At last! My 4410 graft procedure@ Eugenix - 1/2/3 Mar 2022

[Davidf]

Hi all @ HRN

It's been over a week now since returning from my procedure at Eugenix in Delhi, and having fully recovered from a period of many near sleepless nights, it's now time to stop procrastinating and get on with the business of posting a thread of my experience.

Before I start, I've got to say thanks to all those people who made this experience so much easier than it could have been, including, everyone at Eugenix, (many of whose names I didn't get, so I won't name names in case I leave anyone out) as well as all of you good people at HRN who have posted your own threads from which I have gleaned such valuable information.  I thank you all.

First, some background.                      I've been aware of my hair loss since I was 17, and judging from the variable rate of progression over the years, it seems reasonable to assume that I actually may have started losing it at least a couple of years prior.  I'm now 56, so that's upwards of 40 years of hair loss in all.  Way back then, the options available were extremely limited and information even more so.  The little I knew of hair transplants sounded gruesome and so I settled for a few years of watching my precious hairs slip down the plughole while I moved my remaining hair around on top of my head to avoid the detection of others of my predicament.                  Approximately eight years later I became aware of minoxidil for the first time, tried it, didn't like it - it made my (by now) Norwood 2-3 hair feel greasy and generally icky.    A few years later I heard of finasteride for the first time, but the potential side effects were less than appealing and there still wasn't much information, so I just accepted my fate. By now I was about 45 and grateful to only be a Norwood 3-4 as my dad and younger brother had all but lost all their hair by 21.

Anyway, about 18 months ago my hair loss progression picked up speed again, and, armed with new information courtesy of Google and YouTube etc, I decided to investigate all possibilities and research began in earnest.  By January of last year I had started finasteride (generic),also, dutasteride (again, generic) by late March, as well as ketoconazole and microneedling.  By June, I had switched to Propecia when I found that my hair loss was still ongoing.  After 14 months of using fin, I have yet to see any real benefit.  Most people seem to see results, if any, within the first year, but some 'experts' suggest it may take up to 2 years for full results, so here's hoping.

Took some pics (in April/May) and emailed them for assessment to, initially, Dr Bruno Ferreira.  Never did get a response, other than that he was v busy.  Tried others, with varying responses and no progress until a short time later I became aware of Eugenix and their apparent success with higher Norwoods and 'difficult' cases, which I considered myself to be, as I was aware that I had retrograde alopecia and donor that I thought to be mediocre.  Again, I sent some photos for evaluation and Eugenix promptly quoted me a figure of 4700 grafts and informed me that I was a Norwood 4. I did suggest that I thought my graft requirements might be greater, (up to 6000) as I considered myself to be a Norwood 5 by now, but was told that the doctors felt that the number of grafts quoted was sufficient.              Due to the ongoing issues with international travel (and particularly regarding India), as well as waiting on Eugenix's London consultations (that didn't happen in the end) I didn't get to book my procedure until early January, with dates set for March 1st and 2nd.

Thanks to the feedback of Berba11 and others my dealings with the Indian Visa and Consular Application Centre could have been much worse. Only a two hour wait in the centre itself, several unanswered emails after they requested extra information a few days later, another trip back to the centre with aforementioned paperwork, and the very next day, a belated response to my emails, and my passport returned two days later.  A mere sixteen days in all, but at least I had known what to expect.

