Dr. Hasson–FUE-3045 grafts-fine hair-4.5 months post-op

[H & W Doug]

This patient was visiting Vancouver again from Mexico to show Dr. Hasson his progress at 4 ? months. He had 3045 grafts via FUE. Breakdown: 870 single hair grafts, 1789 doubles and 386 three and fours.

His two previous FUT surgeries totaling 4,500 grafts from another clinic yielded very little as the pre-op pics indicate. The growth is just now starting to take shape and he will be back again within 6 months to show his result.

 

[n00b]

tough to make a call as the hairs are shorter in the pre op pics but longer in the post op pics. any idea what the thickness of the hairs are?

[mav23100gunther]

Horrific scar, was he stripped out?

[n00b]

Horrific scar, was he stripped out?

 

interesting...

i thought the scars were similar to what H&W produced.

[bunsenburner]

Doug:

 

I must admit: I agree with Noob. It is difficult to determine whether the patient has any new growth from the FUE or if this is his previous transplants simply grown longer.

 

Also, the extraction pattern in the back looks like less than 3,045 punctures. I have studied pictures of donor areas from other clinics after a similar number of grafts were extracted, and the FUE wounds appear closer together and the extraction area appears larger. My experience is admittedly limited, but the donor area looks similar to 1,000 or 2,000 graft cases I have seen submitted online. Is this not the case?

 

Was this patient not eligible for another FUT procedure? Is Dr Hasson not performing as many FUT procedures?

 

I apologize for the questions. I'm considering Dr Hasson for my own FUT procedure, and this presentation appears different from the clinic norm.

[Bald36]

Doug:

 

I must admit: I agree with Noob. It is difficult to determine whether the patient has any new growth from the FUE or if this is his previous transplants simply grown longer.

 

Also, the extraction pattern in the back looks like less than 3,045 punctures. I have studied pictures of donor areas from other clinics after a similar number of grafts were extracted, and the FUE wounds appear closer together and the extraction area appears larger. My experience is admittedly limited, but the donor area looks similar to 1,000 or 2,000 graft cases I have seen submitted online. Is this not the case?

 

Was this patient not eligible for another FUT procedure? Is Dr Hasson not performing as many FUT procedures?

 

I apologize for the questions. I'm considering Dr Hasson for my own FUT procedure, and this presentation appears different from the clinic norm.

 

Good questions. I was impressed to see the hairline of Spider which was the first FUE result they have shown but since his result was posted I thought the other two or three have been weak. Dr. Wong has a good result but I think the hair was too short to show the potential of the surgery.

 

Was this a manual FUE? What was the punch size? Are you doing big cases for NW4 or NW5 patients? Do you have any pictures of his hair longer before surgery?

[trashpanda]

I think that's a very conservative amount of grafts for that level of loss, top that with the fact that some of those existing hairs were probably already miniturized and on their way out anyways, I think we will have to wait another 2 months to see if this patient had an aesthetic improvement from this procedure. He probably needed 2x or more grafts than he received but maybe he was stripped out. Is there pics of the donor?

[gbhscot]

Face says it all really...."$10000 for THIS"!

[H & W Doug]

This presentation is a bit different than the clinic norm. We could have waited for the full result but thought with all the interest in FUE, we would show some early progress on this patient. He is taking a photo a day and will present in a video at some point when the result is fully grown in which I think will also be of interest. And let’s not forget this is only 4.5 months post-op.

 

I’m going to try and address all the questions:

 

I don’t know the exact caliber of the hair shaft but know it was on the fine side.

 

While the scar from the other clinic is not great, I wouldn’t classify it as “horrific”. I would say our average scar is certainly better than this. They probably seem to look worse when the head is shaved.

 

This patient was pretty much stripped out and FUE was his last option. He’s most likely done after this procedure.

 

It may be a little difficult to determine the growth at this stage but I can tell you he does indeed have good early growth from this FUE with Dr. Hasson.

 

It is a correct number of grafts. I think if you were to take a look at the right side post-op shot, you could estimate something in the 1,000 graft range on that side alone. Adding the other side and back I think you can conclude this number is accurate.

