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NW 4/5a, 2779 FUE, Dr. Diep


Jim75

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I had a recent FUE with Dr. Diep and since this forum was helpful in deciding, I'm contributing my own thread. I'm a NW 4/5a with stable loss for 15+ years. The 4/5a pattern recedes straight back, so it looks pretty bad from the front, and I just got tired of looking at it.

I chose Dr. Diep for his impressive FUE results and aesthetic sense. The goal of this procedure was to reconstruct the frontal third.

 

After waiting 9 months, surgery day went very smoothly: paperwork at 5:30, met with Dr. Diep to go over the plan at 6:00, took sedatives and slept through almost all of it, waking up for lunch and at at the end, around 5.

 

Here is the top and donor, pre-op.

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Here's Day 5. The numbness from the donor started to fade and was a little sore, but not very painful except for one small area by the ear. Recipient was numb. No major discomfort, continuing pain meds.

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On Day 8 I started to wash the recipient, and it was very hard to get those scabs and crusts off. It took four 30 minute sessions of shampoo, rub 5-10 minutes, rinse, repeat, and even then there were crusts left over. Many hairs shed during the wash too. Donor sensation is now at around 50%, recipient is still numb. Still no major pain, and the one spot that was bothering me was subsiding, so I stopped the pain meds around here.

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These are the most recent photos. Donor sensation is now at 80-90% and recipient at 5-10%. Redness is fading, although the photos exaggerate it a bit. In softer light it looks semi-normal from the front. No major shed yet.

 

At this point I'll try to post monthly updates, but if I forget, I should get an e-mail update if you post to this thread.

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Those are great photos and the work looks very good. Keen to follow you progress.

 

I'll bet you wish you could go to sleep for 6 months now and wake up to a Jimi Hendrix.

I'm serious.  Just look at my face.

 

My Hair Regimen: Lather, Rinse, Repeat.

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I like the placement of the hairline, everything looks clean, you should be very happy by 12 months time.


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Work looks clean but 100% your doctor has gone out of the safe zone. I can see extractions in thinning areas of your donor. You clearly weren't a good FUE candidate.

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I'll bet you wish you could go to sleep for 6 months now and wake up to a Jimi Hendrix.

Yes, instant hair, I'd sign up for that.

Congratulations. Happy growing.
I like the placement of the hairline, everything looks clean, you should be very happy by 12 months time.

Thanks to both of you for your threads on Dr. Diep showing the excellent results. They were helpful in selecting him, since, like both of you, I will need at least two procedures to get this all done with FUE.

Work looks clean but 100% your doctor has gone out of the safe zone. I can see extractions in thinning areas of your donor. You clearly weren't a good FUE candidate.

Good observation. But if you're looking at the pre-op photo, that's the result of thinning shears (for manageability) plus lighting harsh enough to show it.

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Looks good to me. Your hair loss has stabilized, are you on Propecia?

 

As for the donor zone, I feel like if your hair loss is stable grabbing from a little out of there and placing it in the front will help you for several years even if it were to inevitably fall out. I think that's a good deal anyway. It's not like all your hairs were taken from outside the donor zone. And maybe your pattern of hair loss has reached is peak and what would be traditionally unstable hairs are, in fact, stable for you. There's no way to tell.

 

As for your procedure, I think it looks very clean and it should come out very nice. Do you have plans for a second HT to address the crown?

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Looks good to me. Your hair loss has stabilized, are you on Propecia?

No, I've never taken anything. It hasn't been too aggressive, maybe NW 2 or so around age 29-30 when I first realized it and steadily going to NW 4a/5a for 15 years, and I'm hoping for an endpoint of 5a (or 6 at worst). I don't think finasteride is worth the risk in my situation, and Dr. Diep also said it's optional.

As for your procedure, I think it looks very clean and it should come out very nice. Do you have plans for a second HT to address the crown?

I'd definitely need at least one more to address the mid-scalp and crown, but I'm waiting to see how this one turns out. If I get a decent result in the frontal third it's going to make all the visual difference, the rest would be a finishing touch.

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  • 2 weeks later...
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Here is the one month (Ugly Duckling) update. Major shedding began on Day 18 and continued until Day 25, when it seemed to stop. About 80% shed and the rest remained in sparse patches, which I may have to trim if they don't fall out soon. There was also some minor skin flaking in the recipient for about a week starting on Day 14.

 

Redness is fading very slowly. It actually looks more diffuse rather than less red, but it's still obvious in harsh light, as in the photo. The donor is about as red as the recipient, and you can see it in harsh light, but it's otherwise not noticeable now that the hair has grown somewhat.

 

Sensation is slowly coming back around the edges of the recipient, but the center is still completely numb. The donor is slightly sensitive but I rarely notice it.

 

I included close-up photos of the donor side and back to show how the one month FUE scars appear on very close inspection. In side lighting (as shown), you can still see a slight texture, with diffuse points of redness. The donor area border is marked with a line, so you can compare to virgin scalp.

 

I will update in one month, when I expect nothing to happen.

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The next few months are the worst stage. Believe me, time flies and it won't be long until the hair starts regrowing. Just try to get on with your life at the moment and as hard as it is, try and resist the constant mirror checking.....:D

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  • 5 weeks later...
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I'm at the 2 month mark, and still stuck in the ugly duckling phase. Redness is very visible; in fact, looking at the pictures, there has been no progress at all with redness since a month ago. The recipient is still numb in the center, with no noticeable progress there either.

