Harry90

It didn’t work out too bad. I have 7 days booked in Brussels for after the surgery which I couldn’t get refunded. So I’ve just decide to spend time seeing a bit of Belgium on day trips. I live in Manchester so going back to see Mwamba in the New Year for a consult wouldn’t be too bad given the short flight. I’d prob rather prefer to have the consult with him especially as I will have surgery with him. Could also get a second opinion somewhere in England as well maybe

Yea mate it is what it is . I will probably be more disappointed at Christmas cause at that point I’d have been looking forward to a much improved hairline and the ugly duckling phase would have passed. Ill see about pictures of the donor. I showed the Dr a picture of one of the problem areas from early 2022 and he said it looked fine then. Hopefully it isn’t DPA- if it is then I’ll have a think about whether it would be worth it doing surgery that might only have good results for a few years. I’m on fin anyway which hopefully will help. The main annoying thing in the future will be I won’t be on a short career break to go through most of the ugly duckling phase with. Any shedding phase would be suffered while working in the office lol

Hi all Apologies for another lengthy post but thought I’d share an update. Went back to Dr Mwambas clinic this morning for a follow up and here were the main things I took from it 1) ultimately the Dr said on balance it was better to wait before proceeding. I took his advice although I’m sure there will be some regrets in the back of my head over the next while 2)I might have misinterpreted his logic yesterday. His main concern is the possible DPA on part of my left side and a little at the back. He said he thinks it is most likely TE but couldn’t be sure. This is why he wants me to use min, and see if those areas with empty pores fill up a little. Then he will have a better feeling of where to extract and plan two surgeries depending if it’s DPA or TE 3)my safe zone donor density is about 70/cm2 and he can extract about 5600 grafts without damaging the donor (of course we need to see if these grafts in this zone are prone to DPA first). I have about 1200 nape hairs available so overall 6800 grafts currently 4)he says i am Norwood V and would need about 6000 overall for good density over the course if 2 surgeries 5)in the areas or weak donor in the safe zone that might be TE, he would prefer to see if they recover from the use of min over the period of about 4 months. He doesn’t want to extract from there are as they are at 30% (anything about 15% is not great) and he could only go up to 40% before possibly damaging the donor 6)if minoxidil was to help and for example there were about 20% currently in the sparse region at TE resting phase, this figure in best cast scenario would fall to 10% at resting phase and this would increase my scalp limit by about 680 to 7400 overall grafts 7)this is part of the reason he recommends to wait. Stronger donor hair comes from the safe region not the nape. He would rather use his best soldiers as he put it than nape or body hair in the front region which requires the most density 8)he mentioned further down the line chest and beard hairs could be used, but better to use them in the mid scalp or crown. I could probably get a few thousand as well out of those areas bringing overall limit to about 9000 ish 9)he is confident I will get full coverage as long as there is no DPA pattern and I continue with fin and start min which was good news. Even with DPA all wouldn’t be lost. I might have be able to get a good few years out of good coverage without transplant 10)I will come back for a consult in a few months to check out the TE issue. I don’t need to shave the donor again thankfully and the only reason it is was shaved yesterday was because the Dr didn’t envisage any issues before going straight to surgery 11) I did ask would it be wise to take the risk now, hope it isn’t DPA and just go ahead and use the 2400 best grafts from my safe zone in the hairline on surgery today (I’m sure many people would have and I might have nagging regrets I didn’t). He said I could but it was risky. He recommended to wait, take the min, hopefully strengthen the safe zone and we could confirm it was TE. If that didn’t work and he then thought it was DPA the first and second surgery might be planned differently. This is ultimately where we left it Like I said, given I am already here, the fact the Dr thinks it is TE, and it might make sense to just proceed with 2400 safe zone grafts and take a chance might have been my best option. But the Dr is much more knowledgeable than me and probably doesn’t advise this scenario to a lot of patients so with some regret I will follow what he suggest and we can revisit it in a few months

Hi lads, yea I have quite a lot of body hair and though beard is a bit patchy, I’m sure there could be decent contribution from there as well. Body hair was mentioned earlier with Mwamba earlier - will follow up with him again when I get to the clinic tomorrow thanks for the input

