Failed hair transplant and negative experience regarding toilet brush effect, moth-eating, poor growth rate, wrong direction of grafts growth and scars
Have you already had a hair transplant done with a very negative experience and only a poor result was achieved and the hair transplant is overall unsightly and failed/ botched? They are not alone!
As reported on Hairforlife, although the number of providers in Germany is rising sharply, the number of complaints, poor results and failed hair transplants is also rising drastically!
Hair transplants are ultimately an intervention on the human body and of course also bring risks for bad results.
Often a failed hair transplant with a negative experience is associated mainly with toilet brush effect, moth-eating, poor growth rate, wrong growth direction of the grafts and scars.
The reason is simply doctors not specialised in hair surgery, little know-how and experience (read in the chapter on risks).
The good news: In many cases, a bad hair transplant can be corrected and significantly improved with a correction by a renowned and experienced hair surgeon, as see the experience report of Marco’s negative but also positive experiences. There is help!
Sat.1 Frühstücksfernsehen on 20.11.2019 about bad hair transplant results – “Hair transplant: is the procedure worth this risk?” – A patient reports on his negative experience with poor growth rate
Hairforlife was awarded a source recommendation in the above-mentioned feature on the TV channel Sat.1 about poor hair transplant results/outcomes.
With the assistance of Hairforlife cooperation lawyer Mr. Christoph Bomke (specialist lawyer for medical law) https://bbp-legal.com/anwaelte/#bomke and the well-known Hairforlife cooperation doctor Dr. Lars Heitmann (Zurich/Switzerland) , Hairforlife was named as a source on the subject of “unsuccessful hair transplantation”. Lawyer Bomke also presented two patient cases of botched hair transplantation presented on Hairforlife, in which compensation could be obtained.
In the article, a patient also reports on his negative experience with a hair operation and poor growth rate.
See the complete video below, or visit https://www.sat1.de/tv/fruehstuecksfernsehen/video/haartransplantation-ist-der-eingriff-dieses-risiko-wert-clip
Failed hair transplantation and bad results: Legal help for botched – bad hair transplantation (carried out in Germany)- Article and Info PDF
There are also legal possibilities and help when it comes to bad results and outcomes, at least to be able to fight for compensation, which may enable you to financially bear the costs of a corrective operation. The dilemma is that corrective hair surgery by an experienced specialist is often much more expensive than the previous bad cheap surgery.
On the subject of legal help, read the PDF Legal help for botched hair transplants (Important: The content is designed for the German legal system).
Further articles and information on negative experiences and botched hair transplants
Please read the following articles and information about failed hair transplantations and patients who have had negative experiences with HT:
Bad hair-op results – help with botched hair transplantation – Author: Christoph Bomke Fachanwalt für Medizinrecht
Anyone who is more closely involved with the topic of hair transplantation or is planning to have a corrective operation will ask themselves what they can do after a “failed hair restoration surgery”.
The number of patients with negative experiences regarding hair transplants, those with bad results/outcomes (poor growth rates, scars, wrong growth direction, toilet brush effect, decimated donor areas, etc.) and thus corrective surgeries, medically called revision surgeries, is increasing and is probably constantly increasing among the number of surgeries taking place at the post-treatment hair surgeons who deal with corrective surgeries.
A major cause for this can be seen in the now quasi-flooding of the market with so-called low-cost providers at home and abroad for hair transplants, which more or less inevitably goes hand in hand with a lowering of the quality of the service provided, which is owed per se.
But even large clinics in Germany, which offer not only hair transplants but the entire spectrum of cosmetic surgery at various locations in Germany and are anything but so-called low-cost providers, often lack the necessary quality. Here, too, there is – as the layman calls it – not infrequent “bungling”.
The main problems that lead to corrective operations are first and foremost the formation of wide scars and/or scars that are too long in the donor area, i.e. the neck or the side of the back of the head, poor scar formation in general when using the FUT method, but also so-called “pitting” when the FUE method is used incorrectly due to too dense removal. Another typical problem is poorly “designed”, unnatural-looking hairlines, insufficient density and, in this context, generally incorrect therapy planning or the use of outdated treatment methods.
