H & W Doug Posted February 9, 2022 Share Posted February 9, 2022 This patient in his mid-40’s from a neighboring province had decided it was time to do something about his receded hairline and frontal zone. It was something that had started to bother him in his 30’s when he noticed his hairline was beginning to erode. He had previously tried a laser cap in hopes that it may improve his hairline to a somewhat acceptable degree. He did not like using it and more importantly he did not see any results which is not unusual in most cases especially where there is little to no existing hair. Certainly, any small improvement, if possible, would not be nearly as significant as restoring the areas with a hair transplant procedure. His initial consultation at the Vancouver surgery center confirmed that his above average donor hair and favorable characteristics coupled with Dr. Hasson and team’s talents would achieve a high-density result and produce the cosmetic impact he was looking for. Considering that with FUE Dr. Hasson can place the grafts at a slightly higher density than would be possible with FUT and given the areas to cover and all other factors, Dr. Hasson felt he would need approximately 5,000 grafts depending on hairline placement. At the end of the day 5031 were required. The procedure was performed over 2 consecutive days. Day 1 consisted of 2,700 grafts of which 300 were single hair grafts,1575 were doubles and 825 were 3-4 hair grafts. Day 2 produced 1326 doubles and 1005 3-4 hair grafts. 2-day totals: 300 singles, 2901 doubles, 1830 3-4 hair grafts. These photos taken at the clinic at his follow up visit represent the result 10 months post-op. 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...
Administrators Melvin- Admin Posted February 9, 2022 Administrators Share Posted February 9, 2022 Excellent density 👏 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 stephcurry30 Posted February 9, 2022 Senior Member Share Posted February 9, 2022 Incredible result but that ahs to be a typo? 5k grafts into the hairline/frontal 3rd? What was the density of the grafts placed? 120 per cm^2? 1 Link to comment Share on other sites More sharing options...
Regular Member JohnnyR Posted February 9, 2022 Regular Member Share Posted February 9, 2022 good result, but 5000 grafts for the frontal third? waste of grafts in my opinion. Link to comment Share on other sites More sharing options...
Senior Member deeznuts Posted February 9, 2022 Senior Member Share Posted February 9, 2022 21 minutes ago, JohnnyR said: good result, but 5000 grafts for the frontal third? waste of grafts in my opinion. He's mid 40's so kinda justifiable Link to comment Share on other sites More sharing options...
digi23 Posted February 9, 2022 Share Posted February 9, 2022 5k grafts seems alot for that area? Good result. Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted February 9, 2022 Valued Contributor Share Posted February 9, 2022 I'm just wondering with a low hairline design why the temple points were decided not to be strengthened? Is this patient on finasteride to prevent any future loss? Great density and thanks for sharing! GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Senior Member Hair4Days Posted February 10, 2022 Senior Member Share Posted February 10, 2022 Great result, great density. Does this gentleman have a projected lifetime graft count of 15k or something? I know he doesn’t have mid scalp or crown loss, but you cannot predict someone’s final balding pattern so I’m curious as to why so many grafts? Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted February 10, 2022 Administrators Share Posted February 10, 2022 Guys, I don't think the before pictures tell the full story, if you look at the graft placement, he had virtually half of his head dense-packed. I could bet that his hairline before and midscalp was heavily miniaturized with hairs that were on their last legs. 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...
H & W Doug Posted February 11, 2022 Author Share Posted February 11, 2022 Thanks for the comments guys! I agree with Melvin that we’re looking at more than just the front third here. He may be approaching a stage 4a and there is some work in the mid-scalp also. There are many things to consider in this case not unlike any case for that matter. We first want to evaluate the present area to cover and the potential future loss as it relates to the total donor supply. And yes, in many cases you can predict with reasonable certainty someone's final hair loss pattern. In this case it was fairly clear to Dr. Hasson that this patient in his 40s who has no miniaturization in parts of his mid scalp and crown will likely not progress past a 4A. This doesn’t even factor in whether or whether not he will use medication. Given this conclusion, if donor reserves are adequate, we can be a little more aggressive with the density because we are not going to have to preserve a fair amount of grafts for future potential loss. We then want to find out what the patient’s goals are and if they're realistic. In this case the patient wanted an appropriate hairline and wanted to be as aggressive as possible with density and placement of the hairline. Dr. Hasson then determined that with his hair shaft diameter, relatively straight hair and stable tissue, he could pack at a high density. He also determined that based on the decided upon hairline, advancement of the temples would not be required and the balance and relationship between hairline and temples would be cosmetically pleasing with the temples left alone . He also notes the native density in the mid scalp and crown and surrounding areas and understands that matching that density or coming close will provide the best cosmetic impact if it poses no risk to attempt to do so. You can see the transition from transplanted hair to native hair is very seamless and you would not suspect that there's any drop in density from the crown/mid scalp to the transplanted mid- scalp/frontal zone. In an ideal transplant, you want that seamless transition and the density should be high enough that it gives the appearance that the patient had never lost any hair to begin with. If you consider that some may estimate a stage 6 has 230 to 240 square centimeters of bald scalp, a stage 5 may have 200, then it wouldn't be a stretch to say that the area that was covered on this patient was somewhere in the 60 to 70 square centimeter range. The estimated grafts per square cm of the transplanted hair might be in the low 80s. So, if we assume 60 square centimeters of bald scalp times 80 per square centimeters you're going to get around 4800 grafts so it is not an unreasonable number. Maybe the area is actually over 60? Maybe the density is actually more than 80? Most of our patients that come to us for these type of results have high expectations, high standards and they have seen other clinic results with perhaps lower densities and they do not feel it looks as good and that they would be happy with that lower density result. I would also add when patients inquire to our clinic, often times they state the previous doctor they chose did not achieve enough density to make them happy. I personally think that this is a spectacular result. I understand it is a little hard to put your arms around the numbers when most of the industry is not able to do this type of density and therefore the average number of grafts that you might encounter as an estimate for this area could be as much as half of this. Back to an earlier comment about this being a waste of grafts. It is my opinion that under these conditions of good donor hair, relatively manageable area to cover and minimal potential future hair loss, it's a waste not to use these grafts in this manner. Why save them for a day that's not going to come? They're way better suited where they are now than in the donor bank. And I can tell you this patient would not have been as happy with 2,500 to 3000 grafts in this area. If there's anybody out there that wouldn't want this hairline or density under these conditions, I would be surprised. However, everyone is likely to have varying expectations and perhaps some would be happy with something less dense which would it still have a fairly substantial cosmetic benefit. There is nothing wrong with that if the procedure is still well executed, especially if density behind is lower, donor reserves are more limited and final hair loss pattern is more aggressive. It all depends on your expectations and what you'd be happy with. For me? If it is possible, give me this hairline and this density in the appropriate areas every time.. 😊 4 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...
Regular Member Viney Posted February 12, 2022 Regular Member Share Posted February 12, 2022 This looks awesome. Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted February 12, 2022 Senior Member Share Posted February 12, 2022 Beautiful work Dr ! I’m envious of this chaps head of hair for his age 😝And yes I can see it’s not just 5k used on the frontal third. 1 Link to comment Share on other sites More sharing options...
Senior Member OliverAtom Posted February 12, 2022 Senior Member Share Posted February 12, 2022 Awesome result but... 5000 grafts????? 😳 😵. Are we crazy? This is what ASMED clinic has been doing for a longgg time now, placing double the number of grafts that are really needed. Sorry, but that hairline would be still completely amazing with just 2500 Grafts, whoever says the contrary, well... Thanks a lot for sharing!!! Link to comment Share on other sites More sharing options...
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