Dr. Hasson/6570 Grafts/ 2 Sessions

[Jotronic]

This case is a bit more mild than what one usually sees out of our clinic. This patient first came to see us in 2009. He wanted his hairline slightly lowered in the corners and the front of his scalp thickened. 4298 grafts were used in one procedure to accomplish his goals.

 

Ten months later he came back in and had a second procedure to rebuild his temple points, just slightly lower the hairline a bit more, and to thicken the crown. 2272 grafts were used to accomplish his goals.

 

The result seen is 2.5 years post-op and I have put together a series of photos showing each stage of his progression. In each photo set the top left image is before any surgery and the top right image is ten months after. The bottom left image is the second procedure 3 days post-op and the bottom right is the final result as of last month.

 

This case represents just another example of how the lateral slit technique, when performed properly with custom cut flat blades, allows for a large number of grafts to be safely placed in between existing native hairs thus avoiding permanent shock loss.

 

 

 

 

 

 

 

[Dutch]

Mild? True

That's a nice result.

Would like to see more cases being presented on here Joe, I'm just being greedy & keep wanting to see more of them. I hope one day I can end up with a similar result

[Jotronic]

More are coming, Dutch. A lot more:)

[NEWHAIRPLEASE]

Nice result!!

[mahhong]

Fantastic result Joe!

 

Out of interest are you able to tell us the age of the patient and whether he is on any medical regime or not? I'm curious because I have very similar hairloss to this but have been unable to tolerate finasteride unfortunately.

 

Also, another question related to this patient (who I am using as a sort of test case for myself based on his photos!). There seems to be a relatively clear differentiation between the visually obvious miniaturized and non-miniaturized zones. Do you anticipate potential further loss in the non-miniaturized areas or do you think it's safe to say his relatively high back and sides native hair will remain as they are with or without medication? I know nothing is certain in this world but I figured the doctor would have a good inkling based on his history and physiology.

 

Hope this wasn't too many questions and thanks again for showing this case; great work!

[hdude46]

The temple points are one of the most ignored parts of a HT but are the one thing that can really tie everything together. Another great result from H&W.

[chrisdav]

Great result.

[orlhair1]

Another great result from H&W.....nice!

[bonkerstonker]

Looks great. One question though does he have product in his hair for the result photos? The reason I ask is his hair looks really healthy and neat and I'm wondering if that's just from the quality of his new thicker hairs.

[Jotronic]

Bonkerstonker,

 

He does have some sort of product in his hair as that is the only way I imagine he could style his hair like that but the stronger appearance of his hair is due mainly to the fact that they are healthy terminal hairs.

Edited April 29, 2012 by Jotronic

[aaron1234]

Wow! It certainly looks like a darker brown to me. But miniaturized hair can lose a bit of its pigment I suppose.

 

Successful transplant #4,568,394 by Dr. Hasson! I love the crown & temple work.

[bonkerstonker]

Yes it weird how the colour of the hair changes when it gets thicker that's the first thing I noticed with my ht it just seemed healthier and darker.

[jclenz30]

Fantastic result Joe!

 

Out of interest are you able to tell us the age of the patient and whether he is on any medical regime or not? I'm curious because I have very similar hairloss to this but have been unable to tolerate finasteride unfortunately.

 

Also, another question related to this patient (who I am using as a sort of test case for myself based on his photos!). There seems to be a relatively clear differentiation between the visually obvious miniaturized and non-miniaturized zones. Do you anticipate potential further loss in the non-miniaturized areas or do you think it's safe to say his relatively high back and sides native hair will remain as they are with or without medication? I know nothing is certain in this world but I figured the doctor would have a good inkling based on his history and physiology.

 

Hope this wasn't too many questions and thanks again for showing this case; great work!

 

 

Great questions! I'm bumping this to see if Joe has this info available.

[irishsailor]

Great result Joe, love the temple points. You can definately tell the docs class when it comes to the temple points :cool:

[Jotronic]

Fantastic result Joe!

 

Out of interest are you able to tell us the age of the patient and whether he is on any medical regime or not? I'm curious because I have very similar hairloss to this but have been unable to tolerate finasteride unfortunately.

