Temporal point looks very unnatural after FUE - advice needed

[thelook]

Hello dear community members!

 

I have had a 2500 grafts FUE with Dr. Bisanga in 2015.

While the frontal hairline looks really nice and natural, I am very unsatisfied with the right temporal point.

 

There are two reasons for this:

1) The transplanted grafts are very strong. There are multiple 2 and 3 multi grafts, resulting in a unnatural look.

2) The hair direction is rather horizontal, very unlike the hair behind the transplanted area, which is more vertical.

 

I would like to have this area restored, as I really dislike the unnatural look.

 

Question is: What is the best way to restore the temporal point? :confused:

 

Should the unnatural looking multi grafts be extracted or should additional grafts be transplanted into the surrounding area?

Has anyone had an an experience like this and which restoration clinics can be recommended?

 

I'm thankful for any advice!

 

Best regards

[thelook]

One more thing:

 

As I learned after my HT (BHR, Belgium), the incisions in one area have been made on day 1, whereas the grafts haven't been harvested and planted until day 2.

This area is located above the temporal peak (see picture), and approximatley 1 - 2 quarters large.

 

This resulted in very low hair density in this area, which has been a further disappointment.

 

Consequently, I can only recommend insisting that all slits will be filled with grafts right away. Otherwise valuable donor material will be wasted.

 

I was really disappointed and shocked, that the so well known and decorated Dr. Bisanga did such an unprofessional job in my case! :mad:

Edited November 22, 2016 by thelook

[Melvin- Admin]

Dr. Bisanga did the temporal peaks? I've got to be honest this is really poor work, the angles are wrong it's too abrupt and harsh, if Dr. Bisanga did this work what did he say about this result? IMO some of those grafts may have to be removed via FUE, however you may get some scarring, as a recommended physician I believe the moderators of this site should contact Dr. Bisanga to get his input on your case.

[mikeyhwk]

First the positive the hairline looks great!

 

but I agree the peak looks odd and goes against the direction of the natural hair. I can't imagine them doing the slits one day and then doing the graft extraction and implantation another day. That wasn't how the office worked when I got my work done. It was all done in stages. Extraction, slit, implantation, then on to the next section and it starts again. What did the clinic have to say about this result and why they operated in that fashion?

[densedream]

I'm dealing with a similar situation. I think temple points are extremely difficult to get right for almost all doctors. That's why many top doctors don't even perform it. I would advise people to skip the temples unless their doctor has lots of photo evidence and skill in performing this skill.

[hsrp10]

I'm almost in shock that the temple points were done by Dr. Bisanga, based on his reputation and also great personal experience with him for both temple corners and most recently temple point work.

 

I was there in the chair in Belgium couple months ago for right side temple point work which is growing nicely now. *Although Dr. Konior had previously placed a few there before which likely provided direction on hair angle etc.

 

I think this was the cause, did you have a mega session done? Also do you remember which tech did the graft placement? (male or female) Hope you can get this repaired !

 

As I learned after my HT (Dr. Bisanga, Belgium), the incisions in one area have been made on day 1, whereas the grafts haven't been harvested and planted until day 2.

 

This resulted in very low hair density in this area, which has been a further disappointment.

[Sean]

Concur that the temple peaks look unnatural. Hopefully, the doc does you right by helping you get it fixed. I hope the mods can elicit a response on your behalf.

 

Wouldn't extracting grafts cause further damage? Can they be lasered instead?

[BaldingBogger]

I must also say I am shocked at this. The work I have seen from Dr Bisanga has generally all been of a good standard. With the occasion sub par result of course most clinics have.

 

I would be very interested to the clinics explanation on this as to how this could have happened?

 

Are they recent pics of your temples? And when did you have the work done?

Those temple pics look like they belong in the ugly duckling stage. Not good

[BHRClinic]

Dear thelook,

 

Apologies for the delay in replying, but due to you having an advisor from another country it took time just to get the information on your case as I myself have had no input and wasn't aware of your case so needed assistance from your respective advisor for your country. I believe also this is on another international forum but will reply myself here and your advisor on the other one for your country.

 

Firstly sorry you are not happy with the temples and we will address that also in this post and I hear you were happy with how the hair line came but of course we wish to have a content patient.

 

We believe your advisor has been in touch with you and that you had a very recent personal consultation with Dr.Bisanga and also a second surgery booked for next month.

 

As I am aware the concern on the temples was addressed then also and a touch up offered and I believe your advisor has had pretty extensive communication with you also with regards to addressing anything needed in terms of additional grafts.

 

Your surgery was over two days, the doctor will traditionally make the recipient sites for the day 1 needed. At times he will need to cut more again for the graft amount for the day if more are needed and conversely there could be more cut in anticipation of placing on day 1 but that may not be used and this is common also, there will be a margin of difference either way.

