What is the optimal Ultra Refined Follicular Unit procedure?

[Gorpy]

Let's keep in mind that details, some of which are subtle, differentiate the doctors from each other. I call them style and technique differences. That doesn't mean one style is necessarily better than the other.

 

If one doctor's technique is to use smaller fu's neatly placed close together, that doesn't mean you are getting ripped off. If it creates fantastic results, you are ultimately the winner.

 

There are other style and technique differences such as:

 

- Some docs fade into the hairline with less density to high density. Others will produce a harder, yet still natural looking hairline.

 

- Hairline design differences obviously exist with all of the doctors.

 

- Exclusive use of lateral slit compared to a combination of lateral and sagital.

 

- Dense forlock spreading out to thinner sides, compared to a more even distribution.

 

- Tendencies to go with a higher hairline vs. a lower hairline that frames the face.

 

- Dense packing vs. less dense packing.

 

- Donar strip closure techniques.

 

- And obviously, huge megasessions vs. multiple smaller sessions.

[NikkiJ]

When I viewed Pats' pictures from H&W I was astounded over the amount of donor tissue that was removed and also how some was taken from above the ear.

 

The reason for my surprise is that it has always been my understanding that you do not want to remove tissue above the posterior occipt bone in the skull, due to the fact that this hair may very likely fall out. This has always been a rule of thumb because the hair located below this bone is genetically programmed differently in most patients, which ensures the growth and success of the transplant.

 

If you transplant hair that has the DNA to miniaturize it will eventually fall out.

[the B spot]

Well, I take a day off from the forum and WHOA!!!!

Anyway, let me take a moment to remind each of us, that we are debating two different philosophy's, and a question of what appears to be inflated graft counts over actual hair transplanted.

Let's start with this--- an industry standard of graft breakdown is 65% 1 an 2 hair grafts, 26% 3's and 6% 4's. Even if a patient is slightly skewed one way or the other, these numbers are typically constant.

1000 grafts

650 1's and 2's

260 3's

60 4's

If we multiply the hair moved here using estimates for 1's and 2's this is what we come up with

325 1's = 325 hairs

325 2's = 650 hairs

260 3's = 780 hairs

60 4's = 240 hairs

total = 1995 hairs for a 1000 graft procedure

Using these estimates please note the actual HAIR to GRAFT ratio is nearly double. I realize that these are estimates, but they represent a industry average which can change slightly from patient to patient.

Using this estimate we can say that a 3000 graft procedure should produce roughly 6000 hairs. We can estimate 200 to 300 grafts either way for physiological make-up, but either way a ballpark number of actual hairs is able to be estimated. This takes us to some very interesting questions---- What are actual hair counts versus graft counts? Does waste percentage increase if many naturally occurring follicular are being split at a higher than "normal" rate? Does pricing reflect naturally occurring follicular units?

3000 graft procedure producing roughly 6000 hairs costs:

2000 grafts = 9000

1000 grafts = 2500

total = 11500

 

a 6000 graft session with roughly 12,000 hairs would cost

2000 grafts = 9000

4000 grafts = 10000

total = 19000

 

This is great, but without hair counts how do we know that 12,000 hairs were moved? What if 8000 hairs were moved, roughly the equivalent of a 4000 graft session that costs 14,000, which is 5000 less? So the question is why pay for 6000 grafts, when you are getting a 4000 graft session turned into a 6000 graft session?

I think this is why we need to understand what is actually being done in these 4000 to 6000+ megasessions. (ie, 8000 1's and 2's versus, 12,000 naturally occurring FU's)

If we look at the information given we can come up with some solid answers. Pat detailed the fact that H&W does NOT keep track of hair count. I think that has to change, in order to put this issue to rest, permanently. Splitting grafts is a practice EVERY clinic employs, and that is a FACT. The question is how much, what is the benefit to the patient, and how much additional donor waste occurs as a result of blade trauma and technician fatigue?