Finally, two weeks later I was in Delhi, staying at the Hilton, a fifteen minute walk from the Eugenix clinic.  Had my blood tests done after breakfast on my first day after having slept for just a couple of hours that morning. This inability to sleep became a pattern for the week.  Fortunately, adrenaline got me through this period, and I seem to have done nothing but sleep since my return home.                         Next day I reported for duty at 11am.  Had all the expected things done, pre-op photos taken, blood taken for PRP etc, and met Dr Arika for the first time when she came in to do the hairline design.  This last part was brief, as expected, when she basically drew two semi circular lines across my forehead, letting me choose which one I was happier with and said it was 7cm from glabella to hairline.  I've since measured it myself and found it to be closer to 8cm, but, as someone who hasn't had a proper hairline in almost 20 years I was just glad to potentially have anything approaching 'normal'.  She also asked me what my overall density aspirations were, to which I responded "good density at the front" and that I was less concerned with the crown.  She agreed and suggested that I could be confident that I would obtain this from the procedure.  And with that she was gone, returning again a little later to do the hairline slits.  If memory serves, Eugenix could have had up to 3 other guys having their procedures done that morning, so I'm sure she was incredibly busy.       At some point, (I forget exactly when) I realised that my temple points hadn't been included in the pre-op designs or been worked on at any time. I was told that this was because they considered that I still had reasonable temple points/peaks and they didn't plan on working on them. I disagreed as I could only see about 12 hairs on my right temple and fewer still on my left.  Eventually, it was decided that I could have some grafts added to my TPs - over 200 to each one in the end.  The bulk of the remaining slits were done by another doctor who introduced herself as Dr P (sorry, I didn't catch the name) and, if memory serves, everything was complete by about 6pm.  Initially it was meant to be a two day procedure but it was suggested that doing everything over 3 days would make it a less strenuous experience. At first I had reservations, (losing a day's recovery at the hotel etc) but it turned out to be the right move as the next two days turned out to be eight and nine hours long respectively and obviously would have been longer still had the slits and the pre-ops not been done the previous day.

Day two was all about extractions and implantations and was a much more painful affair.  This I found surprising as so many people had said they had slept through parts of the procedure. It was only when I returned home that I was reminded of my skin's sensitivity to hot water when showering, razor burn when I shave, etc.  The price of having pasty white skin I suppose.                 At the end of the day the front part of my head had been done and I couldn't wait to get back to the hotel to sleep.  Again, that didn't really happen.  I think I got about 3 and a half hours that night.                            When I got back to the hotel, one of the first things I did was to check everything looked alright in the mirror.  For the most part it was, except for two pea sized spots in my hairline that looked like they had been missed.  I was also aware that a strip of hair running from side to side in my midscalp had not been shaved down as much as most of the rest of my hair.

Day three - again all extractions and implantations, but this time on the crown, behind the under shaven bit.  I made a point of enquiring about these two worrisome elements of my previous day's procedure, to be told that the two spots left devoid of grafts were due to me having a mole in each spot and that the strip hadn't been shaved down because it was thought that there was enough hair remaining there, and that to implant nearby might cause shock loss.  Fair enough, regarding the moles (I hadn't even noticed, despite having little to no hair there for so long), though I was disappointed regarding the strip as I didn't think that there was a lot of hair in that area to begin with and if the finasteride doesn't kick in asap there may soon be next to none there.   Ok, I guess, though I wish someone had said something about these issues before I left the clinic, instead of me only finding out the next day.

Back in the OR, things were somewhat more painful than I would have liked, with anaesthesia being reapplied several times.  At least the beard extractions weren't so bad, probably because there were only 500 in all.                                               Finally, by 6pm (9am start) it was over and I could return to the hotel and relax for a couple of days before returning home.

I did of course go back to the clinic on those days for a headwash and to ask some questions, such as whether they really thought that I had enough grafts implanted in the front half of my head (2,415 including temples, 1,973 excluding) and was told that they thought I had.  Not quite so confident myself as I've since seen other Eugenix patients have upwards of 2500 excluding temples and over smaller areas.  Obviously everyone's different - different head sizes etc, so I guess I'll just have to wait it out.

Anyway, that's it.  Apologies for rambling on, especially as it was only meant to be a summary - and I didn't even mention meeting Dr Pradeep!  Suffice to say, he's everything everyone says he is - his enthusiasm is quite infectious.  All in all, they are a great team at Eugenix and I wouldn't discourage anyone from going there.

Feel free to ask questions - I'm sure I've left something out, I frequently do.

Pics are: 2 X pre procedure.                                2 X day 1                                              1 X day 7                                              1x day 12   

               

Edited March 17, 2022 by Davidf
Rearranged accidentally inserted pics, now in wrong order, complete with messed up final text

[SLA]

Awesome! Looking forward to seeing you as you progress on your journey!

 

[kirkland]

@DavidfAlright - let's get this party started! Congrats on your journey to Eugenix.

Right decision to insist on the temple points. They look really good already!

I look forward to seeing updates as you progress. Those 6-month pics better have a big smile attached 'cause I think you're gonna need it!

All the best, brother!

