Eugenix (Drs. Das/Somesh/Vinita) | 11,102 grafts | NW 6/7 | 28 yrs old | 2022/2023/2024

[general-etwan]

Also, I'm assuming and hoping they can leave the top at this length (or at least some length) through the procedure. Kinda don't want to buzz my whole head right now. 🙃

[keratin_matters]

What do you think about adding some beard grafts in the donor area where there's a patch of retrograde alopecia. 

[Melvin- Admin]

20 hours ago, general-etwan said:

Also, I'm assuming and hoping they can leave the top at this length (or at least some length) through the procedure. Kinda don't want to buzz my whole head right now. 🙃

They should be able too, there’s not a ton of hair to go in between. I think shaving wouldn’t be ideal for you.

[general-etwan]

9 hours ago, keratin_matters said:

What do you think about adding some beard grafts in the donor area where there's a patch of retrograde alopecia. 

Interesting idea. I’ll keep everything on table. Not sure if due to slightly different hair beard hair characteristics, if that’s something they would ever do. Lower on the list of priorities, sides of head not too important to me. 

Edited June 1, 2023 by general-etwan

[general-etwan]

Another pic just from today in somewhat natural lighting. 

[Davahkiin89]

I'm having my procedure done by Dr Somesh just before you on 6th and 7th June.

Your results are looking good so far bro and hopefully this procedure can give you your desired outcome. 

All the best 

[GoliGoliGoli]

On 5/29/2023 at 11:15 AM, GoliGoliGoli said:

I think your primary concern should be making sure you're not left with a disconnect anywhere between the transplanted hair and your natural hair, such as the ones you've highlighted in the lateral humps and back of crown. By adding temple points not only are you using precious grafts, but you're also adding in another potential area for a disconnect to arise down the road as you continue to lose more hair around the front of the ear area. 

I think some of the areas you highlighted earlier as potential places you can pull grafts from are not at all safe areas to be pulling grafts from so I'd really suggest only using very safe donor areas. You seem to be getting a good bit of hair greed which is totally understandable, but to be honest I think in your situation you're best served by being super conservative with the goal of maintaining a natural look. Adding temples does not serve that cause. 

The pic Gatsby posted is really important. I see it often on this forum where people go for what looks great right now, without thinking of the long term. Even people with the very best donor's need to consider the future and plan their HT's around that. But this is even more true in a challenging case such as yours. 

You've made a tremendous aesthetic improvement with your 1st HT that you can now build on. But the only thing worse than looking bald is looking unnaturally bald. By lowering your hairline or adding temple points you run the risk of leaving yourself unnaturally bald. Don't fall into that trap. 

You know, here's what I actually think you should do. 

Don't even bother trying to fill in the full horseshoe area that your highlighted in red. You simply don't have enough grafts to fill in such a big area and it would never look good. You will never be able to achieve a solid connection with your remaining hair down below in the donor area. Instead, you should basically plan to always have the haircut you posted in your last picture from April 12th, and use whatever remaining grafts you have to pull that look off with max effectiveness. Just get really good at giving yourself that exact fade which should be easy because it's basically just clean shaven all around with maybe a little fade work towards the crown. 

You are actually in a fairly precarious position. I don't mean to sound fatalistic, but I think the current plan of trying to fill in all or most of the horseshoe area you highlighted in red in previous pictures will leave you with a bad result. I think your only option is to go with keeping your hair like it is in the last picture from April 12th, and just always rock that single hairstyle for the rest of your life. Luckily it looks pretty good on you. 

 

[Z--]

13 hours ago, general-etwan said:

Another pic just from today in somewhat natural lighting. 

My two cents: Growth was solid where planted, but planning carefully is imperative at this stage. Where @GeneralNorwood highlighted on the humps, imo, would be my priority, if I were in your shoes. I'd absolutely drop temples at this point and accept some balding in the lower crown.

As others said, the only thing worse than a naturally balding look is an unnaturally balding look. Most men lose hair on their crown, but it's not normal to have a disconnect at the humps when you have hair on top.

