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

[GeneralNorwood]

22 minutes ago, Rafael Manelli said:

This makes little sense to me. Does she think you ought to have thin lateral humps because you are young?

 

I don't know 

 

5 minutes ago, Rafael Manelli said:

Did you ask her why she'd do such a low hairline again for such an advanced balding level? 

No, however after a while Dr Arika joined video meeting and i was talking with her about height of the hairline. She said that this is popular subject after procedure, that some people complain that it is too high too. In her opinion if i had made higher hairline, my forehead would look to big and now it looks fine. 

[Rafael Manelli]

6 minutes ago, GeneralNorwood said:

Yes, this is good case study. 

Medication did really good job. It did some part of me thinking that i am Norwood 3V. 

 

Today's nw3v is tomorrow's nw7

Clinics must take into account the progressive nature of hair loss. Even with meds it is risky. 

[Melvin- Admin]

2 minutes ago, GeneralNorwood said:

Yes, this is good case study. 

Medication did really good job. It did some part of me thinking that i am Norwood 3V. 

 

Medication can help regrow some hair. But it will not change you from a Norwood 6/7 to a Norwood 3V. Your baldness classification is set by your genetics. 

Unfortunately, diffuse hair loss is not in the Norwood classification. I’m sorry if I sound harsh, but I was also in denial for many years. I thought because my hairline was still intact I was a Norwood 3. I thought Norwood 6 means no hair on your head. This is not true. It’s not where you are, its where you’re headed. 

A true Norwood 3 has no diffuse loss, the pattern follows the Norwood scale

 

 

This is a Norwood 5/6, despite having hair, that hair is thinning and will eventually be gone, even with meds.

[Rafael Manelli]

29 minutes ago, Melvin- Moderator said:

Medication can help regrow some hair. But it will not change you from a Norwood 6/7 to a Norwood 3V. Your baldness classification is set by your genetics. 

Unfortunately, diffuse hair loss is not in the Norwood classification. I’m sorry if I sound harsh, but I was also in denial for many years. I thought because my hairline was still intact I was a Norwood 3. I thought Norwood 6 means no hair on your head. This is not true. It’s not where you are, its where you’re headed. 

A true Norwood 3 has no diffuse loss, the pattern follows the Norwood scale

 

 

This is a Norwood 5/6, despite having hair, that hair is thinning and will eventually be gone, even with meds.

Your balding is genetic but it's also progressive. You advance usually from Norwood 1 to Norwood 2, to nw3, to nw4, to nw5, to nw6, to nw7, with some variation such as 3V

Every nw7 was once a nw1. 
 

Otherwise, why would Eugenix grade him a 3V?

Edited March 23, 2023 by Rafael Manelli

[Bb111]

On 3/21/2023 at 7:21 PM, GeneralNorwood said:

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 

 

On 3/22/2023 at 7:46 PM, GeneralNorwood said:

 

I think at this point you are not going to be satisfied with your current results no matter what anyone says. I hope you find a surgeon that will help you moving forward to get the results that will make you happy. 

With that being said i really hope Bisanga was more professional than what you are quoting. It's one thing to say I don't agree with what they did but here were are and this how I can help. It's totally unprofessional to turn into a pissing match and ball busting in front of the patient. Maybe the parts you are quoting are out of context so I'm willing you give him the benefit of the doubt. 

Edited March 24, 2023 by Bb111

[Rafael Manelli]

Personally I admire Dr Bisanga's straight talking, no nonsense approach. 

[Gatsby]

@GeneralNorwood if you ask Dr Bisanga which medication should you use post op he will say oral minoxidil. If you ask Dr Sethi the same question he will say finasteride. Which is the right answer? Both. Both surgeons go by their own, subjective clinical experience. They will both have reasons why they recommend what they do whether we agree and follow their advice or not. You have a huge advantage over myself and others and that is you can tolerate oral 5ari's. Stay on them. Do not have a second surgery to address any other weak spots for a long time. If you were 56 I would say otherwise. Your face is framed better than the Mona Lisa so at least you've got a reason to smile if she doesn't! 😉This is what people see first. The framing of the face. At your age when people looked at me they saw either rows of plugs lined up along my hairline, scars, the edge of a wig or ink with scars. Stay on the meds religiously and live your life now while you are young and can enjoy it. Tomorrow is not a given (trust me from the amount of friends/people I've known that are no longer here with us to have the luxury of worrying about what we do). I can't put it more plainly and hopefully in better perspective than this. Wishing you all the best. The babes are back! 🤩

[GeneralNorwood]

9 hours ago, Z-- said:

How did the call go? Would be interesting to get your perspective.