 

The donor regrew fairly well, except for some minor shock loss behind the right ear. You can see through it with the very strong lighting of the photo, but under normal lighting it looks fairly dense. The donor is about as red as the recipient, but under normal lighting it's not visible. Any lingering sensitivity in the donor is now gone.

 

I'm hoping for some improvement in redness by next month, so I can return to more or less a pre-op state, but realistically with a light complexion I'm probably looking at 4-6 months of redness.

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5b32f4f01e909_Month2-Donor.thumb.jpg.c759bf16b61f8ac42e202a7461c2fe92.jpg

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Hi Jim

 

I just noticed your thread your loss looks like mine maybe my crown is worse, your procedure looks good, as I’m about 1 month behind you, just starting the ugly duckling phase myself I feel your pain…

 

Just a quick question, does your redness change throughout the day or stay constant?

 

Because mine changes in the morning it is less red then after a shower/gym it goes redder, then it slowly gets less red.

 

Also, have you tried anything for the redness?

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Just a quick question, does your redness change throughout the day or stay constant?

 

Because mine changes in the morning it is less red then after a shower/gym it goes redder, then it slowly gets less red.

 

Also, have you tried anything for the redness?

Anything that increases blood flow generally (exercise, heat, and so on) will make it temporarily redder, but outside of that, I don't notice a difference at different times of the day.

 

I'm not doing anything to it. Annoying as it is, redness is a part of the natural healing process. On scars I've gotten, it has usually taken nearly a year for redness to completely fade, but it does eventually fade. Also, I don't know of any treatment for redness (other than maybe foundation makeup and a green concealer) that is proven to work and not have side effects.

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  • 5 weeks later...
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I'm still stuck at the ugly duckling phase at 3 months. The redness persists, and it has only barely improved since month 1 and 2. I thought it might last 4-6 months but at this rate, even 6 months of redness seems optimistic. At least I'm getting used to looking at it, but it's definitely the worst part of this phase.

 

The donor is about as red as the recipient. It's not visible under the hair, though, even under the very strong lighting of the photo. The density is back to normal. I feel like I could have another 5,000 grafts taken out of there without it looking thin under more normal lighting.

 

The center of the recipient is still numb. I rarely see threads follow up on recipient numbness, but I'm assuming this is not normal and could be a sign of permanent nerve damage, which is something I didn't bargain for. I'll have to wait and see.

 

The crown looks balder than ever because the hair that used to be covering it is still short. But other than the crown appearance, the redness, and the numbness, I'm back to pre-op. :rolleyes:

 

By the next month's update I should know whether these sacrifices were worth it.

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How long did it take for all the hair to shed after the transplant? I'm almost 3 weeks post op and it hasn't shed and everyone swears it's growing
Some hair came off with the scabs when I began washing on days 8-10. Most of the shedding, however, was from day 18 through day 25.

 

Don't worry, it should shed for you any day now.

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  • 4 weeks later...
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Meager progress. Only about 25% of the grafts have even begun to sprout, which is much worse than I see on successful HTs at this stage. They are still sprouting here and there, so I'm hoping it's just slow growth. Obviously there's no cosmetic improvement, since very few of the sprouts have lengthened and matured.

 

The redness persists. It's better than month 3, but still clearly visible.

 

The nerve damage has improved very slightly, and there is now some very faint sensation in the front-center of the recipient. The rear-center still has zero sensation. At least there is some hope for a partial recovery here.

 

There's nothing I can do but wait to see what happens in the next 1-2 months, and that should tell me where this is going.

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Work looks clean but 100% your doctor has gone out of the safe zone. I can see extractions in thinning areas of your donor. You clearly weren't a good FUE candidate.

 

After looking at the pre op and post op doner photos really could not agree more with the above, work looks amazing but the doner area looks to be a bit thin clearly pre op to me in places and extractions clearly well out of the safe zone on the back and sides.

 

For me on the front third on my first fue I think I would prefer everything to stay 100 per cent in the safe zone so not to go over the same area twice if the grafts do not take was this talked over going outside the safe zone?

 

Only asking and learning as this is something I will be now asking myself, does the safety zone get talked over if extractions go outside (as a newbie could be wrong but I would prefer to may be go outside only when filling in behind the frontal third).

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For me on the front third on my first fue I think I would prefer everything to stay 100 per cent in the safe zone so not to go over the same area twice if the grafts do not take was this talked over going outside the safe zone?

If you think you'll end up a NW7 and want to stay in the universal safe zone, I recommend you look into FUT, not FUE. In my case, based on my age and established thinning pattern, I don't have a problem with the extraction area. If you're concerned about it, though, definitely bring it up with your doctor when you have a consultation.

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  • 4 weeks later...
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About 40% of the grafts have sprouted. On the one hand, this result is lagging for Month 5. On the other hand, so were the Month 3 and Month 4 results, so it could just be slower growth.

 

There are lots of tiny new sprouts and vellus hairs, and they are continuing to come in. If the progress continues at this pace until Month 7, I could be in decent shape by Month 8 or 9. So the waiting game goes on.

 

The redness persists, with minor improvement. The nerve damage healed a little. The recipient is still mostly numb, but has some dull sensation.

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