5000 Fue Performed By Dr. Hasson, Vancouver - Timeline (Cross-Post)

[J5_95]

Hi All,

**This is a cross-post with Hairlosstalk.com, I'm not familiar with either forum so I wasn't sure where would be best to put it**

Finally took the plunge about 2 weeks ago after lots of research and a 6 month Covid delay. I had a trouble finding similar cases to mine, so I thought it would be helpful for folks in the future if I made a timeline. This way I can also force myself to keep better track as well. I'll follow this post up with a couple of others, giving a rough timeline and my thoughts on the process at each stage.

- Previous Hairline: My family has a history of prominent foreheads with high temporal recessions. I had roughly the same hairline from the age of 18 onwards, with only a minor amount of backwards drift until the age of 23; am currently 32. My hair is very fine and very straight, more blonde on top, progressing to a sandy brown on the sides.

- Consultation: I met with Dr. Hasson and Chis at the Hasson & Wong office towards the end of January 2020. We discussed my goals of advancing my hairline and filling in my temporal recessions. Dr. Hasson mentioned I had some thinning in the front and crown. Looking back at photos shows this had started roughly two years prior. He recommended I start taking finasteride to halt and reverse this, which I did roughly 3 weeks after our meeting. Both of them recommended 4000 FUE would be necessary to achieve my goals, and that would be split into two 2000 graft session back to back. I ended up booking for March 2020, however 1 week ahead of my surgery date Covid hit and I had to reschedule. It would have been perfect to ride out the ugly duckling phase in quarantine, but c'est la vie.

- Surgery Day 1: I arrived at 7 AM and was introduced to the surgery team, I can't remember anyone's names but they were all friendly and accommodating. We did the whole photo shoot thing, and then Dr. Hasson came in and we started discussing the new hairline. He mentioned that while my crown had recovered the frontal zone had not and he also noticed some thinning in my temple points. At that time he told me we could stick with the original plan of 4000, but I would most likely be back for a second pass and if I wanted it done in one go I should increase slightly to 5000. I liked the 5000 hairline much better and agreed that I'd like it done in one go, rather than a follow up down the road. Looking back that was a wise choice as I was in for a ride, and am quite glad I am unlikely to need another surgery in my lifetime, or so I've been told. I want to preface by saying this was no fault of the surgical team or clinic, it simply came down to my own biology.
Day 1 was to be spent on the front hairline and day two would be working on the temporal recessions and temple points. They took the first 2500 from my left side, I was given a zopiclone as I would be there for a while, and there was only minor pain from the anaesthetic injections. The extractions were performed by a technician, the doctor returned to make the incisions, and lastly the grafts were installed by a rotating team of technicians, lovely ladies all. In general day 1 was a fairly easy, I was there for about 12 hours, was fed twice and had a pretty chill day.

Surgery day 2 - Day two started largely the same as day one, with a zopiclone and then the right side extractions; I believe I slept through most of this stage. The zopiclone started to wear off roughly halfway through the incision stage, and that was when the road got a little rougher.
I have had problems with general anaesthetic in the past, and usually require extra injections to be completely numb. I also tend to metabolize the anaesthetic quickly and require frequent top ups. Towards the end of the implantation stage I was requiring injections on a steady basis, roughly every 10-15 minutes. For the last 2 hours or so my body was metabolizing the anaesthetic so quickly as to render it nearly ineffective. The team did all they could to accommodate, but at one point we had to take a break because I was shaking so badly that I was making their job difficult, and they were concerned I would pass out.
Over all day 2 was a slog. I've heard no pain, no gain, but it wasn't a lot of fun. Maybe I have a low pain tolerance, who knows...

I returned for 2 consecutive days to have them wash and inspect the sites.

- General Thoughts:
- Dr Hasson's bedside manner is excellent. He noticed immediately how nervous I was on the morning of day 1 and was calming and reassuring. He was obviously quite busy, but took his time and made himself available to answer my questions
- The office has a fairly laid back vibe, everyone is very friendly and were a pleasure to be around
- I was surprised at how little direct involvement Dr. Hasson had with the process, he popped in and out throughout the day. However, the results speak for themselves as you'll see in the follow posts
- The team actually ended up extracting an extra 200 grafts, but as Dr. Hasson only made 5000 incisions these additional grafts were cut into singles and added into existing groups. I was not charged for this, and can assume it was because of a low transection rate?

