Hasson and Wong questions

[Take a chance]

Hi all,

 

Was doing some research on Hasson and Wong and had some questions I was hoping to get answered. Obviously the clinic has had fantastic patient results and has a great reputation. I was hoping either Jotronic or maybe a former patient could help me with these questions.

 

1. Do the Doctors take future hair loss into account when planning the HT and what measures are taken to ensure consistent coverage over the years?

 

2. Are there any measures taken to reduce post operative swelling like steroidal injections to reduce inflammation?

 

3. Are all patients required to take blood tests before HT?

 

4. Will before and after photos be taken for patient?

 

5. What factors determine which Dr will do a patients HT. In other words does each Dr have a specialty area or a patient type they look for. I have seen that Dr Wong does a lot of repair work. Am I right in assuming this?

 

Thanks in advanced.

[Take a chance]

Hi all,

 

Was doing some research on Hasson and Wong and had some questions I was hoping to get answered. Obviously the clinic has had fantastic patient results and has a great reputation. I was hoping either Jotronic or maybe a former patient could help me with these questions.

 

1. Do the Doctors take future hair loss into account when planning the HT and what measures are taken to ensure consistent coverage over the years?

 

2. Are there any measures taken to reduce post operative swelling like steroidal injections to reduce inflammation?

 

3. Are all patients required to take blood tests before HT?

 

4. Will before and after photos be taken for patient?

 

5. What factors determine which Dr will do a patients HT. In other words does each Dr have a specialty area or a patient type they look for. I have seen that Dr Wong does a lot of repair work. Am I right in assuming this?

 

Thanks in advanced.

[dakota3]

Since we are on the subject....

 

Joe how is it that H&W can get so many more grafts in a single session than other surgeons?

 

Do they have a differant method of extraction that other doctors dont use?

[thanatopsis_awry]

Dakota,

 

I invested a decent chunk of time inquiring into just that question, talked it over w/ various people, and I'm curious to see a Jotronic response....my answer (while I don't find it to be absolute in that I don't think I ever got a "yes"/"no" answer from Jotronic or a H&W rep) is that the consistently high graft #s (re: 5k+) come from the *size* of the strips and *where* the strips are taken from. So, basically, a combination of H&W having the will and apparent ability to take such aforementioned strips and close em' up well -- w/ patient consent when going outside the "traditional safezone".

 

I'm a gambler by nature, so I'm always keen to incorporate randomness into the equation: the epic-sized sessions (7k....8k) are a result of the aforementioned and rare -- glorious -- donors.

 

My subsequent question, which may or may not carry weight depending on if the above is true, is why other clinics haven't ventured into such session sizes; the most immediate reason would be that, assuming they are ethical, many/most don't because they don't have enough staff to soundly handle such titanic loads. This, and/or H&W's dexterity in doing the closures is a tecnique that for w/e reason they do not know, or they are not willing to venture into trying.

[Bill - Seemiller]

Take a chance,

 

Because hair restoration surgery should be considered a journey rather than a single procedure, an ethical surgeon will consider your long term hair restoration plans which includes planning for future hair loss.

 

Some clinics will take measures to reduce swelling which may or may not include shots. However, typically postoperative swelling is due to the amount of anesthetic fluid injected into your scalp during the procedure. Any swelling will start in a few days after surgery and typically subside a few days after, up to a week.

 

Some clinics require blood tests while others do not. Hasson and Wong did not require a blood test for my surgery.

 

In my opinion, all clinics should be in the habit of taking good quality before, immediately postoperative, and after photos of the recipient and donor areas. I often use Hasson and Wong as a leading example of how clinics should be taking photos. They are masters at quality and accurate photo taking.

 

Assuming you are a hair transplant candidate, selecting a hair restoration physician is both objective and subjective. Consider your own needs and research surgeons by looking through patient before/after photos (especially those with similar hair loss patterns) and consult with surgeons you are considering. Through extension research and consultation, you should be able to make an educated decision on selecting a surgeon that suits you the best.

 

If you are talking specifically about deciding between Hasson and Wong, both surgeons are amazing and you'd be in great hands with either. Choosing between two elite doctors is hard, no doubt about it. Look through many photos, talk to and meet with their patients, and consult with the docs. This will help you make a decision.

 

Best wishes,

 

Bill

[Bill - Seemiller]

dakota,

 

I don't want to oversimplify this answer, but the bottom line is this.

 

The longer and wider a strip taken, the greater the amount of true follicular unit grafts dissected.

 

There are many factors that go into deciding how long and wide a strip to take including donor laxity, donor density, hair loss patterns and the risk of future hair loss, patient's goals, etc.

 

Surgeons performing these ultra-megasessions have to be comfortable safely taking a longer, wider, strip, when appropriate for the patient. Some surgeons feel more comfortable taking a smaller strip in order to lessen the risk of scar stretching while others believe larger strips can be taken without increasing these risks.

 

Additionally, a clinic needs to have a high number of well trained staff to pull off a larger session like this in a single day. Remember that all the grafts have to be dissected, trimmed under microscopes, and then transplanted into recipient sites. This must be done in a timely manner before the graft survival rates go down after being out of the scalp for too many hours.