This is an question that needs to be answered, in order for us to move forward and understand the nature of the industry at this time. If the hair counts moved in these mega-session prove to be spot on, I will gladly tip my hat to the genius of H&W, and they will have earned a heartfelt apology. If not, then I think we need to re-evaluate these graft sessions, and see what can be done to put things in proper order. I cannot argue with some of the results that H&W has shown over the years, but I can question philosophy and practices.

I hope this issue is resolved to the satisfaction of all the members of this forum, H&W patient or not.

[UGLY MAN 4 LIFE]

Originally posted by Landen:

There is no danger of running out of donor hair if the grafts are positioned wisely. Good clinics do not pack 5000 grafts into a hairline. That's nuts. Proper distribution with the future in mind is key and insures that the future will not be bleak for the patient should they lose more hair.

 

 

No there is a danger. A real danger as a matter of fact. You see as the years roll on the transplanted hair stays thick and strong as the unttransplanted hair recedes and miniaturizes. This is process goes unnoticed, and then the patient looks in the mirror and notices these grafts standing out more and more eventually to the point where it is blatantly obvious that it just doesn't look right. With the donor wiped out, good luck trying to fix it. That is poor surgical planning to exhaust donor reserves in one pass before the patient has COMPLETELY halted hair losss or you some how have a crystal ball and you can see the ultmate norwood level of the patient. It doesn't matter where the grafts are packed. In about 10 years we'll see who is right. 10 years isn't an eternity. There's something brown thrown against the walls, it sticking but it ain't mud.

 

That was a nice break down of price. In the end your clinic makes more and it was a smart financial strategy in the sense that a dollar today is worth more than a dollar tomorrow. Time value of money allows your clinic to reap the benefits of earned interest and you don't have to worry about if the patient has a chance to see the grown out result, not like what they see , and not come back. Whether the patient wants to rush to the point of completion or not, it just isn't in their best interest at times physically and financially.

 

You have been in this game a long time so anything that anyone says, you can come back and say something else. You have been playing this hair transplant game for a long time and your paid to do what you do. You have vested interest. I don't make money from showing the other side of the story and I don't represent any doctor. I speak for all the top docs that can produce good results. Don't drive the economics of the hair transplant industry by running up the graft nubers to a ridiculous level in one surgery. Things change NOT for the good sometimes. Sometimes things are forced to change because people have demanded what they THINK is right because this is what is forced onto them. Even the good conservative docs must reach a point and change for the bad to stay in business.

 

There is NOTHING wrong with a decent moderate size procedure. See how it looks on YOUR head with YOUR hair characteristics. See how YOUR yield turns out. See where YOUR hair loss is heading. See if different technologies come about that are less invasive.

 

And don't cut the grafts up, if what i read is correct. Leave them alone unless you need to make a few extra singles for the front.

 

With inflation at around 3%, it would almost 7 years for your time value of money to count. So unless your crappy results last you 7 years (scoff, ROLFMAO, LMAO, etc, etc) you lose. Clearly you're talking a little bit out of your field on a number of topics.

[UGLY MAN 4 LIFE]

Originally posted by Landen:

Well you can always continue to walk around with your infinitely "natural" results (AKA bald) and go with that. Whatever floats your boat pal

 

You seem quite hostile. Don't let your emotions get the best of you it is simply a matter of different philosophy and it is up to the consumer to decide what is best for them. But to do this they need to see both sides of the story. There are TWO sides to every story.

 

They have good and bad results like every other top doc. The difference is the presence of patients on the forums. It is quite bizzarre behavior that you don't see from other docs. For some reason they have motivation to hang around the forums, almost to the point of policing them as I see you are sort of doing to an extent. Other docs like to stay low key and that is a good thing if they don't want to get involve in the mudslinging for no good reason that goes on. This is once again where the domination of the forums marketing tactic comes into play.