I'd do something like 2,000 -2,500 for the humps (1,000-1,250 each side) and 1,000 to shore up the top of the crown. It'll still be bare at the back, but at least it'll be most natural that way. You can always use fibers or style the hair up to cover that bald patch.

[GoliGoliGoli]

Agreed with the above. I would do something like the picture below. Fill in the areas you need to fill in to successfully rock the haircut you had from the picture you posted on April 12th. This is now your new hairstyle for life. Doing anything more aggressive will look really bad I'm afraid long term.  I'm no expert so take what I say with a grain of salt, but the truth if your balding is going to continue. So trying to "Bridge the gap" between your transplanted hair and natural hair is never going to work for you. So don't even try, just fill in the areas needed to really look good rocking the haircut you had from April 12th. 

Note: My drawing is just a rough idea, you'll need to decide for yourself of course. But DO NOT try to bridge the gap beween your transplanted hair and your natural hair. It won't work in the short term, and it DEFINITELY will not work in the long term. 

[hairman22]

more v poor planning from eugenix

op needs about 4000 more grafts.

if i was you i would go to pitella. Eugenix have some great cases but this is with sethi otherwise im not as sure about them

[GoliGoliGoli]

4 minutes ago, hairman22 said:

more v poor planning from eugenix

op needs about 4000 more grafts.

if i was you i would go to pitella. Eugenix have some great cases but this is with sethi otherwise im not as sure about them

Hell I don't even know if 4000 grafts would fill in the entire area that Etwan highlighted in red. And even if it did and if he had 4000 grafts to use, his balding is going to continue so over time he's going to be left with a weird disconnect if he tried anyways. 

I'm not a huge fan of Eugenix either. But I think this is actually a good lesson regardless of which Dr someone chooses. People think that "doing research" just means finding a good clinic who has past cases of achieving successful results with patients who are similar to you. But "similar" only means so much as everyone's individual case and goals are soooo different. People find a "reputable" clinic with goods results, and then say "Well my research is complete!" and proceed to put the actual design in the hands of the Dr which is the most important and context dependent part. 

THIS IS A VERY BAD IDEA. YOU NEED TO NOT JUST TRUST THAT THE DR'S DESIGN. DOING RESEARCH MEANS THINKING AHEAD TO HOW YOU WILL LOOK IN 5 YEARS, 10 YEARS, 20 YEARS, 30 YEARS. DO NOT JUST BLINDLY TRUST THE DR'S DESIGN. 

[general-etwan]

8 hours ago, GoliGoliGoli said:

You know, here's what I actually think you should do. 

Don't even bother trying to fill in the full horseshoe area that your highlighted in red. You simply don't have enough grafts to fill in such a big area and it would never look good. You will never be able to achieve a solid connection with your remaining hair down below in the donor area. Instead, you should basically plan to always have the haircut you posted in your last picture from April 12th, and use whatever remaining grafts you have to pull that look off with max effectiveness. Just get really good at giving yourself that exact fade which should be easy because it's basically just clean shaven all around with maybe a little fade work towards the crown. 

You are actually in a fairly precarious position. I don't mean to sound fatalistic, but I think the current plan of trying to fill in all or most of the horseshoe area you highlighted in red in previous pictures will leave you with a bad result. I think your only option is to go with keeping your hair like it is in the last picture from April 12th, and just always rock that single hairstyle for the rest of your life. Luckily it looks pretty good on you. 

 

Remember the entire goal of hair transplants is supposed to be hair redistribution. It doesn't matter if the horseshoe area isn't as dense as it would ideally would be. It simply has to have more DHT-resistant hair than it does right now, and match the top and lower sides as closely as possible, so that constant haircuts are not required. The entire reason for thi second procedure is so I don't have to get a faded buzz every 3 days to look good. Nobody got time for that. The horseshoe area is the only the target of this procedure. Otherwise I wouldn't be going back.

8 hours ago, Z-- said:

My two cents: Growth was solid where planted, but planning carefully is imperative at this stage. Where @GeneralNorwood highlighted on the humps, imo, would be my priority, if I were in your shoes. I'd absolutely drop temples at this point and accept some balding in the lower crown.

