Hasson & Wong

[western_star]

For the last few years evryone on site was talking about Hasson and Wong, and just before I left the site was saying that there were some problems with the site and Hasson and Wong. The reason I asked is because I just gopt a flyer that said Pat was just up there and watched them do great work? So what's up?

[Guest]

In my opinion they're the best around. I traveled 5000 miles round trip to have my work done there.

[Rashomon]

Then, why were there problems with them before? What kind of problems were they? How do we know that they have been resolved and won't happen again?

 

Hearing that there *were* problems with someone, but there are not any problems now, still makes me a bit uneasy.

[Pat - Community Publisher]

Western Star,

 

Good to see you back on the forum. Hasson and Wong and this community go way back to the beginning of the Hair Transplant Network over six years ago. Over this time Hasson and Wong and their patients have contributed to the vitality of this community, while elevating the standards and expectations for follicular unit grafting.

 

I've always been and remain a fan of their work. However, over a year ago we did have some differences of opinion about various posts and posters on this forum. This had nothing to do with the quality of Hasson and Wong's work or patient results. Unfortunately, this misunderstanding created a rift for several months. In retrospect, I may have over reacted to some of the Hasson and Wong patients who were posting at that time.

 

Fortunately, Hasson and Wong and I resolved our misunderstanding last fall. We both share a common commitment to helping patients learn about the most patient friendly hair transplant techniques. Hasson and Wong have raised the bar for true excellence in hair restoration surgery.

 

To reflect this higher standard the membership standards for the Coalition were raised very high over a year ago and six members were dropped. Since then Dr. Hasson and Dr. Wong have taken their rightful place as leading members of the Coalition.

 

I'm encouraged by the evolution in hair transplantation that I've witnessed over the past several years. Much of this improvement has been driven by educated patients who won't settle for good enough. The posters on this forum have had a revolutionary and positive impact on the entire hair restoration profession ??“ whether they knew it or not. Kudos to all of you. Members on this forum will continue to drive the evolution of hair transplantation by demanding only the best and helping others to do the same.

 

I think of Hasson and Wong and other leading physician members of the Coalition as allies in this process of setting the high standards that the rest of the profession needs to catch up to.

 

Onward and Upward, Pat

[hairbank]

If you want a bio on Hasson and Wong just take a look at their results. When I think of all HT sub-topics of interest i.e. # of grafts, incisions, placement, donor scar, artistic design (the list goes on), they are excellent in every sense. I'll be updating my Hair Loss Blog soon from HT # 2 with Dr. Wong and am very pleased with the results thus far.

[htownballa]

I've noticed on the H&W site that a lot of the patients' hair in the after pictures are dyed to a lighter color. Is this to reduce contrast between hair and scalp? I wish we could see the pictures with the same color hair in the before and afters.

[western_star]

Hi Pat, It's good to be back even though I haven't really left. This is my site I follow. I was just wondering anbout the issue that was taking place when I left. I thought that maybe something wasn't right with them. I have to admit I felt very comfortable getting evaluated by their guy in Seattle. I felt good about it. I have decided thta when I do get it done it will be with either your guy or H & W. Keep up the good work Pat. Is Rober t still the moderator.

[Pat - Community Publisher]

Western,

 

Choosing between H & W and Ron Shapiro is a very tough choice. They are both at the very tip top of their profession. But yet their philosophies are somewhat different.

 

Ron's work is highly refined and minimally invasive, like H & W's work. This enables him to dense pack when appropriate. But he is typically not willing to take as much donor tissue in one session as Dr. Hasson in particular. But Ron has been gradually increasing the size of his sessions to over 4,000 and even 5,000 graft cases in patients with optimal laxity and donor density.

 

In my opinion Dr. Shapiro's grafts tend to have more hairs on average as well, while H & W's grafts are very small and rarely if ever contain four hair grafts - with most grafts containing 1 or 2 hairs.

 

Dr. Hasson is a strong believer in creating a pattern and angle of incisions that maximizes the shingling of the grafts. He does this in a very deliberate and systematic manner. Dr. Shapiro is also very conscious of the orientation of the incisions and grafts but seems to do it in a more irregular fashion.

 

Their hairlines also have a different look in my opinion. But what a nice dilemma to have to choose between them and other leading surgeons who have mastered follicular unit grafting at an ultra refined level.

 

Robert did a very good job as moderator. But then he feel off the band wagon and went back to being a "SocialDrinker". No actually, he got very absorbed in his college course work. He's a late bloomer since he was a boomer for years in the Navy's Nuclear sub program.

 

However, he did recently make time to help me get our Q and A blog up and running.

