It would be great if hair restoration surgeons could contribute by giving their personal views based on experience as to whether one dense packed session or two lower density sessions are better for overall survival.

I would particularly like to hear from Dr Wong (who I think is a brilliant surgeon) so he can clarify what he said to Emperor.

Julius,
Dr. Wong said just what I said he did, but you should probably call them and report back here, rather than trying to bait an altercation.

I believe that Wong is conservative in his approach. He expressed that if you dense pack too much, there is risk of nothing growing. Ultimately, when it came time for the procedure, I left the question of density to his judgement.

Regarding "one pass procedure", I though I was going to have something closer to Bobman's result. Obviously results vary. Even if all of the grafts had grown, I would probably have still required a second pass. I think the goal is to get an area done in one pass, but I am evidence that this approach does not always pan out. Not saying that H&W are bad or negligent, only that things do not always work out as planned.

The question of yield vs density is a very good one to ask.

My opinion is that they plant at a relatively high density. If everything grows, they get a home run. If everything doesnt grow, or if hair quality is poor, they go back for a second pass. If they didnt attempt a one pass procedure, then patient would be guaranteed to have two procedures, so it is a calculated risk. If they dont go crazy with dense packing, then a good percentage will grow, so even if (say) 500 grafts dont grow, that will not destroy the patients prospects overall.

You should also ask why people only have typically 7K grafts in the bank. This was not apparent to me before the surgeries. ( It is interesting what removing 2-3cm of skin does to the rest of the scalp. You will only know once youve had procedures.)

Another question you should ask is why patients often report reduced yield in 2nd, 3rd procedures. As I watch my #2 grow out, it is curious that the areas that had poor yield before are showing delayed/less growth now. I can only assume it has something to do with the hidden scar tissue that SMG mentioned.

Another question you should ask is about graft size. Looking through results you will see many of the most impressive results are repair patients who had minis or larger FUs. Larger FUs create more scarring (larger incisions), but contain more hairs. If there is a ratio of scarring to hairs, the larger grafts are superior.

Also, chubby grafts require larger incisions, but have shown greater yield. Skinny grafts create less scarring/smaller incisions and can be placed closer together.

Also ask whether the quality (thickness) of transplanted hairs can be influenced by cutting techniques. I have read that grafts which are damaged in cutting will often grown but at a finer caliber. I suspect chubby grafts receive less trauma.

I signed up for Dr. Wong's approach to HT based on the "one pass approach" and large graft counts, but given that I needed two passes anyway, I think I would have gotten a better result going to a clinic that uses chubby grafts, and/or double FUs with medium session sizes. I truly belive that 3000+3000 is going to be better than 6000 or 4500+1500. (of course, after only getting 3000, you will not be close to finished, so getting a very large first procedure will get you closer to your destination, so sacrificing yield for faster results is probably in most peoples best interest.) Smaller session sizes afford the doctor more freedom in choosing better hair, and he can respond to the results of prior procedures better.

You will see a trend that often guys who have say 3-4 medium-small sessions get more density than the guys who try to get it in 1-2 megas. That does not speak the naturalness. I think the skinny graft+megasession provides more natural results, but potentially compromises yield and hair quality.

Julius, keep doing you research and listen to what various doctors say. There is NOT one right approach.

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My Hair Loss Web Site - Hair Transplant with Dr. Wong

Mate, I was not trying to bate an altercation, I just said I think he is a brilliant surgeon!

I actually thought it was a good time to bring it up after reading your posts in Phil Mascallpen’s thread where you seem to write off a one pass approach and imply that dense packing was the ‘culprit’ for less yield.

All I am hoping for is that the good Dr can explain why he said that to you in light of his research.

Can you please try to explain what removing 2-3cm of skin does to the rest of the scalp?

Good point Emperor about many having reduced yield in 2nd, 3rd etc procedures maybe this strengthens the case for a one pass approach, it would be great if a Dr could explain why this happens (if it does at all)?

I once read something on minis and how when combined with fut that the transplant appears denser, although the study came to the conclusion that the same appearance of density could be created with futs alone.

Please direct your questions to the doctors. I am just repeating what I have been told or discovered reading thousands of posts.

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My Hair Loss Web Site - Hair Transplant with Dr. Wong

Emperor...you don't have to answer this if you don't want to but I was wondering if H&W charged you for the second procedure you received? Any discount? I know you were not too thrilled with the yield of the first procedure, but after viewing your hair loss website, I think you'll be very pleased with the outcome of this procedure. Best of luck

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My Hair Loss Website - Hair Transplant with Dr. Hasson

You guys some advice:

If you have a specific question for a specific doctor, contact the doctor directly. If you have questions about how much another member paid for his procedure, contact the member directly.

Airing personal questions publicly is bad form.

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My Hair Loss Web Site - Hair Transplant with Dr. Wong

TheEmperor raises a lot of great questions in his post above.

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My Hair Loss Website - Hair Transplant with Dr. Simmons

Good post!

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take care...