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Everything posted by sl

  1. Great opportunity to be seen and I have a fairly long list already so I expect this to be very well attended...
  2. Yes laxity will return but you need to be careful in the first few months in what you do while the scar will not have full tensile strength, so usually a clinic will say be careful for the first few months in strenuous activity, but the sensation of tightness will pass. The position of the scar and other factors also come into to play in regards to how and if it will stretch. Take care.
  3. Hi HTHOPE, great question and good to see people are looking at donor extractions also now. This patient had 2400 FU, and a good density of 80 FU per cm2, so even with a nicely spaced extraction pattern and well spread as the photos show, we did not need to go over the whole donor of circa 180cm2. We harvest from one side (I see many FUE results only and exclusively harvesting from the rear however), and spread as needed to get the graft numbers and units needed. So, we start from temple and above ear and work round keeping in mind a good spread for the grafts. To extend it to the other ear for the amount of grafts needed and with this patient's density would have meant spreading more, more injections and not needed in that we have not had to over harvest at all to obtain what was needed. So, this is not uncommon. As said over the years I have seen a lot of results from clinics with higher amounts and not spreading more than the occipital area, so very concentrated extractions, but that said we spread as needed but there is no need to go over all the donor from ear to ear for the sake of it if we can harvest the numbers safely without having to extend and as said is common also and we take into account the amount needed and the donor density to give. Dr.B uses a motorised punch and 0.75 to 0.8mm for the most part unless afro hair type etc. Hope helps.
  4. Looks very encouraging and happy for the patient. Dr.Argyrious is doing some nice work after being alongside Dr.B.
  5. Yes I didn't want to see it as such for taking from there but more to see the spread of body hair and beard you have above jaw also as the more spread usually the stronger it is. Essentially start under the chin if you can and go from there.
  6. Be good to see the beard grown a little and how high it rides up your cheeks but for chest and beard you should be fine. If you have any pre-DHT blockers to look at also would be good but you still have decent chest hair so I would guess you have not been effected.
  7. You will have a high percentage of chest hair in the telogen phase and more than 50 percent probably, and it is nearly as long as the active growth phase and they will largely look the same and shed and new hairs will grow and mature. As said unless you are comparing like with like then you won't learn much in terms of the effect of a DHT blocker on your chest hair as we all have thicker and thinner under magnification and especially so more evident if magnified. If you have not noticed it to your natural eye then the chances are it is not an issue for you. If there is any significant change it would be firstly evident to your natural eye and especially if you were to compare photos of pre to post DHT blocker. If you can upload a frontal photo of the chest it would be good to see then also the colour, quality, spreading of it etc.
  8. Yes, essentially you will see from looking at before and after starting DHT blockers and over time to see if it diminished in quality or quantity. You need to see the starting point prior to then see if it has changed and should be evident to the naked eye if there are any significant changes.
  9. The injections are not only to limit pain but to decrease bleeding, so you will not be able to substitute this and injections should not cause transection of the follicular unit. Shock loss is more due to the blood limiting effect of the injections. Numbing creams and Acupuncture will not prepare you for surgery. You need to have proper administration of anaesthesia and we have not ever administered a level that is dangerous and even in large Strips of 5000 plus grafts, therefore you should not really worry about that if you go to a reputable clinic. So, it is not just about pain but also bleeding and the injections also raise the skin up as the fluid enters. If you have pain you bleed more also, so there are a few reasons why this is needed. As said, for Strip , FUE and body hair, a reputable clinic should know the levels they are administering and stay in safe levels.
  10. We have done body hair and beard and not had issued of scarring. It can depend on many factors and I have met patients who have had extensive beard work elsewhere and seen white dots from the extractions, so there are variables. We have done recently a case of removing from under the chin to placing above as you describe and I have the photos and no evidence of scars on them nor even has that been reported to me from the patient as an issue, but as of yet I am not able to share the photos but hope to be able to do so nearer the 12 month stage.
