'Making a Hairline' - Dr De Reys, 2700 Grafts FUE

[NickBaron]

Gentlemen and Ladies,

 

My name is Nicholas Baron and I work for Dr De Reys.

 

We are privileged to have been invited for recommendation by this forum and on behalf of the doctor, I will be presenting a number of patient cases in the weeks to come for your attention.

 

Introduction

 

Before I start, I'd like to say thank you to Bill Seemiller who has been our liaison up to now.

 

Although the Doctor has not had much truck with forums in the past, we, at the clinic, are agreed that HRN is the one we wish to list on because it is run in an independent and fair manner, balancing patient discussion with the surgeon's views as well. It provides valuable information for everyone.

 

I would like to state that I have no medical training and so please do not read my words as those of a medical professional.

 

I have worked with Dr De Reys for many years and if you come to us then, in the first instance, you will be speaking to me.

 

I am also always available after the operations at any stage, whether it be two days, one month or ten years, if you have questions.

 

I will try my best to answer any questions you have here on the forum and will refer them to the doctor where necessary although referral may take time since Dr De Reys is often in surgery. I may not be able to answer all of your questions and I apologise now for those I do not have time to answer.

 

The Hairline: Technique

 

We have chosen to focus on the topic of the hair line with our first patient.

 

Dr De Reys' technique involves the use of a manual punch. He has a range of punches although he generally uses a 0.75mm punch most often.

 

The punch size changes depending on the size of the hair grafts that each patient naturally has. Curly hair types, for example, may need a larger punch size.

 

The doctor only uses a manual punch and never uses a drill.

 

This is because he can get a 'feeling' for the actual hair follicles themselves as he is extracting a graft.

 

To explain further, it is important that the sheath around the follicle is intact when it is extracted. By using a manual punch, Dr De Reys can actually 'feel' the sheath as he is extracting and, in this way, he can make micro-adjustments whilst extracting to ensure that the hair follicle is extracted whole.

 

By doing so, he reduces the risk of accidentally cutting a graft in two. Since almost every graft is extracted whole, this improves the final growth rate.

 

Dr De Reys can extract grafts with either a single hair or multiple hairs using this technique.

 

For the hairline, only single-hair grafts are used.

 

The Hairline: Philosophy

 

Dr De Reys does not believe in so-called 'Brad Pitt' hairlines. He is always concerned that patients do not waste grafts. There are three reasons for this approach.

 

Firstly, the number of grafts available in the scalp is always finite.

 

Using too many grafts for a relatively minor operation will prevent you from having the option to use those grafts later down the line once your hair-loss progresses.

 

This is the main reason: to conserve grafts for future procedures.

 

Male pattern baldness is almost always progressive with hair loss starting in your twenties, increasing at 40 and then thinning out much more over 45. For this reason, the doctor avoids using too many grafts as many of our patients return for more grafts as they age.

 

You can hold back hair loss using medications such as Finasteride however if, you wish to stop taking Finasteride for any reason (starting a family, for example), then your hair loss continues from where it left off. Dr De Reys has written a guidance note on Finasteride which I will publish in a future post.

 

The second reason to avoid using too many grafts is the risk of shock loss.

 

If grafts are placed too close together then the blood supply to existing hairs can be affected.

 

This causes existing hairs to fall out.

 

Although shock loss is always temporary, if it happens, it can be uncomfortable for the patient in the first month.

 

Avoiding shock loss is down to the skill of the surgeon at making incisions.

 

For this reason, Dr De Reys performs every single incision for every single patient himself.

 

He has never used technicians with no medical training to perform this key task. He makes every single incision himself.

 

The third reason to avoid using too many grafts is that it looks unnatural.

 

A high density of hair looks normal when you are young however as you age, it starts to look unusual.

 

Low hairlines over 50 look especially odd and for this reason, Dr De Reys is keen to avoid patients having to face questions about whether or not their hair is real once it becomes clear that their hair loss is not following the common sequence of male pattern baldness.

 

Patient Case 1: 2700 Grafts FUE

 

FUE performed on a 36 year-old patient whose temples had receded and whose frontal third had thinned. Hair loss had been stable for three years and had remained at a similar level to the patient's father. The patient's grandfather was a Norwood 2/3.

 

Treatment plan:

 

2700 grafts were implanted over a two-day operation.

 

For the hairline around 60 Grafts/cm? and behind the hairline 35-40 Grafts/cm?.

 

Day 1: 1300 Grafts

Day 2: 1400 Grafts

 

The hairline was restored first using single-hair grafts placed in two, densely-packed rows. The frontal third was densified on the second day using multi-hair grafts that had been extracted using Dr De Reys' manual extraction technique.

 

All grafts were stored using HyperThermosol.

 

The patient was very happy with the result and growth was strong. The hairline result shown below was at three months. We have asked the patient for more pictures.

 

The patient does not take Finasteride and started use of Regaine Foam only after the three month photos were taken.

 

Patient Photos

 

Preop

 

 

 

 

 

14 Days Postop

 

 

 

 

 

 

3 months Postop - hairline

 

 

 

 

 

 

3 months Postop - donor

 

 

 

 

[TakingThePlunge]

Beautifully designed. Well done!

