Hasson and Wong Donor extractions well out of safe zone!!!

[egghead1969]

I peruse ht forums over the last couple of years reading and researching but a thread where Amanindia at 6 months has me compelled to post my concerns. There are number of patients from Dr Wong and Dr Hasson lately that the donor strips are taken high above the safe zone. I read one explanation somewhere from Dr Hasson but frankly I didn’t buy it. Maybe Amanindia isn't concerned with his strip outside the safe zone which is fine. But then to dismiss it and say Dr Hasson is above questioning is ludicrous. I don't get why he or any other doc for that matter should be above questioning. I read time and time again of guys going to clinics blindly trusting their doctor simply because they are the doctor – this gets me. As a future patient I want to know why this is being done or is allowed. I don’t see any other reputable clinics doing this unless I missed it somewhere. All I can say is these patients better not reach a NW5, NW6 or NW7. Is this really not a concern to anyone else????? This was a concern on another site but the site is busy so it quickly gets buried.

[Atomic]

It does appear that H&W do take strips higher up into the danger zone. How this is going to affect patients is yet to be seen.

[joeyz400]

If it is taken too high I would think you can lose those transplanted hairs. If they are hairs that wouldn't survive male pattern balding you would lose them where ever they are.

[hairthere]

Egg, Welcome to the forum.

 

Firstly, if you are going to come here and make a bold, potentially damaging claim like this...

 

"There are number of patients from Dr Wong and Dr Hasson lately that the donor strips are taken high above the safe zone."

 

...you really do need to provide links (or some type of evidence) to specific cases. Now, I'm not saying H&W cannot make mistakes, but removing a donor strip from an unsafe zone is a pretty big one. Dr. Hasson has a ton of experience and I personally would trust in his expertise on the safety of an individual patient's donor strip.

 

Are you considering H&W for a HT? If so, wouldn't this be a good question to personally address to the clinic? That's what I would do.

[Starkid]

if its potentially dangerous(taking high donor strips), i say wait out and you will be able to see some complaints in the future when the HTs age...if not then may be H and W know what they are doing.

 

and i think this post is gonna make aman more anxious,so not a good time bro!!

[bonkerstonker]

Dr hasson told me that the scars look high but the strip is taken from the thickest area of the donor and also the strip is taken from the bottom side of the joining line scar only not the top or from half and half.

 

Dr hasson knows where your future loss is from checking how long you've been loosing hair and he can see slight miniturising in your donor you don't know you have, when he checked me he found the so called tipical safe zone was miniaturising so if he'd of taken my strip from a normal safe zone my ht would of miniturised for sure so he took mine from slightly higher where my hair was extremely thick and had 0 shrinking after 10 years of loss.

 

Basically he found I had something called retrograde alepecia which is common in mpb where your hair thins from your neck up into traditional safe zone and also in from my sides where my temple points are inwards over my ears. When I got home I grew my hair and checked and needless to say he was right my hair was thinning where I didn't expect it to be and into a traditional safe zone. The key here is you need a surgeon to extract from your safe zone not the average of everyone elses. Simple!

 

Egghead have you any idea how obvious it is that you've come on here to try and slander Hasson and Wong. You join with your blag alias and on that day with your first post you launch a attack like this that has been spoken about 100 times before it's absolutely pathetic.

 

Do you think Dr Hasson who is without doubt the most respected ht surgeon in the world that all the other surgeons look up to and have learnt things from would extract donor strips out of everyones safe zones for the laugh or something you stupid pratt!!

Edited May 12, 2011 by bonkerstonker

[Spanker]

Yes, but looking at his case that the patient put on line for all to see, I thought it was a fair observation in the case that was presented. I do trust H and W, but to be fair after looking at this pre-op, it was fair the mention/ask about.

 

That said, lighting, angle, etc could have been a reason it looked like that.

[splitting hairs]

This has been a major concern of mine with dr hassons work. To see examples look at the patient websites!!! They would argue that they don't go that high on most of their cases, however I've see a lot of cases where they have. Yes you can take into account family history, use of Meds and PREDICTED future loss, but this is risky. I always used to think why do they get more grafts than other clinics - well it's because they take the scar higher and that also allows them to get better quality hair. If the patient is aware of these risks and they are CLEARLY told that the transplanted hair could fall out, then I guess it's ok. Tbh I wouldn't take the risk, especially after all the hassle and expense.

[hairthere]

Splittinghairs, egg made the accusation and claimed there were a "number" of cases where donor strips were taken too high. Therefore he should be providing the evidence. It's not my job to go weeding through every H&W patient web site....

