Unhappy with Eugenix transplant

[asterix0]

It is right to point out that unfortunately, repair patients are more difficult cases than first timers. Your scalp is damaged from previous transplants, people assume it is only the donor that is compromised. Not so, the recipient can be as well, which is a sad truth and further reason to get it right the first time. 

OP I sympathize with you, I hope you find the right solution to get the result you want. I also think the clinic acted fairly here and it is not necessarily there fault as to what your outcome turned out to be.

Edited March 5, 2022 by asterix0

[NARMAK]

1 hour ago, asterix0 said:

It is right to point out that unfortunately, repair patients are more difficult cases than first timers. Your scalp is damaged from previous transplants, people assume it is only the donor that is compromised. Not so, the recipient can be as well, which is a sad truth and further reason to get it right the first time. 

OP I sympathize with you, I hope you find the right solution to get the result you want. I also think the clinic acted fairly here and it is not necessarily there fault as to what your outcome turned out to be.

It's definitely not unfair to point out repairs are harder. There certainly are big limitations that can come with a repair case and there's probably a lot of respected members on here to attest to that. 

I just think its unfortunate all around here but i'm hopeful OP can hopefully get a positive resolution and i do hope we all as a community can learn from cases like these. 

I think @Melvin- Moderatoris fair in highlighting the limitations of hair transplants whether on a virgin scalp or even a repair case moreso, but i'm sure we can respectfully differ in our assessments of the case for OP and perhaps how the situation may have unfolded between the two parties without an attribution of blame. Because at the end of the day, i don't think this is about blaming anybody. I think it's an educational moment for us as a community.

Hopefully OP receives an outcome they can be happy with and Eugenix will be able to assist in that with whatever ways they are fairly able to offer as the clinic within their power. I think that is a balanced view to take here for all viewing this thread and hopefully happens. 

[AJ_HT]

8 hours ago, Melvin- Moderator said:

Dear Community,

I have spoken to the clinic in great detail, including Dr. Priyadarshini and Dr. Sethi, regarding this patients case. The patient went in for a repair on December 2020, after having a poor result at a low-cost clinic. The patient was a difficult case, with fine hair, a compromised donor area, and diffuse thinning. At the time of the first procedure, the clinic planned a strategy of focusing primary density in the frontal hairline, moving upward with lower density towards the midscalp. The patient was satisfied and agreed with this strategy. The clinic planned for 2,500 grafts because that is what they felt they could extract from his compromised donor. The patient later complained that this was a miscalculation, but that is what could be extracted from his donor without overharvesting. After 7 months of his first procedure, the patient began complaining about the density in his midscalp. The patient advised the clinic that he was satisfied with the front, but was concerned about the midscalp- this was proven via text messages which were shared to me. 

The patient returned to the clinic in August 2021, for a free touch-up to the midscalp, even though the main area that was treated was the hairline and not the midscalp. At the time of the touch-up, the patient did not mention being dissatisfied with the frontal zone. His main concern was the midscalp. The clinic performed a free touch-up and treated the area where he requested additional density. 

The clinic has shared the photos below, which indeed show a satisfactory repair to the hairline. Furthermore, they have advised me that they last spoke to the patient in December, in which, they asked him to return to the clinic for an assessment, but he declined, as he did not have the time. He was to contact them back to schedule a time to return, which was not done. The clinic contacted him again on March 2nd, but he didn't respond.

Moreover, at the time of the touch-up, the patient refused to sign the consent form, which specified that results cannot be guaranteed and that multiple procedures may be required to achieve desired density. The patient only signed the consent for surgery.

My Thoughts

After hearing the details of what transpired, I believe the clinic acted fairly, and, in my opinion, offered a free touch-up to an area which wasn't the primary focus from the start. The patient has not shared any photos of his midscalp, which was the area that was treated for free the second time. It appears he now wants another free touch-up to the hairline, but failed to mention any dissatisfaction during his free touch-up. Moreover, It's hard to judge photos taken in different lighting and angles because it's not a true comparison.  In conclusion, I think this is just a case of needing additional surgeries due to the fact of having progressive hair loss and fine hair. I don't believe any patient should expect a clinic to continually perform free touch-ups when one- they did not specify this during their 'free touch-up' and two, knowing that a repair will not achieve perfect density for various reasons, including scarring, decreased blood flow, and in this patients case, having fine hair. 