 

Also, another question related to this patient (who I am using as a sort of test case for myself based on his photos!). There seems to be a relatively clear differentiation between the visually obvious miniaturized and non-miniaturized zones. Do you anticipate potential further loss in the non-miniaturized areas or do you think it's safe to say his relatively high back and sides native hair will remain as they are with or without medication? I know nothing is certain in this world but I figured the doctor would have a good inkling based on his history and physiology.

 

Hope this wasn't too many questions and thanks again for showing this case; great work!

 

 

I believe the patient is about 30 or 31. He is on meds and was for about a year before his procedure. If you have loss similar to the loss that this patient had but no meds are being taken then you may have a similar result but it will be temporary as the native hair will continue to fall out and the hair transplant will be all that remains. This does not necessarily mean that you'll look unnatural or even weird, just thin again as time and hair loss progresses.

 

The degree of further loss into the sides, thereby expanding the area of miniaturization into the areas of stronger terminal hairs, is not expected to continue and if it does it will most likely be minimal with continued use of finasteride. The family history also indicates a NW5A pattern that would have been inevitable without finasteride.

 

I hope this helps but if you have more questions do let me know.

[formertrackstar]

Joetronic,

Wow.. You guys do awesome work.. I always love seeing Dr . Hasson's and Dr. Wong's before/after results..

[Plausibleboss]

This case is a bit more mild than what one usually sees out of our clinic. This patient first came to see us in 2009. He wanted his hairline slightly lowered in the corners and the front of his scalp thickened. 4298 grafts were used in one procedure to accomplish his goals.

 

Ten months later he came back in and had a second procedure to rebuild his temple points, just slightly lower the hairline a bit more, and to thicken the crown. 2272 grafts were used to accomplish his goals.

 

The result seen is 2.5 years post-op and I have put together a series of photos showing each stage of his progression. In each photo set the top left image is before any surgery and the top right image is ten months after. The bottom left image is the second procedure 3 days post-op and the bottom right is the final result as of last month.

 

This case represents just another example of how the lateral slit technique, when performed properly with custom cut flat blades, allows for a large number of grafts to be safely placed in between existing native hairs thus avoiding permanent shock loss.

 

 

 

 

 

 

 

 

Outlanding result by Dr Hasson. He's an artist. Nobody can come close to even 50% of achieving such a great result.

I wish you guys were doing FUE too.

[mahhong]

I believe the patient is about 30 or 31. He is on meds and was for about a year before his procedure. If you have loss similar to the loss that this patient had but no meds are being taken then you may have a similar result but it will be temporary as the native hair will continue to fall out and the hair transplant will be all that remains. This does not necessarily mean that you'll look unnatural or even weird, just thin again as time and hair loss progresses.

 

The degree of further loss into the sides, thereby expanding the area of miniaturization into the areas of stronger terminal hairs, is not expected to continue and if it does it will most likely be minimal with continued use of finasteride. The family history also indicates a NW5A pattern that would have been inevitable without finasteride.

 

I hope this helps but if you have more questions do let me know.

 

Thanks for your reply Joe, very useful!

 

In regards to the continued thinning of hair without finasteride, would a second (and possibly further) procedures go some way towards offsetting this problem? I know so much is dependent on your physiology and available donor, but I'm assuming if you were able to get around 6,000 grafts in one session a second session of 2-3,000 grafts would be a relatively plausible proposition?

 

This patients results are truly stellar! To be honest I'd be happy with more modest results as these look phenomenal. It's interesting to find people who seem, at least, to be dealing with relatively similar hairloss patterns. I'm of a similar age (a year or two younger perhaps) but I'd say my hairloss looked similar to his; perhaps not quite as pronounced in the thinning zone yet but well on the way. There is a range of hairloss history in our family; certainly one pretty severe NW6 into 7, someone who borders 5/6 and someone who is probably more 4 - it's hard to figure out where mine might be heading! At the moment though it seems I have fairly high non-miniaturized borders on the back and sides, so perhaps somewhere around that NW5 mark.

 

Anyway thanks for all the thoughts on this!

