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Patient sent a 9 Month update from last surgery to touch areas of shock loss etc and to touch temple points also to better frame his face.

Quote from Stublu

"It's actually only just gone 9 months and all is well. As per my first op it took a good 6 months before the recipient area on top started seeing real growth. Month 7 and 8 were great and I'm very happy with the result so far. The temple points grew in much quicker and I think add a good bit of shape to my face."

End Quote.

Thanks as always for patient for sharing and allowing us to update.

Hi Ostrich, heal well and your advisor will send all photos next week once they are all uploaded and send you the link to download them.

Please keep in touch with her should you need anything.

Yes as above, patients can be on anti-biotics for folliculitis or other issues and not aware of blacklisted ones and probably you will be given common ones also to take. Your doctor prescribing them for the upcoming surgical work should also be able to explain any possible issues but doubtful you will have any hair issues.

Hi Zeoranger

Many patients take antibiotics post surgery as a precautionary measure and it is not a problem for the grafts. By all means see your clinic but I have not heard of issues with patients taking them and most take them immediately post surgery anyway and for 5 days or so although this may change with different clinics.

All the best for the dermal work.

All the best for you and as said nerves are normal and seems you have done extensive research and met ex-patients also and heard first hand experiences and seen results in person. Sure all will go well for you.

Hi Jugendlich

I am not sure what rep at BHR you dealt with so apologies I don't have specific information on you but if a patient is in early 20s and NW3 then probably was the reason why we were not comfortable to offer surgery as seemingly others also were not from what I read.

Hair loss is progressive and for us that is very young to commit to surgery and there may have been other options for you also to explore in terms of medication and waiting and seeing how things developed.

Clinics will have different protocols so some will believe it is the right decision and others will not, this is not a criticism but a reality and we prefer and are known to be a conservative clinic and I would have personally been suprised had we offered a hair transplant to some one who is early 20s with your loss.

Please feel free to email the rep that you had dealings with and I am sure they would be happy to expand on the reasons if not clear to you in the emails you received and they will have more information than me so can give a more detailed reply.

Sorry we were not able to offer and hope you see improvement in the next months as if I read correctly your surgery was 9 months ago and if so then things can still change and as said the advisor you spoke to can give more specifics to you if you'd like to see why we were not keen on offering surgery.

Best wishes.

Hi Ralphnyc

You have been given some good advice here, still young and loss potential is there from the photos. Be good to get your donor densities checked, the nape and above ears are probably finer aside from the cut, so worth seeing what can be taken and plan from there in design once densities and the safe zones for FUE harvesting are determined as there may be areas such as nape etc that the doctor will not want to harvest from if lower in density and also checking miniaturisation also.

I would personally go as conservative as possible and really take on board what's been said about your age and loss potential and at near 47 myself I can say you will most certainly care how you look as you age, it really is a myth that one stops caring and I am speaking from my own experience as at 20 I really thought I wouldn't care at 40 how I look but the reality is far different.

If your loss were to continue then you may need a Strip at some stage but for smaller numbers then FUE probably is the best option now and as said means you can shave down also and if you need more surgeries in the future can go for Strip or Strip and or FUE depending on how things develop and goals etc.

All the best in whatever you chose and keep in mind the future as wisely said by others.

Hi Durhamboy,

Essentially after 6 surgeries then worth having personal consultations. You have fine hair so if considering beard then let it grow and send photos also to see if can be used in your case as a filler and if colour, coarseness are compatible with the scalp but after the amount you have had then wise to be seen in person and go from there.

All the best.

All the best for your upcoming surgery with us and your advisor will be there for you post surgery also and into the healing and growth stages through to final outcome.

Hi Momo

For FUT the prices for BHR as 3.00 Euros for the first 2,000 grafts then 2.00 Euros thereafter and also this is on our website.

Your advisor will be happy to answer any questions for you whomever you are dealing with so feel free to ask them anything that comes to mind.

All the best.

Thank you for the comments.

The FU breakdown was as follows:-

1 hairs = 731,

2 = 1,167,

3 = 592,

4 = 52,

5 = 1

Patient had very fine hair and this impacted on the amount needed in terms of density. He is now in his 50s so well spotted to those who did.

Hair colour also helped in the result and we had to place well back in into the frontal third in areas to ensure to blend back into native hair that he had.

Hair line design to rebuild the open temples going back over the frontal third, slightly touch his apex to create a natural gentle angle into his temples.

PRE OP AND PLACEMENT

POST OP COMPARISONS

Hair line close up in natural light.

I think that prices should be clear and transparent and especially for virgin cases.

