Eugenix - January 2023 - 5300 grafts

[DH97]

Update?

[Rawkerboi]

Yes waiting for update! I hope things are turning out good.

[Grouse]

Hey man, any update here? Hope you’re well and improving. 

[consequence]

This is disappointing for 7 months, but beard and body grafts are so tricky. How are you now?

[DH97]

any updates on this case? hopefully its a little bit better now

[DH97]

Update?

[Berba11]

Would be great to hear how you're doing @abrorkhasanov

[BaldReaper]

I am really sorry to see this mate, one more failed result from Eugenix and this time from the Sr doctor, at this point they are the clinic to avoid, @Melvin- Admin after the recent subpar results from Eugenix would you consider removing them from the recommended list?

[Melvin- Admin]

12 minutes ago, BaldV said:

I am really sorry to see this mate, one more failed result from Eugenix and this time from the Sr doctor, at this point they are the clinic to avoid, @Melvin- Admin after the recent subpar results from Eugenix would you consider removing them from the recommended list?

Eugenix isn’t on the list, it’s only Dr. Sethi and Dr. Bansal. This surgery was done by Dr. Das, she isn’t and hasn’t ever been on our list. We don’t recommend clinics, we recommend surgeons. I don’t believe there is a failure in yield. 

I think the plan to distribute such a small number of grafts over a large area was not a good plan. No matter who the surgeon is, that number of grafts primarily from BHT would yield the same result, when distributed over a Norwood 7 area. It’s simple mathematics as I stated earlier in the thread.

“But if you do the math, that area was probably 200-250 cm2. You need at least 45 grafts per cm2 to get “illusion” of density. That means you would need 9,000-11,250 grafts in that area to get an “illusion” of density. It would still look thin with short hair, even with those numbers. You need to grow it out a lot more than you have. It looks like its less than an inch on top. You need at least 3 inches to start layering. Also, looks like 1,100 grafts are beard grafts, which means its single hair grafts. You didn’t have a lot of hair placed in that area.”

That said, we haven’t seen a recent update in months. Things may have improved. I will wait to make further judgments until an update is presented. 

[jjalay]

5300 grafts is definitely not a small number of grafts, these photos are from month 7 but if it stayed like this i would say from these 5300 grafts i see only 600-800 grafts that actually grow. The donor area doesnt look in the best shape after the surgery either, OP has bald patches on the sides.

[Jackdaniels]

48 minutes ago, Melvin- Admin said:

Eugenix isn’t on the list, it’s only Dr. Sethi and Dr. Bansal. This surgery was done by Dr. Das, she isn’t and hasn’t ever been on our list. We don’t recommend clinics, we recommend surgeons. I don’t believe there is a failure in yield. 

I think the plan to distribute such a small number of grafts over a large area was not a good plan. No matter who the surgeon is, that number of grafts primarily from BHT would yield the same result, when distributed over a Norwood 7 area. It’s simple mathematics as I stated earlier in the thread.

“

But if you do the math, that area was probably 200-250 cm2. You need at least 45 grafts per cm2 to get “illusion” of density. That means you would need 9,000-11,250 grafts in that area to get an “illusion” of density. It would still look thin with short hair, even with those numbers. You need to grow it out a lot more than you have. It looks like its less than an inch on top. You need at least 3 inches to start layering. Also, looks like 1,100 grafts are beard grafts, which means its single hair grafts. You didn’t have a lot of hair placed in that area.”

That said, we haven’t seen a recent update in months. Things may have improved. I will wait to make further judgments until an update is presented. 

I totally agree.  We can’t make judgements now as a we haven’t seen the final result.
 In addition like you said this area needs double the grafts to look decent and they used 1100 beard grafts which Beard grafts also do not have the same yield rates with normal grafts from donor and they don’t give the same coverage since they are single hairs.. Also the hairs need to be longer in order to provide  good illusion of density, but he had very short hair in the post op photos. 

In general I do believe dr Das of Eugenix is a great surgeon and she have given great yields in her cases. 

