MC10298

Thats the concern. Hopefully I'm wrong.

Sounds defensive ... I think the OP deserves a more considered opinion of his density concerns than this. What is the OP to take away? He's got the wrong shape/size head for density? Density is a measurement FU/Cm2. The illusion of density is somewhat more nuanced, but whatever way you cut it, if you lack FU/cm2 from the start, you will always struggle. Comparisons are what we all do all the time on this board. A prospective HT compares the work of different surgeons before making their decision. You make comparisons when the HT of the week is chosen. @Classygentleman has expressed concern that at 8 months, he lacks the desired density and asks for feedback. He needs a little more to work with than 'no two people are the same'. I've offered my opinion whats yours?

I would ask the doc what he means by 'very diligent'. In other words, to the untrained eye, what should you be looking for? We know that minoxdil can accelerate shedding (this can be desirable to allow a new stronger, thicker hair to emerge) The day 12 photos show some nice density. The donor pixs aren't very clear. Always try to take pixs using the rear camera, on mobiles it's a much better camera than the front facing one. Look forward to seeing your before pixs to see your start point. Good luck & good growth

IMO there was a lack of density from the start. If you compare your ten day photo to a recent example where the stated density was 60g/cm2 reducing to 45 g/cm2 behind the hairline. I have removed the color in both photos to emphasize the contrast.

Many thanks @slfor your reply. Clinical expertise is tricky to scale. Do you present work on the forum from doctors other than Dr B and, do you credit the work to those doctors?

During my research, Dr Bisanga name appears alongside the very top surgeons. Looking on the website (https://bhrclinic.com/team/), BHR is in Belgium, UK, Israel and Greece. How does that even work? Do patients turn expecting surgery by the distinguished Dr Bisanga and get the doctor available at that location? Perhaps one for the rep(s) but also interested in recent patients experience.

I think the discussion on Finaside is valid. It is one of the reasons many top clinics insist on at least 6 months medication prior to an evaluation. If we take the presentation on face value (excluding concealers and lighting) and assume the patient is a hyper responder to Fina, then it raises the question 'did he even need a transplant?'. At the very least, after 6 months of hyper-growth, you'd want to give it another 6 months to re-evaluate. The main takeaway is to get on the meds early, surgery should always be a last resort.

The area marked in blue.

I think that is one of the nice things after a successful procedure that patients can just move on with there lives. For me the only thing missing from this image is improvements to the temporal peaks. Does Dr Maras work in this area? and if so do you have any examples?

Very nice and natural. I notice the procedure was carried out in 2015. Has the clinic had any recent contact/photos?

I don't perceive the OP's observations as negative. I'm sure that we would all encourage a prospective HT patient to carry out thorough research. It would be strange if that patient then became passive and stopped being inquisitive. The OP reported new statistical data provided by the clinic that he felt (and I agree) was of concern and raised questions. Can he change anything now? Perhaps not, but it is important to acknowledge these concerns. This journal documents the OP's journey through the highs and lows. It also provides valuable information to the community, which the OP should be commended for. @urbanite88 have you had satisfactory answers to your questions from the clinic?

Oh and not to forget keep us all updated with your informative progress🙃 - I'm sure everyone is hoping for a great outcome!

I'm sure the OP was joking. His concern is less the donor, which had the smallest possible punch, but rather will he get enough density in the recipient area. To the OP, it's like jumping out of a plane. You do all your checks before the jump to ensure a safe landing. You went with a well-respected surgeon. It's now your job to land it safely ie. minimise stress, maintain the recovery protocol , keep in good health & spirit etc.

I agree, 2100 singles does sound dispropotionaely high. One of the benefits of FUE is the ability to choose the required number of singles for the hairline and then multi-hair grafts for density. Based on the above:- S 2100 D 1140 X 2 = 2280 M 670 X 3 = 2010 (this would be an absolute minimum as you might expect some 4's 5's etc) Total: 6390 (yield of 1.63 per FU, which seems low) How did you arrive at 6200? General comments I agree it would good to know the transection rate. I was reading a post recently where the HT transplant reported. "Dr Ma counted every single punch out loud, which was nice to follow along. His team would then pull out the grafts at the same time and provide live confirmation whether it was good or transected, so he could adjust as he went. " I have seen discussions where HT patients compare the size of punch used. 0.7mm is the smallest I've read. There does seem to be a drive to use smaller punches with an inherently increased risk of transection. Ultimately it is the interest of both the clinic and patient to have a successful outcome. All you can do is check previous results, do your due diligence, and trust in the process.

Thanks for clarifying. It's an important observation you make, lighting, length of hair and angle make such a difference.

First and foremost, find a product you like the taste of. Even one you like at the start will get a bit repetitive. Just like training, consistency is key. Consider an unflavoured powder (a lot cheaper) and make lush smoothies with frozen fruit. Sugar-free syrups can be added to give the shake added sweetness/switch up the taste. Sugar-free syrup example https://www.monin.com/uk/sugar-free-syrups.html

Many thanks for presenting your case. Dr Bruno's work looks very tidy. Will follow with interest my friend. Ps. another vote for the buzz cut look - looks great on you

I'm reading your post that photos taken at the same time but from a slighty different angle can affect the perception of how thick the hair is - correct? The big difference I notice in photo 3 & 4 is hair length, Are you saying these were taken at the same time?

I noticed there are a number of white bare patches in this photo. As others have mentioned, better photo(s) of the donor area prior to the procedure at a comparable length is required. Just an observation - 4800 grafts in a single session is a lot. Time must be a factor, and if time is a factor, does that affect the precision required to spread out the extractions. (?)

Big improvement to your pre-transplant photos. Well managed donor too. Really pleased for you - Enjoy!

I disagree that the OP has been well served by Eugenix. As I highlighted in my previous post, they failed to provide adequate density (even by their own standards). The OP was failed from the initial aggressive hairline design. The OP was repeatedly told density would come; just give it time. Of course, it never happened for reasons we are now aware of. Regarding 'free touch up' - For me, 1500 isn't a touch up. The hairline appears to have moved down and the first few rows packed with a higher density. The problem with reconstruction is the bulk of the previous hair transplanted remains at a lower density. We can see some intervention working within existing hair, but this is limited and fraught with risk from shock loss and necrosis. Talk for 'free' is bizarre. What price do we attribute to the emotional impact? In monetary terms, the cost of travel. All avoidable with a hairline that would have allowed sufficient density from the start. The OP has done a great service to the community by documenting his account. I refrained from commenting after the rep confirmed the low density because I understand it's a stressful time post-surgery. It is an honest account by the OP and therefore deserves an honest appraisal of the procedure.

Interesting case thanks for documenting your progress. You're at the 5 month mark?

The irony is Eugenix produced a very good video explaining required density. Here's the full video:

Many thanks OP for the update. Couldn't put it better myself. For me, this is the elephant in the room. All the talk about poor growth ignores the simple math. The area was large, and the number of grafts for the 1st surgery was insufficient to provide the desired density. The hairline was lowered and flat (i.e. temples had been heavily restored). There is a cost to this aggressive approach and that is density. Look again at the numbers 30 to 35 per sqcm. Even with strong growth of 90%, you get a poor density of 27 to 32 per sqcm. When you consider a full head of hair would have a density of between 80 to 100 per sqcm and 45 to 50 per sqcm is required to create the 'illusion' of density, then sadly, the OP was on a loser from the start.

Temples What went wrong with the temples? Why were doubles transplanted on one side and singles on the other side? The clinic rep (Gabreille Nelson Mukhia) stated in this thread Dr Sethi in his video in the art of Temple point restoration stated