Post-Operative – Page 25

September 3, 2008

Using Rogaine Foam After Hair Transplant – Hair Loss Information by Dr. William Rassman

Dr. Rassman, I was reading a reply to a question suggesting that Rogaine Foam is not a problem 3 months after the surgery, but I wanted to know how soon after the surgery I can start using the foam as opposed to the ointment. My second question is I recently got a hair transplant, I am 22 years old male, after reading through your blogs I have come to conclude that I was a victim of transplant “fraud” which is a shame because I got mine from an institution that boasts itself in being a pioneer in the field. I started taking propecia 3 days after the surgery and still till today (20 days post op) my hair is falling off like no other. How long will this ’shock loss’ continue, it is really beginning to worry me because at the rate at which my hair is falling is unbelievable. I also read a post suggesting I can use a blow dryer on low heat after 10days but when I did I had so many hair fall off It was unreal. What would you suggest? is this normal? When can I start using a blow dryer without worrying about my hair falling at such a rapid pace.

thank you

It sounds like you need a second opinion. You can start using Rogaine Foam about 14 days after a hair transplant. Shock loss could be prevented in most situations with the drug Propecia started before the transplant is done. Shock loss will usually subside up to 4 months or so after it starts (hopefully much less). It sounds like you need a second opinion before you blame the surgical team that worked on you.

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August 29, 2008

Hair Loss InformationPimples a Couple of Days After Hair Transplant? – Hair Loss Information – Balding Blog

Good day,

When I had hair transplant, a couple days later I noticed there developed small (about size of pinhead) yellow “pimples” at base of transplanted hair. is this common ? could it be a dermatophyte infection or tinea and is it problematic ? Thank you !

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At two days after your hair transplant, these pinhead pimples you are talking about may be the tops of the hair transplants. The skin shows in some surgeons hands if they do not trim the grafts closely. At just two days, I would doubt an infection, but certainly go back and ask your doctor to take a look at what you’ve described to me.

August 22, 2008

Scalp Severely Tender 11 Days After Hair Transplant – Hair Loss Information – Balding Blog

Hi! Thank you for providing so much helpful information! I had a hair transplant eleven days ago with a very reputable surgeon. I had 3700 grafts placed in my temples and frontal hairline via strip method. I have been having severe scalp tenderness in my crown where no hair was transplanted. The tenderness does not seem to be improving at all. The crown is much more tender than my donor sites. I don’t have any tenderness in the recipient areas. I contacted my doctor who said this was normal and should improve over the next few weeks. However, I have not read about any other patients having a similar experience. So I would greatly appreciate your thoughts. Do you think this is a typical problem after surgery? Do you think that it will completely resolve? If so, about how long do you think it will take to improve? Thanks in advance!

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I do not know how to answer your question without examining you. At 11 days post-operative, the differential diagnosis could be infection, too tight a closure with ischemia to the scalp (restriction in blood supply), nerve injury, and on and on. Your doctor needs to examine you and let you know.

August 20, 2008

Can a Graft Be Put Back into the Scalp If It Comes Out? – Hair Loss Information by Dr. William Rassman

Hello,
when a graft comes out.. in the first few days.. if it is saved.. can it be put back in the scalp…?

Thank you

Most likely not, because there will be a delay between the graft coming out and being put back into the scalp. Exposure to the air will kill the graft and that occurs in under a minute.

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August 19, 2008

I Don’t Want Shock Loss, But I Don’t Want to Take Drugs – Hair Loss Information by Dr. William Rassman

I am a 25 year old male due to have a hair transplant in a months time mainly to restructure my hairline, but also to thicken my hair on top.

I am worried about shock loss to my thinning hair on top. I am aware you recommend propecia to prevent this, however I do not wish to take any hairloss drugs due to the associated side effects. After telling this to my surgeon he suggested that I treat my recipient areas with minoxidil every day during the week before my transplant, and then to continue it 3 days after my op.

In your opinion does this sound like a good idea? I have not taken minoxidil before. I have read that minoxidil should be avoided for 1-2 weeks after a transplant? Also how long do you think I should continue taking this after my procedure to minimise the chances of shock loss?

Many thanks

I don’t think minoxidil will prevent shock loss to the same degree as Propecia (if at all), which a 25 year old is prone to following transplantation. Just thinking about side effects and experiencing them are different. Most men (98 out of a 100) will not have negative sexual side effects. You can try minoxidil since you are not willing to take Propecia. You clearly have a big decision, considering the investment you are about to make.

I’d suggest that you didn’t use minoxidil directly on the recipient area for 5-7 days following the transplant, but I don’t really have a recommendation of how long to take minoxidil to prevent shock hair loss (as I stated, I’m not sure it’ll do much for preventing shock loss anyway). You may want to discuss this with your surgeon and come up with a good plan tailored for your particular needs.

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August 12, 2008

Is the Alcohol in Rogaine Foam Bad for Recipient Area? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

On the Hair Loss Help Forum, I read where a poster stated that his surgeon told him that Rogaine Foam was bad for the grafted areas post-surgery due to its high alcohol content? Is it safe to use Rogaine Foam in the grafted areas at 3 months post-surgery? My doctor never warned me about this!

