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 1^st one focused on frontal and part of mid area. On 2^nd one, main goal was the crown and we also lowered both temples, reinforcing part of 1^st 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

 

 

 

 

 

On 8/31/2018 at 1:28 AM, Melvin-Moderator said:

To be honest, I’m not totally convinced that your hair loss has stabilized (...) The reason I bring up these issues are because although you have a high degree of miniaturization you still have a great deal of native hair. My main concern is shock loss. 

If I were you I would stick with finasteride and minoxidil for at least a year. No breaks imbetween (...) The last thing I would want is for you to have a procedure and lose a great deal of hair to shock loss and end up looking the same. 

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,

1 hour ago, jimbrann said:

Any updates? Must almost have a full head by now.

Hi jimbrann,

Bennyt89 had some problem with his username and opened a new thread here:

Kind regards,