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Dr. Bisanga - BHR Clinic - 2609 FUE 16-09-2021


LeBerry

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Hello guys,

As I am writing this I just came back from the BHR clinic for my post-operation consultation with Hilde, who is my patient advisor. Before we start I must say that the overall experience with BHR from the point where we first came into contact, has really been 10/10. They are very professional and really care about their patients a lot. Of course they might be more expensive than a clinic in Turkey, but therefore you have the feeling that they take care of everything and you see with their results everywhere online that by picking them you minimize your risk of a outcome which will not satisfy you. This peace of mind justified the costs for me.

The head is throbbing a little bit and I only had 3 hours of sleep last night (however I was able to lay relaxed without any issue for about 8 hours total), but I am absolutely thrilled that I took the step and that everything went without complications so far. Now I am moving into the most important process which is the healing process, but before this will be shared in the coming months I would like to share some background.

Today I am 28 and my balding has started around 18 years of age and I was using topical minoxidil shampoo the first time with 21 I would say. As this was very inconvenient I stopped doing so but ofcourse the balding process progressed. Then with 22 years I started taking finasteride, first 1,25mg a day and since the beginning of June this year I switched to capsules with 1mg a day. I am also using 5mg of oral minoxidil since 3 months (starting from 08 June 2021) to improve my donor area pre-operation.

Apart from that I try to live healthy by eating whole foods, having a lot of regular exercise, being social and try to laugh as much as possible (reduces stress they say ;) )

So upon first contacting the clinic I was looking like this (April 2020, only on my finasteride regime here):
Screenshot_20210917-112339_Gallery.thumb.jpg.134a9fe4752e4376097bbd08a824a9b7.jpg

As can be seen pretty clearly the frontal area is thinning but my crown area has good cover, which I pretty much thank to the religious finasteride intake (of which I have 0 side effects by the way, also not what my reproduction is concerned).

Now let us fast forward one year and a bit, to June 2021, as I was just about to start with the oral minoxidil.

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Now let us fast forward another 3 months to nearly the time where I had the operation and after I had my first three months with the 5mg oral minoxidil added to my regimine:
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What I have observed with the oral minoxidil: better hair thickness, increased body hair length (arms/legs) and more visible body hair in general. If we compare there two shots with the very first shot from April 2020, I feel that my overall hair quality and density has actually improved.

So now let us move to some pre operation foto's of the hairline and after shaving: 

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And then the day after the pre-op consultation I arrived at the clinic at 07:30 to be done at 17:30 that same day. They gave me some valium and overall I did not have any pains, it was a lot less bad then I have expected.

Graft count: 2609

Graft breakdown: 

1 Follicular Unit: 424 grafts
2 Follicular Unit: 1011 grafts
3 Follicular Unit: 1077 grafts
4 Follicular Unit: 97 grafts

Donor density: 80/80

Now the immediately post-operation picture:

image.png.56c1fefa626ae76b4edbf2d8c8ac5bd1.png

Looking forward to share my healing process here with you guys and would like to thank everyone here sharing past experiences for us all to learn, benefit and make an educated decision from.

Cheers

Edited by LeBerry
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11 hours ago, follically challenged said:

Good job man. Good choice of clinic. But i do wonder, won't this donor area look asymmetrical if only taking grafts from the back and just one side?

Thanks!

For this question I would refer to the post of Maa, who has a similar hairtype like I do and has also gotten this 2/3 Donor Area usage by Dr. Bisanga. If you check his final update you can see his donor looks pristine all the way around, and 600 more grafts were harvested:

 

Ofcourse this is no guarantee my donor will recover the same way, but it sure is promising.

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  • 2 weeks later...
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10 Days post operation update

Happy Sunday everyone,

The goal was to be scab free after 10 days, which has been managed without any issue. Hilde from BHR offered superb guidance and the aftercare routine was easy to follow. Happy that I was able to wash my head and get rid of the scabs after 7 days and I think everything looks pretty good.

Was eating out yesterday and decided not to wear a hat inside the restaurant, one of the waiters asked me where I had my HT done. Showed to me the importance of sharing experiences here for everyone to be able to inform themselves as it still seems a sensitive topic. Anyhow, lets move on to the progress:

1484874735_Bildschirmfoto2021-09-26um20_00_43.png.d9414f06e1010c0a638164f3a3f73324.png

 

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Donor:

1982965342_Bildschirmfoto2021-09-26um20_01_33.thumb.png.780f4fa366aef4de40c4e98a133b44dc.png

The next update I will post around the 30 days post OP mark and after that I will keep them coming on a monthly basis.

