HairFairy

In response to 'Haircut's question regarding the count breakdown, Dr. Mwamba states the following: With our FIT, we have low transection rate, so this helps us to approach as close as possible to the final number of hairs displaced or volume hairs. When we extract the grafts, we don't leave them out of the body for a long period of time. We insert them into the recipient sites right after. So we don't have time to count each graft in terms of numbers of hairs per graft. We do that in some cases for research purposes. And we perform our extractions (patient in seated position) in order to synchronize our extraction and placing process which occurs simultaneously. None the less, this is a very popular question in this industry - the graft breakdown in terms of quantity of singles, doubles etc. To answer this question, we will tell you what our standard process generally is but again - each case is different and it may vary slightly depending on the situation. Usually for hair line work, Dr. Mwamba uses singles and doubles in the following proportions: 1/2 singles vs 1/2 doubles (2 to 3 rows of singles followed by 2 to 3 rows of doubles). This is most of the time for patients with thin, blonde or light brown hair. For patients with coarse, dark hair, the proportion is 2/3 singles vs 1/3 doubles (3 rows of singles and 2 rows of doubles). Dr. Mwamba usually grafts at 50 to 65 FU/cm2. Most of the hair line is 7 to 9 cm2 (14 to 18 cm long over 0.5 cm wide). Therefore, the graft counts vary from 350 grafts to 600 grafts (average being 450 to 500 grafts in most cases). The rest of the grafts are full size grafts. We average our grafts and hair counts by providing the CD (or calculated density = number of hairs per grafts).

'Takingtheplunge' - Thank you for your comments. I believe we are scheduled to have a followup with him in July and will get more photos then He reports that everything is looking great and he is very happy! 'krapok' - Dr. Mwamba is well known for his hairlines and does a great job If your scalp donor supply is limited there is the option of body hair transplant (BHT) also. Dr. Mwamba is very skilled at BHT and has been doing it for many years. Let me know if you'd like more info on that. I will be posting some examples on this forum soon. This patient's donor density was MO 83 fu/cm2 ;LA 73 fu/cm2. I will check on the new hairline and temple points density and get back to you Regarding the scar repair and grafting in the donor area....this patient will not allow us to show his donor area in the back of his head and his scars. He has identifying characteristics in that area and wishes to remain anonymous. I will post some photos of other patients that I can show scar repair on soon. Thank you for your questions and comments! Best to you in your journey.

Thank you....Dr. Mwamba is meticulous in his work

This 40 year old patient had 3 previous STRIP surgeries at another clinic over a 15 year period. He has 3 large Strip scars from those surgeries in the donor area. He was very unhappy with the resulting scars, very unnatural pluggy look and bad angulation of the hairs. His goal was to create a more natural look - get rid of pitting and bumpy skin, pluggy look and wrong graft angulation. He also wanted to fill in his 3 previous STRIP donor scars. Total grafts 4,265. Dr. Mwamba’s strategy: Perform FIT (Follicular Isolation Technique) shaven method. Day 1: Plug removal and redistribution – remove and relocate grafts in appropriate direction. Day 2: Fill in temples – Total surface covered was 52cm2. Day 3: Build temple pointes –with soft hairs above the nape hairs. Day 4: Fill in scars in donor – total surface to graft = 24cm2. We grafted at 20fu/cm2 to assure maximum yield This patient is extremely happy to get his life back again. He had been wearing a hat for over 10 years to cover the bad job.

I do not have that breakdown...I will see if I can get it for you

This 50 year old patient came to us with a goal of reconstructing the frontal hair line with a dense packing approach. He had not had previous HT surgery. The approach taken was the FIT (Follicular Isolation Technique) – shaven method. In this method the complete donor and recipient areas are shaved. The FIT method leaves no visible scarring to the naked eye. Acell was also used to promote the healing process in the donor area and good growth in the recipient area. Donor density: 70FU/CM2 Total grafts: 2,589

Patient is very satisfied because his goal was a global light coverage. The growth he got was good. Each patient has different goals, and Dr. Mwamba strives to help them achieve their personal goals. One person may want very thick/dense coverage, but another may want light coverage. I suppose it could also depend on one's budget too. If this had been a different patient he may have decided to do it in two different sessions to achieve more coverage. But in this case, this particular patient did not desire dense coverage. Thank you for the comment

Dr. Mwamba performs both STRIP and FUE. He believes that the two techniques are complementary and what matters the most is the final result . Being in the industry for 11 years, Dr. Mwamba was trained to perform strip surgery. Because of their focus on improving their technique to meet patient's request, we started to develop our FUE technique called FIT in 2003. So Dr. Mwamba has 11 years of experience with STRIP and about 8 years in FUE. Dr. Mwamba believes to better serve his patients he must master all the different techniques and aspects of hair loss.

