ShadowMoon

7 hours ago, Melvin-Moderator said:

These pictures say it all IMO.

Jim, I’m sorry you’re not happy with these results. I hope you can find some happiness. Best of luck to you.

@Melvin-Moderator I feel this comment is inappropriate. It is dismissive of Jim's feelings and also you seem to be implying that Jim has some sort of mental illness.

You've made it very clear that you have a different opinion on what is aesthetic. You like straight, sharp, and dense hairlines. Hairlines aren't like that in nature. They always have vellus hairs in them with subtle asymmetry that make them unique to the person, like a fingerprint. This hairline is not natural, has no such irregularities or asymmetry, and therefore Jim doesn't find it aesthetic. Simple as that. His opinion on his hairline needs to be acknowledged. You don't need to question his mental health.

Jim, your feelings are valid and honestly I would feel the same way. However, once you get the hairline softened up with a second pass I think you'll be good to go. Best of luck, friend. 

20 hours ago, Ian. said:

Hey, last update was looking great! I think this new hair will work in your favor to crush the NCLEX!

Got pre hired, people of earth lend me your energy

@FahriI take 1mg finasteride. For supplements I take Costco hair nail skin multivitamin, D3 a couple times a week, and fish oil. 

It is a real boost! I'm so happy with it.

@RandoBrando517 The ability to separate the follicular units under a microscope to hold as much of the adipose/supportive tissue as possible improves survivability.  Unless you use a larger gauge punch, there is a much higher chance of transection.  If you use a larger punch, the scars are worse than a strip scar.  In my case, the majority of my grafts were triples, and they basically all splayed at the root.  The doc said I could've had a really high transection rate had I gone FUE, so I'm really glad I chose FUT and stuck with it.  Another thought I have is given my age, I'm probably going to need two more procedures over the course of my life at least. 

@hairlossPA I started noticing growth at around 2.5 months. At three months I could use fibers to cover up the thin spots. 

October 16th:

October 28th:

@champybaby I've used Costco brand since the beginning, I go through the six bottles in about two months if I apply twice a day. I use it over my entire scalp minus the back and sides. 

@TommyLucchese I don't know, probably depends case by case. I think I only had around 250 singles so not many.

Ninja edit: I remembered the graft count incorrectly, it was actually 2325 grafts, not 2125.

Hi everyone,

I had my procedure with Dr. Gabel on July 29th, 2020. So, not quite 7 months, but close enough.

• 28 y/o male.
• You might remember my original post. I asked Melvin to archive it. Posting this one as a quick review to get the word out about Dr. Gabel. I'm not on his payroll or anything, and he didn't request a review. I'm doing it as a happy patient. Just do yourself a favor and have a consultation with him. He's low-key one of the most experienced, talented, and ethical surgeons in the country. He learned from Dr. Konior, who is the best surgeon in the world. He doesn't promote himself as much because he personally responds to every consultation request and email, and is involved in all aspects of the surgery. That's including extraction and graft placement. He's a busy guy.
• 2325 Grafts, FUT, ~2.5 hairs/graft on average. Graft breakdown was 212 singles, 955 doubles, 870 triples, and 288 quads.
• Taking 1 mg oral Finasteride daily, no side effects. Was using Minoxidil foam twice daily, but recently switched to once a day about a month and a half ago, because it's expensive.
• Hair loss is mostly stabilized, assuming I don't suffer greatly from cutting back on Minoxidil. When I derma-needled, I noticed way faster growth and fullness. It's not something I see myself maintaining though, so I stopped. I may start again to see if it is as effective as I remember.

Here's what I consider to be my baseline. I've always had a relatively high hairline. This was taken in 2014:

Here's a month pre-op, stabilized on medication for 2 years:

Another angle, taken at Dr. Gabel's office on the day of surgery:

Here is immediate post op:

Some pictures taken in the first ten days:

Here is my ugly duckling phase:

Here are some photos taken today. Just had a haircut yesterday:

Here's the donor in different lighting, #2 guard on the nape faded into a #3:

Very happy with the result, and I think I still have some maturing to go.

Hope you enjoyed! I'll do an update in a few months if any changes occur.