@Melvin- Moderator I appreciate you talking to the clinic for this. But while earlier I thought this was an honest mistake on the clinic's part, it's saddening to see this response from Eugenix, because your post seems to be putting the blame on me for having unrealistic expectations, when that was truly not the case. The facts being represented here are incorrect.

Let me put my points here. And I didn't want to get into this kind of blame game, but it's not fair to blame me for having realistic expectations.

I'm going to try and be as detailed as possible, so please read this through.

Firstly, when I had my call with Dr Sethi 3 months ago, the Mumbai team was to coordinate with me when Dr Sethi was in Mumbai, to fix up an appointment. I had told them that I'm not sure if I want to opt for another procedure (which I have constantly been saying here). But I was never supposed to reach out and follow up.

Secondly, the clinic told you that the midscalp was not the focus of the surgery, and I'd say that's wrong. It was clearly told to me that my frontal AND midscalp would be covered in 2000-2500 grafts. I repeatedly asked Dr Priyadarshini if my midscalp would be covered during the consult, and she said yes. Melvin, since you spoke of text messages, here are some chats I had with Eugenix before my first surgery, that say what I could expect.

This clearly mentions that the frontal and mid-scalp can be covered, but the crown cannot. Now, is it wrong to expect the mid-scalp to be covered when I was explicitly told that the mid-scalp would be covered? I don't think so.

Thirdly, I have been saying this constantly, that I was in month 8 when I went for a touch-up, and back then I was satisfied with my density for month 8. I chose to trust that the doctors have done a good job and it will grow by month 12, so I didn't take this up. In fact, even after the call with Dr Sethi and their team 3 months ago, I waited till month 15 to see if there's any improvement, and only after that I posted this thread yesterday. At one end, we say we should have patience, and at the other end, doctors expect us to tell them if they have complaints in the 8th month itself? What should we, as patients actually do? Trust the doctor or not?

In fact, it's a good thing that you posted these pictures. You can see yourself in this image that the center portion has lower density than the sides - something that didn't bother me back then because I thought it'll improve, but it didn't improve much. So this isn't a case of progressive hair loss either, it's how the density was (also, I'm on finasteride ever since the surgery and my hairfall has stopped now)

 

Sigh, I'm just saddened by the fact that there is so much that I have to say and show, to defend my stance here 😞 

Lastly, you spoke of a consent form. And I didn't want to bring this up in my original post because it would show the clinic in a bad light. But now that you mention it, the form I was asked to sign before the touch-up, wasn't just a consent form. It asked me to sign on a paper which said that I'm happy with the results of my first surgery with Eugenix, and going forward, I will not post my pictures anywhere.

Now here's my question - why will any patient, who is unhappy with their first surgery, sign a form that says that they are happy with it? And why will a good clinic explicitly ask the client not to upload their pictures on social media?

I still have that document with me, which I didn't sign because I thought it was unreasonable. @Melvin- Moderator let me ask you or any other member here - while getting a touch-up, would you sign a document that mentions you are happy with the first procedure, when in fact you are not?

I'm glad I didn't sign it, else I would not be able to post this today.

Blaming the patient's expectations and showing him in a bad light, when the expectations were actually what was committed to him, is really unfair. It just makes me feel hopeless about how the hair restoration industry works. Sure, this may be a one-off case, but this isn't the kind of explanation I would expect from the clinic even for a one-off case. And now, there's even more reason for me to not go there for a free touch-up if they offer one. It's just disheartening!

[AJ_HT]

7 hours ago, Egy said:

excuse me, but why didn't the clinic decide to take follicular units from the beard as well, given that his donor area was compromised and according to them he could only provide 2500 u.f.?  I seem to have understood that Eugenix's surgeons are good in the extraction and implantation of beard grafts and in some cases, such as that of @Gatsby. they have also taken from other parts of the body.

That's exactly my point. If they say that the scalp donor area was insufficient, why take only 300 grafts from the beard? They could have taken more, had the requirement been more. But they quoted a REQUIREMENT of 2500 grafts.

It's one thing to say that we need 4000 grafts to cover your head but we can extract only 2500 from your scalp. It's another thing to say that we need only 2500 grafts for your head. I was told the latter.

9 hours ago, NARMAK said:

Hey Melvin, 

Whilst i appreciate you taking the time to go to the clinic and find all the information. 

My only concern is that the patients frontal hairline density which is even what you say was focused on doesn't seem to have yielded an acceptable result. 

