3382 grafts - Lupanzula

[KO]

I wanted to share my recent experience with Dr Lupanzula in Brussels. I've benefited a lot from reading people's experiences and watching their surgeries mature over the years before choosing to take the plunge, and in turn I hope somebody will find mine helpful. Thank you to Dr Lupanzula and team, and I want to give a shoutout to Mickey85 and Joe-who-must-not-be-named. Both have helped me tremendously over the years when I was researching HTs and helped me with my decision. I will follow up with pictures soon.

 

Hotel

After arriving from Brussels, I took a cab to the Hotel Catalonia (didn't want to bother with public transport). I had thought the hotel's name sounded familiar, as it turns out, it is directly across the street from Dr. Bisanga's clinic (which looks a little bit like a castle). So it's nice that they regularly get HT patients. The hotel is affordable, and in a nice area.

 

The Area

The surrounding area is very picturesque, very old world, and not heavily populated. Most people speak English well, so you can get around. The main language here is French, and it's helpful to know it. But you can get by with English. Near the hotel there is a Chez Frances restaurant for breakfast, and a nice Thai place called Thai Cafe. I chilled in the area for a day before heading to the clinic.

 

The Clinic

The clinic is about a ten minute walk directly south from the Hotel Catalonia. Upon entering, I was greeted by the clinic's patient coordinator Giancarlo. Giancarlo is fluent in multiple languages. The clinic has a very modern design, very "Bauhaus", with plenty of white, and clean lines throughout.

 

Consult

We then met with Dr Lupanzula. He looked through my donor and recipient, and went over my family's history. He noted that while the area to cover was significant, I was a good candidate for a few reasons: 1) Good donor hair - coarse, wavy hair that aids in the illusion of coverage. 2) Darker skin, which reduces contrast, and 3) A good number of multi follicular units. He snipped off hairs to measure the shaft caliber. Then he shaved my head.

 

I admittedly was not looking forward to this. But it was a good idea, not only does it save time the next morning, it puts you in the "zone" mentally for surgery. What's more, I decided that a shaved head, while not the best look, wasn't the worst one either for me, so it's good to know. Post shaving, he measured my donor density under magnification, with the parietal areas having just below 100 grafts/cm and the occipital around 110. He estimated that my donor capacity, if we harvested 30%, would be around 7,000 units, and if we harvested 40% (which would be on the border of over-harvesting), about 9,000. All in all, he considered me a good candidate.

 

He drew a hairline, which I was fine with. I wanted a conservative hairline, but at the same time we still want to make a visual impact. The plan was to harvest and implant most of the grafts on day 1, with the hairline to follow on day 2.

 

Day 1

Day 1 began early, since you're supposed to eat before, I grabbed some croissants from a bakery right across the corner that happened to be open at 6:30am. The Dr gave me the meds and it was time to roll. After changing into hospital scrubs, he gave me anesthetic injections in the back of the scalp. Btw, I knew anesthetic injections were the most painful part of the surgery, and it was true, I found them to be very painful, and they are required multiple times throughout the surgery as a different area is operated, either for harvesting, or implantation. Then again, they are obviously required, so there is no getting around it.

 

Dr Lupanzula uses a a CIT handle manual punch to score grafts. He harvested grafts from the back and sides, one after another. He has a distinctive punching motion where at the end of the forward twisting motion he pushes in the tool slightly, which was noticeable. Afterwards, the grafts were plucked out. This is a weird feeling, you feel a slight popping sensation, similar to how a grape or a berry is plucked off the stem.

 

Keep in mind, you have to stay very still during the procedure, and notify the Dr before moving. Staying still can get difficult when the parietal areas are being harvested because you are lying on your side.

 

The team inspects the grafts under microscope and prepares them for re-implanting. Grafts are stored in ATP Hypothermosol. After harvesting we had lunch. The clinic eats lunch together in their break room, which is nice. Everybody in the clinic speaks English, so language is never a problem.

 

Implantation

Two steps to implantation, recipient site creation and placement. After anesthesia, the doctor used needles to make incisions. This is an interesting process. He moves very quickly in creating the incisions. There is a lot of power, and you can feel the fibrotic scalp being punctured. Given the speed and power, it feels powered by a machine, but it is manual. This process is actually surprisingly pleasurable. Who would think that having 2-3,000 holes poked into your scalp feels good, but it does. Patients who have been operated by the implanter pen also report the same thing.

