NW6 / 38 yrs- HT Consultation

[Melvin- Admin]

3 minutes ago, HCH said:

Thanks Melvin, i am really impressed with Eugenix results specially with high NW grades.

I didn't try oral minoxidil but will look at it. Dr. Pradeep asked me to try topical fin or dut which i am also considering.

Still i couldn't find a good product here in Dubai. What do you think about my donor and the number of grafts suggested by Eugenix ?

I think the donor looks reasonable, 3,000 grafts is also reasonable. I can understand why they lowered it from an aesthetic standpoint. If you were to leave the hairline in the same position and build backwards, you’d be going into native hair and you’d end up looking like schumer

This is what my first surgeon did and it looked ridiculous. There’s a line between being conservative and downright ridiculous. 

[HCH]

11 minutes ago, Melvin-Moderator said:

I think the donor looks reasonable, 3,000 grafts is also reasonable. I can understand why they lowered it from an aesthetic standpoint. If you were to leave the hairline in the same position and build backwards, you’d be going into native hair and you’d end up looking like schumer

This is what my first surgeon did and it looked ridiculous. There’s a line between being conservative and downright ridiculous. 

No way, i prefer to shave it instead 😅

The main reason of doing an HT is to lower my hairline at least (8 to 9 cm), i have a big forehead.

Did you notice any thinning for the transplanted hair or you're still on fin?

 

[MazAB]

I believe that Eugenix would be a no brainer for you. You definitely have others on the short list that are incredible as well. Konior and even HLC, but without question Eugenix would be the best choice with your pattern of hair loss. You do have some frontal recession, and crown work to be done, however the rest falls into the diffused thinning pattern of baldness. With the rest of you existing hair, you need a clinic that has proven results in working on many of those types of patients. 

From what I understand, because they have microscopes that significantly increase magnification, they are incredibly precise with the implantation of grafts in between existing hairs so as to not damage or cause shock loss to the native hair. 

Just another point to consider. 

Here is a clip from Eugenix that breaks it down:

 

[asterix0]

Just wondering, what side effects did you have from finasteride?

 

[Gatsby]

HCH you appear to have very realistic expectations and being able to have an in person consultation with Dr Pradeep is a big plus compared to online, etc. I think the plan that you and Dr Pradeep have is a very good one as you always need to plan surgery/s for over the lifespan and plan to being a Norwood 6 whether one will head that way or not. You are correct that Eugenix do great work in the higher Norwood end and you will be in good hands. Wishing you all the best whichever way you go.

Edited December 19, 2020 by Gatsby

[HCH]

9 hours ago, MazAB said:

I believe that Eugenix would be a no brainer for you. You definitely have others on the short list that are incredible as well. Konior and even HLC, but without question Eugenix would be the best choice with your pattern of hair loss. You do have some frontal recession, and crown work to be done, however the rest falls into the diffused thinning pattern of baldness. With the rest of you existing hair, you need a clinic that has proven results in working on many of those types of patients. 

From what I understand, because they have microscopes that significantly increase magnification, they are incredibly precise with the implantation of grafts in between existing hairs so as to not damage or cause shock loss to the native hair. 

Just another point to consider. 

Here is a clip from Eugenix that breaks it down:

 

Thanks mate, Eugenix are definitely on top of my list. i am just worried on how to preserve my native hair without taking oral fin.

Dr. Pradeep advised me to try dut or topical fin. Not sure what's the difference in term of side effects but i will give it a try.

As for the diffuse thinning, no one mention it to me except Dr. Pekiner. Am afraid my donor is thinning as well 🙄

[HCH]

6 hours ago, asterix0 said:

Just wondering, what side effects did you have from finasteride?

 

It's mostly sexual side effect i.e. decreased libido, erectile and ejaculation difficulty, some pain as well.

I have been using topical minox 5% + fin 0.1% and didn't notice any sides maybe i need to increase the fin dose.

