MAL87

I have nothing even remotely negative to say about general-etwan's previous or upcoming surgeries, but maybe there's a sort of lesson to be learned that part of the initial plan is to ensure these lateral humps are covered in the first go-around. 

I'm heading to Eugenix next month as a NW5 approaching NW6 and I'm going to be sure to mention that there need to be no disconnects there. 

You can wear something like a loose fitting hat or a bandana almost immediately after, so long as it's not coming in contact with the recipient area. Clinics will also usually provide a surgical cap for immediate use. But after 10 days you can wear just about anything, as that's when the grafts are secured. 

When in June is your procedure? I just booked with Dr. Somesh for late July, so I'm eager to see some more of his work (though what I've seen so far is very promising). 

Best of luck and I hope you'll document your progress for us. 

33 minutes ago, A_4_Archan said:

Yeh it may be tempting but its not always a wise thing to go for the tempting things...though i am not saying that he is bad..but there are not many patient reviews about him...so my advice would be to go for the package in which at least dr das is performing the procedure ....if you wanna go for a budget option than there are few others you can look for....this is just my suggestion and you can make your decision based on your survey and understanding....if you are feeling confident enough than you may proceed with him...

Yeah, this was totally my line of thinking initially. But you know what, someone's gotta give the guy a shot. He's clearly got experience with all the assistance he's given Dr. Das and Bansal and I think with the extra I'd be saving, I would be fully set for a second procedure down the line. 

I think I'm going to give him a shot.

@Eugenix Hair Sciences by any chance do you have results you can display from Dr Somesh?

Edit: I've also just found this recent thread with Dr.Somesh as the leading surgeon and the results look pretty great

10 hours ago, A_4_Archan said:

He might be good but yet to see patient reviews about him....as you said you can afford a superior package imo you should at least go with a package in which dr das does the procedure ...

That was my thought process, but considering Dr Bansal was recently in the same package, it's tempting to go with Somesh...

Being a NW 5, I recently decided to go with Eugenix for a procedure likely in late July/early August. I was initially set on the Premium Package, which is now with Dr. Das. I've seen impressive stuff from Das, but going with the Premium Package is double the cost of the Exclusive Package, which features Dr. Somesh as the leading surgeon. 

I had a consultation with Dr. Somesh recently and he seemed like a great guy who knows what he's doing, but I haven't really found any results with him leading. I found some very limited results on here where he assisted, but not going through a high-graft procedure. 

I have enough funds to comfortably go with the Premium, but figured I'd see if anyone has experience with Dr. Somesh first. 

Dr. Gur finally got back with the evaluation and proposal below.

Based on his assessment and some feedback, I'm fairly certain I'll go ahead with Eugenix's plan. While I know that Gur does great work, 3,000 grafts isn't terribly much for my stage of loss and makes me think I could possibly need 3 total surgeries vs just 2 with Eugenix. 

4 hours ago, BackFromTheBrink said:

Sounds like a plan. My advice would be to make sure the planning on the day is done collaboratively and that you're entirely happy with the approach before going ahead.

They'll only really know the hair diameter, hair/follicle ratio and general health of your donor when you're examined in person.

At that point, you can plan with more certainty and make sure that your preferences are understood and catered for.

Eugenix are by all accounts an ethical and skilled team. However, I have seen people comment that planning has seemed less patient involved than is perhaps desirable, so it'll be up to you to take some control over that on the day.

For sure. I know some people have given into clinic recommendations against their own wishes and vice versa, so I fully intend to come to an agreement on the best path forward.

2 hours ago, Rahal Hair Transplant said:

@MAL87,

It’s really important to note that the Norwood scale of hair loss is not an exact measurement tool but a guide to be used to determine approximately how much hair loss one has experienced. Most people don’t fit exactly or perfectly on the Norwood scale of hair loss.  So while a classification can help you and your surgeon discuss your hair loss graphically and use it to help plan your surgery, don’t get too hung up on the number you currently fit into. If you haven’t seen it, I suggest taking a look at the following link and then determining for yourself where you think you fall into currently. 

https://www.regrowhair.com/the-hamiltonnorwood-scale/

Keep in mind also that androgenetic alopecia is progressive and will continue as long as your genetics dictate. It is impossible to predict exactly how far this will go but one can make an educated guess by looking at an established hair loss pattern.

Also, I don’t think it is up to forum members to determine which approach is best for you as an actual strategy and plan should be created by the surgeon who is working on you. I understand that you are still researching so this may be confusing at first.

But ultimately, typically those with advanced hair loss are done in two passes at our clinic. While we certainly do large FUE sessions, there is something to be said about waiting to see how the first procedure grows in and heals and how much further your hair loss will continue in an 8 month plus period.  

