Dr Shapiro or Dr Wong.

[TC17]

Emperor,

 

I did not attack you personally so I do not understand why you feel the need to impugn my credibility by implying that I am somehow disingenuous. I merely responded to what I felt was your attempt to offer justification for acts that I do not feel are in the best interests of patients. I'm a second year law student who hopes to practice as a consumer advocate when I graduate, so when I see behavior (graft splitting) that is geared towards benefiting the clinic at the expense of a patient, I feel the need to interject in the discussion.

 

As for my minimal number of posts, that is a result of being a law student and not having the opportunity to post as often as I would like. That being the case, I do read a great many of the topics and have taken some time to educate myself on the doctors as well as the procedures currently available.

 

I believe fully that PGP was trying to convey the message that the community consensus is that H&W are the ONLY doctors to go to for mega sessions, and that belief may not be accurate. We've all heard the same things like "Rahal for hairlines", "Wong for crowns", "Shapiro for hairlines", "Feller for hairlines", "H&W for mega sessions" etc. More information is not a bad thing. Shaking up the status quo is not a bad thing. The only bad thing is limiting the information available to the patients, and your wish to have this post locked would accomplish that goal.

[TheEmperor]

Originally posted by TC17:

Emperor,

 

I did not attack you personally so I do not understand why you feel the need to impugn my credibility by implying that I am somehow disingenuous. I merely responded to what I felt was your attempt to offer justification for acts that I do not feel are in the best interests of patients. I'm a second year law student who hopes to practice as a consumer advocate when I graduate, so when I see behavior (graft splitting) that is geared towards benefiting the clinic at the expense of a patient, I feel the need to interject in the discussion.

 

As for my minimal number of posts, that is a result of being a law student and not having the opportunity to post as often as I would like. That being the case, I do read a great many of the topics and have taken some time to educate myself on the doctors as well as the procedures currently available.

 

I believe fully that PGP was trying to convey the message that the community consensus is that H&W are the ONLY doctors to go to for mega sessions, and that belief may not be accurate. We've all heard the same things like "Rahal for hairlines", "Wong for crowns", "Shapiro for hairlines", "Feller for hairlines", "H&W for mega sessions" etc. More information is not a bad thing. Shaking up the status quo is not a bad thing. The only bad thing is limiting the information available to the patients, and your wish to have this post locked would accomplish that goal.

 

OK, as a lawyer you understand logic. Prove to us that there is any graft splitting going on.

 

 

Then go back and read my previous thread. Read it twice. Then read it again. If you have not had a HT, you will probably not understand it, but hopefully at some point it will click in your mind before you have your first HT. Good luck.

[PLEASE GROW PLEASE]

Before anything I will apologize to Dr Hasson for calling him a playboy . Its actually a compliment but came across as a jab.

 

Proving they split grafts is hard on here if not impossible.

Alot of signs point to it but online its hard.

Everyone of us has 3 hair grafts and alot of us 4s in the donor. Whats the average 2.3 2.4 Something like that.

You cant say these guys were born with all 1s and 2s so thats why there are none.

There are 3 guys on here that have no gain in saying we have not seen guys with 3s and when there was it was a very small amount

 

1 is myself who is basically done in his journey and has nothing to gain but have seen it with my own eyes more then once with the help of delicate software

 

2 is their own patient [FIXING IT] who has said he got no 3s and 4s. and he has nothing to gain by this

 

3 Is the owner of this site who has nothing to gain and said on his visit he saw limited 3s ,if any

 

Now ask yourself if these guys have nothing to gain then who has something to lose Hmmmmmm

 

Is that enough to say with 100% conviction that thet split graft , no but it certainly is extremely suspicious

This has been going around for years but seems to get more credible each time.

Maybe Fixing it was drunk and me and Pat are blind so theres a chance we are all nuts.

 

Whether or not they split grafts isnt an issue unless they have been misleading us all this time .

Maybe on some they do this and on others they dont but I would like to see a handful of pics showing an appropriate amount of 3s and 4s for there patients.

This would not only satisfy me but show they do indeed use 3s on some or most patients

 

Now in that pic Dr Hasson presented I want to make a comment

I find the numbers a bit skewed in the fact that I cant see them going 2.2 all the way around the head. Ive seen countless times in their drawings that they take the widest part right from the dense meaty part of the back and then narrow the strip quite considerably around the sides..

Im no mathematician but those numbers would be quite different then he posted because of this .

Plus I believe the density is much less on the sides then the back.

