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What Makes For A Good Hair Transplant Candidate?

sl

sl

BHR Clinic Patient Advisor
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#1
Advances have been made in hair loss medications over the last few years, research is giving hope for many if not all hair loss sufferers that a €œmiracle cure € maybe around the corner, but until either of these become main stream and viable options it really leaves a hair transplant to provide growing hair in areas that have lost it. So, is a hair transplant suitable for everyone, why are some people more suited than others, and why are some not suitable at all?

The crucial problem is the donor reserve, the hair has to come from somewhere upon your body and wherever we take the hair from is going to be a finite supply, running out at some point, this area is called the donor site. The most common donor site used by all reputable doctors initially is going to be the scalp, around the sides and back of the head, the areas commonly immune from Male Pattern Baldness, the common hair loss condition in men.

This hair can be €œmoved € to traditionally the top of the scalp (recipient area) to cover the areas that over the years the hair has receded, BUT, if the donor hair is not healthy and weak or in small supply we face a problem, this can make a person not a suitable candidate or provide limitations to performing one or multiple hair transplants. The donor supply coupled with the extent of hair loss the candidate is suffering from at the time but also what the potential for hair loss could be in the future must be equated as best as possible. Obviously this is harder to determine in the early stages of hair loss so any design must be in keeping with the limitations of the donor supply and thinking of the future. Some candidates, a few very lucky people have €œhome run € donor supply, meaning they can treat almost any degree of hair loss, but these candidates should not be seen as average or even very good but the exception to the rule.

Another important aspect in making someone a good hair transplant candidate can be their expectations and goals, short and long term; hair loss is an emotive issue the touches men of all ages, there is no real boundary with some men who want hair, straddles all ages. The temptation of wanting to return to a stage before hair loss is obvious but as suggested this is not feasible due to donor limitations for most. The candidate must first have a good understanding and education as to the pros and cons of a hair transplant, understand their own head of hair and appreciate that sometimes their expectations may have to be diluted a little to what is realistically achievable. This is an important aspect of making a happy hair transplant patient, one who understands the procedure will ultimately be happier and have no regrets with the final result. Those who do not understand can find themselves being unhappy long term because their initial goals cannot be met and either they did not listen to the education they were given or did not receive the information in the first place.

A relatively new avenue is becoming more viable for some candidates, and this allows doctors to use donor hair from alternative parts of the body. Upper body hair, even beard hair has been used with success in combining with scalp hair to provide the candidate with a new resource to open the donor wider. This technique, Body Hair FUE is technically and medically hard to perform, and has many draw backs so it is again vital that the candidate understands fully before trying this option. Assuming BH is a viable technique it should be used as a last resort, for hair transplant repair cases or when the scalp donor is exhausted; the BH hair is very different from scalp hair for one and can look and grow very differently. Another area for BH can be to fill in scarring from previous hair transplants, even good strip scars people like to reduce the appearance of and using BH leaves the scalp hair for the recipient and future loss.

We recommend when possible to have a one to one consultation with a few doctors to assess your situation and gain multiple opinions. If possible also talk to previous patients from these doctors and see their results in person. You will gain an idea how the doctor approaches his surgery and if he is along the same lines as you in terms of results and what is achievable. Becoming hair educated is vital to being a happy hair transplant patient in the long term, especially as it is an emotional issue and sometimes our heart can rule our head when making decisions such as this. So, ensure before making the decision all your questions have been answered to your satisfaction, that you and your chosen doctor have reached a mutual understanding about the results that are possible, now and for the future.



 
Bigmac

Bigmac

Administrator
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#2
Stephen,this is very informative and a good read.

The body hair aspect intersets my curiosity,I`ve read many times that the beard hair is the most rebust and best to use,do you know why this is.

Thanks bm.
 
sl

sl

BHR Clinic Patient Advisor
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#4
Hi BM & CS

Beard hair is obviously situated next to the scalp hair, the sideburn area being the demarkation line. The grafts here are coarser than scalp and than body hair and is as you say the most robust. Body hair especially as you get lower down is much finer both at graft and hair level and appears not only weaker but also temporary. I've lost loads of leg hairs over the years but still have a very strong beard as an example of this. It is also more prone to falling when DHT blockers are used, but again my beard was not really effected by these meds, or if so it was certainly less evident.


Beard hair also grows long unlike body hair that has a certain length it will goto and not beyond, so it apears in growth characters to be similar to scalp.


