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HIStory of a second Hair Transplant Procedure : Dr Bisanga, Dr Feriduni or Dr Keser ?

J

Johanne M.

Valued member
Hello everybody,

To start with, here is a rapid presentation of my case :
Age : 32 years old (France)
Family : Father : NW 5/6 , Grand-fathers : NW 4/5
History : I began to lose my hair suddenly in 1999 at the age of 19. Scalp became oily and this was followed by a dramatic diffuse shedding a few weeks after.
A first procedure was done in June 2002 (age 23) Then during an international congress (Strip procedure). 2050 FU extracted, 1400 were placed and 650 thrown away ! Right half of the scar sutured by Dr Ron Shapiro (very fine, almost invisible), left half done by Dr Minnotakis (almost 1 cm wide on some areas). Density achieved is approximately 30 FU/cm ². Concerning the angle, FU were transplanted straight, which is difficult to design especially on the temples. My case was strongly discussed on hairsite and hairlosshelp. Needless to say more.
Photo 1 was taken in 2003 eight months after the procedure was done, and shows how the FU were spread.

Medications :
- Finasteride between 1999 and 2002. Poor results and acne
- Dutasteride since 2003 (oily scalp suddenly disappeared in a few days, general thickening of existing hair in a few weeks) 0.5 mg then 1.0 mg since 2009
- Minoxidil between 1999 and 2010
- Nizoral 2% ketoconazole since 2010
- Oral minoxidil during a few weeks. A strong shedding was followed by a strong thickening (diameter and density). Same thing with body hair also... Stopped because of fear of side effects.
- About to start Adenogen
Expectations :
- Redrawing a lower (the right side is 1 cm higher than the left one) and more natural hairline
- Densifying the anterior mid scalp which is thinning
- Transplanting say 100 FU in the left scar to see if it grows (slight kelloïd)


 
J

Johanne M.

Valued member
End 2002/early 2003 circa 8 months post-op.

johann10.jpg


johann13.jpg


johann11.jpg


In 2007, at their best !

2007110.jpg


2007210.jpg


TODAY
Bed look :

100_1210.jpg


Wet hair :

100_1211.jpg


100_1212.jpg


100_1213.jpg


100_1214.jpg


100_1215.jpg


Hair combed :

100_1216.jpg


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100_1219.jpg


100_1220.jpg


Scar :
Left side (Minnotakis)

100_1221.jpg


Right side (Shapiro)

100_1222.jpg


After a hair cut (bed look then wet hair under the same bright source) :

100_1310.jpg


100_1311.jpg


100_1312.jpg


100_1313.jpg


100_1314.jpg


Density (Millimeter scale)
Photo 1 : Donor area, circa 2 cm over the scar, left side
Photo 2 : Donor area, under the scar, right side
Photo 3 : Vertex (the snail that appears clear in some photos)


zonedo11.jpg


zonedo12.jpg


vertex10.jpg

 
J

Johanne M.

Valued member
Here is my self evaluation :

- New hairline : circa 15.7 cm ² x 65 FU/cm ² = 1020 FU
- Densifying the transplanted area (which has a density of approvimately 30 FU/cm ² at present) : circa 30 cm ² x 20 = 600 FU
- 200 FU in the center of the anterior region
- Test of 100 FU in the scar to see if it grows (keloïd)


Total : 1920 FU

 
J

Johanne M.

Valued member
Three surgeons were contacted (with maximum data and photos) : Dr Bisanga (BHR Clinic, Belgium), Dr Feriduni (Dr Feriduni Hair Clinic, Belgium) and Dr Keser (Derma Plast, Turkey)

Dr Bisanga :
I obtained an answer very quickly, but no estimation (even approximative) of the number of grafts was given. Dr Bisanga absolutely wants to see me during a personal consultation. After a few e-mails, I finally obtained a piece of information : Dr Bisanga suspects a lack of density in some areas of my donor area and mentioned the possibility to extract the FU that were placed with a wrong angle by DHI (temples).

