Noodles123

Jimcraig152.... I also highly suspect that Diep extracted far more grafts than he implanted in my case.  I had authorized him to only extract up too 1200 grafts due to budgetary constraints.   When the surgery was done I saw that he had extracted 1500 grafts according to my paperwork.  I was alarmed because I thought I would be charged for the grafts but he said he just gave them to me for free which made me very puzzled.  What I have always suspected is that he extracted many more grafts because there was a very high transaction rate.   The fact that he extracted 300 grafts over my limit suggested his transection rate on me was 20%.   

When I have posted my pictures here before people have told me they guessed that the number of grafts implanted was closer to 1200 which coincides with my suspicions.

On 11/8/2020 at 3:25 PM, jimcraig152 said:

I tend to take these photos in the best possible setting. Always, they are taken after a shower, after I've applied Rogaine foam, then soon after everything is dry or near dry. This done in a bathroom in the house where I can close the doors so sunlight doesn't make for inconsistent photos. When I look at myself in my other bathroom, the story is different than what you see in the photos.

Here is my donor 4 days after the surgery where I can illustrate the problems with my donor:

1. Encircled in red is my vertex where I had some thinning already
2. Encircled in yellow is where extractions went really high right next to the vertex and I feel too many punches were taken from too small of an area there
3. Encircled in purple is an area where donors were heavily harvested from too small of an area

So now is how these things look in a different light (from my master bathroom):

Extractions near vertex. Also notice the surrounding donor. Virgin areas are at the absolute bottom of the photo for you to compare. Also those virgin areas are the thinnest part of anyone's scalp naturally.

The band of overharvesting towards the bottom of the donor. Also, notice the state of the surrounding donor.

As for the corn rows, he is a photo closer to what I see in the mirror everyday. I do know it is early. This should fill in at the end of this. But compare those rows to the surrounding natural hair.

As for the density thing, I know things are early. But even with Diep patients that have come to full term and have good density, I believe there is a high toll paid for that density. My procedure was for 2332 FUE grafts. Go take a look around this forum at donor areas for 2000-2500 graft procedures s and see if the math adds up for you.

Everything you pointed out is what I noted with my own surgery. I completely agree with your point that there's a high toll even if you do end up with a decent result. With my transplant he went very far up the back of my head into an area that is potentially vulnerable to Future thinning, my crown. He also focused too much of his extractions in one area resulting in a very visible patch of thinness.   At this point it's very clear that these aren't flukes this is how the man operates.  

I have not seen another surgeon say this - ever.   In fact I think we have had several surgeons agree that this implantation pattern results in the appearance of LESS density precisely because you can see directly through those "rows" of hair.  

And his analogy is pretty silly.  The reason farmers plant in rows is because of EFFICIENCY.  To continue this analogy, those farmers want to water and harvest their crops QUICKLY.   Which funnily enough appears to be the SAME reason Diep implants the hair this way - for the sake of SPEED.   His extraction and implantation patterns are about speed.    You can look through my posts and see pictures I've posted of my donor area, which has an obvious rectangular area that was clearly overharvested.  The contrast / demarcation between the untouched areas and the donor area are obvious.   

YESS...... This is EXACTLY what I have written about.    Diep's implantation style results in straight rows like if you were looking down a cornfield.   You end up with this sparse, see through effect because the grafts are not staggered.   When they are staggered you reduce the amount of space between the grafts and creates a fuller, more dense look.  This has been my NUMBER ONE complaint from my transplant with Diep (almost 7 years ago).   I can't for the life of me understand why in 7 years, he has not done a single thing to change this technique that looks unnatural up close and results in a less dense looking result.    

And as others have mentioned, his extraction patterns leave a lot to be desired because he does not spread the grafts out.  Rather he extracts them all from a localized area, which results in a visible patch of thinness.  This is exactly what I experienced.   And apparently, he has not changed this approach either.   

It's clear that he does this for the sake of efficiency, but it is inexcusable to be cutting corners when you are charging at the very top end for FUE.    

I've made mention of this in the past, but always felt ignored or dismissed, but glad this is now being aired.

On 2/13/2020 at 6:34 PM, ruca2 said:

@Melvin-Moderator I didn't share my results. I had a small FUE from Bosley before finding this site. I then was led to Dr Diep by results posted here and his YouTube channel. From a macro perspective the transplant looks okay and the casual observer wouldn't notice anything out of the ordinary. However, I'm extremely detail oriented (picky and slightly a perfectionist) and can't help but notice major flaws. My donor looked bad. Punches were extremely large, bloody and he left a linear line at the bottom of the extraction zone that almost looked like an FUT scar. I had to have had smp to my donor. Some of his angles in the hairline were too perpendicular and when my hair is shorter it sticks awkwardly up. He did a small section on the temporal side were the hair should have been oriented down and forward. He placed them angled straight back. 

