Jump to content

1869 Grafts with Dr. Diep 2/12/19 (33 y/o Caucasian NW3)


Recommended Posts

  • Regular Member
1 hour ago, shookwon33 said:

Your donor seems to be healing quite well already for Day 4 to be honest! Any pictures of the recipient area on Day 4?

The recipient area looks more or less the same and it's difficult to get really good progress shots because the hair on top was left long and its kind of just falling wherever it wants. I have been avoiding touching the hair in any way or trying to move it out of the way since I don't know if any of the hair has stuck to the scabs from the grafts. But here they are anyway:

 

frontday4.jpg

frontday4-2.jpg

Link to comment
Share on other sites

  • Administrators

Just be careful the hair doesn't tug on the grafts. Everything is looking good the hairline design is staggered really nicely. I really hope you don't forget about us once your hair grows in like so many others haha. Please keep us updated on your progress.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

Link to comment
Share on other sites

  • Senior Member

I'll try to remain respectful because I dont want people getting mad at me. But the donor region right after just makes me cringe. I know it heals well and the results speak for themselves, but I'm just always shocked about how much worse Dr. Dieps donors look compared to all other FUEs I see. I understand they heal just fine. I am happy you went through with it, but it's always been crazy to me.

1 question in general about donor regions/punch sizes.. If a doctor punches at 1mm, do the recipient sites need to be 1mm? It seems like it would make sense. A graft is punched out at X size, so the hole it goes in must be X size. Right? Or do they trim each and every graft after it is extracted to a smaller size to fit into the incision? I feel like larger punches would mean larger incisions which means less dense packing due to how much space each graft needs. Can someone clarify/explain?

  • Like 2
Link to comment
Share on other sites

  • Administrators

The size of the punch has no bearing on the size of the incision. Once extracted; follicular units are separated by 1,2,3,4 and some even have 5 hairs per unit.  Grafts are separated by unit size and the incisions are created accordingly. Perhaps in the 80's it may have been common to punch a graft out and punch a graft in, but those days are long gone. 1mm while larger than average, is not large enough to require additional trimming. Some surgeons may trim their grafts, but it isn't necessary. In fact, some would argue the larger the punch, the more fatty tissue and the healthier the graft. I don't agree, but some have argued this. In regards to remaining respectful,  treat others as you want to be treated pretty simple.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

Link to comment
Share on other sites

  • Regular Member
On 2/17/2019 at 9:12 AM, Melvin-Moderator said:

Just be careful the hair doesn't tug on the grafts. Everything is looking good the hairline design is staggered really nicely. I really hope you don't forget about us once your hair grows in like so many others haha. Please keep us updated on your progress.

Since you are a former patient of Diep's - do you recall what your recipient site cleaning process was? The written instructions I have are fairly vague and I've been erring on the side of caution since I recall the techs telling me that I was bleeding a lot during the graft placement. Yesterday I basically poured a few cups of cold water across the recipient site, lathered up the sponge with the shampoo provided, and squeezed the sponge to let the entire graft area be covered in lather (not making any physical contact). I just let the foam sit there for about a minute or two, then used cups of water to pour off the foam. I just let the hair on the crown flow wherever it did and let everything air dry. I had some small white bubbles that went away after a few minutes.

The vagueness in the instructions is how long I should be letting this area be soaking with the shampoo - and how much water I should be using.

On 2/17/2019 at 9:50 AM, hairlossPA said:

I'll try to remain respectful because I dont want people getting mad at me. But the donor region right after just makes me cringe. I know it heals well and the results speak for themselves, but I'm just always shocked about how much worse Dr. Dieps donors look compared to all other FUEs I see. I understand they heal just fine. I am happy you went through with it, but it's always been crazy to me.

1 question in general about donor regions/punch sizes.. If a doctor punches at 1mm, do the recipient sites need to be 1mm? It seems like it would make sense. A graft is punched out at X size, so the hole it goes in must be X size. Right? Or do they trim each and every graft after it is extracted to a smaller size to fit into the incision? I feel like larger punches would mean larger incisions which means less dense packing due to how much space each graft needs. Can someone clarify/explain?

