Dr. Wong 4476 Grafts

[miklaw]

Can someone explain to me how this transplant can look so different to this one here?

http://hair-restoration-info.c...66060861/m/632105005

[Severn]

Originally posted by Ventuoguy:

Emporer- Was that a tricophytic closure?

 

It's a type of closure that allows hair to grow back through the scar to make it less visible.

 

Can someone explain to me how this transplant can look so different to this one here?

 

Everyone's physiology is different. Then even given two perfect growth rates on two different patients, the individual's hair qualities such as coursness and thickness play a huge part. Just looking at Emereror's pics, it appears at least that he has fine low density hair. This increases the chance of being able to see the scar. For example, I have high density coarse hair. My old Bosley scar is 3-4mm at the back of my head but because of my hair characteristics, I can barely find it.

[TheEmperor]

Originally posted by Bill - Associate Publisher:

TheEmperor,

 

First I want to thank you for taking the time to share your experience in photos. I have to admit, watching you allude to your less than optimal hair transplant for years on this forum without giving details made me very curious. Now that you've shared your results, allow me to make a few observations.

 

No problem.

 

First and foremost, I will admit upfront that I would not be happy if this was my final result. However, given the number of grafts in such a bald area, I'd consider this more of a work in progress. Honestly, 4500 folliculuar units on a Norwood 5A/6 is not going to promote both adequate coverage and density. Hopefully you weren't under the impression that a single procedure was going to give you a full head of hair. In my own experience, I wasn't genuinely happy until after I already received 7550 grafts, and even then, I still wanted more density.

 

I was of the impression that the front would be planted in the first session, and the crown would be adressed in a follow up, maybe also allowing me to lower the hairline or fill in the temples.

 

I asked ALOT of questions trying to find out what my eventual result would be. I even showed Joe pics of some of Dr. Wong's patients that I did not like and wanted to know how my results would stack up compared to them. (Dont want to name any names, but I told him that if my result was not better than patients A and B, that I would just drop the idea of HT and live live bald) There was a particularly sparse patient (A) that had two procedures and still didnt look good. Joe assured me that my result would be much better because he had the finest hair Joe had ever seen. OK.

 

After my in person consult, I asked Joe what Dr. Wong thought of my donor quality, and he said the chart had it marked between medium and fine. That gave some assurance that my result would be better than the really fine haired guys.. so I booked a date.

 

Whether or not every single follicular unit grew, I don't know. However, in comparing all the photos, it does appear that the density in the surgical pictures 9 days post-op are in line with the density of the actual result.In order to determine whether or not you've had optimal growth, I'd suggest an in person consult with Dr. Wong.

 

Im not going to fly up there so he can look at my results. I DO have a bunch of close up, magnified photos of the graft sites. It should be fairly easy to mark off a centimeter of the hairline and compare incisions to actual hairs growing. (What I did previously in my blog was not partiularly accurate.)

 

Obviously, if you proceed with a second procedure, you will have to go through the inconveniences of surgery, healing, potential shock loss, etc. yet again. However, guys with extensive baldness like you and me usually need 2 or 3 procedures before we can truly be happy with the result.

 

I think you have a larger loss pattern and your hairline is lower. You are growing your hair up and combing it back, it also appears to be shorter than mine. The way Dr. Wong did my hair, it grows forward and layers on top of itself. The way yours is done will require more hair to provide the same illustion of density, IMO.

 

That said, I have been gauging my expectations of what Dr. Wong said about my expected result -- that he thought(thinks?) it will be better than Joe's.

 

I look at the amount of coverage Joe has (on his mentor website), and the graft numbers, and what originally seemed like a sure thing, now has me wondering if I will have enough grafts to pull off. I have less real estate to cover, yet. ..

 

The problem seems, that (say) I get 2000 in the next surgery and put 2000 in the front, Then return for a final 1500 to finish the crown. I will have 8K grafts(!!) to cover less real estate at presumably the same density. I thought it would require less grafts becaues my crown is much smaller. I thought maybe the answer was that Joe was not a big guy w/ a small head, but he is actually about my size.