[hairthere]

Splittinghairs, egg made the accusation and claimed there were a "number" of cases where donor strips were taken too high. Therefore he should be providing the evidence. It's not my job to go weeding through every H&W patient web site....

[bonkerstonker]

This below is Doctor Hassons explaination that he wrote on another forum a year ago when people were making comments on his high scars.

 

 

Dear Forum Members,

 

I apologize for not responding to this thread earlier but I haven't been on the forums lately.

 

You are correct in stating that this patient has a high donor scar but as I would explain there is a reason for this. When we select the strip area in the donor zone there are several issues that we examine before deciding which level of the donor zone to excise. The fundamental issue, as you know, is that we must select permanent DHT insensitive hair. How do we determine which hair this is? Before hair is lost to androgenetic alopecia it undergoes changes in both structural and physiological properties. Structurally the hair shaft gets fine - through a process called miniaturization - and the growth phase of hair cycle shortens. The donor area is closely examined with magnification specifically for the presence of these miniaturized follicles. It remains controversial but it is normal to have up to 10% of the follicles to appear miniaturized even in the permanent zone. These follicles are not undergoing true miniaturization but are healthy "young" follicles in the early anagen phase.

 

So we will select the area within the donor zone that has the very least amount of miniaturization. Most people imagine that this area would lie in the center of the permanent zone but this is in fact an incorrect assumption. The reasons for this are:

 

1.) There is frequently miniaturized hair around the ear which spreads in an upward direction. This is extremely common and is very under recognized. It is called "retrograde alopecia".

 

It is my opinion that NW6 stage hair loss with retrograde alopecia is at least as common as NW7 in patients. The Norwood hair loss scale does not recognize retrograde alopecia (or a phase called diffused pattern alopecia), and I believe that at some stage the NW classification should be revised to include this condition which I have already mentioned is extremely common.

 

2.) The upper border of the permanent zone is in some patients very well defined and sometimes it can almost be seen as a distinct line where bald scalp or miniaturized hair meets mature permanent hair. Many years of experience has taught us that for all intense and purposes this line remains fixed throughout an individual's life.

 

Where there is a more gradual transition from miniaturized hair to permanent hair it is very difficult to determine the exact location of the transition from permanent to DHT sensitive hair. In these cases the donor area will be lowered as much as necessary to be sure that the hair excised is permanent.

 

3.) The density of the hair in the permanent donor zone is usually highest high up in the donor zone allowing a greater harvest and potentially larger transplant session.

 

As for the technical aspects of the donor excision which I use the following is my approach.

 

1.) Always excise as high as possible in the permanent zone.

2.) Subsequent surgeries use scalp below this line with excision of the previous scar on each occasion so as only to have a single donor scar.

3.) The scalp below the strip should be stretched rather than the scalp above the donor area. How is this possible???

 

The skin and subcutaneous fat of the scalp lie above and attached to a tough and relatively inelastic membrane called the galea aponeurotica. In general, because these layers are attached they will generally move together. The scalp skin itself however is usually fairly elastic by nature. If the skin below the inferior margin of the donor strip is gently removed from it's underlying attachments to the galea (undermining) it is usually fairly easy to stretch the skin in an upwards direction. The skin above the superior margin of the strip is not undermined and remains inelastic as it is still attached to the galea. When these two skin margins are brought together for wound closure the vast majority of the movement occurs in an upward direction of the inferior area below the incision line. This technique is also useful as it does not expand the area of potentially balding scalp.

 

Once again I apologize for not replying sooner. Hopefully this brief explanation will be of some help.

 

Dr V Hasson

[splitting hairs]

Hair Restoration Journal -2 WEEKS GONE~Staples removed.Scalp clean.

Hair Restoration Journal -Day 3 Post-Op

Hair Restoration Journal -Day 7

Hair Restoration Journal -Week 2

[lorenzo]

Hairthere if you are on top there are always people that want to bring you down. Its human nature. Look at what people say about Dr. Feller sometimes and he is amongst the worlds best and look at that crap he has to take sometimes. I dont get too concerned about comments from newbies because in my views there have almost no merit. In my opinion this will continue happen and rather than take its wrongly I take it as a sign of success. In history of mankind it doesnt matter how good you are there will always be people that will question you. Unfortuantely the minority of people that complain or question are always the loudest and deep down probaly the unhappinest.

[gillenator]

Every patient should be checked for areas of miniturization before surgery. Some patients may show miniturization in the occipital zone where most strips are excised. They may not be losing hair in the parietal zones where possibly some FUE extractions could potentially be made. This may greatly reduce the souce of donor supply but at the same time avoid taking a strip where miniturization may be taking place.