If Im wrong on this let me know. This would also skew the numbers considerably but you could make up for that by cutting grafts into smaller units

 

Now on those pics Jotronic posted on the other thread either enhance the pics or look closely .

Its clear to me at least that the strip is not 2.2. If you straighten out that bent paper ruler and line it up perfectly from where the hair starts and ends its 2 at the most. You can also see where he measured it in inches its 1 3/4 which I believe is 2 cm .

Yes there is some fat on the one side that might make it a mm wider but I believe that the fat is at the bottom of the strip only because of the slanted cut they made for the tricho.

Like I said my math is bad so correct me if Im wrong.

What does all this mean . Well if you take all of this and think rationally those numbers can not be the same as they claim unless you make up for it one way or another

Once again maybe some dont care but sure raises my eyebrows above my hairline.

I again apologize to a few I offended and want to keep this a healthy debate like Bill has asked.

Please feel free to correct me and give me your reason why Dr Hasson

[fixing-it]

Originally posted by TheEmperor:

Originally posted by TC17:

Emperor,

 

Regarding your above post, it is immaterial whether extra work is required of the techs and doctor when grafts are cut. That does not in any way justify increasing the total cost of a procedure. I am not saying that is done by H&W, but your contention that graft splitting requires additional work and is therefore somehow detrimental to the doctor is ridiculous. With that (unnecessary) extra work the clinic receives a significant dollar figure. As I said earlier, if the doctor chooses to split for aesthetic purposes and does not charge extra for the split grafts, that is fine. But since a great many members of this community are not wealthy enough to throw money away on split grafts, I find it incredulous that you would even attempt to justify a practice that increases the cost to a patient by invoking "additional work and overhead for the clinic".

 

That additional work is within the control of the doctor, as he chooses to split the grafts and thus increase the workload. I for one would prefer to receive less grafts, at less cost and receive the same results as one with more grafts, at a higher cost, but with the same number of hairs. While I personally feel that Dr. Wong does TERRIFIC work, I can not say that his sessions of 7,000 grafts are at all better than Cooley or Shapiro with 4,500 grafts.

 

I wish that all members would remember that this is a patient advocacy forum, and that without absolute transparency and open discussion on all issues, the forum will cease to serve its intended purpose of helping all of us. Without posts like PGP's (which admittedly is slightly combative) all members will begin following a group think mentality and blindly believing whatever the consensus is of the most vocal members and most prominent physicians. Such a result cannot be tolerated.

 

It is as if you did not read my post or do not understand it. I am assuming you are an intelligent adult so this must be an attempt to keep a flame war going, which I will not participate in. I'm out of here.

 

As you only have 21 posts, I suggest you are not a vested member in the community and know a bit more about this subject than your typical 21 post member. I think this must be a smear campaign. Bill, you should lock this thread.

 

Emperor,

What does post #'s have to do with knowledge,Remember Notgoingtogobald,He never even had a procedure but posted an average of 18 posts a day for 5 months[ alot of his posts were useless ]until he was kicked off here.I had previous work done before my latest with H&W and was on here learning for over a year before I finally joined in nov. 2007.

I actually learned alot by reading,not necessarily participating.

So going after TC17 because of low post counts makes you seem ------well I dont know.

[Bill - Seemiller]

Please Grow Please,

 

A couple of points since you're still posting on this thread:

 

1. The width of a strip is always measured while it's still in the scalp. Pre-tumescence, it was determined the average width of the strip of this patient (photos included) was around 2.5cm. During tumescence, it was 3cm. Once the strip was harvested and the tumescence faded, it was measured around 2.2 or 2.3 cm. Know that a strip always shrinks a little after it's been harvested due to the lack of tension that it has while it's still in the scalp. In my opinion, you are really reaching now with your new argument that the strip is less than 2cm.

 

2. Fixing-it is one patient and Pat saw one patient during his visit. We also don't know the basis of the conversation between Fixing-It and the technicians. Perhaps the technicians who told him he only has ones and twos cut only ones and twos, but other technicians working on other areas of the strip found 3s and 4s. The closest we can come to proving this ONE patient had no 3s and 4s, is by asking the clinic for a hair count breakdown. This chart then would contain the data from all the technicians working on his strip, not just a couple of them.

 

3. In a previous post you said you would provide photos showing your high resolution blow-ups showing the patients you sampled have only 1s and 2s. Your words: "I wanted to leave this alone but Lorenzo wouldnt let me and now a bomb has been dropped and if they still want me to put together a collaboration of photos showing this I will." When I asked you to provide the photos, you said you couldn't because they were too large. When I asked you to email them to me privately, you were reluctant.