 

Afterwards, his team places the grafts. This last part takes time. Afterwards they had me bandaged, and I was off to the hotel at about 6pm. Afterwards, I sprayed my grafts every 15-20 minutes with saline.

 

Day 2

This day was going to be shorter by design, as 2K grafts were harvested on Day 1 with 1K to follow. The same process followed as the day before, however we were done earlier. Then the clinic bandaged me up and I headed home.

 

Day 1 Postop

Day 1 was the first clinic hair wash. His wife, Sandra washed my scalp, spraying Betadine shampoo on both donor and recipient, and massaged the donor vigorously, and then applied an antibiotic creme to the donor. This is to be done everyday for the first 7 days (which I have done) and afterwards the recipient site should be gently massaged after applying Betadine shampoo.

 

The clinic had a driver take me to the airport afterwards for my flight. I had originally chosen to fly immediately to avoid traveling while swollen, but I didn't experience visible swelling, in retrospect, I would have stayed in Brussels longer, just to give my grafts more time to set before moving. The flight was fine, and to note, it was not uncomfortable or painful to fly after surgery. I had a neck pillow to prevent the donor area from touching the seat rests. I wore a bandanna outside, but took it off when inside the plane, and regularly sprayed with saline.

 

I have finished 1 week postop, and the clinic has remarked that all looks appropriate.

 

Stats:

Single: 621

Double: 1,295

Triple: 1,183

Quadruple: 261

Quintuple: 21

Sextuple: 1

Total Grafts: 3,382

 

2.34 hairs/graft

Hair caliber: parietal/temporal: 55-60 mic., occipital: 60-70 mic.

Density: 45 grafts/cm in outlined area, 40/grafts/cm behind it.

 

 

Medications: Finasteride and Dutasteride alternated daily, Minoxidil Foam 1x day.

Edited December 3, 2016 by KO

[Melvin- Admin]

I will befollowing your case closely, the work looks very clean,this thread will help a lot of English speaking potential patients out there.

Edited December 3, 2016 by Melvin-HTsoon

[hsrp10]

Great writeup, very detailed.

- What was the transplanted hairline density grafts/cm2 and how many techs are involved in the procedure? Especially graft implant phase.

- Also did you go for the temples/temples points? [Edit, I see you later added the pics]

- What made you ultimately choose Dr. Lupanzula?

- Were you the only patient both days?

- Wilfreed the driver didn't pick you up when arriving?

 

The hotel Catalonia has some of the darkest curtains I've ever seen in a hotel lol, really helps with getting some sleep. Btw did you get any belgium waffles at the small store on right side near the main intersection/tram stop? (the hotel for Bisanga and Lupanzula is same as they are close by so I was there before)

Edited December 3, 2016 by hsrp10

[n00b]

thanks for the great writeup KO

will be following your thread and progress.

[ndubya]

Congrats KO,

If you walk out of the Catalonia and turn right, at the street turn right again and walk all the way to the corner, there is a restaurant(sandwich shop). Get the tuna fish, it is excellent.

 

Lupanzulas work looks great, wishing you a great result

[chris39]

Nice write up KO.

 

For the area addressed and number of grafts , this should turn out very nice indeed .

[KO]

Thanks all, I will update this thread regularly. Now it is time to watch grass grow...

[KO]

Great writeup, very detailed.

- What was the transplanted hairline density grafts/cm2 and how many techs are involved in the procedure? Especially graft implant phase. (I believe the 45 is from the Coverage Value Tutorial).

- Also did you go for the temples/temples points? [Edit, I see you later added the pics]

- What made you ultimately choose Dr. Lupanzula?

- Were you the only patient both days?

- Wilfreed the driver didn't pick you up when arriving?

 

The hotel Catalonia has some of the darkest curtains I've ever seen in a hotel lol, really helps with getting some sleep. Btw did you get any belgium waffles at the small store on right side near the main intersection/tram stop? (the hotel for Bisanga and Lupanzula is same as they are close by so I was there before)

 

- I am not sure of the hairline, but the main implanted area drawn out had a density of 45 grafts/cm. 40 grafts/cm behind the original area.

