My 3164 Grafts with Dr. Diep (FUE) -- May 6th, 2016

[jj2000]

I'm a 35 year old male who's hair has been gradually thinning sine my early 20s. My hairline itself has roughly been in tact, but the thinning went roughly past the halfway mark of my head. I've been on proscar/propecia since my early 20s as well, and it's really helped, but I deciding the take the plunge and get a hair transplant.

 

Initially we were scheduled to do 2500 grafts, which I already thought was a little excessive since every other consultation I went through suggested somewhere in the 1500-2000 range. When filling out all of the paperwork, there was a form which specified how many extra grafts the Dr was allowed to pull during the surgery if he felt it was needed. I wasn't exactly sure what to put here as it was unclear to me if I would need extra grafts, so I put down 500 (there was another option to specify no limit, but I felt more comfortable with a hard number in place).

 

Apparently after my head was shaved, Dr. Diep realized that the thinning of my hair actually went farther back than he initially thought (since my hair was longer when I first came in). As such, he extracted more approximately 634 more grafts. He did however not charge me for the extra 134 grafts as I specified 500 on the paperwork. I'm pretty thankful for this as it's not a small number of grafts (nor a small amount of money).

 

The breakdown of the grafts are:

 

1's: 701

2's: 1,309

3's: 692

4's: 432

Total: 3,134

 

Surgery was slated to start at 5:30am, which meant I was up at 4am to shower, prep, and hit the road. Once in the office, Dr Diep drew out the area he would fill in and I took my cocktail of medication and we were off.

 

The extractions themselves were surprisingly painful (especially in one area), so much so that the Dr himself was surprised as he suggested that most patients don't feel that much pain. Either way, he continued to numb the area to make me feel better.

 

From there on out, I don't remember too much, since I woke up so early, I passed out while the Dr made the incisions and the technicians started placing the grafts. I woke up for lunch, ate a bit and then the technicians asked if I wanted to watch some TV, however, I opted to go back to sleep again.

 

Dr. Diep came in around 4pm to make a few extra incision sites and to check in on things and ask me how I was doing. Afterwards, I didn't see him again, but to be honest, I was ok with that. I didn't have any questions and was looking forward to getting home.

 

By 5pm we were done and I was ready to get home.

 

I went back today for a cleaning and spoke with Dr. Diep where he said he was pleased with the results...I'm sure he says that to everyone

 

All said and done, the doctor and his staff were pretty awesome, and I'm happy with the initial results.

 

My main concerns, and general nervousness is the donor area, as it's pretty big and I hope it heals well and quickly. I'm also really nervous about the ugly duckling stage as I'm trying to avoid everyone knowing I had this procedure done

 

I'm staying home for the next week, but returning to work on day 10 and planning on wearing a hat, to help cover things up.

 

I've attached a handful of pics before the surgery (these are actually a few months old, but still representative of my hair loss), and pictures I took today (day 1 post op). I plan on posting pictures once a week until the first month and monthly thereafter until the first year.

[jj2000]

Hmm...Not sure why half the pictures ended up upside down

[E39]

Looks good! I wore a hat going back to work and nobody could tell. Don't worry about the donor, it will heal up nice

[n00b]

Just curious, may I know what was the punch size used?

Also, was it a motorized punch or a manual punch?

[jj2000]

Just curious, may I know what was the punch size used?

Also, was it a motorized punch or a manual punch?

 

By motor, do you mean the robot? I know he didn't use the robot and did it by hand, but unsure if the tool he used had a separate motor to it.

 

I believe the size of the punch was 1mm.

[spyk777]

For that amount of grafts and your level of hair loss should expect killer results

 

The donor will heal quickly and feel untouched.

 

Best of Luck and looking forward to your updates.

[Melvin- Admin]

For the amount of hairloss you have this will be a home run result.

[jj2000]

Thanks for the kinda words...i'm excited to see the results, but of course, tempering my expectations as I know I won't see anything significant for 6-9 months.

 

Also, I forgot to mention that Dr. Diep said the transection rate was around 5% and I also opted for A-Cell. My research on A-Cell seemed mixed, but given the cost of the entire operation, I felt it was worth the extra cost even if there's a small advantage.

