Eugenix, NW3 5200 + grafts / MazAB's 2nd procedure on 10/8/2022 by Dr Pradeep Sethi

[Gatsby]

Very excited for you Armen! 🙏

[Eugenix Hair Sciences]

8 minutes ago, MazAB said:

So hard to believe that the results will eventually morph into something better than this. I land in Delhi today, and scheduled for my procedure with Dr Pradeep this Sunday the 2nd. Can't wait! I'll update you guys once I get the pre-op / post-op pics.

 

Dear Armen, 

We all are waiting for your arrival at the clinic. Dr. Sethi is full of delight to see you. 
 

[Ryan Daniel]

Stay safe Armen and all the best for round 2 my friend🙏

[NARMAK]

39 minutes ago, MazAB said:

So hard to believe that the results will eventually morph into something better than this. I land in Delhi today, and am scheduled for my 2nd procedure with Dr Pradeep this Sunday the 2nd. Can't wait! I'll update you guys once I get the pre-op / post-op pics.

Good luck on the next stage of your journey Armen! 

I think we're all eager to see how much more amazing your result will end up looking. Step 1 has already on many ways looked to be a resounding success but i very much think you're a lot like me, and you definitely want to chase that pinnacle of outcomes. You've done it once and imo, it's nothing if not going to be easier the 2nd time having been through everything and knowing what to expect. 

[Melvin- Admin]

Good luck armen wishing you the best

[Berba11]

Good luck Armen!

[SLA]

Armen...and the crowd goes wild!

[Parasol]

Congratulations, Armen! Good luck and enjoy your trip!

[Boomerang]

Good luck Armen!

[Gatsby]

Wishing you all the best for tomorrow Armen! 👌

[MazAB]

38 minutes ago, Gatsby said:

Wishing you all the best for tomorrow Armen! 👌

Thanks Adrian! With some scheduling conflicts looks like I'll be going on the 3rd.

[GeneralNorwood]

I am curious about new desing  How much did you lower your hairline?

[MazAB]

Hello there @GeneralNorwood, thanks for checking in! I'm currently scheduled for surgery this Thursday. However I did already meet with Dr Pradeep for the planning session. I was inspired by the hairline of Ajit, aka @TheBoy, that was performed by @Eugenix Hair Sciencesand wanted to see if the Dr could replicate a version of that to be fitting and framing to my face. He really took his time with it, and absolutely love how it turned out. I don't have the digital shots unfortunately, but did take my own pictures of the printouts. The quality is bad, but you get the idea. Would love to know what you think...

[NARMAK]

1 hour ago, MazAB said:

Hello there @GeneralNorwood, thanks for checking in! I'm currently scheduled for surgery this Thursday. However I did already meet with Dr Pradeep for the planning session. I was inspired by the hairline of Ajit, aka @TheBoy, that was performed by @Eugenix Hair Sciencesand wanted to see if the Dr could replicate a version of that to be fitting and framing to my face. He really took his time with it, and absolutely love how it turned out. I don't have the digital shots unfortunately, but did take my own pictures of the printouts. The quality is bad, but you get the idea. Would love to know what you think...

The more V shape with the widows peaks something i thought about, in fact it seems my frontalis muscle is ripe for it just to be specifically lowered there lol, but i thought i would just prefer having it more lower and flatter myself, so it's interesting to see you sort of go for that change with the 2nd procedure. The temple points also seem significantly more emphasised with the new lines too. 

How many grafts did Dr Pradeep say this design would be broken down into temple points and hairline? 

Also, are they going to slightly work behind the hairline again to further reinforce the previous hairline zone? 

Final question cause it seems like i'm on a roll at throwing them at you lol, how come things got delayed so much? I know when i was there, my flights pretty much booked and although the procedure got split over 2 days, i don't think i could've afforded a delay of like 4 days. 

[MazAB]

3 hours ago, NARMAK said:

The more V shape with the widows peaks something i thought about, in fact it seems my frontalis muscle is ripe for it just to be specifically lowered there lol, but i thought i would just prefer having it more lower and flatter myself, so it's interesting to see you sort of go for that change with the 2nd procedure. The temple points also seem significantly more emphasised with the new lines too. 