 

Well, that was group video meeting with Hariom, Amandeep, Dr Das and Dr Arika. 

Firstly i had some quick chat with Hariom and he tried to explain why Eugenix graded me 3V. He said that norwood scale doesn't take into account diffuse thining and because of that i have a lot of native hair, they graded me 3V. But i saw many doctors grading cases like mine NW5a or higher. I don't know what is scientific consensus here, but IMO grading case like mine so low, can be misleading. He had some remark that my lateral hump area had become worse since procedure, but i replied that this is not true and one have to look at pictures in same lighting condition to see that this area is stable

Amandeep and Dr Das joined video meeting. Dr Das presented some hopes with further use of dutasteride, which i do not share, because i am already 2 years on DHT blockers. She said that if she did the operation again, she would do everything the same. According to her, not having the hair implanted on lateral humps area was a conscious choice. She agrees with my idea to wait for 18 months mark before jumping into next procedure. 

Then Dr Arika Bansal joined us. We talked about height of the hairline, she thinks that higher forehead would look worse for me. We talked about how many grafts were used for the temples and that a lot of them were doubles splitted into singles, so it wasn't like we used 700 grafts on the temples, but around 400 grafts. She mentioned that it would be better to not use all the donor in next procedure, but use part of it and mix it with beard grafts. I told her that i ordered oral minoxidil 5mg and she said that although she isn't big fan of prescribing it, she saw some good effects from it, so i can hope that in 5-6 months of usage i can see some benefits and limit demand for the grafts. She suggested  that till next procedure i can comb back my hair, so it will look better. 

To sum up, They supported my idea to not rush into next procedure and assured me that they would not leave me and would be in touch with me. Hariom will be in touch with me and the doctors as well if needed. The transplant plan will need to be reevaluate prior to the procedure

 

 

 

Edited March 24, 2023 by GeneralNorwood

[GeneralNorwood]

36 minutes ago, Gatsby said:

@GeneralNorwood if you ask Dr Bisanga which medication should you use post op he will say oral minoxidil. If you ask Dr Sethi the same question he will say finasteride. Which is the right answer? Both.

That's why i will take both 😂

Even more with the switch from finasteride to dutasteride

36 minutes ago, Gatsby said:

You have a huge advantage over myself and others and that is you can tolerate oral 5ari's. Stay on them. Do not have a second surgery to address any other weak spots for a long time. If you were 56 I would say otherwise. Your face is framed better than the Mona Lisa so at least you've got a reason to smile if she doesn't! 😉This is what people see first. The framing of the face. At your age when people looked at me they saw either rows of plugs lined up along my hairline, scars, the edge of a wig or ink with scars. Stay on the meds religiously and live your life now while you are young and can enjoy it. Tomorrow is not a given (trust me from the amount of friends/people I've known that are no longer here with us to have the luxury of worrying about what we do). I can't put it more plainly and hopefully in better perspective than this. Wishing you all the best. The babes are back! 🤩

That's some nice perspective. The idea of not doing any more transplants for a long time is interesting. I will definitely consider this option in the coming months when I use oral minoxidil and my new frontal hair will grow even longer. We'll see if long hair slicked back will be something that will satisfy me. Thank you for your message 

Edited March 24, 2023 by GeneralNorwood

[aaalan]

1 hour ago, GeneralNorwood said:

Well, that was group video meeting with Hariom, Amandeep, Dr Das and Dr Arika. 