[MrGio-WHTCClinic]

Hi. Did the location of the hairline change? Thanks for sharing.

[jj2000]

Hi. Did the location of the hairline change?

 

Not really, as you can see from the initial pictures, the location of the hairline itself was fine, but the coverage was really thin, so we focused more on filling it in.

[jj2000]

Here are some pictures of Day 7 post op. Generally speaking things have been healing fine.

 

The recipient area hasn't bothered my too much, other than being itchy, but the donor area has been surprisingly painful and sensitive. It's actually become somewhat difficult to sleep on.

 

The donor area looks good, although it's still pretty obvious that I had the surgery done, so I'll be wearing a hat when I go back to work on Monday. I'be been putting on the Bacitracin Zinc Ointment ointment, but wondering if anyone has other suggestions on what I can put on the donor area to speed up healing.

 

Tomorrow I'll take a long shower and massage off most of the scabs on the recipient area and will post follow up pictures.

[Melvin- Admin]

Wow if everything goes good your density is going to be amazing, it already looks like you have a full head of hair with the grafts still in. Just get ready for the dreaded shed:(

 

In my first surgery I had Acell cream that I used on the donor area, I don't know if Dr. Diep has this, but you may want to contact his office to see if he does, I put this on my donor area and it helped immensely speed up the healing. Also, I had a burning sensation in my donor area from day 7-14, this is normal the nerve endings that were severed during surgery are growing back and healing it's a normal part of the healing process.

[jj2000]

I got the A-Cell injection, but I'll ask about cream on Monday.

 

The donor area is really sensitive to touch. I have to be extra gentle when I put on the cream and last night I tried sleeping without the neck pillow (e.g. back of head straight on the pillow) and it was too painful, so I had to go back to the neck pillow.

[jj2000]

Here are some more pictures after a very long shower. I didn't get all the scabs off, so I'll give it another go tomorrow.

 

The donor area unfortunately continues to be pretty painful (I still have to sleep with a neck pillow). I'll speak with the Dr's office tomorrow to see what they suggest.

 

(also, it's really hard to take pictures of the back of your head)

[Melvin- Admin]

It will get better by 14 days, in the meantime try aloe vera, it helped sooth the area for me, also try not to wear hats as often, as the hat causes more irritation.

[jj2000]

Just the green aloe vera gel?

 

Also, I've continued to apply the Bacitracin. should I switch to Neosporin (or put Neosporin in addition to it?)

[spyk777]

I did Aloe Vera and Bacitracin.

 

The sensation will surely returning back to normal will take a couple of weeks. Nerve healing is a slow process.

[jj2000]

Thanks for the feedback. This type of pain is really weird, I've never experienced it before. It definitely still hurts to lay my head on anything, but I can manage to sleep with a neck pillow. Wearing hats also takes it's toll, but isn't as bad as actually laying my entire head on a pillow (which sounds odd).

 

The doctor offered to prescribe Neurontin to help with the pain, but I'm on the fence about whether I should take it or not. Searches on this forum turn up little results, so it's seems relatively uncommon. Side effects seem slim other than drowsiness.

 

As for topical treatments. I'm a bit confused between Bacitracin, Neosporin and Aloe Vera. Do you alternate between them? Put them all on at the same time like one big cocktail Or switch between them at certain stages (e.g. X days after Post Op)? So far I've just been doing Bacitracin three times a day (one of those small disposable packets each time).

 

I've also been thinking a lot about what's most important to me given all the variables at play, and despite the pain, I'm still optimizing for best results (which also includes the donor area). So despite the annoying pain, I'd rather focus on minimizing scarring in the donor area and maximizing results in the recipient area (which I imagine everyone in this forum is!).

 

To that extent, I am a little frustrated with myself around needing to wear a hat to work (and the corresponding perspiration/moisture). The irony of having the HT done is that I was very self conscience about my hair loss, and thus very self conscience about getting it addressed

[jj2000]

Here are some pics from 14 days post op. Sorry for the poor quality. Using my phone at the moment.