 

If you're not going to admit these photos as evidence to your conclusion, then they have to be dismissed. Being as familiar with law as you are, I'm sure you understand that if proof can't be provided in court, it's meaningless and the jury has to throw it out. Thus, you can't keep referencing photos that you won't put forth as evidence.

 

I think at this point, it would be beneficial if you admitted publicly that though you have suspicions based on inconclusive evidence that Hasson and Wong cut grafts, that their explanations are plausible and that you could potentially be wrong in your assessment of their work. Let the data present itself over time as hair counts are provided by their clinic moving forward as they promised.

 

Moving forward, they are going to be providing detailed hair counts. Perhaps if they are willing, they will even post additional photos including dissected 3 and 4 haired follicular units and strip sizes that match or even exceed 2.5cm if anyone still has doubts about the one case Joe provided.

 

Best wishes,

 

Bill

[TC17]

Emperor and all other members,

 

I never singled out any doctor or clinic for splitting grafts. Rather, I merely stated my personal belief that such behavior, if being done, is unethical because it artificially increases the cost of the procedure. Don't put words in my mouth.

 

Finally, look what this discussion has achieved for us. H&W will be attaching hair counts to all of their posts from this point forward, thanks in large part to PGP. How is that a bad thing? This thread has created a good thing for all members, and I hope that all of the other doctors rise to the same challenge and begin including hair counts as well.

[Bill - Seemiller]

Finally, look what this discussion has achieved for us. H&W will be attaching hair counts to all of their posts from this point forward, thanks in large part to PGP. How is that a bad thing? This thread has created a good thing for all members, and I hope that all of the other doctors rise to the same challenge and begin including hair counts as well.

 

TC17,

 

Overall, I agree that there have been a lot of constructive input on this thread. Many, but not all physicians provide detailed hair counts. I'm very pleased that Hasson and Wong will now be providing them with their results, thanks in large part due to this community's request for them.

 

Thanks for your input on this thread.

 

Bill

[PLEASE GROW PLEASE]

Im not reaching I said it was 2.

I guess Ill let the members look at what I believe is an unintentional bent paper ruler that is is not measuring exactly as you would to be exact with a ruler .

I love how your not pressuring them to post their pics but me .

How about you post your recent pics for us to see your 3s and 4s You havent shed yet.

That would be the perfect way of showing they used 3s and 4s on you

 

Like I told you on the phone and now your using this against me I just cant post how I found this out like ta da.

Its technology I told you about that is at work or at home using an atlona converter that lets you see your computer images through hdmi.

Im not a computer genius as I had major help learning how to even use this to see let alone somehow post it . Hell I have trouble even typing so I needed all the help I could get but all I can say is I saw what I saw believe it or not.

So yes Bill that is true so Ill leave what I observed out unless someone wants to come here or met me at work and they can report back

I wasnt reluctant its just impossible as I said before that I couldnt see them on my home 22 inch monitor so how could you and also we both were talking like two tweaked crackheads and that got left in the shuffle

 

Now yes your right Pat only sen one patient but Fixing it I believe said two techs told him not one.

 

Maybe what I was looking at was a figment of my imagination.

So based on all the evidence I would say I havent proved they split grafts nor am I trying to and they havent proved they dont.

I do think its a step in the right direction that they now start providing counts.

We can know see with immed post op pics how those grafts were utilized

Like I said on the phone you have your girl take pics or just look at your head and tell us how many 3s and 4s your received. Ill take your word for it even though the clinic your defending happens to be your clinic.

Thats how little I care now but also how much I trust you.

I said this before and this time Im done no matter what If I comment on this subject again please delete my account.

H&W are a top clinic but I have my opinions that Ive posted and will keep inside until proved wrong .

Maybe I am , but maybe Im not ..

[Dewayne]

Originally posted by PLEASE GROW PLEASE:

 

Like I told you on the phone and now your using this against me I just cant post how I found this out like ta da.

Its technology I told you about that is at work or at home using an atlona converter that lets you see your computer images through hdmi.

Im not a computer genius as I had major help learning how to even use this to see let alone somehow post it . Hell I have trouble even typing so I needed all the help I could get but all I can say is I saw what I saw believe it or not.