The OP even stated he never mentioned the frontal hairline because he was 8 months post-op and still awaiting final results for the frontal hairline to mature which is a fair comment and reasonable for a patient. Even you would have to agree a patient can grow and mature over 4 months from 8-12 which would be unreasonable to sometimes complain within for a late grower. Even your own YouTube video mentioned people going from 9 months to 12 months results which looked worlds apart. 

A patient not signing a paper that makes them agree legally that they should expect a sub par result as a possibility shouldn't even be used as a point. No clinic in the world should make a patient sign such a thing imo and a clinic should be taking every care to ensure a positive outcome. I understand the patient was a repair case and of course there's risk with that, but Eugenix have been knocking it out the park. 

All your post imo has done so far is reinforce via clinic pictures that the before and after still show a lack of density in the frontal hairline. 

Eugenix are building a reputation on repair cases and in the interest of fairness to OP, i do not feel he is saying anything derogatory about clinic negligence or anything like that. Merely that the result of the procedures and the touch up did not match with what the expectations were perhaps set by the clinic as a desired outcome for him. 

If the clinic felt 2500 grafts was the maximum grafts possible to extract, i do now wonder whether the conversations had with OP adequately explained the outcome. Even the before picture you posted shows a band around the front almost 1cm in front of the area. I'm unsure why Eugenix didn't look to reinforce the existing hairline, refining it and then midscalp as we've seen them do so many times before.

I think there's factors at play on both sides but right now, i feel OP is here for support and a resolution and we should try help him here as that's what this community was founded on the principles of. I appreciate Eugenix is favoured on here and many members have had great results. Heck, i'm planned to have a procedure with them for that very reason, because i believe they are on balance generally great.

However, right now OP needs a little bit of help and i think we can maybe try bridge things a bit and see what we can do with you connecting to Eugenix and maybe as a community getting to the heart of the matter. 

They say truth is like a coin. You have two sides. 

Your doubts are legitimate. There was no conversation which said that since only 2500 grafts can be extracted, so I can't expect great density. I was told that I NEED 2500 grafts which can more or less be extracted from the donor. Like I said earlier, there's a difference between saying I need 4000 grafts but only 2500 can be extracted, and saying that I need 2500 grafts. I was told the latter.

5 hours ago, asterix0 said:

It is right to point out that unfortunately, repair patients are more difficult cases than first timers. Your scalp is damaged from previous transplants, people assume it is only the donor that is compromised. Not so, the recipient can be as well, which is a sad truth and further reason to get it right the first time. 

OP I sympathize with you, I hope you find the right solution to get the result you want. I also think the clinic acted fairly here and it is not necessarily there fault as to what your outcome turned out to be.

But isn't it a good clinic's responsibility to tell the patient that scarring can make it difficult to achieve good results? And if we assume that this is because of scarring and previous scalp damage, how will a touch-up help in any way? Especially when this will be the third surgery in the frontal region?

8 hours ago, Melvin- Moderator said:

I disagree, I think the hairline grew in well for the number of grafts transplanted. Again, 2,500 grafts to cover half of the scalp isn’t going to yield miraculous density, especially with fine hair- this is the reality of surgery. Anyone who undergoes surgery should understand the reality. 

You cannot expect the clinic to provide more density than what they transplant. The issue here is that given his compromised donor, this is what could be extracted. OP is upset and feels this was a miscalculation, but in reality, this is what could be extracted in one sitting without over harvesting. 

What should be expected from the clinic is to yield the hairs that were transplanted. I do believe that the 2,500 grafts grew well, or as well as they could on a scarred scalp. But, even so, the clinic did offer a free touch-up, in which the patient himself stated he was satisfied with the front. So, should the clinic continually perform free touch-ups when the patient states they are dissatisfied? I don’t believe that is fair, nor do I believe any clinic should operate that way. The clinic offered to see the patient in the office and count the hairs that were transplanted, if any hairs of the initial 2,500 grafts that were paid for did not grow, they have stated they would replace them. I feel that is more than fair. 
 

Again, OP states there has been no contact, but he was supposed to call to schedule an in-person visit, and did not return their call on March 2nd, indeed there are two sides to every story, which is why I provided the clinics side, as we have already heard OP’s. 

Also, we have yet to see the midscalp, which was where he had the touch-up, and he is 7 months from the procedure. These are the facts we have. 

@Melvin- Moderator how do you assume that the reality was a compromised donor, and not miscalculation? You've heard both sides of the story, but it's unfortunate that you say that the clinic is right in their claim, and I'm wrong. I have posted another comment with relevant pictures. Hope you have a look at it and come to a conclusion.