[Vann]

Nice, thanks you for sharing. Do you know the graft count and hair count that was added?

[Gatsby]

Well done David. Dr Arika is an excellent surgeon. Expect an excellent result! I hope you keep updating your journey here and thanks for sharing!

[Davidf]

1 hour ago, kirkland said:

@DavidfAlright - let's get this party started! Congrats on your journey to Eugenix.

Right decision to insist on the temple points. They look really good already!

I look forward to seeing updates as you progress. Those 6-month pics better have a big smile attached 'cause I think you're gonna need it!

All the best, brother!

Ta very much!  If I have anything like the progress you've had, my jaw's gonna ache from non-stop smiling!

[Davidf]

1 hour ago, Vann said:

Nice, thanks you for sharing. Do you know the graft count and hair count that was added?

Yep. Total grafts:            4410                                      Crown:    1995            Frontal half inc temples: 2415

Hair count unknown

[Davidf]

23 minutes ago, Gatsby said:

Well done David. Dr Arika is an excellent surgeon. Expect an excellent result! I hope you keep updating your journey here and thanks for sharing!

Got my fingers crossed for all of us!

[Gramatik]

Good luck mate. So which package of eugenix did you choose and with what price ? Dr arrika did only the slits in the hairline and the rest from other stuff of Eugenix? 

Also 1973 grafts is not a good number for the front part. For this area usually clinics implant 3000 grafts or so to give a good density. But anyway you could always do a second procedure to increase the density in the front.

[Ryan Daniel]

11 hours ago, Davidf said:

 

 

 

This is extremely clean work and very artistic. 

This is when you truly know if a hair transplant was done correctly

Thank you for the detailed photos. It really helps people who want to choose Dr Arika as their doctor for the procedure 

Everything is framed well now for you

Happy growth sir 

[SLA]

5 hours ago, Gramatik said:

Also 1973 grafts is not a good number for the front part. For this area usually clinics implant 3000 grafts or so to give a good density. But anyway you could always do a second procedure to increase the density in the front.

Before we come to conclusions, let's see what the final result will bring. True that the OP can always have another procedure if needed, but may not be necessary.

I know your intentions were good, however, let's send the OP good vibes without the possibility of creating another needless thought for him to focus on. 

[Gramatik]

29 minutes ago, SLA said:

Before we come to conclusions, let's see what the final result will bring. True that the OP can always have another procedure if needed, but may not be necessary.

I know your intentions were good, however, let's send the OP good vibes without the possibility of creating another needless thought for him to focus on. 

The important thing now is to get the maximum survival rate of the grafts.

Also if you read his first post on this thread, the OP already said that the number of 1973 grafts seems quite small to him, because he has seen simillar cases to put more grafts for that area. So i just agreed with him to that point. But we should wait to see the final result ! I hope everything will be fine..

 

16 hours ago, Davidf said:

 

I did of course go back to the clinic on those days for a headwash and to ask some questions, such as whether they really thought that I had enough grafts implanted in the front half of my head (2,415 including temples, 1,973 excluding) and was told that they thought I had.  Not quite so confident myself as I've since seen other Eugenix patients have upwards of 2500 excluding temples and over smaller areas.  

 

               

 

 

 

 

 

Edited March 18, 2022 by Gramatik

[kirkland]

OP has had the entire balding area treated, including hairline, midscalp, Crown and temple points. That is a lot of area to cover for just under 5000 grafts. If his donor characteristics were average or below average then I can see why the clinic stuck with just 2,000 for hairline and mid scalp at this point (excluding temple points)

As everyone has suggested it is better to wait and see how it looks in a year and revisit his options. For comparison, I had 3500 grafts in hairline and mid scalp only, no Crown or temple points. After 1 year I will also reassess my situation. If I do not have enough in the donor for the crown or the temple points then I am happy with the number of grafts where they have been placed.

 

[SLA]

50 minutes ago, kirkland said:

OP has had the entire balding area treated, including hairline, midscalp, Crown and temple points. That is a lot of area to cover for just under 5000 grafts. If his donor characteristics were average or below average then I can see why the clinic stuck with just 2,000 for hairline and mid scalp at this point (excluding temple points)

As everyone has suggested it is better to wait and see how it looks in a year and revisit his options. For comparison, I had 3500 grafts in hairline and mid scalp only, no Crown or temple points. After 1 year I will also reassess my situation. If I do not have enough in the donor for the crown or the temple points then I am happy with the number of grafts where they have been placed.

