NickBaron
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Hi Tysonjames123,
I'm Nick and I work for Dr De Reys.
Ten days is about right before you start doing light sports. Two weeks is needed before doing heavy or contact sports.
I've written a post about what to do after an operation on this forum which you can find here:
Most important, take care of yourself and don't overdo things however grafts are pretty tough so sports are fine once the grafts have had time to 'set'.
Dr. De Reys is recommended by the Hair Transplant Network.
Dr De Reys | Hair Transplant Surgeon in Belgium.
Hi everyone. On Thurs (8/27) I had a neograft FUE hair transplant done. 1500 grafts. I went back to my doctor today (6 days after surgery) for light therapy and he said I was healing very nicely and everything looks great. I asked him several questions about what I can and can't do. He gave me the following "go aheads," and I just wanted to see what you all thought. (I figure it can't hurt to get a second opinion... I'm just trying to be careful.)- He said I can resume working out at the gym since I'm not bleeding anymore and everything looks good.
- He said I don't have to sleep at a 45 degree angle anymore, and I can sleep on my side if I wanted to.
- I finished all prescribed medications. He said I can resume taking things like aspirin, aleve, etc. if I need to. Is that true?
- He said I can resume washing my hair normally (with my fingers and sticking my head under the showerhead) in 4 days... (that would make 10 days after my procedure.)
- I'm going to the beach with some friends this weekend. He said I can go on the beach as long as I wear a hat and don't submerge my head in water.
- He gave me the green light to drink alcohol this weekend. (I drink responsibly. I'm not going to go crazy and risk bumping my head, but I would like to engage in social drinking if it's ok.)
What do you guys think? I would really appreciate feedback on each item! I'm anxious to get back to the gym and lift some weights! And I would love to be able to drink with my friends and get a bit of a buzz this weekend, but not if it means ruining the work that was done on me.
Two more things... today when I was at work, my supervisor came up to me and brushed her hand on top of my head and said, "You shaved off your hair!" It didn't hurt or anything when she did it, and there was no bleeding and it didn't seem like anything fell out. What are the odds she damaged some grafts?
And lastly... I still feel tingling on my scalp at points. Is that normal? And what anti-inflammatory do you recommend I take to reduce some swelling since I've finished my prescription medication? I don't have a lot of swelling, but some around my eyes. Is aleve good?
- He said I can resume working out at the gym since I'm not bleeding anymore and everything looks good.
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Hi Smash1407
I'm Nick and I work for Dr De Reys. The doctor recommends Propecia as a good complement to an HT provided you don't have any side effects.
He's written a guidance note which I've posted on this forum. You can find it here:
Dr. De Reys is recommended by the Hair Transplant Network.
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Hi Navi,
I'm Nick and I work for Dr De Reys. It is possible to retransplant hairs and this is something that Dr De Reys can do because he is an FUE-only.
When it comes to the hairline, this is something that the doctor takes special pride in and I've written a post about his philosophy on this forum. You can find it here:
How does Dr De Reys design a hairline?
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
Dr. De Reys is recommended by the Hair Transplant Network.
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Hi guys. I have been browsing this site for some days and must comment it's a great site with some fantastic stories and results.
*
To make myself feel more comfortable and happy I'm considering FUE treatment.
My background is this...I am 26 years of age, white male with dark hair from Scotland. My grandfather was bald, my father is bald and my older brother is very thin but not bald.*
I began thinning at 20/21 and am now almost completely bald on top, please see photo's I've attached of me currently.
Anyway, as I say I am considering FUE treatment but having read reviews on here I see that people often go for more than one treatment. I didn't realise this. Due to costs, I can't really afford more than one now and another one in a few years time. Is anyone able to tell me, judging by my background and photo's, whether one treatment is likely to be enough for me?
Also, I've read that people often use minioxidil or propecia after treatment.Due to reviews about side effects such as a decrease in libido or ED I was hoping not to use anything like this. Can you tell me do you HAVE to use it after treatment and what would happen if I didn't?
Finally, I've been in conversation with getFUE clinic in Antalya, Turkey. They say by my photos I have a healthy donor area and require around 3500-4000 grafts at a cost of €2900 plus free PRP. They tell me I can expect natural, excellent long term results. This is the sort of value I can afford. Can anyone tell me if this clinic is good? And are there anyone else in Europe who you'd recommend at similar value?
I apologise in advance if I seem ignorant. I don't mean to be, I'm just new to this and don't know where to start.*
Any help appreciated,
Thanks
Hi Libertinedreamer,
I'm Nick and I work for Dr De Reys.
