Dr. Patrick Mwamba

thank you ,your comments are really encouraging us to keep up with our work .

Thank you Mickey . Augustya , I will pray with you and for you .Thank you

The patient we are presenting today is a Norwood 2 patient with straight, brown hairs. His concern: receding temples with a little asymmetry of the hair line (the right side is more prominent than the left). Our Plan: From the middle frontal hair line point, we drew a symmetric hair line. And when we grafted it, we recreated a small, imperceptible asymmetry. Because we drew a low frontal hair line, it was crucial to rebuild the temples pointes to keep a right balance of the face.

We didn't get to that point yet . right now we are investing in learning the process .If we define the final protocol , we will get a list of what is needed ( supplies , man power,etc...) to perform the technique.After gathering all the info , our adm team will work on pricing .

I am with you Crafter , I mentioned one thing in my talk : sometimes , things are very simple and we , as expert in the field , we push our mind far away to get a solution. And it takes just the insight of a novice to point out to the right direction . Now there is a long way to prove this concept ( which for me makes a lot of sense ) .We need hard work , dedication and clear protocols that will be presented to our peers .Their insight and knowledge may also ease or speed up research toward a solution for our patients .

Crafter , I am not sure if I get it right ;you want to know the aim of the technique or the practical protocol of the technique ? The purpose of the technique is primo to get unlimited donor so patient can afford to do what they want ; secundo you can now treat NW6 and 7 hoping to bring them back to an early stage ( NW2 ) . In practice ,we want to reproduce what mother nature does when you shed your hairs at the end of one hair cycle .New hairs come out from stem cells that you find in the original hair follicle .Our goal is to stimulate those stem cells with whatever is available ( growth factors , Prp, ECM,etc...) to generate new hairs follicles.

Hello everybody , I do apologize for the time I took to respond to your inquiries . I was very busy after my trip in India where I had to perform surgery , study Dr Nigam's technique , jet lag ...And back in Belgium I had to start right away my session of surgery . I have been following and reading progress on hair regeneration technology , Dr Gho"s techniques , Intercytex and Aderans works, Dr Hitzig's work , Dr Cooley's work , Dr Nigam's work and my own experience with Acell application . With my technique , I was not able to erase completely white dots in my donor , donor regeneration was about 10 to 30% .One thing I witnessed was the absence of scar formation , the improvement in hair caliber and pigmentation . I kept reading and investigating physicians who were claiming to get above 60 % of success . One of Dr's NIgam rep contacted me and proposed me to meet Dr Nigam who were willing to share openly his technique with me .I therefore accepted his invitation and requested him to perform his technique on my own patient so I can follow up myself the results .And he agreed .So I took my plane ticket and made one step forward . The plan was : I will perform surgery on their patient with my FIT technique and they will apply their products to regenerate the donor ; and they will perform their technique on my own patient .I will follow up both patients in my clinic in Brussels as both of them live in Europe . I was well surprised by his passion and the clarity of his explanation about his techniques and the science behind .I also witnessed result on a live patient and on the patient I was supposed to perform surgery on . I just found out the hair growth he had was from a previous surgery with the hair doubling technique from Nigam . I had proof that I couldn't deny ;but let's agree that you can not generalize it to everybody . That's why I decided to give it a try .He taught me how to perform his technique so I can start to offer it in my clinic in Brussels .It will help me to prove it right or wrong to myself. I shared with him my concerns about mastering the basics of modern hair transplant surgery in order to produce results that should be undetectable , natural and well done .It is only through a quality work that we can make others doctors embrace Dr Nigam's techniques and findings . One of the rule of scientific proof of valid techniques is reproducibility of the same results in another environment if you apply the same protocol. I therefore choose to apply Dr Nigam's technique in another environment ( my clinic ) to prove the validity of his concept . And he totally agreed on that . We just need to finalize our partnership details to make it happen .In the meantime , I am following up the two patients who travelled with me in India ( Dr Nigam's patient and my patient ) and I will go back to India for more training about his technique and I will bring my expertise to train his staff on art and aesthetics of hair transplant surgery . Let's hope , Dr Nigam's technique will bring us to a new way of helping the entire community and I will keep you update .

Our young patient had a big forehead and it is something common in her family .She came to see us with one goal: to lower her hair line and frame her face so she could be able to comb her hair backward. We recommended her to follow the following treatment: LED light once week (Triwings) + Help Hair proteins shake once a day. After 6 months of medical treatment, we scheduled her surgery .We opt for strip surgery for better control of grafts integrity (hair characteristics in black being curve under the scalp).We closed her wound with a double layer sutures. Results started to be noticeable around 4 months and now we are presenting her 11 months post op pictures. The patient as you noticed can now have flexibility with her hair style. Thank you

Thank you for your comments

This young woman was disturbed by receding hairs in the fronto-temporal region. She did not braid her hairs and she used to cut it a lot for styling purpose. One day she just realized hairs were not growing back in that specific region .She couldn’t style her hairs anymore or let it grow longer as it was accentuating and revealing the balding region. She decided to contact us for hair restoration .Her hair thinning was not extensive and limited to the fronto-temporal region .We diagnosed a Female hair loss pattern and recommended medical therapy ( based on Rogaine foam 5% + Help Hair protein shake and surgery) . We performed 1142 grafts FIT shaven in two days. Now, 8 months after her surgery, she is able to let her hair grow longer and feel more confident about herself.

