FUEblonde1985

I’m fairly certain the bald spot I had was on my radar around month 4-5 but I just quietly assumed it would catch up but it never did.

By month 6 you should be able to see which grafts are going to grow. The hair will take a couple years to reach full thickness but if you don’t see any hair at all in certain spots, it probably won’t magically appear down the road. If your main complaint is overall seems thin, it might just need time to thicken.

I’m not sure that I’m talking like it’s a botch job. I’m just stating what the results are and the problems I see. Initially I was just happy to have a full hairline but as time has gone on - the issues have started to become more of a problem for me. Most people who know I had a HT think it looks good and they also agree with the issues I point out. It still looks good because I work around the problems but the fact is there is a significant patch where the grafts seemed to have failed and the hair is definitely not angled correctly. Would some other doctor have done better or worse? No way to know. I’m just not totally satisfied with the outcome and I will go somewhere else next time, presumably with someone that has shown to have more consistent results (and hopefully better trained technicians).

Hey Forum, Adding an update to this thread at the request of Melvin. The transplanted hair essentially looks the same as it did visually from my previous updates. My hair has very slightly continued to thin out behind the transplanted hair - more so in the crown area. I expect I'll probably need an additional HT at some point in the next 5-10 years. It's thinning, but very slowly. I think at the 1-2 year mark, I was pretty satisfied with just having a decent hairline compared to before. Now I am at 3 years and over the last year I've been increasingly less satisfied with the fact that the technician who worked on the right side of my hairline was clearly less experienced or technically competent than the tech on the left. The picture below shows what I am talking about. I can "cover" up this area fairly well so its not an obvious bald patch behind my hairline, but it does really screw up the flow of the hairline overall and quite frankly, looking at some of the results from the more reputable doctors - I really wish I had just bit the bullet and flown somewhere rather than try to stay local w/ Diep. I felt like I paid a premium price for mediocre work. Yes I know many of the photos posted look real good from the front when its styled, but you can't ignore that there is a good square inch where barely any grafts survived, and its only in that spot. That is the primary issue I have, and secondary to that is the angle of the grafts is not natural - that has not gotten any better as one poster above thought. That said, I won't be going back to him for additional HT work. I actually tried minox at the same time I started propecia (around 7 years ago) and got some pretty awful side effects. Heart palpitations, terrible headaches, and somehow it made my face look strange? I'm also using keto shampoo (not much I know) but also started microneedling with a derminator a few weeks ago. I'm going to see how the microneedling pans out for about 6-12 months, and if I am still unsatisfied, I will look into trying dutasteride. I might give minox another go but that is a last resort. I haven't done research lately to see if there are any other promising things people are doing for results.

My last update was 2.5 years post-op so nothing visually has changed since then (except the hair very slowly continuing to thin in back). I'll update though with my thoughts.

Ah I see. That’s what I get for not reading the full post. The issue I had was not at the mid scalp. I had hair transplanted at the hairline and filling in temple areas, but one of the temple areas came out much more sparse than the other. I can style over it well enough but that area of the hairline is clearly missing some density. I could tell the tech doing that side was new because I listened to both techs talk for hours while they did the work.

You might have answered this at some point in the past already - but why didn't you go back to Dr. Diep? And are you on any meds? I'm about two years out from my Diep work and I am getting increasingly less satisfied with the section of my hairline that seemed to come out far less dense than the other, but I don't think I will be going back to Diep for a second pass. One of the still yet-to-be-known factors is what damage, if any, Diep did to the donor area. It "looked" really bad post-op but I am not sure if that actually means anything for future FUE.

Here is an updated picture , 2.5ish years post-op: I've definitely gotten accustomed to working with the transplanted hair. Not sure if its because the hair has become more natural or not from the growth cycle, or just a mental thing. I've also kept the hair about an inch or so longer on top than I used to, and it has helped with keeping the hair looking natural. It has a tendency to want to flow up when its too short. Area on left side never filled in. I've basically accepted it and its fine - it's not noticeable when styled appropriately but you can definitely tell that the hair volume in general is just not as "full" there and I kind of do some voodoo magic with hair product to give it a little more volume there. Will need to fix that in some inevitable future procedure. Hair behind the transplanted hair has held out just fine, crown area slowly thinning but will probably not be a real issue for another 5-10 years. No issues whatsoever with donor area - looks exactly the same as pre-op at the length I keep it (3/4 guard) Overall continue to be satisfied with the outcome. Not perfect but still a solid 8/10.