My feelings : I really appreciated the fact that he answered rapidly but I was disappointed by the difficulty to obtain precise answers (the reasons why he gave me no estimation, the waiting period before surgery, does he consult in Paris...). Sometimes, I was under the feeling that BHR clinic is a "big factory" (not sure if the expression is appropriate)

Dr Feriduni :
I obtained an answer in less than one week and I am under the feeling that Dr Feriduni has really studied my case.
Three strategies are proposed :
Treatment plan I
- Follicular Unit Transplantation to lower the right part of the hair line, add density to anterior mid scalp and balance the symmetry between the right and left part of the hair line
- FUE test of 100 FU (free) into the left part of the scar
Technique : Follicular Unit Extraction
Number of follicular units : 1200-1700 FU in a single day session

Treatment plan II
- Follicular Unit Transplantation to lower the right part of the hair line, add density to the anterior mid scalp and balance the symmetry between the right and left part of the hair line
- Scar correction in Trichophytic Closure technique
Technique : Follicular Unit Extraction in combination with Trichophytic Closure technique
Number of follicular units : 1100-1600 FU in a single day session

Treatment plan III
- Follicular Unit Transplantation to lower the right part of the hair line, add density to anterior mid scalp and balance the symmetry between the right and left part of the hair line
- Scar correction in Trichophytic Closure technique
Technique : Follicular Unit Strip Transplantation in Trichophytic Closure technique
Number of follicular units : 1100-1600 FU in a single day session

Many documents were joined, presenting the different techniques, their advantages as well as their drawbacks.
We can read that the transsection rate is higher with FUE and that the density obtained in the recipient area (30 to 60 FU/cm ²) does not depend on the technique. As far as I am concerned, I thought that the density that could be reached with FUE was higher because of smaller FU.

My feelings : I really appreciated to obtain a precise answer. This really gave me an impression of seriousness, all the more that the different cases presented on their website are perfectly documented (donor area density, mean hair diameter, strategy, equipment used, follow-up...). Moreover, the results obtained, especially with women and children (repair cases) are really impressive.
Nonetheless, I feel a little bit concerned by the graft survival rate with FUE technique, as they can transplant as much as 2000 FU in a single day session. I am under the impression that this is a little bit too much to ensure correct FU extraction...

Dr Keser :
I contacted him through Iainh, his French consultant. It took approximately two weeks to obtain an evaluation. According to Dr Keser, 1200 to 1500 FU are needed. Nonetheless, Dr Keser doesn't know, according to the photos, if the central area behind the hair line has to be densified.

My feelings : I do consider Dr Muttalip Keser as the specialist of the hairline : they usually are dense, irregular, well closed and perfectly natural. Moreover, I would say that growing rate of transplanted FU approaches 100 %. This is a key point for me as 650 FU were thrown away by DHI. More generally, I would like to preserve my donor area. Dr Keser seems to realize each step of the surgery and does not transplant more than 500 to 800 FU per day.
Some negative points however : I would really have appreciated a direct link with docteur Keser. His work is still poor documented, especially on a long term basis after the surgery (one year or so). I also feel concerned by the fact that he may extract FU outside the "safe zone".

Here is an example of a very impressive result with only 1800 FU :
http://www.youtube.com/watch?v=5rICapRDFUE&feature=related

I would like to stress the fact that the top of the head looked thin before the surgery (is this due to excessive light exposure) and looks perfect after the surgery although this area was not densified according to me. Any idea ?

Here are other photos of Dr Keser hairlines :

photo110.jpg


photo210.jpg


2000 grafts before / after

Before

keser210.jpg


keser211.jpg


6.5 months after

keser212.jpg




I am now in my thinking period. So any comment would be well appreciated !


 
Last edited:
Bigmac

Bigmac

Administrator
Staff member
Hi and welcome to the forum.

Can i ask what doctor threw away 650 grafts as this is so wrong, how do you know they threw them away.

If i were you i would try and meet some hairline patients from the chosen doctors and then judge for yourself which one best suits your needs.
 
J

Johanne M.

Valued member
Thank you for this response Bigmac !

Concerning DHI, this was during an international congress. No prior consultation, many surgeons around me like a guinea pig. Many difficulties to clearly express my goals. Noone let me talk. As I began to insist, they tried to force me to take a pill to calm down... Very bad experience. At the end, after a kind of higher bid concerning my donor area, 2050 FU were extracted. But after having transplanted 1400 of them, Dr Minnotakis decided to stop and explained to me that he would do worse than better... This let me a bitter-tasting during the following days... It took many years to accept that a part of me was thrown away. As of today, I simply try not to think about it.

I would really appreciate to meet former patients in real life... But I am not sure that many live near Paris (France) and still consult hairloss fora !
 
T.C

T.C

Member
johanne, How come you stopped minox in 2010 after so long ? whats the feeling out there for Adenogen ? arent many positive reviews yet!.I also had the misfortune of having FUE at DHI 2 times some years ago so I know the feeling.
 
Sparky

Sparky

Valued member
"2050 FU were extracted. But after having transplanted 1400 of them, Dr Minnotakis decided to stop and explained to me that he would do worse than better..."


