Hi Todd
Thats a great question.
To be able to evaluate if a patient's result is optimal, we first need to understand what can realistically be achieved by surgery with each patient. This is unique for every patient due to many factors such as amount of hair loss, age, donor density and hair groupings, size and shape of your head (bone structure), future loss etc... What one patient is able to achieve with 2500 grafts, will be different to another patient.
Therefore expectations and limitations must be clearly communicated and it is also important to understand that if patient's do not have prior consultation with their doctor before scheduling surgery, then their donor density and overall quality of donor is unknown.
Of course, attending consultation can be a challenge for international patients. This is why at BHR, Dr. Bisanga is constantly travelling and offering consultation in many international cities, several times per year to meet prospective patient's and discuss the most appropriate approach and treatment plan for them.
One thing that seems to be of concern for patient's today is early growth, or lack there of it. Many patient's compare their 4 or 5 months growth to other patient's who were impressive "early growers". Whilst all patients naturally want to be in that early growth category, this mindset adds a lot of anxiety for patient's who do grow slower than average. Patient's proceed with hair transplantation surgery to achieve a result. Their final result. Patience is essential and patient's do not achieve their final result until 12 - 15 months post surgery.
Dr. Bisanga welcomes all patients for a follow-up consultation to evaluate and discuss their final result. At the 12 - 15 months stage, if a patient has concerns regarding their yield and feel that their result is not optimal, then we would schedule a follow-up consultation with Dr. Bisanga. This could be done at any of Dr. Bisangas travelling consultation dates, or preferably in Brussels or Athens, where Dr. Bisanga has the appropriate equipment to accurately measure growth rates.
The definition of poor growth varies among surgeons. Some define it as less than 85% of expected growth while others as low as 70% as the cut off.
Dr Bisanga determines acceptable growth rates as between 94% - 98% of expected growth at 12 moths post procedure. Poor growth would be determined as less than 90% of expected graft growth at 12 months post procedure.
Whilst poor growth with a quality physician is uncommon, it can happen. In the case of poor growth, before using further grafts of a patient, one needs to understand why it happened. Are there any undiagnosed underlying skin issues, any other physiological factors such as potential illness, if the patient experienced any complications with healing or care post procedure?
Dr. Bisanga is extremely patient orientated and stands by his patient's. Upon ruling out any physiological cause where poor growth may again be a risk and further grafts wasted, Dr. Bisanga always endeavours for his patients to achieve the very best result, and it is his pleasure to offer "touch-up" surgeries as necessary.