H & W Doug Posted August 30, 2018 Share Posted August 30, 2018 Patient in his mid to late 20’s traveled from New York to see Dr. Hasson about his hairline and frontal zone loss. Good donor with hair shaft diameter on the finer side. Dr. Hasson and team transplanted 4260 grafts to restore the hairline, frontal zone and a small portion of the mid-scalp. 938 were single hair grafts, the remaining 3322 were 2, 3 and 4 hair grafts. We did not always document and break down the singles from the larger grafts back in 2005. Still looking good nearly 13 years later as he approaches 40 years old. Placement shot taken 10 days post-op, we did not usually take immediate post-op shots back in 05. While his scar was good, he wanted to improve it even more. 312 FUE grafts were recently placed into it to further minimize. 18 were single hair grafts, 177 double’s, 117 were 3-4 hair grafts. 1 I am a salaried employee of Hasson and Wong since 2001. Opinions expressed are my own. Hassonandwong.com Link to comment Share on other sites More sharing options...
Senior Member hairlossPA Posted August 30, 2018 Senior Member Share Posted August 30, 2018 this is amazing. im speechless. 4000+ grafts for that hairline? i understand some were put into the midscalp and crown, but he looked good in the pre-op pics. clearly didnt have any concerns about shockloss. this is amazing and something I'm looking to get done. super thin scar and probably made it invisible with the FUE into it. crazy good Link to comment Share on other sites More sharing options...
Senior Member densedream Posted August 31, 2018 Senior Member Share Posted August 31, 2018 Wow, he has less wrinkles after 14 years. Botox works well I see. I would love to have his scar. It's gonna be completely undetectable now more than ever. Link to comment Share on other sites More sharing options...
Senior Member wazaam Posted August 31, 2018 Senior Member Share Posted August 31, 2018 Great scar with additional grafts will be even better. Impressive case that has held up Doug OP has very mild loss or is on meds or both ? Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted August 31, 2018 Administrators Share Posted August 31, 2018 Doug, thank you for this excellent presentation. Do you know if this patient has been on finasteride or minoxidil this whole time? Also, if possible do you mind showing us some pictures of the graft placement if possible? Again, I’m speechless this gentleman looks younger at age 40 then he did in his 20’s. 1 I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
LonelyGraft Posted August 31, 2018 Share Posted August 31, 2018 Looks very good. Like Melvin, id like to know what treatments the patient has been on the last 13 years and was he on any treatments before the transplant? Link to comment Share on other sites More sharing options...
H & W Doug Posted September 3, 2018 Author Share Posted September 3, 2018 Thanks for the nice comments guys! HairlossPA, Actually, no grafts placed in the crown but a few slightly behind the frontal zone. The majority in the hairline and frontal zone. densedream, I actually went back and compared how he aged as I thought he looked pretty good for 40? Wazaam, I would say both. Back in 05, Dr. Hasson had predicted a final hair loss pattern of a 3A. So little if any projected mid-scalp and crown thinning. Looking at him today I would say he was accurate. While not critical in his case, he was on Finasteride back in 05 and is taking it today. Melvin, As I mentioned regarding the 10-day post-op shot, we did not regularly take immediate post-op shots back in 05 and therefore don’t have graft placement pics. jj51702, He stopped Rogaine just before his procedure and we would have advised not to continue using it. I am a salaried employee of Hasson and Wong since 2001. Opinions expressed are my own. Hassonandwong.com Link to comment Share on other sites More sharing options...
LonelyGraft Posted September 4, 2018 Share Posted September 4, 2018 Thanks Doug. Is he on the standard 1mg dose this entire time? Link to comment Share on other sites More sharing options...
Senior Member hdude46 Posted September 5, 2018 Senior Member Share Posted September 5, 2018 On 9/3/2018 at 4:52 PM, H & W Doug said: jj51702, He stopped Rogaine just before his procedure and we would have advised not to continue using it. Why would you have advised to stop rogaine? Link to comment Share on other sites More sharing options...
H & W Doug Posted September 6, 2018 Author Share Posted September 6, 2018 hdude46, The doctors have not been big fans of Rogaine over the years. While its impact can vary from patient to patient, for many who have used it we see some instability of the tissue. Without going into great detail, it can make the procedure more difficult and create some limitations. It has been shown to affect the collagen and some premature facial aging can also occur. In the end, Dr. Hasson would likely not feel the benefit is warranted versus the potential negative effects on the tissue in this case. 2 I am a salaried employee of Hasson and Wong since 2001. Opinions expressed are my own. Hassonandwong.com Link to comment Share on other sites More sharing options...
Senior Member hdude46 Posted September 13, 2018 Senior Member Share Posted September 13, 2018 I've been using rogaine foam for 8 years. Are you suggesting someone like me quit because of the collagen issues? Seems like I'm a little too far down the road for that. Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted September 13, 2018 Administrators Share Posted September 13, 2018 In my opinion, the collagen is somewhat like the libido issue with finasteride. How many patients complain of aging when they are simply aging. Unfortunately, getting older is a part of life. I have been on minoxidil for the past 5 years and i look younger now. Obviously, that’s due to having hair now, but i haven’t noticed “premature” aging. Obviously, if i check back in 15 years I will without a doubt look older thats only natural. I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Senior Member andy_+_+ Posted September 13, 2018 Senior Member Share Posted September 13, 2018 Doug can you provide more information in regards to rogaine and the doctors opinion. Rogaine is one of the 2 big drugs to combat MPB. This is the first I have heard of this. Link to comment Share on other sites More sharing options...
H & W Doug Posted September 17, 2018 Author Share Posted September 17, 2018 jj51702, Yes, I believe he has been on the standard dose. hdude46 / andy_+_+, If you ask us, there is no simple answer as to whether or not someone should use minoxidil. As previously stated, the doctors are not big fans of it primarily due to its effect on the tissue. More bleeding and difficulty while making incisions has the most to do with their less than favorable view. If not for performing procedures on patients who use it, they would likely have a more neutral stance. Over the years they felt Finasteride was a more effective tool in preserving hair and with these negatives in their opinion associated with minox, they would advise some patients stop it. However, if some patients could not take Fin and/or were getting favorable results with minox, they would say keep using it but stop in 4 weeks or more before a procedure and resume after. If a patient was projected to only lose the front and we were going to restore the front through a procedure, they would advise that there was probably no great benefit to using it. If you have been using it for years with success, you can continue using it but without knowing the exact situation, it is hard to give a recommendation. For some it would irritate the skin, for others, the tissue would look fine. Some may be more sensitive to it than others. So as mentioned, no simple answer. Each case is different and ultimately the choice is up to the individual. I personally have never used it and it is unlikely I would need or want to consider using it. I am a salaried employee of Hasson and Wong since 2001. Opinions expressed are my own. Hassonandwong.com Link to comment Share on other sites More sharing options...
Senior Member hdude46 Posted September 17, 2018 Senior Member Share Posted September 17, 2018 (edited) Kind of shocking to hear the docs aren't a big fan of one of only two hair loss drugs proven to work at combating MPB. I think telling someone who has been using minox for years to stop is asking for big trouble. Edited September 17, 2018 by hdude46 Link to comment Share on other sites More sharing options...
H & W Doug Posted September 17, 2018 Author Share Posted September 17, 2018 hdude46, Like I said, every case is different. They may or may not advise stopping it depending on the situation. I've never seen them advise something that may lead to "big trouble" but rather advise something that would avoid it ? I am a salaried employee of Hasson and Wong since 2001. Opinions expressed are my own. Hassonandwong.com Link to comment Share on other sites More sharing options...
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