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1500 FUE grafts with Dr. Diep


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After about a year of mostly lurking on this forum, I have finally done a FUE procedure and am happy to share it with all of you to give back to this very helpful community here.

 

Background is I am 39 and have had gradual hair loss in the front only since around 24 years old. I started taking Rogaine + propecia back then and it slowed things down, but now I’m tired of my high hairline (Norwood 2-3) so decided to get FUE. I cut my hair short so FUE made sense. I live in San Francisco so Diep was the best of the 3 or so local FUE docs I looked at. I called 2 of the more established LA-based doctors, but Diep seemed in the same league (he trained with Rassman, one of the pioneers of FUE) plus the idea of flying to/from the procedure was not ideal. Also my hair is slightly kinky (I am half latin, half white) and Diep specializes in this sort of kinky/curly hair. For peace of mind, I did explain to Diep beforehand not to take hair from high up on the back of my head, to angle it correctly in the front in a natural way, etc. Basically to avoid the "nightmare" scenarios you read about on forums from time to time :)

So on Friday I got the FUE done with 1500 grafts and also the optional A-cell treatment (research on A-Cell is not clear, but it anecdotally does seem to help). Procedure went smooth and ran like 10am-4pm. Not much pain at all and frankly I was in a bit of a haze the whole time given the meds.

BTW, Diep does zig zag the hairline a bit so it is more natural (straight hairline is not natural) and also he does put hair in the front into areas that already do have existing hair to create a more natural look. Hair from the back is diff than hair in the front so blending back of the head hair into front of the head hair is key. And if you are wondering why all the donor hairs are from the back right, it is because he works right-to-left and also each extraction traumatizes the hairs around it, hence better to leave a fresh untouched donor area on the left that I can come back to years from now if I need another FUE.

Attached first 2 pics are right before the procedure (in reality my hair actually looks *worse* than in these pre pics). Next 2 are right after it. Next two are day 1. Next 2 are day 2, where I am right now. I am happy with the results and healing is going well. I am following all the post-op steps including 2 showers a day with GraftCyte shampoo (free from the doctor) with no direct water to the donor or recipient areas. And then after the showers, bacitracin ointment to the donor areas. Also I have been taking Vitamin C every day since about a week prior to the procedure. Lastly, I am using saline every few hours to keep things moist. The saline spray can from Walgreens sprays too hard, so I spray it into a smaller plastic spray bottle (also from Walgreens) so the saline comes out in a fine mist and will not harm the hairs.

 

Also, Diep is doing well these days with many patients. Diep got me a free driver to/from his clinic. I asked the driver about out-of-state patients and the driver told me he does a lot of airport pickups/drop-offs for out-of-state patients for Diep. And while I was at the clinic, Diep had finished a non-fue (flap) procedure earlier and the patient was there. On the way out, 2 patients from the day before came in for their post-op shampoos. And the Dr told me is moving to a larger facility down the street. All of this evidence of course is non-scientific, but it points to a competent doctor. Lousy docs get bad reps fast and business tends to dry up.

Anyhow please reply with any questions/comments!

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Edited by johndoe1
wrong dr listed
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I am curious about the density too. Does not look like dense packing to me....

I am the owner/operator of AHEAD INK a temporary/non-permanent Scalp Micropigmentation Company in the New York area. AHEAD INK is a Milena Lardi trained clinic and uses Beauty Medical equipment and products exclusively.

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Answers to the prior questions/comments:

 

Nope did not hurt. Thank god for the meds. Right now about 72 hours later I have a slight dull pain in the back in a small area but totally manageable.

 

The zig zags are just to create a more natural hairline. A totally straight hairline is not realistic. Anyhow if I hate the "pointiness" later, I can easily buzz it off with my beard shaver.

 

Density is pretty packed. See attached pic. There is a balancing act at work here. If you pack them too tight, it causes more trauma to surrounding hairs, more shock loss, etc. And keep in mind I am just a Norwood 2-3 so I already had a decent amount of hair in this frontal area...we don't want to put too much stress on these existing hairs.

