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  1. Here’s our full list, but definitely recommend Dr. Bisanga and Feriduni as well in Europe. Take a look and submit some virtual consultations. https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN-MOB
  2. @LeBerry Thank you for your post. Very nice documentation and thank you for sharing your photos. It is important that we as patients give back to the community and I have no doubt that many individuals will find value in your thread and journey. Your early photos look great and very clean. You clearly did a good job with scab removal. I look forward to your updates and am excited for you for the months ahead. You are in great hands with Hilde. To copy from previous posts where Dr. Bisanga´s extraction approach has been discussed and explained - Recently on the forum there has been some discussion and possible misunderstanding regarding the pattern of extraction that is often employed by Dr. Bisanga. This is where Dr. Bisanga will harvest on one side of the donor area and not the opposing side There are various motivations why Dr. Bisanga will at times take the approach of only extracting from one side of the patient´s donor. If we start by explaining that much more commonly, we will see patients who have undergone FUE surgery, and the main focus of their extraction pattern is centred on the occipital (back) donor region, oftentimes not extending even slightly to the parietal (side) area. The reason that this is a common approach is that the occipital donor area has the highest density, higher hair groupings and is the richest area of the entire donor. When a doctor is looking to achieve the best result possible, he has therefore chosen the best quality grafts. The concern with this approach is that the strongest area of the donor has been heavily relied upon in that first surgery, meaning that subsequent procedures do not have the advantage of utilising this area to any extent. One of the beauties of FUE surgery, is that it allows the doctor to “cherry-pick” the most suitable and appropriate hairs for specific areas of the restoration. This is essential for designing hairlines and temple points. The most appropriate soft and single hair grafts can be found in the parietal/temporal area of the donor (above the ear). This is one of the reasons why Dr. Bisanga will look to extract from this area. To be able to provide natural and optimal single hair grafts, as opposed to having to dissect thicker multiple hair grafts from the occipital to meet the necessary demands/count of singles for the hairline for example. The question of why we may only extract from one side of the donor, and not the other comes down to several factors. The most simple and obvious is the total graft count of surgery. Taking into account the reasons explained above why Dr. Bisanga will avoid harvesting only from the occipital region, and also prefers to harvest the most appropriate follicles from the temporal/parietal area, due to spreading the extraction pattern over this significant band, there may be no need to extract from both sides. If the desired graft count can be achieved with a very well distributed extraction pattern, then there are more positives to leave an untouched area of donor, with a more specific type of follicle, that can be better utilised for a potential subsequent surgery. We do not from any of our surgeries have cases whereby the extracted side shows visibly less density than the non touched area, and as explained, this is due to still in keeping with an extraction pattern that is sufficiently spread to not contribute to any real visible concern and especially not when the hair has any length. Additionally, before extraction, the donor area must be well numbed. Administering anaesthetic and epinephrine to a donor area can in some patients cause shock loss. As we have already explained that the temporal/parietal area has more softer follicles, and is also an area that can be prone to hair loss and recession the closer to the temporal point. This means that some patients may be more susceptible to shock loss in this area. If a particular patient has a significant graft demand that requires harvesting from both sides, then the reward far outweighs the risk of temporary shock loss. However, in patients whose graft demands can be met by utilising and extracting from just one side, then there is no need to “disturb” both sides at this time. As long as the extraction pattern can be managed in a way that no real visible distinction can be made from one side to the other, then this is Dr. Bisanga´s preferred approach with appropriate patients. Should a patient then in the future experience further loss into his temple points for example or would like to “tweak” his hairline, then we have the advantage of being able to again harvest the most appropriate single hair grafts from that untouched donor area. Our approach also allows a second pass even on previously harvested areas, so does in essence maximise the donor without over harvesting and choking any area or over spreading with needless extra injections, swelling and potential shock loss. It is an approach that has served Dr. Bisanga well in many of his patients. I will link some cases below where this approach has been used. There are many more on the forum. The cases below show hair at different lengths throughout the growth phases to reinforce that there are no donor concerns. I think that it is fair to say that the quality of these results and the appearance of the donor area post surgery are optimal.
