Count Hairs or Only Count Grafts?

[Jotronic]

Gorpy,

 

If you re-read what I wrote, then digest it, then you'll know that I was referring to how you addressed a fellow patient of Dr. Keene, not your own results. I'm not stupid. Instead of asking how many hairs he got, you just answered a few questions. I wasn't asking how many you had as it is irrelevant to the point.

 

"Sorry, I would love to let this die, but since you are now attacking me..."

 

Quoting your own words is hardly an attack.

 

"To the detriment of future patients, I agree not to discuss philosophical and technical differences among the various doctors any more. How's that?"

 

No one is saying you cannot nor should not share your view, just be prepared for debate if what you "think" is then turned into a statement about a clinic that is false.

 

That is all.

[Gorpy]

Well, that's ok. I still KNOW for a fact that Dr. Keene places 3's and 4's (many of them). That's was my point.

Sorry if I didn't carefully read your post. You cloud the issues with so much extraneous text - Gorpy's on a witch hunt, he didn't ask Dr. X for counts, blah blah blah. It becomes tiresome reading.

 

I was prepared and did defend my position and you defended yours. Good debate Joe. Unresolved, but good.

[the B spot]

I understand the argument that has been brought forth and I have read and understood the response from ALL members.

 

Each response is valued and possesses merit.

 

However, the thread is starting to denigrate into more of personal issue, Joe vs Gorpy, Gorpy vs this member, H&W vs The World, etc.....

 

I understand Joe's position by virtue of his relationship with H&W.

 

I understand Gorpy's quest to possess ALL of the facts.

 

I would like to see H&W provide the breakdown of hair to grafts transplantes.

 

So would others.

 

 

Thanks Guys.

J

 

I am editing my post because the thread has been reset to continue the issue at hand, not the issue of 1 or 2 members.

[Gorpy]

To quickly answer that question, Dr. Keene throws in the few extra at no charge (like all docs do), so they were really not even counted. It's kind of like, well, we've got 45 extra here, let's find a place for them. Since Dr. Keene is there placing all the grafts, she can quickly do some stick and place. That's a good topic for another thread - how do any of us know how many grafts we really received?

 

It is time for this thread to die.

 

In the interest of peace on the board and out of respect for Jotronic, I am going to say that the conclusion I drew was based on the data at hand. That data was inadequate, so my conclusion was probably erroneous. If we can get more data in the future that would be much appreciated. Until then I am going to agree with Joe's statement that my conclusion was wrong.

 

Thread closed.

[Pat - Community Publisher]

Once again I see this community is again debating the merits of providing hair counts in addition to graft counts. And once again the vast majority supports having more information (hair counts) rather than less.

 

This debate has been repeated numerous times on this forum over the past few years. Yet this debate has long since been settled and the conclusion was and still is that ALL clinics should provide hair counts in addition to graft counts.

 

Many clinics have responded to the call for hair counts and we now see such hair counts in posts made by clinics and patients alike as well in some member's posting signatures.

 

Yet I'm disappointed to see Joe and apparently H & W still resisting this.

 

If we are going to present numbers then let's use a standard of measurement that works across all clinics ??“ no matter what size grafts they create ??“ counting hairs transplanted. If certain clinics are so adverse to numbers and believe that photos tell the story then perhaps they should not present graft counts.

 

The debate is really long over. Lets move past debating and request hair counts from all clinics and patients when ever graft only counts are presented on this forum. This request should be made of ALL clinics and patients.

 

We all know that clinics can provide this information if they choose to. If this community continually and consistently requests this information it will eventually become the defacto standard. I ask all members to help me make this a standard by requesting hair counts when ever only graft counts are presented.

 

Our web programmer and myself have been working on completely overhauling our website photo galleries to enable all clinics to provide not only graft counts but hair counts, details about the size of the donor strip, comments on the hair characteristics and photos from every view/angle at every stage of the process (before, immediate post op, intermediate months, final results and subsequent sessions).

 

We believe that more photos from more angles/views over all stages of the process along with detailed hair counts and surgical details will give patients far more useful information than the typical promotional "money shot" photos found on most websites.

 

This will be a dramatic improvement over our current photo gallery and IF we can get the clinics to provide this level of detail patients will get far more useful information. It will take time to get all the clinics to provide this more extensive information and photos.

 

But I believe that those clinics who do provide better information, hair counts and photos will ultimately earn the trust and business of more patients.

 

Accountability = Credibility

 

If we all continue to ask for the information we deserve I believe we will ultimately get it.

 

Pat

 

P.S. I changed the name of this topic from "Gorpy" to "Count Hairs or Only Count Grafts?" because the topic is not about Gorpy but providing hair counts.

 

Count hairs not Gorpy's Posts

[Gorpy]

P.S. I changed the name of this topic from "Gorpy" to "Count Hairs or Only Count Grafts?" because the topic is not about Gorpy but providing hair counts.