 

On the forums I have seen them go on to silence their own( fellow recipient of transplant from their clinic) when they come to the board and are not satisfied with their result. The matter is quickly swept under the rug. Results posted are oooed and aaaaaawed if they are one of their own. Good results from other top docs are not necessarily criticized in all cases but there is always that belittling jab thrown in here and there so it doesn't shine like it rightfully should. From a sociological perspective it would be described as gang-like.

 

Jotronic catapaulted his clinic into the spotlight. He came along in early times of this industry, an industry with a dark history, and showed off his results. With his internet savvy, he became the orinal dominant presence on the forums and marketed his clinic to the top. It's none of my business but they owe him alot for what he did for them from a marketing stand point. Had Jotronic gone to any of the other top docs they could have done the same for him in terms of fixing his bad transplant as he is blessed with great elasticity in his donor that allowed for multiple strip procedures to get him to where he is now. Had Jotronic gone to another top doc they would have been the beneficiary of all of Jotronics marketing genious, the average Joe that got saved by his clinic. His clinic took off from his dominant presence on the forums. Had Jotronic poor elasticity in his donor, it would not have had such a happy ending and would not have been as lucrative for both parties involved.

 

You don't see it from other docs because their results are shit. Your other "coalition" docs are totally unimpressive with the exception of one or two doctors. The rest of them use tools that look like someone's been poking your head with a pool queue, plant the hairline with *visible* gaps in the hair - a good example here is the woman who recently had her hairline done and has her picture posted on the photos section. There was no need for a non-fpb patient to conserve donour. Furthermore, her HT will be THIN and I said just that. This simply shows a pathetic doctor not willing to do right by his patient. This woman will NOT be able to wear her hair normally like she may have had the chance to, had she gone to a decent clinic.

 

Joe Tillman did not originall work for H&W when he posted his first photos. You clearly like to view things one way, and you'll clearly have more of these weak points to add because you argue with the logic of a woman, so I'm not going to bother offering any logic backwards, I'll just tell you where you're wrong.

[the B spot]

ALL, we can muckrack back and forth and it really needs to stop, because the root of the issue is simply graft count versus hair count that is all. We can simply wait for H&W to begin detailing how much hair they move, OR, if H&W decides not to employ this practice, we can make legitimate assumptions based on Pat's observations. This is not a Shapiro/H&W battle, nor is it time to begin personal attacks on others. THIS IS A SERIOUS ISSUE THAT COULD HAVE A TREMENDOUS RIPPLE EFFECT THROUGHOUT THE INDUSTRY. Let's take a breath and RELAX, the information we desire will surface.

 

UGLY--- I understand your anger, and trust me, we have ALL been there. However, do not presume to cast the Coalition Doctors as "shit." In doing so, you are destroying the very foundation of what this forum is based on, which is free speech and a collective membership that allows laymen like you and me to critique doctors on a daily basis. As our membership has grown, we have seen several instances of poorly treated patients who have been offered remuneration as a result of the input of this Coalition. Another presumption would be that Pat does not hold these doctors to a higher standard, and in essence you are smearing his name, and what he has worked so hard to build. I would ask that we take the high road here, regardless of any presently falacious statements that have been made or will be made. TRUST ME when I say that this situation will resolve itself in due time, through due dillegence.

[Guest Landen]

There are alot of excellent doctors turning out great results everyday that stay low profile and off the boards. It's all about marketing. Dominate the boards and keep the clinic busy and profit. Domination is the marketing tool. Naysayers are silenced, humiliated, and criticized. It's getting old.

 

Does the the tone of Mr. Ugly Man 4 Life's posts sound familiar to my above quote. This kind of forum bullying has been going on for too long. It needs to stop for the benefit of the consumer.

 

Spin % rates however you feel comfortable and create diversion. This isn't finance class at the university. This is real life where a dollar today is worth more than a dollar tomorrow. Ah yes, the debate tactic where we discredit by saying that one is talking outside his realm of knowledge.

[Guest Landen]

Joe Tillman did not originall work for H&W when he posted his first photos

 

No one said he did but YOU! I merely said he showed off his results.

