Dr. Patrick Mwamba (Fue Clinic) - 1300 grafts - 5th & 6th of July 2021

[Mixed93]

It’s the surgeons job to tell the patient how many grafts they need in order to achieve the required density in my opinion - that’s part of their job… obviously we all do research but we’re not experts. It also doesn’t help that there are barely any afro / curly hair results on here so it makes it a bit harder for us to make an accurate judgement.

 @Ajamilo did the clinic say they will do a second procedure to achieve your desired density free of charge, or will you have to pay for this? (Sorry if you’ve already mentioned it in the thread).

[mustang]

20 hours ago, Mixed93 said:

It’s the surgeons job to tell the patient how many grafts they need in order to achieve the required density in my opinion - that’s part of their job… obviously we all do research but we’re not experts. It also doesn’t help that there are barely any afro / curly hair results on here so it makes it a bit harder for us to make an accurate judgement.

 @Ajamilo did the clinic say they will do a second procedure to achieve your desired density free of charge, or will you have to pay for this? (Sorry if you’ve already mentioned it in the thread).

This makes absolutely no sense to me. The more grafts the patient gets the more money the surgeon makes and the best result they will have (within limits per square cm2). Why would a surgeon decide to implant such low density?

The only reason why no more grafts are implanted is because we have a limited budget or because it has been planed this way by mutual agreement in two stages. The surgeon can then advice it will not be enough or that a second pass will be required or decide to not perform the surgery. I know Dr Mwamba has a policy of helping everyone and not turning around patients despite how difficult the case might be.

 

[Mixed93]

7 hours ago, mustang said:

This makes absolutely no sense to me. The more grafts the patient gets the more money the surgeon makes and the best result they will have (within limits per square cm2). Why would a surgeon decide to implant such low density?

The only reason why no more grafts are implanted is because we have a limited budget or because it has been planed this way by mutual agreement in two stages. The surgeon can then advice it will not be enough or that a second pass will be required or decide to not perform the surgery. I know Dr Mwamba has a policy of helping everyone and not turning around patients despite how difficult the case might be.

 

Which part doesn’t make sense? It sounds like we agree 🤨 all I said is that it’s the surgeons job to tell the patient how many grafts are needed to achieve the required visual density, and not vice versa. In the time I’ve been on this forum I haven’t seen any patient posted journeys with hair type resembling mine, there’s no way I’d personally be in a position to be telling the surgeon how many grafts I need, plus that’s not my job.

Obviously the required amount of grafts  to achieve the desired result should be discussed between patient and surgeon prior to having the transplant, that just seems like common sense.

Edited April 11, 2022 by Mixed93

[RTC]

From all I have read about Dr Mwamba, he has an excellent reputation. However it is a little concerning that Ajamilo isn't getting much communication or answers from the clinic. 

 

[Curious25]

23 hours ago, mustang said:

This makes absolutely no sense to me. The more grafts the patient gets the more money the surgeon makes and the best result they will have (within limits per square cm2). Why would a surgeon decide to implant such low density?

The only reason why no more grafts are implanted is because we have a limited budget or because it has been planed this way by mutual agreement in two stages. The surgeon can then advice it will not be enough or that a second pass will be required or decide to not perform the surgery. I know Dr Mwamba has a policy of helping everyone and not turning around patients despite how difficult the case might be.

 

 

17 hours ago, Mixed93 said:

Which part doesn’t make sense? It sounds like we agree 🤨 all I said is that it’s the surgeons job to tell the patient how many grafts are needed to achieve the required visual density, and not vice versa. In the time I’ve been on this forum I haven’t seen any patient posted journeys with hair type resembling mine, there’s no way I’d personally be in a position to be telling the surgeon how many grafts I need, plus that’s not my job.

Obviously the required amount of grafts  to achieve the desired result should be discussed between patient and surgeon prior to having the transplant, that just seems like common sense. 

A surgeon as experienced as Mwamba will have an idea of the potentials and limits each hair type has when it comes to coverage value. 

To be more scientific in approach, I know some doctors use tools such as Erdogans coverage calculator - I don’t know whether Mwamba does this or not. 

But it’s as simple as measuring the balding/bald areas, and then formulating the total count by multiplying the required density by the size of the area, taking into consideration whether there are already native hairs present etc. 

I agree, that as a patient, part of the service you should expect from your surgeon is to quote you a sufficient number of grafts to achieve the density you have both agreed upon striving to achieve. 

Your example of doctors being more inclined to increase the size of total graft counts @mustang , because the surgery would generate more money, is unethical practice - which we should not expect from any of the doctors listed on this site, correct @Melvin- Moderator ? 

