Dr. Hasson, FUT, 11/3/2016, 5599 grafts, Norwood 6

[Haircharity34]

I am a Norwood 6. I started to lose my hair in my late teens and have been more or less bald since my mid twenties. I waffled a bit over the years considering hair transplant surgery, but finally decided to give it a go, even if that meant debt. I researched many of the top doctors and decided to go with Hasson & Wong. I'm a big HW fan, especially because of their stellar megasessions.

 

I flew into Vancouver (great airport) and met Dr. Hasson the afternoon prior to the surgery date. I liked him immediately. He's intelligent, articulate, confident, professional, and tells you like it is. I like to say "he speaks as one having authority, not like the Pharisees and Sadducees." During the consultation, we discussed the game plan for the following morning -- to knock it out of the park with a single megasession, i.e. harvest as many grafts as possible and find a happy medium in terms of density and coverage. Dr. Hasson has a wonderful team, including Doug, Mike, Christina, Nico, and the technicians -- experienced, focused, personable. I was in good hands.

 

 

SURGERY

 

The next morning we worked on the hairline. I was happy with Dr. Hasson's design and we moved forward with the FUT strip. The cutting and stapling weren't terribly painful, but it was (as Dr. Hasson remarked) a "marathon," lasting almost 2 hours. The graft count was 5599. A bit later, Dr. Hasson made around 3400 incisions on the top of my scalp (I was given a counter), and then the technicians began the implantation. A couple of hours later, Dr. Hasson came in and made another 1400 incisions, for a total of 4800 or so (many of my single grafts were doubled up, 5599 grafts > 4800 incisions). I was a little disappointed that there were so many singles and so few multiples in my graft breakdown, but Dr. Hasson managed to cover around two-thirds of my scalp, which I was happy with considering we had a lot of ground to cover.

 

The technicians were very patient with me in spite of my neck pain (disc herniation) and we finished up the surgery around 10pm. I only slept for 3-4 hours that night due to donor site pain and nausea. I also had significant bleeding from the donor area -- particularly the sides -- that night; grateful for those pillow covers. I went in for a cleaning the next afternoon. I spent one more night in Vancouver and flew home early the next morning.

 

 

RECOVERY: FIRST TWO WEEKS

 

The first 8-9 days of recovery were brutal, and that's coming from someone with an unusually high pain tolerance. I had moderate to severe pain along the sides of the donor area, which were covered in thick black scabs (dried blood) for the first 12 days. I also had moderate pain at the very top of my crown. I slept sitting up for the first week. I babied my scalp 24/7. I was unrecognizable from Day 3 to Day 5 due to facial swelling.

 

I had lots of crusting and cracking on the scalp Day 5 through Day 11. The crusts and scabs came off the recipient area on Day 11 after I soaked my head in warm water for 10 minutes. I expect they would've gone away earlier if I hadn't been so careful in the shower. I managed to get the scabs off the donor area by Day 14 after generous doses of Vitamin E oil and vigorous washing. The staples came off on Day 15. The staple extraction was extremely painful around the sides, but I powered through it as I had received the green light from the clinic.

 

The implanted hairs began to fall out on Day 15. It's Day 25 now and I estimate I've lost maybe 33% of them.

 

 

DONOR SCAR

 

As mentioned, there was an unusual amount of trauma at the donor site above the ears, particularly on the right side. It makes sense considering that I had considerably less elasticity around the sides than I did at the back. Lots of shockloss.

 

I'm trying to keep an open mind with regard to the scarring, but I have to confess that the size of the hairless patch is a little disheartening. My hair is around 2.5 inches long around the sides but the scar is still painfully obvious, even as we're approaching one month post-op. The hairless area spans over 2 inches (from top to bottom) above the right ear. There's still a lot of tenderness there.

 

I'm hoping that my donor scars will be presentable to the public soon, but at this rate I suspect it will be a couple of months. This is quite deflating, and leaving the hair so long at the sides with a bald scalp is a rather unbecoming sight. We'll see.