 

Count hairs not Gorpy's Posts

 

Thanks Pat. I was starting to feel like a punching bag. The whole issue got off track.

 

The Shapiro clinic has set the standard for providing detailed hair counts. Will other leading clinics like H&W step up and do the same? If they would, I'm sure the lesser known clinics would also be pressured to do so.

 

I hope to see that.

[NervousNelly]

Well said Pat. Unfortunately I was not quite as diplomatic as yourself, but only out of frustration as the diplomatic approach wasn't going anywhere.

 

Gorpy I was feeling like a pin cushion myself.

[Middleson]

...testing my updated signature

[bayscholar]

Guys by the same stand point as HC is perceived to be > or more accurate then GC.... I would add that hair shaft diameter/hair characteristics would be just as vital if the goal is to end ambiguity & create an across the board comparison scale. The average person has around 2 to 2.4 hairs per graft but what is the average hair shaft diameter?...does that vary by ethnicity/hair color etc.... Also density has great variance along the strip higher in the back and less in the sides, so there is a lot more to do then just add hair counts if we want to know are d*ck from are balls...you feel me? Don't get me wrong, much as I was ecstatic the day I found this site, I will be equally as hyped when metrics for comparison purposes become available in an unregulated field of HT.

[Middleson]

I am NOT going to update my signature line to include hair shaft diameter.

[bayscholar]

Thanks for capitalizing NOT.....good growth to you anyway in the next exciting months for you Mson.

[Middleson]

good growth anyway?

 

huh?

 

bayscholar, if I've offended you then I apologize. I thought I was being funny. I guess humor doesn't always come across well in a written forum (at least my humor).

 

I really have nothing to contribute to this discussion. I'll move on.

[bayscholar]

much as my attempt at sarcastic humor failed, good growth as spring will hopefully bloom those grafts

[spoon]

I'm not sure I see what the big deal is. Gorpy asked for some counts, which the clinic had earlier indicated they would provide. They haven't been provided. That's about it.

 

The most unusual comment was this one:

 

"Issue #2 is the value of counting hairs itself. As a patient several times over and a patient educator for almost four years I just don't understand what can be gleaned from this that helps a patient understand what he is getting. In fact, as I stated before, I see it actually contributing to MORE confusion. I have patients ask me all the time if they can get "x" number of grafts so they can have results like Patient A. Sometimes, even when I tell them that they will not look anything like another patient they say "ok" but still keep it in their mind so when they do eventually get relatively the same number of grafts I get a phone call. "Well, you got 8000 grafts, why are my results different?" If someone is armed with a hair count too then they have more ammo that to them appears to be logical when in fact hair counts have NOTHING to do with final results. NOTHING, ZILCH, NADA."

 

This makes no sense to me. Hair counts have everything to do with final results. If you plant more hairs, you get a better and more dense result.

[Guest]

With everyone's hair to graft ratio being different due to desity & caliber than the next guy, I believe it is impossible to establish a standard graft/hair count that is going to make sense. These Doctors can't be in such sync with each other that they will produce the same counts case by case. They all have specific techniques that they have developed that work for them. In most accounts I have noticed that most Ht recipients get more grafts than are originally quoted at no charge. ( As Gorpy basically stated ) So if money is not the issue what is? RESULTS! Because most HT average the same $ amount. So the count is not as important as the end result.

[the B spot]

So graft count density is the same as hair count density?

 

So it is more confusing to say Patient A has a density of 55 fu's cm/2 without stating he has a mixture of 1,2,3 and 4 hair grafts as opposed to simply stating he has 55 fu's cm/2 which could be 1's, 1's and 2's, or 1's 2's 3's, etc......?

 

Again, this goes back to my issue with "True Density" and the information that patients need to understand HOW and WHY the end result is achieved.

 

This is the information age, and a time where Doctors no longer possess the "M.D. suit of armor" with regards to their results or methods.

 

We question, we ask, we debate, we chose and we seek information as informed patients and consumers.

 

The idea that we should simply accept "results" is doing us a disservice, and that holds true for ANY Doctor.

 

Anyone know the type and size instrumentation a certain quack in Australia uses? Nope.

 

Anyone know why a certain Dr. in the southern U.S. sells a FUE method that begins with a .7mm extraction punch, but moves to a 1mm+ punch when it becomes difficult to extract grafts without damaging them? The resulting scars are visible after several thousand grafts.

 

Now, this is in no way pointed toward to H&W to say they are harming patients, so don't travel that path whatsoever.

 

The point I am trying to make is that both of the Docs I mentioned are HIGHLY sought after and produce very good results, even with some questionable methodology and ethics.

 

I guess we should not question them because they turn out decent results with a few outstanding patients that post online?

