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JasonB

Safety of Megasessions?

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Dr. Rahal and other docs are able to do megasessions with 4000 and even 5000 grafts in 1 sitting whereas other doctors I have talked to said that they can do at most 3000 and anymore is a big risk for bleeding and a large scar. Why is it that Rahal and some other docs are able to do these big sessions and the other docs say its unsafe?

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I've been thinking the exact same thing for some time now. If Rahal and H&W can do it, why can't everyone else? What are they so afraid of?

 

I no longer buy the argument that the higher the FU/cm2, the lower the yield. I think Rahal has put that debate to rest. After all, the next Rahal mega-session failure I see will be the first.

 

 

Corvettester


My Hair Loss Website - Hair Transplant with Dr. Dorin

 

1,696 FUT with Dr. Dorin on October 18, 2010.

 

1,305 FUT with Dr. Dorin on August 10, 2011.

 

565 FUE with Dr. Dorin on September 14, 2012.

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In my HT pursuit and research I always wondered why this occurred...how can only a select few produce mega-sessions/dense packing? Upon asking some doctors this question, it basically comes down to Dr. skill and comfort with this kind of session. When I first started researching I thought that most decent doctors can do a good HT...but once I started fully researching and meeting with the top docs...I soon realized how much skill really is involved on the Dr's part and also the technicians as they are the ones who have to perform a lot of the work and need to be skilled in dense packing and mega sessions. I don't think all that much attention is on the technicians but they are a big part and I questioned the doctors as to how long their tech's have been with them and their experience. I know Dr. Rahal's techs have been with him for around 11 years...that is exactly what I want because they all know how to work together as a team. Getting back to the original point I feel it comes down to Dr. skill (which includes his training, years performing and his tools used as well).

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I think whether or not a top clinic does mega-sessions of 4K-6K can depend on philosophy. For instance, a doctor could think "I can get a long, wide strip with this patient but should I given the unknown factors such as potential hair loss in the future, how this patient heals, etc.".

 

I also think that a certain level of skill is required of the surgeon to be able to successfully produce these huge megasessions. Below I've copied a portion of a conversation Dr. Ron Shapiro had with Dr. Hasson on these forums back in the day. It's pretty obvious that Dr. Ron believed surgical skill was a necessity in performing megasessions.

 

Nice hearing from you Victor . I hear you are going on vacation soon. You work so hard you deserve it. Thanks for the compliment. But you and Jerry deserve yours as well.

 

I had a question for you if you dont mind answereing on the forum.

 

A 3000-4000 FU session is not that difficult to do at least for me and you .

 

But the 4500-5500-6000 sessions take more skill and technique and I think (or am curious)a specially qualified patient.

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I think there are a number of factors involved. For one, not every patient going to Rahal and H&W have megasessions done. Some don't need it, can't afford it, or simply don't have the donor laxity for it.

 

Planning for the patients' future must also must come into consideration. I think those 4k-and-up sessions are not the norm, but we are certainly seeing more pop up. It's a case-by-base by basis. It would be nice for some of the docs to come on and debate the merits of mega/ultra-megasesson on particular patients. I would love to know specifically what would preclude someone from having a megasession.

Edited by hairthere

I am the owner/operator of AHEAD INK a temporary/non-permanent Scalp Micropigmentation Company in the New York area. AHEAD INK is a Milena Lardi trained clinic and uses Beauty Medical equipment and products exclusively.

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I think there are a number of factors involved. For one, not every patient going to Rahal and H&W have megasessions done. Some don't need it, can't afford it, or simply don't have the donor laxity for it.

Planning for the patients future must also must come into consideration. I think those 4k and up sessions are not the norm but we are certainly seeing more pop up. It's a case by base by basis. It would be nice for some of the docs to come on and debate the merits of mega/ultra-megasesson on particular patients. I would live to know specifically what would preclude someone from having a meggasession.

 

 

I agree. Under the right circumstances with the patient who has sufficient donor, laxity, etc. and the surgeon with the skill set it makes sense. For others it either isn't possible or doesn't make sense to achieve their goals or for longer term planning. The great thing about clinics like H&W and Rahal is that they are going to assess these things and make recommendations accordingly. Both clinics consistently produce fantastic results on the large cases they do. Personally, if I thought I needed a large number of grafts and I was a good candidate for a mega session, I would definitely consider it vs. having 2 surgeries to accomplish the same goal. However I would want to do a few consults to fully understand the pros and cons of both approaches so I could make an informed decision.


