[Solved by Eugenix] Did Eugenix miss assessing my Retrograde Alopecia

[DeltaV]

Hello All,

Please evaluate from the picture if I have retrograde alopecia on the nape. I was surprised when a good friend of mine pointed this out to me recently from the pictures.

I had my procedure at Eugenix dec. 2022 and neither Dr. Pradeep or Dr. Arika pointed this out. Both said that my donor is excellent. But we all know how quick the donor assessment is at Eugenix....just an eye glance. 

Many grafts have been taken from the nape region and implanted and I am paranoid that such a serious issue was missed which can have serious consequences on my Hair Transplant.

[Berik]

Yes, this is one of the downsides of FUE. FUE extracts follicles outside of the "Safe Donor Zone" that are more prone to minitiaurization. One of the benefits of FUT is the strip can be taken from an area in which very few will experience hair loss from, except for those with retrograde alopecia and some other outliers potentially. I'm not a doctor, but to be honest that certainly looks like it could be if that was not done a fade done by your barber. 

Image attached on FUT vs FUE extraction area. 

Edited April 1, 2023 by Berik

[Rawkerboi]

Was your donor area properly examined by Eugenix before Hair Transplant? 

If both the doctors says your donor is excellent, I think it's fair enough to trust them given their expertise in HT

 

[DeltaV]

6 minutes ago, Rawkerboi said:

Was your donor area properly examined by Eugenix before Hair Transplant? 

If both the doctors says your donor is excellent, I think it's fair enough to trust them given their expertise in HT

 

As I mentioned, the donor assessment by both the doctors were just a mere eye glance and not thorough check which is why I am paranoid.

[ThePerseverantWarrior]

It's difficult to say so from this picture. Looks like a faded haircut in the nape region. Do you have any other image?

[gillenator]

1 hour ago, DeltaV said:

As I mentioned, the donor assessment by both the doctors were just a mere eye glance and not thorough check which is why I am paranoid.

So they did not perform a microscopic examination?

[DeltaV]

5 minutes ago, gillenator said:

So they did not perform a microscopic examination?

No microscopic examination at all. Three doctors (Dr Pradeep, Dr arika & Dr. das) from Eugenix examined my donor and didn't take more than 2 minutes in total all three of them.

Edited April 1, 2023 by DeltaV
Typo

[DeltaV]

This is today's pictures of the nape region. I am 3.5 months post op as of today.

[Rafael Manelli]

1 hour ago, DeltaV said:

No microscopic examination at all. Three doctors (Dr Pradeep, Dr arika & Dr. das) from Eugenix examined my donor and didn't take more than 2 minutes in total all three of them.

This is not good.

[gillenator]

5 hours ago, DeltaV said:

This is today's pictures of the nape region. I am 3.5 months post op as of today.

Just from these photos it’s clearly evident IMHO that you have diffusion throughout your donor zone.

Edited April 1, 2023 by gillenator

[DeltaV]

@Eugenix Hair Sciences Please why my donor was not assessed properly?

[DeltaV]

5 hours ago, gillenator said:

Just from these photos it’s clearly evident IMHO that you have diffusion throughout your donor zone.

Thank you @gillenator. Being one of the senior most member of this community, I really value your views. However, I think this is 3.5 month post op picture and maybe due to recovering from shock loss it could be misleading. I don't know, I am just saying this out loud. Also, my barber does keep the nape area short and shaves it off.

I just wished that Eugenix would have done their due diligence when I was physically with them during the planning stage prior to the surgery. 

While I am happy so far with the initial results, it is sometime that will always play in my mind.

 

[aaalan]

1 minute ago, DeltaV said:

Thank you @gillenator. Being one of the senior most member of this community, I really value your views. However, I think this is 3.5 month post op picture and maybe due to recovering from shock loss it could be misleading. I don't know, I am just saying this out loud. Also, my barber does keep the nape area short and shaves it off.

I just wished that Eugenix would have done their due diligence when I was physically with them during the planning stage prior to the surgery. 

While I am happy so far with the initial results, it is sometime that will always play in my mind.

 

On that, how are your results 3-4 months post HT? Any concerns on growth? 

[DeltaV]

8 minutes ago, aaalan said:

On that, how are your results 3-4 months post HT? Any concerns on growth? 

This is what I got from Eugenix at 3 months.

'Thank you for sharing your scalp images, as per Doctor's evaluation your hair growth is good and on track. You might still be experiencing some shedding of your transplanted / pre-existing, which is natural. Please do not worry'.

[Berik]

They've become a full-fledged hair mill. Wow. 

[gillenator]

8 hours ago, DeltaV said:

Thank you @gillenator. Being one of the senior most member of this community, I really value your views. However, I think this is 3.5 month post op picture and maybe due to recovering from shock loss it could be misleading. I don't know, I am just saying this out loud. Also, my barber does keep the nape area short and shaves it off.

I just wished that Eugenix would have done their due diligence when I was physically with them during the planning stage prior to the surgery. 

While I am happy so far with the initial results, it is sometime that will always play in my mind.

 

Thank you my friend, listen, after I took the liberty of enlarging your pic of the primary donor zone, it appears that many of your hair shafts have varying degrees of decreased hair shaft diameter (caliber), which appears to have hair that is DHT receptive…and if some of the loss of density is related to shock loss, that should grow back…best wishes to you.

