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Eugenix 3514 grafts (720 on the temples) May 2022 Dr Priyadarshini Das


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6 hours ago, Rafael Manelli said:

 

Approx 6000 grafts, with your hair type, was never going to be enough to cover the whole nw7 area with good density and that aggressive hairline. So you were always reliant on the meds and it was always a risk. I'm surprised Dr Das was so rushed, by the sound of it.

I don't consider it anywhere near the worst result I've seen. If it helps, I've seen far, far worse. Miles worse. I don't say this to deny your perspective but to give you a new one and for reassurance. It's not that bad. Just reckless and rushed by the sound of it in the planning phase. 

 

Imagine that i was graded Norwood 3V by Eugenix, that was so wrong assesment. 

I meant - one of the worst results from Eugenix, not from whole world of HT ;) 

5 hours ago, Rafael Manelli said:

I went back and noticed you said this. That you didn't foresee the possibility that you'd need grafts on that triangle on the side, especially the left. 

But really, whether you noticed it or not, Dr Das should have noticed it.

I asked her about it why she didn't implant hair there. She said that "couldn't have implanted hair there, at least not until there is enough space between hair". Same speech was about implanting hair ot the top, that it can be harmful to the native hair. But recently when i send here photos she said that we can implant 2500 on the crown and miscalp, just like that. Now everything is possible, because "will do closer implantation in this area". That's some high level of BSing

3 hours ago, Rafael Manelli said:

 

My concern with transplanting the midscalp and crown would actually be the possibility of killing off some of the miniaturised natives. They appear dense and shrunken, which can make them vulnerable to shockloss.

 

 

That was concern of Dr Das before 1st HT, but now this concern dissapeared and she can do 2500 grafts on top. Magic 😂

3 hours ago, Melvin- Moderator said:

Well, different doctors have different philosophies, I have nothing but the utmost respect for Dr. Bisanga. That said, I think you still have plenty of donor left. I was in a similar situation before my last HT.


D1722B64-2FF4-49E9-A66B-7A11C3BAF0B9.jpeg

Can your situation be improved with another surgery? In my opinion, absolutely. Now, will you ever have a full head of hair with no weak spots? Probably not. That’s being realistic.

 

Yeah, that is positive thinking, but imagine that i had more focus at my weak spots like midscalp and lateral humps, like you mentioned earlier in this topic. For my level of hairloss, treating vulnurable areas instead of agressive lowering would be correct choice by professional doctor with plan. And i could have full head of hair, just with higher hairline and without temples. 

 

2 hours ago, Zoomster said:

Please take some hope from this @GeneralNorwood..there’s 5,400 beard grafts in there some where within my midscalp / crown…..if Eugenix deem your beard suitable then as was mentioned earlier a 3k scalp 2 K beard procedure should put an end to your concerns …most of my last crown procedure hasn’t fully borne fruit yet either ..i understand your frustration though ..I’d be feeling the same way .

Ive a feeling you’re going to be ok at the end of all this so hang in there .

 

 

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I don't know if i can put trust in Eugenix team anymore. I am not so stupid anymore like 1 year ago. Vague plan to implant 2500 on the midscalp and crown is not enough for me. 

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5 minutes ago, mister_25 said:

After reading your thread I do have to agree with Dr Bisanga's assessment. 3200 Grafts isn't enough to get you a full head of hair regarding your midscalp and crown but I still feel like 3200 grafts would make you look somewhat normal with just vertex thinning if executed properly and carefully. I feel like the planning here is most definitely working against you but its not unsalvageable and you can at least get to a point that looks natural and not artificial.

Did Dr Bisanga mention how many grafts you could get outside of the safe zone?

 

We didn't talk about getting grafts outside of the safezone, but i will ask about this. 

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9 hours ago, Rafael Manelli said:

This triangle, in my view, is the top priority for naturalness, and will only take a few hundred grafts. It is strange that Dr Das didn't anticipate needing to fill it in, and that she gave you such an aggressive hairline considering what Bisanga has revealed. Perhaps you should ask her about that.

Regardless, what's done is done. You can only move forward. You may have regrets, which are reasonable, but on the plus side you got a natural looking result with high yield, invisible scarring (as far as I can tell) and they have not depleted your donor or harvested in a strange pattern. 

And you're handling the strongest meds available. 

You went to a highly regarded clinic and put your trust in an expert's judgment. You can't beat yourself up about that. 

As for the big red rectangle you just posted, thay could eat up 1000 grafts per side. It would make a big difference though.

