HCH

@j1mmy well said, HT is a customized plan for each individual depending on his situation and expectation.

My hairline density will be 45 to 50 cm2 as explained by the Dr which's acceptable by me as i never had a any sort of hairline to start even thinking about high density.

One should to be realistic, you will never get back your original density. HT is a cosmetic surgery with the aim to enhance your aesthetic.

My surgery is scheduled on Wednesday probably after yours 😂 

3 hours ago, SLA said:

I think Dr. Arika tends to err on the more conservative side...

She even said in a consult with me that Dr. Pradeep (her husband) goes denser that she does. I didn't necessarily think it was a matter of skill. 

Might be that she is more risk averse, but I get the impression she also takes pride in being able to do more with less.

In an interview with Joe Tillman, and also mentioned on a consult with me, she said she can cover a NW6 with 3,500 grafts for a small head and 4-4,500 grafts for a moderate sized head alleviating my skepticism that they recommended ~4,200 for my level of loss.

 

you are right, keep in mind each case is different. There are many factors that come into play such as donor density, hair caliber, skin contrast, head size etc... 

In my case, most of surgeons recommended 3500 to 4000 grafts through video consultation and pics.

I was surprised and confused when she advised for 2500 grafts only. That's why i created this thread to get more info for senior members and ex-patients.

3 hours ago, j1mmy said:

@HCH I saw this and thought of you
 

 

Awesome, i thought it's my head for a while 😂

Still confused why my Dr is hesitant to transplant between my existing hairs ??

I guess she wants to preserve my grafts for the future but going to check with her again.

Thanks for sharing this case 🙏

32 minutes ago, j1mmy said:

Somewhere else, but I will create a thread about my journey the days afterwards  As a European myself, it is challenging enough to travel to another country in Europe - my flight has been cancelled twice already, so I will be disappointed if it will not work out. 

Is your concern of permanent shock loss information you got during your consultation? I have a little more density than you I would guess, and the plan is for around 3500 grafts into the frontal 70%, with a focus on dense packing hairline. This all depends on my consultation on the day in person, and my donor capacity.

To my knowledge,  I have only seen cases of "temporary" shock loss on patients without finasteride, and not sure how many permanent shock loss cases I have seen except around an FUT scar. And believe me, I must have looked at a thousand cases here and other forums. The shock loss as I understand is that the damage to the surrounding area scares the weaker/miniaturized hairs into fully miniaturizing, as they were arguably on their way out anyway, like a dying flower. Permanent shock loss in my head would have to be caused by direct transection, or a blood supply issue. Transection is minimised by experienced and good doctors, as they can see with their microscope if they are transecting during extractions/implantation. They may even intentionally place terminal hairs over very miniaturized hairs - an art I can only imagine. Blood supply seems to be less substantiated. It has been demonstrated that you can transplant very high densities in dense packing (70-80g/cm) with nearly 100% survival. Whilst impressive and possible, it however carries a risk of necrosis, so the risk is not worth it. Many however choose to dense pack up to 50-60g safely, and on a second procedure "touch-up" 10% for more density if needed. I think it is also not substantiated if you can dense pack a large area, without compromising blood supply. 

I have heard Eugenix mention they are comfortable placing grafts if the space is "2mm or more" between hairs, i.e. 25g/cm native density, which could be around where you are. The point is that they WILL be able to feather in grafts into the mid scalp if you wanted to, I have seen many cases of theirs where they have. I have seen hundreds of cases by Dr. Lorenzo on youtube, where he fully restores NW7's back from the grave with 10000 grafts over multiple procedures. It is all based on transplanting between hairs, and between native hairs. You would be surprised what is possible. I think Eugenix often surprises people when they meet them in person, they seem to like to "surprise" you what with is possible. If you want density further back than just the hair line, it is something you should go into the consultation exploring, I would say!

It's really painful getting your flight cancelled twice. Hope this time it works well and you get a successful result. 

Actually, i had a personal consultation with Dr. Arika and she advised not to transplant between the existing hairs. As per my understanding when you have a lot of telogen/miniaturized hairs the risk of permanent shock loss is higher. Honestly, i am ok with my mid scalp density and just need a decent hairline to frame my face and reduce the size of my forehead, crown can be addressed in a 2nd sitting if my donor allows. I checked your profile but couldn't see any pics so maybe your case is different.

BTW, Spain has the best surgeons in the world in my opinion so congrats if you choose Dr. Lorenzo  

19 hours ago, j1mmy said:

Hi HCH,

I am having a surgery in exactly a week, so I can relate to your situation of several months of research .

I agree about your hairline being too aggressive. As someone said before, imagine 1cm of hairline is 1000-1500 grafts for good density. Your suggestion is a solid 2cm, and that is then neglecting everything behind it. 

I recommend you consider M or V shape hairlines, they are actually graft preserving, and age well. Look at Melvin's hairline on youtube if you can. Not to mention that it is very aesthetic, but if he had decided to opt for your suggested hairline in line with his midline-frontal point (the lowest point), he would have to spend more grafts filling in more temples. 

Given that an average donor of 6000 grafts, I don't think it is unreasonable to "use" 2500-3000 on the frontal third, and feather in 500-1000 in the mid-scalp. It is individual, but I think Eugenix recommendation was too limited to the very front for my liking, and your design was too aggressive. 

Temporal points do not need to be fully reconstructed, you have some density and shape to the lower portions of them. You can add some density to the tops of them, as they become your temples and frame the hairline. That way you don't use 700 grafts on the temples, but say, 200. 

Your worries of 45grafts/cm^2 forget that your native density is not 0, as the good DrT alluded to. But, such a density in the front of the hairline should give you a decent hairline. 

