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Yep, agreed with OP. A "mature hairline" is just a slow progression of male pattern baldness as opposed to a quick one. The term really shouldn't be used at all. Also agreed that Norwood 1 hairlines don't look inappropriate on older men. There are legitimate arguments against transplanting a Norwood 1 hairline, but that isn't one of them.

If you guys are suggesting it is implausible to have this kind of result outside of a transplant, there are tons of cases on r/tressless that show otherwise. Although they tend to include microneedling as well. But there are definitely some incredible responders to medication-only regimens. Anyways, in the after picture the guy's hair is much longer and with a combover style, which makes a true comparison harder.

Unpopular opinion I guess but IMO as long as a patient is on a DHT inhibitor they should be considered appropriate for surgery, even if they are as young as late teens. On finasteride something like 90+% of men don't lose further hair, and one year is enough time to verify you're not in that unlucky 10%. On dutasteride you're essentially 100% guaranteed not to lose any more hair. So basically once you get on a DHT inhibitor you can consider your hair loss stabilized, which is the primary precondition for 'ethical' surgery. I don't see what waiting until you're older gets you in this case. Refusing to get on a DHT inhibitor is a completely different story though. A patient should be at least age 30+ in that case, and surgery approached conservatively.

Hair transplant surgeons seem to be generally terrified of temple points, even on patients with mild Norwoods. They love constructing hairlines without temple points, leading to a very characteristic hairstyle. This is what I identify as the "Mark Zuckerberg hairstyle," that is, a low hairline leading to a vertical forehead length that is normal size, but still-recessed temple points which leads to a horizontal forehead length that is not proportional to the vertical forehead width. So your hair ends up looking like... It means if you want to return to a true Norwood 1, temple points and all, you've got your work cut out for you. For me it will require a second transplant, travelling halfway around the world to a clinic not actually afraid of temple points (Eugenix), and more than doubling my total cost. Annoying.

Uh, for those bashing this guy, six months for a refund is absolutely, absolutely outrageous and completely unacceptable. There is no good reason why a refund should take anywhere near that long. Moreover, if you paid by credit card, you won't be able to chargeback after a specified amount of time. For Visa, it is four months.

Well, you should keep in mind that the reputation of Dr. Diep is not the only thing on the line here. The reputation of HRN, or at least the reputation of its list of approved surgeons, is on the line as well. After all, if Diep remains on the list when he doesn't deserve to belong there, then the list loses all meaning. Essentially: are you willing to risk sacrificing the reputation of HRN to save the reputation of Diep?

That FUT scar is atrocious. Even if it was acceptable, FUT in this case was completely unnecessary.

Doubtful. DHT-inhibitors and minoxidil have completely different mechanisms of action. In my experience (with topical, not oral), the two have no synergy whatsoever. If you stop minoxidil you will lose all gains in a timeframe of weeks. Moreover, you will actually shed beyond your baseline level of hairloss, though the shed will regrow and within a few weeks you will return to baseline.

20 hours including 1 stop will be exhausting. You should plan it so that on the day you land, and also on the entire day after, you have nothing planned. That allows for you to be fully rested and have your wits about you on the day you have surgery. It also gives you some leeway in case there are any flight delays. I have a 15-hour no-stop flight to India for Eugenix and that is my planned schedule. I think at least two full days rest post-op is enough to be rested for the fly back. Also, the best way IMO to get through a long flight is sleeping pills. Watching movies or reading just makes time drag.

All those factors probably had little or nothing to do with your poor result. Banging your head didn't do anything unless it caused grafts to dislodge, and you would know if that happened because there would be a lot of blood. The main factor influencing the graft survival rate is not tangential factors like diet but the general surgical technique used (e.g. were the grafts extracted properly and without needless trauma, were they kept out-of-tissue for only a minimal time, etc.). Your best shot at getting a better result next time is to go to a different surgeon. Make sure it is one who has a good reputation on this forum.

The visa process is absolutely, absolutely atrocious. OP, at least you have access to the eVisa. India rescinded the eVisa last year for Canada and the UK for reasons of political retaliation. In Canada you have to submit everything by physical copy via mail, which includes sending the physical copy of your passport. You can only pay by bank draft or equivalent. The listed processing time is 30-45 days, although I am skeptical of this timeframe because the backlog appears to be so bad that a whole news article was published about it a few days ago (https://www.cbc.ca/news/canada/british-columbia/indian-visa-processing-delays-1.6657540). Made any mistakes on your application? They will mail it all back to you and tell you to resubmit it, at the cost of another ~$200 and 1-2 months waiting time. I have my date at Eugenix booked in 9 weeks and have already spent $2.6k on plane tickets. I am very worried that my visa won't be approved in time, or that it will be rejected for some minor error in the application, and I won't be able to go. The only other country I have visited, Turkey, had an online visa process that took 5 minutes to fill out and was approved instantly. I had no idea India's would be like this, and if I had known otherwise I would have never chosen to go to Eugenix.

