Revisiting the Hair Transplant question/decision after coasting along for over a decade using Toppik

[asterix0]

2 hours ago, WhamHair said:

Not sure if this counts but I did take some homeopathic meds many years ago. Not sure what that does but I honestly didn't think I would have the hairline I do at this point. Cannot confirm if there is any correlation here at all. 

I doubt it, some people lose more in the back than in the front, it started like that for me too. Eventually the front started going as well.

[asterix0]

4 hours ago, WhamHair said:

I would rather spend more and do it properly given that the donor supply is finite. I have definitely factored in a long waiting list - which is why I am trying to lock down a strategy in the next couple of months. That way, I am not starting this process when it becomes urgent. 

Good plan. I would look into Dr. Pitella in Brazil, given your Norwood level I think he would definitely give you as close to full coverage as you can hope for. Take a look at some of his results on this forum, there are quite a few good cases. 

[WhamHair]

58 minutes ago, asterix0 said:

Good plan. I would look into Dr. Pitella in Brazil, given your Norwood level I think he would definitely give you as close to full coverage as you can hope for. Take a look at some of his results on this forum, there are quite a few good cases. 

Thank so much for the suggestion. Will spend some time looking at his work.

[asterix0]

19 hours ago, WhamHair said:

Thank so much for the suggestion. Will spend some time looking at his work.

 

[WhamHair]

52 minutes ago, asterix0 said:

 

thanks a ton for sharing this. Will definitely check this out! 

[Turkhair]

2 hours ago, WhamHair said:

thanks a ton for sharing this. Will definitely check this out! 

Pitella is world class. You’re going to be very pleased at the end of it. I also don’t think he recommends finasteride - unlike some surgeons who don’t even operate unless you’re on fin - so he’s perfect for your situation.

Good luck mate

[WhamHair]

11 minutes ago, Turkhair said:

Pitella is world class. You’re going to be very pleased at the end of it. I also don’t think he recommends finasteride - unlike some surgeons who don’t even operate unless you’re on fin - so he’s perfect for your situation.

Good luck mate

This is such great input - and as you rightly said, this fits my situation. There used to be a doctor that was highly recommended on here that did the same. Her name is Dr Radha Rani. What happened to her?

[Turkhair]

1 hour ago, WhamHair said:

This is such great input - and as you rightly said, this fits my situation. There used to be a doctor that was highly recommended on here that did the same. Her name is Dr Radha Rani. What happened to her?

She’s still recommended

https://hairtransplantnetwork.com/dr-radha-palakurthi

New surgeons appear and options increase and people start talking about the new options. That’s probably what happened. I  don’t know anything about her though 

[WhamHair]

1 hour ago, Turkhair said:

She’s still recommended

https://hairtransplantnetwork.com/dr-radha-palakurthi

New surgeons appear and options increase and people start talking about the new options. That’s probably what happened. I  don’t know anything about her though 

I posted a link in my original post that included the list of recommended surgeons but she was not on there. Is there a separate list? Thanks so much for this. 

[Turkhair]

2 minutes ago, WhamHair said:

I posted a link in my original post that included the list of recommended surgeons but she was not on there. Is there a separate list? Thanks so much for this. 

Uh I am not sure, I just googled her name and this forum name and that link came up 😅

Admins can answer better.

[WhamHair]

2 minutes ago, Turkhair said:

Uh I am not sure, I just googled her name and this forum name and that link came up 😅

Admins can answer better.

No worries. This is great regardless. Thanks so much!

[Shadman]

On 9/4/2023 at 8:22 AM, WhamHair said:

Hello All,

So it has been over a decade since I’ve been on this forum. I am headed towards being a NW5. I used to be a regular on this forum in my late 20s as I battled the crippling loss of self-confidence that came from balding in my crown area (but my hairline seemed quite OK – I am actually quite OK with it now too). I discovered Toppik on here and it worked on my crown area. I did not think it would get me by for almost 11 or 12 years but I am at the point to where I think it is running its course in terms of being an effective concealer and the serious decision of getting a Hair Transplant cannot be put off anymore. These days all it takes is the wind or wearing my bike helmet and the gaps in my crown show. I am paranoid about unsavory changes in weather or people leaving the windows open while driving on the freeway. Each container of Toppik no longer lasts for a month like it used to. It’s a shame that this is an issue because with Toppik, I do look younger than I actually am – but there is a part of me that feels like I am being incredibly deceptive due to the use of Toppik. I have attached some photos to give you a sense of what my head looks like with and without Toppik (only one of the photos is a glimse of what my hair looks like with Toppik). For context, I am close to 42 years old now. 