Thanks

Like the old saying goes, “Drunk hair follicles are happy hair follicles!” No, I’m kidding. Actually, Rogaine Foam is not a problem three months after a hair transplant.

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August 6, 2008

What Is This Pimple in My Recipient Area — Infection, Lost Graft, or Something Else? – Hair Loss Information by Dr. William Rassman

I had a transplant almost 4 weeks ago, and last night, I had a pimple start to bleed in the transplanted area, without having touched it at all. Is this a sign of an infection, lost graft, or something that just happens, thank you

It is very difficult to make such a determination without examining you. Based on my experience, this sounds like an epidermal inclusion cyst, which refers to a cyst that develops as a result of the implantation of epidermal elements (i.e., hair follicle) in the dermis. If this is the case, it is not an infection. However, another more serious process (such as folliculitis) can be the culprit. This too can develop after a hair transplant procedure and with this, patients typically require antibiotics along with possibly “opening” up the infected areas to remove underlying infected material (pus). Whatever the cause in your case, make sure to follow up with your transplant doctor.

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July 30, 2008

Hair Loss InformationOver a Week After Surgery, My Donor Area Is Still Sore – Hair Loss Information – Balding Blog

Hi Dr Rassman
I had a procedure done, it’s now day 8 post surgery, and I get my staples out in 2 days. The donor area is still a little sore but not to bad. It’s mainly when I put pressure or sleep on back of my head, and some of the scabs are coming off now. I would like to get some exercise and go surfing.

Should I wait a little longer? Is it normal to feel a little sore in the donor area 8-10 days later? Is surfing 11 days post-op too strenuous, or could the ocean water cause infection? Of course I would take it easy and certainly wash my hair right after.

Thank you Dr. Rassman for your blog and reply

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Since you have staples, I’ll make a wild assumption that you had the strip method surgery, in which case the wound should not be soaked for easily 3-4 weeks after a surgery. If you had a surgery using the follicular unit extraction (FUE) technique, then you could probably go surfing. The wounds are not strong at 10 days, but at about 3-4 weeks, around 70% of the final healing strength will be present. I’d keep waiting.

July 29, 2008

Hair Loss InformationWhat’s This Fatty Hair Falling Out 5 Days After Hair Transplant? – Hair Loss Information – Balding Blog

Hi Doctor,

I had a HT 5 days back and have been shampooing twice a day since day one of the HT. This was advised by the doc anyway. I’m concern that I am having white stuff which look like the graft falling off. It has fatty end on one side and small black point on the other side. Am I losing the graft or just panicking. Thanks

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By your description it may be that you are losing some grafts. I would ask to see the doctor who performed your surgery and have that doctor address your concerns. Some people might lose a graft or two, but this has been unusual in our practice because we are obsessive about proper instructions for the patient.

July 17, 2008

Using Couvre to Mask Linear Hair Transplant Scar (with Photos) – Balding Blog

Hello Dr,

First of all,,,a Fantastic/helpful blog. I am 50 years old. I visited 10 different hair transplant surgeons and decided to go with a doctor in Northern California. I think you hit the nail on the head, when you say ‘you have to feel RIGHT about the surgeon’. I did an FUT for 3000 grafts about 1 month ago, and everything has gone great. We just have to wait and see now as to what will be the outcome.

I wanted to contribute ’something’ to your blog,,,so I decided to send photos of my scar before and after application of a masking black lotion (COUVRE). It takes 1-2 minute, it will not come off with water and it is practically invisible from about 12″ away. The photos were taken by my wife. I keep my hair at 1/4″ length (I know I can go to #2 clippers and still mask it good). I send these photos for folks whom are worried about having the surgery and wanting to keep their hair short.

Now to my questions. I am on Propecia (4 months now) and Rogaine. I also have the laser comb, but I am hesitant to use it, fearing it might damage the ‘babe grafts’. What do you recommend to your patients regarding this scenario. I truly believe the comb works, not as much as the hype, but it DOES work (for me anyway). The question is, can it hurt the newly transplanted/asleep grafts

My second question is related to a comment my surgeon made prior to surgery. I asked, what percentage of the grafts are normally expected to survive. The reply was 113-120%!!!! It was explained by my surgeon that they do not believe in ‘dense packing’ of grafts in a CM2 and by inserting no more than 40 grafts (or was it 40 hairs?!), it insures the growth of all grafts + some regeneration of already dormant follicles!!! I found that pretty interesting, what is your opinion on this?!

Thanks again for all your great help on the blog, keep up the great work

Masking/concealing agents like Couvre can work “miracles”, as your photos demonstrate. There are two surgical solutions that also work well:

Follicular unit extraction (FUE) into the wound will put hair into the scar, or
A trichophytic closure could wipe out much of the wound if the laxity is good enough

The telogen count is about 10% of hairs, but as these telogen hairs grow back, others fall out so I would not expect more than 100%. I have read such studies and they are clearly flawed in their methodology. You can’t believe everything you hear or read. Nonetheless, thank you for contributing your photos and allowing me to publish them! The results after the Couvre look great. The photos are below; click to enlarge.