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Thank you sharing and look forwards to the evolution. You also are in great hands with Ian as advisor for sure.

First surgery is always hard and the patient can be extra light fingered and careful so totally understandable. Swelling usually peaks after a few days and then goes down by day 4/5 or so if one sleeps elevated for a few days, has fluids, massages well to encourage it to drop and I cannot speak for your clinic as such and their post op. If you chose a clinic then it is based on results and trust and that includes this period also but for me personally this now would be overkill and the patient is washing and massaging well also by this stage. I had a lot of surgery and never had same approach as prescribed above myself to that degree of caution. I myself walked a lot and got fresh air and stress release that gentle exercise affords but at this stage you should be edging back to normal routines regards to doing daily tasks. If you had Strip then you will need to be careful in some additional ways but not sure what procedure you had. Take care, have a nice walk and send us a photo of the scenery is my opinion.

You are welcome and this is what forums are for. Heal well.

Thanks for the tag, essentially probably best his own advisor answers any query and will have an audit trail of emails and so can further expand. I have no case nor conversation history and am not familiar with the exact details of conversations so may not cover all queries. I will say though from my perspective, all of our results are a team effort, in my 15 or so years with BHR Clinic and Dr.Bisanga I do not recall any result on any forum from Dr,B alone and I include my own result in this. I would ask patients to be aware prior to consultation as to what they want and if they want Dr.B only, exclusively and without any tech assistance at all then ask that prior to coming so to avoid disappointment on a price. As said our team are integral and represent ALL of our results on this and any forum, so if one likes the results then in essence they are happy with the team as pretty much every hair has been placed by them and they do it day in and day it, it is their sole work. Often taking time to research and meet patients can then remove concern of having techs also as part of the surgery. Some doctors do place alone and are happy to do so and Dr.Bisanga is more than able to or would not offer, but is not a usual request for most of our patients. If done then of course the patient in essence then is the only patient for the day/s as Dr.B will be solely performing all aspects of surgery, so Dr.B and team or Dr.B shared surgery with Dr.Kostis, consultations etc would also not be feasible for the days in which this surgery takes please. A 4000 FUE is a large surgery and would be over several days, probably also more tiring for the patient, more injections etc, lesser grafts per day to keep out of the body time low and I myself do not see merit in it other than the patient prefers to have Dr.Bisanga do all parts from a to z. I have no doubt on Dr.B ability to do it but for closing the clinic to just one patient over several days will need to cover the costs and staff and all usual expenses. If the patient wants this then okay, Dr.Bisanga will provide a price for these requests. If the patient wants Dr.B and the techs or Dr.B and Dr.K shared with techs then the price is per email. So, it is good to have a comprehension of what it implies if the patient wants Dr.B only and for a good few days also. For any specific questions then this patient can of course continue with the advisor they have but I think good to qualify what has been asked and the implications. To date as said I am not aware of any patient on here who asked for this so it is superfluous really to most if not all.

In short, I would agree with the article linked to regarding Minoxidil. You are now 6 days post op and sweating as described will not dislodge a graft and I assume you have isobetadine spray and are washing and cleaning the scalp etc and probably had some anti-biotics for a few days so infection risk is low.

Walk and enjoy..wear a bandanna or a cap if sun is out and just get some fresh air for sanity is my honest thought. I had 8400 grafts and many surgeries and you really should get out and enjoy nature. You will not pop a graft at 5 days. Of course your own clinic is the port of call for their own guidelines but after 15 years in the industry and so many patients..get out and enjoy.

Hope things work out for you and be good to see Dr.M again and he will for sure take care of you.

Hi James, not sure who you are in contact with at BHR or your age etc but you have fine hair and a lot of diffused thinning across the top of the scalp and also the crown is losing quality and lustre and signs of miniaturisation also that will lead to loss. Donor cannot see DUPA from these photos so probably supplementary ones were sent via emails but for sure we need to be honest on what we see and ideally medication is the first port of call to stabilise loss and not be chasing it, and more so if you commit to a hair transplant. Please feel free to communicate with your advisor at BHR If you have any questions but certainly think you need to think twice before committing to any surgery based on these photos and as said I am not sure of your age. We don't reject due to challenge per se as we take on a lot of repair cases also but will be truthful if surgery is not the best option for you based on age, loss potential, donor capacity, meds etc. Just make sure you understand loss potential and what your donor will give once it is assessed for density and miniaturisation etc and if it will give enough to reach your goals. Sincerely all the best in your research.

Thank you so much for coming to us and for sharing...

Well done..this is often a positive outcome from a successful surgery, the ripple effect that it gives, that new impetus for change...it touches the mind, will, emotions and brings about action. I have seen patients totally transformed after.

You are welcome..take care...

I didn't see two threads but commented on the other one...Mel's vid will also comfort you on this.

You should be okay at six weeks...relax and put it past you, this will heal fast. All the best for healing and growth.

