DR TRUE

[the B spot]

Posted By D(by Dr. Hasson)

There are multiple technical factors that come into play during the creation of recipient sites and the subsequent graft placement. These include:

 

1.) When thinning areas are shaved down the "thinning process" takes on a different meaning. With the use of magnification it will be seen that some follicular bundles are absent (and there are wider spaces between remaining bundles) and that some bundles are significantly miniaturized. It will then be possible to place new recipient sites in the place of absent bundles and alongside miniaturized bundles to recreate the density. This can also be done in a uniform manner so that if the pre-existing hair eventually disappears, due to progression of hairloss, the transplant can still look reasonably natural. If the recipient site is not shaved the surgeon must part through the hair again and again looking for any empty spaces and trying to fill the spaces as best as possible. This is not really as exact a process but much more hit or miss.

 

2.) The hair exits the scalp at an exact angle. The only way to precisely match that angle is to buzz the recipient hair down (in a way similar to how ALL doctors need to shave the donor hair when taking out the donor strip).

 

3.) Transection of existing hair below the skin surface is possible if the incisions are not made exactly parallel to the surrounding bundles. We often see this as a "halo" type effect when performing repair procedures.

 

4.) When inserting grafts the technicians can easily identify the recipient sites and ensure that all sites are filled. This can be achieved with no trauma to the pre-existing hair.

 

5.) When hair is buzzed no manipulation of the pre-existing hair is required at all. When the hair is not shaved it needs to be combed through (hundreds of times) by the physician who makes the recipients sites and again by the technician who places the grafts into the sites. This repetitive trauma of combing through the hair again and again will result in "hair shock", a shedding of the existing hair. When this hair falls out in 2 to 3 weeks there will be a 2 to 3 month wait before it returns. Whereas if the hair were buzzed it would grow from day one 1 and keep growing. A number 3 buzz cut often will look good at 10 to 14 days post operatively and blend in with the recipient site well.

 

All these factors are relatively unimportant if you are trying to place to 2 or 3 hundred grafts into recipient sites however if you wish to have the utmost of refined results the difference is night and day.

DR HASSON

 

I hope this helps

[Gorpy]

It should be noted that not every doctor would agree with Dr. Hasson's statements. Doctors routinely disagree and debate such topics. You won't see them jumping on public forums like this and openly debating, but the disagreements do exist. If you ask doctors privately about such topics as exclusive use of lateral slits, shaving the recipient area, etc. you'll hear some compelling opposing arguments.

[the B spot]

Gorpy, I was posting this in response to shaving the recipient area. I do not agree with exclusive lateral slitting, but in another post I detailed that they should be used exclusively in the hairline. I am well aware of the debate raging between clinics, but I think the argument over the results being produced is not even close at this point. I just think it is ridiculous for a guy who has been on this site for a month to start talking about "over-hyped" practices, including lateral slits and shaving down, Gorpy. I understand where YOU are coming from, but we all have to respect the results that Dr. Hasson is producing and if he says this process produces optimal results, then I am ok with it. I also talked to Dr. Shapiro when I went in for mine, and yes he agrees that HT can be performed without shaving down, but shaving down allows larger sessions, higher densitys, and better view of existing hair angulation. So perhaps sessions of 1500 grafts or so, with lower density requirements, shaving is not as pressing. I just want to make sure we are giving the best information to the newer guys, so they understand exactly what they are looking for before they make a decision, that's all.

[Gorpy]

I understand what you are saying. I just want NEW patients to understand that there are varying opinions among some of the very highly respected doctors. That's all. Dr. Hasson's results speak for themselves and he has my highest respect.

[spoon]

Originally posted by the B spot:

Gorpy, I was posting this in response to shaving the recipient area. I do not agree with exclusive lateral slitting, but in another post I detailed that they should be used exclusively in the hairline.

 

"Should" isn't the same as "must", and it's sometimes the case that very strong wording makes opinions come across as facts. There is clearly some difference of opinion on optimal orientation of incisions. The fact that you would insist on lateral slits for your hairline is of course your choice but to say it's "imperative", as you said in the other topic, is misleading especially to new readers of the site.

 

I am well aware of the debate raging between clinics, but I think the argument over the results being produced is not even close at this point.

 

I think it's pretty close. Again, opinions.

 

I just think it is ridiculous for a guy who has been on this site for a month to start talking about "over-hyped" practices, including lateral slits and shaving down, Gorpy.