- 2 technicians were implanting grafts and a third was assisting them.

- I chose Dr L because of a) many patient posted results b) good hairline work c) he does harvesting/incisions

- Yes, only patient.

- Just took a cab, I don't think I had notified the clinic when I was arriving.

- Didn't try the waffles...wasn't sure where to go really.

[Spanker]

Looks good. I dont know about the numbers you gave though. You said your donir density was 100 hairs per cm2, did you mean fu instead of hair? For hairs, that seems low, but you donor appears to be pretty dense. Also, you stated.that you hair is course, and it looks course, but the numbers you gave is very average, so, that just confused me.

 

The work looks very good. I don't know a lot about the doc but you have done a LOT of research do I'm sure that it will turn out great. Like me, you hung.around a long time before pulling the trigger and I think that will pay off.

[home1212]

congrats, hairline design suits your face and looks very natural, grafts look tightly packed as well, should be a beautiful result when it blossoms! best of luck healing and growing..

[KO]

Looks good. I dont know about the numbers you gave though. You said your donir density was 100 hairs per cm2, did you mean fu instead of hair? For hairs, that seems low, but you donor appears to be pretty dense. Also, you stated.that you hair is course, and it looks course, but the numbers you gave is very average, so, that just confused me.

 

The work looks very good. I don't know a lot about the doc but you have done a LOT of research do I'm sure that it will turn out great. Like me, you hung.around a long time before pulling the trigger and I think that will pay off.

 

Thanks appreciate the kind words, good correction. Grafts/cm.

Edited December 3, 2016 by KO

[KO]

These photos are from Day 7 postop. On day 8 as per instructions I started massaging the recipient area for the first time, and was surprised to find a...hard crust. I shouldn't have been, but in the mirror it looked like soft, wet tissue, but there's no better way to describe it than a crust. I gently loosened it with Betadine shampoo and my fingertips (make sure to cut your nails). Now over the next week I'll be repeating this everday, in addition to massaging my donor area with Betadine and applying antibiotic creme.

[hsrp10]

Looks like it's healing very well, can't see many if any scabs at all at this point.

Do they give you a donor area cream called HydroOne ?

[Spanker]

Looking good. What is your hair style goal in twelve months?

[KO]

Looks like it's healing very well, can't see many if any scabs at all at this point.

Do they give you a donor area cream called HydroOne ?

 

I don't think there's much scabbing because there wasn't much blood. But plenty of crusts from protruding follicles of course. He gave me a white cream, no name on it though. May be the same.

[KO]

Looking good. What is your hair style goal in twelve months?

Interesting question, I'd try to keep my hairstyle as is (with more hair though), but I'm open to suggestions.

[KO]

congrats, hairline design suits your face and looks very natural, grafts look tightly packed as well, should be a beautiful result when it blossoms! best of luck healing and growing..

 

Thanks, I hope so for sure.

[Rawkerboi]

As expected Very well detailed write up KO, thanks for sharing your experience!

I am bit surprised by your Doctor choice but the work looks excellent and clean. Grafts look densely packed as well.

Any problems at Security Check @ Airport?

[HairLostYears]

Like me, you hung.around a long time before pulling the trigger and I think that will pay off.

 

I aspire to join this club one day. +1 for procrastinators!

 

KO, I'm digging that hairline too...the artistic irregularities, but not too perfectly imperfect. Think you'll be a happy camper.

[ontop]

Congratulations KO work looks clean & I'm sure you will have a stella result.

[Sean]

Best of luck and happy growing KO. Thanks for the detailed write up. Looking foreward to seeing your progress. Looks like the doctor you chose has a great surgical protocol and does things manually. very few FUE surgeons have such protocols. Sit back and relax and and enjoy it. Congrats!

[delancey]

Happy growing KO. You definitely did your research before pulling the trigger.

 

May I ask you why you chose Dr. Lupanzula?

[1978matt]

Looks good with a lot of hair moved. Should be a belter.

[KO]

Thanks all. I picked the Dr because of a) I liked his hairline work, the cornerstone for HT's even for high norwoods b) He is highly involved in the procedure, doing both graft scoring and incisions c) He has a lot of patient posted results out there for a few years.

[KO]

I"m not sure why my posts are being tagged for moderator approval?