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Fluffhead

Caucasian M41, NW3/2500 Grafts Eugenix, India

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The Backstory

I’ve been balding since I was 17 years old. I first noticed aggressive shedding my sophomore year in university. A year later, I had gone from a NW1 to a NW3. I saw the writing on the wall. Both my grandfather and uncle on my mother’s side were NW7s, and I knew that’s where I was headed. This caused me great distress. As many of you can relate, losing your hair young feels like the funeral dirge of your youth. You stand out, become the butt of jokes and are generally less successful with the ladies. As many do, I began wearing a hat everywhere. I almost never took it off. It became my signature look. By the time I graduated, I was a NW3 Vertex, my self esteem was shot and I was looking for options. I moved to NYC for a job and went to see a doctor to see what could be done. I was subsequently put on finasteride and have been taking it consistently for over 20 years. I managed to halt further recession and regrew my hair back to a NW3. Fortunately, I was a positive responder and have remained so. That said, the damage to my hairline and confidence was done. I’ve continued to wear a hat when not in the office or at formal events, and I’ve sported the same hairline concealing, combover haircut all my adult life.

This past November my best friend passed away in a freak accident at 41 years old. His death got me thinking about living life with greater purpose, urgency and conviction. I started researching hair transplants and found this forum. I’ve read almost every post from the past couple of years. Your stories and photos have been invaluable. Hair restoration is an intimidating process - the cost is high and success isn’t guaranteed. Without a forum like Hair Restoration Network, I don’t know if I would’ve ever had the courage to begin my own restoration journey, but here I am. I am typing this from my room at Eugenix Hair Sciences in Gurgaon India, and I’m scheduled to undergo a 2500 graft, DHT procedure tomorrow morning with Dr. Arika Bansal. I will be throughly documenting my progress here. My hope is that through the power of transparency and information I will empower someone else to begin their own hair restoration journey. 

The Process

After seeing Joe Tillman’s video on the work being done at Eugenix India, I set up an appointment via the website and had a 20 minute Skype conversation with Dr. Arika. She hit many of the talking points echoed on this forum. We discussed my family history, my track record with finasteride, the DHT procedure and how it differs from FUE, proper management of my donor area, a responsible hairline given my age and potential for future loss and the way she would frame my face by strengthening my temple points. After our initial conversation, I felt good, but I wanted a second opinion.

I live in Thailand and did my second consultation with Dr. Path at DHT Clinic in Bangkok. His team estimated 2500 grafts and recommended a FUT procedure. I met with Dr Path’s understudy first. She measured my donor hair density, drew a hairline and was very consultative throughout. Then Dr. Path came in and erased what she’d drawn and remade the hairline. I think he felt the hairline she’d given me was too Asian, and I agree that the redrawn hairline was probably more appropriate. If you’re getting a transplant in an Asian country, you should be aware of this distinction. My only reservation with DHT was their insistence on FUT. While their reasoning behind the recommendation was solid, I left with the impression that it’s what they’re best at performing. Most of their before and after photos were FUT; nonetheless, they were very good. Despite my reluctance to do a FUT procedure, I left DHT feeling like they were my first choice. Management of my donor area is of critical importance, and I felt they had a very good understanding of that. 

I sent pictures from my consultation at DHT back to Dr. Arika via WhatsApp. She then digitally drew her own hairline that I liked even more than the one drawn by Dr. Path. It had a more natural widows peak instead of a rounded look. She then spent the next 2 weeks personally answering every question I had. This level of attention and thoroughness is what eventually what led me to choose Eugenix.

The Trip

The decision to go with Eugenix was easier for me than most because I’m regional. I can imagine for those of you in the US and Europe the logistics might be more daunting. My flight this morning was only 4 hours on Thai Airways, and it was quick and painless. I’ve done a lot of international travel over the years and must say that Indian Immigration was the most laidback experience I’ve ever had. The officers were giving tour suggestions and cracking jokes. I couldn’t believe it.

