Review of True & Dorin. Part 2 of 3: The Procedure & Follow Up Care

[corvettester]

Comprehensive Review of True & Dorin.

Part 2 of 3: The Procedure & Immediate Follow Up Care.

 

What follows is the second part of a three part comprehensive review of True & Dorin. In Part 1, I covered the consultation, the decision to take the plunge and why I chose T&D. You can read it here:

 

http://www.hairrestorationnetwork.com/eve/159626-review-true-dorin-part-1-3-pre-op.html

 

Here in Part 2, I will cover the procedure itself, as well as the immediate follow up care and suture removal. Part 3 will cover the growing phase and final result, so it’s going to be a while before I can write that.

 

I waited to post Part 2 because I knew that I would need two procedures, so I thought it best to review both as one. Therefore, what follows is a composite of my two procedures at T&D. When necessary for clarity, I differentiate between the two; however, for the most part, both procedures had far more in common than any differences.

 

In short, both procedures went smoothly and without incident. The immediate follow up care for both was seamless and without issue. Having done my due diligence, it was everything that I anticipated it would be.

 

Further, the healing process was far more rapid than I had anticipated. By the time I had my sutures removed each time, there was hardly any evidence of my having a procedure at all. There were virtually no complications with the procedure or the healing process: no swelling, no bleeding, no oozing, in ingrown hairs or infections, no excessive pain and no shock loss.

 

 

Now for the long version…

 

I arrived at the clinic at 8:00am, signed the waiver, reviewed the day’s agenda and strategy with the doc, took pre-op photos, took a valium and readied myself for the procedure.

 

Dr. Dorin started with the anesthetic in the donor area. Administering the anesthetic is the only “painful” part of the procedure which is because the doctor has to inject the donor and recipient area with anesthetic via a hypodermic needle. Basically, you’re getting a shot in the head, several shots actually. It stings and it makes you cringe and your toes curl.

 

It’s a very short-lived pain though. The anesthetic only takes moments to kick in and the sting from the needle is immediate and only lasts a second. I’m no hero when it comes to pain either.

 

Once that’s done, the doctor shaves the donor area (actually, he may have done this before the anesthetic, I can’t remember). So he shaves the donor and then he starts the incision. My head was completely numb so I felt nothing at all.

 

Even though I couldn’t feel anything, I could “sense” what was happening to me… and let me say that it creeped me out big time! I mean, you can feel him slicing open your head, yet there is no pain—it’s very surreal!

 

Dr. Dorin cut the donor out in sections, I think he did mine in three sections. He even showed me one of the sections after he cut it out which looks like the excess skin or fatty tissue on fresh duck or chicken, for those of you who debone your own meat.

 

This process takes anywhere form 30 minutes to an hour. I really don’t recall both times because my perception of time is so distorted with the meds and grim reality of what is happening.

 

The doc then sent the grafts off to the techs so that they can start slicing them up and removing the grafts individually. Then he started suturing me up, which probably took another 20 minutes or so. Again, the suturing is completely painless, can’t feel a thing.

 

With my first procedure, I was given a standard closure. With the second procedure, I was given a trychopytic closure. Dr. Dorin decided to go with Trycho for the second because my scar stretched a little bit on the right side after my first procedure. It wasn’t bad at all and most docs would have found it acceptable. Dorin just wanted to see if I might benefit better from Trycho this time. You can see photos of my scar in the 8 Month Update in my Hair Loss Website, link below.

 

After I was all sutured up, I took a bathroom break and the doc let me watch the techs cut up my donor and separate the grafts for a few minutes. There were four techs simultaneously completing this task.

 

Next, anesthetic was administered into the recipient area. It’s the exact same sting as in the donor. After the anesthetic is in, Dr. Dorin started making the incisions into the recipient area. The big difference between the first and second procedure is that the first one was done very quickly. Dr. Dorin was making incisions onto a bald surface, so it only took what felt like 30-45 minutes.

 

For my second procedure, he was making the incisions in between hairs so it took significantly longer, what felt like two hours! Dr. Dorin told me that he had to be careful not to transect hair from the previous procedure.

 

At one point during the second procedure, the anesthetic wore off so the doc had to give me more. I could actually feel him stabbing me with the little incision maker. It hurt, not bad though because of the residual anesthetic. Dr. Dorin was surprised that I could feel it that the anesthetic had worn off so soon.

 

So once he finished up, I took a lunch break with my head covered in blood. Something about surgery and healing makes me ravenously hungry. For both procedures, I wolfed down the sandwich that they had ordered for me. Even though I had eaten breakfast, I was very hungry by the time lunch came.