 

I hope he stays a hair geek for life :-)

 

All the best, Pat

[Jotronic]

No question about it, Dr. Shapiro does fine work and deserves his recognition. The idea that Dr. Shapiro's grafts can conatain more hairs per graft however is based on the fact that he sometimes uses what are called MUG grafts or "multi-unit grafts". These are grafts that have two (or more?) follicular units close together, so close in fact that it is believed that they can be utilized as one graft.

 

Dr. Hasson and Dr. Wong believe that each FU is separate from the other and should be treated as individual grafts. Their respective technicians are instructed to carefully separate all individual follicular units with great care. I don't believe that if one were to compare, graft for graft, the amount of actual hair in each graft when each graft is an actual FU that our clinic would have any less than another clinic that is performing true follicular unit grafting. I've seen too many dissected follicular units over the past three years to think otherwise.

 

There are patients however that have higher numbers of one and two hair grafts that are naturally occuring in the donor area than others. Any doctor when asked should be able to confirm this. One such case is the patient that Pat observed during his visit to our clinic. While his grafts were predominantly one and two hair grafts naturally there were an amount of grafts that were three and four hair grafts which Pat saw for himself. These grafts were placed into the patient's recipient site just as they grew in the donor area.

 

Our grafts are no different than any other reputable clinic's, with regards to hair counts, that is performing "true" follicular unit grafting including Dr. Shapiro's. I will not and cannot BS anyone about this. Anyone that has been around here for a while knows this.

 

Dr. Shapiro is getting to the point where he is performing a few four thousand and possibly even five thousand graft cases just like we've done hundreds of times and I'm sure that his grafts contain no more or less hairs than ours when he is performing true FU grafting.

 

We led the way in performing these larger megasessions and I assume Dr. Shapiro is seeing from our results that they work quite simply because they cannot be denied.

 

We are more than happy to be compared to Dr. Shapiro in any context. In fact we consider it to be an honor.

[Pat - Community Publisher]

Joe,

 

In my opinion, after visiting dozens of clinics and watching the graft cutting, different clinics interpret follicular unit grafts some what differently and trim follicular units into "follicular unit" grafts that on average contain more or less hairs.

 

According to a published study the typical distribution of hairs in follicular units is ??“ 14% one hair, 51% two hairs, 29% three hairs, 6% four hairs.

 

Yet your medical techs told me they never cut four hair grafts, while most clinics doing follicular unit grafting typically do use some four hair grafts. I think one could make a compelling case that distributing hair follicles in grafts of no more than three hairs into smaller incisions makes for a more natural look. Others argue that without some four hair grafts it is hard to build density.

 

I think with enough small grafts one can achieve both naturalness and density. However, to achieve an acceptable density more grafts are required.

 

Thus I think it is important for patients to not only consider the total number of grafts but also the total number of hairs transplanted. Patients need to be able to make "Apple to Apple" comparisons.

 

Most of the clinics I've visited keep "count sheets" that provide a detailed breakdown on the number of grafts and the number of hairs in each. I think this is meaningful information.

 

I have been encouraging both physicians and patients to present such detailed info in their posts. Some physicians have been supplying this information to their patients. For example a post yesterday by a patient of Dr. Cooley's presented the following info ??“

 

Donor Density: 80-100/Fu/cm2

Donor Laxity: good

Donor Length: 32 cm

Donor Width: 1.5-1.2 cm

 

Grafts:

FU Total#

1's 1108

2's 1744

3's 580

4's 75

 

Total 3507

 

I would like to see more posts in which such detailed information is included. I encourage Hasson and Wong and all clinics to supply their patients with hair and graft counts along with their post operative info.

 

Pat

[Rashomon]

"Dr. Hasson is a strong believer in creating a pattern and angle of incisions that maximizes the shingling of the grafts."

 

What is "shingling"?

 

 

"He does this in a very deliberate and systematic manner. Dr. Shapiro is also very conscious of the orientation of the incisions and grafts but seems to do it in a more irregular fashion."

 

What do you mean by "irregular fashion"? What effect does this have?

[Rashomon]

Oh! Thanks for the details on the H&W history, Pat. I'm glad to see that the problems you guys had were more "personal" than professional... especially after seeing some of their crown work.

[Pat - Community Publisher]

Rashomon,

 

To visualize the "shingling" effect imagine shingles on a roof top. They are stacked across the roof top so as to minimize over lap while maximizing coverage. This is similar to what Dr. Hasson strives for.

 

Dr. Shapiro tends to place grafts in more irregular groupings, which is the way he feels they grow naturally on the scalp. He also arranges them in a way so that they optimize the appearance of density.

 

I think there is plenty of overlap in these techniques. So I don't want to over state the difference. Each physician is trying to create the optimal illusion of density, fullness and naturalness with a limited amount of grafts/hairs.

 

Pat