 

There has also been some discussion as to whether or not Hasson and Wong trim smaller grafts, though some have gone a step further to accuse them of purposeful dissection of a follicular unit. It is my opinion that Hasson and Wong cut true follicular unit grafts. Pat, on the other hand, after viewing them in surgery, feel that they may cut smaller grafts. Until they start providing hair counts, I suspect there will continue to be some ambiguity.

 

That said, their results are amazing which is why many (including myself) are patients of theirs.

 

I hope this helps.

 

Bill

[Jotronic]

Take a chance,

 

Your interest in Hasson & Wong is appreciated. I'll try to answer your questions...

 

1. Do the Doctors take future hair loss into account when planning the HT and what measures are taken to ensure consistent coverage over the years?

 

Absolutely the future is considered. It would be irresponsible of us to not consider this issue. We try to make sure the patient is educated about the ONLY options for maintaining any existing hair that may still be present during the procedure. This is Propecia/Proscar and to a less extent Avodart. It doesn't make sense to have to come back over and over again. Beyond this, when we are placing grafts, we are careful not to do so in a manner that will leave the patient looking awkward should they still lose more hair. For those that have received bigger sessions the amount of tissue and hair removed is still relative to what is available in total in that there will be more hair that can be moved to address future areas of loss.

 

2. Are there any measures taken to reduce post operative swelling like steroidal injections to reduce inflammation?

 

None, really. Only about 10% of our patients have any issue with swelling that is considered heavy. Those patients that do experience this usually see the swelling resolve itself at roughly the six day mark. There is nothing wrong with post-operative swelling in that it does not affect the work one iota.

 

3. Are all patients required to take blood tests before HT?

 

No. We perform our procedures with a universal approach in that we consider each patient to be contagious.

 

4. Will before and after photos be taken for patient?

 

Always before photos are taken but after photos are not standard. We will take them however if the patient requests as much as well we will provide a CD with all photos upon request.

 

5. What factors determine which Dr will do a patients HT. In other words does each Dr have a specialty area or a patient type they look for. I have seen that Dr Wong does a lot of repair work. Am I right in assuming this?

 

No, both doctors do a lot of repair work. In fact, it makes up about 30% of our overall patient load. The factors that determine which doc gets which patient usually comes down to who's turn it is. When we get virtual consultations it usually is a simple matter of 1 and 1 meaning that the reviewing doctor is alternated for every other consultation request. Same for in house consultations. One will be assigned to one doctor then next to the other unless of course in either scenario the patient specifically asks for a particular doctor or they were referred by a previous patient of one of the doctors.

[Jotronic]

Dakota,

 

Happy to answer your questions. I'm not sure why thanatopsis says that his questions were danced around because the answers are simple ones which I have written about before online, spoken about on the phone, as well have my colleagues Mike and Doug. And to address one specific point by Thanatopsis, we do NOT venture outside the safe donor zone and any reference or suggestion that we do is very inaccurate.

 

"Joe how is it that H&W can get so many more grafts in a single session than other surgeons?"

 

Experience, size of team, and technique.

 

Experience in that the doctors long ago set out to get more in one session. The two biggest issues in this industry are a lack of coverage and/or a lack of density. Only one thing can address this and that is MORE hair. The question for "bigger" and "more" started about 2000/2001 when the average size session from anyone was maybe 1000 grafts at best. By 2002 we were doing a lot of 3000 graft sessions. By 2003 we hit 4000, 2004 5000, so on and so on.

 

Size of team in that you MUST have a large staff to be able to perform a large session. Both Dr. Hasson and Dr. Wong have 12 and 13 technicians respectively and they are full time. One cannot perform a 5000 graft session with five or six technicians on a regular basis and expect to be home at a somewhat reasonable hour.

 

Do they have a differant method of extraction that other doctors dont use?

 

Yes, and while I won't go into the details (not that they are a state secret or anything) I can say that it takes a comparatively long time for each doctor to remove a big strip. In fact, I was in Dr. Wong's OR the other day filming a procedure and it took him nearly two hours to remove the strip. This was on a virgin scalp too as a repair job with an existing donor scar can take longer.

[Take a chance]

Thank you Jotronic and Bill for your assistance with my questions. Appreciate your help.

[thanatopsis_awry]

Jotronic,

 

I didn't mean to imply that the said questions have been danced around -- for real. Sorry if it came across that way, and on second glance I can see how you inferred that. I basically meant that there has been a degree of ambiguity for me, and I am sure others, in part because of the "naysayers" and people who decry your clinic for things like egregious splitting.

 

Plus, you are a busy dude and I never actually spoke with you directly (I don't recall); hence, I wasn't being coy when I said I looked forward to you answering here as I would take notice.

 

"Safe Donor Zone" -- quite a few people must be misinformed about this. Again, not being coy, truly, but in my discussions w/ various people it has been postulated that *with* patient consent and on select people Dr's Hasson&Wong will venture outside the "traditional safe zone".

 

Anyways, your answers were excellent as always and always appreciated; and I apologize again if my initial query made it seem like I was taking a swipe at you or H&W.