Edited December 21, 2023 by Jackdaniels

[Melvin- Admin]

2 hours ago, jjalay said:

5300 grafts is definitely not a small number of grafts, these photos are from month 7 but if it stayed like this i would say from these 5300 grafts i see only 600-800 grafts that actually grow. The donor area doesnt look in the best shape after the surgery either, OP has bald patches on the sides.

It was 4,200 scalp grafts, 1,100 was single BHT grafts. Let’s assume he had 1.5 hairs per fu, he said his donor was poor. That would be 6,300 scalp hairs and 1,100 BHT hairs. In total, the number of hairs would be around 7,400 hairs total. These photos were at 7 months, the average growth is around 50-60% at 7 months. 

That would be around 3,700 hairs or so on an a Norwood 7 area. I think that looks about right.

 

In my opinion, those grafts should have been concentrated in one area, for maximum density. If you spread out grafts too much you lose visual density. But I don’t see any issues with yield up until that point. 

[BaldReaper]

56 minutes ago, Melvin- Admin said:

Eugenix isn’t on the list, it’s only Dr. Sethi and Dr. Bansal. This surgery was done by Dr. Das, she isn’t and hasn’t ever been on our list. We don’t recommend clinics, we recommend surgeons. I don’t believe there is a failure in yield. 

I think the plan to distribute such a small number of grafts over a large area was not a good plan. No matter who the surgeon is, that number of grafts primarily from BHT would yield the same result, when distributed over a Norwood 7 area. It’s simple mathematics as I stated earlier in the thread.

“

But if you do the math, that area was probably 200-250 cm2. You need at least 45 grafts per cm2 to get “illusion” of density. That means you would need 9,000-11,250 grafts in that area to get an “illusion” of density. It would still look thin with short hair, even with those numbers. You need to grow it out a lot more than you have. It looks like its less than an inch on top. You need at least 3 inches to start layering. Also, looks like 1,100 grafts are beard grafts, which means its single hair grafts. You didn’t have a lot of hair placed in that area.”

That said, we haven’t seen a recent update in months. Things may have improved. I will wait to make further judgments until an update is presented. 

45 grafts per cm is for the hairline, in the mid and crown many reputable doctors implant even 30 grafts per cm and with the right lenght and styling the hair looks great. The result for this amount of grafts , even though it wouldnt provide full coverage, is extremely subpar and is one more example of why everyone should avoid Dr Das (thanks for letting me know it was her because I thought it was Dr Sethi). Lets hope that the situation has improved for the patient

[Melvin- Admin]

11 minutes ago, BaldV said:

45 grafts per cm is for the hairline, in the mid and crown many reputable doctors implant even 30 grafts per cm and with the right lenght and styling the hair looks great. The result for this amount of grafts , even though it wouldnt provide full coverage, is extremely subpar and is one more example of why everyone should avoid Dr Das (thanks for letting me know it was her because I thought it was Dr Sethi). Lets hope that the situation has improved for the patient

I don’t believe it’s fair to judge results at 7 months. You just said the key factor. Length and styling. If I were to cut my hair that short and take a photo under a bright light my hair would look terrible. Length, styling, and lighting is key to how good or bad an HT looks.

5,300 grafts, with 1,100 from BHT, this is what you could expect at 7 months, especially if you keep your hair short where you can’t layer.

 

That said, I think visual density would’ve been better if those grafts were concentrated in the front and midscalp alone. Distributing such a small number of grafts over a large area will never provide visual density, compared to dense-packing a smaller area. 

I don’t know if this patient wanted coverage over density. As a Norwood 7, there are things that you’ll have to accept. Either lower density with more coverage, or density with bald spots. It depends on the patient’s individual goals. Regardless, we should wait to see how a result turns out before casting judgement. 

[Berba11]

53 minutes ago, Melvin- Admin said:

I don’t know if this patient wanted coverage over density.