Your hair loss is reasonably advanced for your age although you are not too young to consider FUE.
What you may want to consider is how your hair loss will progress.
A single operation now to restore your hairline and the front half of your scalp will give you a strong, natural look again and your donor area looks excellent.
A strong donor area is not just good for one operation but will also serve you later if you decide to come back for another operation.
For now, a procedure to sort out your hairline may be wise.
I've posted on Dr De Reys' specific philosophy for hairline restoration on this forum which you can find here:
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
As for medication, as long as you feel you are not having side effects then Finasteride is a good choice.
Dr De Reys prefers Finasteride over Minoxidil (Regaine) and he has written a guidance note on the topic which I've posted here:
All in all, think carefully about how you proceed.
An FUE will not leave you with a large scar across the back of your head.
Your donor area is strong and will provide more grafts in years to come.
An operation to restore your hairline and front half of the scalp seems to make sense at the moment.
Dr. De Reys is recommended by the Hair Transplant Network.
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I think only doctors that perform extractions should be recommended. This reduces the variable of new/inexperienced techs who don't have their name in the door doing a poor job. Technician extraction is just too big of variable.
If I research a doc for a year and "Susan" has done a large portion of extractions in all of the photos and patients that I researched, and "Jane" started 3 months ago and is extracting my follicles, I have no idea what I'm going to get.
Extraction is very important in FUE.
I know some will disagree but that's my thoughts on it.
Hi Spanker,
I'm Nick and I work for Dr De Reys.
I fully agree with your point that extraction is very important in FUE. The way Dr De Reys works is to avoid any use of technicians altogether.
The doctor extracts every single graft for every single patient himself.
One of the main advantages of that is that he builds up his experience at extraction.
By continuous practice, he can refine his technique.
Now, after transplanting many millions of grafts, his technique is such that accidentally splitting grafts never occurs.
This is only possible in the hands of an experienced surgeon.
Since grafts on the head are limited, even a single lost graft is a waste and this is Dr De Reys' philosophy.
I've posted more on his technique for extracting grafts on this forum which can be found here:
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
Dr. De Reys is recommended by the Hair Transplant Network.
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Dear Chris,
My name is Nick and I work for Dr De Reys.
We generally advise patients not to use concealers for the first few days however after a week or so there is nothing stopping you.
The main factor is to allow the skin time to heal after a transplant and also not to cause any risk to the grafts by accidentally knocking them out.
I've written a post on this forum which talks about wearing hats, using concealers and other post-op questions.
You can find it here:
The doctor has also recorded a short video about concealers which you can find on his Vimeo page.
If you've got any more questions then let me know.
Nick
Dr. De Reys is recommended by the Hair Transplant Network.
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Hey Guys,
I'm at day 10 and my scabs are gone and things are looking good.
I'd like this redness to go away and I've heard that distilled witch hazel can help.
Does anyone have any experience with this or other products? Aloe vera gel or juice?
Dan
Hi Abedogg,
This is Nick here, I work with Dr De Reys. We always give patients a series of high-strength Aloe Vera creams, tonics and salves to use after the operation.
Used in the right order, this deals with redness.
@Zeoranger
For the hat question, I've done a post on that on this forum. You can find it here:
Nick
Dr. De Reys is recommended by the Hair Transplant Network.
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Hi Frank,
I'm Nick and I work for Dr De Reys. Are you considering Europe as well the States? Our clinic is based in Belgium.
Nick
Dr De Reys is recommended by the Hair Transplant Network
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My name is Nick and I work for Dr De Reys who is an FUE-only specialist.
Firstly, my thanks and respect to Dr Feller whose medical opinion is of great value to many of the readers here.
Dr De Reys has specialised in FUE since its inception and chooses not to perform FUT.
We expect a very high growth rate mainly because the doctor has developed an extremely precise manual technique after transplanting millions of hair grafts over the years.
Using a manual punch, the doctor is able to 'feel' the root of each hair during extraction and avoids transecting the grafts.
Transection (accidentally splitting the root of the hair graft) can be a major issue for FUE with inexperienced staff or with automatic drills as Dr Feller says.
We preserve the grafts after extraction with the industry-leading nutrient solution Hyperthermosol so graft survival is not an issue with modern FUE as practiced by Dr De Reys.
The main reason why Dr De Reys does not perform FUT is that he is often called on to repair FUT scars.
