FUE Experience w/Dr. Diep MHTA Clinic

[jimcraig152]

 

EDIT:  From discussion, seems that 90% of clinics, the surgeon does not place the grafts. Assistants do this. And it is standard operating procedure. The above sentence has been updated accordingly as is the post's title.

From what I can relate his asstants do it. I'll detail the rest of this process here with pictures and my objective thoughts (insomuch as I can be) here for any others. The jury is still out and I'll reserve the recommendation for others to go to Dr. Diep once I get to through the 12-month post op cycle. Ultimately, it is about the final result. But I'll detail everthing here so others can make informed decisions.

Let's start with the hi-level details:

• Procedure Date:  7/24/20
• Gender:  Male
• Ethnicity:  Southeast Asian
• Age:  mid-40's
• Hair-type:  Fine straight black
• Procedure type:  FUE 2250 (original estimate), 2337 (final graft count)
• Cost:  $8/per graft ($18,696 total cost)
• Finasteride - Started May 2020 (once daily @1mg)
• Minoxidil - Started May 2020 (twice daily to vertex)

At the time of this writing, I am 4 days post procedure.

The Free Consultation:

I initiated contact via the website on 11/3/19. Recieved a confirmed appointment about a week later for 12/26/19, the day after Christmas. 2-month wait period just to speak to Dr. Diep. We discussed FUT for FUE. Being Asian and that our hair tends to grow perpendicularly from our scalps, FUT isn't really an option. Other ethnicities with fine straight hair, growth tends to be perpendicular from the scalp radiating from the vertex. You are luckly in that the FUT strip scar can be hidden better by the way your hair grows from the scalp. But it was FUE all the way for me, being of Southest Asian decent. He drew the proposed hairline with a pen which I was fine with. Mentioned that he would be filling in and blending with my current hairline. I was also fine with this. He explained some payment options and financing. He asked if I was on a restoration plan already or have taken anything to combat hairloss. The answer was no, for which he seemed pleased. I had to ask for a Propecia prescription as he did not offer it. After I raised the subject of propecia, he did tell me where to get it for the best cost savings:  Walmart $7/month & Costco $6/month. He said he would have the prescription sent to a Walmart/Costco near me for pick-up. It would take a few days (maybe a week) with me following-up by email before his staff sent the prescription to Walmart near my house for pick-up (I live about 80 miles away from the MHTA clinic). Ultimately, I had trouble getting it fulfilled at Walmart. I ended up getting my Kaiser Dr. to write me a prescription. I feel Dr. Diep should have offered the prescription during the consultation, and he should have written it so that I could just take it in. He gave me a number of the grafts estimate 2200-ish. I asked, "Is that a lot?". "It's a good amount." He responded. "Will you be able to harvest that much from the supply?" "Yeah." Afterwhich, I was lead back out to the lobby and was told when my procedure date would be:  7/24/2020. The only way I could gaurantee that day was if I put down a $1000 dollar deposit which was non-refundable after 1 week. I paid for the deposit then asked if there could be a sooner opening. His office assistant told me that there would always be opportunities for an ealier procedure as folks drop out. Then was asked how much notice I would need before hand to be ready for the procedure. "A month would be best." She asked me to shorten it to a week. I told her I would need minimum 2 weeks (request time off work and procure funds). She said, "Ok. 2 weeks then". Then I was passed to the money lady who took my deposit payment, handed me my financing options, and away I went.

The consultation was brief but I did feel good about it.

Post-Consultation Follow-up (12/26/19-till-7/24/20). Early Procedure Opportunities

Little if any contact is initiated from MHTA. Emails with payment reminder notifications mostly, some spatterings that follow-up dicussions with Dr. Diep were available through Skype appointment. COVID-19 hit between my consultation and the date of the procedure. Before the pandemic really hit, I had two early procedure opportunities that I was not ready for (mostly due to financial constraints). By this time anyway, the non-refundable $1000 deposit was lost to me. Ultimately, I had to wait the almost 8-month period of my original procedure date. Full payment was due 2-weeks before the procedure, which I was able to make. Some slight issues with charging the amount to the bank requiring the payment to be split up into two transactions. MHTA took care of that (of course they would, right?)

But each time I called in to ask for information to confirm my procedure date/time or to ask a question, I was always told they needed to call me back. Which would be a up to a day later. This tells me that MHTA has a terrible organizational system. Definitely, this statement I am making is a criticism. Also, this would manifest again on the day of the procedure which I shall detail later.

Day of Procedure:  Finalizing the Business Stuff

The call time was 7:30am sharp. I walked in right on time and entered into a seemingly empty office. Some 5 minutes passed before I someone came to attend to me. Then I was asked for my name, which I found odd. The person attending to me then searched through a stack of papers before saying. "Ok, Mr. ----. I need you to fill out these papers. We will be serving lunch to you. You can order anything but no spicy food, no caffiene, and no carbonated drinks." I should have been greeted with something like, "Hi! Are you Mr. ------?" but I was not. You would think the staff would at least be prepared enough to know who was on deck for an operative procedure that day but that wasn't the case. I was put off by this.

The papers that needed to be filled were mostly about allergies to medicine. If I would like two additional recovery treaments at a $600 price each. If I would allow them to shave my head (I answered no, but should have answered yes). If they were not able to harvest through FUE, if they could take grafts from a FUT procedure (I answered no). If I the grafts that I already paid for were not sufficient, would they be allowed to extract up to 100, then 300, or leave it to Dr. Diep's to figure out; a blank check of grafts if you will (I originally answered no). Then there were the disclaimers. No lawsuits. Agree to arbitration. Mind you, I've already paid for the procedure. Don't you think this sort of stuff should have been brought up for agreement before hand?

About an hour after I arrived, I finally was able to see Dr. Diep in his office. We had to cover business stuff. I relented on some of my original answers and allowed him to harvest beyond the estimated 2250 grafts (In the end, 87 extra grafts were extracted for a total of 2337 grafts). Honestly, I understand the graft amount is an estimate. But I feel this is some corrupt auto industry-type billing. A trained doctor should be able to give an estimated range to the patient. If under, then the patient should be due some money back. If over, some transparency would go a long way to fostering confidence for the patient to at least know what they are up against. This running up billable hours/events practice is off-putting. I am pretty sure, no one has left Dr. Diep's office with a windfall.

