Category: Post-Operative

Hi Dr Rassman, I have an important question for you regarding the study of hair grafts you conducted with Dr Bernstein in 2006. The study states that the Dr. Was able to tell when the growth center for the hair had been pulled out by looking at what he pulled out by eye.

My question is this:

• how do you physically identify when the growth center has been pulled out?
• Is there always blood?
• Does bloody mean that the centre has been removed for certain?
• If a hair comes out and there is a dried out “bulb” shaped skin on the end of the scalp, does that mean that the graft has been lost or the graft was a dead one?
• did this study account for partially loose scabs?

After about 4 to 5 days, some of my scabs started to loosen…i started to gently brush some of them with my fingers and some of them were loosely stuck by a strand of skin, which I pulled gently with enough force to remove the scab. My question is this-

• how can I identify when I have pulled out a growth centre and when I haven’t?
• Do you think there was a good chance that I pulled a graft out?
• Lastly, your study includes 18 gauge needles only. What is the standard size needle use or what range sized needles do you use?

Thanks so much for your time and thanks for the study!!!

Firstly, here is the article you referenced, as originally published in Dermatologic Surgery in 2006 — Graft Anchoring In Hair Transplantation — PDF file or HTML

Your email is not clearly written, but I think that you are asking about the hairs we pulled out on varying days after surgery to determine if the graft growth center was left behind. To answer that question, we asked the pathologist to identify the critical parts of the hair that determines growth (the bulge area near the sebaceous gland in particular) and this would include all parts of the hair and what is called the dermal sheath. If this was pulled out, we could safely assume the the graft would not grow. This was not done with the naked eye, but rather by the pathologist under the microscope. By having a specialist look at the grafts that were pulled out, we had an impartial expert make the judgments. I hope that this answers your questions.

With regard to your other questions, please read the article carefully, as we put it all there. Without a microscope and experience, you probably would not be able to tell the status and that is why we put the article together, to be able to guess what is really happening. When the scab is present on the surface, it is likely that the graft growth center can come out.

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I am still feeling numbness over the area of my surgery 2 months after the procedure. Is that normal?

I assume you mean numbness in the donor area (back of the head). Your doctor should check for numbness over the distribution of the major occipital nerves if the numbness is very wide. Most people who feel some numbness are experiencing the cut cutaneous nerves just above the incision. These should not extend more than an inch and they should return in time. Best to check with the doctor who performed your surgery.

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Hi,
Im 4 months post op and noticed some dead skin peeling off fro the recepient area while combing my hair after shower.

There was no blood behind. Just Dead skin with some attached hair to it. is there anything to worry about? Will the hair grow again in place of the dead skin?

thanks

This is probably crusting that you haven’t washed off. I have seen this on people who were too gentle with their post operative washing. See your hair transplant doctor to ask about your post-op care.

hello doctor

i’m three months post a hair transplant operation, i started to note a scalp pimples appeared stating from the second month after the operation, i had told by the doctor who did the operation to me don’t burst these pimples as this could lead to follicular death!, but sometimes i got to burst the white head of the pimples spontaneously. is it true what he told me about damaging the FUE???? this could happen when combing or whatever i do actions to my scalp by mistake.

also i read on the internet that this is normal and a very good sign to hair regrowth underneath the scalp.

another question please, now and after the third month hair density is very thin, is it normal ? and what is going to happen in the next 3 months, can i really got 5 or 6 times the hairs which i got now ? or it depends on something i don’t know it ?

thank you so much

Many of your questions should be asked of your surgeon. I do not know enough about your case to address most of your questions. Some people do develop cysts after surgery and they tend to ‘pop’ by themselves with warm compress soaks. If you develop folliculitis, then you could lose a graft under the skin, but folliculitis needs to be treated, again by your doctor, not me over the internet.

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