Dr. Mwamba - 2600 to frontal third, 12 month results

[JessicaWHTC]

Hello from Dr. Mwamba's clinic in Bruxelles, Belgium! A patient recently sent us pictures of his 12 month results.

 

We grafted 2600 FIT grafts to the frontal third to strengthen the hairline and add overall density to the front. As you can see from the before and after pictures, it made quite an impact! Perhaps if he comes in for a follow up visit, we can get even more detailed pictures.

 

This patient had an average calculated density of 2.5 hairs per graft. This is the density occurring naturally in the donor area. Because this patient chose FIT, Dr. Mwamba was able to pick and choose the grafts to extract. This allowed the patient to increase his yield to around 13,000 hairs transferred to the frontal third. Another benefit to the flexibility of FIT is that Dr. Mwamba can choose the finest hairs for a very natural frontal hairline, and coarser hairs to add density throughout the front.

 

 

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I am not a doctor. I am a surgical tech trained in hair transplant. My opinions are not necessarily those of Dr. Mwamba. My advice is not medical advice.

 

 

 

[Bill - Seemiller]

JessicaWHTC,

 

Welcome to the forums. Since it appears that you work for Dr. Mwamba's clinic, it would be helpful if you could put that information under your signature for your future posts.

 

Due to the pictures you posted, however, I can't really comment at this time because the photos aren't great comparison photos. Truthfully:

 

1. The before/after pictures are taken in such completely different lighting, that the hair appears to be dirty blonde in the before pictures and dark brown in the after pictures.

 

2. The angles of the before pictures (especially the first one) reveal the hair loss in a significant way. The angles in the after pictures (especially the first one again) is angled at a tilt which makes the hair appear thicker.

 

3. The hair length in the before pictures is significantly shorter than the after pictures.

 

If you could help us out by posting more closely related comparison pictures which would give a better representation of the work done by Dr. Mwamba, I'd appreciate it. It would also help if both sets of pictures either both use flash or both do not use flash.

 

Thanks,

 

Bill

[JessicaWHTC]

Originally posted by JessicaWHTC:

A patient recently sent us pictures of his 12 month results...Perhaps if he comes in for a follow up visit, we can get even more detailed pictures.

 

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[Bill - Seemiller]

Jessica,

 

I know that you already posted that...however, my post was not only for your benefit but for the benefit of the members reading these forums. You have to understand that, though you may not be doing this, many clinics are big into photo deception...using lighting and angling to present results better than they really are.

 

So if you are serious about showing the work done by your clinic, I do hope that you will push to get more detailed photos. Please understand, this is not meant to be an offense to you...it's just simply for the benefit of the community. We'd also love to see some immediately post op pictures of the recipient and donor area. Also any after shots of the donor area would be appreciated as well.

 

Bill

[JessicaWHTC]

Sorry, Bill.

 

These are the best and only pics I have for this patient.

 

I am aware that some clinics, (who shall remain nameless at this time), do play with lighting and such to create the illusion of good transplants. No doctor should be judged by on pictures alone.

 

For better pictures of Dr. Mwamba's work, see this post: http://www.hairrestorationnetwork.com/eve/showthread.php?t=146383

 

There are also more posts to come.

 

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[Bill - Seemiller]

Great Jessica,

 

I appreciate your approach on this forum...sharing pictures, results, and detail and letting the results speak for themselves. I"m sure others will chime in as well on your posts. Again...thanks.

 

Bill

[hairtech_]

Hello, I remember this patient also. I was there assisting Dr. Mwamba. This is really great, however I have to agree with Bill concerning shady lighting practices of other clinics. I also have to side with JessicaWHT as I do not think she is known for doing those things. She has a good reputation for hair.

[the B spot]

It would be helpful for the intra-operative pics to be posted.

 

We would like to see the extraction sits and the recipient areas.

 

Also, hair and graft counts would be helpful as well.

 

It is nice to see some fue work, but I would ask for the instrumentation sizes used per patient and we would like to see some shaved down patients in order to view the donor after 3-4-5000+ extractions.

 

For your information, this is not a forum where members will accept before and after pics with a graft count, especially from a doc so closely associated with another "fue" doc located in Atlanta.

 

It is going to be important for your clinic to show the donor areas as many patients have been led to believe that fue or fit is scarless, which is completely false.

