I had a graft procedure 7 days ago. I hit my head and caused a small cut about the size of a pencil eraser where I had transplants. Will I lose the grafts in the area?
It would be unlikely to lose grafts 1 weeks post surgery, however, if the skin separated that distance and healed on its own, it will develop a scar in the area. I am sure you have seen many men with these small scars in their heads that came from such injuries.
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I had a hair transplant a few weeks back and got symptoms of the flu on the 10th day. Is it possible that this will hurt the growth yield of the hair transplant?
There is no connection between the flu and a hair transplant, either before or after the flu. Many times people will ask if they can go forward with a hair transplant while they have or are recovering from the flu. As a hair transplant is performed under local anesthesia, there is no danger to your health to have a hair transplant with a fresh case of the flu, nor is there any impact on growth from a hair transplant days or weeks after you recover from the flu.
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With follicular unit transplants, I’ve read that the unit can consist of 4 or 5 terminal hairs and 1 or 2 vellus hairs. Why transplant the vellus hairs along with the terminal hairs? I thought vellus hairs were what happened to terminal hairs after extensive miniturization? Do the vellus hairs serve a function in the transplant? Do they eventually become terminal hairs or something? I’m just a bit confused. Vellus hairs do not become terminal hairs that I know about, but maybe I am wrong and would have to study it over a prolonged period of time to determine it.
Thanks
We don’t decide to transplant vellus hairs as they come along with the terminal hairs in a follicular unit. You can not separate the vellus hairs without damaging the terminal hairs. Why and for what purpose would you suggest doing it?
I had a hair transplant 15 months ago using the strip method procedure. I only had the temple areas done for my receding hairline. I am happy with the procedure, however i would of liked slightly more density. I told this to my surgeon who said he could preform another transplant but i was confused to why he couldn’t of transplanted such two small areas in one session. My worry is that my scar although really well concealed and unnoticeable it is very long. Im worried i dont have enough donor hair now incase i developed into a norwood 7 (completely bald). I know unless you seen me face to face and analyzed my head you couldn’t tell however here is my question. If my transplant surgeon has used alot of donor supply another strip procedure would obviously not be a good idea.
Here is my thinking and i might be wrong so please explain if i am. If i have already had a strip procedure and i wanted another transplant i think FUE would be a better second procedure as you have ability to choose hairs from different areas from the donor area thus being able to use more hairs than you could from a strip procedure. The reason for this is that a strip procedure can only can only be extracted in one long strip which is wasting useable hairs, however with FUE i feel that if someone has had a strip procedure which has used a large amount of surface area obviously another strip procedure would be difficult as theres not enough space for another slit and but with FUE you could extract hairs from all over the donor area. Am i thinking correctly. The doctor told me he transplanted 1464 hairs. is that too much for a receding hair which goes back 2 inches, which means he mustn’t of transplanted that many? Please reply. Thank you NHI team.
I really don’t have a clue as to the size of your recipient area for those 1464 hairs. Assuming that it was 1464 hairs (not grafts), that means that the strip taken should not have been very large (in surface area, that is). The normal person has 1250 hairs (or 625 two-hair grafts) per square inch. At a transplant, you can calculate just what you received by figuring out the square area of the recipient area. Let’s say, for example, that you had 4 square inches of hair transplants in an area that was originally bald. That means that if you had normal hair without balding, the area we are talking about would have had 5000 hairs (or 2500 grafts) in it. If your surgeon put in 183 grafts per square inch, that reflects about 29% of the original density into that recipient area for an average Caucasian density. That is a reasonable number of grafts from a density point of view, but fullness reflects many other factors, including thickness of the hair shafts (coarser produces much more bulk than fine hair), color contrast between hair and skin color (the lower the contrast the better), the degree of wave or natural curl (straight hair is not as good as wavy hair), and the hair styling you use (short requires more density, but long does not unless the hair is fine).
The average donor supply for a typical male is about 20,000 hairs (or 10,000 grafts) and this is dependent upon the laxity (looseness) of the scalp. Based upon the number of grafts you receive as discussed above, you should have a great deal of donor hair left. The scar should be managed by your doctor and removed with the next surgery and a trichophytic closure should be done to manage the scar. Be sure that your laxity is good and do the exercises before the next surgery (see video). There is much controversy to the issue of just how dense one has to make it. I generally shoot for 25% or the original density, but in the very front of the hairline I might go a bit higher (35-40%) if the hair is fine. Transplanting hair into a bald area has mechanical limits that may reflect growth, graft damage and other factors unique to the surgical team and your unique circumstances.
