H & W Doug

It is a topical antibiotic, see my May 14 post. Melvin/abg, See below. Post-op photos from his second session which yielded 3,074 grafts. I would say the scar is pretty good considering all of the previous scar tissue Dr. Wong had to contend with. In this round Dr. Wong rebuilt the temples and strategically added density to selected areas most in need of improvement. He also removed most if not all of the inappropriately placed grafts in the hairline from his previous procedure. This patient should be looking very good compared to where he started after this one. Luckily for him he had sufficient donor and picked the right surgeon this time around.

This patient in his mid-40’s from a neighboring province had decided it was time to do something about his receded hairline and frontal zone. It was something that had started to bother him in his 30’s when he noticed his hairline was beginning to erode. He had previously tried a laser cap in hopes that it may improve his hairline to a somewhat acceptable degree. He did not like using it and more importantly he did not see any results which is not unusual in most cases especially where there is little to no existing hair. Certainly, any small improvement, if possible, would not be nearly as significant as restoring the areas with a hair transplant procedure. His initial consultation at the Vancouver surgery center confirmed that his above average donor hair and favorable characteristics coupled with Dr. Hasson and team’s talents would achieve a high-density result and produce the cosmetic impact he was looking for. Considering that with FUE Dr. Hasson can place the grafts at a slightly higher density than would be possible with FUT and given the areas to cover and all other factors, Dr. Hasson felt he would need approximately 5,000 grafts depending on hairline placement. At the end of the day 5031 were required. The procedure was performed over 2 consecutive days. Day 1 consisted of 2,700 grafts of which 300 were single hair grafts,1575 were doubles and 825 were 3-4 hair grafts. Day 2 produced 1326 doubles and 1005 3-4 hair grafts. 2-day totals: 300 singles, 2901 doubles, 1830 3-4 hair grafts. These photos taken at the clinic at his follow up visit represent the result 10 months post-op.

Mattk494, I would say about 3,500 to 3,700 grafts went to the hairline/frontal zone/mid-scalp while around 2,000 to 2,200 went to the crown. For just the hairline? maybe 1,300? It is better to do as much as possible in one surgery in cases such as this with extensive loss. If the clinic can execute, there are a number of reasons this is best. It is more cost effective to do one 5800 grafts procedure than two sperate 2,900 graft procedures. Most patients would also want the result sooner rather than have to wait another 8-12 months to have phase two and then another year for the same result that could have been achieved the first time. It can also be more efficient to cut the scalp once rather than twice. Mega session survival rates in the hands of a capable surgeon and team present no concerns. All things considered, the number is not as important as how the grafts are handled and stored. If properly handled and stored, grafts can survive for 24 hours outside the body. And of course, the surgeon needs have the skill to safely place a certain number of grafts in a given area. Some may not have the skill, experience or confidence to pack to a certain density. In our clinic, if there are limitations as to how many grafts we can harvest, it is because an individual patient may present certain factors preventing a large session such as less than average donor hair and limited scalp mobility(FUT). Our ability, technology and process will not limit us.

Hasson and Wong patient advisor James is back again in Ft. Lauderdale Florida next month on December 15 and 16. To meet him and see if you are a good candidate for a hair restoration procedure at our clinic, reserve your spot here: https://hassonandwong.com/consultations-in-your-city/You can learn more about James, the process and his history with Hasson and Wong here: https://hassonandwong.com/hair-transplant-toronto/You can also call 1-800-859-2266 Toll-Free or email us at info@hassonandwong.com.

We’re excited to announce Hasson and Wong patient advisor Rob will be back in London on Nov 13th. To meet him and see if you are a good candidate for a hair restoration procedure at our clinic, reserve your spot here: https://hassonandwong.com/consultations-in-your-city/ You can also call 1-800-859-2266 Toll-Free or email us at info@hassonandwong.com. You can also learn more about Rob and his history with Hasson and Wong here: https://hassonandwong.com/my-life-changing-hair-transplant/

