EricEdwards

On 3/26/2024 at 11:38 AM, general-etwan said:

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 hopeful that you're latest procedure is going according to plan for you. I admire your persistence and perseverance. I've gotten cold feet over the past number of months. 

On 3/31/2024 at 4:20 AM, Gatsby said:

Six weeks post op HT3

Six weeks weeks has passed since I had 800 scalp and 400 hundred beard grafts transplanted into the crown. I am truly in the bowels of the big ugly duck 🫣🦆 I’ll hang onto the mullet (why not) and color and trim my hair at three months. This third post op period has definitely felt like the longest one by a country mile. 

Very impressive and well done.

On 1/25/2024 at 11:12 PM, mtb said:

3 months since second procedure. 12 months since first procedure. Can see a little growth but it’s covered by my longer hair. Shock loss won’t resolve for another month or two. Mid scalp and crown set to start filling in. Some non-flash photos as well as flash

 

 

 

Excellent result. Cost involved?

On 11/24/2023 at 6:03 PM, Marcelo Nunes Cravo said:

Hello everyone, my name is Marcelo Nunes, and I'd like to share my recent experience with a hair transplant here with you.

A total of 12,219 grafts/20,685 hairs were implanted, extracted from both the donor area and the beard.

Considering my class 7 baldness, I'm genuinely surprised by the quantity achieved by my doctor. 

Eagerly awaiting the final results.
If anyone has questions, feel free to ask; I'm here and ready to share. Thank you.

How much did it cost and How many procedures were required ?

On 11/3/2023 at 4:34 PM, Stewie said:

Literally just had a consultation today with Eugenix pushing this exact same agenda, it took me a while to convince them, but its something I want doing too, as makes no sense having a native hair horseshoe on my head  

👍

On 11/3/2023 at 8:31 PM, Stewie said:

funny enough they did and literally about an hour ago I got another WhatsApp call kind of back tracking. bit, saying they'll do what I asked and then banging on about using all my beard grafts for donor farming even though I told them my donor does not bother me. It was kind of like this last time and I really had to fight hard to get them to do what I wanted, I feel lll have a similar battle this time, as now they are going on about maybe 1000-1500 scalp grafts which is all good but then hardly any beard even though this could be used for density, so lets see, I am sure ill get there with them in the end

I think when clients start using the words like battle to convince clinicians on their goals, this may not lead to a favourable long term outcome, in my opinion. Based on my observations and opinion, the best hair transplant specialists, are first and foremost, psychotherapists who come to an agreement on managed expectations. 

On 11/29/2023 at 5:31 PM, Berba11 said:

Are you sure that 5K+ graft count doesn’t include beard hair? Pittella has no issues going in early with beard grafts so 5K doesn’t sound too far fetched between both scalp & beard. 

That's a very good point as to whether or not it was implied beard hair in the 5k count.

3 hours ago, Grouse said:

Hoping for the best outcome OP - thanks for sharing your experiences. Hope you’re doing well these days. 

I agree. 

On 12/21/2023 at 7:31 PM, Melvin- Admin said:

Eugenix isn’t on the list, it’s only Dr. Sethi and Dr. Bansal. This surgery was done by Dr. Das, she isn’t and hasn’t ever been on our list. We don’t recommend clinics, we recommend surgeons. I don’t believe there is a failure in yield. 

I think the plan to distribute such a small number of grafts over a large area was not a good plan. No matter who the surgeon is, that number of grafts primarily from BHT would yield the same result, when distributed over a Norwood 7 area. It’s simple mathematics as I stated earlier in the thread.

“

But if you do the math, that area was probably 200-250 cm2. You need at least 45 grafts per cm2 to get “illusion” of density. That means you would need 9,000-11,250 grafts in that area to get an “illusion” of density. It would still look thin with short hair, even with those numbers. You need to grow it out a lot more than you have. It looks like its less than an inch on top. You need at least 3 inches to start layering. Also, looks like 1,100 grafts are beard grafts, which means its single hair grafts. You didn’t have a lot of hair placed in that area.”

That said, we haven’t seen a recent update in months. Things may have improved. I will wait to make further judgments until an update is presented. 

It could be the clinic made an offer they couldn't refuse (subject to not discussing on public forums until further notice) but then again I could be wrong!