My transplant is 17 months post-op - its been 6 weeks since getting the new finasteride rx.

Hello, I've been taking finasteride for about 6 years now. During that time it seemed to be working pretty well, dramatically slowing my rate of hair loss. I cannot recall the specific brands that I took over the years, I believe I've used multiple generics as well as the Merc brand. I also had a hair transplant 17 months ago in the hairline (documented on this forum). My pharmacy recently filled a prescription and gave me Dr. Reddy's generic finasteride. This was about 6 weeks ago. I've noticed over the last couple of weeks and increased amount of shedding and my hair "feels" worse, lifeless, thin, etc. I've had a hair transplant and some of the hairs (including the transplanted hairs) look and feel lifeless/wirey and I've noticed my transplanted hairs are shedding as well. Does anyone have any experience with this brand of finasteride? It feels like it is less effective. Its also very disturbing that some of my transplanted hairs are shedding after only 17 months (maybe these are just the hairs that never actually shed during the initial transplant?) Is shedding transplanted hairs after this short of a time span normal? Could this just be my body adjusting to a new version of the drug and I can expect regrowth in a few months? Thanks.

I had my follow up today (the delay was my fault) - we didn't discuss a whole lot because my feelings overall about the procedure have gotten somewhat more positive since my last posting here. We mainly discussed the thin patch on my right temple and his explanation was that the success of grafts in that area is commonly lower because they try to use the smaller single grafts in order to have a smoother transition into the temple point area. I'm not sure if I buy that since the other temple area clearly grew much better - and as I said previously my gripe with that area was that the hairs on the left temple were quite thick and it was a harsh transition to the temple points. So, if they are indeed trying to use thinner single grafts in the temple area, they didn't seem to apply that strategy to my left temple. I suspect the difference between the left and right side was the differences in technicians - I was fairly awake towards the end of the procedure and I can recall hearing the technicians talking to each other and it sounded like the technician on my left was having some difficulties placing the grafts. Either way, there is no point in stressing or speculating and the point is that there is just some variation to expect for any procedure and that's just the nature of hair transplants as they are now. Going to my previous point about my overall feelings about the procedure, which seems generally true for most transplants - the transplanted hair continued to evolve over the last 5 months (I'm at month 17 now) - its slightly thicker and more natural feeling and looking. Its hard to tell if this is a result of having significantly longer hair (haven't cut it in 4 months because everything is shut down in Cali) but in general it just looks/feels more natural than when I last posted. I would have to say my opinion about my own procedure seemed to mirror that of hairvanity's transplant with the same doctor https://www.hairrestorationnetwork.com/topic/49399-2022-grafts-with-dr-diep-fut-revision-surgery/ - he seemed to have doubts early on during the "end stage" but felt satisfied once he got to the 1.5 year mark. This is probably a mix of the hair getting better and also relaxing our expectations of "perfection." I would venture to guess that many of the "perfect" looking transplants you see on this forum and elsewhere are generally of the same quality as mine with less picky patients and taking good photos. My hair looks fantastic if I style it and take some good angles, but I can make the transplant look pretty mediocre if I choose to (see above). People happy about their transplants are going to post their best photos - people unhappy will try to take the worst photos. With a few exceptions, your transplant is probably going to look as good as the good ones you see if you go to a well reputed doctor. This still leaves what I think is the big elephant in the room regarding Diep and that is the donor area @Tentpole91. Again, my donor area looks great (nothing has changed from the photos above), you cannot tell at all that hair was taken from that area. I haven't seen the hair at a 1 guard, but at a 2 guard you can't really tell either - the only way you can see the thinness is if you look at the hair from a very specific angle (so that the follicles are directly pointing at your field of view). I doubt that any doctor could remove a significant percentage of hair but leave it looking undetectable from all angles. I have many things to nitpick about my transplant, but the donor area as it appears now is not one of them. This still leaves the question as to what impact, if any, Diep's punch technique has for any future harvesting from these areas. That I cannot know, and that might also be the reason that I choose a different doctor. Honestly I think the only way to draw any conclusions about this is to hear feedback for people that have had multiple rounds with Diep - I haven't seen any (although I haven't looked specifically). For what its worth, Diep said any future procedures with him will be offered at discount. I'm not sure if thats because of my dissatisfaction with the right temple, or if he does that for all his patients. I may or may not take him up on that, but that won't be for quite a few years down the road.