Prior to using Toppik as my cosmetic crutch, I did do an in-person consultation at Dr Konior’s office. I did not meet Dr Konior. I only met his assistant. Since I was in my late 20s at the time, they did not seem too keen on jumping the gun with the surgery – especially since there were signs that my hair loss had not stabilized. I totally respected their decision. I was uncomfortable by Dr Konior’s assistant insisting that I would have to take Propecia to minimize shock loss. I’d rather have a bald head than risk some of the unsavory side-effects of Propecia (that in worst case scenarios can be long-term) – especially since I have had testosterone issues even without using any of this.

While I think I’d be happy with a better hairline, it doesn’t bother me nearly as much as the gigantic sinkhole that is my crown area. As you can see, there is very little hair on it. Even if I get half of that covered, I would be ecstatic. Now I realize that in general, hair surgeons prefer working on the hairline first and then the crown via a subsequent surgery.

In view of the above, my questions are as follows:

a.       Have any of you started with the crown and have had success with that approach?

b.       I see many folks that have pointed out Eugenix. They seem to have locations in both Mumbai and Gurgaon. Are the standards of work comparable in both locations?

c.       Did any of you get by doing this without shaving your head completely?

d.       Did any NW5 folks on here have any success without the use of Propecia?

e.       I checked out the following link for hair surgeons: https://hairlosslearningcenter.org/coalition-physicians . Are these the only recommended surgeons. I remember Radha Rani used to be highly recommended and she did not show up in this list. Any reason why?

f.        For those of you using Toppik as a concealer, did you have to stop using it for a while after having  your hair surgery?

 

Any input with regards to the above would be super helpful. Thank you in advance!

 

To answer your question B, both of the centers of Eugenix maintain the same standard of work. Gurgaon is their head of operation center. Most of their international patients had their procedure in Gurgaon, same applies for me also. Around 40 minutes drive from the airport. But no Matter which location you select, quality of work will be same. 

In my opinion, you should also address the frontal part. A new hairline will shape your face. Moreover, you should select a clinic where they take your pre existing hair in consideration and implant in between. 

[mrmane85]

If you don't want to take Finasteride then I would consult with Dr Pittella as he doesn't recommend Finasteride and is top 2 in the world when it comes to high NW's like yourself 

[WhamHair]

21 minutes ago, mrmane85 said:

If you don't want to take Finasteride then I would consult with Dr Pittella as he doesn't recommend Finasteride and is top 2 in the world when it comes to high NW's like yourself 

This is great. You are the second person to mention this - so I will definitely check out Dr Pittella's work.

[WhamHair]

7 hours ago, Shadman said:

 

To answer your question B, both of the centers of Eugenix maintain the same standard of work. Gurgaon is their head of operation center. Most of their international patients had their procedure in Gurgaon, same applies for me also. Around 40 minutes drive from the airport. But no Matter which location you select, quality of work will be same. 

In my opinion, you should also address the frontal part. A new hairline will shape your face. Moreover, you should select a clinic where they take your pre existing hair in consideration and implant in between. 

Mumbai might be easier since the location is close to where my mom lives in that city. And yes, the frontal part/hairline is key. That still takes precedence over the rest. thanks so much! 

[Gatsby]

Dr Pittella would be an excellent choice. His ability to respect the donor management is incredible. All the best @WhamHair. 👍

[WhamHair]

On 9/10/2023 at 1:32 AM, Gatsby said:

Dr Pittella would be an excellent choice. His ability to respect the donor management is incredible. All the best @WhamHair. 👍

I just reached out to him with my photos. Let's see what emerges from the consultation. Will keep you all posted on how this pans out. Thank you so much! 