In our observations we also notice a higher % of multiple strong groups the higher up, upper torso/beard compared to lower and leg, arm etc, so basically more hairs per graft.

With BH, the angles can be very different when removing, harder to predict sometimes, especially on the beard hair.

 
H

hairtech

valued member
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#6
I agree... the closer to the scalp... it seems that hairs grow much like a scalp hair. Body hairs... that being a chest... and/or leg hairs... seem to be limited in the growth cycle... so the question is this. Where is the demarcation. Does anyone know this? *nl The reason that I ask this is because we have been harvesting beard hairs also... and this is a question that is unanswered...
 
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sl

sl

BHR Clinic Patient Advisor
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#7
Hi hairtech,

I do not think it is easy to generalise on a standard demarcation line, obviously, for us anyway, there are areas of the body we do not think worth harvesting per se, but we still look at each case on its own merits. For example we had a case recently where his upper chest hair was more robust than his beard, also contained more multiple hair groups, his lower torso or abdomen although hairy, the quality reduced quickly compared to the upper.

Obviously the hair quality plays a large part but it is not just about the quality of hair but also the technique employed to extract the hair. The punch type, size, the doctor's personal extraction technique, proximity of each harvested graft, good knowledge of anatomy and follicular unit changes within the skin. These are aspects that have to be developed to build a successful protocol and encompass the above to provide the best yield and minimum scarring for the patient.
 
H

hairtech

valued member
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#8
Yes I agree with you here. And especially with extraction experience. However, time after time... comparing a beard hair to an extraneous body(chest, leg) hair still leaves me in thinking that beard hairs are superior to body hair... in that they have more of the scalp properties i.e. growth cycle, and courseness... not everyone but a large percentage does.

On a different note Stephenl... I get questions as to who I would recommend a patient to go to in the UK. Who would you recommend someone outside of your clinic (of course) for a consult for FUE?;)
 
sl

sl

BHR Clinic Patient Advisor
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#9
Hi Hairtech

I've been asked that question 4 or 5 times this year. In essence if I felt they were not good enough for me to go to then I don't feel comfortable in recommending them. With recommendation comes huge responsibility.

Working with a doctor daily gives an insight that few are priviliged to and can't be gleened elsewhere.

I could never recommend without knowing a doctor well, his protocols, experience, ethos and grown out results. I'd need to see many results physically before I even felt I could suggest, let alone recommend.

The patient really has to do his research for himself and come to an educated decision as to whom he will choose, see ex-patients, have a consultation, use forums such as this one etc. These are the type of things we say to the seeker presently without recommending per se.




 
H

hairtech

valued member
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#10
obviously your ststement goes without even having to say this. Most seasoned posters and readers know this.

My question to you is this. Outside of your clinic... who else would you recommend in the UK for FUE? I also get this question more than 20 times a month. Yes recommendation comes with a huge responsibility. And there are not many posters that work for a particular clinic and will recommend unbiasedly another clinic in good faith. Since you live in the UK, this information can help me recommend for others. :)

I can say with full unbiased confidence that Patrick Mwamba, MD-Belgium has my full recommendation. And I believe Bisanga is also a good choice.

Your thoughts?
 
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Sparky

Sparky

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#11
I personally wouldnt recommend that anyone has HT surgery in the UK, they should either go to Europe or the USA. I aslo wouldnt expect Stephen to recommend another clinic nearby his own clinic.

Its easier to recommend a clinic in Europe if you are based in the USA, but if I worked for a clinic in Europe, I wouldnt recommend a different clinic in Europe, I'd say the same as Stephen, that they should do thier own research, thats what I did, if they cant take that responsibility upon themselves, then they shouldnt be getting an HT in the 1st place.
 
H

hairtech

valued member
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#12
I agree sparky. Research by the patient is paramount. And then there is a point at which a patient looks to others for a simple recommendation to consult with a good clinic. Since there are a plethora of shills and sharks on the internet hair forums, it is hard to find a real unbiased person.

I myself have spent years trying to be unbiased and recommend physicians that I have had personal experiences working with them and/or knowing others that have had a good reputation based on time tested results.

So I myself would recommend in Europe: Lorenzo, Mwamba, Devroye, and Bisanga.

