… Like, you know, they spend the time, the resources, the energy to do this and not getting the results for I’m gonna hear from you in just a moment of all the reasons why. That’s gotta be kind of the biggest fear someone has going into this.
Dr. Danyo: Absolutely. I mean, a lot of times, you know, people have had prior hair transplants and their hairline might be off, or it’s kind of in the old days, the hairlines were like too far forward and came back too far. So they were like this really big U-shape, almost like a diving board. And you could just look at someone and say, “Okay, you’ve had hair transplant before.” So, you know, a lot of the stuff we’ll talk tonight is just kind of fixing that, or I’ve had people that have been overharvested. We had somebody recently that had way too many grafts completed, an African American female. I usually limit the graft count to about 1500 at any one time. And actually, 3,500 grafts were taken from the donor site. And it literally obliterated her donor site to where now that had to be addressed with transplant.
Clark: Wow, so it was like borrowing from one place too much.
Dr. Danyo: Exactly.
Clark: And now the problem is you just moved the problem area.
Dr. Danyo: Exactly. Yeah. So actually, her donor site had a little bit of hair in the traditional donor area, like on the bottom and a little bit up top. She had a lot of hair more on the top of her head with no kind of female pattern hair loss. She had more traction alopecia upfront, you know, from braiding. But, you know, kind of the top just above her donor site was actually really thick. So we had to just get a little creative and, you know, pull from areas that we typically don’t do. Because her hair when I evaluated, it looked like there was no process of female pattern hair loss going on. I mean, it feel like these are permanent hairs that we’re moving. We were able to move them actually into the donor site and get coverage. So I did my first case on her about six months ago. And two weeks ago, we did another case of 500 grafts. And I think I fixed the situation. I think she really had some good coverage, even at 6 months out from the first procedure with 750 grafts and we did 500 more. And I think it’s just going to, you know, build onto what we did before and, hopefully, that’s gone.
Clark: So when this happens, how long does it take for someone to realize, you know, they’re at another practice or having a procedure from someone else, and we’ve gone through a whole host of scenarios in the past of maybe it’s a technician or maybe it’s a salesperson selling? Like, you know what I mean? Like, there’s a lot of ways it can go wrong, but how long after the procedure does it take for someone to realize, oh, no, this is not at all what I was expecting?
Dr. Danyo: Well, you know, it takes about six months before you really start seeing some significant growth, you know, after you have a procedure. And it can take 12 to 15 months until the final results are in. So it’s kind of like this, you know, slower process. Occasionally, you’ll see people where…I have seen people where they’ve had hair transplants done maybe two months before and, you know, they call or come in for consult and they’re just not happy. A lot of times it’s more with how the hairline was constructed. I really do not like hairlines that are just one big U-shape, you know, where it kind of comes in at an acute angle. And oftentimes, we just have to soften it up by kind of rounding the curves, those angles. And the other would be just really large, chunky grafts upfront really straight.
And what we need to do is sometimes I have to even take an extractor and take out some of those larger follicles and kind of move them back behind the hairline. And then we, you know, create single grafts and stagger them to make a nice soft hairline. So those are all pretty simple, you know, fixes. Obviously, the one with the donor site was complex and it was very devastating because it just did not look normal. She almost looked sick, you know, and she had to wear her hair in a certain way. It really was very distressing.
Clark: Definitely. I mean, so much of this is so connected to our identity and her self-confidence. And, I mean, you know, it’s who we are.
Dr. Danyo: Yeah. Now we do have, you know, plenty of patients that have had prior hair transplants where they just did not get the results that they wanted. Where they were promised, say, 2,000 grafts or even more, and it almost looks like they had 500 or 1,000 grafts.
Clark: I mean, if I…oh, sorry, I didn’t mean to interrupt.
Dr. Danyo: No, go ahead.
Clark: Well, I was just gonna say for someone like me, you know, sometimes like if I don’t really know what I’m looking at, I might not, you know, be able to count that or see that. But when you look at it, you can pretty much instantly tell what that problem is?
