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Here we have a Dr Bisanga case now 11 months post op, 2100 FUE to rebuild the hair line and behind.

You may notice the natural hair has a "cow lick" and this was important to follow, not just for cosmetic reasons to keep but because it was "part" of the person and his identity but does have challenges in creating.

Below collage pre-op, post op and 11 months post op.

As said looking good for 6 months and made a nice difference and more to come.

Not often we see cases this large, so thank you to the clinic and patient for sharing it and glad it made a positive difference for the patient and that is what counts.

* BHR Clinic

* Dr. Christian BISANGA

* Age: 29

* Medication: Finasteride and Minoxidil

* Technique: FUE

* Donor density: 70/70/80

* Hair: Medium-Fine

* FUs: 1,888

* Previous surgeries: No

* N? of hairs per graft:-

- FU 1 hair: 474

- FU 2 hairs: 768

- FU 3 hairs: 628

- FU 4 hairs: 18

1888 FU = 3966 hairs = 2,10 hairs / FU average.

All post op photos provided by patient.

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Before

Pre-post surgery

4 Months 1 Week

9 Months

[imghttp://i1296.photobucket.com/albums/ag14/bhrclinic2/1888%20FUE/9Meses2_zps863f685d.jpg[/img]

As said really, 1 to 2 mm is very good but also depends on the size of Strip taken, and if a revision etc, so several factors come into play but agreed as said, 1 to 2 mm is deemed very good.

That's rolled back the years. Looking very good.

5 Weeks off is plenty, the most I got off was 3 weeks and had no problem going back to work. You can still have some redness but nothing that should cause any major issues.

All the best with your surgery.

Hi Mondayhead

For one month is pretty much as expected, your hair looks medium fine and shock loss is also very normal from the Strip and takes time to come back in again. Please keep in touch with your advisor who can go over with you post op stages and answer questions for you and give specific advise for you. Keep washing and get rid of the scabs gently. Some will apply bio oil or simple vaseline also to aid healing and apply from side to side.

Nice result Mick. Hope Dr.Lorenzo is also giving you some Spanish lessons on the side!

Thank you for the comments.

Dr.Bisanga prefers suturing, it takes more time but certainly is more comfortable for the patient post op and also with suturing he has his own way of doing it as commented upon already.

I've seen good closures with both techniques so it is not a case of wrong v right but preference on what the doctor may prefer and not a dogmatic approach.

Age: 34

Meds: Finasterida / Minoxidil

Technique: Strip

Density donor area: 80/80/90

Graft total 3,510

Previous surgeries: No

- FU of 1 hair: 574

- FU of 2 hairs: 1288

- FU of 3 hairs: 1077

- FU of 4 hairs: 571

3510 FU = 8665 hairs. Average = 2,46 hairs/ FU.

All post op photos supplied by the patient and not the highest definition but thanks to the patient for being willing to show his case. We will try for better photos also.

Pre-Post surgery

13 Months

Thanks for the update.

Glad the shock loss came in, it takes time but usually does come in okay as the hair cycles again.

The growth is five months to the day so still early and improved from four months so going in the right direction.

As you say some grow faster than others but it seems to be coming in all over where placed, not dense but we are still early and things will pick up in the coming months in terms of density and quality of hair also, so, try to be patient. I've been there many times before and I know it is not easy post op and especially with the shock loss you had also, but much more to come at this stage.

Thank you for the comments and question.

In short a hair line design can be based upon several variables and factors, bone structure, age, potential loss etc. At pre-op the hair line is drawn in consultation with the patient, there may be several designs before one is agreed upon and as said several things are considered also in this.

Here is a sharper hair line in this case here for example:-

http://www.hairrestorationnetwork.com/eve/169814-body-hair-fue-nw6-patient-after-chemo-therapy-bhr-clinic-dr-bisanga.html

Some will have greater flexibility on what can be done as said bone structure is important and often it is good to see pre-loss photos to see how the face was framed. It must not be too "mechanical" and symmetrical, as for most facial bones are not totally symmetrical and often too much symmetry is a give away for surgery, so there is a need for an appreciation of this also in any design.

