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Dr Lupanzula, FUE Hair Transplant, 2100 grafts, Mar-20

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H

harry1001

member
Hi all,

In the spirit of ‘paying it forward’ here’s my review of my recent transplant with Dr Lupanzula.

Summary

Norwood 4, Aged 55. Had full head of hair till around 50.

FUE procedure, 2111 grafts, 4444 hair, on surface area of roughly 50cm2.

(Another procedure to be done in a year, for the crown and back of the head.)

Graft details :

FU’s Hair

1 Hair 443 443

2 Hairs 1086 2162

3 Hairs 509 1527

4 Hairs 78 312

Total FU’s 2111 4444

Background:


Mid 50’s, started losing hair around 8 years ago. I had been thinking of a transplant for 3 years as my hair have been shedding with increasing speed. Now at Norwood 4 I would say and knew that this year I would have to pull the trigger. Denial, fear of pain, and the negative emotions associated with anything to do with hair loss kept me from doing it.

Anyway, I did some research – I read these and other forums. Read lots of reviews. Where are the negatives ones? There seem to be very few of those – so I wondered how many of the reviews are actually genuine?

Had a face-to-face consult with two very well know doctors. Met Dr Lupanzula in Feb in London, and I liked what I heard. Asked further questions via his assistant Scott, who was, and continues to be, very responsive and informative, without being pushy or ‘sales-manny’. A week later I signed up. They had a slot in 3 weeks’ time, and I looked forward to anxiety and sleepless nights till then.



The Event

My pre-op consult was the same day as my operation, and this was fine with me. Day started at 6:30am. Photos takes, hairlines drawn, blood samples taken for the blood tests, hair shaved off. Dr Lupanzula did all of these himself.

Around 9:00am is when the main event started. Scalp anesthetised, and I lie on my front whilst the doc extracts the follicles from the donor. This lasted around 2.5 hrs. Then followed the incision stage where the doc made the openings for the extracted follicles to be transplanted and this was fairly quick, maybe an hour or just over.

The final stage was the placings, which was done by two technicians and lasted for around 2.5 -3 hours.

The whole process was finished by 5:30pm, and I then joined the doctor for a chat, Q-and-A and a well-deserved baguette.

My experience

Pain
– this was the ONE thing which had prevented me from taking action for 3 years cos someone ones said to me “Oh, my brother-in-law had a transplant, and he said it’s really painful”. Well, I had the complete opposite experience - practically no pain at all. The only tiny bit was when the injections were used to numb the scalp, and on a scale of 0-10 where 0 is “No pain”, I would measure mine at 2. It’s like having an injection when a blood sample of taken from the arm – there is a little prick that lasts a few seconds.

I am a real whoos when it comes to pain, so if you are like me, and have been holding back, then let me reassure you – if you pick the right doctor/clinic, then the pain is minimal. In fact, numerous times, during the day I fell asleep – at one point, both the technicians were laughing as my snoring became so loud that it even woke me up.

That night I was expecting throbbing of the head, but nope, nothing. The most awkward part is having to sleep at 45% angle at night – I liken it to being on a long-haul flight in an economy seat, ie. inconvenient and fidgety, but not painful.

The next day, I was given a 1000mg paracetamol to take, but I didn’t need to take it as there was literally no discomfort at all.

Doctor/Clinic/Staff

I’m trying to not make this sound like a sales pitch, but here goes :

Wonderful. All three. The doctor is really relaxed and chilled and that calmed my nerves. We even shared a few laughs while he was drilling around my head, and I tried to impress him with my 10 word knowledge of the Swahili language. The facilities are very modern and well-equipped. The technicians are friendly, and one invited me to look through the microscope while he was separating my follicles. During the 2.5 hours of the placings stage, I was free to pick my favourite Netflix shows to watch while the technicians quietly did their job.

Support

Pre-booking : All the comms are via Scott, the client liaison chappie. He’s very responsive and provided me all the info I needed. All the forms, payments etc were done online very efficiently, and within two days of me saying ‘Yes’, we had everything finalised.

During the day : the doctor is very open to discussion, didn’t rush at all, and answered all the questions I had in a rational manner. The support staff too are very polite, respectful, and helpful. I was of course, the only person being operated on during that day, and this was important to me.