I was met outside gate 4 by the Eugenix drivers. They were very nice, polite and easy to coordinate with via WhatsApp. The trip from the airport to Eugenix was roughly 30 minutes, and traffic was fairly chaotic. If you’ve never travelled to a developing country before, this might be a little concerning. The scenery isn’t the best, and Delhi is very smoggy this time of year. Poverty is fairly ubiquitous, and you’re going to see it on full display in the streets. It’s also chilly, so bring a jacket if you’re coming in the winter.

When I arrived at the facility, I was greeted by Suryakant who is the grounds manager. His charisma and warmth immediately put me at ease. I was shown to my room to drop my bags and then taken down for some coffee and a tour. Once the short tour was over, I was given lunch in my room. They ordered me chicken salad and one of the best butter chicken dishes I’ve ever had. Next the lab came to my room to take blood samples. This was an extra 3200INR that I had to pay in cash. Since then, I have been sitting and typing this report. I’ve been told that later in evening they will be bringing me dinner and informing me of tomorrow’s start time. The room is really comfortable and well appointed, so I’m perfectly fine with this arrangement. Will update with pictures and more information after the procedure, and I will do my level best to reply to all legitimate questions for the life of this thread.

Updated: 12/01/2020

The Night Before & Cost Breakdown

At around 6:45PM, I was taken to the office to register, photocopy my passport, fill out a “waiver” and complete a short questionnaire. I also paid for my transplant. Because I was carrying cash, I told them I wanted to get that out of the way. I’m not sure if it’s standard practice for them to ask for payment in advance, but my guess is they’d be flexible if for some reason you had qualms about it. For the sake of transparency and to provide the most informative post possible, I’ll divulge that I opted for the “Comprehensive and Exclusive” package which guarantees Dr. Arika’s full involvement in the crucial parts of the procedure (more about this later). I now see that they are offering a “Premium” package. I believe this development is very recent. Two weeks ago when I scheduled my procedure it wasn’t available. I believe the only difference between the two is that with the Premium package Dr. Arika will do the hairline implantation herself. Had I known this I would’ve opted for Premium. Trust me when I tell you that you want Dr. Arika’s immense talent involved in as many steps as possible.

I was quoted 345,000 INR for 2500 grafts. This included 18% GST which is mandatory on all cosmetic procedures in India.

  • 100,000 INR by wire
  • 245,000 INR in cash the night before

In the end, they were able to get 2700 grafts, so I paid an extra 28,320 INR the day after my surgery (today) by credit card. Dr. Arika discussed these extra 200 grafts with me during the procedure. It turns out my donor area and graft quality were above average which gave her the confidence to go for more, which of course, I was completely fine with.

In addition, I’ve subsequently been charged 1,290 INR for all my post-op meds. Personally, I feel these should be included in the cost of the procedure, but the cost is nominal. I also purchased a year’s supply of generic finasteride which came at the rock bottom price of 2,400 INR. I pay 1,600 THB per month in Thailand for Propecia which at the current exchange comes to $53 USD/m.

So, in total I’ve now paid 377,810 INR (excluding the year’s supply of Finasteride). If there are any surprise charges at checkout tomorrow, I’ll update accordingly.

After I paid, they took my blood pressure and Dr. Arika came down to go over the game plan for the next morning. The consult lasted around 15 minutes, and we didn’t discuss my hairline or restoration plan. That would happen the next morning. Once the consult was over, I returned to my room for the evening.

The Surgery

I was told they’d come get me at 9AM, but it turned out to be around 9:30AM. [Side note] In my experience here, things tend to run around 30 minutes late to the agreed upon time. For me, this hasn’t been a big deal because I live in Thailand where everyone is always late, but the clinic should probably tighten things up a bit to instill more confidence.