While Dr. Rahal is very scientific and methodical, he is also very artistic.  Artistry is equally important in determining the final outcome and result.  For example, at our clinic, we will provide you with all the numbers including

* grafts per square centimeters (FU/cm2)

* hairs per square centimeter (H/cm2)

* Area of the scalp to be covered

* total # of grafts

* total # of hairs

* hair count breakdowns

* hair shaft diameter (in microns)

All of these numbers and variables will ultimately determine the result along with placement and angle of the transplanted follicular units, determined by the recipient decisions made by the doctor.  This is where artistry comes in which is determined by skill and experience.

How many grafts that can actually be harvested and transplanted safely during a single procedure and over the course of a lifetime will depend on many factors   Dr. Rahal uses a formula based on each patient’s specific characteristics to determine what t can be safely harvested and transplanted without making the donor area too thin, etc.  

Long story short, in order to provide enough coverage and density in the front and back, you will likely need at least two passes assuming you have enough donor.

 I hope this helps 

Rahal Hair Transplant

 

 

Thank you for the input! And of course, I won't base my decisions on what others think, but some advice and opinions are always welcomed. 

I am also fully aware that I will need two procedures to achieve my desired results and that's totally fine. 

Again, I appreciate the advice.

1 hour ago, BackFromTheBrink said:

Thank you. I still find it surprising that Dr Arshad got the density given the number of grafts used.

Remember though, it was a result for surgery and finesteride. I suspect I was fortunate enough to have a really good yield, a high hair to graft ratio, intelligent planning and a good response to the medication.

The crown is a black hole for grafts. I've seen 3k and upward used for just the crown and it still leave scalp showing. 

I suspect a thorough analysis of your donor area would influence the plan significantly. One of the reasons for recommending finesteride is that it would slow down loss, but also improve donor and recipient (so you should have more donor capacity,  reduced demand for grafts and reduced shock loss).

Have you thought about what you're looking for? For example, if you had to have a weaker area, where would it be?

I took the approach that framing my face was more important. After that, I'd rather my midscalp was dense.

If I had to, I'd settle for an age appropriate look where my crown was starting to thin (think Frank Lampard).

I'm now hopefully I can tackle the crown too. I'm at the point where it bothers me enough to consider another procedure but those around me (including my hairdresser) think I should be thankful for the hair I now have and leave it alone!

Front (in bright sunlight)

Vs crown 

I'm glad I just hopped on Fin. I tried it for a few months, I think, about 8-9 years ago but got spooked by the side effects. I don't know how much 2-3 months is going to help pre-op, but it's better than nothing. 

And it's hard to decide which area I would be comfortable leaving weaker, but I'm thinking it might be mid-scalp. It's where I have the most hair up top, currently, so maybe Fin and Minoxidil can help. My crown has been probably my biggest sore spot, since even when I shave my head that's the most glaring hole. 

At this point, I think I like Eugenix's plan of giving me a strong hairline and covering the crown, then going back to fill the crown and mid 8-12 months later. Like, looking at your crown, I would totally be satisfied with that for now.

8 hours ago, BackFromTheBrink said:

You can see the details here.

Its thickened up further since then and I'm much happier with my hair after the procedure.

I'll probably get a much smaller second  procedure for the crown now that we know how much impact finesteride had on recovering hairs.

 

I 

Those are impressive results man. Hard to believe that was achieved with only 3100 grafts. 

Kinda gets me thinking that maybe I should divide the 1700 grafts they're planning for the crown to share with the mid-scalp. Maybe like 1000 for the crown and the rest mid-scalp.

7 minutes ago, BackFromTheBrink said:

Thats the thing though - you'll both need two procedures, unless you go for a gigasession, and that's not a great idea unless you have a fantastic donor. If you have a bad result for a single 3000 graft procedure it will leave you with option, unlike a much larger surgery.

As I said, I feel my 3100 grafts made a massive difference, so it's not as if you'll need to wait for 2 years before seeing results.

Do you have a link to your results that I can take a peek at?

5 minutes ago, BearsFan88 said:

To be honest, you don’t need premium package with Gur.  He makes incisions.  His techs are well trained to implant.  You never see a bad case from him with his standard package.  
The problem you’ll run into is the same as me.  He will propose around 3200 grafts or so for $3,000eu, and we both need much more than that.  So with gur it will be a two trip transplant at least one year apart 

im leaning gur because I want the peace of mind of having my entire front done, before I burn up a bunch more grafts. Plus, he’s half the price so I can basically go twice and pay roughly the same. 

That's pretty much my conflict, too. But I'm also totally impatient and want more grafts upfront that lead to a lighter second operation 😬

5 minutes ago, BearsFan88 said:

How much was eugenix charging you??