Firstly i had some quick chat with Hariom and he tried to explain why Eugenix graded me 3V. He said that norwood scale doesn't take into account diffuse thining and because of that i have a lot of native hair, they graded me 3V. But i saw many doctors grading cases like mine NW5a or higher. I don't know what is scientific consensus here, but IMO grading case like mine so low, can be misleading. He had some remark that my lateral hump area had become worse since procedure, but i replied that this is not true and one have to look at pictures in same lighting condition to see that this area is stable

Amandeep and Dr Das joined video meeting. Dr Das presented some hopes with further use of dutasteride, which i do not share, because i am already 2 years on DHT blockers. She said that if she did the operation again, she would do everything the same. According to her, not having the hair implanted on lateral humps area was a conscious choice. She agrees with my idea to wait for 18 months mark before jumping into next procedure. 

Then Dr Arika Bansal joined us. We talked about height of the hairline, she thinks that higher forehead would look worse for me. We talked about how many grafts were used for the temples and that a lot of them were doubles splitted into singles, so it wasn't like we used 700 grafts on the temples, but around 400 grafts. She mentioned that it would be better to not use all the donor in next procedure, but use part of it and mix it with beard grafts. I told her that i ordered oral minoxidil 5mg and she said that although she isn't big fan of prescribing it, she saw some good effects from it, so i can hope that in 5-6 months of usage i can see some benefits and limit demand for the grafts. She suggested  that till next procedure i can comb back my hair, so it will look better. 

To sum up, They supported my idea to not rush into next procedure and assured me that they would not leave me and would be in touch with me. Hariom will be in touch with me and the doctors as well if needed. The transplant plan will need to be reevaluate prior to the procedure

 

 

 

that sounds like fairly good aligned discussion!! 

[mister_25]

2 hours ago, GeneralNorwood said:

Firstly i had some quick chat with Hariom and he tried to explain why Eugenix graded me 3V. He said that norwood scale doesn't take into account diffuse thining and because of that i have a lot of native hair, they graded me 3V. But i saw many doctors grading cases like mine NW5a or higher. I don't know what is scientific consensus here, but IMO grading case like mine so low, can be misleading.

I don't think any Norwood Classification can be used to accurately label your case. Best way I could describe your case is a Norwood 5A with lateral humps recession. Which is alot more different than just a regular NW5 or a NW6. 

3 hours ago, GeneralNorwood said:

Amandeep and Dr Das joined video meeting. Dr Das presented some hopes with further use of dutasteride, which i do not share, because i am already 2 years on DHT blockers. She said that if she did the operation again, she would do everything the same. According to her, not having the hair implanted on lateral humps area was a conscious choice. She agrees with my idea to wait for 18 months mark before jumping into next procedure. 

I wouldn't count on medication regrowing anything in the future, but rather use as preventative treatment to reduce the odds of things getting worse than they are. 

I also feel like if her idea of not having it addressed in the first procedure was a conscious choice of a multi part plan, it should of been addressed with the patient in detail during the first procedure.

3 hours ago, GeneralNorwood said:

Then Dr Arika Bansal joined us. We talked about height of the hairline, she thinks that higher forehead would look worse for me. We talked about how many grafts were used for the temples and that a lot of them were doubles splitted into singles, so it wasn't like we used 700 grafts on the temples, but around 400 grafts. She mentioned that it would be better to not use all the donor in next procedure, but use part of it and mix it with beard grafts. I told her that i ordered oral minoxidil 5mg and she said that although she isn't big fan of prescribing it, she saw some good effects from it, so i can hope that in 5-6 months of usage i can see some benefits and limit demand for the grafts. She suggested  that till next procedure i can comb back my hair, so it will look better. 

Although the hairline does look really good on you, if Dr Bisangas assessment is true it was indeed not in your best interest if your goal was to get the closest thing possible to a uniform head of hair (which is what I imagine most people want). 

Regarding the temples, I've heard the issue with dividing multis into singles is that multi hair grafts tend to be thicker grafts when in reality for temples you want to use finer hair grafts. Hopefully if I'm incorrect someone can step in here to correct me but I dont think that is adding up. Also do they mean 400 Grafts on each temple or 400 in total? Regardless I honestly you got pretty big graft mileage if each temple was 400 grafts.

I remember you were saying that Dr Bisanga thinks your beard hair is not ideal for hair transplantation. Did he explain why? Because Eugenix here seem to think the opposite and both are highly regarded experts in the field.