OMG! I would go absolutley mental!
 
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J

Johanne M.

Valued member
T.C wrote:
johanne, How come you stopped minox in 2010 after so long ? whats the feeling out there for Adenogen ? arent many positive reviews yet!.I also had the misfortune of having FUE at DHI 2 times some years ago so I know the feeling.

I found it an heavy treatment... With poor results. I even had the feling that it made things worse.

Have you undergone another procedure after DHI ? Do you have a personal choice between Bisanga/Feriduni/Keser ?

I would really like to discuss the different points I stressed. Don't want another bad experience anymore...
 
M

mars

Valued member
I would do a scar revision with trichophytic closure the scar looks bad on thr dhi side and get grafts via strip with that,reasons for my opinion are-u will have a a better scar plus gratfs and a full fue bank of grafts for future,i think put fue into scar will only do so much and will entail a few sessions and since you have a bad scar already strip is def the way to go as far as im concerned..you will get evrything done in one shot.
 
J

Johanne M.

Valued member
This is actually a strategy that I consider, that could be the one to adopt for the long term... Nonetheless, I fear a new wider (even wider) scar ::;mb
 
T.C

T.C

Member
Johanne, My last procedure was 2007 with them so I am looking into getting the misplaced hairline sorted and some 2 hair grafts removed that they placed on one side also add density in front and behind.I still have a good crown and little thin in mid scalp but improved with propecia after 2 years.I just bought some regaine foam to try on the top area but will only use once a day as have seen some good results from it but if it doesnt help will stop. I recently had a consult with Feriduni who said I needed 1500 and about 6/8 2hair grafts on hairline removing.I LIKE his hairline designs and the yield he gets after looking at results for a few years. Bhr are a good choice also,depends on your own preference. Wouldnt consider Keser as all the results are on young guys with low hairlines but you dont stay young forever.Its all very well giving people what they want but sometimes what you want isnt whats good for you in the long term !!.
 
J

Johanne M.

Valued member
T.C, would it be possible to see photos of you ?

Keep us updated concernins Rogaine foam... I heard everything about it, good as wel as bad experiences !

I really hesitate between those docs but should I consider FUE, Dr Keser seems to get better coverage than Dr Feriduni (maybe less transection rate... ?).


 
T.C

T.C

Member
Heres my situ people,the area just behind hairline there are gaps like you can just see on my left side. Think you should see clinics in person to look at your donor especially as it has been compromised before as foto consults are not enough unless you have virgin territory at the back. Keser hasnt got alot of results available to view compared to others and like you said taking out of safe zone is an issue.
 

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J

Johanne M.

Valued member
Do you schedule a surgery with Dr Feriduni ? Sorry if I don't respond. I am about to go on holidays for two weeks ! :T:
 
T.C

T.C

Member
Heres the money shot with the hair spread out to show the thin areas.I can easily hide it even with short hair and im not overly botherd about it,only sometimes.My hair calibre seems quite thick in texture with a wave to it so I dont need a high density put in.A modest increase in density and better hairline design will set me straight when the time comes which isnt yet.
 

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L

lcsulla

Valued member
I understand having a scar revision. And what that Greek doctor did to you was criminal.

But having said all that...I don't really see any hairloss. Maybe the front, where its combed down? But the rest... I think most people on this board would slaughter small animals to have as much hair as you.
 
R

recedingboy

Valued member
Hi,

prior to this thread I had not seen Dr. Keser's work. I am based in the U.S. but his work seems very impressive.

One common thread I'm seeing by the most experienced FUE docs is use of a manual drill. Most docs in North america use a motorized drill. I questioned this and the response I got was that whether it be a manual or motorized drill is irrelevant what is important is what that doctor uses more and likes best.

Thats all nice and dandy, but why is it that the top FUE docs based on experience almost all seem to use manual punches? Just a coincidence?
 
N

nuance2005

Member
hi

it looks like you have an awesome head of hair. Did you even need a HT? Also it looks like you haven't suffered any loss in the last few years. Your wet hair reveals you have good density even near the hairline. I would say just get a scar revision.
 
E

ejj

member
good spot receding boy ! basically its all about money , patients are more educated and want fue rather than being disfigured with a big unpredictable scar .

A lot of Drs cant do fue , hence the never ending inventions .. scribes, neograft, choi , and many more .. now there is even `arty robot` with a whopping 1.3 mm diameter punch,.. to do the job some Drs cant do . It would appear that some of the best results are from Drs using a manual extraction device .

regards
ejj
 
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