Before I was lead out of his office, there were two final things that I found peculiar. One was this question:  "What do you do for a living?". Then the cocktail of pills I had to take that included Xanax. I stupidly answered the question. Then later realized that it could be used to run up billing/hours events. As for the Xanax, I've lived a wild life and know what Xanax is used for recreationally. I would find out later why it was given to me.

Day of Procedure:  Operations Prep

I was given a smock to change into. Then directed to the restroom where I was told to use it as I wouldn't be able to later. There was no mirror in the restroom. My personal belongings were to be kept in the cupboard in front of the operating chair. Then my blood pressure and temperature were taken. I was then told I could lay back in the chair which was uncomfortable as heck. There were pillows which would have helped, but I was not offered them until I asked for them. I was on the chair for another hour before the procedure started. As I waited, I must have asked if Dr. Diep was with another patient. He was. Then I asked how many procedures they do a day. The answer was 2. My procedure was scheduled for 12 hours. Around 10am, Dr. Diep walked in and asked me if I was ready. "Let's do it." I answered. Then I was wrapped up so my head could be shaved.

Regarding the shaving, I understand the donor site must be shaved for extraction. But the receipient site was also shaved back. This would add to the recovery time. Shaving the receipient site is to ease the procedure for the clinic, not taking into account how off-putting this would be for the patient. The entire sides of my head was shaved. The back shaved up to the vertex. The front shaved from the hairline to the vertex. As a man, I wear my hair long, shoulder length. I expected a 90's boy band shave around the sides and back. I was left with a rooster puff/Roman praetorian helmet hairdo, although it was sideways. I did not allow them on record to shave my head bald. And they didn't. But the shave job I was left with effectively rendered me with needing to shave my head all the way on my own after a few days of recovery, which I did. I can't imagine if you are a woman that this would fly. as a man, I am fine with it. But it is clearly a sign of not putting the patient first. The woman that shaved my head would play a bigger part in all of this later.

As the shaving is going on, I was given general anesthesia for what I was told "to relax me". One shot to each upper arm. Now the procedure call time was an early 7:30am. I am not a morning person, plus I slept maybe 3-4 hours the night before. I ended up being under most of the time. Then I was told the worst part of all this was going to occur:  administration of the local anesthesia which required about 20 needle shots to my forehead and around my scalp. Yeah, it did suck and was painful. But that was no where near being the worst part. The worst part was yet to come.

Day of Procedure:  Into the Procedure

I must have fell asleep sometime after the local anesthesia was administered. But I woke up at some point during parts of the extraction due to pain and discomfort. No biggie. I told Dr. Diep I was in a bit of pain. He told me to let him know if I felt pain. And I could feel him administer more local anesthesia. Then I went under again. Don't know if I was given more general anesthesia. But what needs to be called out at this point is that this was the last time I was aware that Dr. Diep was hands on with the procedure. I did not see him or hear his voice again until the very end. I didn't see him as we broke for lunch. I didn't see him as we returned from lunch. Later when I woke up during the grafting, I did not see or even hear his voice during the most important part of the procedure:  the grafting. From what I know, Dr. Diep was hands on only during administration of local anesthesia and parts of the donor extraction.

We broke for lunch. Dr. Diep's assitants handed me my food and drink. I finished it. Used the batchroom. Then was lead back to the chair which looked quite awful from the blood and fluid drip. I could feel the blood and fluid drip on my back through the smock. Now I know it wasn't a good idea to be handed another smock to change into as that would risk grafts being yanked out. But at least they could have changed the beddings on the operating chair during lunch. It looked like I was climbing into the pits of a meat processing plant.

I went under again after I climbed into the chair. Don't know if I was administered more anesthesia or not. I came to on the precipice of full consiciousness. The Xanax in full effect as the television playing in the background made me utter a silly joke. Then the worst part of the procedure came into play. The joke I uttered drew a response from two female voices. It was then that I realized, the artistry that Dr. Diep speaks of in his Youtube videos and where he gained his reputation and skill from  years of experience was not being performed by the board certified surgeon I hired to perform the transplant. The woman that shaved my head worked on my left side. Some other woman worked on my right side. I know nothing of either's qualifications and did not know before hand anyone other than Dr. Diep would be handling any part of the grafting procedure. I asked some question, specifics of which I don't remember. But the answer I received was "Dr. Diep just tells us how the grafts are to be applied and that's all we do." I went under again. Now I know why the Xanax was given to me.

EDIT:  From discussion with other forum members, assistants placing the grafts into the incisions is done at 90% of all other clinics. So I do feel better now. But that also does not change that coming to know this during the middle of the procedure was the worst part of the procedure. You can read further discussion on this subject in subsequent replies.

Finally, it was done at some time around 10pm. I finally see Dr. Diep. He mentions two things:  He was able to keep the extra graft amounts to right around 2300 (from 2250), which was good. And he mentioned that I moved around a lot. Then he walked out. His assistant gives me final instructions, meds, head wraps, fluid barriers. As I grabbed my stuff, I found the only mirror in the operating room. It was laying on the counter. A frosted brown tree branch covered parts of the mirror. I could see the some of the early results. It looked good. But I was very disappointed with the shave job. The assistant then walked me out. At this point, some of the misgivings I woke up to by finding that two people other than Dr. Diep had worked on the grafts had been temporarily forgotten. I was just happy the job was over. I drove the 80 or so miles home. I know I shouldn't have but I felt fine and made it home safely.

Post Procedure:  Day 1-4

DAY 1: Saturday

There was significant swelling on the right side of my head. But there was no pain the day after. Just some discomfort. I felt no itching either. I could now have a close look at the job that was done. In looking at the receipient site, I could clearly see the differing result of having two separate people of varing skill worked on either side. The right side clearly shows some grape-vinyard like rows that you would see across a hillside winery. Some of that was also visible on the left side, but less so. The woman that worked on the left side was the one that shaved my head. She must have been the senior-most assistant as her work was better. I have no idea which of the women worked on the right side. But the right side was clearly inferior work.

In looking at the donor site, the incisions did not look bad. But I came to an immediate conclusion in that there was no donor grafts left. This is going to be a one shot deal.

