I'd like to add to the wealth of knowledge about Dr. Diep since it seems he has many reviews here that are mostly positive. The jury is still out on this one, but I have high hopes so far.
I am 33 years old and paid ~16k total for this FUE procedure and it was booked about 9 months in advance. I *almost* backed out a few days before after reading some scary reviews on realself and after hearing Dr. Diep's reputation for using a large punch size, but I went ahead anyway since he had a solid reputation on this forum. I've always had a high hairline since I can remember (I recall a girl calling me out for a receding hairline when I was 16), but I don't think I actually had noticeable miniaturization occurring until about 27. My father is nearly completely bald, and my brother's hair (who is about 7 years old) has progressive hairloss that is a bit worse than mine. I would say that for most men my age that are suffering from pattern baldness, mine is relatively milder (likely due to my early attempts at treatment). Some might say I am crazy for getting FUE at this stage of hairloss, but it is bothering me enough and it is difficult to style the hair the way I want (I have a huge forehead so I generally wear it down and to the side). My hair is currently receding in the temple areas a few inches and I believe it is starting to thin in the crown area as well. Here is where my hair currently is:
You can kind of see on the right side of the picture of my temple area where I think the hairline used to be - one sole surviving hair seems to be nice and thick still.
As far as treatments go, I probably have propecia and keto use for the last 4 years or so to thank for the relatively minor hairloss I have (compared to my brother at least). I hadsides when I started propecia, so I experimented with dosage and and also used grape seed extract as a way to counteract the effects (I forgot the mechanism involved but I read about it a long time ago and it seemed to work). I landed on taking approximately .5 mg every 3 days. Any more often and I start to get foggy brain. I sometimes try to increase it to EoD but I just can't do it because the brain fog messes with my job performance.
Anyway, on to the stuff you guys probably care about. I initially paid for 1750, but Dr. Diep convinced me it would be a good idea to at least give him an allowance of an extra 100 based on the line he drew to restore my hairline. I also went with the A-cell - cost wasn't that huge of an issue for me and there didn't seem to be any drawbacks other than extra cost:
This was exactly what I was looking for - even though I was tempted to lower my hairline a bit since my forehead is so large, I decided ahead of time that I should keep it conservative and simply restore what I had previously. I didn't want to deplete all my donor hair in case I needed more in the future. I also wanted to avoid possibly having an artificial looking hairline by at least having native hair closer to blend in with the implanted hair. I've seen Diep do magic with hairline lowering, but I've also seen some less than stellar results so I didn't want to take any chances. The half a CM or so that it appears to be lowering is simply because you can't really see the few straggler hairs that had not yet receded.
As far as how the procedure went, it was fairly typical as others on this forum have described. The Dr. was already working with a patient when I arrived at 7:30, and he told me that he would be done with that patient in the early AM and would be with me for the rest of the day (that turned out to be not really true - once he finished making the recipient incisions, he only came and checked on the technicians performing the implants every now and then). I was given a concoction of pills and then waited about an hour and a half before the doctor came to begin the extractions (around 9:30-10). I did not fall asleep like most others describe but I was fairly relaxed. I experienced some pain from the anesthetic injections, and also had some pain during some of the FUE extractions in a particular area, and I recall him giving additional anesthetic injections for that. I don't know what size punch he used, but he indicated during pre-op that he used between .9 and 1mm - he explained his reasons for the larger punch and while I am aware I could have insisted on a smaller punch, his results speak for themselves and I think its best to let the doctor do things his way. Many of the criticisms I've read thus far regarding the punch size have been focused on how the donor area looked just after the procedure, but I haven't seen any real criticisms of his donor areas in the long term - and I also had not read of donor reserves being unusable as a result.
The FUE extractions came from the back and my right side, as seems to be common with Dr. Diep (and debated about in other threads). I think the jury is still out as to whether this should really be done, but I can say that the left side of my donor area is well preserved for any future need, though I am not sure I like how far near the right ear he went with the extractions. That said, I will generally not be buzzing my hair very short anyway (5 guard minimum) so I don't think this will be an issue for me - you can see from the photos how I generally wear my hear. He made sure to minimize any shaving of hair at my hairline since I plan to return to work after 3 weeks and I am hoping (though I am skeptical) to disguise the work with a mixture of clever styling, makeup, topik, etc.