Although I do think Eugenix is a great clinic, I personally would lean more into Dr Bisanga as a option. He is known as a much more conservative doctor and he has a bit of a reputation with blonde hair which you have.

[mister_25]

5 hours ago, Melvin- Moderator said:

Medication can help regrow some hair. But it will not change you from a Norwood 6/7 to a Norwood 3V. Your baldness classification is set by your genetics. 

Unfortunately, diffuse hair loss is not in the Norwood classification. I’m sorry if I sound harsh, but I was also in denial for many years. I thought because my hairline was still intact I was a Norwood 3. I thought Norwood 6 means no hair on your head. This is not true. It’s not where you are, its where you’re headed. 

A true Norwood 3 has no diffuse loss, the pattern follows the Norwood scale

 

 

This is a Norwood 5/6, despite having hair, that hair is thinning and will eventually be gone, even with meds.

I feel like the Norwood System isn't on the same page as someone that has little to no information on balding. It can be a bit misleading.

In my case I also believed I was a Norwood 3, maybe a Norwood 4 when I first started trying medication, but after I got very familiar with HTs and the inner workings of hair loss, I realized that I was a Norwood 4 with signs of going into a Norwood 6!

I don't feel like its denial in every case, its more like a lack of information. It doesn't clarify that you can be a Norwood 6 with hair everywhere in the Norwood 3 areas, and it leads no room to labeling diffuse thinners. 

[Curious25]

3 hours ago, GeneralNorwood said:

He said that norwood scale doesn't take into account diffuse thining and because of that i have a lot of native hair

Well that’s just dumb. 
 

The NW scale has categorised commonly found patterns of male pattern baldness and labelled them as stages. 
 

Whether it is bald scalp or miniaturised hair - that is still your balding pattern, and what you can expect to advance to in years to come. 
 

If this is an attempt to justify the aggressive design on your surgery, it just doesn’t work. Any Dr worth his salt would have identified you were far beyond a NW3V pre op - your temple point/lateral hump area showed progression that is only really seen in NW7’s.
 

 

[Rawkerboi]

You are planning to switch from Finasteride to Dutasteride completely or plan to take Dutasteride weekly? 

As we all know, Finasteride blocks 75% of DHT and Dutasteride Blocks 92% of DHT

 

Edited March 24, 2023 by Rawkerboi

[Curious25]

And for what it’s worth - I’ve not read the ins and outs of the full thread, but have the general idea. 
 

My takeaway for you is that it’s important to consult with multiple doctors, because there will always be a variety of perspectives, skill levels/capabilities, surgical approach, restoration ethos etc. Therefore like all things in hair restoration, there isn’t a one size fits all answer, even for your own individual case. 
 

In the same light, I also think the former Eugenix patients chiming in with their own personal experiences should be taken with a pinch salt, because it’s pretty amusing to imagine a patient viewing your photos online, to feel they are in a better placed position to say what is and isn’t feasible for yourself, contrary to what a world class surgeon who has had the opportunity to physically examine you in person suggests. 
 

I hope you get to where you want to be in the end. 

[Adam561]

Took me 30 minutes to read everything. 
@GeneralNorwood It is good to know the outcome of the meeting. Diffuse thinning cases cannot be graded in NW but I will call you a 4/5A. I agree with the fact that the approach was aggressive, you should have not gone for this high approach at the same time the clinic should have counselled you well on the pros and cons. 

What I see here is fantastic results from 1st sitting but there will be a need for 2nd one. Duta 0.5mg, oral/topical minoxidil and continue for it for another 6-8 months. Hope for the best, Eugenix is always supportive towards their patients. I would request other forum members to not to spice up things here and definitely there's no comparison between two world renowned clinics. Both are good and specialized in their fields. Your thoughts changed very much after consulting with Bisanga, you should not have shared this here at the first place, even if you did, I am sure if you tell Dr. Bisanga about the entire case then he wouldn't have said the same thing. 
Anyways please dont be oversure by any doc opinions, take care and keep us updated. 

[CharlesBarkley]

On 12/2/2022 at 2:14 PM, GeneralNorwood said:

This is very good comparision that shows it could'v forseen that sides wouldnt keep up with the powerfull transplant on the front, especially left side. 