 

It would be ideal to have every patient physically examined by the doctor "in the consultation". That way every patient receives a formal diagnosis for their type of hairloss and where their candidacy for the procedure is established because some people are not candidates for HT surgery or make poor candidates at best. It gives the patient and doctor an idea of how much surgical restoration can be done based on available donor. That way there are no surprises on the day of surgery.

 

And some patients (primarily men) do in fact have retro-alopcia whereby strip may not be the way to take donor for them. This is where FUE may again enter the equation. The FUE surgeon can then cherry pick where the grafts can be extracted in other regions of the scalp where terminal hair can be harvested. This can be expalined in the consult as the doctor examines the patient's hairloss and donor supply.

Edited May 12, 2011 by gillenator

[bonkerstonker]

Hair Restoration Journal -2 WEEKS GONE~Staples removed.Scalp clean.

Hair Restoration Journal -Day 3 Post-Op

Hair Restoration Journal -Day 7

Hair Restoration Journal -Week 2

 

It's interesting that the 2 full grown out ops above have been a big success the 3rd isn't even a high scar and the fourth is aman India who imo is a compulsive panicer who's likely to get a good result in the end all you've proved here is nothing.

[Blake Bloxham]

Stonker,

 

Thank you for attaching that response from the clinic!

[TC17]

It's clear that egghead had an ulterior motive for starting this topic, but that fact doesn't mean that the point raised isn't valid. I'm not going to spend my time digging through old patient logs, but I can say that I too have seen many examples of strips taken very high. And whle Dr. Hasson has taken the time to explain why he does so on other forums, I just just don't buy the explanation. The sides on many men drop far below where some of those strips have been taken. Granted, it doen't matter what anyone else's hair does, only your own, and if your hair doesn't drop on the sides, then you're safe. However, Dr. Hasson cannot know what a patient at age 35 will look like at age 55 with regards to the height of the hair on the side of his head. And as for retrograde alopecia forcing the strip to be taken higher, perhaps instead of taking a higher strip, that should be viewed as a sign that a hair transplant shouldn't be done on that particular patient in the first place. Just because H&W do something, or say something, or hold a particular philosophy, does not mean that it is right. This myth of infallibility needs to go away and go away soon.

 

I hope that we are all mature enough to engage in a discussion about this topic without resorting to name calling, posturing, or cheerleading. Egghead's goal was to see this turn into an online fracas. Do not let him accomplish that goal. We can disagree with one another and remain civil and respectful.

[Anouar]

Great post TC17

[bonkerstonker]

It's clear that egghead had an ulterior motive for starting this topic, but that fact doesn't mean that the point raised isn't valid. I'm not going to spend my time digging through old patient logs, but I can say that I too have seen many examples of strips taken very high. And whle Dr. Hasson has taken the time to explain why he does so on other forums, I just just don't buy the explanation. The sides on many men drop far below where some of those strips have been taken. Granted, it doen't matter what anyone else's hair does, only your own, and if your hair doesn't drop on the sides, then you're safe. However, Dr. Hasson cannot know what a patient at age 35 will look like at age 55 with regards to the height of the hair on the side of his head. And as for retrograde alopecia forcing the strip to be taken higher, perhaps instead of taking a higher strip, that should be viewed as a sign that a hair transplant shouldn't be done on that particular patient in the first place. Just because H&W do something, or say something, or hold a particular philosophy, does not mean that it is right. This myth of infallibility needs to go away and go away soon.

 

I hope that we are all mature enough to engage in a discussion about this topic without resorting to name calling, posturing, or cheerleading. Egghead's goal was to see this turn into an online fracas. Do not let him accomplish that goal. We can disagree with one another and remain civil and respectful.

 

 

Tc17 It winds me up when people come on here with blag aliases to cause trouble for doctors there for i don't mind lowering my self to their standard and start name calling because i can not see them to smash their heads in.

 

People like your self who raise a concern with your real profile i have nothing but respect for and i'm happy to debate civily.

 

I feel strongly about this for the simple reason why would Dr Hasson bother risking a high scar if he wasn't completely sure.

 

I also believe this sentance he wrote above to be true.....

2.) The upper border of the permanent zone is in some patients very well defined and sometimes it can almost be seen as a distinct line where bald scalp or miniaturized hair meets mature permanent hair. Many years of experience has taught us that for all intense and purposes this line remains fixed throughout an individual's life.

 

I lost my hair very fast over the space of 8 months when i was 20 years old i did not recede i just recieved my full norwood 5 shape diffuse at the same time and i looked like a right wally over night to the point i thought i was poorly but hospital tests proved it was mpb. Today 11 years later i have the exact same loss the barriers of the norwood 5 shape have not been broken at all the only thing that has happened in 12 years is my diffused norwood 5 area has thinned further therefore from somone like me with extremely aggresive hairloss i would of by now broken the norwood 5 barrier for sure.