So yes Bill that is true so Ill leave what I observed out unless someone wants to come here or met me at work and they can report back

I wasnt reluctant its just impossible as I said before that I couldnt see them on my home 22 inch monitor so how could you and also we both were talking like two tweaked crackheads and that got left in the shuffle

 

 

 

Aren't you the one who called me a hillbilly?

[PLEASE GROW PLEASE]

I got a little in me to Deeeeeewayne

[Drew35]

All I know whatever Hasson and Wong are doing I can't wait until they do it on my own head.

 

 

I have seen many Norwood 6s transformed by these 2 fantastic Doctors!

 

 

I believe that splitting 4 hairs is advantageous for a Norwood 6 like myself.

The way Hasson and Wong use lateral slits and insert the hairs in a "shingle" effect makes a Norwood 6's head look THICKER. That's exactly what I want.

 

 

I don't believe their is a difference in hairlines between Shaprio's incision technique and Hasson and Wong's incision techniques, but the difference TO ME is the Norwood 6 patient's hair looks thicker by H&W's techinique.

 

 

Also, Hasson and Wong are more aggressive in, the first session, at filling in recessions and temples.

 

I don't want to wait 2 years to have those areas addressed.

[Bill - Seemiller]

Please Grow Please,

 

I'm not using anything against you. All I'm asking you to do is send me the photos privately and I'll work my magic over here to see if I can see what you're seeing. You can also send them to a few other members if you want to run the same exercise if you don't trust my judgement .

 

One point worth noting: I don't care how large anyone can make a photo. If the photo resolution is only 1200 X 800 (for example), blowing them up on a large screen is going to show a huge blurr beyond what the resolution of the photo can actually portray.

 

Sadly, unless you provide the photos, they're inadmissable.

 

Regarding my hair transplant, I'm still waiting for my hair counts. I will provide them when I get them. And I'll tell you what, if you can tell me how to differentiate the last 2068 grafts from the other 7550, 3800 of which were from two different doctors and capture the kind of close-up detail required to count hairs with a $150 kodac camera, then I'll do this for you . Of course, even so, it would only prove the kind of hair groupings used in my case, not overall. Of course, we could also assume that Hasson and Wong will provide me accurate hair count breakdowns and when I get them, I'll post them .

 

I do believe the burden of proof to provide hair counts and surgical details falls on the clinic. I have not given Hasson and Wong a free pass simply because they're whom I chose for surgery. However, the burden of proof falls on anyone who makes claims that have been challenged. Just as we hold physicians accountable for their claims, so must posters be held accountable for theirs. Hasson and Wong already told me they'll be providing hair counts and photos in the future. What about you?

 

The 2.2 or 2.3 cm measurement from the harvested strip is actually an irrelevant number anyway, since it always shrinks due to the lack of tension on the skin as it would be still attached to the rest of the scalp. Whether you see it as 2.0, 2.2, or 2.3, the fact is, it's wider inside the scalp. Post-tumescence (which makes the area swell), there is a measurement of approximately 3cm. Therefore, I think everyone can safely conclude the width of the actual strip as all clinics would measure it inside the scalp pre-tumescence would be between 2cm (your lowest number) and 3cm (the highest number with tumescence).

 

Even if we shoot for the low side guestimate of 2.3, if we have a 2.3cm wide strip on average X 29cm X 80 true FU/cm2 (the average), we'd get a graft count of 5336 true follicular units, which is very close to the 5404 that were harvested in the example provided.

 

Again, this is one case, but even without hair counts, the math adds up that they did all follicular unit grafting on this patient.

 

I expect as Hasson and Wong begin to provide detailed hair counts for all their future surgeries, we'll get to see the big picture for what it really is.

 

Although I suspect there will always be those who will call clinics doing cutting edge work, liars. There are still those clinics out there that claim ultra refined follicular unit grafting and dense packing is never appropriate and will cause vascular issues and result in poor growth. Yet physicians of the Coalition of Independent Hair Restoration Physicians perform these types of procedures all the time with great success. Kudos to all of them for providing first-rate results to balding men and women like us .

 

Best wishes,

 

Bill

[thanatopsis_awry]

Man, I get bogged down with work and I miss this juicy behemoth of a thread....

 

My instincts have me tending to side with PGP's points of contention. Plus, it's obvious beyond doubt that he is passionate for patients above all else -- and even if he is wrong from time to time, it is good that even some "misplaced passion" forces docs to step it up some and keep on their truthful-toes. Gotta keep it as civil as possible, of course. Anyways, H&Ws results with super-large # cases are totally remarkable by the facts themselves. PGP himself has said as much, and it's not like he's a pitbull out to destroy them -- I think if he was it would be pretty obvious to most of us!