As others said, the only thing worse than a naturally balding look is an unnaturally balding look. Most men lose hair on their crown, but it's not normal to have a disconnect at the humps when you have hair on top.

I'd do something like 2,000 -2,500 for the humps (1,000-1,250 each side) and 1,000 to shore up the top of the crown. It'll still be bare at the back, but at least it'll be most natural that way. You can always use fibers or style the hair up to cover that bald patch.

8 hours ago, GoliGoliGoli said:

Agreed with the above. I would do something like the picture below. Fill in the areas you need to fill in to successfully rock the haircut you had from the picture you posted on April 12th. This is now your new hairstyle for life. Doing anything more aggressive will look really bad I'm afraid long term.  I'm no expert so take what I say with a grain of salt, but the truth if your balding is going to continue. So trying to "Bridge the gap" between your transplanted hair and natural hair is never going to work for you. So don't even try, just fill in the areas needed to really look good rocking the haircut you had from April 12th. 

Note: My drawing is just a rough idea, you'll need to decide for yourself of course. But DO NOT try to bridge the gap beween your transplanted hair and your natural hair. It won't work in the short term, and it DEFINITELY will not work in the long term. 

That said, I agree with these specifics here, of course. Priority should be front to mid lateral ridge area, with gradual less focus on the lower crown. The lower crown will need some grafts, though, as the upper crown has already been worked on, so the lower crown cannot be completely ignored or there will be an unnaturally low bald spot. They're going to have to put some grafts there, guaranteed. Maybe less dense than the upper crown; but it has to pass as not having a huge visual distinction. Remember there isn't much more balding to go for me. I was already a NW 6/7 in early 20s, which in part makes it at least a bit simpler in terms of future-proofing than someone who is unlucky enough to suffer from slow hair loss continuing all the way to NW7 over decades.

[general-etwan]

9 hours ago, hairman22 said:

more v poor planning from eugenix

op needs about 4000 more grafts.

if i was you i would go to pitella. Eugenix have some great cases but this is with sethi otherwise im not as sure about them

Respectfully disagree. Do you understand the extent and difficulty of what my situation was? I knew and agreed to our first HT covering the entire top, hairline to upper crown, knowing the lateral ridge and lower crown areas would continue thinning and would need to be addressed somehow, some way in the future. What would your planning have been? I didn’t hear any alternative. To rip away 9,000 grafts in one procedure, massacre donor area, and implant all over an area that would have then suffered shock loss? That can't be done. And I don't have that donor. The most important areas to get hair first are the top, midscalp to front hairline.

I don't need 4,000 more grafts. That might be your opinion but you're not me so you don't get to decide what my goals are. If we can get 2,000-3,000 (which I think we can with beard hair used again if necessary) redistributed to lateral ridge areas, that is going to make a massive improvement of overall uniformity.

My situation has already improved tremendously thanks to the job the team at Eugenix did the first time. 

9 hours ago, hairman22 said:

if i was you i would go to pitella. 

I could never afford that.

Edited June 2, 2023 by general-etwan

[general-etwan]

8 hours ago, GoliGoliGoli said:

Hell I don't even know if 4000 grafts would fill in the entire area that Etwan highlighted in red. And even if it did and if he had 4000 grafts to use, his balding is going to continue so over time he's going to be left with a weird disconnect if he tried anyways. 

I'm not a huge fan of Eugenix either. But I think this is actually a good lesson regardless of which Dr someone chooses. People think that "doing research" just means finding a good clinic who has past cases of achieving successful results with patients who are similar to you. But "similar" only means so much as everyone's individual case and goals are soooo different. People find a "reputable" clinic with goods results, and then say "Well my research is complete!" and proceed to put the actual design in the hands of the Dr which is the most important and context dependent part. 

THIS IS A VERY BAD IDEA. YOU NEED TO NOT JUST TRUST THAT THE DR'S DESIGN. DOING RESEARCH MEANS THINKING AHEAD TO HOW YOU WILL LOOK IN 5 YEARS, 10 YEARS, 20 YEARS, 30 YEARS. DO NOT JUST BLINDLY TRUST THE DR'S DESIGN. 