In looking at the new hairline. I do like the shape and do think it will work with my face. I have a big forehead and head overall. But I am ok with the hairline's arc. I am not so sure about the feathering and naturalness of it. It is very much a line.

I am following the hygiene guidelines to the letter.

DAY 2: Sunday

Swelling on the right side of my face/head began to subside. I am feeling fine. Some discomfort. Lots of secretions still. But less than after the first night. I can't believe I am saying this, but thank God for the pandemic. The shave job they gave me is horrible. Good thing we are locked in. I order a set of clippers from Walmart. They arrive tomorrow. I look forward to shaving off the rest of this rooster top that is left on my head.

I am still following the hygiene guidelines.

DAY 3:  Monday

Swelling on the right side of my face/head is almost completely gone. But has flowed into my right eye area. My eye is now completely black & blue, darn near swollen shut. I am feeling fine otherwise. Some tingling. No pain. A random itch here and there. I am taking the swelling and infection meds. Skipping the pain and sleeping meds that I've been given. I am still following the hygiene guidelines.

By the late afternoon, I get the follow-up call. I tell them I am fine and am only taking the swelling and infection meds. I'm told the other meds are to be taken on an as needed basis. The conversation quickly goes into the business part. There were 87 extra grafts taken at $8 per graft. An extra amount of $696 which I'd have to pay. I am fine with the extra payment and let Dr. Diep's office assistant know when I expect to make payment.

By now I remember waking up to find two people other than Dr. Diep performing the grafts. I want to speak to him to express my misgivings. I am told even a phone discussion is going to have to be scheduled and that he would be out the following week. Or I can send an email in. Nooooo. I want to speak to Dr. Diep. Email is not going to cut it. I want to ask how many grafts can be harvested if I need a follow-up procedure. I want to ask why he did not perform the grafts. I want to ask about the qualifications of the people that performed the grafts. I want to know what the follow-up schedule is going to be like. I hang up the phone.

Knowing from experience that it is always best to get things in writing, I call back and ask for a written invoice for what I owe and state I will not make further payment until I receive it. I am told it will be sent to my email. As of this writing a day later, I have yet to receive that final invoice.

DAY 4:  Tuesday

The clippers arrive. I carefully shave what is left of my once shoulder length hair. I am clean shaven for the first time in my life. But am looking forward to using the medicated shampoo to on the receipient site for the first time I drip on lather. It feels good. I gently squeeze lukewarm water from the sponge to rinse it off. In the heat of summer it air dries quickly. I feel some weight off my head. My blackend right eye is getting better. Some bruising can now be seen near my right ear. My left eye is beginning to swell up. No blackening or blueing on the left eye however. I am looking foward to getting beyond Day 7.

The sensation in the donor site goes from being mildly discomforting to a near soft heat radiating on the back of my head. It is not warmth that I feel. It is more of a reminder than there are close to 3000 holes poked in the back of my head.

=========================================

If you've gotten this far, you can put together for yourself there are some flaws with Dr. Diep's practice. I'll try to be objective as possible so that you can make your own decisions.

I'll edit this post with pics shortly. But let me ask for those that have had work done with Dr. Diep, who performed the grafts? Did Dr. Diep do them for you?

• If YES, are you happy with the results?
• If NO, are you happy with the results?

[jimcraig152]

Before Pics:

 

 

 

 

 

 

 

 

 

 

Edited July 29, 2020 by jimcraig152
Pic resizing.

[jimcraig152]

Post Pics:  Day 1

Here is the shave job. You can see there is significant swelling.

 

[jimcraig152]

Here are Day 3 Pics.

• Swelling has went down significantly, but my right eye is black & blue
• You can see the donor site
• Top of head pics show the graft sides. They are the reddish areas, obviously
• And there is my new hairline. I am liking the shap and curvature. I do feel it is a bit too much of a line however

[jimcraig152]

Day 4 Pics.

I am finally able to rinse the recipient site. Can you see the hillside-like grape vinyard-like graft rows?

• Left side was done by the woman that shaved my head (likely, the more senior assistant)
• Right side was done by some other woman
• Neither side was done by Dr. Diep!

One shot deal. Sucks to have found out that Dr. Diep doesn't/didn't do the grafts. All I can hope for now is is of the grafts take. More pics and an update at the end of week 2.

 

Edited July 29, 2020 by jimcraig152
Photo edit.

[jimcraig152]

10 hours ago, transplantedphil said:

Theres a lot to unpack here so ill just focus on some basic stuff, and hopefully others can answer any questions/give you more feedback

If I understand this correctly, are you saying Diep now gets his patients to sign a contract saying they cannot sue him, bur rather have to undergo arbitration instead? And he does this after payment has been made? If so thats dodgy AF and needs to be presented to the HT community. 

Its generally industry standard to not charge for extras so again this is dodgy. There was even a thread about it here; https://www.hairrestorationnetwork.com/topic/54982-what-happens-with-extras-at-the-end-of-the-day/ . As there is no formal regulation in the industry however it ultimately comes down to how you individually negotiate with your respective clinic.

That is/was the case. Arbitration only. I agree to no lawsuit. The verbiage was something to the extent of results cannot not be guaranteed and I am in agreement with this and cannot hold MHTA liable. Cannot sue. Can only be offered arbitration---something to that extent. Payment was made first. I did not see the final business papers to sign until the day of the procedure, 2 weeks after the payment was due. Now I know there is a pandemic and all. But some better effort should have been put into transparency.

I should have taken pictures of the final agreement with my phone and posted it here.

10 hours ago, transplantedphil said:

One question though, when you say "perform the grafts", do you mean the transplanting of the grafts into the incisions? Most clinics are like this. However if you meant someone else other than Dr Diep is doing the extractions of the grafts or making the incisions then there would be a real issue (I believe a medical doctor could even lose their license in LA if this was the case). Regardless it's disappointing none of this was made clear to you at the time of your surgical procedure.

