Considering a Repair HT after 3800 FUE

[VladRojas]

 

@mustang Thank you for the information. I'll see Dr. Mwamba in Atlanta this Saturday.

To clarify, you suggested patch testing for growth. Can the low-density pass work as a patch test, or do they have to be separate procedures?

Based on this, which option would you recommend?
Option A: Patch test first, then low-density pass for vessel creation, followed by the second pass at higher density.
OR
Option B: Low-density pass first for vessel creation and growth assessment, then decide on the second pass at a higher density after six months.

In your experience, are there any other measures I can take to increase the survival rate of the first pass or patch test? you mentioned using PRP during the slit creation, but what about using PRP weeks before and/or between procedures or taking finasteride? I'm asking because I want to do what I can to improve the success of the graft survival.

[JP28]

1 hour ago, VladRojas said:

 

@mustang Thank you for the information. I'll see Dr. Mwamba in Atlanta this Saturday.

To clarify, you suggested patch testing for growth. Can the low-density pass work as a patch test, or do they have to be separate procedures?

Based on this, which option would you recommend?
Option A: Patch test first, then low-density pass for vessel creation, followed by the second pass at higher density.
OR
Option B: Low-density pass first for vessel creation and growth assessment, then decide on the second pass at a higher density after six months.

In your experience, are there any other measures I can take to increase the survival rate of the first pass or patch test? you mentioned using PRP during the slit creation, but what about using PRP weeks before and/or between procedures or taking finasteride? I'm asking because I want to do what I can to improve the success of the graft survival.

Is Mwamba back to work in Atlanta?

 

[mustang]

3 hours ago, VladRojas said:

 

@mustang Thank you for the information. I'll see Dr. Mwamba in Atlanta this Saturday.

To clarify, you suggested patch testing for growth. Can the low-density pass work as a patch test, or do they have to be separate procedures?

Based on this, which option would you recommend?
Option A: Patch test first, then low-density pass for vessel creation, followed by the second pass at higher density.
OR
Option B: Low-density pass first for vessel creation and growth assessment, then decide on the second pass at a higher density after six months.

In your experience, are there any other measures I can take to increase the survival rate of the first pass or patch test? you mentioned using PRP during the slit creation, but what about using PRP weeks before and/or between procedures or taking finasteride? I'm asking because I want to do what I can to improve the success of the graft survival.

You can do either. An entire low pass or a specific area low-medium pass. I would do a low density pass in FUT scar. My patch test was done because I had a FUE depleted spot.

Finasteride won't help nor PRP after the surgery. The graft either reconnects to blood supply within the first days or it doesn't. 

You can increase your iron intake 6 weeks before surgery to  try to have our red blood cell count as healthy as possible (more oxygen in your blood) and workout daily. The healthier you are the better the chance. Don't smoke of course.

 

[Etownone]

Good luck. 

I think Dr Mwamba will Def help you.  

He helped me with some spots in my donor area and my FUT scat.   He's very good at that.   

[SXP92]

19 hours ago, JP28 said:

Is Mwamba back to work in Atlanta?

 

He has some appointments in Atlanta this upcoming weekend, but he's not officially back to doing procedures in the US. I had a virtual appointment with him for a similar issue a few months ago and told me that he is actively working toward finding a suitable clinic space in the US which he said would most likely be in either Atlanta or the Washington DC area

[gillenator]

I cannot officially speak for him however my premonition is that he would be spending time in the Atlanta clinic where he was primarily trained by the world renowned dynamic surgeon who’s last name rhymes with Pole.

[gillenator]

On 2/14/2023 at 3:51 PM, VladRojas said:

Hi @gillenatorand @mustang thank you both for your answers. @gillenator May I ask for the name of the Doctor you mentioned who is an expert in repair procedures (DRT) based in Georgia?

Yes, I also read that the yield of beard hair is great, especially for the donor area where we want to achieve density.

