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3382 FUE - Dr. Lupanzula - Brussels

K

KO

Valued member
I don't typically post on this forum, but I wanted to share my experience with Dr. Lupanzula. I've benefited a lot from watching other posters' surgeries evolve, and hope somebody will find mine useful.


Hotel
After arriving from Brussels, I took a cab to the Hotel Catalonia (didn't want to bother with public transport). I had thought the hotel's name sounded familiar, as it turns out, it is directly across the street from Dr. Bisanga's clinic (which looks a little bit like a castle). So it's nice that they regularly get hair transplant patients. The hotel is affordable, and in a nice area.

The Area
The surrounding area is very picturesque, very old world, and not heavily populated. Most people speak English well, so you can get around. The main language here is French, and it's helpful to know it. But you can get by with English. Near the hotel there is a Chez Frances restaurant for breakfast, and a nice Thai place called Thai Cafe. I chilled in the area for a day before heading to the clinic.


The Clinic

The clinic is about a ten minute walk directly south from the Hotel Catalonia. Upon entering, I was greeted by the clinic's patient coordinator Giancarlo. Giancarlo is fluent in multiple languages. The clinic has a very modern design, very "Bauhaus", with plenty of white, and clean lines throughout.


Consult
We then met with Dr Lupanzula. He looked through my donor and recipient, and went over my family's history. He noted that while the area to cover was significant, I was a good candidate for a few reasons: 1) Good donor hair - coarse, wavy hair that aids in the illusion of coverage. 2) Darker skin, which reduces contrast, and 3) A good number of multi follicular units. He snipped off hairs to measure the shaft caliber. Then he shaved my head. I admittedly was not looking forward to this. But it was a good idea, not only does it save time the next morning, it puts you in the "zone" mentally for surgery. What's more, I decided that a shaved head, while not the best look, wasn't the worst one either for me, so it's good to know. Post shaving, he measured my donor density under magnification, with the parietal areas having just below 100 grafts/cm and the occipital around 110. He estimated that my donor capacity, if we harvested 30%, would be around 7,000 units, and if we harvested 40% (which would be on the border of over-harvesting),about 9,000. All in all, he considered me a good candidate.He drew a hairline, which I was fine with. I wanted a conservative hairline, but at the same time we still want to make a visual impact. The plan was to harvest and implant most of the grafts on day 1, with the hairline to follow on day 2.


Day 1

Day 1 began early, since you're supposed to eat before, I grabbed some croissants from a bakery right across the corner that happened to be open at 6:30am. The Dr gave me the meds and it was time to roll. After changing into hospital scrubs, he gave me anesthetic injections in the back of the scalp. Btw, I knew anesthetic injections were the most painful part of the surgery, and it was true, I found them to be very painful, and they are required multiple times throughout the surgery as a different area is operated, either for harvesting, or implantation. Then again, they are obviously required, so there is no getting around it. Dr Lupanzula uses a a CIT handle manual punch to score grafts. He harvested grafts from the back and sides, one after another. He has a distinctive punching motion where at the end of the forward twisting motion he pushes in the tool slightly, which was noticeable. Afterwards, the grafts were plucked out. This is a weird feeling, you feel a slight popping sensation, similar to how a grape or a berry is plucked off the stem. Keep in mind, you have to stay very still during the procedure, and notify the Dr before moving. Staying still can get difficult when the parietal areas are being harvested because you are lying on your side. The team inspects the grafts under microscope and prepares them for re-implanting. Grafts are stored in ATP Hypothermosol. After harvesting we had lunch. The clinic eats lunch together in their break room, which is nice. Everybody in the clinic speaks English, so language is never a problem.

Implantation

Two steps to implantation, recipient site creation and placement. After anesthesia, the doctor used needles to make incisions. This is an interesting process. He moves very quickly in creating the incisions. There is a lot of power, and you can feel the fibrotic scalp being punctured. Given the speed and power, it feels powered by a machine, but it is manual. This process is actually surprisingly pleasurable. Who would think that having 2-3,000 holes poked into your scalp feels good, but it does. Patients who have been operated by the implanter pen also report the same thing. Afterwards, his team places the grafts. This last part takes time. Afterwards they had me bandaged, and I was off to the hotel at about 6pm. Afterwards, I sprayed my grafts every 15-20 minutes with saline.


Day 2
This day was going to be shorter by design, as 2K grafts were harvested on Day 1 with 1K to follow. The same process followed as the day before, however we were done earlier. Then the clinic bandaged me up and I headed home.


Day 1 Postop

Day 1 was the first clinic hair wash. His wife, Sandra washed my scalp, spraying Betadine shampoo on both donor and recipient, and massaged the donor vigorously, and then applied an antibiotic creme to the donor. This is to be done everyday for the first 7 days (which I have done) and afterwards the recipient site should be gently massaged after applying Betadine shampoo. The clinic had a driver take me to the airport afterwards for my flight. I had originally chosen to fly immediately to avoid traveling while swollen, but I didn't experience visible swelling, in retrospect, I would have stayed in Brussels longer, just to give my grafts more time to set before moving. The flight was fine, and to note, it was not uncomfortable or painful to fly after surgery. I had a neck pillow to prevent the donor area from touching the seat rests. I wore a bandanna outside, but took it off when inside the plane, and regularly sprayed with saline. I have finished 1 week postop, and the clinic has remarked that all looks appropriate.


