general-etwan

As the others have said, no debate here. Smile has produced a lot of very bad and scary results, bad pluggy hairlines and butchered donor areas. Even with Eugenix’s least expensive package, you can rest assured that they will take proper care of your donor area and will create a natural looking, soft and mature hairline. The design strategy of Eugenix is one of the best in the industry. You’ll still want to be personally proactive and take an assertive role in directing your own design and outcome. The more knowledgeable you are about how everything works, the better. And do not go to Smile; there is a good chance they’d butcher donor area and produce an unnatural looking hairline.

About having a HT? What’s your situation?

I see what you mean. Dr. Vinita is very nice and keeps it very simple, but if you were to go there I’d say you need to be very knowledgeable and assertive about exactly what you want. They’ll do what you want if you are assertive and dictate it exactly. The doctor only makes the slits at Eugenix; extraction and implantation is done by techs. But good luck whatever you decide on. Yeah, I’ll be looking to get SMP only on my recipient area too and figured it’d be okay to do a few months after HT. Thanks!

Great surgeons might not need this precise quantitative analysis, but it definitely gives anyone who uses it an edge. Just like no one really needs to own a cell phone to live but most people would agree it gives you an edge in life. Tech/AI/robotics will inevitably continue to improve many fields.

Eugenix does great frontal/hairline work; they are very good at artistic design and looking natural with good density. Just one of a handful of good options I'm sure you have. How soon after your first HT did you get SMP done? Curious how soon it can be done after a HT.

Well, 2 weeks after the 3rd HT and I have to say my donor area is still looking a little too immaculate for my liking. My biggest worry is that still not enough has been used from my donor area. I know that sounds crazy, but my donor has recovered very well after each procedure and it seems that I had far more strong and healthy grafts there than anyone could have initially imagined. I think, though, that my next project in line will probably be a light SMP all over the recipient area. I have seen some good cases of this online recently where SMP was combined with HT results and the visual illusion of density looks very good and is completely undetectable from a distance. Getting the appearance of good thickness on top is very important to me with the types of haircuts I want to be able to sport, so I think a light SMP across the whole top will be a good tool to utilize.

This is a good one!

Looking very good!

Yeah I understand what you are saying. Good link to reference, I'll bookmark it. I still think after reading it that the main point against taking 1 mg 7 days a week is that doing so will lead to a complete saturation level and further buildup in the body that is unnecessary; at least that's the way I understand it. This is likely what happens in people who complain of side effects months after starting, or after stopping and calling it "post-finasteride syndrome." Taking 0.2 mg 7 days a week reduces DHT by 69%; taking 1 mg 7 days a week reduces DHT by 71%. Or, converted to weekly amounts, 1.4 mg reduces DHT by 69% and 7 mg reduces DHT by 71%. That's so close it's pretty much insignificant. So it seems to me that keeping the weekly total to 3-5 mg avoids that oversaturation while still essentially reaching very close to the peak of DHT-blocking benefit from the finasteride response curve. In the end, I highly doubt that 3 or 4 days a week vs. 7 makes any substantial difference in how significant of positive results one sees from taking finasteride. I think if you get at least 3 or 4 mg a week, that's essentially pretty good.

These doctors feel that based on the finasteride dose response curve, which flattens off at about 0.8 mg, 3-5 mg per week is all that is necessary to get maximum effect without letting finasteride over-accumulate in the body, which is likely what happens in many patients who complain of side effects. Personally, I’m going to see if I can add dutasteride Saturday and Sunday, as others have done, and keep finasteride at MWF or maybe Monday through Friday at the most.

Willing to take it only if 1) body hair growth increase can be kept to a very minimum (not a fan) and 2) I can be convinced that it’s safe for heart. My family has suffered a lot of heart failure/blocked arteries/atrial fibrillation so I need be extra careful about how I treat my heart in my life.

Correct. What do you mean by UFs? They haven’t officially estimated future availability of anything. But I think my donor can have another few thousand taken. The donor area is still physically darker in color due to still being more dense with thicker, darker hairs. First two were the exclusive package; third was the simplest comprehensive package as I wanted to save money by booking hotel and transportation on my own.