How many grafts did Dr Pradeep say this design would be broken down into temple points and hairline? 

Also, are they going to slightly work behind the hairline again to further reinforce the previous hairline zone? 

Final question cause it seems like i'm on a roll at throwing them at you lol, how come things got delayed so much? I know when i was there, my flights pretty much booked and although the procedure got split over 2 days, i don't think i could've afforded a delay of like 4 days. 

Hey bro! The main reason for the change. I've always loved the widows peak. I think it gives such a natural appearance that many hairlines form and build out from. Also quite simply put, I think it really has such a cool, kick ass, aesthetic look about it.😎 

Also, without revealing what my hairline preference was, when I asked @Melvin- Moderator what his thoughts were on a hairline redesign, he perfectly described the design I was already thinking. Which made me motivated even more as it confirmed and validated what I knew I wanted for a redesign. Aside from it having a nice aesthetic look to it, Melvin mentioned that it is more age appropriate for me as I'm not bring down the entire hairline a full centimeter and rounding off to the corner temples. Since visually people gauge your hairline at full center, I can form a widows peak coming down at the desired spot, and then taper off on the sides. Makes it more age appropriate from the side angles and even at center view, while also helping to conserve grafts and donor for future use if necessary. And if ultimately, I love how it looks more than the traditional rounded off hairline, it's a win, win all around for me from a design perspective. Thank you @Melvin- Moderator! Your guidance and support is forever appreciated by myself and so many others on this forum.

Dr Pradeep has predicted roughly 2100 grafts plus/minus between extended hairline, temple points, and doubling down on density in existing recipient areas. My first procedure was 2762 plus 2100 should fall me in close to 4800 scalp grafts total between both procedures which is a MEGA TON of grafts considering that my hairloss was not too significant at NW3. This will really help me achieve the goals of having it much denser and a lot thicker all around. In the end, I'll be just fine with a higher graft count in an overall smaller region, as long as I follow one very simple basic rule ~ DON'T LOSE MORE HAIR!!! LOL!🤣

From a scheduling perspective, I never really set a hard date. We did have a date marked as a place holder, but it was set loosely as the Doctor had a number of different commitments. This is a much different trip for me this time around as I'll be traveling and vacationing around India and plan to stay until the 21st, so no real rush. With that said, I believe either Thursday or Friday I should be on the operating table.🙏

Edited October 5, 2022 by MazAB

[NARMAK]

4 hours ago, MazAB said:

Hey bro! The main reason for the change. I've always loved the widows peak. I think it gives such a natural appearance that many hairlines form and build out from. Also quite simply put, I think it really has such a cool, kick ass, aesthetic look about it.😎 

Also, without revealing what my hairline preference was, when I asked @Melvin- Moderator what his thoughts were on a hairline redesign, he perfectly described the design I was already thinking. Which made me motivated even more as it confirmed and validated what I knew I wanted for a redesign. Aside from it having a nice aesthetic look to it, Melvin mentioned that it is more age appropriate for me as I'm not bring down the entire hairline a full centimeter and rounding off to the corner temples. Since visually people gauge your hairline at full center, I can form a widows peak coming down at the desired spot, and then taper off on the sides. Makes it more age appropriate from the side angles and even at center view, while also helping to conserve grafts and donor for future use if necessary. And if ultimately, I love how it looks more than the traditional rounded off hairline, it's a win, win all around for me from a design perspective. Thank you @Melvin- Moderator! Your guidance and support is forever appreciated by myself and so many others on this forum.

