BHRClinic

Hi, At present the patient is taking Dutasteride + Minoxidil. Kind regards,

Hi, We have recently received the pictures of this patient of Dr. Bisanga at 15 months, so we would like to upgrade his result. 15 Months Comparison 0-15 Months Kind regards,

Hi, Thank you very much for the comments. @jj51702 , I will contact the patient and ask him which is the dose of finasteride he is taking now. Regarding the pre-op pictures, the hair was not shaved at that moment: recipient area was very thin and most of the hair was miniaturized. @John Baris , honestly I don't think the number of grafts was very high but the opposite. Take into account that rebuilding a hair line and temples may require at least 1500 grafts, and in this case we focused on the whole frontal area doing a very conservative design. If this guy would have come to us without using any medication, we would probably have advised it to start with it and re-asses one year later. But this patient was under medication for more than 5 years and the only way to recover the area was through a surgery (being conservative as we explained). Kind regards,

Hi, This patient was 24 years-old when he had his surgery. We usually do not accept patients at that age because most of them have small recession on the hair line and temples, and we advise to start using medication. Nevertheless this patient had a high degree of miniaturized hair on the whole frontal area after more than 5 years under medical treatment (Finasteride + Minoxidil). Dr. Bisanga assessed all these aspects and we finally accepted him as a patient doing a conservative approach in terms of design and number of grafts. Here the data: BHR Clinic Dr. Christian BISANGA Age: 24 at the moment of the surgery, 31 on pictures showing current result Technique: FUE Medication: Finasteride (5 years before procedure)+ Minoxidil (7 years before surgery) Donor densities: 70-70-80 FUs/cm2 Hair Caliber: Very Fine, most of FUs of 2 hairs (not many 3-4s) Total FU used:- 1909 * FU breakdown:- 1s 410 2s 1017 3s 447 4s 35 TOTAL: 1909 That means 1909 FU = 3925 Hairs. Average = 2,05 hairs/FU. Pre-Post Surgery 7 Years Comparison 0-7 Years, Dry-Wet Hair

Hi, I will contact the advisor of Kimura50 and see if he can upgrade his case. Kind regards,

Hi, @ jj5102, Dr. Bisanga was trained in hair restoration by Dr. Cole when FUE technique was relatively new. Then in 2003 Dr. Bisanga went ahead and developed his own FUE technique. @ Spex, thank you very much for your comments. Kind regards,

BHR Clinic Dr. Christian BISANGA Age: 34 Technique: FUE Medication: Dutasterie + Minoxidil Hair Caliber: Medium Fine Total FU used:- 1682 * FU breakdown:- 1s 332 2s 850 3s 500 TOTAL: 1682 That means 1682 FU = 3532 Hairs. Average = 2,1 hairs/FU. The goal of this surgery was to improve the coverage in the crown area. Dr. Bisanga recommends to reinforce also the surrounding area with native hair in order to avoid an “island” effect short-mid term if hair loss progresses. Before Pre-Post Surgery 20 Months

Dear Jayboy61, Thank you very much for the upgrade. Hope the appointment with Dr. Bisanga goes well in a few days :). Anything you may need just let us know. Kind regards,

BHR Clinic Dr. Christian BISANGA Age: 36 Technique: FUE Medication: No Donor densities: 70 FUs/cm2 Hair Caliber: Medium Fine Total FU used:- 5976 * FU breakdown:- 1s 898 2s 2388 3s 2271 4s 419 TOTAL: 5976 That means 5976 FU = 14.163 Hairs. Average = 2,37 hairs/FU. The goal of these surgeries was to cover the whole top area on this NW-5 patient. With that on mind, Dr. Bisanga proposed 2 surgeries: the 1st one focused on frontal and part of mid area. On 2nd one, main goal was the crown and we also lowered both temples, reinforcing part of 1st surgery as well. Final pictures show the current result after 6 months from last procedure, so it can improve during the following months. Pre-Post Surgery 1st procedure - 2017 Pre-Post Surgery 2nd procedure - 2018 6 Months post-op 2nd procedure Before - After Kind regards,

BHR Clinic Dr. Christian BISANGA Age: 37 Technique: FUE Medication: Finasteride Donor densities: 70-80-75 FUs/cm2 Hair Caliber: Medium Fine Total FU used:- 2284 * FU breakdown:- 1s 500 2s 1136 3s 621 4s 27 TOTAL: 2284 That means 2284 FU = 4743 Hairs. Average = 2,07 hairs/FU. The goal of this surgery was to rebuild hairline and temples after a previous surgery with a low yield. Recipient area had plugs and pitting after that procedure. Before Pre-Post surgery 1 Month 5 Months The patient at present is pretty pleased but we obvioulsy expect more yield to come in the following months. Kind regards,

