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Raphael84 last won the day on March 26

Raphael84 had the most liked content!

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About Raphael84

  • Rank
    Senior Member

Basic Information

  • Gender
  • Country
    United Kingdom
  • State

Hair Loss Treatments

  • Have you ever had a hair transplant?
  • Hair Transplant Surgeon
    Dr. Hussain Rahal
  • Current Non-Surgical Treatment Regime
    Propecia (Finasteride)

Representative Information

  • Name
  • Doctor Representative For
    Dr. Christian Bisanga

Recent Profile Visitors

3,588 profile views
  1. I was fortunate enough to attend this particular conference in Manchester last year and it was very interesting to watch Dr Zarevs presentation and understand his approach. As to be expected, many surgeons continued to discuss his patients considerably high graft counts after his presentation and whilst some were extremely interested and had further questions, others less so. Dr Zarev was very transparent with surgical information and approach. To try and better understand the two patient examples that were presented - a) It is said that most individuals will lose up to 50% of native hair density before it being visually obvious to the naked eye that hair loss has occurred. b) An average donor density on an average patient is understood to be around 70cm2/FU c) Each hair follicle has unique hair groupings. Generally between 1 - 4 hairs per follicle. In an average hair restoration procedure, the average hair count per follicular unit is around 2.2 hairs. When individuals speak of transplanted density, to be speak of this alone is very misleading and confusing. Apart from areas that receive grafts containing only single hairs, such as the first few mm of the hairline, transplanted density should be discussed alongside hair groupings. It is generally understood that the higher the transplanted density, the "fuller" the illusion of hair. This is only true to an extent. Density of 50 cm2 using follicles containing one hairs = 50 hairs Density of 30 cm2 using follicles containing two hairs = 60 hairs 60 hairs will appear "fuller" than 50 hairs despite using less grafts and placing at a lower density. d) Another presentation from a different doctor listed 10 leading surgeons, and their "average" safe donor zone. The area of scalp that they felt in most cases did not lose hair to male pattern baldness. The differences were very interesting and quite eye opening. I tried to find it to post, but unfortunately couldn't. Naturally the larger the area, the higher the follicle count. The higher the follicle count, the more grafts that each doctor would be able to harvest from the area they have deemed the safe zone. It is safe to say that Dr Zarev had one of the most aggressive and larger "safe donor zones". The two examples in the above video - The first patient - was deemed to have a donor area of 336cm2, that contained a total of 25,520 follicles. 12,620 follicles were taken from this area, meaning more than 49% of the donor density. Remember the above point a) where a up to 50% of density can be lost (in this case extracted) before seeing a visible decline in density to the naked eye. Occiptal Density - 84cm2 (Above the average density in point b)) with an average of 3.1 FU/cm2 (Very impressive considering the average of 2.2 as explained in point c). Temporal Density - Measured in 2 areas as 68cm2 and 56cm2 for an average of 62cm2. It is common to have a lower density in the temporal region but still with 2.4/2.5 FU/cm2. Therefore this patient had donor characteristics much more favourable than the average patient. The second patient- was deemed to have a donor area of 330cm2, that contained a total of 27,050 follicles. 11,370 follicles were taken from this area, meaning 42% of the donor density. Remember the above point a) where a up to 50% of density can be lost (in this case extracted) before seeing a visible decline in density to the naked eye. Occiptal Density - 99cm2 (Significantly above the average density in point b)) with an average of 3.2 FU/cm2 (Very impressive considering the average of 2.2 as explained in point c). Temporal Density - Measured in 2 areas as 68cm2 and 56cm2 for an average of 62cm2. It is common to have a lower density in the temporal region but still with 3.1/2.5 FU/cm2 at an average of 2.8 F/cm2. Again, very favourable donor characteristics, even more so than the first patient. Some of the concerns that fellow doctors were discussing were - Understanding that hair loss is progressive and even with hair loss preventative medication, hair loss in most will continue. The debate is, having used such a large/aggressive donor surface area (safe zone) as mentioned in point d), if these areas were to experience loss with dropping of the lateral humps (sides) and the lower crown, the transplanted hair taken from these areas would also be lost, and the transplanted recipient area may become disconnected from the sides/back. In every individual, the ageing process over time means a drop in overall hair density. This includes the donor area. If a patient has already had 50% of his donor density extracted, with further thinning in the donor through natural ageing, this would push the decline in density above 50% meaning that it may well now become visibly thinned