Didn’t want to pay that price tag.

A few more official pics from after part 2 where you can better see the additional lateral hump and behind-the-temple grafts added. Also, they sent me official grafts counts and I made a slight correction to overall beard graft count vs. scalp: I'm still at about 11,102 total; 9,246 scalp vs 1,856 beard.

They just ask me if I'm on the same regimen as before. I take finasteride 3 days a week and use minoxidil a few times a week when my hair is shorter. (Why only 3?...because more in-depth research has shown that the maximum hair-saving effects from finasteride max out around 3-4 mg/week, and higher doses beyond that don't seem to show significant benefit). They did however recommend I try adding Dutasteride 2 days a week Saturday and Sunday. My dermatologists at home won't prescribe Dutasteride for hair loss, however, so I'll have to order through some online platform if I decide to add it. @Shadman They also recommend oral minoxidil to me but I’m not sure that I want to go on it yet. I’m turned off by the increase in body hair all over as opposed to just the scalp. Also not convinced it has no effects on the heart.

It won't. Just don't wear super tight.

For a HT that minor, really can't distinguish a difference at all. Both good doctors and would handle your case well.

Thanks! Please update title to Eugenix (Drs. Das/Somesh/Vinita) | 11,102 grafts | NW 6/7 | 28 yrs old | 2022/2023/2024 No, they’ve never given “remaining numbers” immediately after any of my procedures. I’ve always seen it as personal preference on how much thinning a person wants to accept in the donor region. I’m sure I’m pretty close to my “end” but I think probably up to another 1,000 or so could be extracted right from the center of the rear scalp donor area, still the thickest and most dense area of hair on my entire head.

Yeah, Dr. Pradeep is there late into the night a lot, says he doesn’t sleep much, and I think there are people at the clinic 24/7 in case a patient needs anything immediate. I’m very satisfied we covered all the areas I was stressing about so yeah looking forward to seeing results.

Somesh wanted to add several hundred grafts to the frontal behind-the-hairline region from the beginning. I suppose because that is the most important area to make look strong because everyone sees you from face on. That work would’ve started a few mm behind the existing hairline but I wanted to adjust the left side of the hairline just a tiny bit, so that’s when he just decided to implant grafts from the newly drawn hairline point to the midscalp. The hairline wasn’t lowered overall. The center point is still the same height above glabella. The left corner was just made a little fuller. Dr. P said it was good. Now when I measure from glabella to each temple corner, eyebrow corner to each temple corner, etc both sides are pretty much the same. It looks like around 717 grafts were implanted in that frontal region, adjusted hairline to a few inches back.

Also, not sure if I ever shared this picture from Fall 2023 before I buzzed my head, which I shared with the docs. So if it was looking like this after the first 2 procedures, I'm really excited to see the results from the 3rd.

