general-etwan

I was anxious about cleaning up the top but barber insisted it would look even better just taking a little bit off:

11 months after 1st HT; 2 months after 2nd HT. I've started mentioning to some new people that I've met recently that I've had a HT, and everyone is in disbelief/would have never guessed/knows nothing about them. A pretty refreshing feeling to finally get to that point where I blend in as having normal looking hair for my age. 

The temples and 2nd-HT area have begun to grow in.

11 months after 1st HT; 2 months after 2nd HT:

No fibers, no powders. Only sea salt spray some days.

3 minutes ago, Gatsby said:

Donor's looking solid mate for 1.5 months post op! 👌

Yeah, actually those first 2 pics were from a few weeks ago so let's say 1 month for those!

1.5 months post HT #2; 10 months post HT #1

On 7/27/2023 at 1:33 AM, sekiro109 said:

Did you ask for the top of your hair to be unshaved? Did they offer to shave it? 

No need to shave it since no further implants were made in the area of hair that grew out. They could have shaved it If I requested but I wanted to keep it at the length it has grown to. 

On 7/1/2023 at 9:19 AM, stephcurry30 said:

Looking good how on earth did I not see this thread? Insane! 

Welcome! I may not be as active on here as others at times, but I’ve tried to be very transparent with my case and situation since I know I have a very severe case of MPB. I’m simply here to show anyone who told me it wasn’t possible for me to ever be satisfied with hair transplants that they were incorrect, and yes it is! 

At the beginning, the whole “illusion of density” reality that is hair transplants scared me and I was skeptical. I’ll never have anywhere near the density of someone without hair loss. But the real truth is that at a certain point of density, the “illusion” truly does become visually enough to appear satisfactory to the public. Knowing I have hair on top now that frames the face, and knowing that from a distance nobody even suspects that I ever had severe hair loss, has been life changing. 

Some recent pics.

After all scab removal:

Some other news:

(it was a long day and I was tired...expression is not reflective of how happy I am about how it's looking!)

Looking good. I am interested to see how you manage that small area of "transition" in the lower crown from the transplanted hair to the remaining native donor hair. I will have a similar situation coming in some months. I expect that by growing it all out to some short-to-medium length, that it will be able to be blended fairly undetectably. Your transition zone isn't as drastic as mine, I don't think. 

1 hour ago, Xanadu said:

Is sea salt spray working well?

1 hour ago, Xanadu said:

I asked ChatGPT

 

"Despite its benefits for achieving a beachy, wavy look, using sea salt spray frequently can have some negative effects on hair health.

Salt is a natural dehydrator, which is why it's able to provide that texturized, voluminous look that sea salt spray is known for. However, when used frequently, the salt can strip away the natural oils that keep your hair moisturized and protected. This can lead to dryness, brittleness, and potential breakage over time.

To mitigate the potential for damage, many sea salt sprays will include ingredients such as aloe vera, coconut oil, or other essential oils to counterbalance the drying effect of the salt. These ingredients to some degree can mitigate some of the damaging effects of sea salt and prevent it from drying out too much.

It's also a good idea to use sea salt sprays sparingly and not as part of your everyday hair care routine. Instead, consider it as a product for occasional use when you want a specific look. After using a sea salt spray, you might want to use a deep conditioner or hair mask to replenish any moisture that may have been lost.

As always, everyone's hair is different, so how your hair responds to sea salt spray can vary. If you notice your hair becoming dry, brittle of falling out after using a sea salt spray, it might be a good idea to reduce your usage or look for a different product that might be more suitable for your hair type."

Maybe use it sparingly mate. If the above is correct.

I know all about sea salt spray; everything has pros and cons and nothing is perfect. Sea salt spray really works best on medium to longer length hair, helps bring out volume and fluff. So my hair hasn't quite ever gotten to that length yet. To come; to come...

11 days? Impossible for it to be a graft unless it was implanted improperly by which it likely would had already come loose. Looks like just sebum shaft and hair. Graft is locked in skin.

17 hours ago, asterix0 said:

GeneralNorwood seems like a fun guy to have a sleepover with but I think I'll pass 😃.

The point is, your thread has attracted a lot of attention because your case is very interesting, any hair transplant enthusiasts would be interested to see your result, which I think has been very good so far.

Sorry if you got offended by the insinuation of fiber use, I think from the discrepancy of the pictures it is not out of the realm of reasonability to wonder how there can be that much of a contrast in the various lighting conditions.

I do think the use of grafts for your temple points is interesting also, normally in such high Norwood cases it is preferred to use the grafts for the limited coverage on top. I am (was) a Norwood 6 before my transplant, so I understand this thinking. 

