civic

If op has any doubts & given that surgery is booked months in advance, it's probably best to pull a plug. Having doubts & or uneasiness is lock of trust in set doc, & that is totaly understandable. If i felt same with my doc, i would cancel . Why put your nervous system thru unnecessary stress. There should be solid trust between patient & doctor. Because at the end of the day it will always bother you. Give it few days and see how you feel then make rational decision.

I would not even entertain the idea of transplant at this age & stage. Hair loss is progressive as you are aware, use meds, toppik, till it doesn't work anymore. And if you can sustain that till late 30s or early 40s, thats is best time for ht. I was in similar situation as you & glad a doc i went to at young age (28)  told me don't rush surgery. I used rogaine & toppik till the wheels fell off ,  now in early 40s booked for 5k grafts, glad i waited as techology progressed ,  more research options are available. As you get older , you will be more acceptive if HT doesn't pan out as you hoped. During younger yrs it is almost impossible to accept, but surgeries have risk. I fully accept the risk at this point of my life.

30 minutes ago, deeznuts said:

I booked my surgery with Dr. De Freitas on a Monday (I was pretty insistent on that) just cause statistically, Monday is the day when people are most productive.

Also, it seemed really nice to me that I would be able to fly in any day from Friday to Sunday and have an entire weekend off to figure things out

Same here, i booked Mon-Tuesday, 2 day FUE with my doc,  wanted to make sure the doctor is well rested, but from OP, it seems some doctors work weekends, i guess we just gotta trust the universe, not dwell on what's beyond our control

2 minutes ago, JoeMan said:

Also, you're never too deep into the process to cancel if you see red flags. Not at all implying this is one but I'm just saying that if you start to feel uncertainty about other things as well, canceling is always an option.

He will most likely lose the deposit, but peace of mind is priceless.

Looks good!  Did he advise you to take fin or dut?  I had a consult with him few months ago, in my situation he did not recommend meds.

Perfect! Looks so natural.

I think in such case it is best to consider hair system, you are very young & already NW6, i honestly would not continue finasteride or rogaine, they only slow down & not prevent furhter loss. By age 40, you can already imagine what will remain of donor area (even with fin or dut). No point messing with hormones when probability of sucsess is slim to none. Please do not fall for any clinic that will promise full coverage. I am just being honest, and not trying to crush your dream. But you have to be real with yourself, & not end up with irreparable regret.

I think 6-7k grafts is too much in your case. Depending on age & if you are on fin or dut, 4k grafts is more than enough, & your donor looks good for FUE, i wouldn't limit this case to FUT, (unles they determined your hair is on thin end or grafts too far apart in donor.)

2 hours ago, MB297 said:

I did not take any side post op pics but yes mostly it was ear to ear. He said the 1 and 2 hair grafts don't stick out, is this bs?

Then it should have at min 3k grafts with average density. You should definetly ask them for strip photos. Perhaps they thought you are not that knowledgeble, naive, from initial consult. Always ask tough questions from doctors, this forum gives you plenty of research info.

Was the strip from ear to ear? Photos don't show sides post op. This will give us idea how many grafts approximately harvested.

This is very sad, i wonder what did they do with rest of grafts from that strip? Since any average Fut strip has at minimum 3k  grafts, the pic above shows like 600-900 implants, did they just throw away rest of grafts?

2 hours ago, Grouse said:

May I ask how you got in touch? Zarev seems to be too busy to respond, no?

I think Zarev is very selective with his clients just like Cuto. Check closely their before/after, most if not all their patients have ideal hair characteristics. I totaly respect them being overly selective, they want to keep their portfolio pristine. Not many doctors have such philosophy, and that is fine as long as patient understands the outcome might not be as expected. They both have lomg wait list, might not be worth waiting months or yr for consult only to be turned down. But try, perhaps they do online photo assessment to advise if its even worth the wait.

Based on photos i would chose H&W for FUT, hair characteristics appears on thin end. Donor is not too strong to withstand large fue without loooking sparse.

35 minutes ago, Gokuhairline said:

nyc ht is just bat shit insane....i'll pay $3,000 for a 1BR but not 15K for a HT lmao. 

Top Nyc docs prefer small graft work, it's their niche, mostly to frame hairline on much older people who are happy with few hairs that can be transplanted. I respect that. 

Donor is super good, given your age is over 40, i would safely go for 5k grafts fue full coverage . 3.8k grafts will not give good density, you seem to be NW5+

As i mentioned earlier, my strong opinion is surgens need to be more selective in cases they can confidently perform. I have yet to see a post where eugenix rejected a candidate. There is another thread by someone currently who underwent 3k grafts with them, which clinic itslef was hesitant on, but proceeded. I am trully concerned for his outcome. 