1. I DO know that Dr. Diep performed at least parts of the extraction, if not all. I was awake for some of that time and could hear his voice behind me as I expressed I was in some pain.
2. I do NOT know for sure what his two assistants were doing as they worked on the front side of my head (which can only be the part of the grafting process). I could not see their actions from my reclined position on the chair as they were above me working beyond my line of sight. What I did feel through the anesthesia did not feel like they were making incisions. I am concluding they were performing transplanting the grafts into the incisions (as you've asked). Also, you can see from the early results their is a difference in the application due to the skill/technique from one assistant to the other.
3. I was not awake througout the entirety of the grafting process. But the times I was awake, Dr. Diep was not present in the room.

There is no mention of the qualifications of Dr. Diep's staff on his site. There was no mention of the team that would be working with him. I met them all that day. Absolutely none of them introduced themselves to me by name. Not even the receptionist introduced herself. I don't remember if any of them had name tags. I know of one other person's name from his staff as Monica from phone calls and emails. But none of them introduced themselves to me in person.

Quote

Diep isnt exactly known for his ethics tbh ... patients in the past have mentioned his lacklustre consultation skills, his shitty donor management, and Ive even seen a few botch jobs of his removed from this site as well. I also remember another patient couldnt even get back his deposit.

Not sure about his ethics. I am not sure it is an ethics issue at all; at least not at the time. I do think there is an operations management issue for sure. Customer service is lacking. And the virtual silence between the consultation and the procedure was definitely off-putting. I'll even use the word disturbing. Therefore, his consultation skills are as you say lackluster. I can attest to that.

I am far too late for the deposit.

10 hours ago, transplantedphil said:

Your post op work looks ok although it does seem Diep extracted far above the safe zone. Did you remember if he marked out your donor properly in pre-op and checked for miniaturisation?

After seeing the donor site, I do feel he went beyond the safe zone. Hopefully this turns out well. I do have a large head however if that makes a difference.

In fact, he did not mark the donor site at all during the consultation or on the date of the  procedure. Now, I did have a long shoulder length hairstyle. Perhaps from seeing that he did not feel the need to. But there was no marking of the donor site with a marker at all. As for physically checking, there was some action performed by him flipping through my long hair but it was performed in a matter of seconds. No scope or tool of any kind was used for gauging.

Thanks for the post-op comment. Makes me feel a little better.

10 hours ago, transplantedphil said:

? 

Hopefully you can at least walk away from this experience with a good result. 

Hopefully, I do. Will keep this logged for everyone to follow so they can make informed decisions.

EDIT:  I am going to focus on post-op care for the duration of the 2-week period. Please feel free to comment and ask questions. I won't be back to answer or respond until after the first 2-weeks (8/8/2020). Don't want to stress and lose the new plugs I got. Keeping things positive 😃

Nevermind the EDIT on the line above. I've striked it out. I feel better after some discussion with other forum members and it has a therapeutic effect. Plus I know discussion now will help others make informed decisions.

Edited July 29, 2020 by jimcraig152

[asterix0]

Man, this is a crazy story. I hope it works out for you, but clearly this clinic has transparency issues. 

On the one hand, as the patient, I suppose you could have asked in advance if the doctor would be performing all the implantations and extractions. But it is also ethical for the doctor to disclose ahead of time to the patient if this will be the case or not. If he did not do so, suspecting he would lose you as a customer if he did, this is simply wrong.

 

 

[Melvin- Admin]

What do you mean by “he didn’t perform the grafts” do you mean he didn’t place the grafts? If that’s what you mean then no, he doesn’t place the grafts, the technicians do- this is common practice for 90% of the clinics. 

As for the paperwork, from what I recall I signed a form that said results are not guaranteed, and a variety of issues could occur, including poor growth. I think it’s standard for surgeons to provide you this before surgery, even my other surgeon did, as no surgeon can guarantee growth. Lastly, about extra grafts, he asks before you have surgery if you want more grafts he can extract more if possible, but you pay for the difference at the end. None of what you wrote is anything out of the ordinary.

As for swelling etc. That is a normal part of the procedure, please refer to this video

 

[Melvin- Admin]

6 hours ago, jimcraig152 said:

After seeing the donor site, I do feel he went beyond the safe zone. Hopefully this turns out well. I do have a large head however if that makes a difference.

In fact, he did not mark the donor site at all during the consultation or on the date of the  procedure. Now, I did have a long shoulder length hairstyle. Perhaps from seeing that he did not feel the need to. But there was no marking of the donor site with a marker at all. As for physically checking, there was some action performed by him flipping through my long hair but it was performed in a matter of seconds. No scope or tool of any kind was used for gauging.

Thanks for the post-op comment. Makes me feel a little better.

Hopefully, I do. Will keep this logged for everyone to follow so they can make informed decisions.

EDIT:  I am going to focus on post-op care for the duration of the 2-week period. Please feel free to comment and ask questions. I won't be back to answer or respond until after the first 2-weeks (8/8/2020). Don't want to stress and lose the new plugs I got. Keeping things positive 😃

Also, marking the donor site is not something that is done during the consultation, it is done once your head is shaved.

I had similar feelings as you did, and I was actually quite upset that I was asleep for part of the procedure, but looking back, I had buyers remorse. I started to think I made a huge mistake, and 7 months later, I realized it was the best decision of my life.

Now, not saying that’s gonna be you, but if I were to bet I would say it’s likely. Reminds me of two other members that turned out happy, but were very skeptical in the beginning. @hairvanity and @FUEblonde1985 

Trust in the process, don’t over stress, and most of all happy growing. Please do keep us updated on your progress 🙂

[jimcraig152]

5 hours ago, asterix0 said:

Man, this is a crazy story. I hope it works out for you, but clearly this clinic has transparency issues. 

On the one hand, as the patient, I suppose you could have asked in advance if the doctor would be performing all the implantations and extractions. But it is also ethical for the doctor to disclose ahead of time to the patient if this will be the case or not. If he did not do so, suspecting he would lose you as a customer if he did, this is simply wrong.

You're right. It is on me/the patient to ask.

However, in the absence of the patient asking, I feel a minimal level of disclosure should be automatic. I remember when the disease of cancer was taking my mother. Every single person that walked into her room down to the orderly introduced themselves to her. Being bedside with her during this, I can assure that each "Hello Mrs. ------. I am SoAndSo/ I'll be your -----./ I'll be bringing your lunch. /I'll be giving you your bath." made a huge difference. Even as I passed some of my mother's staff people in the hallways, I recognized them and was able to say hello. Some even asked for updates about my mom.