Edited May 13, 2011 by bonkerstonker

[lorenzo]

Great post bonkerstonker

 

What get me is that some posters actually feel that they have discovered a great mystery. Something that the doctor is either not aware of or trying to fool us all. They actually feel that a top doctor like Dr. Hasson would jeapodize his patient and is reputation in order take a higher scar.

Rather than ask that has been done in the past and answered quite extensively by Dr Hasson they decide to question. They actually think they are educated both the posters and the doctor and even overlook all other aspects. Forget the fact that Dr. Hasson is amongst the world best, shows the best quality pictures and video. The fact that he has an amazing repuation amongst everyone around the world. He has done thousands of surgeries and thousands of content and happy patients. Forgot all those facts to have your own person agenda.

Edited May 13, 2011 by lorenzo

[Anouar]

Unfortunately, Lorenzo your post is not so great. It's polar opposite of TC17, where he is objective, thinks clearly and actually puts out serious thought in what he writes to make you think.

 

I too saw these strip scars and found them to be in a curious position. I think H&W are one of the best but are they or anyone else above criticism? I want to ask questions and not bury my head in the sand. I want technical info. Your best argument is people want to bring down H&W and so there you go again with your pom poms and by the way since you are blond now, it really suits you.

 

You don’t put out s any objective info instead you’re like a popcorn movie a lot of action and blowing up things but no real substance.

[egghead1969]

I think I’m within my right to post my concerns. If you take my concerns slander then I apologize. As stated in my first post I don’t think anyone is above being questioned. I started out as a fan of H&W’s work but I’m turned off by the high scars. I won’t be making an appointment with them because there’s no good explanation for going above the safe zone. The patient from hlh where Dr Hasson gave his explanation the donor looked better below the extraction site. Anyway, I’ll keep researching until I find the right fit me.

[bonkerstonker]

You are within your right to express concerns definitely and maybe I've been out of order towards you but I'm a passionate person with a bit of a temper sometimes so I apologise.

 

It would look more of a real concern if you at least used the same alias on all ht forums rather than springing out of the blue on here and diving straight into a attack.

[lorenzo]

Anouar no doctor is above criticism. Dr Hasson has explained his position and his reasoning behind why he take some strip higher. His response was not only very educational but intelligent and explanatory in my opinion. Now the doctor has stated his, now why not show example where you feel that the doctor has taken the strip out of an unsafe area where the grafts grew and later fell out? He has been on the website for over 10 years so I am sure if what you are saying is correct there would be alot of example of this. Dr. Hasson take the strip out of safe area sometimes its lower sometimes its higher every patient is different. It all has to do with the size of the donor. .

 

Egg I cant speak for the clinic. If indeed you were interested in seeing H&W and you have some concerns I feel its a win win situation for both you and the clinic. If you dont understand Dr. Hasson explanation or feel he is lieing it works out fantastic that you dont want to book an appointment with them. After all it would be a waste of time for everyone concerned.

Edited May 13, 2011 by lorenzo
spelling

[bonkerstonker]

I just wanna clarify and show my position as it does look a lot like I'm a hw cheerleader but In actual fact I don't cheer anything other than my self. On the other hand i will support anything that I think is right and go to war with my own mother over it.

 

In this particular case I have the insight and research I did on these high scars before I had my ht and obviously decided it was safe. I do admit these scars are very high compared to other surgeons and the illusion they make when only the bottom side of the scar is extracted makes them look even higher but they are lower than they look.

 

Over the years because I have seen hw pave the way for other surgeons and do things first that everybody thought was contreversial like doing megasessions first when people said it was too much to be done in a day some people even said they cut grafts into 2 in order to make their graft count higher but now everyone does megasessions, people also said lateral slit was no good and the grafts wouldn't sit now everybody uses that technology they gave to drs for free, With regards to high scars I seen another advantage being pioneered which was the higher up grafts in the donor are the thickest and best thus giving better coverage it also maximises your donor, what's the point in having a common safe zone for everyone when everyones safe zone is very different dr hasson has clearly worked out how to spot a persons safe zone and believes so strongly in it that he does all his patients like that and as he says the ones he is not sure about he doesn't risk. You've got to remember he has seen more balding/bald men than we've had hot dinners and has watched people bald as they have come back to him for more work in other areas. I believe in the future surgeons will realise this and once again follow suit

 

This topic is definitely worth debating though and i can understand why it scares people as it did scare me before I looked into it and spoke to dr hasson in person about it.

Edited May 13, 2011 by bonkerstonker