Post-Operative – Page 52

April 3, 2006

Hair Loss InformationScarring in Recipient Area After Transplant – Hair Loss Information – Balding Blog

I wanted to know if there is any scarring on RECIPIENT AREA…and this scarring as bad as that in donor area….i mean does recipient area scarring heal fast?? Thanks

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The recipient area rarely shows scars. That is because the wound where the hair is put in is made with a fine needle and a needle does not leave significant tracks. Donor scars usually measure a width of about 2mm, but with a trichophytic closure, that width can be hidden inside hair that grows through the scar. Scarring in the recipient area is very rare. When it occurs, it occurs for two reasons:

When the hair is coarse and the healthy coarse hair has a wider shaft exiting the skin, it may create a very small dimple.
Infections in the area where the hair was transplanted, which will disappear when treated.

With the old techniques, the recipient area had a series of problems that made them quite detectable. That was because the grafts were larger than the follicular units themselves and this older style batched a series of follicular units together into the recipient area. These older graft techniques moved considerable amounts of skin with the grafts and the skin created an obvious whitish disc which: (1) could be higher or lower than the surrounding skin producing a phenomenon called ‘cobblestonning’, (2) would be depigmented make the grafts ‘whitish’ in appearance, and (3) they often clumped the hair within them together producing a stalky appearance, rather than the delicate normal follicular units with the modern technique. With the pure follicular unit transplants, on the other hand, the recipient area should be undetectable in most people within a week, unless there is persistent redness . The abnormalities I discussed above should not be seen with these small follicular units.

March 30, 2006

Transplanted Hair Fell Out After I Had Spinal Surgery – Hair Loss Information by Dr. William Rassman

I had a hair transplant 8 months ago to supplement the hair transplant I had 25 years earlier. This recent hair transplant was to soften the hairline and add fullness. After about 3-5 months the hairgrafts were successful and I was quite pleased with the result. However, in late January I had major surgery (spinal fusion with titanium implants). Since that time it appears that many of the recent grafts have fallen out revealing the crude hairline from my original hair transplant and less fullness than before spinal surgery. Is this a form of “shock loss”? If so, will these grafts recovery and grow hair?

It is highly unusual for transplanted hair (taken from the correct donor area) to fall out. In the few instances I have seen it, every time I have observiced ‘permanent hair’ falling out for some reason, the hair returned. This was never in response to another surgery (e.g spinal surgery), but rather usually a response to another hair transplant. If this is truely hair taken from the permanent zone, it will almost certainly return. What I said abobe applies to men’s permanent donor hair zone.

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March 23, 2006

Smoking Cannabis After Hair Transplant – Hair Loss Information by Dr. William Rassman

First off let me say I find your answers to be very informative.

My first question is: Will cannibus affect my hair transplant I had on Feb 08/06? I don’t smoke cigarettes but cannibus helps me deal with my occasional back pain.

Secondly when can I resume my normal jogging of a couple miles in the morning? As well as doing chin ups and push ups? I have been told exercise of these sorts will only expand the the donor scar.

Thank you and i appreciate your advice.

Medically speaking, smoking cigarettes (even the cannabis / marijuana kind) promotes poor wound healing by decreasing blood circulation. It may have an impact on your hair transplant, however, I do not know how much of an impact it will have.

Exercises such as sit-ups that may have a potential to stretch the back of your scalp will also have an impact on your donor scar. Running 1 week after surgery is not a problem. Although you can probably resume most of your regular activity after one or two weeks post surgery, the scar takes about 6 months to a year to completely set and in the first 3-6 weeks, the wound structural elements that make for good solid healing change and build. I generally tell my patients not to do the type of exercises that stress the neck muscles like body press or sit-ups for up to 6 weeks. A few of my patients even ran marathons a few weeks after surgery without any negative effects.

March 16, 2006

Using Concealers After Hair Transplant – Balding Blog

A few of us on a HT site have been debating if there are any adverse effects to the scalp when using concealers such as Dermatch, Courvre, Toppik. Personally, I have used Dermatch and have not experienced any accelerated hair loss. What do you recommend to your patients, and how long after a HT is it safe to use one.

Thanks for this great site, I just found.

Many hair transplant patients use a hair piece after their surgery or agents that cover the scalp with a powder or paint type of product such as Dermatch, Courvre, or Toppik. We usually recommend waiting 5 to 7 days post surgery to start wearing hair pieces or using concealers. I generally like to see the ’scabs’ gone before the use of Dermatch, Courvre, Toppik, etc, because the grains of powder can lodge below the scab and become an irritant. After a week, when the individual hair follicles have taken hold in the scalp, these agents can be used as needed.