And as for FUT, if you're going to do FUT yothe conventional wisdom is to strip out and then do FUE. Starting with FUE and then doing strip is not the best idea because FUE will harvest some hairs from the strip area, thus making any strips you get less profitable. However, those hairs aren't wasted. They've been used for FUE. So it shouldn't be too big a deal. 

Strip candidacy depends on scalp laxity. 

Not many European surgeons are known for FUT these days. Bisanga and Lupanzula do it on occasion. Drs Muresanu do it regularly. Dr Ball in the UK does it.

It's a wise choice if you want to eke out every graft you can. 

I think you should consider it. 

20230321_123106.jpg

 

 

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Instead of implanting in this white area, Doctor pushes forward and implant in blue area, because patient said that he wants the temples, because he saw great marketing videos from Eugenix on youtube. The outcome - patient looks like sick person. 

Edited by GeneralNorwood
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Where I've drawn this red line is where I expect your final destination would be without meds. You get an indication based on the part line, density differentials and anatomical features. Filling in that white triangle would bridge the gap between the nw7 zone and the temple points, allowing a natural look.

I find it strange that Dr Das would say she couldn't implant on a very thin area (the triangle), because it already had too much hair. It was clearly thin to begin with. Adding more hair there would not have taken too many grafts and would be necessary for a natural outcome. And now they claim they can just add grafts to the vertex, where there is a lot of native hair? Strange. In fact she did had a few hundred grafts to the crown. Those grafts could have been put in the triangles in my opinion. 

I still think that this is salvageable, if dutasteride holds up (likely) and you get 3 or 4000 grafts more.

20230321_220014.jpg

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Some men thin on top first and keep their hairlines intact, so a natural look is definitely, for sure achievable.

The question is whether a dense look is achievable, and how best to use the limited grafts that remain. That's the real conundrum.

You may wish to reach out to more doctors for their opinions.

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2 minutes ago, Rafael Manelli said:

I find it strange that Dr Das would say she couldn't implant on a very thin area (the triangle), because it already had too much hair. It was clearly thin to begin with. Adding more hair there would not have taken too many grafts and would be necessary for a natural outcome. And now they claim they can just add grafts to the vertex, where there is a lot of native hair? Strange. In fact she did had a few hundred grafts to the crown. Those grafts could have been put in the triangles in my opinion. 

 

1500 to the Crown and 1000 to midscalp. Funny thing is that during 1st HT she said "if you hadn't so much hair here on the crown, i would implant 1500, but in this circumstances i can do only around 300". 

Now 1500 is fine. Maybe even 3000, why not 😂

The issue here is just not being honest with patient and not presenting solid few steps plan. 

 

2 minutes ago, Rafael Manelli said:

Some men thin on top first and keep their hairlines intact, so a natural look is definitely, for sure achievable.

The question is whether a dense look is achievable, and how best to use the limited grafts that remain. That's the real conundrum.

You may wish to reach out to more doctors for their opinions.

Of course, now i am not in a hurry. I will make professional photo shoot soon then maybe i will buzz cut my hair, because it pisses me off. 

I have to come now with solid plan, not some retarded one like in 1st procedure. 

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39 minutes ago, Rafael Manelli said:

What does it look like brushed back? Maybe you can cover the thin part with the front. Could try toppik as a temporary fix. 

Yeah, that was the plan to grow hair longer and comb it back, using headband like @Rolandas did after 1st HT. I am checking it sometimes if it looks good, but now it's still  little to short to make propper slickback. I can give it few more months to grow and decide if i want to keep hair longer or cut it short. However my situation is different then Rolandas, because my lateral humps area is worse. Dr Bisanga told that my lateral humps are going NW6/NW7.

 

I am using fibers, but i don't like using this sh*t. You have to use hairlocking spray too and it's not good for hair. It's not solution that you want to use everyday. Personally i don't want to use it at all. 

Fibers blend the color, but do not give density. It repairs color of "white triangle" thing, however front is dense and curly and back is flat and not dense, so it looks weird. 

I was thinking about coloring all the hair, so the miniaturised hair will have same color as the transplanted one... 

 

Edited by GeneralNorwood
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1 minute ago, Rafael Manelli said:

It would be interesting to hear Eugenix chime in here.

No it wouldn't. I never saw that they took resposinibility for their mistakes. But i saw attacking patient for being unhappy of his procedure 

What can they say. That patient agreed to this plan and repeat this weak argument that "there was risk to implant between existing hair". 

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4 minutes ago, Rafael Manelli said:

The one thing I can guarantee is that they are reading this thread. 