I think you aren't wrong to cringe at the donor area - this seems to be characteristic of Dr. Diep's patients due to the size of the punch. I think that if I hadn't done my research prior to the surgery, it would have freaked me out as well when comparing it the 1-day post-op photos from other doctors. However, knowing this reality, and also hearing the doctors explanation (says it gives him a healthier graft to work with), I knowingly accepted it. To me, the real consideration is how the donor area looks *after* healing - and Dr. Diep is not hiding the ball here. There are plenty of videos posted showing the donor areas in the months following the extraction areas, and they look no different than the donor areas subjected to smaller punches. Melvin's pictures in this thread are just one example. Perhaps there is a perceptible difference if someone cuts their hair with a very short guard on the back - but this isn't something that I will likely do. I will say, however, that a second major consideration of the Diep's donor areas is the viability of future FUE procedures, and whether or not the punch has any implications for future extractions in the same area. To this - I can't say I've found any definitive answers - and it may be a real issue for me in the future if my hair loss continues if this extraction method does jeopardize the surrounding grafts. I don't know enough about this to offer an opinion.

Here is one example of someone that I think has similar hair type to mine - his donor area looks untouched:

I can say as to the immediately post-op photos that might explain some of the mess - I bled more than usual per the techs. I'm not sure if this is due to semi-regular marijuana smoking (1-2x/week) leading up to the procedure, or the regular supplements that I take (I stopped 1 week before the procedure but many of the things I take were on the list), or my high blood pressure (the tech said it was 166 right before the drugs kicked in, but insisted that was normal since I was really nervous about the procedure). Other than that, I am an exceptionally healthy individual (I don't smoke cigarettes, drink alcohol, eat junk food, I've exercised/weight trained 2-3x/week since I was 17 years old, and I rarely get sick).

I'll continue to update this thread with progress pictures over the coming year. I can say right now though that I don't have any major concerns with the work other than the need for him to revise his printed post-op instructions, and I'm looking forward to the results.

Edited by FUEblonde1985
Link to comment
Share on other sites

  • Regular Member

Picture of where a towel hit my head. I'm not sure if I just never noticed this before or if something dislodged from the graft, or if I just wiped the scab off. Hard to tell if this is any different than earlier in the AM when I had just washed since I hadn't been taking very close up pictures. There was no blood or anything.

missing.thumb.jpg.be7e4461005bee5b23bcfb0caf9d2005.jpg

 

Here is a picture from same spot before I hit my head:

zoomday5.jpg.1bc305d84cdfb09aba4fae3b9ec12566.jpg

 

 

Link to comment
Share on other sites

  • Senior Member
On 2/13/2019 at 10:21 PM, FUEblonde1985 said:

The FUE extractions came from the back and my right side, as seems to be common with Dr. Diep (and debated about in other threads). I think the jury is still out as to whether this should really be done, but I can say that the left side of my donor area is well preserved for any future need, though I am not sure I like how far near the right ear he went with the extractions. That said, I will generally not be buzzing my hair very short anyway (5 guard minimum) so I don't think this will be an issue for me - you can see from the photos how I generally wear my hear. He made sure to minimize any shaving of hair at my hairline since I plan to return to work after 3 weeks and I am hoping (though I am skeptical) to disguise the work with a mixture of clever styling, makeup, topik, etc.

Ha, I see you've read my thread!

TBH, it may still look rough at 3 weeks post-op returning to work but I'm about 6 weeks and the donor is not too noticeable.

I would imagine that if there were really issues with how Diep does extractions then enough people would've complained over his 14 year career and he would've changed his style.

As for the weed, maybe try vaping it instead of smoking? My understanding is that smoke of any kind reduces blood flow, which can hinder healing, but I think you'd avoid that issue with vaping. 

Link to comment
Share on other sites

  • Senior Member

From a very satisfied patient of Dr. Diep myself, I have every confidence this will turn out great for you. It's difficult to play the waiting game, I know, but you will be rewarded.
Yes please keep us updated on your progress.

