3001 FUE grafts with Dr Sethi from Eugenix. March 1st to March 3rd.

[Parasol]

@Tony711 Thanks for updating so quickly. I’m happy Dr. Sethi has reached out!

Please keep us updated. It’s very important to know what went wrong here before committing to any future transplants.

[Melvin- Admin]

7 hours ago, Tony711 said:

Hello,

 

Dr Sethi got back to me this morning , he agreed nothing much has improved since last time.  He said to give him time, so he can research it and get back to me. 
 

Meanwhile, I will post the monthly updates. 

I’m glad Dr. Sethi reached out. I do feel like he’s challenged himself taking on your case. I don’t think there’s any other surgeon that would have taken you on as a patient. Given your history of previous hair transplants which failed and thinned out. There may be a physiological cause that doesn’t make you a candidate. I know he prides himself in taking on the most difficult cases, but given your history, this was one that should’ve been declined in my opinion. I propose doing smp. Now that there’s some hair, shaving with smp may be the best option moving forward.

I DO NOT think you should attempt any further surgeries, unless there’s a comprehensive biopsy to rule out any underlying conditions. Even then, I would proceed with caution, a small test would need to be done to ensure the grafts grow. 

[Jackdaniels]

I feel sorry to see this bad result mate. The yield of grafts seems to be quite low , which contributed in a bad outcome… 
Did dr Sethi said any reason why you did not get the expected outcome? 

 

Edited January 6, 2023 by Jackdaniels

[Tony711]

1 hour ago, Parasol said:

@Tony711 Thanks for updating so quickly. I’m happy Dr. Sethi has reached out!

Please keep us updated. It’s very important to know what went wrong here before committing to any future transplants.

Will definitely update.  Thanks!

[Tony711]

1 hour ago, Melvin- Moderator said:

I’m glad Dr. Sethi reached out. I do feel like he’s challenged himself taking on your case. I don’t think there’s any other surgeon that would have taken you on as a patient. Given your history of previous hair transplants which failed and thinned out. There may be a physiological cause that doesn’t make you a candidate. I know he prides himself in taking on the most difficult cases, but given your history, this was one that should’ve been declined in my opinion. I propose doing smp. Now that there’s some hair, shaving with smp may be the best option moving forward.

I DO NOT think you should attempt any further surgeries, unless there’s a comprehensive biopsy to rule out any underlying conditions. Even then, I would proceed with caution, a small test would need to be done to ensure the grafts grow. 

I’m hoping he has a solution.  I have done SMP before but probably won’t go back to that though. 

[Tony711]

21 minutes ago, Jackdaniels said:

I feel sorry to see this bad result mate. The yield of grafts seems to be quite low , which contributed in a bad outcome… 
Did dr Sethi said any reason why you did not get the expected outcome? 

 

He hasn’t said anything yet. He said he will research and let me know. 

[Melvin- Admin]

7 minutes ago, Tony711 said:

I’m hoping he has a solution.  I have done SMP before but probably won’t go back to that though. 

First a biopsy is required. If you’re cleared, then I would start on some antiandrogens for 6 months, because it’s clear your donor is thinning, which means the transplant will thin. If you’re able to thicken the donor then maybe you can consider surgery again. 
 

The most important thing are the expectations. I honestly don’t believe you’ll get much better than @BeHappy who has used mostly BHT in small sessions. You have to really think if it’s worth it to you. Dr. Sethi is a great doctor and very caring, so I’m sure he’ll find a solution that you’ll be happy with. That said, he does have a tendency to push himself and try and achieve the impossible, but sometimes it’s not possible. As a patient, you need to really think about what’s realistic and what would satisfy you.

 

[Berba11]

@Tony711,

I'd definitely pay great attention to @Melvin- Moderator's careful thoughts here. You need to first check there's no underlying issues causing the graft yield to be less than the initial post-op work seemed to show.

