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Depleted donor repair - donor to donor VS body to donor


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Hello all, I’m currently considering a donor repair surgery, to restore a normal look to the back and sides of my head. I had a 3,000 graft fue 1 year ago but was over harvested, results of which you can find on this forum.

I’ve had some SMP sessions, but they’ve not really had the desired effect.

with that in mind, I’ve contacted 2 doctors and the 2 I am considering are dr feriduni and dr bisanga. Interestingly though, they have both proposed different strategies.

feriduni - donor to donor, in order to harmonise and even out the density in my donor area giving a natural look.

bisanga - body to donor, using 50% beard and 50% chest graft to replenish the donor and cover the scarring. 

here are some other bits of info to give more context. I’m 35, Norwood 3 (before surgery), using minoxidil for 1 year (minimal response), suffered bad side effects from fin, recently finished 3 prp treatments (awaiting results), as well using various other shampoos, supplements etc. I’ve tried most non surgical methods with minimal result. So I am expecting to have further surgeries in the future. The main issue is I have limited scalp donor, but good body donor.

has anyone had any of the above surgeries? I recently saw an excellent case on this forum from mwamba of donor repair so I’m hopeful. Any thoughts on pros and cons and which method to choose would be much appreciated. My pics attached at longer and shorter lengths. The longer length pics are post SMP. Thanks 
 

 

 

 

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Edited by Mr Sinister
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Why aren’t you considering Mwamba out of interest? He appears to be one of the pioneers in this donor replenishing movement, and also has a clinic in Belgium where your other two options are, as far as I am aware. 
 

I would contact @mustang RE. your case.  
 

Your hair quality looks good to me, 

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1 hour ago, Curious25 said:

Why aren’t you considering Mwamba out of interest? He appears to be one of the pioneers in this donor replenishing movement, and also has a clinic in Belgium where your other two options are, as far as I am aware. 
 

I would contact @mustang RE. your case.  
 

Your hair quality looks good to me, 

Mwamba was my first choice, because of mustangs experience. However I haven’t had a response from them yet. I will try again.

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The SMP actually did a really good job but the problem is you had really large gaps which become more obvious with longer hair on the sides. The SMP won’t replace the bulk of real hair. Whoever punched your grafts out during your first surgery had no clue what they were doing. I’m curious how it looks at a shorter guard like a .5 or #1 with the SMP.

You have a thick beard it looks like. I think Bisanga’s game plan is better using beard and chest hair only because I remember you saying in another thread you also weren’t happy with the results in your recipient area so if you have any precious donor area hair that can still be extracted it should be used to improve the results in your recipient. But first things first you need to fill in the donor scarring. Good luck with whatever you choose to do.

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Just my two cents, but I think this does not look as bad as you think it does. You are no doubt somewhat overharvested, but you have good color and coarseness to your remaining donor hair and if you grew your hair a bit longer this would be even harder to detect. You may wind up with shock loss in the donor site after donor to donor transplant, and some of that hair may be permanently lost.

I fear you are chasing a result that you may never get and you may always be dissatisfied.

For the readers of the forum, this shows that 3K grafts by FUE can sometimes result in overharvesting. I see a lot of guys here getting huge transplants via FUE and you can tell from the surgical pics they will wind up overharvested. Those people do not always repost in a year to show their donor.

For a lot of guys 3K is more than they can move, especially in one setting. Be careful everybody. 

 

 

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13 hours ago, Sam818 said:

The SMP actually did a really good job but the problem is you had really large gaps which become more obvious with longer hair on the sides. The SMP won’t replace the bulk of real hair. Whoever punched your grafts out during your first surgery had no clue what they were doing. I’m curious how it looks at a shorter guard like a .5 or #1 with the SMP.

You have a thick beard it looks like. I think Bisanga’s game plan is better using beard and chest hair only because I remember you saying in another thread you also weren’t happy with the results in your recipient area so if you have any precious donor area hair that can still be extracted it should be used to improve the results in your recipient. But first things first you need to fill in the donor scarring. Good luck with whatever you choose to do.

Yep spot on. The spacing between hairs is so big that SMP in this situation doesn’t work, hence why Im looking at adding some density in via grafts, then perhaps more SMP. I would love to have my hair shorter so it blends better with SMP, but my scalp has been left pretty discoloured, even after 1 year, so it looks pretty bad at shorter lengths. Having tested different lengths, my best defence is to have slighter longer hair on the back and sides. Thanks 

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4 hours ago, qui bono said:

In terms of Feriduni's approach admittedly I havent seen any donor to donor transplant repairs before, but it could be an effective approach. Can you ask Feriduni to share any examples with you?  I guess the cons to this is that youre only 35 and have mentioned you cannot tolerate fin and are expecting further surgeries - which is to say at a NW3 if you experience any further balding you might regret utilising the remainder of your limited scalp donor to resupply your donor when the recipient area is generally seen as taking priority. The donor to donor approach also has the potential to accumulate more noticeable scarring (although this is highly unlikely given the standards of Feriduni) but I outline this as its important to be aware of the risks. Does Feriduni offer BHT btw? If not this might be the reason it hasn't been suggested.

Like @Sam818I think Bisanga has the better approach. If you experience further balding Bisanga's approach means you would still have some available donor grafts available for the recipient, and some of his BHT repairs are truly incredible (I think there was one by @Corbinite ) Ultimately though its going to come down to your body hair characteristics and how well they match your scalp hair. 

Ideally I'd get in-person consults with both before deciding. Do you know your projected NW and has Bisanga commented on your body hair?  I wish you luck.

Yep, this is my thinking too. To save as much scalp donor as I can for future surgeries. Feriduni does offer bht, but i think he might be looking at it from a final result only angle, rather than thinking about longer term planning.

bisanga has seen pics of my beard and chest hair and is happy there is plenty of donor. He’s estimated 750-1000 grafts split 50/50 between chest/beard. 

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On 11/29/2020 at 11:00 AM, Louisjams said:

For the readers of the forum, this shows that 3K grafts by FUE can sometimes result in overharvesting. I see a lot of guys here getting huge transplants via FUE and you can tell from the surgical pics they will wind up overharvested. Those people do not always repost in a year to show their donor.

For a lot of guys 3K is more than they can move, especially in one setting. Be careful everybody. 

 

And that is why FUT is still a better option for some people. He probably could have gotten 6000 grafts in 2 FUT sessions and still not have a problem with the donor. People get FUE so they can buzz it short and then some of them end up trying to grow it longer to cover the depleted areas as this guy is doing. FUE works great if you have excellent, thick, high density donor, but not everyone has that.

 

 

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Al

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(formerly BeHappy)

I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here.

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1 hour ago, BeHappy said:

 

And that is why FUT is still a better option for some people. He probably could have gotten 6000 grafts in 2 FUT sessions and still not have a problem with the donor. People get FUE so they can buzz it short and then some of them end up trying to grow it longer to cover the depleted areas as this guy is doing. FUE works great if you have excellent, thick, high density donor, but not everyone has that.

 

 

I've not seen pre op pictures of OP, but looking at his native hair, I would argue he probably was one of these ideal candidates you talk about, with thick, high density hair - I would suggest his current position is likely to be due to an unfortunate choice with a poor clinic.  

The whole FUT v FUE debate is pretty stupid really, theres too many factors to consider when you just simply pose the question 'what's better FUT v FUE'. Perhaps if the questions were more orientated to be 'What will help me achieve extracting the highest number of grafts' there would be more obvious answers - however which technique is the 'best', is ultimately subjective to the individual. 

 

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