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H & W Doug

Elite Coalition Physician
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Posts posted by H & W Doug

  1. This Vancouver area patient in his mid-20’s was heading for a stage 7 with retrograde loss as well.

    Despite those 2 strikes, with good quality hair and a big number, Dr. Wong was able to create quite a transformation. Full coverage with temple reconstruction was achieved using 5955 grafts via FUT. 1333 grafts were singles, 3464 doubles and 1158 3-4 hair grafts. He restarted Finasteride at the time of surgery. These photos were taken 13 months after his procedure with the hair slightly wet.

     

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  2. Vancouver area patient in his early 30’s was bothered by his receded and weak hairline and he liked to keep his hair very short on the sides and back.

    2274 grafts via FUE were placed to restore the hairline blending into the frontal zone.

    363 single hair grafts

    1667 double hair grafts

    244 3-4 hair grafts

    .8 mm punch

    Slightly less than average donor hair, fine in texture.

     

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  3. Wow, amazing results! Thanks for sharing Doug
    Great coverage!

    I agree Trashpanda/David! Thanks for the comments

    does he have any grafts left?

    Dr. Hasson estimates about 2,500 grafts left

    Very nice. Patient must be thrilled.

    Do you have a pic of the donor area?

     

    Yes he is very happy!

    Here is a pic of both before and after

     

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    Is this a local pt? I would love to see his 12 months to compare the density from 7.5 to 12 mo.

     

    He is local; I will try and get him in at the 1 year mark

     

    As far as the density issue, we'll see how much improvement in the coming months but I'm not sure what one should expect in this case. This density is pretty good considering the texture of the hair and amount of virtually bald skin that was covered. The patient wanted complete coverage rather than ultra-dense packing in the front leaving an incomplete crown. Any lowering of the hairline and increase in the density up front would not have achieved his desired end result. I think sometimes these big numbers can deceive. In the end a stage 6 that is basically completely bald needs 6-8,000 grafts just to get complete coverage. Complete coverage throughout and high density? Not likely in a case such as this. While it may not appear to be as dense as expected, I have to say in person it looks very good and the impact to his appearance and life was profound. Maybe most importantly, the wife likes it :-)

  4. This 40 year old patient from Vancouver had several friends who had previously had hair transplants with Dr. Hasson. Finally after years of consideration and then seeing his friend’s results, he decided it was time for his turn. 7.5 months and 7185 grafts later, he was very pleased with the result and impact to his appearance. The breakdown: Single hair grafts: 2579, Doubles: 4201, Multiples: 405. Hair texture: medium/coarse. This is also a good illustration that if the strip is removed properly with the right surgeon, the width of the strip should not correlate to the width of the scar. In this case, some areas of the strip were 4 centimeters wide. As you can see, the scar is a non-issue and hard to see. In cases such as this that require a large number of grafts to cover a large area, FUT is still King.

     

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  5. How many grafts put in the crown..because my crown almost is the same!!

    1534 grafts were placed in the crown. 34 singles,700 doubles and 800 multi's

     

     

     

    Congrats Dr. Wong. I'm sure your patient is very pleased at 5 months. Fortunate number of doubles and multiples. Great progress.

    Thanks JohnC. He is very pleased and appreciative that Dr. Wong also suggested hairline work. Before his procedure he was focused on the crown only and didn't expect rebuilding the hairline would have such a positive impact. Many of his friends are now commenting on how good everything looks. I agree. Clearly a solid decision to include the hairline.

  6. Hasson and Wong don't use sleeping pills they use a guy name Chuck that comes by and knocked you out. Chucks is not only a body builder he trained in kickboxing and is an patient from Hasson and Wong. You may have seen him on franks red hot sauce commercial talking like Arnold. Usually one good punch from him you are knocked out for the whole day.

     

    I don't mean to brag but it took Chuck 3 punches to put be under....

  7. This Vancouver area patient in his late 30’s came to see Dr. Wong about his crown. While he didn’t seem too bothered by the hairline and front, Dr. Wong convinced him that a nice cosmetic upside would be realized if he included restoration of the hairline also in his procedure. 2429 grafts were placed via FUE. 138 were singles, 1491 were doubles and 800 multi-hair grafts. These photos are only 5 months post-op. He will be in again for updated photos in September.

     

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  8. That's interesting Doug. What yield difference in percent has been observed between FUE and strip at H&W?

    Amazingly enough not much if any. Based on a recent conversation I had, you could make a case that our FUE may even be higher under certain conditions. With both in the very high 90%, it's nice for a patient with typical donor area characteristics to know that yield should not be a consideration when deciding between FUT and FUE at our clinic.

  9. I'm assuming 3,801 FUE grafts were taken over 2 days, correct??

    Correct Dutchie

     

     

     

     

    Why is there no photo of the crown after? Can we see what the back looks like, like if we were standing behind him?

    Since we didn't transplant the crown and there is no difference between the before and after standing behind him I didn't feel there was any value in posting basically two of the same photo.

  10. Hi Doug,

     

    Wouldn't you say that extracting 50% of someone's total donor zone vie FUE will make the donor zone see through in the average patient?

     

    As a general rule, Dr. Wong says no, but there could be variables in every case. While indeed it will be less dense, you shouldn't notice much difference. As an estimate, what has been taken in this patient represents around 30% of what was there and I see no real visible difference. So if we consider hypothetically another 30% or so taken which would represent 50% of the original total, it seems to be reasonable.

  11. Bunsenburner,

     

    I would say there have been changes to Dr. Hasson’s approach to removal of the strip over the years but in the most recent years I believe he has dialed in his technique and not much has changed. The last major change was the switch to the trichophytic closure which was quite a few years ago now.