Post-op : I asked if I could come back the next day so someone could show me how to wash my hair, and of course, they were very happy to do so. In fact, I would say, whichever clinic you use, make sure you go back the next day, so they can clean you up properly, and show you good maintenance techniques. The staff even offered to video me having my hair washed for my personal use when I return home.

I will keep in contact with the doctor and have 3 and 6 monthly face-to-face consults when he visits London.

I feel great right now. I just want the ugly-duckling stage to pass quickly, and I look forward to seeing the results.

If you have any questions, feel free to ask.


Front_before Medikemos hair transplant.jpgLeft_before Medikemos hair transplant.jpgRight_before Medikemos hair transplant.jpgBack_after Medikemos hair transplant.jpgLeft_after Medikemos hair transplant.jpg
 
Bigmac

Bigmac

Administrator
Staff member
Hi Harry.
Welcome to the forum and thanks for sharing your detailed write up.
Having a full head of hair nearing your 50's, then losing quite a bit, equaling a Norwood 4 just goes to show how risky things can be for younger guys who use up most of or all their donor at a young age.
Apart from that, the work looks good as usual from Dr Lupanzula and the team. Good to hear you're getting great support from Scott.
The ugly duckling phase will soon pass with things returning to normal.
You have thinning on the crown, are you taking any medications to prevent further loss? If no meds, are you trying anything else?
I'll look forward to following your progress.
All the best.
Bm.
 
bullitnut

bullitnut

4 awesome repairs with SMG
Welcome to the forum dude looking at the pics it should provide a great improvement....I personally like Dr Lupanzula's work a lot so I'm sure you chose a quality Doctor and i appreciate you documenting your surgery for us to read....people tend to underestimate just how important it is for people to read about their progress imo....but speaking from experience it really does make a difference when you get to hear all about what it's like at different clinics and seeing different doctors results.....without people like you it makes researching much harder so thank you.
 
Scott Medikemos

Scott Medikemos

Valued member
Thanks for taking the time to complete this thorough testimonial Harry. This is exactly what a patient researching their options needs to enable them to make an informed decision. You take us through things right from the beginning from when you started hairloss, through to consultations, decision making along with an in-depth breakdown of the day itself with pictures. Excellent reading. Now I look forward to your periodic updates. Heal and grow well my friend.
 
T

Todd

member
The punch holes look small and spaced out, I bet you cant see anything when they heal. Do you know what size FUE punch they used on you?
 
H

harry1001

member
Firstly, I need to clarify that what I express here is NOT a review of Dr Lupanzula or Scott - they have both been fine. I last spoke with Dr L on the day of the operation, and he was professional, pleasant and a gentleman. Scott has been my contact since and he has always been polite and very responsive. This is a review of the results. Writing this update is an unpleasant experience - on the one hand I don't want to be seen as discrediting anyone (because that is not the intention), but on the other, I'm looking for help and assistance. I have been in denial about my transplant for a couple of months at least, and yesterday I came to an brutal realisation.

I attach my 9 month photos below. As you can see, things are not going according to plan. I'm understandably very disappointed and concerned.

Inked20201208_right2.jpg


Inked20201208_left2.jpg
Inked20201208_front.jpg


Before_after_front.PNG

The very last photo is the Before/After - the left one one was taken by Dr L an hour before the op, and the right one was taken yesterday.



When I asked why my results are so poor, the official answer was that I need to wait for the full 12 months before an assessment can be made, and the doctor will only look at the photos at that point. That may be a fair point, but I find it difficult to believe that somehow the grafts will all suddenly spring to life in the next 3 months.

So, I come looking for feedback and advice pls from experienced people :

1) How do I establish what's gone wrong? How can I work out the reason for this poor result?
Could it be because of :
a) my body chemistry or genetics (eg maybe low iron levels, low protein intake etc etc). I doubt if this matters, but I don't smoke, rarely drink and am physically fit.
b) poor handling/usage of the grafts during the procedure.
c) the planting wasn't done properly and the grafts failed to take hold.
2) What action can I take to remedy this situation? Who else can I talk to?
3) Has anyone else had such a poor result after 9 months (with any doctor) and then gone on to achieve reasonable density?
4) Is it possible for a doctor to tell, after examining my head, whether the implanted hair are just in the sleeping phase, or whether they are dead?
(Also, I would really like to reach out to others who have had failed transplants, so pls feel free to PM me.)

