Looking for advice/expectations for upcoming procedure at H&W

[hairison_ford]

I have a 2500-3000 FUE booked with Dr.Hasson in a couple months. I've done a fair amount of research and lurking on this forum so I'd consider myself pretty well-informed on hair loss/transplants at this point, but it would be good to get some advice from some of the users on here on what I should expect going in and what I should discuss with Dr.Hasson the day of the procedure.

For background: I'm 27, started gradually losing hair at around 16/17, but have been taking finasteride for the last 2.5 years which seems to have halted the hair loss. I'm also taking 2.5mg/day of oral minoxidil starting mid-October 2022, though I don't think it's had any noticeable impact so far. Most of the men on both sides of my family are shaved bald (dad, both grandpas) so I would probably be destined for minimum NW5+ without medication. As of now, my hair loss is mostly concentrated in the frontal third, but I do have some modest thinning throughout the mid-scalp/crown (though not noticeable enough to warrant a hair transplant in those areas). Had an in-person consult with Dr.Hasson where he did a quick comb-through of my hair and quoted me 2500-3000 grafts to restore the frontal third. He also mentioned that I had a top 10th percentile donor area (dense and coarse hair), so that was reassuring.

I've seen a couple negative reviews of Dr.Hasson lately on this forum, but he still seems to be a top surgeon based on the vast majority of his results, and I live close so it seemed like a natural fit for me. I do want to be prepared on the day of surgery though, so hoping to get some advice from folks here on the following:

1) I've attached some pics of my hair and a (poorly drawn) sketch of what I think is a realistic goal for the hairline. I'm hoping for a mature hairline with good enough density to match the fringe in the front, which has held up pretty well -- is that reasonable to achieve with the quoted 2500-3000 grafts? I've seen posts on this forum where Dr. Hasson increased the graft count on the day of surgery compared to what was quoted after further examination, sometimes by a significant amount. I'm hoping that the in-person consult I had with him (as opposed to virtual where it's harder to estimate accurately) makes that less likely to happen, but I'm prepared to go up to a maximum of 3500 grafts if necessary.

2) My temple points are somewhat recessed/concave looking, although they've also held up decently well I think. Temple point restoration seems to be tricky to make look good even for experienced surgeons, so I'm leaning towards not having anything done to them (other than closing off the temple), but wondering if folks think it's necessary for the points to be brought in/reinforced in order to make the hairline framing look natural.

3) Assuming I stay on finasteride, what's the likelihood that I would need a second transplant within the next decade? This is a decent chunk of my savings, and I have other financial goals in life that I want to save for, so I'd be reluctant to do another one in the near future. The advice seems to be that most people need more than one procedure (especially if they're young like me), but I'm hoping that Hasson's dense-packing combined with medical therapy can hold off the need for another one at least until I'm in my mid-late 30s. Is that realistic or should I adjust my expectations?

Any other tips/advice are welcome! Thanks!

[Melvin- Admin]

If you had an in-person consultation, there shouldn’t be any issues. I don’t see how you would need more than 3,500 grafts for the hairline you desire. 

I don’t think you require temple points, but the best temple points in my opinion were done by Dr. Hasson. @Aftermath

I would say it’s a 50/50 whether you’ll need another HT before 40. You might start to slightly thin in the crown. But, it might not bother you at that point. Unfortunately, only time will tell.

[BurnieBurns]

You'll be to one of the best pairs of hands with Dr Hasson. No Doctor is perfect and that's the truth.

I agree that there it would be very unlikely he's need more grafts on the day since you've had an in person consultation. Pictures are very limiting to go off because even when taken well you can't tell how big the persons head it.

Your current temple points look fine in proportion to your desired hairline so don't think any work is needed there. Of course, he wouldn't start the surgery until you're 100% clear with the plan and given the ok.

It is impossible to say when you'll need another transplant, but if you're going strong on finasteride and oral minoxidil (I'm assuming this is why he'd still operate on you given your age) then you'll likely be in a solid place for a while. You could also upgrade to Dutasteride or even increase the dose of oral Minoxidil if you find yourself losing ground.

PS. You definitely have won the jackpot in terms of Donor characteristics.