Melvin, I think the issue in this case is that it wasn't explained to the patient that he'd need two passes to achieve homogenous coverage. So there was a lack of clear communication and planning as well as expectation management. If you read back through, there was no discussion about the need for a second surgery.

The results at 7 months (and assuming they'll improve further) I think would probably be ok if they were seen within the context as being part one of a two surgery approach.

Hopefully we hear from @abrorkhasanovsoon and that his inactivity on here is either because he's enjoying his new hair or he's simply giving things more time to grow out before updating.

[GoliGoliGoli]

Patient should have never been accepted as a candidate. Bad scalp to hair color contrast, low caliber of hair thickness, history of not tolerating Fin, severely compromised donor with advance NW7 pattern and sever retrograde alopecia, wide head meaning a larger number of grafts needed compared to someone with a smaller head.

Eugenix accepts patients that other Dr's who specialize in high NW cases would likely turn away. Even worse, they accepted him for surgery with Dr Das who is not known for handling extreme high NW cases. Seems that they prioritize financial gain over the interest of their patients. Really shameful. 

 

[Reina]

The result for the amount of grafts used and the huge area looks fine so far. He needs a second pass to achieve a better coverage and leave his hairs to grow.  He didn’t even have favourable characteristics imo..doctors are not gods to give good coverage to patients with bad donor, bad characteristics and huge recipient area…

@Eugenix Hair Sciences is a top clinic for such higher Norwood cases and I don’t think any other clinic would had given better result to this patient with one pass

 

Edited December 21, 2023 by Reina

[Britanium]

For me it was another poorly planned case, I went back to read what the OPs expectation was. Here is what he wrote:

was very honest and realistic about my expectations, which was a coverage if possible and if not, just framing of the face at first and if possible a second surgery to fill out whatever. I had my initial consultation with Dr Sethi in London, at which point he provided encouraging words and said that they can easily do the surgery and that I have enough hair for a procedure actually (I was fairly surprised about tbh). So I booked through everything and finally done it.

So let's see what's happening now when he hopefully updates us. Personally I think another 2 procedures would be necessary and I'm not sure he has enough in reserve to facilitate that. I already see the donor area looking a little thinned. 

[jjalay]

22 minutes ago, Britanium said:

For me it was another poorly planned case, I went back to read what the OPs expectation was. Here is what he wrote:

was very honest and realistic about my expectations, which was a coverage if possible and if not, just framing of the face at first and if possible a second surgery to fill out whatever. I had my initial consultation with Dr Sethi in London, at which point he provided encouraging words and said that they can easily do the surgery and that I have enough hair for a procedure actually (I was fairly surprised about tbh). So I booked through everything and finally done it.

So let's see what's happening now when he hopefully updates us. Personally I think another 2 procedures would be necessary and I'm not sure he has enough in reserve to facilitate that. I already see the donor area looking a little thinned. 

Even with this poor planning after 5300 grafts this is not how it should look like after 7 months. I dont know how the result is looking now but if it stayed like this, i only see 600-800 grafts that actually took. I think the OP should give an update on this.

[Britanium]

20 minutes ago, jjalay said:

Even with this poor planning after 5300 grafts this is not how it should look like after 7 months. I dont know how the result is looking now but if it stayed like this, i only see 600-800 grafts that actually took. I think the OP should give an update on this.

Oh yeah for sure the poor planning is one thing, the growth we can see so far is another. I just need to see the update really to comment further. I cant imagine their has been a wild improvement but let's see to make sure. 

5k+ was never going to do the job, but the yield I am seeing isnt anything like that. We await with bated breath. Hopefully the Op can provide a update... 

Edited December 22, 2023 by Britanium

[Berba11]

29 minutes ago, jjalay said:

Even with this poor planning after 5300 grafts this is not how it should look like after 7 months. I dont know how the result is looking now but if it stayed like this, i only see 600-800 grafts that actually took. I think the OP should give an update on this.