For ref, I started using Rogaine foam from 01-Apr at Dr L's recommendation, and then was advised to switch over to Dutasteride at the beginning of Oct, but I stopped it after a month and returned back to Rogaine due to side effects.

Guys, pls be brutally honest with me. I'm not looking for sympathy, nor for false hope. Neither am I looking to blame anyone. I'm looking to understand what's gone wrong.

Much appreciated.
 
Bigmac

Bigmac

Administrator
Staff member
Hello Harry.
Waiting 12 months is the normal protocol before a final conclusion is drawn.
I would have expected more growth in the transplanted areas at month 9 providing there are no underlying issues that are preventing optimal growth.
There is a small percentage of patients who unfortunately do experience little growth for an unknown reason. It is referred to as the X factor. This however does not help you understand what is preventing optimal growth for you. At 12 months you may need a scalp biopsy to check for any scalp conditions.
It could be your DHT levels are high and your hair loss is still accelerating. In your comparison pictures, your crown looks to have worsened, your humps/sides have dropped and it appears your forelock has thinned. Without Finasteride/Dut you only have Minox which is not as effective.
Would you be able to dye your hair? This way the finer grey hairs in your after picture will show up more and make comparing them more accurate.
I know the clinic will work with you to investigate every possible avenue if the final growth is not what it should be.
I hope that helps.
 
H

harry1001

member
Hi Bigmac, thank you for the informative reply. Yes, in my next pics, I will dye my hair first. I accept that 12 months is the standard cut off date before decisions are made. Meanwhile I aim to research thoroughly the reasons why transplants fail o that at least I can ask the right questions at that time.
I definitely have less hair now that I did before the transplant.
The reason for the minox is that it was recommended by Dr L as we had a chat after the operation.
 
Bigmac

Bigmac

Administrator
Staff member
Hi Harry.
I know Dr Lupanzula runs a good clinic with high standards so I would 99% rule out your possible causes b and c.
b) poor handling/usage of the grafts during the procedure.
c) the planting wasn't done properly and the grafts failed to take hold.

These below are a few conditions that could be a possible cause.
Lichen planopilaris
Thyroid disease
Diabetes
Autoimmune diseases
Lupus
Scarring Alopecia
Certain medications

You could be going through a massive shedding phase due to switching hair loss meds but I don`t think it would have the effect you`re having but in hair restoration, you can`t rule it out completely.

I know the clinic will work with you to get to the bottom of it if it hasn`t improved by the 12 month mark.

Sometimes a second smaller procedure is done to see if the grafts grow with a high survival rate.

I`m here for support if you need it.

Bm.
 
bullitnut

bullitnut

4 awesome repairs with SMG
Harry... Sorry to hear about your situation... Like Bigmac, I know and understand how dissapointing it is when your transplants don`t turn out as expected or they fail. You`ll be feeling stressed, worried and sometimes hopeless in a dark place. It`s important not to let it take over your life... I was in a downward spiral with no hope until Bigmac reached out to me, offered me hope and eventually helped me get repaired.

We need to establish what has happened here... Firstly, what was your growth like around months 5-6-7?
Switching between meds can play havoc with your regimen. Did you have a reason for switching?
Maybe Anagen effluvium which causes large amounts of hair to fall out rapidly during the growth phase.
It does look as though you`re losing more native hair.
Your loss from 50 onwards was quite rapid. Could there be an underlying reason as mention in Bm post?

Let's look at a worst case scenario... It stays as it is. At 12 months Dr Lupanzula examines you, you have a biopsy, there are no conditions found that could cause this... What to do next? Your donor looks very strong, another procedure is achievable... You wait another 6 months to see what response you have to the meds... You have a small test procedure.

I would first have a health check with your GP... Have some blood work done, speak to Dr Lupanzula about when is the right time to have a scalp biopsy. Don`t lose hope.

If I can help with more support just give me a shout.
 
H

harry1001

member
Thanks bullitnut for a wonderful reply.

Firstly, what was your growth like around months 5-6-7?
Switching between meds can play havoc with your regimen. Did you have a reason for switching?