 

Not offended at all, just want everyone to understand that it is improper and disrespectful to state a fabrication as fact and then ask someone to confirm it as such. A learning experience for some on proper interaction and engagement. The last few months involved me using fade haircuts and sea salt spray to try to maximize the look. If I do ever use fibers in the future, I’ll want to try them on the crown area just in the back. 

I definitely felt like doing the temples was a big aggressive move a few days ago but looking at some more pictures, the temple work is actually pretty minor compared to most who’ve had temple work done. Also maybe a product of my natural temples having recessed so much already, but point being, looking from the front, this temple work only really gets me back to average-framing territory, so I think it’s going to end up being a good bargain. I’ll share some more pics soon…

5 hours ago, mnvbrtn said:

@general-etwan

so even you got the dr somesh package,

Dr Das and SethI involved too?

how much it costed for second procedure?

 

Dr. Das was assigned my 2nd procedure too since she did the first one and was the only doc personally familiar with my situation from first consultation to now. Dr. Somesh performed some slit creation with Dr. Das; I actually see that now on some video that we got. I didn’t realize at the time because I was trying to mentally sleep through the hours. I’ll update the post for proper accuracy. Dr. Sethi wanted to give his input on the overall plan and make sure we maximized my situation. He didn’t perform any physical work. I won’t state the final cost right here but you can always do the math on your own for the exclusive package for the # of grafts plus the 18% GST. 

6 minutes ago, Z-- said:

First congrats on hopefully a successful second procedure! Think if you were fine with the outcome before, this should be more than enough tide you over for the foreseeable future, assuming the same level of growth as the first operation (and there's no reason to think that it wont'). That said, I've got two questions.

Do you have a sense of how many grafts you've got left for future use in the event that the crown expands? The reason I ask is that it looks like they've left a gap between the donor area and the transplanted hairs in the crown (similar to  @Niko1s procedure, and I recall you mentioning that you wanted to avoid that). Think 900 grafts or so going to the front and temple points was, imo, a bit too aggressive for my personal taste, but tbf, I didn't think they'd be able to pull an additional 3,000 scalp hairs either. My only worry in this case is that if there is a lack of donor hair for future expansion, beard grafts don't look good, especially when placed next to each other. Second, did the doctor promote or try and dissuade you from seeking to lower the hairline and add the temple points? I'm curious what their position was there for posterity sake.

In any case, as you said, you felt like it was more important to aim for focusing on a better appearance for the future, and if you're on medication, you'll hopefully be able to retain what you've got to avoid future risks above.

Thanks! To answer the questions:

1) No, I'm not sure of exactly how many grafts I'd have "left" for future procedures. In my opinion, that concept is actually pretty arbitrary anyway. I know people like to try to do the math of it and put a number on it, but in reality everyone is different and it may change over time as you see how the area recovers after a procedure, and there really isn't a set number that can be pinned down to say "That is the max and we can't go past that." I think it really just comes down to personal preference on how much back-of-head depletion someone wants to accept to perform HTs. I'm at about 6650 back-of-head extractions and so that definitely seems to be getting up there. I doubt I'd be able to have much more taken, but perhaps enough to cover any small gap that may develop. I did make that comment in relation to Niko1's procedure. Dr. Sethi gave me his opinion on why he can't completely "close the gap" by going all the way up and into full native hair, though: I still have an area of decently-strong native hair slightly above the ring of where the "full, unthinned" donor begins, and if he transplants into that area, it just does trauma to the native hair and is an unwise use of overall hair, which to date hasn't been able to be cloned. That science makes sense to me and so I feel much better about it after taking time to digest that. That said, it seems that for example Dr. Zarev literally transplants right up to the most prominent edge of hair change and leaves not even a mm of gap. You can see in some of his patients' photos that everything looks 100% homogenous and he literally starts implanting right on the edge of where he stops extracting. So I don't know. Different techniques from different doctors, maybe. Not sure what the best is. That's something we could discuss here.

2) Dr. Sethi encouraged me to do the hairline lowering and temples. It was primarily his confidence that we could do it and that it would make a big improvement to overall appearance that I trusted and agreed to. Dr. Bansal counseled me on both options equally; she did not take a side, but gave equal explanations of the aggressive vs conservative (leave hairline and temples receded) approaches and made me fully aware of the pros and cons of each option. Ultimately, I expressed my personal feeling, mostly in conversation with Dr. Sethi, that if I had to choose an area of obvious thinning/baldness to have over the entire scalp, I would most prefer it to be in the back around the crown area because fibers and other visual techniques can be used there to help conceal it. But I would never want to use fibers towards the front or sides of my head. So, it made the most sense for me to take the more aggressive strategy (that still wasn't reckless or idiotic) while I had the chance because I might not go back. Unlike some who get addicted to the pursuit of perfection with HTs, I kind of hope I can be done with this stuff sooner rather than later...or at least for a good chunk of time. I'm going to want to be spending money and dedication towards other things in life. So I wanted to take a swing for the hairline lowering and temples while the most rational financial and cosmetic option was in front of me. And we only did it after the sides and back were taken care of satisfactorily. 