For corrective surgeries, be it for necessary scar correction(s) at the back of the head by means of FUE treatment and/or Tricho (Trichophytic Closure Technique, also known as the “guarding technique”) or the “re-styling” of the front hairline for a natural aesthetic result or the thickening by the hair surgeon carrying out the corrective surgery, treatment costs alone regularly amount to well over 10,000 euros.
Many patients do not have the necessary money for corrective surgery, which is usually much more expensive than the “disfiguring” initial intervention.
The suffering of the patients who suffer from the unsuccessful interventions does not decrease, but increases the longer they have to live with what they perceive to be a disfiguring result, and not infrequently also leads to psychological stress, which becomes noticeable both privately and professionally through a lack of self-confidence, loss of self-esteem, lack of success, and so on.
This automatically raises the question of when the patient affected by a failed hair transplantation has a claim for damages and compensation for pain and suffering against the clinic for the unsuccessful initial procedure or against the surgeon.
Damages are not only the compensation for pain and suffering, but also the costs of necessary revision operations (which are regularly significantly higher than 10,000.00 EUR) as well as the costs of the failed or even disfiguring initial operation.
As a rule, the claims made therefore range from 25,000.00 to 35,000.00 EUR. In some cases, however, they are significantly higher.
On the one hand, claims can be made if there was a treatment error. This is the case if – to put it simply – the treatment was not carried out in a professional manner, i.e. in a manner that fell short of the medical standard under medical law.
In the case of the “results” already described above, such as the formation of wide scars and/or too long a scar in the donor area (neck), “pitting” in the case of an incorrectly applied FUE method due to too dense removal or due to improper handling of the hollow drill supported by a micromotor, or even poorly “designed”, unnatural-looking hairline, or insufficient density in the individual case, use of outdated methods (mini-micro-graft method, punch), this can be easily affirmed from the point of view of the well-trained and careful hair surgeon – whose behaviour is, so to speak, the yardstick – as a rule.
Because the yardstick here is: how would the well-trained and careful hair surgeon have behaved and would these “results” have been avoided with professional application?
Another important aspect of when and why claims can be made is the breach of the duty of disclosure by the clinic.
First of all, it will always be found that the information is provided by an independent or employed (marketing) employee of the clinic, who is not a doctor or even a hair surgeon himself.
Much here is reminiscent of the common image of a salesman who wants to sell his goods – in this case the operation.
According to established case law, such information is ineffective in Germany, as it may only be provided by a doctor who is appropriately qualified.
For this reason alone, the intervention in question in this case fundamentally constitutes an unlawful bodily injury.
Furthermore, it is also settled case law that in the case of cosmetic surgery – and this includes hair transplants – comprehensive and unsparing information must be provided about all risks associated with the procedure.
Very often, if not regularly, risks that materialise later, such as the formation of wide scars (provided that there is no treatment error in the individual case), are concealed, so that the patient experiences a “rude awakening”, so to speak, only afterwards because of a realised treatment risk, about which he should have been informed in advance and the knowledge of which would have led him to reject this treatment method.
It also happens again and again that only one treatment method is to be sold, so to speak, while existing treatment alternatives are not presented or are presented incompletely.
If there are equally medically indicated treatment methods, as is the case in the area of hair transplantation with FUT vs. FUE, and which have significantly different risks or chances of success with regard to the removal method and thus represent real options for the patient, the clinic must provide information about the respective treatment alternative with its chances and risks in an accurate and complete form.
However, it is up to the patient to decide, after receiving the appropriate information, which method of treatment should be used and which risk he or she is willing to take.
If, for example, this does not happen either, there is also a breach of the duty to inform in this respect, which generally leads to the patient’s consent to the intervention being regarded as ineffective, i.e. invalid, with the consequence that there is unlawful bodily harm.
