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Hi Bald36, I am not the person who replies now as has been given to others a while ago but out of courtesy will as I have seen your question was not answered.

Dr.B is currently in the USA but I believe in Washington area. Please feel free to email hilde@bhrclinic.com who will be able to further assist and apologies for the late reply.

Hi David, all the best for your new position and you will be an asset for sure and a loss for H+W. You've always come across as a gent and an honest guy and well respected in the industry. I am sure all will go well.

Hi Zeoranger

Sorry for the delay, effectively someone else is taking over the posting now for BHR for a while and will be up and running soon but I will reply now to avoid delay.

We placed around the first surgery area, probably further behind and certainly lower in front also and then went over the area and would have placed amongst previous work to add density once the patient was shaved but essentially a larger area than the initial surgery was addressed.

The patient was deemed a repair and this can mean abnormalities in the skin such as micro scarring and there are generally more challenges than a virgin case would have presented, so growth can be harder for sure on these cases where you have to re-visit an area.

Hope helps.

Patient wrote at 8 months "Everything is going really well and I couldn't be happier with the results.I am beyond satisfied with my result".

Here are his photos and I have to say, looks amazing and thank you for sharing.

Photos at 8 months.

Patient had a 1200 FUE with another clinic and was not content with density achieved so came to us for this to be addressed and is very happy with the outcome,

1 hair : 432

2 hairs: 658

3 hairs : 530

4 hairs : 52

5 hairs : 3

TOTAL 1675

Age 34 years

No medication.

Pre-surgery

Placement

Result at 13 Months

Comparison

The patient did share update and photos to me and looked very good even early on so hopefully he will be able to update here also.

Yes, congratulations to you Janna.

Hi Sunseeker

Thanks for the question.

The practical "safe zone" for Strip is not comparable as such to the safe zone mentioned for FUE.

For Strip it is with regards to an area safe to take a Strip from and to remove tissue, whereas for FUE it is where the hair itself is safe to take. For example, here the FUE goes down to above the nape, if you look you see it shaved and a thumb size area non touched before it goes down then to neck hair.

The FUE area is greatly extended to harvest grafts from all over the donor and can be circa 180 cm2 on a good candidate and is spread throughout the donor when the patient has good hair evident. It will differ (the safe zone) for patients in size and some can be 6cm x 30cm as said and for others 4cm x 30cm or less taking into account other factors such as retrograde alopecia etc that limits FUE safe areas or previous surgery etc. It can also change over time as one ages.

So, hope I answered but basically the techniques differ greatly and for sure Strips are far more local in a specific are and take all of the grafts in the defined Strip zone ( a rich and well defined area) . It is not global in terms of harvesting throughout and needs to be not too low to Stretch and neither too high to have issues of the loss dipping into it.

FUE is taken throughout and for sure what is safe for FUE in terms of good quality hair would not be the same for Strip because you simply would not take it in any part of the donor but usually keep it to the defined safe area that is traditionally used. There are of course variations but I am talking in general.

Hope helps.

Hi Baldrick, thank you for the kind comment.

Apologies to reply now but have been tied up in consultations this weekend with Dr.B.

We usually prefer a shave to then place in and amongst any native hair. To be precise if you are able to upload or send photos we would be happy to comment for your case specifically.

All the best.

Nice change here Peter! Very natural.

Patient has medium fine hair and a fair size area addressed with just over 3,000 grafts.

As said it will be a two stage approach in the least will be needed and the patient had good starting density to allow a further surgery and still at 9 months he will see further improvement to come but already has made a nice change for him. Thank you to patient for sharing the photos and hope we can have updates also on this and for subsequent surgery.

Scars can stretch in the early months post surgery as yours seemingly did also.

FUE into the scar will help it but would be at a low density of 30 FU per cm2 usually. Hard to see from the photo the condition of it but may be wise to see a doctor or dermatologist locally and see if it can be helped with injections if raised up and go from there or see what your HT doctor recommends if he has seen you in person.

Usually if you have stretched twice then placing into the scar is probably the safer option to break it up and avoid a revision that can stretch again.

One pass may be enough if the hair is kept long or you may need another pass to get to the density you want in the scar but it is a slow approach due to the nature of scar tissue and challenges there for growth,

Hi hyperhair. It is unlikely the scar will improve at this time. Your doctor may recommend cortisone injections to help flatten it and then FUE into it will help usually to camouflage the scar and bring back vascularity and also improve the appearance.

If you can put some photos then you will probably be able to get more specific feedback.

Hi Cork

I would echo Spex in that both very good and ethical doctors and try to have live consultations with both if you visit Brussels and go from there and feel free to send photos for an assessment if not done so already.