[the B spot]

Landen, no prob, but I would ask that you stop the personal attacks at this point. Both you and Ugly seem like very intelligent people, your arguments are understood at this point, but I would hope that we could cool off a bit and wait. I am just as guilty as the next guy, but I would think that this topic is so important that we could keep it relaxed until we find out something definitive.

Just trying to keep it cool, although I know its hard sometimes

[Guest Landen]

the B spot,

 

He is attacking. I am speaking.

[Janna]

Since my posting has caused such a heated debate, I thought this thread warranted another posting. One thing I did not mention before, when I visited H&W I only viewed Dr. Wong's surgery. His grafts were put into three piles. It was from Pat's posting which stated Dr. Hasson's case of 5100+gr. with just two piles of 1's and "others", and that there were past concerns brought up on the Forum that raised some concerns for me. I don't think anyone is purposely splitting FU's, or suggest that the doctors are dictating this. From an assistants point of view, there is some individual judgment when looking at 3 and 4 hair groupings as to whether they can be kept as 3's and 4's, or safely made into 1's and 2's. There is a natural tendency for assistants who will later plant into all the small, close incisions to cut the grafts to fit those microscopic size incisions unless the doctor makes the appropriate size incisions for the corresponding size of the grafts. I stated exactly why we keep a cutting log in my "comments". We also know what the hair count is and know right away if the patient has below average, average, or above average density. On occasion when a patient has very low density, we've restructured our fee to coincide with the hair count rather than the graft count.

 

I don't agree that H&W are "ripping" patients off. Nor are we ripping patients off if we opt to do two sessions instead of one. Either way, I believe both fee structures are moderate considering the caliber of work. Whatever H&W comfort level may be, and whether they are equipped to handle such large session is up to the individual physician. My contention is if Dr. Shapiro has concerns he has not been able to put to rest at this juncture in regards to mega sessions that exceed 4500grafts on a routine basis, our clinic should not be viewed as less than stellar. Also, the misconception on the Forum that everyone is an ideal candidate for a mega session bothers me as there's bound to be disappointed patients. Even the patients who get exceptional work of 2000-3000 grafts feel insecure.

 

It's perfectly fine to have different techniques and beliefs as voiced by many on this Forum. I've gotten to know Dr. Wong in the last couple years from Conferences and my visit to his clinic, and I personally trust and respect him. I'm sure I'd say the same for Dr. Hasson if I got to know him as I know he has many happy and satisfied patients. The two clinic doctors get along very well and have mutual respect for one another.

[spoon]

Originally posted by Janna:

One thing I did not mention before, when I visited H&W I only viewed Dr. Wong's surgery. His grafts were put into three piles. It was from Pat's posting which stated Dr. Hasson's case of 5100+gr. with just two piles of 1's and "others" [stop quote]

 

[continue quote] There is a natural tendency for assistants who will later plant into all the small, close incisions to cut the grafts to fit those microscopic size incisions unless the doctor makes the appropriate size incisions for the corresponding size of the grafts.

Reading your post, I have some questions about "custom cut blades". Suppose you have a 3,000 graft surgery. How many different blade sizes are used for that surgery? If it's only a few different sizes, does that imply that a given patient has a very consistent graft size? Moving on, consider the 1's, 2's, 3's, and 4's. How different is the size of each type of graft (what variation in 10ths of a mm, for example?). Then, in the technique where the slits are made first and the grafts planted afterwards, how do the planters know which grafts to use in which slits? I don't mean in the hairline where there are singles (although this goes back to my first question, are all singles from a given patient the same size), I mean in the midscalp where you would have the multi-hair grafts.

 

Any clarification would be appreciated.

[Pat - Community Publisher]

I agree that after all the showing and talking is done, it comes down to how many hairs are successfully relocated.

 

I like nutrition labels on the food I buy and I like the estimated vehicle MPG posted on the lot.

