FUT with Dr Diep 4000 grafts - not satisfied

[HT1404]

Ok I have recently became aware of this forum and wanted to share my experience that would hopefully inform others going forward.

I had an FUT surgery with Dr. Diep in Sep 2018 with a ~4000 graft count.

Initial consultations:

Dr. Diep was very helpful and was answering all questions I had during my consultations. I was reluctant between doing an FUT vs FUE, but given the extent of hair loss I had endured, Dr. Diep recommended that I go with an FUT, and I decided to go with it too. Dr Diep recommended doing all these scalp stretching exercises prior to my surgery which would be about 3 months after the consultation. However, since I was doing a bit of research before hand, something took me aback. In the consultations, I felt there wasn't enough care or examination done to my specific case. I was given the freedom of choosing how many grafts I wanted which seemed a bit odd to me. How would I know how much grafts can be extracted using an FUT If I don't know the density and elasticity of my scalp. I don't want to have a big piece taken if that meant the elasticity of my skin didn't allow for it and that I would have a stretching scar later on. You would think there is some procedure to figure that out. But anyhow, he is the expert, so I went with a 4000 for my case (5000 grafts was also offered).

Here is a before pic:

Surgery day:

Ofcourse don't remember much of it, but it went fine and by the end of, there were an extra ~300 grafts extracted so an added $$$$ (which in fairness was agreed to before surgery anyway). Took a couple of pics right after when I arrived home:

 

 4 days post surgery:

Eventhough I was following all instructions, there was a lot of scabbing and blood coagulation forming over the frontal part mainly. Hey I guess I have a super bleedy head.

 

Week and half post

Scabs had fallen off but at that point I think there was some type of infection that maybe if attended to before wouldn't have affected the hair follicles later on.

 

2 and half weeks post surgery

This is when I was given an appointment to go back to see the Dr and remove the sutures. When he saw me, he immediately prescribed me topical anti bacterial medication but I think at that point it might have been a bit late (looking at results now). After that the nurse helped me remove the sutures which seemed like it was a bit early in my case as the wound from the FUT seemed like it hadn't healed fully. Reason being is that there was also lots of scabbing over the wound (which delayed its healing I think).

1 year post surgery

Hair had grown in and looking better in general for sure, but I dont think the survival rate was high for the follicles given what I described earlier. Also, the scarring is massive and I really have to wear my hair in the back a bit longer to cover.

But under the sun is worse:

And here is the scar:

 

Conclusion

Overall I am not satisfied with the results for both the donor and recipient areas. I don't think my case was handled with care and some mistakes were made along the way. I am now looking to revise the scar in the back and for recommendations on other surgeons around the west coast area that have a demonstrated record. My thoughts are:

• The followup was 2.5 weeks after surgery during which I had developed lots of scabbing that hindered the growth of the hair in the recipient area and the healing of the scar in the donor area. I was not instructed really in detail as to how to handle this situation since at that point I didnt know much and I thought this was normal. 
• Removal of sutures might have been a bit early too as the wound was still almost fresh!
• The FUT strip might have been too wide for my specific case (not sure), but I felt like there was not enough care taken about figuring out my specifics (density of hair, elasticity, etc ...)
• The survival rate for those hair follicles implanted in the front was low and as seen in the pic under the sun they are very sparse. I would have thought with 4000+ grafts, at least the frontal part would look thick but that pic under the sun tells the whole story. I think maybe if I was instructed to take the topical earlier, maybe that would have helped?

Anyhow, this is my experience. Maybe I am one of the unlucky ones that even if everything was done properly and correctly, my scalp and biology just didn't work in my favor. 

[Gasthoerer]

Do you have some more pics e. g. pics from the clinic (before, after, intra)?

You results doesn't look like a homerun, but you are a NW6 from this pics and your hair calibre looks mediocre too. I am also not sure if your hairstyle is ideal. 

[Fue3361]

I wouldn’t be very satisfied either.  

[Z--]

Do you have better quality photos showing your hair from a slightly further distance (like photo 4)?

In any case, sorry this happened -- I would expect much more density in the front with 4,000 grafts used. Safe to say I'd look into possible repair work or a transplant by H&W/Eugenix given the high Norwood and remaining grafts.

[follically challenged]

So sorry to see this, man. I'm sure there must be some expert surgeons out there that can assist with this..?

Perhaps you can reach out to H&W? I hear they are ethical and have good after-care, but be prepared to pay as they are a tad expensive too.

[Fue3361]

I agree that both H&W and Eugenix are good options 

[aaron1234]

The results and the scar are unfortunate.  Have you been in touch with the clinic?  As the others have said we need higher quality pre-op photos to accurately assess your case.  Are you on finasteride or minoxidil? 

