NW6 / 38 yrs- HT Consultation

[HCH]

Thanks a lot, i found one source but it's too expensive 100 euro/ bottle 🙄

Are you also considering a hair transplant with Eugenix? it sucks tourist visas are still suspended.

[HCH]

Gents,

I reached out to Dr. Pekiner and Erdogan, both of them recommended to use fin for 6 months and then re-evaluate my case. It seems they want to check the response for medication even though i mentioned clearly i had some side effects after 2 months using it.

Any thoughts on this? Am i taking a big risk while i am not on fin? 

 

[JohnBob]

On 1/6/2021 at 4:53 PM, HCH said:

Gents,

I reached out to Dr. Pekiner and Erdogan, both of them recommended to use fin for 6 months and then re-evaluate my case. It seems they want to check the response for medication even though i mentioned clearly i had some side effects after 2 months using it.

Any thoughts on this? Am i taking a big risk while i am not on fin? 

 

Don't have an answer for you but guys with a hair loss pattern similar to yours are usually the ones that respond better to finasteride. Have you though about trying topical dutasteride? There is some anedoctal evidence in the forums that it's more potent and has less side effects than fina, oral or topical. 

By the way, have you noticed any improvements after you started micro needling and minoxidil? 

[HCH]

3 hours ago, JohnBob said:

Don't have an answer for you but guys with a hair loss pattern similar to yours are usually the ones that respond better to finasteride. Have you though about trying topical dutasteride? There is some anedoctal evidence in the forums that it's more potent and has less side effects than fina, oral or topical. 

By the way, have you noticed any improvements after you started micro needling and minoxidil? 

Thanks Jhon, actually i found an Italian pharmaceutical company that produces topical fin but it's too expensive 100 euro/ bottle. Do you know any topical Dutasteride that can be shipped online? unfortunately, it's not available here in Dubai. 

As for your last point, yes there is some improvement in the crown and the hair has thicken-up a little bit. See below my before and after photos. 

Last month i started crushing 8 mg fin and mixing them with Min. Not sure if it will work 😂

[JohnBob]

13 hours ago, HCH said:

Thanks Jhon, actually i found an Italian pharmaceutical company that produces topical fin but it's too expensive 100 euro/ bottle. Do you know any topical Dutasteride that can be shipped online? unfortunately, it's not available here in Dubai. 

As for your last point, yes there is some improvement in the crown and the hair has thicken-up a little bit. See below my before and after photos. 

Last month i started crushing 8 mg fin and mixing them with Min. Not sure if it will work 😂

For 3 months, not bad man, hopefully the hair will keep improvement. 

Regarding ordering online Duta, @mustang may have something to say about this

[HCH]

Thanks mate, actually it's 15 months. Without DHT blocker there's no hope  

[mustang]

It can be ordered here: https://fueclinic.com/ 

[HCH]

18 hours ago, mustang said:

It can be ordered here: https://fueclinic.com/ 

Thanks a lot 🙏

[HCH]

Finally, i got my visa approval to India and confirmed my booking with Eugenix.

Will open a new thread documenting my full journey soon  

@Melvin-Moderator @Gatsby @mustang@JohnBob @JohnAC71 @MazAB@PizzaWolf@dobler@BDK081522@deitel130 @Homeerestre @giegnosiganoe @plus                                Any tips or suggestions would be appreciated👌

[Britanium]

13 minutes ago, HCH said:

Finally, i got my visa approval to India and confirmed my booking with Eugenix.

Will open a new thread documenting my full journey soon  

@Melvin-Moderator @Gatsby @mustang@JohnBob @JohnAC71 @MazAB@PizzaWolf@dobler@BDK081522@deitel130 @Homeerestre @giegnosiganoe @plus                                Any tips or suggestions would be appreciated👌

Excellent news ! When is your booking date ? What was the final plan agreed ? 🙏

[SLA]

Wow! Looking forward to cheering you along your journey!

[HCH]

16 minutes ago, JohnAC71 said:

Excellent news ! When is your booking date ? What was the final plan agreed ? 🙏

End of next week, still trying to book a slot in the weekend. Hopefully i will get an update tomorrow.

As per my last consultation with Dr. Arika, she recommended 2500 grafts for the hairline only without touching the existing hair.

I am attaching 2 pics and would like to hear your opinion:

1- Dr. Arika hairline design

2- My hairline design

[ITA]

59 minutes ago, JohnAC71 said:

confirmed my booking with Eugenix.