10 hours ago, Berba11 said:

Out of interest then Melvin, how come Eugenix can post on here as 'Eugenix' and showcase the work of Dr's other than Dr P & Dr Arika? I've seen results for Dr Das posted by Eugenix on here. Personally I've no issue with that per se - I like seeing the results all the same - but that does seem to fall outside of the rules.

Also I have to say the distinction between the two founding Dr's and the organisation we know as Eugenix seems somewhat murky. If you endorse the two founding Dr's, then almost by default that's an endorsement for the organisation as a whole given any other Dr's operating under the Eugenix banner are ultimately the responsibility of it's two main founders. As with any organisation, the buck stops with the owners. Would you not agree that recommending/endorsing Dr A & Dr P but not their clinic more broadly is a bit of a grey area?

The clinic states that the quality of the surgeries are unaffected by the individual surgeons or pricing package, as all surgeons have been trained to a set standard of the clinic. I am open to correction on this however.

2 hours ago, Bandit90 said:

Head shape greatly influences the amount of grafts required for full coverage. The more Brachycephalic a head shape, the more grafts required to achieve a desired result. Unfortunately, the  OP has a very Bracycephalic head shape, which means he needs A LOT more grafts to achieve an illusion of density. It is absolutely pointless comparing his results against an OP with a Dolicephalic head shape (i.e Caverman). IMO this is a very under spoken about subject in hair restoration, people tend to compliment a surgeon for achieving full coverage with lesser amount of grafts, which can be true to an extent, but a lot of times their head shapes tend to allow this.

I wish the OP well with his result, and the fact he hasn't updated for a few months, can often mean he is happy with results and moved on (which i truly hope is the case here). 

 

Thanks for this. One of the things that I was curious about, was not just the shape of head but the overall size, and whether this impacts on graft numbers and density. Contributors to this forum have answered that for me, including the video of doctor Pittella.

2 hours ago, BaldDude said:

topical fin 0.05 once daily from minoxidilmax.  my DHT and free test is low

I was thinking of taking topical finasteride but I'm unsure if it's available in my country

18 minutes ago, BaldDude said:

Not in my case, my testosterone level is pretty low after using DHT reducers for over a year.

Interesting. What did you take?

2 hours ago, BackFromTheBrink said:

I’m confused. Why would taking 5 times higher dose of finasteride result in higher dht levels?

Yes it does seem counterintuitive that increasing finasteride may lead to an increase slightly in DHT levels.

However, looking at the video below, it may seem that taking finasteride at levels above 1 mg may not lead to a significant reduction in DHT levels. 

I welcome your thoughts on the video below which was presented by two physicians:

https://youtu.be/htBPxLOC47I?si=5h2-lNSxWHUtzmP9

2 hours ago, Niko said:

Very well done Eric,

I was eagerly awaiting to see your results and I'm happy to see that mine and yours are very close now.

Granted, I'm around NW 1.5, I've stopped it on time, I can't guarantee regrowth to anyone, but completely stopping hair loss I think that's more than a guarantee at this point, and my hairs did thicken a bit compared to 3 years ago, the only exception would be if someone was so susceptible to DHT that hair loss occurs at even normal levels, but that's what they mean when they say genetic hair loss, they mean those types of cases.

The next step is to figure out how to make hair follicles grow again, I'll be trying dermaneedles of 2mm-2.5mm once a week, I've been doing about 1.5-2mm for a long time now once a week, and i'll be adding rosemary oil and mint right after the puncturing (and continuing with everyday applicatons of oils), to see if it makes any difference once it breaches the bloodstream.

I hope this thread was helpful to anyone reading, regrowing your hairs is hard but stopping hair loss is DEFINITELY possible without taking fin/dut.

Thank you Niko. You had started my journey on natural DHT reducers. 

I'm considering purchasing my derma roller in the next week or so. Based on my research it seems that 1.5 mm is the optimum depth of needle. Anything over 2mm may lead to damage to the hair follicle roots. 

2 hours ago, BaldDude said:

Very interesting. Does a lower serum DHT always lead to a lower scalp DHT?

That is the question. Based on my empirical observations I haven't seen any increase in hair follicles but I haven't seen any decrease either. I am going to continue with my citizen research for another 12 months to see if my male pattern baldness has stabilised. 

Another interesting phenomenon with taking DHT reducers, it may lead to a slight increase in testosterone levels. Based on my testosterone results being above the upper threshold, at 47 years of age, one may conclude that this may be correct.