[BDK081522]

Sorry to read about your situation @HT1404. While I agree that higher quality pictures may help to decipher what went wrong here, I think that we can all see the result is not where it should have been given the amount of grafts extracted. Your result in the hairline and mid-scalp should have been better for what you paid. You mentioned that you may have had an infection, however, from your 1.5 week photo it doesn't seem like there is any active infection going on. The recipient area looks very normal for 1.5 weeks post-op. Maybe there was something that isn't coming through in the pictures which led to the topical antibiotic that he prescribed but it is hard to tell. Dr. Diep does tend to get more scabbing then other elite surgeons for a couple of reasons. I believe he uses larger incisions and meatier grafts with less intraoperative cleaning (spraying). This tends to lead to more scabbing but generally speaking this shouldn't be an issue with yield. Your case certainly demonstrates a lack of density compared to what was implanted (yield issue) and a very large FUT scar in the donor area. I think that it is pretty standard to remove FUT sutures around the 2 week mark so I don't think anything with this timeline and your healing incision seems off. Scarring is a very individual entity and it is hard to predict how they will heal. However, there may have been too much tension on the closure or just not enough scalp laxity to take such a big strip. Both of which should have been noticed by Dr. Diep beforehand. There are many great repair surgeons available to help get you the result you deserve. I think your course of action should be an FUT scar revision (if you have enough laxity) combined with an FUE for the most pleasing result. Consult with Dr. Gabel, Hasson & Wong, and Dr. Konior and they will get you where you want to be. 

Edited December 30, 2021 by BDK081522

[FUT4000]

10 hours ago, HT1404 said:

Ok I have recently became aware of this forum and wanted to share my experience that would hopefully inform others going forward.

I had an FUT surgery with Dr. Diep in Sep 2018 with a ~4000 graft count.

Initial consultations:

Dr. Diep was very helpful and was answering all questions I had during my consultations. I was reluctant between doing an FUT vs FUE, but given the extent of hair loss I had endured, Dr. Diep recommended that I go with an FUT, and I decided to go with it too. Dr Diep recommended doing all these scalp stretching exercises prior to my surgery which would be about 3 months after the consultation. However, since I was doing a bit of research before hand, something took me aback. In the consultations, I felt there wasn't enough care or examination done to my specific case. I was given the freedom of choosing how many grafts I wanted which seemed a bit odd to me. How would I know how much grafts can be extracted using an FUT If I don't know the density and elasticity of my scalp. I don't want to have a big piece taken if that meant the elasticity of my skin didn't allow for it and that I would have a stretching scar later on. You would think there is some procedure to figure that out. But anyhow, he is the expert, so I went with a 4000 for my case (5000 grafts was also offered).

Here is a before pic:

Surgery day:

Ofcourse don't remember much of it, but it went fine and by the end of, there were an extra ~300 grafts extracted so an added $$$$ (which in fairness was agreed to before surgery anyway). Took a couple of pics right after when I arrived home:

 

 4 days post surgery:

Eventhough I was following all instructions, there was a lot of scabbing and blood coagulation forming over the frontal part mainly. Hey I guess I have a super bleedy head.

 

Week and half post

Scabs had fallen off but at that point I think there was some type of infection that maybe if attended to before wouldn't have affected the hair follicles later on.

 

2 and half weeks post surgery

This is when I was given an appointment to go back to see the Dr and remove the sutures. When he saw me, he immediately prescribed me topical anti bacterial medication but I think at that point it might have been a bit late (looking at results now). After that the nurse helped me remove the sutures which seemed like it was a bit early in my case as the wound from the FUT seemed like it hadn't healed fully. Reason being is that there was also lots of scabbing over the wound (which delayed its healing I think).

1 year post surgery

Hair had grown in and looking better in general for sure, but I dont think the survival rate was high for the follicles given what I described earlier. Also, the scarring is massive and I really have to wear my hair in the back a bit longer to cover.

But under the sun is worse:

And here is the scar:

 

Conclusion

Overall I am not satisfied with the results for both the donor and recipient areas. I don't think my case was handled with care and some mistakes were made along the way. I am now looking to revise the scar in the back and for recommendations on other surgeons around the west coast area that have a demonstrated record. My thoughts are:

• The followup was 2.5 weeks after surgery during which I had developed lots of scabbing that hindered the growth of the hair in the recipient area and the healing of the scar in the donor area. I was not instructed really in detail as to how to handle this situation since at that point I didnt know much and I thought this was normal. 
• Removal of sutures might have been a bit early too as the wound was still almost fresh!
• The FUT strip might have been too wide for my specific case (not sure), but I felt like there was not enough care taken about figuring out my specifics (density of hair, elasticity, etc ...)
• The survival rate for those hair follicles implanted in the front was low and as seen in the pic under the sun they are very sparse. I would have thought with 4000+ grafts, at least the frontal part would look thick but that pic under the sun tells the whole story. I think maybe if I was instructed to take the topical earlier, maybe that would have helped?