Not a single person on Dr. Diep's staff introduced themselves to me. Introduction upon being in the presence of the patient the first time should be that "minimal level of disclosure". But nope. I had none of that. I even recall as I was waiting a for an hour in the operating room, one of his staff came in. Grabbed a microscope. Looked me dead in the eye for a good moment. Turned, then walked out without a word being said.

I already mentioned that the chair was uncomfortable. But I did not mention that for virtually the whole time I was on the chair before the procedure began, a different assistant was in the room with me the whole time. She didn't say a word till I asked for a pillow. As she handed that to me, finally someone was smart enough to ask if I was comfortable in the chair and made adjustments. As she was doing this, she still didn't introduce herself to me :).

3 hours ago, Melvin-Moderator said:

What do you mean by “he didn’t perform the grafts” do you mean he didn’t place the grafts? If that’s what you mean then no, he doesn’t place the grafts, the technicians do- this is common practice for 90% of the clinics. 

Alright, so then I feel better about this and will update the posts accordingly. Do not want to spread disinformation. But yes, placing the grafts was not done by Dr. Diep as far as I can tell. It was done by his assistants for most of what I could tell.

But knowing this before hand would have been nice. Knowing at "the minimal level" that I described above ("Hi! I am SoAndSo.) would have eased things. Instead, I was given Xanax to take care of any concerns. Is Xanax a part of that normal 90% regiment that you are refering to?

Quote

As for the paperwork, from what I recall I signed a form that said results are not guaranteed, and a variety of issues could occur, including poor growth. I think it’s standard for surgeons to provide you this before surgery, even my other surgeon did, as no surgeon can guarantee growth. Lastly, about extra grafts, he asks before you have surgery if you want more grafts he can extract more if possible, but you pay for the difference at the end. None of what you wrote is anything out of the ordinary.

Right. That is some of the same paperwork I signed; "results not guaranteed". I also mentioned I was fine with paying for the extra grafts. The out of ordinary part was that I paid for the procedure in FULL already. So would you say, if not out of the ordinary, out of proper order of sequence? Or is full disclosure first, followed by payment not ordinary?

Another thing that I can add here is that Dr. Diep mentioned once I take the cocktail of pills. He cannot change anything. So basically these decisions were presented as "Blue Pill/Red Pill" decisions. Many of these decisions really require some time, thought, dialog, and research before coming to a conclusion. Yet these go/no go decisions were presented moments before I was walked into the operating room. This can't be ordinary, or if it was, I am sure you can agree, is not good practice, yeah?

Quote

As for swelling etc. That is a normal part of the procedure, please refer to this video

I have no problem with the swelling. I expected that. And I feel fine now. I felt fine when I had the significant swelling. Not everyone reading this is going to have the same knowledge you or even I have.

Again, I stated I am going to try to detail everything and be as objective as possible for others to make informed decisions.

3 hours ago, Melvin-Moderator said:

Also, marking the donor site is not something that is done during the consultation, it is done once your head is shaved.

Now I was specific on the day of the procedure that I did not want FUT before I took the pill cocktail. At some point before I take the pill cocktail, there is the ethical dilema that comes into play here.

Because if we 1) agree on the hairline drawing. 2) agree not to do FUT. But 3) the donor site is not sufficient, then the doctor should wave off that he cannot agree to ethically complete the proceedure through  FUE without going beyond the safe zone. He then A) re-emphasizes the alternative FUT. B) reaches a new agreement with the patient on the hairline design given the low donor availability through FUE. Going beyond the FUE safe zone in this industry is a black & white/plain as day violation of ethics, no matter if the patient insisted or not, correct? Because the other side of the argument is quite clear:  the doctor stands to make more money if done as FUE but it requires violating ethics. And with more money on the line for the doctor to lose, the doctor's willingness to voilates ethics should be made known.

Now, I could be wrong here, but I feel ideally FUE donor supply assessment should be done during consultation. But it should definitely be done right as my head is shaved. Like I don't need to take a cocktail of pills for my head to be shaved, correct? From the photos I've posted, in your opinion, did he go beyond the safe zone and therefore violated ethics?

Quote

I had similar feelings as you did, and I was actually quite upset that I was asleep for part of the procedure, but looking back, I had buyers remorse. I started to think I made a huge mistake, and 7 months later, I realized it was the best decision of my life.

Now, not saying that’s gonna be you, but if I were to bet I would say it’s likely. Reminds me of two other members that turned out happy, but were very skeptical in the beginning. @hairvanity and @FUEblonde1985 

Trust in the process, don’t over stress, and most of all happy growing. Please do keep us updated on your progress 🙂

Right. I am trusting the process. I am just shocked that the process at MHTA was/is so opaque. Again, I am reserving a recommendation until this entire 12-month post-op has passed. It may just turn out better than I expected. Right now, I am liking what I SEE in the mirror (not so much about the donor site however); NOT liking what I SAW in hindsight.

And yes, that is the point. Keeping progress updated so that others can make informed decisions. I'll go edit the OP now about graft placement.

Edited July 29, 2020 by jimcraig152
grammar

[Melvin- Admin]

43 minutes ago, jimcraig152 said:

You're right. It is on me/the patient to ask.

However, in the absence of the patient asking, I feel a minimal level of disclosure should be automatic. I remember when the disease of cancer was taking my mother. Every single person that walked into her room down to the orderly introduced themselves to her. Being bedside with her during this, I can assure that each "Hello Mrs. ------. I am SoAndSo/ I'll be your -----./ I'll be bringing your lunch. /I'll be giving you your bath." made a huge difference. Even as I passed some of my mother's staff people in the hallways, I recognized them and was able to say hello. Some even asked for updates about my mom.

Not a single person on Dr. Diep's staff introduced themselves to me. Introduction upon being in the presence of the patient the first time should be that "minimal level of disclosure". But nope. I had none of that. I even recall as I was waiting a for an hour in the operating room, one of his staff came in. Grabbed a microscope. Looked me dead in the eye for a good moment. Turned, then walked out without a word being said.