That said, this was a very ambitious attempt, and I'd have been quite surprised to see 2500 beard grafts and only 500 scalp grafts produce a decent density.

Lastly though... You just look like a bloke that has thinned out, balding hair. It's not a total disaster aesthetically speaking by any means, albeit I accept it's not where you wanted things to be.

[Tony711]

1 hour ago, Melvin- Moderator said:

First a biopsy is required. If you’re cleared, then I would start on some antiandrogens for 6 months, because it’s clear your donor is thinning, which means the transplant will thin. If you’re able to thicken the donor then maybe you can consider surgery again. 
 

The most important thing are the expectations. I honestly don’t believe you’ll get much better than @BeHappy who has used mostly BHT in small sessions. You have to really think if it’s worth it to you. Dr. Sethi is a great doctor and very caring, so I’m sure he’ll find a solution that you’ll be happy with. That said, he does have a tendency to push himself and try and achieve the impossible, but sometimes it’s not possible. As a patient, you need to really think about what’s realistic and what would satisfy you.

 

Will definitely look into a biopsy and antiandrogens.  Thanks!

[Tony711]

1 hour ago, Melvin- Moderator said:

First a biopsy is required. If you’re cleared, then I would start on some antiandrogens for 6 months, because it’s clear your donor is thinning, which means the transplant will thin. If you’re able to thicken the donor then maybe you can consider surgery again. 
 

The most important thing are the expectations. I honestly don’t believe you’ll get much better than @BeHappy who has used mostly BHT in small sessions. You have to really think if it’s worth it to you. Dr. Sethi is a great doctor and very caring, so I’m sure he’ll find a solution that you’ll be happy with. That said, he does have a tendency to push himself and try and achieve the impossible, but sometimes it’s not possible. As a patient, you need to really think about what’s realistic and what would satisfy you.

 

Are there any antiandrogens you recommend? I wasn’t sure if they sell on Amazon or not? 

[Melvin- Admin]

12 minutes ago, Tony711 said:

Are there any antiandrogens you recommend? I wasn’t sure if they sell on Amazon or not? 

I’m using xyon it’s a topical gel. They’re gonna be releasing dutasteride in a few months. I would recommend that, it’s the strongest anti androgen. It also doesn’t go as systemic. So less sides.

[Gramatik]

22 minutes ago, Tony711 said:

Are there any antiandrogens you recommend? I wasn’t sure if they sell on Amazon or not? 

Most of your transplanted grafts were from beard (2500 grafts from beard, 500 from scalp), which are not affected by DHT..so i dont understand how antiandrogens would help in your case.Beard grafts are not affected by DHT, and they are safe zone, so finasteride, dutasteride will not help...

Anyway in any case now its a bit late for a hair loss therapy...you should have taken it at least 6 months before the surgery.

Edited January 7, 2023 by Gramatik

[Tony711]

12 minutes ago, Melvin- Moderator said:

I’m using xyon it’s a topical gel. They’re gonna be releasing dutasteride in a few months. I would recommend that, it’s the strongest anti androgen. It also doesn’t go as systemic. So less sides.

Thanks! Will look into.  Will probably see my doctor and go on Dutasteride for now. 

[Tony711]

10 minutes ago, Gramatik said:

Most of your transplanted grafts were from beard (2500 grafts from beard, 500 from scalp), which are not affected by DHT..so i dont understand how antiandrogens would help in your case.Beard grafts are not affected by DHT, and they are safe zone, so finasteride, dutasteride will not help...

Anyway in any case now its a bit late for a hair loss therapy...you should have taken it at least 6 months before the surgery.

That’s true about the beard hair, so I guess I can forget about antiandrogens. 
 

Thanks!

[Z--]

I completely agree with Gramatik. It's weird people are blaming you for not taking anti-androgens or claiming that your donor is thinning. Given that they were beard grafts taken, those ought to have grown in without those two being factors.