 

Drew makes an interesting theory, and it's something I've previously considered and think might have some real validity. Is splitting actually advantageous, especially on those upper NWs....? If so, H&W's "stats" might get a quasi-artificial boost but one in the same their results get a very pure boost to the benefit of the patient. This is rote speculation; but, I'd love to hear some Dr's/reps' opinions on whether having a disproportionate # of 1s and 2s could theoretically be to a patient's best interest....

 

Pat has famously remarked on hairs vs. grafts with his pizza-pie analogy. Let's take a quintessential H&W case -- say, 5k-6k grafts -- and let's assume that 3s and 4s were indeed reduced and split to inflate the ~5500 grafts number. What would this be comparable to? The result of this hypothetical case, unless I'm mistaken, should be equivocal to a Rahal, SMG, Feller, Cooley, et al. of a lesser graft # where such splitting did not go on, and the actual amount of hair being moved would be roughly if not exactly equal. The results should then stack up rather equitably, no? I have yet to see a grown out ~5500+ graft case from anyone aside from H&W -- if this is in fact a result of some form of splitting on their part, there should nonetheless be cases out there by other clinics (on the larger side still, of course) that should approximate the coverage/density given due to # of hairs being moved while the actual graft tally should be smaller.

 

I don't have any actual cases in mind to fill this "experimentation", but they exist and I'm sure they'd be fairly accessible. Ultimately, with the aforesaid assumptions, if we properly compare a "quintessential H&W" case to a number of other clinics the results given, filtered through their respective # of grafts, should tell us something quite telling.....my brain is fried from work and heavy deadlifts so my logic here might be totally off and the said "experiment" could carry little to no weight.....(?!?)

[TheEmperor]

Let me summarize what I said earlier:

 

The claim is that H&W are "over cutting" their FUs, to make more grafts.

 

My question is how do we know other clinics are not "under cutting" grafts?

 

The surface assumption is that over splitting FUs benefits the doctor and that they have some ulterior motive in over splitting grafts.

 

I contend that there are advantages for the doctor to "under cut" grafts. Lets say they get a patient with good laxity and take a strip on the larger side for them. Then they examing the tissue and see many closely spaced doubles and singles.

 

The technicians could be trained to routinely split these down to individual 1s and 2s, or they could be trained to keep them together. If they are cut down to smaller grafts, then that means a 14 hour surgery, which the clinic may not be prepared, probably is not prepared to handle on a routine basis.

 

So I would argue that there is AT LEAST as much incentive for clinics to undercut. The limiting factor, ultimately, is how long the team wants to stay into the night planting grafts.

 

Then I ask, what is best for the patient? We all know that grafts are compressed when they heal, so I believe that erring on the smaller, less detectable side will be better for the patient. Raising the costs 10% and extending the surgery 2 hours is for the patients benefit.

 

Can we really accuse H&W of being greedy, given their fee structure? Look at guys like Rassman, charging $10/graft.

 

I contend they are doing what they believe to be best for the majority of patients. Say they get a coarse haired individual in there, and the techs are trained to keep borderline large grafts (could be one graft, could be two) "in tact". WOuld this be risking some plugginess? Wouldnt is just be best to err on the side of caution and routinely cut grafts small?

 

So here is my HTN saying:

 

"Good results are good results. Pizza has nothing to do with it."

[Drew35]

Originally posted by TheEmperor:

Let me summarize what I said earlier:

 

The claim is that H&W are "over cutting" their FUs, to make more grafts.

 

My question is how do we know other clinics are not "under cutting" grafts?

 

The surface assumption is that over splitting FUs benefits the doctor and that they have some ulterior motive in over splitting grafts.

 

I contend that there are advantages for the doctor to "under cut" grafts. Lets say they get a patient with good laxity and take a strip on the larger side for them. Then they examing the tissue and see many closely spaced doubles and singles.

 

The technicians could be trained to routinely split these down to individual 1s and 2s, or they could be trained to keep them together. If they are cut down to smaller grafts, then that means a 14 hour surgery, which the clinic may not be prepared, probably is not prepared to handle on a routine basis.

 

So I would argue that there is AT LEAST as much incentive for clinics to undercut. The limiting factor, ultimately, is how long the team wants to stay into the night planting grafts.