This can be done in a number of ways:
1. A trichophytic closure can used to attempt to 'seal' the scar although such seals often reopen, especially after physical activity.
2. The other way is to fill up an FUT scar with FUE grafts in order to conceal the scar.
Dr De Reys always prefers to maximise the number of grafts in any operation and he sees scar repair as a waste of valuable grafts.
These grafts could be used to build density or create a stronger hairline so, in his view, this is a waste of grafts.
The number of grafts available is limited so wasting even a single graft is a loss.
Dr Feller rightly mentions the risks of badly-performed FUE however he also points out that,
"FUE is the "have your cake and eat it to" procedure. And in some cases this may be the case. Such as in the hands of very dedicated and very experienced physician practitioners who carefully screen their patients."
This describes Dr De Reys' work and this is what we do.
We are careful with patient expectations however after transplanting using only the FUE method for many years on a range of patients, right up to Norwood 5/6, our experience is that patients are extremely happy with the strong growth they get from Dr De Reys' technique.
They are doubly pleased that they do not have a large horizontal scar across the back of their head.
Wearing your hair short is something that you can do comfortably with FUE.
It gives patients the freedom to choose how they wear their hair.
From our view, these are some of the main reasons why patients choose our clinic.
There are a few of our FUE-only patient cases on this forum which can be found by searching for Dr De Reys which I would encourage you to do.
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Hi Youngun,
My name is Nick and I work for Dr De Reys.
Our prices are amongst the best in the world for worked carried out by an actual European surgeon.
Other clinics may use technicians to do most the work however with us, it is the doctor himself who does the work.
This is especially important in a hair transplant since the process of extracting grafts manually is very different to using an automatic drill.
With his manual technique, Dr De Reys is able to ‘feel’ the root of each graft when he extracts.
By making micro-adjustments and through his many years of experience, he is able to extract each graft whole.
Automatic drills, as used by technicians working for doctors in other clinics, provide no such feedback and this means that grafts become transected.
The manual technique prevents this and so it results in a much higher growth rate.
Dr De Reys performs every single extraction and incision on every patient personally.
This is the main difference between Dr De Reys and clinics offering cheap transplants.
We expect a growth rate of over 95%.
If you've got any more questions then please let me know.
Nick
Dr De Reys | Hair Transplant Doctor
www.hair-transplant-doctor.co.uk
info@hair-transplant-doctor.co.uk
See the doctor on:
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Hi Pedro,
My name is Nick and I work for Dr De Reys.
It's not unusual for growth not to appear until the seventh month. This is different in every patient.
Smoking is a major factor which affects growth. Anecdotally, we've seen patients who do a lot of cardio-vascular exercise have good growth although it's definitely not a necessity.
Growth in some patients takes longer than others. At seven months, my advice is to keep waiting.
It's only around the twelve month mark that you will start to see the final results so seven months is too early.
Nick
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Hi DDS,
My name is Nick and I work with Dr De Reys. It's quite normal to feel an itching under the scalp after a transplant.
This can persist for up to a year as grafts continue to come through and, in some cases, longer. We expect almost all grafts to show after a year however in some cases this can take longer.
We find that a good diet and healthy exercise (especially cardio-vascular which promotes blood flow) can lead to good results in patients although grafts are generally very hardy and need little encouragement to grow.
The main issue is that they are extracted and implanted properly.
Nick
Dr De Reys | Hair Transplant Doctor
Hair Transplant Doctor | Dr De Reys
info@hair-transplant-doctor.co.uk
See the doctor on:
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Patient Case 2500 Grafts FUE
This patient's wish was to focus on the hairline. Although his hair loss was apparent throughout the scalp edging into the crown, the patient discussed his treatment options with the clinic.
The patient confirmed that he would start taking Finasteride after the operation to minimise future hair loss and Dr De Reys performed an FUE procedure to deal with his current baldness.
Treatment plan:
2500 grafts were implanted over two days.
The hairline was restored first using single-hair grafts placed in two, densely-packed rows using Dr De Reys' manual extraction technique.
You can read more about his technique in one of these posts:
What technique does Dr De Reys use to extract hairs?
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
How does Dr De Reys design a hairline?
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
Dr De Reys' manual technique means the growth rate is much higher and it saves grafts.
This is especially useful in the hairline since extraction of single-hair grafts requires a delicate touch that's not possible with automatic drills.
All grafts were stored using HyperThermosol.
The patient was vey happy with the result and will send more photos.