I was taken to the clinic part of the facility where they briefly put me in a holding room. Then I was summoned to the photography room to meet Dr. Arika. This is where she drew my hairline and discussed her plan for the surgery. I defaulted to her expertise on the hairline. I came into this with reasonable expectations, so I let her dictate what would look best cosmetically while still being responsible. At this stage, she also marked other sections of the scalp that we’d tackle if there were sufficient grafts after completing the primary restoration in my frontal area and hairline. In her opinion, I wouldn’t need much temple point work. She also stressed that since I had a lot of hair already in my frontal zone she didn’t want to risk extensive shock loss by over packing the area. She stated that our objective would be “optimal” packing instead of dense packing. This sounded very reasonable to me, and I appreciated her straightforward assessment. Once the consultation was done, they took a full set of pictures of the proposed hairline. Next they had me change into scrubs and proceeded to shave parts of my head. A full shave of the head was left for after the operation.

I then was taken back to the holding room where I met Dr. Anil the assisting physician. Dr. Anil is an older gentleman who practiced ophthalmology for 35 years. He’s been training at Eugenix for a little over a month. He’s an incredibly personable and knowledgable doctor whose presence was a comfort throughout. He did my blood pressure work and administered all my pre-op medications which included a benzodiazepine. His role during surgery was to monitor the injections of the local anaesthetic and monitor my vitals. He was in the room the entire time, but didn’t actually do any restoration work. My head was then washed with an antibacterial agent and prepped for surgery by a technician. They took more blood for the PRP therapy, and then I was off to the operating room.

I believe the operation started a little after 10. Things began to get a little hazy at this point due to the benzo and my adrenaline fighting each other. I was definitely nervous when they began injecting the local anaesthetic. It didn’t hurt, but it wasn’t comfortable either. Your head gets very numb, and it feels like there is a lot of pressure being exerted on your skull. Once the local was administered, Dr. Arika came in and did all the slits. When she does the slits, you can’t feel a thing. Her touch is very light and she moves quickly. Once the slits were done, they had me roll over on my left side. They then proceeded to administer the local to the extraction zones. Once that was done, Dr. Arika did all the scoring of the grafts herself. During this part of the surgery, you get a feel for how well rehearsed the staff is. Dr Arika moves methodically across the donor area punching grafts and her staff harvests them. Simultaneously, the grafts are being inserted into the slits by a technician. This symphony of movement and coordination is the technique they pioneered called Direct Hair Transplantation, which is essentially FUE with a twist. After the initial extraction and implantation on my right temple zone, they had me roll over on my stomach and the process repeated itself on my frontal zone. Finally, they sat me up and finished the frontal section almost completely. At this point, they called lunch. The time was around 3:15PM. Lunch was 40 minutes. It was nice to have a breather and walk around a little.

After lunch I had the left temple zone, the hairline, temple points and “bonus” area left to do. This is where Dr. Arika informed me that my grafts had been of a much higher quality than expected and that she could go for roughly 200 more grafts if I wanted them. She said that she would create 6 rows of singles on my hairline with some of the extra grafts and then go after some of the thinning areas on the mid part of my scalp. She also mentioned that I would have roughly 3000 grafts left after all was said and done. In my case, the hairline work was done by a technician and then Dr. Arika did the final touches. The rest of the zones were handled in a manner identical to how they were done in the morning. We finished at around 8:15PM.

I was then sent back to the holding room to get my post op consultation. This part was pretty straightforward, so I won’t go into details. If anyone has any questions, feel free to reach out to me in a DM. I was back in my room by 9:00PM where I had dinner. They brought me a travel pillow to use, so I wouldn’t disturb the grafts during the night. I wasn’t in any pain and had no trouble falling asleep. When I looked at the sleep data on my watch this morning, I had had one of the best night’s sleep in months. Go figure!

A Note on Dr. Pradeep and Dr. Arika

I’ve come to find out that Dr. Arika and Dr. Pradeep are married. They are both dermatologists by training and both graduated from AIIMS (think the Harvard University of Indian medical). I didn’t have a chance to meet Dr. Pradeep, but it was intimated by several people I met in the clinic that he’s a very personable man and a patient favourite. His improbable rise from rural poverty to pioneering surgeon is venerated by all who know him. He is philanthropic and has built schools, roads and donated substantial amounts of money to better the condition of those in his childhood village. Many of the technicians at Eugenix are from his village. To use an American sports colloquialism, he is the “face of the franchise”.