 

Then I ask, what is best for the patient? We all know that grafts are compressed when they heal, so I believe that erring on the smaller, less detectable side will be better for the patient. Raising the costs 10% and extending the surgery 2 hours is for the patients benefit.

 

Can we really accuse H&W of being greedy, given their fee structure? Look at guys like Rassman, charging $10/graft.

 

I contend they are doing what they believe to be best for the majority of patients. Say they get a coarse haired individual in there, and the techs are trained to keep borderline large grafts (could be one graft, could be two) "in tact". WOuld this be risking some plugginess? Wouldnt is just be best to err on the side of caution and routinely cut grafts small?

 

So here is my HTN saying:

 

"Good results are good results. Pizza has nothing to do with it."

 

 

Fantastic post!

 

 

I will specifically request that Dr Wong split my 4 hairs.

 

I believe this is the way to go for a Norwood 6 like myself.

 

I have heard many hair transplant Doctors do not like to work past 5:00pm, but it has been documented that Hasson and Wong have put in a 12, 14, 16 hour day on there mega-session patients!

 

I read where one mega-session patient of Dr Hassons was worked on until Midnight! How in the heck is cutting grafts trying to take advantage of a patient when Hasson and Wong are putting in such long hours?

 

Hasson and Wong could cut less grafts and make just as much money with less hours by charging more per graft.

 

It's obvioulsy about pride and the results to these guys!

 

I haven't heard of any other clinic being willing to work such LONG hours.

 

 

I am going to specifically request that Dr Wong NOT do a hair count and rather have his technicians FOCUS on doing there jobs cutting the grafts properly.

 

The more grafts the better. Especially with Hasson and Wong's lateral slit techinique!

 

 

The results speak for themselves and in my opinion this hair count argument is irrelevant.

 

Just give me the results baby!

[lost my swagger]

I am going to specifically request that Dr Wong NOT do a hair count and rather have his technicians FOCUS on doing there jobs cutting the grafts properly.

 

The more grafts the better. Especially with Hasson and Wong's lateral slit techinique!

 

 

The results speak for themselves and in my opinion this hair count argument is irrelevant.

 

no not really. its not the more grafts the better all the time.. you can request whatever you would like though its your money....but its all about hairs man. HAIRS... 6000 hairs is 6000hairs PERIOD.. however if you take my 4 hair FUs and start splitting them up ALL THATS HAPPENING IS IM PAYING YOU MORE MONEY!!! how is this hard to understand??

 

what H&W has is a track record of VERY nice results AND NOBODY IS DISPUTING THAT NOT EVEN PGP WHO SOME OF YOU WANT TO MAKE THE VILLIAN. and while the results are what matters.. if a SMART person looks at this from a FINACIAL stand point, i dont care how great the clinic results are if they are splitting grafts unnessarily then they are RIPPING YOU OFF IMO.

 

just think if you can turn 3600FUs into 4000FUs.... now after you have done that a few hundered times on many many patients we are takin ALOT OF EXTRA CASH IN THAT CLINICS POCKET... its smart from a business standpoint... but a regular patient defending that practice?? eh, knock yourself out i guess.

 

if you ask me its not very ethical way to run ones practice

 

just give me my grafts as the grow NATURALLY...baby!

[Drew35]

Originally posted by lost my swagger:

 

no not really. its not the more grafts the better all the time.. you can request whatever you would like though its your money....but its all about hairs man. HAIRS... 6000 hairs is 6000hairs PERIOD.. however if you take my 4 hair FUs and start splitting them up ALL THATS HAPPENING IS IM PAYING YOU MORE MONEY!!! how is this hard to understand??

 

what H&W has is a track record of VERY nice results AND NOBODY IS DISPUTING THAT NOT EVEN PGP WHO SOME OF YOU WANT TO MAKE THE VILLIAN. and while the results are what matters.. if a SMART person looks at this from a FINACIAL stand point, i dont care how great the clinic results are if they are splitting grafts unnessarily then they are RIPPING YOU OFF IMO.

 

just think if you can turn 3600FUs into 4000.... now after you have done that a few hundered times on many many patients we are takin ALOT OF EXTRA CASH IN THAT CLINICS POCKET... its smart from a business standpoint... but a regular patient defending that practice?? eh, knock yourself out i guess.

 

if you ask me its not very ethical way to run ones practice

 

just give me my grafts as the grow NATURALLY...baby!

 

 

 

If you are comparing clinics that use the same slit techniques I agree about the hairs, but I believe the lateral slit technique seperates Hasson and Wong.