I don't think you are being a perfectionist by pointing these things out.  If you go to page 2 of this thread, I posted my pictures of my Diep procedure and I noted the exact same things.   My donor is obviously thinned out because of questionable extraction patterns.  Instead of spreading it over a larger area, he focused all of my extraction in a small area on the back of my head.  He also went out of the safe zone and went too far up on my crown, which frankly makes that area look thinner.  One, the hairs in this area are susceptible to miniaturization.  Two, it has made this area look thinner which is the last thing you want your crown to look like.     You can literally see the rectangular thinned out donor area on the back of my head.  It was not feathered out at all.

Is my transplant decent looking? Yeah, but I think there isn't the kind of attention to detail you would expect out of a clinic that charges on the higher end for FUE.  With the linear implantation pattern, the work doesn't look as dense as it could because of all the spaces in between the grafts.   He could easily fix this by modifying his approach and stagger the grafts at the hairline and keep his linear pattern behind the hairline.   

I posted my own pictures earlier in the thread showing this linear pattern that he implants the follicles in.   He clearly does it for efficiency.    I'm honestly not a fan at all of this technique because it makes the transplanted area look sparser than if he had staggered the grafts.  If you have grafts implanted in rows, then you will have rows of spaces that you can see right through.  Imagine looking at a corn field.  You can look down the rows of spaces.  Now imagine if the grafts were staggered.   The spaces in between each graft would be minimized and you get a denser looking result.  If you look at how a clinic like H&W implants their grafts, it is staggered so you cannot see into the spaces.   You may use the same number of grafts but you get more coverage of the scalp precisely because the grafts are in a staggered pattern.   

I get he does this for the sake of speed, but it sacrifices some degree of naturalness for efficiency.   One of my main complaints about my own transplant with Diep is that it looks sparse because there is too much space between the grafts.  

I'm all for honest debates, but disappointed that ad hominem attacks are allowed to stand and not moderated.   The verbal abuse and name calling is so beneath this forum.  

On 4/28/2020 at 3:05 AM, EricL said:

I saw a doctor promoting another brand of topical finasteride (not sure whether he is affiliated with the product), with the combination of minoxidil + retinoic acid.

https://www.hihappyhead.com/product/men-topical-finasteride-for-hair-loss/

But it seems there is an additional compound which is retinoic acid, which Minoxidil Max doesn't have.

He basically writes you a prescription which is sent to a compounding pharmacy that he's working with to make the formulation. 

1 hour ago, Tentpole91 said:

@Melvin-Moderator that’s good to know. I think it’s possible to simultaneously hold that he is a great surgeon but also that he takes some shortcuts compared to others who charge $10/graft.

And that’s my point — compared to the whole population of surgeons, he is likely top tier. But compared to the others who charge top dollar, he’s a bit of an outlier in terms of his approach.  

Regarding the straight lines: there have been two people on this thread who have commented on how the grafts are placed in straight lines. One of whom had surgery with Dr. Diep prior and called this out as an issue. So yeah: no proof yet that it gives sub-par results, but another thing to note I suppose. 

Completely agree with your assessment.   To be clear, my result was decent, but not spectacular.   Pretty much all the grafts grew in, so you can be assured that your transplant will be successful.  That  said, do I think Diep is in the same league as a Rahal or H&W?  No.   His level of artistry is just not quite at that level.  Do I think he is in the 90% percentile in terms of results?  Yes.  That said, he doesn't offer the same meticulous attention to detail as the Rahals, H&W, and Koniors of the world.   I think that's a fair statement.  

No shade to Diep at all.

So the main takeaway if you go to Diep?  You're gonna get a good result and you can be assured most of your grafts will survive.   But also be aware that the extraction pattern might leave patchy areas in the donor zone.   

My friend went to Rahal as a pretty advanced Norwood 4/5 and his hairline is absolutely STUNNING.   After seeing his hairline, I was just floored by how artistic and dense packed it was.  

While my transplant grew in fine, I still have some issues with it.  I experienced the same things Tentpole91 enumerated above.  He harvested all the grafts from a small area on the back of my head, so that area looks noticeably thinner and frankly obvious with a 3 guard and below.   And I've already mentioned the straight line graft placement, which is very obvious from my photos.  Not sure where the confusion is. 

I will say that at a social distance, the rows of hair grafts are not noticeable, but I have caught a few people doing double takes of my hairline when they are a bit closer.   

I've attached a pic of how my hairline looks today with no concealors.  My hairline was lowered about 3/4 inch because I had a large forehead.  The density from the beginning was always pretty thin.   And you can see that the gaps in the initial graft placement made the hairline look sparse.   I was about a Norword 3 and had about 1500 grafts placed to lower the hairline.   So that whole area never had any hair to begin with.    