  3. @Ras why would you want to sacrifice the outcome of your surgery and pay more for a UK Doctor that isn’t skilled in African hair just to avoid a 5h Eurostar train to Brussels where you have the best Doctors in the world for African hair; Dr. Lupanzula or Dr. Bisanga… Please consider getting on that 5h train instead of paying more to get a worst result and possibly have to get on that train anyway to get a repair surgery. Wish you all the best with your HT.
  4. As i'm new here at HRN, and used HRN much to educate myself, i mean learned much by HRN members like @Egy, @MachoVato, @Portugal25 , @Melvin- Moderator, and many other, if continue count i'm afraid will forget someone, so my apologize, if didn't added rest of members helped me much to understand this matter about HT, hairloss, levels of hairloss like norwood-hamilton, good clinics, top clinics, bad clinics, hair mill clinics, all those learned here, and by my adittional research allaround.... Thought about 1 thing last days, as i'm near to decide which clinic/doctor to choose, probably some of top 5 in Turkey, as mentioned ago main reason is my private life's situation, and can't wait 12-18x months for some clinics like dr. Lorenzo, which by opinion is one of best, dr. Bisanga too, and cause of some other complications, flights, but mostly cause of long waiting list, so thing what about i thought, is "who" are these "top" doctors which perform these not so simple HT surgeries, when i say "who" not mean, only their results, websites, prices, social networks, as you know that not all failed cases will be posted at this forum, as not all people who get HT by some of "top" doctors-clinics post at HRN, and some of cases we'll never know, mostly here post members who were active before their HT, trying get here experience, help, how to choose etc. , and in respect of HRN help, get back with results, so my question who are doctors is related to their backrounds, in meaning their education, experience in which area, like Plastics surgery, general surgery, Dermathology, or whatever.... As we know, good education is base for every success in some area, as it's base, as think not so ok surgery perform dr. Urologist, dr. Psychologist, dr. Diabetologist, etc etc. , as in some of hair mill clinics, doctor who is in front of those clinics has no any connection to surgery, but absolute different area, and he acts like a dr. XX who "perform" HT surgery, think no one patient with cardio problems, will like to hear that his cardio surgery will perform some dr. Dermathologist, instead dr. Cardio-srugeon. I say this, casue as more researched, more realized, that allaround are many doctors, who just participated in some courses of HT surgery, or worked with some famous HT surgeon, but in that case if no real education at least in any kind of surgery, as some of doctors from list - table i'll post here, for ex. worked in General surgery, in Thoracic surgery, etc. , such doctors can easy adapt to surgey as HT, as worked with much more complicated srugery areas, but if doctors only had some short courses, or non-formal educations by working in some clinics and learned by colleague, did you think it's enough? In this case, we can say technician who work 5-10 years with famous doctor like dr. Lorenzo, Bisanga, almost have knowledge, like doctor who didn't specialize at least 3-4y in some hospital's surgery, of any surgery area... As docotr who is just graduated general Medicine, has no much experience to perform surgery, if really by formal education didn't practice surgery and got speciaization in some surgery area. I say this, cause there is just regular doctor - medicine doctor, or in some countries called doctors of general practice, without any kind specialization oficial, as oficial specizalizations in Medicine, usual take 2-4 years depend of country, and it's oficial, to get status of specialist doctor of some area, like spec. Cardio-surgeon, spec. Plastics surgeon, and what's nearest to this HT area is specialization in Plastics surgery, or any other kind surgery experience think is good. So, would like hear your opinion about this theme, do you think is enough doctor who only graduacted 4-5y faculty of Medicine, without specialzation in any surgery area, perform these HT surgeries, only based on learning in some private clinics, like first assist main doctor, and then by 2-3y, open himself/herself clinics and offer HT surgery services? Maybe i'm more than other suspicios and careful, and watch things by more sides than need, but ok, it's forum, open discussion ,, and all we can say our opinions ... I say , cause in area where i work, some job can't perform engineer other area, but only specialized engineer for specific project area. Here is about our lifes, heads, as engineer's mistakes can fix by money, payment of mistakes, but if doctors not well educated, mistakes sometimes can't be repaired and money will not help . Used @Portugal25 nice table as reference for "top" doctors table, from his thread all credits go to @Portugal25 for his great work, and sure if he agree about using his table as reference, if not, i'll delete my table with "top" doctors education table. Would like hear your opinions on this theme, what you think is education very important, or you'll accept even it's doctor only doctor of Medicine - bacis education , 4-6 years 1st level university education - doctor of general practice, and not have formal education in any area of surgery, but just non-formal education by practice in work of private clinics like assisting main doctor? P.S. These information about education found mostly by googling, from different sources like ISHRS, websites of doctors, etc. , and all are oficial informations. List is long, and when open photo, use bigger ZOOM to be able read education of all doctors.
