2 Session Procedure

[SlowlyThinning@59]

Have any of you guys had a two day session procedure? I am schduled to have sessions on July 2md and 3rd and don't know what to really expect. I'm looking forward to the procedures and want to get them behind me even if I have to put up with some discomfort and pain. Thanks, John

[SlowlyThinning@59]

Have any of you guys had a two day session procedure? I am schduled to have sessions on July 2md and 3rd and don't know what to really expect. I'm looking forward to the procedures and want to get them behind me even if I have to put up with some discomfort and pain. Thanks, John

[Gorpy]

Oh, are you talking about surgery on consecutive days with Dr. Keene?

[Bill - Seemiller]

SlowlyThinning,

 

Are you referring to strip or FUE? Which doctor are you going to?

 

2 day sessions with FUE is pretty common, but strip is not.

 

Bill

[TheHairLossCure]

I have heard that Dr. Keene sometimes does large sessions, strip I believe, over 2 days. I would be interested in hearing more about this.

[nobuzz4me]

I suppose one strip is taken day one and closed up. The additional scalp incisions and grafts for day two are the taken from the remaining strip. I suppose the left over strip is kept viable in a cold solution or frozen? This would worry me regarding graft survival and final yield?? Anyone know for sure??

[Bill - Seemiller]

nobuzz,

 

From the few things I've read about graft survival, I don't believe this would work...but I could be wrong.

 

Perhaps the strip is removed in parts (part one day, and part the second day?)

 

I just don't see the point.

 

I'd certainly like an explanation of this method.

 

Bill

[TheHairLossCure]

Bill,

 

I believe you are correct that the strip is removed in 2 parts. There are many studies that suggest that graft survival diminishes if the grafts are out of body too long, regardless of the storage solution.

[the B spot]

I am not a fan of consecutive day strip sessions.

 

Call it what you will, a patient should be able to recieve in excess of 3000 grafts in one day, with 4000+ a realistic option at several clinics as well.

 

If you want patients that need/want 4-5K sessions, you should hire the staff to do so.

 

J

[Bill - Seemiller]

THLC,

 

Yesk, I agree...I have also read some of these studies.

 

B Spot,

 

I agree with you 100%.

 

Bill

[MrJobi]

That doesn't seem right..

 

I will wait for clarification

[Hairtechnician]

Hi all,

 

Dr. Keene does offer a consecutive day surgery for over 3000 grafts. She has sufficient staff with plenty of experience to do the procedure in one day. However, she prefers to keep the placing in her own hands, and does most of the placing herself with one of her most experienced nurses (who has been with her for over 10 years). That is longer than many doctors have been doing this procedure.

 

Dr. Keene also wants to limit the length of the surgery in any one sitting for patient comfort. A 12 hour day sitting in a surgery chair can be very long. The time that it takes to place the grafts will vary depending on scalp and skin characterisitics, as well as your clotting. That is why she won't schedule more than 3000 grafts in a single day session.

 

Just to clarify, the strip is removed from one side of the donor area the first day, and the other side of the donor area the second day.

 

Dr. Bobby Limmer also has been doing a consecutive day surgery for over 10 years with great success.

 

If you have any further questions please call the office and we would be happy to clarify for you. You can also read more about the consecutive day surgery approach on Dr. Keene's website at www.hairrestore.com and click on megasession.

 

I am a hairtransplant surgical assistant and independent contractor for Dr. Keene

[Bill - Seemiller]

hairtechnician,

 

Thank you for the clarification.

 

It appears there are varying opinions on this...mine remains that I personally don't like the idea of it.

 

IMO, the patient is inconvenienced, has to go through the surgery twice rather than once, has to take an extra day off, etc.

 

I am glad to hear that there has been great success...but IMO, the benefit doesn't outweigh the cost of a second surgery day...all so Dr. Keene can place the grafts herself.

 

Recognize that this is my opinion and I recognize others will have opposite opinions.