39 minutes ago, Melvin-Moderator said:

Jim, 

I have been more than tolerant, but I will not tolerate these accusations. @SWdan just gave you his own account as another fellow Diep patient, I’ve never met @SWdan in my life, @Skyb gave his account, and again not someone I’ve ever met before. 

You have a clear agenda, and anyone who doesn’t play to your narrative gets discredited instantly. But if @SWdan had come and shared what you consider bad results, you wouldn’t have been so dismissive.

This is now the second time you’ve made accusations against me, first time calling me “Diep mafia”, now saying my friend got “white glove treatment” for being my “BFF.” Literally, right after another forum member gave their own personal account of their experience.

I’m tired of having to babysit this thread with outrageous claims from people who’ve never been to Diep, or have had any interaction with him. Members of the community are getting tired of it. You set your agenda from the start, no one is gonna change your mind, even if your results turn out great, which I’m sure it will, your agenda is set. That’s fine, you can feel however you’d like about your results, and share your feelings. But I will no longer tolerate baseless accusations. I hope I’ve made myself clear. 

@Melvin-Moderator   Jim was saying when a patient comes in with a complaint to this forum, you personally reach out to Diep for them to get a resolution. I've seen that many times. 

I find it absolutely ridiculous that you never respond to the perfectly legitimate complaints we have against diep's technique. You still haven't even looked into @Specific-violinist60archived thread to determine if the transection rate was upwards of 40%. I even pm'd you about it and you never responded. You want to talk about agendas? 

You never respond to Diep making corn rows and saying they grow better that way. No, they do not. They look like shit and no other elite surgeon does that.

You never respond to Diep always using 1mm punches. It causes unnecessary harm and no other elite surgeon does it that way.

You never respond to him mutilating one side od people's heads. He says it's to preserve the other side for later surgeries. That's stupid and irresponsible, and no other elite surgeon does it that way.

How about you address our complaints against this surgeon and give us some answers so we don't have to do your job and make sure patients that come here know the facts and how polarizing Diep is compared to literally every other surgeon in the same price range? Your results are not better than any other konior, cooley, lupanzula, h&w FUE patient, yet you don't see his patients looking like someone took a meat tenderizer to the back of their head. Look at every Diep FUT scar posted on here, they're absolute garbage.

On 7/29/2020 at 1:04 AM, jimcraig152 said:

Here are Day 3 Pics.

• Swelling has went down significantly, but my right eye is black & blue
• You can see the donor site
• Top of head pics show the graft sides. They are the reddish areas, obviously
• And there is my new hairline. I am liking the shap and curvature. I do feel it is a bit too much of a line however

 

 

 

Hey @jimcraig152, I only just realized we had basically the same procedure. You had 13 more grafts than me, and we have almost identical placement, albeit mine is a bit more conservative. I wanted to throw in my 3-day post op as contrast:

I think objectively, I like your hairline design more than mine. I think your age and pattern afforded you a bit more wiggle room. I think the temple closure I got is about as aggressive as I'm willing to go at the moment. 

5 hours ago, jimcraig152 said:

Furthermore, extracting follicular units is a delicate process that cannot be rushed. Otherwise the primary goal of FUE is defeated:  to have less visible scarring allowing for increased flexibility to wear shorter hairstyles. Look at this video here at even how brisk Dr. Gabel performs the activity, there would be no way Dr. Gabel could complete 1000 excisions in one hour.

This is more telling than you know. Dr. Gabel is fast. He is the type of person that walks 4 mph. He does iron man triathlons. Not only that, he has been performing FUE since 2003. If he does it at that speed, that is the rate that he has found to be the absolute fastest you can go while still achieving the most optimal results and avoiding transection. 

On 11/8/2020 at 2:22 AM, jimcraig152 said:

Ok, cool. In a real world scenario, transection rate has to be added in. Plus some punches are further dissected into smaller FUE units. But the number of punches should be roughly equal to the number of FUE's, unless the rate of transection is really high. So the formula for a X-amount FUE procedure would be:

 

[(Number of Punches) * (Rate of Transection Loss)] - (Follicular Units Lossed to Transection) + (Punches further dissected into lower hair units) = X-amount FUE Procedure

So at what rate of transection loss would you say a patient is due a refund + restitution?

