general-etwan

They have several different packages; if you are okay to have one of the other doctors who work there do it and the techs, they are one of the more affordable big clinics in the world. Just fyi in case you didn’t know they have packages for like $1.45 and $0.75 per graft.

Excellent work, going to be a great result. You should take finasteride 3 days a week to help slow future loss as you age.

Just wanted to share a comparison between early December 2023 (6 months after my 2nd HT) vs. today (March 18 2024, 9 months after my 2nd HT). I was a bit depressed back in December with the state of the sides of my head...not the transplanted area, but the native hair area. I'm not sure why it looked so patchy and uneven. It could have been stress; I really don't know. But it seems to have recovered and grown in better now. I still have the retrograde alopecia above the ear, but it's not as noticeable and ultimately not a huge concern of mine. I could always get subtle SMP there to help decrease the appearance of it. Also, the behind-the-temple areas have grown in decently well (I originally thought I'd need some grafts there in a 3rd HT but now I don't really think it's necessary). The picture on the right shows my hair buzzed to an equal length all over, so that you can see the density variation at uniform length. Having HT #3 soon. Focus will be on increasing density all across the top. I expect and hope for 3,000-4,000 grafts to be used between scalp donor and beard hair. I think we'll be able to get 2,500-3,000 from scalp donor so then it will be up to me how much beard I want to use. I suspect that most of the adding of density should go to the hairline-to-midscalp region (maybe 60% of what we do) and then a bit less to the crown area (maybe 40% of what we do). Or maybe 50/50 since my crown is trailing behind everything else at this point. I guess whatever they decide will look the best based on where I'm at right now.

The only use I would consider for the “nape” hairs that are circled are for slight temple strengthening. My left temple is a bit weaker than my right and both could possibly use some strengthening (not moving farther forward; just adding grafts to the area) to make them appear darker and not as light and fading. Those light nape hairs could be used there. Also, those nape hairs I have make the back of my neck look messy and so it would be more about getting rid of them than heavily relying on them for middle-of-scalp strength (they wouldn’t go there; only to light areas like temples). The less I would have to constantly shave them, the better and cleaner my neck looks.

Thanks for the responses so far everyone! Makes perfect sense to focus fully on increasing density front to back. I will be inquiring about going on dutasteride to help preserve donor hair strength long term. My dermatologist would not prescribe it for me for hair loss the last time I inquired about it so I’ll have to get it from somewhere else. If anyone knows of ways to buy a whole bunch of it in bulk please let me know. I still have several months of finasteride left that I got for free so I’ll try to use that up. And SMP I won’t consider until after 3rd HT as will not want to interfere with actual hair graft placement planning. Better to assume no SMP and go from there.

Very true. If all eventually goes well with density and I can grow my hair out into a medium length messy fringe type, the precise hairline area can be covered too and it doesn’t need to be super low to look good.

I can see Dr. Sethi wanting to do something like this to my hairline/temples. But of course *only* if we take care of priority density on top first. This is only an idea for very best case scenario but if it doesn’t happen it’s okay.

I did not. They never responded back to me with an opening for a video consultation. Pittella is booked way too far out for my liking too and his cost is out of my range. I think he’s doing great work. Just not going to be an option for me.

Oh, and here is my current donor region. Still looks solid, looks thick and feels thick. I really do think we'll be able to take another 2,500 from it. I've seen some cases where people have slightly thinned out rear donor areas from HTs and it's not devastating at all if it's spread out well. One of these cases I believe to be Tiger W o o d s, who I'm convinced had a HT sometime after 2015 (not that it turned out that great on top) and the back of his head looks a little bare, but no one has ever said a thing about it because the truth is most people don't care what's going on back there. Reminder that I've had about 6,300 taken from my rear donor so far. I think we can get another 2,500 from rear donor + 250 from each side lock (500 total) + 500 beard (maybe up to 1,000 if I am willing to do it). That's 3,500-4,000 more we can add to the top to increase density putting grand total at 11,700-12,300 grafts if we do all that. Tiger W o o d s' scalp donor depletion. I would be more than willing to accept something like this for higher density on top:

