FUEblonde1985

Thank you both for the reassurance. I need to just stop looking in the mirror.

Hey guys, I'm on day 12 from my FUE surgery. On day 8, I was advised to begin directly massaging the recipient area to attempt to get off remaining scabs after soaking the the hair for 10-15 minutes. My scabbing/crusting seemed to be pretty stubborn. I was very gentle for days 8 and 9 when massaging, and I was getting a little bit at a time, but most of the junk just stayed stuck in the recipient area. It was clearly loose, but it wouldn't come out, and I was too afraid to do anything outside the instructions. For reference, this was my left temple on day 5, before there was really any attempt at getting scabs off: This is how my left temple looked on day 8 right after the washing/massaging: Today, (day 12) I felt like a little more direct action was needed, I kept the recipient area under the shower head (with the nozzle set to half pressure so its fairly light) while massaging/rubbing. I noticed today that it seemed like the recipient area was looking a lot different than before, so i took a picture and indeed it seems like about half of the hairs have fallen out already. It seems early, since most of what I've read is shedding happens about a month after. But I've also read that the grafts are fairly secure after the first 72 hours, and definitely fully secure by day 8-10. I was by no means scrubbing my hair like I normally would pre-op (think maybe like the same force you would use to pet an unfamiliar dog?). There was no blood or anything, though if there was any pain from it I would not have noticed because my recipient area is still totally numb. Here is how it compares: So my question is - is this just early shedding of the hairs? Couldn't see much of anything in the bathtub. My second question is - I haven't been able to find any pictures on the web of people whose hair is full of the white stuff that my hair has. I'm a little worried that all of those are grafts that just didn't take, or "popped" out post-op due to bleeding (I was told that I had a lot of bleeding during my surgery). These seem like they might be dumb questions and I think there is no issue, but...post-op anxiety about everything is getting to me.

Day 12. Still not able to get the recipient area completely clean. Starting to wonder if I am just am not being aggressive enough with the cleaning, or if its a result of having the area completely dry for 3 days post-op. You're right that the long hair isn't helping, but I like that I will still have something to work with since I need to minimize the appearance at the office (I work in a very professional setting and also have daily contact with clients). The spot on the back that seems to look bald appears to just be a weird result of lighting. The top of my head near recipient area is still completely numb. I know that numbness can last months, but still concerning since no changes in sensation since day 1. Can't even feel a needle poke.

Day 9: Still a lot of white stuff remains. Seems like its mostly loose, but I'm too afraid to use any more force than indicated by instructions to get it out, so there it will remain. Back of my head is getting itchy, likely from all the flakes that aren't getting out. There seems to be a couple spots on the hairline where there is a "row" of follicles that didn't live on. Not sure if this was just the hairs there all coming out when i got hit in the head on day 5, or if the grafts were lost. Can't tell if donor is looking better because the hair is longer or if the color is getting better. I'll probably stop posting daily updates since it seems to be a bit OCD, but I figure anyone else that is doing the same process with Diep will find it helpful to see what the day-to-day looks/feels like.

Some extras if its helpful to see other parts of the donor. The greasy appearance is from the bacitracin ointment:

Here are some current photos from the area you focused on that might help shed some light. Again I'm not saying your wrong, and maybe these photos from 9 days after support what you're saying. I'm just not so sure that anything can be said conclusively from the photos alone. I didn't have the benefit of my fiance taking photos so this was the best I could do with the iphone flash behind the head:

I don't disagree with most of what you're saying, except citing "basic laws of reality" as authority. I'd be interested to see what Dr. Bisanga says on this (still looking for it). Again I'm not saying you're wrong - but keep in mind that the photo I took was one day after, where there is maximum inflammation of the tissue surrounding the punch, and a lot of dried blood. I can also tell you right now looking at the punch sites now that there are healthy hairs growing in places where the tissue is still red - this would tend to suggest against drawing anything conclusive just from the visual depiction one day post op. I think taking a look at this selection (below - he has any entire category of videos looking at donor scar) might be more helpful for making any visual determinations. Now, I probably know a lot less than most of the people posting on this forum, so I have no idea how these videos compare to donor areas where a smaller punch is used. But I think that is a much more valid visual comparison to make than using mine.

That doesn't answer the question though. There is no doubt that the donor areas look different. The question is - do those differences indicate transection of nearby donor follicles? From what I've gathered, a larger punch results in a larger FUE scar. But I've seen no evidence to suggest transection of nearby follicles is also a consequence. To suggest that just based on appearance alone is mere conjecture, unless you have some source that supports this claim. I'm sure any lay person would look at ANY fue donor area on day 1 and assume that the hair on that area is ruined just based on appearance alone, and we all know that's not the case. I'm not saying that it can't be true, but I'm just asking if you have any authority that says so. It's not helpful for anyone else reading this to speculate about possible complications of this Dr's work just on mere guesses. Your guess is as good as my guess that my donor looks bad on day 1 because of my excessive bleeding or skin type.