No, I think there is some mis-understanding... So what I wrote previously I would say is an accurate description and worth a re-read ...."this patient had approx 500 grafts from a previous surgery, very sparse growth and not all of them grew by any means and it was some punch-outs. " End Quote. Summary of the above:- 1.So 500 more or less first HT elsewhere.. he is not sure of the exact amount himself so this is his recollection. 2. Poor growth from the 500, not all grew, sparse appearance. 3. We punched out some of them, i.e (some of the under 500 that grew). Hope clarifies, i.e we did not do 500 punch-outs as there were not 500 even from the first surgery..

Many thanks..yes nice outcome for him and more so as a patient who had had poor surgery prior. Calibre Medium Fine. @HappyMan2021, this patient had approx 500 grafts from a previous surgery, very sparse growth and not all of them grew by any means and it was some punch-outs and place then the new hair line. The punch-outs were not in high density together so that also is a plus. Second photo down on post-op shows the residue of punching some out outside the new hairline on one side.

That is normal and especially for a first hair transplant it can be a harder process as is all new. My first HT, (2006), I recall a friend had his the day prior and his first four months were agony in that he was constantly checking and looking and I took the opposite approach and i just ignored it and time flew. I remember telling him, a watched pot never boils..so we got together a year or more later and discussed how we both had a different first 4 months. We both got good results though but the waiting was not easy. Things get worse before better and this is the usual process. Keep in touch with your advisor and ask them anything you need and you can DM me anytime also.

Thanks for the comment and I agree education is always important. Not sure what you mean by full disclosure on this post ...meds were in the top of the presentation from the start, age has been posted also once permission is given. Graft counts and donor and recipient photos are here and with also a good timeline of growth. If the issue is minoxidil then most if not all clinics on here have patients who are solely on this or as said not on any medication at all. There are also doctors who have posted openly they do not prescribe DHT blockers. So, I think it is a complex issue and for me best not to be tagged to one clinic per se. If you know a clinic on here who has zero patients on minox then feel free to put it in your thread. You may even have commented positively on cases on others whereby they are not on DHT blockers. You didn't know this patient was 33 nor that he was on oral min when you first commented with issues, although as said the meds were clearly mentioned. If a patient who is 33 or maybe even more now and on oral minox should not have surgery then really as said I think you could review a lot of cases. BHR Clinic and in particular Dr.Bisanga and the advisors are known for education and this is from the first email to the consultation that is extremely in depth and with the most advanced equipment. We have a youtube channel dedicated to education so I don't personally understand the questioning of if we educate a patient, when truth is on this forum I don't know many more active clinics with educational posts, videos, interviews and inside the op-room videos and all. Dr.Bisanga is this weekend when not performing surgery often holding workshops or giving presentations as he is as we speak. No patient has surgery with BHR Clinic without being thoroughly educated and the irony is on this forum also we have had people say we are too negative and too strict and Bisanga turns down many that others take, so it seems we have gone from one extreme to the other. I do think it would be helpful for you to do this on your own thread and not here per se. If you have your own personal case and photos and story up then please send it to me as I would be good to see it.

Respectfully yes, a separate thread rather than on a particular patient case from a particular clinic. Your initial concern was we had not put medical info when we had, it then changed to Oral min being the problem and as I have said this is not a BHR exclusive issue. It is wider than this more so as you are now saying topical min is not effective long term. I do think best to have your own thread and be clear on your issues with minoxidil, both oral and topical would be better. Do you also have concerns whereby the patients are on no meds at all, or very early 20s, or with no donor photos ever shown or with recipient sites that look like they were done with a pitchfork? This patient is now 33 as per earlier question.

Old drug, fairly new for hair loss per se so longterm efficacy as such for that I guess will be harder. I guess you mean to say Oral minoxidil not fin? I won't try to hijack this into an Oral Minox debate and probably it is wider than BHR so maybe start a different thread for that but we have seen positive results as has the forum moderator himself and other clinics. Finasteride also some will lose effectiveness and or come off for family planning or have issues tolerating it or many patients will simply not wish to go onto a DHT blocker. So, minoxidil is an option and the oral version does seem to be very effective. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759057/ https://pubmed.ncbi.nlm.nih.gov/32622136/ https://www.sciencedirect.com/science/article/abs/pii/S0190962220321095 https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia https://www.inventiva.co.in/trends/is-oral-minoxidil-safe-for-reversing-hair-loss/ Thanks Mel for your input also.

Yes always good to have. Not sure if you read the introduction, third line down.... but it says he is on medication ..Oral MINOX . Sharing age is down to the patient wanting us to share more personal information.

Safe trip back and looking forwards to seeing the next step. It is so great also to see full face photos and really happy for you in this. Thanks for sharing your journey with us.

Very nice.. thank you for sharing!

Super happy for you!

Looking good Gatsby.. happy new year to you.

Elevation for the first three nights is usually enough as this is when there is more manifestation of post-operative swelling that you want to encourage to drop and also if you are in a comfy pillow or travel pillow then it will lock you in well and keep weight of the head. I have never done more than 3 nights like this personally and really no reason not to sleep normally after that, but each to their own preference.