[sunsurfhair]

On 4/2/2023 at 9:43 AM, gillenator said:

Thank you my friend, listen, after I took the liberty of enlarging your pic of the primary donor zone, it appears that many of your hair shafts have varying degrees of decreased hair shaft diameter (caliber), which appears to have hair that is DHT receptive…and if some of the loss of density is related to shock loss, that should grow back…best wishes to you.

Hey Gillenator does Dorin examine donor w microscopes? This is really interesting thanks for pointing this out. 

[gillenator]

Yes and you should want this done during the in-person consultation.

[Melvin- Admin]

It’s hard to judge from these pictures. Do you have any pictures with your hair longer? It looks like you have a taper fade, which would make the nape appear thinner. 

[DeltaV]

1 hour ago, Melvin- Moderator said:

It’s hard to judge from these pictures. Do you have any pictures with your hair longer? It looks like you have a taper fade, which would make the nape appear thinner. 

Some pictures 6-8 months Pre HT that I could find.

[Captain Haddock]

On 4/2/2023 at 5:57 AM, DeltaV said:

Thank you @gillenator. Being one of the senior most member of this community, I really value your views. However, I think this is 3.5 month post op picture and maybe due to recovering from shock loss it could be misleading. I don't know, I am just saying this out loud. Also, my barber does keep the nape area short and shaves it off.

I just wished that Eugenix would have done their due diligence when I was physically with them during the planning stage prior to the surgery. 

While I am happy so far with the initial results, it is sometime that will always play in my mind.

 

As someone who suffers from retrograde too, that does look like the nape thinning. It usually thins in the middle and leaves an outline around the edges - I have it to fade it out in my cuts.

Edited April 4, 2023 by Captain Haddock

[DeltaV]

14 minutes ago, Captain Haddock said:

As someone who suffers from retrograde too, that does look like the nape thinning. It usually thins in the middle and leaves an outline around the edges - I have it to fade it out in my cuts.

Thanks @Captain Haddock for sharing your experience. I believe Eugenix has used nape grafts on my temples and we'll see how they turnout in coming months. But there is surely a long term risk in using these grafts.

[A_4_Archan]

Actually this is the only drawback of fue....if you have to extract more grafts than many clinics are going above and beyond the safe donor zone...

Suppose you have retrograde alopecia than you will loose those nape hairs in future but most of your nape hairs would have been used to fill both sides of temples so if you loose them than your temples would look thinned out and you can bear that if other grafts on the top and crown stays good....

[bobs person]

On 4/1/2023 at 11:53 PM, DeltaV said:

As I mentioned, the donor assessment by both the doctors were just a mere eye glance and not thorough check which is why I am paranoid.

Hi Berik, I would like to build on this as well as I felt exactly the same way- Eugenix's doctor examination pre surgery seemed to be extremely careless and worrying. 

In short, I had my surgery done with eugenix last year, and pre surgery, Dr Arika and Dr Das also just took a 30 seconds glance at my donor area and transplant area with their naked eye, without any microscopic examination or examination with any equipment, even though I mentioned I was rejected by 2 other doctors before because of high chance of permanent shock loss. 

Before Eugenix, I went to 2 other doctors, who did microscopic examinations of my transplant areas and donor area, and said that it will be a risky surgery as I may be prone to permanent shock loss in my transplant area. 

After reading about how Eugenix has top tier doctors on this forum, I decided to visit Eugenix to give them a try and flew to India. I was prepared to be rejected by Eugenix and lose my deposit if they examined my transplant area and felt the same about permanent shock loss, as no surgery is better than a failed surgery.

However, I was quite shocked when there was no microscopic examination of any kind, but just a brief naked eye glance.  From my understanding, microscopic assessment before surgery is a standard procedure.

Even after I mentioned that I have seen 2 other doctors who cited a high risk of permanent shock loss, all Dr Arika and Dr Das did was glanced at my transplanted area for another 10 seconds before saying it's fine. I decided to trust the doctors ( though very worried) and went ahead with the surgery.

Now that the surgery is done, it does look like i am having shock loss, but I am still waiting for it to be fully grown and am praying that it will grow out. 

Regardless of the results of my transplant, I think potential transplant goers should be aware that it seems like eugenix does not perform any microscopic examination of donor and transplant area pre surgery, and will just decide whether to go ahead with the surgery through a naked eye examination. As such, if you are unlucky and have weak donor/ transplant areas, it may not be properly assessed, and there may be a higher chance of a failed surgery if you did go ahead with the surgery,

[NegativeNorwood]

Brutal. Meanwhile, non oficially recommended by the forum doctors like Zarev take an average of 2 hours to assess donor zone and design a very thorough plan before touching a single hair (screenshots taken from a Youtube video):

 

On top of that, you paid for the top package that includes Dr Sethi. IIRC, the price is 8.3$ per graft (this man paid 25k usd for 3k grafts):

As a reference, Zarev charges 5$ per graft, and so do many top tier doctors that take hours inspecting the donor area with microscopes. I would expect this kind of eyeballing and lack of planification by a hairmill that charges less than 1$ per graft, but at 8$ per graft this is unbelievable.

It's very sad to see that a recommended clinic doesn't even care about inspecting your donor with microscopes (let alone a Zarev level examination), we really can't take anything for granted.

I'm very sorry for what happened to you OP and to @bobs person, it really doesn't make any sense.

It is a shame because I've seen great Dr Sethi results, and really like most of his temple work and hairline designs, in addition of the naturalness his hairlines usually have. He should take an hour or two to examine the donor closely before working, like any reputable doctor does, otherwise he's doing a huge disservice to his talents and to his patients.

 

Edited April 4, 2023 by NegativeNorwood