I work for Shapiro Medical Group. And I am able to recommend other clinics based on their reputation. I never see people who work for a clinic doing the same. I would recommend a clinic near my clinic... um let's say Dr. Harris in Colorado. And then it is up to the patient to do his/her research and choose a clinic that might be best fir for him or her.

This type of posting shows an unbiased educational approach.
 
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Sparky

Sparky

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#13
You have a different perspective having worked with so many surgeons, if I had only worked with one surgeon, and his work was very good, I wouldnt feel comfortable sending a patient into the unknown.
You have had the oppertunity to observe all of these surgeons in action, and therefore know first hand what they are capable of.
 
H

hairtech

valued member
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#14
yes and it also provided me a sense of how each physician approaches his surgery and the little technical differences they have. :)
 
Sparky

Sparky

Valued member
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#15
But you dont know 100% for sure how good the docs are that you havent worked with.
When your talking about someones life, which is what this comes down to, as I was operated on by bad surgeons and it made me totally depressed and questioning life, so I personally would only recommend Dr Bisanga, as hes the only surgeon that operated well on me, so I know 100% that he wont butcher someone up and ruin thier lives. I cant say that about any other surgeon 100% as I havent seen thier work in the flesh.

I would recommend Dr Shapiro but not with the conviction that I recommend Dr Bisanga, as i've onluy seen pics of Dr Shapiros work, but i've seen Dr Bisangas work in the flesh.
 
H

hairtech

valued member
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#16
Understandably so sparky...

Since I have worked in this field... I have unfortunately seen horrible work from butchers. I have had to help in many repairs. So it is extremely important to me that I help to educate folks. If someone asks for a recommendation... my answer will be that of someone that I know will be a good choice based on the history of the clinic. This field has many skillful HT docs. Not just one.
 
sl

sl

BHR Clinic Patient Advisor
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#17
Continuing on this theme..


An area that I never thought about and thankfully never will have to is having a repair and all the mental anguish that goes with it. People such as topcat, sparky, plug, zion, scarred and many others I have the utmost respect for the way they deal with this. As a patient I made my choice and here I am today, some may say "there by the grace of God" others may say due to research, luck or judgment? Regardless, the fact remains many people past and today become repair cases for the future.

This industry is no different from any other, there are the good, bad and very ugly, and I think it is the responsibility of the good to try and educate as much as possible, even if the truth hurts and it does sometimes. It is not always possible from stopping someone making a mistake, we all do in life, and we all go against the sane advice we are sometimes given. The trouble is a hair transplant not just leaves physical scars but mental ones too. Provide more information to the new guys especially, those who are vunerable to various tactics, give them something to think about and question, rather than just letting their heart rule their head.

So, making a good HT candidate, in my view, personal view and also from my fortunate position now is do all the research you can, be open about your goals, be realistic and don't kid yourself, talk to many doctors, if it turns out some are bad so be it, you have learnt, see patients in the flesh is gold when possible. Someone who has sat in the chair and been poked and proded will tell you their story and let you know what you are getting into. A good candidate will then work with the doc, have full disclosure about what he is doing, feel comfortable with his choice and be prepared for the future.

Also wanted to add, partly in response to a question on another forum but Bigmac discussed here about the Beard/Body hair.

We do not believe BH to be the "panacea" of hair tranplantation, but we do believe for us anyway we have developed BH to be a viable source to use..... on the right candidate. We still look at each candidate as is, but for example and assuming beard is viable we are happy to look at scar repairs of a few hundred, and in a case I posted 600 beard amongst scalp hair. You will not see us doing 20K BH procedures, we feel we can preserve the donor better, limit signs of extraction and potential get more growing hair with smaller sessions. We do however feel it can have a good place for the patient.


 
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H

hairtech

valued member
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#18
Ya I agree stephenl... We also have been doing more BH cases in the last year. Not promoting it... more like if a client wants to try it... has exhausted all other sources... and fully understands the variability of the yields from person to person then yes we will try it. IMO over the years, the best hair outside the scalp IS the beard hairs... Moreover... the farther from the scalp there is a significant increase in difficulty of graft harvesting. In other words... a beard hair (IMO) is easier to extract than a leg hair...

However, this is totally just an overall opinion from a set number of patients over time... Obviously there are exceptions.... Sofarsogood (dr. Umar),Zayden (Dr. Arvind),and Topcat (Dr. Bisanga) are good examples of BHT beyond the beard that showed good results.

Please don't make me say the failures in BHT... It is a slippery slope.
 
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