 

I am taking this issue a bit further in this thread if only to ask where do we draw the line?

 

Let's get together on this and ask EVERY DOCTOR to give us these numbers.

 

If we can be given a total hair count along with graft counts it will allow us to quantify and measure Doctors, to a certain extent, when we can use all the factors:

 

Age, Hair Type, Hair Color, Degree of Baldness, Strip Dimensions, Graft Count, Total Hair Moved, Hair Count Breakdown, Hairline Placement, Hairline Density, Overall Density, Post-Op Redness,Scabbing, Incision Sizes, Blades vs Needles, Staples vs Sutures, Trico vs Standard Closure, Resulting Scar, Resulting Coverage, Resulting Look, Cosmetic Improvement, Overall Patient Care (before, during and after session) Doctor Philosophy and Future Planning, Quality and Experience of the staff, Condition of the Operating Rooms.

 

Last but not least--- Patient expectations met, unmet, or exceeded.

 

At least this is how I try to quantify and assess the level of a Dr or Clinic.

 

I do admit though, that I AM a hair geek

 

Thanks

J

[Pat - Community Publisher]

So the count is not as important as the end result.

 

THE COUNT is the end result.

 

What else does a patient get from a hair transplant if not growing hairs?

 

Some of the top clinics such as the Shapiro Medical Group use some double follicular units (containing 4 to 5 hairs) in certain patients like myself in the central areas to achieve the optimal illusion of density, while other top clinics create sub follicular units (containing 1 to 2 hairs) from naturally occurring 3 and 4 hair follicular units that are used in large numbers in the central areas to create density. Yet by using graft counts alone these very different grafts are counted as the same, while the double follicular unit graft can contain four times as many hairs as the sub follicular unit graft.

 

So is acknowledging such differences in grafts really "contributing to MORE confusion" as stated in a prior post? I think hair counts add clarity not confusion and that the members of this forum can handle the math. Those who don't want to deal in meaningful numbers can just look at photos if they prefer.

 

So let's not post graft counts on this forum without the actual hair counts. If we are going to count lets count accurately. All clinics have these hair counts and can provide them to their patients.

[Middleson]

I don't know if this will be helpful or not, but I grabbed points for and against hair counts as a valid comparison tool from this thread. I left out anything related to "witch hunts, personal attacks, etc.."

 

Points made Against Providing Hair Counts as a point of Comparison:

-not of significant value in the grand scheme of things

-does nothing to explain final results

-it only adds fuel to the fire

-it is not the actual number of hairs above and beyond the number of grafts but more so the TYPE of hair which is important

-Hair shaft diameter, coarse vs. fine, curly vs. straight, hair color contrasted against scalp color. These factors have a far greater impact than anything

-the issue seems to be beyond counting hairs

-I for one could simply care less. It is the final product I care about.

-The last thing on my mind next year when the hair grows in, will be number of hairs per fu.

-All it comes down to are results

-Comparing graft to graft counts between other clinics are comparable

-How do you really put a price on how great it feels to have a second lease on life

-I just don't understand what can be gleaned from this that helps a patient understand what he is getting

-I see it actually contributing to more confusion

-If you are a patient, ask for them, if you aren't how is that your business if the patient himself is not complaining???

-If someone is armed with a hair count too then they have more ammo that to them appears to be logical when in fact hair counts have nothing to do with final results. nothing, zilch, nada.

-Should clinics also make it standard practice to give out other details such as dystolic/systolic blood pressure readings, micrometer measurements of hair shaft diameter, exacting density placement diagrams, total volume of anesthesia used, background checks and qualifications of technicians?

-the continued education of how hair characteristics play a role in final results should be improved first as it continues to be the #1 shortfall when people are learning about their options

-With everyone's hair to graft ratio being different due to desity & caliber than the next guy, I believe it is impossible to establish a standard graft/hair count that is going to make sense.

 

Points made For Providing Hair Counts as a point of Comparison:

-I'd like to see detailed hair counts

-if we are going to compare Apples to Apples, it is vital we have exact information to get an accurate comparison

-as people surf this forum and educate themselves, people begin to want to know not just how many grafts they can get, but how many hairs

-It's all about the numbers

-providing detailed hair counts doesn't appear to me to be problematic

-We want to know what the hair moved is versus the graft count

-I'd like a hair count because I think it would be nice to know how many hairs I received (rather than an average)

-I find such detailed information useful, since the trimming of grafts is rather subjective and the average number of hairs per graft can vary from clinic to clinic

-I believe that physicians and their patients should ideally provide not only their final graft count but also the amount of hairs moved so that patients and potential patients can compare "apples to apples". After all, ultimately it is the amount of hairs and how they are distributed in the recipient area that determines what a patient achieves.