 

What’s more, I noticed that I had a significantly increased appetite for the first week or two after the procedure. I mean, I was eating everything in sight in huge quantities.

 

Next came the graft placement, which was done entirely by the technicians. There were three techs who worked on me. This too took a good deal of time, especially for the second procedure, for the same reasons sited above.

 

Again, it was completely painless, couldn’t feel a thing. I could “sense” it though which is just weird. The techs will chat you up if you want but each time I was so zonked that I wasn’t much for conversation. I think I feel asleep for a few moments too.

 

The worse part, in my opinion, was having to sit so still for such a long amount of time. I mean, I’m fine to sit and read or write for hours, but I’m kind of fidgety, which is a big No-No when it comes to URFUT. You have to sit still and not move a muscle. My back started cramping, I started getting anxious, etc.… it sucks.

 

Three quarters of the way through the second procedure, the anesthetic wore off again. I started to feel them placing the grafts and it really stung. So they put some more anesthetic in and all was well.

 

After the grafts were placed, I was glad to be done. I was cleaned up, had a final discussion with the doc, had some photos taken and was out the door.

 

The next two weeks will differ from person to person. For me, the first HT was the first procedure that I had ever had. I’ve never broken a bone or had any illness. So I was in pretty bad shape. I think a lot of it had to with the medication, my body just isn’t used to it.

 

True & Dorin give all patients a post-op video to watch at home. It explains what to expect for the first two weeks and then gives you a break down of what to do and when to do it in 3-4 day segments, over the next two weeks. It was very instructional, informative and helpful. It answered almost all of my questions and explained everything well.

 

I had to go back to the clinic the next day for the post-op cleaning and examination. Each time it was pretty difficult to make it there and by the time I arrived each time, I had to go straight to the patient’s room to lie down because I thought I would be sick.

 

The first time I took a cab to and from the clinic which was a huge mistake. Just too much bouncing around and abrupt stops. The second time I took the subway, which was much better, despite so many people. T&D’s clinic is conveniently located just two blocks from NYC’s Grand Central Station.

 

The first three nights are the hardest because you have to be so careful to sleep upright and not roll over. A travel pillow is essential in my opinion. I used one for the first two weeks after both procedures. I made sure to take plenty of painkillers and an Ambien right before I went to bed so that I wouldn’t be moving around. I was always glad to wake up in the exact same position that I had gone to sleep in.

 

The clinic called me after a few days to check up on me and make sure everything was going well.

 

By the end of the second week I went back to have my sutures removed. This hurts. Nothing unbearable, just stings, especially the beginning and end of the suture area because that is where the doc ties the knots.

 

After the sutures are removed the doc comes in and examines your scalp and scar and answers any lingering questions. From there on out, it’s all about the wait.

 

In conclusion, I found my procedure and immediate post-op care to be exceptional and exactly what I anticipated. Both procedures went without incident and I felt very supported and taken care of throughout. The doctor and staff were all very professional, well organized and prepared, as well as hygienic.

 

I experienced no post-op complications: no swelling, no bleeding and no shock loss. Everything went according to plan and was up to my expectations and standards. I would strongly recommend Dr. Dorin to anyone considering an HT in the future.

 

As always, any thoughts, comments or questions are welcomed…

 

 

Corvettester

Edited August 25, 2011 by corvettester

[bonkerstonker]

Out of interest If you knew you needed 2 procedures why didn't you just have 1 big session?

 

With respect just having 1700 in your first session makes no sense, it would of been much wiser to just have 1 Ht of around 3000 grafts which could of easily been done by most elite surgeons and would of given you your required result faster, less post pain, probably less time off work and saved on donor transection.

Edited August 24, 2011 by bonkerstonker

[corvettester]

Out of interest If you knew you needed 2 procedures why didn't you just have 1 big session?

 

With respect just having 1700 in your first session makes no sense, it would of been much wiser to just have 1 Ht of around 3000 grafts which could of easily been done by most elite surgeons and would of given you your required result faster, less post pain, probably less time off work and saved on donor transection.

 

 

Bonkers,

 

I consulted with several elite clinics, none of which suggested that I have 3,000 grafts done in one session. I thought it prudent to listen to the experts on this one...

 

The highest estimate I got from any of the elite clinics was from your clinic, Hasson & Wong, who suggested that I go for between 2,000-2,500 grafts FUT.

