Episode 19:
What Could Go Wrong with a Hair Transplant?

Hair Restoration Podcast - What Could Go Wrong

The following is a transcript of Episode 19 of the Hair Restoration With Dr. Daniel A. Danyo podcast. In this episode, Dr. Danyo explains what happens when a hair transplant goes wrong. He breaks down some of the most common issues that arise when the physician is not directly involved in the procedure, and shares important red flags to watch out for when choosing a hair transplant doctor for your upcoming hair transplant.

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Dr. Danyo: If you’re going to a place where the physician is not even involved, you’re really putting yourself at a medical risk. Proficient doctors, the leaders in the field, they get involved, they analyze, they evaluate the scalp, they come up with risks and benefits and options.

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 explains what happens when a hair transplant goes wrong. He breaks down some of the most common issues that arise when the physician is not directly involved in the procedure. And he shares some important red flags to watch out for when choosing a doctor for your upcoming hair transplant. There’s so much to talk about. So let’s dive right in. Dr. Danyo, how are you doing, man?

Dr. Danyo: I’m doing great, Clark. How about you?

Clark: I’m doing well. I’m looking forward to another conversation. I’m always learning so much from you and not only from this particular topic, but all the interesting things that you do in your life that, you know, really makes you who you are, and also contributes to this passion that you have with hair restoration and it’s…

Dr. Danyo: I appreciate you. You have a great energy and we’ve had awesome feedback about you.

Clark: Oh, really?

Dr. Danyo: You know, they’re like, “Who’s this Clark guy?

Clark: I wanna come down and visit, and I know there’s lots of movement and activity you’re always getting into. And I know, you know, when your patients come back and visit you for their follow-ups and, you know, they’ve got the big smile, and high fives going around and, you know, I wanna be part of that moment.

Dr. Danyo: Yeah. Exactly. Well, you don’t need hair, that’s for sure.

Clark: Yeah. Well, I am excited. We’ve got a great topic today and, you know, all of these topics usually stem from common questions that you’re getting, but this one, in particular, is basically, “What could go wrong with your hair transplant?” And I would love to hear kind of your approach to that. Maybe the approach you’ve seen and heard other doctors have with this. So let’s just kind of open-ended here of just when you first hear the phrase, “What could possibly go wrong with a hair transplant,” what do you think?

Dr. Danyo: Well, I mean, a lot can go wrong, but I think the key just like any organization or any process, I mean, it starts at the top. It starts with leadership. And, unfortunately, in hair restoration, you know, doctors are not really all that involved. I mean, you got a sales guy, you know, trying to sell certain number of grafts. You don’t talk to the doctor, even maybe come to the procedure thinking you’re gonna meet the doctor, and then, “Oh, this is our technician. You know, they’re gonna take care of you.” And the doctor is not all that involved. So when you have kind of a key leader, I mean, the doctors, they’re the leaders of the team, right off the bat, you know, a lot can go wrong.

Clark: That is concerning. So let’s just start from the beginning there. So you get a salesperson and they’re saying, “Hey, you know, let’s sell you this.” And basically, you know, this is a salesperson, this is not a trained physician, you know, on hair transplant. So they might be selling something from the beginning you might not need, or selling you too much than what you need or not enough because there’s a balance. Like what goes into that? What are the things that they might not even be thinking about because they’re not a doctor?

Dr. Danyo: Well, I mean, the key to being, I think, a successful doctor is you’ve gotta build a relationship with the patient. And it doesn’t mean that you’re spending days with them or knowing them for years. But, you know, when I do consults, I’m doing a lot online because of COVID, where I don’t really even get to meet people, but I think with all the outreach we’ve done with this podcast, our website, all the blogging that we’ve done, I mean, people do research. And, you know, I’ve already set the tone, like, people already know me, you know, a lot of times before I even talk to them, which is great. So I’m kind of able to quickly build a relationship, and that relationship is built on kind of a foundation of trust that I’ve got the experience. I’ve got, you know, things backing me up on the web, you know, our podcast, reviews, things like that. But building that relationship of credibility is just so important. So when you have like a sales guy who’s not really even part of the procedure, I think it just sets a terrible precedent for bad things to happen.

