01-25-2011, 09:54 PM
Before and After (6 Months)
01-25-2011, 09:55 PM
I had a procedure performed by Dr. Wong in Vancouver in July 2010 and am still beside myself regarding how far he exceeded my high expectations. I apologize in advance if this seems obsequious.
Dr. Wong initially quoted me 4,500 grafts and I ended up getting 5,001 grafts. I would consider myself a NW4. He dense-packed the front and, as a result, this one procedure got me across the finish line. The lighting in the after pic makes my hair look slightly thicker than it is at this point (Month 6). However, I still have several months of growth left.
Life After The Procedure
All I can say is that if you are the type to go through with this, then you are likely the type who will seize the world of opportunities that will come to you as a result. Professionally, my receding hairline helped me, so I see no change in that area of my life.
But, imagine this: Imagine a romantic interaction where you no longer feel like youíre pushing a rock up a hill, where there is an equal amount of excitement and risk-taking on the part of both parties. Imagine a scenario where itís all about the chemistry. Imagine people chasing YOU.
Thatís what life is like without this affliction. And it can be yours. Stop sitting at home wishing. Stop looking at your paycheck and WISHING you could make enough money to buy your life back. Go out there and figure out how to make it happen. Now, onto the detailsÖ
Iím 30 and previously had one hair transplant at age 23 (Dr. Orentreich [Count = 950]). At the time, I did not know how paltry 950 was as it was considered average-sized by most surgeons in 2003. The result was acceptable, but did not do all that much to improve my appearance. Since then, I have been plotting and planning the time when I would do this.
My 30th birthday was always the line in the sand for me and I am happy to have achieved such an important milestone on-schedule.
That said, be certain to look at the big picture and make sure that the timing makes sense for you. Do not put yourself in financial straits to do this because you should not do it unless you can do a large session and get a dramatic result. Also, make sure that you have no significant life events for about 2 months following the procedure. Your head will be shaved and the growth will be thin.
Choice of Doctor
Documented Results. Any doctor you consider should have extensively-documented results. You should be able to see their work in detail and compare, over a large number of trials, the quality of their output. You should be looking for close-up shots and preferably high-res video. You should study menís hairlines in advance of viewing their results so that you know what a truly good result is versus a merely average one.
Year in Practice. It is true that even the greatest doctors had to start out somewhere, sometime. But, Iím not going to be their first patient or even one of their first 100. I would stick to doctors who have been doing this for at least 10 years and preferably those who focus exclusively on hair transplantation as their sole practice.
Use of Cutting Edge, but Proven, Techniques. You should be looking for doctors who are forward-looking as this is an industry that is rapidly advancing. If you stick to only considering experienced doctors with demonstrated success, then the use of cutting edge techniques presents less of a risk as their experience will check any process-related errors that a less experienced surgeon might make.
Willingness to Perform Large Sessions. Any doctor who will not go above 3,000 grafts (if you need it) is too prudent in my view. Do not accept any excuses regarding their conservative view. What I hear when a doctor touts smaller sessions is the fact that they want to keep their fixed costs low by running leaner and securing a recurring revenue stream. That is not your problem, so donít make it so. Doing large sessions requires large numbers of technicians to dissect the grafts (I had 8 people working on me, I think) and it means patients are less likely to come back for more. Again, not your problem. Any doctor who refuses to get you close to or at where you want to be after one session (maybe two if >NW4), does not have your interests in mind. How can you trust someone like that?
Willingness to Re-Create Frontal Hairline. The doctor you select should be willing to completely re-create your frontal hairline and plant hairs where no native hairs exist (i.e., where youíre bald). Do not take this for granted as many doctors simply fill-in the existing balding pattern because they are not confident enough in their own artistic skill to implant into an area with no native hair to guide them. Let me ask: If your hairline has receded, how happy do you think you will be with a simply fuller receded hairline?
Willingness to Vary the Size of Recipient Sites. Many doctors decide on one size to cut the recipient sites for the entire recipient area. This is misguided. The result of doing this is several-fold: First, in cases where the site diameter is too large relative to the size of the graft being transplanted, the hair may not stay. Second, in cases where the site diameter is too small relative to the graft being transplanted (more probable), the hair will be pushed in tightly, often resulting in an unnatural appearance. Third, because the frontal hairline should consist primarily of single-hair grafts, recipient sites that are cut too large take up more space than a smaller diameter recipient site. The impact of having sites cut too large for what is being put into them is that you get fewer hairs per square centimeter. The result is less density. Dr. Wong custom cuts the recipient sites based on the size of the graft being transplanted (1-4 hairs). For smaller grafts at the frontal hairline, the site will be cut smaller. For larger grafts, the site will be cut larger. He invented the tool he uses to custom cut his blades and he cuts his blades in the operating room only after he has extracted the donor site and has an idea of the count of 1s, 2s, 3s, and 4-hair grafts.