 

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2 minutes ago, ffar said:

Hmm happy for you. I was told by people here that my hair are too good to get HT, and you have similar situation like me. I will wait for results from you.

Hi ffar, thank you. In the end I think you should do as you feel is best, it is a very personal decision. For me, I deem my forehead as relatively high and I was able to stabalize my hairloss over the last five years. The time was right I felt and the goal with this HT is to have me set for the coming 10 years at least.

How good your hair is, is mainly yours to judge. To check if a HT is advisable based on your current situation, I would suggest you go for a personal consultation with a renowed clinic.

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Thanks. In 2,5 years I will be 35. I guess by this time hair loss(the worst part) is rather over. So i will go after hairline fix. At the moment everything looks great except hairline thanks to minoxidil 5mg per day. 

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2 minutes ago, ffar said:

Thanks. In 2,5 years I will be 35. I guess by this time hair loss(the worst part) is rather over. So i will go after hairline fix. At the moment everything looks great except hairline thanks to minoxidil 5mg per day. 

That sounds like a solid plan based on your situation. 👍🏼 For me it was the goal to have a good situation before 30 and I already accepted the fact that I will probably need a second procedure in the future.

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Does someone have experience with going into a sauna after a HT

Online I read many different angles as to in which timeframe it is allowed again. Some say after healing for 14 days, some say after 30 days and some say to wait even as long as three months post operation.


The reason I am asking is because I am looking to do a Temazcal on the 17th of October (exactly 31 days post OP) and another one on the 22nd.
The Temazcals are connected to an important event I am participating in, so I am looking for some back up that supports the idea that I can resume visiting a ''sauna'' after 30 days.

Thank you in advance 🙏🏻

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@LeBerry Thank you for your post. Very nice documentation and thank you for sharing your photos. It is important that we as patients give back to the community and I have no doubt that many individuals will find value in your thread and journey.

Your early photos look great and very clean. You clearly did a good job with scab removal.

I look forward to your updates and am excited for you for the months ahead. You are in great hands with Hilde.

On 9/17/2021 at 11:04 PM, follically challenged said:

But i do wonder, won't this donor area look asymmetrical if only taking grafts from the back and just one side?

To copy from previous posts where Dr. Bisanga´s extraction approach has been discussed and explained -

Recently on the forum there has been some discussion and possible misunderstanding regarding the pattern of extraction that is often employed by Dr. Bisanga. This is where Dr. Bisanga will harvest on one side of the donor area and not the opposing side

There are various motivations why Dr. Bisanga will at times take the approach of only extracting from one side of the patient´s donor.

If we start by explaining that much more commonly, we will see patients who have undergone FUE surgery, and the main focus of their extraction pattern is centred on the occipital (back) donor region, oftentimes not extending even slightly to the parietal (side) area.

The reason that this is a common approach is that the occipital donor area has the highest density, higher hair groupings and is the richest area of the entire donor. When a doctor is looking to achieve the best result possible, he has therefore chosen the best quality grafts. The concern with this approach is that the strongest area of the donor has been heavily relied upon in that first surgery, meaning that subsequent procedures do not have the advantage of utilising this area to any extent.

One of the beauties of FUE surgery, is that it allows the doctor to “cherry-pick” the most suitable and appropriate hairs for specific areas of the restoration. This is essential for designing hairlines and temple points. The most appropriate soft and single hair grafts can be found in the parietal/temporal area of the donor (above the ear). This is one of the reasons why Dr. Bisanga will look to extract from this area. To be able to provide natural and optimal single hair grafts, as opposed to having to dissect thicker multiple hair grafts from the occipital to meet the necessary demands/count of singles for the hairline for example.

The question of why we may only extract from one side of the donor, and not the other comes down to several factors. The most simple and obvious is the total graft count of surgery. Taking into account the reasons explained above why Dr. Bisanga will avoid harvesting only from the occipital region, and also prefers to harvest the most appropriate follicles from the temporal/parietal area, due to spreading the extraction pattern over this significant band, there may be no need to extract from both sides. If the desired graft count can be achieved with a very well distributed extraction pattern, then there are more positives to leave an untouched area of donor, with a more specific type of follicle, that can be better utilised for a potential subsequent surgery.