 

Funny thing today was my twin bro had no idea I did the FUE. Today I sneakily got him to leave work and come into my car to talk (did not mention the fue). He noticed I had grown out a beard a bit and commented on it but did NOT notice the fue at all. I had to point it out to him and he had to stare to see it. Granted, if I had been outside in the light he would have seen the redness…but still cool he didn’t notice it :)

 

My immediate concern now is the redness in front. For 7 days you do not want to put any chemicals on the front. But after day 7 the Dr said Benadryl cream (it has antihistamines) will help. I need this b/c I return to work next Monday. Then the longer term concern is the dreaded “shock loss” where all my nice follicles possibly start falling out. Fingers crossed I am one of those lucky few who does not get it. I have been on Propecia/Rogaine for like 15 years so apparently that helps mitigate shock loss.

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Edited by johndoe1
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Congratulations! Look forward to updates.

"Doc" Blake Bloxham - formerly "Future_HT_Doc"

 

Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

 

All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Day 5 update. Pros are that the scabs/crust in the recipient area are coming off and so far no shedding/loss of any grafts. Also, the donor area holes are healing and the area is starting to become being hidden by surrounding hair.

Cons are that I still have pain in the donor area above the right ear. Not terrible pain, but a dull, persistent pain. That area had a lot of trauma with so many punches in it, so I guess it’s lingering nerve/tissue damage. Hopefully it will go away soon. Also, the recipient area is still pretty purple. It is getting better though. I hope to be back at work in 5 days so I will start using some aloe at the 7 day mark (2 days from now) to see if that helps. Luckily I have one of those jobs where I can work remotely so that will buy me more time.

See photos. The hairline looks pretty good, but of course the purple skin also makes it look better J Anyhow, as we all know, the final verdict is 12 months from now.

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Day 10 photos attached. Here is the good & bad.

 

Good: Scabs all went away pretty much by day 8. Showering 2-3 times with indirect water helped. So did Bacitran in the donor area and constant saline spray in the recipient area. Swelling and bruising around the eye went away a few days ago as well. On the recipient & donor areas around day 9 I used aloe only since the follicles are firmly in place. Hair growth has been noticeable in the recipient area. In the donor area, I have done some hair clipper ju-jitsu to blend the donor area shorter hair with the surrounding thicker hair so it is difficult to notice.

 

Bad: In the recipient area, redness persists. Hopefully the aloe helps with this. I had planned to be back at work yesterday but am putting this off due to the redness - it is more noticeable than the photo indicates. Luckily I can work remotely from home no problem :) Also I still have dull pain in the donor area in 2 points: at the back top of my head and also somewhat above the ear. Hopefully it goes away.

 

For those considering a FUE/FUT don't believe the hype about no pain, within 2-3 days no one will notice it & you are back at work, etc. In corner cases that might happen, but that is not the majority. Plan on 7-14 days to lay low.

 

BTW, I dyed my hair before. Hence the brown is replaced with some grey.

 

Lastly, standard disclaimer applies: "shock loss" still will happen. And final density still has me a bit nervous. Ultimate verdict is at the one year mark!

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At the pre-op consultation, Diep initially designed it by drawing the line in removable pencil on my head and I approved it. We didn’t want it unnaturally low. Also we made it so it was a “rounded” hairline lower in the middle/front because this is natural for my white/Hispanic background (if say I had been Asian it would have been a more flat/straight hairline).

 

Right before the procedure he drew the line on my head again and I had a chance to closely look at it and approve it again. I appreciated that….given the time/cost/pain involved, it is key the patient likes the hairline :)

 

Day 17 and still redness. Totally agree I need to keep waiting. I hear with some people it can be several months before all the redness is gone…

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Hey JohnDoe,

 

I appreciate the pictures. Dr. Diep is someone I've been considering for a while now too. The only reason I haven't taken the plunge is because I'd like to wait a bit longer to see how advanced my hair loss gets, and because I want to see some more examples of donor area scarring with FUE. We've all seen the really terrible pictures of FUE scars, but those are of the extreme. I'd like to see pictures to get an idea of the average - if the donor area is noticeably thinned, and how the scarring looks.

 

Keep taking those pictures! It would be good to see your donor area in a month or two when things have kind of settled. Do you usually keep your hair cut that short? If so, even better. I usually go for a taper at the nape of my neck, and I'm interesting to see how well it would all fade together.