[Mickey85]

Great to see Dr De Reys posting results on here for potential recommendation. I look forward to viewing them.

[Sean]

"He has never used technicians with no medical training to perform this key task. He makes every single incision himself.'

 

Are you referring to donor extractions as well, or just recipient site incisions?

 

Bravo to the doctor and clinic. Instead of using motorized power drills, multiple patients per day, you try to maximize graft yield for a patient via manual fue in a two day surgery for the patient if needed. I think it can be concluded that this trait is very rare amongst most FUE surgeons today. It is like you truly personalize the surgery for your individual patient and do it nice and steady.

 

Based on what you presented, I liked how you positioned this persons temple corners, they are not "C" shaped nor at sharp 45 degree angles, to create more natural grounded facially framed look. The hairline looks uniform without any differing elevation on one side versus the other. the grafts look well placed and refine and truly looks like you were careful about working around native hairs. The donor looks quite decent.

 

OP, I also liked the fact you are not making irrelevant doctor like advice and controversially unproven medical recommendations as a person that is just working at the clinic, as you clearly stated you are not a medical professional.

 

What are Dr. De Reys current fue rates, pricing?

 

Based on donor, how many grafts would this patient have remaining for future use, that's if he needs a restoration for other parts of scalp in future?

 

Please do keep us posted with the final outcome.

[Blake Bloxham]

Nick,

 

Beautiful work and excellent presentation! Look forward to seeing more from the clinic. Nicely done!

[Rawkerboi]

Very neat work and good presentation! Looking forward for final outcome!

Keep us updated!

[NickBaron]

Dear Sean,

 

Thanks for your questions. I will answer them one by one.

 

Question 1: . ""He has never used technicians with no medical training to perform this key task. He makes every single incision himself.' Are you referring to donor extractions as well, or just recipient site incisions?"

 

I am referring to both although it's worth bearing in mind that the extraction process itself is a two-step procedure.

 

First the punch is used to release the hair follicle. Many follicles are released in this stage.

 

In the next stage, the newly released follicles are 'harvested' and then placed immediately into the HyperThermosol solution to preserve them.

 

The 'releasing' stage with the punch involves making an incision into the skin.

 

This is entirely performed by Dr De Reys. Every single punch is made by the doctor himself.

 

The harvesting stage is performed by the doctor and his staff together. Having two persons harvesting at the same time minimises the time that the grafts may be out of the body and so prevents any loss of grafts.

 

I hope that makes it clear.

 

In addition, the actual incisions that are made in the scalp with a scalpel before placement are also done by the doctor himself.

 

So to sum up, every single incision as well as every single punch for every single patient is always done by Dr De Reys personally.

 

Question 2: It is like you truly personalize the surgery for your individual patient and do it nice and steady?

 

Yes, this is true. Dr De Reys would rather take an extra day to complete the surgery properly.

 

For this reason, he often takes three days to perform a 3000 graft FUE as he does not like to rush procedures.

 

This does mean that Dr De Reys does not operate on as many patients as some other clinics do however we see this as an advantage because it guarantees better quality.

 

Dr De Reys has transplanted well over 1.5 million grafts in the last few years.

 

Question 3: What are Dr. De Reys current fue rates, pricing?

 

At this stage of the recommendation process, I am not allowed to provide you with this information publicly. You are welcome to private message me for more information.

 

Question 4: Based on donor, how many grafts would this patient have remaining for future use, that's if he needs a restoration for other parts of scalp in future?

 

I will refer this question to the Doctor. Please be patient with his answer because the Doctor is usually very busy with surgery.

 

If you have any more questions then please feel free to let me know.

 

Kind regards,

 

Nick

 

 

"He has never used technicians with no medical training to perform this key task. He makes every single incision himself.'

 

Are you referring to donor extractions as well, or just recipient site incisions?

 

Bravo to the doctor and clinic. Instead of using motorized power drills, multiple patients per day, you try to maximize graft yield for a patient via manual fue in a two day surgery for the patient if needed. I think it can be concluded that this trait is very rare amongst most FUE surgeons today. It is like you truly personalize the surgery for your individual patient and do it nice and steady.

 

Based on what you presented, I liked how you positioned this persons temple corners, they are not "C" shaped nor at sharp 45 degree angles, to create more natural grounded facially framed look. The hairline looks uniform without any differing elevation on one side versus the other. the grafts look well placed and refine and truly looks like you were careful about working around native hairs. The donor looks quite decent.

 

OP, I also liked the fact you are not making irrelevant doctor like advice and controversially unproven medical recommendations as a person that is just working at the clinic, as you clearly stated you are not a medical professional.

 

What are Dr. De Reys current fue rates, pricing?

 

Based on donor, how many grafts would this patient have remaining for future use, that's if he needs a restoration for other parts of scalp in future?

 

Please do keep us posted with the final outcome.

[Sean]

Dear Sean,

 

Thanks for your questions. I will answer them one by one.