Patient Photos
Pre-op 1
Pre-op 2
Immediately post-op
6 months post-op
Here's our listing on the HRN forum:
Dr. Rudi De Reys - Hair Transplant Surgeon in Belgium
You can find Dr De Reys’ answers to more questions here:
What about medication?
Can I wear a hat after a transplant?
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Patient Case 2000 Grafts FUE
The patient presented with thinning temples and hair loss throughout the front half of his scalp. Bearing in mind that the patient did not wish to take medication, Dr De Reys performed an FUE procedure to restore the hair line and fill out the frontal half of the scalp.
Treatment plan:
2000 grafts were implanted in a single day.
The hairline was restored first using single-hair grafts placed in two, densely-packed rows using Dr De Reys' manual extraction technique.
His technique ensures that grafts are not cut in two because the doctor is better able to 'feel' the root of the graft than a technician using an automatic drill.
This means the growth rate is much higher and it saves grafts.
All grafts were stored using HyperThermosol.
The patient was vey happy with the result and has more grafts conserved in case his hair loss progresses.
Patient Photos
Pre-op 1
Pre-op 2
Post-op 3 months Front
Post-op 3 months Left
Post-op 3 months Right
You can find our listing on this forum here:
Dr. Rudi De Reys - Hair Transplant Surgeon in Belgium
You can find Dr De Reys’ answers to these questions here:
What about medication?
What technique does Dr De Reys use to extract hairs?
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
How does Dr De Reys design a hairline?
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
Can I wear a hat after an operation?
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My name is Nicholas Baron and I work for Dr De Reys.
Patients would often like to know how they'll look in the first few weeks after a transplant.
Immediately after a transplant, the area may be raw however the grafts themselves 'set' very fast.
Still its wise to wait a week before washing the hair although we supply all patients with a range of high strength Aloe Vera tonics, salves and creams to get through the first weeks and make sure everything is healing properly.
Small crusts usually form around the hair and after the first wash, it's ok to start very gently kneading and massaging the crusts to help them drop off.
They will drop off on their own anyway although a little light massage definitely does not hurt them provided you're careful.
Patient Case
Dr De Reys performed FUE on a patient who presented with light hair loss in the temples. He was treated in a single day.
Treatment plan:
Day 1: 1500 Grafts
All grafts were stored using HyperThermosol.
The patient was very happy with the result and sent in photos after two weeks.
Pre-op:
After two weeks:
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
You can find our listing on this forum here:
Dr. Rudi De Reys*Hair Transplant Surgeon in*,*Belgium
You can find Dr De Reys’ answers to these questions here:
What about medication?
What technique does Dr De Reys use to extract hairs?
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
How does Dr De Reys design a hairline?
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
Can I wear a hat after an operation?
Hair Transplant Doctor | Dr De Reys
See the doctor on:
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Hello all,
This is Nick Baron here with the next part of Dr De Reys' cases for the forum.
For the previous cases you can look here:
On Dr De Reys' Technique for Making a Hair Line
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
On Extracting Grafts:
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
On Dr De Reys' Views on Medication:
This time I'm looking at common post-op questions from patients. Here are some common questions:
1. Can I wear a hat immediately after a transplant?
We do not recommend this due to the risk of infection.
2. Can I wear a concealer like Toppik after a transplant?
You can, but after two weeks.
3. How soon can I return to sports?
After one week for light sports and two weeks for heavy sports (including all contact sports)
4. When can I use gel or wax in my hair after a transplant?
After you have washed your hair for the first time, so after two weeks.
Dr De Reys has answered these questions and many more personally on his Vimeo page.
Here are some more questions you can find answers to there:
What shampoo should I use after a transplant?
Why do transplanted hairs shed?
When can I dye my transplanted hairs?
When can I lift weights after a transplant?
Is there swelling after a transplant?
When can I go to the beach after a transplant?
Is it possible to scratch out the grafts by accident?
What food is good for my transplanted hair?
Do I still need to take medication after a transplant?
You can find the answers to these and many more questions on Dr De Reys' Vimeo Page.
Now, here are two more patient cases:
Patient Case 5: Dr De Reys, 3000 Grafts FUE
FUE performed on a patient who presented with extensive hair loss throughout the scalp.
Treatment plan:
Day 1: 1500 Grafts
Day 2: 1500 Grafts
All grafts were stored using HyperThermosol.
The patient sent follow-up pictures at six months, twelve months and 18 months. The patient was very happy with the result.