 

Pictures of the procedure show that grafts were placed on Day 1 on that area.

 

Day 2 more grafts are punched, more recipient sites are cut and older ones re-opened that were not used. I have had multiple surgeries myself and this was also the case for me also and it is a simple matter of them being opened for placement as they will close naturally.

 

This has no effect on the donor and no wasting of grafts, so please be assured of that. The same amount of grafts and sites are cut but as said there can be some from day 1 that need opening again.

 

The hair is coarse and shorter there and transplanted hairs can come in coarser and darker and more wirey and will take time to cycle and refine and it can be less of an issue on a hair line or elsewhere but more of an issue on temples and for some as said this is the case while the transplanted hair softens. When short the hair will also have a curl and can be wirey and go in several directions naturally, aside from the angles and direction of the transplant. Time is needed for it to relax but it can be an issue while doing so.

 

That said, when Dr.B saw you he acknowledged we need to soften the temples and add density and he will put also some grey hairs there to help in this effect and add as needed free of charge but he did acknowledge a touch up would be needed and I believe this was agreed and surgery planned now in the next month.

 

Any other questions feel free to contact your advisor who will be happy to assist and sorry for any inconvenience caused but rest assured we will do what it takes to make the temples perfect for you as agreed prior and your advisor also will be proactively in contact to confirm anything needed and to answer any further concerns you may have.

 

Kind regards,

[thelook]

Hello guys, thank you for your responses!

And densedream, sorry to hear you're dealing with a similar situation.

 

It helps a lot hearing your honest opinion, I appreciate it a lot!

 

My HT in Brussels was in July 2015.

From my understanding it was not a mega session, as there were 'only' around 2500 grafts placed, however in different regions (front, temples, beard).

 

Placing of the grafts has been done by two female assisstants. Left side was done by a young French woman, right side by an Asian looking woman.

That I remember well, as they were working on my head for several hours.

 

The side shots in my first post are from October 2016, which is around 15 months post op. The shot where you can see more of my forehead is from mid 2016.

 

Concerning your questions:

 

To tell the truth, my BHR consultant did not recognize my problem for a long time at all.

When pointing to the unnatural temporal peak I remember him writing, that he can not see anything unnatural (in German that was, as I live in Europe).

 

The same thing happened with the unplanted slit area: I only discovered this by coincidence, as I was looking at old post-op pictures, wondering about the very low local hair density in that specific area.

The cosultants response was, that Dr. Bisanga does not work this way and this can not be correct.

 

As a result, I was waiting and hoping the hair would get better, which it did not.

In addition, it has not been easy for me to build an opinion, as I was not speaking to anyone about my transplant except my BHR consultant.

 

This is actually my main motivation to post this here: getting advice on my current status from a neutral source and the best way to achieve a fully satisfying result.

 

I have to say, that after my first procedure I have been at the BHR clinic in mid 2016, however, a clear an honest statement, that the result is not what it was supposed to be, has not been made.

 

Dr. Bisanga did however offer a follow up HT, in which my concerns were supposed to be met.

For this second procedure a discounted charge has been offered. (I think it was 4,5 instead of 5 Euro per graft or something like that, and 5 instead of 6 Euro for beard hair)

 

To the English BHR Consultant:

Thank you for your caring and detailled response!

 

While I appreciate what you have written, I disagree on what you have written about planting slits.

 

I believe that it very well makes a difference if the grafts are planted right away or the next day, as the slit (=wound) starts the healing process right away. Re-opening it the next day is just an unnecessary second incision creating further stress and a lower growth ratio.

While not being an expert on this, I have proof for my theory on my head.

 

Also, from the picture, the not planted slit area is maybe the size of a quarter and a half. So it's not like there have been only 'few' incisions reopened.

 

Like I mentioned earlier, when it comes to me, a lot of trust in your procedures and your expertise has been lost.

 

Further, I believe it is better to admit to a mistake once it has happened, than just say that it doesn't really matter and everything will be fine.

Then again, that's just my personal opinion.

[Melvin- Admin]

Thelook the temporal peaks were transplanted on July 2015 correct? If so that means that it has been nearly 18 months. I don't think the results will improve, this work IMHO needs to be either refunded or redone free of charge, I respect Dr. Bisanga and considered going to him myself, but looking at this result objectively with no bias it is a poor result, typically it takes 18 months for hair to fully mature and any frizz to settle. At this point it has been nearly 18 months if your temporal peaks don't look any different then I doubt they ever will. I hope you can reach an amicable solution with the clinic.

 

I've heard of other clinics creating recipient sites first but it's not very common, I do feel there could potentially be some issues especially if the sites have begun to heal, perhaps the slits can become to small for the grafts causing the grafts to die, I don't know I'm no doctor but it seems like a logical possibility, would like to hear the opinion of some doctors on this.