Yeah, it's really difficult to find cases where people buzzed their hair short like I just did after entire-head hair transplants. When hair is medium to longer length the longer strands bundle together and can look thicker from afar. I can compare myself to others all day but everyone's situation is unique and I think all I can do is examine the fact that my original native hair is essentially completely gone, compare my first HT graft placement after scabs came off to my current state, and see whether it makes sense. Looking from the side profile view, it looks exactly how I would expect it to look. Looking straight down on the top, the density looks low, but that seems to just be the reality of a NW7 with only 5,300 original grafts on that area. I absolutely plan to use SMP as another tool in combination with a 3rd HT. Just trying to decide whether SMP session should be done before or after that 3rd HT. Yeah, well that hairline idea I had was before I realized how much I need to increase density. Now that I figure that I want another 3,000-4,000 all across the top to increase density, obviously hairline adjustment isn't at the top of the list. My analysis is that my hairline is still a bit high though and the temple corners are definitely recessed from the front view. But, that may just have to be a reality of being a NW7 MPB guy. We can't make everything perfect. But knowing how much Dr. Sethi likes to maximize the front view, and the fact that Bandit90's hairline is lower and flatter (and spoiler alert...won't reveal too much but Bandit90 just had his 3rd procedure and Dr. Sethi did hairline and temple work again, bringing everything even tighter at the front)...I couldn't rule out that Dr. Sethi might want to do hairline work with me too, even though it seems unrealistic right now. Here, you can see what I mean about temple recession. I have a big and wide foreheard: There could be multiple different strategies to changing this: 1. Is to add grafts to temples, bringing them further forward. 2. Is to lower hairline, making forehead not as tall. 3. Is to do a little bit of both. But I suspect the number of grafts needed to do this kind of additional hairline/temple work could be anywhere from 500-1,000 and I just don't know if that would be a wise use of grafts at this point. I want to make sure I get a lot more density up top first.

Yes, absolutely considering SMP as an added tool in addition to a 3rd HT. Question is, should I have SMP done before or after the 3rd HT. That's something I need to research and figure out. I've always considered adding dutasteride but honestly not convinced that it would be anything miraculous for me since my hair loss was far too aggressive and intense for finasteride to do anything about. I don't want to castrate myself if it's only going to make a tiny difference over the years. Oral minoxidil - my dislike about it is the increase in overall body hair growth and potential of heart side effects. If I can be convinced on those two points maybe I'll try it, but it's not going to grow new hair where there is none, just very minorly strengthen the existing hair. I would guess that to have completely aesthetically undetectable hair loss, I'd need another 8,000 grafts on top, but that's in a world of unlimited donor. I think another 3,000-4,000 on top would be enough to deliver a satisfying result of density and allow for almost normal styling of the hair. You look at some of these NW7 cases and they've had 12,000-15,000 total grafts. So even though 8,300 is a lot in the world of HTs, for us NW7s it's really no surprise that even more are needed to generate better appearance of density.

Ok, here are some pics with it all buzzed evenly because I got bored. When I went to my barber, he cut it varying lengths from back to front to make it look thicker, but I wanted to see what buzzing it all to equal length showed. Might as well do it once. First pics are under harsh light Wet hair: In the car; in more natural lighting obviously it looks denser: As for the possibility of my yield being poor; I think the current view vs. the grafts 1 week after my first HT match up pretty well pattern wise. I don't know. I think it's more just so much surface area to cover and most people never buzz their hair like this after a HT. My growth came fast and strong and I remember essentially all grafts were growing by month 5 or 6. My "final results" were front-loaded. They came fast and everything's been essentially the same since then. 1 week after 1st HT (Sept. 2022) vs. now (Feb. 2024)

Well, I got bored and annoyed with my hair length so I decided to have some "fun" and give myself a buzz cut. It's winter so it's the easiest season to hide it until it grows back...and it looks like I'll need to for a bit. I buzzed the entire top down to an even 12 mm and the sides and back to 5 mm. I want to notify anyone following this that it's essentially see-through; transparent. I figured the density would show its true self when buzzed short, but it was difficult to accept at first. I will share pics if y'all want to see and promise to go lightly on the situation. I'll need to understand exactly where I stand. I was hoping the density would be higher, but compared to my post-procedure pics, the results from HT#1 seem consistent with the graft placement. I think the yield is good. The angles of grafts all look good. I ultimately think 8,300 grafts simply isn't enough for me. When the hair is longer, the longer strands bunch together to make it look fuller, but buzzed short, the reality of the surface area to cover vs the number of grafts is seen. By now I have surely lost all the original native hair on top of my head, to the Norwood 7 pattern, so the only hair that remains is transplanted hair and I think the reality is that 8,300 grafts across the entire top and crown still just isn't enough. A big step in the right direction, but not enough to be content. Looks like my 3rd procedure will have to be a big lift and put all grafts to increasing density. The good news is my donor still looks essentially untouched and I personally think we can take another 2,500 from just the rear donor, plus maybe another 500 from my thick sidelocks, plus up to 1,000 beard grafts. That adds up to another 3,500 to 4,000 that could go to the top.