 

I think the answer comes down to two things. Fine quality of donor hair and (maybe) less than 100% yield.

 

Based on my characteristics prior to surgery (lots of donor), Joe told me I was in the driver's seat. Its interesting that once you get half way across the river you find out you may not have as much in the tank as you once thought.

 

The only thing that concerns me is that while your scar looks fine in my opinion, your donor area looks a little thin in several of the photos you posted showing the scar. I wonder if that may be why your scar may be showing through. I posted one of them below.

 

I think that is the primary issue and ive talked about it in other threads. The side hair is fine. Its less useful for building density, and covers the scar less effectively.

 

The surgery did make the sides worse. This may be because 1-2cm was taken from the middle and the rest of the skin stretched out... or perhaps just the skin in the vicinity of the scar was stretched, making it look thinner. .. or perhaps there was some permanent shock loss.

 

Anyway, I am hesitant to tap the sides for much more hair because A) it is of lesser quality and B) It will make sides even more see through.

 

The scar can still _barely_ be seen through the hair when it is 1.5" long. At some point it will be visible no matter how long the hair is.

[Anouar]

First emperor I want to thank u on a great right up. I too agree that your results are less then optimum. This gives prospective patients and idea that less the perfect results are possible. Potential ht patients should weigh the pros and cons of this procedure. Now you have to ask yourself is this result an outlier of the bell curve or not? Typically, you see far better results posted on this forum from H&W. It seems to be that no top doc is immune from producing less than stellar results. Since you are worried about a second strip procedure, I would research fue. It seems that Dr. Bisanga has a good reputation here and might be able to help. Although I would tread lightly on this. Before you commit to 2000 grafts, I would do a test patch maybe of 500 just to see the outcome. Obviously, you want to be careful with your donor hence the 500grafts. I know you're worried about downtime but conserving your donor should you choose a second procedure is vital in your situation. I wish you best of luck?

[Jotronic]

Hdude,

 

I did not say he was a NW6. I said he had work in a NW6 pattern. I could have been more clear by saying that the strip of hair he had in the center of his scalp was thin enough to warrant a significant amount of the harvested grafts to be placed in this area thus the placement was as if he were a NW6. He was anything but a NW4 and barely scraped into being a NW5A.

 

The Emperor,

 

I only remember one of the patients you referred to as being too thin to meet your expectations. He was a NW7 with extremely fine donor hair. I specifically remember that the claim by Dr. Wong that you would have results "better than" mine was because he thought he was going to get a considerable amount of more hair than he did. Because you did not need crown work the area to work in, as you mentioned, was smaller. Turns out you got 400 less grafts in one session than I did in two sessions in a relatively similar area. This does not take away from the fact that we wish to do right by you. I ask again that you call the office so we can discuss this. In case you lost our number it is 1.800.859.2266. I will be here till 5:30 PST today.

[rpachigo]

I really appreciate the effort in documenting your journey. I cannot praise you enough for showing us every step of your progress and analyzing it so thoughtfully. I think these results are subpar for H&W and I hope you get the results you deserve. Definite improvement but could have been better. I would definitely if wanting to do more, go to someone who does not shave the head - several here obviously. It will not affect yield imo and possibly allows the surgeon to see the angle of your new native hair when planting. Your growth from the ONEs also does seem less than the TWOs possibly because those grafts are even more fragile than the bulkier ones - careful, gentle handling of those ONEs from slicing/dicing to placement with jeweler's forceps is muy importante.

 

I think you have a slightly widened scar but really not that bad but when strip dimensions get wider (I assume your width was over 1.5 cm), I think this sort of thing can set you up for a wider scar even with pre-op scalp massage and meticulous adherence to post-op care.

 

All the best.

[hairshare]

I know I said this before but I really have to question this again because perception is so important. If TE had posted this blog with a very positive tone and said how happy he is with the result, I severely doubt that anybody would comment that this result was substandard, let alone have someone call it a "repair job". Maybe I am wrong but I just really feel like this was a good result. I have seen results that are a lot less steller than this one yet the patient was happy and people kept commenting how good the patient looked. Look around, you will find plenty of those types of cases. As mentioned previously, I showed TE's results to unbiased eyes (in the form of my parents) and BOTH said that this result was a great result. My father is very critical of these things and he said TE's results came out great.