I have had consultations with Dr. Umar and Dr. Mwamba. They both suggested that I would need around 1500 to 1750 grafts to make it look decent in my donor area. They suggested extracting hair from virgin areas on the scalp (Nape and Temples) and also from the beard, stating that this repair procedure would help a lot to make it less obvious that my donor was overharvested. They both said that SMP would give the final touch to make it look great. However, I am not a big fan of SMP because I do not want ink in my body. Therefore, I am trying to seek other resources before resorting to SMP.

Dr. Bisanga said that he would not perform any procedure and that only SMP would help. I felt a bit annoyed by his response, given that I saw he has helped worse cases than mine. What do you think of this? It makes me wonder if Dr. Mwamba and Dr. Umar are not truly honest. However, it makes no sense because they are top surgeons.

My realistic expectation for the repair procedure is to minimize the evidence that I had a procedure done on my donor area. As long as it looks better than it does right now, I would be happy.

Any feedback would be greatly appreciated. @Archan @Melvin- Moderator @Tiger2050

Thank you

VladRojas, the world renowned surgeon based in the Atlanta, GA area is the one who primarily trained both Dr. Mwamba and Dr. Bisanga…his last name rhymes with Pole.

[SXP92]

On 2/15/2023 at 10:32 PM, VladRojas said:

What was the result of your visit with Mwamba?

@mustang Thank you for the information. I'll see Dr. Mwamba in Atlanta this Saturday.

To clarify, you suggested patch testing for growth. Can the low-density pass work as a patch test, or do they have to be separate procedures?

Based on this, which option would you recommend?
Option A: Patch test first, then low-density pass for vessel creation, followed by the second pass at higher density.
OR
Option B: Low-density pass first for vessel creation and growth assessment, then decide on the second pass at a higher density after six months.

In your experience, are there any other measures I can take to increase the survival rate of the first pass or patch test? you mentioned using PRP during the slit creation, but what about using PRP weeks before and/or between procedures or taking finasteride? I'm asking because I want to do what I can to improve the success of the graft survival.

 

[VladRojas]

Hello, I ended up seeing Dr. Mwamba this past February. After a two-hour examination, he told me that my donor area, mainly the right side, was over-harvested. He also mentioned that the see-through of my new hairline could be fixed with 500 grafts, as he noticed bad angled and multiple grafts. His approach to repair the donor area is a combo of donor restocking + BHT Beard and chest. He said that we would need about 1200 grafts to homogenize to give it a better look to my donor. On the bright side, he noticed that the scarring on my skin was good and didn't look as white, likely because of my skin color. 

Dr. Mwamba and I agreed to repair my donor area next month, by then it will be a bit more than 7 months from my original FUE, but after sharing my recent pictures with Dr.Mwamba we are considering repairing the hairline at the same time with my donor repair. If this is the case. How am I supposed to sleep after the procedure? 

In the long term, i would like to have grafts in the bank for future procedures because i know my baldness will keep progressing. After his examination this is my total graft available:
Scalp: 1k ; Beard:1.5k; Chest/belly: 1k-2k
He will extract 500 grafts from the scalp to repair the hairline and 1.2k grafts from the beard and chest. He will remove those 500 grafts from the scalp, mainly from areas with major contrast with overharvested patches. 

What do you guys think of the approach mentioned above, where the hairline and donor area are repaired during the same procedure? Additionally, if the donor repair is successful and the area looks more homogeneous, does it increase the likelihood to extract more grafts from the donor area in a more planned pattern way for future procedures?

im also 
@gillenator @Etownone @mustang @Gatsby @Melvin- Moderator @Mr Sinister
I attached the latest pictures so you can take a look,  By the way, i asked my barber to do a fade haircut from the bottom to top, trying to minimize the visual effect of my overharvested area.  So far your feedback has been very helpful.  I really appreciate it. 

 
 

Edited April 5, 2023 by VladRojas

[patronovski]

I also have a similair problem and want to fix my donor as well. What dit Mwamba said about chest hair? Is he planning to use those to fill in the donor? What about success rate? Keep us updated with your progress.

