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2700 FUE front then 1500 FUE crown


Leopold_CAN

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Hello fellow forum users, here's a bit about my FUE journey and finding out something important that I did not find in my years of research prior to my first FUE. And that is, extraction punch size. A smaller punch size will help with the healing & scarring and may prevent shock loss. *Different doctors use different punches*. In 2017 I had 2700 FUE with Dr. Diep. He was an ok doctor, friendly, friendly staff, but he seems to have used a fairly large punch size, larger than what was required from my recent doctor. I was not impressed that as I was laying on the procedure chair almost falling asleep form the drugs, Dr. Diep mentioned (in a cheery joking fashion though) to move quickly as he had a concert to attend that night. Coming from out of country - Canada -  that was disappointing knowing now he was confined to certain time restraints, where 2700 FUE is a big job. He was very quick with the extraction punch, I woke up for parts of it, and couldn't believe how fast someone could extract single hairs. At the time this was impressive, but now realize this may not be best practice. It seems a larger punch may enable faster extraction, but makes for more scarring and difficult healing. Dr. Diep's office also had poor follow up, as twice i had emailed sending in pictures to ask if healing looked ok or asking questions on ointment use on donor area and had no response for a while each time, so I called after a few days to a week of waiting then sure enough they would open my email and give a simple answer over the phone. I am also disappointed in having my procedure on a Saturday as Dr. Deip's office was closed on Sunday so my wife had to do my first donor area wash on Sunday. This was not ideal, but we went in Monday/Tuesday for cleaning at Dr. Diep's office. Cleaning was ok, but there was lots of pain due to how large of a procedure I had and extraction tool size. I had trouble sleeping for almost 3 weeks due to pain and the sensation in my donor area, it felt really uncomfortable and numb. 

I recently had 1500 FUE with another doctor, and it was quite a different experience, a smaller punch size overall, and a tiny punch size for single hairs above neck, much better healing process, almost no pain meds required during operation or days after, amazing follow up from the doctor and staff, more on that later). 

I got the pics down to size for easy viewing, but less detail is shown. You're welcome and sorry. :)

Enjoy

Pre-Op (2017 - Dr. Diep)

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Immediate PostOp (2017 - Dr. Diep)

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Notice extraction up to crown (some are hairs presumably susceptible to further thinning, so not ideal for transplant). Also, the extraction punch size can be seen from picture 3 is quite large. 

 

Day 1 (Dr - Diep)

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Day 6 (Dr. Diep)

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Day 10 (Dr. Diep)

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Day 15 (Dr. Diep)

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Day 33 (Dr. Diep) - Lots of what appears to be shock loss. Most of it temporary. Donor area still very red, was pretty embarrassing at work, tried to wear hat as much as possible. Terrible time :(

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Month 4 (Dr. Diep)

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Month 6 (Dr. Diep) - All turned out ok with this hair length. The sides show some thinning depending on how my hair is cut. The back held up much better.

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Month 12 - depending on hair length, thinning shows through on the side. Buzz cut is pre-op for 2nd procedure at different clinic. (Pre-Op for 2nd FUE)

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Overall I'm mostly ok with the results, the hairline looks pretty natural but I really dislike how large of an extraction punch was used, the scars show with a buzz cut, or if my hair is not quite combed the right way. I would recommend Dr. Diep if doing a smaller amount of grafts, and location is nice in Los Gatos.

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - Next procedure - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Since I did not want to go through this healing process again, I sought out another doctor. I really liked Dr. Konior's results and post-op day of procedure pics, however he was fully booked, I then spoke with the other doctor at his office, Dr. Nadimi. She was great, very knowledge and very thorough in our email's/skype coonsultation. Her reviews/results were great, so I booked in 7 months in advance.

The procedure with Dr. Nadimi could honestly not have been any better, everything was great! She methodically extracted every hair by taking time to line up the punch each time (I was awake for most of procedure). Only meds I took were two valium before procedure, all pain was handled with local anaesthesia, and there was no pain during extraction/implanting (only the initial anaesthetic needles I could feel). For a couple days after I took ibuprofen just to prevent pain, but it was really good anyway and sleeping was great every night, no pain. Worst part of the whole things was sitting in a hotel confined to my room for the most part ha ha, watched lots of Netflix! I went to Dr. Nadimi's office everyday for a week after the surgery (I didn't have to, but since I was in town they requested I do so if i wanted, so I did :) ). They cleaned my donor for first 3 days, then I took over as it was healing great. They were super friendly and Dr. Nadimi stopped to see me each visit to see how it was healing. Here's the pics so far, everything is going well!.... (pre-op posted above as Month 12)

Here's some more pics. Keep in mind, still see some scarring from first surgery, and hair is a bit thinner from already having a surgery. Enjoy.