Dr. Arika, on the other hand, is the quintessential surgeon. She is sharp, well spoken, incredibly intelligent and a master technician. She has a no nonsense attitude and a very direct way of speaking. This woman has coauthored a textbook, gives talks at conferences and does prototyping of punches and other tools of the trade in her spare time. She lives and breathes hair restoration surgery. During my procedure, I asked the team if it would be ok to change the tunes from some mix of crappy Western pop to classical music. Dr. Arika then paused and said, “You can change it to whatever you want. The grafts are my music”. Technically, she is every bit Dr. Pradeep’s equal.

Make no mistake. Both are serious surgeons who take their craft very seriously. If you’re concerned that Eugenix might be a transplant mill, I can assure you it is not. You’re in world class hands with both Dr. Pradeep and Dr. Arika.

I have included snaps from my head post op. Excuse the poor quality. Was taking them myself using my phone. Will try to follow up eventually with the pictures Eugenix took. Also took a screenshot from last night's sleep monitor from my Apple Watch.

Wet Preop Hair 1.jpg

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Edited by Fluffhead
Update to the story. Post Op Pictures Added.

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Hello Fluffhead.

You have gone to great doctors,  I had my own HT there recently.You will be very well looked after by everybody @Eugenix Hair Science as the whole team go out of their way to ensure you have the best possible experience and result. Relax and enjoy your stay.

.....Paddy...

 

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cool pics bro.. btw most Indians have a very good work eithic with techs that really care for their job which is a big plus!

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10 hours ago, LaserCap said:

Why did they take blood samples?

I'm told they take pre-op bloods for the transplant. HIV/Hep C etc, full blood counts, blood coagulation to make sure you dont have hereditary or medically thinned blood still. 

 

Looking forward to your results mate! I'm heading their way soon too

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I find this despicable.  Just another way to make more money.  They can do the transplant regardless of the outcome! 

Typically during the initial consultation they'll take a medical history.  It is then they'll figure out if you do have HIV, if you've been taking blood thinners, etc.  

Just another irritant I find from practices abroad.

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23 minutes ago, LaserCap said:

I find this despicable.  Just another way to make more money.  They can do the transplant regardless of the outcome! 

Typically during the initial consultation they'll take a medical history.  It is then they'll figure out if you do have HIV, if you've been taking blood thinners, etc.  

Just another irritant I find from practices abroad.

Isn’t it for the safety of their staff? I’ve heard there are clinics that refuse to take on hiv positive patients in Turkey, I believe they are the exception and not the rule however 

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That's just plain ignorance.  You don't get aid by just contact.  And hopefully they're using gloves. Perhaps they are worried the doctor will puncture someone accidentally? 

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Mods please feel free to delete this post. I was trying to figure out how to quote!

Edited by Fluffhead

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On 1/10/2020 at 9:18 PM, LaserCap said:

Why did they take blood samples?

From the clinic counsellor:

You shall be required to perform certain blood investigations:
Hb, Platelets, TLC, DLC, HBA1c, Anti-HCV, HIV 1&2, RBS (Random Blood Sugar), PT (Prothrombin time)

Most importantly 2 things:
1. Blood pressure should be normal
2. Blood sugar levels Should be normal

That is what they wrote to me. The guy who took the blood was very professional, and yes he wore gloves. No bruising today. 

 

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Day 1 Post Op

Nothing much happened today. Woke up around 8:30AM. Felt good. No bruising or swelling to speak of, and I had very little oozing on my pillow from my donor area. The staff called me down at around 4PM to wash my donor area. Have included some pics. Everything seems to be doing well. Will fly back to Thailand tomorrow at 11:00AM. Will continue to update in the days ahead. Pictures will get better when my wife can assist!

Post Op D1 Doner2.jpg

Post Op D1 Donor.jpg

Post Op D1 BE.jpg

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On 1/13/2020 at 7:36 AM, paddyirishman said:

Be careful with your medication and heal well.

....Paddy...

Thanks, kind sir. Your posts helped me take this leap. 