 

[HCH]

19 minutes ago, Gatsby said:

HCH you appear to have very realistic expectations and being able to have an in person consultation with Dr Pradeep is a big plus compared to online, etc. I think the plan that you and Dr Pradeep have is a very good one as you always need to plan surgery/s for over the lifespan and plan to being a Norwood 6 whether one will head that way or not. You are correct that Eugenix do great work in the higher Norwood end and you will be in good hands. Wishing you all the best whichever way you go.

Thanks Gatsby, you're right the in person consultation is totally different.

My plan actually is a bit different than what Dr. Pradeep suggested as i am thinking to only do the frontal half with 3000 to 3500 grafts and keep the crown for a later stage. i don't wanna end up with a hairline and an island in the crown if i lose my mid scalp native hair which most probably will happen in the future.

Any thoughts on this? don't you think 2200 grafts for the frontal area is very less?

[Gatsby]

Yes I admit 2,200 does sound light for coverage of a full frontal half however Eugenix appear to have nailed the art of using less grafts to achieve the illusion of more coverage obtained. Is Dr Pradeep planning to use grafts solely from scalp grafts? I know Eugenix heavily recommend the use of finasteride for life regardless of one's hair loss and I have noted you are unable to use this. Perhaps Dr Pradeep is thinking of retaining your finite graft supply for the future if required? The final point though is that you have to feel 100% confident and and on track with whichever surgeon you choose. So bear this in mind if you go ahead with a hair transplant and remember that you should be made to feel that you can never ask enough questions with your surgeon. That in itself is as important as the procedure itself is. Wishing you all the best.

[plus]

Just grow your hair longer and use toppik for a few more years. I think it would look great because that's one of the perks of diffuse thinning: you can create an illusion of density easily. If you grow it long enough you can even lower your hairline by letting the hair sleep onto the forehead.

After some more years you can revisit hair tranplant. You'd also be more sure about donor thinning then.

[HCH]

3 hours ago, Gatsby said:

Yes I admit 2,200 does sound light for coverage of a full frontal half however Eugenix appear to have nailed the art of using less grafts to achieve the illusion of more coverage obtained. Is Dr Pradeep planning to use grafts solely from scalp grafts? I know Eugenix heavily recommend the use of finasteride for life regardless of one's hair loss and I have noted you are unable to use this. Perhaps Dr Pradeep is thinking of retaining your finite graft supply for the future if required? The final point though is that you have to feel 100% confident and and on track with whichever surgeon you choose. So bear this in mind if you go ahead with a hair transplant and remember that you should be made to feel that you can never ask enough questions with your surgeon. That in itself is as important as the procedure itself is. Wishing you all the best.

Appreciate your input Gatsby, yes he will only use scalp grafts. Actually, i didn't have enough time to discuss his plan in details as he was in a visit to Dubai and i got the chance to meet him in person. For now tourist visas to India are suspended so i am taking my time to search and come out with a proper plan. I believe he's planning for a light coverage that matches my existing hair probably 40-45 grafts/cm2. he will only implant the frontal 1/3 without touching the mid scalp but still i think 2200 grafts for the marked zone is not enough. If you do the calculation it will cover maximum 50 cm2.

Anyway, i will call him again to better understand his approach.

[HCH]

On 12/19/2020 at 11:47 AM, plus said:

Just grow your hair longer and use toppik for a few more years. I think it would look great because that's one of the perks of diffuse thinning: you can create an illusion of density easily. If you grow it long enough you can even lower your hairline by letting the hair sleep onto the forehead.

After some more years you can revisit hair tranplant. You'd also be more sure about donor thinning then.

Nice idea Plus, i never used toppik  

My main problem is that my hairline and temples have receded dramatically. Actually i don't have a hairline to grow 😂  

I attached one pic with longer hair.