Dr Pradeep has predicted roughly 2100 grafts plus/minus between extended hairline, temple points, and doubling down on density in existing recipient areas. My first procedure was 2762 plus 2100 should fall me in close to 4800 scalp grafts total between both procedures which is a MEGA TON of grafts considering that my hairloss was not too significant at NW3. This will really help me achieve the goals of having it much denser and a lot thicker all around. In the end, I'll be just fine with a higher graft count in an overall smaller region, as long as I follow one very simple basic rule ~ DON'T LOSE MORE HAIR!!! LOL!🤣

From a scheduling perspective, I never really set a hard date. We did have a date marked as a place holder, but it was set loosely as the Doctor had a number of different commitments. This is a much different trip for me this time around as I'll be traveling and vacationing around India and plan to stay until the 21st, so no real rush. With that said, I believe either Thursday or Friday I should be on the operating table.🙏

Yeah, i can definitely see the lower middle point as the focus not costing lots of grafts and then lowering down slightly on the corners helping keep it more age friendly. It's always the final look you compare with but does sound like you have given it all proper thought. 

I think as well that given your age, and the hair loss seeming to be stable, spending maybe up to 5k grafts like this to get that hairline, it's probably not as massive a risk as if you were 25 and Norwood 3 with having just recently started medication and losing a little ground. Plus, i believe you are still taking Finasteride so if you wanted, there's still Dutasteride and Minoxodil on the table maybe. 

Definitely looking forwards to the journey. I thought it seems like it would be easier when people look at people who are a lower Norwood like 2 or 3 when getting it done, but it doesn't work like that at all imo. Unless it's super small, it's definitely something we notice and psychologically end up going through that journey. The good thing for yourself is that you now know from that first time  "Oh, this is normal, it happened before" and can adjust mentally better to those tough times you went through. Not even Melvin managed to do it perfectly as that's human nature, but it's definitely going to stand you well. 

Enjoy the trip in India! Wish that i could have done something similar myself, but er... politics huh.

 

[MazAB]

Current regimen:

Finasteride 1mg - 6x per week

Dutasteride 0.5mg - 1x per week

Topical Minoxidil 5% - once daily

Microneedling 1.25mm - 1x weekly

Low Level Light Therapy - 4x per week - 15 minute sessions

Tons of supplements good for body and hair - previously mentioned in my thread

Strict diet, HIIT and Resistance workouts

Hormetic Stressors - Fasting / Cold and Heat therapy

 

[NARMAK]

1 hour ago, MazAB said:

Current regimen:

Finasteride 1mg - 6x per week

Dutasteride 0.5mg - 1x per week

Topical Minoxidil 5% - once daily

Microneedling 1.25mm - 1x weekly

Low Level Light Therapy - 4x per week - 15 minute sessions

Tons of supplements good for body and hair - previously mentioned in my thread

Strict diet, HIIT and Resistance workouts

Hormetic Stressors - Fasting / Cold and Heat therapy

 

Honestly, didn't even realise you were taking more than Finasteride in terms of core treatments. I thought the rest was Vitamin supplements etc. 

Thanks for sharing. So you definitely do have more than enough scope to fully switch over to Dutasteride or increase the dosage where necessary. Heck, even the Minoxodil i think you could on that dosage do 2x a day right? 

So yeah, you're definitely leaving yourself room for if you start slipping. The other thing is that we may get treatments like Pyrilutamide which if it works by severing the receptors on the scalps DHT ability to bind, then you could even probably stay with Finasteride and still benefit from a solid response. 

Well, i am definitely looking forwards to seeing your new journey Armen whilst slowly but surely getting towards the end of my own first stage. 

[MazAB]

42 minutes ago, NARMAK said:

Honestly, didn't even realise you were taking more than Finasteride in terms of core treatments. I thought the rest was Vitamin supplements etc. 

Thanks for sharing. So you definitely do have more than enough scope to fully switch over to Dutasteride or increase the dosage where necessary. Heck, even the Minoxodil i think you could on that dosage do 2x a day right? 

So yeah, you're definitely leaving yourself room for if you start slipping. The other thing is that we may get treatments like Pyrilutamide which if it works by severing the receptors on the scalps DHT ability to bind, then you could even probably stay with Finasteride and still benefit from a solid response. 

Well, i am definitely looking forwards to seeing your new journey Armen whilst slowly but surely getting towards the end of my own first stage. 