Yes, you should do a biopsy, but if you're cleared, then that indicates a failure on the doctor's end -- not yours and you should receive a 100% repair at no cost or a refund. If the biopsy reveals an underlying scalp condition, that's another issue and you should focus on that first.

[Tony711]

4 hours ago, Z-- said:

I completely agree with Gramatik. It's weird people are blaming you for not taking anti-androgens or claiming that your donor is thinning. Given that they were beard grafts taken, those ought to have grown in without those two being factors.

Yes, you should do a biopsy, but if you're cleared, then that indicates a failure on the doctor's end -- not yours and you should receive a 100% repair at no cost or a refund. If the biopsy reveals an underlying scalp condition, that's another issue and you should focus on that first.

I noticed the scalp hair that was transplanted around the hairline they grew out perfectly, it’s the beard hair which seems to come out but not growing.   

[Melvin- Admin]

7 hours ago, Z-- said:

I completely agree with Gramatik. It's weird people are blaming you for not taking anti-androgens or claiming that your donor is thinning. Given that they were beard grafts taken, those ought to have grown in without those two being factors.

Yes, you should do a biopsy, but if you're cleared, then that indicates a failure on the doctor's end -- not yours and you should receive a 100% repair at no cost or a refund. If the biopsy reveals an underlying scalp condition, that's another issue and you should focus on that first.

I'm not blaming him for not taking anti-androgens. You're taking what i'm saying out of context. Tony isn't to blame at all. What i'm saying is that he shouldn't get any additional surgeries/repairs, unless he has a biopsy and gets on antiandrogen for at least 6 months to see if his donor gets better. If you look at his photos it appears that his donor is affected by DHT. Again, in my opinion, he should have been denied for surgery (definitely not his fault).

I agree with the last part, except he should not get any additional surgery unless he is cleared for underlying conditions, and he should get on some sort of antiandrogen to see if his donor can improve. Otherwise, a repair in my opinion is not a good solution.

[Z--]

1 hour ago, Melvin- Moderator said:

I'm not blaming him for not taking anti-androgens. You're taking what i'm saying out of context. Tony isn't to blame at all. What i'm saying is that he shouldn't get any additional surgeries/repairs, unless he has a biopsy and gets on antiandrogen for at least 6 months to see if his donor gets better. If you look at his photos it appears that his donor is affected by DHT. Again, in my opinion, he should have been denied for surgery (definitely not his fault).

I agree with the last part, except he should not get any additional surgery unless he is cleared for underlying conditions, and he should get on some sort of antiandrogen to see if his donor can improve. Otherwise, a repair in my opinion is not a good solution.

We both agree that there is very, very little growth and the patient is not at fault. Therefore our options are that it’s either an underlying issue (nothing to do but have the patient to fix it) OR the doctor has not succeeded (meaning the onus is on the doctor to provide an equitable solution). 

If a biopsy reveals that his scalp is normal, I’m hopeful that you’ll stand behind the statement that Dr. Sethi ought to provide a repair at no cost or a full refund.

Anything less is disgraceful imo. Every doctor I hold in highest regard has accepted responsibility before 12 months. Konior and Couto, for example, offered repairs at just 6 months of poor growth in recent cases. 

I hope Dr. Sethi provides a follow-up response and solutions soon. I’ll withhold my judgement of his ethics until then.

 

[Melvin- Admin]

If his scalp is normal, then of course a repair free of cost is necessary. There’s no question that Dr. Sethi would do this, he’d probably even put him up at the farmhouse and provide him with food. I have no doubt about that. To me, that’s not the issue. I know Dr. Sethi will do the right thing. 

For me, the issue is surgery. I just don’t believe that’s the right solution. Now, I don’t know what other solutions there are, possibly a combination of things like I’ve mentioned. 

Refunds are not something that I advocate for because there are no money back guarantees. As patients were assuming this risk. The surgery may fail, if it’s within the surgeons control, then they need to repair it free of cost. If it’s outside of their control I would still expect them to treat it and then do a repair. But money back refunds are usually not an option. Of course, that’s something that is always dealt with on a patient to physician basis. 