[WhamHair]

So I heard back from both Dr Pitella’s clinic as well as from Eugenix. Both of them were prompt with their initial response. Dr Pitella’s clinic asked me to submit some information via a google form. It has been almost a week since I submitted that form but I have not heard back from them. I will follow up tomorrow for what it is worth. Eugenix has been calling almost regularly to set up a phone consultation after providing an estimate of grafts (extracted from both my scalp and beard) require for both my hairline and crown. I am still unsure as to how to view their eagerness. They indicated that there is a 2-month waiting list for the actual procedure to be done. This is far shorter than I had expected. My sense was that the waiting periods typically exceed 6 months – so this was a bit of a surprise (albeit a pleasant one). As for my concerns around the use of oral Finasteride, this was the response from Eugenix:

“If you choose not to take finasteride in the future, we can still perform the surgery because we have observed that finasteride doesn't impact the final results (1 year) of hair transplant. However, it's important to note that finasteride can prevent further baldness and improve the longevity of transplanted hair. If you're considering alternatives, we recommend consulting our doctors through a video consultation to explore options like finasteride gel or minoxidil. Without finasteride, you may experience thinning in non-transplanted areas and, in the long term, even the transplanted area could become miniaturized. Our aim is to provide you with the knowledge and the intake of finasteride is solely your decision.”

I appreciate them not being wedded to the idea of making the use of oral finasteride a pre-requisite for the surgery. In theory, I am not opposed to finasteride gel or minoxidil. I am wondering what the general take on that is here as a substitute for oral finasteride. Thoughts?

For those of you that have you leveraged the beard area for transplants, were there any long term scars there? This was the response I received from Eugenix when I asked them about this:

“There shouldn't be visible scar of the extraction as we C*** punches, which are sharp and result in small wounds, leading to faster healing. I am sharing you few examples below which can give you an over all idea of beard extraction.”

They actually even sent me photos (attached) of what this would look like. I am wondering how close this is to a typical situation wherein the beard area is used for grafts. Any thoughts?

Thank you all for your guidance as I navigate this somewhat scary path.

[Shadman]

59 minutes ago, WhamHair said:

So I heard back from both Dr Pitella’s clinic as well as from Eugenix. Both of them were prompt with their initial response. Dr Pitella’s clinic asked me to submit some information via a google form. It has been almost a week since I submitted that form but I have not heard back from them. I will follow up tomorrow for what it is worth. Eugenix has been calling almost regularly to set up a phone consultation after providing an estimate of grafts (extracted from both my scalp and beard) require for both my hairline and crown. I am still unsure as to how to view their eagerness. They indicated that there is a 2-month waiting list for the actual procedure to be done. This is far shorter than I had expected. My sense was that the waiting periods typically exceed 6 months – so this was a bit of a surprise (albeit a pleasant one). As for my concerns around the use of oral Finasteride, this was the response from Eugenix:

“If you choose not to take finasteride in the future, we can still perform the surgery because we have observed that finasteride doesn't impact the final results (1 year) of hair transplant. However, it's important to note that finasteride can prevent further baldness and improve the longevity of transplanted hair. If you're considering alternatives, we recommend consulting our doctors through a video consultation to explore options like finasteride gel or minoxidil. Without finasteride, you may experience thinning in non-transplanted areas and, in the long term, even the transplanted area could become miniaturized. Our aim is to provide you with the knowledge and the intake of finasteride is solely your decision.”

I appreciate them not being wedded to the idea of making the use of oral finasteride a pre-requisite for the surgery. In theory, I am not opposed to finasteride gel or minoxidil. I am wondering what the general take on that is here as a substitute for oral finasteride. Thoughts?

For those of you that have you leveraged the beard area for transplants, were there any long term scars there? This was the response I received from Eugenix when I asked them about this:

“There shouldn't be visible scar of the extraction as we C*** punches, which are sharp and result in small wounds, leading to faster healing. I am sharing you few examples below which can give you an over all idea of beard extraction.”

They actually even sent me photos (attached) of what this would look like. I am wondering how close this is to a typical situation wherein the beard area is used for grafts. Any thoughts?