Absolutely what you say is exactly my plan! Wanted to see how well I tolerated Dut first before moving on to 2x weekly. Not sure about 2x per day minoxidil only because my scalp gets really itchy and flaky when I over do it, and I'm also seeing better results combining the microneedling. I should also add that once per week, about 12 hours after microneedling, I do apply minoxidil twice that day for high absorption.

Counting the days down for Kintor Pharma's Pyrilutamide! Once it finishes all the trials and is officially approved, I will absolutely add to the arsenal of treatments. I'll keep on the good fight with Fin and Dut and Pyrilutamide will be layered on top of both of them since it has a completely different mechanism of action blocking the androgen receptors instead of DHT. If you do all that and still lose your hair, you would at least die knowing you've done absolutely everything possible to not lose your hair! 😉

Edited October 5, 2022 by MazAB

[NARMAK]

11 minutes ago, MazAB said:

Absolutely what you say is exactly my plan! Wanted to see how well I tolerated Dut first before moving on to 2x weekly. Not sure about 2x per day minoxidil only because my scalp gets really itchy and flaky when I over do it, and I'm also seeing better results combining the microneedling. I should also add that once per week, about 12 hours after microneedling, I do apply minoxidil twice that day for high absorption.

Counting the days down for Kintor Pharma's Pyrilutamide! Once it finishes all the trials and is officially approved, I will absolutely add to the arsenal of treatments. I'll keep on the good fight with Fin and Dut and Pyrilutamide will be layered on top of both of them since it has a completely different mechanism of action blocking the androgen receptors instead of DHT. If you do all that and still lose your hair, you would at least die knowing you've done absolutely everything possible to not lose your hair! 😉

Yeah, 100%. I think your story and many others show us this isn't a one and done battle, but a long term plan and fight for as long as you want to keep your hair. 

The new treatment hopefully not being expensive should help bring more firepower to the table. Especially for those not able to tolerate DHT inhibiting medication or those who suffer really aggressive hair loss when younger. I'm excited to see it help as many as possible. 

I know it's a HT thread, but do keep us updated in small part how you felt this trip to India was different to the first time and what sort of stuff you get up to

[LookMaxx]

2 hours ago, MazAB said:

Current regimen:

Finasteride 1mg - 6x per week

Dutasteride 0.5mg - 1x per week

Never understood why people do this. Taking finasteride with dutasteride is redundant. Dut blocks both types of enzymes more effectively causing massive reduction in DHT. Finasteride wouldn’t have any enzyme to bind to and just circulate looking for some.

Then there’s the half life. Both drugs have extremely long half lives. Dutasteride has insanely long half life which increases with age. 3 to 5 weeks!. Then there’s dosing. Finasteride takes 2 days to get out of bloodstream and 1mg has approximately the same suppression as 0.5mg. 1mg/day is high dose for hairloss, to combine that with 0.5mg dutasteride. Sheesh…that’s massive. 

I understand wanting to suppress DHT but it just doesn’t make sense to load up on medicine like this when less dose and lesser frequent dosing achieves equal efficiency. 0.5mg dutasteride once two weeks will be more than effective, can push it to once per month or 3 months because dutasteride just doesn’t leave the system easily. Or finasteride alone at 1mg/day is sufficient. I use 0.2-0.5mg fin twice or thrice a week depending on when I remember.

On the other end of spectrum you have the PFS crazies who are insistent on making finasteride the devil drug. Convinced it shrinks penis size, making ass numb, makes you impotent and forever changes your genetic makeup to the point you will commit suicide to escape it. If you deny any of this, you are lying. And every doctor who thinks PFS is made up BS is a liar paid by big pharma.

I find this really amazing. The two extremes. I don’t think DHT levels need to be reduced to eunuch levels for hairloss to stabilise ie completely zero. Neither does lack of DHT causes hair to grow, the best you can achieve is stabilisation and reversal of miniaturisation. Minoxidil is the only thing that can regrow hairs and that’s more important. There are people who take min alone with good efficiency, combining that with fin is the gold standard. There’s also reduction in prostate size, if you completely nuke DHT it will shrink prostate size massively I imagine and I don’t know if that’s really what you want as a healthy man. 

