DR. Hasson taking donor too high?

[aWidowsPeek]

Not trying to start a big thing,just really wondering what the deal with this is? I have seen a few of these lately...

 

Hair Restoration Journal -Day 7

 

Seems pretty risky

[aWidowsPeek]

Hair Restoration Journal -Post Op

[TC17]

It's certainly out of the universal safe zone. Whether it's too high will depend upon whether that particular patient loses hair from that area. There's no real way of predicting that, but I'd never let a doctor take a strip from that high on me, but that's just me.

 

ps, i hope khan78 sees my reply to this post. I recall him implying that I was unfairly signaling out his clinic for non safe zone extractions. hopefully this will show that if anything, I'm consistent.

[Sparky]

my dad is bald where this guys scar is, and so are most of the bald men I know, well out of the safe zone.

 

People were happy to have a go at Dr Keser for taking too high, but when its about H&W people are all like "leave them alone" Tad biased really because both those scars are miles out of the safe zone.

Edited June 26, 2010 by Sparky

[aWidowsPeek]

I really do not understand why Hasson who is clearly at the very top of the HT industry would be taking strips this high? We all know it's pretty much crazy and i'm glad you guys agree. I'd really like to hear what Hasson has to say about this. Honestly i can't think of any good reasoning to do such a thing.

 

I know people will pop up to justify this,but how can you? Those scars are at least 2 inches out of what we all consider "the safe zone".

 

Was it harvested that high to be able to take more donor out for a larger graft count?

[aWidowsPeek]

I didn't know that on another board this topic had been going on for awhile...

 

Hair Loss Help Forums - Very high scar by dr. hasson

 

Hey Stardog, i hope everything is fine with you and that your ht turns out great but i noticed you keep saying in the above thread "we will just have to wait and see in 15+ years" Dude,it doesn't matter that you are in your mid 30's. Anybody that knows their stuff on hairloss realises that hairloss is UNPREDICTABLE! We have all seen guys with great mops of hair into their 30's/40's then woooooooosh it starts flying of their head.

[Bill - Seemiller]

Guys,

 

There are always exceptions to the rule and at times, it may be appropriate to go outside the universal safe zone. The concerns regarding Dr. Keser were because we weren't familiar with his work and we wanted to see evidence that going outside the universal safe zone wasn't the norm. Dr. Hasson has a long history of providing excellent results and in most cases, he takes strips inside the universal safezone.

 

I hope this helps.

 

Bill

[Sparky]

I'm not having a go at H&W, but those scars are on top of those guys heads, if they dont stay on Proscar for the rest of their lives, I'd say all that transplanted hair is gonna thin out.

[The Cure]

"People were happy to have a go at Dr Keser for taking too high, but when its about H&W people are all like "leave them alone" Tad biased really because both those scars are miles out of the safe zone. "

 

I have to agree with you Sparky. Although it's never black and white. Some surgeons get set upon for much less controversy. I would be concerned if my scar was to be positioned this high. Possibly the highest i have ever seen, why?? I would like to see this scar shaved down in 3 months, very interesting to watch.

 

Ju

Edited June 26, 2010 by The Cure

[TheEmperor]

One of my complaints from my surgery with Dr. Wong is that the act of removing strip will actually make the bald spot larger. The act of removing tissue, slides the scalp back and down.

 

For someone who was a NW5 with a very small baldspot, a strip surgery can make the baldness evident from the sides and behind, where before it was not visible.

 

I believe that Dr. Hasson is showing an evolution in strip harvesting to avoid pulling the hair down. Harvested this way, it is clear to me that there is much less tissue to stretch on top, and the majority of stretching and scalp movement will occur below the scar.

 

This scar location also allows the patient to buzz the sides.

 

My belief is that is would be much better to have a fine linear scar showing from the sides, than it would be to pull the rim hair down so that your baldness class is higher. If the fine linear scar DOES become visible many years down the road, it would be easier to transplant around the scar to hide it, than it would be to bring the whole rim up the amount that was lost.

 

The rim hair is the difference between getting a full looking transplant and getting a wispy combover.

 

For the most part, that is a superior location for the scar.

[Sparky]

I'd be more worried about the expensive transplanted hair falling out when MPB advances, if your going for the full head being transplanted like this case, you dont want to be on Proscar for the rest of your life, but I think these guys will have to be.

[TheEmperor]

I'd be more worried about the expensive transplanted hair falling out when MPB advances, if your going for the full head being transplanted like this case, you dont want to be on Proscar for the rest of your life, but I think these guys will have to be.

 

Only a bit of the incision goes up into the danger zone, imo. Those hair mixed in with the other transplant hair will cause a slight thinning if they shed.

[EpilepticSceptic]

I agree and disagree with TheEmporer.

 

Yes, the rim hair in many patients is of a much higher quality. In my case this was definitely true. My scar is not as high as these, but it definitely does follow the rim hair for which I am grateful. Who wants to spend big $ on a HT and end up with a thin looking combover result ?

 

And yes, you will want to be on Proscar for the rest of your life. I've already been on it for 10+ years, so there's no issue there for me. I advocate that 99.9% of HT patients (strip or FUE) would be fools to not be committed to taking Proscar for the long term. The safest bet is to be on it for many years before any HT, and to know that it works and that sides are minimal and tolerable. If you are under 50 and have history of advanced balding on either side of your family, then either commit to taking Proscar for life or just go bald and forget about HTs -- period. That is my advice, to not save whatever hair you have is completely foolish.