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Day 3 Post Op

No pictures from yesterday because I was flying all day, but not much had changed anyway. No problems getting through the airport. I rocked the surgical cap all day and nobody bothered me about it. I believe the plane ride dried my scalp out a bit and exacerbated the swelling in my face. The team at Eugenix should consider offering the little spray bottles of saline solution for those of us who travel from overseas. I had to dump my large bottle to get through security, so there was a 4 hour period when I was unable to spray my head. 

Overnight I experienced an uptick in itchiness. At one point in the night, I brushed the transplant zone on my right temple involuntarily with my hand. That area is a little raw today as a result. Don't really feel any pain but perhaps a tad of soreness.

I feel my donor area is healing nicely. The transplant zone has scabbed over and is pretty tight. 

Dr. Arika and the team have checked in on me everyday. Already looking forward to Saturday when I can wash my head!

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Day 7 Update

Everything has been smooth sailing. The swelling has gone down significantly. Scalp in the transplant area is still pretty numb, but it doesn't bother me. I continue to sleep on my back using a travel pillow so as not to disturb the grafts. Tomorrow I will do my first hair wash and remove the scabs. I feel my donor area has healed well thus far. Will update once more after the wash. 

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Days 8-10 Post Op

On Sunday, day 8, I finally took a shower and began to work off the scabs. At first it was very difficult, and I didn't want to push it too much. When your scalp is numb it's difficult to gauge how much friction you're applying to the scalp. This makes the process a bit tricky. I contacted Dr. Arika, and she said it was fine to work them off slowly over a few days. On day 2, I wrapped my transplant area with warm, moist gauze and let it sit for 20 minutes. Then I shampooed with J&J infant shampoo and let it sit for another 10 minutes. Then I applied a little more pressure in trying to remove the scabs. In doing so, I had 2 transplanted hair shed in my hand. I immediately stopped and rinsed off. I then proceeded to work the scabs off in front of the mirror very gently with 1 finger. Using the mirror was a big help, and I didn't experience anymore shedding. Today I did a shorter soak and followed the scab removal technique from yesterday. I had no shedding and was able to remove most of the remaining scabs. My scalp is pretty red at the moment. It's almost like I got a sunburn. My donor area is recovering slowly, but appears to be doing fine. There's a bit of discomfort, but I'm following @paddyirishman advice and applying aloe vera to the area. Seems to be helping. Pictures are from this morning. My staff thinks I look good with a buzzcut. I rocked a blue surgical cap for a week, so my entire team knows that I got a transplant. I didn't try to hide the fact. Just owned it. Doing so has been incredibly freeing.  

Side note: The post op literature that Eugenix gives says that you can resume heavy weight lifting after 7 days. Today I had to move a piece of furniture in the office and didn't think twice about it. The weight was around 35lbs if I had to guess. I moved it only a sort distance, but it required me to bend over and strain. Since doing so, my transplant area has been pulsing. It's been over an hour and this sensation hasn't subsided. I've reached out to Dr. Arika, and she says there is nothing to worry about. This feeling in my head, however, is a bit disconcerting. I've been so careful this entire time. Moral here is to take it easy. Don't do anything that might jeopardize the investment even if the post op guidelines say otherwise. The subsequent feelings of paranoia aren't worth it ;). Hope you're all having a great day! - Fluff

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Hello Fluff. 

Your recipent is looking really good.   The redness is normal, and it will fade away week by week.  Well done on removing the crusts, it's a big step forward. 

Your doner area looks really clean and is healing well.  Yes the Aloe Vera Gel for your doner area has great healing properties. You will be finished your medication,  so  you can relax now as your grafts are well and truly anchored at this point in time. 

If you check in on my thread their is some great tips and advice for you on your journey.

All the best Fluff

....Paddy....

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Day 20

I officially started shedding this morning. Caught around 10 hairs in my hand while I was shampooing. Over the past week, I've been losing 1-2 hairs every day or so, but it hasn't been that noticeable. Today felt different. I'm ready for the shed. The quicker they leave the quicker they can come back. 