I'm planning to go with the Premium package with Dr. Das, which would be $2.54/graft. I really wish I had gotten in before they updated their plan pricing, but it is what it is.

But the pricing is also why I'm still waiting to hear back from Dr. Gur, because I would go with his premium package where he does the work for like half the price of Eugenix.

8 hours ago, BackFromTheBrink said:

I'd say your loss is similar to mine (Norwood 5). Fortunately I didnt have retrograde so managing my donor wasn't as tricky.

I had 3100 grafts to cover the frontal third (and a few reaching back to the vertex) and did not lower the hairline.

I planned to wait to see how the donor recovered and whether finesteride helped with regrowth before a potential second surgery.

I think a similar approach would work well for you. 

Yeah I'm not sure I need to lower my hairline much from where it would be, based on my currently non-existent hairline. 

I actually just hopped back on finasteride yesterday (and will be on minoxidil next week) in hope that I can strengthen the donor area, but also because the docs think that I can get some regrowth in the mid-scalp.

I think I'm leaning fairly heavily towards Eugenix at this point.

9 hours ago, duckling said:

Honestly if your beard is good then i would have had no worries going with eugenix plan. 2.7k-3k scalp grafts and rest beard mean you rough have same amount of scalp grafts for next sitting and if beard is still good then you get upwards of 8k grafts. 
 

if you think your beard and scalp donor is not that good (probably get a trichoscopy locally ) then gur will use those decent sized grafts conservatively.  And his hairline i am sure will not be this lower. ( it is actually not that lower but gur may give higher hairline considering your future grade)

I've got a pretty strong beard, so that's not a concern, fortunately. After my video consult with Eugenix, they upgraded the amount of grafts from 4200 to around 4500-4700. 

I might update their hairline design to be a bit more conservative so I can save those grafts for the scalp.

6 minutes ago, BearsFan88 said:

Did Gur propose filling your frontal area but not lowering your hairline? That’s what he recommended for me. My hair similar to you 

Gur is actually the only one who hasn't gotten back with a proposal or plan, but I'm hoping he can by this weekend. 

However, Eugenix provided the following attached plan, which I'm not opposed to.

Either way I go, I'm planning for a conservative hairline, which I know Gur is usually good for

On 3/2/2023 at 9:09 AM, Knightrider said:

Yeahhh! I understand.. but 2500 grafts would be very less to fill in the density.Dr Gur might reduce the graft when i see him i person, what i have read reviews of others. I guess I’m better to go with Eugenix.

A few months later, have you decided who you're going with? I'm debating the same three clinics.

2 hours ago, Hazy said:

Hello,

1. Norwood 5, maybe heading towards a 6 depending on your family history.

2. You have a decent amount of thinning on the sides and the vertex bald spot is fairly low. I think if they get 3,000 from the donor area at once that would be impressive, they would need to stay fairly narrow in the back to avoid the thinning vertex or retrograde alopecia. Definitely do two procedures, maybe 2,500-3,000 grafts at a time. In the mean time you should be on finasteride oral and minoxidil oral (or topical) as your doctor sees fit, maybe you can recover some of the thinning. Microneedling once a week wouldn't hurt (1.5mm depth).

While it would be super great to get 4-5K grafts at a time you need to consider:

• Grafts don't live forever outside of the scalp and need to be implanted relatively soon, the timing depends on the holding solution they use
• Planting grafts too close together runs the risk of compromising the blood supply and losing some grafts

Because of this, it's likely better to do two reasonably sized procedures (2,500) than one MEGA procedure. I'm curious to see what others think.

Thanks for the input. That's fairly in line with what I was thinking

Hi all, this is my first post so be gentle. I'm fully decided on finally getting a transplant this year and want a little user input based on clinic feedback I've received. 

So far, I've reached out to HLC Ankara, Eugenix and Dr. Gur in Turkey and will likely reach out to a few more. One of the reasons I'm lookin for feedback is because Eugenix preliminarily graded me as Norwood III (although we have a first video consult this weekend), but I feel like I'm almost definitely a NW V, or late state IV. Neither HLC or Gur have graded me yet, but HLC said they could transplant 4,000-5,000 grafts, with about 1,000 coming from my beard. And since I'm aware that Gur usually maxes out around 4k grafts, thats about in line with HLC. 

I think my main questions are as follows: 1) What would you grade me based on the pictures I've sent to the clinics, 2) Since I absolutely know I will need two procedures for max coverage, is it wiser to take, say, a conservative approach with Gur (choosing his VIP package) and go for about 3500-4k grafts, or go with Eugenix who will likely get more grafts out of me for better immediate coverage, then go back for the rest? I'm also going to choose a conservative hairline because I'm not tryin to be Brad Pitt over here.