 

Edited December 24, 2020 by HCH

[DrTBarghouthi]

I did not spot whether you mentioned your current age or not. I would definitely focus on the frontal (no hair area) and also adding density to your Mid scalp region. The crown can be done depending on your age or simply work in the front part of it and leave a naturally thin area in the actual crown. I think the frontal empty area will require around 2200-2500 grafts depending on your hair average. The Midscalp will take around 800-1000 grafts of added density. This would be the priority at this stage. Ofcourse the crown can be addressed conservatively too. 

[HCH]

On 12/19/2020 at 4:07 PM, DrTBarghouthi said:

I did not spot whether you mentioned your current age or not. I would definitely focus on the frontal (no hair area) and also adding density to your Mid scalp region. The crown can be done depending on your age or simply work in the front part of it and leave a naturally thin area in the actual crown. I think the frontal empty area will require around 2200-2500 grafts depending on your hair average. The Midscalp will take around 800-1000 grafts of added density. This would be the priority at this stage. Ofcourse the crown can be addressed conservatively too. 

Thanks Dr. for taking the time to read and comment on my thread.

I am 38 yrs now and as you mentioned the crown is not my priority for now. Not sure if you have seen the hairline design which is dropped by 2 cm.

In your experience, what's the size of the marked zone in the attached pic? i guess it's around 70 to 80 cm2 so if the Dr. is aiming for a density of 40-45 grafts/cm2 then he will need minimum 3000 grafts. Does it make sense?

 

 

 

Edited December 24, 2020 by HCH

[DrTBarghouthi]

No worries at all. Yes this area is usually around 80 cm2. Given the fact that some of it has hair and some of it has no hair at all, I would assume a 3000-3500 graft range to be excellent (lower end to higher end). 

[DrTBarghouthi]

Although I wouldn't agree with the pronounced temporal points reconstruction in my opinion. You will need them defined and reconstructed to match the new hairline, but I wont bring them that forward. 

[dobler]

You are a very good candidate, your donor is great, and you are almost 40. So it's a good sign.

You can get your hair back. Good luck!

[HCH]

13 hours ago, dobler said:

You are a very good candidate, your donor is great, and you are almost 40. So it's a good sign.

You can get your hair back. Good luck!

Thanks Dobler, i don't have high expectations. if i can have some coverage in the front that would be great.

Have you done any HT ?

[dobler]

1 minute ago, HCH said:

Thanks Dobler, i don't have high expectations. if i can have some coverage in the front that would be great.

Have you done any HT ?

Done 2 of them. 1st in 2016 2900 frontal third. 2nd in 2017 2800 crown area.

You can find some more details in my posts.

[HCH]

7 hours ago, dobler said:

Done 2 of them. 1st in 2016 2900 frontal third. 2nd in 2017 2800 crown area.

You can find some more details in my posts.

After reading your post, the 1st advice i should expect from you "shave it and own it" 

Still can't believe how did you loose all the transplanted hairs in such a short period. if your scalp is healthy then definitely HTs are false.

[dobler]

23 minutes ago, HCH said:

After reading your post, the 1st advice i should expect from you "shave it and own it" 

Still can't believe how did you loose all the transplanted hairs in such a short period. if your scalp is healthy then definitely HTs are false.

Well, if it happened to me, it doesn't mean it will happen to everyone.

In your case, you are almost 40. Your baldness is kinda stable at this point. So given your good donor, you can achieve a very good result! 

[HCH]

On 12/18/2020 at 2:53 PM, HCH said:

Hello Gents,

After 5 years of HT research, it's time to take a decision that might be a big failure or success.

Hence, i am would like to hear your biased opinion and recommendation.

