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Patient had 2 previous Strip hair transplants that resulted in incorrect angles and directions over the frontal third. The goal was to improve his hair line and increase the density over the area to look natural. Pictures are before, placement and 9 months post op. Pre BHR repair. Placement 9 Months Post op 12 Months Post op 14 Months Post op Patient's testimony. A couple of weeks ago while taking a coffee at my local cafe an older man started to talk to me. We were talking about age, the man was 88 and in great shape. He said that the secret for a long life is a healthy life style by which he meant staying physically in shape and eating healthy. The man asked my about my age and was amazed when I told him that I was 33. He said that I looked like 24 and that I would probably never lose one single hair in my life. For me this was a great compliment. The fact is that I've lost a lot of hair and it started early. My story goes back to when I was 14. I was a good looking guy with a lot of hair and were popular in school. In the eight grade I started to notice a receding hair line. I couldn't believe it, I had just discovered girls and life was great and now I was losing my hair. This was in the beginning of the 90's and there was no Finasteride (and I was too young anyway) and hair surgery was unknown at the time. The situation became worse and when I was 19 I was already an Norwood III. I was really depressed and became more and more isolated. The turnaround came in 1998, when I did my first hair surgery on "X" Clinic in Sweden. The result was poor with 90 degree angles and a lot of pitting but you couldn't see it because it was hidden by my own hair and I was happy for the moment. In 2008 I had lost more hair despite eating Finasteride for 9 years. I decided to do my second surgery at clinic X, a decision that I deeply regret. Again the result was very poor, but this time it was very obvious because I had lost more of my own hair. The hair line was too straight and looked artificial, the hair was placed in a 90 degrees angle, so I couldn't use my own hair from the back to hide it, they used multiple grafts in the hair line placed with 30 grafts/cm2, there was a lot of pitting and it looked like doll hair. Again I was very frustrated and depressed, my hair looked terrible and I couldn't hide it. About a year later I talked to a guy on the internet. He too had done 2 hair transplantations on "X" Clinic and after that he did a repair wuth BHR Clinic. He sent my some pictures and I was truly amazed by the result! The result from BHR Clinic looked very natural and there was no way to see that he had done surgery. I met Dr Bisanga, Phil and Stephen on a consultation in Sweden in may 2010. The first that caught my eye was Stephens hair. I was wondering if he had done surgery or if it was he's own hair, it looked fantastic. The consultation was really good, they were professional, informative and non selling. They gave their honest opinion about the result that I got from the Swedish clinic, this is my point of view but I think they were shocked by the result. They also told me that I needed about 2500 grafts to cover my old hair line. For me it was an easy decision, I mailed them and went to Brussels one month later. this was in june last year and it's been 14 months since the surgery. There isn't words to describe how happy I am with the result. The hair line is very natural and I haven't had a hair line like this since I was 14. I have stopped worrying about my hair, have become happier and more outgoing and life is great! For the first time in almost 20 years I can look in the mirror and actually like the face and the hair that I see and I get compliments for my hair and my looks. I've certainly become more vain, but I think that I deserve it after all years of isolation. I would recommend BHR to anyone that needs surgery, thanks Dr Bisanga, Phil, Stephen and all the staff of BHR Clinic, for giving me my hair and life back, you guys are doing great work! Regards P.R Sweden

Scabs at 13 days is often a sign of being a little too light fingered with the washing. We recommend from day 8 the patient wash and massage the scalp when wet and massage with the weight of the fingers and using the tips in circular motion to break down any crusts and if possible 2 x a day and this will really speed up the healing process and break down the crusts and scabs as you do. It will feel like grit coming off the scalp and this is part of the process. If first surgery then some are understandably scared to massage but it really needs to be done and as said at day 13 should have a pretty clean scalp, so don't be shy but massage and was well to speed up this process. Hairs coming off is not an issue, it is the normal process for them to do so as you wash and the graft as such is safe. Of course, see your own clinic for their specific advise also with regards to washing and all the best.

Thanks ejj for updating. After 3,800 FU out of the beard it still looks good and more to come. Some would be fortunate to get this out the their scalp let alone the beard so has been a good source for you for sure and as said we will tap into it again.

Hi Jonnydrama Thanks for the update and really glad things are going so well at this stage and making a real cosmetic and practical difference for you and look forward to the updates and here when needed. Let me know how things go with the nettle root also as many do ask me about benefits of it and so far from patients I know it does seem to be working well, self included.

Doctor Bisanga will be in Geneva to hold consultations on May 3rd, 2014. They are free of charge and without obligation and an opportunity to get donor density, laxity, design, etc looked at and discuss surgery type recommended and associated graft numbers needed. We also offer a check-up for previous patients. For further information please contact Carmen at:- carmen@bhrclinic.com who will then give venue details and send required documents for those who wish to be seen.