8 hours ago, AA1989 said:

There seems to be a fundamental difference of opinion/misunderstand.

Can we see photos see photos of the donor pre and post surgery?

I can post images of the donor, but like someone rightly mentioned, we can't comment on the donor availability by looking at pictures. Doctors can't even give an assurance before shaving the donor, and understandably so. So I highly doubt pictures will help. Happy to share them though, if needed.

 

6 hours ago, SadMan2021 said:

I would not go back for a 3rd procedure at the same clinic that had previously provided 2 unsatisfactory results.

 

 

Thankfully you understand how it feels.

[AJ_HT]

7 hours ago, AA1989 said:

@AJ_HT Can you clarify, do you want another free touch-up as Melvin suggested? If so, why have you not responded/returned to the clinic? This position seems at odds.

If you are not looking for any additional free work,

What do you feel the clinic could have done differently?

What would be a satisfactory outcome to this thread?

@AJ_HT I want to say it takes a lot of courage to present your case and listen to feedback. While you are unhappy with the results, you have made progress.  If you have additional donor capacity, you have options for the future.

Like I said, after having 2 procedures there and still unhappy, I'm not sure if I want to opt for a third procedure with them. Also, I have the numbers of the Eugenix counselling and follow up team saved in my phone. Haven't got a call from them in the last 3 months. But irrespective, even if I did, after their stance yesterday that Melvin posted about, I highly doubt I will have faith for another procedure.

I feel the clinic could have paid more attention to the case and set realistic expectations before the surgery, if they felt the donor or the earlier scarring was an issue. Nothing of that sort was told to me before I went ahead with the procedure. Also, the calculations for number of grafts seemed off, because I have a thick beard which could be used for extraction if the donor was insufficient, but I was told that 2500 grafts only would be needed. We did end up using about 300 grafts from the beard, but the total requirement that was told to me was 2500. So there is definitely something amiss.

[AA1989]

57 minutes ago, AJ_HT said:

Lastly, you spoke of a consent form. And I didn't want to bring this up in my original post because it would show the clinic in a bad light. But now that you mention it, the form I was asked to sign before the touch-up, wasn't just a consent form. It asked me to sign on a paper which said that I'm happy with the results of my first surgery with Eugenix, and going forward, I will not post my pictures anywhere.

I hope this is a just a misunderstanding. A Non-disclosure agreement very serious allegation. Their use is considered unethical within the community. Melvin wrote a very good article on this very subject.

 

Quote

It’s clear that any hair transplant surgeon/clinic that require their patients to sign an NDA are trying to enforce their silence, if the procedure turns out a failure.

Quote

This would lead me to question any review that this surgeon/clinic may have online. One thing is clear, they will not allow any negative reviews. Unfortunately, surgical hair restoration is not an exact science and even the best surgeons have lackluster results. However, the sign of a great surgeon is how they stand by their work and most importantly the patient.

https://www.regrowhair.com/would-you-go-to-a-hair-transplant-surgeon-that-makes-you-sign-an-nda/

[AJ_HT]

1 minute ago, AA1989 said:

I hope this is a just a misunderstanding. A Non-disclosure agreement very serious allegation. Their use is considered unethical within the community. Melvin wrote a very good article on this very subject.

 

https://www.regrowhair.com/would-you-go-to-a-hair-transplant-surgeon-that-makes-you-sign-an-nda/

It wasn't an NDA. But the document had a clause which said that I am happy with my first surgery, and going forward, will not threaten Eugenix for any deficiency in service, and will refrain from posting any pictures, videos, tweet or message on any social media that could damage their reputation. It was a loosely worded statement and hence I didn't sign it.

[JoeMan]

After hearing both sides, I do believe that Eugenix maybe miscalculated the grafts required. I also agree that I wouldn't return after they seem to have blamed you in a way to Melvin. To me it didn't seem like you were even asking for free work from them which was implied, although in my opinion, I believe the remedy for a reputable clinic such as Eugenix would be to attempt to resolve it in a less confrontational manner. To me the yield looks low in the front and I can understand why you aren't happy. 

If this was a less touted clinic, I believe most people on this site would say that the result was less than optimal. While I understand that Eugenix churns out good work normally, I believe that this case fell short. 

Reading the text the OP posted, Eugenix seems to imply that mid scalp will be filled as well. Being disappointed with the mid scalp at 8 months seems legit as very few grafts were placed there. Waiting for the front to grow in is something I've seen several experts say in this forum. 