Clinics Consultation:

1. Eugenix (In person consultation) : Dr. Pradeep suggested 2200 grafts for the hairline (frontal 1/3) and 1500 for the crown (attached pics for hairline design)
2. Dr. Konior (online consultation) : 3000 grafts for the hairline (frontal 1/3); Crown can be done in a 2nd sitting after 6 to 12 months.
3. HLC (online consultation): 3800 - 4200 for the hairline (frontal 1/3) and giving more density for the frontal half.
4. Dr. Pekiner (online consultation): Rejected my case due to diffuse thinning on top, insufficient donor and probably retrograde alopecia/ DUPA
5. Dr. Yaman (online consultation) : 4000 grafts for the hairline and mid scalp (see attached pics for hairline design)
6. Dr. Bhatti (online consultation): He suggested 3500 - 4000 scalp & beard grafts for the hairline and mid scalp but wasn't sure about my donor or confident for a good result.
7.  Dr. Bicer (online consultation): 3200 - 3400 grafts for the hairline and mid scalp; crown can be done in a 2nd sitting 

Current Medication:

Minoxidil 5% twice a day since 1 year

Micro-needling 1.5mm once a week since 1 year

Saw palmetto 320 mg one tablet a day since 1 month

Perfectil multivitamin 1 tablet a day since 1 year

Vitamin D3 5000 IU 1 tablet a day since 2 years

 

Thanks in advance for your contribution. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hello guys,

Re-attaching my pics as it was delete it by mistake.

I had another consultation with Dr. Arika and we agreed to reconstruct the hairline and temples only which will need between 1800 - 2200 grafts.

The crown area will remain untouched at this stage. According to her, any implantation between the native hairs will be too risky and may lead to permanent shock loss. 

As such, i have changed my regimen and added fin 2mg/week + saw palmetto 320 mg 1 tablet/day to strengthen may native hairs. Hopefully i won't get any side effects with low dose fin.

On a side note Dr. Pekiner is still insisting to start on fin and reassess the situation after 6 months. he would like to check the response of medication pre-op.

Happy to hear your opinions and comments

[deitel130]

I agree with the approach to focus on frontal third for now. Since temple points and hairline is also being lowered a lot of grafts would go into that. Personally I would lower the hairline to half of what you have drawn in the pic as it will require a good number of grafts for acceptable density otherwise you will be unhappy. I do agree that Eugenix would be a good choice due to the fact they have good experience with using beard hair if needed. Also, if you can get your hands in topical Finasteride that will be helpful and strengthen your existing hair and reverse some miniaturization. Best of luck and let us know how things go.

[HCH]

7 minutes ago, deitel130 said:

I agree with the approach to focus on frontal third for now. Since temple points and hairline is also being lowered a lot of grafts would go into that. Personally I would lower the hairline to half of what you have drawn in the pic as it will require a good number of grafts for acceptable density otherwise you will be unhappy. I do agree that Eugenix would be a good choice due to the fact they have good experience with using beard hair if needed. Also, if you can get your hands in topical Finasteride that will be helpful and strengthen your existing hair and reverse some miniaturization. Best of luck and let us know how things go.

Thanks mate for your advice. Actually i am still unconvinced on the suggested number of grafts but the Dr. said she will only implant the bald area with a density of 40 - 45 grafts/ cm2 🤔 

Anyway, i am not aiming for a high density and my priority is to lower my hairline with minimum 9 cm height as my forehead is really too big.

The final design will be confirmed during the operation day or the day before.

As for the topical fin, do you have any resource for a gel brand ? I don't like the mixed one (min +fin) as the dosage is very low 0.1%. 

[deitel130]

1 hour ago, HCH said:

Thanks mate for your advice. Actually i am still unconvinced on the suggested number of grafts but the Dr. said she will only implant the bald area with a density of 40 - 45 grafts/ cm2 🤔 

Anyway, i am not aiming for a high density and my priority is to lower my hairline with minimum 9 cm height as my forehead is really too big.

The final design will be confirmed during the operation day or the day before.

As for the topical fin, do you have any resource for a gel brand ? I don't like the mixed one (min +fin) as the dosage is very low 0.1%. 

I use oral Finasteride but there are others here using topical so hopefully someone can provide details.