3rd Procedure March 21, 22, 23 2024 Package with Dr. Vinita performing surgery (slits) + Dr. Somesh and Dr. Pradeep in on planning & design. As I said over the past few months, I really wanted to have this 3rd procedure before summer. Eugenix informed me that Dr. Pradeep wanted to see me during my time there so they only gave me open dates during which he'd be there. In February the dates of March 21-22 came open and it was a good fit with my schedule, so I booked it. That puts the timeline at 9 months after my 2nd procedure last June (and my 2nd procedure was similarly 9 months after my 1st procedure in Sept 2022). Left home Tuesday night, arrived in Delhi/Gurugram Wednesday night, procedure took place on Thursday and Friday, and then we did a part 2 additional work on Saturday. I left late Saturday night to return home. As we talked about recently, my primary goal for this procedure was to add density to the top areas. The projection from February was for 2,900 grafts, using some beard hair. Planning & design with Dr. Somesh + Dr. Vinita resulted in a plan to focus on the frontal area and the crown area. The pattern that Somesh drew up wasn't what I was originally expecting; I just assumed density would be added uniformly all over. But I guess what they really try to do is identify the exact areas in need of most improvement based on how well growth came in from the last time. Some areas trailed behind other areas in density when examined up close and needed the most work. Additionally, I expressed my desire to slightly reposition my hairline, due to the fact that the left temple corner was previously higher than the right when viewed straight from the front and the left side of my face is weaker than my right. So I wanted to bring the left side of the hairline down just slightly by 1-2 mm for better balance for my liking. Secondly, Somesh and Vinita proposed doing "donor farming" in the areas of retrograde alopecia that I have above my ears on the sides of my head to try to achieve a more filled look, using beard hair (I've had that retrograde thinning since my teens). I agreed to do it, but made clear I didn't want to use a ton of beard hair to do this; just a little. Somesh drew up the following: We identified the crown region (mostly the lower crown and reaching up into the side crown areas), the frontal/hairline area, and the above-the-ears donor farming areas as the recipient areas. We identified the rear scalp, the neck hairs, the sidelocks, and the beard as donor areas. I expressed that I wanted to be aggressive with taking scalp donor as I felt it had held up very well through 2 procedures so far and would be totally fine with a little thinning to achieve more density up top. Dr. Somesh understood my goals and explained that he would homogenize the area as much as possible and try to smooth over the boundary between the lower crown and the rear donor area, creating a more uniform look. Plan was for 2,500 slits total. Dr. Pradeep came to see me and reviewed the design, made sure the hairline adjustment measurements lined up, and approved of it. He said he doesn't usually like to do donor farming using beard hair, but in my case, my beard hair is decently similar to my scalp hair and so it would be acceptable to do. Dr. Vinita made all the slits according to the design and on Thursday they extracted from rear scalp donor and implanted 616 grafts in the frontal/hairline area. It was getting into late afternoon/evening and I had some oozing so we finished up for the day. On Friday we started at 9 am and they extracted more from the scalp donor, used that in the crown area, added some more grafts to the front hairline and did the hairline adjustment, and then extracted beard grafts for use in the donor farming areas above the ears They put 145 grafts on the right donor farming and 87 on the left donor farming (232 total). In total, 2,500 grafts were added to the frontal area, the crown areas, and the donor farming areas combined. Early evening we finished up and I went back to the hotel to rest, but soon something happened...I was in the bathroom reviewing the scalp and had pulled my surgical cap off and noticed 4 hair grafts had come loose from the donor farming region above my right ear. I'm not sure how it happened, they seemed to not be deep enough into the slits and were just sort of hanging there and the surgical cap might have gotten caught on them pulling them loose. One had already fallen and was just laying on my neck. They were obviously not all the way in the skin so I touched two and they fell right off. The 3rd bled just a little as it came out. I was simultaneously chatting with @Bandit90 and mentioned what happened and he said to let Dr. P know asap. This was around 10:30 pm Friday night. I messaged Dr. P and he arranged a driver to bring me in for him to look at. Got into the clinic after 11 pm, he had a look and unfortunately I lost those 4 grafts but he had his team quickly extract 4 more from beard and added them back to the donor farming area above the right ear. I appreciated this so much, as he absolutely did not have to do anything until Saturday but his immediate care is just world-class. I think the above-the-ear skin is more difficult to push the grafts into and for some reason those 4 didn't make it in deep enough. After Friday's work, 2,500 grafts total: Late Friday night when reviewing everything I felt there were a couple little things I still noticed: 1) I felt there was a larger gap between dark, thick hairs on my left rear lateral hump area compared to my right: 2) There were still small gaps in the