Here, too, it is completely irrelevant whether the practitioner is a so-called large clinic with various locations in Germany or a small UG that uses doctors who fly in as surgeons and offers hair transplants at dumping prices.
In summary, it can be said that no one needs to put up with a failed hair transplant with a poor result.
Private expert opinions from renowned hair surgeons on the question of treatment errors in the unsuccessful initial procedure are more than helpful here, even if many things are often obvious even to the layperson. In addition, a thorough review of the treatment documents – requested by the lawyer – is indispensable when pursuing claims and examining the case.
In the case of patients with legal expenses insurance, the costs of extrajudicial and judicial prosecution are generally paid by the legal expenses insurance without any problems.
Info: This article applies in particular to German law. Patients who have been treated in Germany or abroad and there is a representative of the clinic in Germany.
Christoph Bomke, lawyer, specialist lawyer for medical law
Another article about bad results: The patient case of Mr. F. from southern Germany with thick grafts, poor growth rate and scars – 15,000 euros compensation for a botched hair transplant – Author: Christoph Bomke Specialist Lawyer in Medical Law in cooperation with Hairforlife Andreas Krämer
Mr. F. (22 years old in 2005), who comes from southern Germany, had a full head of hair at the time. However, he was bothered by his slightly receding hairline and considered having it removed by means of a hair transplant – inspired by a TV report on hair transplants.
For advice on his options, he presented himself to a so-called plastic surgeon in southern Germany. As is so often wrongly assumed, Mr. F. also assumed that a specialist in plastic surgery also had the qualification/training for hair transplants. However, he was not aware of the fact that hair surgery and hair transplants are not part of the training catalogue of a specialist in plastic surgery at that time in 2005 and also until 2015.
After several insufficient explanations (Mr F. only learned about this in 2013), the said plastic surgeon performed a hair transplantation using the strip method (FUT) and mini/micrograft transplantation on patient F. in June 2005 in southern Germany. The result of this hair transplantation was disastrous. The grafts in the front of the recipient area were much too thick and the overall “density” was insufficient due to low density and also a poor growth rate, which appeared absolutely unnatural from an aesthetic point of view.
The patient felt disfigured. His life was very burdened by this extremely negative experience and disastrous result of the botched hair transplant, which resulted in clearly negative changes in his life. For example, the patient suffered greatly from the constant worry that he would be approached about the visually visible features of the botched hair transplant that showed on the front of his head. Likewise, he was extremely embarrassed by the extremely wide and crescent-shaped scar that shone through and inevitably attracted the gaze of third parties, which made Mr F. very insecure. In desperation, he got hair replacements (contact skin) to hide his disfigured head from the eyes of third parties. He lived with this hair replacement until 2013, when he found the courage to change this condition.
He read about the HLC Clinic/Team Dr. Özgür in Ankara/Turkey on the website Hairforlife.info and learned that the Hairline Clinic specialises in repair work for botched hair transplants.
When Mr. F. arrived at the Hairline Clinic for his first consultation, even the clinic director, Dr. Özgür, was shocked by the result of the previous hair transplant and said that he had never seen such a bad result of a hair transplant before. Subsequently, the first corrective treatment was carried out on Mr. F. at the Hairline Clinic Ankara: The mini/micro grafts were removed and approx. 3,000 grafts were transplanted using the FUE technique.
The result caused enormous enthusiasm in the patient! Compared to the catastrophic hair status resulting from the 1st hair transplant, he could now look forward to a phenomenal improvement and thus a completely new attitude towards life.
In a further treatment, a scar correction is carried out on Mr F. at the HLC Clinic. This is done at a later stage, as corrective operations are usually carried out in several steps/surgeries in order to protect the patient, the donor material and the areas to be treated and thus to be able to achieve the best possible result. The last unnatural grafts are also removed from the hairline. However, these treatments are still pending.