I already mentioned that the chair was uncomfortable. But I did not mention that for virtually the whole time I was on the chair before the procedure began, a different assistant was in the room with me the whole time. She didn't say a word till I asked for a pillow. As she handed that to me, finally someone was smart enough to ask if I was comfortable in the chair and made adjustments. As she was doing this, she still didn't introduce herself to me :).

Alright, so then I feel better about this and will update the posts accordingly. Do not want to spread disinformation. But yes, placing the grafts was not done by Dr. Diep as far as I can tell. It was done by his assistants for most of what I could tell.

But knowing this before hand would have been nice. Knowing at "the minimal level" that I described above ("Hi! I am SoAndSo.) would have eased things. Instead, I was given Xanax to take care of any concerns. Is Xanax a part of that normal 90% regiment that you are refering to?

Right. That is some of the same paperwork I signed; "results not guaranteed". I also mentioned I was fine with paying for the extra grafts. The out of ordinary part was that I paid for the procedure in FULL already. So would you say, if not out of the ordinary, out of proper order of sequence? Or is full disclosure first, followed by payment not ordinary?

Another thing that I can add here is that Dr. Diep mentioned once I take the cocktail of pills. He cannot change anything. So basically these decisions were presented as "Blue Pill/Red Pill" decisions. Many of these decisions really require some time, thought, dialog, and research before coming to a conclusion. Yet these go/no go decisions were presented moments before I was walked into the operating room. This can't be ordinary, or if it was, I am sure you can agree, is not good practice, yeah?

I have no problem with the swelling. I expected that. And I feel fine now. I felt fine when I had the significant swelling. Not everyone reading this is going to have the same knowledge you or even I have.

Again, I stated I am going to try to detail everything and be as objective as possible for others to make informed decisions.

Now I was specific on the day of the procedure that I did not want FUT before I took the pill cocktail. At some point before I take the pill cocktail, there is the ethical dilema that comes into play here.

Because if we 1) agree on the hairline drawing. 2) agree not to do FUT. But 3) the donor site is not sufficient, then the doctor should wave off that he cannot agree to ethically complete the proceedure through  FUE without going beyond the safe zone. He then A) re-emphasizes the alternative FUT. B) reaches a new agreement with the patient on the hairline design given the low donor availability through FUE. Going beyond the FUE safe zone in this industry is a black & white/plain as day violation of ethics, no matter if the patient insisted or not, correct? Because the other side of the argument is quite clear:  the doctor stands to make more money if done as FUE but it requires violating ethics. And with more money on the line for the doctor to lose, the doctor's willingness to voilates ethics should be made known.

Now, I could be wrong here, but I feel ideally FUE donor supply assessment should be done during consultation. But it should definitely be done right as my head is shaved. Like I don't need to take a cocktail of pills for my head to be shaved, correct? From the photos I've posted, in your opinion, did he go beyond the safe zone and therefore violated ethics?

Right. I am trusting the process. I am just shocked that the process at MHTA was/is so opaque. Again, I am reserving a recommendation until this entire 12-month post-op has passed. It may just turn out better than I expected. Right now, I am liking what I SEE in the mirror (not so much about the donor site however); NOT liking what I SAW in hindsight.

And yes, that is the point. Keeping progress updated so that others can make informed decisions. I'll go edit the OP now about graft placement.

I will be correcting the title, because not placing the grafts is irrelevant. Only two surgeons I know actually place grafts. It is widely known that this is done by technicians.

I cant say I agree with the other issues you’ve raised. I’m not entirely sure if you thoroughly researched the process beforehand. I know I was given paperwork prior to the surgery on what would happen. It’s common for doctors to give valium and other anti-anxiety pills prior to surgery. My other surgeon did the same thing. I was given an injection of xanax to calm my nerves. 

I understand your experience may have not been enjoyable, but some of these points are splitting hairs, no pun intended. Furthermore, your comments on a safe zone aren’t necessarily accurate. The safe zone varies from person to person. There is no “universal safe zone” because that would imply that every person will be a Norwood 7, which is not true, and actually rare. 

My safe zone is different than your safe zone, you may have higher sides, no crown thinning. Therefore, the available grafts for you will be different than my available grafts. It’s fairly common for FUE to go beyond the classic FUT area- this is the only way FUE can even reach a high number of grafts. I find that my healthiest most robust hair is actually right below the lateral humps, which is outside of the so-called “safe zone.” 

Now, if the argument is whether those grafts will survive forever? No one knows, that’s part of the argument to go FUT over FUE, but I personally feel that the majority of patients are fine, as long as they do not have Norwood 7 baldness in their family.

Overall, I appreciate you being skeptical as it does help others who may feel the same way after surgery, but some of the points are a little bit of overthinking in my opinion. I look forward to seeing your updates 🙂

[jimcraig152]

14 minutes ago, Melvin-Moderator said:

Overall, I appreciate you being skeptical as it does help others who may feel the same way after surgery, but some of the points are a little bit of overthinking in my opinion. I look forward to seeing your updates 🙂

Fair enough. I stated in the OP that it is all about results and will reserve the final recommendation for once when this entire 12-month post-op process is done. At this stage, it might be overthinking, but conveying my thoughts also does help others with their decisions and formulating their game plans. Also, fair yeah?

18 minutes ago, Melvin-Moderator said:

I cant say I agree with the other issues you’ve raised. I’m not entirely sure if you thoroughly researched the process beforehand. I know I was given paperwork prior to the surgery on what would happen. It’s common for doctors to give valium and other anti-anxiety pills prior to surgery. My other surgeon did the same thing. I was given an injection of xanax to calm my nerves. 

Thorough researching is a relative thing. I can assure you that I did as much researching as I felt comfortable with to make the decision and pay for the large expense. I think of myself as a very thorough person. Maybe you can also tell this by my writing. Still though, it might not have been enough. Again, the term thorough is a relative word. The other part of this is that the patient puts their faith into the doctor. The doctor is a doctor afterall. For instance, let's say rather than a cosmetic hair transplant procedure, the procedure at hand is more life threatening or is an actual life or death non-emergency procedure. Disregarding the procedural terms for now, can we agree that any contractual terms are best disclosed on any other day and/or time than the 10-15 minutes I was given before being walked into the operating room? I don't know who worked on you. But I certainly was not given these final terms at any time between the consultation and the date of procedure from Dr. Diep; I can assure you of that.

