Dr. Jean Devroye

Updating the post: new pictures, one year after the HT! Enjoy them. Dr J. Devroye

High density Hair Transplant of a special pattern, results 4 months post-op. This 55 years old patient presents a quite unusual baldness. In fact the vertex is almost totally bald while the rest of the hair is perfectly normal and shows no sign of miniaturisation. Due to his age, the significant amount of hair available and the small area to be covered, we decided to make a high density ASMAP. Strip dimensions: 26 cm * 1.3 = 34 cm2. Starting density: 88 FU/cm2. Estimation of the graft number: 34 * 88 = 2992 grafts. Eventually, we had 3033 grafts for 7823 hair or a very high number of 2.58 Hair/graft. This is due to the fact that almost half of the grafts had 3 or 4 hair. 193 FUT1 1361 FUT2 1027 FUT3 433 FUT4 19 FUT5. The completely bald area measures 75 cm??. The covered area is about 100 cm2. So, the final density is about 80 hair/cm??. The incisions are carried out according to the original orientation. There is a high density of incisions, and also the coupling technique (which consist in combining a Single with a FU2) was used. The result after 4 months only is already impressive. All the grafted hair grew. The structure of the hair is not perfect yet and the diameter is still a little weak but we can already see that the final density will probably be enough, and a second surgery will not be necessary. Dr Jean Devroye MD

This 69 years old patient never had any hair transplant. He has very thin hair but they are curly, which is a positive factor. The density is excellent, with 93 FU per cm?? and a theoretical amount of 1.88 hair per graft. (see picture) The strip measure 24.5 cm *1.5 cm so 36.75 cm??. So we should have 3655 grafts and 6886 hair. Finally, we reached 3150 grafts for 7050 hair, so 2.24 hair per graft (725 FU1, 1241FU2, 893 FU3, 291 FU4). This shows that, contrary to a widespread practice, we do not subdivide our follicles but we use to couple on the same graft 2 very close FU. Thanks to the pairing technique there is a higher proportion of FU2, FU3 and FU4 than on the actual donor zone. The advantage is that we give a better density by using richer grafts, and the cost of the surgery is reduced for the patient. The result was already very promising after three months, but it has improved after 6 months. After one year, it became very natural. This is a good illustration of the gradual evolution of hair texture, in fact the hair transplanted become thicker months after months. As the vertex was not covered, the patient wants a second hair transplant. In my own opinion, it is not essential. The trichophytic closure gave a very discreet result. Dr. Jean Devroye MD www.hairtransplantsurgery.co.uk www.hair-transplant-pictures.com

Dear bighosedragger, since many years ago, I adopted a technique that earned me the nickname "Dr. Spray". The principle of this technique is simple, I discovered it by chance. I used to ask my patients to apply a physiological liquid on the recipient area with a spray for an hour or two. One day, I was expecting the patient of the day before so to check the situation of his surgery after first night. This patient came back to my clinic with a very clean aspect. It was virtually impossible to tell that he had a HT the day before. He told me that he used the spray very widely during the night that followed the intervention. Since then, I systematically ask my patients to do the same. In fact, it is important to moisten regularly the area so to keep it damp (every 10 to 20 minutes). Moreover, especially during the first and the second hour, the use of the spray permits to avoid small blood crusts. Sometimes, a late oozing of yellowish liquid can appear 3 or 4 hours after the surgery and, in this case as well, I recommend cleaning vigorously with the spray. Of course, the patient never touches the grafts. The benefits of this procedure are doubles. First, the receiving area is very clean, this allows the patient to come back quickly in his social life. Then, even if I did not make a double blind scientific comparison, I really have the impression that the number of patients keeping their grafts after intervention is more important with this technique. Thanks to it, there is a gain of time in terms of regrowth. Dr Jean Devroye MD

This 62 years patient presents a recent hair loss. For two years he noticed a loss of hair on the anterior part which actually extends to the vertex. In the middle of the forehead there is a little area covered by hair. The option chosen is perform an asmap, so to cover the anterior part but also to cover the area behind it in order to prevent any future hairloss. The day after the intervention, the patient is worried about the temples which would have not been sufficiently covered, and I reassure him. The aspect of the surgery is very clean thanks to the use of physiological liquid used during the night following the intervention. Evolution is fast and encouraging. When he came back for the removal of the stitches, the grafts were still there. In the 9th month regrowth is complete. The trichophytique closure gives a perfect scar. Technical data : 2939 grafts for 7036 hair (2.39 hair per graft). Details : 548 FU1, 1059 FU2, 979 FU3, 332 FU4, 21 FU5. Dr Jean Devroye MD

