George Clooney

I hope things worked out but even if they didn't, would love to see an update. 

On 9/4/2023 at 3:38 PM, consequence said:

 

@stockholmare's hair

I don't want to worry you but I have to second what @Giddylot said earlier. The density unfortunately seems a bit low. For example, compare to @stockholmare's pics below with yours above. He ended up having a sparse result and was lost to follow up after his revision. Your follicle distribution looks almost identical to his.

I think Couto is able to get away with less dense packing with his Spanish/Portuguese patients because of their dense thick hair and darker hair and skin color, but I don't think it always translates well for his international patients. There have been a few cases (~8 or 9 between here and recuperar out of maybe 50 or 60) where things ended up looking a little stringy at the end for similar reasons. His artistry is excellent though, no doubt about that.

Your yield so far looks excellent, the stringiness is because the transplanted hairs just haven't thickened up and the packing is a bit scant. I hope things beef up, but if not there's always PRP and revisions. Please keep us updated.

Would love to see an update when you get a chance, preferably with a headband if possible. Also curious as to how your second intervention turned out. Please let us know!

5 hours ago, 5BetaReductase said:

Really? A biopsy without any other symptoms besides shedding? You gotta be kidding me…. Lichen planopilaris (which I assume is what you’re referencing) will typically have symptoms of erythema, inflammation, flaking, etc.

 

I would see someone familiar in dermoscopy first to look at my scalp before jumping into a biopsy

It could be a forme fruste of it. Just odd to see "shedding" when everything was going so clean up until this point, especially in this time frame. And biopsies are relatively minor procedures. Hopefully it's the anagen/telogen theory that Rolandas put out in his video but if not would be good to know early.

On 5/23/2022 at 10:08 PM, Rolandas said:

Month 10

Very late update, but it's worth mentioning.

While transplanted hair grows nicely, I've noticed increased shedding for the last few months.
Most of the time they're thin, miniaturised-like hair, but sometimes they look really strong, transplanted-like hair.

Of course at first I wasn't bothered as I know this is due to hair growth cycles of native hair as I've started oral minoxidil almost a year ago (it's about time for them to shed after all!), but since it was happening for a few months, even I of all people started slowly getting worried.
In terms of thicker hair that shed it's likely due to, again, hair growth cycles, or rather de-synchronisation of the anagen phase, since we know all transplanted hair are forced to go into the same anagen phase after the Transplant, so some of them usually go back to their original cycles at about 10-15 months after the transplant.

Anyways, I've discussed this in more detail in this video alongside some pictures and videos 

Regarding the shedding, you might want to consider switching to dutasteride from fin, adding 2% ketoconazole and getting a biopsy to make sure you don't have lichen.

5 minutes ago, Melvin- Moderator said:

First of all, I don’t do this job for money. I will have you know that I work a full-time job. Secondly, you are comparing a botched result where I was unhappy to this result which is good and the patient is happy. 

You are purposely misconstruing the situation to make yourself appear justified for nitpicking a person’s result, when you yourself don’t have the courage to share your own pictures. It’s easy for you to nitpick someone, when you won’t show your own hair. 

As for the surgeon you mentioned, he did have patient reviews, just not on the forum, he’s had several recent posts, and most certainly deserves to be recommended. The fact I took down the recommendation after hearing the feedback, shows that we do things as a collective. 

Lastly, we are the only forum that allows negative reviews, the good, the bad, and the ugly. You’ve been here 3 months but have asserted yourself as an authoritative figure on how the forum should be run lol. Do not respond to this post, any further posts send a pm.  If you don’t like it there’s the door 🚪 👋🏼 

This non response and attacking instead of responding to the substance of what I said is what I expected. Whether or not I show my own hair has nothing to do with my comments on another user's posts.

Anyways, your forum your rules. If you want to use it for advertising that's your choice. There are other more open forums out there. Hasta luego.

On 2/18/2022 at 10:03 AM, Melvin- Moderator said:

This forum was created for patients interested in sharing their genuine reviews. Patients who put themselves out there. We exist because of guys like @ADil who share their experience. I will not have anyone posting to try and nitpick them and bring them down, especially someone who doesn’t share themselves, and is anonymous. 

The reason everyone comes here is to see real reviews, the moment people feel uncomfortable posting because they may get nitpicked and brought down, is the moment this forum dies, and that I will not allow. Sharing real reviews and experiences isn’t advertising. That’s the reason why we hold these reviews so highly. No one is being paid to post, they post because they’re paying it forward to help others out there see what a genuine candid result looks like. 