 

Dr. Rahal suggested around 2,000 and SMG suggest around 1,500-1,800. Dr. Beehner suggested 1,500-1,700 and Dr. Law suggest 1,500. Nuhardt 1,500-1,800. Dr. Path in Bangkok suggested 2,300-2,700, which was the highest.

 

T&D were definitely on the conservative side, no doubt, which was one of the reasons that I decided to go with them. Essentially, the decision to go conservative was my decision. I didn't want to risk a big session if I didn't need it, I wanted to see if I could get by with less. Also, I knew that most people opt to undergo two procedures, typically for density, whether or not they need to. I've seen plenty of dense packing sessions that had to go back for a second pass...

 

Different doctors have different philosophies. It doesn't mean that one is better than the other. I didn't want to risk a big session due to the increased risk of shock loss and lower yield. Also, all the dense packing docs wanted to shave part of my head, which I wouldn't allow... how's that for downtime?

 

Had I chosen any of the other doctors, it appears that I would still have to go back for a second pass. So in that respect, I'm glad I went conservative and I stayed local, among other reasons.

 

Although I've seen some outstanding results from dense packing single mega-sessions, I think it is over-hyped. If it were so much better, why wouldn't more docs be doing it? Most docs I consulted with cautioned me against it. I simply chose not to buy into it and I'm happy with my decision. Thus, to use your phrase, I think it's "much wiser" to play it safe.

 

 

Corvettester

Edited August 25, 2011 by corvettester

[Cant decide]

As you said, its a matter of preference. Some go conservative and some aggressive. But I think the term "Aggressive" has to be defined. In my opinion, aggressive means a doctor who is willing to and can extract and handle procedures over 4000 routinely for patients who have extensive hair loss and thus a need. That in my opinion is a good aggressive approach. However, if a surgeon is aggressive meaning they plant an inordinate and unnecessary amount of grafts in an area just to achieve a very dense one pass result that could have been just as good with fewer grafts, or a lower than warranted hairline, that is a bad aggressive approach.

What I do not like is when a doctor tells a patient that they should do say 3000 grafts in one round when they have the characteristics to obtain and clearly need 5000. I consulted with a top doc who told me 3000 was all I would get and never brought up the fact that other docs are doing much larger sessions. It was just that he typically did not do sessions that large. As long as a conservative doc tells patients what they truly feel the max is that can be extracted in one go (not just them but any doc in their opinion), then a patient can decide for themselves if they want to go aggressive or not.

If I had listed to this doc, I would have done 3000 in the first round and been back in the chair a year later when my desire was to get it done in as few surgeries as possible which I was able to do with Rahal.

A little off the topic sorry….

By the way CT, your hair would look good with 1700 done, 1300 done, 3000 done, or none at all. I would have killed to have your hair starting out

[orlhair1]

Corvettester, I would think in your case that you definitely made the right call. It was entirely possible that your first surgery would have been all you would need.....it was just the growth issue that resulted in you getting the second one, from what I understand. You consulted with a lot of top clinics, most of which gave you the same advice as T&D.

 

At the end of the day, different clinics have different approaches and each person has to decide for themselves what they want to do. I was fortunate in that all but one clinic I consulted with suggested close to the same amount of grafts to accomplish my goals. One clinic suggested an additional 1,500 grafts and I went with the majority and more conservative approach. I guess time will tell as it continues to grow, but I am very comfortable with the approach I decided to take.

[hairthere]

"What I do not like is when a doctor tells a patient that they should do say 3000 grafts in one round when they have the characteristics to obtain and clearly need 5000"

 

That's why it is so important to consult as many top clinics as possible and to really do your homework. Approaches, and graft counts, can vary greatly from clinic to clinic. The one factor that should not is the quality of the work done.

 

Corvettester, Nice write-up. The take-home video they give is a nice touch. Good growing to you.

[bonkerstonker]

Corv that makes a lot more sense and yes I agree safe is the best way. Like I say it's a bit of a bummer having to go through it twice but that should be it for you now.

 

Now I think of it from your angle it's different for you as you have a really long thick fringe that completely hides the situation I suppose every time you look in the mirror you probably see no change but for me and most others 2 surgeries is a real annoyance.

Edited August 25, 2011 by bonkerstonker

[Ahairdown]

Hey Corv, awesome write up... Thank you for sharing your experience.

[corvettester]

Corvettester, I would think in your case that you definitely made the right call. It was entirely possible that your first surgery would have been all you would need.....it was just the growth issue that resulted in you getting the second one, from what I understand. You consulted with a lot of top clinics, most of which gave you the same advice as T&D.