90 to 95 % FIT/FUE 5 to 10 % strip /FUT I do believe a good practice will have to master the two techniques to cover a large amount of patients . Some cases need a combo FIT -FUT to cover the entire bald area in one session . Other cases such as black people may be better of with a FUT because you can have a better control of quality grafts .I will present good results of both strip and FIT in black people in the future .But I do agree in such case strip is easier than FUE . But FIT provide so many advantages over the strip in comfort that it will definitely replace the strip as the standard technique .Doctors will just have to take time to get good training to avoid all the bad works we used to see in the past .FIT is a more challenging technique and you will pay cash if you don't take it seriously .

Correct about shock loss . Correct about beard ,scalp and pubic hairs allocation in recipient area . The location about where to put beard hairs will depend on patient's goals . One category will be fed up with the surgery and would like to fix the scar so they can wear their hairs shorter ; Others will be seeking about cosmetic appearance , therefore , you will privilege the frontal zone and vertex .

By Definition , transplanted hairs are stronger hairs than your native hairs in recipient area .The later are inclined to shed because they are so advance in the hair cycle .And you can notice it by their caliber or pigmentation status . So if you are transplanting in the same area , of course the transplanted may fall due to shock loss but the probability is lower than your native hairs .

Of course .We routinely harvest 1000 to 2000 beard hairs in some patients and mixed them with scalp hairs or alone for hair restoration or scar repair , etc... Pubic hairs are also a very good source that we also use .The limit with pubic hairs is the quantity you can get .So far , we do harvest 200 to 300 pubic and we usually mix them with beard , and chest . In BHT quality , I will say you have beard number 1 , pubic as number 2 , chest 3 , abdomen 4 and legs . Arm pit are also good but very challenging to get them .Some patients had good back hairs , and arms or forearms .We have used all of them with of course variable outcomes .

Thank you FUEonly for your question and kind remarks . I do design first the hair line on the forehead .Most of the time , I asked the patient to draw what he believes is the perfect or desired hair line for him. Then I drew mine .And it give us a base for our discussion until we get to a common agreement about the location and the shape of his hair line . Then I will use The hair line design mask or the laser device to adjust the symmetry . The next step will be to select the grafts and place them in an irregular , random fashion. Yes I have been involving in BHT since 2003 .Beard are coarse hairs , with different texture .They are mostly in anagen phase and do grow very good. You just have to be aware it could not match with your existing hairs .Therefore , placing them in a spread fashion among your existing hairs is the best way ;otherwise you may have cluster of strong beard surrounded by thin scalp hairs .Beard hairs have great indication in hair restoration surgery .You just need to use them accordingly to get a maximum cosmetic impact out of them .

1635 in crown : 1024 in front

Thank you

We are presenting the results of the following patient. He had previously a hair transplant in Frontal Zone, FUE surgery, and came to us because he was not totally satisfied. He had a double goal: 1. Fill in his vertex area ( 66 cm2 in size ) 2. Reinforce the density on top. His donor area had a follicular density of 63 Fu/cm2 and a hair density of 156 hairs /cm2 .Even though the follicular density was below the average (Normal range of donor follicular density is 70 to 90 Fu/cm2), it was compensated by the calculated density (number of hairs per follicle) which was equal to 2.4 hairs per graft vs. 1.8 to2.2 hairs per follicle on average .He also had coarse black hairs .The contrast hair /skin was not high. We decided to proceed in two steps to avoid overharvesting and thinning in some area of his donor .We grafted 1135 grafts by FIT shaven in the vertex .One year later , we did another 1524 grafts spread between the vertex ( 500 grafts ) and the top ( 1024 grafts ). We are presenting his results two years after he walked in our office.

Thank you for your questions . Let me start with Hariri . -The number of grafts you may get from the nape hairs depend on your nape hairs characteristics in terms of texture , and density .Some patients have hair loss in that area and you can not use such grafts . I my own experience , I have been able to harvest around 1200 grafts in the region below the occipital protuberance or the forbidden area for strip . -I do not use CIT but FIT . FIT stands for Follicular Isolation Technique .The last technique ( FIT ) was developed at IHTI Dr Rose and the entire team were involved in finding a way to ease the FUE process .We end up by hiring engineer to create appropriate tools to decrease the transection rate and came up with the depth control concept and the use of stainless still sharp punch with a specific design ( called today CIT punch ) .We wanted to put a brand name to our FUE protocol. McdesSLK , I don't really know if I get your question right but I will try to answer > An average donor area with 70 to 80 fu/cm2 has 14000 to 16000 follicles .You can harvest up to 40% in total to be safe but in one session , you can go up to 20 % .So 2800 grafts to 3200 grafts is the average grafts you can harvest safely in majority of patients . From your example , it seems like you are asking about graft yield from the FUE .In my hand , I average 98 to 99% .If I do 300 punches , I will usually get 295 to 300 grafts . I used to recommend it to patients too .But it dries the skin and some patients may experience skin irritation .And others patients may have allergy to this product ( from literature ) .It doesn't damage the grafts but you can cause discomfort to the patients if he falls in those sensitive to the product .I prefer to use baby shampoo or non medication neutral shampoo .If I see a clear sign of skin infection ( commonly folliculitis ) , then I will use isobetadine shampoo or hibiscrub soap .