One criticism I had about this procedure is once the extractions/incisions were done and lunch was provided, I asked for another round of sedatives (xanex/valium) since what I had so far wasn't really doing the trick and I had much more time to remain in the chair. I wasn't provided that - I am not sure why.
The second half of the procedure was fairly uncomfortable - I was generally conscious and could feel each insertion of graft (though no pain from it initially). The inability to move at all due to the inserting of grafts, combined with the very chatty techs who were talking/laughing very loudly inches from my ear talking about all sorts of things (strip clubs, dating, etc), and the lack of any sedative effect, made for a very uncomfortable 6 hour process. I believe they started inserting the grafts around 2pm, and when 5 rolled around or so and I was basically wide awake, I asked how much longer it would be, and I was told 2 hours. Well, 2 hours rolled by and I asked again how much longer, and I was told 30 minutes. The anesthetic had mostly worn off and I was starting to feel pain/pressure and decided to just power through it (they asked if I wanted the Dr. to come apply more anesthetic but I declined since they were almost done, I thought). But it took another hour and a half and everyone from the office was pretty much gone except the technicians and the doctor. The post-op instruction lady came in and decided to give me my post op instructions and sign it while I was still laying on the chair and getting grafts placed, which I thought was kind of odd (do you think I am going to remember this well while I am getting stuck with grafts?) I understand that things happen and just sometimes take longer, but I couldn't help but feel like there was a sense of being rushed at the end (techs complaining about being hungry and what not).
By the time things were wrapping up, I was asking for the painkillers prescribed to try and get ahead of the pain that I could feel coming on. The painkillers they gave me did not seem to have any effect on me (Tramadol) so my girlfriend and I drove straight to the pharmacy, and wouldn't you know everything was closed by 10pm, and the one 24 hour pharmacy was out of percocet. Most people describe the post-op pain as being relatively minor but I was experiencing the worst head pressure/pain I had ever felt. I ended up quickly glancing through the post-op instructions and seeing something about how ibuprofen can be taken 4 days post-op and in my pain and dizzyness from the valium, believed that meant I could take ibuprofen and took 3 (turns out I wasn't supposed to do that because of the blood thinning effect). While his written instructions, if you actually parse out the language, say that you can take ibuprofen after the 4th day, it is very easy to misread the instructions if you are in a daze from the sedatives and in a lot of pain. I was mildly annoyed because my girlfriend had been in the waiting room since 4 pm and could have picked up the prescriptions for me as I had asked (but they declined to let her because they said they already had painkillers for me).
A word about the post-op instruction packets - I also don't understand why there are two different sets of post-op instruction packets which address the same issues and in some cases are contradictory (one set of instructions are telling you how to clean the recipient area each day after surgery but the second set clearly says you should *not* touch the recipient area until day 4).
Dr. Diep was very pleasant during the pre-op but I didn't talk with him much after the procedure. I believe he came in to check on the technicians about once every 30-45 minutes during the insertion of the grafts and to take final photos.
I went to my first post-op wash and was hoping to get a rundown of how he felt about the procedure, but he was too busy when I was there, so I am hoping to catch him in one of the other cleanings if possible. Anyway, here is the stuff you guys probably care about:
Other than taking ibuprofen after the surgery, everything seems to be normal. Once I woke up, i was no longer in pain and haven't really felt anything yet. The doctor told me the ibuprofen won't have any effect on the graft survival, it can just cause excessive bleeding from the donor area (doesn't seem to be a huge issue at the moment). I also apparently misinterpreted the pre-op instructions regarding smoking - the warning made specific reference to the dangers of nicotine - so I assumed that smoking marijuana was still OK (I used marijuana semi-regularly 1-2 times/week), and had smoked it 4 days prior to the surgery. Dr. Diep didn't like that but said it should be fine, but advised me to refrain from any marijuana use for an "entire year" ?!?!. From what I've been reading, it seems that the general MO is to refrain from smoking anything for a month or so, but after that I can resume. Cannabis has been show to inhibit growth of hair generally from what secondary sources I've read, but it doesn't appear from anything I could find that would cause the failing of hair grafts once the grafts are fully healed. If anyone has better information they could chime in?
Anyway, thanks for listening. Any tips to disguise the hair implant would be greatly appreciated - I can't wear a hat as I work in a courtroom so its very important to look professional. I might also just need to fess up and tell everyone why I took a 3 week vacay - but we''ll see. Thanks for listening.