 

But TE, you have every right to be happy about your result as the next patient does. I suggest you work with the clinic and map out the next steps.

[Drew35]

TheEmperor,

 

Compared to where you started from I think you look much better.

 

Once you have your second procedure, with Dr Wong, you will look great!

 

 

I am a bad Norwood 6 so I knew that I would need at least 2 to 3 surgeries.

 

In the first surgery we just went for maximum coverage. On my second surgery Dr Wong will focus on my hairline and crown. It seems that is his plan for you, also.

 

 

Did you request maximum coverage in your first procedure?

 

Obviously if Dr Wong was unable to get as many donor grafts as he wanted it would complicate your first procedure.

 

 

Putting your before and after photos together shows how much better you look. I am using your 10 month photo for comparison.

 

 

 

I think once you have your second procedure you will be very happy.

 

Good luck to you.

[Bill - Seemiller]

TheEmperor,

 

I understand your reluctance to fly to Hasson and Wong just to evaluate growth. Perhaps there are other physicians recommended by this community you can consult with to garner some professional in-person input in addition to sending as many photos as possible to Hasson and Wong for an evaluation.

 

Honestly, in looking at the graft placement in the surgical photos, it appeared that coverage, not density was the primary goal of the procedure. The density of the grafts placed in the front is actually relatively low. Take a look at your 9 day post-op photo I took from your patient website below:

 

 

I'd actually suggest that you and I had/have similar ground to cover. Take a look at your and my before photos below:

 

 

I can't speak for what was said during the consultations or what was promised, but given your level of baldness and the number of grafts placed, I'd consider your hair transplant a work in progress that could easily be improved with a few thousand more grafts.

 

Best wishes,

 

Bill

[Ventuoguy]

quote:

Originally posted by Ventuoguy:

Emporer- Was that a tricophytic closure?

 

 

It's a type of closure that allows hair to grow back through the scar to make it less visible.

 

Severn-I know what it is, my question was, did Emporer have a tricophytic closure? If so, why is it so much more visible than expected?

[splitting hairs]

From looking at the photos and reading what has been written, here is my opinion:

 

I think that the patient looks far better after the surgery. Yes, the front isn't as dense as most of us would like, but I think that the patient had high expectations - basically he thought he could achieve a great result in one surgery. That doesn't happen very often.

 

IT USUALLY TAKES AT LEAST TWO SURGERIES TO GET A DECENT HEAD OF HAIR. WELL DONE, STEP ONE IS COMPLETE - NOW GO BACK FOR ROUND TWO AND DR WONG WILL, AS ALWAYS DO A GREAT JOB.

 

You cant get results like joetronic or Bill in one surgery.

 

My advice is go and get 2-3000 grafts to finish the crown and add density to the hairline. Also, make sure you get on propecia.

 

good luck

[Ventuoguy]

It does appear that Emporer's hairline was implanted at a lower overall density than some other H&W patients. Obviously this was a conscious decision on the part of Dr. Wong. There are alot of little outcroppings of single hair grafts it appears that are of fairly low implanted density. This, coupled with what appears to be fine donor hair, and a fairly high contrast ratio scalp/hair color I believe accounts for the result. Comparing Emporer's result to Jotronics result from his FIRST HT, I'd say that the primary difference in result is due to the fact that Joe has more dirty blonde type hair which is closer to his scalp color. Remember, also that Jotronic had mini/micro grafts already there prior to Dr. Wong's work and Dr. Wong was camoflaging them. Remember that even though Dr. Wong was hiding Joe's micrografts, those grafts DO add to density in my opinion.

[rpachigo]

I do see a lower density as noted on POD 9. I wonder if that was the gameplan.

[Raphael84]

Why would this be the "gameplan". It makes no sense to me, other than the obvious coverage over density. But even then, surely a more balanced outcome could have prevailed?