 

Looks as if the OP did not really have any grafts placed in the mid scalp due to pre-existing hair.

I am sure the results will be good and there can always be a round #2

[Davidf]

On 3/18/2022 at 8:36 AM, Gramatik said:

Good luck mate. So which package of eugenix did you choose and with what price ? Dr arrika did only the slits in the hairline and the rest from other stuff of Eugenix? 

Also 1973 grafts is not a good number for the front part. For this area usually clinics implant 3000 grafts or so to give a good density. But anyway you could always do a second procedure to increase the density in the front.

I went with the Exclusive package @120 rupees plus 18% tax per graft.  I did however ask if Dr Arika might do the design and incisions as she had only recently stopped doing these in this package.  The result was a compromise, with her doing the incisions on the hairline only.

All told, I received 2415 grafts in the frontal third, including temples. Not a bad number, though I would feel more confident with 4-500 more as I'd expected, in truth.  Only time will tell.

[rob7331]

Work looks great, as expected. I think the hairline design is going to be quite appreciated once everything grows out- going more conservative allows higher graft availability elsewhere and generally increases density, in my experience. You have a large area to cover so I think that was definitely the right call.

I see what you mean about the little spots with no grafts in them. Ultimately I think it'll be a negligible difference - just keep in mind the golden rule about hair transplants (they are an illusion of density) and try to keep expectations in check, especially remembering to stay patient until month 12.

If it ends up happening, also remember that going for a touch-up later in life to add density is completely normal (and quite common). When you're slick bald (like we both were before our HTs) consider that they're literally creating an 'area with hair' from scratch. Even with good donor characteristics and high yield it's rare to get it 100% satisfactory on the first pass.

Our baldness pre-op is pretty similar. Here's an example below of what I mean (pre-op before first and second surgery).

[Davidf]

On 3/20/2022 at 3:53 AM, rob7331 said:

Work looks great, as expected. I think the hairline design is going to be quite appreciated once everything grows out- going more conservative allows higher graft availability elsewhere and generally increases density, in my experience. You have a large area to cover so I think that was definitely the right call.

I see what you mean about the little spots with no grafts in them. Ultimately I think it'll be a negligible difference - just keep in mind the golden rule about hair transplants (they are an illusion of density) and try to keep expectations in check, especially remembering to stay patient until month 12.

If it ends up happening, also remember that going for a touch-up later in life to add density is completely normal (and quite common). When you're slick bald (like we both were before our HTs) consider that they're literally creating an 'area with hair' from scratch. Even with good donor characteristics and high yield it's rare to get it 100% satisfactory on the first pass.

Our baldness pre-op is pretty similar. Here's an example below of what I mean (pre-op before first and second surgery).

Thanks.  I'm actually (relatively) relaxed about everything really.  Whatever will be,will be etc.  For now I'm happy to be approaching the end of week three without any issues like infections etc.  Like yourself, I'll just be waiting it out, for as long as it takes. 

In your case, your hair characteristics, (blonde, curly) will undoubtedly help on the density front.

Congrats on dodging a bullet re your first transplant with Dr Torgerson, by the way.  That could have turned out sooo much worse.

Edited March 22, 2022 by Davidf
Punctuation

[rob7331]

Excellent, in that case it's happy growing ahead

You're right about Torgerson, it could have been bad for sure. I got lucky, but I don't recommend that clinic to anybody.

[Vann]

Any updates?

[OliverAtom]

On 3/17/2022 at 11:21 PM, Davidf said:

Hi all @ HRN

It's been over a week now since returning from my procedure at Eugenix in Delhi, and having fully recovered from a period of many near sleepless nights, it's now time to stop procrastinating and get on with the business of posting a thread of my experience.

Before I start, I've got to say thanks to all those people who made this experience so much easier than it could have been, including, everyone at Eugenix, (many of whose names I didn't get, so I won't name names in case I leave anyone out) as well as all of you good people at HRN who have posted your own threads from which I have gleaned such valuable information.  I thank you all.