Stats:


Single: 621

Double: 1,295

Triple: 1,183

Quadruple: 261

Quintuple: 21

Sextuple: 1

Total Grafts: 3,382

2.34 hairs/graft Hair caliber: parietal/temporal: 55-60 mic., occipital: 60-70 mic.

Density: 45 grafts/cm in outlined area, 40/grafts/cm behind it.


Medications: Finasteride and Dutasteride alternated daily, Minoxidil Foam 1x day.


Pre op





Shaved down







Donor area








Immediate post op





7 days post op








11 days posst op


 
P

postdoc

Valued member
That's some of the cleanest work I've seen ever. You should have a fantastic result!
 
B

Bastion

Member
Great write up. The work looks very clean. Healing process is going well also.
 
F

FUE GUY

valued member
Great looking donor zone.

What size punch did Dr Lupanzula use?
 
K

KO

Valued member
Thanks for the wishes, I hope with the combination of good multiples and good caliber, it will result in good coverage. Now time to hope for yield!

FUE guy - not sure of the punch size unfortunately.
 
janna

janna

Invaluable Member
You should have a beautiful result considering your graft count of 3382 grafts plus you had loads of 3 hair grafts so your hair to graft ratio is higher than average. On top of that you're on Propecia and Rograine Foam and also have existing hairs in the recipient area.

Looking forward to following your progress!
Best regards!
 
Bigmac

Bigmac

Administrator
Staff member
Hi KO, thanks for sharing your story with us, I'm sure your journey will help many. The work looks great, very neat and tidy.
It all should produce a very nice result. Looking forward to following your progress.
All the best.
Bm.
 
K

KO

Valued member
janna wrote:
You should have a beautiful result considering your graft count of 3382 grafts plus you had loads of 3 hair grafts so your hair to graft ratio is higher than average. On top of that you're on Propecia and Rograine Foam and also have existing hairs in the recipient area.

Looking forward to following your progress!
Best regards!
Bigmac wrote:
Hi KO, thanks for sharing your story with us, I'm sure your journey will help many. The work looks great, very neat and tidy.
It all should produce a very nice result. Looking forward to following your progress.
All the best.
Bm.
Thanks, very much hopeful this is the case! :)
Attached are my Day 21 photos
 

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Nervousnelly

Nervousnelly

The Coolest Member
You are going to have great results given the graft/hair count and as Janna pointed out you still have some existing hairs. Good stuff! Enjoy the ride.
 
B

Bastion

Member
A few more weeks should have your hair evenly matched, back to its pre operative state.
How red does it look in real time?
 
K

KO

Valued member
Hope so. The redness subsided actually by the end of week 1 and I didn't notice it after that. I think redness is supposed to be more common among lighter skinned patients.

One thing I'm somewhat concerned is that the implanted hairs don't seem to be growing. Based on what I've read, the implanted hairs grow for a few days then shed....
 
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D

Dazzster26

Valued member
Congratulations on your HT with Dr Lupanzula his results are very consistent , I can only state what the other members have said your going to be blown away when this transformation comes through all the very best friend

Merry Christmas


Daz
 
Bigmac

Bigmac

Administrator
Staff member
Don't worry about the implanted hairs not growing. Most of mine never grew, just stayed the same length, then shed. Some in my crown never shed, just stayed there for months feeling prickly. These were stalled hairs, it was nothing to worry about. The hair shafts were just sitting in place and a simple pluck got them out with no force. The bulbs were safely implanted going through their growth cycles.
 
Bigmac

Bigmac

Administrator
Staff member
All looks normal at 6 weeks. Did all your implanted hairs shed?
 
K

KO

Valued member
Not all of them. Many are still there, but slowly shedding. I have some acne spots on the scalp, awaiting response from the clinic on whether/how to treat it.
 
Westcoaster

Westcoaster

member
Looks good, with the hair count I reckon it'll be a home run. Is it acne or folliculitis you're experiencing?
 
K

KO

Valued member
Unsure, going to the derm tomorrow. I occasionally get acne with a few pimples on the scalp that come and go.
 
K

KO

Valued member
As an update, I was being too gentle with shampooing my hair. Over the last few days I've been more aggressive in massaging my scalp and using my fingertips to move the grafts that were lying flat on my scalp, and the grafts in the front have indeed come off.
 
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K

KO

Valued member
Joe noted that I was being too gentle with my scalp, and over the past week I've been firmly massaging it with my fingertips and indeed, there are a lot of dormant hairs that were just sitting still on my scalp, I believe they matured after month 1. So they've come off and now it looks like the ugly duckling stage...Also the pinkness wasn't there the first 3 weeks postop, but emerged after day 21.
I have uploaded some closeup photos to my gallery if you are interested. Unsure how to insert them here though.















 

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