  5. At top doctors/clinics usual is practice, that even technician alo attend serious courses, education in-house or at certified institutes for education for ex. about FUE, or other technics, and some of dr. like dr. Bisanga, and few other, visit other clinics and educate their stuff, think no one top doctor/clinics will allow himself to work with uneducated/unexperienced technicians, as they are their "right" hand, and cause of reputation they will not allow such employees, at some top clinics like Egy wrote some of tehnician work 5-10 years with same doctor, and they get by their doctors education too. And like posted in previous reply to Egy, at top clinics technicians mostly don't perform most important parts of HT surgery, but usual those which not so critical, and even that part they do under monitoring of main doctor, that makes difference between hair mill and top doctors/clinics, and by that way can make difference hair mill vs. top doctors/clinics. And btw there is not always qualification of Dr. "well and good" , check x hair mill clinics and you'll see qualifications of doctors, there is doctors who absolute have no any experience in surgery, no specialization, or any degree of eduaction in surgery, else some courses, trainings, 1-2x, and then such doctor perform surgery on your head, and you see 3-4 hair grafts - multi-grafts on front of your head, hairline , and x other examples... That's why still important we check education of doctors and experience, even those top doctors-clinics, and between them 20s to choose one which by our opinion is best choice for us, sure if more members provide, more informations about other doctors results, member @Portugal25 can expand his table, and add new doctors, and i can check their education-experience, and add info. Sure all we can make mistakes of declaring some doctors as "top", but that's why this forum exist, as here some doctors/clinics were in recommended list, but cause of later poor results, less care about patients, more bad stories of patients and after-care, bad results, removed from that list, at HRN primacy is on quality, results, facts, and that's why @Portugal25 made his list, and i made this table, just to contribute in some way to get more quality choice for all HRN members , by providing more informations, more views of future choice docotrs.
  6. Nice and accurately said. At "top" doctors/clinics, mostly main doctors, for ex. dr. Bisanga, Ferduini, dr. Bicer, or anyone other from "top" doctors, do mostly main part of surgery , like extraction (to avoid damage grafts by technicians) and opening channels mostly do main doctors too, as that's too very important part , and some of doctors do part of implanting graft, and sometimes rest do technicians, as when well extracted grafts and well opened channels on head, implanting is less dificult, and this way usual lead to solid results.
  7. Saw palmetto is a waste of time, just stick with fin and oral min and hope for the best. Dr. Bisanga was correct to refuse you as a patient, but the meds might help you hold on to what you have. Give dermmatch and/or toppik a try too.