• Balding is close to done. NW7 by mid 20s.
• 4000 grafts not needed for my goals here. 2,000-3,000 can still make a big improvement.
• The goal must be to close the disconnect. And if someone holds a gun at your head and forces you to choose where you want the disconnect to be, you should choose lower on the sides of the head because it's more typical to shave and fade that area, meaning the top and lateral ridge areas of your head can be grown longer as they should be. You don't want choose disconnect where it is right now, higher up, with longer hair below it.
• There is no lesson here other than perhaps you're inserting your own inaccurate perspectives into this a little too much. 
  • My process of doing research did not just involve looking at some other good cases and then going with it. The current situation I have was predicted and discussed by me, Dr. Das, and team last year. None of what you said is representative of me or my process.

Edited June 2, 2023 by general-etwan

[general-etwan]

I agree most grafts will need to be concentrated along the middle lateral ridge areas. But the transplantation zone has to follow the line of the pattern of hair loss. This is NW 7 patterning - the "game over" pattern is there; if anything it will dip very gradually over the rest of life, but it's already 90%+ of the way there. So you have to fill the area appropriately in order to be able to let hair grow for a few weeks and not have an unnatural disconnect in the mid-to-high ridge regions. It's a good time for a reminder that we notice every little detail as HT-invested people whereas the vast majority of regular people do not think about hair loss patterns very much and they will not notice minor issues. The goal, in my perspective and what I teach to others, is always as much redistribution as possible (without massacring donor area) to the top and lateral ridges of the scalp, as that is where hair needs to be for appealing presentation. There are multiple different ways to handle issues on the sides of the head, SMP for example, that I don't endorse for top-of-scalp use because people focus on the tops of our heads and they usually look too unnatural when used there.

Here's another visual representation of what I believe it should look like. Lower crown will need some grafts, but less than lateral ridge areas. 

Edited June 2, 2023 by general-etwan

[general-etwan]

@Niko1 Any feelings or advice on my 2nd HT next week? You and I have a very similar hair loss pattern and also very similar HT design strategies. I see the way they wrapped around with your remaining horseshoe pattern and took care of your ridges and lower crown with 2,000 grafts.

Edited June 2, 2023 by general-etwan

[GoliGoliGoli]

This will be my last post in this thread, but I would be very careful with this notion I'm picking up here that you think your balding is "done" or "very close to done" just because you are NW7. Everyone's "safe" donor hair is DHT resistant, not DHT proof. This is particularly relevant for you because your hair follicles show an extremely high affinity for DHT. This is why I think an extremely conservative approach is warranted. The long term is a long time, and it's not just about being happy with the result 1 year post op. With balding you never know where and when it will stop and that's especially true being NW7 at your age. 

[general-etwan]

1 hour ago, GoliGoliGoli said:

This will be my last post in this thread, but I would be very careful with this notion I'm picking up here that you think your balding is "done" or "very close to done" just because you are NW7. Everyone's "safe" donor hair is DHT resistant, not DHT proof. This is particularly relevant for you because your hair follicles show an extremely high affinity for DHT. This is why I think an extremely conservative approach is warranted. The long term is a long time, and it's not just about being happy with the result 1 year post op. With balding you never know where and when it will stop and that's especially true being NW7 at your age. 

Thanks for all of your contribution and you’re welcome to discuss any time. You don’t have to declare that any given comment will “be your last.” Notice I stated DHT resistant a few comments up; we fully understand. But the fact is the pattern of hair loss is already almost entirely visible. The end of the road already came for me, and it’s about battling back. Each person should prioritize what they value most. I know that personally, I’m not going to care as much what my hair looks like at 50 as I do right now. Youth is fleeting. And this isn’t meaning that I don’t understand the proper way to plan HTs out over the years. I’ve spent hundreds of hours since I began this journey thinking about all of this. I think about it every day. Niko1’s design looks proper for the situation he faced. We’ll make sure we put together a realistic and proper plan next week. 

Edited June 2, 2023 by general-etwan

[lunch_owl]

On 6/1/2023 at 3:44 AM, general-etwan said:

Interesting idea. I’ll keep everything on table. Not sure if due to slightly different hair beard hair characteristics, if that’s something they would ever do. Lower on the list of priorities, sides of head not too important to me. 

I would prefer overharvest the donor area making it blend in with transplanted hair and refill the donor with body hair like chest or leg hair. Beard grafts probably would look unnatural, also the thickness of the beard hairs would be better on top of the head than other body hair imo.

[EricEdwards]

On 5/29/2023 at 4:30 AM, Gatsby said:

@Fox243 I’m a Norwood 7 and my donor at 45 was nothing compared to when I was 26. Always better to err on the side of caution. The donor area you are referring to is DHT resistant. It’s not DHT proof. 

Very good point

[Gatsby]

4 hours ago, general-etwan said:

Thanks for all of your contribution and you’re welcome to discuss any time. You don’t have to declare that any given comment will “be your last.” Notice I stated DHT resistant a few comments up; we fully understand. But the fact is the pattern of hair loss is already almost entirely visible. The end of the road already came for me, and it’s about battling back. Each person should prioritize what they value most. I know that personally, I’m not going to care as much what my hair looks like at 50 as I do right now. Youth is fleeting. And this isn’t meaning that I don’t understand the proper way to plan HTs out over the years. I’ve spent hundreds of hours since I began this journey thinking about all of this. I think about it every day. Niko1’s design looks proper for the situation he faced. We’ll make sure we put together a realistic and proper plan next week. 

I promise you that you will care about your hair at 50. Trust me on this. 👍

[mr_peanutbutter]

2 hours ago, Gatsby said:

I promise you that you will care about your hair at 50. Trust me on this. 👍

 

 

hair will be a important part for self image and confidence regardless of age but in your 20/30 hair is more important. baldness get exponentially more common with older age (if you stick out from the peers it makes it extra hard) and it also affects other aspects of life less.

 

and your look impacts your life quality and experience the most in your young age.

 

a good looking guy and a not so good looking guy will most likely have a very different college experience socially. the difference in that regard between a good looking and a not so good looking man (both in their 50s) wont be as drastic, other factors get more important.

Edited June 2, 2023 by mr_peanutbutter

[Xanadu]

4 hours ago, mr_peanutbutter said:

 

 

hair will be a important part for self image and confidence regardless of age but in your 20/30 hair is more important. baldness get exponentially more common with older age (if you stick out from the peers it makes it extra hard) and it also affects other aspects of life less.

 

and your look impacts your life quality and experience the most in your young age.

 

a good looking guy and a not so good looking guy will most likely have a very different college experience socially. the difference in that regard between a good looking and a not so good looking man (both in their 50s) wont be as drastic, other factors get more important.

On the other hand, a 20 year old can be a great athlete and be buff and being completely shaved with some sun glasses is a cool look. Whereas, a 50 or 60 year old guy all these things are much harder to pull off to compensate for losing hair.

Edited June 2, 2023 by Xanadu

[ready4Hair]

3 minutes ago, Xanadu said:

On the other hand, a 20 year old can be a great athlete and be buff and being completely shaved with some sun glasses is a cool look. Whereas, a 50 or 60 year old guy all these things are much harder to pull off to compensate for losing hair.

As a six year old guy why is that,

[GeneralNorwood]

 

Dr. Muresanu speaks in this video about importance of balance between frontal and lateral hair. 

 

 

 

 

As you already now, this lower crown area can be managed with decent fadecut. Though i understand that visiting barber very often is not comfortable option. 

 

 

Melvin didn't adress lower crown in his last HT and his final result is great. He is contemplating one more HT in this area, because he is addicted to HT's 😅, nevertheles, how you look like in the back has the least importance from all sides. The most important is frontal look, then sides and top.

 

Therefore i would seriously think about completely skipping in 2nd HT this area between to red curved lines that you drew on the back (lower crown). You can ask Melvin about this, because he was standing before similar choice. 

But my thinking is - why waste precious graft in the back area, the least important area, when there areas with high priority to work on? You can always go back to this area later, you are young, you have time

 

 

 

Edited June 2, 2023 by GeneralNorwood