15 minutes ago, GeneralNorwood said:

Yes, but the question is what is your plan for styling the sides. 

I am asking because for example Captain Haddock tried the skin fade after his HT and it didn't turned good for him. Personally i think that barber could handle this better, because left temple was cutted to short in his situation. For some reason left temple is often weaker in Eugenix cases. Anyway, i think that after HT on temporal peaks, skin fade can work, providing that temple peaks won't be cutted too short. 

Captain Haddock's example : 

https://www.hairrestorationnetwork.com/topic/58556-frontal-nw2-restoration-eugenix-m-26-december-10th/?do=findComment&comment=634369

 

Nothing specific as I sit here today; it's impossible to have an exact expectation or plan this far in advance and for it not to change as you discover what works best. I'm sure I will try several different lengths and styles. Remember, most people in the general public do not hyper-analyze hair patterns like we do. I have multiple different options available to try including short length, medium to longer length, all-star barber fade (my guy can do anything necessary to get a good look), SMP, and nothing. I'll figure it out when the growth comes.

Yeah I remember looking at Haddock's situation. I think it was clear to me that the temple grafts were implanted at mostly a backwards-facing angle, whereas Haddock's native hair on the temples and sideburns laid straight down or even a little southeast facing. I think that distinction is why it ended up looking improper. My native temple hair seems to lay downward to slightly backwards-facing, so we'll see how the transplanted hair comes in. I may be able to tell once the scabs come off.

I agree about the wide variety of guidance depending on clinic. It's strange, but some will want to put out extra-cautious guidance while others just keep it to the simple scientific truth. In my opinion, I think no physical exercise should be done for 1 week after transplant (just typical movement whatever required for daily activities, assuming your job isn't physically-intense. Someone like a construction worker would definitely need to take time off work). After 1 week, I really think light to moderate athletic activity is fine. Sports are fine, as long as they are not extremely strenuous. After my first HT, I resumed weightlifting after 1 week once all scabs were off and had no problems. Contact sports I would definitely give 2 weeks. I think at 2 weeks, assuming no complications, full activity can be resumed even for intense athletic people with no worries.

Incredible as always!

As for the temples, which is a very valid and important part to think and talk about, the aggressiveness of that plan was fully communicated to me. Obviously, the conservative strategy was to do nothing at all to the hairline and temples and leave them all receded. I agreed to do it, after a night of thinking, knowing the hair behind the implanted temples could continue to thin somewhat over decades. However, it's not a severe risk like someone early on in hair loss would have with implanting a heavy hairline and risk losing all the hair behind it. In my evaluation it's a much smaller risk, due to my hair loss being so advanced already. I also plan to ramp up my medication and topical treatments in the future (I've done as little as possible so far, really). I made sure that they did the fronts of the temples with single grafts, light hair and light density, and we looked at pictures of when I was younger showing my temples always having been pretty light, trying to replicate that as closely as possible. My entire hair situation will never look 100% flawless or 100% natural but I am long past accepting that. I am satisfied with all the areas covered and work done so far and just can't wait for it all to grow out.

7 hours ago, GeneralNorwood said:

I got banned for my last post for a week and I'm step away from getting a permanent ban if i continue to post "negativity" in others people reviews. 

Let me at least explain myself. 

When i saw your photos that you presented before 2nd HT, i was really surprised about the state of lateral humps area. I just couldn't belive that the change comes only from different angle or lighting. I noticed that color in humps is different and i made in my head  this theory about fibers. And then i became too sure of it and started being too accusatory, for which i am sorry. 

 

Actually, this photo explains everyting to me. If you published it before, i would better understand this situation . In this photo hair weren't combed, they were more chaotic and problem at lateral humps is easily visible. 

On this photo hair were combed and it provided fuller look on humps. But you needed HT in this area anyway back then. 

 

So to sum up, i don't think you used fibers. Though i think you could post photos that revealed more weaknesses back then. However to be honest, at beginning of my journey i posted more flattering photos too. 

 

So that is my explanation, I won't be posting much in other's people jorneys anymore, since Melvin is only waiting for my next "negative" opinion, so he can give me permaban. It feels a bit like elementary school here and Melvin is like a teacher picking on me. But I'm an adult now, so I just leave the classroom

A simple "I'm sorry" would have done. You're only putting yourself at more "elementary school" risk by continuing to make silly comments like "I feel like I'm being picked on." Additionally, I actually never comb my hair, so the above pics are not "combed vs not combed" either; just random variations from day to day and honestly stop taking it so seriously. No need to attempt to explain what can't be explained any further. Just improve your behavior, and there are no worries. 🙄

This is my thread, and I'm telling you now to just stop making childish posts like you are. Post in the same style as others, or not at all! 😉

12 minutes ago, Fox243 said:

 

No need for any beard grafts?