  8. Yes, in all my posts if you check, i never suggested anyone to choose those hair mill clinics, where such clinics by naming clinics with "dr. XXXX" results that people think at such clinics really will get HT by doctor-surgeon, and reality is will get it by low skilled technician + lowe paid, low experienced, at all not ok any technician do most of job, specially important parts like extraction and opening channels. Sure at "top" clinics, technicians do part of job, as someone need assist doctor,as it's huge job, but point is that whole time is under control of doctor, or most of time... Yes, i know about such cases, my haridresses suggested me too some hair mill clinics in TR , sure said thanks , but decide research further, was near almost 2-3 hair mill clinics to choose, but fortunately found this great forum, which helped me much to make difference hair mill vs non hair mill clinics, etc. , and now on road to find solid clinic... But in many cases people are unfortunately limited with money too, as not in all countries solid finance situations at people, like in EU, and then later by wrong choise of hair mill x complications appear.... Yes, Greviews, Trustpilot , etc. many people take as reference of good clinics, then inst, fb, yt where can see only 2 photos before/after, where you can't know is it real patient, or some random photos stolen from other websites, soc. networs, etc. , at beginning i did same, checked Greviews, trustpilot, but when saw x reviews with 1 post, or same names x times, or some copy-paste reviews, realized it's mostly fake, and even at quora, reddit, can be some fakes... So most reliable place to find solid clinics is forums with real threads, where posted 1-12m photos, and specially forums like HRN where no paid threads, where freedom of anyone post his thread without worry to be modified, deleted, etc. even it's thread about "top" clinics, or recommended here, that makes difference HRN vs rest of forums, at many forums admins, mods are paid to delete threads where reviews not so well, as hair mill clinics participate as donators of such forums... I still didn't perform my 1st HT, soon plan it, and whole time read this forum, will try some other, and still research, and will need some time to make my decision for my 1st HT, hope will not make mistake... Planned choose some of Spain - Lorezno,Freitas,Ferreira, Beligum - Feduini, Bisanga, PT - Pinto clinics/dr, but as there too long waiting list in this moment at most of clinics recommended here from these 3 countries is waiting like 12-18 months, and cause of my private life situation-complications, business projects, will need choose some clinic in Turkey, one of these top mentioned previously like HLC, dr. Pekiner, dr. Bicer, Kevser, Demirsoy etc. Only what still is strange for me, that even most of these "top" clinics, don't do analyze of skin scalp, analyze of donor area by dermatologist or their deeper analyze like do dr. Bisanga, dr. Ferduini, dr. Lorenzo, and think in Turkey dr. Pekiner and HLC do deeper analyze, and not accept patients if after analyze realize not good donor area, and suggest some medication like finestaride, etc. and then to come again to check donor area, rest of "top" clinics mostly dont do this.
  9. Dr. Bisanga is such a top-notch ethical doctor, one of the best in the business.
  10. Hello everyone, I've received so much information from this site that I feel compelled to give back. About me: I'm 50, Asian American/Belgian male and have been thinking about doing a hair transplant for years. I remember my father in his earlier years of hair loss and how discouraged and powerless he felt. Today, I'm fortunate to be in a position (financially and emotionally) where I can do something about my own hair loss. I have a confirmed procedure with Dr. Bisanga in Brussels for the 25th of November, 2020. My airplane ticket has been purchased (from SFO-BRU) and apartment reserved on AirBnb. Will keep this page updated.....
  11. In this latest presentation from our "Inside the Op Room" series, Dr. Bisanga shows and explains his approach to cutting recipient sites, discussing angles, feathering, hair groupings and light penetration to best achieve the desired "illusion of coverage". This is a very educational video and even more valuable is that we have this very patient´s own documentation and result thread to show the evolution and growth of this procedure (below).
  12. Absolutely agree, as some of "top" surgeons as dr. Bisanga, Konior, Ferduini, use motorize punches too, and think it's not about tool used, manual or morotized, but it's about doctor's skills, experience, knowledge... Price manual vs. motorized is result amount of work, manual requests more time, effort, etc. and then manual is more expensive... And about prices, agree with some members above, if someone has budget 10k, and if satisfied with work of some dr./clinics , and such dr./clinic instills him more confidence, feeling more comfortable with that choice, it worths give 10k, as most of us do it 1 or 2x times in life, depend of hair situation, and then money shouldn't be main reference to choose or not some dr/clinics, as our confidence, and relaxed at time of surgery can't pay any amount of money, but sure need to be in some defined budget, sure if we are not Elon Musk, and budget not too important item .
  13. I think Dr. Bisanga would disagree with you on pre made slits being an “old technique.” He gets some of the best results on this board and recently even stated in a video that implanters can cause more trauma to grafts.
