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Dr. Bisanga - BHR Clinic 2858 FUE 0 - 8 Months - Fast, Dense & Natural Growth


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The patient wanted to treat his recession and re-establish a hairline. This was achieved by shaving and working back into his frontal third. He is in his late 30s.

Here we have the development showed as 2,5 and 8 months and the patient will endeavour to provide through to the 12-month period. 

Needless to say, he is already happy with the outcome so far and can expect more to come. The intricacy and cleanness of the work can be seen here in both donor and recipient as is our signature at BHR Clinic.

Graft Breakdown:-

1s = 453 (453)
2s = 1511 (3022)
3s = 855 (2565)
4s = 39 (156)
Total:- 2858/6196 - 2.16 Average.

Video:

 

Pre Surgery

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Post Surgery

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2 Months

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5 Months

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8 Months

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Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@drchristianbisanga.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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4 hours ago, Calihome1 said:

Nice result, but, seems like a ton of grafts for a small area

I can understand whilst "on the surface" and at first glance that this may appear as a higher graft count, but this is really where genuine understanding and education regarding hair restoration surgery and achieving consistently excellent results comes into play. It is important to "scratch beyond the surface" and really examine facial/scalp markers to have any real understanding of the realities of the case.

 

1367846683_ScreenShot2022-11-24at15_32_24.thumb.png.49aad702cd5974a6d00adc8c45265abb.png


If you look at the above image, you can see that the hairline and those initial cms alone are being completely rebuilt from essentially zero. Whilst the patient has some weaker native hairs still in place and so it does not appear as though the hairline is being "lowered", restoration can not rely on these hairs neither for illusion of density nor for any longevity and so the approach taken in such a restoration is to rebuild as if these hairs are not present.
Therefore this is a reasonable surface of essentially bare scalp.

The first mms alone will have required in the region of 500 grafts as is detailed by the doctor in a previous video for another case -

 

Additionally the temple recession is much deeper than appreciated and much deeper than the standard frontal third restoration. If you look at the following image, and as you can see with the line from the back of one ear, to the back of the other ear, this is deep into the mid scalp and grafts placed into the areas of temple recession and amongst native hair to reinforce are almost in line with the marker.
It may not be completely obvious in the photo, but if you with your hands find the back for your ear and then follow that line onto the top of your head, you will feel how far back this point is from the hairline and how close to the vertex.

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Not to mention that the patient naturally has fine hair and therefore placing must be uniquely appropriate to his personal characteristics in order to be able to achieve the result that the patient has.

Edited by Raphael84
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Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@drchristianbisanga.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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Stellar result. I see some thinning in the crown though. Patient is only in his 30s so it is not a good sign for the future. 

Edited by Mike10
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Solid uniform growth, and a very nice hairline design - Excellent result. 
 

RE the graft count;

Aside from the patients’ fine hair calibre, and what I presume to have been hidden thinning behind the recessed hairline, Dr Bisanga is one of the Dr’s in the industry that aims to actively ‘transitionally transplant’,  which helps blend the focus area of restoration into the native sections, as well as help the appearance of native areas that will inevitably become subject to further loss down the line. 
 

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Dr. Bisanga =

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On 11/24/2022 at 4:25 PM, Calihome1 said:

Nice result, but, seems like a ton of grafts for a small area

Seems like it. Patient needs to be on medication because also he has some thinning in the crown. 

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Always good to have a regimen of medication in place as hair loss is progressive and despite what some of us may want to believe, loss can and will evolve until our final days.

This patient will be 40 next year and so based on his pre operative images had actually retained a good amount of hair for his age, but medication would certainly help to stabilise over the longer term as is always the case.

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Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@drchristianbisanga.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 11/24/2022 at 10:25 AM, Calihome1 said:

Nice result, but, seems like a ton of grafts for a small area

I think people viewing cases like this compare it to other cases where less grafts were used for the same surface area treated. It’s understandable to get confused. I’ve seen many cases where patients had around 3000 grafts covering the entire zone underneath that red line @Raphael84 posted, including that middle portion that wasn’t worked on. As he explained, the corners do go pretty deep, so that’s where extra grafts were placed.  But i can see why people question why  2858 grafts were used in an example like this and not to include the center portion.@Raphael84can correct me if I’m wrong, if  that center portion that is untouched right now is grafted in the future it would take maybe 500 or so grafts to match its surroundings? So essentially 2800+ 500 would put this patient at 3300 grafts for coverage in his entire frontal third into his mid scalp which is a standard graft count for this surface zone. I hope I explained this correctly. 

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Looking at the image below, I have added the yellow line from the hairline to the mid scalp area, and then duplicated this exact line. You can see that the duplicated line starting from the mid scalp line actually surpasses the posterior scalp in this photo, showing that the frontal restoration covers slightly more than half of the length (front to back) of the top of the scalp (of course we are looking at a photo and can not accurately understand the scalp curvature or bone structure). 

On 11/27/2022 at 3:38 PM, Hair4Days said:

I’ve seen many cases where patients had around 3000 grafts covering the entire zone underneath that red line

Depending on final hairline design and placement, 3000 grafts would normally present a complete frontal third restoration, but not a frontal half at required density
This patients native density was around 80FU/cm2 which is above average. His hair thickness was "fine", so to be able to achieve the appropriate illusion of density, a particular density was required in placing.
Less grafts could have been used, but then this would have presented a lesser illusion and a lesser visual of naturalness and perceived homogenous density and certainly would not have been able to reinforce thinning areas such as the deeper temple recession, which would have meant a lesser result and potentially needing to return to reinforce the recession in the future.

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Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@drchristianbisanga.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 11/27/2022 at 7:38 AM, Hair4Days said:

I think people viewing cases like this compare it to other cases where less grafts were used for the same surface area treated. It’s understandable to get confused. I’ve seen many cases where patients had around 3000 grafts covering the entire zone underneath that red line @Raphael84 posted, including that middle portion that wasn’t worked on. As he explained, the corners do go pretty deep, so that’s where extra grafts were placed.  But i can see why people question why  2858 grafts were used in an example like this and not to include the center portion.@Raphael84can correct me if I’m wrong, if  that center portion that is untouched right now is grafted in the future it would take maybe 500 or so grafts to match its surroundings? So essentially 2800+ 500 would put this patient at 3300 grafts for coverage in his entire frontal third into his mid scalp which is a standard graft count for this surface zone. I hope I explained this correctly. 

Only 500 for that entire middle portion? That doesn’t sound right

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On 11/30/2022 at 10:44 AM, Calihome1 said:

Only 500 for that entire middle portion? That doesn’t sound right

It depends on how many grafts are needed for a frontal half restoration for this patient. If the number is 3500 then that middle portion would need 700. 

maybe @Raphael84could give further detail on graft count for that middle portion in the event it thins out.

What is this patients projected graft availability in his donor?

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