Thanks for the comment guys! Dr. Hasson determined this patient’s final hair loss pattern is a stage 3A. In this case his safe donor zone would be much larger than say a stage 5-7. Therefore we can be more aggressive with the area to harvest. There is a relationship between hairline placement and temple location. The farther advanced the temples and points, the lower the hairline can be. They must balance with one another. If we want to significantly lower the hairline and its safe, the temples need to be advanced to match the hairline. In some cases a complete temple reconstruction is not recommended, in others it is. In this case temple advancement/reconstruction was not necessary or advised. The patient will usually be presented with several hairline placement options. He may have always had a higher hairline and felt more comfortable with a more conservative hairline design and location. Dr. Hasson may have been able to go a little lower here if desired but too much and the hairline would start to look top heavy without advancing the temples. In most patients, one side does have more recession than the other. I’m not seeing a much of a difference in the temple point location here. Some reasons to switch to FUE from FUT can include finding that the scalp is tight and harvesting the desired number of grafts via FUT could be a challenge. While we have transitioned from an exclusively FUT clinic to performing more FUE than FUT, we have implemented some practices that have greatly reduced the chance we may consider a switch at the time of the patient’s visit. While I agree we want to minimize any surprises once the patient has arrived, I would not characterize this as “unprofessional”. On the contrary if the switch is ultimately in the patient’s best interest. Let me repost some of the patients comments in case you guys missed it: “I got a haircut a couple days ago, so the sides are pretty short. There is no visible scaring in the donor area and you can’t tell there are have been any hairs extracted. Overall I would say that I am super happy with the results (was a great last minute decision to go with FUE vs. the originally planned FUT too).” I thought his comments may have been of some interest but I didn’t think it would get this reaction…..so much for the transparency and providing the additional info 😊

Patient in his early 30’s from Calgary choose Hasson and Wong after doing extensive research. His decision was also influenced by a friend that recommended he see Dr. Hasson. Starting to lose his hair at the age of 18, it was roughly 15 years later when he decided to do something about it. The plan was for Dr. Hasson and team to rebuild the hairline and frontal zone working back into the mid-scalp as necessary. 4228 grafts via FUE were harvested. Day 1 consisted of 200 single hair grafts, 1972 doubles and 28 triples for a total of 2200 grafts. On Day 2, 2028 doubles were extracted. Due to limited options on the busy schedule, day 1 was separated from day 2 by 6 days instead of the customary back to back day approach. You can see in the placement photos there was a fair amount of crusting left over from the previous day 1 session 6 days prior. For the extraction sites as seen in the photo, left side harvest on day 1, right side on day 2. These result photos were sent in by the patient about 1 year post-op. Some comments he also added with the photos: “It was around 6 months it really started to thicken up. I got a haircut a couple days ago, so the sides are pretty short. There is no visible scaring in the donor area and you can’t tell there are have been any hairs extracted. Overall I would say that I am super happy with the results (was a great last minute decision to go with FUE vs. the originally planned FUT too).”

Thx for the comments guys! He did not send any good donor shots but we'll try and get some when he comes back. It is a topical antibiotic.

This Canadian patient in his mid-20’s from a province outside of British Colombia had a previous poorly executed FUE procedure in Pakistan. Two years removed from his disappointing results, further research and due diligence revealed he should turn to Dr. Wong for answers and a solution. His goals were to create adequate density and coverage to all areas with emphasis on the frontal zone and crown. Fortunately he had good donor hair and a high degree of laxity and it was determined that to achieve his goals and maximize the result, FUT would be the preferred method of extraction. The impressive harvest of 5,783 grafts consisted of 1320 single hair grafts, 3198 doubles and 665 3-4 hair grafts. It is also noted that Dr. Wong removed some of the previous improperly placed grafts from the hairline at the same time. The patient will return to have the remaining old hairline grafts removed which will greatly enhance the overall appearance of the newly constructed hairline. I may also add that for this type of outcome following an inferior procedure that has compromised the donor area as depicted in the pre-excision pics, a patient must have above average laxity and above average donor hair. These photos were sent in by the patient 7.5 months after his procedure. You can also hear some reference to this case in Dr. Wong’s recent Instagram live interview with Melvin.

This Vancouver area patient in his mid-30’s found Hasson and Wong through some online research. Genetics for hair loss on his mother’s side started to become apparent by the age of 30. A meeting with Dr. Wong confirmed FUE would be the best option. The procedure to rebuild his hairline and necessary areas of the frontal zone required 2165 grafts. 103 were single hair grafts, 1732 were doubles and 330 were triples. These results only 7 months post-op at this stage have exceeded both his expectations and those of his family members.