 

 

SUMMARY

 

Dr. Hasson managed to get a very good graft count (5599 grafts). The hair-to-graft ratio is less promising than I'd hoped for (1.64; 9200 hairs) but, as Dr. Hasson pointed out, I have excellent hair -- coarse, especially the hair at the back -- so we're still expecting happy results. I am a firm believer in Dr. Hasson's abilities and eagerly look forward to seeing the fruits of his labor next year.

 

Total grafts: 5599

Total hairs: 9200

Average hairs per graft extracted: 1.64

Hair quality: very good (coarse)

Edited November 29, 2016 by Haircharity34

[Haircharity34]

As mentioned above, there has been a good bit of shockloss around the donor site above the ears, particularly on the right side. Here are a few photos for reference.

[TakingThePlunge]

Thanks for sharing your experience! The new hairline is going to look fantastic! Looking forward to following your future updates.

 

Sorry to see you got hit with shock loss in the donor area. It will take some time to resolve but I'm sure it will be just fine in time.

 

Best of luck!

[delancey]

Hi haircharity,

 

Congratulations on your procedure.

 

Above you mention that 4800 grafts in total were extracted but in the title it says you had 5599 grafts implanted. Why is there a discrepancy?

[Haircharity34]

Hi Delancey,

 

Good question. If I understand correctly, it's quite normal for there to be a difference in the number of grafts and incisions, as many doctors will double (or even triple) up single grafts into incisions. In my case, I had an unfortunately high number of single grafts, so they made sure to double them up, especially in the back near the crown. I was bummed that we were only able to get 9200 hairs with such a high graft count (5599), but that's just the way the cookie crumbles, I suppose.

[delancey]

Hey HC,

 

Got it. Well, you've got coarse hair which should contribute favorably to the result.

[Haircharity34]

Here's an updated pic of the donor shock loss at the one month mark. I'm not worried about the top of my scalp, but I'm discouraged by the donor area. I was completely blindsided by it, and it seems it could've been easily avoided if we were a bit less aggressive with the strip on the sides. Had I known the strip would've been so traumatic on the sides -- pain, severe shock loss -- I may have reconsidered.

[Spanker]

That is pretty bad. What is the clinic saying about it?

[KO]

Yeah, the big strip is unfortunately unavoidable if you want to go the mega session route. It looks harsh now but the redness will cool a bit and the shock loss will subside over the next few months.

[Haircharity34]

The receptionist simply encouraged me to be patient and said that there is no way to predict shock loss; it apparently hits 5% of HT patients.

 

I agree that shock loss is not *always* predictable, but I am under the impression that the likelihood of shock loss increases drastically depending on how the scalp is handled -- particularly when the scar is closed tightly.

 

Mine was extremely tight. I remember that the cutting of the strip took nearly 2 hours. At the end, Dr. Hasson breathed an audible sigh and said, "That was a marathon." Strips don't typically take that long. I think mine proved to be a challenge, and I suspect it was because of the aggressive approach in an area -- the sides -- with limited elasticity.

 

Hence the extensive bleeding from the sides the first night, the thick black scabs (see pictures above), and the severe pain for the first two weeks.

 

I'm not a hair expert, but it didn't take me long to get a basic read on the elasticity of my scalp during the month prior to the procedure. I could readily tell that I had good elasticity on the back of my head but relatively poor elasticity on the sides above the ears. The difference between the back and sides was unmistakable.

 

I just wish we could've gone easier on the sides; the hair on the sides was thin anyways, so reaching for an extra 0.5 centimeter didn't yield much anyway.

[Spanker]

I feel ya. That really sucks. It did look like you had kind of weak sides and I agree you probably didn't get a look from the little bit extra. Heal week. Hope you bounce back and get a happy outcome.

[SADbutTRUE]

welcome to the forum ,heres to great growth, ive seen a lot of cases from HnW, and shockloss almost always comes back,just takes a few months.

[Melvin- Admin]

I have never been a proponent for mega sessions, there is to much on the line in one shot, unfortunately all you can do at this point is wait, hopefully this thread will help some guys out there considering getting a mega session done. The good thing is that the shock loss should return in the meantime maybe you could use dermmatch to camouflage it.