Nope! They were available if needed, but we used as much scalp possible first, then moved to the sidelocks (thick hair there), and that's all we needed.

@Melvin- Moderator Please feel free to update title to something like 

Dr. Das, Eugenix | 8,300 grafts | NW6/7 | 27 yrs old | 2022 & 2023

This work looks incredible.

In my opinion Zarev really uses literally every possible area of the donor that he can. I mean, he's going right up to the edges of DHT-resistant hair, including the nape of the neck areas, the sides of the head, etc. Really doesn't play around. He sees it all; he utilizes all of the area. That's how he's able to get so many grafts in these mega sessions.

And still the donor looks good and not overharvested. I think you're going to have a fantastic final result.

All back home in the USA. Trip went by in a flash. Back to life. I really hope to be able to do some actual tourist traveling to this part of the world in the future, but for now it's all work and no play for me

⭐2nd HT⭐
Areas to be addressed, in order of importance: 1) Lateral humps and lower crown, 2) hairline and temples (if enough donor supply)

Thursday June 8th ended up being entirely dedicated to planning and slit-creation and Friday June 9th was the transplant. Dr. Sethi personally invested time and input into the design and strategy alongside Dr. Das. He talked to me extensively about my situation, our plan, life, and all kinds of things. It was a fun time. We talked a lot about the situation of the progressive ring around the sides and back of my head and how to address it as best as possible. For those who understand, as hair loss continues to progress, the individual hairs continue to thin and decrease in diameter. If a hair has not yet decreased approximately 50% of its original diameter, it is still decently strong and can be maintained or recovered though proper medication and topical treatment, and donor hair cannot be transplanted too heavily into this area because it can damage the native hair too much. For hairs that have lost over 50% of their original diameter, they essentially cannot be rejuvenated, and these areas are the areas that can be transplanted into without hesitation. This is why, as we know, hair transplants cannot always go full-on straight up to the final/ultimate predicted edge of all future hair loss. They have to be done carefully and safely in respect to existing hair. The edge of the ring of hair loss, in advanced cases like mine, can also continue to lower over the years.

So, priority was filling all the areas where the hairs have lost enough diameter and density that they can never be recovered. Areas that still contain decent amounts of hairs and decent hair thickness were filled with less density of transplanted hair, creating a proper gradient. Lateral humps and lower crown were addressed in this manner.

Dr. Sethi also consulted with me that my preexisting hairline was acceptable at about 8-8.5 cm (above glabella) but that he really tries to get patients to around 7 cm and it's especially a big benefit to young guys to have strong framing of the face. He recommended a hairline and temple design alongside Dr. Das that we would try to tackle after the lateral humps and lower crown, if donor supply was good enough. Dr. Bansal also counseled me on the perspectives of the temple and hairline plan, all making clear that it was completely my decision to make if I wanted to do the hairline and temple work after the sides and back. I decided that I wanted to do it, if we had solid enough donor for it not to be unwise. Dr. Das did end up feeling confident enough in all my donor to continue and tackle the hairline and temples. The temples were of course addressed in a gradient as well, with lighter hair starting at the fronts and then progressively thicker hair toward the back sections.

In summary

• 2977 grafts total
  • 2,020 on lateral humps and lower crown
  • 305 on right temple
  • 310 on left temple
  • 192 on new hairline
  • 150 behind hairline
• Donor:
  • 2650 from back/side scalp
  • 162 from right side locks
  • 165 from left side locks

Dr. Das and Dr. Somesh created the slits; Dr. Somesh also sat in during some of the implantation and talked to me a lot, and Dr. Sethi dropped in a few times.

As always, I am extremely thankful to and appreciative of the entire team, to every single member including those who greeted me, took my vitals, prepared my medication, took all the photos, counseled me on the design, administered the local anesthesia, extracted, separated, and implanted my grafts, cleaned me up, comforted me, conducted post-care, and all my chauffeurs and all the staff who made the visit and transportation possible. I feel excellent about the way this one is going to turn out. Another handful of long months ahead for growing  

You're going to be amazed and thankful for the process and the care that the whole team takes of you. Dr. Das is great and you are in great hands with your situation. Make sure you're prepared for the travel, and then trust the team. Looking forward to seeing your progress!

29 minutes ago, MAL87 said:

@general-etwan Hey man, you're going for round 2 this week, right (if not already in Delhi)? Have you and the docs settled on the final plan yet? I'm lookin forward to seeing the end result. I think you guys know what's best for you at this point and should come out looking like a million bucks. 

I’m all done. But in for a long flight home and won’t be posting anything for a few days. So y’all will have to wait in suspense