  14. Dear Community, this forum helped me a great deal in my decision making process but also in making myself knowledgeable around the whole topic of HT. Therefore I wanted to give something back an let you participant in my journey, starting from the procedure I underwent at Dr. B's clinic end of January. About myself 31 years old Hair loss started at around 20 I would say and progressed really slow towards the status you now see on my pre-op pics Never took any medication, but have now started with Minox 5mg daily Graft breakdown 1 FU: 402 2 FUs: 1,298 3 FUs: 1,200 4 FUs: 77 Total: 2,977 at avg. 2.32 hair / graft I'm not going into detail w.r.t. the day of the procedure and the procedure itself as I thing this is pretty well know by now. Having said that, I'm of course very happy to answer any questions should you have any! What else to say? I'm obviously very happy and excited with this step and am looking forward to the coming months. In terms of healing and first days post-OP, I can say that I never had any pain (didn't even need the painkillers the clinic gave me with the after care package). 90% of the scrabs came off at day 9. My donor healed up quite nicely and looked pretty much back to normal at around day 7 I wanna say. Below you will find my pre-OP pics
  15. It is with great pride and pleasure that we present this case from Dr. Kostis and thank you to the patient also for allowing us to do so. He will keep good progress and share with us through to the 12 month mark. Dr. Kostis who himself underwent a hair transplant earlier in the year and has seen very fast and tremendous growth, here also it is good to see that his own patient is following in the same trend! Dr. Kostis has been dedicated to this field for the past 2 years and with close training under world renowned Dr. Bisanga, has himself now earned the right to use the BHR Clinic name and is presenting cases that are already showing the signature tune of Dr. Bisanga himself, fast growth, clean extraction with an educated pattern, a very natural and methodical spreading of the grafts to ensure that not only the right follicular units are used in the hair line, but also, there is a strategic placing throughout the frontal third to give the best illusion for minimal grafts used. Here Dr. Kostis cut the recipient sites that give the depth, direction, density, angulation and overall result that the patient is looking for and with a conservative approach, keeping in mind future loss, was able to cover a significant area with 2950 grafts. In short the result at 5 months is looking good and is already a significant transformation for a patient who is himself a doctor and very happy with how things are going. The best is still yet to come but here is a glimpse of what we will see in the coming months and also the quality, attention to detail, the growth and donor preservation that Dr.Kostis had developed and flourished under the eye of Dr.Bisanga, and indeed in keeping with all of the aspects that we deem important. The patient is not on any medication for hair loss. Graft Breakdown:- 1s 410 = 410 Hairs 2s 1382 = 2764 Hairs 3s 1011 = 3033 Hairs 4s 147 = 588 Hairs Total: 2950/6795 = 2.3 Average Hair per graft. Pre-surgery Placement Comparison Placement Donor At 5 Months 5 Months Donor
  16. Hello Mdc2021, Portugal25 gave you table of really good doctors with very important informations about them. Before my repair HT I spoke with almost all these clinics and doctors (except Dr. Demirsoy, Dr. Bicem, Dr. Maras, Dr. Nedimi and Feller&Bloxham). For me first league are Dr. Couto, Dr. De Freitas, Dr. Lorenzo, Dr. Konior, Dr. Feriduni, Dr. Bisanga, Hasson&Wong and HLC. Best newcomers are Dr. Ferreira and Dra. Vila. It depends how much money do you want to spend and how far do you want to travel. But remember. You (and everyone) have limited donor area. More important than money are grafts. Also estimated number of grafts in your case (3000+) are too many. Rather choose more expensive doctor who needs less number of grafts to achieve optimal result than cheaper who needs more grafts. If I went to the first operation and considered the money, I would choose Dr. De Freitas in Valencia (also Barcelona), Spain. I suppose you have good flight connection from Denmark to Spain. 3,50 eur for first 1000 grafts, 2,50 eur for every next graft, hotel included. If you want to the best, then Dr. Couto. But he doesn´t take new patients now. And if you consider Asmed, please check my story:
  17. In this episode of "Bitesize with Bisanga", Dr. Bisanga discusses the challenges and considerations when performing an FUE procedure on patients who have had previous FUT surgery.