 

Take Care,

J

[Bill - Seemiller]

hairtech,

 

I do have to ask...what is an Independent Clinical Consultant? The word independent leads me to believe you do not work for a specific clinic...but then what do you offer in your consultations? Just wondering...

 

Bill

[nobuzz4me]

I agree with B-Spot - fue sessions of this size will likely leave the donor area looking like ground beef.

 

Didn't "Cousin-it" use this Doctor??? LOL!

[Bill - Seemiller]

LOL nobuzz....

 

Nah, that was Dr. Mogobo or something...and he received 1,000,000 FU remember? Still looking for that doctor...nowhere to be found

 

Bill

[hairtech_]

Ok guys let's try to be educated on this... Ive never seen ground beef in a donor area even from large sessions of FIT/FUE, however back in the days of plugs, where the individual plug had 20-40 follicular units... well that looked like a shotgun appearance. When one takes a single unit, by whatever means, could in fact be undetectable even after a shave down. A strip can be taken and also be close to undetectability. Damn I've seen this too. But over a group of 1000 strip scars and comparing that to 1000 FUE/FIT scars... What is the the bottom line here? Draw your own conclusions. I like all. What is good for all? I don't know. Why?

 

Nothing that has cut into the skin is scareless. A scar is formed as a repair process of our body. Everyone scars differently. One can minimize chances of scarring, and most strip/FUE/FIT doctors try to do this. But no one can predict scarring.

 

I do not work for any specific clinic on a full time basis.

 

con?·sul?·ta?·tion (k?…??n's?‰?„?l-t?„??'sh?‰?„?n)-n.The act or process of consulting. A conference at which advice is given or views are exchanged.

 

This forum is a consultation.

[Bill - Seemiller]

nobuzz,

 

I don't necessarily agree that a larger FUE session will leave the donor area looking like "ground beef", however, there certainly is a concern of what the scarring looks like...it will certainly depend on the size of the instrumentation used and where these donor hairs are extracted. So I do echo B Spot's request...we'd like to see photos of the donor area shaved down for these patients if pictures are available...or any patient from this clinic for that matter.

 

hairtech,

 

I know what consultation means. Don't insult my intelligence. I suppose I could put "Independent Clinical Consultant" under my name too since surely I have spend a lot of time on this and other forums offering much advice over the years. But typically those who have titles get paid for what they do.

 

So I'll ask it this way:

 

Are you just giving yourself a fancy title or do you get paid for your consultation services? If you get paid for your services, what exactly are you charging for...advice? And if you are charging, why go to see you when you can get a multitude of free advice on the forums? Cheers my friend.

 

Bill

[the B spot]

I have seen some fue donor that did not look very good.

 

I think many here would be very surprised at the scarring left behind for those who use .9-1.3mm punches.

 

Remember, punch size is the size of the hole in the punch, and when Doc's give a puch size, they do not add the the size of the needle wall, which can add .2-.3mm on to the actual incision.

 

A clinic claiming to use .9mm extractions is correct, but the actual "hole" is 1.1-1.2mm wide, so tread carefully when speaking about extraction tools.

 

I do not think a real difference exists between fue and fit--- if you are extracting individual follicular units with punch or extraction device, it is fue.

 

The method and patented tools that is proprietary to each dr most certainly varies, but dressing things up and giving them fancy names for marketing is uneccesary, right?

 

BTW, I am contacting Pat so we can work out a deal so that each of my posts pay me something.

Until Tom came along, I had no idea we were worth so much.

 

Bill, I suggest you do the same buddy.

 

Jason

Inventor of the radical thought theorem surrounding transplanted hair growth and increased sexuality.

This entitles me to free refills on every cup of coffee I drink, INCLUDING Starbucks.

My advice is no longer free.

[hairtech_]

Again I am not compensated for my posts. What really strikes me as odd is how someone could become angered at someone who offers unbiased information based on visitation to different clinics? Instead... bashings occur. Check this out.

 

FIT exists and have seen spectacular results.

 

FUE Exists and have seen spectacular results.

 

Strip Exists and have seen spectacular results.

 

FIT exists and have seen questionable results.

 

FUE Exists and have seen questionable results.

 

Strip Exists and have seen questionable results.

 

 

Hhmm, now how do we find the best technique? Well, you go on the internet... and read... and I feel lucky to be an outlet of information that has never been spoken of.

[JessicaWHTC]

[sorry this answer is so long, but its a complicated question! ]

 

Firstly, any incision into the skin can cause a scar. Even a paper cut.