Pre-op:
Postop:
Six months postop:
12 months postop:
18 months postop:
Patient Case 6: 2300 Grafts FUE
FUE performed on an older patient who requested a conservative hair line. In line with his age and wishes, Dr De Reys focussed on creating a completely natural look whilst preserving the maximum number of grafts in case the patient wished for more grafts in the future.
Treatment plan:
2300 grafts were implanted over a two-day operation.
Maximum density was focussed around the hairline using single-hair grafts and multi-hair grafts were used throughout the rest of the scalp.
Day 1: 1300 Grafts
Day 2: 1000 Grafts
All grafts were stored using HyperThermosol.
The patient was very pleased with the result and to date has not requested any additional procedure.
Preop:
Post op 12 months:
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Hallo everyone and first of all, a very happy new year to one and all.
Now secondly, here is our third update for Dr De Reys.
This time round, we are presenting two cases at once – cases 3 and 4.
Before we do that, here is our position on medication, specifically on Finasteride (Propecia) and Minoxidil (Regaine/Rogaine).
As a side-note, for larger operations which may need body hair transplantation or for eyebrow transplantation, Dr De Reys works with Dr Villnow in Germany who offers these techniques.
Dr De Reys himself is a scalp FUE specialist and does not offer FUT (strip method) or any other technique.
He performs all of his surgery using scalp FUE which he does using his specialised manual technique.
For more on his technique, please take a look here:
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html'>http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
And here:
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html'>http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
Medication and hair transplants
Our position on medication is that both doctors recommend Finasteride for hair transplant patients over Minoxidil.
We offer the guidance note below to patients who are interested in knowing more about this.
In our experience, it is wise to take medication (Finasteride or Minoxidil) alongside a transplant however, there are two important things to consider:
1. Stopping medication
Once enough grafts have been transplanted to cover all balding areas and all grafts have had the chance to grow out then the patient might consider stopping medication and relying on transplanted hairs alone.
It may take many years to get to this stage and the results vary strongly from patient to patient.
2. Not starting medication
Some patients will have side effects from medication and in those cases, we advise you not to take medication.
Although medication is a good complement to a transplant, it is absolutely not necessary for transplanted hair at all.
Medication, specifically, Finasteride, is only good to protect any remaining hairs that you might have on the top of your head, in balding areas.
Please read the guidance below for the details on how this works.
Protecting your existing hairs is good for a transplant because it helps with density however it is not essential.
If a patient does not wish to take medication for whatever reason then he or she should not take it.
Questions
For those who are interested taking medication to preserve their existing hairs then please read our guidance below.
If you have any questions on this topic then please let me know or write them in your comments.
As mentioned in previous posts, I am not a medical professional and so please do not take this as medical advice.
If necessary, I will refer your questions to the doctor however please be patient with the answer as they may be too busy to answer promptly.
Guidance on Finasteride
Both Dr De Reys and Dr Villnow recommend Minoxidil or Finasteride as a complement to the hair transplants (usually Finasteride).
The usual dose of Finasteride that the doctor prescribes is 1mg per day.
Finasteride was originally approved as a treatment for prostate problems.
As a prostate cure, it is usually prescribed in 4mg tablets that are also taken daily.
It is only as a hair loss cure that it's prescribed at 1mg per day.
Even at 4mg per day, Finasteride has undergone clinical trials to make sure it is safe for human consumption.
Both Dr De Reys and Dr Villnow recommend Finasteride over Minoxidil because the way it works is better known to science.
Finasteride (Propecia) inhibits the take-up of the male hormone, dihydrotestosterone (DHT), in hair follicles which prevents them from shrinking (miniaturising) and eventually falling out.
Minoxidil (Rogaine/Regaine) also bolsters exisiting hairs but the exact reason why is less clear to science at the moment.
It is a side-effect whose cause is not 100% mapped out to the doctors' satisfaction at this time.
So far there have been no scientific reports of major complications in humans with either drug but the doctors’ opinion is that they prefer to stick to what has been scientifically proven - i.e. Finasteride.
Both of these treatments preserve your existing hairs as long as you keep taking the medication.
They usually do not cause lost hairs to return.
With Finasteride, only existing hairs are affected. The transplanted hairs do not need Finasteride because they are permanent.
The hairs on the side and back of your head (the donor area in a transplant) are not affected by DHT in the same way that the hair on the front and top of your head is (the recipient area).
This is due to genetic programming that is the same in all men.
The combination of the transplant and using Finasteride to prevent your remaining hairs from falling out yields the best result in our experience.
If you are concerned about side effects then you should speak to the doctor although he notes that Finasteride/Propecia has now been in use for more than a decade.