Your challenges with medication are a shame. I agree that topical dutasteride seems worth looking into, or your topical OR oral finasteride should not be daily, and be cautious. A small amount goes a long way in terms of its effect on DHT, and maybe negates side effects. 

I think that even though oral minoxidil is becoming increasingly popular for the braver people, as some good Dr's are prescribing it. It is worth remembering that oral minoxidil is the very origins of topical minoxidil, but topical was created exactly for the very reason that oral minoxidil was not a viable option for treating hair loss.

You are doing a great job of doing your due diligence, and I don't think you will be dissatisfied with Eugenix, but as you see, it helps to be an educated patient, to maximise the best possible chance of being a satisfied patient. 



 

Appreciate your contribution and advise, are you going with Eugenix as well ? did you confirm the date?

Actually the 2500 grafts will be used for the hairline. i am a diffuse thinner so any work between the existing hairs will be too risky (permanent shock loss). 

The hairline design is the most aesthetical of a HT so i am trying my best to have it done properly so i won't regret it in the future.

As for DHT blocker, i am now on oral fin M/W/F for last 3 months and surprisingly i didn't notice any sides. The main challenge in my case is to delay future hair loss and use my donor efficiently.     

Thanks to this forum and community members for offering their service to educate and guide people in the right way.

19 hours ago, Gatsby said:

Congratulations @HCH! In my opinion I would put your trust in Dr Arika. You will need a hairline to grow into (not out of). If Dr Arika is suggesting to build on the temple points then I would go with that. I know it’s difficult when we have our own preferences but Eugenix has a massive body of work under their belt and they are concerned about treating hair loss over the lifespan. Ironically in my consultations I want a much higher hairline but they are proposing a much lower one in order to camouflage my frontal hairline scar. I am really looking forward to following your updates and wishing you all the best!!

Thanks mate for your support, i definitely trust her but having an HT for the 1st time makes a bit confused and undecided.

Hopefully things will go as planned and will update you all soon. 

@Melvin-Moderator i see your point, but what about rebuilding the temple peaks ? does it look really bad? 

2 minutes ago, Egy said:

@HCHThe line drawn by you for your new hairline seems a bit too "aggressive", too low, trust the doctor Arika

You are right, it should be higher but this is the shape i like. 

if you noticed in the 1st pic, she wanna rebuild my temple peaks which is not really necessary in my opinion. Anyway, the final design will be decided on the procedure date.

16 minutes ago, JohnAC71 said:

Excellent news ! When is your booking date ? What was the final plan agreed ? 🙏

End of next week, still trying to book a slot in the weekend. Hopefully i will get an update tomorrow.

As per my last consultation with Dr. Arika, she recommended 2500 grafts for the hairline only without touching the existing hair.

I am attaching 2 pics and would like to hear your opinion:

1- Dr. Arika hairline design

2- My hairline design

Finally, i got my visa approval to India and confirmed my booking with Eugenix.

Will open a new thread documenting my full journey soon  

@Melvin-Moderator @Gatsby @mustang@JohnBob @JohnAC71 @MazAB@PizzaWolf@dobler@BDK081522@deitel130 @Homeerestre @giegnosiganoe @plus                                Any tips or suggestions would be appreciated👌

it doesn't look bad, maybe it needs some more time to blend nicely with your existing hair.

Did you reach out to Dr. Arika about this?

8 hours ago, is_batman_bald said:

Is pure concentrated fin better than morr-f which is minox mixed with fin?

Of course, the dosage is more effective.

however, you can still try Morr-f and see if it works for you.

32 minutes ago, Melvin-Moderator said:

Wow that’s very expensive.

yes, did you know anyone using fin powder?

I found it very cheap on Alibaba, thinking to mix it with min solution 🤔

9 hours ago, is_batman_bald said:

there is a product which people buy from India called morr-f. is this finasteride gel any different from that?

no, it's just minoxidil solution mixed with fin.

The gel is a pure concentrated fin.

Dr. Arika told me last week that they are dealing with a pharmaceutical company to compound fin gel in India as it's difficult to ship it from Europe.

Here is a link for a company in Italy that sell fin gel http://www.farmaciaparati.it/ 

Honestly i found it too expensive 110 euros for 1 month supply.

Looking good at this point, you will have a great result for sure

What about the shock loss? would be nice if you can attach some pics of your donor.

any updates on the final result?

Happy for you bro, excellent result 

On 2/25/2021 at 1:28 PM, Abo Leel said:

Thank man! But do you think if i cut it short as if its cut guard 2 for example will this affect the progress??

 

no issues with that, just ask your barber to use a scissor.

Hey bro, thanks for the updates.

Everything is normal at this stage, hair will continue to grow, thicken up and mature in the coming months.

Just relax and stop overthinking   Early growth is an advantage, you will have a good result at the 6 month mark.

As for your wedding, you can use fiber since you already have some hair on the top. 

yes we are curious to see your progress

You should have completed the 2 months mark by now.

On 12/29/2019 at 3:42 PM, Abhinay Singh said:

Thank you so much , sure we will.

Awesome, would love to see his final result !

18 hours ago, mustang said:

It can be ordered here: https://fueclinic.com/ 

Thanks a lot 🙏

Thanks mate, actually it's 15 months. Without DHT blocker there's no hope  

30 minutes ago, Egy said:

@HCHThe fact that the clinic has been close to him throughout the journey is already a great thing, I assure you that it is not for everyone, transplantation is not an exact science, often, for many factors, something can go wrong, regardless of what  ,Eugenix is offering him a free touch-up, Cinik with me still has not spoken, yet I have had a scalp biopsy with which I have ruled out some particular problem.

I agree, every clinic has some bad results. However, it would be great if the clinic rep can give some insights about this case to clear any doubt or question mark. As you all know they have different packages and it could be one of the poor results where the Dr. involvement is very limited.