Thanks mate 1) Yea I don’t really remember any talk of donor but then again I think I had a similar online consultation with Eugenix and not sure if it came up there either 2) True - I thought this when I left the clinic. With Dr Mwamba suggesting we re-visit the donor in 3/4 months, I obviously wouldn’t need to shave it for an in person consultation so why now? I’d say it was because the Dr wasn’t envisaging any issues with the donor so we could go straight from there to surgery. Bit annoying now to have to wait for it to grow out but obviously a minor thing compared to the delayed/possible cancelled surgery On the point about him working on just the safe zone area tomorrow and then 2nd surgery nape and area where minoxidil might work, I think the issue is we can’t predict for sure the minoxidil will work as he would like. As a result , I’d be left with only 3800 grafts which isn’t enough really for decent coverage thereby making surgery one pretty much redundant. Yea will find out tomorrow what the Dr thinks can be done with 3800. It’s strange because I’ve looked on the forum at other testimonials and it looks like my donor is stronger but I guess the eye test isn’t always perfect. It would be a great shame if this doesn’t work out. If I’d have know about this donor issue earlier (Couple years back) I probably would have tried minoxidil there and then and if that didn’t help, then pretty much abandoned the surgery notion altogether (for a few years anyway). I’ll give the min treatment a try and keep on with the 1mg Oral fin and see where I’m at after that. Hopefully it isn’t a diffuse donor issue thanks again for the quality feedback

Hi mate Yea agreed on the nape issue. And if I indeed do have DUPA and not my donor hair looking weak due to some other issue then I will have problems getting good coverage over the course of 2 surgeries. At that point I’d probably need to look into using body/beard hair which I certainly wouldn’t be against using. The situation is ultimately very disappointing - if all had gone well I’d be near finished my first day. As I said , now is the perfect time to get surgery given it has been in the back of my mind for so long and I was well prepared for the next few weeks and months. I will speak again to Dr Mwamba tomorrow again. If indeed he confirms it best to delay the procedure and see if minoxidil will have a pretty good effect, then I can look into rescheduling it. I agree he has had been ethical pointing out the concerns and advising me not just to jump into surgery. Thanks for your advice

4) we didn’t do work on the first day because after Dr Mwamba raised his concerns, we discussed the options at length. His recommendation was to delay the surgery until we at least see how the minoxidil works. If it was to work then perhaps I could reschedule later to get the first surgery done. If it didn’t work and my donor was still weak then it mightn’t be worth doing at all. He mentioned a refund would be allowed in the case of the surgery being cancelled on this basis. regading the 2 day bit, I mentioned if I was to come back and do the surgery tomorrow as day one what would be the situation. He intimidated there would still be enough time on Tuesday to make it a 2 day surgery. I am booked here for the next 6 days anyway so accommodation wouldn’t be an issue 5)Yes the Drs concern was the sparse areas in my safe zone . He said it might be due to diffuse thinning there or probably Teologum Effluvium possibly caused by stress (which I don’t suffer from unless it was due to upcoming surgery) . There were a few closed pores and dried scalp which is where he thinks there could be improvement from oral minoxidil. I believe this swung his decision to at least postponing. By having stronger safe zone, He wouldn’t need to harvest from the nape for first surgery, and if the minoxidil worked I would have stronger donor area for second one further down the line 6) my end goal would be to try and maximize coverage with what I have, starting of course on the hairline. I feel 6800 although below average would be good for what I am looking for. I mentioned to the Dr about a second surgery down the line. His and mine main concern now is with the present condition of my safe zone donor, there wouldn’t be enough grafts to extract for a second. This would be the main issue as opposed to surgery one. I am leaning towards postponing this based on what Dr Mwamba has recommended. He wouldn’t have suggested it I don’t think in case he had concerns about the long term. If indeed the donor density does strengthen to allow for two good surgeries, it might be more prudent to wait despite the efforts put into this and the fact I will have a shaven head for a while. The fact he mentioned about a refund if there is no point going through with surgery at all after we see how the minoxidil worked is a small factor. But I would much prefer everything to work out and have a good head of hair again. thanks again for your response

Thanks mate for the detailed reply . I’ll go through each point in order 1) I did send pics of the donor in my original consultation pics At the start of 2022. There was no comments then about the donor being weak and I don’t believe it has changed much since then. It wasn’t mentioned on my online meeting I don’t believe 2) The head was shaved after taking the pics I guess so he could get a better view of the donor area and where to harvest using the microscope. Or could this have been done in similar details without shaving the donor ? 3) I agree that the 2350 grafts would be a good start. And I am under no illusion that it would be a future one and done case. I always knew this would require a second visit. The issue seems to be that Dr Mwamba isn’t fully convinced that without the minoxidil helping to strengthen my donor, I would have enough Grafts for a second surgery. It was actually the Dr himself who said in his opinion I should wait a few months before proceeding( when hopefully the minoxidil he advised me to take had the desired effect) . As much as I would like to get it done now, and had mentally prepared myself, the way he has described to me is it is quite risky