 

Photos are useful in demonstrating the artistry of a clinic. But ideally physicians and patients posting on this forum should provide hair counts for various size grafts. Measurements of the width and length of donor area removed would also be useful information.

 

More accurate and detailed information serves potential patients/consumers better so they can compare "Apples to Apples". Let's use consistent standards of measurement here on this forum.

 

Graft sizes are just not consistent enough across clinics (even those doing "follicular units") to be an accurate standard of measurement.

 

Some clinics even use grafts that contain "follicular unit families", which are two follicular units that are so close to each other that they are virtually a single follicular unit. Such follicular unit family grafts can range from 2 or 3 hairs to 5 or even 6. Should these grafts be counted with the same weight as one hair grafts that were created for the hairline? Do we want to compare oranges to apples or apples to apples?

 

Consumer demand created food ingredient labels and MPG stickers. If the members of this and other forums make hair counts, rather than only graft counts, a standard expectation then in time I suspect they will get them. As they say "ask and you shall receive". I know that I intend to request hair counts and donor strip sizes from all posters who present only total graft counts with out hair counts.

 

Those who don't like numbers can choose to ignore them if they like.

 

Accurate information is better information. I'm confident that all top clinics can provide such information if they choose to and can compete successfully on a level playing field.

 

Bottom line - Count the hairs on your head not the grafts on the tray.

 

All the best to all of us. Pat

[Gorpy]

I agree Pat that the hair count is usefull information. So I recently asked my doctor to provide that information as you can now see in my signature.

[tkerr22]

You don't see it from other docs because their results are shit. Your other "coalition" docs are totally unimpressive with the exception of one or two doctors.

 

I take offense to this as my doc is one of the coalition doctors and I had great results with him. Please don't use your anger as an excuse for ridiculous comments as this will not help your case.

[bayscholar]

Pat I agree hair count info is useful it helps empower the end customer. As hair count is more comparable then graft count(given the variance discussed in thread), it is not a reach to think more records will be kept (again its not rocket science its a spread sheet). Your food label comment made sense, ironically I shop at my local farmers market co-op no labels but taste and quality second to none. I do think as a patient of H&W I would like to have a complete detailed break down, I read this forum almost everyday why not get more numbers to compare accurately across the board.... a coalition standard. My reality is I flew out of the country to see Dr.Hasson for I found his product quality to be second to none. Wanted to put a positive note for my HT Doctor, I do not work for H&W at all, but I did have a good experience all around with my HT so far, Dr.Hasson was honest and straight forward. But yes numbers can help keep alot so I finish as i started; I agree Pat.

[Janna]

Spoon,

 

Basically, a patient's one hair grafts are going to be the same size with a certain percentage of them being finer in caliber. Despite the two different size of ones, they are inserted into the same size incisions. We purposely pick out the finest ones to place at the very front points. The regular size ones are then place just behind the fine 1 hair grafts. Here's a break down of the blade sizes based on average caliber hairs: 1 hair grafts-.7mm, 2 hair grafts-.8mm, 3 hair grafts-.9mm, 4 hair grafts-1.0mm. There's slight variation to these sizes depending on how strong, curly, or fine the hairs are. We've gone as small as .65mm for ones on one patient, and as high as .8mm in another patient. As the doctor begin making incisions, we test by inserting a graft into the appropriate size incisions to make sure the grafts fit.

 

Experienced techs can tell the different size incisions and know where differnt size grafts should be placed. More importantly, the doctor directs us to where he wants the grafts placed.

[Jotronic]

First, in reference to my employ at H&W. Hey, it's an old horse, why beat it? Anyone with a cool head about them and has been around for a while knows that when I started out I was just one guy with a website and a little trigger happy on my new digicam. The rest is history, (and a history that allows me to sleep well I might add). Even back then people were at times questioning my relationship with H&W but the fact remains that as I shared my results as they were happening so I had no idea what the final outcome would be. That's the beauty of how our patients post. You see the immediate post-op and the subsequent development as close to real time as can be found without a 24 hour webcam in their living rooms, bedrooms etc.