- The number of grafts sounded high to me, but I trusted the Doctor's recommendation and the density looks as though it directly matches that of my native hair. 

- Graft Breakdown:

Day 1 : 2512 FUE extracted . 300 single hair grafts – 1714 2 hair grafts and 498 3 to 4 hair bundle grafts. Total number of hairs 5222.

Day 2 : 2650 FUE extracted . 150 single hair grafts – 1867 2 hair grafts and 624 3 to 4 hair bundle grafts. Total number of hairs 5774.

Combined number of grafts 5162.

Combined number of hairs 10,996.

Edited October 9, 2020 by J5_95

[J5_95]

Previous hairline for reference.
I was told by the Doctor that I had an exceptional donor, and could accommodate upwards of 9000 grafts if it was ever necessary. He also told me that I have a big head, and there was a limit to how low he could bring my hairline down. I appreciated the candor.

[J5_95]

Day 2 after the returning home.
I was given a cream that was reapplied after each wash at their office, but was not given any sort of saline solution spray. The cream kept the recipient site moist for roughly 3 days post op. Because I was pumped full of so many anaesthetic injections the swelling over the next few days was WILD.
As you can see, the donor sites look exceptional. They reddened slightly over the next few days, but I was surprised at how they looked out the gate.

[J5_95]

Day 4
Very minimal scabbing. I didn't take many photos as this was when the pain started to ramp up, so I spent most of the day pretty drugged up.

[J5_95]

Day 5
To my eye everything looked pretty good. Donor area was basically healed on the left side by this point. This was the first time I washed it myself. Was supplied a shampoo from the clinic.

[J5_95]

Day 7
95% of the scabs were gone, and swelling had reduced to a level where I could get a better idea of what the new hairline would look like. You can see the lines where day 1 and day 2 meet. I'm hoping that they fill in a bit and the differentiation between the zones isn't apparent forever.

[J5_95]

Day 10
Continued recovery. This was roughly the time that the pain started to reduce to the point that I no longer needed t3's to sleep through the night. However my right side still has a dull throbbing. Pain up to that point had been roughly 6-7/10 depending on time of day and if I had been moving around too much.

[Britanium]

Wow 🤩 you chose a elite Dr so I have no doubt this will be a excellent result. Fantastic artistry! With that amount of grafts it’s going to give great density too. 

[J5_95]

Day 15
That brings us up to today. Recipient site is still fairly numb but I slowly regaining feeling. Left side donor is mostly healed, only slightly tender to the touch. Right side is just a bit behind, with a low and dull throbbing.
I'm overall really pleased with the work performed. I think the new hairline much better frames my face I'm excited to see it progress.

I'll post again in another week or so, as the shedding starts, and then taper off until I have more results to display.

[J5_95]

Thanks John! I'm excited to see it progress, and finally have the relatively youthful hairline I wasn't able to experience previously

[Britanium]

Must be nice knowing you have at least another 4000 grafts in the bank too! Your in a great position now. 

[giegnosiganoe]

Thanks for documenting this so well. The work looks good.

I have some questions:

1. Can you share more before pics? An additional one from above would be nice.

2. "The extractions were performed by a technician" - Can you elaborate on this? Did Dr Hasson punch the grafts, and then left it to the technician to remove the grafts?

3. "The team actually ended up extracting an extra 200 grafts, but as Dr. Hasson only made 5000 incisions these additional grafts were cut into singles and added into existing groups" - Are you saying that the additional grafts were cut into singles, and then added into recipient sites that already had existing grafts?

[J5_95]

Happy to share more pictures

The grafts were punched and removed by the same technician.

Yes, the left over grafts were cut into singles and then added to existing incisions containing 2-3 hair bundle grafts. When I asked the tech about this she told me it was possible to combine single and double together, but combining groups doesn't work well. Kind of like grafting a branch to a tree.