 

Cheers,

 

Bill

[NervousNelly]

Hairtech,

 

I have to agree with Bill on this one. As much as I appreciate the talents of Dr. Keene and her attention to detail, there are now several equally skilled docs/clinics producing awesome results.

 

My guess is that those that don't want to travel and others that really, really want Dr. Keene to do the megasession would go for it. Also there may be the limited few that would choose to do a 2 dayer.

 

What we all have to remember is that they are talking about sessions of 3000+ which are not as common anyways.

 

NN

[the B spot]

Well..... whatever, right?

 

I don't really think there has been clarification and I still find it ridiculous to think that there are all of these technicians running around, etc... and these sessions still take 2 days.

 

As far as Dr. Limmer doing them for over 10 years 2 things: I would not use them as a basis or support for your argument AND it is 2007, not 1997.

 

I am not arguing for or against this practice, but say it for what it is, you do not want to pay additional staff and you nor your staff wish to endure 10,12,14 hour days on a consistant basis.

 

You just stated that Dr. Keene doesn't place all of the grafts herself, so if you have someone who has that much experience (the tech who has more experience than most doctors), start training someone else!!!!!

 

Dr. Keene produces good results from what I have seen, so AGAIN, I guess choose to go get 2 days of surgery or go somewhere else and do it in one.

 

J

[Bill - Seemiller]

I believe there WAS clarification on the process, but there is clearly not a full understanding of WHY this process takes place.

 

I agree that it is nonsensical and I don't like it.

 

But I guess there isn't any REAL harm, as results are not affected negatively.

 

But I think most patients would opt for a single session in one day. Of course, I'm speculating...but I know I would go somewhere else to do a larger session in one day.

 

Bill

[nobuzz4me]

I have nothing to add other than:

 

The day after any transplant is a day to stay in bed with limited movement to prevent scar stretching. I know that second day must be brutal on the patient.

[Bill - Seemiller]

Good point nobuzz...I didn't even think of the fact that the day after a transplant you're already going to be sore, tired, and not want to do anything but take it easy.

 

Jumping in the chair again will be the LAST thing I'd want to do...

 

Bill

[Guest bro66]

I had my second HT session a year after my first, don't think I could do it the very next day, too sore, tired, esp. tired of sitting in that chair. Why are you having a two day procedure? Why can't it all be done in one session?

[Janna]

Even though we have not tried the 2 day sessions at SMG, I think there's merit in the technique. It's not just a matter of having enough staff, though you do need plenty for mega sessions. Lets say you have 20 techs for cutting and planting. Tired staff is not your concern, but you can only have two - three planting grafts at one time. If the planting is harder than normal and the total surgery time takes 12-16 hours, the patient is having to sit still for all that time. Doing 15-2000 grafts takes 6-7 hours. Most patients are not so fatigued to come in the second day. There are some patients who know sitting still for over 12 hours is not an option. For those patients the 2 day session is just what they're looking for. Not to mention they like the fact that their doctor is so hands on.

 

It's not for everyone. It's a good thing there's plenty of options out there for all.

[Bill - Seemiller]

Janna,

 

This topic has been spread out over two threads...so some of this is probably repeat...

 

I believe this method could ONLY have merit for extremely large sessions where the surgery might take over 12 hours. I think as B Spot said, 5000+ grafts.

 

Even still...I think putting the patient through the trauma of surgery twice (especially when a patient is already at their sorest - the day after surgery) is a BAD idea, ESPECIALLY for smaler sessions of 3000 grafts.

 

There is just no VALID reason for it that I've heard.

 

I don't think it merits the patient to go through two days just because he/she is a micro-manager and wants to do the job themselves.

 

If they really feel their staff (techs) are inadequate to plant the grafts, it's TRAIN the existing staff OR FIRE AND HIRE new ones (I realize it takes a good amount of time to train technicians).