 

Question 1: . ""He has never used technicians with no medical training to perform this key task. He makes every single incision himself.' Are you referring to donor extractions as well, or just recipient site incisions?"

 

I am referring to both although it's worth bearing in mind that the extraction process itself is a two-step procedure.

 

First the punch is used to release the hair follicle. Many follicles are released in this stage.

 

In the next stage, the newly released follicles are 'harvested' and then placed immediately into the HyperThermosol solution to preserve them.

 

The 'releasing' stage with the punch involves making an incision into the skin.

 

This is entirely performed by Dr De Reys. Every single punch is made by the doctor himself.

 

The harvesting stage is performed by the doctor and his staff together. Having two persons harvesting at the same time minimises the time that the grafts may be out of the body and so prevents any loss of grafts.

 

I hope that makes it clear.

 

In addition, the actual incisions that are made in the scalp with a scalpel before placement are also done by the doctor himself.

 

So to sum up, every single incision as well as every single punch for every single patient is always done by Dr De Reys personally.

 

Question 2: It is like you truly personalize the surgery for your individual patient and do it nice and steady?

 

Yes, this is true. Dr De Reys would rather take an extra day to complete the surgery properly.

 

For this reason, he often takes three days to perform a 3000 graft FUE as he does not like to rush procedures.

 

This does mean that Dr De Reys does not operate on as many patients as some other clinics do however we see this as an advantage because it guarantees better quality.

 

Dr De Reys has transplanted well over 1.5 million grafts in the last few years.

 

Question 3: What are Dr. De Reys current fue rates, pricing?

 

At this stage of the recommendation process, I am not allowed to provide you with this information publicly. You are welcome to private message me for more information.

 

Question 4: Based on donor, how many grafts would this patient have remaining for future use, that's if he needs a restoration for other parts of scalp in future?

 

I will refer this question to the Doctor. Please be patient with his answer because the Doctor is usually very busy with surgery.

 

If you have any more questions then please feel free to let me know.

 

Kind regards,

 

Nick

 

From what you wrote, this is what I gather. Seems like this clinic is truly about patient safety, where doctor does basically all of the FUE work. The work truly looks ultra refined. This clinic also takes it time and actually personalizes and caters to one patient at a time, for even three days if they have to. Seems like your process maximizes yield and reduces wastage of valuable patient donor grafts. You do not use techs to extract and so forth, as techs have varying years of experience, come and go, and are not doctors (especially when it comes to FUE extraction). You do fue strictly by manual extraction versus power drills and other systems. Not many, if any, fue clinics in North America operate this way. This is what I call consumer safety and protection/security of a FUE patient. This shows a higher level of business ethics. This is the type of FUE doctor forums should recommend as he truly meets the standards of recommendation. Hard work pays off, and by looking at your yield in patient results consisting of higher norwood levels, it shows. Recommending a doctor is all about consumer security, patient protection and this doc defines it. A person gets their money's worth at lower rates. Your clinic is setting the right standard. You have described your response and surgical process eloquently. I can't believe you werent recommended when William posted his results. It is only now a forum has picked up and considered recommending you.

 

Do you have any results showcasing dense hairlines and temporal work?

How would you categorize your yield rates on most of your fue patients?

Do you ever utilize beard or body hair for transplantation?

Do you work on repair patients?

What punch sizes do you use?

[hairweare]

A doctor who performs FUE exclusively and controls all aspects of the FUE procedure with years of experience should be on anyone's short list who seriously considering a HT. That his rates are more than competitive and that he is centrally located in Europe are big pluses as well.

[Lateatnight]

Hi Nick,

how many patients the Doctor does at the same time per day?

Are there more than 1 surgery room?

Any nurse or tech involved?

 

Amazing work that in the picture, look forward to see more from Dr De Reys.

Thanks in advance

[Questionmark]

Does the clinic intend to regularly showcase results? This was what had been announced if I comprehend it correctly from the first post of "Nickbaron": "We are privileged to have been invited for recommendation by this forum and on behalf of the doctor, I will be presenting a number of patient cases in the weeks to come for your attention."

 

Now the "weeks to come" have come and gone. When do we we get to see a representative amount of results, so we can evaluate the quality of the recent work of Dr. deReys? I am active on the german forum Alopezie.de for years now, and he had a very good reputation, but in the last two years lost this due to several members had subpar results, and as far as I know none with a good, or even as good result to qualify the surgeon to be amongst the worlds elite club the HRN recommendation represents.

 

Surgeons on this site usually provide results over many many months before even being discussed for recommendation, beside numerous patients own threads over years.

 

So thank you for providing a considerable and meaningful amount of recent material which shows not beds to rest on and chairs to sit on, but results results results. As this is what counts in the end.

[wibbles180]

I too would like to see more of the doctors work as I would certainly add him to my short list if I could see some more of his work ideally videos like are provided by lorenzo and erdogan .

What are people's thoughts on the 2 step method explained by nick. Where the follicles are all punched and then extracted after versus erdogans/lorenzo one step method ?

[microman]

yes, i too would like to see more of dr de reys work on the site.