Why do you say that? I don't believe the Dr. used a punch size that is different than what he ordinarily uses. Keep in mind my donor area looked really bad on day 1 likely due to the excessive bleeding. Is there any evidence to suggest that Diep's punch size results in transection of adjacent units?

Day 8. This was the first day I'm instructed to do direct cleaning of the recipient area. I spent about 20 minutes under a very low pressure shower head (my attachment allows control of the flow) directly on the recipient, and then spent about 6-8 minutes with soap rubbing the recipient area. The area felt like there was a protective shell around it, and it was a lot harder than I anticipated. There wasn't a whole lot that came loose from the rubbing, but once I rinsed I could see many little white pieces coming off the area. There were a few small hairs as well, and only one bit that looked like it could be a graft (but it seemed like it was more likely just another white bit with hair attached). The "cracked" areas from day 5 still look a bit bare, but I'm not sure yet if its just because the scabs around have not yet fallen off completely. I would guess maybe 30% or so of the scab/crust came off, so I'll repeat the process tomorrow. Donor area is feeling good, sometimes itchy, continuing with 3x/day bacitracin ointment. This was my first opportunity to really soap up my crown hair and its looking a bit ridiculous right now. Hoping my barber can make some magic happen prior to my first day back at the office (3/4). Took some closeup shots of the recipient area right after the washing - if this looks off to someone please let me know. From what I can tell, its normal.

Day 7

I really appreciate the response. The picture you posted I think looks very similar and it gave me a huge sigh of relief. I can't figure out why this period is so nerve wracking and I'm getting stuck trying to figure out every detail that is happening with my hair. Wish I could just smoke some weed and wake up a year from now. Diep's e-mail response to this: "I showed your photos to Dr. Diep and he said at this stage there is nothing we can't do. We won't know the affect until 1 year from the day of your surgery. But it looks like you are in the shedding phase, cracks and crust that appears in the recipient area are normal, expect more to occur."

Day 6: Again did a cleaning of the backside, and also the front. I am getting a bit concerned that Dr. Diep's instructions regarding the cleaning of the recipient area are wholly inadequate. Essentially his instructions are to clean *only* the donor area for the first 3 days. Then on days 4-7, clean the recipient area by indirect flow of water, squeezing soap onto the area, then indirect flow to rinse, with no direct touching or patting whatsoever. As a result, it seems like there is a thin film of residue all over my recipient area. Yesterday, when it was nicked with a towel, a part of that film was cracked and started to peel slightly. Today, after cleaning, I took more photos of the area and it appears that the crack is getting larger and peeling further. Other areas are starting to peel as well. Does this have any implication for the grafts? I'm not sure - I've seen posts in other threads where this is reported as normal. However, there are dozens and dozens of Dr. responses on realself indicating that this is *not* normal and that the recipient area is not being cleaned well enough. So far, I have not been able to get a response from Diep's office (I e-mailed them photos yesterday and today, and they told me he will get back to me when he can). Here are closeups of my overall graft area: Here is how the donor area is looking:

Picture of where a towel hit my head. I'm not sure if I just never noticed this before or if something dislodged from the graft, or if I just wiped the scab off. Hard to tell if this is any different than earlier in the AM when I had just washed since I hadn't been taking very close up pictures. There was no blood or anything. Here is a picture from same spot before I hit my head:

Donor Area day 5. I accidentally whacked myself in the head with a towel while folding. Hoping I didn't damage any grafts doing that. From what I've read, the grafts are mostly secure by day 5.

Here is how the front is looking on day 5 immediately after the washing. The recipient area still has had no direct contact other than from water and soap suds, so it seems like most of the scabbing/crusting is still there.

