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Hello everyone,

I would like to start this topic on my experience and I will post the results over time.

Currently I don't have all the data and pictures with me but I will share now what I have and later I will add to it.

35y old, NW3-4v I think and hairloss has been bothering me since I'm 18 or something.

I underwent a 3060 FUE surgery to restore hairline plus frontal third.

The decision wasn't easy but what made me go through with it was seeing the results that can be achieved these days.

Also the fact that I was doing something about it rather than just whining and complaining about hairloss and always facing the decision of shaving everything off, which didn't really appeal to me. I whore my head shaven a lot when I was a kid, and it doesn't suit me well with my long neck and ears that stick out. It might be better than just looking balding, though, so if one day the hair transplant result isn't good anymore, I will contend with just shaving everything off. But let's hope otherwise!

Regarding Dr Lupanzula, I had consulted a couple other highly regarded surgeons and Medikemos clinic always reacted quite timely and the first consultation with Dr Emorane Lupanzula went really great, he went to depth into explaining me all the ins and outs of the procedure and was very patient with my extensive list of questions. The location was convenient to me, and the budget, even though not cheap at all comparing to other clinics you may find these days, was still within my reach, adding to that Dr Lupanzula has a pretty good reputation and his documented results were very encouraging so I went through with it.

He also asked me what was my priority, to fill the crown or the hairline, I said my priority was definitely the hair line and the upper part, since it had the most direct aesthetic impact on my face and the crown would consume a lot of grafts. Also considering that the crown responds quite well to minoxidil and with some length of hair and maybe some concealer it can be dealt with.

I also went a period between the first appointment and the operation, of treating my dermatitis using Nizoral shampoo and also applying  a vegetable oil called "huile de Jojova" to improve the donor hair health, together with applying topical minoxidil+finasteride supplied by the clinic, to preserve the remaining hair on the top I still had. This period lasted around 7 months and I got the impression it was very beneficial to the operation since the donor grafts were of quite good handling quality according to him and his technicians who placed the grafts.

Regarding the surgery, initially it was meant to take place over two days, and I thought "this is great, better chance of graft survival since less time sitting out of my scalp" however the day of the operation everything was done the same day, we started at 6h30 and were done at around 18h00. I was later relieved all was done by that day, since it was quite taxing to sit on a chair the whole day with people poking at your head the whole time. I wouldn't be thrilled to repeat that procedure the day after.

Some more details about the surgery: a motorized punch was used to remove the grafts (I think 0.8 mm but not sure) by dr Lupanzula himself and all the incisions were performed by him as well. The graft placement and follicle sorting at the microscope was done by two of his technicians. Pain-wise it was fine, only the anesthetic injections were quite painful but didn't last long so you suck it up during the shots and later you're fine.

I don't have the follicle count, but I remember it being around 350 and the density to be around 2.55 (avg hairs per follicle?). I have the impression the 350 single FU is quite low when I see other similar cases with 3000 FUE that count up to 600 single FU's. Apparenlty they had a hard time harvesting enough single FU's from my donor area so they had to manually split them at the microscope and this is why the 2.55 is a low value, but not to be worried about, according to Dr Lupanzula. I am not sure I understand it completely, as once the graft is implanted, I don't see the difference it makes coming from a single hair follicle or coming from a split multiple hair follicle, the density should not be impacted by that. Maybe someone can explain that better to me?

For the recovery it was quite smooth I must say, pain-wise it was always very bearable and it didn't prevent me from sleeping or anything. The itching feeling was a bit harder but didn't last long.

Below you will find pictures before the operation, the same day, and 6 days after, and 3 weeks after.

pre-op:

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OP Day: (I don't yet have the pictures taken by Dr Lupanzula, which are of higher quality and variety, I will post them as soon as I have them)

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6 days post-op (All the crusts were gone, I was feeling great with it. I was hoping it would stay this way, but as expected, it didn't take long until the new hairs started falling and the perceived density to decrease):

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3 weeks post-op:

Now the difference between native and transplanted hair is evident, and a good part of the transplanted hair has already fallen, I was expecting it to happen later, (from 3w to 8w) but for me it started already at about 2 weeks. My hope is, the faster it falls the faster it will grow back again. My GF who took the pictures noted one can see the follicle stems where the hairs have fallen, which is a good indicator that the grafts didn't fail and I can expect the final density to be close to the expected one. But I will only know after 12 months, right? this is a bit daunting to be honest.

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That gap that can be seen is a scar that the doctor didn't place any grafts there, hence the hole.

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I am on finasteride 1 mg and am taking a vitamin complex with zinc and biotin and other stuff.

The donor part is doing great, no pain at all, it healed really fast, Dr Lupanzula really knows what he's doing there.

As expected there is a part of the scalp with some numbness due to nerve damage, this should come back overtime, and it doesn't bother me that much.

Maybe thinking of taking MSM to help with the growth and Aloe Vera for the scalp, even though I'm quite happy with the redness on the scalp, it is pretty mild.

I will also start applying Regaine (minoxidil) now, only to the crown, since I wasn't allowed to use it until after 3w post-op.

I will post the operation pictures once I have them.

Please let me know what you think, is it on the right track? any signs I should be worried about? 