Hi mate, thanks for the reply. I believe 6000-6500 would be needed for good coverage as my mid scalp and crown are quite thin as well. Yep I always knew I would require two surgeries for full coverage. The first one for proposed 2500 was for the frontal region only anyway. With regard to the single surgery to just frame the face, I was thinking the opposite. Dr Mwamba mentioned without improvements from the help of minoxidil in the sparse parts of the safe donor area, I would only have about 3800 scalp grafts overall so about 1500 after proposed survey one tomorrow (which was alarming). I read as well that using nape hairs is not as useful as they are non-DHT resistant so 600 of them to be used might not give me the desired result. Ultimately as you say, it is the lack of possible grafts I would have left for a necessary second surgery further down the line that really is the concerning part. I will speak to him again tomorrow but the Dr mentioned this morning, based on the donor area he seen today, he would side with not going through with the surgery right now. thanks again for the feedback

I will just add Dr Mwamba said this had happened before to a client of his and the person came back a year later with a stronger donor. Guess it shows the advantages of in-person consultation

Hi all Apologies in advance about the long post but hoping for some advice and feedback on my situation. Today was supposed to be Day One of my surgery with Dr Mwamba. I arrived at the clinic at 8.50 and signed the relevant forms and had my pictures taken with the team. After meeting Dr Mwamba, more pictures were taken, I had the hairline design drawn which looked perfect and had my head shaved (probably first time in 25 years). Next I went with Dr Mwamba and his assistant to check out the donor density and this is where the problems began. Upon review of my donor, the doctor reckoned my donor density was below average at about 70 per cm2 and the classic donor zone had a few sparse sections where it might be a danger to extract from. He mentioned I had dry scalp here and the sparseness could be stress related (and hopefully not DPA). He did mention that my nape was stronger although reinforcing the hairline and frontal third with hair from here mightn’t provide the desired density. All in all this was hugely disappointing as I had planned this surgery for quite a while and it leaves me in a dilemma. The doctor mentioned I could come back tomorrow and he would be able to extract about 1750 from the classic region and about 600 from the nape, so not far off the 2500 originally planned. Having arranged certain things of my life around the surgery I would love to choose this option. However, I will more than likely need to go back at a later date to do mid-scalp and crown as well. If I was to postpone the surgery and take minoxidil as advised by Dr Mwamba, he thinks the donor will strengthen in a 3/4months and I will have more and stronger grafts to play with (around 6800 overall). However, if the minoxidil didn’t have the desired effect, I wouldn’t have enough grafts for a second surgery to do my mid-scalp and crown. So to finish up here, my heart wants to get the surgery down tomorrow for the 2350 as planned. However, my head is saying I mightn’t get the best result right now and it might be better to come back at a later date and see if minoxidil has increased my donor density and will give me not just a better initial surgery, but the possibility of a good second one as well. Thanks for any advice- I thought it would be best to put it on the forum before I spoke again with Dr Mwamba tomorrow

Hi Ajamilo, I chose Mwamba at the end of last year knowing he had availability for sure in Summer 2023. With the other doctors i mentioned there would have been a much longer wait time outside of someone else cancelling and me being able to jump in. Mwamba seemed to have a good reputation on here up until recently as well . Pekiner I would def choose instead if I had the option of surgery tomorrow especially as he seems to produce great hairlines. But hoping I can get the best result possible and at least good improvement to what I have currently. What are your main drawbacks with Mwamba ??

Cheers mate, good to get some feedback . I’m thinking I’ll probably play it a little safer with the gym just to make sure. No point in rushing back too soon and causing issues just for the sake of a few days. Hoping the anaesthesia isn’t as bad as some of the awful experiences some posters seemed to have had lol

Thanks RTC, did you arrange the washes in advance with Dr Mwamba or on the day of surgery. How would you rate the experience with him - I read your thread. Outside of the lack of communication were you satisfied or disappointed. Thanks

Thanks HappyMan for the detailed reply. Just on the first point regarding the communication, nope I wasn’t expecting too much more from the team. They provided some details when I booked the surgery like directions etc. I Was just wondering if it was standard practice for them or other surgeons to reach out close to the date with some prep details. All good on that though 2. Cheers for that I can pick the aloe Vera, baby shampoo and travel pillow in Brussels 3. yes the wash isn’t essential. It was more because I’ve seen other patients post that they went back for it. I should be fine doing it by myself though if it can’t be accommodated Thanks for the advice on this