@AJ_HT I wish you luck going forward. If it was me, I'd look for a repair from a different top clinic but if you've depleted your donor, maybe this is not worth it. 

[JoeMan]

 @AJ_HT can you post this document? Sounds like something most people wouldn't sign.

[AA1989]

@AJ_HT 

At the heart of your complaint, you believe the clinic miscalculated the number of grafts required to provide the density you expected.
The clinic contends they harvested the maximum number of grafts they could without overharvesting an already depleted donor.

It seems the clinic was being ethical in not wanting to leave you with a destroyed donor. We see on the forum many instances of a badly depleted donor - its tragic. As clinics often get paid by the graft, there is a financial incentive to over harvest.

Two questions:

Why would the clinic choose to make less money unless they felt there was a high risk of damaging your donor?

Why would the clinic use beard grafts unless they felt there was a high risk of damaging your donor?

 

[JoeMan]

1 minute ago, AA1989 said:

@AJ_HT 

At the heart of your complaint, you believe the clinic miscalculated the number of grafts required to provide the density you expected.
The clinic contends they harvested the maximum number of grafts they could without overharvesting an already depleted donor.

It seems the clinic was being ethical in not wanting to leave you with a destroyed donor. We see on the forum many instances of a badly depleted donor - its tragic. As clinics often get paid by the graft, there is a financial incentive to over harvest.

Two questions:

Why would the clinic choose to make less money unless they felt there was a high risk of damaging your donor?

Why would the clinic use beard grafts unless they felt there was a high risk of damaging your donor?

 

Why would they lower the hairline? Why even touch the mid scalp? If the donor is depleted then a more conservative approach would be beneficial I believe. This would yield maximum density in the frontal area which we all know is what we see first. Lowering the hairline seems like it was a miscalculation by the clinic in my opinion if the donor couldn't support it. 

Maybe the OP insisted on a lower HL but it just seems to me like they somehow miscalculated. If he had additional beard hair, why not pull more? 

[AA1989]

6 minutes ago, JoeMan said:

Why would they lower the hairline? Why even touch the mid scalp? If the donor is depleted then a more conservative approach would be beneficial I believe. This would yield maximum density in the frontal area which we all know is what we see first. Lowering the hairline seems like it was a miscalculation by the clinic in my opinion if the donor couldn't support it. 

Maybe the OP insisted on a lower HL but it just seems to me like they somehow miscalculated. If he had additional beard hair, why not pull more? 

I'm prepared to give the clinic the benefit of the doubt on re-establishing a new hairline, given it was a repair job. The repair is not to lower the hairline. Rather it is by-product of creating a new natural hairline. A poor hairline from a previous procedure often has multiples, mis-angled grafts, incorrect design.

[JoeMan]

6 minutes ago, AA1989 said:

I'm prepared to give the clinic the benefit of the doubt on re-establishing a new hairline, given it was a repair job. The repair is not to lower the hairline. Rather it is by-product of creating a new natural hairline. A poor hairline from a previous procedure often has multiples, mis-angled grafts, incorrect design.

Even if so, you can clearly see his before and after pictures. The very front is thin afterwards. This is the area where they lowered the HL and no hair was present before. If they didn't have enough grafts then why not take more from the beard? 

I stand by my statement after seeing cases like @Gatsby on here where they literally jumped through hoops to get the job done. While his case and results are unknown, it just shows what they are capable of if willing. 

[AA1989]

The OP should reflect on how realistic their expectations were. Having been told you were a Norwood 5, you are asking if 2000-2500 grafts are enough to cover not only your frontal and mid-scalp but also your crown.

Those 3 areas amount to approximately 200cm2 on a NW5. The math tells you 2500/200 is 12.5 grafts/cm2. The 'illusion of density' only really starts at 40+ grafts/cm2.

This may sound like a criticism, but as someone who has experienced a previous poor HT, consulted multiple doctors, you should have known the basics of density and coverage.

[JoeMan]

15 minutes ago, AA1989 said:

The OP should reflect on how realistic their expectations were. Having been told you were a Norwood 5, you are asking if 2000-2500 grafts are enough to cover not only your frontal and mid-scalp but also your crown.

Those 3 areas amount to approximately 200cm2 on a NW5. The math tells you 2500/200 is 12.5 grafts/cm2. The 'illusion of density' only really starts at 40+ grafts/cm2.

This may sound like a criticism, but as someone who has experienced a previous poor HT, consulted multiple doctors, you should have known the basics of density and coverage.