Since you are a former patient of Diep's - do you recall what your recipient site cleaning process was? The written instructions I have are fairly vague and I've been erring on the side of caution since I recall the techs telling me that I was bleeding a lot during the graft placement. Yesterday I basically poured a few cups of cold water across the recipient site, lathered up the sponge with the shampoo provided, and squeezed the sponge to let the entire graft area be covered in lather (not making any physical contact). I just let the foam sit there for about a minute or two, then used cups of water to pour off the foam. I just let the hair on the crown flow wherever it did and let everything air dry. I had some small white bubbles that went away after a few minutes. The vagueness in the instructions is how long I should be letting this area be soaking with the shampoo - and how much water I should be using. I think you aren't wrong to cringe at the donor area - this seems to be characteristic of Dr. Diep's patients due to the size of the punch. I think that if I hadn't done my research prior to the surgery, it would have freaked me out as well when comparing it the 1-day post-op photos from other doctors. However, knowing this reality, and also hearing the doctors explanation (says it gives him a healthier graft to work with), I knowingly accepted it. To me, the real consideration is how the donor area looks *after* healing - and Dr. Diep is not hiding the ball here. There are plenty of videos posted showing the donor areas in the months following the extraction areas, and they look no different than the donor areas subjected to smaller punches. Melvin's pictures in this thread are just one example. Perhaps there is a perceptible difference if someone cuts their hair with a very short guard on the back - but this isn't something that I will likely do. I will say, however, that a second major consideration of the Diep's donor areas is the viability of future FUE procedures, and whether or not the punch has any implications for future extractions in the same area. To this - I can't say I've found any definitive answers - and it may be a real issue for me in the future if my hair loss continues if this extraction method does jeopardize the surrounding grafts. I don't know enough about this to offer an opinion. Here is one example of someone that I think has similar hair type to mine - his donor area looks untouched: I can say as to the immediately post-op photos that might explain some of the mess - I bled more than usual per the techs. I'm not sure if this is due to semi-regular marijuana smoking (1-2x/week) leading up to the procedure, or the regular supplements that I take (I stopped 1 week before the procedure but many of the things I take were on the list), or my high blood pressure (the tech said it was 166 right before the drugs kicked in, but insisted that was normal since I was really nervous about the procedure). Other than that, I am an exceptionally healthy individual (I don't smoke cigarettes, drink alcohol, eat junk food, I've exercised/weight trained 2-3x/week since I was 17 years old, and I rarely get sick). I'll continue to update this thread with progress pictures over the coming year. I can say right now though that I don't have any major concerns with the work other than the need for him to revise his printed post-op instructions, and I'm looking forward to the results.

The recipient area looks more or less the same and it's difficult to get really good progress shots because the hair on top was left long and its kind of just falling wherever it wants. I have been avoiding touching the hair in any way or trying to move it out of the way since I don't know if any of the hair has stuck to the scabs from the grafts. But here they are anyway:

Donor area day 4. This was my first attempt at washing the head myself (previously went to clinic each day for wash of donor area), and the first day that I was instructed to clean the recipient area. It was pretty awkward figuring out the best way to do this solo, but washing the donor area was fairly straightforward. For the recipient, I had to use a cup of cold/lukewarm water and just pour over the head, and then use a medical sponge to lather up some of the "graftcyte" shampoo provided by the office and squeeze it so the lather gets all over the grafts. I let the soap sit on the recipient sites for about a minute or two, then used a cup to rinse off. Not sure if I did it correctly but I didn't see any grafts come out in the water, although my recipient area still looks fairly the same, just a little less crusty. Leaving the hair on my crown long has made the cleaning of the recipient area a bit tricky.

Hey all, I had an FUE operation done 4 days ago (you can read full thread on other post) but I had a quick nagging question. I've currently been sleeping at a 45ish degree angle with stacks of pillows behind me, and a neck pillow provided by the office. The neck pillow is quite stiff and I usually have a towel behind my head to absorb any moisture (the Dr. has me applying antibiotic ointment 3x/day and its keeping everything fairly moist). I notice in the morning the back of my head near the neck area the skin is a bit more irritated from the pressure against the pillow and likely small rubbing through the night. Should I be taking any extra precautions for the donor site in regards to sleep? I imagine it would be impossible for me to sleep upright such that the back of my head is not making any contact, but I also want to minimize any eventual scars in the area, and I'm not sure if causing irritation to the donor area would cause any issue. This is how I generally am sleeping, if you can imagine a neck pillow around this woman's neck as well: Here is what my donor area is looking like at day 3: The red circle is where I am feeling the irritation.

Please stop posting in this thread. I'm trying to provide constructive information for other people who are considering treatments with this doctor. Your comment about my donor area looking subpar immediately after surgery is well taken (you aren't fooling anyone by being purposefully literal to backtrack from the clear intent of your comment) - I think most people can agree the large punch looks a bit worse than the work of other doctors. But I think it remains to be seen whether or not this temporary condition has any lasting meaningful consequences - from what I've seen, the donor areas of Diep's patients look great after they heal, and his results speak for themselves in terms of his reasons why he uses the larger punch. And you can see from my pre-op photos that I've accepted the possibility of larger FUE scar since I don't wear my hair terribly short on the sides and back.

I'm keeping my fingers crossed. My donor area appears to be consistent with other Diep's patients (which generally looks worse than other doctors). I anticipated this, and accepted this because I have not seen any posts on this forum from people who had donor areas looking bad after a few months.

For comparison - this was my general styling pre-op.

Donor area day 3. Tech at the office said healing is coming along well. I have no pain but definitely numbness on the top of my head. Tomorrow will be the first attempt at cleaning the recipient area. I am anxious to get a chance to clean some of the dried blood out of my existing hair. I may be receiving some benefit from a different light angle that is making the donor area appear less red today but there is definite improvement.

Donor area day 2. Once concern that I had, but neglected to ask the Dr. about - is how the rest of my crown is looking. Obviously there is a good amount of hair there, but I'm not sure how the crown's density is compared to the sides and back density and whether or not I am going to have a much denser hairline with a comparatively less dense vertex area.