19 minutes ago, EricEdwards said:

Yes interesting observation. Apparently, taking greater than 1 mg of finasteride does not lead to an inherent increase in reducing DHT levels. Hence the 5 mg of finasteride phenomenon as outlined in my citizen research. I am open to correction however.

At 4:38 in following video, two medical practitioners outline the benefit of 1 mg of finasteride as opposed to anything greater:

https://youtu.be/htBPxLOC47I?si=5h2-lNSxWHUtzmP9

1 hour ago, BaldDude said:

Very interesting. Does a lower serum DHT always lead to a lower scalp DHT?

Yes interesting observation. Apparently, taking greater than 1 mg of finasteride does not lead to an inherent increase in reducing DHT levels. Hence the 5 mg of finasteride phenomenon as outlined in my citizen research. I am open to correction however.

On 9/12/2021 at 10:33 AM, Niko said:

I wanted to share my short story here. About 2 years ago at age 22 my first signs of hair loss had shown, I experienced hair thinning on my entire head and some loss, though minimal, mostly major miniaturization, but it was noticeable.

After much research and thought I decided to risk it and give Saw Palmetto 550 mg a chance before trying anything more serious (like fin/min), to see how I would react. I've also linked some cropped pictures of laboratory test results below that were taken.

The picture with the highest DHT of almost 3300 PG/ML was in September of 2020, up to this point I was only experimenting with natural topical solutions, and although for example the Jamaican castor oil I was using helped to prevent further loss, it didn't help with the hair density so I wanted to try something else.

The second picture of 1890 PG/ML was after 2 months of Saw Palmetto 550mg x2 a day, started using it in Jan/Feb of this year and did the lab result in March, and the third lab test is from the month of May, after introducing Stinging Nettle Root tea once a day in tandem with Saw Palmetto, from March to May, it completely stabilized and was within normal range. Just for experimental purposes I stopped using both SP/SNR for about a month and a half and wouldn't you know it, DHT levels started rising again, who'd have thought?  

I quickly got back on the regime again and it stabilized.

Regarding Saw Palmetto I only had "side effects" for the first few days where erections were very weak, after that everything went back to normal and I haven't experienced any side effects, neither from SP nor Stinging Nettle Root. 

People did comment that they see a big difference from a couple of months and now regarding my hair, though I'm not satisfied yet. Though I can definitely see a lot less hairs fall out now when I stroke through my hair, It used to be 10-15, now it's 2-5 hairs, so I legit think it's worth a try before going on any meds, but I think it will take a long time to see improvement, still, I halted all further hair loss.

I finally received the results of my dihydrotestosterone test. This was my first test which followed six months taking organic pumpkin seed oil and stinging nettle oil. I will attempt to compare, as best I can, the results of Niko with my results in relation to the impact of natural remedies on dihydrotestosterone levels. Whilst I did not take the test prior to taking the natural supplements, nonetheless, I will compare the result with Niko who had taken the test both before and after his natural supplements.

My Profile
Age: 47
Baldness type: Norwood grade 5/6

Supplements taken:

➤20 mL of organic stinging nettle (Salus brand) daily for six months

➤1 tablespoon of organic pumpkin seed oil daily for over six months.

Niko Results:
In order to give a comparison of results. I have attempted, as best I could, to convert Niko's units from pg/ml into mnol/L. I undertook this conversion using ChatGPT and Google Bard.

Niko Test 1: Without supplements - dihydrotestosterone level -3299.7 pg/ml = 11.36 mnol/L

Niko Test 2: With Stinging Nettle tea and Saw Palmetto supplements - dihydrotestosterone level - 1890.8 pg/ml = 6.51 mnol/L

Niko Test 3: With Stinging Nettle tea and Saw Palmetto supplements - dihydrotestosterone level - 614.4 pg/ml = 2.12 mnol/L

My Results:
Eric's Test: With 20 mL of organic stinging nettle tea and 1 tablespoon of organic pumpkin seed oil daily - dihydrotestosterone level 1.88 mnol/L

Eric Edwards testosterone test 30.47

An interesting observation is that my testosterone level is on the upper limit of normality. This is intriguing given that I'm a middle-aged man. I was informed by my hair transplant specialist that my testosterone levels would "normalise". This seems not to be the case.