Well, when i told Dr Bisanga that i had HT in Eugenix, he asked surprised "Dr Pradeep Sethi did your HT?". I replied that it was Dr Priyadarshini. Later Dr Bisanga said, that he will bust Dr Sethi's balls about this case 😂

Sethi can try to BS patient like me, but not such experienced doctor like Bisanga ;)

Edited by GeneralNorwood
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Dear @GeneralNorwood,

Thank you for bringing your concerns to our attention. As you may recall, we discussed the thinning and progression of your baldness. We recommended a conservative approach that would focus on transplanting upon the thinned-out areas, such as the front and temples and a small number of grafts in the crown. However, you wanted a more aggressive approach and wanted your temples to be restored like some of our other patients.

After careful examinations with loupes, we performed a mutually agreed hairline positioning and temple recreation. To meet your expectations, some grafts were put in the crown (in a small transplantable area only). The thinning areas were not transplanted consciously, and you were satisfied with the results at 9 months. 

As you discussed with Dr Das on February 27th and agreed to wait for 18 months, get your mid-scalp and crown re-evaluation, and opt for 2nd sitting, we should wait for that. You can send us your pictures for an evaluation after 6 months from now. Our advice for you is to continue with medications like finasteride/dutasteride. 

If you want to speak in detail on a video consultation with Dr Das, please let us know, and we can find a good time to schedule a video consultation for you.

 

Please do not hesitate to contact us with any further concerns or questions. We are with you in this & will continue to ensure your satisfaction.

 

Warm regards, 

Eugenix Hair Sciences

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1 hour ago, Eugenix Hair Sciences said:

Dear @GeneralNorwood,

Thank you for bringing your concerns to our attention. As you may recall, we discussed the thinning and progression of your baldness.

I don't recall. I recall that Eugenix graded me 3V, which was clearly wrong. 1 year ago i really belived that i am 3V, which was clearly wrong. Eugenix classicication reinforced my false belief. 

1 hour ago, Eugenix Hair Sciences said:

 We recommended a conservative approach that would focus on transplanting upon the thinned-out areas, such as the front and temples and a small number of grafts in the crown. However, you wanted a more aggressive approach and wanted your temples to be restored like some of our other patients.

Well, that is true that I said that i want the temples to be made and  i showed some other patients work as examples and based on this dr Das drew the hairline. At first i was surprised that Dr Das drew hairline even lower then i imagined (it was just above level of muscles, Dr Bisanga even said "look, your hairline is so low  that if you raise your eyebrows, your hairline is moving"), but unaware of further consequences, i agreed to this harline, because it looked good. Btw, Eugenix first reccomendation was to don't implant any hair on the crown> It was only implanted in small number (351 grafts) because i insisted on implanting  hair on the crown.

I wasn't properly educated about my situation (see wrong norwood classification). I wasn't informed that 2nd procedure will be necessary and which areas should be covered in next steps. 

It is a job of ethical doctor to present solid HT plan, that will look natural. Doctors from all around theworld decline stupid ideas from the patients. For sure i didn't want white holes in lateral humps. Lateral hump area which is going to NW6/7 according to Dr Bisanga, was area that was never talked about and look how it looks now. Terrible. 

But as expected, now Eugenix tries to shift blame on the patient. Yes, it is my fault that i didn't see thousands of patients, didn't perform thousands of operations, didn't know sh*t about my state of baldness and didn't come with solid plan with proper donor managment. For sure. 

1 hour ago, Eugenix Hair Sciences said:

The thinning areas were not transplanted consciously, and you were satisfied with the results at 9 months. 

 

Based on what you claim that i was satisfied with the results at 9 months? Many times i did send the photos and reported that i am not happy about this white holes in lateral humps.

So why exactly there was not transplantation on lateral humps thinned area if it was concious decision? 

 

1 hour ago, Eugenix Hair Sciences said:

As you discussed with Dr Das on February 27th and agreed to wait for 18 months, get your mid-scalp and crown re-evaluation, and opt for 2nd sitting, we should wait for that. You can send us your pictures for an evaluation after 6 months from now. Our advice for you is to continue with medications like finasteride/dutasteride. 

Well, i didn't agree to anything. Dr Das invited me that i can come for second HT right now. I wrote that i want to wait more (18 months is my idea). And the reason i am not in a hurry is that i want to make now solid plan.  

Thank you for great advice with taking finasteride/dutasteride 🤣

Importance of taking medications was talked through with Dr Das. I can't deny that. Taking fin/dut is my long-term commitment. I will be changing liquid minoxidil to oral minoxidil 5mg, upon the advice of Dr Bisanga. 

1 hour ago, Eugenix Hair Sciences said:

If you want to speak in detail on a video consultation with Dr Das, please let us know, and we can find a good time to schedule a video consultation for you.

