FUE with Dr. Bisanga

[Tomislav]

Hi all,

 

This is my first post on this forum. I am a 40-years-old guy with a diffuse hairloss behind a relatively low hairline. Some call it a Ludwig-type hairloss. I'll let you judge from the pre-op pictures I will post. In a few hours I am due to undergo a hair transplant at the BHR clinic in Brussels with renowned Dr. Bisanga. I plan to post here a detailed account of my future progress.

 

A little history: I remember first noticing a loss of density at the age of 18. After then, the loss has progressed very very gradually. In 2006, when I was 30, I started taking minoxidil 5% and continued this treatment until 2011. I think the minoxidil had completely stopped my hairloss and even caused some regrowth. However I hadn't realised how effective that had been until I quit... a decision I now very much regret. In a few months I lost a lot of hair, and in 2012 I considered a transplant for the first time, but it took me five years before I decided to go through with this decision.

 

I took a few pictures back in 2012 and I must say not much has changed since then, which makes me optimistic about the speed of future hairloss. My goal is to significantly increase hair density between my hairline and the vertex of my head. I don't care very much about filling my temples... in fact I'd quite like ending up with a Norwood-2 pattern, as I like the mature look it gives. I opted for a FUE transplant because I don't mind shaving my head, and I would like to keep this option open.

 

I chose Dr. Bisanga precisely because of his conservative approach and his expertise with the FUE technique. I had a consultation with him last September and was found to have a density of 70 UF/cm3. He recommended me with 3000 grafts, which is what we are aiming for.

 

Below a couple of pictures taken yesterday. Wish me good luck!

 

[Tomislav]

And here are pictures with longer hair. The first three are from 2012. The next three were taken six months ago, before my consultations. The scruffy look is to better show my hairloss... I don't usually wear my hair like that

[hsrp10]

good luck with your surgery!

Bisanga does good work

[Khop]

Hi Tomislav,

How did your procedure go with Dr Bisanga?

I know it's only early days but I am booked in for a couple of months time to have a similar procedure of around 3000 grafts so really interested in how you are going with it all.

Were you scheduled to have the surgery over 2 days?

Will the 3000 grafts give you enough density or will you have to go back in a couple of years time to add further?

How are you finding Belguim?

Hope it's all going well for you mate and looking forward to seeing some further posts and I am sure great results. I think you picked a great doctor to perform fue.

All the best

[TakingThePlunge]

Thanks for sharing taking the time to post about your HT! I hope you'll continue to update us.

 

Happy Growing!

[Tomislav]

A quick update: after 2 days of surgery, I am now going back home. It was a very good experience, everyone at the BHR Clinic is very nice and eager to help. After reading the very detailed account by JohnnyDrama in this forum, I asked Dr. Bisanga if we could perform PRP therapy, with the hope that it would speed up and improve the recovery. It really worked well for JohnnyDrama… do read his story if you haven’t already done so, as it’s really well written and instructive. Dr Bisanga immediately agreed, but advised me to go through other PRP sessions in a few months, something I will look into.

 

As for the surgery itself, currently all looks in place and fits closely with my demands. I will post some pictures when back home, but here is the breakdown of my grafts:

 

1 UF: 430

2 UF: 1570

3 UF: 620

4 UF: 370

 

Hope this helps!

 

PS. Hi Khop, no I do not plan going back. I really hope this one surgery will be enough. I had minimal contact with Belgium, basically just hotel-clinic-hotel-clinic. Good luck with your surgery

[Tomislav]

Here are some pictures I took today, at day 4.

 

I also have some immediately post-operative pictures, but I'll wait until I get the ones that were taken at the BHR clinic, as they will definitely be of better quality. Some notes follow. Please feel free to comment in any way (critical comments included).

 

- Donor area. Scars are healing fast. I'm applying a cream provided by BHR twice daily, and it seems to be really working well. Making them invisible as soon as possible is very important to me, as I'm going back to work in a bit more than a week. Strangely, the donor area is more painful now than immediately after the procedure. I guess this is a sign of the healing that is going on deeper down around the nerves.