Don't pay any attention to Bicer rejecting you lol, she is overly conservative - even relative to the fact that hair transplant surgeons as a whole tend to be conservative in general. I had similar hair loss as you and she also rejected me. Every other elite clinic I contacted accepted me.

One definite issue I see is, as the OP pointed out, there is a very clear gap consisting of poor density hair which is immediately behind the transplanted hair, on each side of the head. That part definitely needed to be filled in, and the fact that it wasn't looks to be a big error on the part of Eugenix. Anyone want to defend Eugenix on this?

Eugenix seems to be the one of the only clinics in the entire world that actually recognizes the importance of temple points and makes an attempt to generally construct them on patients. Even on a Norwood 6! This in my opinion puts Eugenix qualitatively a step above every other elite clinic.

Well, I have never seen a transplant where donor hair was taken from, say, the very center of the crown, to implant into the hairline. I am asking whether a surgeon would do this on request.

I have the following question: consider a patient that has their hair loss completely controlled via finasteride or dutasteride. The patient is a Norwood 3 and so has no crown loss and only wants to transplant to the hairline. Can the patient ask the surgeon to extend the donor region to "unsafe" regions of the back of the head, for example smack dab in the middle of the crown? The purpose of extending the donor region in this way would be to lower the risk that an overharvesting appearance occurs. For this patient there should technically not be much risk taking from this region because, although those follicles would be prone to androgen-induced miniaturization, it has already been established that the patient's hair loss is completely controlled. If in the scenario I described the patient asked for this, is there a reason the surgeon would refuse? Thanks.

I'm trying to decide between the premium package and the super premium package at Eugenix. They both involve Dr. Bansal. The premium package costs 2.64 USD per graft, and stipulates that slit creation is done by the Dr. and extraction and implantation are done by techs. The super premium package costs 4.39 USD per graft, and stipulates that slit creation + all extraction + some implantation is done by the Dr., with the remaining implantation done by techs. But it seems like it would be exhausting for one person to do slit creation AND all the extraction (and then on top of that, some implantation too). You might be risking a worse result just because of the exhaustion factor. Money is not a huge factor for me here as I would rather pay more for a higher chance of a successful result, but I almost feel more comfortable going with the cheaper option so the Dr. can focus her energy on the slit creation alone and just have techs take care of the extraction and implantation, which I gather can usually be competently done by techs (and are generally done by techs in most top clinics). What do you guys think? I would be getting 1000-1500 grafts. Thanks.

Honestly, saying no to a 38-year-old who has been on multiple-year+ finasteride is absurd. It isn't "ethical" at all; this isn't some 19-year-old freaking out at the first signs of hair loss while also refusing to get on a DHT-inhibitor. It's not about a risk-reward assessment either; hair transplant outcomes are actually very low risk if you go to an established surgeon.

Maybe you scared him off with the level of detail you provided and thus the seemingly high expectations. Even for an elite top-price surgeon there is always a risk-reward assessment done. To the next clinic you contact I would try showing pictures of these issues in a simpler, more condensed manner.

I suspect the prescribed post-op aftercare regimens are mostly a bunch of fluff. This is supported by the fact that they tend to dramatically differ from clinic to clinic. I was also given saline sprays and a dizzying array of shampoos and lotions, and didn’t touch any of it. I just couldn't fathom why they would significantly help, since none of them had active ingredients. In my opinion all you need to do is: 1.) take the post-op antibiotic, and 2.) don't disturb the grafts. If you do those two things you will be fine. Nevertheless, my "official" recommendation is to follow the instructions of your clinic. By the way, grafts are definitely not 100% secure by 72 hours. 9 days is the minimum according to a scientific study commonly referenced on here (https://www.bernsteinmedical.com/research/graft-anchoring-in-hair-transplantation/).

I am very interested in the answer to this question too.

I'm a 30 year-old male. I've been on 0.5 mg/day dutasteride since age 20 and so my hair loss has been stabilized for about a decade. I wanted to restore what's been lost of my temples. The loss may not look like much but it gives my forehead a wide look that I dislike. I previously tried minoxidil, RU58841 and dermarolling but not much result came from that, so I'm turning to FUE. The blue line in the pictures show the area I want to restore. How many grafts do you think? Thanks.