Please do not hesitate to contact us with any further concerns or questions. We are with you in this & will continue to ensure your satisfaction.

 

I will make professional photosession soon and then send pictures to Eugenix. Unfortunately, i don't think that you would want to present this pictures on your instagram. 

 

 

 

However, if somebody is less than 35 years of age and they have good donor at that particular age we should not be very happy and optimistic because there is a chance  that in coming decade or two decades of life , those donor area may undergo miniaturization. 

Edited by GeneralNorwood
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Dear @GeneralNorwood

We completely understand your perspective and would like to clarify that we are not shifting blame to you as a patient. We want to make that clear. 

We would like to schedule a call with you tomorrow afternoon to discuss the issues or concerns you may have regarding your surgery. We want to make sure that all of your questions are addressed.

Please let us know a convenient time for you, and we will make the necessary arrangements. We appreciate your cooperation and look forward to speaking with you soon.

Regards, 
Eugenix Hair Sciences

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5 minutes ago, Eugenix Hair Sciences said:

Dear @GeneralNorwood

We completely understand your perspective and would like to clarify that we are not shifting blame to you as a patient. We want to make that clear. 

We would like to schedule a call with you tomorrow afternoon to discuss the issues or concerns you may have regarding your surgery. We want to make sure that all of your questions are addressed.

Please let us know a convenient time for you, and we will make the necessary arrangements. We appreciate your cooperation and look forward to speaking with you soon.

Regards, 
Eugenix Hair Sciences

Of course, We can talk, i will message Rajat. 

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How did Eugenix not think you were a potential NW7?

It was obvious.

Did they examine your native hair closely before the surgery?

You have to plan for the worst case scenario.

 

Edited by hairman22
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5 hours ago, hairman22 said:

How did Eugenix not think you were a potential NW7?

It was obvious.

Did they examine your native hair closely before the surgery?

You have to plan for the worst case scenario.

 

3 hours ago, Rafael Manelli said:

Indeed the Norwood 7 potential was obvious, in my opinion. He presented with a large area of diffuse thinning. 

 

I can give you my perspective back then. I came to India one week before HT, on 27th april 2022. I visited Eugenix 5 days before operation and talked briefly with Dr Das. She had first opportunity to examine my scalp. She said that we will only implant hair on the front and the temples, because on the top(crown) there are a lot of miniaturised hair and there is risk of harming them. At this moment i thought this is very responsible approach. Then we did first photosession, i never published this photos in this topic, but here they are

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So although i was balding, it looked natural and pretty decent, because i was keeping my sides and back rather short. I didn't fully understand level of my miniaturisation and my diffuse thinning. I had 5 days to look at the photos and the weakest area that i noticed was the crown and i wrote about this to Dr Das. Based on my remark, she said that we can implant around 300 grafts on the crown (it ended up 351 grafts). 

I didn't think for a second that if we implant hair on the front, there will be huge contrast between the front and this hair on lateral humps. But for a skilled person, it should be obvious, because my donor is a lot darker then this miniaturised, light hair on the lateral humps. 

 

Then at the day of operation, we made photos like in the first post of this topic: 

1.6.thumb.JPG.52c3e31d76fa7539a27f55f20f

 

On this photo it is even more obvious that strong HT on the front will look unnatural compared to weak side/lateral humps area. But to give you perspective, i didn't look for long at this photos with drawed black line. There was this guy who connected camera to tv through cable and was holding it in hands. He was switching photos using buttons in camera. So it's weird, but you feel kind of pressure to not watch this photos for long, because you feel like this guy won't be standing in front of tv with camera in his hands for 30 minutes and changing every other photo every 3-4 minutes. 

Anyway, propably even if i was holding this camera in my hands and looking on this photos for 10-15 minutes instead of 2 minutes, i wouldn't come up with better plan, because i didn't understand my state of baldness back then. 

 

 

To elaborate how unawared i was, imagine that this was one of the first photos that i send to Eugenix for evaluation of HT possibility

3bdaf662-0026-4fed-a384-a3e516bc0a7f.JPG.6fa5291b4f0dd75992c450d67f2605a7.JPG

 

They quoated 1500-1700 on the crown, on which i replied surprised something like this "why so much grafts? ,  my crown improved a lot since i am taking finasteride". 

 

 

And then i send them picture from daylight to prove my theory 😂

 

daylight.thumb.jpg.efee2c085432eaaf649fd3954a1cf208.jpg

 

And i was like "You see, i have a lot of hair on the crown". And Eugenix replied (both Dr Arika and Dr Das) that this is true and i don't need grafts on the crown at all. So the plan changed from 1500-1700 grafts to 0. 