 

FIT and FUE can only be called "scarless" when compared to the old strip scars. At the time FIT and FUE were first appearing, it probably seemed "scarless" in the excitement of the time. Since then, people have been taking a more in depth look at the effects of hair transplant on the donor. Thus the terms describing them are no longer specific enough.

 

There is no need to take anymore donor hair than is absolutely necessary (you never know how much you might need in the future as hair loss is mostly unpredictable).

 

There is also no need to create more trauma than is absolutely necessary with the advances in technique and equipment that are available today. For example, there is no need for 2-3mm punches anymore. They are obsolete and bad technique.

 

When I talk about punch sizes, I am referring to the current technology available, which, depending on the surgeon's definition of "diameter" or "size" ranges from .5-1.5mm. This is not necessarily FIT sizes or Dr. Mwamba's sizes, just sizes that I have seen reported on the forums and other publications.

 

Punch sizes are difficult to compare because not all punches are created equal. Some of them don't even look similar.

 

As B spot points out, there is an inside diameter and outside diameter to the punches. So it is hard to tell which diameter a particular clinic or surgeon is talking about.

 

And besides inside and outside diameter, there are a dozen or more other tiny details and aspects that can be variable in the punch design and technique alone.

 

Dr. Mwamba uses a kind of instrumentation that is unique to FIT. He can change and adjust different parameters to customize the surgery, and more specifically the harvesting, or "punching" of the donor grafts. Hair characteristics, angles of growth, dermis thickness, etc. also change from one area of the scalp to another. So, he keeps making tiny adjustments to best facilitate the intact and complete removal of the graft as well as the donor healing and overall appearance of the harvested donor.

 

Some, OK, many of the details about his punches and techniques are intellectual property and protected by law. (Which is a shame because I love talking about the technical aspects of FIT).

 

The idea is to have the punch size and other parameters "fit" the follicular units. It is not about large or small. It is about the punch being appropriate.

 

For example, let us simplify things by pretending that there is not inside or outside diameter and the scalp is a flat, two dimensional surface. The punch creates a circular cut around the follicular unit. At the epidermal level (on the surface of the scalp), the hairs of the follicular unit are close together, fascilitating a very small diameter incision. As you travel deeper into the dermis and subcutaneous layers, the hairs of the follicular unit splay out and travel in different angles. Sometimes they curve under the skin at nearly unpredictable directions. This necessitates a punch of larger diameter (not a large punch, but larger than the epidermal size of the unit).

 

If a punch that is too small for the follicular unit is used, hairs and follicle sheaths can be damaged or destroyed. This can cause the death of the hair, shock loss, ingrown hairs, hairs growing in the subcutaneous tissues, and the need to punch out more follicles to complete the surgery.

 

If a punch that is too large for the follicular unit is used, obviously, there can be more scar tissue created than necessary. It can also damage the neighboring follicular units, causing the same consequences as when a punch is used that is too small.

 

There are also some techniques that maximize the safety of the follicles while minimizing the scarring produced. But that's another story entirely.

 

Here is a link to pictures of Dr. Mwamba's donor results, pre-op and at 12 months post-op: http://www.hairrestorationnetwork.com/eve/showthread.php?t=149881 The patient's donor area is cut to a length of about 3-5mm long. The patient is looking down with his chin to his chest and the camera is almost resting on the back of his shoulders. This way, you can look up between the hairs directly to the scalp.

 

There is not really visible scarring. At most, there is a gap between follicular units, which will occur regardless of punch size.

 

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[Bill - Seemiller]

Jason

Inventor of the radical thought theorem surrounding transplanted hair growth and increased sexuality.

This entitles me to free refills on every cup of coffee I drink, INCLUDING Starbucks.

My advice is no longer free.

 

ROTFLMAO!!!!

 

Bill

---

Genetic Clone Producing paradigm for transplanting hairs into recipient sites AND additional people into forums

Not only are my posts not free, but each of my clones must be sacrificed a dowry for anyone requesting the advice of the almighty Bill

[Bill - Seemiller]

Just for the record...B Spot and I are targeting two different concerns here. Where his primary concern in this thread is about scarring (and rightfully so), my primary concern is about the difference between FUE and FIT. I believe both are very important topics, and BOTH of us have touched on that concern. So your responses to both are indeed appreciated.

