Category: Post-Operative

Dear Dr. Rassman/other doctors at Balding Blog,

I have gone through a FUE hair transplant 2 months ago and I have some concerns. I appreciate and look forward to your answers. (I have directed them to my surgeon already and just want to get a second opinion from a reputable source)

Around 1100 grafts were transplanted to my temporal area (to fill up the balding area in my left and right front part of my head). A few days after the FUE surgery, I noticed that all my grafts were around 2mm long. It has been 2 months since the surgery, and I noticed that around 5% of the grafts kept growing (at 2 months now, they are around 2cm long). At the 4-week mark, around 85% of the grafts have grown to 5-6 mm long but have stopped growing since then (so they experienced no growths since 4 weeks ago) and 10% of the grafts never grow at all since the surgery (still at their original transplanted 2 mm length).

Would you please tell me if the above situation normal or not? Assuming the 5% that keep growing will still continue to grow, for the rest of the transplanted hairs, after they shred, will they come back? I am a bit concerned that for the 10% that experienced no growth at all since the surgery, they will never come back after shredding. And is it normal for around 85% of the transplanted hairs to grow from around 2mm to 5mm after a month, then stop growing at the 1-month mark and begin their shredding phase and then come back a few months later?

Thanks.

Sometimes after a hair transplant surgery it may seem like the hairs are growing a few millimeters, but they are usually just hairs being pushed out before they fall out (since a hair shaft can be as long as 5mm beneath your scalp). If you gently tug on those hairs you may notice how easily they come out. Otherwise, I suppose anything is possible.

With regard to your observations on the rate of growth, I would wait another 2-3 months and then reassess your situation, hopefully with your doctor. At that time, please feel free to send me a follow-up if you’d like to update our readers.

I have undergone my 3rd hair transplant surgery in March 2010 and I am at the 8 month mark. I am mostly satisfied with my results, but hoping for some more growth and increased density. I was wondering if the transplanted hair takes longer to emerge and mature when you have had successive hair transplants. I was told by my doctor that the hair transplants take longer to emerge after the third hair transplant and i should expect some more hair growth and increase in density.

I would like to get your thoughts around this. Thank you.

I’m not sure why your surgeon would’ve told you it takes longer for hair to grow after the multiple procedures, because the growth period is roughly the same for each surgery. The third surgery should grow at about the same time as the first one did. If you are concerned about growth, speak with your doctor again. I occasionally see some growth occur between 8-12 months, but that is usually in addition to what is grown by the 8th month.

You should be alarmed if there is no growth within the one year time frame, but less concerned if it has only been under 6 months. In your case at 8 months, you should see some good growth by now with hopefully a little more in the coming months.

I’m 6 months into my hair transplant and it seems to be getting thinner from about 2 months ago. I was under a great deal of stress a few months back. Could that cause a thinning of the newly transplanted hair. I use Rogaine and Avodart every day. The doctor said it was ok to use on the new hair. At the 4 month mark it really looked promising. However it has definitely thinned since then. Any suggestions on the cause?

Hair transplant surgery is highly variable in terms of the individual patient, as well as the techniques used by clinics and doctors. Many people who have a hair transplant will actually lose some of their original hair and that may be the cause of what you are seeing.

The general estimate is that it can take 4-8 months to see results, and usually the majority of the results are visible by the 8th-12th month. I’d follow up with the doctor that did your surgery.

This has been a great blog for unbiased info- appreciate it.

I had a transplant surgery about 13 months ago, mostly on my front area, as one side of my hairline was receding and thus giving me a comb over look. It wasn’t that bad yet, but I could foresee it becoming worse so I wanted to get it taken care of immediately.

Well, 6 grand later and 13 months and I look exactly the same. After the surgery, I had plenty of thin, short hair spurting where the transplant was done. I was told those would fall out and grow back in thicker. Well, they fell out and have yet to grow back. I followed all the guidelines for recovery, have remained on Propecia daily as well.

One thing I did notice during the surgery (I was awake) was that the actual doctor did very little of the ‘harvesting’. His interns/aids did 95% of that and the doctor would come in every hour to take a look. Would this have anything to do with the hair not having grown back?

In this economy, 6 grand is a lot to lose and I feel as if I’ve been duped here. At the consultation their representative assured me I’d have a full hairline again and this surgery would be all I needed for life providing I stay on Propecia. Well, unless something drastic happens with my appearance due to this surgery, I will have to have another surgery providing I can afford it in the future.

Also, from what I’ve read, Rogaine will not help me in the frontal areas for hair regrowth/maintaining. Is there anything that will help?

Appreciate your time so much!

How long were you on Propecia prior to the surgery? Have you considered that you have continued to lose your native (non-transplanted) hair and now are left with just the transplanted hair? It would sort of be a one-to-one trade off. Unfortunately, you will continue to lose more of your native hair even with Propecia. Some people respond better than others, but perhaps you weren’t a good responder to Propecia. I’m just guessing though, as I don’t have all the information.