Clark: Theme of trust is something that I think every episode comes out one way or another. And that’s what I’m hearing from you right here. So when you meet this potential patient, and you do a lot of…you know, even a lot of virtual consultations, I believe, just to kind of…from the beginning, just to see, “Hey, is this the right fit for you,” right? And that’s changed a little bit over the last, you know, year-plus, year and a half with what we’ve seen with COVID and how that’s changed things. So you talk to a lot of people, you’re able to identify what they might need and then just have that dialogue. And that probably also gives you a chance to understand what is it that they’re actually looking for. Because I think, as I’ve been learning more about this, someone doesn’t necessarily just want more hair. What they’re trying to get back in their life is the confidence and feeling maybe how they used to feel. And so, that’s a pretty intimate and emotional set of objectives. And so you’re with them during that process too.

Dr. Danyo: Oh, absolutely. And again, that requires a lot of trust and really kind of the culture that I have in my office in kind of how we present ourselves online. I mean, the last thing I want is to be like some sales guy. And the fact is, I mean, I am busy and, you know, we’re really blessed to be booked out multiple months, but, you know, I think a lot of my patients are willing to wait that long because they understand that the whole picture that we’re presenting, I think it’s based on a good set of values that we have towards the patients and just, you know, our leadership. And that goes full-circle. Everyone in my office, I think we’re all on the same page. And within the office, I mean, if we have issues, they feel comfortable talking with me, I feel comfortable talking with them. And that just kind of sets the framework to have excellent communication from start to finish, and then excellent results with execution of, you know, whatever somebody’s coming for, hair transplant, PRP, whatever. And I think that’s where we kind of set ourselves apart.

Clark: Before we talk about what the next step is, you know, maybe them seeing the technician and not seeing the doctor, you mentioned your values. Is that something you can maybe just take a moment and share just from the top of your head, some of the values that you do have and why it’s so important for you to be part of the process from start to finish?

Dr. Danyo: Sure. Yeah. I think, you know, the big values that I hold in relationships or trust is definitely a huge one. I think the value of empowerment, I love empowering other people. I get almost more joy when other people get happy than when I get happy without that. And that kind of funnels over to patients. You know, it’s kind of you’re working on them and they get a good result and they feel empowered. I mean, that kind of energy is what I feed off of.

Clark: That’s good. I mean, this is an important aspect of all of this.

Dr. Danyo: Yeah. So when we talked about what can go wrong in a hair transplant, I mean, the fact of the matter is that a lot can go wrong and it takes a lot of dedication learning case after case, refinement in your skills and what you do. It could be as simple as numbing up somebody right. You can numb up somebody terribly wrong, potentially even inject medication into a blood vessel and have, you know, drop in blood pressure, you know, emergency type things if you don’t do things correct. Increased pain. I mean, those are all relative things. I mean, the things that are really awful is when somebody pays, you know, upwards of $8,000 to $10,000, $12,000 for a case, presuming that they got, you know, 2,000 or 3,000 grafts. And in reality, they didn’t get that number or the results just were not good. And they feel terrible. They feel like they exhausted a lot of their donor site and they obviously wasted their money and time.

Clark: So when you exhaust a donor site, are you able to go back to that or is it kind of once you’ve used it, you have a limited amount of tries?

Dr. Danyo: Yeah. I mean, you can go back in, there’s no question, and grab more. But it’s kind of like having a full tank of gas and then somebody just, you know, drove the car and took 40% of the gas.

Clark: Yeah. Almost like that feeling when you’re driving somewhere, and you get there, and you forget your wallet and got to drive back home.

Dr. Danyo: Oh yeah. Or your wife borrows your car and you’re like, “Oh,” you know?

Clark: Right. That’s another good point.

Dr. Danyo: Yeah. But, you know, I think there’s a lot more despair when somebody goes through that and they’re anticipating results, they don’t get it. A lot of times they’re kind of led down the road by saying, “Oh, give it some more time, give it some more time.” They can even be a year and a half out, “Oh, give it some more time.” You know, a lot of times, it’s funny, patients do consults with a lot of different offices and a lot of offices are saying, “Well, we guarantee, you know, that this works.” And patient says, “Do you guarantee?” And I say, “I don’t have to guarantee.” We get good results. And if things aren’t right…sometimes, you know, the hairline can be off a smidge or there can be, you know, one side that looks a little bit more dense to the other, I mean, those are things that I correct. But I can’t think of a single case where there was an absolute failure of grafts as I’ve seen other people go through at different offices.

