As promised, here is my account of my visit to Dr. Joseph Williams of Las Vegas:
My HT appointment was scheduled for a Saturday morning at 8:00am. I was told to arrive at 7:45 to take care of some pre-op activities. One of the technicians, Diana, met me right on time to take some pre-op photos, review the medications I had been given, change into a smock, etc. By 8:00am Dr. Williams greeted me and we started drawing in the proposed hairline. This was the same as we had done during my earlier consultation, but of course this time it was for real so he took a little longer to get it just right. I was pleased with what he proposed. I wanted to make sure my hairline was not too low or unnatural, as even as a kid I have had a high forehead.
The next step was to review the donor density by magnification. I expected a large strip as my hair has always been thin. I am a big guy with a large noggin', so in order to cover sufficient real estate we had been targeting 3000 grafts. With my donor density this resulted in a strip about 33cm (13") long, from ear to ear. I don't recall how wide the strip was, but Dr. Williams was concerned about minimizing the scarring so I don't think it was very wide.
Now it was time for the shots. Needles don't bother me so this was not a problem. Though I can understand that some people are frightened by the prospect. To be honest, there was some pain involved as they had to make several injections to numb my head. But the pain was minor and very temporary. As it would turn out, this was the only pain associated with the procedure. With the preliminaries out of the way, I laid face down on the table so the doctor could begin to remove the donor strip. I estimate this only took about 20-30 minutes or so, and it was completely a non issue. With my head numb, I felt nothing. Though I could hear some sounds when he was cutting near my ears. It was not disconcerting, just a weird experience. Doctor Williams uses a trichophytic closure with staples. This part of the procedure seemed to go very quickly and easily.
Now it was time to get settled in the chair and start the myriad of tiny incisions. The donor strip had yielded 3335 grafts, but I do not know the breakdown of how many single, double, or triple follicular units there were. All I had to do for the next couple hours was watch a DVD movie while the doctor got to work. Again, this was a total non-issue for me. I never felt any pain or discomfort.
Lunch was arranged for me, so once the pizza arrived I took the opportunity for a bathroom break and was able to look in the mirror for the first time. Fortunately, I had viewed enough photos on this site to know what to expect. My head was covered with thousands of little red dots.
After lunch, it was time for another movie while the technicians completed separating the grafts under microscope. Eventually, it was time to start placing the grafts. This was a long process as there were a high number of grafts. I was told that I should not feel anything and to let them know if I did. Once, I started to feel the insertion of the grafts on my right side. It was not painful at all, but I could feel something. So we stopped and they administered another few shots to keep me numb. After another hour or so I was at my most uncomfortable. This was not due to any problem at my head, rather the other end. Just like sitting on a long plane ride, after several hours in a chair my butt starts to hurt. All three technicians worked diligently and never complained despite being on their feet the entire time. Rather, it was me who had to call for a couple breaks so I could stretch and walk around a bit. They did try to keep me comfortable with pillows and blankets. During this time, Dr. Williams would routinely check in on progress and verify all was well.
After the last grafts were in place, another round of pictures completed the procedure. The doctor reviewed my instructions with me again (such as washing my hair), staple removal procedure (I don't live in Vegas so would not come back for the removal), and gave me a goodie bag with appropriate shampoo, bandanas, etc. Even though I felt fine he advised me to take a pain pill once I retuned to my hotel room so that I would be OK once the numbness started to wear off. After that, I drove back to the hotel and treated myself to a nice steak dinner!
I did use a sleeping pill that night and propped myself upright on the bed. I slept great and awoke with virtually no pain. I could feel a tightness at the donor area where the skin was under tension, so I took another pain pill. I very carefully washed my hair, donned my bandana and took a short flight home that afternoon. Doctor Williams called me before I left to make sure all was OK. He also gave me his cell phone number in case I had any problems or questions. But all in all, it was a very trouble free experience. I expected maybe a little more trauma, so it was a pleasant surprise how easy it was for me. If pain or great discomfort is a concern for you while considering a HT, in my experience it should not be. I imagine most people would have a far worse experience at the dentist. For the post-HT pain, I think the key is to stay ahead on the pain pills. If you wait until the pain starts then you have to wait for the effects of the pills to kick in. Physically, I feel perfectly fine to return to work immediately. But I am staying away for about 10 days for cosmetic reasons. I hope that the redness subsides by then and that there is no facial swelling (there is none yet).
The entire experience was easier than I expected it to be. I do like the fact that Dr. Williams only handles one patient per day. So the entire team was focused only on me and there is no possibility of cross contamination, if that is a worry for anyone. I have found Dr. Williams to be very caring and concerned with his patients' well-being. His staff have been helpful to me and the technicians (Jay, Willy and Diana) were professional and very friendly. I would like to thank them all for treating me well.
I am still having problems accessing my web log. But when this is fixed I will upload some pictures so I can document the process. Certainly, if anyone has any questions I am happy to help and offer my opinion. I am happy thus far and I hope in several months things will only be better.