Great choice 👍

[ITA]

@HCHThe line drawn by you for your new hairline seems a bit too "aggressive", too low, trust the doctor Arika

[HCH]

2 minutes ago, Egy said:

@HCHThe line drawn by you for your new hairline seems a bit too "aggressive", too low, trust the doctor Arika

You are right, it should be higher but this is the shape i like. 

if you noticed in the 1st pic, she wanna rebuild my temple peaks which is not really necessary in my opinion. Anyway, the final design will be decided on the procedure date.

[Melvin- Admin]

53 minutes ago, HCH said:

End of next week, still trying to book a slot in the weekend. Hopefully i will get an update tomorrow.

As per my last consultation with Dr. Arika, she recommended 2500 grafts for the hairline only without touching the existing hair.

I am attaching 2 pics and would like to hear your opinion:

1- Dr. Arika hairline design

2- My hairline design

I think your hairline is a little too aggressive and low. As a Norwood 6 you should arch the corners back, to conserve your donor supply.

[HCH]

@Melvin-Moderator i see your point, but what about rebuilding the temple peaks ? does it look really bad? 

[Melvin- Admin]

30 minutes ago, HCH said:

@Melvin-Moderator i see your point, but what about rebuilding the temple peaks ? does it look really bad? 

I think your grafts would be better served elsewhere. The temple points aren’t that bad. 

[Gatsby]

Congratulations @HCH! In my opinion I would put your trust in Dr Arika. You will need a hairline to grow into (not out of). If Dr Arika is suggesting to build on the temple points then I would go with that. I know it’s difficult when we have our own preferences but Eugenix has a massive body of work under their belt and they are concerned about treating hair loss over the lifespan. Ironically in my consultations I want a much higher hairline but they are proposing a much lower one in order to camouflage my frontal hairline scar. I am really looking forward to following your updates and wishing you all the best!!

[j1mmy]

Hi HCH,

I am having a surgery in exactly a week, so I can relate to your situation of several months of research .

I agree about your hairline being too aggressive. As someone said before, imagine 1cm of hairline is 1000-1500 grafts for good density. Your suggestion is a solid 2cm, and that is then neglecting everything behind it. 

I recommend you consider M or V shape hairlines, they are actually graft preserving, and age well. Look at Melvin's hairline on youtube if you can. Not to mention that it is very aesthetic, but if he had decided to opt for your suggested hairline in line with his midline-frontal point (the lowest point), he would have to spend more grafts filling in more temples. 

Given that an average donor of 6000 grafts, I don't think it is unreasonable to "use" 2500-3000 on the frontal third, and feather in 500-1000 in the mid-scalp. It is individual, but I think Eugenix recommendation was too limited to the very front for my liking, and your design was too aggressive. 

Temporal points do not need to be fully reconstructed, you have some density and shape to the lower portions of them. You can add some density to the tops of them, as they become your temples and frame the hairline. That way you don't use 700 grafts on the temples, but say, 200. 

Your worries of 45grafts/cm^2 forget that your native density is not 0, as the good DrT alluded to. But, such a density in the front of the hairline should give you a decent hairline. 

Your challenges with medication are a shame. I agree that topical dutasteride seems worth looking into, or your topical OR oral finasteride should not be daily, and be cautious. A small amount goes a long way in terms of its effect on DHT, and maybe negates side effects. 

I think that even though oral minoxidil is becoming increasingly popular for the braver people, as some good Dr's are prescribing it. It is worth remembering that oral minoxidil is the very origins of topical minoxidil, but topical was created exactly for the very reason that oral minoxidil was not a viable option for treating hair loss.

You are doing a great job of doing your due diligence, and I don't think you will be dissatisfied with Eugenix, but as you see, it helps to be an educated patient, to maximise the best possible chance of being a satisfied patient. 



 

[j1mmy]

And by the way, it may seem like a small difference you achieved so far with your medications, but that area of crown you filled in must be around 1000 grafts. That is exactly the beauty of what a long-term strategy can offer people, and most likely more of that if you can find a viable fin/dust option. 