[thelook]

The transplantation was in July 2015, correct. I also doubt that my situation will improve anymore, hence the desired repair procedure.

A touch up for the temporal area has been indeed offered by BHR clinic, however, I would not want to take that risk at the moment.

I would rather look for a true expert in this field, even if it takes some time.

 

When it comes to Dr. Bisanga, however, let me say this, based on my personal experience:

His work on the frontal hairline is close to perfect. I am very pleased with the result in this area.

Transplanted beard hair looks good as well.

 

Even the left temporal peak has been done quite well. The only real big disappointment was the right temporal peak.

 

So, from my understanding, temporal peak restoration may just not be Dr. B's strong side, but this does not mean, that he isn't a good doctor.

On a personal level, I think Dr. Bisanga is a very respectful and decent individual.

[hsrp10]

Very glad they are backing up their work as expected!

And I hope it all works out for the best for you.

 

I think Dr. Konior and Dr. Lorenzo (if you can get an appointment with them which is the tricky part..) do very immaculate temple point work, and I've also seen some nice temple corner restoration work from ASMED (Dr. Erdogan). If you're looking to go with another clinic for repair.

Even the left temporal peak has been done quite well. The only real big disappointment was the right temporal peak.

It is my belief and gut feeling from looking at the result that the tech who transplanted the right temple peak was inexperienced at how to place grafts in this area. Hope BHR also corrects this.

[TakingThePlunge]

BHRClinic,

 

Thank you for taking the time to respond to thelook's concerns. From his comments, it's clear that he's very happy with the hairline and that even one of the temporal points looks just fine. However, the one he is concerned about certainly has an unnatural appearance and requires revision.

 

As every here has acknowledged, Dr. Bisanga has a stellar reputation not only for his excellent work but his dedication to patient care and satisfaction. I'm sure he'll do everything in his power to ensure a happy outcome.

 

Regarding the issue of premaking recipient sites, I wanted to point out that this is not so unusual. Both Shapiro Medical and Dr. Bernstein have discussed the benefit of making slits the day before surgery due to the benefits of reduced bleeding, higher visibility, faster healing and a lower incidence of graft"popping". Anyone interested in more information on this can check out the following resources...

 

What Are The Benefits Of Pre-making Recipient Sites For Hair Transplants? - Dr. Bernstein

 

What Are the Benefits of Pre-Making FUE Hair Transplant Recipient Site Incisions? - Shapiro Medical

 

"thelook", please keep us updated on your case. Overall you had an excellent outcome. This temporal point issue should be a simple fix for Dr. Bisanga.

[BHRClinic]

Dear thelook,

 

Thank you for the reply and honesty.

 

Dr.B has assured me he can fix the temple.

 

The hair line and other temple I believe you are happy with and he has said to me personally he can touch up and deal with this area.

 

That said, if you do not wish to come back and as you say have not the trust to do so then we ourselves understand and sorry that this may be the case for you and will stand by any decision you make.‎

 

In any event please let your wishes be known to your advisor who can liaise with the clinic ‎and settle one way or the other for you.

 

All the best.

[Carbolic]

Hello dear community members!

 

I have had a 2500 grafts FUE with Dr. Bisanga in 2015.

While the frontal hairline looks really nice and natural, I am very unsatisfied with the right temporal point.

 

There are two reasons for this:

1) The transplanted grafts are very strong. There are multiple 2 and 3 multi grafts, resulting in a unnatural look.

2) The hair direction is rather horizontal, very unlike the hair behind the transplanted area, which is more vertical.

 

I would like to have this area restored, as I really dislike the unnatural look.

 

Question is: What is the best way to restore the temporal point? :confused:

 

Should the unnatural looking multi grafts be extracted or should additional grafts be transplanted into the surrounding area?

Has anyone had an an experience like this and which restoration clinics can be recommended?

 

I'm thankful for any advice!

 

Best regards

 

 

 

Sorry to hear of your disappointment. I am sure BHR and Dr B will do everything they can to improve the situation and ensure you are satisfied with your results.

 

I have always found Dr B to be a gentleman with genuine integrity to be of the highest calibre. So I would not worry.

 

Out of interest, which technician carried out the work to your right side?

[GuyFromTheUK]

left side and the rest looks good; very very poor result on the right; would really like to know what went wrong, a little worrying :confused:

[thelook]

I'd like to thank everyone for your helpful advice!

 

I've been thinking a lot the last couple of days. Mostly on how to repair the poor temporal peak on the right, and also if I should visit Dr. Bisanga a second time.

 

Here's what I came up with:

I will be having a second procedure at the BHR clinic indeed!

 

That being said, let me explain my goals and motivation for the second transplant:

 

I'd like to improve the density of my hairline, which is good but not perfect.