 

I think it's equally ridiculous to equate knowledge with length of time on a site. There are a lot of sources for information on transplants and I think a lot of people lurk around for months or even years before they sign up on a message board.

I also talked to Dr. Shapiro when I went in for mine, and yes he agrees that HT can be performed without shaving down, but shaving down allows larger sessions, higher densitys, and better view of existing hair angulation. So perhaps sessions of 1500 grafts or so, with lower density requirements, shaving is not as pressing. I just want to make sure we are giving the best information to the newer guys, so they understand exactly what they are looking for before they make a decision, that's all.

It's a noble goal but once again it's very important to understand that opinions differ, and that excellent results are also produced with different techniques. I read comments on another site from a lead tech at a clinic that I don't think I can mention here and the tech said it makes no difference to them if the existing hair is longer or shaved down. Also, you'll never get a statistical study that shows (a) that shaving down the head produces a statistically significant increase in angulation accuracy, or (b) a visually significant increase in angulation accuracy. I can come up with theoretical experiments for each type of study to measure those things but this post is already long enough. You'll only get the empirical argument which says OBVIOUSLY the angulation is better. That's not the same as science and nobody will convince me otherwise. To me personally (opinions, opinions) I have to go back to the question asked by tony71, what do you tell co-workers? What would you say in a social situation? Some people would practically die of embarrassment. I work and live in a pretty social environment and people talk, and no matter what the behavioral theorists say, I believe most people, myself included, care what other people say and think. A transplant, for some, is personal business. For others it isn't. Nice that there's a choice for both groups.

 

New guys should also have that information before they make decisions.

[the B spot]

Great Response Spoon, but again, we are not throwing terms like "over-hyped practices" around are we? I agree with much of what you said, but from my personal view, (take with a grain of salt) and I stand behind what I say. No problems here, everyone has an opinion, and is good these types of debates are open to all who read them. I will say this, everything I say or beleive in is only to promote the BEST hairtransplantation for EVERYONE, regardless of who they ultimately choose. Yes, HT can be done without shaving down, yes doc's can close without using the Tric closure, yes docs's can get "good" or "solid" results without employing the lateral slit technique, but because we only get a few chances to get this stuff right, it is important that we look at giving ourselves the greatest chance for success. Of course, I am NOT a doctor, but I think some of us here would in fact make many HT doctors sweat should we walk into their offices, simply because of the questions and the knowledge we have gleaned. To close this, I never equate knowledge with time on-board the site, as evidenced by many new posters, but there is a certain way to comment on these types of things when we make statements like "over-hyped" that someone could find misleading. By my posting, Gorpy's and yours, we have effectively given the new or partially educated a great, respectful discussion that includes BOTH sides of the argument, supplying them with usefull information. Thanks Again!

[Gorpy]

I can guarantee, you would not make Dr. Keene sweat. In fact, that would be fun to watch. Anyway, the point is, there are always two sides to an argument. You actually have not heard the technical details of her argument. I have, but like I said, doctors will not get on these public forums and openly debate each other.

[John_in_NC]

Buzzing Down: Must it be with no guard, or can the doctor do just as good of a job with a #1 or #2 guard buzz?

[tony71]

Hi Guys,

 

Well I went to NYC and met with Dr.True and the meeting went well.

 

He took his time and went over everything and answered all my questions. He said if I decide to go through with the HT, he can do around 1500 to 2000 from the back of the head and since I do have enough bodyhair (chest) the rest would be from the chest and the back.

 

He showed me some examples of the body hair transplanted and compared them to the hair taken from the back donar area and they look pretty much the same.

 

I just wanted to know if anyone on this forum had body transplant and how did it go?

 

Thanks

[Glock08]

Hey Tony:

Glad to hear things are working out for you.

 

I'll be heading down this afternoon for my HT tomorrow w/ Dr. True. Keep ya all posted.

 

_______________

0-One's

0-Two's

0-Three's

0-Fours's

 

Hope that changes...

 

Pre-Medicated and follicular challenged

Glock08

[nikkop23]

Tony,

The body hair route is controversial--I assume that's the final option since your back hair donor would be depleted? Can Dr. True comment on body hair yield, % of hairs that are in resting phase at any given time (much higher than head hair from what I've read), and his experience with BHT in his practice? My sense is that nobody has had very good results with it so far, and I'd hate to see Tony be disappointed with the results all over again. Anybody else see this as a possibility?