  18. Seems this not anymore rule, that if doctor does 1 patient per day = possible good results, good clinics, i mean about these clinics from Turkey, mostly Istanbul, as many of them started advertise "we do 1 patient per day" , cause read here at HTN few threads about some HT clinics, like if remember "Long hair center" clinics , where at their website they advertise same "our doctor does only 1 surgery per day" , but then saw by same doctor here horrible results, only rule if 1 patient per day = threads with photos pre-op and post-op , by 1 to at least 10th month, when results are best visible, all other are mostly marketing tricks, else really good quality doctors like in manny threads mention dr. Fereira, dr. Bruon, Bisanga, and few more from EU, and maybe 2-3 clinics from Turkey, need be very careful, as in Turkey 90% is marketing tricks, inst, fb posts, no where whole case photos 1-10 months, but fake photos used from who knows websites, etc. , and then it's lottery get in such clinics good results, they sometimes do it good for some youtubers, influencers, to promote them, but mostly they do mass-production, where technicians, nurses do job of surgeon, what's really not acceptable, as no one nurse or tehnician can have skills, feeling as well experienced, educated surgeon as dr. Fereira, as technician most do copy-paste job, they dont use much brain in such jobs, but do what surgeon says, and if surgeon not whole time monitor process, problems happen, as happened in few of cases here members, at dr. Cinic clinics, dr. Erdogan - ASMEG-dr. Koray Erdogan, both they are maybe solid surgeons, but if they are not included in whole process, but mostly only figures who are with big smile on websites, and 5-10 minutes spend with patient, and mostly act as "painters" , and not surgeons, results are questionable... Its just my 2 cents, regarding this matter, after readin many threads here at this great forum, and today registered, to be more active, as im in looking for "good" clinics ... Thanks all of you, brave, friendly, who posted your photos, experiences, and i'm sorry see some members get cheated by some clinics...
  19. HIV status not be a factor in a potential patient's eligibility for a hair transplant, so them denying you saved you some leg work in determining if they are indeed reputable or not. I'm glad you found this forum and that their response sparked you to do more research. As the others mentioned, Dr. Bisanga seems like the way to go based on the options you've narrowed it down to. If you're still unsure, use the list of recommended surgeons on the forum to keep researching and narrowing it all down. Best of luck!
  20. Dear All, I would like to share my experience at the BHR Clinic Brussels. Below my details & caracteristics: - Male- 29 yo- Norwood 3- Treatment Minoxidil (pills) & Saw Palmetto- Density of the donor area - 80/85 cm²- Estimation of the donor capacity 8000 I live in Belgium hence I only had physical consultations with Dr. Lupanzula, Dr. Feriduni & Dr. Bisanga. The 3 of them are in my opinion talented and gifted surgeons. I opted for Dr. B as I had a pretty good feeling with him, we were completely in line with the approach and strategy. A big plus, the clinic is literally 2 kms away from my home. We agreed on recreating the hairline and filling the tempels with an estimation of 1800-2200 grafts. Seen the current circumstances and the fact that I have to work from home this was the ideal time to have the surgery. He had some open slots left still this year so I opted for the 23/11/20. The day of surgery It has already been well explained on the forum how professional Dr B and his crew are, I will quickly go through it. So we had a quick review of the design, we than fully shaved the head and went to the operating room. The injections were the most painful part of the exercise but only lasted for about 5-10 minutes. Dr. B perfoms all the punching and the technicians do the extractions. Secondly Dr B takes care of all the incisions and the technicians the implementation of the grafts. At the end of the surgery I had a little surprise, all the incisions were not filled so we started over and he extracted an additional 150 grafts. I have to say he was a real gentleman on that as those grafts were free of charge. Then finally we went over the rules/recommandations and products I should be using to have an optimal recovery Below the breakdown of the grafts:- 1 FU = 435- 2 FU = 779- 3 FU = 843- 4 FU = 293 . Enjoy the reading, Babou
  21. With the ever increasing demand in FUE surgery, we are fortunate to be able to see some of the most impressive and refined hair restoration results. Unfortunately, we also see more and more poor quality surgery that presents no end of issues for patients. One such issue is the lack of understanding and respect for donor management protocols leaving the patient with an overharvested and depleted donor area. In the following video, Dr. Bisanga breaks down some of the important elements of understanding the donor area and emphasises the need for an in-depth evaluation and an appropriately tailored approach for each patient based on empirical date.