Observations:
As you can see from the above test, my dihydrotestosterone level is within the same parameters as Niko's result. In fact, it appears to be somewhat better lower at 1.88. Nonetheless, this is predicated by the conversion of units. Although I have noticed a decline in my libido somewhat, I have yet to see any observational impact on my male pattern baldness. Also, from looking at the result depicted above, the lower limit and upper limit of dihydrotestosterone is between 0.33 - 3.01 nmol/L for males. This is based on my interpretation of the "units"and may mean that my dihydrotestosterone result is within the the normal range. However, I am open to correction on this.

My Goal

My goal is to stabilise my male pattern baldness prior to a planned hair restoration. I shall continue to take the supplements for the next several months to ascertain if this is the case. 

Finasteride Impact
I was intrigued to know what impact finasteride would have on the dihydrotestosterone levels. Based on inputs into Google Bard, I received the following results in regards to the impact of finasteride on dihydrotestosterone levels [1],[2][3],[4]:

Dosage       Typical DHT Level (nmol/L)
1 mg daily             0.27-0.57

It is my understanding that 1 mg of finasteride, taken daily, is the standard prescribed daily dosage for the treatment of male pattern baldness and that there is no inherent decrease in DHT levels with an increase in finasteride intake above 1mg.

Conclusions:
I acknowledge that my experiment of sorts, could not be considered in any way based on sound experimentation principles. Nonetheless, the rough results indicate that natural supplements of stinging nettle and pumpkin seed oil may have a positive impact on reducing dihydrotestosterone levels, in my opinion. Based on my experience, I have yet to see this transferring into a positive impact on reversing my male pattern baldness. I have been using the said supplements for the past six months and there is no improvement in my male pattern baldness. I have noticed that my hair follicles are somewhat more stronger to touch but this is negligible. I have noticed a somewhat slight reduction in my libido. My core goal is to have the intervention maintain my current hair prior to undertaking hair restoration surgery. I will continue to take the supplements for the next several months and observe my male pattern baldness. If my male pattern baldness does not stabilise, I may consider using finasteride 1 mg per day. 

References

[1] National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): https://www.healthline.com/health/propecia

[2] Mayo Clinic: https://www.mayoclinic.org/drugs./finasteride./drg-20063819?p=1

[3] U.S. National Library of Medicine (PubMed): https://www.ncbi.nlm.nih.gov/books/NBK513329/

[4] The Endocrine Society: https://pubmed.ncbi.nlm.nih.gov/22563890/

40 minutes ago, Berba11 said:

That's the off-schedule pricing. Normally it's 5EUR per graft (but you'll be waiting a few years just for the consultation alone).

Thank you very much

On 10/15/2023 at 7:29 PM, anxious6 said:

Hi all. I wasn't going to post anything here, but I see there's a lot of continued interest in Dr. Zarev and I feel I owe this community a lot in terms of researching my options to make an informed decision. Apologies if the write up is a little shorter and the pictures aren't the same quality others have provided. 

I'm 34 and first noticed hair loss at 18 or 19. I was a norwood 3 by 22 and then made a steady progression to a norwood 6 by around age 30. Apart from brief stints on minoxidil I was not on medication during this time. That was such a dumb mistake. Anyway, I've been on oral finasteride + topical minoxidil for a couple of years now and actually have seen stabilization and a tiny bit of regrowth, though not enough to make a significant cosmetic impact. My father's side of the family is all Norwood 1s and 2s - my grandfather had a thick ronald reagan head of hair at 89 - but mother's side is all norwood 5 - 7s. 

I made the decision about a year ago to get a hair transplant after seeing some of the surprisingly strong results from Eugenix and Hasson and Wong on this forum for people with Norwood 6+ patterns. I had consultations with Eugenix, H&W, Pitella and C*le. I had reached out several times to Zarev during this time, based on Hugo's results, but had not gotten a response. In February I sent in two final messages through his website (one in English and one in my best-attempted translation to Bulgarian) letting him know I'd be interested and willing to pay off schedule pricing. A couple of weeks later his coordinator reached out and set up a call with Dr. Zarev and requested more pictures. Dr. Zarev and I then spoke a few weeks after that for about half an hour on the phone about the photos, his techniques, family history of hair loss, etc. He said he thought i would be a candidate based on pictures / discussion, however there was no way for him to know without seeing me in person. He agreed to try and fit me in if they had a cancellation, but I would need to arrive 3+ days beforehand for an in person consultation as part of the same trip, and there was a real possibility I would get there and he would determine I was not a fit. I agreed. In early May I got a call asking if I could make it in for a 6/2 consultation followed by surgery on 6/5 and 6/6 if all checked out.