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I can tell you that the donor areas scars for me are not too bad. I just now shaved down to approx a shaver guard 1.5 and didn't seem to see any difference in the donor area. I normally was a 1 level with the shaver before. I also have had friends look hard to see scars and they have to look VERY hard and then say they can notice tiny areas missing hair..but nothing too noticeable. That said scarring does vary based on the surgeon, how well you do the post-op instructions, and plain old genetics.

 

I will post an update in a second. Also, here is another Diep FUE patient who is like 30 days before me:

http://www.hairrestorationnetwork.com/eve/173759-2-781-grafts-dr-diep.html

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24 day update:

 

I have been on a multi-week work trip but when back home will post 30-day pics.

 

So crappy old shock loss has hit, as expected. It has taken out at least 50% of the transplanted hairs. Even some of the non-transplanted hair have fallen out. Before was a Norwood 2/3 and now I am prob a 3/4. Plus I can’t dye my hair so now grey hair is showing. So I look 5-10 years *older* then before the HT. Also, my recipient area is still reddish (not as bad as before) and numb. I applied aloe from days 9-15 but it did not seem to help much with the redness. Good times J

 

To be clear, I am not trying to play the gloom card here. Everything that is happening is fully to be expected and I knew this going in. You will look worse before you look better. And that “better” takes around 12 months (can be earlier/later). So for anyone considering a HT, go in eyes wide open on this. Any doc who says you will be back at work in 2-3 days and no one will notice a thing, an HT is painless, etc, is not being honest and you prob should look at a diff doc. Sure, there can be exceptions to this if the HT is minimal and you have long hair to hide it, but still. I fortunately had my hair at shaver length 1 before, so my short hair will not raise an eye with co-workers/friends.

 

On a diff note, I may resume Rogaine (been using it for 10+ yrs), but Rogaine is strong stuff with some harsh ingredients. It caused some itchiness on my head pre-transplant. So right now with the recipient area still red and numb, I don’t want to put something that strong on it.

Anyhow, that's it for now. Just gotta wait it out...and say my nightly prayer that my transplanted hairs all come back, thicker & stronger :)

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yep... just gotta tough it out. I was going through all the emotions post surgery. I had ridiculous shockloss. I'm not talking about the transplanted hairs falling out, which is expected. A lot of my native hair in the hairline fell out and I looked BALDER post surgery. It was a very rough initial 3 months. Eventually everything did recover, thank God, and luckily I do not think I had any permanent shockloss of the weaker hair in my hairline.

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  • 2 weeks later...

Been late in this update, but here is an update for day 37/week 5. See attached photos with hair shaved down to level 1 and dyed. Anyhow, I am right in the "ugly duckling" phase from shock loss. Not only have 80%+ of the transplanted hair fallen out, but some of the surrounding pre-existing hairs have too. So I have gone backwards in the Norwood scale at least half a step. Also redness is still present in the now-bald recipient area matching up exactly with where the new hairs went. Good times :)

 

I can tell that some coworkers who I have not seen me in weeks notice something is off and I see their eyes dart up to my head. But they are too polite to say anything :) Anyhow, I just gotta wait it out for the hair to come back. I restarted rogaine a week ago (never stopped propecia) so hopefully that jump starts things.

 

On the positive side, my recovery after the HT was pretty smooth The ingrown hairs and nerve pain went away around 2-3 weeks after. Also, per the attached pics, the donor area hair blends in relatively well with the surrounding hair. Yeah, if you know I had a HT and you are looking for it, you will see the hair is sparser where the donor hair was taken from. But at shaver level 1, a lot of skin shows regardless, so the donor area is not noticeable to the average person.

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John,

 

Thanks for the update! Looks like everything is rolling along as expected.

"Doc" Blake Bloxham - formerly "Future_HT_Doc"

 

Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

 

All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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  • 3 weeks later...

Hey there Johndoe1 thanks for the updates. I have a question for you, I have my hair transplant scheduled next month and as I was going over the paperwork I read this part where it says that a steroid injection is used in order to prevent swelling post the surgery. Did you have such injection as well? If so, any side effects?

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