[DavidAnderson]

Hang in there haircharity. Sorry to see the amount of shock you have and realise how difficult it is for you to deal with right now. I have seen shock like this before from a difficult closure for it to all grow back again. It does take around 4-6 months on average. Please kep us updated.

[Haircharity34]

I've appreciated the comments thus far. Thank you.

 

Here are a few shots a week shy of 2 months. I'd say 80% of the newly implanted hairs have fallen out, 20% have remained. The numbness is 90% gone on the scalp, and the scalp is no longer uncomfortably tight. The scalp is still quite red in the front.

 

Unfortunately, the donor scar is still a mess. The redness has subsided a bit, but the massive bald spot over the right ear is still painfully obvious and the scar is still tender around the sides. Also, a few smalls scabs have appeared over the hairless skin over the last week.

 

It's been a long couple of months, and I suspect it'll be quite a while before the donor scar is healed.

[fortune11]

I've appreciated the comments thus far. Thank you.

 

Here are a few shots a week shy of 2 months. I'd say 80% of the newly implanted hairs have fallen out, 20% have remained. The numbness is 90% gone on the scalp, and the scalp is no longer uncomfortably tight. The scalp is still quite red in the front.

 

Unfortunately, the donor scar is still a mess. The redness has subsided a bit, but the massive bald spot over the right ear is still painfully obvious and the scar is still tender around the sides. Also, a few smalls scabs have appeared over the hairless skin over the last week.

 

It's been a long couple of months, and I suspect it'll be quite a while before the donor scar is healed.

 

The side scars can be a real problem as laxity is much less than at the back of the head. I had a tight scalp issue as well with my HT #3 (look up that thread if you can) . dark red / black scabbing very similar to yours and then ultimately their was some keloid (raised scar) formation. Dr Ron was extremely helpful throughout the process and even got me a pro bono SMP at another clinic (which faded with time unfortunately) to fill in the scar until the time I could see him again.

 

Lack of scalp laxity is why I went the FUE route this time around and used the opportunity to fill in some hair in the scar, I really didn't want to take a chance with scar excision in case there was further expansion similar to the prior procedure.

 

My experience - the scar will get a little better with time but what I see in your pics right now precludes anything less than #5 haircut on the sides/back even down the road. So you should mentally prepare yourself for that.

 

BUT ... above all, the growth from my HT #3 was so phenomenal that it enabled me to change my hairstyle completely and be able to look 5-7 years younger than what i previously was. So the scar is a nuisance but will be less so as time goes on and the results of your HT start to come in. Right now at this stage and understandably so, all one can think about is the scar.

 

So hang in there for now. Down the road you should reach out to H&W for scar repair since in my opinion they should be obligated to make at least one attempt to fix it , free of charge.

[chris39]

It's still fairly early days after your procedure , so hopefully your shock loss will recover over the coming months .

 

I notice you mention a 5% shock loss rate . To be honest , I think that's a very low estimate of actual shock loss following surgery , especially strip .I had a patch of shock loss following my HT , and I've read numerous reviews where it occurs .

 

For this reason , I'm really thinking about FUE if I have another surgery , even though FUSS would possibly produce the better yield .

[baldlivesmatter]

Here's an updated pic of the donor shock loss at the one month mark. I'm not worried about the top of my scalp, but I'm discouraged by the donor area. I was completely blindsided by it, and it seems it could've been easily avoided if we were a bit less aggressive with the strip on the sides. Had I known the strip would've been so traumatic on the sides -- pain, severe shock loss -- I may have reconsidered.

 

Hi Haircharity34,

 

Not to pile on, but that scar is pretty brutal. You made a good call in going with H&W though (IMO the best strip surgeons in the world) so it may end up healing just fine. Can I ask why you didn't decide to go FUE? I had an FUE about 10 days ago and my scars are practically invisible.

[Haircharity34]

Thanks for the feedback guys. Good to hear other perspectives.

 

More pics at 2.5 months. Seeing slight growth on the scalp, but the donor scar is still ever-visible despite the fact that the hair on the sides is now over 3 inches long. And having long hair on the sides with little to no hair on top is very unsightly. I'm still a mess.