 

Where I disagree with Emporer is when he says removing a strip will make a crown bald spot larger. That has not been my experience at all. I'm near 1.5 months post-op from a large strip session and my bald spot has not become any larger. It was already pretty small (2" X 2"). Scalp geometry does change a bit, however. My whorl on my crown is different from most as it is positioned on the right/back side of my head. This did move a bit, but for me it's no big deal. I had a 2.0/2.5 X 30 cm strip removed on a small head, so if tissue stretching was indeed expanding the crown area than my bald spot should have enlarged -- but it did not.

 

I think maybe in Emporer's case it just could have become more noticable if the geometry changed and it moved down a bit ? Also, one cannot rule out further MPB progression. I have seen guys who did great on Fin/Dut for years go from a NW5 to a NW6+ in less than 1 year, especially in the late 30s age bracket. That's why I say wait til at least 40s to get a HT, and only after being on Fin for 10 years and confirming that it has stopped the loss.

Edited June 26, 2010 by EpilepticSceptic

[TheEmperor]

ES,

I dont think removing the strip makes the bald spot larger in equal proportion to the amount that was taken, but it does have an effect. IOW, my bald spot is not 3cm larger on each side. I would say it is more like 1-1.5.

 

The grafts have to come from somewhere. Either the skin stretches locally to the incision, or the skin slides and moves so the wound can be closed. The skin can move upwards (from ear) or downward. I believe it is a combination of things.

 

None of the alternatives are really good. If most of the stretching takes place local to the scar, then you would end up with a thin area around the scar. (I have this). If the skin stretches over the entire surface (ie skin moves) then the baldspot would have to be made larger, unless the strip is taken high and with geometry that would prevent it from stretching down. In that case, most of the stretching would happen under the scar.

 

 

When you are healed up, do the scalp exercises and you will see that your forehead skin moves. Your entire scalp moves.

 

Also, everyone may be different. It is probably not correct to say everyone is the same, I only know what happened in my case.

[Danielkiwi]

Hi ES

 

I think you are contradicting your statements. You first say that one should be on proscar for many years before taking the HT. You then say that some of your friends lost the hair suddenly after being on proscar for a while..i dont want to jinx you or something but what happens if the same things happens to you..i think it is a well known fact that propecia loses its effectiveness after 10+ years as it is. i think our body gets immune to any kind of medication..and what if you suddenly develop sides..as people age, they will definitely loose hair below the crown area and if the strip scar is taken high, there is a huge risk of loosing the transplanted hair and also disclosing the scar...and hence it is a catch 22 situation!!

[EpilepticSceptic]

Danielkiwi,

 

First of all, where did you get the following information: "it is a well known fact that finasteride loses its' effectiveness after 10+ years" ? As far as I know there have been no controlled medical studies to corroborate this statement; so if you are getting this info. from online forums (like propeciahelp.com) then the info. is skewed IMO.

 

Let's not forget that finasteride is a prostate medication that's been around since the early 90s. There are many older (60+) men still taking it after nearly 20 years and who would otherwise have developed serious prostate conditions. Has it stopped working for them ? And how would you know that ?

 

I've been on it for over 10 years now and it has essentially arrested my hairloss completely. I can show pictures from when I was age 30 and it's obvious that my hairloss was halted and the remaining hair in the MPB danger zone is quite healthy. Actually, the remaining hair in the MPB zone is healthier looking today than it was even 5 years ago -- so if anything the medication has been working better for me over time. Sides have always been the same from day 1, watery semen. This has not changed and remains consistent.

 

Every case is different. When i said that propecia stopped working after "years" I meant several years (3-5), not 10+ years. Alot of guys will have it work good for the first 2-3 years and then the loss kicks in again and they lose alot of ground. I don't see too many posts on forums where people are generally pro-finasteride saying that the typical time frame for the medication's loss of effectiveness is the 10 year mark; come to think of it, I don't think I've seen even one.

 

Then again, all HTs carry a risk. So does getting into a car and driving down the road to buy a pack of cigarettes -- you might just get into a wreck.

Edited June 27, 2010 by EpilepticSceptic

[Danielkiwi]

You are rite. there have been no mecical studies to corroborate the effectiveness of propecia for 10+ years...but do you think merck would have the motivation to do so...then again who is to say that it will not loose its effectiveness...i think the orginal point of this post was to discuss the position of the scar...which i personally feel should not be that high..it would def. give you a better yield in the current future but carries a higher risk in the longer future..using your analogy if you go to buy a pack of cigarettes, you would def not want to overspeed in your excitement and carry a higher risk of the wreck!!

[aWidowsPeek]

Anytime someone brings up Proscar like it is some amazing drug that automaticaly stops you from losing any more hair i have to laugh. We all know Proscar doesn't work for everyone. We all that even when it works it doesn't work forever. So relying on a drug and keeping your fingers crossed isn't going to stop your scar from eventualy showing!

 

AS The Cure mentioned, these are some of the highest scars i've seen.

 

It's not going to get resolved (if then) until Dr. Hasson speaks up and let's us all know what the deal is. Although he will probably just say what jotronic already said in the hairlosshelp post.

[RCWest]

That almost looks like the edge to where he could lose his hair to. I don't understand that :confused:. Should have taken that much lower!

[bonkerstonker]

I have a scar that high and Dr hasson explained to me that some people like my self and the others with high scars suffer from retrograding where we thin in from the sides which i have been doing for years and also thin from the bottom upwards so he harvests from the best possible thickest area rather than from my sides which are minturasing as we speak.

 

If joe sees this he can explain a bit better than me.