[Z--]

29 minutes ago, Melvin- Moderator said:

If his scalp is normal, then of course a repair free of cost is necessary. There’s no question that Dr. Sethi would do this, he’d probably even put him up at the farmhouse and provide him with food. I have no doubt about that. To me, that’s not the issue. I know Dr. Sethi will do the right thing. 

For me, the issue is surgery. I just don’t believe that’s the right solution. Now, I don’t know what other solutions there are, possibly a combination of things like I’ve mentioned. 

Refunds are not something that I advocate for because there are no money back guarantees. As patients were assuming this risk. The surgery may fail, if it’s within the surgeons control, then they need to repair it free of cost. If it’s outside of their control I would still expect them to treat it and then do a repair. But money back refunds are usually not an option. Of course, that’s something that is always dealt with on a patient to physician basis. 

I can accept the supposition that surgery may not be the best option. However, if that had been and remains the case, the doctor ought to have rejected the patient or make very clear the limitation of the surgery. 

From Toni’s post above, it seems like the limitations of hair restoration had not been made clear. I consider Sethi’s work as generally exceptional, but if Toni had been a poor candidate from the beginning then Dr. Sethi, as you mentioned, erroneously took the case. 

While I generally support repairs - esp. from ethical doctors - in such instances, I do believe a refund is warranted, especially if follow-up surgery will do more harm than good. 

I rarely ever see Sethi make mistakes or have poor yield (he’s clearly top-tier at Eugenix and worldwide), but how he handles those rare instances will dictate whether I and others consider him ethical going forward. 

[Melvin- Admin]

1 minute ago, Z-- said:

However, if that had been and remains the case, the doctor ought to have rejected the patient or make very clear the limitation of the surgery. 

 

100% he should have been rejected. Dr. Sethi pushes himself and prides himself on taking the toughest cases that no one else will take. But some times the best option is to do nothing. Tony is such a great guy and I want the best for him. It’s an unfortunate situation. Tony were rooting for you, hit me up if you need any help or additional resources.

[davidn]

Just saying @Tony711that I saw a video of you playing the piano when at Eugenix with @Bandit90and thought 'what cool guy' in your situation the options are smp, just doing nothing or Hair system.

 

Edited January 7, 2023 by davidn

[Tony711]

31 minutes ago, Melvin- Moderator said:

100% he should have been rejected. Dr. Sethi pushes himself and prides himself on taking the toughest cases that no one else will take. But some times the best option is to do nothing. Tony is such a great guy and I want the best for him. It’s an unfortunate situation. Tony were rooting for you, hit me up if you need any help or additional resources.

Thanks man.  I went ahead and buzzed the hair to 1  1/2 to even it out. I feel the beard hair still growing so I figure maybe if I buzz it down and even the hair all over eventually it may work out. 
 

I will take some pics tomorrow and post with the buzzed hair. 
 

 

[Tony711]

21 minutes ago, davidn said:

Just saying @Tony711that I saw a video of you playing the piano when at Eugenix with @Bandit90and thought 'what cool guy' in your situation the options are smp, just doing nothing or Hair system.

 

Thank you! It has been years I haven’t played the piano but Dr Sethi wanted me to play.    I have had SMP in the past it works but I probably wouldn’t do it again.  I also had hair system too, from Richard Farrell since he did the Hollywood stars in CA. It’s amazing but the maintenance is just too much. 

[davidn]

4 minutes ago, Tony711 said:

Thank you! It has been years I haven’t played the piano but Dr Sethi wanted me to play.    I have had SMP in the past it works but I probably wouldn’t do it again.  I also had hair system too, from Richard Farrell since he did the Hollywood stars in CA. It’s amazing but the maintenance is just too much. 

What didnt you like about smp?