Anyhow, this is my experience. Maybe I am one of the unlucky ones that even if everything was done properly and correctly, my scalp and biology just didn't work in my favor. 

Have you tried contacting Dr. Diep's office for a repair? How else was your post op care? Do you have significant medical issues? Have you seen a dermatologist for any skin conditions?

[HappyMan2021]

it's always rough seeing a negative hair transplant on here - and its particularly tragic when the patient had done their research and even spending the big bucks on a top surgeon results in a negative result. Just goes to show there is always a degree of luck involved in the success of a hair transplant. 

having a bad result due to a physiological factor is the exception, not the norm, so please assume that is not the case unless proven otherwise. Plus, one of the reasons you paid big money for a top-tier surgeon  is because the elite surgeon should be experienced, equipped, and give enough personalized attention to the patient to identify and workaround and/or adapt to any issues that come up. 

I think 3 years may be too much time to ask Dr. Diep for a repair or refund. 

But please keep in mind for next time, if you are paying thousands or tens of thousands of dollars for a service you are well within your right to ruffle some feathers and ask questions, demand a repair, etc. if you have a poor outcome. 

 

Edited December 29, 2021 by SadMan2021

[HT1404]

Thanks everyone for the reply and for the recommendations. Ill try to get more photos up soon.

To answer some of the questions above:

• I was in touch with the clinic, and Dr. Diep offered me a scar revision in which he would also take out some more hair to implant at the front. He said he would charge me for the hair but not the scar revision which seems ridiculous because in any case he has to get the strip out for the hair. So it is like getting another hair transplant again and having to pay for the mess that was caused.
• I dont have any medical or skin issues. I had actually went to the dermatologist recently for my yearly check.
• For the topical, I know the pics don't show, but I recall Dr. Diep saying how there was some infection at the hair implant site that would damage the hair follicles and that is when he prescribed me the topical. Same thing goes for the scar, I recall Dr. Diep was taken aback when he saw my scar but I felt like he tried not to show any reaction as to not alarm me and then said he would do a scar revision.
• I agree that I had paid top $$$ for top service and I got none of that I believe. 

I just dont trust going again for a scar revision at Dr. Diep's office after going through this. How can I guarantee that I won't get a similar result!!.

Anyhow ill post more photos in a bit.

[HT1404]

Ok so as promised I am uploading a bunch of pictures. The pic qualities of the days right after surgery are not that great but still good enough.

Pre surgery (1 day before):

4 days after surgery:

1.5 weeks after surgery:

It is at this point you start seeing the infection I think, little lumps in the forehead. More evident I think at the 1 month mark (shown later)

1 month after surgery:

2 months after surgery:

Today:

Notice the spacing and how there is not density to the hair at the front. It is almost like I never had a transplant, mind you 4000 grafts!!

[BDK081522]

It seems that all of your post-op pictures look relatively normal to me. There is one or two that show what could be a bit of an infection but it's only on a couple of areas and should not have affected the whole recepient zone. While we'll never know the answer for why your transplant failed I think it's safe to rule out infection as the sole cause. I would not recommend going back to Dr Diep for a scar revision or repair. If he left you with a scar like that and such a disappointing result the first time what's to say it wouldn't happen again. Sometimes it's just unexplainable why low yield occurs and it does happen to almost every surgeon. However, the issue with Dr Diep that is solely on him is his implant angles, hair direction, and rows. In your photos, where he closed off the temple angle above the temple point, the hair direction is completely wrong. He angles the hair straight backwards. All the surrounding hair angles down and slightly forward. This should never happen with an elite surgeon. 

[pre-screened]

Sorry to see this happen to you its very frustrating - go to Hasson & Wong if West Coast focused…….literally wouldn’t dream of going anywhere else in N.A….you’ve very little wriggle room to fix things up given amount grafts taken in first FUT, size of the scar itself & area to be covered in second pass. When grafts are at a premuim only go next to the true elites like H&W, Konior.

In regards to Diep…….& watching this forum…….I’ve seen too many of his FUT scares display stretching/poor closures……..I’m not sure if he’s too aggressive re: size of the strips or simply his closure technique lacks elite level skill/care……but I’ve seen enough on here whereby I wouldn’t let the guy FUT my worst enemies head.

