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

[Shadman]

On 3/27/2024 at 1:42 AM, general-etwan said:

Somesh wanted to add several hundred grafts to the frontal behind-the-hairline region from the beginning. I suppose because that is the most important area to make look strong because everyone sees you from face on. That work would’ve started a few mm behind the existing hairline but I wanted to adjust the left side of the hairline just a tiny bit, so that’s when he just decided to implant grafts from the newly drawn hairline point to the midscalp. The hairline wasn’t lowered overall. The center point is still the same height above glabella. The left corner was just made a little fuller. Dr. P said it was good. Now when I measure from glabella to each temple corner, eyebrow corner to each temple corner, etc both sides are pretty much the same. 

It looks like around 717 grafts were implanted in that frontal region, adjusted hairline to a few inches back.

Got it, I think after adding some density in that frontal region it'll definitely look more fuller.

Did you discuss anything regarding your current medications ? What medications you're on currently ?

[general-etwan]

8 hours ago, Shadman said:

Got it, I think after adding some density in that frontal region it'll definitely look more fuller.

Did you discuss anything regarding your current medications ? What medications you're on currently ?

They just ask me if I'm on the same regimen as before. I take finasteride 3 days a week and use minoxidil a few times a week when my hair is shorter. (Why only 3?...because more in-depth research has shown that the maximum hair-saving effects from finasteride max out around 3-4 mg/week, and higher doses beyond that don't seem to show significant benefit). They did however recommend I try adding Dutasteride 2 days a week Saturday and Sunday. My dermatologists at home won't prescribe Dutasteride for hair loss, however, so I'll have to order through some online platform if I decide to add it.

@Shadman They also recommend oral minoxidil to me but I’m not sure that I want to go on it yet. I’m turned off by the increase in body hair all over as opposed to just the scalp. Also not convinced it has no effects on the heart. 

Edited March 28 by general-etwan

[general-etwan]

A few more official pics from after part 2 where you can better see the additional lateral hump and behind-the-temple grafts added. 

 

Also, they sent me official grafts counts and I made a slight correction to overall beard graft count vs. scalp:

I'm still at about 11,102 total; 9,246 scalp vs 1,856 beard.

[general-etwan]

13 hours ago, AGL77 said:

Great news and wishing you the very best on your 3rd HT. Been following your case and want nothing more for you than to get the win. One question I have is why do you choose not to have Dr. Das involved in this procedure? Thank you!

Didn’t want to pay that price tag.

[hair_forever]

1st HT: UF 4000 - BHT 1300 = 5300
2nd HT: UF 2977 - BHT 0 = 2977
3rd HT: UF 2269 - BHT 556 = 2825

Is correct?

Have they estimated other UFs that can be withdrawn?

You performed all three surgeries with the same package Eugenix?

Edited March 28 by hair_forever

[general-etwan]

On 3/28/2024 at 11:37 AM, hair_forever said:

1st HT: UF 4000 - BHT 1300 = 5300
2nd HT: UF 2977 - BHT 0 = 2977
3rd HT: UF 2269 - BHT 556 = 2825

Is correct?

Have they estimated other UFs that can be withdrawn?

You performed all three surgeries with the same package Eugenix?

Correct. What do you mean by UFs? They haven’t officially estimated future availability of anything. But I think my donor can have another few thousand taken. The donor area is still physically darker in color due to still being more dense with thicker, darker hairs.

First two were the exclusive package; third was the simplest comprehensive package as I wanted to save money by booking hotel and transportation on my own. 

Edited March 29 by general-etwan

[Dragonsphere]

On 3/28/2024 at 7:42 AM, general-etwan said:

They just ask me if I'm on the same regimen as before. I take finasteride 3 days a week and use minoxidil a few times a week when my hair is shorter. (Why only 3?...because more in-depth research has shown that the maximum hair-saving effects from finasteride max out around 3-4 mg/week, and higher doses beyond that don't seem to show significant benefit). They did however recommend I try adding Dutasteride 2 days a week Saturday and Sunday. My dermatologists at home won't prescribe Dutasteride for hair loss, however, so I'll have to order through some online platform if I decide to add it.

@Shadman They also recommend oral minoxidil to me but I’m not sure that I want to go on it yet. I’m turned off by the increase in body hair all over as opposed to just the scalp. Also not convinced it has no effects on the heart. 