Vancouver area patient in his late 30’s started to become increasingly bothered by his receding hairline. Evaluation of his case at the clinic by Dr. Hasson resulted in a recommendation of around 2,500 to 3,000 grafts using the FUE method of extraction. Hairline placement would ultimately determine the final number of grafts required and the agreed upon hairline would eventually require 3058 grafts and the procedure was completed in one day. 300 were single hair grafts, 1512 were doubles and 1246 were 3-4 hair grafts. He started Proscar at the time of his procedure to help maintain his hair behind the transplanted area. He noted his experience at Hasson and Wong was a very good one and he was very happy with his decision. Very appreciative of what Dr. Hasson and the team did for him. These photos were taken at the clinic 20 months post-op. First 2 sets of post-op pics are imed post-op The next 2 sets are 1 day post-op and 3 days post-op respectfully

Thx for the comments guys!

Hi Guys, This is an interesting thread and a little amusing to me for which I will explain. I worked daily side by side both doctors at the clinic for a good 15 years. During that time I would be the driving force when it came to patients result photos/video. Every opportunity I would get to capture photos or video I would take. At times I would take up to 150 photos to get the right angle, lighting etc. to match with the before pics for the best presentation. When I started working remotely, the onus was placed more on the doctors to take photos. At the end of the day, Dr. Hasson is a better photographer than Dr. Wong. Often times I would see a great Dr. Wong result that I couldn’t use because the quality and quantity of the photos was not up to standards. We have preached for almost 2 decades about no flash, good clear photos in good lighting, transparency in presentations etc. and that in this day and age there is no good excuse why clinics can’t present good clear photos. So if Dr. Wong was to present me with only 6 photos that didn’t have the right angles etc. to accurately capture the result, I would not post. Before photos could also be a factor but in the end, Dr. Hasson has more results I can use to post than Dr. Wong. But hopefully Dr. Wong will catch up, I’m still working on that 😊. I kind of kid that he’s a great surgeon but not as good a photographer. Maybe not as excited either to take photos than to perform surgery. As far as his age, he performed my first procedure almost 20 years ago. I find him to be just as motivated and excited to perform procedures today as he was back then. I don’t see any sign of him slowing down as he really enjoys his work. Still at the top of his game, I don’t anticipate him retiring anytime soon. As for the gallery, new additions often times get placed on the first page. Periodically I will take a look to reshuffle and balance the results a bit between doctors. We’re certainly due for a reshuffle.

Hi Melvin, Thank you for including me in the conversation. I would say I generally agree with most of the comments here. We have found over the years that for those with less than ideal scalp mobility who needed a larger number of grafts, the scalp stretching exercises were productive and if done properly and diligently could increase the yield substantially. Some factors such as scalp thickness and makeup could influence to what degree we would be optimistic that enough laxity could be produced. Now days we still have the option to stretch the scalp in cases were necessary but we'll also often gravitate to FUE in a lot of these instances depending on all factors. BeadHead, If a patient is having his first FUT procedure with us, the location of our scar is placed in such a manner that we can go in on a second FUT and remove the old scar and create a new one. When doing repair cases or cases when a patient had his first procedure elsewhere, we would always attempt to remove the old scar and replace with a new scar but often times the location of the pervious scar would be inappropriate and we might be able to remove only some of it but not its entirety. There are also cases where we'd need to create an entirely new scar. You may be able to get a sense of how much mobility your scalp has by reviewing this video: https://hassonandwong.com/scalp-laxity-exercises/

This Local Vancouver patient was suffering from hair loss that began at the young age of 25. The obvious area of concern was the crown. Dr. Hasson and team transplanted 3004 grafts via FUE and extracted 2105 double hairs grafts and 899 3-4 hair grafts. He had above average donor hair and had been using Finasteride for a year prior to his procedure. These photos were taken only 6 months post-op. The first post-op photo set is immediately post-op the day of the procedure. In order, the next set is 1 day post-op, next set is 1 day post-op, next set 5 days post-op, next set 5 days post-op, last set 1 week post-op.

This patient stopped in to the clinic this week and we took some updated photos. He'll be 2 years post-op in less than 2 months.

Thank you for the comments guys! Thx also for letting me know about the error Cosmo! Fixed. I will come back later to address a few of the other questions/comments here.

