Help - Advice needed

[Chris.P]

Hi

I saw Dr Mwamba for a consultation in London last year and he suggested I have 1,000-1,500 FUE in my hairline and frontal 1/3rd. 

I have had 3 punch graft procedures with the Nobel Clinic, the last in the year 2000.  I am feeling terribly self conscious about the pluginess.  I am desperate to get it sorted.

I thought it importent to research all avenues so I asked the advice of someone who has had great results.  He has a hotline to his surgeon and he asked about the number of grafts.  He said that 1,000-1,500 was far too small an amount for my situation, saying i needed 3,000- 3,600 FUT by strip.  This really depressed me as I suspect I don't have adequate laxcity and a strip incision would take in the donor plug scar tissue as well as follicles.  I feel a big scar would be yet more butchery. 

I respect Dr Mwanda's skill and ethicacy so i would appreciate his response to the suggestion i received for 3,000 FUT instead of 1,500 FUE.   Would the latter make a significant difference to my hairline?

This is really getting me down as I felt the 'cherry picking' approach would suit my repair case.  Now I feel my hopes of a normal look is unattainable.

I've included a couple of :






Thanks in advance.
Chris Petty

[MyWHTC]

Hi Chris,

Thanks for posting on the forum and telling us about your situation. I think it will be best if we can get on the phone with you, with your chart on hand, so that we can speak to all of your concerns with a full understanding of the details of your case. Don’t feel depressed about the situation – we simply need to sort things out

The real question is: what do you want? Is your goal to camouflage the prior pluggy grafts? Or are you hoping to also achieve fullness in the frontal zone?  By selectively de-bulking grafts and strategically placing a relatively small number of grafts, you can often attain a very elegant and natural repair result. On the other hand, if you are looking for full results then, yes, you will need more grafts.

Sometimes it is disconcerting to hear different professionals offering different advice. I would only add, however, that Dr. Mwamba offers repairs surgeries that most clinics do not and, as a result, approaches will differ. I would imagine (just as a layman looking at your pictures) that you are a candidate for FUE, graft de-bulking, strip, and/or a combination. I am of course at a loss without having spoken with you. It really comes down to a) what you expect for a result, b) your preferences for the type of surgery, and c) what Dr. Mwamba feels he can and cannot realistically deliver.

If your goals or expectation have changed, we may need to alter the plan. Thanks again for posting and we shall be in touch. Additionally, please feel free to use this board as a resource should you have any further questions/comments.

[tshinos]

Hi Chris,
Your goal was to restore a more natural hl and make frontal area more dense.
When you have a pluggy look,there is two principles I follow:1).Remove the pluggy grafts then build up a new hair line later (at least one month later). 2) You graft the area and build th hair line a little bit upfront to camouflage the plugs.Wait 9 months to a year to see all the growth and then remove the obvious grafts that still stick and look unnatural.
Usually when a patient ,like you,tell me he wants hairs,I will start by putting hairs (solution number 2) and then later on if we need to remove some.Because in the process of graft removal we always loose hairs and you want to maximize your density.So it is advisable to take advantage of what you have and add a little bit more.At least we will achieve coverage and maybe half way of naturalness in frontal hair line that we could adjust easely.
Now,how many grafts?
3000 to 3500 is the amount I will use to treat a virgin scalp who wants grafts in the same region as you.Because of your previous surgery,your scalp (and I saw you in person) is altered ;we called that microscarring .And everybody knows how difficult grafts grows in that type of environment .Scarring could impair hair growth.The better advice is to graft it at low density to improve blood circulation quality in order to give a better chance for graft survival the second time.
Of course you will need 3000 to 3500 to make that region look very dense but not in one session.I will start with a 1500 grafts (FUE).
You can also do a strip but it is more invasive .There is patients who had punch grafts scar so closely that any FUE Or FIT was impossible to realize;therefore you go with strip.The only thing is graft limitation you can get with the strip especially if laxity is low .
Repair cases takes multiple steps to achieve it .And we are commited to go through all the process with you until we (together) achieved your goal.Good luck.

[Chris.P]

Thankyou so much for your informative replies.  I feel more positive about the situation now. 

I wish I wasn't so concerned about my hair, but I can't kid myself that it doesn't matter to me.  For many men losing their hair is no big , in fact they can look better without it.  I realise a full head of hair is not a realistic ambition which is why I am mainly concerned with the frontal 1/3rd.

It feels rediculous to me that for the past few years I haven't been able to walk down the street on a windy day without feeling agonising self consciousness.  Yet compared to the problems some people have with their health, my issues seem self-indulgent.  But I guess if quality of life is affected, regardless of the cause, then it matters.

Thanks again.

[Jessica.Mywhtc]

I don't think you are being self indulgent at all.  Your appearance is tied to your confidence and therefore your health.  Your goals are attainable and realistic.  When I think of the range of patients that Dr. Mwamba has, from the easiest to treat to the most difficult repair, you fall right in the middle.

[Chris.P]

I don't think you are being self indulgent at all.  Your appearance is tied to your confidence and therefore your health.  Your goals are attainable and realistic.  When I think of the range of patients that Dr. Mwamba has, from the easiest to treat to the most difficult repair, you fall right in the middle.

Thanks for that Jessica. That's reassuring to hear.   

[EclecticT]

Any of you guys who live in Europe considering improving the look of your hair, Dr. Mwamba IS the Doc.

Dr. Mwamba is one of the best doctors in the world. He is a master of all of the techniques from repair work to strip to FUE. I should know. He has helped with my transformation.

As an added bonus, it looks like Jessica is now working with Dr. Wmamba in Belgium. She is top-notch.

[Jessica.Mywhtc]

  Thanks EclecticT 

[Chris.P]

Any of you guys who live in Europe considering improving the look of your hair, Dr. Mwamba IS the Doc.

Dr. Mwamba is one of the best doctors in the world. He is a master of all of the techniques from repair work to strip to FUE. I should know. He has helped with my transformation.

As an added bonus, it looks like Jessica is now working with Dr. Wmamba in Belgium. She is top-notch.

I've just got back after having my procedure with Dr Mwamba.  It was such a relief to have such a skilled surgeon like Dr Mwamba and such a dedicated and well trained team working on me.  It was just a shame I didn't see you there Jessica.

I look forward to the results.  I have taken some 6 day post op pictures which I have emailed to Dr Mwamba.

[MyWHTC]

Chris,

I'm so pleased that you had a nice experience with Dr. Mwamba and the team. Please keep in touch - on the forum or directly with Dr. Mwamba. We will love to follow your progress. Drop us a line if you have any questions!