[mustang]

4 hours ago, Curious25 said:

 

A surgeon as experienced as Mwamba will have an idea of the potentials and limits each hair type has when it comes to coverage value. 

To be more scientific in approach, I know some doctors use tools such as Erdogans coverage calculator - I don’t know whether Mwamba does this or not. 

But it’s as simple as measuring the balding/bald areas, and then formulating the total count by multiplying the required density by the size of the area, taking into consideration whether there are already native hairs present etc. 

I agree, that as a patient, part of the service you should expect from your surgeon is to quote you a sufficient number of grafts to achieve the density you have both agreed upon striving to achieve. 

Your example of doctors being more inclined to increase the size of total graft counts @mustang , because the surgery would generate more money, is unethical practice - which we should not expect from any of the doctors listed on this site, correct @Melvin- Moderator ? 

Exactly, as far as I am concerned Mwamba did the exact opposite here. He was too conservative perhaps.

It's a repair case with a decimated donor, you can see how thin the transplanted grafts are, the best grafts were probably gone. 

I would have advice to go with 2.500 for that area but if the patient didn't have more money and a 2 or 3 stage surgery was planned it's a valid approach. 

It is indeed true that afro hair requires less grafts in normal conditions to achieve good coverage but these grafts are thin and density is way too low, I think another 500-600 will do the trick to at least look OK. Now to look great probably another 1.000

[Melvin- Admin]

4 hours ago, Curious25 said:

 

A surgeon as experienced as Mwamba will have an idea of the potentials and limits each hair type has when it comes to coverage value. 

To be more scientific in approach, I know some doctors use tools such as Erdogans coverage calculator - I don’t know whether Mwamba does this or not. 

But it’s as simple as measuring the balding/bald areas, and then formulating the total count by multiplying the required density by the size of the area, taking into consideration whether there are already native hairs present etc. 

I agree, that as a patient, part of the service you should expect from your surgeon is to quote you a sufficient number of grafts to achieve the density you have both agreed upon striving to achieve. 

Your example of doctors being more inclined to increase the size of total graft counts @mustang , because the surgery would generate more money, is unethical practice - which we should not expect from any of the doctors listed on this site, correct @Melvin- Moderator ? 

What are you trying to say here? This patient had an extremely compromised donor area. If the goal was to get the maximum money, the donor would have been further damaged and more grafts would have been harvested. You can always remove more, but never put it back. 

[Melvin- Admin]

@Ajamilohas asked me to take down the thread. I’m posting this and will leave it up for a few hours until I take it down. 

[ITA]

@AjamiloIt does not seem fair to the communities that you asked @Melvin- Moderatorto delete this thread, at least without knowing why you did it.  Did you get pressure from the doctor, did you get a refund, or were you promised a free touch-up to do it?

[mustang]

Why would he get a refund? The grafts that were implanted grew, it's not the physicians fault. You can see they are extremely thin looking because of a decimated donor and that the implanted density was way too low because of budget constraints or 2 stage planning.

A free touch up is definitely warranted provided the area is measured and calculated, if only 70% of grafts grew then obviously any reputable clinic will perform a free touch up to cover the difference. 

Dr Mwamba is the nicest person you'll ever meet. Ask any of his patients here. He would never pressure a patient to do anything, not even getting to get more grafts so he wouldn't risk threads like these on repair jobs.

 

[ITA]

1 hour ago, mustang said:

 

Why would he get a refund? The grafts that were implanted grew, it's not the physicians fault. You can see they are extremely thin looking because of a decimated donor and that the implanted density was way too low because of budget constraints or 2 stage planning.

A free touch up is definitely warranted provided the area is measured and calculated, if only 70% of grafts grew then obviously any reputable clinic will perform a free touch up to cover the difference. 

Dr Mwamba is the nicest person you'll ever meet. Ask any of his patients here. He would never pressure a patient to do anything, not even getting to get more grafts so he wouldn't risk threads like these on repair jobs.

 

Sure it's as you say, but it sounds weird to me that all of a sudden, the OP asks @Melvin- Moderatorto delete the thread, don't you notice something weird too?  I do!

[Ajamilo]

17 hours ago, Egy said:

@AjamiloIt does not seem fair to the communities that you asked @Melvin- Moderatorto delete this thread, at least without knowing why you did it.  Did you get pressure from the doctor, did you get a refund, or were you promised a free touch-up to do it?

Yes - It's true that I asked Melvin about it and actually did it for my own reasons. But I have reconsidered it and will continue to provide future updates on the case.