Post-Op (2018 - Dr. Nadimi)

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 Day 2 (Dr. Nadimi)  - my wife couldn't believe how small the extraction punches were :)

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Day 3 (Dr. Nadimi) - healing very well! Keep in mind there's some scarring and thinning from previous procedure.

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Day 8 (Dr. Nadimi) - things are going well!

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That's all I have for pics so far, I'm almost 2 weeks now, and everything is great!

:)

Edited by Leopold_CAN
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On 11/28/2018 at 5:30 PM, shookwon33 said:

Im sorry but something seems a bit off about this review. Dr. Diep doesn't perform surgeries on saturdays ?

Hello, no need to apologize. Mine was on a Saturday, yes. I'm not sure what his normal schedule is, but that's when mine was. 

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On 11/21/2018 at 2:28 PM, wheretogo said:

Happy growth mate.

how many months past between your 2 surgeries?

Thanks! Just under 13 months between surgeries. I'll have more pics soon from the latest. Super happy with the healing process from Dr. Nadimi's office. She uses the best tools/instruments and has great staff! I highly recommend her as a physician.

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Did you add some grafts to the front too in the second HT?

i'm almost 10 months post op and thinking about doing my crown too, can feel scalp haven't healed totally, wondering if 12 months will be enough.

if it is not rude, may i ask how much you pay per graft?

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I have read a few times about punch size and specifically Dr. Diep using a larger one, has this ever been addressed by Dr. Diep or anyone else on this site?

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Link to what I did to grow my hair back without a transplant. 2 year update. 

 

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On 12/5/2018 at 9:22 AM, Shifty said:

I have read a few times about punch size and specifically Dr. Diep using a larger one, has this ever been addressed by Dr. Diep or anyone else on this site?

I haven't asked Dr. Diep about it (i'm pretty upset and just want to move on, found better doctor. Dr. Nadimi). Haven't ready anything about it on this site either. I'm a little disappointed that this site has such a high recommendation for Diep. My donor area likely would be in much better shape today had I found Dr. Nadimi sooner. 

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On 12/5/2018 at 2:10 AM, wheretogo said:

Did you add some grafts to the front too in the second HT?

i'm almost 10 months post op and thinking about doing my crown too, can feel scalp haven't healed totally, wondering if 12 months will be enough.

if it is not rude, may i ask how much you pay per graft?

Hi, had some grafts added to the front temple area, yes. 12 months from everything I've read is pleanty - but always best to talk to the physician to get their perspective. It's not rude to ask price no, both doctors were around the $6/graft USD. 

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Hi, is your hair thickness above average?

There is a huge difference in punch size between the two doctors and it does seem the first HT the extractions have gone outside the safe zone on the sides how old are you? 

The punch sizes seem to be around the same size as in the below thread.

 

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18 hours ago, john1972 said:

Hi, is your hair thickness above average?

There is a huge difference in punch size between the two doctors and it does seem the first HT the extractions have gone outside the safe zone on the sides how old are you? 

The punch sizes seem to be around the same size as in the below thread.

My hair used to be above average density yes. I am extremely disappointed in the punch size that Diep used. It is my belief that he uses a large punch so he can extract faster without having to line it up to the follicle as accurately. He was very fast in his extractions. Whereas Dr. Nadimi was methodical and you could hear her talk about lining up the extraction punch and she took her time. Wish I had never gone to Diep, ever. And yes, Diep went well out of the safe zone, Dr. Nadimi pointed that fact out as well during my operation. Not happy with Diep. 

Go to Dr. Nadimi for a good procedure!

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1 hour ago, hairlossPA said:

great write up. how would you rate the 1st transplant results (without factoring in the punch sizes)? 1 being poor, 5 being excellent.

any comment/concern from the new doc about your crown dipping?

1st transplant rate 4/10. Diep didn't cover temples properly, pulled donor area from outside of safe zone. Not sure how it'll hold up over time. I didn't ask Dr. Nadimi about crown dipping, I know the risks. 