Another possible scenario is that your surgery was a failure due to problems that occurred during the procedure. Again, I’m just guessing as I have no idea what was done during the procedure. I’ve written before about what issues could’ve resulted in the transplant to not grow, and it seems that most of the problems that occur are with the technical staff. Technicians are an important part of the procedure in cutting and placing the grafts, and the doctor does the cutting of the strip and placement/design of the graft sites. Have you spoken to the doctor that did your surgery?

I stress getting a Master Plan to remind readers as well as my patients before undergoing any surgery.

I’m a year post-op on my 2nd HT procedure, 6300 grafts total including my 1st round.

While my results are dramatic and I am quite pleased for the most part, the crown area is still somewhat sparse, and upon my recent 1-year follow-up, I am told there is the issue of some donor hairs that have, according to my doc, become thinner in diameter or possibly even miniaturized due to genetic programming that came with those grafts (in other words, at the time the grafts were transplanted, they were of even diameter and size, but some weakened and shrunk according to him). He took some extreme closeups and showed me the photos on a computer.

I had always believed from my research, that miniaturization is halted or cannot occur in transplanted hairs. Is this not true, and what do you recommend to protect my investment other than finasteride and/or minoxidil?

It’s difficult to provide an accurate answer to your question, because I do not know what you have…

Donor hairs do not normally miniaturize for men with male pattern baldness (MPB), so I must assume there is something more going on or there’s something that wasn’t diagnosed. I would ask your doctor about the cause of your problem and what you can do to for it (in other words, you need a diagnosis). If you do not receive a satisfactory answer, get a second opinion from another physician!

For example, I have seen a few patients over the years who had hair transplants by other doctors, but didn’t know that they had diffuse unpatterned alopecia (DUPA). Their donor hair had significant miniaturization and the transplanted hairs eventually were also miniaturized. I am not implying that you have DUPA, but this gives you an idea of how things are not so simple when undergoing a hair transplant.

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I have undergone hair transplantation recently, can i wash my recepient hair with shampoo as i use to wash before transplantation, can i expose to sunlight after 3 month?

At 3 months, you can wash your hair properly as you have always done. Sunlight exposure should be in moderation and progressed to more and more sun over time. The use of a sun blocker is always a good idea unless there is so much hair that you have shade from that hair.

Is a hair transplant really as painful as Marc Jacobs suggests?

The article says: “Jacobs said the transplant was excruciating, remembering, ‘I couldn’t sleep on my side, and I couldn’t put my head back.’ He said it hurt more than his tattoos but that it was definitely worth it. Ouch.”

Marc Jacobs Dishes On Painful Hair Transplant: ‘I Couldn’t Put My Head Back’

There is some level of pain involved, as let’s not fool ourselves into thinking this isn’t a surgical procedure we’re talking about. That being said, everyone will have a different idea of what is painful and what is just annoying. I’ve previously written about what pain patients can expect from a hair transplant — Pain with a Hair Transplant.

During the surgery itself, some patients find the initial injections more annoying than painful… and once those injections numb the area, you certainly shouldn’t feel any pain during the hair transplant procedure. After the surgery, depending on the type of procedure that was done, you might have to sleep on your side instead of on your back.

It’s impossible to say whether you’ll find a hair transplant to be as painful as Marc Jacobs says, but as physicians we definitely try to minimize pain (and annoyance) as much as we can. Remember though, pain is temporary… hair transplants are forever.

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Hello Dr. Rassman! I am very grateful for the information that you provide for all of us trying to find legitimate ways to mitigate hair loss and for answering my questions in the past.

It has been almost three months since my hair transplant procedure and I am looking forward to the results. I do recall however that 3 days after my procedure, a friend of mine inadvertently tapped my head back then with a folded box. There was no pain, no bleeding occured and the force of the tap itself was lightly moderate.

My question would be: Could that tap may have affected the grafts in the recepient area that the box may have touched? I’m just concerned that that particular single tap (no taps or hits with any object have occured since then) may have affected any of the grafts that the box may have touched back then. Any input would be greatly appreciated. Thank you!

As long as it was a single tap, and the box was folded, and the color of the box was brown… you should be fine.

In all seriousness, it’s common to be overly-worried about the results of your hair transplant since at just three months you’re probably not seeing growth… but a light tap on the head is nothing to be concerned about.

Hi –

Is it normal for some, but not all of the transplanted hair to remain in the transplanted area? I thought that it was an either/or kind of thing — either you were apart of the minority of s that would retain all of the transplanted hair or all of the transplanted follicles would eventually shed. I am going on 5.5 weeks now, and probably 85% of the transplanted hairs have shed, but there remains some hairs here and there that have “taken root” so to speak and begun growing. Should I expect these to fall out eventually? I have never heard of doctors talk about some but not all the transplanted hairs falling out.

Thanks!

For those that aren’t familiar, after a hair transplant surgery it’s common for the grafts to take root and the hairs to then fall out, with growth taking a few months to occur. A minority of patients (less than 5% is my unscientific guess) continue to grow the transplanted hair immediately after surgery.

I really have no way to know if you’re one of the rare patients that doesn’t go through the dormant phase following a hair transplant (it doesn’t have to be all-or-nothing in regards to immediate growth), and only time will tell if your hair will hold. In any case, keep your fingers crossed that the 15% of remaining transplanted hair continues to grow.