I will say that you have greater flexibility with FUE to choose grafts that could match with temples points works . With strip harvesting , we like to use grafts from temporal region ( auricular region) because of their thin texture and close look to temples points hairs .Unfortunately ,some other patients have lightly pigmented hairs in the temples points .And just after it , you have strong pigmented hairs in temporal region and it continues in the occipital region .Those are the classic area for strip harvesting . To find similar hairs , you need to go in the nape hairs region , region forbidden for strip harvesting .

THE PATIENT PRESENTED ABOVE IS 40 YEARS OLD WITH A NORWOOD 3 VERTEX PATTERN. HE IS ON PROPECIA FOR 3 YEARS .HE CAME TO OUR OFFICE DISSAPOINTED AFTER A FIRST ATTEMPT OF FUE SURGERY IN ANOTHER CLINIC TO CORRECT HIS RECEDING TEMPLES. RESULT FROM FIRST SURGERY: 1. POOR YIELD IN THE TEMPLES WITH LOW DENSITY 2. BAD HAIR ANGULATION THAT LOOKS LIKE HORNS 3. PLUGGY LOOK WITH SCARRING TISSUE IN RECEDED TEMPLES. 4. WHITE DOTS IN DONOR AREA BARELY NOTICEABLE WITH SHORT HAIR CUT TO REPAIR THIS CASE, WE RECOMMENDED THE FOLLOWINGS ACTIONS: A. LOWERING FRONTAL HAIR LINE TO DISGUISE PREVIOUS WORK B. GRAFTING DENSITY OF 50 FU/CM2 IN FRONTAL HAIR LINE AND 40 FU/CM2 IN TEMPLES C. ADD ANAGEN STIMULATORS (HELP HAIR PROTEIN SHAKE AND VITAMINS ,LASER CAP OR ROGAINE TO HIS CURRENT ANTI-DHT TREATMENT WE PERFORMED HIS SURGERY IN 2 DAYS :FIT SHAVEN 1920 GRAFTS .IN IMMEDIATE POST OP ,WE EXPOSED PATIENT TO LED LIGHT ( TRIWINGS ) TO ENHANCE HAIR GROWTH , PROVIDE ANTIOXYDANT EFFECT AND PROMOTE BLOOD CIRCULATION AND ANTIINFLAMMATORY PROCESS ( HELPS TO DECREASE PAIN AND EDEMA IN POST OP ) .HE ALSO APPLIED THE HAIR CYCLE BIOTIN SPRAY AS MOISTURIZER IN THE FIRST DAYS POST OP AND HAIR CYCLE SHAMPOO . THE PATIENT NOTICED FIRST GROWTH AROUND 5 MONTHS POST OP AND FULL GROWTH AT 7 MONTHS .WE ARE PRESENTING HIS RESULTS AT 9 MONTHS POST OP.

NApe hairs characteristics ( fine , a little bit depigmented ) will match perfectly for that purpose . You should also be aware that nape hairs can also go through the miniaturization process and fall .And if you don't prevent this with medication , you can loose the grafted hairs in the future and your solution will not be permanent .

Thank you all of you , your comments are really encouraging us to target no less than excellent work . Mickey , I usually promise 1000 grafts per day .This take off the pressure of rushing during the day of surgery .I spend most of the time one to 2 hours during the pre-op consultations to make sure I am on the same page with the patients .And then , you have all the possible events ( Nausea, patients who don't support anesthesia ,etc..) that could slow down the process . so 3000 grafts will be done in three days .Even though we know we usually do 1500 grafts per day with no pressure . I use both CIT punch and the versi handle with the SUPER PUNCH .

Since his young age, the patient had no sideburns, no temples points and thinning in the ear line above the ear .He didn’t have any signs of hair loss or didn’t notice any shedding. No past medical history (except a white coat blood pressure). We decided to perform the FIT shaven technique. In post op , we recommended Hair cycle biotin spray to speed up healing process and keep the grafts moist ,healthy ( antioxidants , anti-inflammatory ingredients , ,etc…) , and the Help Hair whey protein to speed up the growth . BEFORE PICS AFTER 6 MONTHS PICS WE GRAFTED 500 FOLLICLES IN RIGHT SIDE AND 512 FOLLICLES ON THE LEFT TEMPLE POINT, SIDEBURN AND EAR HAIR LINE .OUR DENSITY WAS AROUND 50 FU/CM2. FIT SHAVEN /FUE ALLOW US TO EXPLORE DIFFERENT TYPE OF SURGERY WITH BETTER COMFORT FOR THE PATIENT.

Thank you guys for your kind words .