First, some background.                      I've been aware of my hair loss since I was 17, and judging from the variable rate of progression over the years, it seems reasonable to assume that I actually may have started losing it at least a couple of years prior.  I'm now 56, so that's upwards of 40 years of hair loss in all.  Way back then, the options available were extremely limited and information even more so.  The little I knew of hair transplants sounded gruesome and so I settled for a few years of watching my precious hairs slip down the plughole while I moved my remaining hair around on top of my head to avoid the detection of others of my predicament.                  Approximately eight years later I became aware of minoxidil for the first time, tried it, didn't like it - it made my (by now) Norwood 2-3 hair feel greasy and generally icky.    A few years later I heard of finasteride for the first time, but the potential side effects were less than appealing and there still wasn't much information, so I just accepted my fate. By now I was about 45 and grateful to only be a Norwood 3-4 as my dad and younger brother had all but lost all their hair by 21.

Anyway, about 18 months ago my hair loss progression picked up speed again, and, armed with new information courtesy of Google and YouTube etc, I decided to investigate all possibilities and research began in earnest.  By January of last year I had started finasteride (generic),also, dutasteride (again, generic) by late March, as well as ketoconazole and microneedling.  By June, I had switched to Propecia when I found that my hair loss was still ongoing.  After 14 months of using fin, I have yet to see any real benefit.  Most people seem to see results, if any, within the first year, but some 'experts' suggest it may take up to 2 years for full results, so here's hoping.

Took some pics (in April/May) and emailed them for assessment to, initially, Dr Bruno Ferreira.  Never did get a response, other than that he was v busy.  Tried others, with varying responses and no progress until a short time later I became aware of Eugenix and their apparent success with higher Norwoods and 'difficult' cases, which I considered myself to be, as I was aware that I had retrograde alopecia and donor that I thought to be mediocre.  Again, I sent some photos for evaluation and Eugenix promptly quoted me a figure of 4700 grafts and informed me that I was a Norwood 4. I did suggest that I thought my graft requirements might be greater, (up to 6000) as I considered myself to be a Norwood 5 by now, but was told that the doctors felt that the number of grafts quoted was sufficient.              Due to the ongoing issues with international travel (and particularly regarding India), as well as waiting on Eugenix's London consultations (that didn't happen in the end) I didn't get to book my procedure until early January, with dates set for March 1st and 2nd.

Thanks to the feedback of Berba11 and others my dealings with the Indian Visa and Consular Application Centre could have been much worse. Only a two hour wait in the centre itself, several unanswered emails after they requested extra information a few days later, another trip back to the centre with aforementioned paperwork, and the very next day, a belated response to my emails, and my passport returned two days later.  A mere sixteen days in all, but at least I had known what to expect.

Finally, two weeks later I was in Delhi, staying at the Hilton, a fifteen minute walk from the Eugenix clinic.  Had my blood tests done after breakfast on my first day after having slept for just a couple of hours that morning. This inability to sleep became a pattern for the week.  Fortunately, adrenaline got me through this period, and I seem to have done nothing but sleep since my return home.                         Next day I reported for duty at 11am.  Had all the expected things done, pre-op photos taken, blood taken for PRP etc, and met Dr Arika for the first time when she came in to do the hairline design.  This last part was brief, as expected, when she basically drew two semi circular lines across my forehead, letting me choose which one I was happier with and said it was 7cm from glabella to hairline.  I've since measured it myself and found it to be closer to 8cm, but, as someone who hasn't had a proper hairline in almost 20 years I was just glad to potentially have anything approaching 'normal'.  She also asked me what my overall density aspirations were, to which I responded "good density at the front" and that I was less concerned with the crown.  She agreed and suggested that I could be confident that I would obtain this from the procedure.  And with that she was gone, returning again a little later to do the hairline slits.  If memory serves, Eugenix could have had up to 3 other guys having their procedures done that morning, so I'm sure she was incredibly busy.       At some point, (I forget exactly when) I realised that my temple points hadn't been included in the pre-op designs or been worked on at any time. I was told that this was because they considered that I still had reasonable temple points/peaks and they didn't plan on working on them. I disagreed as I could only see about 12 hairs on my right temple and fewer still on my left.  Eventually, it was decided that I could have some grafts added to my TPs - over 200 to each one in the end.  The bulk of the remaining slits were done by another doctor who introduced herself as Dr P (sorry, I didn't catch the name) and, if memory serves, everything was complete by about 6pm.  Initially it was meant to be a two day procedure but it was suggested that doing everything over 3 days would make it a less strenuous experience. At first I had reservations, (losing a day's recovery at the hotel etc) but it turned out to be the right move as the next two days turned out to be eight and nine hours long respectively and obviously would have been longer still had the slits and the pre-ops not been done the previous day.