Surgery - Dr. Ron Shapiro FUT 6/14/11 - 3048 grafts

 

Surgery - Dr. Ron Shapiro FUE 1/28/13 & 1/29/13 - 1513 grafts

 

http://www.hairrestorationnetwork.com/orlhair1

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The main reason why is because you have to have a huge team all the time like hasson and wong have so it's a lot of wages to pay, from a business point of view it's better to have a small amount of staff because if you're quiet for a few weeks it's not costing you 10 wages for no income.

Edited by bonkerstonker

Bonkerstonker! :D

 

http://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=1977

 

Update I'm now on 12200 Grafts, hair loss has been a thing of my past for years. Also I don't use minoxidil anymore I lost no hair coming off it. Reduced propecia to 1mg every other day.

 

My surgeons were

Dr Hasson x 4,

Dr Wong x 2

Norton x1

I started losing my hair at 19 in 1999

I started using propecia and minoxidil in 2000

Had 7 hair transplants over 12200 grafts by way of strip but

700 were Fue From Norton in uk

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I just had my HT session, 3000 grafts.

I guess doing 4k or 5k means also more anaesthesia which is a burden for the body.

The scar is bigger, everything more stress for the body. It is just a bigger surgery.

For my part I feel 3000 are enough. I am okay now three days after surgery but already 3000 and about 7 hours of surgery is not nothing. Those days after were not my best of my life physically ;-)

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The main reason why is because you have to have a huge team all the time like hasson and wong have so it's a lot of wages to pay, from a business point of view it's better to have a small amount of staff because if you're quiet for a few weeks it's not costing you 10 wages for no income.

 

 

I do agree with this at some point but performing a megasession is a huge risk and responsibilty also. I mean when a surgery ends and you say to a patient that he recieved 6000 instead of 3500 , you obviously take his expectations high and when the yield is poor , there comes a bad doctor.

 

The graft count and performing a megesession is one of the biggest priorities of a ht patient and I can understand that since it's mine too. But every doctor who are recommended on this site has their unique feature. In my opinion (%100 subjective) Dr.Hasson is the best out there for graft count , Rahal for hairlines , Wong for thinnest scar , Bisanga for FUE yield , Lindsay for scar revision , Shapiro for repair. It's just like basketball; some is best for scoring ,some for rebound ,some for assists ,some for.... you get my point.

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Yes i get you bro definitely but i just feel that most docs don't do megasessions simply because of the business risk. Also it would take a lot of skill and patience but i'm sure most good docs could do it with the required workforce behind them.


Bonkerstonker! :D

 

http://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=1977

 

Update I'm now on 12200 Grafts, hair loss has been a thing of my past for years. Also I don't use minoxidil anymore I lost no hair coming off it. Reduced propecia to 1mg every other day.

 

My surgeons were

Dr Hasson x 4,

Dr Wong x 2

Norton x1

I started losing my hair at 19 in 1999

I started using propecia and minoxidil in 2000

Had 7 hair transplants over 12200 grafts by way of strip but

700 were Fue From Norton in uk

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Having witnessed many before and after megasessions I want to give my input. There is alot of aspects in order to perform a successful megasession.

1) The patients has to have both the donor, the want and the needs to have a megasession.

2) The doctor has to have a capability to perform megasession.

3) The clinic must have both a large staff and most important an experienced staff.

There are other aspects as well. There are also some myths.

1) Megasessions causes bad scar. Wrong. The doctors experience, patients healing causes bad scars. There is no different in scaring from my experiences whether is a larger session or smaller session. Only difference is that the scar can be longer when you compare 1500 grafts to 6000 grafts. In my opinion the more surgeries you perfrom on a patients the greater the chance of a less than perfect scar.

2) The larger the amount of grafts greater risk of poor growth. Wrong. This is a myth made up be doctor looking for reason to justify reason why they dont perform larger grafts. Just look at Dr. Rahal, Dr. Hasson and Dr. Wong to prove this is wrong.

 

think there are a number of factors involved. For one, not every patient going to Rahal and H&W have megasessions done. Some don't need it, can't afford it, or simply don't have the donor laxity for it.

 

 

 

This is well said. I have experienced this with alot of Italians. They either dont need the extra grafts or dont have the laxity for it.

I had a person that came from Italy to have his second surgery. He was a friend of a former patients that now we are good friends as well as this patient. When he was deciding on a surgery he visited a few clinics in Europe. He came to the decision that a doctor in Europe was able to do a megasession (with FUE) and he didnt need to come to Canada. I wished him good luck. I believe he ended up with around 5500 grafts(900 were FUE). When I met him his results. was below average. Since his FUE was done on the hairline it was very good but the rest didnt grow so well.

He explained that the doctor performed the FUE first. After that it took almost 16 hours to finish the surgery and even the doctor himself was cutting grafts under the microscope to close to 1am. This is an example of a doctor that didnt have the staff to order to perform a megasessin and it cost my friend probaly 1500-2000 grafts that didnt grow.