I understand the logic behind it ( DHT suppression) but it just feels redundant to medicate so much with little benefit when the same could be achieved with less medication and more freedom.

[MazAB]

30 minutes ago, LookMaxx said:

Never understood why people do this. Taking finasteride with dutasteride is redundant. Dut blocks both types of enzymes more effectively causing massive reduction in DHT. Finasteride wouldn’t have any enzyme to bind to and just circulate looking for some.

Then there’s the half life. Both drugs have extremely long half lives. Dutasteride has insanely long half life which increases with age. 3 to 5 weeks!. Then there’s dosing. Finasteride takes 2 days to get out of bloodstream and 1mg has approximately the same suppression as 0.5mg. 1mg/day is high dose for hairloss, to combine that with 0.5mg dutasteride. Sheesh…that’s massive. 

I understand wanting to suppress DHT but it just doesn’t make sense to load up on medicine like this when less dose and lesser frequent dosing achieves equal efficiency. 0.5mg dutasteride once two weeks will be more than effective, can push it to once per month or 3 months because dutasteride just doesn’t leave the system easily. Or finasteride alone at 1mg/day is sufficient. I use 0.2-0.5mg fin twice or thrice a week depending on when I remember.

On the other end of spectrum you have the PFS crazies who are insistent on making finasteride the devil drug. Convinced it shrinks penis size, making ass numb, makes you impotent and forever changes your genetic makeup to the point you will commit suicide to escape it. If you deny any of this, you are lying. And every doctor who thinks PFS is made up BS is a liar paid by big pharma.

I find this really amazing. The two extremes. I don’t think DHT levels need to be reduced to eunuch levels for hairloss to stabilise ie completely zero. Neither does lack of DHT causes hair to grow, the best you can achieve is stabilisation and reversal of miniaturisation. Minoxidil is the only thing that can regrow hairs and that’s more important. There are people who take min alone with good efficiency, combining that with fin is the gold standard. There’s also reduction in prostate size, if you completely nuke DHT it will shrink prostate size massively I imagine and I don’t know if that’s really what you want as a healthy man. 

I understand the logic behind it ( DHT suppression) but it just feels redundant to medicate so much with little benefit when the same could be achieved with less medication and more freedom.

Thanks for the advice. Food for thought for sure. My thought process for my own dosage mainly is that I've been taking Fin for over 26 years. 1mg daily has been an everyday drug with no days missed for that long. No issues ever, so the Dut I decided on as an added insurance policy to block both Isoenzymes. Is it overkill? Probably, but even over the 26 years on Fin my hair did slightly miniaturize and recede. That could just be aging, but once a week Dutasteride has not been an issue. May stick with 1 time a week after reading your comments though. 

Forgot to add also that I'm likely to reduce both Finasteride and Dutasteride doses once Pyrilutamide hits the market. It'll be a game changer for sure and will set my mind at ease so I'm not overdoing it with suppression of DHT. Again thanks for the advice on that point.

Edited October 5, 2022 by MazAB

[LookMaxx]

1 hour ago, MazAB said:

Thanks for the advice. Food for thought for sure. My thought process for my own dosage mainly is that I've been taking Fin for over 26 years. 1mg daily has been an everyday drug with no days missed for that long. No issues ever, so the Dut I decided on as an added insurance policy to block both Isoenzymes. Is it overkill? Probably, but even over the 26 years on Fin my hair did slightly miniaturize and recede. That could just be aging, but once a week Dutasteride has not been an issue. May stick with 1 time a week after reading your comments though. 

Forgot to add also that I'm likely to reduce both Finasteride and Dutasteride doses once Pyrilutamide hits the market. It'll be a game changer for sure and will set my mind at ease so I'm not overdoing it with suppression of DHT. Again thanks for the advice on that point.

I was surprised to see you take such extreme measures because you have a full head of hair and nobody can confuse you for balding. In your 40s you can chill and enjoy the hairs 😄. The protocol you’re using is something someone in their 20s should use destined for early path to NW7 with really aggressive hairloss but even then it might be overkill. Fin is no joke and dut is like a nuke for DHT completely obliterating it. 