  11. Nobody wants an unnatural hair line and this is the biggest give away for those who have had a hair transplant and that something is, shall we say, not quite right, in this aspect. People should talk to your eyes and not your hair line, and I have spoken to many patients who said that sadly is the case for them from previous surgery. This video exploits some of the golden rules used in order to give a natural result. Not only the employment of grafts used but the design implemented. Most patients today expect an undetectable hairline that has enough density after one session and blends well with their native hair and of course with their facial features. Watch this to see some of the aspects you need to consider before pulling the trigger! One thing worse than hair loss is a poor transplant that screams I am not natural! I hope you enjoy this informative presentation by Dr.Bisanga. Regards stephen@bhrclinic.com
  12. I live in SE Asia, and Asians don't have any upper body hair, so I really look like a monkey to them. ..That made me laugh, and yes I am sure it is not the norm for them. In my case in essence you are not multiplying, if you split a double into two singles, and the single stays in the donor and a single grows it is just splitting the unit. Mine was not intentional back then in the day and not working in the industry then I didn't give it much thought other than I noticed them growing back from source and as a laymen could see then that the FU in my chest had healed to give growth again and through the exact same spot it was punched in. Whatever they pulled out I don't honestly know if they were any good and how many were transplanted. You are on an interesting concept that is not far from this idea and is a variation on this and is a mouthful to say but it called "PL-FUT" or AKA. "Partial longitudinal-follicular unit transplantation".
  13. Do you know if they used manual or motorised punch and what sizes also?
  14. @lovinitl9, I am on contact very regularly with this patient and he has not reported any differences. Also the grafts would have then been mixed so not all in one area transplanted, so it does make any difference less likely to see also. @BeHappy, Yes, having lots of hair even on the chest does not mean all are good, there is a pattern also usually to the finer vellus and the thicker usable. You have a lot of abdomen hair but some areas evidently the quality is less and finer, so it will be a case of cherry picking and taking the best quality. Be great to see some photos of how it came out if possible also. I am sure you got a pretty decent outcome to want to do more, so that is a real plus. Did you notice any change in quality on the scalp over the years? Assuming it was years ago you had initial work done. Thanks.
  15. I had a patient who told me after that he got his wife to button his arms inside his shirt, to not then scratch his head. I said be careful as if you fall from bed you will have no protection to stop the fall. For the next surgery he had I told him to put washing up gloves on so even if he touches his scalp he wont scratch out a graft, so it is an added layer of protection. Ideally sleep with scalp exposed and breathing and put yourself in a nice travel pillow that keeps you in position and slightly elevated and sleeping on your back for the first few nights. Cover hands, not scalp essentially.
  16. Thank you for the comments Pangloss. In the photos you see men with even good chest have longer and darker hairs and even though the first person has a lot of abdomen, you see them also finer and therefore a longer resting phase is evident and a shorter growth phase than the chest has that is more abundant and darker and better quality. As said this is the norm, but I have seen some patients, and ethnic groups also play a part and I recall some southern Europeans who have very strong abdomen hair that is very good but always they have had good chest hairs as a consequence and a carpet of hair that is all terminal. Some will in essence have more "terminal" hairs grow, some will remain vellus and this is genetics that is individual to them. Also medication plays a part, as DHT blockers can weaken body hair, so Minoxidil has a positive effect. I would agree with Dr.Bhatti for the norm of the anagen phases for most, but you may be one who has little difference in the anagen phases of abdomen to chest, an exception more than the norm, so for your case it could be different. Dr.Bisanga has many years of experience in Strip/FUE and body hair, and unlike many he is not a recent convert to FUE, but has been doing it since inception of his career that now spans 20 years, and also has seen a lot of and performed a lot of body hair cases and in his experience he says scalp is king, beard is prince and then you need to evaluate the rest, but usually will, unless exceptional circumstance, limit himself to beard and chest and even then cherry pick the good and stronger ones from the pattern that the patient has. Beard also has variations throughout it and usually the peripheral areas are finer so have less of an anagen phase. If you are on Minoxidil you may notice this increases also. The rate of growth you quote for stomach is not usually transection as if transection is clear then they would not be transplanted unless in good condition still and in the hope something would grow, so it is more survival of them from the operation. Of course they can take longer to grow than scalp hair due to the phases being different to scalp and I have known some even get growth at two years on body hair. Back in 2007 I had a training doctor punch 300 grafts on my chest, I got small dots and could see where they were punched from and got hairs come back in these same spots, so the follicle was transected and the part left behind re-grew from my chest, so it had not been fully captured and chest is harder due to angles splaying around and it was interesting to see the re-growth in the original area. Back hair can be very coarse, but normally those who have back hair and on shoulders also, have an abundance of chest that is also tapped into firstly. Like anything, there are the rules and then the exceptions who may genetically have different characteristics and be able to exploit that. If you would like to post photos or even send me photos of your case then I will pass to Dr.B to assess for you an give you his opinion on what he would harvest from for you.