[VladRojas]

@mustangi see that you replied, but I couldn’t see your answer for some reason 🤷‍♂️it said something like doing only my right side so I can sleep on my left? If you could please respond again  

[Gatsby]

I don’t see a problem doing the hairline and donor farming at the same time. I had donor farming into my scars with a hair transplant twice. Sleeping is going to be difficult even if you just do the donor farming alone so you are better off killing two birds with one stone. The time will pass. All the best. 

[Mr Sinister]

my thoughts - don't do you front hairline just yet. my hairline is similar. a little thin. some double grafts. poor angles. but we are in the unfortunate position where we have very limited donor. you want to save as much donor for future years. 500 to the hairline doesn't sound like a lot, but when your mid scalp and crown completely go you will be begging for 500 more grafts on top 🤣  at least for now, you have some sort of hairline which is an improvement on before. don't aim for perfection. think long term. and in the future if you still want to improve the hair line you can look at it then.

also, just remember, beard donor success rate is lower than scalp. And chest/belly even lower still. a lot lower. so that 2,700 number could easily look close to 1,500 when transplanted. that's why my advice is to think about preserving as much donor as possible for the future. but with mwamba you're in good hands.

good luck

 

[Gatsby]

Another option or additional option could be SMP in the donor area as long as you keep your hair short. In the future if you feel the donor area needs more density in it's appearance SMP could solve this problem.

[VladRojas]

@Gatsby @Mr Sinister
 

Thank you for your response. I agree with both of you.
What's my priority right? I think that id like to improve the right side of my donor and if possible the density of the hairline. Actually, Dr. Mwamba mentioned that the position and design of the hairline is not bad, but he recommended extracting the multiple grafts with bad angles and repositioning them.

I wonder if using a smaller quantity of grafts, such as 300, would improve the appearance of the hairline. 

[Happyhead]

@VladRojas I believe that after a couple more months, you’ll be in good shape. Actually, right now, it doesn’t look as bad as you may think.

@gillenator I have to ask; is Dr JPC in Atlanta black listed on this forum? I actually did a consult with him in January… I tried searching this forum for any reviews and even tried reaching out to @Melvin- Moderator to ask his opinion (I wasn’t able to dm Melvin due to me being a newer member with minimal posts). Thank you in advance.

 

[gillenator]

Happy head…I do not know what the details are concerning Dr. JPC situation in this community other than his name is not allowed?…I am a former employee (VP Patient Services) of his clinic when Drs. Rose, Mwamba, Bisanga all worked together.

[VladRojas]

On 4/4/2023 at 5:53 PM, VladRojas said:

Hello, I ended up seeing Dr. Mwamba this past February. After a two-hour examination, he told me that my donor area, mainly the right side, was over-harvested. He also mentioned that the see-through of my new hairline could be fixed with 500 grafts, as he noticed bad angled and multiple grafts. His approach to repair the donor area is a combo of donor restocking + BHT Beard and chest. He said that we would need about 1200 grafts to homogenize to give it a better look to my donor. On the bright side, he noticed that the scarring on my skin was good and didn't look as white, likely because of my skin color. 

Dr. Mwamba and I agreed to repair my donor area next month, by then it will be a bit more than 7 months from my original FUE, but after sharing my recent pictures with Dr.Mwamba we are considering repairing the hairline at the same time with my donor repair. If this is the case. How am I supposed to sleep after the procedure? 

In the long term, i would like to have grafts in the bank for future procedures because i know my baldness will keep progressing. After his examination this is my total graft available:
Scalp: 1k ; Beard:1.5k; Chest/belly: 1k-2k
He will extract 500 grafts from the scalp to repair the hairline and 1.2k grafts from the beard and chest. He will remove those 500 grafts from the scalp, mainly from areas with major contrast with overharvested patches. 

What do you guys think of the approach mentioned above, where the hairline and donor area are repaired during the same procedure? Additionally, if the donor repair is successful and the area looks more homogeneous, does it increase the likelihood to extract more grafts from the donor area in a more planned pattern way for future procedures?

im also 
@gillenator @Etownone @mustang @Gatsby @Melvin- Moderator @Mr Sinister
I attached the latest pictures so you can take a look,  By the way, i asked my barber to do a fade haircut from the bottom to top, trying to minimize the visual effect of my overharvested area.  So far your feedback has been very helpful.  I really appreciate it. 

