Category: Post-Operative

Dr. Rassman:
Thank you for your service to this country when you served in the US Army. I am a 26 year old male who recently had a hair transplant procedure in late March which involved about 1,500 follicles (FUE). Immediately after the surgery I noticed tiny hairs throughout my frontal area where I have been experiencing thinning for the past few years. I was told by my doctor that these tiny hairs were normal and that they would likely fall out in 2-4 weeks. It has now been about 2.5 months since the procedure and I believe I still maintain about 80% of these tiny hairs. Is this a bad sign for future growth? Will these hairs retard growth? Please let me know. Thanks.

I’d ignore these hairs. If they are the same length as the day they were put in, they will eventually fall out and new hair will grow from the transplants. Some people keep these beard-like hairs for months after a hair transplant and there is nothing to read into this observation. They aren’t a sign of future growth in a positive or negative sense.

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Three months ago I got a hair transplant and over that time the hairs that were put in fell out. Is this transplant going to fail?

Normally the hairs that are transplanted do fall out in the first few months and then they get replaced by your body at about 3-5 months with new hair. If the transplant is a success, you should see 80-90% of the results in 8 months. Patience is your friend at this point!

Dr Rassman

I have a query that has always interested me but I have never quite found the answer to. Why does newly transplanted hair grow at different timelines to each other (either scientific or theoretically). For instance I had a hair transplant nearly 6 months ago. Today I could see a couple of new hairs popping through, yet my first good initial growth that I could visibly see was just before the 3 month mark. I find it amazing that there can be such a time buffer between growths, yet all the transplanted hair was inserted in my head within a 4 or 5 hour timeframe!! Surely all the hair should grow back within that timeframe??

Thanking you for your time.

I do not have a good answer for you, but I can offer some speculation. Some hair follicles remain dormant longer than others, but it has nothing to do with the time it took to place the grafts in your scalp. All of the hairs on the head are growing at different and overlapping cycles. So naturally the transplanted hair would behave in a similar way. It may have something to do with the time in the cycle the hair was in when it was moved.

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Hello, I had a hair transplant early in january, roughly two months ago, it was only a small procedure of about 700 grafts. However I have been reading about the scabbing process and I am very concerned that I may have damaged my grafts. I was very careful after surgery for about two weeks, the scabs were still strongly in place so i followed advice and scrubbed a little harder and let them soak. During weeks 3 – 4 the scabs were still there, not attached to my head but somewhere near the end of the grafts, most of them being lose. The area was very itchy and the scabs looked a mess being very flakey in my hair.

Anyway over 2 or 3 days i used my finger to rub and loosen the remaining scabs, considering it was nearly 4 weeks on i thought this would be ok. When picking the scabs off some of the grafts were still attached to the scabs. I have been told that it is natural for the grafts to come out first with the scabs and that after 2 weeks the grafts are fixed in place so its hard to damage them. However i am very worried that the result i achieve will be poor because I didn’t just let the scabs be, the rate they were going i think it could have been about 5 weeks before they would have gone. I know picking (encouraging) the scabs to come off when the hair is dry is wrong, but i didn’t at the time. Do you think any permanent damage will have been done?

kind regards.

I do not know why your scabs would be there at a month after surgery. Just washing your hair with soap and water should’ve taken them off. I would like to know if the grafts were the large plugs, which used to produce scabs lasting 2-3 months with poor hygiene.

We did a graft anchoring study, which basically concluded that as long as the scabs are in place, the grafts might come out. Pulling scabs and grafts from the scalp just is a set-up for infection (folliculitis). Good hygiene should have started the day after surgery. Where were your post-operative instructions? The surgeon should’ve provided them to you.

Hi Doc! I have another question that I haven’t been able to track down an answer via search engines. I had my last transplant surgery 16 years ago, and all the recipient sites where they put the grafts are light red in color. Is this usually a histamine reaction or some kind of blood stain? It shows more after I get out of a warm shower. Please let me know what this is, and if there is a fix for it (laser resurfacing, etc.) Thanks a bunch!!

16 years is a long time for recipient sites to look anything but normal. Histamine response to heat may be possible, causing increased circulation with the shower heat… but I am just guessing and I’m not enthusiastic about that explanation. I would like to see you if that is possible, but if you’re located too far from my offices in California, I’d suggest you go see a good dermatologist.

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I underwent a mega session of 2884 grafts and was worried on the 20th day as my scabs didnt fall off. So I contacted my doctor who told me to do a gentle massage. I did it but during this massage what I noticed was that there were some scabs that had hair attached to it. Does it mean I have pulled the graft even after 20 days!?

I would like to clear that i massaged with my fingers ( not nails ) in a slow circular motion.

Waiting anxiously for a quick response.

I’m confused. You called your doctor who performed your surgery to ask about scabs, but you’re asking me if the grafts were pulled out? The problem is that you should not have waited until 3 weeks after surgery to do a proper washing of your recipient sites!

Some of the hairs should be falling out on their own with or without scabs, but the roots of the grafts will still be in place, as seen in the article we published in 2006 — Graft Anchoring in Hair Transplantation [PDF file].