SLA

Amazing result! Interesting that Rahul chose to have such a low hairline rather than going more mature and focusing more beard grafts for crown coverage. The results are truly remarkable. I think it is important to remember that Rahul has insane beard genetics so much so that Dr. Arika said if he shaved in the morning, he would have to shave again at night (or something like that) which enabled him to harvest ~9k beard grafts. When Eugenix posted this on their YouTube channel, I asked if they could harvest more grafts from Rahul's beard and they said 'yes', however, it would completely deplete the beard hair. They say most men can harvest ~3-4k beard grafts without affecting the cosmesis of the beard.

Nice hairline design to build in recession appropriately to save on use of grafts for entire scalp! Will he ever go for crown work?

What I like about this case is the OP had pretty much no hair and is achieving an excellent illusion of density across entire head with only 4k scalp grafts (I think around 1,100 from beard). If the OP wants more density in the crown which was covered more lightly, he probably has at least 2k scalp graft left not to mention a couple of thousand beard grafts. How is that for donor preservation? Eugenix intelligently combines beard grafts in the most inconspicuous places on higher norwoods from the get go, so they don't stand out, which is why I am not sure the best approach for higher norwoods who go down the FUE route is to exhaust scalp grafts before turning to the beard. With the latter approach, beard grafts may have to be relegated to regions such as the crown where they stand out more. Just my thoughts and open to hearing what others think!

You will continue to see more growth and maturing! Looking great!

Holy cow- this looks great, especially for the than 6 months! You have many more months of growth and looking forward to your continued progress! How does it feel for you to have hair?

@Ajamilogo to the last post on Monday in the thread I posted here to see some examples of how SMP might 'thicken' a HT.

Okay @Naveenkumar- I understand, I thought it would be helpful to those choosing the same package you chose to know the actual doctor so when your results turn out amazing (fingers crossed) that they could try to request the same doctor. Happy growing!

Hi @Chances101- I like @Niko1example of progressive added density over 3 FUE HTs- one with Dr. Bhatti and final 2 with Eugenix

Definitely think 2-3 stage approach. Each case is different and depends on hair characteristics on how many grafts are needed/utilized. Eugenix tends to use fewer grafts as a whole as they are very good with doing more with less, which is why they said 3k grafts while another doctor said 4k. Eugenix seems to be very conscious of optimizing the donor region. As for density, if you desire more density after 2 HTs, you can get more density in areas provided you have additional donor resources- scalp and/or beard. I have seen cases with Eugenix in which they added density over the course of 2 or 3 HTs. @Niko1is a good example of progressive density. @Zoomstergot excellent results and while I don't think he needs more, he is planning a 2nd HT with Eugenix to get more density. Even if you don't get superb density, you can always supplement by getting SMP and/or use a light dusting of fibers. Hope this helps!

Hi @Naveenkumar- Do you remember the name of the doctor that led your surgery?

Fantastic @Naveenkumarfor sharing your experience and giving back to the community. The initial work looks great and wishing you lots of good growth. Who was the doctor that lead your transplant?

Hope all is well @MNIK and can't wait to see.

If you look at the literature on efficacy of finasteride, you will see there is not much difference between a smaller dose of .25mg daily versus the 1mg daily. I don't remember the exact difference, but you could look it up. That being said, I would consider reducing dose and building up. I have also heard that sometimes the body needs time to adjust to new meds.

Hang in there, it will be worth it!

Based upon what I have seen Eugenix do with high NWs with non-optimal scalp donor, I vote for them all the way. Just check this forum and you can see many examples of working with these types of patients to give complete coverage who you would have thought were beyond repair! Their secret is knowing well how to infuse beard with scalp. Any reason why you are not opting to do FUT? There is some evidence showing that if you can maximize donor grafts over a lifetime by doing FUT and FUE.