[Jotronic]

In regards to the continued thinning of hair without finasteride, would a second (and possibly further) procedures go some way towards offsetting this problem? I know so much is dependent on your physiology and available donor, but I'm assuming if you were able to get around 6,000 grafts in one session a second session of 2-3,000 grafts would be a relatively plausible proposition?

 

It would go some ways towards offsetting the problem, yes. However, most patients cannot get 6000 in one procedure so this is a set back in your approach as it may mean that three surgeries would be necessary instead of two. The way I look at it, and what I always tell patients, is that you won't ever be able to regain fully what you've lost and once the hair is gone it will never be the same again; not completely. I know you understand this but it cannot be stressed enough in the interest of maintaining proper expectations. That said, aggressive loss patients do have hope as long as they don't expect the moon. If they do then they'll wind up with a lump of coal.

 

This patients results are truly stellar! To be honest I'd be happy with more modest results as these look phenomenal. It's interesting to find people who seem, at least, to be dealing with relatively similar hairloss patterns. I'm of a similar age (a year or two younger perhaps) but I'd say my hairloss looked similar to his; perhaps not quite as pronounced in the thinning zone yet but well on the way. There is a range of hairloss history in our family; certainly one pretty severe NW6 into 7, someone who borders 5/6 and someone who is probably more 4 - it's hard to figure out where mine might be heading! At the moment though it seems I have fairly high non-miniaturized borders on the back and sides, so perhaps somewhere around that NW5 mark.

 

It sounds like you have a muddied family history. Which side is the loss more severe on? Which side of the family do you resemble most or do you have a somewhat equal mix of physical characteristics? I have a theory that the more you look like one side of the family the more you will follow the hair loss common to that side of the family. My own family is a great representation of this. My baby brother looks more like my mother's side of the family and there is no aggressive hair loss to speak of. The worst I've seen on my Mother's side of the family is a NW3A and my baby brother follows the same pattern and he is 36 years old. I resemble my Father's side of the family more so by this you can guess that there is much more severe loss to see here.

[mahhong]

It would go some ways towards offsetting the problem, yes. However, most patients cannot get 6000 in one procedure so this is a set back in your approach as it may mean that three surgeries would be necessary instead of two. The way I look at it, and what I always tell patients, is that you won't ever be able to regain fully what you've lost and once the hair is gone it will never be the same again; not completely. I know you understand this but it cannot be stressed enough in the interest of maintaining proper expectations. That said, aggressive loss patients do have hope as long as they don't expect the moon. If they do then they'll wind up with a lump of coal.

 

 

 

It sounds like you have a muddied family history. Which side is the loss more severe on? Which side of the family do you resemble most or do you have a somewhat equal mix of physical characteristics? I have a theory that the more you look like one side of the family the more you will follow the hair loss common to that side of the family. My own family is a great representation of this. My baby brother looks more like my mother's side of the family and there is no aggressive hair loss to speak of. The worst I've seen on my Mother's side of the family is a NW3A and my baby brother follows the same pattern and he is 36 years old. I resemble my Father's side of the family more so by this you can guess that there is much more severe loss to see here.

 

Your observations about family history are really interesting. My maternal grandfather was the NW6/7. I haven't that many photos of him but I found a few of him aged about 26-27 and whilst he still has a head of hair (at least based on the angle of the images), it's clear it's in recession pretty deeply around the temples (not the corner of the hairline, the actual temples).

 

My grandfather on my father's side has relatively minimal hairloss, although he did (maybe still does) take oral minoxidil for his heart - I have no idea what if any benefit this may give him. I'd put him in the NW4 category. His hair is thinner all over the top of the head but he still has decent density apart from a relatively small bald crown and a bit of recession, with a strong back and sides still, into his 70s. His son (my father) has more pronounced hairloss which is pretty much NW5.

 

The two family lines probably couldn't be more different genetically speaking. My maternal grandfather was small (5'4 maybe) and very thin all his life, no matter what he ate or did. His frame was very slender indeed and his features quite pronounced; relatively big, pointed nose and ears etc.

 

My father's side are stocky, bulky men, prone to put weight on easier and much broader physically.

 

Interestingly I have a brother and we sound very much like you. I'm the stocky, slightly bigger one and he's a good 3-4 inches shorter than me and naturally slender no matter what he eats virtually. I definitely take more after my father's side!