I will post cases as we go on and show different designs also ranging from pointed to more flatter hair lines and of course rounded ones also.

Hi Mickey

It is more of taking each case on merit, if the patient has advanced loss and we can reach their goals via FUE then so be it.

FUE takes from density and not surface area like Strip does, so as long as they have the donor to give and to get to where they want then great. My own case was started 6 years ago and a NW6, but I had very high donor density and also willing to use beard so was a candidate as my goals could be met with what I had. I've met many NW6 sufferers who were not candidates simply because they did not have the density to give what was needed to meet their goals. It is supply and demand at the end of the day and some will in essence be able to give a lot more grafts if the density is high and the safe zone to take from is a good size also.

I think more and more want FUE only so it for us is important to measure donor densities, safe zone to take from, and then with the data see what can be safely taken without over harvesting the donor and explain to the patient the area that can be covered.

Like me as said for some body hair can also be a good addition and part of the equation when seeing what is possible.

We are not against high norwood restorations via FUE as my personal case shows, and was started many years ago, but it is a matter of making sure we can get to where the patient wants to get with that technique alone.

Our patient wanted to rebuild his frontal third area keeping a relatively conservative hair line, he uses medication to sustain the growth of his native hair. Here we have before, post op and then growth up to 14 months post op.

Our patient had undergone previous surgery resulting in poor growth in the recipient area and a donor that in areas was impossible to now harvest from. The goal was to repair his hair line whilst trying to preserve his donor, the Strip technique was best suited to this in his case. He is also on medications to try to sustain the growth of his native hair.

Hi Bertie, all the best for the surgery. You will be in good hands with doc and team.

I imagine school is merciless but be positive, you are making a decision for good so focus on the gain to come. Follow the post op to the letter as I am sure any good teacher would.

Looking forward to the updates.

The previous surgery was with another clinic and in the temple areas. It really wasn't enough to address the loss and thus needing to address it well with us. It was two years prior to having Strip with us.

Hi MAGNUMpi

Good logical question.

Many patients will keep a tuft at the front, the options are 1, go over it and place in and amongst it as you say to foresee it falling and give longevity to the surgery in that no touch up needed. This is the option if the hair is miniaturising and obvious to fall and if not on medication also.

Option 2 is to place around it and not amongst as such and more the option if the doctor feels the quality is good there and we have cases such as this and for years still not issue with it falling and especially so if the patient is on medication. We have posted cases of such here also but I discuss also with patients I book personally both the options when this is relevant and then the doctor will also see on the day, and we discuss the merits in both approaches. If in doubt then fill it is the basic rule as long as the patient knows that more graft numbers will be needed but as said if the hair is good quality and on medication then there is an option to leave it as such.

If worst case scenario the patient does lose there then we will take care of it on when needed but these are in the minor cases from what I can see.

Thank you for the comments.

Regarding the photos he is happy for full face to be used on all it is just the original photos and the video were blocked as a precaution but he is happy to show his result as is.

Our Patient had a small FUE session before, around 500 grafts, he now wished to properly address his hair loss and repair the frontal third. Dr. Bisanga used FUT for this procedure because it was a better technique to use considering his previous op to reach the numbers needed.

Here we have a compilation of Pre Op and 12 Months Post Op pictures.

Close Up hair line and frontal third pictures, with wet and dry hair, showing hair line direction and angles off well.

Placement of grafts

Full face Update

Video update on this case.

Hi Mondayhead

Thank you for sharing your experience.

As said, hairs will fall and mostly happens after a week as you wash more, then week 2 to 3 and by week 4 usually all gone.

The post operative documents will also help with these details so please ensure to contact also your advisor who will be happy to go over them and the whole post operative process with you.

Video update.

All post op photos provided by the patient. I will provide updates as and when possible.

Before

Pre Op

Placement

Strip closure

6 months

Thanks for sharing that. Strip and FUE in synergy sounds a good approach, maybe put some beard there also, I am sure you have plenty if you let it grow!

I think your videos are getting cult status.