You will be in good hands with either.

All the best.

Nice outcome Garage..well done and happy for patient.

The rule of thirds and the "Vitruvian Man" is something to take as a guide but really need to take into account your own characteristics and loss potential, age, donor etc, as this will dictate what is wise to go for. But of course as a rough guide is fine but expect it to be honed more once you have donor data etc and all that is needed in designing and planning for you.

All the best.

Hi Borrn2Shine

As said the hair line is nice and natural and you are only going to age also.

In answer to your question if you were to lower it then yes, a new hair line needs to be established with single FUs then going back with two and then multiple units, so in essence a repeat of the first surgery and then blend back into the current hair line.

Wait a good year to see how it comes in as you may be very happy with it then and not need to change anything at all. But if you do decide to lower it then this is easier than removing and going higher, so a positive there!

But having good quality hair coming in will make a nice difference and frame your face and be patient and assess at 12 months and go from there as in terms of thoughts and wants it can change dramatically as the hair transplant grows in.

All the best.

Hi Arrek, I think a wise approach if one has Lichen Planopilaris, a slow approach is probably best and hope you have had good growth from the last surgery and looking forward to the updates.

All the best.

* BHR Clinic

* Dr. Christian BISANGA

* Age: 39

* Technique: FUE

* Medication: No

* Donor densities: 70-80-100 FUs/cm2

* Hair Caliber: Medium Fine

* Total FU used:- 3055

* FU breakdown:-

1s 647

2s 1396

3s 777

4s 235

TOTAL: 3055

The goal of this surgery was to spread back into the frontal third or slightly beyond thus opting for a conservative line design and taking into account the patient's age, loss, ultimate goals .

A second operation for the crown is the next stage.

Pre-Post surgery

9 Months

0-9 Months Comparative

spot on..

If those photos are at three weeks then you've been too light fingered by far. As said here, start massaging and getting the scalp clean now.

It's always hard to know on the first op what to do and many are over cautious but really get washing and massing well now. Speak to your own clinic if you have concerns and let them guide you if needed but should see massive improvements in the next days if you wash well.

Looks good esrec and should make a nice difference for you and looks like Dr.Ron placed well back into native hair also as well as giving you a new hair line.

Don't analyse too much now as you are swollen and it does lift everything but should really come in well for you.

Great write up and will for sure help others who have to go through decisions.

All the best and relax as much as you can now it's over and enjoy some downtime from work if you can.

I am not the patient rep for Arekk but do applaud his updates as you do.

He did say on his other thread that he was diagnosed with a skin condition and this is also known to attack hair follicles and has undergone treatment for this since discovery.

QUOTE:-

Photos 25 days after ht.

Biopsy have shown that I have lichen planopilaris, an uncommon inflammatory scalp disorder, it accelerates balding proces. I have to use topical corticosteroids.

http://www.hairrestorationnetwork.com/eve/178901-1000-grafts-fue-dr-bisanga-2015-march-3.html

We did 1,000 grafts and is a tester for more I would assume but really his own rep or the patient himself can probably comment as I am going only from what I see on his other thread also and would say a skin condition is a significant issue when it comes to hair health and growth.

The clinic of course have stood by him and he is seeing very good growth from the 1,000 then done in a second surgery and since having treatment for the skin condition that could have played a part in the first outcome.

Am happy to see the second op does seem to be coming in well and wish him continued growth and then he can review with his rep and the doctor for next stage. I believe they will meet with Dr.Bisanga on Saturday.

Hi Esrec, thank you for the kind words and was a pleasure talking to you and as said you are in good hands with Dr.Ron or any of the clinics you have approached. Nerves are totally normal and I get them even after many surgeries so that's all normal for sure.

Keep us posted and all the best and you will should get a very nice outcome.

Age: 28

Norwood classification:NW4 diffused thinner.

Hair Characteristics: medium fine

Donor Density: Measured in 3 areas as 70/70/80 Follicular units per cm2

Graft breakdown:-

1s 667

2s 1147

3s 1015

4s 159

Laxity: n/a

Miniaturisation: 10 to 15 percent

Medication:- None at time of surgery then patient went onto Minoxidil post op and has continued.

Recommendations:

2500 to 3000 grafts for frontal third with conservative hair line. Minoxidil also recommend to assist the thinning hair on top.

Pre-surgery design

Placement

Donor Extractions

Result at 12 Months Photos Provided by Patient.

Patient Quote:-

The transplant really came out great and I'm very pleased with the result. Looking back the change is really remarkable.

I'm still using Minoxidil and it's seems to hold for now, hopefully for few years.