Link to comment
Share on other sites

  • Administrators
5 hours ago, FUEblonde1985 said:

Picture of where a towel hit my head. I'm not sure if I just never noticed this before or if something dislodged from the graft, or if I just wiped the scab off. Hard to tell if this is any different than earlier in the AM when I had just washed since I hadn't been taking very close up pictures. There was no blood or anything.

missing.thumb.jpg.be7e4461005bee5b23bcfb0caf9d2005.jpg

 

Here is a picture from same spot before I hit my head:

zoomday5.jpg.1bc305d84cdfb09aba4fae3b9ec12566.jpg

 

 

Nothing to worry about, you should only worry if you see blood. That looks like a scab that came off. In terms of washing, I took a bowl of luke warm water with the shampoo Dr. Diep gave me, but even if you run out just use baby shampoo. I mixed the shampoo in the bowl of water and slowly poured it over my head dabbing it gently with a sponge. I did this for about 5-10 minutes. Past 7 days you can massage the area a bit harder to remove the scabs and crusts. By that time the grafts are definitely secure.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

Link to comment
Share on other sites

  • Regular Member

Day 6: Again did a cleaning of the backside, and also the front. I am getting a bit concerned that Dr. Diep's instructions regarding the cleaning of the recipient area are wholly inadequate. Essentially his instructions are to clean *only* the donor area for the first 3 days. Then on days 4-7, clean the recipient area by indirect flow of water, squeezing soap onto the area, then indirect flow to rinse, with no direct touching or patting whatsoever.

As a result, it seems like there is a thin film of residue all over my recipient area. Yesterday, when it was nicked with a towel, a part of that film was cracked and started to peel slightly. Today, after cleaning, I took more photos of the area and it appears that the crack is getting larger and peeling further. Other areas are starting to peel as well. Does this have any implication for the grafts? I'm not sure - I've seen posts in other threads where this is reported as normal. However, there are dozens and dozens of Dr. responses on realself indicating that this is *not* normal and that the recipient area is not being cleaned well enough. So far, I have not been able to get a response from Diep's office (I e-mailed them photos yesterday and today, and they told me he will get back to me when he can).

Here are closeups of my overall graft area: 

IMG-0623.thumb.JPG.cc4c100716d9fe4a51861ff97012adf1.JPGIMG-0622.thumb.JPG.0c20b6c46badf47c4b652ba9089cfd09.JPGIMG-0621.thumb.JPG.1e4655f89828474a7459aa12c41131f7.JPGIMG-0620.thumb.JPG.b11eaef5cd4701972feebbf5d15b1a6c.JPGIMG-0619.thumb.JPG.6e35742e66491802ea8ce8664eab8d59.JPG

IMG-0616.thumb.JPG.95fdbf019321fe3349530ba322047cf1.JPG

Here is how the donor area is looking:

Backday6.thumb.jpg.16d0b49c20abc8bfb206b81d4c5443f4.jpg

Link to comment
Share on other sites

  • Administrators

You have nothing to worry about. My hairline looked almost identical at 7 days. Gently dabbing the grafts with a soft sponge should help loosen up the scabs. You can also let it soak with luke warm water and shampoo for 10-15 minutes prior to dabbing the scabs. 

 

E0B28A64-5CCC-4159-A102-15A0C8CAC945.jpeg


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

Link to comment
Share on other sites

  • Regular Member

I really appreciate the response. The picture you posted I think looks very similar and it gave me a huge sigh of relief. I can't figure out why this period is so nerve wracking and I'm getting stuck trying to figure out every detail that is happening with my hair. Wish I could just smoke some weed and wake up a year from now.

Diep's e-mail response to this:

"I showed your photos to Dr. Diep and he said at this stage there is nothing we can't do. We won't know the affect until 1 year from the day of your surgery. But it looks like you are in the shedding phase, cracks and crust that appears in the recipient area are normal, expect more to occur."