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1 hour ago, Kiwi Guy said:

Another case of Dr Diep's donor extracting really leaving a moth eaten like donor area... did Dr Nadimi give you an idea of how many available hairs you had left in your donor after the first procedure?

Dr. Nadimi pretty much said with where my donor was when I came in, it's pretty much extract a safe amount now, and see how it grows in (which I though was respectfully honest). As opposed to Diep who said I have more than 6000 donor if need no problem. I'm thinking of using neck/beard hair for next FUE - pending some research...

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1 minute ago, Leopold_CAN said:

Dr. Nadimi pretty much said with where my donor was when I came in, it's pretty much extract a safe amount now, and see how it grows in (which I though was respectfully honest). As opposed to Diep who said I have more than 6000 donor if need no problem. I'm thinking of using neck/beard hair for next FUE - pending some research...

Oh really... does Konior/ Nadimi do beard transplants etc as well?

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17 minutes ago, Kiwi Guy said:

Oh really... does Konior/ Nadimi do beard transplants etc as well?

Yes, Dr. Nadimi does beard hair extraction for FUE. On my donor area on back of my head she used a super small extraction tool which even after 1 day of healing there was almost no sign of extraction. She says she can use that same tool or smaller one for neck hair extraction. So I'm not worried about scarring on neck, just whether or not the hair will look natural when placed on scalp is all i'm concerned about. 

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8 minutes ago, Leopold_CAN said:

Yes, Dr. Nadimi does beard hair extraction for FUE. On my donor area on back of my head she used a super small extraction tool which even after 1 day of healing there was almost no sign of extraction. She says she can use that same tool or smaller one for neck hair extraction. So I'm not worried about scarring on neck, just whether or not the hair will look natural when placed on scalp is all i'm concerned about. 

Do you know what size punch she would be using for neck hair extraction? Is it an 8mm punch? That may still leave scars

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3 hours ago, Kiwi Guy said:

Another case of Dr Diep's donor extracting really leaving a moth eaten like donor area... 

I had my first procedure 5 years ago and did a lot of research before then. I wasn't crazy about Diep's work then. After I had my transplant, I stuck around the forum for a bit then rode off into the sunset. Got a second procedure this month and revisited the forum. It had appeared Diep's stature had risen in the past 5 years. But when I see what he did to this patient's donor site, I'm appalled. Just a completely irresponsible approach to harvesting. 

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3,425 FUT grafts with Dr Raymond Konior - Nov 2013

1,600 FUE grafts with Dr Raymond Konior - Dec 2018

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2 hours ago, Since21 said:

I had my first procedure 5 years ago and did a lot of research before then. I wasn't crazy about Diep's work then. After I had my transplant, I stuck around the forum for a bit then rode off into the sunset. Got a second procedure this month and revisited the forum. It had appeared Diep's stature had risen in the past 5 years. But when I see what he did to this patient's donor site, I'm appalled. Just a completely irresponsible approach to harvesting. 

Yeah I hear you there. I think he does really good work on the hairline and also his FUT work seems really solid but his donors consistently seem butchered with the punch sizes he uses. Is there a correlation between his good hairline work and his larger punch sizes... is it a double edge sword? Does he get good grafts from his bigger punch sizes but also depletes the donor zone in the process?

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4 hours ago, Since21 said:

revisited the forum. It had appeared Diep's stature had risen in the past 5 years. But when I see what he did to this patient's donor site, I'm appalled. Just a completely irresponsible approach to harvesting. 

I appreciate the direct, honest response. 

 

2 hours ago, Kiwi Guy said:

Yeah I hear you there. I think he does really good work on the hairline and also his FUT work seems really solid but his donors consistently seem butchered with the punch sizes he uses. Is there a correlation between his good hairline work and his larger punch sizes... is it a double edge sword? Does he get good grafts from his bigger punch sizes but also depletes the donor zone in the process?

I dont think these things are related in his case to the extreme the donor is botched. From my experience I'd say he cares only about the end result of the new hairline so puts his effort into that mostly, and I say mostly cause i'm not happy about how he left the temples or connected the new hair zone to the existing (left noticeable gap). The large extraction tool is likely associated with him wanting to harvest as fast as he can - not to do with follicle damage concern in a small tool. He took little time in lining up the tool to the follicle in any extraction I was awake for, he was carelessly fast in extraction. I'm pretty disappointed/upset to say the least in Dr. Diep. 

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