 

To Landen specifically,

 

I wish I knew why you feel so passionate about your points that honestly do not have any merit. You specifically implied that our ability to get large sessions were ripping patients off. I then broke down the fee structure that is shared by most of the top clinics to show how it actually saves money for the patient. Your rebuttal was simply, what appeared to me anyway, a "yeah well" response that is based on your feeling about this subject without having actually spent any time in our clinic and most likely having never seen one of our patients that have received one of these big sessions.

 

I present to you these examples...

 

 

 

I dare say that if this was not 5200 "complete" grafts but rather a bunch of ones and twos then this patient would have a result that would be much thinner in appearance. You can see that with the 2600 FUE and 400 minis he simply did not have any respectable coverage not to mention density. Yes, they added to the final outcome but this is hardly a mere doubling of what he already had (add up the previous two procedures). No, this is the result of having a big session and giving the patient what he was originally hoping for WITHOUT cutting corners. To put this into simple and understandable English...we do not divide bigger grafts into smaller grafts to inflate graft counts, rip anyone off, or to give false impressions that other clinics are useless.

 

With regards to the "dangers" of these large sessions. I say again, these large sessions are not packing 5000 grafts into a hairline. If a NW6 comes to us and wants us to do the best job that we know how for him AND IF he is a candidate for a big session then THIS is where it is in his best interest to get such a session. 5000 grafts will do wonders for a NW6 and if he were for some reason to progress further into a NW7 then he WILL have more grafts to spare if that need does indeed arise. You said earlier in this thread "Hey lets just wipe out all of this patient's donor in one sitting...". Impossible to do, simple as that. You, and everyone for that matter, need to understand that if a patient is a candidate for a 5000 graft session it is not so at the expense of future work. Being able to get more in the future is inclusive in being a candidate for a big procedure. You could say that being a candidate for a future session is by definition a patient that has excellent donor laxity AND donor density that not only suits the session in the here and now but also for more sessions should the patient need it. In our experience patients have an average of 6500 to 8500 grafts total. That is an average and with averages being what they are it means that indeed there are patients that can be limited to less than 6500 total as well as those that are limited to more than 8500 (yours truly for one). Those that have less than 6500 available will instead have a first go with perhaps 2500 grafts. This number is strictly for argument's sake but you get the gist of it. We do not want anyone to think that we get 5000 grafts for every patient. Quite the contrary, 5000 grafts is the exception rather than the rule as the, again, average sized session in our clinic is 3500 on the low end and 4500 on the high end.

 

There is also the issue of how numbers are achieved for those patients that do not need a lot of coverage but rather need a smaller area with more density. Over the past four and a half years of speaking with patients of other clinics since I signed on to this very site as a "noob" WAY before I became professionally involved in this industry I found that the #1 complaint was the lack of density from their respective procedures. Even today you see people posting on this and other forums saying this. What do they wind up doing? You see where this is going, they go right back into the chair to do it all over again. What Dr. Hasson and Dr. Wong have done is recognize this problem and address it with larger numbers RELATIVE to the patient's donor area supply. While one clinic may hit a NW4 with 1500 grafts we'll hit it with 3000, again, IF it makes sense with the final donor supply in mind. This is of course just an example so please, anyone reading this do not expect a standard of 3000 if you are a NW4. Always keep in mind the phrase "relative to the individual patient's donor supply".

 

With regards to the future, your arguments have been echoed by other clinics for a few years now but the FACT of the matter is simple. If the grafts don't grow then there would be gaps in the scalp showing where the grafts did not take. We do not see this and if we did we would scale back to examine what may be the cause. To imply anything else would be to say that we are being less than honest and that simply is not acceptable. I reiterate that almost five years ago when I had my first session with Dr. Wong 3000 grafts was considered to be ludicrous. "It won't grow. The blood supply will be compromised. The donor area will be used up". Now, these same clinics are doing the exact same thing. Why is this? Landen, I'm very curious as to what your answer will be regarding this.