After a couple of trips to the clinic to see Dr. Hasson, this Vancouver area patient decided to proceed a few years after his initial visit. Bothered by the loss in front, the plan was to rebuild the hairline and frontal zone working back into the mid-scalp as far back as necessary. FUE was the preferred method of choice as he wanted the option the cut the hair very short on the sides and back. Overall donor hair was above average with average texture. The 2 day FUE procedure totaled 4903 grafts. Day one yielded 2643 grafts of which 300 were single hair grafts, 1518 were double hair grafts and 825 were 3-4 hair grafts. Day 2 completed the task with an additional 2260 grafts. 1331 were doubles, 929 were 3-4 hair grafts. These after photos were taken at the clinic 1 year post-op. The first 2 post-op photos were taken at the end of day 1, the remaining 4 taken 2 days after day 2.

Thx for the comments guys! Coady, Thank you for the comment and question. There are a few factors involved to determine what may be possible when formulating a realistic game plan. In this case or any case for that matter, there can be a big difference between the potential accomplishments from clinic A and clinic B. To achieve this result in one session, there are certain factors that need to be in place: #1 and perhaps the most important, a highly skilled surgeon with a talented and experienced staff with the right technology at their disposal. #2 and perhaps as important would be that the quality and quantity of the donor hair has to be sufficient. Other factors such as final hair loss pattern, supply versus demand also play a role but without the first two, this result coupled with responsible preservation of the remaining donor area is likely not possible. It is possible and likely however that for most clinics there are limitations as to what they can achieve. These limitations my include a smaller staff which would not enable them to successfully execute a procedure of this size. It is also possible that the staff would be able to handle a large procedure but the surgeon may not possess the skill and technology to place the grafts at the appropriate density that would allow for this type of number and coverage.

Thx for the additional comments guys! Curisous25, Yes, he is quite pleased as you can imagine and I will post a video soon in which he shares some of his thoughts on his experience. Dr. Hasson rated his density at slightly above average. On a scale of 1 to 5, he was somewhere between a 3 and 4. Overall donor hair was about average, maybe slightly above and rated a 3. This takes into consideration a comprehensive overview of the quality and quantity of the donor area. These numbers may not always translate from patient to patient as far as how many total grafts may be available in reserve. Taking into consideration this patient had a larger sized head as mentioned, the square centimeters of available donor hair would also be larger and therefore the total donor bank would likely have more grafts in this case than someone with the same rating and a smaller sized head.

Cristero, There can be several factors involved when determining safe zones, final hair loss pattern etc. If a patient is going to end up a stage 7, miniaturization and thinning of the non safe zone will usually show signs visible to the doctor by the age of 29. In nearly all cases, the more aggressive the final hair loss pattern, the earlier it will show its signs. The doctor will take in all the factors such as family history, use of medication but examination of the areas in question will usually be the most important part of the diagnosis. And like anything else, experience and knowledge is important and after seeing tens of thousands of cases, they get pretty good at it. In my nearly 20 years at Hasson and Wong, I've not seen a case where one of our patients was harvested outside of the safe zone. Often times the strongest hair is fairly high up.

Thx for the comments guys! deitel130, He was on Proscar at the time of his procedure and continues its use. We estimate about 3,000 grafts left in reserve.

This Vancouver area patient in his mid-30’s was increasingly having trouble styling his hair to conceal the thinning areas. He initially filled out the online consultation form from our website. We estimated something in the 4,000 to 5,000 graft range via FUE to be possible and would achieve a significant cosmetic improvement. Due to his proximity to the clinic, we also invited him in for an in house evaluation. Considering all factors associated with his donor hair and the areas to restore, Dr. Hasson determined something closer to 6,000 may be possible and necessary considering his above average stature and larger than average sized head. Ultimately 6,048 FUE grafts were harvested over 2 days. Day 1 yielded 300 single hair grafts, 1,508 doubles and 1,298 3-4 hair grafts for a total of 3106 grafts. Day 2 completed the task with an additional 2,942 grafts. 1270 doubles and 1,672 3-4 hair grafts. These photos were taken 10 months post-op.

Thank you JohnAC71. Thank you aaron1234, FUT was considered but the patient in the end preferred FUE and liked the idea of not having a scar.

Hi Curious25, Thank you for the question. I would not say the extractions are outside of the traditional safe zone. Each "safe" zone varies from patient to patient. For instance, a stage 6 will have potential or realized loss farther down below the crown whorl and therefore less area to harvest from compared to a stage 5A. The lower the number on the Norwood scale, the larger the safe zone will be compared to say a stage 7. Unfortunately, conversely the higher the number on the scale, the smaller the safe zone. Maybe a more accurate statement might be: Donor capacities via FUE for Norwood scale 2-4's may be double that of stages 6-7.