As I have seen, Eugenix are masters with beard hair which could make all the difference in the world for you. They know how to mix scalp and beard primarliy in the mid-scalp region. Utilizing beard may get you to full coverage after 2 sittings. If you went with Bicer using only scalp, you might have to live with a bare crown. As for beard, there are some potential limitations. (Just posted this in another post so just had to cut and paste) 1. Different cycles than scalp hair- beard hair can go into resting (telogen) phase more often giving transplant appearance of being more sparse at times. 2. While beard hair diameter is more robust than scalp, they usually only have 1 hair per graft rather than 2-3 commonly found in scalp grafts. One doc said that you can think of one beard graft as 60-70% of one scalp graft 3. Not everyone's beard grows exceptionally well 4. Some people's beards tend to nicely complement scalp hair, but for others there is a big mismatch such as straight scalp hair but super wavy beard hair Dr. Arika from Eugenix with tons of beard hair experience told me- 60% of the time, beard hair on scalp achieves excellent results, 20% of time moderate and 10-20% of time disasterous. I have heard most men can get 3-4k grafts from beard over the course of 2 sittings. On the bright side, those with very strong beards can get more. There is a case of someone whose story is in this forum named Rahul who went to Eugenix. He was severely bald NW7+ and had a depleted donor from a couple of other failed or partially failed HT surgeries. Since his beard was super strong, over the course of 3 surgeries, they harvested not much more than 1k scalp grafts, and 8.5k+ beard grafts and I believe a few thousand from the chest to create unbelievable results. The way the doc described his beard genetics was they are so strong that he needed to shave 2x per day. I think the two key questions are the following: 1. Is your beard hair somewhat similar to your scalp hair in terms of appearance and not significantly different (ie. one curly and the other straight)? 2. How fast does your beard grow? For instance, if you shaved this morning, what will your beard look like 24 and 48 hour later? Dr. Arika asked me this question and when I said that if I shave this morning, the next morning I can see that something has changed giving the outline of a beard but no real stubble until day 2, she told me I probably have between 3-4k lifetime beard grafts. Let Eugenix know that you understand your scalp donor is not the strongest, but you desire to get as close to full coverage as possible in 2-3 sittings and wanted to know what they think about your lifetime graft and beard donor potential. Hope this helps!

Did Eugenix talk anything about using beard grafts to mix in with your scalp donor? In a situation like yours, the beard can be your major friend and I have seen a lot of success with Eugenix.

For sure, amazing results. As for beard, there are some potential limitations. 1. Different cycles than scalp hair- beard hair can go into resting (telogen) phase more often giving transplant appearance of being more sparse at times. 2. While beard hair diameter is more robust than scalp, they usually only have 1 hair per graft rather than 2-3 commonly found in scalp grafts. One doc said that you can think of one beard graft as 60-70% of one scalp graft 3. Not everyone's beard grows exceptionally well 4. Some people's beards tend to nicely complement scalp hair, but for others there is a big mismatch such as straight scalp hair but super wavy beard hair As one recommended HT doc with tons of beard hair experience told me- 60% of the time, beard hair on scalp achieves excellent results, 20% of time moderate and 10-20% of time disasterous. I have heard most men can get 3-4k grafts from beard over the course of 2 sittings. On the bright side, those with very strong beards can get more. There is a case of someone whose story is in this forum named Rahul who went to Eugenix. He was severely bald NW7+ and had a depleted donor from a couple of other failed or partially failed HT surgeries. Since his beard was super strong, over the course of 3 surgeries, they harvested not much more than 1k scalp grafts, and 8.5k+ beard grafts and I believe a few thousand from the chest to create unbelievable results. The way the doc described his beard genetics was they are so strong that he needed to shave 2x per day. Hope this helps!

Very well said @Raphael84

I think another great example is Eugenix work with @Zoomster in which 7,000 total grafts were extracted (5,600 scalp and 1,400 beard). He was slick bald NW6+ with average donor at best. Check out his 15 month results on page 19.

Once again, @Raphael84, thank you and Dr. Bisanga for the thorough responses and walking through your reasoning on this topic with so many differing opinions. It is so challenging to decipher between marketing and truth.

I like the SMP examples and should work really well for you! Looking forward to seeing the progress.

Interesting point @Domino. I assume that it is probably a case by case basis depending on donor, but if one were to have an average donor, if one were to start with FUE what is the maximum amount of grafts that could be harvested before FUT no longer becomes an option in that you couldn't conceal a strip scar. Any ideas @Raphael84? I heard Ron Shapiro in the interview Melvin had with the Shapiro Group say not to go over 4k grafts with FUE if one wanted to do FUT in the future.

Thanks @Raphael84for taking the time to really address your clinic's thoughts on these questions. Greatly appreciated!

Looks good and thanks for the detailed write up. Were the after photos only after the 1st sitting and 3,000 grafts or all 6,622 grafts?