Representative for Hasson & Wong.

 

Dr. Victor Hasson and Dr. Jerry Wong are esteemed members of the Coalition of Independent Hair Restoration Physicians.

 

My opinions are my own and do not necessarily reflect the opinions of Hasson & Wong.

 

My Hair Loss Website - Hair Transplant with Dr. Hasson

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He explained that the doctor performed the FUE first. After that it took almost 16 hours to finish the surgery and even the doctor himself was cutting grafts under the microscope to close to 1am. This is an example of a doctor that didnt have the staff to order to perform a megasessin and it cost my friend probaly 1500-2000 grafts that didnt grow.

 

Ouch! All that for naught. Sad.

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Ouch! All that for naught. Sad.

 

I dont think it was the doctors intent for that to take place. I feel that either he misunderstood the surgery and didnt have enough staff. Once again the FUE looked good.


Representative for Hasson & Wong.

 

Dr. Victor Hasson and Dr. Jerry Wong are esteemed members of the Coalition of Independent Hair Restoration Physicians.

 

My opinions are my own and do not necessarily reflect the opinions of Hasson & Wong.

 

My Hair Loss Website - Hair Transplant with Dr. Hasson

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So funny, this topic came up. I emailed Dr. Carman and Dr. Reed this question yesterday. I was comparing their practice to Dr. Wong. Dr. Carmon does awesome hair lines with fewer graphs (averaging 2500 per session) while Wong covers a lot of ground (average 4500 graphs)

 

Dr. Carman from CA responded saying the following:

 

The reality is that in general, most patients do not have 5000 natural occurring follicular units available in a single setting, and, if that

many naturally occurring follicular units ARE harvested, the donor strip would be quite large, thus placing the average patient at risk for unsightly scarring

or other complications. My rule of thumb is to obtain the largest number of available follicular grafts (that are needed) without subjecting my patients to unnecessary

risks. As for results, I let those speak for themselves.

 

 

I like Dr. Carman's response, but am not sure if some of that risk is because- simply the surgery is SUPER DUPER long, and that it takes a lot of patience, energy- and a lot of blood loss on our part. It does make me question the dr's skill. If the dr. had some expereince in both worlds (including Mega Sessions) instead of just pushing for less graphs, I would have evidence to believe that after doing both surgeries why he prefers less.

 

However, One post today said Dr. Rahal just did a 7,160 graph sugery (WOW). However, I have noticed that those who do these lateral slit surgeries subject themselves to looking like "crap" for the next 6 months as their scalp is healing very red and inflamed- and the donor scar wraps pretty much around the whole head, which can have an impact on future donor areas.

 

I would love if other dr.'s chimed in on this discussion.

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Laze interestng post.

 

The reality is that in general, most patients do not have 5000 natural occurring follicular units available in a single setting, and, if that

many naturally occurring follicular units ARE harvested, the donor strip would be quite large, thus placing the average patient at risk for unsightly scarring

or other complications. My rule of thumb is to obtain the largest number of available follicular grafts (that are needed) without subjecting my patients to unnecessary

risks. As for results, I let those speak for themselves.

 

 

 

Let say a patient needs 5000 grafts. Do you think that doing two surgery of 2500 grafts would cause less scarring than one of 5000? Without any disrepect towards the two good doctors you have mentioned this is the type of answer you will get from clinics that are unable to to perfrom large sessions. This is my opinion

 

I have noticed that those who do these lateral slit surgeries subject themselves to looking like "crap" for the next 6 months as their scalp is healing very red and inflamed- and the donor scar wraps pretty much around the whole head, which can have an impact on future donor areas.

 

 

 

That have seem 100's of hair transplant patients. A patient that posts regulary on this website recieved 4700 grafts and two days post op he looked amazing. The inflamed is incorrect and so for redness I am not sure. There a gentlemen that recieved 7800 grafts 10 days ago and he has very little red. . I am not sure if redness has more to do with a patients gentics compared to number of grafts.

If you feel its better to do two surgeries of 2500 compared to 5000 once that for everyone to decide for themselves. I think most people rather get it over with within one year rather than have to take time off twice and wait twice the time to have the same results. Also in many cases 2 transplants of 2500 will cost alot more than 5000 once.

Just my opinon.

 

.

Edited by lorenzo

Representative for Hasson & Wong.

 

Dr. Victor Hasson and Dr. Jerry Wong are esteemed members of the Coalition of Independent Hair Restoration Physicians.

 

My opinions are my own and do not necessarily reflect the opinions of Hasson & Wong.

 

My Hair Loss Website - Hair Transplant with Dr. Hasson

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