 

- Recipient area. As normal, the speed is less impressive but it is also healing well. It has gone from the purple immediately post-op to the current light red. Scabs are small and few. I apply saline water generously every 2 hours and delicately wash the whole head once a day with a shampoo containing Iso-betadine, also provided by the clinic. From what I see in forums and was told at the clinic, redness can stay there for long. Not really sure how much control over this I will have. As for pain, I don't feel any. In fact the whole area is totally numb

 

- The transplant itself. I am happy with the conservative approach agreed with Dr Bisanga. Density at the top was my primary goal, but I realise that the area to cover was fairly large (my estimate is about 90-100cm2), and with 3000 grafts, that gives about 30 grafts per cm2. I really hope the native hair in the recipient area, although mostly miniaturised, will manage to hang there for a few more years - it would definitely add to the density... Also worth noting is the slightly asymmetric design at the front: while on the left (my right) the grafts have been transplanted behind the existing hairline, on the right (my left) the transplant starts right together with the hairline. Not sure why the doctor did this, but I don't really mind it, as in any case I do not comb my hair symmetrically. In fact it will be interesting to see which of the two approaches gives the better result, in case of a future touch up.

:rolleyes:

Edited February 11, 2017 by Tomislav

[Tomislav]

Pictures at day 14.

 

As you can see I have some shock loss behind my right ear, which is a bummer. Based on others' reports, I expect this to completely disappear in about 4-5 months. Before that I hope the area will stay limited, so that the surrounding hairs can cover it.

 

As for the rest, everything is going according to plan. I hope that the pre-existing hairs in the recipient zone will not fall. Sensitivity in the recipient zone is slowly coming back to normal. Redness seems to be minimal compared to what others experienced. This may have something to do with the PRP treatment.

[mikeyhwk]

that's so weird, I had my surgery with dr Bisanga as well and that is almost the exact spot of where my shock loss was. Worked looked really clean, strap in for the long slow ride now

[Tomislav]

Hi Mikey, when did you have your surgery? When did your shock loss appear and when did it go away? Did you post any pictures anywhere?

 

I was thinking of applying hydrocortisone cream for one more week around the area of shock loss to prevent it from spreading, as I read that it's used to treat alopecia areata sometimes... did you do anything special yourself?

[mikeyhwk]

Hi Mikey, when did you have your surgery? When did your shock loss appear and when did it go away? Did you post any pictures anywhere?

 

I was thinking of applying hydrocortisone cream for one more week around the area of shock loss to prevent it from spreading, as I read that it's used to treat alopecia areata sometimes... did you do anything special yourself?

 

I had my surgery early september 2016. My shock loss was there as soon as my hair grew in. I actually had 2 spots of shock loss, right ear like yours and then left side bottom of the hairline at the back. The left side was far larger but both grew back in about 3.5 months. Looked patchy and stupid for a bit lol. It'll be coming up on 6 months starting next week for me. I didn't post pictures, honestly I was stressed out enough about it that I didn't want to hear a negative peep about it in the off chance I was a slow grower and once the shock loss hit I didn't want to hear somebody elses horror shock loss story, didn't need any additional worries so just kept it to myself and a few friends i've made here on this site who get regular updates from me. I'm all on schedule tho. Just waiting for the hair to thicken up.

 

I didn't do a thing to it that wasn't on the original sheet they gave me and it all went fine. I was already applying a different med for inflammation I had pre op that dr B had recommended so that was the only thing I applied that wasn't on the instruction handout.

[Tomislav]

Thanks Mikey, that's very helpful and makes me a little less stressed about it, although I am really worried about the shock loss spreading more (right temple looks already weaker today).

 

Looking forward to hearing about your results in a few months!

[mikeyhwk]

Thanks Mikey, that's very helpful and makes me a little less stressed about it, although I am really worried about the shock loss spreading more (right temple looks already weaker today).

 

Looking forward to hearing about your results in a few months!

 

and cant wait to share it. Lets hope it keeps on progressing as it has been. I will follow your thread keenly. Happy growing

[KO]

This is going to be great. The hairloss is is pretty limited to a frontal area, so when you hit that with 3k grafts, it is going to be dramatic.

[Tomislav]

Here are two pictures at day 24. Shedding has started in the recipient area (as normal), and the shock loss on my right side has progressed

At the moment it is the shock loss that worries me the most. I know the lost hairs should come back, but at the moment it's not easy to conceal and it is holding me back from social life. This is a relatively small price to pay, should the end result be a good one (thank you KO for your optimistic comment!!!)