Cheers

 

 

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4 Months Update: Some more growth but I can see still many follicles that need to break through and join the party. I'm starting to see that 6 months will be definitely too early to judge th

I had the same feeling when looking at similar cases that something closer to 4000 would be more indicated to the covered area. it was the hairline and frontal third as you can see in the picture

I think we need the actual graft count, because an average of 2.5 hairs per graft should be more single haired fu’s. My second FUE my average hairs per graft was about 2.7 and I had a lot more single

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Good luck! I look forward to seeing the progression. I have been impressed by the few Lupanzula results in the forum.

Would be great if you could share the clinic post op pictures. Do you have fine or coarse hair?

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On 1/7/2020 at 8:46 PM, TheForkLift said:

Thanks Marshall and Melvin! Yes, definitely clean work.

Any tips regarding the MSM or Aloe Vera?

Cheers,

I used aloe vera as my scalp was quite red, unsure if it helped to be honest as it syayedvred quite a while but worth trying even as a moisturizer for the area

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12 minutes ago, duchaine said:

how large was the treated area?
3000 UF seem a bit low to me

I think it should be good.  The number of hairs was over 7100 (see graft breakdown above) which is about what I had in my first HT over a similar surface area.

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16 minutes ago, duchaine said:

how large was the treated area?
3000 UF seem a bit low to me

I had the same feeling when looking at similar cases that something closer to 4000 would be more indicated to the covered area.

it was the hairline and frontal third as you can see in the pictures, not the crown. also the hair line didn't come a lot down, he was quite conservative as I already had a naturally high forehead as a kid and it would be a more natural look for my age (35).

I asked to Dr Lupanzula and he didnt agree with that, according to him the implanted hair density would be enough at 47 hairs/cm2 if I recall correctly.

I guess I will only know in some months if the density is good!

Cheers

 

 

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37 minutes ago, 1978matt said:

Looks good and will be a big change to your appearance.

And yes, us pastey white guys don't look good with shaved heads!

haha this is really true. and who wants to look tanned all year round.

thanks for the encouragement.

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28 minutes ago, 1978matt said:

I think it should be good.  The number of hairs was over 7100 (see graft breakdown above) which is about what I had in my first HT over a similar surface area.

I think is very good. Wonder how lapaszula covered a such big area with that small amputa of FUs.
In my case, I had a 3.25 rate/Uf, the area to cover was much smaller and used 2066 grafts

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This looks really clean, something interesting I find is that you had 3000 grafts done and only 350 were singles?  I thought more single grafts would be needed since you are restoring your hairline, obviously the doctor knows what he is doing, good luck!

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5 minutes ago, Melvin-Moderator said:

The work looks incredibly clean, Lupunzula is a true FUE craftsman.

@Melvin-Moderator, the forklift have only 11% single among his FU.
Do you know if there is a specific number/ratio of singles/multiples to rebuild the hairline?

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7 minutes ago, duchaine said:

@Melvin-Moderator, the forklift have only 11% single among his FU.
Do you know if there is a specific number/ratio of singles/multiples to rebuild the hairline?

I think we need the actual graft count, because an average of 2.5 hairs per graft should be more single haired fu’s. My second FUE my average hairs per graft was about 2.7 and I had a lot more single haired grafts. I believe his numbers are probably off.

That said, you need only the first row to be single haired grafts. I think 350 single haired grafts could work staggered. 

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13 minutes ago, duchaine said:

@Melvin-Moderator, the forklift have only 11% single among his FU.
Do you know if there is a specific number/ratio of singles/multiples to rebuild the hairline?

350 is probably ok provided the hair is not coarse.

Lets say the hairline is 15cm long.  To implant 47 grafts /cm in the first 0.5cm deep you need 15 x 0.5 x 47 = 353 singles.

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10 minutes ago, 1978matt said:

350 is probably ok provided the hair is not coarse.

Lets say the hairline is 15cm long.  To implant 47 grafts /cm in the first 0.5cm deep you need 15 x 0.5 x 47 = 353 singles.

I had only 256 singles/2066 total FU.
really worried about the result I can get!

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I also had the same doubt regarding the total number of single FUs.

regarding the coarseness of the single FU's, these were specifically taken from the side donor region, above the ears, where they say the hairs are finer and more suitable for the hairline.

so I guess that should already help.

and 1978matt nice you came up with the numbers, it does make sense and 15 cm for the hairline seems quite realistic.

 

Cheers

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  • 2 months later...

3 months update:

Hello everyone,

As expected, the results are not yet there at all. some grafts have sprouted and some are still under the skin. Overall, I've been getting some nice remarks like "dude, you already look like you have much more hair" other not so nice remarks like "that didn't work, at this stage you should already have all the hairs there".

I think the surrounding native hair is helping with the coverage so it gives overall a fuller look.

Of course we all know results vary, and definitely 3 months is too early for any conclusion, since typically only 20/30% of the grafts would have grown.

Have a look at the pics (taken the 12 March - 3M mark) and let me know what you think:

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4 Months Update:

Some more growth but I can see still many follicles that need to break through and join the party.

I'm starting to see that 6 months will be definitely too early to judge the success, so I guess 9 to 12 months will be closer to the end result.

It is a long wait! What do you guys think? Is it in line with typical cases, or is it slower?

those white specs are not dandruff, just leftovers of some wax I used to comb the hair.

 

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