Here is my almost 8 month update. The hair more or less seems to be at its final form. I can't really notice much of a difference between 6 month and 8 month in terms of growth or thickness. I think the hair is becoming less "wirey" and a little more natural over time. However, the angle of the hair still seems a bit different than the native hair around it - the native hair wants to naturally drape forward and down, whereas the implanted hair tends to want to be pushed upwards a bit. I think for most guys this would be a non-issue since combing the hair back is a good style for implanted hair - but not mine. My hair generally works better when styled forward and to the side (big forehead) and the implanted angle is making that a bit of an issue. Not sure if this will resolve over time. The area behind the hairline at my right temple is also weak. There is a patch there, about a dime size, where almost no hair took. I can cover it up effectively, but you can tell that the spot is missing volume. I don't know if I will try to fix it in the future, but there is a not insignificant number of grafts there that failed. I won't post any close-up photos yet until I get to the 12 month mark, but its one aspect that hasn't worked out. Other than those comments, I am mostly happy about the results. Nothing to say about the donor area as there are no issues with it and it looks the same as it has since the last photo I took of it. The three photos from the bathroom are harsh lighting, one dry hair and two wet/damp. The other two are in more generous lighting.

I've been in back to back trials these last couple months and I haven't had a chance to even breathe. I'll update when I have a chance. Haven't even gotten a haircut during this time.

5 month update. Pros: The redness is mostly gone, or at least you can't really see it unless you look for it. The hair has been growing quickly, and it seems as if what is going to grow has already started growing. I got a lot of early growth, but I don't know that anything "new" is coming in. Donor area from what I can see is not showing any obvious thinning, and I've been cutting it to a 3. I am pleased each time I get a haircut (every 3-4 weeks now) that the hairline is looking better and better each time and it has become much easier to style it the way I want to. Definite improvement from pre-op. Cons: Either my eyes are playing tricks on me from my increased density at the hairline, or my general frontal third area behind the transplanted area is looking thinner than it used to. Not sure if this is delayed shock loss, or if switching to brand propecia has caused reduced effectiveness, or maybe its more effective but I am getting a shed that seems to often happen when people start propecia. The thinning area is more noticeable on my right side, which is the side where the the hair was extracted from. No idea if they are related, since the thinning area obviously isn't where hair was extracted, but the other side doesn't seem as affected. I've also concluded (I was watching and suspected around 2.5-3 month mark) that a small area in my right temple, just behind the hairline, just isn't growing. I didn't take any close up pictures yet of that spot (I have a couple from months 3-4) but looking closely you can see there is about a small dime sized spot where barely any hair grew. I'm not sure what happened there, as it seems odd that a chunk of grafts would all fail in the exact spot, but at this point if there is nothing coming out, its probably a loss. You can see in one of the photos below the area where you can see the thin spot. I don't think any gain in thickness around this area will suffice, as the goal of this procedure was to not have to style my hair in a way to fix the thinning hairline. I will likely ask that this area be touched up (it really is only missing maybe 30-40 grafts?) The implanted hair is still very wirey (is that a word?) and doesn't have the consistency of the hair around it. It blends much better when short, but looks a bit awkward when the hair around it gets longer. The hair is also continuing to grow straight up, so I've been using a small amount of blowdry heat in the AM to keep the hairs manageable and blend in.

Here is my 4 month progress. My left side seems to be growing a bit better than the right side, and there is a small area in the right near the temple that is a bit sparser than everywhere else. The redness is (slowly) getting better. For some reason the redness is more obvious than pictures than IRL.

Yes

Don't rub the recipient area until day 8 per the instructions from Diep. The scabbing will get really hard and it will feel like a thin shell, but the instructions are to keep the scabs in place until day 8 since by then the grafts are fairly secure.