When paying for what's considered a top clinic, I don't believe he needs to know such things. He should do his homework, I agree, but if they led him to believe that 2500 was sufficient then the clinic misled him. Of coarse I agree that the OP should elaborate more on this to ensure that he wasn't told that he can only expect low density. 

Edited March 6, 2022 by JoeMan

[AJ_HT]

57 minutes ago, AA1989 said:

@AJ_HT 

At the heart of your complaint, you believe the clinic miscalculated the number of grafts required to provide the density you expected.
The clinic contends they harvested the maximum number of grafts they could without overharvesting an already depleted donor.

It seems the clinic was being ethical in not wanting to leave you with a destroyed donor. We see on the forum many instances of a badly depleted donor - its tragic. As clinics often get paid by the graft, there is a financial incentive to over harvest.

Two questions:

Why would the clinic choose to make less money unless they felt there was a high risk of damaging your donor?

Why would the clinic use beard grafts unless they felt there was a high risk of damaging your donor?

 

Why would the clinic quote that I need only 2500 grafts in the first place, if I actually needed more? I'm actually surprised that a clinic can be believed to not make a simple mistake in terms of calculation, but there are so many questions directed towards me.

Like I said, it's one thing to say that I need 4000 grafts but only 2500 are available and hence we can only do the frontal portion. But it's another thing to say that 2500 grafts are what I need. It was also told that out of the 2500, we could use beard grafts if needed. The point being - a total of 2500 grafts were needed, of which we may need some grafts from the beard.

4 minutes ago, AA1989 said:

The OP should reflect on how realistic their expectations were. Having been told you were a Norwood 5, you are asking if 2000-2500 grafts are enough to cover not only your frontal and mid-scalp but also your crown.

Those 3 areas amount to approximately 200cm2 on a NW5. The math tells you 2500/200 is 12.5 grafts/cm2. The 'illusion of density' only really starts at 40+ grafts/cm2.

This may sound like a criticism, but as someone who has experienced a previous poor HT, consulted multiple doctors, you should have known the basics of density and coverage.

With all due respect, why would you want to nitpick on this point and extrapolate it with my expectations? So what if I asked this question? Is it wrong in any way? I just asked a question, didn't insist on my crown being covered, just like I didn't insist on lowering my hairline, or anything else. But it's very evident from the chat, of what I was quoted in terms of number of grafts.

And instead of seeing the chat where I was quoted 2500 grafts for the frontal and midscalp region, it's surprising that you're picking on the fact that I asked about my crown. Am I missing something here? 🤔

[Gatsby]

I don't have a dog in this fight. However I will say this. Not everyone makes for a good candidate for a hair transplant (biologically, psychologically or otherwise). I am a prime example of this for everyone who has followed my inauspicious beginnings. That being said at the end of the day there's my opinion, your opinion and somewhere in the middle is the truth (which is never established on any internet forum regardless of the topic). I think after one has had a bad result from a Mumbai hair mill, an 'elite' Melbourne surgeon or else where, there is some onus of responsibility to carry out your due diligence in research. The same as it is for everyone who is looking at their first surgery (in fact perhaps even more so as a repair patient). Am I even a candidate for a hair transplant? I can't speak for the OP but for me I was not when I had my first two surgeries. I've just spoken to Dr Sethi and to the original poster I recommend he is the one you need to have a discussion with (IMHO) about what you believe is required to address your concerns. If you don't feel comfortable signing ANY type of paper work then why would you go ahead feeling comfortable to have any kind of surgery? No one here will ever know the truth of what was said verbally except the original poster and Eugenix. At the end of the day when all is said and done, often more is said and less is done. Your concerns are valid to you but what is it you want or expect from a surgery, free or otherwise? That's a question that only you will ever know the answer too. I'm all for free speech (look what happened to me). But when free speech is used to tell the truth it needs to tell all the truth. All the best.

[Ryan Daniel]

Please show us how the back donor area looks today and also under your chin beard area

[ITA]

11 hours ago, AA1989 said:

The clinic did use beard grafts (see OP's 1st post)

ah, ok, I didn't remember reading it. Is it still possible that the OP beard was only available for 300 grafts?

Edited March 6, 2022 by Egy

[Mike10]

In my view, all top clinics have bad results and unhappy patients. The risk is lessened with a top clinic but not eliminated expecially when the patient does not have good charecteristics to do HT. It is crucial though how the clinics handle these cases. 