We do not from any of our surgeries have cases whereby the extracted side shows visibly less density than the non touched area, and as explained, this is due to still in keeping with an extraction pattern that is sufficiently spread to not contribute to any real visible concern and especially not when the hair has any length.

Additionally, before extraction, the donor area must be well numbed. Administering anaesthetic and epinephrine to a donor area can in some patients cause shock loss. As we have already explained that the temporal/parietal area has more softer follicles, and is also an area that can be prone to hair loss and recession the closer to the temporal point. This means that some patients may be more susceptible to shock loss in this area.
If a particular patient has a significant graft demand that requires harvesting from both sides, then the reward far outweighs the risk of temporary shock loss. However, in patients whose graft demands can be met by utilising and extracting from just one side, then there is no need to “disturb” both sides at this time. As long as the extraction pattern can be managed in a way that no real visible distinction can be made from one side to the other, then this is Dr. Bisanga´s preferred approach with appropriate patients.
Should a patient then in the future experience further loss into his temple points for example or would like to “tweak” his hairline, then we have the advantage of being able to again harvest the most appropriate single hair grafts from that untouched donor area.
Our approach also allows a second pass even on previously harvested areas, so does in essence maximise the donor without over harvesting and choking any area or over spreading with needless extra injections, swelling and potential shock loss.

It is an approach that has served Dr. Bisanga well in many of his patients.

I will link some cases below where this approach has been used. There are many more on the forum. The cases below show hair at different lengths throughout the growth phases to reinforce that there are no donor concerns.
I think that it is fair to say that the quality of these results and the appearance of the donor area post surgery are optimal. 

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Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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Work looks incredibly clean.

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I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

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  • 2 weeks later...
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1 Month post surgery update

Hello guys,

Everything is going pretty well. The shedding was hard and started about eight days ago.

I take finasteride (1mg) and minoxidil (5mg) like I have normally and I have been supplementing 1600mg MSM.
Since about 10 days I massage Emu oil on the recipient before bed, as this is supposed to help against the redness.
After I started applying I can confirm that the redness faded quicker than before, however I do not have a comparisson with previous procedures.

On the donor area on the side my skin is a little irritated which comes from touching it I guess.
Using some cream now which is making it better already. You can also notice some shockloss near my temple point where they took the fine singles, I do not find this alarming as it will grow back.

As for the pictures:

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Donor:

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Donor side with some minor shockloss and skin irritation (little bit wet because of cream):

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Non-donor side:

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Thats it for now, will return in 30 days again with more pictures. Feel free to ask any questions in the meantime!

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First of all, thanks for sharing your journey. I myself will undergo a FUE procedure with Dr. Bisanga in november and this gives me a great idea of how the first days/month will look like.

You mentioned no pain during the procedure. Did the numbing injections hurt a lot, or was it manageable? Can't wait to see your next update, looking great so far.

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Early months can be the most frustrating with some post operative redness and awaiting those first signs of growth, but you are looking good, exactly as expected and with some further patience you will have some exciting months ahead.

Thank you for the update.

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Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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On 10/16/2021 at 11:59 PM, capillus incrementum said:

First of all, thanks for sharing your journey. I myself will undergo a FUE procedure with Dr. Bisanga in november and this gives me a great idea of how the first days/month will look like.

You mentioned no pain during the procedure. Did the numbing injections hurt a lot, or was it manageable? Can't wait to see your next update, looking great so far.

That is great. You will have a great experience I am sure.

First you will be sedated with some type of valium which makes you very relaxed. This must have played a part in not feeling the numbing injections, as well as a steady hand and experience of the one administering them.

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  • 4 weeks later...
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2 Months post surgery update

Hello gentlemen, tomorrow will be the 2 month mark officially as my day of treatment was the 16th.

I see more and more small hairs coming through, still it can be considered the ugly duckling stage.
As I will be on travel from Thursday onwards I have decided to buzz everything down to pre-op shortness again at the barbers as I have kind of liked that length!
After I will just wait and see how it grows back to decide on what length of hair to pass through the next stage with.

Currently this is my status:

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Some donor/non-donor side shots:

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Looks really good! Did you already cut it on your last pictures? It seems you already got this length at month 1 (non transplanted hair).

I got my transplant 4 days ago and the itching is heavy. Did you experience this too? If yes, between which days and when did it go away/ease off?

Good luck!

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