Oral minoxidil would help safeguard you against senile alopecia. 

This is the natural thinning of the donor area which is present in those who do and do not have MPB. 

In regards to body hair, I can confirm this is almost guaranteed.

Its not a bad thing imo, my beard has got thicker and I have more chest hair. 

I just view it as more grafts for potential harvesting. 🤣

[general-etwan]

46 minutes ago, Dragonsphere said:

Oral minoxidil would help safeguard you against senile alopecia. 

This is the natural thinning of the donor area which is present in those who do and do not have MPB. 

In regards to body hair, I can confirm this is almost guaranteed.

Its not a bad thing imo, my beard has got thicker and I have more chest hair. 

I just view it as more grafts for potential harvesting. 🤣

Willing to take it only if 1) body hair growth increase can be kept to a very minimum (not a fan) and 2) I can be convinced that it’s safe for heart. My family has suffered a lot of heart failure/blocked arteries/atrial fibrillation so I need be extra careful about how I treat my heart in my life. 

[Dragonsphere]

3 hours ago, general-etwan said:

Willing to take it only if 1) body hair growth increase can be kept to a very minimum (not a fan) and 2) I can be convinced that it’s safe for heart. My family has suffered a lot of heart failure/blocked arteries/atrial fibrillation so I need be extra careful about how I treat my heart in my life. 

1) Unlikely, I've gained a minor monobrow due to it. You could always laser any unwanted growth off. 

2) You could always speak to a cardiologist and have seem pre tests done and be monitored. 

At the end of the day, you should do what you feel comfortable with but always consider the future. 

Edited March 31 by Dragonsphere

[Fox243]

I don't see the point of oral minoxidil -- just apply topical minoxidil all across the scalp. Why use an oral drug when topical can do the job almost just as well? Convenience is always the argument but I'd prioritize safety over convenience always.

[Dragonsphere]

7 hours ago, Fox243 said:

I don't see the point of oral minoxidil -- just apply topical minoxidil all across the scalp. Why use an oral drug when topical can do the job almost just as well? Convenience is always the argument but I'd prioritize safety over convenience always.

I use oral minoxidil due to having seborrheic dermatitis. Both the foam and liquid version exacerbate it. 

Due to the fact it stays in the bloodstream longer, i believe it is more effective but that is just my own personal theory.

To protect yourself from senile alopecia you would literally need to apply it topically like shampoo, i.e. all of you head, back and sides.  

[SLA]

On 3/28/2024 at 3:42 AM, general-etwan said:

I take finasteride 3 days a week and use minoxidil a few times a week when my hair is shorter. (Why only 3?...because more in-depth research has shown that the maximum hair-saving effects from finasteride max out around 3-4 mg/week, and higher doses beyond that don't seem to show significant benefit).

Hi @general-etwan- Very interesting. Do you have any links to studies which show how hair saving effects from finasteride max out around 3-4 mg/week? I would be interested in seeing it.

Much appreciated and I am a BIG fan of your journey. Sending you best wishes and positive thoughts.

[general-etwan]

43 minutes ago, SLA said:

Hi @general-etwan- Very interesting. Do you have any links to studies which show how hair saving effects from finasteride max out around 3-4 mg/week? I would be interested in seeing it.

Much appreciated and I am a BIG fan of your journey. Sending you best wishes and positive thoughts. 

 

These doctors feel that based on the finasteride dose response curve, which flattens off at about 0.8 mg, 3-5 mg per week is all that is necessary to get maximum effect without letting finasteride over-accumulate in the body, which is likely what happens in many patients who complain of side effects.

Personally, I’m going to see if I can add dutasteride Saturday and Sunday, as others have done, and keep finasteride at MWF or maybe Monday through Friday at the most. 

Edited April 1 by general-etwan

[SLA]

17 minutes ago, general-etwan said:

 

These doctors feel that based on the finasteride dose response curve, which flattens off at about 0.8 mg, 3-5 mg per week is all that is necessary to get maximum effect without letting finasteride over-accumulate in the body, which is likely what happens in many patients who complain of side effects.

Personally, I’m going to see if I can add dutasteride Saturday and Sunday, as others have done, and keep finasteride at MWF or maybe Monday through Friday at the most. 

