• 07-30-2021 07:27 AM
    Raphael84hair
    Raphael84 - My Surgery - Dr. Bisanga BHR Clinic - 3466 Grafts - FUE 0 - 5 Months
    In my own journey throughout the years and long before I was in my current role as patient advisor for Dr. Bisanga, I have spent many hours and found incredible value from hair loss forums. Being able to share frequent patient results from Dr. Bisanga is always a pleasure of mine and knowing that in doing so, it really adds to the essence of the community and can help to show what can be achieved.

    With that being said, I am very happy to be able to present my own case and give back on a personal level.

    In all honesty I did not intend to present my surgery photos until 12 months post op when I would have been nearer to my “final result”. This was because as many of you will know this was not my first surgery. I had previous strip surgery in 2012 (not with Dr. Bisanga) and was satisfied with my results at that time, however due to progressive hair loss, this meant that this surgery required "revisiting" the same area which was therefore not virgin scalp in the frontal half. Non virgin scalp means that quality of skin will be less due to making of previous recipient sites and subsequent scarring and this can have an impact on yield, and growth can oftentimes take longer to develop in repair surgery. I knew that I may have to be patient, but fortunately that has not been the case.

    I had FUE surgery with Dr. Bisanga 5 months ago with the following objectives -

    *Rebuild my hairline and increase density through the frontal third
    *Strengthen my temple points (as conservatively as possible)
    *Reinforce my mid scalp and crown
    *Place beard grafts into my previous strip scar (if possible)

    This was a lot to ask in one surgery, especially considering my quality of candidacy.

    In essence, any patient who is a candidate for hair restoration surgery does not have a “perfect” head of hair, but there are different levels to candidacy from excellent through to borderline and then obviously non candidate.
    We often seen “hollywood” hairlines achieved on patients with focused loss and what would appear to be a great donor. That certainly isn’t my case and isn the case for many.

    Challenges of surgery were -

    *Larger pattern of loss/decline
    *Retrograde alopecia (Dr. Bisanga explained that it is likely emphasised by my strip closure pulling my nape “higher”)
    *Average/below donor density
    *Below average hair groupings
    *Fine hair
    *Previous strip scarring

    Surgery was always going to be challenging in terms of achieving the necessary graft numbers but I was well aware of this and understood that we may not have been able to have achieve all of my objectives. This really highlights how realistic expectations are key. As is my intention with all patients who I have the pleasure to communicate with, education is fundamental.

    My surgery was scheduled over 2 days and I arrived in Brussels the days prior to my procedure for a thorough consultation using the state of the art equipment and software to allow Dr. Bisanga to assess the current status of my hair and scalp and discuss his approach.

    Due to using oral minoxidil and finasteride, I was very pleased to hear that my donor was stable and without any signs of miniaturisation throughout. I discontinued meds several years back and lost quite a lot of ground at that time.

    At 38 years of age, I wasn’t looking to lower my hairline at all despite it sitting high at over 8.5cm+ from the glabella. I really wanted to proceed as conservatively as possible in order to preserve as many grafts and achieve as much coverage as possible with an appropriate hairline as I age and inline with the shape of my face and considering my hair characteristics and donor specifics.

    One concern that Dr. Bisanga did have was some potential scarring on my scalp.

    Dr. Bisanga wanted to rule out any possible concerns such as scarring alopecia and decided to take a “punch” biopsy to remove a small tissue sample to be sent to the lab for testing. This then required a few stitches which were removed several days later. You can see the stitches in the post operative images and actually as this area did not receive any grafts to allow and encourage optimal healing, you can actually make out a weaker area in my recent photographs.

    Fortunately my biopsy result came back without concern and without the presence of inflammation or scarring alopecia.

    Surgery days went very smoothly as expected and after assisting many patients over the last years throughout their journey, it felt great to be taking my place in the chair. Dr. Bisanga explained that I had tough skin and I was burning through anaesthetic which meant the need for more numbing, but he reported easy harvesting despite my follicles sitting quite deep in my donor.

    We didn’t want to push too heavily or aggressively on my donor as my hair is fine and we didn’t want to further expose my strip, and as with all of us, loss is progressive and being conscious of this it was agreed that we would harvest approximately 2400 from the scalp with further supplementation from my beard using it to great effect in placing into my mid scalp and crown. As expected, all of my beard grafts represented single hairs and due to this being my first beard session, it was decided not to push far beyond 1000 grafts to allow a good distribution in terms of extraction sites and ensure optimal healing.