  17. Thanks for the comments and questions and for the photo also. Be good to see how that came in for you. Chest and abdomen hair for many is vellus, it can in time mature to terminal hair and even when it does for the most part, the richer area is usually the chest. Of course there are some that will be extremely hairy all over but playing to the norms, and my case also, I had chest hair prior to stomach coming in and this became thicker in time but huge parts remained vellus and usually above the belly button zone there is the richer area usually in a vertical line. I have met many who had chest hair but no stomach hair but not ones who had loads of stomach hair but not chest. Here are some photos of regular guys to show this. As said some may buck the trend of course and there is not a one size fits all but playing to the norms, we prefer beard, then parts of chest where the patient has good quality terminal hair. Cautions are DHT blockers and how they effect the body hair also that then can be more prone to falling. I lost body hair on DHT blockers but my beard remained the same. Also aside from angles, there is more body fat around the abdomen and therefore less taut also for punching and as said parts of the abdomen will have less of an active growth phase resulting in vellus hair type. A man can have a lot of stomach or indeed chest hair but much of it still vellus. Beard throughout the zones change in quality and the peripheral areas are usually weaker and the moustache stronger. Most will ask for under chin to limit any visible impact should they have scars from the surgery. The below photos show some patterns of growth, density and hair quality changes in chest and abdomen areas for three individuals. All have a fair amount of chest but abdomen is weaker in all three in density and quality, so we keep these factors in mind and it is important to utilise the best body hair for the patient to obtain the best result and educating in terms of the video the coarseness, count, cycle etc are different and transection or growth rates can vary. Once we get to body hair it usually means the patient has exhausted the scalp, so we need to give them the best chance of success and take the best quality hair then usually presents itself and generally there is a demise as you go down from chest to abdomen.
  18. Great information here Ian, very thorough in all aspects. Thanks for creating and uploading it.
  19. Sorry to hear of your issues. Glue can cause issues to the skin and especially long term usage. Aside from that wearing as hair piece and then transitioning to surgery is not that easy. A hair system gives a full coverage and hair line in a position that surgery won't give, especially for advanced loss and if your donor is not that good. So, it can put you in a very hard position to then transition to surgery, remove the hair system and keeping it off while you heal and then eventually being happy with surgery.I have not seen many guys go through with it due to the challenges and limitations of their donor compared to what a system can give. You need to see how you react to the glue used and ask about the long term usage and how it will effect your scalp before committing to it. All be best!
  20. Thanks for posting and full face also! I would agree with the advice given here already. You are still young and not on meds. Your crown will drop as is evident from the photos and not the thickest donor, especially above the ears and also the nape area. So, make sure to get real empirical data on your donor and densities, miniaturisation and the safe zones you can take from because for your age you have extensive loss and it will progress. Your sides could drop also as you age and you want to make sure that with your donor limitations and future loss potential that there is longevity to whatever you do. A surgery of 2,000 is not a lot and would need to be a very conservative design to then go back to mid-scalp. Whatever you do, keep in mind future loss and that it needs to look natural and keep some in the bank for any sides dipping. Your beard is not strong above the jaw from the photos. All the best to you!
  21. Just to remind those who wish to attend then this is today 6pm CEO time, so 5pm UK.
  22. Yes, experience has been my teacher plus the many whom I have met and dealt with over the years.. I hope this can help some not feel alone and have had almost word for word the same reply to my WhatsApp as you have written here from others.