1 Comment

  1. dr. feller
    September 7, 2006 @ 10:36 pm

    There is no such thing as a “sub follicular unit”. The only entity that might even qualify for this title is a transected graft. You either have a fully intact “follicular unit” or you have multiple follicular units bound together in one graft which is simply known as the “minigraft”. To me, “sub follicular units” and “follicular families” are only slang terminology whose meaning shifts from practitioner to practitioner (sometimes criminally so) and is therefore unreliable and useless.

    Drs. Hasson and Wong’s philosophy is relatively simple, yet few doctors have embraced it: ‘Dissect your donor tissue down to the lowest follicular unit grouping possible and then re-implant those grafts close together.’ This is what nature did. Any reasonable person, doctor or otherwise, would have to agree with this concept, however, to actually achieve this goal requires major changes in even the best hair transplant clinics:
    1. Lateral slits must be employed to allow for dense packing with minimal popping.
    2. Grafts must be dissect FAR more meticulously and carefully
    3. Staff must be enlarged to handle the increase refinement
    4. The recipient sites must be made far smaller than before. Rarely a slit above 1mm
    5. Placing smaller grafts into smaller slits requires greater skill, patience, and teamwork
    6. The overall time necessary to perform a procedure increases
    7. The overall overhead costs increase

    Any objection by HT doctors and their “consultants” against ultra-refined megasessions as performed by Drs. Hasson and Wong may be attributed directly to the resistance and refusal to rise to the challenges created by the seven changes listed above (among others). This is why whenever I read of an objection to these ultra megasessions I just tune them out. These arguments are mostly made by doctors who are simply looking for a justification not to rise to the new level set by these two excellent doctors. Here are the most popular yet unjustified reasons most clinics use when asked why they don’t perform ultra megasessions:
    1. The scalp’s blood supply can’t handle such large cases.
    2. The grafts can’t stay out of the body that long
    3. The donor area can’t handle that amount of trauma
    4. The patient can’t sit that long in the chair
    5. The staff can’t handle that much work
    6. The scar will be larger than if two or more smaller procedures were done.

    It is beyond the scope of this “comment” to go into depth on why each of the above are not true, but I will say that each one has an easy solution IF the doctor and the clinic rise to the challenge of instituting the changes I listed above.

    I know this because I met Dr. Hasson at an HT meeting in 2002 and listened to him speak about his philosophy and method in detail. He made his point and supported it with reason, photos and a live patient. I realized I had to improve my procedures to this level and incorporated his techniques into my practice. The improvement in results that could be attained in just one surgery was remarkable. Yes it was hard and it was expensive, but the results speak for themselves.
    The way of the future is ultra refined megasessions. To do less than 2,500 to 3,000 grafts in a single session should become a rarity, and until it does, this field will not have achieved it’s full potential. Out of the thousands of clinics performing HT worldwide, there are perhaps 5 or 6 that have seemed to embrace the ultra megasession. This number must increase and all doctors need to put the effort in to do so.

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