Say if you have a guy that has a 1000 FUE procedure, and there are:

1. 1030 punches in his donor area, he went to a Super Elite surgeon (3% transection loss), no refund due
2. 1050 punches in his donor area, he went to an Elite surgeon (5% transection loss), no refund due
3. 1100 punches in his donor area, he went to an Excellent surgeon (10% transection loss), no refund due
4. 1150 punches in his donor area, he wen to a Good surgeon (15% transection loss), no refund due
5. 1151-1250 punches in his donor area, he went to Turkish-mill (16%-25% transection loss), questionable if refund is due

Safe bet that if the patient went to a reputable clinic in the US and had greater than 25% transection loss, the patient is due a refund at a minimum? And if let's say the rate of the rate of transection is between 40%-50%, the patient is automatically due a refund + restitution, would anyone agree?

As long as the patient has a decent outcome, everything is good. sarcasm

On 11/3/2020 at 10:59 PM, jimcraig152 said:

Hey @baldlivesmatter,

Thanks for stopping by. In the 3 months since I have been on this forum, I have seen all the great results from Dr. Diep. Those results are at least a year old. And if you participate frequently on any internet forum, you know it is bad "netiquette" to bump an old thread. That is why I haven't commented on those old threads, not that I am being dismissive.

I think your hair looks great. I acknowledged that in this very thread back in this post, BTW. As for my results, no doubt I will look good at the end of my journey. No doubt even as I pragmatically assess my current progress, I look good now. However, it is very easy for hair loss sufferers to be pragmatic in affirming their results. Simply because, where we were once bald, we now have hair! So we have to be ecstatic, yeah? #cartwheels.

The problem with approaching assessments pragmatically is to be dismissive of any/all inherent shortcomings. True, no hair transplant is perfect. But the shortcomings are clearly as a result of compromises that could have been avoided and cannot simply be dismissed. Let's call the identification of these repeated shortcomings for what they truly are:

Compromises employed by Dr. Diep at the expense of diminished aesthetic results that the patient is seeking in surgical hair restoration.

These compromises allow Dr. Diep to save his time during any given day. That time saved then is leveraged to maximize his revenue stream through increased volume of patient procedures performed per day (2 full procedures per day) and increased pre-consultations arranged per day (effectively, $1000 per pre-consultation).

In these discussions, I am reminded of having recently watched a WWII documentary. The theme explored in the documentary was this:

“The only thing necessary for the triumph of evil is for good men to do nothing.”

As a brother in the struggle, I am happy for you and the results you've attained. However, these baby doll grafts were delivered by Dr. Diep as a result of compromise. This unnatural hairline was delivered by Dr. Diep as a result of compromise.  The decreased flexibility for a FUE patient (like yourself) to wear shorter hair styles is a result of compromise. Dismissing these things gives Dr. Diep a pass, allowing these shortcomings to be applied on fellow hair loss sufferers to follow. Dismissing the criticisms, turning the other cheek, is all that it takes for these shortcomings to continue to exist.

Well said. What irks me is that you can eloquently describe the problem with supportive evidence, yet it is not addressed by the moderator. Instead, it is only repeated that Diep has more than a dozen happy results. It is not the successful cases that define a surgeon, it is the bad ones. Where did the surgeon go wrong? Was it his fault, or the patients pathophysiology? Top surgeons have perfected their craft to the point where, when patients have a poor result, it is most often a problem with the patient, not the technique. Even so, the very elite can predict these shortcomings and minimize them by modifying certain aspects of the surgery, as is described in most of Dr. Konior's posts.

I have seen no indication that Diep does anything to accommodate these shortcomings from patient to patient, and that is why he gets more negative results than other surgeons affiliated with this site. Yes, he gets good results, but he also gets a lot of bad ones. Those need to be analyzed.

9 minutes ago, anotherhairlosssufferer said:

Urgh this thread is a handful. I am VERY afraid of the baby-doll hairs and scarred donor, but also Dr. Diep had pretty good results in the past and looks like he produces a huge yield consistently so it's very hard to say, clearly there were some bad results recently. I am following very closely.