Clark: Right. There’s a lot of things that can go wrong. And you were talking earlier about… So if I think of this as a linear step-by-step process, so, on the other hand, what you don’t want is a salesperson from the beginning. They don’t really understand what’s going on. Then the technician comes in later on, once there’s something that they’ve [inaudible 00:11:52] you know, they’re moving forward with this and you were sharing some examples. Maybe they…you know, they’re not at the same professionalism and training as a doctor.

Dr. Danyo: I’ll be honest with you, Clark, this is such a massive problem in the industry. They don’t really…

Clark: How big are we talking?

Dr. Danyo: Massive. I mean, it happens in pretty much every city, every state where you have different clinics that have hair restoration as basically a product or a procedure that they perform. They don’t really specialize in hair restoration, they do hair transplant. And, you know, there are technicians that roam all over the country that are unlicensed. You know, they’re not PAs, they’re not nurses, they’re not physicians. And I know in Georgia, you know, that’s not a legal situation for an unlicensed person actually extracting human tissue, which is a hair follicle graft, doing all of the medication management, including sometimes sedation and all the injectable nerve blocks and anesthesia, and then placing the grafts, and the doctors, you know, have this in their office. I mean, it’s placing them at a major risk, but I think it’s ethically wrong for the doctor to even consider that. And I also think it’s ethically wrong and immoral to provide the service, which essentially is not legal.

Clark: So is there any way that a patient would even have a way to detect that, like, “Wow, this person who’s claiming to do this, they don’t have any credentials. They don’t have…” I mean, are there any red flags, you know, that someone like me, you know, someone who doesn’t have the perspective you have who could detect this?

Dr. Danyo: You just have to do your homework. I mean, you have to look at the reviews. I mean, there are some offices where the reviews are, “The doctor wasn’t even involved in my case.” Well, that’s a massive red flag. It’s, like, you need to go somewhere else. If the consult is done or even an in-office visit and you don’t even meet the doctor, or when you meet the doctor, they are kind of standing behind. They’re not even looking at your head. They just said, “Oh, yeah, we’ll take care of things. We’ll be doing 2,000 grafts.” That’s not what a doctor does that is proficient in this. Proficient doctors, the leaders in the field, they get involved, they analyze, they evaluate the scalp. They come up with risks and benefits and options. So I think it’s important, especially if you’re a patient that’s already signed up for procedure and you haven’t checked all those boxes that the doctor’s been involved, I think it’s time to look elsewhere because you have choices.

Clark: That makes sense. So something…an actionable thing someone could do as they’re looking and exploring their options, ask, “Hey, I wanna talk to the doctor. I wanna get the doctor’s perspective on this.” And if you’re getting, “I don’t know, you know, he or she’s busy,” or whatever, that’s a red flag.

Dr. Danyo: It’s a red flag. And, you know, some of the complications that I’ve seen, I’ve seen, you know, just poor graft survival, I’ve seen grafts that are pitted or the hairs that are placed…are corkscrew because they maybe didn’t make surgical slits deep enough and then the grafts got twisted or kind of curled. So they have permanent kinky hair. The grafts can be at a weird angle, hairline off, poor density. And then the donor sites, I’ve had three patients recently that have had severe depletion of their donor site and also had poor results. Meaning that they couldn’t get the grafts properly, so they had to do more attempts to get grafts. And they essentially killed off a lot of the donor site.

In fact, one of them, I had to place 750 grafts back into the donor site from the top back of the head into the donor site because it was so thin. I mean, this is not good stuff. And that was after one procedure. So there’s a lot of scary stuff out there. The marketing looks so, you know, sleek and slick and people get excited. But I think, you know, if you’re a listener, and I’m not trying to say come to my practice, but look at websites and say, “Are they sales marketing me, or are they telling a story of what they can provide for me? Is there a story of the actual physician involved in what they have to offer?” That’s just so important.

Clark: That makes sense. The story of the physician.

Dr. Danyo: Exactly.

Clark: And the story of the people who have shared their experiences because if someone’s had a great experience, there’s a lot of ways that they’re gonna share that positive experience.

Dr. Danyo: And it’s so important to have communication followup-wise, and patients feel comfortable that they know that if anything wrong, they have communication access to me. We’ve got multiple ways. So that’s how people get great results. And that’s how we get really good reviews and, you know, good follow-up pictures.