 

By the way, I would be very happy to get any suggestion on how to style my hair to conceal this... I have thought about shaving my hair on the sides, but I'm worried that the small scars from FUE would be visible. At the moment, my plan is to grow the surrounding hair so as to cover it... but it may take about 1 or 2 months...

[Tomislav]

Quick update at the end of week 5. In the past few weeks, the recipient area has thinned progressively, a consequence I guess of the normal post-op shedding. The frontal area is more or less as dense as it was before the operation. Should the shedding be over at this point, I would consider myself very lucky, as I was expecting a much worse "ugly duckling" look by this time. Fingers crossed!

 

As for the donor shock loss, nothing new on that front. I am slowly getting used to it, which certainly makes life easier...

[JohnArbuckle]

Nice dude, you are going through a real transformation. Keep us updated!

[Tomislav]

Hello everyone, sorry for the long silence, but not much happened in the last couple of months. I am now at exactly 3 months post-op and I'm happy to report that I can see many new hairs sprouting along the hairline. I can also see some new hairs behind the hairline, but the density seems to be much lower... Obviously, the new hairs are very very short (1mm at most) so I'm afraid none of this will be visible in the pictures below.

 

Not sure how to interpret the difference between the hairline and behind it. It may be that the hairs I'm seeing are mostly the ones I lost because of shock loss, so the difference may be due to the fact that pre-op I already had many more along the hairline than behind it. Or it may simply be a false impression, as it is harder to spot a 1mm hair behind other hairs. Anyway, time will tell. I'm staying optimistic.

 

As for the donor shock loss on my right side, as you can see, it is still very evident. Longer hair actually makes it more visible. Here as well I can observe a few small hairs sprouting. In addition to being very short, they also appear to be very thin — much thinner than those I see in my recipient zone — so I reckon it's impossible to see them in the pics. I hope that in a month or so they will be providing some coverage over there!

[JohnArbuckle]

Hello everyone, sorry for the long silence, but not much happened in the last couple of months. I am now at exactly 3 months post-op and I'm happy to report that I can see many new hairs sprouting along the hairline. I can also see some new hairs behind the hairline, but the density seems to be much lower... Obviously, the new hairs are very very short (1mm at most) so I'm afraid none of this will be visible in the pictures below.

 

Not sure how to interpret the difference between the hairline and behind it. It may be that the hairs I'm seeing are mostly the ones I lost because of shock loss, so the difference may be due to the fact that pre-op I already had many more along the hairline than behind it. Or it may simply be a false impression, as it is harder to spot a 1mm hair behind other hairs. Anyway, time will tell. I'm staying optimistic.

 

As for the donor shock loss on my right side, as you can see, it is still very evident. Longer hair actually makes it more visible. Here as well I can observe a few small hairs sprouting. In addition to being very short, they also appear to be very thin — much thinner than those I see in my recipient zone — so I reckon it's impossible to see them in the pics. I hope that in a month or so they will be providing some coverage over there!

 

Thank you for the update. Happy growing.

[Tomislav]

Some news at the 4 months post-op mark. Compared to a month ago I am a bit less optimistic. But let's first start with the good news:

 

The shock loss behind my right ear is becoming less and less apparent. The thin and wispy hair I first noticed a month ago are increasing in numbers and thickness. A month from now the shock loss will hopefully be no more visible.

 

Then the not-so-good news: it seems that the short hair I had observed in the hairline have stalled at about 1 or 2 mm. I now interpret the fact that they are short and thick as a bad sign: it may be that these hairs were there all along since my operation, and that I did not notice them simply because I was not looking for them, or because they were surrounded by hairs of similar length. Now that the surrounding hair have grown, they have become noticeable.

 

I was able to take a zoomed picture (see below, and notice the short hairs above the red dot on my skin). Could it be that their blunt end is the result of the shave I had 3 months ago?! Of course if someone with magnifying glasses could look into this, the answer would be immediately evident I believe... In the same picture notice that there are a few other hairs whose end is progressively thin. I think these are hairs growing healthily. I hope to be able to take a new zoomed picture of the same area in about ten days and compare it to this one. That may allow me to answer a lot of the questions above.

 

On top of this, I see no signs of thickening in the recipient zone. This is ultimately what worries me most. I know I know... I have to be patient

[HairThereAndEverywhere]

I think you're looking good on top. I've seen posts where the transplanted hair really didn't begin making a cosmetic impact until around month 6-8. So I think you just have to hold tight and a positive result is on its way.