Thank you very much for the comments, Spex. Kind regards,

BHR Clinic Dr. Christian BISANGA Age: 30 Technique: FUE Medication: MinoxidiL in the past, not now Donor densities: 70-70-80 FUs/cm2 Hair Caliber: Medium Coarse Miniaturization: some on donor area Total FU used:- 1660 * FU breakdown:- 1s 441 2s 943 3s 273 4s 3 TOTAL: 1660 That means 1660 FU = 3158 Hairs. Average = 1,90 hairs/FU. The goal of this surgery was to rebuild the temples. Pre-Post surgery 1 Month 5 Months 7,5 Months Comparison 0-7,5 Months

Dear Jayboy61, Thank you very much for the upgrade, It looks very good but we will wait till the end of the process and Dr. B will assess it in detail in case we need to do something. Kind regards,

BHR Clinic Dr. Christian BISANGA Technique: FUE Medication: Finasteride Donor densities: 70-70-80 FUs/cm2 Hair Caliber: Very Fine Total FU used:- 1819 * FU breakdown:- 1s 400 2s 798 3s 621 TOTAL: 1819 That means 1819 FU = 3859 Hairs. Average = 2,12 hairs/FU. The goal of this surgery was to rebuild hairline and temples and improve the frame of his face. Pre-post Surgery 2 Weeks - Donor area 2 Months 6 Months 9-10 Months Comparison 0-10 Months

Thank you very much for the upgrade, Jayboy61. Kind regards,

Hi PeloDinero, All the images we have posted in this case are very clear and defined. We have also post several pictures with wet hair, which are extremely realistic of the result achieved till now. If you have any doubt about the result you can also see the video combing the area and showing the scalp. Regards,

Hi, I spoke to the clinic and they confirmed the pictures were taken the same day in 2 different rooms of the clinic. Last one was taken with flash probably. The patient has "salt and pepper" hair so probably if the light conditions were different (also wet hair in the 1st ones and dry in the last one) it can give that impression about the colour of the hair, but that's not the case. Regards,

Hi PeloDinero, Thanks for your comments. I would have to confirm it with the clinic, but I believe all pictures were taken the same day. Definitely they are at 6 months mark. That said, in the 1st 3 pictures of the comparisons the patient had wet hair, and in the one with blue background it was dry, and probably on another room with different light. Hope it helps. Kind regards,

That looks normal after 3 weeks. Just be patient in the next 2-3 months. Best wishes,

Hi, You can see a video of this patient on the following link: https://www.youtube.com/watch?v=QE24KTFycqI Thanks.

BHR Clinic Dr. Christian BISANGA Age: 40 Technique: STRIP + FUE Medication: No Donor densities: 70-80-90 FUs/cm2 Hair Caliber: Medium Fine, slight wavy Miniaturization on donor area: No Previous surgeries: Strip surgery in the past Total FU used:- 6161 = 3986 Strip + 2175 FUE * FU breakdown:- 1s 1068 2s 2719 3s 1958 4s 416 TOTAL: 6161 That means 6161 FU = 14044 Hairs. Average = 2,28 hairs/FU. The goal of this patient was to cover all his baldness in one procedure, so he decided to combine both techniques (Strip + FUE). Pre-Post surgery 6 Months Comparison 0-6 Months

That's a very good advice. It is totally understandable to think of a surgery when you see some pictures, but the 1st step is to stabilize the situation. You have a big % of native-miniaturized hair on top. Using finasteride without any breaks for 9-12 months at least can help a lot, and if you can wait at least 2-3 years more with the same conditions, perfect. A short-term surgery could kill native hair which can improve with medication. And being that young you must look into the future since you will probably lose more hair in years. That means donor area has to be very well managed, because you will care about hair when you are 30, 40, etc. Best wishes,

Hi Bismarck, The next result we will share as soon as possible is a case where patient had a "combo" surgery using Strip and FUE techniques in the same procedure. If I am not wrong Strip grafts were used on frontal-mid section, and FUE behind to restore the whole area. Dr. Bisanga used 6000+ grafts in total. Hope to post it very soon. Kind regards,

Hi Kimura50, Thank you very much for the upgrade. Everything looks fine considering the current stage. Maybe it is true there's that area on the centre of the hair line, but also true that hair there parts a little in opposite directions. Once the new hair settles down I think it will look good. But as previously said, I think the current result is very good. Whatever you may need just let us know. Best wishes,

Hi jimbrann, Bennyt89 had some problem with his username and opened a new thread here: Kind regards,