After Dr. Özgür had informed Mr. F. about the various deficiencies and the lack of information regarding the hair transplantation (carried out in 2005), he later learned through Hairforlife about the possibility of having recourse to a specialist lawyer for medical law. Mr. Christoph Bomke, lawyer (medical law firm BBP Rechtsanwälte, based in Berlin), specialises in such cases of damage and has already been able to help many injured Hairforlife customers so that they could receive compensation for damages and pain and suffering. Mr. F. also made use of this help and entrusted the specialist lawyer for medical law Christoph Bomke with his patient case. In 2015, a lawsuit was filed against the plastic surgeon from southern Germany, who was accused of massive technical errors and, above all, deficits in information:
* Lack of information about the fact that the FUE technique was already known in 2005 as a modern, gentle and quasi scar-free method, through which absolutely natural results can be achieved
* Lack of information about the fact that this doctor has neither the training for hair surgery, let alone sufficient experience in this field
* Failure to inform the patient that the use of finasteride, a drug prescribed for hair loss, can stop the progression of hair loss – with a probability of over 90%
The Bamberg Higher Regional Court upheld Mr F’s claim against the doctor in question in 2017, and Mr F was awarded approximately €15,000 in damages by way of settlement. The Higher Regional Court found that Mr F’s claims were in no way time-barred. However, due to the lapse of time of almost 10 years, the court only took contributory negligence as a basis, whereby the claimant’s claim for compensation for pain and suffering and damages was to be reduced to only approx. 15,000 €. Justification: The plaintiff could have undergone repair treatment much earlier, then the psychological damage and all other negative effects would in all likelihood not have arisen to the extent they have now.
If Mr. F. had already filed his claims against the practitioner in the first years after the hair transplantation, he could have hoped for a considerably higher compensation, which could well have been in the range of twice the amount of money now received.
This patient case is extremely interesting – and is representative of a large number of similar cases that are brought to Hairforlife time and again. Once again, it becomes clear how important it is not to make any rash decisions and to only choose a practitioner who has an appropriate reputation, is specialised in hair transplantation and can therefore also prove a wealth of experience. In doing so, one should not shy away from a somewhat longer journey or flight and should not make the choice of a proven specialist for hair transplants dependent on the location of the clinic!
When choosing a practitioner with a location in Germany, it is very often a specialist in plastic surgery. In particular, if the clinic’s range of treatments also includes cosmetic corrections, the surgeons treating there usually have no explicit hair surgery training. Other qualifications are in no way equivalent to hair surgery training! There is also usually a lack of experience that renowned and proven experts in hair surgery can prove.
At Hairforlife, those interested in hair transplantation have been receiving comprehensive information for more than 15 years, as well as answers to all questions that are decisive when choosing a renowned practitioner. All Hairforlife cooperation partners are, without exception, specialised clinics for hair surgery.
This patient case also illustrates that it is still possible to assert claims against the practitioner even after ~10 years post-op. No one should lose heart after a negative experience with hair transplantation and resign themselves to their burdened life situation! It is not known to many people, but the treating physician is also liable if he does not inform the patient that the progression of hair loss can be stopped with a high probability by means of the drug finasteride. In the case of a lack of information in this regard, the doctor is regularly liable for the progression of the hair loss. Do not remain inactive, but give yourself the chance to find your way back to a normal, fulfilled life.
Article: Failed FUT strip hair transplantation: The patient case of Marcel S., unbelievable, but unfortunately not an isolated case – Author: Hairforlife Andreas Krämer in cooperation with Christoph Bomke, specialist lawyer for medical law
Info: This article applies to German law. Patients who were treated in Germany or abroad and the clinic is represented in Germany.
Hairforlife presents a patient case from 2009 onwards, which illustrates the serious mistakes made by practitioners in the exercise of their strictly prescribed legal duties – and the consequences this can have for patients. In particular, the arc possibilities that result from this for injured patients are also illuminated.
Special thanks go to the lawyer Mr Christoph Bomke (specialist lawyer for medical law), who supported this report with his friendly cooperation.