Combination STRIP/FIT/BHT with 1,813 grafts. Donor density of 90FU/CM2. This patient in his late thirties and classified as a Norwood 3-4 was advised to do Hair Transplant Surgery when he had a consultation at another clinic. After 2 strip procedures with this other clinic, the patient was very disappointed. He had 2 large scars in the donor area and a pluggy look in his hairline and frontal area. His growth was very poor also. When he came to Dr. Mwamba his goal was to repair the scars from the previous surgeries at another facility and to disguise the bad grafts in the frontal area. We filled in corner of hairline to make line straighter. We reduced one of the scars and grafted chest hairs into the other one to camouflage it. The STRIP we took to reduce the size of the first existing STRIP scar was 1 cm wide and we got 1,000 grafts from it. 800 grafts were also taken by patchy shaven method FIT. The second existing scar was too low (in the nape area) and too large (2cm wide). So chest hairs were grafted into it to break it up. OUR APPROACH: -Graft removal on the first line of frontal hairline by FIT/FUE technique with bigger punch (1.3mm) and sutures to close punch holes. No signs of scarring at all. -To increase density, we recommended STRIP surgery (first to correct and decrease the size of the existing top scar of 8mm wide and second to get the grafts to implant in the frontal zone). -Because of the previous scarring, we limited the size of our STRIP to 1 cm wide. We got around 1,000 grafts from it. - We harvested the other 800 grafts by FIT patchy shaven so the patient could be able to comb his hair over the donor area and it would not show. This is an advantage we allow patients who choose to be discreet. In the photos you can see how just patchy area was shaven in donor area to make the extractions and then when the hair falls down over it is hidden.

Summarization of a FIT procedure done in 2009 (3,781 grafts). This patients goal was a global light coverage so recommended 35fu/cm2. At 10mo f/u results were very natural and no sign of white dots. Good growth! 1. ‘Megasession’ implies a graft count from 3,000 to 4,500 grafts. Above 4,500 grafts we classify the procedure as a ‘Gigasession’ as this type of work is not done routinely in many clinics. Here we present a 50-year-old patient, classified as a NW 2V, who was bothered by his bald vertex. He had fine brown hairs. We recommended that he also refine his hairline and lateral humps to reach a complete harmonious coverage. The journey took 4 days and I will briefly describe our protocol. We usually start by pre-op pictures and a discussion with the patient to determine the patient's goals. 2. After taking detailed pictures, we jump in the painful moment. We must shave the whole head in order to achieve such a large goal of 3,781 grafts. We do not shave systematically. We listen to our patient’s desires and try to accommodate them if we can. That is why we do offer the ‘FIT Patchy Shaven’ and ‘Unshaven FIT’ option available for patients who cannot be totally shaven. However, in Megasessions it must all be shaved. The next step is to start our drawings in the recipient and donor areas to determine the surface to treat - we assess natural angulation of the hairs, donor density, and recipient density with a Proscope. We like to be very systematic and leave little room for a random approach. The only area I do not follow a systematic pattern is when I make incision sites for the hairline. I usually follow my immediate inspiration. The hairline I build Monday will not be the same as the one I will do on Tuesday. 3.The following pictures will also show the recipient and donor areas the first day and second day (I didn't put the 3rd and 4th day). I wanted to underline in these pictures how we move from area to area, respecting the logic of nerves supply to allow a comfortable anesthesia and also our willingness to work simultaneously in both donor and recipient areas. This allows us to minimize the time the grafts are out of the body. That's why you will see placing in one side and donor open sites in the opposite side. 4. Post-Op pictures summarizing the entire work done by the WHTC team under the close supervision of Dr. Mwamba. 5. We usually shampoo the patient’s head every day during the surgery….and if still in town, the first day Post-op. We take this opportunity to review the Post-op instructions and encourage the patient as he begins his year journey until full growth is realized. 6.For the sake of better assessment of details of our work, we take before and after pictures that we can show to our patients and to the general public (with the patients’ permission). We sincerely thank our patients as the pictures help many that are seeking Hair Restoration Options. Photos help them to make the right decision whether to proceed with surgery or not and which Doctor to choose based on the proven results. Photos can also encourage those with hair loss that there is hope for them also. We realize that results vary from person to person since there are many factors involved in the process and each case is different. We strive to post as many different cases as possible so that many scenarios are represented with good results.