Took me about 16 hours. I think they guarantee it within 3-4 days.

Yeah I’ll take one tonight, though it’s important to realize that looking straight down with my hair at this length is misleading and not very telling of much because the length of hair varies and some areas look thinner just by how the hair happens to be laying. I’d have to buzz my hair short for you to really see what you’d want. Angled pics actually are more visually telling at this length.

Almost 8 months after HT #2 and 17 months after HT #1. Right after showering. I saw someone in another thread mentioned that I have gotten poor growth and that 8,300 grafts should be enough; not sure about that; as far as I have monitored, the vast majority of grafts transplanted have grown and grown pretty well. I think it's just very difficult to get the density high when the donor hair isn't super thick (mine isn't, I'd say average) and there's so much surface area to cover on a NW 7. But I haven't noticed any substantial number of grafts not grow well. If I could be wrong about this, let me know. In planning for #3, I'd like to highlight the following points: The behind-the-temple areas look better now and I'm not sure any more grafts are really needed there at all anymore. At very short buzzed length, there can be a visible gap (because the transplanted temples are thicker and the area directly behind them is a bit miniaturized), but grown out a little, it's not that noticeable. I think it may be worth flattening the corners of the hairline just a tiny bit at the front corners. When you see me from the front, the visible upper temple corner recession is very deep, especially with the hair combed back, which means the lateral hump regions are not as strong as they could be. A big reason for the lateral hump areas still looking a little weak is because of the deep upper temple corner recession. The original hairline was a proper start for HT #1, but now spending a few hundred grafts to bring each corner slightly lower may be worth the visual improvement. For example, in Tom Brady, who is rumored to have had hair work over the years (and even if he hasn't, he still serves as a good example of this), the corners of his hairline are flatter, which promotes a slightly more youthful look as opposed to deep temporal recession. I think @Bandit90 also had his hairline slightly "flatter" than mine towards the corners and I'm a big fan of his. I understand this is a risky area to get right but I have confidence we can get it right. It will be a very minor, careful lowering. You can see the drastic change in density that still remains between the crown region and the upper donor region; notice how the crown hair lays flat and close to the scalp (because of much lower density) and the upper donor region sticks out straight more (because it's denser and thicker). This drastic change in density still has to be smoothed out more for my liking. I will be adamant that a decent number of grafts be taken from my rear donor region again and moved north to further homogenize things. We have to remember that "baldness" is largely inferred due to a drastic change in hair density at some point on the scalp. If things are smoothed out as much as possible, even if the overall hair density is lower, the general public does not infer "baldness" nearly as much. My vision for slightly lowered corners of hairline, which could increase visual appearance from the front:

Yes, Bernstein and Wesley do FUE. Bernstein was an "inventor" of FUE back in 2002. My donor is still in good shape, I promise. I still want to be fairly aggressive, as I don't mind serving as an experiment of being aggressive in maximizing density on the top and potentially using SMP or other strategy to smooth over donor area; but I really don't even think I'll ever need to use SMP at all. If anything, I'll get it on the top to fill in any weak region. Most people truly do not care about the look of the sides and back of your head, and compared to so many botched cases where clinics butcher people's donor areas, I'm very grateful that I've been taken well care of so far and no common folk in public would even guess there has been anything taken from my donor area. Wet hair pics coming soon...wait for it...!

Yeah, well USA clinics can be very picky because they are charging a TON of money for HTs. So, it can be somewhat fair for them to refuse you if they don't think the outcome would validate the price they'd charge you. Many doctors also just don't want to deal with advanced, highly difficult cases...there's a lot of stress and resources involved and high potential for unhappy patients. Carlos Wesley of NYC is another quality doctor who is very picky and conservative with his HTs; he seems to do pretty nice work but let me know if you ever see him operate on someone who is a NW5 or higher because I haven't. A lot of doctors just stick to NW1-4s.

It wasn't because I was too young; it was because I had too advanced of hair loss. Bernstein in NYC literally told me I'd never be happy with any outcome, full coverage was not possible, and doing a HT would do more harm than good and turned me away. It's fine that I didn't meet Bernstein's criteria of a proper candidate (every doctor has the right to formulate their own grand strategy and pick and choose patients as they wish), but it's also true that Bernstein's clinic didn't care about my goals in the whole thing; they tend to stick to their more traditional, more rigid vision of a HT. And many other USA clinics approach it that same more traditional way. Will be sharing wet combed back pics next.