As for anti-anxiety pills, I actually made this comment to Dr. Diep upon learning the pill cocktail had Xanax in it: "Xanax?! You didn't tell me we were going to have fun during all of this." Knowing the effects of Xanax, having taken it recreationally a few times during life. So you can tell, I had no discomfort about taking Xanax. The discomfort was waking up to two people not Dr. Diep working on my procedure was my biggest concern. Wouldn't a explanation of procedural terms, an introduction from his staff, identifying who does what would have worked better than Xanax alone?

Now going back to the procedural terms that I've described. I'll accept that you are hinting that I did not educate myself enough. I'll admit to it if you want (although, I feel otherwise). I may have put too trust faith in the process (which ironically enough is what you are telling me to do now). Let's allow others to absorb my experience so that they can make their informed decisions and formulate their gameplans, yeah?

59 minutes ago, Melvin-Moderator said:

Furthermore, your comments on a safe zone aren’t necessarily accurate. The safe zone varies from person to person. There is no “universal safe zone” because that would imply that every person will be a Norwood 7, which is not true, and actually rare. 

My safe zone is different than your safe zone, you may have higher sides, no crown thinning. Therefore, the available grafts for you will be different than my available grafts. It’s fairly common for FUE to go beyond the classic FUT area- this is the only way FUE can even reach a high number of grafts. I find that my healthiest most robust hair is actually right below the lateral humps, which is outside of the so-called “safe zone.” 

Now, if the argument is whether those grafts will survive forever? No one knows, that’s part of the argument to go FUT over FUE, but I personally feel that the majority of patients are fine, as long as they do not have Norwood 7 baldness in their family.

I agree with you that there is no universal safe zone. And given my donor site and my genetics, who knows yet how this will turn out. But I did describe to you how Dr. Diep assessed donor supply on me. Can you give your opinion and compare it to your donor assessment as a reference for others?

Lastly, I want to comment about your buyer's remorse remark. I don't have any....yet. What I bought won't be delivered until another 12-months out. I stated from the beginning, I am liking the early results and expressing critical remarks as I need to in detailing my experience. I think you can surmise from what I've detailed that there is room for improvement in Dr. Diep's practice. Yeah, no one likes a critic. But if Dr. Diep, or any of his staff, or anyone considering having work done with him is reading this, let it be known that it is not the criticism that matters. It is what is done with the criticism that does.

[Melvin- Admin]

11 minutes ago, jimcraig152 said:

I agree with you that there is no universal safe zone. And given my donor site and my genetics, who knows yet how this will turn out. But I did describe to you how Dr. Diep assessed donor supply on me. Can you give your opinion and compare it to your donor assessment as a reference for others?

In my first surgery, the surgeon only looked at my baldness, and didn't even look at my donor. That said, the surgery ended up being mediocre, which led me to come here and research. I visited at least 7 to 8 top-notch physicians in person, and only three examined my donor with high magnification. I believe that surgeons can eyeball pretty accurately how many grafts they can take, and whether the donor is poor. I mean after looking at so many donor pictures, I'm pretty good at spotting a poor donor by just seeing it in pictures. Not to mention, medical tourism basically survives from surgeons just looking at the donor without inspection, and they basically rely on seeing pictures. 

[aaron1234]

2 hours ago, Melvin-Moderator said:

My safe zone is different than your safe zone, you may have higher sides, no crown thinning. Therefore, the available grafts for you will be different than my available grafts. It’s fairly common for FUE to go beyond the classic FUT area- this is the only way FUE can even reach a high number of grafts. I find that my healthiest most robust hair is actually right below the lateral humps, which is outside of the so-called “safe zone.” 

Truth!  My healthiest hairs are also above the "safe zone".  Sometimes people here use the words "safe zone" when in reality they are referring to the "strip zone".  I don't see a problem with the donor extractions here, though the recipient rows are a bit too straight-lined for my taste.  If you have great yield then that issue will hopefully will be a non-issue.  

[asterix0]

@jimcraig152 how many surgeons did you consider before selecting your doctor? Did you have additional consultations, virtual or in person?

I think you will likely have a good result as your donor seems good, so just let the process play out and not stress too much. 

I will say though, that I wish these parts of the process became more of an industry standard (if this industry had better regulation, or any regulations at all):

1. The doctor should be able to provide the patient with a spectrum of lifetime donor supply and donor quality estimates, using microscopes or other tools to do this assessment. How conservative or liberal he/she is with this estimate should also be disclosed to the patient.

2. The doctor should always disclose who is performing the extractions, incisions, and placements, and their background and experience level.

3. The doctor should also, should the patient so desire, be able to provide yield percentages and graft survival percentages of their surgery. If a shaving of the head, or trimming down hair lengths post transplant is part of the process, then the patient should have the right to request this to get a more precise picture of how successful the transplant was. 

I may make a separate thread with these points to see what other forum members think of this, I don't mean to hijack your thread 🙂.

 

[Montreal]

if 90% of the surgeons don't place the grafts how can they get credit for a good job ? 

[jimcraig152]

2 hours ago, aaron1234 said:

Truth!  My healthiest hairs are also above the "safe zone".  Sometimes people here use the words "safe zone" when in reality they are referring to the "strip zone".  I don't see a problem with the donor extractions here, though the recipient rows are a bit too straight-lined for my taste.

Well, I don't know about your safe zone. But agreed with the rest. I am also glad that someone else agrees that the rows are too straightline as well. And thanks for the vote of confidence with the extractions. I'll post side angles of the donor site because in looking it from that angle, it might tell a different story. It does for me. Will ask you again how you feel about the donor extractions when I do.

2 hours ago, aaron1234 said:

If you have great yield then that issue will hopefully will be a non-issue.  

Yup. Regardless of the experience, HT is about results. So in 7-12 months, if I can update my OP on this thread with stellar resulting pictures, then those pictures will hold much more weight than any of this dialogue.

1 hour ago, asterix0 said:

@jimcraig152 how many surgeons did you consider before selecting your doctor?