 

With regards to Dr. Shapiro and his excellent staff. They are top notch and no one should think otherwise. There are simply two different approaches here that in the end will result in a happy patient. Some patients prefer one approach over the other and I will not argue if their view does not align with ours however when the disagreement reaches the point of accusations of negative assumptions because details are not understood then they need to take a moment, step back, and realize that if we were not delivering what we promised then the well over one hundred patients that have documented online in one way or the other would be screaming for our heads and not their elation which has fortunately been the case.

[Bushy]

Originally posted by Landen:

They mean nothing because you have different people with different characteristics.

I hate to break the news to you, but hundreds of H&W patients with all sorts of characteristics post thousands of pics and they all seem to grow incredibly well. Some slower, some more quickly, but they all seem to grow. That's why I went to them; that's why so many others do. Quality speaks for itself, and rather loudly.

 

The results don't speak for themselves. Take any of the top docs let them cut a huge strip out of the donor harvesting a bunch of grafts, let the techs insert them and you will have the same result in the same patient.

And I can perform open heart surgery. Gimme a scalpel and a few nurses. C'mere, lemme fix your heart for you. Do you actually believe your own words?

 

The rest of your comments are so preposterous, it's hard to reply intelligently.

[Bushy]

Originally posted by Landen:

There is NOTHING wrong with a decent moderate size procedure. See how it looks on YOUR head with YOUR hair characteristics. See how YOUR yield turns out. See where YOUR hair loss is heading. See if different technologies come about that are less invasive.

 

And there's even less than nothing wrong with just staying bald!!! DON'T GET A HT, and call it a friggin day! I'll try to make this very simple, since you seem to be missing the obvious point:

 

Donor grafts = finite.

Ethical doctor = figures out where to place these finite grafts so no run out.

[Bushy]

Originally posted by Landen:

They have good and bad results like every other top doc. The difference is the presence of patients on the forums. It is quite bizzarre behavior that you don't see from other docs. For some reason they have motivation to hang around the forums, almost to the point of policing them as I see you are sort of doing to an extent. . . . This is once again where the domination of the forums marketing tactic comes into play.

 

. . . His clinic took off from his dominant presence on the forums. Had Jotronic poor elasticity in his donor, it would not have had such a happy ending and would not have been as lucrative for both parties involved.

 

Dude, I don't mean to be getting personal, but you are bordering on delusional. We have all heard the old "payed marketer/shill" accusations. They are so old Adam must have used them. H&W patients document their hair loss before, during and after. If the docs sucked their business would long have closed. The succeed because their work is the best out there. I was one hour away from a Bosley surgery when I discovered THIS WEBSITE. I then spent 5 months researching, inquiring and investigating. I chose H&W because they were simply, in my opinion, the best. They did not pay me to go there. They did not bribe me. Jotronic did not threaten to kill my next of kin if I did not go there. My pictures are not doctored. I am not a Martian. I AM A REAL PERSON WHO GOT A REALLY SPECTACULAR SURGERY BY A VERY REAL SURGICAL WIZARD NAMED VICTOR HASSON. AND I'M REALLY EXCITED AND LOVE SHOWING OFF MY NEW HAIR.

 

H&W took off because they are incredible. The best marketing plan is only as good as the product behind it.

[Gorpy]

Hi Joe, H&W definitely produce spectacular results. I am however curious. You say H&W do not break down bigger grafts into smaller grafts to inflate graft counts... Was that Clintonesque speach meaning you do break down larger grafts but for valid reasons, or that you simply don't break down larger grafts ? If at least one of your techs didn't ever leave 4 haired fu's intact, was she eroneously cutting grafts she shouldn't have or is that standard policy?