behind-the-temple areas, which I talked about months ago. When the hair is buzzed down very short or shaved, you can see the dark hairs that were transplanted last year, then a region of thinned blonde hairs, and then dark hairs again. I really wanted to even that out, and also, we had not used any of the corner-of-the-neck hairs that we originally identified as usable. Those neck hairs of mine have always annoyed me; if they aren't shaved almost daily, it just makes the back of my head look sloppy. Nature gave me hair growing down my neck but not on the top of my head, lol. So I really wanted to get rid of them and use them somewhere more important. I messaged Dr. P about these two concerns and he said we'd go over everything on Saturday in the center. Saturday, driver picked me up at noon and the team took me upstairs in a new area. Hung out there for a while and met a few other guys, two from USA and one from Poland. Dr. P, myself, and Dr. Somesh examined my pics on a big screen. They agreed to add some more grafts to the lateral hump areas on both sides, more on the left than the right, and use the neck hairs previously identified as usable for the behind-the-temple filling to address all of my concerns and further homogenize dark hairs across the scalp. We did that Saturday afternoon and Somesh and Dr. P checked in on my final results after: They added 71 grafts to right temple, 68 grafts to left temple, 74 grafts to right lateral hump, 112 grafts to left lateral hump...using 139 grafts from the neck area and 186 beard grafts, for a total of 325 additional grafts, bringing the total for the week's procedure to 2,825 grafts. Overall, I did have a lot of pain again this time. I don't know what it is with me and local anesthesia, but it wears off after a little while and I dealt with a very intense burning sensation over most of the recipient area each day. Somesh asked me what my pain level was from 1-10. Truthfully, it was about a 7-8 but I said "3 or 4" to downplay it a little because I didn't want them to have to stop, and Somesh said "3 or 4?!?! It should only be a 1 or 2." LOL. They gave me some additional medication to try to help with the burning feeling. I'm very glad I pushed for that additional work, to close as many gaps as possible, however minor or unnoticeable at longer hair length. I wanted to be able to maximize my options for future haircuts and really just maximize uniformity where possible. Here's something I have to say in summary about the clinic for anyone wondering how operations are going these days: Eugenix has been expanding and they do take on a lot of patients. There are a handful of people having HTs done every day, between Drs. Bansal, Das, Somesh, and Vinita. Big team, a lot of moving parts. People are coming and going all day. You do start off getting what you pay for in terms of planning investment. If you go with the lower tiered packages, you're obviously not going to get as much investment in planning or deep-maximization-of-strategy as you would at the more expensive packages. Unless you're paying for Dr. Pradeep or Dr. Bansal to make all your slits, this is not a process in which you and your doctor will have an extremely deep examination and then analyze and mull over a plan for days and weeks before having the procedure. Eugenix is performing a lot of procedures. As a patient having a HT here, you really should be personally knowledgeable, proactive, and assertive in what you want, and make sure they address all of your concerns. If you don't have deep knowledge of the HT industry or HT design and need a doctor who will hold your hand from start to finish, and who can put many hours of investment into your situation, due to he or she performing fewer operations overall, there are plenty of options in the world for that. Every clinic has pros and cons; the pro to Eugenix is they have made it possible for me to have this work done all before my 30th birthday and at a very reasonable cost. They are also very ethical and careful with donor management, all of which I have a lot of gratitude for. Grand Total Graft Counts from each procedure: The fact that they've been able to use over 9,000 grafts from my scalp donor is remarkable. My donor has turned out to be a lot stronger than I could have ever expected. I do expect some visible thinning after this procedure but hope it won't be too bad. Please update the title of this thread to: Eugenix (Drs. Das/Somesh/Vinita) | 11,102 grafts | NW 6/7 | 28 yrs old | 2022/2023/2024

I’m saying he’s highly selective as in he performs a low number of procedures in comparison to others. You can’t even get a consultation with him within the year, and I think he performs surgeries on less than half the days of a month probably. But not sure of the exact numbers so if anyone knows, do say.

I’m pretty sure Zarev doesn’t perform a surgery every day. I think he probably only performs a surgery less than half the days of the month, right? They just stopped open consultations too.

"Improvement" has to be profitable or at least not overly stressful on profits. Naturally, most doctors/clinics have no reason to push for more and better when they are increasing their profits satisfactorily as is. Let the one or two pioneers in the world do the risk-taking and wait for the technology to become easily accessible and mainstream. But not much incentive to do so right now when most people get good results from standard FUE transplants. A big of the success of the Zarev cases is that he does his surgeries by hand from start to finish, and is extremely selective in his hand-picked patients.