I would also like to point out again that this has nothing to do with budget or two-step surgery as far as I know. I dont really know why you keep repeting this after i explained it for you AGAIN MUSTANG or JOSHUA. 
I think it is obvious to most people the aggressive appearance you have shown in this thread and the repetedly accusation about my private finances and what me and Dr.mwamba talked about. 
I know for sure how important this case is for you. I do not really have so much to do with your affiliation with this clinic and honestly i dont care either. But i have previously asked you to stay away from my thread and hope you can respect that. There are anyways many other Mwamba threads on this forum you can spam down and do what u usual do.

Anyway I was assured by Mwamba during the consultation that this was estimated to be enough to get a good growth and density. This was what i talked with him privatly about. He even said that I had the opportunity to lower my hairline 2.0 cm and we would then implant something with 1880-1990 grafts. And we now know that this calculation would have given the same result anyway. But i am of course happy I stack to 1.5 cm since it was good enough aesthetically. So frankly this is far from good enought. And i am unhappy with the result. If I had had the knowledge that people have shared with my here such as grafts were separated as i see now, I would of course have demanded that he had put 2000 grafts instead of 1300. But i havent talked with him to be honest so when i do my personal consultation in Belgium i can for sure give more info about it

I know that my donor is not the best and I actually explained it in the thread. My intention was first to fix it and that was the plan. I even mentioned the case of Joshua to him and he told me that I had a better starting point than him. So according to him i did not need a lot of BHT to make it a lot better. So I should rather make the even so my donor area would give the same density overall. And one can also see it in the picture above when i grow it out. Is a lot better visually than before and off course i thank him for that.

This has really bothered me a lot and given me many sleepless nights and i dont feel good about this issue.  At the same time, I have things I have to focus on in my private life, such as school, work, etc. so i can change the focus from this thing.
For that reason I will only share updates forward and hopes that is okey for the people   The main reason for this thread was to updated my journey so if you guys want to discuss pliz do it on another thread

Edited April 13, 2022 by Ajamilo

[mustang]

I have zero knowledge of your personal financial situation nor do I know who you are, I am speaking out of common sense here and I am glad you will keep this thread alive. I think it's the best for everybody and specially for Dr Mwamba so he  (or the clinic) can chime in and gives their version of things.

I am sorry me commenting here bothers you but this is a public forum and we are all entitled to read and participate within the boundaries of respect. This said, I will not continue for your peace of mind.

I hope you get the results you want in the end, it sucks not being satisfied with an outcome but this thread has been in my opinion unfair to him to say the least. 

Yes, it's very important for me that he gets the credit and his valued for the excellent surgeon he is. I am in debt with him for having taken my case, that doesn't mean I can't be objective when a case is not great, all clinics have great, regular and bad case and yours is not great by a mile but I don't think it's the clinics fault, at least not entirely. 

If I saw 2.500 grafts implanted and this outcome then yes but that's not what happened and it has to be clarified why.

[Dr. Patrick Mwamba]

Hello everyone ,

I read the thread and i would like to tackle some issues .

Repair cases is a though call for both the patient and the physician.

The donor area was depleted .Surgery outcome depends a lot on donor quality ( density , caliber , pigmentation).And the goal of the patient was to fix the donor and to lower the hairline.

My first recommendation was 2000 to 2500 grafts , to couple with SMP. My staff told me the patient can afford only 1500 grafts .I can not expect a full coverage by lowering the number of grafts but I was shooting for an average , decent coverage that could bring us back on track with a little bit camouflage from SMP and other artefacts.

For me , this procedure was a first step as we had to deal with harmonizing the look of  the donor and lowering the hairline.And I didn't do even 1500 grafts but only 1300 grafts :WHY ? Donor management was my first goal .

Communication and misunderstanding of the entire process is the first issue to resolve in our next meeting.

Unrealistic expectation usually leads to unsatisfied patients.And it is my role to let the patient know this is not a one shot or a home run procedure .All the ingredients were not present .This is a marathon . And it is my failure  if the patient didn't get it correctly.

 

[Dr. Patrick Mwamba]

WHAT IS THE DENSITY FOR FHL IN AFRO HAIRS ?

I presented a topic at the ISHRS meeting about the topic .

Because we use singles and doubles to build the FHL , you have to do the same density as in caucasian ( 50 to 60 FU/cm2) to got a decent coverage .

The curl and the caliber to reduce the density plays for behind .You need to use soft hairs from nape ;otherwise it may look pluggy .

Same apply to coarse asian hairs .You can not put them in the hairline.You need to chase fine and soft hairs to make it look natural .Therefore you need to apply the same principle for density in hair line .

We can all share others concepts about coverage , hair volume and hair density .