Two other surgeons (one in LA and one in San Diego), both of whom were recommended to me from actual patients (a few co-workers and a college friend) that had procedures done with them. Travel would have not been an issue had I selected these doctors because those patients offered to allow me to stay with them. Also, I can work remotely. I decided on Dr. Diep when I found a childhood friend was a patient of his. That childhood friend, Dr. Diep, and I are all from the same ethnic descent. The results I saw from the other patients vs. Dr. Diep's, my friend having been a patient of Dr. Diep's, and our same ethnicity is what made the choice for me.

1 hour ago, asterix0 said:

Did you have additional consultations, virtual or in person?

Specifically with Dr. Diep, no.

So I just found this out minutes ago. Dr. Diep uses onpatient.com to manage additional consultations. All of these invites from onpatient.com sent from him were filtered as junk mail. Lovely! I searched for all things related to "MHTA" and confirmed I responded to them all. Then searched for all things related to "Diep" and only then found the onpatient.com invites sitting in my junk box which were sent on 2/22, 3/5, and 3/15 only. Here is what the invite offered:

"Good day and hope you are doing well! I am inviting you to connect with me through my patient portal onpatient. onpatient is a platform that allows you to view your medical records, schedule appointments, fill out forms before coming into the office, and securely communicate with your doctors."

Ok, so that might be an issue on my side and I might be as much to blame here. Whatever forms I was to fill out never got filled out till the day of the procedure. Of course, no flags were raised on the MHTA side. Now I understand we are in a pandemic and MHTA might have been shutdown at some point and I could have been unfairly victimized due to circumstances. But the Bay Area economy has been open for a while now. Plus, follow-up for upcoming patients file completeness does not require in-office presence (I wouldn't think).

Otherwise, all follow-up with MHTA was mostly through email. Few phone calls. And a packet sent to me.

1 hour ago, asterix0 said:

I think you will likely have a good result as your donor seems good, so just let the process play out and not stress too much. 

I will say though, that I wish these parts of the process became more of an industry standard (if this industry had better regulation, or any regulations at all):

I am. I am looking at the Day 5 results now and am really liking what I see. If I get a good yield, I am going to be looking good! If I sound stressed, it is probably my writing style.

But still, there is room for improvement at MHTA.

1 hour ago, asterix0 said:

1. The doctor should be able to provide the patient with a spectrum of lifetime donor supply and donor quality estimates, using microscopes or other tools to do this assessment. How conservative or liberal he/she is with this estimate should also be disclosed to the patient.

2. The doctor should always disclose who is performing the extractions, incisions, and placements, and their background and experience level.

3. The doctor should also, should the patient so desire, be able to provide yield percentages and graft survival percentages of their surgery. If a shaving of the head, or trimming down hair lengths post transplant is part of the process, then the patient should have the right to request this to get a more precise picture of how successful the transplant was. 

I may make a separate thread with these points to see what other forum members think of this, I don't mean to hijack your thread 🙂.

I especially like #2. The latter half of #3 is probably especially important for women as hair shaving is a particularly impactful to them. It will be really hard to enforce #1.

But yeah, sounds like a good idea; do it. Real change comes from building the new. Perhaps there is a budding HT surgeon out there reading what you will discuss and applies it to his practice.

And it was a pleasant hijack :).

[RecessionProof]

Sorry to hear about your experience, if it makes you feel better I've seen lots of Diep post-op pics similar to yours that have gone on to look really good. Stay strong and happy growing!

[naakmuka]

19 hours ago, Montreal said:

if 90% of the surgeons don't place the grafts how can they get credit for a good job ? 

The Dr. I am consulting with was very up front about it when I asked. He told me he will be doing the harvesting and he will be creating the incisions in the recipient area. His technicians will be doing the actually implanting into the incisions.

[jimcraig152]

3 hours ago, RecessionProof said:

Sorry to hear about your experience, if it makes you feel better I've seen lots of Diep post-op pics similar to yours that have gone on to look really good. Stay strong and happy growing!

It does make me feel much better. In speaking with you all about my experience, I do feel much better. I knew in my gut I made the right decision when I went with Dr. Diep and look forward to sharing the results with you all.

[Britanium]

You definitely chose a excellent Dr. I have no doubts you will have a stellar result. 

[jimcraig152]

Day 7:  Friday

These photos where taken about 30 minutes after the wash.

I think I am going to go another day or two with the sponge wash on the donor site and drip lather on the receipient site before I do the shower thing. There is no water softener at my house and I ordered one of those water softener shower attachments that will be here tomorrow. Just want to be extra careful during this stage. Bad idea or no?

Yesterday, I took the pain meds for the first time because the donor site was just a little beyond discomforting, no pain though. The donor site ointment ran out yesterday and I wasn't able to get full coverage during the last application. Actually, using just one package during previous days, I was barely able to get full coverage. On day 1, I used two packages. Probably why I was feeling a little beyond discomfort yesterday. Barrier sheets ran out days ago. Same for head coverings which I only wore when I had to step out from time to time. I've been using my last barrier sheet for 2 days now. Same for head covering.

With such a large donor site, MHTA should have given me extra donor ointment. Like 2x per day instead of just 1. At least 7 barrier sheets would have been nice. As for head coverings, I think I was give 4 or 5. I think 7-10 would bee the right number of head coverings (unless it is perfectly ok to re-use them).

Now for the pics:

BACK

Right side.

Left side.

Now the front:

Top 1

Top 2

And the ever so important hairline

View 1

View 2

I am digging the look of the new hairline. Seems a bit like a line too much right now. Who knows how it will turn out thou.........Ahhh, ahhh, ahhh..... See what I did there? I just caught myself. Gotta focus on the positive and that is I am happy right now. That is the important thing. Got this whole Asian Wentworth Miller/Prison Break-action going on with the clean shaven head.

I'll let you guys be the critics now.

[Melvin- Admin]

The donor ointment isn’t anything special, it’s basically neosporin. I don’t  think it’s necessary at this point. Looks like you’re healing well. Very reminiscent of @bondi and @shookwon33

[Montreal]

I would try coconut oil for healing the donor area it has good properties.., what do you think ?

[jimcraig152]

51 minutes ago, Melvin-Moderator said:

The donor ointment isn’t anything special, it’s basically neosporin. I don’t  think it’s necessary at this point. Looks like you’re healing well. Very reminiscent of @bondi and @shookwon33

It does help soothe the discomfort though.