    With this being the approach, I was always going to fall slightly short in terms of placing grafts throughout my entire previous strip scar, and so therefore it was decided that we would commit to one side of the scar (approximately 260 - 300 grafts) which was still a bonus. Not the standard approach but in my case, it presented a great opportunity to be able to see yield throughout my scar tissue and at a later date, be able to return for further surgery, shave down and really understand and present what beard into strip scars can achieve by comparing both sides.

    Healing was very straightforward. I am obviously well versed in our post op care but instructions are simple and all products are provided in the post operative kit and despite a few initial “uncomfortable nights” as expected, recovery was generally quite quick. In fact, I was working and responded to patients in the evening on my surgery days.

    Being completely transparent, I was in no way expecting such early growth. Especially as despite a significant graft count, hair count with beard was lower and this was placed over a larger surface area, therefore I was/am extremely pleased to see density come in so quickly. Even now, improvement continues and I have several months to go.

    I am absolutely thrilled and not having to think twice about your hair when you wake in the morning really does have an impact on your day to day life and not having to worry regarding product and styling etc is a game changer.

    A big thank you to Dr. B and his team of amazing technicians and a shout out to all my colleagues at BHR who have shown their support. It is a special clinic and one that I am very proud to be part of.

    On a personal level, I genuinely get great satisfaction from supporting patients on their journeys and am thrilled to see their response and how their confidence grows and impacts many facets of their lives.
    I can honestly say that it has been a hugely positive experience and my results at this early stage speak for themselves and I couldn’t be happier.

    Many other patients have taken similar steps in their own hair restoration surgery and I remember the first forum case that I read some 15+ years ago. It was overwhelming, daunting, interesting and very exciting to see that there is hope, and there will be individuals who are reading cases today for the first time. Such communities are integral in the journey of many patients, it certainly was mine and I felt it important to continue to pay it forward and support the community.



    BHR Clinic

    Dr. Christian BISANGA
    Technique: FUE
    Donor density: 70/70 FUs/cm2

    Breakdown of grafts:-
    2366 Scalp Grafts + 1100 Beard Grafts (Single hair)
    1s - 1714
    2s - 1341
    3s - 411
    Total Grafts :- 3466

    Total Hairs :-5629

    Average Follicular Unit (Scalp) = 1,91 hairs
    Average Follicular Unit (Scalp + beard) :- 1.62 hairs

    https://www.youtube.com/watch?v=FxGOaVGypkA

    PRE SURGERY FRONT

    https://i.imgur.com/KucuFJn.jpg

    TOP ELEVATION

    https://i.imgur.com/JJC5jpk.jpg

    https://i.imgur.com/c8hp6tw.jpg

    PRE SURGERY RIGHT

    https://i.imgur.com/3gROSPP.jpg

    PRE SURGERY LEFT

    https://i.imgur.com/hGfbC6w.jpg

    PRE SURGERY REAR

    https://i.imgur.com/Vu3OzMX.jpg

    PLACING LEFT VIEW

    https://i.imgur.com/Cs3vGb6.jpg

    PLACING RIGHT VIEW

    https://i.imgur.com/gynXebF.jpg

    PLACING WITH BIOPSY

    https://i.imgur.com/BMQfBHl.jpg

    DONOR REAR

    https://i.imgur.com/h50ei2M.jpg

    DONOR LEFT

    https://i.imgur.com/BZyw5gx.jpg

    DONOR BEARD

    https://i.imgur.com/G0FXFop.jpg

    5 MONTHS POST SURGERY

    LEFT 5 MONTHS

    https://i.imgur.com/9qrFOlG.jpg

    RIGHT 5 MONTHS

    https://i.imgur.com/o0VNnGm.jpg

    TOP 5 MONTHS

    https://i.imgur.com/FviXxvd.jpg

    https://i.imgur.com/7g2Y2ol.jpg

    https://i.imgur.com/3sbVeRd.jpg

    REAR DONOR

    https://i.imgur.com/90N92dk.jpg

    https://i.imgur.com/t1tMVJy.jpg

    COMPARISON 5 MONTHS

    https://i.imgur.com/ZTFGrbu.png

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