[Dillpickle123]

6 hours ago, Dr. Patrick Mwamba said:

Hello everyone ,

I read the thread and i would like to tackle some issues .

Repair cases is a though call for both the patient and the physician.

The donor area was depleted .Surgery outcome depends a lot on donor quality ( density , caliber , pigmentation).And the goal of the patient was to fix the donor and to lower the hairline.

My first recommendation was 2000 to 2500 grafts , to couple with SMP. My staff told me the patient can afford only 1500 grafts .I can not expect a full coverage by lowering the number of grafts but I was shooting for an average , decent coverage that could bring us back on track with a little bit camouflage from SMP and other artefacts.

For me , this procedure was a first step as we had to deal with harmonizing the look of  the donor and lowering the hairline.And I didn't do even 1500 grafts but only 1300 grafts :WHY ? Donor management was my first goal .

Communication and misunderstanding of the entire process is the first issue to resolve in our next meeting.

Unrealistic expectation usually leads to unsatisfied patients.And it is my role to let the patient know this is not a one shot or a home run procedure .All the ingredients were not present .This is a marathon . And it is my failure  if the patient didn't get it correctly.

 

That makes sense That’s what I thought 2k-2.5k grafts now this makes a whole lot of sense now for the area that you Dr suggested but other factors made it so that less grafts were implanted 

[Melvin- Admin]

10 hours ago, Dr. Patrick Mwamba said:

Hello everyone ,

I read the thread and i would like to tackle some issues .

Repair cases is a though call for both the patient and the physician.

The donor area was depleted .Surgery outcome depends a lot on donor quality ( density , caliber , pigmentation).And the goal of the patient was to fix the donor and to lower the hairline.

My first recommendation was 2000 to 2500 grafts , to couple with SMP. My staff told me the patient can afford only 1500 grafts .I can not expect a full coverage by lowering the number of grafts but I was shooting for an average , decent coverage that could bring us back on track with a little bit camouflage from SMP and other artefacts.

For me , this procedure was a first step as we had to deal with harmonizing the look of  the donor and lowering the hairline.And I didn't do even 1500 grafts but only 1300 grafts :WHY ? Donor management was my first goal .

Communication and misunderstanding of the entire process is the first issue to resolve in our next meeting.

Unrealistic expectation usually leads to unsatisfied patients.And it is my role to let the patient know this is not a one shot or a home run procedure .All the ingredients were not present .This is a marathon . And it is my failure  if the patient didn't get it correctly.

 

Thank you for taking the time and clearing that up. It does make sense that would be the goal. Dr. Konior once told me, after several hair transplants, managing the donor is equally as important as growing hair on the top. 

[Ajamilo]

I think this is my last update for now

This is the density atm and i am sure it will not get better at all. Been using caps to cover up since it is weird to walk like that in the street with so low density and low survival on the hairline. Honestly it looks just weird and the friends i have shown are telling me the same.

I was going to do biposy next week with my main doctor but since i learned that you get scarring from the test and they basically remove a tissue from that part of your head and this case the hairline i passed it. I also sent my pictures to two highly recommended clinics on this site and one of the best and both commented on my skin condition. Also just to point out I never had this skin condition when I did my first surgery in turkey. so blaming that i have vulnerable skin so i get easily scarring on my recepeint is to easy to say without any evidence.

I also canceled my appointment with Mwamba. Honestly i dont see any reason to have it and i think i just need peace in my mind and try SMP or something on the hairline in mean while

[RTC]

How is your donor area Ajamilo?

Hopefully you can have one final pass and it would improve it significantly. What type of skin issue do you have?

[Ajamilo]

On 5/2/2022 at 9:45 AM, Aslitarcan sucks said:

How is your donor area Ajamilo?

Hopefully you can have one final pass and it would improve it significantly. What type of skin issue do you have?

I got scars on the hairline and also cobblestoning. I had a video consultation with Dr.Wong when i shaved it down and that was the first comment he said because the scars was visible trought the entire hairline so he was wondering where i went. After what i got told regarding the  cobblestonnig is that recepeint sites was not done deep enought. I dont know who fault it is since it is not only mwamba who is working on you. At least 50 prosent of the time is another doctor name Ali that was working on me. Is really sad and depressive because i paid a lot more money to be safe and do my best but i got scars, cobblestoning and bad growth on the hairline from them

[RTC]

5 hours ago, Ajamilo said:

I got scars on the hairline and also cobblestoning. I had a video consultation with Dr.Wong when i shaved it down and that was the first comment he said because the scars was visible trought the entire hairline so he was wondering where i went. After what i got told regarding the  cobblestonnig is that recepeint sites was not done deep enought. I dont know who fault it is since it is not only mwamba who is working on you. At least 50 prosent of the time is another doctor name Ali that was working on me. Is really sad and depressive because i paid a lot more money to be safe and do my best but i got scars, cobblestoning and bad growth on the hairline from them

Ahhh man, I am sorry to hear that. You have decided not to go back and show Dr Mwamba?