Who else should I look at? I am ok with losing the $1000. Hasson&Wong? Who has consistent results/good donor and natural hairline?

Konior if you have an unlimited budget and want to wait. I have never seen a result of his that isn't impeccable.

55 minutes ago, anotherhairlosssufferer said:

In our conversation he said that bigger punches secure higher survival rate, I can't remember if he said he would use 1mm but that's how he justified it (and he explained why - there is a higher risk of cutting the root off with smaller punches). To me it made sense, but true I don't want to butcher my donor area. As for the corn rows - @Tentpole91had a pretty bad case here and I'd like to avoid that.

Diep said himself in one of these threads his survival rates are between 5-15%. This is actually less than any other top clinic, which say no more than 5%. Keep in mind, there's no real way to tell an exact number. What responsible surgeons do is take their time while doing extractions to minimize transection rate. I've listened to several talks on this subject from top surgeons and there are many examples of FUE cases done by every other affiliated surgeon on this site. They all use 0.8mm punches for the vast majority of their patients and their survival rates are comparable to Diep's who seems to exclusively use 1mm punches. I would wager Dr. Konior has a much higher survival rate and lower transection rate than Diep and he uses as small a punch as he can get away with to save the donor area from unnecessary scarring.

At some point as a responsible doctor and surgeon, you need to look around and see what all of your colleagues are doing. He stands alone in his extraction and incision techniques and his results are not any better, and oftentimes worse, than H&W, Konior, Cooley, etc. He may achieve adequate density in most cases, but his donor areas are much worse off and he doesn't achieve a natural appearance much of the time.

43 minutes ago, Micky597 said:

Hey Jim, 

As you know, I've had a surgery 6 weeks ago with Dr. John Diep. I've been keeping a close eye on your thread. Seems there's a lot of unsatisfied patients. Seeing all these people coming forward, I can't help feeling a little depressed and worried. However, I do think you dodged a bullet. The difference between your second month and your third month is crazy.  I really hope I'll be in similar position. The ugly duckling phase is real. 

Also, what do you guys think of John Diep's "corn-row technique" when it pertains to curly hair?

Curly hair doesn't seem to have the same issues. Diep's afro results are fantastic. This is likely because he uses 1mm punches, which gives a huge margin of error and doesn't require as much time as if you were using 0.8mm punches. Downside is it scars your donor area up pretty good. Even top clinics sometimes resort to using larger punch sizes for afro hair so that often can't be avoided, not the case if you have straight hair. 

1 hour ago, anotherhairlosssufferer said:

This honestly looks pretty good given that it's only 3 been months. Could be that finasteride is playing a role too. Exited to see where you'll be in 3-6 months.

However, you are describing your experience as way too harsh in my opinion. Could be that Dr. Diep could have done a better job in certain aspects, and I don't know enough to claim one way or the other but you haven't gotten the final result yet and you're making bold claims that he butchered you for good.

Critique is good and thank you for this thread but I scheduled a surgery for next year and reading through this I can't tell if I made a mistake or not. The tone of it makes me think maybe I did but reading the details makes me think that you just have a different opinion on how to go about stuff. Wish there was a more objective take.

Here is an objective take:

Dr. Diep has poor donor management technique. He uses 1mm punches, which is no longer considered best practice by any top clinic in the world. With advancements in technique and surgical expertise, 0.8mm punches provide adequate clearance of the follicle in the vast majority of patients, which minimizes donor harm and scarring. Diep universally uses 1mm punches on all his patients.

By his own words, specifically in Baldlivesmatter's post, he says he intentionally harvests one side of the donor area before going to the other side. Look at every single FUE case of H&W, Konior, Shapiro, Lupanzula, Cooley, etc. and you their donors are nowhere near as mangled as Diep. Not only do they use smaller punches with better results, they also utilize the entire donor area to prevent overharvesting. 

Dr. Diep utilizes a corn-row technique, which he has defended several times as being the best method for growth, using the metaphor of farm crop. In my entire life, I have never seen hair grow in straight lines, so why the hell would you implant them in that way if you are trying for a natural appearance? Not only that, farmers do not plant in rows for growth - they do it so they can utilize farm equipment which needs room to fit between the crops.