So basically, they adapt to the thinking of the customer, regardless how stupid it is 😄

Edited by GeneralNorwood
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I think your favorable hair to scalp color contrast made the situation look better than it really was. 

At your age, this was obviously a nw6/7 in the making. The native hairs are still worth saving, but the contrast between them and the grafts in terms of caliber and color calls for more of a blend, filling in gaps and weaker areas between the two. I still don't see why they did new temple points but didn't fill in the whole temple area behind them. Just an unusual choice. 

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7 minutes ago, Rafael Manelli said:

At your age, this was obviously a nw6/7 in the making. 

True. Not nw3V for sure. 

8 minutes ago, Rafael Manelli said:

The native hairs are still worth saving

Yes, regardless of different color and limited lenght and calibre, they give some density. 

12 minutes ago, Rafael Manelli said:

I still don't see why they did new temple points but didn't fill in the whole temple area behind them. Just an unusual choice. 

Maybe that was the goal :

ronaldo.png.67375686c990ac5d0f21509545b6fa89.png

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I have to admit I’m slightly confused by your criticisms. Is there a contrast between the newly transplanted area and the weaker areas behind it? Yes. 
 

But your level of loss would require multiple passes anyway. Your frontal third, though aggressive, looks excellent and the growth and density are really good. Your scalp & beard donor seem in good health and you’re on finasteride. 
 

What you need now is to find a surgeon that feels more confidence about getting into the areas where you have native hair than Dr Das does. 
 

If she didn’t feel confident going in there then in the long run it’s good that she didn’t attempt it, even if in the short term you have to manage the contrast (shorter hair cut plus a light sprinkling of fibres will more than do it). 
 

Your situation isn’t a million miles from @Bandit90‘s in that a two step approach (at least) is required, though you have the benefit of having some native hair to cling onto whereas John didn’t. 

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I don't agree with the notion that high Norwoods always require multiple surgeries. Hasson, Wong, Zarev, Pitella, Lorenzo and even Eugenix have proven that wrong by doing enormous graft numbers in a single session. 

It just depends on the surgical team and their resources. If you have a large enough staff you can do big sessions.

Bandit90 may have lacked natives, but seems to have had a better donor capacity. He's had tons of grafts. GeneralNorwood was told he has about 6500 grafts. That was never going to be enough to cover a nw7 area with great density and that hairline, unless the meds work flawlessly. 

I agree with @Berba11's other positive comments though. The growth from the first session was good. 

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23 minutes ago, Berba11 said:

 Is there a contrast between the newly transplanted area and the weaker areas behind it? Yes. 

"Contrast", it is very gentle word for this situation. Don't you see that it looks terrible and very unnatural?  Dr Sethi could easily make video about this case, to present mistakes in HT, only if this surgery wasn't made by Eugenix. 

23 minutes ago, Berba11 said:


But your level of loss would require multiple passes anyway. Your frontal third, though aggressive, looks excellent and the growth and density are really good. Your scalp & beard donor seem in good health and you’re on finasteride. 

At the day of procedure i didn't imagine that final result will look so bad that i will be forced to do next surgery ASAP, believe me. 

My scalp donor is limited to around 3000 and according to dr Bisanga it is not enough to cover huge thinning area on midscalp/crown and lateral humps. He said that my beard is not so good for HT. Just read this post https://www.hairrestorationnetwork.com/topic/66820-eugenix-3514-grafts-720-on-the-temples-may-2022-dr-priyadarshini-das/page/3/#comment-707399

 

23 minutes ago, Berba11 said:

 

What you need now is to find a surgeon that feels more confidence about getting into the areas where you have native hair than Dr Das does. 
 

If she didn’t feel confident going in there then in the long run it’s good that she didn’t attempt it, even if in the short term you have to manage the contrast (shorter hair cut plus a light sprinkling of fibres will more than do it). 
 

Do you really think it is about confidence, if she proposed recently to implant 1500 on the crown and 1000 on the midscalp? 

 

23 minutes ago, Berba11 said:

 

Your situation isn’t a million miles from @Bandit90‘s in that a two step approach (at least) is required, though you have the benefit of having some native hair to cling onto whereas John didn’t. 

Good, that you bring out Bandit90, because Eugenix planned 2 surgeries for him  from the start and i didn't have such plan. We talked only about 1 surgery. 

Edited by GeneralNorwood
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1 minute ago, Rafael Manelli said:

 

I agree with @Berba11's other positive comments though. The growth from the first session was good. 

 

So what if the growh was good, when  there was no solid plan - Dr Bisanga

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