Norwood classification: NW3 Hair Characteristics: Medium Fine Donor Density: Measured in 3 areas as 70/80/90 Follicular units per cm2 1s 528 2s 1194 3s 750 4s 191 Total grafts 2663 PRE-OP PLACEMENT 5 MONTHS PROVIDED BY PATIENT 12 MONTHS PROVIDED BY PATIENT

Many thanks for the update and hope to see continued growth and change in the next months. Anything you need please let us know.

Thanks for the comments. The patient went on Minoxodil at surgery 14 months ago but it hasn't helped his crown unfortunately. With his age he doesn't wish to go onto Propecia so also suggested some alternatives he may look into. I agree the hair line is just right and he will only get older and late 30s so we said go conservative in approach and keep in mind future possible loss as he wisely did and we will address the crown in the coming months for him.

Patient late 30s and on Minoxidil. Graft breakdown:- 1s 415 2s 629 3s 720 4s 145 Total 1909 DESIGN PLACEMENT 14 Months Post Surgery

Thanks Chris for updating from the start, you've been a real gent to work with and as you say more changes will come as the hair cycles and this is a slow process but it will soften more and more and get more lustre and you will see this slowly. We will keep in touch and thanks for sharing your case and experience from the apprehension at the start to the confidence at the end. Looking really nice.

I take 1/4 teaspoon 2 x day with water. Some will take more for non hair related issues. Any herb can have side effects so wise to see a doctor/specialist before taking to make sure is recommended and any side effects it can have.

I get mine from justingredients via amazon and take in powder form. Not sure if you are UK based but if so then this is a good outlet.

Hi Tony I am on it and so far so good, been 7 months and have honestly seen some new hairs on it under my ht hairline coming in. Not saying it will work for all but for me so far so good and very inexpensive. I was on Saw Palmetto for years and in the first years had also some regrowth on that and after researching decided to go with to nettle root due to the way in which it works. Worth trying for sure and you don't need a lot of it, I get mine in powder form and use, far cheaper also that way.

This is grown in and some years after he came to us initially. The patient naturally wears his hair forwards as you say so we then took photos and video of it also combed back to expose the hair line and then one can compare to the pre-op also with the hair line exposed and combed backwards. Basically he has the option to do both but preference, age, fashion will often dictate styles.

Before embarking upon any surgery it is important to consider many factors and ask many questions. Like any important decision in life, surgery is a decision that should not be taken lightly or in haste. The way in which one approaches the subject will usually change depending on several criteria, age for example is an important factor. The younger the hair loss sufferer is the more prone they could be to making rash decisions and ones that could be more emotionally based rather than logic based in an attempt to regain what was lost as soon as possible and this is also understandable. Hair loss at an early age is devastating and the initial thoughts are often very emotional, indeed mine was. Little to no thought is often given with regards to any future loss and many therefore fall into the trap of having surgery too young to only regret it at a later stage as they are then chasing further loss without necessarily having the donor to complete and cover the eventual loss they will suffer. I and others have seen this time and time again in consultations with patients who have been too young and ill prepared for the next years of loss. Most clinics will have good protocols in place before offering a surgical solution and age and potential loss is usually considered very early on and something we at BHR Clinic will seek to educate on and also see this in other clinics also and glad to say nobody has a monopoly on good practice. Medication is also a topic discussed at early stages. The hair loss sufferer today has many more options available to them that simply were not there in years past and I as an elder hair loss sufferer really had no options when younger at all other than risk the array of so called cures out there that were both expensive and ineffective and I shudder when I recall all the things I personally tried. FDA approved medications are now widely available, Propecia and Minoxidil are at the forefront of these options and the patient is advised to see their own GP or healthcare provider who can take into account also medical history and then advise on suitability. There are also other treatment options accessible with varying success in the form of Low Level Laser Therapy (LLLT) and even herbal approaches, such as Saw Palmetto or Nettle Root for example, that for some may also be beneficial or other supplements such as Keratene Retard or the like, the list is indeed growing steadily. Once age, medication and future loss have been discussed then the next step is to look at the individual goals of the patient. What are they seeking to achieve and how? What technique is preferred or indeed practical? The doctor/clinic will usually ask for clear photos, age, medication, goals, previous surgery history in the initial emails in order to provide an initial assessment to the inquirer. Then a consultation is usually booked, so that aside from the initial assessment, a more in depth evaluation can be undertaken. At this stage, both clinic and inquirer should have a good understanding of the case, and any possible complications, and therefore the time spent in the consultation can be most productive and address some hands on issues, such as the doctor checking density, laxity, while also considering the prospective hair design, and any further hair-loss potential etc. The elementary issues of a transplant should have been ideally dealt prior to this stage but there will be room for a question and answer session and usually photographs or on screen displays of the inquirer’s donor area will be available for them to see. Visual aids help tremendously in helping the doctor to explain such things as donor density, miniaturisation, while also photographing any potential design. Once the data has been collated the doctor can then explain the best options available to the patient, be it medication or surgical etc. If surgical then the technique best suited for them is discussed, based upon their hair loss, goals and immediate and long term expectations. The inquirer is wise to get several opinions as doctors and clinics do vary greatly in approach, so, it is prudent to initially contact several clinics and then narrow the selection down to a few for consultations. Meeting patients could then be the next option so that one may see the work of the clinic in the flesh, while also asking additional questions that may be of help before deciding on surgery. Of course meeting the clinic rep is of paramount importance, not only to see the quality of the work but also to gain more knowledge about the clinic and doctor. If the above is followed, then the inquirer is certainly on the right road and will limit, if not eliminate, the risk of making poor decisions. All the best in your own journey and approach.