Dr. Diep's FUT incisions and scars are ridiculously bad. Look up every single FUT case on this site, it's night and day difference between any other affiliated surgeon.

Dr. Diep does two cases a day, and has both extractions and incisions done before lunch so his techs can do the rest. This is not done by any other top clinic in America or any top clinic in Europe that I have heard of. If anyone has any examples, let me know. Imagine your surgeon rushing through your procedure to get to the next one. My own procedure was from 0630-1700. It was a relatively low graft case. He is not a slow surgeon. I've heard of cases where Dr. Konior was operating until 11PM. He has decades of experience. Why the hell is Diep trying to get his cases done so fast?

Dr. Diep has several cases of using doubles and triples in hairlines and temple points. I have not seen any other top clinic make this mistake. It is unacceptable.

Dr. Diep makes his patients sign a form after payment but prior to operation that requires arbitration instead of litigation. In one case, a user here by the name of @Specific-violinist60 posted a case where he had 900 grafts implanted but over 1300 holes in the back of his head. The post has since been archived. I spoke to the moderator of this site on another thread where he said he would look into the archived post to verify for himself that there were 1300 holes and only 900 grafts implanted, as proven by pictures, but he never responded. I pm'd him a couple weeks later, and he didn't respond again. You can take of that what you will, but to me it is very telling.

Bottom line is, the end does not justify the means. That is @jimcraig152's point in this thread. You cannot simply judge the end result. Donor management is equally if not more important. Diep half-asses his extraction technique by minimizing the spread over the back of the head, which saves him time. His incisions are done in rows for the sake of expediency. The right temple of all his patients is worse looking than the left side, because he starts on the left and moves to the right. When he does full crown work, it is always done in rows. 

All surgeons have at least one unhappy patient. It is naïve to consider otherwise. The problem is, Diep had by my count five unhappy patients post on this site in the last year. I haven't seen a single completely satisfied patient post on this site that had their procedure in the last year. I can use objective standards to show how his results are at the very least unnatural. All of his caucasian patients with straight hair have hairlines that look like a ken doll if you zoom in. I posted all of them within the last three years on another thread, so you can see for yourself.

14 minutes ago, Hoohair said:

Yes I agree. I am just curious.

I have done quite a lot of research over the years and now I am curious as I am experiencing this first hand for once and looking for the answer if anyone knows. I have never found a definitive answer to the question apart from the answer 'Its normal'.

 

I am in no way worried

 

Many thanks.

 

 

There is no published research analyzing survival rates based on bulb still being attached to the graft after a transplant. The best you'll receive is speculation and even that you won't be able to apply to your situation because it is entirely up to your unique physiology.

Whenever you think about spending time to analyze this sort of data, consider if it is relevant to the outcome of your surgery. I can understand trying to gauge if an intervention is effective by counting hairs lost in the shower and tracking a trend over time. 

At the end of the day, what's done is done, and all you can do is wait.

On 10/15/2020 at 4:24 PM, Curious25 said:

But your logic in this case is subjective to the individual.  

For example; 

If a person weights their cognitive function as being a, if not the, fundamental component that contributes towards their quality of life, and their hair loss is merely a bugbear, 

Then medication which is potentially able to address the bugbear, however comes with a recognised side effect profile that suggests cognitive function may be adversely affected, their logic would be to prioritise what they deem to be a more valuable attribute to their day to day life, and avoid something that may pose a risk to this, in the vain of trying to address what they perhaps deem as a minuscule issue in comparison. 
 

In this scenario, the same logic would be applied regardless of whether the individual has read a 1000+ ‘Scare mongering’ threads relating to brain fog, or from just having simply had a consultation with an ethical prescribing doctor, who by duty of care has advised of possible side effects. 

Cognitive function is not listed as a possible side effect of finasteride by any clinical study. Neither is "brain fog." I have taken fin for over two years, have no side effects, experienced great regrowth, only regret is waiting as long as I did or I probably wouldn't have even needed a transplant.

Looks great man! 

Running two patients at the same time and having both done before 1 pm is an immediate disqualify. 