 

Link to comment
Share on other sites

  • Regular Member

Day 8. This was the first day I'm instructed to do direct cleaning of the recipient area. I spent about 20 minutes under a very low pressure shower head (my attachment allows control of the flow) directly on the recipient, and then spent about 6-8 minutes with soap rubbing the recipient area. The area felt like there was a protective shell around it, and it was a lot harder than I anticipated. There wasn't a whole lot that came loose from the rubbing, but once I rinsed I could see many little white pieces coming off the area. There were a few small hairs as well, and only one bit that looked like it could be a graft (but it seemed like it was more likely just another white bit with hair attached). The "cracked" areas from day 5 still look a bit bare, but I'm not sure yet if its just because the scabs around have not yet fallen off completely. I would guess maybe 30% or so of the scab/crust came off, so I'll repeat the process tomorrow. Donor area is feeling good, sometimes itchy, continuing with 3x/day bacitracin ointment. This was my first opportunity to really soap up my crown hair and its looking a bit ridiculous right now. Hoping my barber can make some magic happen prior to my first day back at the office (3/4).

Took some closeup shots of the recipient area right after the washing - if this looks off to someone please let me know. From what I can tell, its normal.

FrontDay8.thumb.JPG.bfa7eb40f48e3839522be993b301cebb.JPGFrontDay8-2.thumb.jpg.01d37213af1c5699964ed3c93b3a3105.jpgBackday8-3.thumb.jpg.caee35dc66834b16811d8293487c425b.jpgBackday8.thumb.jpg.86cf1cc40f94faf730aa34050cb9bf55.jpgBackday8-2.thumb.JPG.618e63498c7c581dc972c7c52e9a0b14.JPG

Link to comment
Share on other sites

  • Regular Member
42 minutes ago, Curious said:

I would be concerned, based on the photos of the donor, that in the process of extracting targeted follicles, the doctor sliced through adjacent follicular units.

Why do you say that? I don't believe the Dr. used a punch size that is different than what he ordinarily uses. Keep in mind my donor area looked really bad on day 1 likely due to the excessive bleeding. Is there any evidence to suggest that Diep's punch size results in transection of adjacent units?

Link to comment
Share on other sites

  • Administrators
39 minutes ago, FUEblonde1985 said:

Why do you say that? I don't believe the Dr. used a punch size that is different than what he ordinarily uses. Keep in mind my donor area looked really bad on day 1 likely due to the excessive bleeding. Is there any evidence to suggest that Diep's punch size results in transection of adjacent units?

This is something that’s been regurgitated for quite some time. In fact, I’ve heard arguments on both sides. As patients, we don’t really know all of the surgical intricacies. One surgeon may favor a smaller punch and another a larger punch. One may favor a manual and another a motorized. Every surgery has it’s particular set of tools, just like anything. Dr. Konoir made a great analogy of what’s  better a flathead screwdriver or a phillips head screwdriver? Depends on the job. 

My first surgery was 1mm punches and second was .9mm no adjacent damage. Btw you think your crown looks ridiculous look at how mine was, btw thats .9mm with Dr. Diep as well. 

EB9AB3D7-F1C6-4980-A69E-603F11E77A78.jpeg


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

Link to comment
Share on other sites

  • Regular Member
1 hour ago, Curious said:

Compare the photos of your donor area to the FUE post-op photos of the donor area of patients of Dr. Konior or Dr. Gabel.  I think you'll notice a difference.

That doesn't answer the question though. There is no doubt that the donor areas look different. The question is - do those differences indicate transection of nearby donor follicles? From what I've gathered, a larger punch results in a larger FUE scar. But I've seen no evidence to suggest transection of nearby follicles is also a consequence. To suggest that just based on appearance alone is mere conjecture, unless you have some source that supports this claim. I'm sure any lay person would look at ANY fue donor area on day 1 and assume that the hair on that area is ruined just based on appearance alone, and we all know that's not the case. I'm not saying that it can't be true, but I'm just asking if you have any authority that says so. It's not helpful for anyone else reading this to speculate about possible complications of this Dr's work just on mere guesses. Your guess is as good as my guess that my donor looks bad on day 1 because of my excessive bleeding or skin type.

Edited by FUEblonde1985
Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...