Dr. Patrick Mwamba

Complaint : Fronto temporal recession Diagnosis : Traction alopecia Treatment plan : Prp , laser cap , surgery ( Unshaven FUE ) 2000 grafts performed in 2 days with manual FUE .

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In this case , no removal . Just lower the hair line , use singles and doubles , place them respecting angles , add density in the current hair line and he will be Ok . Another 500 to 1000 grafts .( depending on final location of hair line and grafting density )

see through effect because of light density and impression of pluggy look because i believe of hair angle which looks too straight ( I mean vertical ) .

Good coverage and good achievement in just one session . I am still not satisfied with the hair line look ( picture number 3 ) .

Nice result .

Indeed , the lighting is too dark compared to the good pictures they took at the clinic . The patient doesn't have a good studio . It makes the comparison hard to tell especially when it comes to density .I feel like the hair line looks a little bit pluggy too . We need a better light resolution to check it .Overall , good gain .

The common ground of causes of hair loss and hair shedding is microinflammation around the bulb . DHT ( in androgenetic alopecia ) will link with the AR ( androgen receptor ) ;this complex will interact with the DNA of Derma papilla cells and lead to secretion of TGFbeta , BMP , DKK1 which are proinflammatory molecules . The goal today is to fight and reduce the inflammation around the bulb .Among powerful anti inflammatory products , you find Prp . The whey protein will get transform to GSH ( Glutathione ) , a powerful anti oxydant and anti inflammatory molecule .The GSH is anti TGF beta , anti PGD2 ( prostaglandines) and anti IgE.

Patient's objectives : lower frontal hair line We recommend FUE surgery and medical therapy ( Prp, Help HAir whey protein , local treatment with onion juice and rice water ) . Results presented at one year post op .

Hi Roxas , Your hair line is not bad but you can do a small surgery to make it the way you like . Hair loss is indeed progressive but if you commit to take medication or follow a treatment , you will slow down the process . I usually recommend treatment that is not too aggressive to begin with as we know you have to commit for your entire life . ( prp, Help hair whey protein, laser cap and other local treatment ) . And if in the future , you loose a lot of hairs , you can do SMP . I just opened a practice in Atlanta (GA ) and you can book an in person consultation to really understand all the different options you have . I will post some results for black patient in this forum to broaden your perspectives .

Good point Tav . FIT shaven relate to the donor area .We also make the difference ( fully shaven , partial shaven - donor shaved ,recipient untouched- patchy shaven , and non shaven also called unshaven ) . We know where the patient is heading .To make any plan , age is one of the most important factor .This patient is 41 years old .He is not in the risky category of the twenties .You may choose to be more agressive than conservative . Then comes another factor : the patient's goal . This one was clear ;He wanted to restore the status he had 5 years ago ( thin look with a bald vertex ) but most important ,he wanted to look natural . No need to be agressive .We decided to graft at 30 to 35 FU per square cm with the exception of hair line where we went up to 40 to 45 in the middle frontal hair line . The third factor we usually consider is finances .Very important !!! The patient is taking alpha estradiol for his hair loss .No classic treatment as we know . In the post op we usually recommend the help hair whey protein for 6 months once a day and then 2 or three times per week after that . It could be an explanation about the better look of his temples points . Thank you for your comments .

We are presenting a classic case of a Norwood 3 patient of 29 years old with receding temples. He is under medication (propecia and minoxidil 5%) for 10 years. We recommended FUE by FIT full shaven (i.e. donor and recipient shaved). We grafted the entire frontal zone with different density: 1.Entire frontal hairline at 50 Fu/cm2 2. Right temple and left temple at 40 Fu/cm2 3. Middle front at 20 Fu/cm2 because of presence of existing hairs. In the results pictures you will notice a thin look in the forelock .It could be the natural evolution of hair loss that left him right now with only grafts from the surgery grafted at low density.

We are presenting results after 6 months for hairline work. Hairline work is one of the major requests in our field. When rebuilding it, the doctor has to always think about balance of face, naturalness, and density. To get the face balanced, we should always consider rebuilding or reinforcing temples points, especially when we are lowering hairline Angulation of hairs from temples pointes to middle frontal hairline will vary from flat (1 to 5 degrees) angle to 35 to 40 degrees. And this will play a big role in naturalness. Density will give us the impression of fullness and coverage and in our practice, we like to stay between 50 and 60 follicular unit per square cm. Use of medical therapy is always encouraged and you get fast results from it.

We also harvested from the regular donor as well .

bmorelaxing , the technique you are referring to is called FIT farming : replace scalp hairs donor with body hairs in order to maintain donor appearance .We usually use Body hairs from beard , chest or leg .BHT will keep their own characteristics ( caliber , color ) .We observed a change in length .they have tendency to catch up with the length of your scalp hairs . Now , the test about hair multiplication we did in India didn't bring to much outcome .We noticed no marks in the donor area after using a bigger punch.In recipient area , it was a failure ( no hairs are growing so far ) .The informations we gathered from that case report led us to apply others protocols we are still testing ( used of fresh DP cells , growth factors ( wnt , Prp, Acell,...) .I wish I could have my own lab to culture stem cells and conduct the study on more cases .