 
 

Hi @gillenator @mustang @Etownone May i ask your feedback on this post? About my future repair with Dr.Mwamba? 
Also the fact that he suggested to fix my hairline w/ 500 grafts, but I’m afraid to run out of grafts for the future.

 

[Etownone]

Well,  I think the hairline is most important,   so if he can fix it with 500.... that will make a big difference.  

And repair the donor with 1200 Beard and chest...  sounds like it would also make a huge impact since you like to cut your hair so short like mustang. 

In my situation..  He fixed my hairline by lowering it a little,  but tbh, I'm not 100% satisfied because it needs more density.  I think in your case since he's just filling in for density, 500 would make a big difference. 

And he also filled in some spots in my donor area, but I still can't cut it too short cause I can see the over harvesting spots. So I keep it at a length that hides the over harvesting pretty good. 

I'm already looking into another repair job with Dr Mwamba.   

Heres a pic of my hairline after Dr Mwamba lowered it just a little....  It definitely could use more density.  Both pics taken on same day but different lighting. 

 

Edited April 10, 2023 by Etownone

[gillenator]

9 hours ago, VladRojas said:

Hi @gillenator @mustang @Etownone May i ask your feedback on this post? About my future repair with Dr.Mwamba? 
Also the fact that he suggested to fix my hairline w/ 500 grafts, but I’m afraid to run out of grafts for the future.

 

Listen my friend, you have an extremely complex repair case and since none of us are experienced repair surgeons, my advice is to follow the approach and surgery plan proposed by Dr. Mwamba…the approach makes sense and utilizing all available grafts whether by relocating or harvesting new sources of donor…the bottom line is that he will IMHO do an excellent job with a difficult case…he is one of the best repair surgeons world-wide and would be a top choice.

[VladRojas]

Obviously I decided to do the repair procedure with  Dr.Mwamba bc of his great reputation. Nevertheless, if I ask questions here is bc I already made a bad decision on my previous FUE by not doing enough research or not asking people for suggestions.  @gillenator

 

@Etownone thank you very much for your feedback. Yes, I can see the difference of your hairline under different Lightning.  Do you have pics of your donor before and after the repair ? 
 

[A_4_Archan]

29 minutes ago, VladRojas said:

Obviously I decided to do the repair procedure with  Dr.Mwamba bc of his great reputation. Nevertheless, if I ask questions here is bc I already made a bad decision on my previous FUE by not doing enough research or not asking people for suggestions.  @gillenator

 

@Etownone thank you very much for your feedback. Yes, I can see the difference of your hairline under different Lightning.  Do you have pics of your donor before and after the repair ? 
 

Imo you can consider idea of dr mwamba and can go for both the thing together ...if he is sure about it than i don't think there will be any issue...and if you wish to stay very very safe thn just go for hairline and do smp on donor area and keep fade cut so its looks normal....its a tough choice bt you only need to think about it and take decision ...cause here everyone will have their own different opinion and understanding and you may get confused...so just stay calm and think about it and talk to dr mwamba one more time and tell him about your confusion and see what he has to say and than take your decision ...

[SXP92]

@VladRojas Please keep us all posted as you go through with the procedure. I would love to see immediate post-op pics as well. Are you going to Brussels for the procedure? I heard from one of his staff members that he is officially coming back to Atlanta, most likely starting mid-July. And the goal is for him to be operating out of the US on a recurring basis

[CharlesBarkley]

 

Very interesting thread. I would go for the suggestion from @Gatsby and would just do SMP on the donor. 
And looking at your hairline, I would say you need at least 850 grafts. Thanks for sharing all this precious info.

[VladRojas]

Hi @A_4_Archan
Yes,  i mean i think ill go with what he suggested of 1k grafts to fix my donor from beard and chest. Also 500 grafts from donor to improve the hairline. 
Hopefully, if things go well. If i want to improve the looks on my donor i might do SMP.