There may be times with repair work that a doctor or clinic would prefer to assess in person before quoting and this is understandable if they need to see the challenges and what can be done and it may need often a combination of techniques and can include body hair also. But for standard procedures there should ideally be clear documentation on this and available on the clinic's website in my opinion.

There

Hi Bob

Would agree with Janna, really wise to have some consultations in person to see the toll the surgeries have taken on the donor and to check densities and especially miniaturisation around the scar area that is possible.

To do a revision would need good laxity and also scar positioning and any fibrosis etc all need to be taken into account to see if this is the right option. But after three surgeries and 3k taken then would advise to be seen in person and get some very good data on your case to then see what is then the best approach to do.

All the best.

Nice result so far for the patient.

Thanks for updating ejj and glad it has made a nice difference for you from where you started and thankfully you had a good beard supply to tap into.

Patient asked me to post his 24 Month update as per below:-

At 24 Month update

Hi, sorry its late, but here's my 24 month update. I've had all my growth and the hairs seem to have fully matured. Im really happy that I can finally use styling products and style my hair. I have the freedom of not having to wear a hat or worry about my hair blowing in the wind only to uncover a bald patch!

This is by far one of the best decisions I have made in my life so far and if I needed any future work doing, I wouldn't hesitate due to the great experience I have had from having the procedure done and the confidence it has in turn given me.

Massive thanks to Dr Bisanga and his team and of course Steven who has been there every step of the way.

Nice outcome and all the best for the patient.

Thank you for the comments.

To re-iterate on this case, the most important aspect of a hair transplant is listening to what the patient wants, usually this is the first question that Dr.Bisanga will ask in a consultation.

Then we proceed to check the donor to see if the goals are possible or wise for the patient, we take into account the donor density and on this patient it was on the lower side as noted in the readings given, then age, potential future loss, bone structure and what is natural for the patients also to have in terms of design.

Firstly the goals were not to have a design that would necessitate 4,000 plus grafts, if it were then we would not have been comfortable offering the surgery taking into account the donor and how much this patient can give with FUE long term. So, the patient's goals were from the offset a conservative approach, he has never had a low hair line naturally and to create one would probably then change his appearance drastically in a way that is not natural and bone structure and facial features also need to be taken into consideration here.

Once the donor is measured under magnification we have a figure of what can be taken from the donor safely. If a patient has naturally lower density then front loading 4k plus grafts for us as said is probably not wise and gives little to no thought to future loss, it also extends the hair line to crown considerably, so if there is more loss then the patient will have less grafts to go backwards as a significant amount have been invested in going forwards and we call this “front loading”.

Going aggressive in design may be fine for some patients if they indeed firstly wish for this approach and have the donor to allow for it and have some donor still for future loss. As said for this patient per se it was not part of the plan at all and the fact he was willing to share his result means he is happy and achieved the result he was looking for. The hair line was lowered and loss behind dealt with and within keeping to what he had naturally before loss.

We don’t believe in the same one size fits all approach for any patient but base what is done on the above factors, so not all will have low hair lines but for some a less conservative will be the approach taken and will be the right approach and one that the patient themselves wish for. We recognise we all have different tastes and what we perceive to be a good transplant and it makes the world a much better place for sure.

Hi Kootrapali.

Be good to see full side profiles left and right and full rear. You are not a NW6 but more NW5A, your sides and crown appear still to be high and if your donor is good then you should be able to get a good result.

Medication and age are issues so may wish to look into FDA medication to keep what you have as you can drop also in time. See your own doctor for suitability for them.

If you can supply more photos then forum users, doctors can assess more for you.

All the best.

My pleasure and thank you for the comments.

Hi FUE2014.

Both patient and clinic would not have put another 1500 to be honest as the patient's native density was on the lower side and this would have then been near to 4000 grafts used and a larger area to cover backwards if loss continued. So, in essence future planning and conservative use of donor were the objectives whilst making a nice difference for the patient and keeping in mind any potential loss.

Age: 32

Graft break down-

1s 455

2s 805

3s 758

4s 249

Total 2267

Hair Characteristics: Medium Fine

Density 60/60/70

Medication to be confirmed.

Patient had hair loss pattern with miniaturized front and temples. Goal was to reinforce front and close temples to frame face with a natural design. Patient said the result has improved even more after 12 months and we can look forward to more updates in the future.

All post op photos provided by the patient and many thanks to him.

Design

Placement

12 months

Thanks for updating and very nice and natural as you said and thank you for updating. Keep us posted and we will be happy to do any slight changes needed but have to say very nice from the photos and takes time for that softening to happen that you mentioned also.

Thanks for updating Stinger and good to have those comments. I had the same from people who never knew I had undergone surgery and a nice feeling.

All the best for continued growth in coming months.