[Pat - Community Publisher]

I agree that BHTs to date have been controversial and very unproven. I'd like to hear Dr. True's ideas on the procedure and its effectiveness to date.

 

Glock best wishes for a great surgery tomorrow. I expect you will have plenty of hairs and grafts to put in your signature.

[Hats Head]

Glock08

Hey Glock It has Begun. Good Luck .. Don't forget the Salad .. I get my stiches removed Thursdy .. So I'll be seeing the good Doc

[tony71]

Dr. True showed me some of his patients sample hair both from the head and body and they looked pretty much the same and they grew longer than they would have if they were still on the chest.

 

I'm still 50 50 about doing it specially when it comes to BHT.

[the B spot]

The only way I would try body hair is if a doc was offering BHT in small sessions FOR FREE. As of now, there simply is not enough data on BHT to warrant paying for it at this time. At least from my perspective. In addition, I would only consider body hair in my crown only, not in the hairline or mid-scalp regions. Again, these are just my PERSONAL opinions, and my views that I am sharing with the membership.

[Bill - Seemiller]

My PERSONAL opinion is stay away from BHT. I haven't seen enough results to even think about it...but that's not to say that the results aren't out there. Anyway...that's just my personal opinion. I too would like to hear what Dr. True has to say about it's success...and even moreso, would like to see before/after pictures of patients who have gotten BHT.

 

Bill

[tony71]

I have a quick questions, can someone tell me from the pics I have which is on page two, Dr True said he will do between 1500 to 2000 FU with 30/40 cm2 for the hairline behind it.

 

I don't know much about the 30/40, but with 1500 to 2000 is it possible to get good coverage?

 

I do have fine hair or I guess its sparse.

[Mark H]

Tony, I'm not the most knowledgeable on this, although I did stay at a Holiday Inn Express last night...no seriously I just had an HT of over 4000.

 

My hair loss was a little more than yours I think. I WAS an NW5 I believe. Anyway, my guess is that about 2000 would nicely establish a hairline, but would taper towards the back and not give great coverage towards the crown.

 

Its hard for me to tell, because none of your pictures actually shows the top of your head, but you appear to have significant balding at the crown, I just can't tell what's inbetween.

 

In anycase, establishing the hairline is the key. As to 30-40, that is about half normal coverage. That would be considered fair coverage for an HT I think, because baldness becomes noticeable as hair density drops below half.

 

I doubt the thickness will rival what your system shows, but it will gove you good hairline coverage I'd think. Is 2000 it for you? Is that the end of your donor hair?

 

How did Dr. True set your expectations?

 

Others with more experience than me will probably correct me if I'm off base.

 

 

mark h

[tony71]

Mark,

 

Thanks for your reply.

 

I should be staying at Holiday Inn Express too. lol

 

Dr True wants to redo my hairline, since he said it looks to good. lol

 

Anyways back to my pic, the middle hair (top of the head) befoe the crown area is my own hair still. But like you said the crown area is balding, still has some hair but lost most of it thats where the BHT comes in.

 

He wants to take between 1500 to 2000 from the back of the head just for the hairline and most of the front and the mid section and crown we have to go with the body hair.

 

From what he said he said the front will be to a point covered that I would be comfortable to not wear a system anymore. If Dr True can achive that and get the front to be pretty much covered, I would be happy.

 

And definately do not want it thick like my system, I have to add gel to my system to make it more natural.

[L'Anonyme]

Tony,

Dr. True did some hairline work for me, so I write as someone familiar w/ his clinic, but I don't know about the body hair approach. Did I read you correctly that it would be for the crown only? Did Dr. True show you grown-out results of BH in the crown, and did they look good? I wish he would post examples in this forum so we could all see how your expectations are being set. Best of luck to you if you decide to move forward with it.

[tony71]

L'Anonyme,

 

He wanted to use the BHT for the crown and some on the top, doesn't want to use it for the hairline or the front he prefers the back of my head for the hairline and front.

 

He did show me one pic of this guy who had a gap between his side hear and some leftover hair on the top and he filled the gap with the BHT and it didn't look bad at all.

 

He then showed me some samples of hair he had taken of his patients after they had the bht and the hair grew. It looked no difference than the hair in the back, he did say once the BHT is done the hair forms the same charateristic as the hair that is from the back of the head.