Marcel S., a 25-year-old patient from North Rhine-Westphalia, went to Dortmund in 2009 at the age of 19 to undergo a hair transplant at a German provider. This is a clinic group for cosmetic corrections, which has numerous locations/clinics in Germany. Using the FUT method (Follicular Unit Transplantation), 900 grafts (follicular hair units) were to be transplanted at a cost of €4,000.
As is often the case, information and therapy planning were carried out by a marketing employee of the clinic entrusted with the operation. This circumstance alone led to the invalidity of the patient’s consent to the FUT treatment from the beginning and thus to the illegality of the intervention, since according to established case law, the duty to inform cannot be transferred, but must be carried out by the doctor performing the intervention. Moreover, the patient had signed the information sheet provided by the clinic at his place of residence, after this form had been handed over/transmitted to him beforehand.
At no time did a timely, personal and trusting discussion take place between doctor and patient to inform them about the procedure and in particular about alternative methods (FUE). This, however, is stipulated by constant case law! The necessary information before the operation was therefore to be regarded as “not having taken place at all” from several points of view.
If a clinic refers to the surgeon providing information on the day of the operation: information provided on the day of the operation is generally considered to be late! Thus, the consent to the FUT operation of the patient Marcel S. was also invalid for this reason according to case law. Regardless of these omissions, which in themselves justify liability, the unsparing information required for cosmetic surgery was not given according to the current legal situation.
The constant jurisprudence of the supreme and higher courts places very strict requirements on the information of a patient before cosmetic surgery! The patient must be informed comprehensively and unsparingly (BGH, VersR 1991, 227; OLG Düsseldorf, OLGR 1993, 320, 321; OLG Oldenburg, OLGR 2002, 50 ff. OLG Hamm, judgement of 29 March 2006 – 3 U 263/05 in juris).
The analogous statement of this “established case law”:
The less a medical intervention is medically required, the more important is the quality of the patient information! If a patient is advised to undergo a treatment/intervention/surgery, or if he or she wishes to undergo a treatment that is not medically necessary, the patient information must not only be detailed and comprehensive, but the patient must also be informed in detail about the prospects of success of the treatment and any harmful consequences.
However, the 19-year-old patient Marcel S. was not given this information; this unsparing information did not take place at any time. Thus, from the outset, the present surgical intervention on the patient was not covered by his signature/consent under any of these aspects and the treatment thus constituted an unlawful bodily injury. For this reason alone, the clinic was fully liable.
The patient Marcel S. suffered a considerable loss of quality of life after the treatment in the Dortmund clinic. A large longitudinal scar extends from ear to ear at the back of the head.
This can result in various impairments (especially with a corresponding predisposition). Temporary or permanent feelings of tension can occur, which are often described as painful. In addition, unpleasant skin irritations can remain even if the healing process is good. Apart from the physical discomfort that may occur, patients often suffer, especially from the visual loss: with short hairstyles, the scar is visible! This means that a free choice of hairstyle is no longer possible, which is clearly at the expense of the light-heartedness that patients hope for after a hair transplant. The patient Marcel S. has also had to live with this loss of quality of life since the operation. It is well known that former patients who were incorrectly treated with the FUT procedure (skin strip removal) suffer the most from scarring.
In addition to the violations of the obligation to inform the patient mentioned above, various (typical) treatment errors occurred:
– The broad scarring that is frequently encountered with improper FUT treatment could have been avoided in any case, especially in the width that was present in this patient’s case
– There was initially no question of a linear/linear scar in this patient
– The patient had retained an approximately 15 cm long scar from the surgical intervention at the back of the head, extending from ear to ear. The non-linear (let alone line-shaped) scar also varied in width, which is also very common. The scar was clearly wider in the outer areas than in the central scar region, which was due to a lack of care/incorrect incision as well as incorrect (treatment) skin suturing by the surgeon
Furthermore, a “typical” treatment error was present in this patient:
Already since 2005, the trichophytic closure technique (grow-through technique), which has been available in hair surgery for more than 10 years, has been listed and recommended in the guidelines of the professional societies for strip removal. However, this modern closure technique was not used in Marcel S.’s case, which resulted in (and in his case even more so) broad scarring. The trichophytic closure technique describes a modern method of suturing wound edges together after skin strip removal. This trichophytic closure technique allows hair to grow through the scar area. This makes it possible to optimally create scars so that they later remain largely hidden from third parties due to the hairs that have grown through.