 

Keep in mind that if you do break them down, I'm not being critical. Based on your resuls, maybe that's a better philosophy (lots of smaller grafts densly packed). It could be the preferred method of the future. Sorry, but as B-Spot says, until you give hair counts that perception is going to exist. Based on the pictures you have shown, you say that if this patient had received only one's and two's it would not look as dense. Well, I don't know about that. That's a heck of a lot of grafts.

 

Based on my knowledge and what Janna said, you must use differing blades for 3 and 4 hair fu's. You would, therefore need to count them in order for the doctor to make the proper sized incisions. Doctors make the incisions during the long and tedious graft trimming process. It is at this time that the techs are calling out numbers that the doctor is using as a guide for incision making.

 

Again, thanks for your input. I think as patients become better informed their their thirst for knowledge of such details increases. Oh, and how many incisions are actually made with a pool queue at your clinic? Just kidding

[Jotronic]

Gorpy,

 

I had to laugh out loud when I read your post. Sheesh, NO we don't break down grafts save for the rare occasion when a few singles might be needed for a hairline or if a graft is just so big that no matter how you place it the result will be pluggy. All clinics do this and it is usually when the patient has pasty white boy skin with dark, really coarse hair. Yes, I did inhale and no I did not know a thing about Al and the monks.

 

Regarding blade sizes, yes, you are correct but it's there's more to it than techs just calling out the numbers and blades are made based on this. The different sized grafts are actually laid out next to each as Dr. Hasson or Dr. Wong match them up with the raw blades so they know how to cut the width and the length.

[UGLY MAN 4 LIFE]

Originally posted by Gorpy:

Hi Joe, H&W definitely produce spectacular results. I am however curious. You say H&W do not break down bigger grafts into smaller grafts to inflate graft counts... Was that Clintonesque speach meaning you do break down larger grafts but for valid reasons, or that you simply don't break down larger grafts ? If at least one of your techs didn't ever leave 4 haired fu's intact, was she eroneously cutting grafts she shouldn't have or is that standard policy?

 

Keep in mind that if you do break them down, I'm not being critical. Based on your resuls, maybe that's a better philosophy (lots of smaller grafts densly packed). It could be the preferred method of the future. Sorry, but as B-Spot says, until you give hair counts that perception is going to exist. Based on the pictures you have shown, you say that if this patient had received only one's and two's it would not look as dense. Well, I don't know about that. That's a heck of a lot of grafts.

 

Based on my knowledge and what Janna said, you must use differing blades for 3 and 4 hair fu's. You would, therefore need to count them in order for the doctor to make the proper sized incisions. Doctors make the incisions during the long and tedious graft trimming process. It is at this time that the techs are calling out numbers that the doctor is using as a guide for incision making.

 

Again, thanks for your input. I think as patients become better informed their their thirst for knowledge of such details increases. Oh, and how many incisions are actually made with a pool queue at your clinic? Just kidding

 

Wouldn't logically it be better for H&W to understate graft counts? So they lose a few hundred bucks per surgery but gain massive market share because their results look so fantastic for such small numbers. Hyping up the grafts and not provding the results is stupid and will lead to people speculating about yield problems - that's not a positive thing to differentiate yourself on, you're better off doing and saying nothing.

[Jotronic]

Speaking of wasting grafts, I was just browsing the forums and ran across Domie's thread. 4900 grafts in one session with Dr. Wong. At five months out I don't interpret his exhuberation much less his photos as representative of someone that had his grafts wasted or had low growth rates due to vascular damage, transection rates, or whatever else you can throw at it. This is a classic case of what I'm talking about. His donor is not depleted and if he loses more on top then he's got more if he needs it. You see, the density while of course is highest at the front decreases toward the back. If he needs more in the back then it won't need to be as much as he's already had. Just smaller touch ups.

 

Domie's Hair Transplant

 

Here's another one by Bushy. This is a patient that came back for #2 and now he's got well over 7000 grafts. What does he get in return? Complete coverage and not a hint of his former bald self and he's only at four months.

 

Bushy's hair transplant