There's way more than 800 grafts that have grown in, come on... The pictures with super harsh lighting overhead aren't the best pics to judge - that kind of lighting is the enemy of even the best HT's. The more neutral lighting pic from the OP shows much better growth - more in line with what we'd expect - but clearly not enough coverage to get to where the OP will want to be and not yet looking as impressive as his early post-op buzz cut images.

I don't have any issue with the approach if this was clearly intended to be a two-step process. Some people opt to focus on the frontal third & midscalp and then the crown separately to cover a NW6 or 7 and some people go with a more "all over" pass two times. Both are fine and we've seen both approaches done really well from Eugenix. My personal issue here is that the OP wasn't informed by Dr Das that this would really require at least one more surgery, and he's left the clinic in the belief that 5,300 grafts would do the job. If he doesn't have enough grafts to make a proper second pass of it then he should have been declined as a patient owing to the fact he doesn't have the required donor resources to meet the desired aesthetic goals.

If he were able to conjure up 2-3,000 grafts on a second go and focus on the frontal third & midscalp (compromising on the crown), I think this could end up in a pretty good place. Obviously it would be handy to see how things have progressed so far though.

[jjalay]

18 minutes ago, Berba11 said:

There's way more than 800 grafts that have grown in, come on... The pictures with super harsh lighting overhead aren't the best pics to judge - that kind of lighting is the enemy of even the best HT's. The more neutral lighting pic from the OP shows much better growth - more in line with what we'd expect - but clearly not enough coverage to get to where the OP will want to be and not yet looking as impressive as his early post-op buzz cut images.

I don't have any issue with the approach if this was clearly intended to be a two-step process. Some people opt to focus on the frontal third & midscalp and then the crown separately to cover a NW6 or 7 and some people go with a more "all over" pass two times. Both are fine and we've seen both approaches done really well from Eugenix. My personal issue here is that the OP wasn't informed by Dr Das that this would really require at least one more surgery, and he's left the clinic in the belief that 5,300 grafts would do the job. If he doesn't have enough grafts to make a proper second pass of it then he should have been declined as a patient owing to the fact he doesn't have the required donor resources to meet the desired aesthetic goals.

If he were able to conjure up 2-3,000 grafts on a second go and focus on the frontal third & midscalp (compromising on the crown), I think this could end up in a pretty good place. Obviously it would be handy to see how things have progressed so far though.

This is another case similar to to the OPs with 4600 grafts from Eugenix. There is apparently a big difference:

 

[Melvin- Admin]

3 minutes ago, jjalay said:

This is another case similar to to the OPs with 4600 grafts from Eugenix. There is apparently a big difference:

 

You can’t compare cases, head shape and size, donor density, hair thickness and overall donor quality is different for different patients. 

Two patients can have 4,000 grafts from the same surgeon and look vastly different for the reasons listed above. 

This patient also has more hair and higher sides. His skull shape is also thinner, a flat wide skull shape requires a lot more grafts because its a wider and larger surface area.

 


 

In my opinion, OP needs at least 10K grafts to have visible density and even then it won’t be full every where. At the end of the day. It’s all mathematics like Dr. Pittella says

 

[Berba11]

23 minutes ago, jjalay said:

This is another case similar to to the OPs with 4600 grafts from Eugenix. There is apparently a big difference:

 

Melvin has beat me to it but the case you linked is quite different. He had a bit more native hair on top, better donor, smaller head and a much smaller area in total to cover compared to the OP. 

[Bandit90]

Head shape greatly influences the amount of grafts required for full coverage. The more Brachycephalic a head shape, the more grafts required to achieve a desired result. Unfortunately, the  OP has a very Bracycephalic head shape, which means he needs A LOT more grafts to achieve an illusion of density. It is absolutely pointless comparing his results against an OP with a Dolicephalic head shape (i.e Caverman). IMO this is a very under spoken about subject in hair restoration, people tend to compliment a surgeon for achieving full coverage with lesser amount of grafts, which can be true to an extent, but a lot of times their head shapes tend to allow this.

I wish the OP well with his result, and the fact he hasn't updated for a few months, can often mean he is happy with results and moved on (which i truly hope is the case here).