Dr. Danyo: Yes. I mean, it comes down to density or, you know, if the grafts are damaged, sometimes the hair just comes in really thin or it comes in at weird angles or even like curly when the hair is straight. And, you know, these can be really bad situations, especially if it’s on the frontal hairline. I’ve seen grafts that are going at all different angles. And you just have to wonder how did this happen? And the only thing that I can think is that, you know, the doctor just wasn’t involved. And, unfortunately, because, you know, what I do…I do all the extractions and I place all the grafts. You know, when I’m placing looking at getting perfect depth control, angulation control, and curl control, and then, you know, trying to make a density that is natural, it’s not like all lined up, looking like Arlington National Cemetery or something, but, you know, it’s kind of randomly organized, which is kind of difficult to do.
But also kind of keeping a relatively consistent density and getting as much coverage as you can with how many grafts you’re doing. But definitely, it’s devastating when somebody’s had a big procedure and for whatever reason, either the growth was bad or the results, you know, just didn’t happen as promised. And, you know, it’s something that I step into. Unfortunately, a lot of times the donor site is kind of tweaked out, you know, where it’s been, you know, kind of on the verge of being overharvested. So we have to be creative. You know, for the guy patients or male patients, we go to beard, sometimes chest and abdominal hair. Potentially could even use pubic hair if you wanted to. You could use even armpit hair, axillary hair. So but generally, you know, I go to beard first because it has a similar growth cycle as the head hair. And then I go to chest and abdominal hair. But, you know, I’ve been able to kind of provide bonus grafts in a very large number if needed to get things done.
Clark: Wow, I had no idea.
Dr. Danyo: Yeah. I think the biggest disaster that I saw as a physician, he started early on, had a scalp production. They really don’t do those anymore where they take kind of a center almost, you know, like a quarter moon slice of scalp out of the center of the scalp, and then under tension bring the wound edges together to kind of what take out the skin of the scalp.
Clark: What? Sounds terrible. When did they stop doing…when did they start and stop that?
Dr. Danyo: They started it in the ’80s. It was really big. I mean, there were a couple of years where it was just a very popular thing to do. But the problem is that the crown develops like this weird diamond shape. And the other thing is it kind of stretches out to donor sites so it can look thin on the sides, and even the hairline above the ears can be elevated. So it kind of has a funny look. So that was one aspect of this patient. And then he had the plugs, you know, the full thickness plugs where they take like, you know, a 5-millimeter punch, full-thickness skin graft and punch out scalp in the head and then sow that in. Now, this procedure is not done anymore, but it was popular in the ’90s, especially, and ’80s. And you had that doll’s hair look, it never really looked natural.
Clark: That’s bad news. That’s bad news. We’ve talked about that before here.
Dr. Danyo: Yeah. Exactly.
Clark: Those were all old, old, old practices and that’s a huge misconception as well when they think of hair transplant, they think of those old images of, like you said, the doll hair.
Dr. Danyo: Yeah. But, you know, we had to be really creative and he needed a new hairline. So I was actually able to get about 750 grafts from his donor site without overharvesting. But that was it. I mean, I couldn’t get any more out of the donor site. And then over a series of multiple procedures, I did 4,000 grafts from his beard, and he actually still has a beard, believe it or not.
Clark: Whoa, 4,000 grafts is…
Dr. Danyo: Yeah. Over multiple procedures.
Clark: That’s a forest.
Dr. Danyo: Yes. And he still has…
Clark: And he still has a beard. That’s impressive.
Dr. Danyo: Yes. And then I took 3,000 from his chest. So with all that said, I did around 8,000 grafts and covered his full head. And keep in mind before, he would never take his hat off. It was a real disaster. So I think when I look at people for corrections, I kind of offer a different approach to say we can do beard and body here. We can possibly exploit what you have left in the donor site without making it look thin, and kind of use that combination to create a good look and great results. Yeah, a lot of these guys, they get a lot of different consults and they come in kind of dejected and, you know, I don’t try to oversell myself, but a lot of the stuff we’re talking about right here nobody really brings up. And when I do, it’s just like the light bulb goes off and they’re happy and then we just go for it.