 

We're both losing our hair and I've been trying to monitor it a little bit to see how we differ through the process! My hairloss is starting to get pretty noticeable now but it seems (hopefully) relatively confined to a thin(ish) strip at the top of my head. It's definitely thinnest at the crown and hairline though I'm resigned that the whole top is on its way out, but my back and sides seem relatively high and had appeared to stay that way over the last 3-4 years, whilst the balding area has thinned pretty considerably (I can literally feel the margin where the hair becomes much bulkier and thicker when I run my hand through my hair). My brother (who is a couple of years younger) had much earlier and more pronounced thinning in his crown but his mid-scalp and hairline have held up longer, although it's clear they are thinning too. His "pattern" does seem to be more extensive than mine, though, with the hairloss seeming to extend further down the back and sides of his head.

 

I probably will give finasteride another trial though I am fairly confident it won't pan out, so I'm trying to think about realistic hair restoration plans that don't include finasteride. That obviously limits the sort of density you can hope to achieve and makes planning a bit trickier, but it seems (at least to me) doctors are becoming more knowledgeable and understanding of what to look out for and how to identify and monitor patterns of hairloss. So I'm hopeful there might be a plan that will work and restore a good head of hair, though obviously not the head I once had! To be honest as long as it was a relative improvement on where I am now (without concealer) I'd be very happy; I'm still managing to just about hide the worst of it with a bit of concealer though it's becoming pretty clear around the hairline and crown now!

 

Anyway thanks again for all your insight Joe, and congratulations on yet another superb procedure!

[Jotronic]

Mahhong,

 

You said something that triggered a memory. My father also took oral minoxidil for years. I mean to say decades for blood pressure issues and when he quite taking it he lost A FREAKING LOT of hair. He went from about a NWIIIV or NWIV to about a 6.5 or 7 in a matter of a few years. His subsequent heart issues and flip flop medical regimen (cardiac meds) may have had something to do with it but I think the stopping of oral minox was the biggest blow to his hair.

 

From what I read about your history you appear to have the deck stacked against you so I do recommend that you proceed cautiously but I think you already know this. At the very least you will lose the top, maybe in the pattern of a 5A (keeping your crown mainly intact) and hopefully the sides won't degrade too much. If the demarcation from the thin hair to the strong hair seems broad with a wide transition then this might not be good. I believe a stronger demarcation of miniaturized hairs to terminal hairs helps to give a glimpse into where the loss will slow or stop.

 

Anyway, continue readying, watching, asking and you'll make the right decision I'm sure.

[Spanker]

I have one side of my family that is all pretty bald, and one side that isn't. That makes it difficult to gauge hairloss for me. Most of my family on the bald side were bald before they were my age. Like in their mid-20s. My dad held on to his a little longer, but was noticeably balding by my age.

 

For someone like me, family history is not that good of an indicator IMO. But I guess is you start to go bald in your 30's, you will end up pretty bald if you live long enough.

[mahhong]

Spanker - I agree, it is tough! Nobody can truly know, not with all the indicators and prognostics in the world. I've seen men start going bald in their late 30s and by their 50s they're NW5/6 and men start going bald at 25 and by 40 they're only NW3/4. It's a cruel thing because you may dodge the bullet or you may not.

 

Joe - That's interesting about your father as well. I'll have to find out if my grandfather is still on the minoxidil but he has a lot more hair than my dad does, although their "pattern" is relatively similar.

 

I'm hoping I'll be something around a 5A. I say "hoping" because I don't realistically see it being any better than that, but of course it has the chance to be worse! My back and sides have seemed to remain stable the last 3-4 years though, whilst the top of my head has thinned pretty noticeably. The current demarcation between miniaturized and non-miniaturized hair seems pretty stark at the moment though, so I'm hoping that remains relatively stable in the future. I think if I'm lucky enough to keep it that way my chances of a decent restoration would be good with a good doctor. It's too early to tell though, so it's a case of watching, waiting and planning!

[aim4hair]

Amazing result.. But looking at the patient pre op pic and the high number of grafts he received, i think it was not very challenging to achieve such result.

 

How many more grafts he can use for future HTs (if needed) ?