Well done for your surgery and many thanks for your kind words, (ma di che) Heal well, I am only down the road so always happy to meet you and you are a guy who deserves a great result and sure you will get it. Good graft breakdowns with numbers and a nice average so should give a nice outcome for you.

Patient looks so much better and better late than never.

At 21 really think twice about surgery as you do not want to be chasing loss, as said here keep the money in your pocket and see how medication goes for you if not yet considered. I had a lot of hair at 21 and none at 37, so loss is progressive and really too early to commit to something that you could very easily regret.

Once you are at the stage of wishing to gain further information regarding the surgical options available, it is usually helpful to have some idea of the type of surgery you are considering, i.e. Strip/FUE or even Body Hair transplantation, then short listing and contacting the clinics that perform the required surgery is the next step. The price and location of the clinic may also be factors and although important, should not be the overriding considerations when making your decision. The world is becoming increasingly smaller with travel and inexpensive also so making the effort to meet a doctor and visit a clinic/s is worth it. Most clinics will have an online consultation form or email and can be easily contacted. Remember to send as much information as possible and don’t make the clinic feel as if they are “pulling teeth” in order to get the required information and photos from you. Minimally one should include age, medication, any previous surgery issues, previous or current illnesses, goals and time scales. Photos sent should show each profile fully, be clear and not grainy, be recent, without any gel or concealer and clearly expose hair loss on front, back, sides and top of the scalp. Use a comb to part the hair if needed to give an idea of density and hair groupings if at all possible. If there have been any previous surgeries then mention as much detail as possible, technique and graft numbers, include any scarring to either the recipient or donor areas and any irregularities known. Also an accurate measurement of any scarring is also useful. Video footage may also be of great help and especially to give an indication of scalp laxity. Seek to give as much information as possible and not to hide anything. The photos are not opportunities for “selfies” to show how much hair you have or how good you look but an opportunity to get an accurate first appraisal so expose as much as possible to help this. The clinic will keep any and all information confidential so no need for the inquirer to blank out any parts of their face and in fact providing full face photos often ensures a better assessment and will give a better perspective of the hair-loss and bone structure types etc. Once the information has been sent it is good practice for clinics to respond promptly. If however you have not seemingly received a reply in a timely fashion then be sure to check the spam folder before inquiring again as clinics often respond quickly only for the reply to end up in the wrong folder, so check and then reply if nothing arrived. The clinic should give an initial assessment based upon the information and photos supplied and this is usually followed with an option of a personal meeting with the rep or doctor to further discuss your case. This may not always be the case for international inquiries and the doctor may ask for a patient to be seen in person if there are concerns from the initial pictorial evidence. Try to contact several clinics in order to get a balanced view as to what is needed or recommended. Uploading the case to a forum is another advisable avenue, however, the seeker may wish to remain anonymous in this situation and therefore cropping or editing the photos to some degree may be needed here. Usually once the above processes have been followed, the inquirer will have a good idea as to what is achievable and may then wish to proceed with a personal consultation. The Consultation If and when a consultation has been arranged, make sure you give yourself plenty of time to arrive, to be assessed and to travel home. Bear in mind that the doctor may also be performing surgery on other patient/s that day, so possible delays in being seen should also be considered when making return travel plans. The consultation as such should take approximately thirty minutes for the doctor’s hands on works to be done and questions answered, some may take longer. Make a list of questions beforehand that you wish to ask once there. It may be helpful to email these to the clinic beforehand so that the clinic may prepare the answers in anticipation of the consultation and indeed will ensure the whole process is more productive and efficient. Many clinics will have an extensive open dialogue prior to the consultation stage in order to answer as much as possible prior to the consultation itself, thus making the consultation more productive for both parties and avoiding the going over of basics that should have been aptly dealt with by this stage. When you attend the consultation, make sure your hair is free from any gel and concealer so that the assessment can be accurate. If you do wear any such products while travelling then make sure to wash off before the consultation and re-apply after if need be. Hair should not be shaved to the bone, try to have at least 3mm of length if possible and be prepared to remove