Also, farmers plant in rows to accommodate machinery for planting, watering, and harvest and for crop to spread roots more freely to either side. Has nothing at all to do with nutritional supply. He was talking out of his ass. 

1 hour ago, ryan-str said:

UPDATE: I filled out the online form that’s in the BHS Athens website and I heard back. They asked for more pics to see the donor area and I sent the ones here below. I should get their feedback soon. The light in my bathroom is very strong that’s why I took the pics there (and that’s why the scalp is very visible - less shadows than irl)

Here's an idea of an aggressive hairline vs a conservative hairline. That conservative hairline also gives you temple closure, which might even be a little too aggressive considering your age and amount of loss. 

11 hours ago, jolly said:

you are out of touch with reality , finasteride disrupts the endocrine system .... as estrogen raises on supression of dht .... do not blindly follow the pharma research .

they have a motive .... watery semen , ED and mood swings , Depression , suicidal thoughts... and most lethal PFS   just do not happen without messing the hormonal balance ,and there is NO smoke without fire ... why do you think so many men complain ? ... who doesn't  want more hair ?  , yet there are so many who dont wanna touch that shit .... WHY? 

 when i started propecia  2 years back i also thought all this is BS and only a small percentage of men have sides , and I was also ware of the nocebo effect ... yet  it took life out of me just after 5  months , but luckily I recovered after 1 year , 

but  I do not want to debate ,as  i know this will get endless . in the end ... its your life ...... its your Problem 

the hormonal balance is very delicate even a minor tampering throws the body out of wack ,,,,,  what are you talking of man ? do you have any knowledge on the subject ?

Not going to derail this thread to debate the side effect profile of finasteride. There's enough conversation on this site to look it up if you want. Or you can read any of the large studies done on propecia. I've been taking it daily for two years and have had no side effects with great regrowth.

12 hours ago, Curious25 said:

The body’s subject to a fluctuation in hormones during menstruation, of which the temporary hormonal imbalance causes the side effects . . The same principle stands for introducing something that interrupts the body’s regulation of balancing hormones on a daily basis. 
 

I didn’t realise birth control grew on trees in the US. 

Yes it's provided to any woman who wants it through non-profit organizations, primarily planned parenthood.

12 hours ago, ryan-str said:

What do you mean by “conservative hairline”? And can you elaborate on why FUT would last for longer? I thought FUE and FUT were equivalent. Thanks!

You get more grafts if you start with FUT. You're able to get more grafts over the course of your life, that's what I mean by future-proofing it. Nothing is 100% of course, it's just doing everything you can to save yourself from trouble 20 years down the road.

17 minutes ago, Curious25 said:

In my own personal experience with ex partners and friends, I have seen adverse side affects range from mood swings, anxiety, depression, low sex drive, high sex drive, acne, hair thinning, irregular periods, bouts of months without periods, PID and fertility problems

You're mostly describing a normal menstrual cycle there. 

Birth control is also free.

2 hours ago, ryan-str said:

Hi guys,

 for your feedback! I'd like to address your comments:

Thanks for the recommendation. I see Bisanga is worshipped in this forum and I would like to schedule a consultation with him I'd like to know what he has to say. I really do not like my empty temples, they make it hard to have longer hairstyles. Do you think if I get a lower hairline it will not blend with my

Thanks for your advice, I'll definitely keep it in mind. I feel I might have to wait a little longer and just wait to see if PRP + my therapy can regrow something and stabilize it before I can go for a HT. I too believe the recipient area has an effect on the implanted hair, that's part of why I want the effect of my therapy to be stable before I undergo such stressful (and pricey) procedure. I wanna hear what Bisanga has to say, I will keep you posted.

As for finasteride, tbh sex is good and I read if I should get any side effects it would be from the start, not two years into the treatment...

 

BTW, what do you think is the difference between BHS in Brussels and Athens (apart from the price being allegedly half as much in Athens...

Don't worry about finasteride, it's not messing with your hormones to the degree that your body can't compensate. Women taking birth control is much more significant and that is prescribed to the majority of women in America, at least. 

At 26 I'd say you can get a hair transplant IF you are willing to settle for a mature, conservative hairline. The second thing is you should strongly consider FUT if you want to future-proof your transplant.