However at the day of procedure i didn't see this possibility. One can speculate if adding more grafts on the sides in the 1st procedure would be better then adding more grafts in extra procedure. 

 

Anyway, here are some photos from 2020, when i wasn't taking any medications and didn't care about my baldness 😄

 

 

And here is comparision between February 2021 when i started finasteride and minoxidil and August 2021 

 

wow what a change just with meds.

 

[CharlesBarkley]

15 hours ago, GeneralNorwood said:

Yes, it is 6 cm from glabella to MFP. 

 

There is not further progression of baldness, just to be clear. You have to compare pictures in the same lighting condition. This is January 2022 vs January 2023 : 

 

 

Just another person. What a change.

[Rafael Manelli]

The Norwood system should always be taken with a pinch of salt because it's not absolute. It's just descriptive.

You were obviously a diffuse 7. A 7 pattern with a lot of diffuse thinning rather than total baldness. In graft requirement that means you're closer to a 5 than a 7 if you can retain the natives.

Anyway, I agree with what @Gatsbyand others have said tjya you have a great hairline and framing now. If it were me, I'd have done mostly the same thing.

But I don't quite get the point of not having another surgery for a long time, because I don't see how further hair loss would alter the plan. Whether you get 3000 grafts on the vertex now or in 20 years, what difference will it make? I'd get it done ASAP. But that's just me. 

[Z--]

I've read the entire thread, and I'm afraid I agree with Bisanga.

First, I'd disregard anyone suggesting that Bisanga is trying to one-up a competitor or that he did anything wrong giving you his opinion. No one seems to bat an eye when he says a Turkish clinic did a poor job, so why is it any different because it's Eugenix? Bisanga has a long enough waitlist as it is and is without a doubt one of the most ethical doctors in the industry. I applaud his honesty to benefit you even if it comes at the risk of upsetting his peer.

For context, I'm not too different from your level of loss. When I'd reached out to Eugenix a few years ago, they'd listed me as a 3V as well and suggested lowering the hairline. That said, Konior, H&W, and Bisanga all warned me that I was going to be a Norwood 6/7 with limited lifetime grafts and encouraged a conservative approach - advising against hairline lowering.

All that is to say, while I respect the talent at Eugenix and the growth they're able to achieve, I'm still highly critical of their planning. I suppose that's what happens when you frequently rush the consultation phase and do multiple surgeries a day.

The issue that many people here perhaps willfully disregard isn't that you need multiple surgeries, but that you have limited grafts and you clearly seem to have preferred having a fuller crown and midscalp instead of a lower hairline. That likely isn't possible anymore.

You should never have been assessed where you were, but were you were going to be. A good doctor ought to advise their patients of the risks they're taking. It clearly didn't happen here. I hope they do right by you.

Edited March 24, 2023 by Z--

[GeneralNorwood]

Today i received oral minox 5mg from Belgian pharmacy. I ordered 2 times 100 capsules, so i have supply for more then half year. 

 

Photo after i took first capsule for future reference : 

 

 

My hair were in a mess, so i decided to take a shower. After blow drying  hair look somewhat better:

 

 

 

 

Guys, do you think it's better to abbandon liquid minox completely if i am taking oral minox now?  I could for example use dermapen + liquid minox once weekly, as a bonus. 

Edited March 24, 2023 by GeneralNorwood

[Rafael Manelli]

1 hour ago, Z-- said:

The issue that many people here perhaps willfully disregard isn't that you need multiple surgeries, but that you have limited grafts and you clearly seem to have preferred having a fuller crown and midscalp instead of a lower hairline. That likely isn't possible anymore.

This.

[Rafael Manelli]

I would abandon liquid minoxidil completely for the oral version.

 

[GeneralNorwood]

2 minutes ago, Rafael Manelli said:

I would abandon liquid minoxidil completely for the oral version.

 

Can you elaborate? I don't know the details, but i remember that oral version and liquid have different mechanism. 

Also microneedling+liquid minox is superior to liquid minox alone. 

[BaldingEagle1]

How many months has it been since your surgery @GeneralNorwood?

I would def slick the hair back. do a sexy man bun