 

Looking back at your original pictures, your hair was thinning in an interesting progression. You did have that quasi-hairline prior to your HT and the thinning was in sort of a circle behind it. Without as much loss on the crown either which is a really nice spot to be in, in my opinion. So those hairs on your hairline I think are native ones growing back and the transplanted ones are just going to take some months to catch up. At the end of the day, I think you'll have a good result. Maybe not as thick as a movie star but enough coverage to look good.

 

As for the shock loss, that's a bummer that that happened. Trust me when I say that no normal person looking at you will care about that in the slightest. People might notice it but maybe they'll think there's a cool scar from a fight you got into under there. I don't think you have to worry about that cosmetically. And like you said, it seems to be growing in so that's good.

 

Have you considering buzzing your sides and back down to a .5? That way it'll blend back in with the shock lossed portion and those parts will grow in together. It's a very popular hair style to be short on sides and long on top, so you might just want to buzz down those sides and wait for everything to come in together in the next couple of months. I think you're right on track.

Edited June 9, 2017 by HairThereAndEverywhere

[Tomislav]

I think you're looking good on top. I've seen posts where the transplanted hair really didn't begin making a cosmetic impact until around month 6-8. So I think you just have to hold tight and a positive result is on its way.

 

Thank you for the encouraging words! I must say I have been looking for cases like this here on the forum, but haven't managed to find much. Do you have names of "late blooming" forum members so that I can look at their pictures?

 

Looking back at your original pictures, your hair was thinning in an interesting progression. You did have that quasi-hairline prior to your HT and the thinning was in sort of a circle behind it. Without as much loss on the crown either which is a really nice spot to be in, in my opinion. So those hairs on your hairline I think are native ones growing back and the transplanted ones are just going to take some months to catch up.

 

That's very possible. Or they are transplanted ones whose follicle has some trouble producing the new hair...

 

As for the shock loss, that's a bummer that that happened. Trust me when I say that no normal person looking at you will care about that in the slightest. People might notice it but maybe they'll think there's a cool scar from a fight you got into under there. I don't think you have to worry about that cosmetically. And like you said, it seems to be growing in so that's good.

 

Yeah I really think it is going to get back to almost normal. The cosmetic difference with a couple of months ago, when it was a 100% bald patch, is already huge. And I don't feel self-conscious about it anymore

[mikeyhwk]

I wouldn't stress it yet, at 4 months my hair looked like a whole lot of nothing. I was well behind where i started off. Looked awful, my native hair was long the new hairs were in all stages of growth, some came out early, some just started to come out and some hadn't come out at all so I was so uneven and wondering what the hell would come from it. Now at almost month 10 my hairline is thick and getting better as the quality of hair gets better. You're making progress, just get used to these emotional peaks and valleys, you're going to have periods where you feel great and then you'll crash again lol... right now it doesn't feel like all the hairs are growing then you'll see a bunch and feel happy...then you're going to start freakin out again because while the hairs show up you still see peak thru and start wondering if it'll be dense enough then it'll slowly start to get denser so you said it, you just have to be patient.

[Tomislav]

I wouldn't stress it yet, at 4 months my hair looked like a whole lot of nothing. I was well behind where i started off. Looked awful, my native hair was long the new hairs were in all stages of growth, some came out early, some just started to come out and some hadn't come out at all so I was so uneven and wondering what the hell would come from it. Now at almost month 10 my hairline is thick and getting better as the quality of hair gets better. You're making progress, just get used to these emotional peaks and valleys, you're going to have periods where you feel great and then you'll crash again lol... right now it doesn't feel like all the hairs are growing then you'll see a bunch and feel happy...then you're going to start freakin out again because while the hairs show up you still see peak thru and start wondering if it'll be dense enough then it'll slowly start to get denser so you said it, you just have to be patient.

 

What an emotional roller coaster... Thank you mikey!

[Tomislav]

I've asked BHR Brussels to send me the pictures they took on the day of my surgery. Here they are. In a few days I will be posting my 5-month update, so it will be useful to make the comparison.

 

Bear in mind that I had shaven my hair about a month before the operation, so my hair in these pics is much shorter than what I intend to wear in the future. I feel that these pics are a very harsh representation of how I was before.

Edited July 6, 2017 by Tomislav