I realize that the number of corrections I am presenting on this site is important. This is due to the high proportion of bad hair transplants still carried out in Europe. Patients who find themselves in this unfortunate situation, with a non Aesthetic result, look for someone who can achieve a quality surgery. This is probably the reason why I am doing so many corrections. This 35-year-old patient has already undergone two hair transplants in Belgium, with the removal of two vertical strips... Huge grafts were placed on the entries, with a pluggy result, definitely not looking natural. I used the classical technique, as it gives the best results, it consists in removing most of the plugs thanks to FUE punches and then to place an important number of FU1 (singles) before the plugs. The plugs are surrounded by many FU2 (two hair grafts) to avoid reinforcing the effect of the visual barrier. The central part, between the temples, has also been reinforced so that in the future the aspect remains satisfactory even if the hair loss will continue. The donor area was not very rich, and a relatively moderate number of grafts and hair was reached. 1533 FU, 2910 Hairs, FU1 : 419, FU2 875, FU3 215, FU4 24. Despite the limited number of grafts, the result is excellent and the pluggy aspect is now almost undetectable. Dr Jean Devroye MD

This 29-year-old patient noticed that he was thinning at the age of 25. He had a first little hair transplant in a ???beauty center??? but he was clearly disappointed by the results. Moreover, as you can see on the picture, the scar was a little too broad. We decided to proceed to an ASMAP transplant, optimal coverage of the anterior part and then the vertex. He agreed to shave the recipient area, but finally the work will be done with all the hair in place. The donor area is excellent, its density is 90FU/cm2. Finally, we reached 3782 grafts for 8543 hair. The average diameter of hair is important as well: 93 microns. Here is the details of follicular units: FU1: 547, FU2: 1863, FU3: 1054, FU4: 257, FU 5: 16. Many observations can be made: the number of ???singles??? is limited at the minimum, knowing that we need 400 to 450 FU1 for the anterior line, it is better to leave the grafts as they come. Meanwhile, the proportion of FU3, FU4, and FU5 is important. Thanks to those FU it is possible to increase the density without increasing the number of incisions. The result obtained after 11 months is very natural, the anterior line has been carefully made so to look very natural. The scar is thinner than the previous one. The recovery was quick and thanks to the fact that we did not shaved his hair, his entourage did not notice the work done. Dr Jean Devroye MD

SUPERB and FAST REGROWTH, 2500 Gr. 5393 40 years old patient, since many years she was progressively thinning on the whole frontal area and on her temples. She started an androcur treatment 5 years ago which has slightly improved the situation. It is almost certainly a genetic pattern since her grandmother suffered the same type of hair loss. The indication is excellent, the donor area is rich. The strategy consists in reaching a maximum number of grafts, to place a large amount of FU1 (singles) for a blurry aspect of the frontal line. On the following lines, the density of incisions remained important and FU3 or FU4 grafts were used. Thanks to the pairing (association into the same incision the 2 hair grafts) I managed to increase the hair density. The patient's post-op was fine, without a hitch. The fall of the grafts was early and almost total. Then the regrowth occurred very quickly. After 3 months only, we could already see the regrowth. The actual result is really early as it is a 6 months post-op. The aspect is already very natural. Hairs are still short but in a few months, the new hair will be perfectly integrated into the original hair. Moreover, the trichophytic closure made the scar unnoticeable. Number of grafts 2500, Number of hair 5393 (2.16 Hair/graft). FU1 552, FU2 1121, FU3 679, FU4 148 Surface covered 33.8 cm2 + 34.5 cm2=68.3 cm2 Average density placed (incision/cm2) = 36 FU/cm2 Average density in hair (Hair/cm2)=79 Hair/cm2 Dr Jean Devroye MD www.hairtransplantsurgery.com www.hair-transplant-pictures.com

Hi M1A1, "The density of his donor area is on the average (69 FU/cm2). A wide strip is removed, its total area is 46.2 cm2. Therefore, we expected 46. 2 x 69 = 3096 grafts". As you probably know I measure the area of the strip from close-up pictures with a home made software named Hairmes The measure is very accurate. The length of the strip was 29.6 cm. The width was variable with two maximum of 1.5 cm to the right and 1.7 cm to the left.

Tim is very nice person, and as he wrote, he is a 43 years old restaurant owner. In the morning, right before the surgery, he asked me if I could make a hair transplant that will be undetectable on the day after as he had to go to a public meeting with three hundred guests. A real challenge. Fortunately for us, and you'll see it in the pictures, he had enough hair on the front part so to hide the work done. He preferred to cover the balding areas on a horseshoe shape, with priority to the vertex and grafting the two corridors linking the vertex with the anterior line. The density is not very strong, however, we reached 3229 grafts/6772 hair (FU1 695, FU2 1673, FU3 713, FU4 148.) The covered surface measured, as usual, with Hairmes software measures 111.5 cm. Therefore, the average density is 29 FU/cm2. The strategy adopted consists in cutting no hair. During any intervention, as we usually do, we hydrate and clean profusely the area with saline. The most important was realized by Tim himself. During the first hours of the night, he profusely sprayed the saline to prevent any crusts. The next morning, I sprayed his hair with water in order to eliminate the excess of salt bring by the saline. Then, the hair was dried using a hair dryer blowing tepid air. A last adjustment of the hair, and there you go! Dr Jean Devroye MD www.hairtransplantsurgery.com www.hair-transplant-pictures.com