Nevertheless, both doctors recommend that you stop use of Finasteride in the presence of your spouse for the entire nine months of a pregnancy and for one month before conception if you wish to be sure that you are in line with the manufacturer's guidelines.
According to Dr De Reys, the chemical Finasteride leaves the system within two days.
In case you are interested in finding out more, here is an abstract from a 2012 medical paper looking at the effects of Finasteride in a sample of over 3000 Japanese men (only sample sizes of over 2000 are considered statistically significant).
Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japan... - PubMed - NCBI
Patient Cases
(For Patient Cases 1 & 2, please look here:
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
and here:
http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html
)
Patient Case 3: Dr De Reys, 1280 Grafts FUE
FUE performed on a patient with strongly receding temples.
Treatment plan:
1280 grafts were implanted in one day with focus on the temples.
All grafts were stored using HyperThermosol.
The patient sent follow-up pictures at one year and is very happy with the result. If more grafts are needed for a future operation then the donor area has plenty of grafts left.
Pre-op:
Immediately post-op:
After twelve months:
Patient Case 4: Dr De Reys, 1500 Grafts FUE
Patient 4 had strong hair loss in the frontal third with a complete loss of hair line.
Treatment plan:
1500 grafts were implanted in the frontal third in one day.
For the hairline around 60 Grafts/cm2 and behind the hairline 35-40 Grafts/cm2.
All grafts were stored using HyperThermosol.
The patient was very pleased with the result and sent follow-up pictures after one year including one shot taken outdoors in natural light.
Pre-op:
Immediately post-op:
After twelve months:
Outdoors:
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My name is Nicholas Baron and I work for Dr De Reys.
We are currently putting cases forward for approval by the forum to reach recommended surgeon status.
This is the second of those cases and today we are looking at Dr De Reys' technique for extracting grafts.
You can find the first case, which was about creating hairlines, as a thread on this forum too.
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-'>http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-'>http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html'>http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
Following on from a question asked on that post by a senior member, Sean, we've chosen to make this post about graft extraction.
Extractions: The Technique
The extraction process itself is a two-step procedure.
First Dr De Reys uses a manual punch to release the hair follicle. Many follicles are released in this stage.
In the next stage, the newly released follicles are 'harvested' and then placed immediately into a nutrient-rich solution called HyperThermosol in order to preserve them.
The 'releasing' stage with the punch involves making an incision into the skin.
This is entirely performed by Dr De Reys. Every single punch and incision is made by the doctor himself.
The harvesting stage is performed by the doctor and his staff together.
Having two people harvesting at the same time minimises the time that the grafts may be out of the body and so prevents any loss of grafts.
Here is a photo of the doctor 'harvesting' grafts with his team after the punches have been made.
In the photo, the doctor can be seen holding a small circular vessel to place the grafts into.
Here's a close-up of that vessel:
If you look closely at this photo, you can see that every single graft in that bowl has only a single hair attached to it.
Separating single-hair grafts and multi-hair grafts is essential for a good result in a hair transplant.
Single-hair grafts are placed in two rows at the front to create a natural-looking hairline.
Multi-hair grafts are placed behind the hairline to create density.
So the focus in any operation will be to restore the hairline first and then create density throughout the scalp.
Extractions: The Philosophy
Dr De Reys specialises in a manual punch technique which causes as little damage as possible to the 'sheath' around the hair which is known as the follicle.
You can see that the follicles in the above photo are all intact.
Dr De Reys' view is that this technique is safer than using an automatic drill and means the final growth rate is much higher.
For more on this manual technique, please read our first post on making a hairline.
http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html
Patient Case 2: 1640 Grafts FUE
FUE performed on a patient with hair loss mainly on the temples. Hair loss was stable at the time the patient came to the clinic.
Treatment plan:
1640 grafts were implanted over two days.
For the hairline around 60-65 Grafts/cm?.
Day 1: 800 Grafts
Day 2: 840 Grafts
The hairline was restored using single-hair grafts placed in two, densely-packed rows. Around 600 single-hair grafts were used for the hairline. The temples were filled with multi-hair grafts
All grafts were stored using HyperThermosol.
The patient was very happy with the results and sent pictures at 10 days, 26 weeks and 34 weeks.
Patient Photos
Immediately post-op:
10 days post-op:
26 weeks:
34 weeks
Clinic Photos
Please note that I have no formal medical training and so please do not read my words as those of a medical professional.