FUE as a unique procedure is not very efficient in most surgeon’s hands. I believe that you are incorrect about FUE vs strip surgery. The strip method may be more efficient in the long term. Once you had a strip, it may be better to remain with it. With regard to your scar, some people just form wider scars than others. The use of special closures like trichophytic will automatically force hair to grow through a wound, but it does not sound like that is the type of closure the doctor used on you.
Progressive balding is something that occurs in every person with genetic hair loss, but fortunately only about 7% of the male population will end up with the Norwood Class 7 pattern. All good surgeons should have a Master Plan for your worse case scenario for balding, so if you should be unfortunate in developing a Class 7 pattern (even with good drug therapy) you should still have a normal appearance. I have been doing this for 18 years, and I admit that did not have the same type of common sense in my first year in practice as I do have now. There is no real substitute for that type of experience, particularly in determining the rate and degree of balding progression.
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Hello Dr. Rassman (and contributing doctors),
I have a question that I believe is something most of your readers might wonder:For us hopeless (hair) romantics, what would you say is the best possible scenario for someone undergoing a HT procedure? Put another way, is it possible for someone with limited (or even moderate) balding to realistically expect to repair their hair loss to the point of zero detectability? …Hypothetically of course
Absolutely! Non-detection for a hair transplant is a reality on most patients who get them, provided that the densities are brought up to enough of a level to produce the fullness that normal densities will have. Without knowing more about your hair loss pattern, hair characteristics, color, skin, etc, it would be difficult to give you realistic expectations. If you visit me in my office in Los Angeles, I’ve got plenty of patients (and some on my staff) that have the type of transplant which is completely undetectable. I mean, who wants their hair to look transplanted? Nobody! As I always say, seeing is believing and our Open House events show this on many of the patient models who visit us from time to time.
I use minoxidil and nizoral shampoo and am considering a hair transplant procedure in the future. Will it be necessary to suspend use of these products before or after hair surgery? If so how long before and how long after?
I just tell patients to continue on their treatments up until the day before surgery and then restart them about a week after surgery. Withdrawal effects from minoxidil will not occur in 1 week. Always discuss pre and post care with your surgeon, though.
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Actor/comedian John Cleese, possibly best known from his days with Monty Python, has made a public admission to a hair transplant he’s had. It’s difficult to tell how much of an effect it has had though, since I can’t seem to find good photos to compare. So popular, particularly in the UK, that it warranted 2 articles in the same paper about it:
Even so, going public about a hair transplant is courageous, but it should not be. Public embarrassment is a result of an old association that hair loss reflects a lack of masculinity and with that hangover from the old days, that image remains. In addition, doing a hair transplant suggests that the men who do it are vain, yet this is really a take charge issue in getting the man in the mirror to look like he wants to look. No one likes paying the price of aging, so a hair transplant which often subtracts years from a person’s appearance, allows the man in the mirror to look more youthful. Try to imagine him without hair and I think that you will get his message.
You said on one reply, in reference to sleeping on transplanted hair, “On occasion, transplanted hair will become more curly and even wiry, so look carefully at the transplants and see if the character is the same as the non-transplanted hair.”
My transplanted hair has become more curly and even wiry like you said. Why has my transplanted hair done this, it didn’t used to be like this, and sometimes isn’t. Is it permanently damaged now, or does it just sometimes happen. How did it happen.
Your hair transplant is likely not damaged. Sometimes the texture of the newly transplanted hair can be different. It can be permanent, but it should grow out normal as it goes through a full hair cycle (2-3 years). It is one of the nuances of the hair transplant surgery that should have been explained to you before the surgery, although it is rare.
At 4 weeks post op i have significant shock loss on the donor area primarily just behind each ear where the loss is. Not so bad in middle but still some. Is it normal for more loss behind the ears and will it grow back?? Is that area more prone to shock loss than the middle of the back of the head.
Thanks
Sometimes the donor area can experience hair loss from the stress and/or tension from the surgery. Unlike the shock loss in the recipient area, the hair loss in the donor area should grow back in a few months to a year. I would follow up with your surgeon and have him/her further evaluate it.
Hello,
I am a female, 26 years old who just had a hair transplant ( 1000 grafts). It is 16 days post-op and Im starting to lose alot of hairs ( not the transplanted ones). Can shock loss occur this early on? Or is this something else ?
thank you very much in advance
Any hair loss between 2-12 weeks after surgery is often a sign of shock loss, so what you’re seeing fits within that timeframe. Check with your doctor.