His corn row placing continues to bug me every time i see it in post-op pics………it fails the central tenet of all cosmetic surgery which is naturalness……nature does not corn row your follicular units…..depending on density, hair caliber, graft yield Diep gets away with this on lots of cases…..but its a terrrible approach to take……and indicative IMO of surgeon failing to reach the true elite of the elite in terms technique/professionalism etc.

@BDK081522 ‘s highlighting of technical failure of temple point graft direction above is pretty damning - again points to a surgeon who falls short of the elite standard 

[HT1404]

yes, I had the temples also done by Dr. Diep and they do look a bit unnatural. 

I will now start my journey of trying to correct for the mistakes that were made along the way. Any feedback about Dr. Mohebi? He is also West coast and I heard good things about him too.

[FUT4000]

38 minutes ago, HT1404 said:

yes, I had the temples also done by Dr. Diep and they do look a bit unnatural. 

I will now start my journey of trying to correct for the mistakes that were made along the way. Any feedback about Dr. Mohebi? He is also West coast and I heard good things about him too.

he's good, try to avoid behnam

[Guanyu76]

This is horrible tbh. Maybe @Melvin- Moderator can contact Dr.Diep regarding your case? Whether you chose to follow through with him again or not is up to you, however you should absolutely get information as to what went wrong, especially with 4,000 grafts.

[HT1404]

yeah honestly I never understood the severity of this until I started looking here in the threads! 

[digi23]

The main problem with Dr Diep is that he plants the grafts in rows so even his "homeruns" looks pluggy in my opinion. He never get good density this way, it always looks empty inbetween the rows, which is pretty sick considering his pricing.

For your situation 4000 grafts I think would be ok for that area generally, if you take a look at some top Drs like Dr Bruno Ferreira transplanted pretty much the same area with 3500 grafts at @Rolandas Norwood 5A area with fine hair(0.55mm) in the first transplant with great success. 

I think you should consult with someone else, like H&W if you are going for another round of FUT.

Edited December 30, 2021 by digi23

[Z--]

Thanks for the photos, @HT1404. Not going to sugarcoat it, but this is one of the worst results I've seen -- elite doctor or otherwise. How he managed to make 4,000 grafts look like sub-750 is beyond me. Obviously not your fault -- and its heartbreaking when someone does the research and selects a so-called "elite" doctor only to be butchered. You deserve better.

This isn't going to get any better. I'm going to echo the sentiment above; Diep is too inconsistent nowadays. For every 4-5 home-runs I've seen, there is one severe misfire as is seen here. I'd suggest contacting H&W or Konior asap to fix this.

We are here for you and wishing you luck on this journey. This is 100% recoverable. 

[Fue3361]

I'd request a refund after this kind of result.  

Also, i don't know about everyone else, but I agree with the poster a few posts above about the rows.  I've never been a fan of surgeons that implant in rows.  I think those results are never as good as they would have been with more random implanting patters.  Just from the fact that hair never grows naturally in rows should be enough of a reason.  

[FUT4000]

51 minutes ago, Nairphss said:

Diep is terrible. he is NOT elite and should not be mentioned in the same circles as elite. 

the lack of accountability post op just compounds the problem. Office staff is inexperienced, seems like bunch of young high school girls trying to manage a medical clinic. He sedates you heavily so you have no idea what is going on. 

 

it’s shameful he is asking you to pay for more grafts when the procedure he performed was an utter failure. doesn’t matter anyway I would not want him touching my scalp after that result; so the point is moot,  but any surgeon worth his salt would want to correct such a botched job for free sort of a second chance to prove himself. 

There is nothing you can do to change the past. Post the reviews on google and Yelp if the office is not agreeing to the refund. Heck post even if they do refund you. Don’t sign anything. 
 

you have one shot to fix it. Do your home work very carefully. 
 

 

 

 

 

Just curious did you have a HT with Diep. only reason i ask is your specifics about his office and HT process 

[Fue3361]

I was sedated too for my surgery but I’m personally a fan of that, wouldn’t consider it a negative.  I just got there, and woke up with everything done.  Way easier than sitting for hours and hours awake.

[Fue3361]

I was completely out.  Got there, last thing I remember was talking to anesthesiologist, then waking up post op.  I’d not want to do it differently.

 

That said, this should only be done with the right medical personnel around, as you said.

[asterix0]

22 minutes ago, Fue3361 said:

I was completely out.  Got there, last thing I remember was talking to anesthesiologist, then waking up post op.  I’d not want to do it differently.

 

That said, this should only be done with the right medical personnel around, as you said.

I understand your point, but if you are awake you can actually count the grafts as they are implanted, to make sure you are getting what you expect. Also, to know who the hell is operating on your head (is it the doctor, a technician, who??)