-We want patients to request this info and receive it, no questions asked

-Grafts are not equal to hairs

-let's try to get all the facts so users on here can make a choice on similar data

-The debate is really long over. Lets move past debating and request hair counts from all clinics and patients when ever graft only counts are presented on this forum. This request should be made of all clinics and patients.

-The count is the end result. What else does a patient get from a hair transplant if not growing hairs?

[Janna]

Wow, four pages of posts on whether a hair count is necessary information or not. I think people would agree that this thread could go on forever with the two sides. The thing is each person/patient is different. What's important to one person is not necessarily important to another. So, is it wrong to want information? I can say approximately half of our patients want the specifics to their surgery. Do we think those patients are critiquing or questioning our work? We take no offense at their desire to know every aspect of their surgery.

 

Counting grafts as we cut and keeping 1's, 2's, 3's, 4's, and double FU's separated has always been part of our procedure. It helps the doctor make the correct number of incisions as well as the right size incisions corresponding to the graft size. It's always been important for Dr. Shapiro to know exactly what he has as his philosophy is selective distribution for 3's and 4's to maximize density in certain areas. Maybe because this part of surgery was in place before I started working for Dr. Shapiro that I see no confusion about providing graft and hair count, but rather clarity of what the patients should expect of his outcome. I can honestly say that knowing the hair count has never confused any of our patients. The hair count also helps us during a patient's follow-up.

 

Dr. Wong was kind enough to let me view couple of his surgeries last summer. I actually helped cut some grafts and plant a few. I have great respect for Dr. Wong and after my visit I probably had more respect and admiration as he is one of the nicest fellows around. I don't believe there's anything deceptive about Dr. Wong, his surgeries, or numbers. There was nothing technically or philosophically different about Drs. Wong or Shapiro's surgeries. As I viewed and spoke to Dr. Wong about his surgeries, we both agreed that his surgeries were very similar to Dr. Shapiro's. IMO, the only thing a little different were their approach to the hairline. Artistry is subjective and their works speak for themselves. With that said, I ruffled some feathers last September when I questioned the "two pile" method of Dr. Hasson (from Pat's visit and other sources). Dr. Hasson's preference for random distribute of grafts behind the hairline made sense. So I laid my question/assumptions to rest as I chalked it up to different approaches/philosophies for different people. I think the only thing now is the lack of hair count despite Dr. Hasson stating he would start providing the numbers last September. Hopefully, all clinics will provide this data.

 

Middleson, thanks for taking the time on for/against hair count. Too bad for me as it took all day for me to read the entire thread. Good thing today was a quick surgery day.

[hairbank]

To this point, we've seen varying opinions on the graft/hair counts. I'd like to slightly shift focus onto what I believe is monumental when it comes to graft/hairs and a number of other issues when it comes to HT's. To what extreme are we going to measure?

 

At this point, we have a defined list of Coalition Surgeons. How did they get to be members? By complying with these requirements. While I am not as interested in hair counts as some are, I do understand the value it provides. However, if we are going to start holding clinics accountable for hair counts, should this not be a prerequisite for Coalition Membership? At this point, it appears several want to see hair counts only not every Coalition Surgeon provides them. Rather than hear any more back/forth for/against comments, if hair counts are important enough that a surgeon not providing them is going to be viewed in a negative fashion by the forum, why not take all of the guesswork out of it and just require it? I'm interested in opinions on this issue.

 

By the same token (and I mentioned this earlier), to what extent are we going to technically evaluate the work of a surgeon? We have several Coalition Surgeons that, while the work quality is good, the overall package may not be. How many of them can perform a mega session by today's standards exceeding 4000 grafts? Maybe 4 or 5 of the surgeons? Isn't this also a "quality" issue as many NW 4+'s need well over 4000 grafts for the appearance of density, so, are we going to recommend they go somewhere that can give them that number in 2 sessions, or one? As has been shown, it's much more cost effective, saves grafts....etc, to have one pass, if feasible.

 

Maybe B spots mention of 2 separate Coalition recommended lists need developed?? In any case, if we are going to start holding surgeons accountable for something as specific as hair counts, I believe it needs spelled out. At this point, it's merely opinion-based on what we'd LIKE to see and not a requirement.

[the B spot]

Hairbank-- perhaps a 2 tiered approach to our Coalition Membership is necessary.

 

If enough people want to discuss it, then lets start another thread to keep it separate, so we can a get a true read on it.

 

I am for it.

 

In referring back to this thread, I am for hair counts from every clinic.

 

Thanks Bank,

J

[NervousNelly]

This is a shame.

[John_in_NC]

I am trying to guess why this debate: Does anyone think that H & W are fudging the numbers by spliting grafts or ....what?

[NervousNelly]

John NC possibly prior to insulting me earlier you should have actually read the posts.

[John_in_NC]

Originally posted by NervousNelly:

John NC possibly prior to insulting me earlier you should have actually read the posts.

 

when did I insult you or anyone????