I'm not sure I have much to add to MTB's experience with Dr. Zarev in person. My consult with him lasted 2+ hours, most of which was taking pictures and taking measurements. We then talked about potential progression of loss. While it was apparent to me in my photos that my crown was dipping very low and wide, Dr. Zarev also let me know that my sides could dip further as well, which I did not know going in. If so, he estimated that in my final pattern and with an age appropriate / not overly high hairline I would likely need 13,500 - 14,000 total grafts for the coverage and density he thought was satisfactory, however I only have ~12,500 available without over depleting the donor area. At some point down the road I might have to make the choice between a thinner crown or over depleting the donor area and keep the side shaved at a 1 - 2 guard from that point forward, similar to the norwood 7 results that have been discussed on this forum. I was fine with either scenario as it was better than i had been expecting when I first started researching this. With that he agreed to move forward.  

Surgery both days started with a  10am arrival, roughly an 11am surgery start and we did not finish til after midnight. Roughly 3800 grafts each day. Dr. Zarev is the only one touching your head throughout the surgery. Sitting / lying there for that long is uncomfortable, but I didn't feel almost any pain throughout the process. Upon wrapping up the second day We ended up with a  total of about 7700 grafts. I should know the exact number but I can't remember exactly - I'll go back and check with Dr. Zarev in my next monthly update with him to confirm because I might be off by 100 in either direction. 

Like an idiot i bumped my head getting out of the cab going back to the hotel. I was distraught, but the next day, when i came back in for my first wash, Dr. Zarev said I had lost 10 grafts. He offered to re-implant there, but said it would not make a noticeable cosmetic difference, even though they were all clustered together at the convergence of midscalp and crown. I decided not to do anything else. From there my head swelled up like a balloon and then subsided over the 8 days post surgery in Sofia. I traveled back to the US on Day 9 post op and washed off my scabs the next day. Assuming all goes well we will be looking for a date to go back around month 10 for a second session. 

I feel like I have had slower growth than Hugo or MTB, and that kind of freaked me out around month 3. Ha, I know that it's within the normal range not to have any real growth showing at month 3, but given Hugo's insane amount of early growth and MTB's promising early returns, I was pretty worried. Then about 3.5 mos in things started to pick up. I'm at 4 month and 8 days now, and it's crazy to look back at how much has changed in that time. I still have a long way to go, but I'm not nearly as concerned as I was before. One last thing, is that even though it is difficult to get in touch with Dr. Zarev initially, once you are a patient he is very responsive. At the very least we text on whatsapp about progress each month and he's called me twice to check in. 

So that should wrap it up. I'll post pics below when I get a chance later today. 

 

 

If you don't mind me asking what was the cost? I see on their website it's €9 per graft which is in the premium range.

On 12/16/2023 at 9:35 PM, mtb said:

Had my second hair cut today since my first procedure (not counting Dr Zarev shaving the sides for second procedure). Some before and afters. Also a few of where I came from albeit with different lighting.
 

At this point nearly all the grafts from the second procedure (Oct ‘23) have cycled and fallen out and will start sprouting randomly in the next couple weeks (at least that was my experience with first procedure in Jan ‘23). Still some donor shock loss which should take another two months two recover. 
 

 

Truly an excellent result. What was the overall cost? Forgive me if this was already answered.

On 12/16/2023 at 12:27 AM, BackFromTheBrink said:

Doesn’t that just mean they’ve studied the effects for that long. The same article says that the long term effects are unknown.

Well, you have a point. 

On 12/11/2023 at 10:15 PM, BaldDude said:

I don't see anything about long-term effects.  I have read reports of users on reddit saying they've gotten similar side effects as finasteride (loss of libido, ED etc.).  Saw palmetto is very weak compared to finasteride tho so I expect this is very rare.

"Saw palmetto is likely safe when used for up to 3 years."

https://www.webmd.com/vitamins/ai/ingredientmono-971/saw-palmetto

On 4/20/2022 at 2:53 PM, RTC said:

Optimale

But they don't offer DHT testing

Eurofins provide DHT testing in Ireland so I imagine they may also do this in the UK