[hair2live]

Hello to all.I m a new member and i m trying to make a good research because i m about to have an HT in next 4 months with a top doc

I have to say that i m very disapointed about the results i see lately specially from top doc clinics like H&W because i was about to come in touch with them as they consider to be the best in the world for me.

And lately i have to say that results like that and some other, is NOT like the results i use to see...can anybody explain me WHY??????

What happened????I m great fan of this clinic and i rest all my hopes to them,but now i see something is going wrong...what is it??? i m not considering about FUE because i think it is not good so far for many reasons we already now....I NEED TO SEE THE RESULTS I USE TO SEE FROM H&W....density...hairline naturality etc sorry for this...

[hair2live]

Please also check this one 4.500 grafts and check his crown....of course he have great difference but what about the crown that H&W is popular about it?????

http://hair-restoration-info.c...66060861/m/292103151

[hair2live]

All i want to say is this:

IF H&W is not that good anymore for some reason and not able to provide the services they use to....then i m sorry but i have no chance...no other Doc in THE WORLD can help me out and i know what i m telling you...

i had some Terrible HT s in the past and i can tell you that the HT industry is very dirty and they always take advantage of us....THATS WHY THEY HAVENT FIND ANY SOLUTION FOR HAIRLOSS...BECAUSE THIS INDUSTRY CAN ALWAYS SAVE MONEY FROM US...transplants,drugs,hairsites promises...

I need to see the old time H&W AGAIN...with the briliant results....i know these cases is very rare lets say 20 to 5000 BUT...what if i m one of them???????i m very scared to death...this clinic for me is the last chance...i ll wait to see more results in next 4-6 months to xcheck...

[aaron1234]

Emp,

 

Sorry, I didn't see this thread until today. I'm so glad you finally came out with photos and your surgeon as it helps to better inform the community and in turn gives you some better feedback. Your documentation could not be better!

 

You are right. You definitely look better, actually much better, but the frontal density could be improved. And I'm sorry to say that I just have to repeat what has already been mentioned. I think a second procedure will finish you off. I know the ugly duckling stage sucks, as I'm just getting out of it myself. But the ugly duckling stage for your second pass, even if you shave, will probably be more tolerable than the first time. Mostly because you will have the transplanted hair from your first procedure growing back.

 

So I guess you just need to weigh the pros and cons between a couple inconvenient, awkward months and the rest of your life not being completely satisfied with your hair. I know there are no guarantee's that the second HT will be perfect, but you put one foot into the game already. Please keep us informed with your decision.

[Bill - Seemiller]

hair2live,

 

Hasson and Wong is still a world class hair restoration clinic. There's plenty of evidence on this forum to prove they're not only still brilliant, but have gotten even better over the years. You can find dozens of examples of their impressive work in the "Results Posted by Leading Hair Transplant Clinics" forum and posted by patients over the years. For high definition videos demonstrating their results, you may want to view Hasson and Wong Hair Transplant Videos.

 

Quite honestly, if Hasson and Wong's results don't impress you, then your expectations are probably way too high. Thus, I'd suggest you're not a candidate for a hair transplant at all.

 

Rid your head of any dreams of restoring a full head of hair with the density you once had. Frankly, unless you are older with minimal hair loss, achieving "true density" is impossible.

 

On a Norwood 5A (similar to "TheEmperor's" level of hair loss), it would take approximately 22,500 follicular units to achieve true density in the balding areas evenly distributed throughout the scalp. The average patient has a donor hair supply of approximately 6000 to 7500 follicular units via strip. Thus, strategic placement of the grafts will ultimately determine the outcome of the result. It will also be somewhat see-through in harsh lighting. This is just a reality us baldies have to live with.

 

If you are indeed genuine about seeking hair loss solutions, I'd encourage you to start a new thread, share your hair loss story and allow the members of this community to offer their opinion. Be sure to include photos showing mulitple angles of your scalp of your current hair loss.

 

Best wishes,

 

Bill

[hair2live]

Bill

Thank you for your respond Bill.