However, according to constant jurisprudence, a certain treatment method no longer satisfies/meets the quality standard to be maintained if new methods are available that (and/or)
– involve fewer risks for the patient
– are less stressful for the patient
– promise better chances of recovery
– and are essentially uncontroversial in medical science
(Constant case law, see only BGH, judgement of 26.11. 1991 – VI ZR 389/90 -)
According to the treatment documents of the patient Marcel S., the trichophytic closure technique was not applied when his FUT treatment was carried out. Consequently, the quality standard to be complied with according to case law (as described above) was not met in the case of this patient.
Apart from this, the treatment planning of the 19-year-old patient was noticeably faulty. The hairline was set much too low with the number of grafts transplanted in this case. The achieved “density” (as far as this can be spoken of at all) is absolutely unacceptable, especially for this reason. In addition, the holes for the implants, as well as for the spacing, were obviously set much too large.
In this context, it should be noted:
Already in 2005, the so-called “Dense Packing” was available. This method describes a way of grafting by means of which an extraordinarily high density in the recipient area can be achieved. By using this treatment method, a hair status can be achieved that does not reveal to third parties that a hair transplant has taken place when seen with the naked eye (see also the article regarding Dense Packing in Hair Transplantation).
All in all, an unaesthetic and absolutely unsatisfactory/bad result was achieved for the patient. As a result, the patient Marcel S. contacted Hairforlife/Andreas Krämer in 2015 due to his negative experiences and sought expert advice on aftercare providers, possibilities and prospects for the first time. It is not uncommon for patients to spend their full budget on a hair transplant and subsequently have no funds available for an expensive repair operation, which is what happened to this patient. Due to extensive good contacts in the field of hair transplants, Andreas Krämer was able to recommend a specialist lawyer for medical law (Christoph Bomke) to the patient Marcel S., who informed the patient about his legal situation and the corresponding possibilities and took on the case. Thus, at the end of 2015, Marcel S. asserted claims for damages and compensation for pain and suffering against the treating clinic through his legal counsel.
After a relatively short time, an agreement was reached and the clinic’s liability insurance paid 15,000 euros in damages to settle the claims. The patient thus not only received his treatment fee back, but in particular also compensation for pain and suffering and the necessary budget for a corrective procedure by a renowned hair surgeon.
Patients can claim back the entire fee for cosmetic treatments/surgeries in particular if the costs of the follow-up treatment required due to treatment or information errors exceed the fee for the initial intervention, as was the case with this patient (OLG Zweibrücken, judgement of 28.02.2012, 5 U 8/08). In addition, this comes into play if a cosmetic operation that is unlawful due to a lack of or inadequate information does not produce the desired result or even a deterioration (OLG Düsseldorf, judgement of 20.03.2003, 8 U 18/02; OLG Stuttgart, judgement of 17.04.2001, 14 U 74/00; OLG Zweibrücken, judgement of 28.02.2012, 5 U 8/08; OLG Nürnberg judgement of 25.07.2008, 5 U 124/08). This also applied to this patient case.
Marcel S.’s claims were not time-barred, even though the treatment in his case had already taken place 6 years ago. The beginning of the limitation period with regard to a doctor’s liability presupposes knowledge of the circumstances giving rise to the claims. In practice, however, a patient only acquires this knowledge by consulting an appropriate specialist, usually the “after-treatment specialist”. In the case of Marcel S., accordingly, only in 2015 after contacting and consulting Hairforlife.
Marcel S. was overjoyed after the all-round care and consultation by Hairforlife. Thank you very much for this – I will gladly take this as an incentive for future problem cases, where hopefully an acceptable solution can also be found in the interest of the patient.
With best regards,
Yours, Andreas Krämer