Clark: I love it. So as we’re going through the list here of all the doom and gloom of what could go wrong, you’ve shared a lot. You’ve given a lot of great examples and not only that, but ways to…you know, red flags to keep an eye out for. Are there any other thoughts that you have of other things that you’ve seen go wrong? I mean, there’s a lot we’ve already covered, but anything else that you can think of?

Dr. Danyo: I mean, the good thing is that hair transplant, hair restoration is pretty fixable, you know, if there are issues. But again, if the donor site is used, sometimes we have to grab hair from the beard or from the chest for the guys. Women, it can be a tougher situation. Luckily, we don’t see really the over-harvesting in women just because they don’t have kind of the hair transplant needs as the guys do. But I think the key is that it can definitely be fixed in most situations. So it’s not the end of the world. I mean, the biggest thing though is just getting the procedure done so that there’s nothing medically that happens in a procedure. And I think if you’re going to a place where the physician is not even involved, you’re really putting yourself at a medical risk. Any procedure you can have a reaction to, a medication injected, or be oversedated, or you know, you just never know. You know, I’ve had my share of situations that…

Clark: Everyone’s body is different. Oh my.

Dr. Danyo: …required me to put my doctor hat on during a procedure. Everything turned out well…

Clark: Whoa, tell me about maybe an example or story there of… Because I know this is very unlikely that something like this would ever occur, but things…you know, everyone’s body is different.

Dr. Danyo: Yeah. I mean, I’ve had people… One guy had an allergic reaction to a medication where he actually went into some anaphylaxis, meaning more like a shock reaction to the medication.

Clark: Oh my.

Dr. Danyo: So, you know, he dropped his blood pressure and we had to stabilize that and get IV fluids going and inject some epinephrine and some IV steroids to kind of get things turned around. But we ultimately ended up just calling 911 who came and they took him and he did fine. But again, that’s a situation where a non-physician wouldn’t know what to do and basically, putting somebody in harm’s way, which is not acceptable in the least.

Clark: That’s a good reminder. I mean, this is a medical procedure. And for you, if someone’s not listened to the podcast before, we’ve sometimes talked about your past, the work that you were doing before you made the pivot go into this full-time. Maybe that might be a good reminder to share what you were doing as a doctor before this work.

Dr. Danyo: Yeah. I was in physical medicine and rehabilitation and pain management. I did a lot of interventional spine work, you know, doing spinal injections and I was certified in acupuncture. And I generally do between 10 to 20 spinal injections a day. And we had personal training in our office and physical therapy. We did a lot of nutrition at work and kind of some life coaching stuff. But the thing that really kind of drove me away was just pain management in general. I mean, it’s just filled with so many ethical challenges and dilemmas that I faced, whether it was the narcotics that our societies were teaching us to write, high doses of narcotics, and saying that everything was okay, you know, and you had the drug companies and worker’s comp and personal injury. It just kind of drove me to a place to say, “You know what, this isn’t who I am and I’m gonna make a change.”

So it was pretty major change going from that past life in physical medicine rehab and pain management to hair restoration. But there’s just so much that carries over from that practice to what I do now that gives me special skills to make the procedure less painful and go smoothly. And, you know, I’ve done so many injections like critical injections in the spine doing the type of hair transplant I do, which is follicular unit extraction using needle punches. You know, it’s like having an extra digit or something like that, you know? So it’s kind of part of me.

Clark: Well, hey, this has been really insightful and it is something…it’s a serious commitment and, you know, someone who’s on this discovery phase of trying to find the right thing for them, there’s a lot to consider. And you’ve shared some really good red flags to look out for, the possibilities of things. If you don’t have the right person doing this work, things can go sideways.

Dr. Danyo: Exactly.

Clark: So, hey, Dr. Danyo, I think this answers all my questions. This has been super insightful as always, and I can’t wait for us to get together again and keep these conversations going.

Dr. Danyo: Likewise, I appreciate every podcast and look forward to the next one. Take care.

Clark: Hey, thanks for listening to “Hair Restoration with Dr. Daniel A. Danyo.” Book your consultation today with Dr. Danyo by calling 678-845-7521, or visit them online at nahairrestoration.com. And be sure to follow, rate, and review this podcast wherever you listen to your audio content.