You are very right of everything you said and finally i might be not good candidate for an HT.

I m just having great expectations from this clinic because of the talent they both have and for the ethics that represents this clinic..

And as you said we will never be able to have our hair back as we use to have...just an approach of this...i hope hair cloning will be soon available and H&W will have thousands of grafts in their hands to place in each head....

I finally do insist that H&W plus 3 more docs are the best surgeons in the world depending of what type of hairloss pattern each one of us has.

[hairlosscursed]

Hello hair2live.

I totally understand your feelings about the situation as i had some bad transplants in the past but you have to realise what Bill told you.I recently had An HT with Dr Hasson and i have many expectations like you and i really can t wait to see...check my photos if you want and compare them with yours if you have any to see the difference in the work quality they are doing from day one.

Of course now i m at my 5th week and there is no point to show anything because as you know it s too early...We all know that H&W has nothing to prove as the results we have all seen these years are very good.

You also have to understand that each head is different(shape, density, angles, laxity,hair quality, reactions to surgery etc) which i m sure you know very well.

I wish you the best and if everything goes well for me i ll post my photos to check the final result which i hope to be as good as i expect.

Good luck

[coscanoer]

In my opinion naturalness is just as important, if not moreso, than density in getting a good-looking HT. The thin singles in your hairline may be the bane of your existence now, but you might not feel the same way if your hairline had thick 2s and 3s in it, that would stand out to the eye when seen in conjunction with your overall low-density hair.

 

If I were in your shoes I'd mostly leave the front two rows alone, and look to add density from the 3rd row back. This will make you look reasonably thick, yet natural. You have thinner hair and a bald-spot; a wall-of-hair hairline would look "wrong".

[Julius]

I just checked out your blog and was rather shocked to find out this was H&W work. The hairline placement did not look great in the post op picture. I think you always needed more than one procedure though at your Norwood stage. H&W are bellwethers of hair restoration who are known for consistently producing stellar results. Maybe they could offer you a discount on a second procedure to address the density and scar. I would use the 2k but leave the crown thin (I know you probably don't want to hear that) then go fue for the scar. I think Jotronic's response indicates the probity of this clinic.

[TheEmperor]

Everyone,

 

I appreciate all your comments.

 

The positive comments confirmed that my situation is improved (that is always nice to hear) and gave me some hope that the scar situation is not hopeless. OTH, the critical comments confirmed some of my feelings and helped me to put things in perspective, motivating me to get the work completed.

 

I spoke to Joe and will be returning to Dr. Wong in the next few months for #2. I was able to articulate my concerns about the hairline density and the scar, and we have a plan that will get me where I need to be.

 

The plan is to focus 1500-1800 grafts in the front, while being careful not to over harvest the sides; hopefully minimizing the scar. Any remaining grafts will be placed strategically in the crown.

 

This is a bit of a modification to my original plan, where everything would be done in two procedures. Having time to reflect on my situation over the past year, I have accepted that the crown may not be finished in #2. My hope is to get the front completed. Any subsequent crown work (#3) can be more easily fit into my schedule without impacting my appearance.

 

 

I think my dissatisfaction was a combination of high expectations and some miscommunication. The reality is that I was originally estimated to get 5500 grafts, but for whatever reason, they only got 4500 grafts. (I think my donor density is low.) Dr Wong may have been shooting for a front-to-back total coverage which we didnt quite get. I was expecting a "5000 in the front, Bobman Style" result.

 

Im still not sure if it is feasible for everyone, but my advice for prospective HT patients is to get the front nailed down in one pass if possible. The most absurdly difficult aspect of the whole process is the recovery and waiting for growth. I wore a hat in public for a long time. This time, I will cover the work until the scabs are gone, but after that will just deal with any awkward stares until it all grows in.

 

Thanks everyone for your support.

[aaron1234]

Sweet Emp! I'm f'in pumped for you right now! I think you are making the right decision. Yes, the first few weeks will be difficult but you'll be just fine for the long growing process since you already got some good hair already in place. Sweet!