We are all entitled to our own opinions. But there’s no WAY in hell, I’m gonna start allowing random anonymous posters bring down those who contribute to our community. You can call it whatever you like. There is a time and place to discuss opinions and critiques, reviews are not one of them, point, blank, period. 

I really delayed responding to this for some time so I could comment with some equanimity. Sometimes talking to you feels like an exercise in futility so I will just leave it at this:

If I recall your history correctly, you had a bad first procedure and were then rescued by Diep, followed by your recent experience at Eugenix which will hopefully be a positive outcome. Despite this difficult history you recently tried to have a surgeon included on your recommended list that had ZERO patient submitted cases. How would you feel if a user looked at that recommendation and had the same botched result you did with your first surgery?

Providing constructive feedback in threads about user experiences is part of the reason people post their cases on forums in the first place. If we wanted blind positivity we would go to a therapist. Please keep in mind that a large part of this forum's success has been its honesty. This openness is rapidly disappearing from this space and has made it incredibly difficult to trust your opinion as of late. This is not an opinion I hold alone, I've had communications from other forum members in the same vein.

I understand you have to pay the bills but come on Melvin, this "positivity at all costs" comes across as financially motivated. Please, please be reasonable. Your forum, your rules but I'm telling you there is the potential for you to do something great here. Don't go the way of bald truth.

On 2/19/2022 at 12:11 AM, Gabreille Nelson Mukhia said:

The growth looks amazing. Plus there's more time to go for the full growth. 

To bring it back to the thread, yes this is a solid point. I wouldn't consider doing anything else until 18 months if at all. This is still a nearly perfect result and we're only at 10 months.

And it's not only that sometimes we see more hairs sprouting, but I've noticed with posted cases that the transplanted hairs also seem to get a "softness" to them and lie in a more natural orientation over this time frame.

Very few users, positive outcome or not, post their results after a year so it's hard to say much but I really hope @ADil keeps updating us!

Eugenix is clearly putting out world class outcomes and they're doing it consistently. Congrats on your outcome, you look like a different person.

Well your first surgery was hair magic and this second one is Da Vinci-esque as you put it.  

I'm not sure if we'll see you again but if you come back would love to see some shots with your hair pulled back.

Also, other than finasteride are you taking any medication or doing anything to maintain your hairline?

On 2/16/2022 at 7:01 AM, Melvin- Moderator said:

@George Clooney

Journey threads are not appropriate to be discussing this, there’s already a thread discussing temple points. Trying to point out flaws on someone’s thread is unacceptable. Do not do it again. 

I would be very cautious of advocating this -- this should not be an advertising forum. A large reason HRN has any integrity is because part of its purpose is to increase transparency in the hair transplant industry. Censoring opinion in the guise of "maintaining a positive environment" comes across as being profoundly commercially motivated.

We can't provide constructive criticism in threads? The entire forum is *filled* with threads discussing the quality of hair transplant outcomes. You're singling me out unfairly because you have a bias towards this clinic. Essentially doing the same thing you did with Diep back in the day.

I'm not going to censor my opinion if I can provide constructive feedback. If you'd like to ban me, feel free. It's you forum, if you want to turn it into an advertising platform that's your choice but I can assure you will come back and bite you.

Yes agreed.

One thing I would say looking at this case a second time is that the frontal hairline is *slightly* sparse/pluggy in pics.

It's a tough balance between survival and density but this is probably at the lower end of what we see from Eugenix (which is a testament to their consistency).

If OP usually wears his hair down or doesn't mind it's probably not worth a second pass, but he might benefit from a few hundred along the hairline.

2 hours ago, NARMAK said:

Personally i think there's become a "standard" design many clinics tend to use but i think there's got to be scope for a holistic tweak. 

Personally i don't know if waiting any further than what we have today and the principles of temple point restoration will actually lead to a better outcome. I would say perhaps we need more capable and numerous options for temple point reconstruction but i think and i have no way to prove this. The majority of people don't require a full temple point reconstruction. They need a small booster/augment or they sometimes have strong temple points and only need to have the corner temporal areas lowered. 

I think every surgeon has his "signature" look for temples. You can ask them to adjust or modify slightly, but it's usually a minor variant of their baseline.

That's why this place is so invaluable, with people showing their immediate post op results and hairline design, it gives us an opportunity to understand the thought process that went into the procedure.

It does seem like we've been in a period of refinement of previously known techniques, but one thing I enjoy about hair restoration is that there always seems to be something interesting around the corner.

Your point is well taken though; hoping for some miracle cure probably isn't that wise of an approach. Do your research, find your guy, and when it's time it's time.