Thanks @general-etwan- Yes, I have seen this video and I know they are not the 1st to say this. Not that they are wrong persay, but seems to be only based on observation and not a long term study.

I like the following link and trust Rob English from Perfect Hair Health as he is a medical researcher and is very thorough and always objective. There seems to possibly be some evidence of the 3-4 times a week theory, but is not conclusive.

Yes, dutasteride is also a good idea. 

I'm following your journey closely and rooting for you! I am confident that you will achieve your goals!

https://perfecthairhealth.com/how-often-should-i-take-finasteride/

[general-etwan]

5 hours ago, SLA said:

Thanks @general-etwan- Yes, I have seen this video and I know they are not the 1st to say this. Not that they are wrong persay, but seems to be only based on observation and not a long term study.

I like the following link and trust Rob English from Perfect Hair Health as he is a medical researcher and is very thorough and always objective. There seems to possibly be some evidence of the 3-4 times a week theory, but is not conclusive.

Yes, dutasteride is also a good idea. 

I'm following your journey closely and rooting for you! I am confident that you will achieve your goals!

https://perfecthairhealth.com/how-often-should-i-take-finasteride/

Yeah I understand what you are saying. Good link to reference, I'll bookmark it. I still think after reading it that the main point against taking 1 mg 7 days a week is that doing so will lead to a complete saturation level and further buildup in the body that is unnecessary; at least that's the way I understand it. This is likely what happens in people who complain of side effects months after starting, or after stopping and calling it "post-finasteride syndrome."

Taking 0.2 mg 7 days a week reduces DHT by 69%; taking 1 mg 7 days a week reduces DHT by 71%. Or, converted to weekly amounts, 1.4 mg reduces DHT by 69% and 7 mg reduces DHT by 71%. That's so close it's pretty much insignificant. So it seems to me that keeping the weekly total to 3-5 mg avoids that oversaturation while still essentially reaching very close to the peak of DHT-blocking benefit from the finasteride response curve.

In the end, I highly doubt that 3 or 4 days a week vs. 7 makes any substantial difference in how significant of positive results one sees from taking finasteride. I think if you get at least 3 or 4 mg a week, that's essentially pretty good.

Edited April 2 by general-etwan

[general-etwan]

Well, 2 weeks after the 3rd HT and I have to say my donor area is still looking a little too immaculate for my liking. My biggest worry is that still not enough has been used from my donor area. I know that sounds crazy, but my donor has recovered very well after each procedure and it seems that I had far more strong and healthy grafts there than anyone could have initially imagined.

I think, though, that my next project in line will probably be a light SMP all over the recipient area. I have seen some good cases of this online recently where SMP was combined with HT results and the visual illusion of density looks very good and is completely undetectable from a distance. Getting the appearance of good thickness on top is very important to me with the types of haircuts I want to be able to sport, so I think a light SMP across the whole top will be a good tool to utilize.

Edited April 5 by general-etwan

[EricEdwards]

On 3/26/2024 at 11:38 AM, general-etwan said:

3rd Procedure

March 21, 22, 23 2024

Package with Dr. Vinita performing surgery (slits) + Dr. Somesh and Dr. Pradeep in on planning & design.

As I said over the past few months, I really wanted to have this 3rd procedure before summer. Eugenix informed me that Dr. Pradeep wanted to see me during my time there so they only gave me open dates during which he'd be there. In February the dates of March 21-22 came open and it was a good fit with my schedule, so I booked it. That puts the timeline at 9 months after my 2nd procedure last June (and my 2nd procedure was similarly 9 months after my 1st procedure in Sept 2022).

Left home Tuesday night, arrived in Delhi/Gurugram Wednesday night, procedure took place on Thursday and Friday, and then we did a part 2 additional work on Saturday. I left late Saturday night to return home. 

As we talked about recently, my primary goal for this procedure was to add density to the top areas. The projection from February was for 2,900 grafts, using some beard hair.

 

 

 

Planning & design with Dr. Somesh + Dr. Vinita resulted in a plan to focus on the frontal area and the crown area. The pattern that Somesh drew up wasn't what I was originally expecting; I just assumed density would be added uniformly all over. But I guess what they really try to do is identify the exact areas in need of most improvement based on how well growth came in from the last time. Some areas trailed behind other areas in density when examined up close and needed the most work.