[HCH]

19 hours ago, Gatsby said:

Congratulations @HCH! In my opinion I would put your trust in Dr Arika. You will need a hairline to grow into (not out of). If Dr Arika is suggesting to build on the temple points then I would go with that. I know it’s difficult when we have our own preferences but Eugenix has a massive body of work under their belt and they are concerned about treating hair loss over the lifespan. Ironically in my consultations I want a much higher hairline but they are proposing a much lower one in order to camouflage my frontal hairline scar. I am really looking forward to following your updates and wishing you all the best!!

Thanks mate for your support, i definitely trust her but having an HT for the 1st time makes a bit confused and undecided.

Hopefully things will go as planned and will update you all soon. 

[HCH]

19 hours ago, j1mmy said:

Hi HCH,

I am having a surgery in exactly a week, so I can relate to your situation of several months of research .

I agree about your hairline being too aggressive. As someone said before, imagine 1cm of hairline is 1000-1500 grafts for good density. Your suggestion is a solid 2cm, and that is then neglecting everything behind it. 

I recommend you consider M or V shape hairlines, they are actually graft preserving, and age well. Look at Melvin's hairline on youtube if you can. Not to mention that it is very aesthetic, but if he had decided to opt for your suggested hairline in line with his midline-frontal point (the lowest point), he would have to spend more grafts filling in more temples. 

Given that an average donor of 6000 grafts, I don't think it is unreasonable to "use" 2500-3000 on the frontal third, and feather in 500-1000 in the mid-scalp. It is individual, but I think Eugenix recommendation was too limited to the very front for my liking, and your design was too aggressive. 

Temporal points do not need to be fully reconstructed, you have some density and shape to the lower portions of them. You can add some density to the tops of them, as they become your temples and frame the hairline. That way you don't use 700 grafts on the temples, but say, 200. 

Your worries of 45grafts/cm^2 forget that your native density is not 0, as the good DrT alluded to. But, such a density in the front of the hairline should give you a decent hairline. 

Your challenges with medication are a shame. I agree that topical dutasteride seems worth looking into, or your topical OR oral finasteride should not be daily, and be cautious. A small amount goes a long way in terms of its effect on DHT, and maybe negates side effects. 

I think that even though oral minoxidil is becoming increasingly popular for the braver people, as some good Dr's are prescribing it. It is worth remembering that oral minoxidil is the very origins of topical minoxidil, but topical was created exactly for the very reason that oral minoxidil was not a viable option for treating hair loss.

You are doing a great job of doing your due diligence, and I don't think you will be dissatisfied with Eugenix, but as you see, it helps to be an educated patient, to maximise the best possible chance of being a satisfied patient. 



 

Appreciate your contribution and advise, are you going with Eugenix as well ? did you confirm the date?

Actually the 2500 grafts will be used for the hairline. i am a diffuse thinner so any work between the existing hairs will be too risky (permanent shock loss). 

The hairline design is the most aesthetical of a HT so i am trying my best to have it done properly so i won't regret it in the future.

As for DHT blocker, i am now on oral fin M/W/F for last 3 months and surprisingly i didn't notice any sides. The main challenge in my case is to delay future hair loss and use my donor efficiently.     

Thanks to this forum and community members for offering their service to educate and guide people in the right way.

[j1mmy]

38 minutes ago, HCH said:

Appreciate your contribution and advise, are you going with Eugenix as well ? did you confirm the date?

Actually the 2500 grafts will be used for the hairline. i am a diffuse thinner so any work between the existing hairs will be too risky (permanent shock loss). 

The hairline design is the most aesthetical of a HT so i am trying my best to have it done properly so i won't regret it in the future.

As for DHT blocker, i am now on oral fin M/W/F for last 3 months and surprisingly i didn't notice any sides. The main challenge in my case is to delay future hair loss and use my donor efficiently.     

Thanks to this forum and community members for offering their service to educate and guide people in the right way.

Somewhere else, but I will create a thread about my journey the days afterwards  As a European myself, it is challenging enough to travel to another country in Europe - my flight has been cancelled twice already, so I will be disappointed if it will not work out. 

Is your concern of permanent shock loss information you got during your consultation? I have a little more density than you I would guess, and the plan is for around 3500 grafts into the frontal 70%, with a focus on dense packing hairline. This all depends on my consultation on the day in person, and my donor capacity.