If you have any questions then I will try my best to answer them here on the forum and will refer them to the doctor where necessary although referral may take time since Dr De Reys is often in surgery. I may not be able to answer all of your questions and I apologise now for those I do not have time to answer.
Before finishing this post, I'd like to add that the photos of surgery taken above were in Dr De Reys' old clinic.
The clinic now has a new facility which includes its own private in-patient bedroom where patients stay throughout their visit (and on the night they arrive).
Here are some photos of the new clinic:
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Dear Sean,
Thanks for your questions. I will answer them one by one.
Question 1: . ""He has never used technicians with no medical training to perform this key task. He makes every single incision himself.' Are you referring to donor extractions as well, or just recipient site incisions?"
I am referring to both although it's worth bearing in mind that the extraction process itself is a two-step procedure.
First the punch is used to release the hair follicle. Many follicles are released in this stage.
In the next stage, the newly released follicles are 'harvested' and then placed immediately into the HyperThermosol solution to preserve them.
The 'releasing' stage with the punch involves making an incision into the skin.
This is entirely performed by Dr De Reys. Every single punch is made by the doctor himself.
The harvesting stage is performed by the doctor and his staff together. Having two persons harvesting at the same time minimises the time that the grafts may be out of the body and so prevents any loss of grafts.
I hope that makes it clear.
In addition, the actual incisions that are made in the scalp with a scalpel before placement are also done by the doctor himself.
So to sum up, every single incision as well as every single punch for every single patient is always done by Dr De Reys personally.
Question 2: It is like you truly personalize the surgery for your individual patient and do it nice and steady?
Yes, this is true. Dr De Reys would rather take an extra day to complete the surgery properly.
For this reason, he often takes three days to perform a 3000 graft FUE as he does not like to rush procedures.
This does mean that Dr De Reys does not operate on as many patients as some other clinics do however we see this as an advantage because it guarantees better quality.
Dr De Reys has transplanted well over 1.5 million grafts in the last few years.
Question 3: What are Dr. De Reys current fue rates, pricing?
At this stage of the recommendation process, I am not allowed to provide you with this information publicly. You are welcome to private message me for more information.
Question 4: Based on donor, how many grafts would this patient have remaining for future use, that's if he needs a restoration for other parts of scalp in future?
I will refer this question to the Doctor. Please be patient with his answer because the Doctor is usually very busy with surgery.
If you have any more questions then please feel free to let me know.
Kind regards,
Nick
"He has never used technicians with no medical training to perform this key task. He makes every single incision himself.'Are you referring to donor extractions as well, or just recipient site incisions?
Bravo to the doctor and clinic. Instead of using motorized power drills, multiple patients per day, you try to maximize graft yield for a patient via manual fue in a two day surgery for the patient if needed. I think it can be concluded that this trait is very rare amongst most FUE surgeons today. It is like you truly personalize the surgery for your individual patient and do it nice and steady.
Based on what you presented, I liked how you positioned this persons temple corners, they are not "C" shaped nor at sharp 45 degree angles, to create more natural grounded facially framed look. The hairline looks uniform without any differing elevation on one side versus the other. the grafts look well placed and refine and truly looks like you were careful about working around native hairs. The donor looks quite decent.
OP, I also liked the fact you are not making irrelevant doctor like advice and controversially unproven medical recommendations as a person that is just working at the clinic, as you clearly stated you are not a medical professional.
What are Dr. De Reys current fue rates, pricing?
Based on donor, how many grafts would this patient have remaining for future use, that's if he needs a restoration for other parts of scalp in future?
Please do keep us posted with the final outcome.
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Gentlemen and Ladies,
My name is Nicholas Baron and I work for Dr De Reys.
We are privileged to have been invited for recommendation by this forum and on behalf of the doctor, I will be presenting a number of patient cases in the weeks to come for your attention.
Introduction
Before I start, I'd like to say thank you to Bill Seemiller who has been our liaison up to now.
Although the Doctor has not had much truck with forums in the past, we, at the clinic, are agreed that HRN is the one we wish to list on because it is run in an independent and fair manner, balancing patient discussion with the surgeon's views as well. It provides valuable information for everyone.
I would like to state that I have no medical training and so please do not read my words as those of a medical professional.
I have worked with Dr De Reys for many years and if you come to us then, in the first instance, you will be speaking to me.
I am also always available after the operations at any stage, whether it be two days, one month or ten years, if you have questions.