When you poke a hair bulb , you can get a lot of free stem cells in your solution ( hundred of thousand ).If you can culture them , you can go up to million cells .DP cells are trichogenic but they loose their trichogenicity with time . We want to take advantage of the period when they are trichogenic and expect them to communicate with existing stem cells around miniaturized hairs and influence them positively .That's our goal . We know that cells at that level communicate through signals .I do agree that culturing cells ( DP cells , Epidermal cells , and cells from blood vessel ) , you will get a better chance to grow hairs .( Study of prof. GERD in Germany ) . We keep trying at our level as we can not culture cells to work with fresh DPcells .We do not waste grafts .We usually take 100 grafts , poke them with a needle and reimplant them.Studies demontrated in the past that transection beneath the lower third of the hair shaft can generate a new follicles .So we expect the poked grafts to grow , especially if you boost them with growth factors and nutrients . Thank you for your comments .

After using Dr Miracle product to perm her hair, the patient had a burning sensation on the temples points followed by surinfection (presence of pus) .It took 2 weeks to heal and the patient was left with a scar (left temple point). She also had thinning in fronto temporal region, typical of fronto temporal recession in Female Hair loss pattern. We opted to graft her with the strip technique. In frontal hair line , we applied a density of 45FU/cm2 .In Left temple point , the grafting density was 35 Fu/cm2 and on right temple point , 30 Fu/cm2 . We also injected Acell + ATP + fresh DP cells in recipient area. During post op, we recommended Help Hair Whey protein + Help Hair vitamins + Rogaine foam. WE ARE PRESENTING HER RESULTS AT 9 MONTHS POST OP.

The patient we are presenting today is a Norwood 3 who wanted to lower the FHL and restore density in frontal zone. We recommended surgery plus our classic medical therapy. In our technique, we shaved the back donor completely and the recipient area wasn’t shave at all .We often do that for patients who request it for quick social reinsertion. We grafted the frontal hairline at 50 FU/cm2, the temples at 40 FU/cm2 and the forelock at 30 FU/cm2. Lower density in forelock aim was to avoid shock loss .To compensate it , we did implant grafts of 3 hairs per follicle to reach the same hair volume . The patient is very happy.

The patient was diagnosed with Female Pattern Hair loss characterized by a fronto temporal recession. As in our all female patient we do recommend medical therapy along side with the surgical treatment. Our medical therapy consists of two categories: 1. Rogaine foam 5 % once a day 2. Help Hair vitamins twice a day in this case or help hair protein + help hair vitamin for those who like to use the shake. Please look at results in the following lines: Since we have introduced Help hair products in addition to Rogaine foam 5%, we do observe early growth as you can notice at 3 months in this case: Now at one-year post op, the patient is enjoying her results: Thank you

Female hair line is a very interesting subject .In most cases , it is a rounded hair line and you should respect naturalness by applying the principles of using only singles followed by doubles and finish with a mixture of regular follicular units .

The patient colored his hairs ...

The patient came to us anxious about his options .He had two strip surgeries in the past with very poor growth. Even though with a camouflage combing, he was unable to hide his problem. He was afraid to go for another strip surgery (because of a wide scar in his donor; fortunately, it is flat and not hypertrophic) He was Norwood 6 to 7, with a poor donor area (under 60 fu/cm2 on average) , thin and straight hairs . He also had dermatitis on his scalp: brown crust on his scalp + erythema (redness of the skin). We decided to treat him first with LED light + Neobacitracine . After one month of treatment, the lesions (crusts and erythema) disappeared. We decided to go for the surgery: broad coverage at low density with the FUE by FIT shaven technique. Results after one year brought back hope and joy in his life. Little things can lead to huge transformation in someone life.

Hair transplant surgery could arm somebody if we do it without proper training. The patient came to see us for hairline work. He did a surgery 4 months ago to another clinic and he was concerned by the post op evolution. After close up examination during our in person consultation, we came up to the following conclusions: -Low frontal hair line (chooses by the patient) -Wrong hair angle in FHL and temples points (hairs pointing upward) - Pluggy look -Pitting and ridging combined Our goal was to refine the hair line and camouflage all the bad work .We were obliged to follow the designed hair line and lower it a little bit to build up something in front of the existing one. Otherwise we had to remove some grafts in the front (very expensive surgery and very challenging protocol) and then rebuild a new hairline on second intention. We didn’t choose the latter option because: 1.the patient is under medical treatment for hair loss (it will stabilize hair loss progress), 2. He didn’t present a pattern of advanced hair loss or signs of miniaturization that could point toward an extensive hair loss in the future and 3. The patient wanted a low hairline in first place. Here are the results after two days of intensive work. Now, I will present some close up pictures to illustrate the entire process from design to results: Finally, we will summarize the patient story as followed: And the preferred patient’s hair styling.

Thank you guys .