Over the past 10 days or so, I've had this noticeable pulsing, tingling feeling right behind the transplant area. Honestly, it's been distracting and a little worrying. I don't feel it when I wake up, but it gets progressively more noticeable throughout the day. By the time I'm ready for bed, it's down right annoying. Dr. Arika said this will go away eventually, so I'm eagerly awaiting that day.

My donor area is recovering slowly. Don't want to say there is shock loss or over harvesting yet, but compared to some of the threads on this forum I feel my regrowth is a bit below baseline. I'm not too concerned about it though (yet). Doctor Arika said I still have around 2500-3000 grafts left, but I'm starting to doubt that. Time will tell. 

Redness in the transplant area is going down at an almost imperceptible rate. I've had some acne pop up on my forehead near the hairline. Haven't had a breakout in 20 years. Hopefully it's just dry skin. I've also had some pretty aggressive dandruff. 

Pictures are in direct window sunlight at 8am. I think I will use this for all my pictures going forward. Seem pretty natural. Will update again at 1 month. IMG_0243.jpg.b36d1ebd8e42cf3f5362b86ee6a11553.jpgIMG_0246.jpg.cbe7ca1ba2d48cf9e00c38ea55aadcd5.jpgIMG_0245.jpg.7d6cfd2f784f3045d17c1a076f7a452c.jpgIMG_0244.jpg.aeb6fd657b9efc9f6f7a17f8c8af1530.jpgIMG_0236.jpg.fa08e47edb8cb3719ac30109b53098f0.jpgIMG_0238.jpg.0418319b3c692e7b61780af36525329a.jpgIMG_0247.jpg.545e8ebe9758795c07f224b7dc991cd4.jpg

 

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Hello @Fluffhead. That was a fast 20 days. You are over the worst of things now with taking medication and headwash  and minding your newly implanted grafts. 

Yes I had the tingling etc on my scalp also, it is a sign of your nerve endings coming back to life and will fade. 

It will take a while for your doner to grow out and some hair will go into sleeping mode for 2 or 3 months, so it will look much better then. 

Yes you are correct, now the shedding and that means looking forward to the hair growing back as soon as possible.

You look great , your hairline really suits you. The redness will fade away more again over the next few weeks. I have some good tips on my own thread to help,  for you around this stage of your journey .

All the best Fluff

Paddy

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2 hours ago, Loadrunner said:

@Fluffhead how is the growth going. Did you undergo heavy shedding?

Hi @Loadrunner. Thanks for asking. Things have been moving along. My recipient is still noticeably red, but it doesn't bother me much. Haven't had any pimples. I have lost a lot of the implanted grafts, but have kept more than I expected. Sometimes it's difficult to tell what is my natural hair and what isn't. My hairline has more or less disappeared. Haven't noticed any regrowth yet. 

Happy with how my donor looks for 49 days.

Have been using Minoxidil foam for around 3 weeks on my crown area, so I'm starting to see significant shedding there. Hopefully it all rounds out in another 6 months time. Going to add dutasteride .5mg/week starting tomorrow in addition to my regular dose of finasteride. Also, just added Nizoral 1% to my routine. 

Have included some pics in various lighting. 

Will update each month from here on out. Will do another short post on March 11th with better pictures.

Happy growing to all!

Fluff

 

 

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Everything is looking great, I must say i'm very impressed by their facilities, it looks top-notch. Eager to follow your progress.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

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Hello Everyone,

Hope you're staying safe. Forgot to post my 2 month update. Pictures were taken on March 11th, exactly 2 months post op. Will update again on April 11th. No itching, no pimples only redness in the recipient. My donor is almost completely healed. Looking forward to getting through the ugly ducking stage. Hopefully I'll start seeing some regrowth in the coming weeks. 

Current routine:

Minoxidil foam 2x per day on the crown - just started this 45 days ago. Have definitely experienced some shedding.

Biotin 10,000mg 1 x per day

Dr. Reddy Finasteride 1mg/day

Avodart 1 x per week on Monday

Nizoral 1% 2 x per week. 

Surge Shampoo daily. This is expensive. Might not continue once the bottle is done. 

 

 

 

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