Additionally, I expressed my desire to slightly reposition my hairline, due to the fact that the left temple corner was previously higher than the right when viewed straight from the front and the left side of my face is weaker than my right. So I wanted to bring the left side of the hairline down just slightly by 1-2 mm for better balance for my liking.

Secondly, Somesh and Vinita proposed doing "donor farming" in the areas of retrograde alopecia that I have above my ears on the sides of my head to try to achieve a more filled look, using beard hair (I've had that retrograde thinning since my teens). I agreed to do it, but made clear I didn't want to use a ton of beard hair to do this; just a little.

Somesh drew up the following:

 

 

We identified the crown region (mostly the lower crown and reaching up into the side crown areas), the frontal/hairline area, and the above-the-ears donor farming areas as the recipient areas. We identified the rear scalp, the neck hairs, the sidelocks, and the beard as donor areas. I expressed that I wanted to be aggressive with taking scalp donor as I felt it had held up very well through 2 procedures so far and would be totally fine with a little thinning to achieve more density up top. Dr. Somesh understood my goals and explained that he would homogenize the area as much as possible and try to smooth over the boundary between the lower crown and the rear donor area, creating a more uniform look. Plan was for 2,500 slits total.

Dr. Pradeep came to see me and reviewed the design, made sure the hairline adjustment measurements lined up, and approved of it. He said he doesn't usually like to do donor farming using beard hair, but in my case, my beard hair is decently similar to my scalp hair and so it would be acceptable to do.

Dr. Vinita made all the slits according to the design and on Thursday they extracted from rear scalp donor and implanted 616 grafts in the frontal/hairline area. It was getting into late afternoon/evening and I had some oozing so we finished up for the day. On Friday we started at 9 am and they extracted more from the scalp donor, used that in the crown area, added some more grafts to the front hairline and did the hairline adjustment, and then extracted beard grafts for use in the donor farming areas above the ears They put 145 grafts on the right donor farming and 87 on the left donor farming (232 total). In total, 2,500 grafts were added to the frontal area, the crown areas, and the donor farming areas combined.

Early evening we finished up and I went back to the hotel to rest, but soon something happened...I was in the bathroom reviewing the scalp and had pulled my surgical cap off and noticed 4 hair grafts had come loose from the donor farming region above my right ear. I'm not sure how it happened, they seemed to not be deep enough into the slits and were just sort of hanging there and the surgical cap might have gotten caught on them pulling them loose. One had already fallen and was just laying on my neck. They were obviously not all the way in the skin so I touched two and they fell right off. The 3rd bled just a little as it came out. I was simultaneously chatting with @Bandit90 and mentioned what happened and he said to let Dr. P know asap. This was around 10:30 pm Friday night. I messaged Dr. P and he arranged a driver to bring me in for him to look at. Got into the clinic after 11 pm, he had a look and unfortunately I lost those 4 grafts but he had his team quickly extract 4 more from beard and added them back to the donor farming area above the right ear. I appreciated this so much, as he absolutely did not have to do anything until Saturday but his immediate care is just world-class. I think the above-the-ear skin is more difficult to push the grafts into and for some reason those 4 didn't make it in deep enough.

After Friday's work, 2,500 grafts total:

 

 

Late Friday night when reviewing everything I felt there were a couple little things I still noticed:

1) I felt there was a larger gap between dark, thick hairs on my left rear lateral hump area compared to my right:

 

2) There were still small gaps in the behind-the-temple areas, which I talked about months ago. When the hair is buzzed down very short or shaved, you can see the dark hairs that were transplanted last year, then a region of thinned blonde hairs, and then dark hairs again. I really wanted to even that out, and also, we had not used any of the corner-of-the-neck hairs that we originally identified as usable. Those neck hairs of mine have always annoyed me; if they aren't shaved almost daily, it just makes the back of my head look sloppy. Nature gave me hair growing down my neck but not on the top of my head, lol. So I really wanted to get rid of them and use them somewhere more important.

 

I messaged Dr. P about these two concerns and he said we'd go over everything on Saturday in the center.