 

I've stayed in touch with the clinic. I've received several responses to my e-mails, all very short and predictable, along the lines of: "This is normal in cases of shock loss and the hair will grow back in the next few months. Let us know if you have any questions." The clinic's responses suggest that this level of shock loss is normal and unrelated to the way my scalp was handled.

 

It is admittedly a bit frustrating. I might be mistaken, but this level of shock loss does not exactly seem *normal* to me. Moreover, it doesn't seem like this shock loss just appeared out of thin air. My donor area on the sides, particularly the right side, was severely traumatized from a wide FUT strip and an extremely tight closure. I knew something was up when I experienced extreme pain on the sides (especially the right) for a full two weeks after the surgery, not to mention the crazy black scabs and so forth (see my earlier posts). I think this could've been easily avoided if we had been a little less aggressive in cutting the strip.

 

Any thoughts?

[KO]

^Probably true, but only thing to do now is to move forward. Fingers crossed.

[Melvin- Admin]

Hey haircharity,

I understand and empathize with your frustration, the shock loss seems normal, I experienced some shock loss in the donor area in my second procedure it all came back, so I don't think you have anything to worry about. With that said, in hindsight yes the strip could have been less aggressive. However, smaller strip means less grafts which means less hair. In the pursuit of maximizing the session I feel surgeons are feeling pressured to take larger strips, not singling out any clinic in particular because I think a lot of surgeons do this. At this point the strip was taken and there's not much else left to do besides wait for growth, it will be challenging but should be well worth it once growth occurs.

[fortune11]

I have never fully understood why don't surgeons take a crescent moon shaped strip -- so thinner at the sides and thicker at the back of the head (where there is more donor hair and more scalp laxity) - that would solve most of the side scar issues. The strip could be smaller in length as well .

 

All you can do now is move on and hope for the best, but if my experience is any guide , that side scar will never show enough improvement to be rendered invisible at short haircuts. This is the single biggest drawback of FUT that cannot be overcome. There are many who live happily ever after with pencil-thin scars and I counted myself among those until my HT#3 when the scalp finally gave up and said " no more" . Nonetheless , like i said , the growth from the HT was so good that for me the trade off was worth it in the final analysis.

[jcs87]

Hi Haircharity, I'm doing some research on DR. Hasson and just came across your thread. Would you mind posting an update regarding (1) Growth in the recipient area and (2) what ended up happening with the severe shock-loss and wide donor scar issue.

[Haircharity34]

Hi jcs87,

 

I'm glad you prompted me to revisit this thread. I'm long overdue for an update, particularly since it is a positive one. :-)

 

I've seen excellent growth in the recipient area, and the area of shock loss has improved a good bit as well. The right side still appears a *little* thin whenever I get a fresh haircut and cut the hair there under an inch or so, but it's hardly conspicuous. Furthermore, Dr. Hasson is more than happy to fix up the scar free of charge whenever I can make it to Vancouver again -- i.e. transplant some grafts to the shock loss area.

 

Here are a few comparison photos -- pre-op and 9 months post-op. Note: My wife took the post-op photos using her camera and a blue poster, so that's why the lighting and background are slightly different.

 

Again, now that I've seen good improvement on the shock loss side, I can say very confidently that I'm glad I went with Dr. Hasson. It's worth noting as well that I tend to be a worst-case scenario with a lot of stuff, whether it be food sensitivities, seasonal flu, you name it. I have a feeling that I would've had some degree of shock loss regardless of how much my scalp was babied.

 

Dr. Hasson and his team are very professional if you have to walk through any post-up issues, as I did. And Dr. Hasson's hairlines are among the very best. I'd definitely commend him to you.

Edited December 9, 2017 by Haircharity34
Wanted to add a comment on the photos

[jcs87]

This looks great and so happy that things took a turn for the better for you. It's always so worrying when you see people worried about their results and then they go silent and are never heard from again.

 

Do you have any head down shots like this by any chance?

 

Did Hasson work on your crown at all? It's a bit hard to tell from the post-op photos but it looks like you guys left the crown alone?

 

Also, are you on finasteride? The texture of your hair looks great in these most recent photos.