  22. You can see what I did for my temples. Click the Bisanga link in my signature. It was 6 weeks ago so there's nothing to show at this point. But I kinda regret not getting more grafts. I will likely get a mini transplant to fill them in more later next year, perhaps 50-75 grafts... probably by Dr. Mwamba in his Atlanta location.
  23. Thanks guys, I have written down all the HT clinics you recommend. These are: Dr Bisanga, Dr. Bruno Pinto, Dr. Ximena Villa, Dr. Bruno Ferreira, Dr. Lupanzula, Dr. Feriduini, Dr. Rafael De Freitas, Dr. Couto, Dr. Lorenzo, HLC, Dr. Mwamba, Eugenix and HDC off the top of my head. Who is @DrTBarghouthi- can I have a chat with him and get his feedback? What clinic is he a part of? Should I contact Eugenix as well?
  24. In my own journey throughout the years and long before I was in my current role as patient advisor for Dr. Bisanga, I have spent many hours and found incredible value in this very forum. Being able to share frequent patient results from Dr. Bisanga is always a pleasure of mine and knowing that in doing so, it really adds to the essence of the community and can help to show what can be achieved. With that being said, I am very happy to be able to present my own case and give back on a personal level. In all honesty I did not intend to present my surgery photos until 12 months post op when I would have been nearer to my “final result”. This was because as many of you will know this was not my first surgery. I had previous strip surgery in 2012 (not with Dr. Bisanga) and was satisfied with my results at that time, however due to progressive hair loss, this meant that this surgery required "revisiting" the same area which was therefore not virgin scalp in the frontal half. Non virgin scalp means that quality of skin will be less due to making of previous recipient sites and subsequent scarring and this can have an impact on yield, and growth can oftentimes take longer to develop in repair surgery. I knew that I may have to be patient, but fortunately that has not been the case. I had FUE surgery with Dr. Bisanga 5 months ago with the following objectives - *Rebuild my hairline and increase density through the frontal third *Strengthen my temple points (as conservatively as possible) *Reinforce my mid scalp and crown *Place beard grafts into my previous strip scar (if possible) This was a lot to ask in one surgery, especially considering my quality of candidacy. In essence, any patient who is a candidate for hair restoration surgery does not have a “perfect” head of hair, but there are different levels to candidacy from excellent through to borderline and then obviously non candidate. We often seen “hollywood” hairlines achieved on patients with focused loss and what would appear to be a great donor. That certainly isn’t my case and isn the case for many. Challenges of surgery were - *Larger pattern of loss/decline *Retrograde alopecia (Dr. Bisanga explained that it is likely emphasised by my strip closure pulling my nape “higher”) *Average/below donor density *Below average hair groupings *Fine hair *Previous strip scarring Surgery was always going to be challenging in terms of achieving the necessary graft numbers but I was well aware of this and understood that we may not have been able to have achieve all of my objectives. This really highlights how realistic expectations are key. As is my intention with all patients who I have the pleasure to communicate with, education is fundamental. My surgery was scheduled over 2 days and I arrived in Brussels the days prior to my procedure for a thorough consultation using the state of the art equipment and software to allow Dr. Bisanga to assess the current status of my hair and scalp and discuss his approach. Due to using oral minoxidil and finasteride, I was very pleased to hear that my donor was stable and without any signs of miniaturisation throughout. I discontinued meds several years back and lost quite a lot of ground at that time. At 38 years of age, I wasn’t looking to lower my hairline at all despite it sitting high at over 8.5cm+ from the glabella. I really wanted to proceed as conservatively as possible in order to preserve as many grafts and achieve as much coverage as possible with an appropriate hairline as I age and inline with the shape of my face and considering my hair characteristics and donor specifics. One concern that Dr. Bisanga did have was some potential scarring on my scalp. Dr. Bisanga wanted to rule out any possible concerns such as scarring alopecia and decided to take a “punch” biopsy to remove a small tissue sample to be sent to the lab for testing. This then required a few stitches which were removed several days later. You can see the stitches