Mirroring Direction of Native Hairs. One of the biggest giveaways of any hair transplant is the unnatural direction of transplanted hairs relative to native hairs. You should ask any doctor you are considering what he does to address this and he should be willing to display his artistry in this respect. The correct answer you should be getting is that he takes seriously the need to mirror the direction of native hairs.
Use of Trichophytic Closure Technique. If you are doing a large session, you are going to be harvesting a lot of scalp. The result is going to be a high-tension closure. This is okay, but there is an increased risk of the scar expanding in width, which you want to minimize. Any doctor you select should be skilled at applying the trichophytic closure technique. What this technique does essentially is fold one edge of the skin over the other in such a way that the hair grows through the other edge of the scar. The result over time will be a scar which is very small and hard to detect and any expansion of the scar will be accounted for by the fold created by the closure. Note that sometimes this closure cannot be performed because there simply is not enough tissue available to do it. But, a doctor not willing to perform it for this reason versus a doctor unschooled and unpracticed in the act are two different things. Avoid the latter.
Efficient Use of Donor Hair. There are some doctors our there who push their skill in creating a strong frontal hairline. Iím all for that (key criteria Ėsee above!) and I planned for many years to go to one in Toronto who is well-known, though controversial on these boards. As I did more research, it became clear to me that he was harvesting very large donor sites, but only focusing on the frontal hairline. If you need nothing anywhere else, then maybe that is ok. But, most of the time we need broader coverage than that. The doctor you select should be getting broad coverage with anything at or above 3,500 grafts. If a doctor is only working on the temples and hairline and extracting around 3,000 grafts, then he is not making efficient use of donor supply.
Use of Finasteride
Using Finasteride is like shampooing the inside of your scalp. It is the key to blocking most of the DHT that is the cause of this affliction. I would strongly recommend you get on it a good time (a year) before you have a procedure. Not only will it stabilize your loss and give the doctor a good idea as to where he should be deploying the supply you give him, but it also decreases the magnitude of any shock loss following a procedure. Also, in my opinion, a healthier scalp leads to a quicker recovery.
Please never forget the following: SCALP LAXITY EXERCISES WORK. THEY WORK. Dr. Wong directed me to begin doing scalp laxity exercises a month before surgery. I took his at-home instructions to another level and paid to have my scalp massaged for 30-mins a day. It was the best $1,000 I have ever spent. The supply of donor hair is a function of only two things: (1) Scalp Laxity and (2) Donor Density. You cannot control the density of your donor site. You can control the laxity of your scalp up to a point. Dr. Wong said that had I not done the exercises, I would have only likely gotten maybe 2,900 grafts. How he calculated this, I have no clue. But, what I do know is that I got 5,001 grafts, which is 72% more hair than 2,900. That is the difference between one procedure and two.
01-25-2011, 09:56 PM
Planning the Trip
I stayed in Vancouver for two weeks. I know that a lot of folks stay near the clinic, but I would advise staying right in the center of downtown. Itís a bit more centrally located and since you will be pretty isolated during your recovery, you can try to get a room with a view or a balcony and not feel like youíre on lockdown in the middle of nowhere for an extended period of time. Cabs are easy to get and cheap. I would say that (2) weeks was a perfect amount of time to stay. (1) week would have been cutting it too close, but I was certainly ready to go home after the end of the second week.
The Office, Staff, and Logistics
If you care about the wallpaper or the view from the office, whether or not they will bring you lunch, or what DVDs they have available to watch during the procedure, then you have bigger issues to worry about. But, suffice it to say that the office is exactly what one would expect from a world-class operation such as H&W. The staff is probably the best in the industry and probably the most ethical, which is understandable given that the skill of H&W sells itself. My best advice would be to go there treating this as their space. They are the experts and they do this every day. Iím always amazed when I read/hear about guys watching action flicks or talking on the phone while having this procedure done. I stayed as still as possible and talked very little while being worked on. Think of it as an 8-hour detention with a reward that will payoff for life. Keep yourself in check and let the staff focus.
Consider whether or not you bleed a lot, have taken blood thinners, or are on a high anti-oxidant diet. If you are, then you should let them know so that they can give you a Vitamin K shot the day before to decrease the bleeding. A heavy bleeder makes the procedure exponentially more difficult to perform and will lead to a less stellar result.
Youíre getting scalped. There is simply no way around that at H&W. Strip is all they do because they believe in large sessions, which I wholeheartedly agree is the only way to go. I was very upfront about my low tolerance for pain, however. Dr. Wong again exceeded my expectations in this respect. He continually topped-up the anesthesia and I literally felt nothing. Now yes, my eyebrows were numb for a day or two, but Iíll take that over pain any day. Also, one of the key benefits to the Vitamin K shot and the decreased bleeding is that you retain the local anesthesia better. More bleeding equals more anesthesia being bled out.
Good Luck, Guys!