I am concerned that you mentioned they were kind of unsure with your case ( donor area having wider apart hair, thinner hair, and they had closed room discusions among themselves on how to proceed) do you think if final outcome is less than you desired you will be ok with decision? To be fair, you mentioned they gave option to opt out of surgery upon in person evaluation hair assesment, which they said greatly differs from online photos.

It is best for you to not look at price but quality at this point, donor supply appears very limited, not much can be further harvested , if you can pull off shaved sides and back with SMP, i think it would be the best route.

1 hour ago, Melvin- Moderator said:

Dear Community,

I have spoken to the clinic in great detail, including Dr. Priyadarshini and Dr. Sethi, regarding this patients case. The patient went in for a repair on December 2020, after having a poor result at a low-cost clinic. The patient was a difficult case, with fine hair, a compromised donor area, and diffuse thinning. At the time of the first procedure, the clinic planned a strategy of focusing primary density in the frontal hairline, moving upward with lower density towards the midscalp. The patient was satisfied and agreed with this strategy. The clinic planned for 2,500 grafts because that is what they felt they could extract from his compromised donor. The patient later complained that this was a miscalculation, but that is what could be extracted from his donor without overharvesting. After 7 months of his first procedure, the patient began complaining about the density in his midscalp. The patient advised the clinic that he was satisfied with the front, but was concerned about the midscalp- this was proven via text messages which were shared to me. 

The patient returned to the clinic in August 2021, for a free touch-up to the midscalp, even though the main area that was treated was the hairline and not the midscalp. At the time of the touch-up, the patient did not mention being dissatisfied with the frontal zone. His main concern was the midscalp. The clinic performed a free touch-up and treated the area where he requested additional density. 

The clinic has shared the photos below, which indeed show a satisfactory repair to the hairline. Furthermore, they have advised me that they last spoke to the patient in December, in which, they asked him to return to the clinic for an assessment, but he declined, as he did not have the time. He was to contact them back to schedule a time to return, which was not done. The clinic contacted him again on March 2nd, but he didn't respond.

Moreover, at the time of the touch-up, the patient refused to sign the consent form, which specified that results cannot be guaranteed and that multiple procedures may be required to achieve desired density. The patient only signed the consent for surgery.

My Thoughts

After hearing the details of what transpired, I believe the clinic acted fairly, and, in my opinion, offered a free touch-up to an area which wasn't the primary focus from the start. The patient has not shared any photos of his midscalp, which was the area that was treated for free the second time. It appears he now wants another free touch-up to the hairline, but failed to mention any dissatisfaction during his free touch-up. Moreover, It's hard to judge photos taken in different lighting and angles because it's not a true comparison.  In conclusion, I think this is just a case of needing additional surgeries due to the fact of having progressive hair loss and fine hair. I don't believe any patient should expect a clinic to continually perform free touch-ups when one- they did not specify this during their 'free touch-up' and two, knowing that a repair will not achieve perfect density for various reasons, including scarring, decreased blood flow, and in this patients case, having fine hair. 

That's why we have to respect surgens who decline certain cases, they know from experience if patient will be satisfied with final product. There are many threads where some people complain  surgen rejected them, truth is if they are top tier doctors, you have to respect that or accept gamble outcome somewhere else.

9 minutes ago, AJ_HT said:

@civic I don't think this will require 2.5K grafts. Looks more like 500-800 grafts to give a good density, but I'm no doc here. Besides, the thought of opting for another procedure itself is just upsetting.

The contrast between scalp and hair seems a bit high,  or it's a sun glare?, tough to say from above pics. But usualy with high contrast , good surgens dense pack for optimal look, hence, more grafts used .

Sorry to see such happen. I think at the very least they should fix the front, it does look thin, sparsed. Did they say how many grafts you have left in donor? If more than 3k, then they should hit that hairline hard, at least 2.5k grafts. If 90% of grafts survive, it will look awesome.

At this stage i absolutely would not even entertain idea of getting HT. You have a lot of native hair, try everything to save it & use toppik when needed. 

I am a big proponent of FUE, however, i have to admit, these larger FUE cases we see 5-7k grafts, even from top clinics have more risk for younger patients, i would say under 40 with advanced NW5-6 is huge risk. Why do you think some top FUE clinics would not accept you if you are not on fin or dut? It's because to not over harvest, and limited donor in advanced Norwoods, they often extract from non safe zones, no other way around it, so finasteride will help slow the miniturization of those folicles. We don't know yet how such large FUEs will hold up 10-15 yrs from now. But with FUT we do ( if strip is from safe zone). 

With that said, im still booked for FUE in Summer, i accept the risk am in early 40s .

May i ask what exactly was wrong with 1st surgery? It just seems native hair a bit receeded at corners. The donor area was a concern , but more was harvested from it?

I think donor is good, it seems your hair is curly which can make it look sparse if you slept on side or did not brush it.