Yeah pyrilutamide will be interesting.

[Mountinvan]

I thought taking Fin and Dut as a combo was a non-no---but dug a little deeper from hairlosscure2020:

Finasteride and Low-Dose Dutasteride Combination Treatment

March 4, 2019 admin 125 Comments

Almost anyone who takes 5α-reductase inhibitors to reduce dihydrotestosterone levels (and treat hair loss) chooses either:

1. Finasteride (1 mg/day; brand name Propecia). Or,
2. Dutasteride (0.5mg/day; brand name Avodart).

I have discussed the dosage and efficacy of both Finasteride and Dutasteride in lengthy detail in the past. Most people take either 1mg Finasteride per day or 0.5mg Dutasteride per day to treat their hair loss.

While Dutasteride inhibits all three isoforms of 5α-reductase (types I, II, and III), Finasteride only inhibits the type II and III isoforms of the enzyme. Dutasteride inhibits a significantly greater percentage of dihydrotestosterone (DHT) in comparison to Finasteride.

Taking Both Finasteride and Dutasteride to Treat Hair Loss

A few years ago, one of this blog’s frequent commentators mentioned taking Finasteride for six days a week and the much stronger Dutasteride for one day a week. This would theoretically limit the side effects from taking the much more potent Dutasteride for all seven days of the week.

I blew off this idea as pointless, since Dutasteride by itself has such a long 5-week half-life (Finasteride has a 6-hr or so half-life). So one might as well just take Dutasteride once or twice a week and completely ignore taking Finasteride to keep things simple. In fact I myself have been taking 0.5mg Dutasteride every two days rather than daily for a couple of years now.

However, a short time after the above commentator made the suggestion, another blog reader made the following comment:

Dan
DECEMBER 8, 2016 AT 2:58 PM

Hi,

I have just been advised by a hair transplant surgeon, that if you combine 1mg finasteride daily with 0.5mg dutasteride once a week, you can expect regrowth. He learnt this from a recent conference he attended. A hair specialist presented a paper which showed good results from combining finasteride regularly with just one capsule of dutasteride per week on top. I’m yet to try this, but am willing to give it a go and just stop the dutasteride if there is no change or bad side effects.

And then yet again, someone else made the below comment last year:

Tom
FEBRUARY 8, 2018 AT 6:20 AM

I had been on Propecia alone for 15 years. Noticed hair started to thin again in 2016. Added Avodart in Jan 2017 and I can honestly say my hair is better and thicker than all the years on just Propecia. I take Propecia every day and one 0.5 Avodart once a week. Never had any sides at all. I did have a shed when I added the Avodart, but stick with it and within about 4 months I could feel and see new hairs. My hairline is better than I can remember. It has taken one full year of this dosage to fully appreciate just how effective it has been. I will continue until things change and then reassess, but hopefully that won’t be for a very long time.

Combination Therapy: Finasteride and Low-Dose Dutasteride

While doing research for this post, I came across a 2013 study from Australia that found combination treatment on one male patient quite effective. Finasteride by itself was not working for him, but adding 0.5 mg Dutasteride once per week drastically improved the hair growth results. Before and after photos can be seen in the study.

Edited October 5, 2022 by Mountinvan

[ZeeMan]

4 hours ago, MazAB said:

Current regimen:

Finasteride 1mg - 6x per week

Dutasteride 0.5mg - 1x per week

Topical Minoxidil 5% - once daily

Microneedling 1.25mm - 1x weekly

Low Level Light Therapy - 4x per week - 15 minute sessions

Tons of supplements good for body and hair - previously mentioned in my thread

Strict diet, HIIT and Resistance workouts

Hormetic Stressors - Fasting / Cold and Heat therapy

 

Hey @MazAB The new hair line plan looks amazing, all the best with the procedure! I'll be in Delhi next month for my HT. What do you use for LLLT? I've been using the LaserCap - 30 min alternate days.