Edited January 18, 2023 by BurnieBurns

[Chrisno]

Will be interested in following your journey. I have the same hairline as you, but somewhat less receeded and a little bit lighter brown hair color. I am scheduled for a 2000-2500 graft surgery in June with Hasson. He was my first pick. I only had an online consultation. I am not planning any temple work, only hairline. I want a hairline that will look good also when I'm 50.

[asterix0]

Out of curiosity, which recent results have you seen that you like from him?  

[Tiger2050]

Quote

I've seen a couple negative reviews of Dr.Hasson lately on this forum

You’re in great hands with Dr. Hasson. There is only one recent review from an unhappy patient from Dr. Hasson but you’ll find every doctor has some unhappy patients if you dig deep enough. Unhappy patients are a lot louder than happy patients.

Edited January 18, 2023 by Tiger2050

[asterix0]

On 1/18/2023 at 2:48 PM, Tiger2050 said:

You’re in great hands with Dr. Hasson. There is only one recent review from an unhappy patient from Dr. Hasson but you’ll find every doctor has some unhappy patients if you dig deep enough. Unhappy patients are a lot louder than happy patients.

To be fair, from what I have seen he uses a lot of grafts (in my opinion too many) for small surface areas. I would caution that the OP should find recent results (in the last year) that he likes, and compare them with other top surgeons for similar graft numbers and see if he is still confident with his choice.

 

[BrockLanders]

I had a procedure w/ Dr. Hasson in Oct 2021. Outdoor lighting in direct sun (if you're losing hair you know what that means). Your hairline seems pretty similar on the before so i'm sure you'll have a great result with him and his team.

 

Edited January 19, 2023 by BrockLanders

[hairison_ford]

Thank you guys for the input so far. Sounds like my expectations are reasonable from what I'm hearing.

5 hours ago, asterix0 said:

To be fair, from what I have seen he uses a lot of grafts (in my opinion too many) for small surface areas. I would caution that the OP should find recent results (in the last year) that he likes, and compare them with other top surgeons for similar graft numbers and see if he is still confident with his choice.

 

I think I've viewed most of the results that have been posted in the last year from Hasson patients. A lot of them are still partway through the growth stages and some seem to have stopped posting updates, so tougher to point to many with final or near-final results. @BrockLanders result looks pretty great as you can see above. My graft quote is a fair bit lower than the 4500 he got, but looks like there was more work done in his mid-scalp than there will be in my case. I thought the one below that was posted recently was also pretty great: 

I think pretty much all of the final results I've seen from Hasson in the last couple years look good aesthetically. I get what you're saying though about some cases having what seems like more grafts than you'd expect were necessary given the surface area, but that's partially why I wanted to consult the knowledgeable folks on this forum on what you guys felt would be a typical number of grafts for the area I'm hoping to get covered. My understanding is that the 2500-3000 quote is fairly typical for what I'm hoping for, and wouldn't be out of line from what other top surgeons would recommend for the surface area (basically everything in my frontal third minus the tuft/temple points), but it would be good to know if I'm off the mark there. 

[deeznuts]

On 1/19/2023 at 10:37 PM, hairison_ford said:

 

I think pretty much all of the final results I've seen from Hasson in the last couple years look good aesthetically. I get what you're saying though about some cases having what seems like more grafts than you'd expect were necessary given the surface area, but that's partially why I wanted to consult the knowledgeable folks on this forum on what you guys felt would be a typical number of grafts for the area I'm hoping to get covered. My understanding is that the 2500-3000 quote is fairly typical for what I'm hoping for, and wouldn't be out of line from what other top surgeons would recommend for the surface area (basically everything in my frontal third minus the tuft/temple points), but it would be good to know if I'm off the mark there. 

I've always thought Dr. Hasson's philosophy was that he'd rather give you the grafts you want in one go rather than have you somewhat disappointed and have to come back for a round two. 

A lot of people talk about hair greed, where they basically get a transplant and find out they want a bit more density or they want their hairline a bit lower or they want some better temple peaks... Hasson just gives it to you in one surgery rather than doing it in 2 or 3 surgeries. 

The reality imo is that you can give the illusion of density but there's only so much you can do at the hairline to give an illusion. There's no shingling happening at the hairline.  If you're styling it up the only thing that's going to save you is density or toppik. Though maybe doctor's have some secret sauce to give you a good illusion of density that I don't know about.