Category: Post-Operative

About 3 weeks back i had got a bandage wrapped tightly around my head after a surgery i underwent. Since the bandage was tight, initially it hurt a bit for about 2-3 days, after which the pain subsided. The bandage eventually came off about 4 days later(it was on for 1 week in total). a week after it came off i noticed that area (about 1/2cm in diameter) had formed a kind of scab. A week after that the scab became hard and looked ready to fall off. So a few days back while gently scratching that portion of my head, the scab came off in my hand, and along with it a bunch of hairs growing through it. My worry is that, will this hair grow back? The area where the scab was now looks healed. This happened on the front crown portion of my head, just above my forehead. Will the new growth take long? Thanks.

I don’t really understand the anatomy as you described it. Wrapping the head for a week… well, I have never heard of that excepting in World War I when soldiers had head injuries or Hollywood wanted to get audience sympathy. What I do is put a ‘tennis’ type band around the head (like a sweat band) to keep pressure on the donor wound and take it off next morning just before the hair is washed.

Generally, if the grafts have not been pulled out by the head bandage, they should start to grow in 2-5 months after the surgery and then continue at a rate of about 1/2 inch per month.

hi doctor,
i just had a FUE procedure last month and fine crusts had been forming on the transplanted hair since 1 week after the procedure and it had remained there and even multiply till now! The doctor’s explaination is that i didnt wash my hair properly even though i wash my hair daily. He even said that the crusts will hinder the growth of the transplanted hair which makes me worried! Can i know what is the consequences if the crusts still remain there even after 6th,7th week? Will it really affect the growth of my new hair? Thanks!

It sounds like your washing is poor and the existence of crusts at 7 weeks reflects poor hair hygiene. I agree with your doctor on a better washing approach, but I do not agree that the crusts will stop the growth when the time comes to grow.

Hi there Doctor Rassman, I’ve got a question for you about graft safety/anchoring. It has been roughly 13 days (12 days, 14 hours) since my procedure – I had a temporal/hairline restoration of about 2200 grafts.

My question is simple, at 12-13 days post-op is there any single circumstance that can dislodge a graft? My crusts started flaking off about 9 days post-op. I have been washing using the fingertips to gently massage and soak the crusts, and they seem to be flaking off no problem. Sometimes throughout the day, i will gently massage the scabs with my fingertips (without washing my hair, just dry) and the crusts will continue to flake off. I am noticing hairs in many of the scabs, but I know this is normal.

However, I noticed a few particularly persistent scabs. I did not peel or pull on the scab, but rubbed it much more vigorously with my finger tips until it came off, however, I noticed a slight bit of bleeding in the area where the scab was.

I have two questions.
1) If you do not see any bleeding, but see a hair/bulb in your crusts as they flake off, is it 100% certain that the growth center has not been dislodged?
2) If you DO see bleeding, is that generally a guarantee that the growth center has been dislodged with the scab?

There are no 100% guarantees, but it is probable if there is no crusting and you did not pull out the graft (and it shed on its own), a hair with a bulb after 12 days will leave behind the growth center. See the medical paper I co-authored, Graft Anchoring in Hair Transplantation (PDF file).

Bleeding should not change what I said above, but why are you bleeding 12 days after a surgery?

Paid advertisements (not an endorsement):

What is your opinion on Sun exposure for a new Hair transplant patient? Is there a danger to getting any direct sun on the scalp at all? If so, what is the proper waiting time after the surgery? Is it only sunburn I need to worry about? If I use sunscreen on my head, what is the correct SPF I should use. I was told direct sun might slow or prohibit any new growth. Thank you for taking time to respond.

UV light is not good for fresh wound healing and is known to slow it down. This would be most sensitive in the first few months, which is when I would suggest using a good sunscreen with an SPF factor of 45 or more. Generally, it is easier to wear a baseball cap.

Paid advertisements (not an endorsement):

I had a FUE about 3 months ago, I was just wondering if being sexual active could cause a negative outcome in my hair growth since there is large amount of testosterone being produced during this time…? Thank you

Very active sex is safe within a couple of days after a hair transplant (FUE or strip). I tell this to people as a routine, but passive sex is ok the night of the surgery. Why are you waiting?

Paid advertisements (not an endorsement):

Doctor can you please help me with this topic. A few days ago I had my first HT procedure for 4300 grafts. My Doctor told me that the hair under my ear is thinning therefore not leaving me with the best of donor hair. How is it possible that hair from the back is falling out?

There are some inconsistencies in what you’ve told me. 4300 grafts in one surgery indicates that the donor area is very rich with hair and the densities are high. That is not consistent with problems in the donor area, which can be seen in diffuse unpatterned alopecia (DUPA), for example. People with DUPA never can get yields like you have received. When I learn of a single procedure of 4300 grafts, I assume one or more of the following:

1. Very high densities
2. Loose scalp
3. Grafts cut down into one hair grafts — which means in normal densities, you got about 2300 grafts (and paid more money for less actual grafts)
4. Doctor who is dishonest and lied about the numbers to rip the patient off

That last item is far more common than I would want to see. The times that I get 4300 grafts (usually over 9,000 hairs) from a donor site (without cutting the grafts into 1-hair grafts) are substantially less than 5% of all patients. As the originator of the megasession, I feel this makes me an expert on the subject.

Poor donor hair under the ears almost always reflects upon donor hair in the back of the head to some degree. The existence of a poor donor supply on the sides of your donor area should be similar to the hair in the back of your donor supply and as such, 4300 grafts just does not calculate in my book. I wrote the original articles in the medical literature dating back to 1993 on this very subject (see NHI Medical Publications).

For your sake, my fingers are crossed that your grafts grow in nicely and you got the 4300 grafts you paid for… and I am hopeful that you did not get screwed.