Very impressive result, especially regarding the limited number of grafts. Well done Dr True... Dr Jean Devroye

Nice, natural and dense...very good repair Kudos Bill. Dr Jean Devroye

Superb! I love the shape of this very irregular hairline. I think it will inspire me. The density is also very high for a reasonable amount of graft. Congratulation Bernard??¦

His salt and pepper hair are thick, which is an advantage. The total area to be covered is important : 74.4 cm for the zones 1 to 3, and 94.9 cm2 for zone 4 and 5. There is an area on the middle front which is still well hairy and this area is not evolving since many years. As this patient wants to fill the whole balding area, the following strategy is defined : One, the aim is to reach as many grafts possible. Two, to cover zones 1 to 3 with a maximal density. The small central area is grafted as well but with a lower density, the rest of the UF will be spread on the vertex (zone 4 and 5) without seeking to reach the maximal density. The density of his donor area is on the average (69 FU/cm2). A wide strip is removed, its total area is 46.2 cm2. Therefore, we expected 46. 2 x 69 = 3096 grafts. Finally, we will have 3218 grafts including: 747 FU1, 1662 FU2, 673 FU3 and 136 FU4, for a total of 6634 hair. 2200 grafts will be placed on the zones 1 to 3, which represents an average density of more or less 30 grafts per cm2 and the posterior area got the 1000 grafts remaining, with a minimum density of more or less 10.5 greffes per cm2. I made a trychophytique closure. After 8 months, the regrowth is excellent and the patient is very satisfied with his new look. He is thinking about a second transplant so to improve the density on the vertex, and maybe to add some UF on the anterior part as well. This patient is a good example of how, sometimes, it is important to manage the surgery as we have limits imposed by the donor area, of course limited, and the recipient area which is important. Despite the densities, relatively low because of the surface to be covered, the final aspect is entirely satisfactory. Dr Jean Devroye MD

Hi everybody, Recently, I discovered the answers made to the post of FemaleHt. First of all, let me say that the work of my colleague and friend, Dr Feller, was superb and undetectable... so discreet that at the beginning I did not notice that she had already had a previous transplant. The scar was almost invisible. It is true that, as a matter of principle, I never shave the recipient area during woman transplants. I believe that a "trauma" linked to this shaving has to be avoided in women already worried by their lack of hair. So far, I think that the goal of a hair transplant is, above all, to reach an excellent aesthetical result and a good regrowth. There is no doubt on the fact that this is exactly what happened with Dr Allan Feller first surgery: an excellent aesthetical result and a good regrowth. Moreover, I visited his office recently and I can attest the quality and the devotion of dr Feller and his team, as well as the very high quality of his work. Dr Jean Devroye MD

For 6 months, I have been using my own prototype for FUE surgeries. It has the advantage of turning alternatively with a very low angular motion, and the regulation of the speed is made using a foot treadle, allowing a work as refined as done by hand. However, the work is easier because the hand has only to maintain the punch on the right angle and it is no longer moving. Thanks to it, I increased a bit the speed of the extraction (but I did not reach 700 grafts per hour!) and nowadays I can reach 1500 grafts per day, instead of 1200. You can see a video of the work on YouTube: You will also see the results of the harvest, the first day, almost FU3 and FU4 only with a very low transection rate. Concerning the transection rate, I do not think that the engine brings an improvement. It is more the experience of the surgeon and the size of the punches that influence the risk of transection. As far as the size of the punches is concerned, I am not a small 0.7 mm punches believer. For several reasons, I use 1 mm punches rather. I was able to observe that, by using small punches, the transection rate is surely going to increase. Also, we are obliged not to take the most beautiful grafts as too big for the punch size. Finally we get little and poor grafts which are not, in my opinion, going to grow very well. The scars obtained with 1 mm punches are frankly small and when the hair is cut very short I have not seen any difference of aspect on areas where a 0.7 or 1 mm were used. If the patient says he wants to shave his head completely, I recommend him just to avoid any kind of hair transplant because both scars, made with 0.7 or 1mm punches, are still slightly visible. I am working actively on another prototype; it should be ready in a few weeks. Some sophistication will be added but I will talk about them later on... Dr Jean Devroye MD www.hairtransplantsurgery.com www.hair-transplant-pictures.com