Day two was all about extractions and implantations and was a much more painful affair.  This I found surprising as so many people had said they had slept through parts of the procedure. It was only when I returned home that I was reminded of my skin's sensitivity to hot water when showering, razor burn when I shave, etc.  The price of having pasty white skin I suppose.                 At the end of the day the front part of my head had been done and I couldn't wait to get back to the hotel to sleep.  Again, that didn't really happen.  I think I got about 3 and a half hours that night.                            When I got back to the hotel, one of the first things I did was to check everything looked alright in the mirror.  For the most part it was, except for two pea sized spots in my hairline that looked like they had been missed.  I was also aware that a strip of hair running from side to side in my midscalp had not been shaved down as much as most of the rest of my hair.

Day three - again all extractions and implantations, but this time on the crown, behind the under shaven bit.  I made a point of enquiring about these two worrisome elements of my previous day's procedure, to be told that the two spots left devoid of grafts were due to me having a mole in each spot and that the strip hadn't been shaved down because it was thought that there was enough hair remaining there, and that to implant nearby might cause shock loss.  Fair enough, regarding the moles (I hadn't even noticed, despite having little to no hair there for so long), though I was disappointed regarding the strip as I didn't think that there was a lot of hair in that area to begin with and if the finasteride doesn't kick in asap there may soon be next to none there.   Ok, I guess, though I wish someone had said something about these issues before I left the clinic, instead of me only finding out the next day.

Back in the OR, things were somewhat more painful than I would have liked, with anaesthesia being reapplied several times.  At least the beard extractions weren't so bad, probably because there were only 500 in all.                                               Finally, by 6pm (9am start) it was over and I could return to the hotel and relax for a couple of days before returning home.

I did of course go back to the clinic on those days for a headwash and to ask some questions, such as whether they really thought that I had enough grafts implanted in the front half of my head (2,415 including temples, 1,973 excluding) and was told that they thought I had.  Not quite so confident myself as I've since seen other Eugenix patients have upwards of 2500 excluding temples and over smaller areas.  Obviously everyone's different - different head sizes etc, so I guess I'll just have to wait it out.

Anyway, that's it.  Apologies for rambling on, especially as it was only meant to be a summary - and I didn't even mention meeting Dr Pradeep!  Suffice to say, he's everything everyone says he is - his enthusiasm is quite infectious.  All in all, they are a great team at Eugenix and I wouldn't discourage anyone from going there.

Feel free to ask questions - I'm sure I've left something out, I frequently do.

Pics are: 2 X pre procedure.                                2 X day 1                                              1 X day 7                                              1x day 12   

               

Thanks for sharing with so many details. 
You will look like ANOTHER person this coming Xmas 🙇🏻‍♂️ 😊

Please, keep sharing all the updates!

[mrmane85]

Should be around the 4th month mark now. Can you share some updates when you have time @Davidf?

[Davidf]

Ok. Update time. Last week (Sunday 3rd July) was 4 calendar months since my procedure with Eugenix in March. 

Overall I'm quite pleased with how things have progressed, especially in the last few weeks. It helps that having kept my hair pretty short for the first 3 months, I've recently refrained from cutting it, other than to tidy it up a little. 

Quite a few grey hairs have turned up on the scene, but that's hardly surprising as all the hair transplanted to the front of my head came from the sides where I was going grey anyway. 

Long way to go yet, but as I say I'm happy with how things are progressing for now.

All the best

1st two pics are from July 6 (One day short of 18 weeks)

Next two are June 6

[Bb111]

Starting to fill in. Looking good so far. 

[Eugenix Hair Sciences]

Looks absolutely amazing.

[Gatsby]

Looking right on point and then some for four months! 👌