 

hairtech,

 

Again I am not compensated for my posts. What really strikes me as odd is how someone could become angered at someone who offers unbiased information based on visitation to different clinics? Instead... bashings occur. Check this out.

 

 

We are just having a little fun with you...it's not in attempt to bash you. Cheers bro.

 

Jessica,

 

Dr. Mwamba uses a kind of instrumentation that is unique to FIT. He can change and adjust different parameters to customize the surgery, and more specifically the harvesting, or "punching" of the donor grafts.

 

...Some, OK, many of the details about his punches and techniques are intellectual property and protected by law. (Which is a shame because I love talking about the technical aspects of FIT).

 

So is this a standard differentiator then? Is the instrument used to extract or isolate grafts always different with FIT than FUE? Does every clinic who performs FIT use this instrument? If so...then how can it be protected by law...doesn't make sense. If not...then it's not a standard differentiator between FIT and FUE, since each doctor has their own instrumentation. This is where the ambiguity seems to become circular...never-ending.

 

Either way...I'm not sure I understand why his equipment is protected by law. The only reason to "protect" equipment is so nobody else can use it or steal it, so to speak. But wouldn't ethics conclude that medical enhancements should be shared with peer physicians and not kept sacred?

 

Conventions and meetings occur in various places where doctors get together to share what they know...why is this a big secret? That's why it appears to me that there is something fishy going on. There doesn't seem to be any secrets regarding any other method.

 

Bill

[hairtech_]

Bill,

 

LOL, ha, ha ,ha exactly!

[JessicaWHTC]

Yes. FIT surgeons use instrumentation that is unique to them.. Surgeons must have permission to use the FIT instruments or to call their procedure FIT.

 

Why?

 

In the wrong hands or when used improperly, these instruments can cause damage to patients. If a surgeon wants to use these instruments, they must be trained and tested thoroughly. They must also agree to FIT standards, which are basically ethical standards of practice held by most upstanding surgeons.

 

If a doctor wants to open their own FIT clinic, he/she must complete a residency with an FIT surgeon.

 

However, this still doesn't mean that FIT is better than FUE or anything like that.

 

Eventually, FIT instruments will be available to all. The doctors have chosen not to make them widely available yet because they are forever tweaking, adjusting, modifying, etc. Everytime they say an instrument is complete, a patient comes in with parameters that are outside that instrument's range of capabilities, and they start modifying again.

 

Prototypes have been featured at conventions and meetings such as ISHRS events. Lectures have also been given about surgical findings, case studies, statistical growth studies, and FIT techniques that are ready to be made available to the public. Dr. Mwamba has a very good track record at these events.

 

This is a common occurrence in other surgical fields as well. For example, if an oral surgeon (who mostly extracts impacted wisdom teeth), wants to offer his patients dental implants (permanent false teeth), then that surgeon has to attend courses, be trained, get approval from a board or directors, obtain a certificate, etc. before he can be allowed to perform the procedure or obtain the instruments and supplies.

 

The field of hair transplant is not well regulated by the government. Any surgeon can offer hair transplants to their patients without certificate or additional licensure. Regulation has to start somewhere. How else are we going to offer more patient protection for the future?

 

Until then, all we have are internet forums to drive the unethical and the uneducated out of business.

 

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[Bill - Seemiller]

Jessica,

 

Thanks for the response.

 

Are all FIT instruments, therefore standard across the board between FIT clinics? Since doctors are forever tweaking...which ones are responsible for making the enhancements and then rolling out the enhancements to the other FIT clinics? Or is it more free-hand where any of the clinics can make the change but then are obligated to distribute it? Are there variations within the FIT instruments or are they ALL exactly the same?

 

But since the FIT instrument (even if it is standard across the board through FIT clinics), since the "mystery" has not been revealed as to what it is...how can the public really know the difference between FIT and FUE instruments? How do we know they are not the same? And even if they are NOT the same...wouldn't it be fair to say that these instruments for FIT accomplish exactly the same thing as the instruments used for FUE?

 

What I keep coming back to...is no matter how any of these questions are answered, the distinction between FIT and FUE is still very vague and unclear...practically non-existent. And with the definition that FIT is a variation of FUE, since there are variations between each clinic that performs FUE anyway, how can FIT differ so much from other variations of FUE where it is called a different hame?

 

See what I mean?

 

either way...thanks for participating in the conversation. Once the mystery is revealed, perhaps I'll be able to comfortably use the term FIT, but until then, I'm going to continue to call it FUE

 

Bill