 

Exactly!

 

To this day, many posters still rave about what a great result and clear improvement I had from my first HT, which is funny considering that I had a relatively low yield. No doubt, I had a significant cosmetic improvement. However, it just wasn't at the level I had anticipated. I'm glad my doc shares my high standards.

 

I can only wonder what I would have done if I had gotten a 100% yield...

 

 

Corvettester

[Cant decide]

CT - With respect to my hair charecteristics, believe it or not, I believe I would fall into the average category. My hair is medium in caliber and I have somewhat fair skin with dark hair. What saved me is my hair to graft ratio. I was at about 2.3 with allot of threes. Dr Rahal covered ALOT of territory,however, he did not touch the center crown. He did put some coverage in the crown laterals to complete the side profile. The crown is not horrible now but I will likely get it addressed in a couple of years. Also, believe it or not, I was planted at 59 in the hairline, 55 immediately behind that, 50 in the mid section, and then tapering to 40 down to 38 way in the back. I also think I was lucky to have an almost 100 percent yield. I am told I still have 5000 grafts left. I plan on my next procedure being my last so I am going with about 2500 in the crown and possibly some very minor temple work and then keep the remaining 2500 in the bank for any future unforeseen and unexpected loss.

 

Take Care and happy growing to you my friend

[corvettester]

Can't Decide,

 

I went ahead and moved my comment to your thread because it is completely off-topic here, but very much on-topic for your case. It's a very interesting discussion and worth looking into, so let's finish it up there...

 

http://www.hairrestorationnetwork.com/eve/160548-5000-grafts-dr-rahal-pics-2.html#post2277101

 

 

Corvettester

Edited August 26, 2011 by corvettester

[Ar674]

He even showed u what the piece looks like??? Right there?????? That should of told u he'snuts!!!! Amatuers go to him becuase they dont know any better!!!

[bonkerstonker]

He even showed u what the piece looks like??? Right there?????? That should of told u he'snuts!!!! Amatuers go to him becuase they dont know any better!!!

 

 

What you on about? Odd comment!

[Ar674]

odd comment???? u mean what r u on??? look here kid or should i say amatuer.....t&d arent the right people for density!!

[TakingThePlunge]

Ar674,

 

Interesting first post you have opted to make. For your information, True and Dorin regularly produce outstanding results. They are both esteemed members of the Coalition of Independent Hair Restoration Physicians and are well respected not only by this community but also by their peers.

 

This community is by and for hair loss sufferers. You are welcome to participate in this community and share your honest thoughts and experiences. However, making false and unsubstantiated claims regarding the skills of physicians and demeaning the members of this community with terms like "kid" and "amateur" with a clear agenda to incite controversy is in direct violation of our Terms of Service.

 

Have you had a transplant with Dr. True or Dr. Dorin? Have you had a transplant at all? If so then I welcome you to share the details of your procedure as well as your pre and post-operative photos.

 

If you wish to remain a member of this community then you will adhere to its rules. I look forward to your further contributions.

[JayWalker]

He even showed u what the piece looks like??? Right there?????? That should of told u he'snuts!!!! Amatuers go to him becuase they dont know any better!!!

 

Oh dear.

As Bill says, please share your experiences, documented with pictures.

[bonkerstonker]

Bills not said anything and how can he share his pictures he's not indicated he's had a Ht.

 

I just want to know what he's talking about where has this piece comment come from true and dorin don't do pieces as far as I know.

[salami]

Hey Bonker,

 

It looks like he is referring to a "piece" of the donor strip. See this quote from Corvettester's original post:

 

"Dr. Dorin cut the donor out in sections, I think he did mine in three sections. He even showed me one of the sections after he cut it out which looks like the excess skin or fatty tissue on fresh duck or chicken, for those of you who debone your own meat."

 

All I am going to say is that True & Dorin are a top notch clinic. As professional as they come.

[bonkerstonker]

It's been a long time since I've read the first part as this thread is quite old thanks.

 

Have you any idea why he cuts the donor like that I've never heard of anything like that before?

Edited February 11, 2012 by bonkerstonker

[Mountinvan]

I always enjoy reading Corvettester's posts. They are truthful and insightful. Hope we can get an update on his progress--5 mos. now?

[bonkerstonker]

He's got loads of updates have a look in patients photos.

[Mountinvan]

Didn't know about the Feb update. He has every right to seem plaesed. Looks like its going to be a great result with no more hair worries.