     

    ? Is there any point in the course of a normal day where he would be extracting FUE follicle grafts and taking a FUT strip? Or is it always one or the other?

    Do you mean on the same patient or 2 different patients?

     

    Dutchie,

     

    2 days.

  12. This patient recently stopped by to show his result and discuss another FUE procedure to address his crown. He is very pleased with the outcome and will be back later this year or early next to add coverage to the crown. Dr. Wong estimates 2,500 to 3,000 grafts should do it. Considering the area to cover and his fine hair, the result made quite a significant cosmetic impact. The 3801 graft breakdown: 994 single hair grafts, 2162 doubles, 632 triples, 13 four hair grafts.

     

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  13. This presentation is a bit different than the clinic norm. We could have waited for the full result but thought with all the interest in FUE, we would show some early progress on this patient. He is taking a photo a day and will present in a video at some point when the result is fully grown in which I think will also be of interest. And let’s not forget this is only 4.5 months post-op.

     

    I’m going to try and address all the questions:

     

    I don’t know the exact caliber of the hair shaft but know it was on the fine side.

     

    While the scar from the other clinic is not great, I wouldn’t classify it as “horrific”. I would say our average scar is certainly better than this. They probably seem to look worse when the head is shaved.

     

    This patient was pretty much stripped out and FUE was his last option. He’s most likely done after this procedure.

     

    It may be a little difficult to determine the growth at this stage but I can tell you he does indeed have good early growth from this FUE with Dr. Hasson.

     

    It is a correct number of grafts. I think if you were to take a look at the right side post-op shot, you could estimate something in the 1,000 graft range on that side alone. Adding the other side and back I think you can conclude this number is accurate.

     

    Dr. Hasson is still performing a high number of FUT procedures but the percentage has slightly decreased as the FUE percentage has increased.

     

    I agree Dr. Wong’s result was very good but that patient would benefit from growing his hair out longer. I have indicated that to him so I’m hoping for an update with the hair longer. While I might like to think of myself as a modern day Vidal Sassoon, some patients have their own ideas about hair styles despite my advice :-)

     

    It was a manual .85 mm punch.

     

    We are doing bigger cases in the 4,000 graft range on stages 5-6.

     

    We only have pre-ops with how this patient came to the clinic with short hair. He could not grow it out because he indicated it looked too thin and unnatural.

     

    As far as the face, I usually get the patient to smile but I failed to do so this time, my apologizes. I can say he was very pleased to this point and had indicted he was receiving positive comments about the improvement. We’ll look forward to his next visit and if I’m taking the pics I can assure you I’ll have him smile on the updated set of photos!

  14. This patient was visiting Vancouver again from Mexico to show Dr. Hasson his progress at 4 ? months. He had 3045 grafts via FUE. Breakdown: 870 single hair grafts, 1789 doubles and 386 three and fours.

    His two previous FUT surgeries totaling 4,500 grafts from another clinic yielded very little as the pre-op pics indicate. The growth is just now starting to take shape and he will be back again within 6 months to show his result.

     

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  15. Aftermath!

     

    What can I say? Spectacular! It was always great to see you here even though I couldn’t figure out why you wanted more hair. But I have to say, I can’t argue with this! Glad it has worked out so well for you and thank you for sharing your result and experience here. I do have a post-op shot from your last procedure taken here which I have requested to be processed. I hope to have it ready to post tomorrow.

  16. BaldPatient2, it was nice to see you at the clinic this week. As per your request, I have posted photos we took here just short of the 7 month mark post-op to compare with your pre-op pics. I want to give a little more information and my opinion on your case and touch on a few things we discussed on your visit. When I saw you, my thoughts were there is a considerable cosmetic improvement taking shape. While I understand it is as thick as you would like, the difference is considerable and we expect continued improve in the coming months. We had 2902 graft to work with. Of these 2902, 922 were single hair grafts, 1753 were doubles and 227 were 3-4 hair grafts. Your hair is also on the finer side. I believe you wanted some small improvement in the crown which made sense so 400 grafts were committed there. Of course this small number is not expected to make a very big impact but I think the subtle difference justified this decision. This left around 2,500 for the frontal zone and some mid scalp. Especially with finer hair, we would have liked to have something closer to 4,000 to work with ideally in these areas but the less than ideal number is what Dr. Wong had to work with. We wouldn’t expect a very dense result, but a nice cosmetic improvement nonetheless. As we say, it is a numbers game, the more we have for any given area, the thicker and denser we can make it. If you had only had one previous procedure, maybe Dr. Wong could have harvested a larger number of grafts and placed more in the frontal zone and mid scalp. As he mentioned you still have a decent number of grafts in reserve. If necessary we can add more to the front after everything grows in. In the end we do want you to be happy and Dr. Wong will add to the front if you desire at some stage. Dr. Wong can only play the hand he’s dealt when it comes to harvesting and placing grafts. If you were a virgin patient when he first saw you, maybe things would be different. However, you still in my option have something that looks natural and much better than if you were bald or thinning significantly and we will take the necessary steps to help you achieve further improvement if further surgery is your desire. Let’s see how it looks in a few more months. As a side note, I have also included photos of the scar as Dr. Wong combined the 2 scars from your previous 2 procedures into one. See you in a few months.

     

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  17. BaldPatient2,

     

    I thought I would give you and the community a better idea of where you are at this stage. I agree with everyone that it is still early to assess the final result. I do have access to your pre-op photos taken here at the clinic the morning of surgery and have compared them to your most recent photos. I think this will shed a better light on how things are shaping up. I see a nice transformation and improvement with more expected to come. It is often the case we don't remember what we looked like before surgery. Often patients coming back for their follow up visits are surprised at how thin or bald they were before their procedure. I hope this helps.

    And thank you David for interjecting on this thread.

     

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