Also attached a pic of my donor.  You can clearly see the thinned out area in the shape of a rectangle on the back of my head.  These pics are all recent. 

Look at the placement of the grafts.... They are in straight lines, back to back.   You can clearly see how the grafts are not staggered and they are placed in straight lines.   From a distance it looks fine, but there are clearly gaps and less appearance of density from this kind of placement.   

I had a transplant by Diep years ago, and while the result was good for the amount of grafts placed I always had one gripe.   I REALLY did not like the placement of the grafts in straight lines like a cornfield.   For one, it causes wider gaps and a more see-through appearance that I've noted in my own transplants and others who have gone to him.   If he staggered the grafts it would cover more gaps and give the appearance of greater density.  

After all these years, he is apparently still using the same placement style.  I suspect that this is done to make the process quicker for himself in making the incisions and for his staff in placing the grafts.   

Again, I'm happy overall with my transplant, but this has always been an issue with him that I've noticed. 

What's your DIY method?     The only reason I haven't done this myself is because I don't want to use minoxidil as a base.  The intense shedding is too much for me to handle, so I want to use a finasteride only solution.  I've seen people post online about using an ethanol / propylene glycol vehicle.    

Any idea where one might find a pre-made vehicle solution that would work with finasteride?   

On 3/21/2020 at 1:29 PM, CosmoKramer said:

It’s not just the espionage you sheepified dimwit....it’s the perfect storm of China’s retribution for Trumps trade war with them, see how easily it’s all forgotten now. Why is it such a hard thing to believe that a major financial and military and surveillance superpower that has gained financial and manufacturing dominance over the rest of the world economy and gained everyone’s dependence on it, that when it’s threatened by a trade war & a populist uprising, that they suddenly have a “viral” outbreak just as the temporary trade impact extension expired (which now they cheer victory that they have zero new infections), and likely not a reason to shut down the brave massive people protesting for their rights in Hong Kong...how convenient a timing....but you’re to ignorant to even possibly consider connecting the obvious dots.

No one will fare better during this Global Great New Depression than China, $3 Trillion in cash reserves, plenty invested in gold reserves, billions borrowed from the world bank to prevent others from borrowing...but hey it’s all good.

https://www.npr.org/sections/goatsandsoda/2019/01/31/689960866/flush-with-cash-china-continues-to-borrow-billions-from-world-bank

Your "rationale" doesn't even really make sense on closer inspection.   So if China concocted this virus to bring down the US economy as retribution for the trade war, then all they have ACTUALLY done is dealt a serious, protracted blow to their economy, now that brand China is in the toilet.   It's like cutting your nose off to spite your face.   Their economy is already sputtering towards a major collapse and the pain will be felt for years to come.   

Based on your hair characteristics (fine hair, advanced hair loss) I think you'd be better served by an FUT.  You need lots of grafts to make an appreciable difference and FUT is still the best way to maximize your total grafts. 

Any reason why you didn't go with Rahal for a second procedure?  Which doctor did you choose for the jaw implant?

On 1/6/2019 at 8:59 AM, Aftermath said:

 

Taken today, 3 years or so after the last procedure, just to prove it doesn't all just fall out after a couple of years!lol

Just wanted to say that your results are incredible.... And that I hate you...lol.  

Hoping one day I'll be touched by Rahal's hands. 

Quote

 

I would bring the temples forward a bit to match the lower hairline.  Your hairline is lower, but the temples are still a bit further back.   It would make it a bit more in proportion.  

Uh yeah sure bruh.... try writing in a style that doesn't scream shill.

So is the current pricing for Rahal still $8 FUE and $4 for FUT in Canadian dollars? Any info about current pricing is appreciated. Thanks.

Purely speaking from my own experience, but at the time of my surgery I had already taken finasteride for about 5 years. It did nothing to stop shock loss. In fact, my shock loss was pronounced and excessive. Everything seemed to regrow, but don't count on it making a difference in regards to shock loss. I think like the posters above said, it's really more a function of how traumatic the surgery was and your body's ability to handle that stress.

OMG..... almost spit out my drink. This is stunning!!

Where is everyone even getting this topical finasteride?

Pretty telling that there are virtually no result videos.

The sense of losing control. It's a stark visual reminder of how little control we have over our bodies and our eventual decline.

Ugh. But you are right, having the ability to intervene at all is a good thing. There are worse things that can happen to us physically that we have ZERO ability to stop.

I think when it comes down to artistry for hairlines, Rahal is really amazing. Konior is probably on par with Rahal. That said, if you are only considering FUE, Rahal does use a tech / nurse to do a lot of the extractions. That's not to say the tech (Mike I believe) isn't highly trained, but it is something to be aware of.