 

I respectfully disagree with you about "not splitting hairs" when using the LATERAL slit technique. Especially on a Norwood 5,6,7. The lateral slits give a "shingle" effect to the hair, which makes it look thicker. To ME.

 

 

You are entitled to your opinion, but to me a Norwood 6 patient's hair looks thicker at Hasson and Wong. I believe that is due to the lateral slit technique they use.

 

 

This is just my own observation from the photos and research I have done.

 

Dr Shapiro does a fantastic hairline, but for a Norwood 6, I believe Hasson and Wong are the best way to go if you want the illusion of thicker hair with their lateral slit technique.

[fixing-it]

Originally posted by Bill - Associate Publisher:

Please Grow Please,

 

A couple of points since you're still posting on this thread:

 

1. The width of a strip is always measured while it's still in the scalp. Pre-tumescence, it was determined the average width of the strip of this patient (photos included) was around 2.5cm. During tumescence, it was 3cm. Once the strip was harvested and the tumescence faded, it was measured around 2.2 or 2.3 cm. Know that a strip always shrinks a little after it's been harvested due to the lack of tension that it has while it's still in the scalp. In my opinion, you are really reaching now with your new argument that the strip is less than 2cm.

 

2. Fixing-it is one patient and Pat saw one patient during his visit. We also don't know the basis of the conversation between Fixing-It and the technicians. Perhaps the technicians who told him he only has ones and twos cut only ones and twos, but other technicians working on other areas of the strip found 3s and 4s. The closest we can come to proving this ONE patient had no 3s and 4s, is by asking the clinic for a hair count breakdown. This chart then would contain the data from all the technicians working on his strip, not just a couple of them.

 

3. In a previous post you said you would provide photos showing your high resolution blow-ups showing the patients you sampled have only 1s and 2s. Your words: "I wanted to leave this alone but Lorenzo wouldnt let me and now a bomb has been dropped and if they still want me to put together a collaboration of photos showing this I will." When I asked you to provide the photos, you said you couldn't because they were too large. When I asked you to email them to me privately, you were reluctant.

 

If you're not going to admit these photos as evidence to your conclusion, then they have to be dismissed. Being as familiar with law as you are, I'm sure you understand that if proof can't be provided in court, it's meaningless and the jury has to throw it out. Thus, you can't keep referencing photos that you won't put forth as evidence.

 

I think at this point, it would be beneficial if you admitted publicly that though you have suspicions based on inconclusive evidence that Hasson and Wong cut grafts, that their explanations are plausible and that you could potentially be wrong in your assessment of their work. Let the data present itself over time as hair counts are provided by their clinic moving forward as they promised.

 

Moving forward, they are going to be providing detailed hair counts. Perhaps if they are willing, they will even post additional photos including dissected 3 and 4 haired follicular units and strip sizes that match or even exceed 2.5cm if anyone still has doubts about the one case Joe provided.

 

Best wishes,

 

Bill

 

Bill,

Being that I had a small to medium size procedure and was only there for about 6 hours I only had 2 techs that were dissecting the strip into grafts and 2 other techs implanting the grafts.When I asked about a hair count breakdown I was told 1's and 2's and when asked about 3's & 4's was then told what I have already posted.

Seriously Bill,Do you really believe they have certain Tech's only dissecting 1 hair & 2 hair groupings and different Tech's doing the 3's & 4's ?That would mean a tech would have dissect a couple then hand the piece of flesh to a different tech and back and forth.I dont think so and you know better.

Bill,with you being a very conscious/awesome/fair moderator here and giving so much valuable input over the years why have you seemingly not wanted your own hair count breakdown chart for your last 2 HT's?Or better yet demanded it knowing this has been a HOT TOPIC for a couple of years now.

The only sheet I saw, only showed the total graft count I was to pay for and no hair count chart.If anybody needs more info go back and read my last couple of posts again until you understand.

Bill please answer the Question I posed for you,Thanks.

[fixing-it]

Oh and by the way,PGP and Lost My Swagger really do get it!!!

[Bill - Seemiller]

Fixing-It,

 

In no way am I suggesting that they have specific techs cutting particular hair groupings. All I'm suggesting is that it's possible that the two technicians who said you had no 3s and 4s didn't have any in their section of the strip. I'm not even suggesting that this is the case - only that it's a possibility that may have been overlooked.

 

And for someone so animate about me answering their questions, you have yet to answer mine .