Clark: So what were the results of the individual where you did 8,000 grafts? How did that play out? You said that was one of the worst cases that were brought to you from someone else that did a bad job.
Dr. Danyo: Well, I wouldn’t say a bad job. It’s just over the years of the scalp reduction and then the plugs and then he had a strip, and then just kind of natural aging. It just was not a good situation. But we got great coverage and, you know, we have a very happy patient. So that’s kind of my approach just in these situations because most of the time when I have to correct something there’s kind of sadness, there’s regret. You know, I have a lot of people that have had strip scars, that have really large scars that wish they hadn’t done a strip and wish they had found me earlier, but, you know, that’s in the past. We can put grafts in strip scars. We can do micro-pigmentation, you know, to conceal strip scars. So there’s a lot of things that we can do to really correct this and just kind of move past the past.
Clark: There is a path forward.
Dr. Danyo: Yes.
Clark: Now the way to begin that path, that just starts with a consultation, right? And you can quickly be able to see, you know, what the story is here and what the options are and kind of guide them through that.
Dr. Danyo: Yes. Yeah. I do all of the consultations. We kind of have a couple of steps before I get involved with the consultation. I used to get involved early on, but there were just a lot of consults with people that really didn’t have in their mind what they wanted. So after we kind of go through the steps with my office staff, who’s really trained to ask the right question and we can look at pictures or videos that people send. And then I can do either a video call or a phone call or come into the office. But, you know, 40% of my practice is from out of the state. So it’s kind of tough to fly in, but I do occasionally get people that fly in. Somebody recently flew in for a consult from Boston. But it’s not before…
Clark: Hey, North Atlanta, there are some cool things nearby. [Inaudible 00:21:02] trip out of it.
Dr. Danyo: Exactly. Alfred is awesome. But, you know, a lot of this can be done online. And then when people come in, you know, for the visits, we know we’re gonna do hair transplant and we can just modulate what we’re doing. Because that day, you know, the patient is gonna be with me and nobody else, and my technicians who help me, but it’s not like I have multiple cases going on. So we can either increase the graft count, decrease it. We can choose beard hair, chest hair. We can do things on the fly because I do all the work.
Clark: That is a big distinction. You do all the work and you’re with them every step of the way. I love it. Well, hey, this has been really insightful. You know, there’s folks out there who have had not-so-good experiences, right? And there’s maybe failed procedures that they’ve gone through, but there is a path forward, there are options. So just reaching out to your team just to get the conversation going, just to see what the options are. You have a great team, super friendly.
Dr. Danyo: And we’re happy to help in any capacity.
Clark: Well, Dr. Danyo, thanks so much for another great conversation. I appreciate it.
Dr. Danyo: Oh, thank you, Clark.
Clark: Hey, thanks so much for listening to “Hair restoration with Dr. Daniel A. Danyo.” Book your consultation today with Dr. Danyo by calling 678-845-7521. Or online at nahairrestoration.com. And be sure to follow, rate, and review this podcast wherever you listen to your audio content.
Dr. Daniel A. Danyo is the founder and medical director of North Atlanta Hair Restoration, specializing in treating hair loss in both men and women. He is one of only 300 people in the world certified by the American Board of Hair Restoration Surgery.
He is a member of the American Board of Hair Restoration Surgery, International Alliance of Hair Restoration Surgeons, American Hair Loss Association, and The International Society of Hair Restoration Surgery.
He is also an early adopter and pioneer of Shave-less FUE, one of the most discreet surgical procedures available for hair restoration. Dr. Danyo performs every procedure himself, from start to finish. He individually extracts and places every graft on every patient. Learn more about Dr. Danyo on his Meet Dr. Danyo page.