Saturday, driver picked me up at noon and the team took me upstairs in a new area. Hung out there for a while and met a few other guys, two from USA and one from Poland. Dr. P, myself, and Dr. Somesh examined my pics on a big screen. They agreed to add some more grafts to the lateral hump areas on both sides, more on the left than the right, and use the neck hairs previously identified as usable for the behind-the-temple filling to address all of my concerns and further homogenize dark hairs across the scalp. 

We did that Saturday afternoon and Somesh and Dr. P checked in on my final results after:

 

They added 71 grafts to right temple, 68 grafts to left temple, 74 grafts to right lateral hump, 112 grafts to left lateral hump...using 139 grafts from the neck area and 186 beard grafts, for a total of 325 additional grafts, bringing the total for the week's procedure to 2,825 grafts.

Overall, I did have a lot of pain again this time. I don't know what it is with me and local anesthesia, but it wears off after a little while and I dealt with a very intense burning sensation over most of the recipient area each day. Somesh asked me what my pain level was from 1-10. Truthfully, it was about a 7-8 but I said "3 or 4" to downplay it a little because I didn't want them to have to stop, and Somesh said "3 or 4?!?! It should only be a 1 or 2." LOL. They gave me some additional medication to try to help with the burning feeling.

I'm very glad I pushed for that additional work, to close as many gaps as possible, however minor or unnoticeable at longer hair length. I wanted to be able to maximize my options for future haircuts and really just maximize uniformity where possible.

Here's something I have to say in summary about the clinic for anyone wondering how operations are going these days:

Eugenix has been expanding and they do take on a lot of patients. There are a handful of people having HTs done every day, between Drs. Bansal, Das, Somesh, and Vinita. Big team, a lot of moving parts. People are coming and going all day. You do start off getting what you pay for in terms of planning investment. If you go with the lower tiered packages, you're obviously not going to get as much investment in planning or deep-maximization-of-strategy as you would at the more expensive packages. Unless you're paying for Dr. Pradeep or Dr. Bansal to make all your slits, this is not a process in which you and your doctor will have an extremely deep examination and then analyze and mull over a plan for days and weeks before having the procedure. Eugenix is performing a lot of procedures. As a patient having a HT here, you really should be personally knowledgeable, proactive, and assertive in what you want, and make sure they address all of your concerns. If you don't have deep knowledge of the HT industry or HT design and need a doctor who will hold your hand from start to finish, and who can put many hours of investment into your situation, due to he or she performing fewer operations overall, there are plenty of options in the world for that. Every clinic has pros and cons; the pro to Eugenix is they have made it possible for me to have this work done all before my 30th birthday and at a very reasonable cost. They are also very ethical and careful with donor management, all of which I have a lot of gratitude for.

Grand Total Graft Counts from each procedure:

The fact that they've been able to use over 9,000 grafts from my scalp donor is remarkable. My donor has turned out to be a lot stronger than I could have ever expected. I do expect some visible thinning after this procedure but hope it won't be too bad.

Please update the title of this thread to:

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

I'm hopeful that you're latest procedure is going according to plan for you. I admire your persistence and perseverance. I've gotten cold feet over the past number of months. 

[general-etwan]

3 hours ago, EricEdwards said:

I'm hopeful that you're latest procedure is going according to plan for you. I admire your persistence and perseverance. I've gotten cold feet over the past number of months. 

About having a HT? What’s your situation?

[Gatsby]

On 4/5/2024 at 7:13 PM, general-etwan said:

Well, 2 weeks after the 3rd HT and I have to say my donor area is still looking a little too immaculate for my liking. My biggest worry is that still not enough has been used from my donor area. I know that sounds crazy, but my donor has recovered very well after each procedure and it seems that I had far more strong and healthy grafts there than anyone could have initially imagined.

I think, though, that my next project in line will probably be a light SMP all over the recipient area. I have seen some good cases of this online recently where SMP was combined with HT results and the visual illusion of density looks very good and is completely undetectable from a distance. Getting the appearance of good thickness on top is very important to me with the types of haircuts I want to be able to sport, so I think a light SMP across the whole top will be a good tool to utilize.

The more hair in your donor now at your age the better for the long haul in years to come mate. I think SMP now would not be a bad idea to create more illusion. It won't involve surgery and will give you the appearance of more hair (although I think you will smash it once this last procedure kicks in). All the best @general-etwan.