in the post operative images and actually as this area did not receive any grafts to allow and encourage optimal healing, you can actually make out a weaker area in my recent photographs. Fortunately my biopsy result came back without concern and without the presence of inflammation or scarring alopecia. Surgery days went very smoothly as expected and after assisting many patients over the last years throughout their journey, it felt great to be taking my place in the chair. Dr. Bisanga explained that I had tough skin and I was burning through anaesthetic which meant the need for more numbing, but he reported easy harvesting despite my follicles sitting quite deep in my donor. We didn’t want to push too heavily or aggressively on my donor as my hair is fine and we didn’t want to further expose my strip, and as with all of us, loss is progressive and being conscious of this it was agreed that we would harvest approximately 2400 from the scalp with further supplementation from my beard using it to great effect in placing into my mid scalp and crown. As expected, all of my beard grafts represented single hairs and due to this being my first beard session, it was decided not to push far beyond 1000 grafts to allow a good distribution in terms of extraction sites and ensure optimal healing. With this being the approach, I was always going to fall slightly short in terms of placing grafts throughout my entire previous strip scar, and so therefore it was decided that we would commit to one side of the scar (approximately 260 - 300 grafts) which was still a bonus. Not the standard approach but in my case, it presented a great opportunity to be able to see yield throughout my scar tissue and at a later date, be able to return for further surgery, shave down and really understand and present what beard into strip scars can achieve by comparing both sides. Healing was very straightforward. I am obviously well versed in our post op care but instructions are simple and all products are provided in the post operative kit and despite a few initial “uncomfortable nights” as expected, recovery was generally quite quick. In fact, I was working and responded to patients in the evening on my surgery days. Being completely transparent, I was in no way expecting such early growth. Especially as despite a significant graft count, hair count with beard was lower and this was placed over a larger surface area, therefore I was/am extremely pleased to see density come in so quickly. Even now, improvement continues and I have several months to go. I am absolutely thrilled and not having to think twice about your hair when you wake in the morning really does have an impact on your day to day life and not having to worry regarding product and styling etc is a game changer. A big thank you to Dr. B and his team of amazing technicians and a shout out to all my colleagues at BHR who have shown their support. It is a special clinic and one that I am very proud to be part of. On a personal level, I genuinely get great satisfaction from supporting patients on their journeys and am thrilled to see their response and how their confidence grows and impacts many facets of their lives. I can honestly say that it has been a hugely positive experience and my results at this early stage speak for themselves and I couldn’t be happier. Many other patients have taken similar steps in their own hair restoration surgery and I remember the first forum case that I read some 15+ years ago. It was overwhelming, daunting, interesting and very exciting to see that there is hope, and there will be individuals who are reading cases today for the first time. Such communities are integral in the journey of many patients, it certainly was mine and I felt it important to continue to pay it forward and support the community. — BHR Clinic Dr. Christian BISANGA Technique: FUE Donor density: 70/70 FUs/cm2 Breakdown of grafts:- 2366 Scalp Grafts + 1100 Beard Grafts (Single hair) 1s - 1714 2s - 1341 3s - 411 Total Grafts :- 3466 Total Hairs :-5629 Average Follicular Unit (Scalp) = 1,91 hairs Average Follicular Unit (Scalp + beard) :- 1.62 hairs PRE SURGERY FRONT TOP ELEVATION PRE SURGERY RIGHT PRE SURGERY LEFT PRE SURGERY REAR PLACING LEFT VIEW PLACING RIGHT VIEW PLACING WITH BIOPSY DONOR REAR DONOR LEFT DONOR BEARD ] 5 MONTHS POST SURGERY LEFT 5 MONTHS RIGHT 5 MONTHS TOP 5 MONTHS REAR DONOR COMPARISON 5 MONTHS
  25. They are easy to open. I have got mine as well from Dr. Bisanga... I open them, remove more or less 2.5mg and close them. 5mg was giving me chest pain. So far with 2.5mg I'm doing ok. I just finished one box, so that's 3 months. Not sure if I can see any improvement.
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