 

Generally speaking things have been going as planned. The scabs took a few days to get them all off (and I still feel an occasional few in the donor area). When washing my hair, and fair amount came fell out, which I believe is expected. I couldn't tell if some of them included the root or not (e.g. whether it was the root attached to it, or just the wet scab). The redness has gone down a lot and not that noticeable (my skin color and dark hair definitely help).

 

I've been wearing a hat at work for the last week, but will avoid it this week. I'm also going to start exercising/running tomorrow and looking forward to it. I triple checked with the Dr, and he said it's fine, provided I wash my hair shortly after

 

The donor area however has continued to be pretty painful. I believe it's a combination of general bruising and the lack of nerve regrowth, so I decided to take Neurontin. The pain has slowly been getting better, yet I still have trouble sleeping at times, especially on my back since the back of my head is most sensitive to touch. I did bacitracin three times a day for the past two weeks and have started aloe vera twice a day, but that whole area still feels "stiff" for lack of a better term, especially when I tilt my head up.

 

I'm expecting to start losing a lot of the implanted hair soon, but crossing my fingers that the shock loss isn't too great so I can go back to my usual look to provide natural coverage against the sun as summer approaches.

[Melvin- Admin]

Everything is looking great, you should expect the donor area to improve within the coming months as well. If you're not taking minoxidil you may want to start, I really do feel that it can help a lot with shock loss.

[jj2000]

I'm not taking minoxidil, but you're right, I should. I have a few separate questions about that, but will post in a separate thread.

 

However, related to this thread, I have noticed more bumps on my head throughout the day and in the mornings, but I don't feel them after sitting in the shower for a few minutes, so they don't feel like scabs.

 

They look like dandruff, and feel pretty superficial when I rub my head. Wanted to double check that this is expected/normal. My only real concern is that they are not scabs as I know I should have gotten all of those off now.

 

Also, worth mentioning, that when I rub my head more hair starts to fall off, so fair to say the shedding phase has begun

[jj2000]

21 Days Post Op

 

Not too much to share, about half the implanted hair has fallen out as expected. The redness has gone down pretty significantly.

 

I've started taking minoxidil and staying out the sun as best as possible. I've also resumed working out and running, but wear a hat whenever I'm outdoors.

 

The donor area unfortunately continues to be painful. It's a mix between a really bad bruise and that numb feeling you get when your arm falls asleep. I still have trouble sleeping on my back, but the sides of my head are much better.

 

Also, this week I've had these really weird sensations run through the donor area. Best way to explain it is goose bumps on steroids. It doesn't hurt and only lasts a few seconds, but it's really intense.

[spyk777]

The paresthesias (Neuralgia) will slowly fade away. It did last me several days to a month or so.

Lyrica (I think you tried this already), Neurontin, Pamelor, Cymbalta, lidocaine jelly etc. may be considered based on your consult with Dr. D.

I just chose to ignore it.

 

Thanks for update. Look forward to your progress. Cheers.

[jj2000]

1 Month Post Op

 

The shock loss is pretty severe. I've lost a lot of hair on the top of my head and it feels like the redness got worse. I wonder if using minox has increased the loss and the redness (I use 1ml once a day).

 

I'm also surprised by the amount of redness in the donor area; I'm actually don't see it as red when I look in the mirror, but it's clearly red when I look at the pictures.

 

I'm also slightly worried about infection. I've had a bunch of small bumps (small enough where they are difficult to see in the pictures) on my scalp and even at the top of my forehead. They've also surfaced on the top of my ears. They are super tiny and only noticeable to touch, but it's still concerning. I'm not sure if it's related or not, but has me worried.

 

I totally understand the ugly ducking phase now. I didn't expect my shock loss to be this significant, so I wasn't as worried about it, but now that I've lost a lot of my existing hair, this is when those random questions pop into your head: What if it doesn't grow back? What if I was in the sun too long? What if exercising has screwed things up? I know the answer to most of these questions is to just wait it out and things will turn out ok, but that doesn't keep them from running through your head

 

Going forward I'll post updates on a monthly basis.

[spyk777]

Everything looks as expected from my humble experience. Doubts, second thoughts, shock loss all are part of the challenges we must overcome. It is a leap of faith in the end!!

 

Any slight concern of infection should be addressed with Dr. Diep.

 

Best.