I’m maximizing my personal schedule logistically by having the 3rd in the near future. Don’t want to go into details but believe me, can’t have the next in 1-2 years. If I am to do it, it has to be by this coming summer. Just the way life has fallen for me. Final end result doesn’t have to come before next procedure. I demonstrated that having my 2nd 9 months after the 1st. The hair just has to be sprouted, growing and easily visible for proper planning. Then when the full results of each come, it all comes together. Thanks! Come a long way so far but still have a bit to go to achieve what I want out of this.

Just in the early planning stages now, so by the time I have it, it will be at least 10 months since #2. All hair from last one should be well growing and visible. Not worried there. I think my biggest takeaway so far from my first 2 procedures at Eugenix is, they've been pretty conservative and we haven't been as aggressive as I ultimately want to be. I appreciate being careful at the beginning and being safe, but at this point I can see that my donor area has remained very strong after taking around 7,000 grafts from it. My hairstyle goals have changed a bit since the beginning of all of this and now my plan is to be able to wear medium to longer-length hair, not have super short fades all the time. Therefore, the most important thing for me is still to increase density all across the top and in the crown area. The contrast between the transplanted area and the upper boundary of my rear donor area is still much too drastic. More hair needs to be moved from my rear donor to the top to smooth things out the way I want to. I can grow the hair on the top longer and leave it messy and shaggy to help cover any potential thinning on the sides or back of the head. It's very important for me to increase density on the top at this point; the sides and back of the head are simply much less noticed by people and it really doesn't matter if they get a little thin. Hardly anyone notices those areas, and I can always use SMP if needed for added fill-in. The world of hair transplants is really a huge spectrum of strategy. American clinics refused to work on me at all (extremely conservative), and relative to them, Eugenix is more aggressive and willing to take on a big project. Yet, at the same time, Eugenix has still been very careful with my donor, and now that I can see it's held up very well, I want to be more aggressive in moving more to the top. I can tell it's going to be an uphill battle getting them to agree to meet my aggressive plan for #3, but confident we can get there. As for other clinics, I simply don't have the finances to pay higher prices, and Eugenix already knows my situation and I very much approve of the quality of work they've done with me.

Unfortunately your donor hair (and remaining DHT-resistant hair) is very thin and sparse, do that does not bode well for a high-graft scalp only transplant. Only a few thousand grafts could be taken from your rear scalp donor area, and that's not nearly enough to produce an overall uniform look of any solid density. I'm afraid if you insist on trying a transplant you'd have to agree to use beard hair and even body hair, and that's a whole other beast and challenge. The math honestly isn't good for your situation of hair quality. Medication (finasteride) for at least 10 months is a must first if you really want to see if it can be done

Just as it does in those most recent pics. Most days I just use tea tree conditioner and occasionally sea salt spray on top. Kind of messy, not combed or held tightly in place. Thin area is primarily still the crown. Entire top of head could use some more density, but it's overall decent and with hair grown to medium length it looks okay. Not sure how many more grafts we'll be able to add there to increase density in procedure #3...TBD.

7 months after HT #2; 16 months after HT #1 Things are blending overall much better now. Planning for HT #3 right now. I know some here endorse a more conservative route, but ultimately please respect that I will ultimately do what addresses my personal goals for the next 1-3 decades, and I do want to have a 3rd procedure to address some remaining areas of need, and maximize my situation while I'm young. I also have had a change of heart about my length of hair; in the past I said I would maybe just keep my hair faded super short forever. Maybe the lower sides and back, sure, but as for the top and lateral hump areas, I want to be able to grow my hair longer. With good density on top, I can grow it to longer length and hide any slightly lacking areas. The rugged, medium-to-long messy look is one I hope I have the option of rocking at some point. I want the behind-the-temple areas addressed with a few hundred grafts max, and I want increased density across the entire top, eliminating the horseshoe pattern as much as possible. I expect to be able to get another 2,000-2,500 grafts moved. I will then use SMP on donor area if needed (if it becomes too thin), but I'm not concerned about that because slightly thin donor isn't a terrible look at all and you can see many other cases who have it, and if hair on the top is maximized, no one cares at all that the back and sides are a little thin; it's a barely noticeable thing in overall appearance, Black = recipient area Red = donor area Below is a photo from last month showing how well my rear donor has recovered from first 2 HTs: