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

[EricEdwards]

On 1/9/2023 at 2:53 AM, general-etwan said:

Hello everyone. Have some more 3.5 months pics to share. Looks to me like solid progress for 3.5 months. My treatment regime is the following: finasteride every other day; minoxidil and RU58841 daily; ketoconazole shampoo every other day. Plus moisturizer daily for scalp health.

  

 

That said, for anyone who read the early talk about the procedure design, there was area in the lower crown that Dr. Das and I agreed not to address in this procedure because of the amount of grafts and size it would add to the entire procedure, and wait to see if that area would recover from further medication (at the time of the transplant I had been on finasteride for about 7 full months).

It is clear to me at this point that this lower crown area is not going to improve any further with finasteride + minoxidil. Male pattern baldness is simply too strong in my genes and has done its damage. I've been taking finasteride now for 12 months and since I have no major side effects, I will of course continue to take it to further protect the entire head from DHT, but I think to expect any lower crown regrowth going forward would be unrealistic.

Looking ahead, I will be embarking on a new career journey in the 2nd half of 2023 and my schedule and ability to travel and attend to things like this will become less under my control. Therefore, I think I want to address this remaining area with more grafts, before the summer, while I can still go anywhere and do anything whenever I want.

I think that my donor area at 3.5 months looks great, and despite our early worries about how many grafts we could ultimately take from it, when grown out to this length it looks visibly very great to me:

 

So, with 4,000 grafts already taken from scalp donor, I would think that another 1,000-2,000 could be taken. As I've said from the beginning, even if this entire back area was visibly thinned, it wouldn't bother me as much as it might bother some people. I care far more about hair on top of the head for aesthetic appearance. I could absolutely accept visible thinning in the donor area, so long as it's done uniformly and not in uneven patches. Most people when they are looking at your head, they are not evaluating the back of your head for density or style. There are multiple options to handle that area including actual shaving, fading, SMP, or growing longer to hide extractions. And most people are not looking at the back of your head much.

I'm already fully invested in this journey so might as well keep going to max out what we can max out while it's most convenient for me.

Here is the back in unflattering lighting. The area above the black line has been taken care of already, at least decently well. Maybe more grafts could be added for more density if necessary. But the area outlined in red is what I will want to address. I just want this area to be more uniform with the area beneath it; the back of the head. Uniformity always looks better, even if thinner, and considering most of my donor area is still pretty thick and dense, it seems like we can do a redistribution here and further even out things across the scalp.

I plan on discussing with Eugenix if this is an option we can move forward on, preferably before the summer. Anyone have an opinion on how many grafts might need to be moved to try to even things out between this area and the donor area? I think 1,000-2,000 could do it. I also have beard hair which could be used again, if necessary. 

Looking fantastic. 

[MazAB]

@general-etwan everything looks great so far! I personally found that you need to re-learn your hair and master the nuances cutting and styling which will certainly evolve as you progress.

In the meantime, I agree with @Melvin- Moderator, probably best to find a barber that can customize and master the best fade and cut that best suits you.

[Xanadu]

On 10/9/2022 at 9:19 PM, general-etwan said:

3-4 days after procedure, upon arrival back home. 4th pic is donor area up close after a few days.

 

 

 

Meant to say in my original post, too:

I understood going into this that I would never have the density of pre-hair loss, or even the density that I briefly had wearing systems. I fully understood the hairline would have to be conservative, as well as the difficulty of the thinning ring area that could not be addressed in this procedure. Still, this was absolutely the best way forward for me, and if I can regain some framing of the face with some coverage on top, that will be a success to me.

I wonder what happened here. In the pics immediately after op the grafts looks very evenly distributed, but then here 3-4 days later, there are gaps likes broads rivers forming with no grafts. How come?

[Berba11]

3 hours ago, Xanadu said:

I wonder what happened here. In the pics immediately after op the grafts looks very evenly distributed, but then here 3-4 days later, there are gaps likes broads rivers forming with no grafts. How come?

This is totally standard as the scabs dry, crack & separate. It will normalise once the scabbing has gone. Happens after virtually every transplant to varying degrees. 

[Xanadu]

6 hours ago, Berba11 said:

This is totally standard as the scabs dry, crack & separate. It will normalise once the scabbing has gone. Happens after virtually every transplant to varying degrees. 

Yes, I have seen that. I just onder why it happens. If zooming in it really appears that the grafts are moving (are being puched?) away from these 'rivers'.

But yes, it seems to be the way it is for most.

 

[general-etwan]

On 1/22/2023 at 1:42 AM, Xanadu said:

Yes, I have seen that. I just onder why it happens. If zooming in it really appears that the grafts are moving (are being puched?) away from these 'rivers'.

But yes, it seems to be the way it is for most.

 

It baffled me too for a while until I understood it, at least I think. Not every slit scabs up. There are not gaps/rivers between graft implantation as seen in the scabbing pictures. The scabbing sometimes occurs beyond the actual slit, and for whatever reason the slits next to that one may not scab up, leaving the illusion of a "channel" where there was nothing inserted. Something like that. But it's just an illusion created by the scabbing pattern. You can see after the scabs come off if the distribution of grafts is good.

[general-etwan]

4.5 months update. A bit unsure about progression; part of me feels like growth has stalled but maybe it's an illusion due to really ugly duckling stage of some areas thickening and others not, yet. I have not cut any hair on the top since the HT. Also, I'm dealing with 2 concerns:

My retrograde alopecia above my ears seems to have worsened and it is unfortunately very apparent at this hair length. Yes, they took some grafts from that area of the head, but not many (most on the side of the head were taken from higher up). I had this retrograde alopecia pre-HT, obviously, but it looks worse than ever. When I buzz my hair shorter it's less noticeable, and I assume if I grow it longer it will be less noticeable too...but at this length it's unfortunately bad. 

Also, I'm getting quite a bit of acne-type bumps on the scalp regularly; a few times every week. Not sure why as I'm very clean, wash my head twice every day and use both Dove and Ketoconazole shampoo. I'm using minoxidil, pyrilutamide, and RU58841 daily so not sure if it's one of those causing it or not.

How much more progress should I realistically expect in the next few months? I feel like I saw a lot of early growth compared to most people. Most people don't seem to notice major growth until about 4 months but mine started at 2 months and months 2-4 saw pretty significant growth for me. So, not sure how much more to expect...   

[honey21790]

stick to the medication and trust the process i can see a great progression from where you start and still have many more months to improve im sure you gonna be satisfied

[general-etwan]

Feel like I owed you guys a better picture, after showering, without hat-hair lol...so it shows a better presentation of the hair laying more naturally...

4.5 months

[Madhur Vansil]

41 minutes ago, general-etwan said:

Feel like I owed you guys a better picture, after showering, without hat-hair lol...so it shows a better presentation of the hair laying more naturally...

4.5 months

With the grade of baldness you had and coverage done the growth is faster than most people I have seen so it’s a positive sign and you getting the acne here and there means that hairs follicle is trying to    come out from beneath the scalp and start growing .We both were operated exactly same day and by same surgeon .Hope you remember 🙂

Edited January 30, 2023 by Madhur Vansil

[Gatsby]

I had the opportunity of meeting Dr Das over the past two weeks and to say that I was really impressed with her both as a surgeon and a person is a huge understatement. @general-etwan I have a theory that I have not taken the time to research and it is only from personal experience. I believe that after surgery the scalp, having undergone a lot trauma from a hair transplant, requires up to 12 months to heal. I definitely thought I had a very poor donor, not just before my first repair procedure, but also after it. It wasn't until I got to month 8 that I found that it really began to bounce back! So much so that to my complete surprise I was able to harvest more than 3k scalp grafts on my second repair procedure that I underwent two weeks ago. Patience is a hard thing if we see things like retrograde alopecia, shock loss, etc. I really wouldn't be judging results now at all. Whether that is your growth or the condition of your donor. Personally I would be sticking with FDA approved drugs for hair loss and I found oral minoxidil to being of great benefit in my case. All the best! 👍

[Bandit90]

I would say you look bang on the money for 4.5 months, very similar position to me. I had a grafts implanted on my lateral humps and parts during my second sitting, which are now starting to make a big difference, I think this will be very much the case for you too, as you prepare for sitting number two. Retrograde-wise I would worry about it too much, a good fade cut can conceal it. You are on the meds so any progression will have slowed right down. 

[asterix0]

It will improve more, 4.5 months is still early. The next 2 months you should see plenty more growth so don't worry. 

[Niko1]

Just stumbled on your thread for the first time Today ! Don't know how I've missed it ?

 

Stay Positive mate, there is Defiantly more growth to come. I just had a HT for the Lower Crown and Lateral Humps, 2 weeks ago, worth having a look at Bandito90s thread also for an idea of Transplantation in those Areas........

Its a waiting Game now Give it some time experiment with hair styles and lengths to see what works for you.

If growing it out, worth tying a sliced back undercut. Grow it out long so you can cover the thin Lower Crown.

 

Just a heads up, the Native Hair in your Lateral Humps and Lower Crown are Miniaturised, Less Pigmented and COULD be on their Way Out. If you Transplant in those thinning areas, you COULD (most likely) Lose you Native hair due to trauma of the transplant (shock loss). Therefore you will require a higher number than might initially think. Probably 3000 and above.

Ive seen some people get considerable regrowth in those areas, through the used of medication.

 

Why was Dr Das so conservative with Beard Extractions ? Did she check your Chest Hair Calibre.

[MazAB]

Lots of progress unrealized at this point at only the 4.5 month mark. You've come a long way and look outstanding at this stage of the game. Stay optimistic because so much WILL improve from here. Not to mention, having additional procedures in the future will nail down any area of weakness for you. I'm loving it so far my friend!

Follow my Journey with Eugenix and Dr Arika Bansal!

[GeneralNorwood]

Clearly you had taken some grafts from area that you have retrograde alopecia. Not the best area to take grafts from. Shouldn't it be no-go zone?  

Now maybe it's some shockloss and it will improve, but by simple logic this beforehand thinned area will be less dense then before HT, because you had taken grafts from there. 

Maybe i am missing something, we will see how it will turn out in few months. 

 

Edited February 1, 2023 by GeneralNorwood

[keratin_matters]

3 hours ago, GeneralNorwood said:

Clearly you had taken some grafts from area that you have retrograde alopecia. Not the best area to take grafts from. Shouldn't it be no-go zone?  

Now maybe it's some shockloss and it will improve, but by simple logic this beforehand thinned area will be less dense then before HT, because you had taken grafts from there. 

Maybe i am missing something, we will see how it will turn out in few months. 

 

Agreed. The area should have been marked out and avoided for extraction. But it seems that they've extracted from the zone at the same density as elsewhere.

OP should try some minoxidil on the area to speed up the recovery if it is shock loss. Worst case scenario, one can do some beard hair grafting or SMP in the area. 

[Madhur Vansil]

2 hours ago, keratin_matters said:

Agreed. The area should have been marked out and avoided for extraction. But it seems that they've extracted from the zone at the same density as elsewhere.

OP should try some minoxidil on the area to speed up the recovery if it is shock loss. Worst case scenario, one can do some beard hair grafting or SMP in the area. 

Minoxidil is a good option and hope for some re-growth in the desired area 

[mrmane85]

Your at the very early stage of the process so just hang tight for now as in another 3-4 months you'll have a much better idea of what you're working with 

[general-etwan]

On 1/31/2023 at 2:11 PM, Niko1 said:

Just stumbled on your thread for the first time Today ! Don't know how I've missed it ?

 

Stay Positive mate, there is Defiantly more growth to come. I just had a HT for the Lower Crown and Lateral Humps, 2 weeks ago, worth having a look at Bandito90s thread also for an idea of Transplantation in those Areas........

Its a waiting Game now Give it some time experiment with hair styles and lengths to see what works for you.

If growing it out, worth tying a sliced back undercut. Grow it out long so you can cover the thin Lower Crown.

 

Just a heads up, the Native Hair in your Lateral Humps and Lower Crown are Miniaturised, Less Pigmented and COULD be on their Way Out. If you Transplant in those thinning areas, you COULD (most likely) Lose you Native hair due to trauma of the transplant (shock loss). Therefore you will require a higher number than might initially think. Probably 3000 and above.

Ive seen some people get considerable regrowth in those areas, through the used of medication.

 

Why was Dr Das so conservative with Beard Extractions ? Did she check your Chest Hair Calibre.

Yeah, I'm trying to be patient with it and still treating all areas of prior thinning with of course finasteride, minoxidil, and recently added RU58841 and pyrilutamide. RU & pyril are of course not yet FDA approved but have shown potential to increase hair growth and hair diameter. When my current bottle of RU runs out I decided I will just stick to minoxidil and pyrilutamide. Pyril looks quite promising, if you look at some of the recent news on it. I believe it's in phase 3 trials for treatment of androgenic alopecia and acne, and could eventually replace finasteride entirely if it succeeds. At the very least, could be a valuable topical tool to save native hair prone to thinning.

Was 1300 grafts conservative beard extraction? Possibly because I stated that I didn't want to totally decimate my facial hair since I do like to sport facial hair. But, one place they could have taken more from is my sideburns area, which they actually had outlined with a surgical marker as suitable to be taken during the extraction phase, but they ultimately did not take any from there for whatever reason. Chest hair I'm not interest in touching.

[general-etwan]

On 1/31/2023 at 9:49 PM, GeneralNorwood said:

Clearly you had taken some grafts from area that you have retrograde alopecia. Not the best area to take grafts from. Shouldn't it be no-go zone?  

Now maybe it's some shockloss and it will improve, but by simple logic this beforehand thinned area will be less dense then before HT, because you had taken grafts from there. 

Maybe i am missing something, we will see how it will turn out in few months. 

 

Yes, as I mentioned some were taken from there but as you can see in the pictures, few compared to elsewhere across the donor. My donor was not excellent, so we needed to take as much as we could possibly take. Very few grafts were taken from the area up to maybe 2 cm above the top of the ear; more was taken from higher up on the side of the head. Not the end of the world...in the future I will either grow the sides longer to conceal, or maintain a much shorter fade.

[general-etwan]

On 2/1/2023 at 1:23 AM, keratin_matters said:

Agreed. The area should have been marked out and avoided for extraction. But it seems that they've extracted from the zone at the same density as elsewhere.

OP should try some minoxidil on the area to speed up the recovery if it is shock loss. Worst case scenario, one can do some beard hair grafting or SMP in the area. 

Definitely a lower density to some degree. Still took grafts from right above the ear, which in a perfect world wouldn't be done, but you can see in the photo it's less than higher up on the side. Yes, using minoxidil there now daily. Will handle with better length choice of hair in future.

Edited February 4, 2023 by general-etwan

[general-etwan]

4.5 months

 

I have to say, I don't know that the feeling of having hair on my head again has really sunk in yet. I essentially have felt bald since about 16 years old because literally that's when my hair started aggressively thinning and I started hat wearing to hide the feeling and look. At 27 I now have more hair on the top than I've had since age 15ish, so it's a pretty surreal thing to see. It really hasn't yet sunk in yet. When I don't wear a hat I still feel like I have no hair up there since I've felt that way for a whole decade. Going to have to get used to this new situation for sure.

Edited February 4, 2023 by general-etwan

[general-etwan]

  

[Mohammad Hussen]

Looks to be going well bro, im quite sure the growth will speed up during the coming months, keep us updated 🙂