[Gramatik]

@AJ_HTcan you post the document that Eugenix said you to sign a form, saying that "I am happy with the results of my first surgery with Eugenix, and going forward, I will not post my pictures anywhere"

Because if Eygenix indeed did that, that's very serious and looks unethical clinic's behavior.

[NARMAK]

@Melvin- Moderatori want to try and help suggest a solution here to hopefully get a positive ending and outcome for @AJ_HT with your assistance please, because i genuinely think you're the best placed as the intermediary for us as a community and the clinic.

I said before there's no intention here to play a blame game by myself. I just want both parties to get a happy outcome in the end. 

It looks like there's an offer that's been made to do an in person evaluation for OP of the survival of grafts. You also wish to have that checked and okay, for whatever is implanted that's fair to check. However i would like to in the interest of fairness and quite possibly the confusion between the OP and the clinic reps per some of the text messages posted, clarify whether the OP donor area could only support a maximum of 2500 grafts for any procedures or just for this single procedure. With an outlook more grafts can be extracted for a 2nd procedure where necessary. It does seem like they managed to extract a further 800 grafts for the midscalp as part of a touch up. 

So, my personal thoughts are this as a solution:

1) In person evaluation by Eugenix to compare implanted grafts from the first procedure and graft survival

2) Evaluation of donor area on both scalp and beard to support any possible future transplant

3) If step 2 yields sufficient donor supply, a preliminary plan that could help address the density issues of the frontal hairline in a paid for procedure or if per step 1, grafts didn't survive, a combination of paid and free grafts. 

@AJ_HTcan only state if mentally he would be prepared to go back to Eugenix for any evaluation let alone any further procedures but i would say in the interest of openness and fairness, maybe you should do the evaluation and this should be something Melvin can be part of to show back to the community with evidence what has been done, evaluated etc. for full transparency.

Right now, i do feel that perhaps there's been a misunderstanding between parties and the expectations set by OP and Eugenix. 

I do genuinely feel the clinic are in the driving seat when it comes to repair cases or any hair transplant and perhaps only they can present the technical reasons for lowering the hairline down rather than reinforcing the density at the hairline pre-op. Especially if it transpires that the maximum grafts OP could yield in total for any procedure was 2500. A patient can and perhaps does have expectations of full coverage even in terms of the illusion of density but if a clinic regardless of name and reputation take on this case, i'd have thought the primary goal would be to probably inform the patient if the midscalp will not get sufficient coverage in a single pass that's the only surgery possible with their depleted scalp donor. 

It looks like OP may have needed a second procedure to fully add density. Kind of like @Zoomster but i do not know if this was properly conveyed.

Again, i am hoping for a positive outcome for all parties. As @Gatsbysaid he doesn't have a dog in this race. I guess neither do i in many ways. I guess as a patient booked in for a procedure myself it does make me slightly wonder about my own potential outcome but i'm still on the whole hopeful that a positive resolution can be reached for both parties. 

[asterix0]

@AJ_HT But isn't it a good clinic's responsibility to tell the patient that scarring can make it difficult to achieve good results? And if we assume that this is because of scarring and previous scalp damage, how will a touch-up help in any way? Especially when this will be the third surgery in the frontal region?

Yes, you are right that it is. I had assumed that they told you this, if I was wrong on this assumption I apologize. 

My interpretation of the sequence of events was:

- You were given a graft estimate, but were told based on your previous surgeries and donor status that it is a more risky procedure because of these circumstances. 

 

[Mggm]

5 hours ago, Gramatik said:

 

 

5 hours ago, Gramatik said:

AJ_HTcan you post the document that Eugenix said you to sign a form, saying that "I am happy with the results of my first surgery with Eugenix, and going forward, I will not post my pictures anywhere"

Because if Eygenix indeed did that, that's very serious and looks unethical clinic's behavior.

I do remember signing a form for my surgery but it was more along the lines of "I am aware that a hair transplant surgery is not a guaranteed success and I am willing to go ahead with the surgery knowing that I may not get the desired result". I do not remember seeing anything asking me not to post the results of the surgery on forums or videos.

[Melvin- Admin]

11 hours ago, AJ_HT said:

@Melvin- Moderator I appreciate you talking to the clinic for this. But while earlier I thought this was an honest mistake on the clinic's part, it's saddening to see this response from Eugenix, because your post seems to be putting the blame on me for having unrealistic expectations, when that was truly not the case. The facts being represented here are incorrect.

Let me put my points here. And I didn't want to get into this kind of blame game, but it's not fair to blame me for having realistic expectations.

I'm going to try and be as detailed as possible, so please read this through.