I will try my best to answer any questions you have here on the forum and will refer them to the doctor where necessary although referral may take time since Dr De Reys is often in surgery. I may not be able to answer all of your questions and I apologise now for those I do not have time to answer.
The Hairline: Technique
We have chosen to focus on the topic of the hair line with our first patient.
Dr De Reys' technique involves the use of a manual punch. He has a range of punches although he generally uses a 0.75mm punch most often.
The punch size changes depending on the size of the hair grafts that each patient naturally has. Curly hair types, for example, may need a larger punch size.
The doctor only uses a manual punch and never uses a drill.
This is because he can get a 'feeling' for the actual hair follicles themselves as he is extracting a graft.
To explain further, it is important that the sheath around the follicle is intact when it is extracted. By using a manual punch, Dr De Reys can actually 'feel' the sheath as he is extracting and, in this way, he can make micro-adjustments whilst extracting to ensure that the hair follicle is extracted whole.
By doing so, he reduces the risk of accidentally cutting a graft in two. Since almost every graft is extracted whole, this improves the final growth rate.
Dr De Reys can extract grafts with either a single hair or multiple hairs using this technique.
For the hairline, only single-hair grafts are used.
The Hairline: Philosophy
Dr De Reys does not believe in so-called 'Brad Pitt' hairlines. He is always concerned that patients do not waste grafts. There are three reasons for this approach.
Firstly, the number of grafts available in the scalp is always finite.
Using too many grafts for a relatively minor operation will prevent you from having the option to use those grafts later down the line once your hair-loss progresses.
This is the main reason: to conserve grafts for future procedures.
Male pattern baldness is almost always progressive with hair loss starting in your twenties, increasing at 40 and then thinning out much more over 45. For this reason, the doctor avoids using too many grafts as many of our patients return for more grafts as they age.
You can hold back hair loss using medications such as Finasteride however if, you wish to stop taking Finasteride for any reason (starting a family, for example), then your hair loss continues from where it left off. Dr De Reys has written a guidance note on Finasteride which I will publish in a future post.
The second reason to avoid using too many grafts is the risk of shock loss.
If grafts are placed too close together then the blood supply to existing hairs can be affected.
This causes existing hairs to fall out.
Although shock loss is always temporary, if it happens, it can be uncomfortable for the patient in the first month.
Avoiding shock loss is down to the skill of the surgeon at making incisions.
For this reason, Dr De Reys performs every single incision for every single patient himself.
He has never used technicians with no medical training to perform this key task. He makes every single incision himself.
The third reason to avoid using too many grafts is that it looks unnatural.
A high density of hair looks normal when you are young however as you age, it starts to look unusual.
Low hairlines over 50 look especially odd and for this reason, Dr De Reys is keen to avoid patients having to face questions about whether or not their hair is real once it becomes clear that their hair loss is not following the common sequence of male pattern baldness.
Patient Case 1: 2700 Grafts FUE
FUE performed on a 36 year-old patient whose temples had receded and whose frontal third had thinned. Hair loss had been stable for three years and had remained at a similar level to the patient's father. The patient's grandfather was a Norwood 2/3.
Treatment plan:
2700 grafts were implanted over a two-day operation.
For the hairline around 60 Grafts/cm? and behind the hairline 35-40 Grafts/cm?.
Day 1: 1300 Grafts
Day 2: 1400 Grafts
The hairline was restored first using single-hair grafts placed in two, densely-packed rows. The frontal third was densified on the second day using multi-hair grafts that had been extracted using Dr De Reys' manual extraction technique.
All grafts were stored using HyperThermosol.
The patient was very happy with the result and growth was strong. The hairline result shown below was at three months. We have asked the patient for more pictures.
The patient does not take Finasteride and started use of Regaine Foam only after the three month photos were taken.
Patient Photos
Preop
14 Days Postop
3 months Postop - hairline
3 months Postop - donor
Redness and scarring normal at 2.5 months post?
in Hair Restoration Questions and Answers
Posted
Hi dollasign,
I'm Nick and I work for Dr De Reys. Redness is normal after a transplant so it's worth just being patient for now. It will pass.
We give our patients a range of high strength Aloe Vera products which help with the redness in the first few months.
I've written a post about how to care for your hair after a transplant which you can find here:
http://www.hairrestorationnetwork.com/eve/178332-hats-concealers-post-op-questions-dr-de-reys-3000-grafts-2300-grafts-fue.html
Hope it all goes well for you
Dr. De Reys is recommended by the Hair Transplant Network.
Dr De Reys | Hair Transplant Surgeon in Belgium.
op