Especially the area on the right side could use some additional grafts in order to look fully satisfying.

 

Also, I'd like to have the mistreated area (where the slits have been planted the following day) repaired, which looks very poor at the moment.

 

I believe that Dr. Bisanga is capable of achieving these goals.

 

When it comes to the right temporal peak, I am not so sure.

I will certainly hear what solution Dr. Bisanga will suggest, however, I will not accept any further work in this area, unless I'm a 100% convinced.

 

At the moment I am thinking of at least extracting some of the ridiculous looking triple grafts from that area.

This way the temporal peak would look a little softer. Additionally, I could get a follow up procedure only addressing this area, from an expert on this field.

 

I've attached a couple pictures, two of them taken directly after my first transplant at BHR, the rest showing my current status.

 

I'm excited about your opinion!

[thelook]

Carbolic, you were asking about the technician, working on my right side.

It was a female assisstant of Asian decent.

 

I remember her well as she 'accidentally' started shaving off the rest of my hair on the second day, which I specifically asked not to do.

By the time I realized what was going on, it was too late. :mad:

Edited December 13, 2016 by thelook

[hsrp10]

Hope the second procedure works out and the community thanks you for naming the tech.

Helping other patients avoid the same mistakes and pitfalls is what this site is all about.

[harryforreal]

... typically it takes 18 months for hair to fully mature and any frizz to settle. At this point it has been nearly 18 months if your temporal peaks don't look any different then I doubt they ever will.

 

Frizz? What about the fact that the hair is much blacker than the native hair? This is my main concern. Is it blacker because it comes from a different area of the scalp? Or because the transplant process actually changes the hair?

 

The thing is this: what difference does it make to add further density if transplanting hairs actually permanently changes the both the thickness and color of the hair follicle?

 

The mantra is always, "Add more density!!!" "More density and it will blend better!!!" "More density and you won't notice the doubles and triples!!!"

 

But if the hair shaft permanently changes color and becomes permanently thicker in diameter (and we're talking 18 + months here), how does adding MORE thick, black hair at the hairline help to soften the hairline and make it appear more natural when it doesn't match the surrounding hairs?

 

I'm at 5 years, and the hairs are thicker and darker. How long for the hair to "cycle"???

 

I should add I actually have looked very closely at Dr. Bisanga's hairlines and considered approaching his clinic for improvement to my own transplant. But in the end, I'm not sure it's an issue of surgeon's technique as much as a simple impossibility with regard to matching hair color and diameter.

 

Sometimes I wonder if there is more blood supply at the front of the head, and if it's "feeding" these hairs "super" nutrients and making them grow "BIG and STRONG, THICKER and therefore DARKER". Does thicker hair caliber result in darker hair color?

 

I swear these hairs at the front of my hairline are thicker and darker than any native hairs anywhere else on my head.

 

What do you think, TheLook? Are these hairs in your temple darker and thicker than any native hairs on the back of your head? Or do you think they are the same as the hairs on the back of your head, but because they have been moved to the front, the contrast between the front native hairs and back native hairs makes them stand out?

 

Either way, it seems to me that making transplanted hairs from the back match native hairs in the front is quite possibly a technical limitation. Obviously, transplanted hairs can grow; but it doesn't mean it looks natural.

[harryforreal]

The hair is coarse and shorter there and transplanted hairs can come in coarser and darker and more wirey and will take time to cycle and refine and it can be less of an issue on a hair line or elsewhere but more of an issue on temples and for some as said this is the case while the transplanted hair softens. When short the hair will also have a curl and can be wirey and go in several directions naturally, aside from the angles and direction of the transplant. Time is needed for it to relax but it can be an issue while doing so.

 

I would like the BHR clinic representative to respond to my question above, if possible. I just wonder about the ability to make transplanted hairs really match the softer, native hairs in the front. Je suis frequentement en Europe, et j'ai pensee de venir au clinic BHR avant. Mais...s'il n'est pas possible de fabriquer, de creer un similarite entre les deux, je ne vois pas un raison d'arreter chez vous.

[aWidowsPeek]

Sorry if it's already been asked but did Bisanga use blades or implanter pens?

[Sam23]

Softenning the hairline is really an issue in hair transplant that no doctor so far give true picture about it

 

Only said using one hair graft would be enough which is not true

[johnsmith20172017]

I would like the BHR clinic representative to respond to my question above, if possible. I just wonder about the ability to make transplanted hairs really match the softer, native hairs in the front. Je suis frequentement en Europe, et j'ai pensee de venir au clinic BHR avant. Mais...s'il n'est pas possible de fabriquer, de creer un similarite entre les deux, je ne vois pas un raison d'arreter chez vous.

 

Dr Umar uses nape and leg hair to soften hair in the hairline. He brings it forward slightly too.