Firstly, when I had my call with Dr Sethi 3 months ago, the Mumbai team was to coordinate with me when Dr Sethi was in Mumbai, to fix up an appointment. I had told them that I'm not sure if I want to opt for another procedure (which I have constantly been saying here). But I was never supposed to reach out and follow up.

Secondly, the clinic told you that the midscalp was not the focus of the surgery, and I'd say that's wrong. It was clearly told to me that my frontal AND midscalp would be covered in 2000-2500 grafts. I repeatedly asked Dr Priyadarshini if my midscalp would be covered during the consult, and she said yes. Melvin, since you spoke of text messages, here are some chats I had with Eugenix before my first surgery, that say what I could expect.

This clearly mentions that the frontal and mid-scalp can be covered, but the crown cannot. Now, is it wrong to expect the mid-scalp to be covered when I was explicitly told that the mid-scalp would be covered? I don't think so.

Thirdly, I have been saying this constantly, that I was in month 8 when I went for a touch-up, and back then I was satisfied with my density for month 8. I chose to trust that the doctors have done a good job and it will grow by month 12, so I didn't take this up. In fact, even after the call with Dr Sethi and their team 3 months ago, I waited till month 15 to see if there's any improvement, and only after that I posted this thread yesterday. At one end, we say we should have patience, and at the other end, doctors expect us to tell them if they have complaints in the 8th month itself? What should we, as patients actually do? Trust the doctor or not?

In fact, it's a good thing that you posted these pictures. You can see yourself in this image that the center portion has lower density than the sides - something that didn't bother me back then because I thought it'll improve, but it didn't improve much. So this isn't a case of progressive hair loss either, it's how the density was (also, I'm on finasteride ever since the surgery and my hairfall has stopped now)

 

Sigh, I'm just saddened by the fact that there is so much that I have to say and show, to defend my stance here 😞 

Lastly, you spoke of a consent form. And I didn't want to bring this up in my original post because it would show the clinic in a bad light. But now that you mention it, the form I was asked to sign before the touch-up, wasn't just a consent form. It asked me to sign on a paper which said that I'm happy with the results of my first surgery with Eugenix, and going forward, I will not post my pictures anywhere.

Now here's my question - why will any patient, who is unhappy with their first surgery, sign a form that says that they are happy with it? And why will a good clinic explicitly ask the client not to upload their pictures on social media?

I still have that document with me, which I didn't sign because I thought it was unreasonable. @Melvin- Moderator let me ask you or any other member here - while getting a touch-up, would you sign a document that mentions you are happy with the first procedure, when in fact you are not?

I'm glad I didn't sign it, else I would not be able to post this today.

Blaming the patient's expectations and showing him in a bad light, when the expectations were actually what was committed to him, is really unfair. It just makes me feel hopeless about how the hair restoration industry works. Sure, this may be a one-off case, but this isn't the kind of explanation I would expect from the clinic even for a one-off case. And now, there's even more reason for me to not go there for a free touch-up if they offer one. It's just disheartening!

Firstly, 

I'm not here to defend anyone or any clinic. But I must report my findings as I see them. You are a Norwood 5 so 2,500 grafts is not going to fill up half of your head with perfect density. This is a fact. To date, we have yet to see one picture posted of your midscalp, which was the section that was touched-up. You have been posting pictures of your frontal hairline, which again, you agreed looked good one month prior to your touch-up. 

Here are the facts:

1. You had a previous poor surgery, which made you a difficult case from the start, for various reasons scarring, etc. 

2. We haven't seen any pictures of your midscalp, which is still growing at 7 months

3. You agreed prior to your touch-up that you were happy with your hairline

4. You were told that your donor would not support more than 2500 grafts, which is in the text you shared.

At this point, you do not want to return to Eugenix, which is your right as a patient. I think the community has enough to draw their own conclusions. I refute the idea that patients are absolved of everything. We are not children. If you spend time researching hair transplants, you would know #1. You will require multiple procedures to achieve desired density. #2. Hair transplants are an illusion of density, and your hair will not look perfect in all circumstances. That is why I created this thread

I cannot comment on your touch-up because again, you have not posted any photos. On appearance, it looks like you are now unhappy about the hairline, months after having a touch-up for the midscalp. The clinics offer to count your grafts and replace any that haven't grown is more than fair in my opinion, and what else can we expect from a clinic? Should a clinic be forced to add 4,000 grafts when the patient paid for 2,500 and agreed to that number? No, I don't believe that is fair, nor should it be expected.