What follows is a summary of a number of articles I've come across in the literature about the aesthetics of frontal hairline design and determining location. Images were taken from Shapiro et al "Hairline Design and Frontal Hairline Restoration" (2013) and Garg et al. Decoding Facial Esthetics: A Method Which Includes Forehead Curvature (2017).

This discussion may seem a little heady for people new to hair loss research, but if you can be patient with the terminology I think you might find some insight to have a more nuanced discussion with your surgeon about your procedure. Particularly if you're going to a clinic that is less well recognized or with younger surgeons, this might help seeing if they've done their homework.

Temple points can be difficult. I thought this article was very interesting in terms of its discussion of graft orientation and how to distribute multis vs single units of hair.

The other subtlety that I've struggled with is knowing where I would want to place my frontal hairline. Many people describe Da Vinci's "Rule of 1/3rds" - forehead to glabella is 1/3, glabella to base of nose is 1/3, base of nose to chin is 1/3:

This is where placement should go for a young hairline or in a patient that has relatively minimal loss, but probably too aggressive for someone with limited donor or a high Norwood. Another approach is determining the mid frontal point (MFP) and assessing where the middle of the curve is between the dome and face in the horizontal and vertical planes:

There is about 3 cm of leeway with this approach -- 7 cm for aggressive hairlines, 10 cm for conservative. This is assuming you have an "average" head size. A lot of intuition and experience come into play here, it's not carved in stone, so to speak.

Regarding temporal points, Shapiro discusses what he feels are unnatural transplanted hairlines as well:

Determining temporal point placement is difficult. Every temple point is a triangle made by the junction of frontal and temporal hairlines. If a surgeon places a frontal hairline that goes into the patients native temples without reconstruction, you can end up with an unnaturally wide and rectangular forehead. There are certain surgeons that are known for this approach. It also seems like FUE specific surgeries involve less bulking of temple points than strips, but perhaps that's because style preferences of surgeons have changed over time. For aggressive lower hairlines, temple points should generally be sharper and for those with more recession there is a natural smoothing/curvature at the apex of the point that happens over time. FTA = frontotemporal angle and LEL = lateral epicanthal line (from the outside of your eyebrow).

There is a lot more to hairline creation than described here but this might be a good place to start for those that are struggling to understand which clinic is the right one for them.

Most important is not to rush your surgery. The techniques will only get better with time and the longer you wait the more opportunity you'll have to see how your native hairs will evolve, particularly if you're taking medication. My crown continued to bulk up from finasteride for years after I began the medication, for example, to the point where I no longer needed crown work. Your face is your calling card and it can be impossible to recover from a botched surgery. Don't fall in love with marketing and don't let people accuse you of analysis paralysis.  Patience is paramount.

I really appreciate this forum, the hard work Melvin puts into it and the humility and honesty of everyone who's willing to put their case out there. There is something really special going on here and I think open spaces like this are future of cosmetic medicine (and probably medicine as a whole).

I hope you all found this helpful!

@GuyFromTheUK you have been through a lot, I admire your patience. May I ask if you have been on finasteride? How is your current state?

From where you started 11 years ago that's a great transformation.

Would love to see a shot of your hairline with your shiny new iphone in outdoor conditions!  

Beautiful result. What really stands out to me with your case is the severe plugginess of you Turkish procedure in the pics was so dependent on lighting:

But after your repair even someone who's had a hair transplant themselves I think would have difficulty catching that you've had work done. Certainly the average person in the lay public would never suspect a thing.

Incredible early growth. Please keep us updated @gradina22, very inspiring case.

Have you been tested for lichen planus?

On 1/30/2022 at 7:44 AM, eyesonyouuuu said:

1.) I have started fin 1 mg daily

 

Have you thought about BHT? You have been through a lot -- if you are patient and persistent better days are coming.

Any updates @musab?

@eyesonyouuuu I'm not sure if we'll ever see you again but if you return I'd like to know why only 800 grafts? Was it a limited donor issue? 

And did you ever get follow up from Eugenix? Is your donor totally depleted now for future surgeries?

@ADil did you ever get the second procedure?

On 8/24/2020 at 3:15 AM, Andrea said:

5) Good opinions on Indian forums: there are many very positive user opinions on Eugenix. The results are natural and undetectable.

@Andrea Would love to see a follow up  

Also, to which Indian forums are you referring?

Niko, not sure we'll see you again but if you do come back would you mind posting your hair style without the rear combover so we can get an idea of yield?

Also may I ask your age?