to the naked eye. Dr Zarevs results are phenomenal. There is no denying that such restorations are very impressive and such graft counts eye opening. I believe that he will be a name that will attract interest in the future. I very much hope that these patients results stand the test of time. He is a very clever and innovate surgeon. Other doctors concerns are understandable based on some key concepts of hair loss and hair restoration. Time will tell. Every single patient is completely unique in every aspect. Donor density, hair characteristics, follicular groupings, hair texture, measurements of head, measurements between facial features, race, skin tone, hair colour, objectives etc.. Comparing an average patient to such high graft counts would be very inaccurate. I was very interested and intrigued by Dr Zarev and will continue to look out for his results and see his evolution. It was one of the more interesting presentations of the event.
  2. I wish you luck. Choosing your surgeon can be a difficult decision. Take your time. Dont rush. As Melvin said, do your research and reach out to previous patients etc.
  3. Dear Forum UsersWe are happy to announce Dr.Bisanga will be in London on the 22 August 2020 to hold consultations. These are free of charge and with limited availability but a great opportunity to have your hair loss examined including donor density measurements, check for miniaturisation, hair groupings and calibre, loss potential, suitability for surgery, surgery type, design, graft numbers etc.If interested then please feel free to send me an email:- ian@drchristianbisanga.comThank you.
  4. The following post operative photos have been provided by the patient and are at just over 3 months post procedure. The patient is currently very pleased with the early growth that has been achieved and has offered to continue to provide further photographs over the next months to follow the evolution of his restoration. PRE SURGERY IMMEDIATELY POST SURGERY 3+ MONTHS POST SURGERY
  5. As @Melvin-Moderator explained, shaving can be key when transplanting into already reasonably dense areas. Non shaven recipient procedures are becoming more popular and requested for obvious reasons, but it is rarely the best option for the patient in terms of quality and long term result. Shaving allows the doctor to clearly see the exit angle and direction of the native surrounding follicles. The skill of the doctor is also obviously very important in this aspect.
  6. @jonathande Many clinic are beginning to open up again now, albeit with increased safety measures and less clinic traffic. Where are you based?
  7. @Eden83 Thanks for sharing your photos. I would agree, based on your photos you appear to be a good candidate. Your frontal graft count will ultimately depend on your preferred hairline design and placement and how much thinning you have actually experienced behind this. To have a completely natural result, grafts would have to be placed into your native hair to have a smooth transition of density. As you have experienced some loss in your crown, its promising that you are using minoxidil to maintain strength in your native hair. I read that you are using once daily, using twice each day can be much more efficient in terms of what it can achieve. As you are willing to travel, you have a handful of genuinely solid options. Take your time, reach out to those doctors whose results impress you and the doctors have a proven track record and stellar reputation. Then some doctors you will be able to dismiss for you personally as they just dont feel right, meaning that step by step, you will find the absolute best option for yourself. Looking at your photos, there appears no reason why you can't achieve a very successful result. I wish you all the best.
  8. Appreciate your kind words. Thanks Stephen. Hopefully others will be able to take something valuable from the content.
  9. One of the most common questions that we receive from individuals who may be considering FUE surgery is along the lines of, "will my hair transplant be a success?". It is certainly a question that I would be asking before proceeding with surgery. In the following video we discuss some of the potential risk factors to be aware of. Quality of FUE surgery has many variables and the most important factor with your choice in doctor is to minimise as much risk as possible and give yourself the very best environment and circumstances to achieve the most optimal result possible.
  10. PATIENT RESULT - 5.5 MONTHS BHR Brussels Dr. Christian Bisanga Graft Count - 2402 Technique: FUE Patient Age: 27 Hair Caliber: Medium
  11. @Afrohead Dr Bisanga often uses beard hair when appropriate for the patient. My colleague Stephen has recently put together an excellent video regarding how Dr Bisanga uses body hair. Its very educational and a great watch. You will find it at at the following thread -
  12. Excellent presentation. Very valuable information!
  13. @jame$ Looking fantastic. Impressive growth and density at this reasonably early stage and with further maturing and settling to look forward to, things will continue to improve. You are a very diligent and level headed guy. Your results are well deserved and I couldn't be happier for you.
  14. Nice and encouraging compliments @Welwyn We are all looking forward to follow your progress.