any hair systems also prior to attending. There is usually a pre-consultation form to be filled out upon arrival in order to give the doctor as much medical history and information as possible before the consultation takes place. Please be honest and open with regard to all questions as your information is all that the doctor is privy to, they are not mind readers so correctness here is vital. The consultation should be relaxed yet informative and well worth the effort in attending. It should not be like a game of chess whereby the atmosphere is one of a battle, but moreover, trusting, honest and open from start to finish while seeking to work together. Some clinics will “snip” the donor region in several places with scissors in order to read the densities in the various donor regions and this is something that Dr.Bisanga is known for, in order to get accurate information and to view the donor under magnification. The snips are very small and easily disguised so should not be of concern. Usually density is measured and seen on a screen display and is recorded and documented. Laxity is also usually considered, and especially so if Strip is to be the principal surgery type. The doctor will also typically look for any miniaturisation in the donor or recipient areas and also and where relevant proceed to design aspects and graft numbers, technique will be discussed. At this point it is prudent to also photograph any design, so that there is a clear record of what is drawn as this can be easily forgotten afterwards. Make sure any design is washed off prior to departing and usually an alcoholic swab is used for this purpose. The doctor will also write a summary with measurements taken for hair line design etc. Surgery costs, numbers of days needed for the surgery and possible dates may also be discussed, as well as your questions answered. It is then common practice for a post consultation summary to be sent to the inquirer. If any of your questions are left unanswered at this stage then do not panic, there will be a follow up dialogue via emails or phone calls in order for any outstanding questions to be covered. Some may find it helpful to record the consultations in the form of an audio recording and this is usually agreeable, but wise and courteous to ask the clinic for permission before doing so Try to have several consultations and if possible get the most out of your trip if going overseas to visit a clinic. Search if there are any other reputable clinics nearby that may also be visited. All of this will take organisation so sufficient time needs to be dedicated to planning. Some clinics will be booked up months in advance, so ensure to contact any prospective clinic early in order to plan your schedule. Once a consultation has been given, please be aware that the findings will have a shelf life as such. If more than six months passes from the time of the original consultation then the clinic may ask for new photos or another consultation in order to re-assess your situation and requirements before offering prospective surgery. The consultation will not only provide you with the required medical data, but will give you a feel for the doctor and the clinic. You may also be able to see an example of the clinic’s work, if there are reps available in the clinic that have themselves undergone surgery. It is unlikely you will be able to see any live surgeries as such, although most clinics will be able to provide ex-patients for you to meet in person prior to surgery. If there has been considerable time and expense spent in attending the consultation then the clinic may also, in good will, offer a slight discount on any prospective surgery in order to cover some of the associated costs of the visit. BHR Clinic offers this as we recognise the effort and costs incurred by the prospective patient. A clinic charging for a consultation is becoming more of a rarity but any such payment is usually put towards the surgery costs, should the inquirer as such proceed with the surgery. You would need to check such detail with respective clinics. Lastly, consultations should be without any obligation or pressure to proceed to surgery and we indeed as a clinic pride ourselves on our reputation for giving good, honest advice to the seeker in a professional yet relaxed atmosphere. The inquirer should leave the consultation with more knowledge regarding their own personal situation and will have the specific date needed in order to make an informed decision or access to the information needed post consultation. All the best for those going through this process.

Patient had previous FUE in another clinic prior to coming to us to restore hair line. Age:- 40 Medication: Finasteride Breakdown of grafts : 340 x1s, 1407 x 2s, 1065 x 3s, 246 x 4s Came to us to rebuild the hair line and blend back into native hair. Pre-op Post surgery Video here when patient came for a check up:-

Mick is a very down to earth guy for sure and glad all went well. All the best for the healing and growth to come.

Thank you for the comments. I spoke to the rep for this patient and he said the patient has no hair products in and didn't use any prior to surgery either from what I have been told. He has coarse and some wave and curl to the hair that when grows will allow for a very good effect.

Thanks to the patient for this 15 Month update.

Looking very good and will make a nice improvement in time for the summer.

Thank you for posting Grigriman and always a pleasure talking to you. Heal well and speak soon.