 

I suppose, only the patient can answer this question and perhaps the answer will vary for everyone...

 

BUT...

 

Would YOU the patient rather sit in the chair for 14 hours in one day OR sit in the chair for 8 hours the first day and 8 hours the second day, take an extra day off, go into surgery the second day sore to get cut up again, etc.

 

I realize that 8+8 = 16 and not 14, but you MUST consider the extra hours of preparation by the doctor/techs, re-applying the anesthetic, etc.

 

I don't know...I suppose it's good to have options...but I just don't feel that this method is in the best interest of the patient.

 

Cheers,

 

Bill

[Janna]

I think I stated that it's not for everyone.

I don't see the harm if the patients themselves are in agreement with their doctor on how they're going to best accommplish their goals.

 

I've found that people's degree of pain threshold varies quite a bit, their tolerance to sit still in the chair varies just as much. For those patients with ADD or ADHD, it may be a good option for them.

 

I also know you can't just put a number of hours to the number of grafts. There is an average number of hours you can determine by experience, however, circumstances arise, which can delay a procedure longer or shorter than expected. You won't know until the procedure is at hand. It doesn't matter how many trained tech's you have when you have a bleeder, or the patient doesn't take well to the medications he's given and has to get up every 10 minutes.

 

By what you're saying, Bill, if 2000 grafts are going to take 8 hours one day and another 8 hours to do another 2000, then how long would a 5000+ graft case take in one day? Can you definitively say just 14 hours? I just don't think you can predetermine how long a procedure will take given many variables. Of course with experience techs get faster and faster, but really, where do you draw the line with these mega sessions? Do you cut it at 14 hours, or enduring 16 hours okay? Is that in the best interest of the patient?

 

I think it's good to have different options for different people, that's all.

[spoon]

Originally posted by the B spot:

As far as Dr. Limmer doing them for over 10 years 2 things: I would not use them as a basis or support for your argument AND it is 2007, not 1997.

Still down on Limmer? Why are you so critical? The comment was that he has been doing it "with great success" so why are you in a position to dismiss that so thoroughly? Have you even been to the clinic to see a surgery? Let me tell you something else - not much has changed from what leading edge clinics in 1997 were doing compared with now. Some clinics in 1997 were doing in excess of 3000 real grafts - by "real", I mean with 2.1 to 2.3 hairs per graft. Those sessions took in excess of 10 hours, as they do now. So I really don't see the point of commenting on 1997, nor do I understand your fascination with taking shots at Limmer.

 

I am not arguing for or against this practice, but say it for what it is, you do not want to pay additional staff and you nor your staff wish to endure 10,12,14 hour days on a consistant basis.

How are you not arguing against it? The entire basis of your commentary is to argue against it.

 

What qualifies you to say so conclusively that the motivation for the 2-day session is that she doesn't want to pay additional staff, or that the staff doesn't want to endure long days? Why are you so quick to dismiss the argument that such a long day in the surgical chair is more than some patients can handle? I was in the surgical chair for about 10 hours or so, and it was excruciating to not be able to move around.

 

FYI I'm not endorsing the 2-day idea myself but once again you are posting opinions in such a manner as to imply (a) more knowledge about the practice than you actually have, and (b) that your opinions should be taken as factual truths. I do not agree with that.

[MrJobi]

Hi

 

I agree with you on possibly jugding a doctor however whoever says the technology hasn't changed in the last 10 years is mistaken

[NervousNelly]

Spoon,

 

Although in this instance I will agree with your statements(except the 10 yr. deal--No way), I wonder why it seems like the only time we see posts from you is to question, disagree, correct or discredit fellow members.

 

I believe that you are a very knowledgeable source and I think that we could all benefit immensely if some of your insight was used in more of a positive manner. Your beliefs and opinions are just as valuable if stated on their own as opposed to always quoting others and then disagreeing. Is your glass ever half full??

 

NN