[Mike10]

It is clear The result is not what it should have been. To be fair, this was a tougher case, repair case, afro hair plus limited budget. So it also needs to be put into perspective. A lot of these so called Drs do not even take on case like this.

Edited May 17, 2022 by Mike10

[Ajamilo]

It has now been over 1 year since I had 1300 grafts surgery with Mwamba. I have really tried to move on with life and think of something else and do other activities than thinking about hair even if it is difficult haha.

It has not really gotten any better than the last update about the hairline and is still whizzpy, quite thin and needs to be covered daily with hair spray and fiber. I have been growing out the mid-scalp and its density with the curliness has become much better with the help of oral minoxidil and finasteride. So what i do now is  to comb my hair forward so that I can hide some of the hairline, since it is quite tiring to put on toppik and hair spray almost every day. I tried smp with three treatment on the hairline but the ink went away after some time.
I think I also mentioned earlier that I got some cobblestoning on the hairline. I visited my main doctor and he gave me a cream supposdly will help against it. But I am quite unsure if it has any effect at all.
 
 I think I can also say a lot about the communication with the clinic. I really feel, if I can say it from the bottom of my heart, that they have been pretty bad. I feel that the result is one thing, but as a young person I go through a lot. So having a person or clinic that follows you up and supports you is very important for the mental helth i guess. The phone call with one of their representatives, Carla, went bad and that made me feel really angry since she was quite rude and inconsistent under the convensation. First she told me that they support me and if I felt that things were not good or goin well, then they would correct it. Since they want the best for their patients and always correct dissatisfied patients. But then when i complained about the density issue and i did not think it would improve a lot, then she told me that they will measure if my hair has grown and if it has grown 80% then I had to cover and pay for myself. She also generally had a pretty rude tone and was yelling sometimes during the whole conversation so that is sad too

But anyway, I have to continue with my medication, in same time try to talk to other doctors who can possibly help my situation

Edited June 29, 2022 by Ajamilo

[RTC]

1 hour ago, Ajamilo said:

It has now been over 1 year since I had 1300 grafts surgery with Mwamba. I have really tried to move on with life and think of something else and do other activities than thinking about hair even if it is difficult haha.

It has not really gotten any better than the last update about the hairline and is still whizzpy, quite thin and needs to be covered daily with hair spray and fiber. I have been growing out the mid-scalp and its density with the curliness has become much better with the help of oral minoxidil and finasteride. So what i do now is  to comb my hair forward so that I can hide some of the hairline, since it is quite tiring to put on toppik and hair spray almost every day. I tried smp with three treatment on the hairline but the ink went away after some time.
I think I also mentioned earlier that I got some cobblestoning on the hairline. I visited my main doctor and he gave me a cream supposdly will help against it. But I am quite unsure if it has any effect at all.
 
 I think I can also say a lot about the communication with the clinic. I really feel, if I can say it from the bottom of my heart, that they have been pretty bad. I feel that the result is one thing, but as a young person I go through a lot. So having a person or clinic that follows you up and supports you is very important for the mental helse i guess. The phone call with one of their representatives, Carla, went bad and that made me feel really angry since she was quite rude and inconsistent under the convensation. First she told me that they support me and if I felt that things were not good or goin well, then they would correct it. Since they want the best for their patients and always correct dissatisfied patients. But then when i complained about the density issue and i did not think it would improve a lot, then she told me that they will measure if my hair has grown and if it has grown 80% then I had to cover and pay for myself. She also generally had a pretty rude tone and was yelling sometimes during the whole conversation so that is sad too

But anyway, I have to continue with my medication, in same time try to talk to other doctors who can possibly help my situation

Thanks for sharing bro and sorry to hear about the situation. I hope you will sort it with a new procedure

[mustang]

I am really sorry man, it sucks when we are not satisfied with the outcome. I have had 12K over 15 transplants and still need to use Toppik if I want my hairline to look perfect and I have had over 3.000 grafts on it or more so one surgery of 1200 grafts was never going to do it. 

I wished you would have gone back to Dr Mwamba so he could have increased your density and in 6 months you would be in a completely different position.

Hopefully another Dr will be able to help you and resolve this, you just need a 800 graft touch up at max and will look quite good, stay positive