Thank you all for your guidance as I navigate this somewhat scary path.

Regarding the eagerness, I think they're trying to be responsive as much as they can. Whenever I asked them any questions before finalizing my procedure, they were ready to answer always. You  can start finasteride three/two times in a week to see how it is behaving.  If you don't want to take it completely, then you still have many options. You can go for oral minoxidil & finasteride gel or you can go for minoxidil and finasteride topical solution. Usually topical finasteride hardly give any sides. Regarding the scar, Eugenix use very sharp punches to extract grafts so there shouldn't be any scars. In my repair procedure,  they extracted 150 wrongly placed grafts from the hairline. Initially up to 3-4 days it might be noticable but after a week there would be no scars.

May I know what number of grafts they're intially suggesting for the coverage ?

Edited October 8, 2023 by Shadman

[WhamHair]

17 minutes ago, Shadman said:

Regarding the eagerness, I think they're trying to be responsive as much as they can. Whenever I asked them any questions before finalizing my procedure, they were ready to answer always. You  can start finasteride three/two times in a week to see how it is behaving.  If you don't want to take it completely, then you still have many options. You can go for oral minoxidil & finasteride gel or you can go for minoxidil and finasteride topical solution. Usually topical finasteride hardly give any sides. Regarding the scar, Eugenix use very sharp punches to extract grafts so there shouldn't be any scars. In my repair procedure,  they extracted 150 wrongly placed grafts from the hairline. Initially up to 3-4 days it might be noticable but after a week there would be no scars.

May I know what number of grafts they're intially suggesting for the coverage ?

Thanks so much for the prompt and helpful response. I definitely want to avoid oral finasteride altogether. Thanks for the reassuring assessment of beard area scars. I have to admit that when I was a lurker on this forum over a decade ago, beard hair transplants were NOT a thing so I was a bit taken aback by that suggestion. As for grafts, this is what they are proposing:

Proposed Harvest from Scalp: 3500

Proposed Harvest from Beard: 700

[Shadman]

3 minutes ago, WhamHair said:

Thanks so much for the prompt and helpful response. I definitely want to avoid oral finasteride altogether. Thanks for the reassuring assessment of beard area scars. I have to admit that when I was a lurker on this forum over a decade ago, beard hair transplants were NOT a thing so I was a bit taken aback by that suggestion. As for grafts, this is what they are proposing:

Proposed Harvest from Scalp: 3500

Proposed Harvest from Beard: 700

I can understand why you don't want to take finasteride completely. But you still have other options. I think above estimated grafts would be enough to give you good coverage. Best wishes

[WhamHair]

2 hours ago, Shadman said:

I can understand why you don't want to take finasteride completely. But you still have other options. I think above estimated grafts would be enough to give you good coverage. Best wishes

thanks so much. I am just worried that with such a large number of grafts taken from the scalp, I might not have enough for a future HT. Thoughts? Thanks once again.

[Shadman]

7 hours ago, WhamHair said:

thanks so much. I am just worried that with such a large number of grafts taken from the scalp, I might not have enough for a future HT. Thoughts? Thanks once again.

I think you'll still have grafts available for future session. But you can discuss again with the clinic so that they plan accordingly. in my procedure, I was running out of grafts so Dr. Decided not to extract more. Because if they extract more, it'll look over harvested, an ethical approach from the clinic.  But If it was some other clinic scenario might've been different. 

Edited October 9, 2023 by Shadman

[WhamHair]

4 hours ago, Shadman said:

I think you'll still have grafts available for future session. But you can discuss again with the clinic so that they plan accordingly. in my procedure, I was running out of grafts so Dr. Decided not to extract more. Because if they extract more, it'll look over harvested, an ethical approach from the clinic.  But If it was some other clinic scenario might've been different. 

This is good to know. Thank you so much for the reassuring response! 

[WhamHair]

UPDATE: I have my online consultation scheduled with Dr Pitella this Wednesday. I obviously have a set of questions that I plan to ask. That being said, are there any questions that some of you wished you had asked during your online consultation that you wouldn't mind sharing? Please let me know. Thank you in advance.