The aim of this surgery was to improve the density of hair on the anterior part, and the temples. As the donor area was rich, we planned to remove a strip for about 3000 grafts, and we reached a little bit more 3047 grafts. Singles: 791- FU2: 1279 - FU3: 772 - FU4: 72 - FU5: 2. Thanks to the good elasticity of his skin, the suture was easily made and the scar is unnoticeable. After 6 months, this patient sent me some pictures (he is leaving in Austria), they are not very high quality but they clearly show the improvement. Dr Jean Devroye www.hairtransplantsurgery.com www.hair-transplant-pictures.com

I would like to give my testimonial regarding the new instrumentation developed by DrAllan Feller. Yesterday, I had the opportunity to visit Dr. Feller in his private clinic, in Great Neck, and to witness to a 950 grafts FUE surgery. I had also the privilege to use the extractor on about fifty grafts. First of all, let me specify that I have a good practice of the FUE technique. I regularly perform sessions of 1200 grafts per day. I generally perform this surgery manually but for some months, I have been developing a new motorized system connected to a dentist handpiece. There is an alternative rotation (just like the movement obtained when it is done manually). That is why I am particularly interested in every motorized system for the FUE. I know four systems: Dr. Cole's one, which is like a drill and the patient should be sit. The calvitron invented several years ago by Dr. Pascal Boudjema and updated by the use of punches of small diameter. In New York, Dr. Reed and his assistant Larry Leonard are using it. There is also a new FUE-Extractor system developed by Pascal Boudjema, commercialized by Leadm.co.kr (http://www.youtube.com/hairscience). Finally, there is the Feller Motorized F.U.E device. Dr. Feller explained me, step by step, how he reached the actual result. A whole series of details like the position of the punch which is not centered the use of a pile rather than a wire, the internal system of rotation??¦ no doubts that the final version is the result of a long reflection. I also had the opportunity to see the previous prototypes. Dr. Feller's system is extremely well thought. The handpiece is entirely alimented by an internal battery, which avoids cumbersome wire, and it is possible to make a complete sterilization, which is not the case of the Korean system. The realization is neat and precise. The punch turns perfectly in its axis. The punch is carried out in a way so to reduce the frictions to the minimum (the internal diameter of the punch is slightly larger than the diameter of the sharp part). It is very handy. During the tests, I obtained beautiful grafts from the start even without wearing the Zeiss Loops that I usually use. In conclusion, Doctor Feller's device is a superb instrument; probably many surgeons will love it. Nevertheless, it is possibly better to learn how to extract grafts manually, before switching to this motorized version. In fact, the manual skills really permits to 'feel' the work carried out. It allows us to use and begin with this technique which is of course very charming but very time and energy consuming. I can only recommend the use of this new design, of course it is not miraculous so to let any doctor to practice a FUE correctly, but it remains definitively as an advance in the field of the Hair Transplant. Moreover, I really appreciated the philosophy of Dr. Feller as he does not seek via this instrument to increase the number of grafts obtained per day but to make the procedure lasts the less possible, in this way, both the patient and the doctor will be less tired. Finally, I liked the concern of Dr. Feller who accepted to share his experience and his skills. It is a shame to note that very often the FUE techniques and skills are jealously kept secret by their inventors. Probably they have the illusion of being and remaining the only ones that deserve to use those techniques.

Sorry for the delay of the post, but finally we are adding some nice pictures of Mike's surgery. His hair loss started when he was 17 years old, and he had a first hair transplant made in Denmark, but the results were unsatisfying. Even if he is still very young, he decided to make a second surgery to correct the results. Together we planned the best strategy to adopt: to work on the anterior part so to draw a new hair line and not working on the vertex, where he still has hair, so to keep more grafts for the anterior part. The anterior line had some imperfections, so I removed one by one some plugs via the FUE technique. I made a new hairline, and you can see the little red spots which are the corrections. We also decided to draw the temples and to add grafts on the sideburns as well. The former scar was removed, and I sutured it using the trichophytic closure. The removal of the stitches was planned 22 days after so to reduce the effect of stretch back. 2764 grafts 5974 hair placed Mike's donor area was balanced, with a high number of singles and doubles (follicular units with one hair and two hair). Finally we had 743 grafts singles, 1048 with 2 hair, 753 with 3 hair and 216 with 4 hair. His hair is quite thin. The size of the incisions: 0.7 mm for the singles, 1 mm for the doubles and 1.3 mm for the 3 and 4 hair. Dr Devroye please have a look at each picture individually: mikethedane+DrDevroye http://hair-restoration-info.c...521087683/m/60710839

My assistants do use microscopes every time. They never used loupes or magnification or worst, naked eyes to cut the grafts. Second, we do very thin slivers before cutting the grafts. Consequently, the cutting is easier and the rate of 3 and 4 hairs FU is hight ( very important to reach a good density of the Frontal tuft area). I have 5 to 6 binocular microscopes. Yours truly, Dr Jean Devroye