 

1. Did you ask the clinic to provide you with hair counts? They do provide them upon request, though at the time, they didn't separate the 3s and 4s, so they would be seen as "multis" or "bigs".

 

2. If you are certain there were no 3 and 4 hair grafts, why not ask Hasson and Wong why another recommended doctor is providing you with contradictory information?

 

3. Also, did you see another doctor before or after you had surgery with Hasson and Wong? If after, why?

 

Now to answer your question:

 

"With you being a very conscious/awesome/fair moderator here and giving so much valuable input over the years why have you seemingly not wanted your own hair count breakdown chart for your last 2 HT's? Or better yet demanded it knowing this has been a HOT TOPIC for a couple of years now."

 

It's not that I don't want them. I've asked for them for surgery 2, 3, and 4, and they were provided to me by Dr. True for my second surgery and Dr. Hasson for my third surgery. I just never got around to posting them and didn't get them yet for my 4th one. Frankly, I'd probalby have to email each doctor and ask for them again.

 

Why you may ask? Because though I am the Associate Publisher and moderator of this community and want very much for clinics to answer the call of the community, as a patient individual, I'm not as up in arms about it as others are. Therefore, though I'm a firm believer that hair count information is helpful, I was more concerned with what I was seeing in the mirror. Once again, I thought about it enough to ask for and obtain the information - but I never got around to posting it and now would have to email each doctor to obtain it. Perhaps I will at some point.

 

Once I obtain the hair count information from my last surgery, I'll post it on my own thread - not this one.

 

Bill

[Dr. Jerry Wong]

I've been recording not only graft counts but the actual break downs in terms of 1 hair 2 hair and larger (3-4) hair grafts for years and it is in every patient's chart. Anyone who's had surgery with me in the last 12 to 15 years have this information recorded in the OR chart and these are available on patient's request. Very few patients are interested enough to even request this information so it's very surprising that there is so much third party interest.

Over the years H&W pioneered the technology to safely transplant sessions of 5000+ grafts and have shared this information at the annual ISHRS meetings. Even with the information provided the surgical and team skill required to safely do a 5000 graft case not only takes years to develope but the team itself has to be willing to put in the long hours to do a surgery of this size. That may be the reason that there is only a handful of clinics that are capable of doing a 5000 graft session. As far as I'm aware the latest member of the 6000 graft clinic is Dr Tykocinski from Brazil.

For the non believers a video presentation of the technique I use to harvest wide (2cm+) strips was presented at the last ISHRS meeting. In order to safely remove a wide strip the surgeon has to have the ability to examine the scalp and determine the maximum that can be harvested at any spot. This skill takes time and experience to develope but is essential when maximizing donor harvest. Some surgeons do not want to work on the edge but would rather take a smaller strip and stay within their comfort zone. Any clinic that are grafting in the 3000 graft range are generaly moving sufficient hair to make a cosmetic difference and if that is their comfort zone that's OK. To argue that they are moving the same amount of hair as our 5000 graft cases needs to be backed by photographic evidence. I would love dissect our strips into 3000 grafts and finish 3 to 4 hours earlier but not many people want mini grafts these days.

After many years and thousands of 5000+ grafts in advanced (NW6) cases I'm totally convinced that if the donor laxity allows that 5000 to 6000 grafts in the first surgery is the way to go. In this way the front and top 2/3 to 3/4 will be covered after the first surgery leaving the crown and temples for the second surgery. The argument that other clinics are moving the same number of hair in their 3000 to 4000 graft cases as our 5000 to 6000 graft cases can be easily solved. Let line the pictures up and see if there's a difference in the density and coverage. I know that there are individual variation but if we put enough of them together we should get a pretty good idea of what the differences are.

J Wong

[Gorpy]

Hey PGP. Good to see you going strong. You're a good man with good points.

[PLEASE GROW PLEASE]

Hey Bill I know I said I wouldnt repond anymore on this subject but why are Lorenzos posts gone.

It makes it seem like Im talking to myself .

I know you cleaned up some of the harsh things I said but was curious why his posts are gone.

I loved reading how there translator wanted to get it on like the Thrilla in Manila

[generic1]

The removal of Lorenzo's posts detracts nothing from the comprehension of the thread.

[PLEASE GROW PLEASE]

Yes your right about 90% of it removed had nothing to do with understanding the thread but his first post was about their philosophy and a few other things that got this thread going.

That should have been left but after thinking about it Bill didnt remove them Lorenzo did so I suppose thats on him