 

[giegnosiganoe]

@H & W Doug can you confirm that the technician punched and removed the grafts? I thought that only the surgeon was allowed to do that?

[Ken23]

Any issues/sides with propecia? What was your experience using the medication ? 

[Briguy]

Yes thats the process at H&W. I've had 3 surgeries with Dr. Hasson. 

[giegnosiganoe]

15 minutes ago, Briguy said:

Yes thats the process at H&W. I've had 3 surgeries with Dr. Hasson. 

Interesting, I've never had a HT before but for some reason I had the idea that only surgeons were allowed to do the extractions. Maybe that's only in the US?

[Mycroft]

Normally I'd say 5,000 grafts for such a small area of the scalp is irresponsible, but if you've really got 9,000+ you should have plenty of grafts to cover the rest of the scalp if you start seeing loss elsewhere.

[Zaagirad]

@giegnosiganoe

Technicians can remove and place the graphs, but Dr. Hasson makes the slits into the scalp (I believe in Canada and maybe the US only a Dr. can make the incisions required for placing graphs).

I had a FUT with Dr. Hasson in 2018. He removed the donor (cut and sealed the donor area) and then made all of the incisions on the top of my head. The technicians cut and placed all of the graphs. Dr. Hasson monitored throughout the day and made more slits as required (my surgery was almost 12 hours).

For FUE they can do the extraction as well.

[J5_95]

18 hours ago, Ken23 said:

Any issues/sides with propecia? What was your experience using the medication ? 

Not that I've noticed. Unless something manifests as late as 8 months out I'd say I'm in the clear.

As far as experience, it fully repaired the slight thinning in my crown and halted any thinning in the front, but I couldn't tell of any thickening there. My hairline had never been particularly strong, even looking at photos 10 years back, so it looked normal to me. According to the doctor is it more effective on the crown than other areas and that outcome was to be expected.

13 hours ago, Mycroft said:

Normally I'd say 5,000 grafts for such a small area of the scalp is irresponsible, but if you've really got 9,000+ you should have plenty of grafts to cover the rest of the scalp if you start seeing loss elsewhere.

Totally agree, but I asked him more than once about this as I was really concerned about overharvesting. According to him I had little cause for concern, given the 9-10 in the bank pre-op and a low likelihood of requiring another operation in the future. I had been researching clinics for the better part of 18 months, and chose them based on their consistent quality of work. So when he said that was number needed to obtain the density that would look best I trusted his judgement.

I should say that the photos do belie the size somewhat, and the recipient area appears larger in person in relation to untouched portion; I've got a pretty big head 😅.

18 hours ago, giegnosiganoe said:

Interesting, I've never had a HT before but for some reason I had the idea that only surgeons were allowed to do the extractions. Maybe that's only in the US?

Worth noting that the lady working on me had been part of their team for over a decade, and she has it down to an artform. I can understand and appreciate the benefits of specialization in a setting like this, rather than having a jack of all trades approach.

[win200]

This looks like it'll be terrific.  Very tidy, dense packing. Looking forward to seeing this result.

[Nearsevn]

On 10/10/2020 at 10:41 PM, giegnosiganoe said:

Interesting, I've never had a HT before but for some reason I had the idea that only surgeons were allowed to do the extractions. Maybe that's only in the US?

Only in the US

[giegnosiganoe]

53 minutes ago, Nearsevn said:

Only in the US

I find it interesting then that FUT is so much cheaper even in Canada, when FUE is less work for the Dr (they don't need to cut the strip). Sure it's more work for the technicians doing the extractions, but I don't imagine they're getting paid thattt much anyway?

[Melvin- Admin]

15 hours ago, giegnosiganoe said:

I find it interesting then that FUT is so much cheaper even in Canada, when FUE is less work for the Dr (they don't need to cut the strip). Sure it's more work for the technicians doing the extractions, but I don't imagine they're getting paid thattt much anyway?

Let’s not make assumptions. H&W has technicians who’ve been with them for decades. It’s because they’re getting compensated fairly. 
 

@J5_95 awesome report, thank you for sharing. Work looks superb and those temple points 👌🏼

[hairlossPA]

looks great. please keep us updated!