Diep explained to me that he thought the no saline/no touching for 4 days was the safer method for preserving graft integrity in the first week. It seems like there are two schools of thought and either approach has pros/cons. Keeping the recipient dry allows some level of protection for the grafts since the scabbing will hold them in place. I've also read that keeping the area moist/clean and preventing excessive scabbing provides reduces the probability of skin infections. Either way, best to just follow the doctors instructions. By day 8, those scabs are going to be stuck to your head and its going to take some work to get them all off. By the way, if you notice any breakage in the scabbing where it looks like bald spots where there are no hairs/crusts, don't worry about it. It does't mean there are no grafts there - I had a few spots in my recipient area where it looked like crusts broke off and there were no hairs, but the hair there did grow just as well as everywhere else.

3 month update. Around 2-3 weeks ago I was looking and wondering why I was seeing sparse growth from hairs that never shed, but nothing new. I decided to use one of those vanity mirrors to look really closely and noticed that there were hundreds of extremely fine white hairs that were poking out. Apparently there are a ton of hairs growing, but they are nearly invisible under regular light - the camera doesn't even pick them up zoomed to the max. So I took a few photos using the vanity mirror light from a specific angle and you can clearly see there are a ton of hairs growing - most about 1/3 of the length of my native hair. The right and left side of the photos you can see all those invisible hairs, but you can't see the ones near the center of the hairline just because of the angle and light. The recipient area still has redness - it looks a bit better in these photos since the temperature of the lighting is different, but its getting slowly better over time, and the hairs are starting to mask it. Not a lot to say about donor, looks more or less the same.

I think I can answer this, having left the hair on top long with the same doctor. There are no substantial benefits to shaving the entire head in terms of your long term results. Having your head shaved will make it easier to clean when it times to get the scabs off. Having long hair on the crown will cause lots of bits to get stuck in the hair, and you will be really nervous the first time rubbing the area, so it can be kind of a hassle. There is also the possibility that your hair will get stuck to existing scabs during the first few days where you will be pouring water on the recipient area - theoretically you could dislodge grafts that way - though I imagine just being cautious can easily avoid that. Diep is not going implant hairs into an area that is not shaved. So, the hairs directly on your existing hairline will be shaved back about half a cm or so for him to implant into the area. I would also add that you should be realistic about your ability to cover the hairline. You will need really long hair on the top to be able to effectively cover it, and its probably going to look goofy when the the sides and back of your head are shaved all the way up to the vertex. I had asked to have my hair left long on top for my procedure, and it "sort of" worked out, but the tech shaved WAY up on the back and sides so I had no hair near the temple area to push forward. Leaving the hair long on top seems to work better for other doctors when they don't extract from so high up on the back and side so you are able to leave hair in the temple area long, but for me it looked a bit awkward. It took about 5-6 weeks for the back and sides to be long enough to look relatively normal. The pictures below show how it looked by day 12

There is itchiness in the recipient area however not severe - I'm not fighting back the urge to itch it but it does feel a bit itchy when washing it.

Week 9. Good news is the donor area looks fairly undetectable. So I'm not sure the concerns from the last 4 pages panned out. There is basically only one spot near the hump at the bottom of the donor area that is thin - probably because I kept scratching that area and was getting pimples there. The hair on back is about 2-3 weeks out from a 3 guard, so a 5-6ish guard. Bad news is the recipient area is still red. If its still the same by month 3 then I will reach out to the Dr about an in personal evaluation to ensure there is no issues.

I'm month 2 with the same Dr and had the same hairless white strip issue around day 5. Mine happened because I knicked my head when a bunch of towels fell on my face, but apparently this cracking in the "scab shell" is common when following post-op instructions that keep the recipient dry for the first few days. No idea if it affects final result or not. My areas that were cracked have not yet shown any signs of growth.

The pattern you see is pretty typical for this doctor. If you do a search on this forum you will see many other progress photos from this doctor and there are many dozens of videos on youtube showing the final results, all of which you will see look to be some of the best HT results you will find on the the internet - to the extent that there have been questions posted on this forum and elsewhere as to whether or not his results are legitimate. I'm not sure what source Gasthoerer has to indicate that micro irregularities are a necessary component to produce good results. If you consider the fact that even the best transplant procedures have less than 100% growth, that alone will produce irregularities in the final growth. In terms of the number of grafts - 2000-2500 is generally the upper limit in terms of how many FUE grafts you can do in one procedure. If he is a NW5+ then he will probably need more than one procedure to fill in that large of an area. For what its worth, I am guessing the pictures you posted are from day 5. I can say that his recipient area looks nearly identical to mine on the same day. You can look at my post history for the thread.

Day 45ish.