 

Dr. Hasson is still performing a high number of FUT procedures but the percentage has slightly decreased as the FUE percentage has increased.

 

I agree Dr. Wong’s result was very good but that patient would benefit from growing his hair out longer. I have indicated that to him so I’m hoping for an update with the hair longer. While I might like to think of myself as a modern day Vidal Sassoon, some patients have their own ideas about hair styles despite my advice :-)

 

It was a manual .85 mm punch.

 

We are doing bigger cases in the 4,000 graft range on stages 5-6.

 

We only have pre-ops with how this patient came to the clinic with short hair. He could not grow it out because he indicated it looked too thin and unnatural.

 

As far as the face, I usually get the patient to smile but I failed to do so this time, my apologizes. I can say he was very pleased to this point and had indicted he was receiving positive comments about the improvement. We’ll look forward to his next visit and if I’m taking the pics I can assure you I’ll have him smile on the updated set of photos!

[ontop]

To be honest after being through the mill 2 times before H&W & then showing what he has upto date I dont think I could smile.

still way to early & H&W is proberly doing there best they can under the circumstances.

 

We should have to wait & see how all this ends up.

[Spanker]

Ouch. Tough crowd. At four months, expectations should be juuuuust on the better side of pre op, but way too early to tell the success or failure of the HT.

 

I feel saying that this guy had a horrific scar is hyperbole.

 

My question about the case is how many grafts do you pull before you start inserting them? I know some extract 1k, insert, 1k, and so on, but it looks like more than 1k on your dish there, so I was curious.

 

This guy has a tough road. Dark fine hair, light skin, poor yield on prior procedure, fairly low hairline for his level of baldness, large area to cover.

 

I see early growth already and I'm looking forward to seeing the follow up. While not every result will be a wow result, what patients bring to the table are much more variable that the skill of top docs. But I am putting a bet on the table that this result will look significantly better at 9 and 12 months.

[ontop]

Tuff crowd yes but way to early to call at this point.

I'm pulling for him to at least get a satisfying result he can move on with his life.

 

Myself would love to know the clinic/s who done this x2 FUT prior Surgery for this poor soul as they are clearly inexperienced.

[Spanker]

Tuff crowd yes but way to early to call at this point.

I'm pulling for him to at least get a satisfying result he can move on with his life.

 

Myself would love to know the clinic/s who done this x2 FUT prior Surgery for this poor soul as they are clearly inexperienced.

 

On the bright side, probably because of his fine hair, it was still natural and not pluggy.

[bunsenburner]

Doug:

 

Thank you for answering my questions. A follow up: has there been any changes in the way Dr Hasson removes the strip in FUT surgeries? Is there any point in the course of a normal day where he would be extracting FUE follicle grafts and taking a FUT strip? Or is it always one or the other?

[Dutchie]

Doug, were the 3,045 FUE grafts taken out in 1 day or over 2 days??

[H & W Doug]

Bunsenburner,

 

I would say there have been changes to Dr. Hasson’s approach to removal of the strip over the years but in the most recent years I believe he has dialed in his technique and not much has changed. The last major change was the switch to the trichophytic closure which was quite a few years ago now.

 

? Is there any point in the course of a normal day where he would be extracting FUE follicle grafts and taking a FUT strip? Or is it always one or the other?

Do you mean on the same patient or 2 different patients?

 

Dutchie,

 

2 days.

[Spidey]

If you look at my four month progress, it's not that much different. The only difference is that this guy had his whole crown more or less re done, where as mine were my corners. The rest of my native hair took away from the focus of my corners which still was pretty whispy.

 

Regarding the number of holes in the donor area and eyeballing the number of grafts, especially when comparing to other surgeons is not accurate. Firstly, you don't know if other cases, the number of donor extractions exceeded the number of grafts actually implanted... If their transection rate was 10%,, then for every 1000 extractions, there would be an additional 100 "holes" in the donor area that led to grafts being thrown out. Unless you count each extraction site, I think it is pretty ignorant to comment and more or less say that HW is over charging/under extracting for their FUE.