To my knowledge,  I have only seen cases of "temporary" shock loss on patients without finasteride, and not sure how many permanent shock loss cases I have seen except around an FUT scar. And believe me, I must have looked at a thousand cases here and other forums. The shock loss as I understand is that the damage to the surrounding area scares the weaker/miniaturized hairs into fully miniaturizing, as they were arguably on their way out anyway, like a dying flower. Permanent shock loss in my head would have to be caused by direct transection, or a blood supply issue. Transection is minimised by experienced and good doctors, as they can see with their microscope if they are transecting during extractions/implantation. They may even intentionally place terminal hairs over very miniaturized hairs - an art I can only imagine. Blood supply seems to be less substantiated. It has been demonstrated that you can transplant very high densities in dense packing (70-80g/cm) with nearly 100% survival. Whilst impressive and possible, it however carries a risk of necrosis, so the risk is not worth it. Many however choose to dense pack up to 50-60g safely, and on a second procedure "touch-up" 10% for more density if needed. I think it is also not substantiated if you can dense pack a large area, without compromising blood supply. 

I have heard Eugenix mention they are comfortable placing grafts if the space is "2mm or more" between hairs, i.e. 25g/cm native density, which could be around where you are. The point is that they WILL be able to feather in grafts into the mid scalp if you wanted to, I have seen many cases of theirs where they have. I have seen hundreds of cases by Dr. Lorenzo on youtube, where he fully restores NW7's back from the grave with 10000 grafts over multiple procedures. It is all based on transplanting between hairs, and between native hairs. You would be surprised what is possible. I think Eugenix often surprises people when they meet them in person, they seem to like to "surprise" you what with is possible. If you want density further back than just the hair line, it is something you should go into the consultation exploring, I would say!

[HCH]

32 minutes ago, j1mmy said:

Somewhere else, but I will create a thread about my journey the days afterwards  As a European myself, it is challenging enough to travel to another country in Europe - my flight has been cancelled twice already, so I will be disappointed if it will not work out. 

Is your concern of permanent shock loss information you got during your consultation? I have a little more density than you I would guess, and the plan is for around 3500 grafts into the frontal 70%, with a focus on dense packing hairline. This all depends on my consultation on the day in person, and my donor capacity.

To my knowledge,  I have only seen cases of "temporary" shock loss on patients without finasteride, and not sure how many permanent shock loss cases I have seen except around an FUT scar. And believe me, I must have looked at a thousand cases here and other forums. The shock loss as I understand is that the damage to the surrounding area scares the weaker/miniaturized hairs into fully miniaturizing, as they were arguably on their way out anyway, like a dying flower. Permanent shock loss in my head would have to be caused by direct transection, or a blood supply issue. Transection is minimised by experienced and good doctors, as they can see with their microscope if they are transecting during extractions/implantation. They may even intentionally place terminal hairs over very miniaturized hairs - an art I can only imagine. Blood supply seems to be less substantiated. It has been demonstrated that you can transplant very high densities in dense packing (70-80g/cm) with nearly 100% survival. Whilst impressive and possible, it however carries a risk of necrosis, so the risk is not worth it. Many however choose to dense pack up to 50-60g safely, and on a second procedure "touch-up" 10% for more density if needed. I think it is also not substantiated if you can dense pack a large area, without compromising blood supply. 

I have heard Eugenix mention they are comfortable placing grafts if the space is "2mm or more" between hairs, i.e. 25g/cm native density, which could be around where you are. The point is that they WILL be able to feather in grafts into the mid scalp if you wanted to, I have seen many cases of theirs where they have. I have seen hundreds of cases by Dr. Lorenzo on youtube, where he fully restores NW7's back from the grave with 10000 grafts over multiple procedures. It is all based on transplanting between hairs, and between native hairs. You would be surprised what is possible. I think Eugenix often surprises people when they meet them in person, they seem to like to "surprise" you what with is possible. If you want density further back than just the hair line, it is something you should go into the consultation exploring, I would say!

It's really painful getting your flight cancelled twice. Hope this time it works well and you get a successful result. 

Actually, i had a personal consultation with Dr. Arika and she advised not to transplant between the existing hairs. As per my understanding when you have a lot of telogen/miniaturized hairs the risk of permanent shock loss is higher. Honestly, i am ok with my mid scalp density and just need a decent hairline to frame my face and reduce the size of my forehead, crown can be addressed in a 2nd sitting if my donor allows. I checked your profile but couldn't see any pics so maybe your case is different.

BTW, Spain has the best surgeons in the world in my opinion so congrats if you choose Dr. Lorenzo