My growth was poor at the 6 month stage, which is when Scott realised that it's not progressing as planned and recommended I move to dutasterite. In fact, after month 5 I was getting a little concerned and just thought that I was a slow grower and tried to be patient.

Could there be an underlying reason as mention in Bm post?
I don't know - that may well be the case. But there were certain blood test done an hour before the surgery, not sure if they show anything but I think that they were done for legal reasons, as the results of those were not available until after the operation had actually been carried out. Maybe there is something in my scalp causing this, maybe my body chemistry is off. It would be nice if I could figure those things now so they could be addressed earlier. But as it stands, and with these dreaded Covid lockdowns, I'll have to wait till the 12 month mark when hopefully I'll get a thorough examination by Dr Lupanzula, and see what he recommends.

Really appreciate your response.
 
bullitnut

bullitnut

4 awesome repairs with SMG
The switch halfway through could be the reason, it may be playing havoc with your body, time will tell. Do you have a picture showing the growth at this point? Many patients are just slow sprouters at 6 months and beyond.
Establishing what has happened at 12 months is the next stage...Then the decisions have to be made on what to do next.
One thing in your favour is you never had a 4000 or 50000 graft procedure that could have used up all your donor. You should have plenty left to have another Fue if that's the way to go.
 
F

Foody

member
@harry1001 I found your thread while searching for answers that are relevant to my situation, namely LLP or Scarring Alopecia. The listed suggestions ;
Lichen planopilaris
Thyroid disease
Diabetes
Autoimmune diseases
Lupus
Scarring Alopecia
Certain medications

I am wondering, did your hair improve when you reached 12 months? Or, was one of the listed suggestions a factor in why it went wrong?
 
bullitnut

bullitnut

4 awesome repairs with SMG
Harry….Did you have your hair assessed by the doc once you reached 12 months? Was there any improvement growth wise?
 
S

SantoOwels

member
I was diagnosed with llp about 5-6 years ago now. I went in for something else but they mentioned I had it. The dermo mentioned about a hair transplant and problems but at the time it was not something I was considering anyway. I started to think about getting FUE, there is not much directly related to llp and hair transplants in respect to real cases and I came across someone on a forum. His FUE had not worked out because of llp was diagnosed after.
 
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S

SantoOwels

member
I thought your pictures looked familiar, it was your case that I found. Shame you did not update here, I know from reading you were going through things, but it would help people like me to get a full picture. I noted in June this year you said after a biopsy in the UK you were diagnosed with LLP.

34D8D70A-578B-4AD3-93D2-60DACC3F62D0.jpeg




How have you moved forward, is there any light at the end for your hair?
 
Bigmac

Bigmac

Administrator
Staff member
It’s come to my attention that the user Harry has been making false and disparaging comments regarding this forum on one other hair platform, as well as by messages to users. His narrative has been to spread false, misleading, and potentially defamatory comments about Hair Loss Experiences (HLE).

Harry commented on a clinic result, stating he wished he had chosen that clinic. As a result, giving the sense his choice of clinic was wrong. When in fact, his choice of clinic would have made no difference to his result due to his underlying medical condition. HLE edited the comment by Harry as it gave a false narrative to his choice of clinic. Considering he had an underlying condition (LPP), and the post could be interpreted incorrectly and disparaging to his clinic.

This was explained to Harry, including, if he still wished to comment/update on the result that was perfectly fine. But not to suggest his result was due to negligence by the clinic and would have not occurred at another clinic. Harry agreed with this at the time.

Recently, Harry has decided to post giving a false and misleading impression of the event. Deliberately omitting the reason for the edit. Rather Harry has decided to misinform by giving the impression the edit was made with an unethical motive in mind. Harry has deliberately gone out of his way to give a false impression of how HLE is managed. Ultimately attempting to portray HLE as unethical.

HLE is committed to being an open platform for users to debate and review their experiences. This helps many to research when it is made with openness and truthfulness. HLE does not recommend any one clinic that posts or not on HLE. We pride ourselves on this openness of choice and impartial approach to helping the hair loss community. HLE has the case fully documented. Harry has been notified and to date has not replied. Only Harry will know what motivated him to make these false statements.

The thread is now closed. Harry had every opportunity to update but chose not to.
 
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