March 13, 2006

My Doctor Told Me To Sleep A Certain Way for 6 Months After Transplant – Hair Loss Information by Dr. William Rassman

i had a hair transplant 2 month ago. the doctor advised me to sleep in a certain way for 6 month, to wash my hair only with baby shampoo. unfortunately, after a month and half after the transplant i started doing foolish things, sleeping the way i always sleep, washing my hair with neutrogena and nizoral shampoo, sometimes even putting pressure on my head. do you think that i could have affected the transplanted grafts . i already see new hair coming out;however, it is not even. also i have noticed that a lot of my hair in the front is falling. headaches are also present.

I like to joke with my patients and tell them, “No sex for 6 months after your hair transplant surgery”. Back in 1992, I had a patient come from Asia and I told him this joke with a laugh in my voice (I am now convinced that the laugh was not translated by the translator as the patient only spoke Korean). At about 3 months, I got a call from Korea by a different translator telling me that my patient passed a message to me: No hair transplant is worth giving up his sex life. Then, I realized that my humor does not work for non-Americans so I now always qualify my jokes being sure that what I say is understood clearly. I may joke with my patients about their sex life and every one of them confirm that they would rather just go bald, so the laugh is mutual.

Joking aside, you can sleep normally a few days after surgery. You can use normal shampoos. You can resume normal activity (yes, even sex). You can even (gently) scratch your head if it itches, run a marathon at the 5th day and do whatever aerobic exercises you want at the 5th day as well.

I suggest that you educate your hair transplant surgeon.

March 9, 2006

Gentle Hair Brushing After Transplant – Hair Loss Information by Dr. William Rassman

I am looking for a “gentle” brush (not so much for my hair, but for my scalp so that I don’t harm my transplants while the scalp is tender. I am also concerned about brushing taking out some of the hair I still have. Do you have a recommendation for me?

A soft brush or one with wide teeth will be gentler on your scalp/hair than the standard comb. Many people want to treat these new hairs from a transplant as special. As the scalp does not have normal sensation, a soft brush may also help. I tell those people who are actively losing their hair not to brush too hard, for the hairs that are fragile may be helped out of the head of the balding person with vigorous brushing. For softer more gentler combs, take a look at: Tenderheaded.com

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March 3, 2006

I Have An Existing Scar in the Donor Area – Hair Loss Information by Dr. William Rassman

I plan on having surgery done but only problem is i have a existing scar and then i will have 2 scars. now i want to know if it is possible to get the scar removed. Also after having surgery what would be the down time from playing sports exercising? thank you for your time

Usually, the old scar can be removed with a second surgical procedure. Down time for a standard strip harvesting surgery in our hands indicates full resumption of most physical activities like soccer within a week. I generally ask patients to avoid things that cause the neck muscles to tighten like sit-ups or body press. I have had one of my patients compete in a 150 mile bike race on the 6th day after strip harvesting.

March 2, 2006

How Long After a Transplant Can I Wear a Sports Helmet? – Hair Loss Information by Dr. William Rassman

Hi,
I am wondering how long after a transplant can I begin to wear a ball hat and a hockey helmet? I play hockey and am wondering if I would have to stop playing because the helmet would definitely rub. Would that cause a problem?

You should wait a full 5-6 days after surgery to wear hats that might knock out some grafts or even touch the grafts. You don’t want anything sitting on those little guys during that time – baby them! After that, though, wearing hats or helmets is fine but do not let it rub on your donor wound. If you had an FUE procedure, then anything you want, even scuba, is good after 5-7 or so days.

March 2, 2006

Using Minoxidil 6 Weeks After Transplant – Hair Loss Information by Dr. William Rassman

dear Dr. Rassman,

i am a 45 year old man. i had HT about 6 weeks ago. all the crusts have gone. i have started using Rogaine and Proscar. I wash my hair almost everyday. i start noticing that some of the transplanted hair fall out, and my transplanted area looks patchy. you said that shedding is not common for older men who are using Proscar. is my case unusual? will the hair grow back evenly?

also, minoxidil causes redness and itchy. suddently some of the grafts start bleeding, eventhough i did not touch them (just pour water on the head). is this serious? i am losing the grafts?

please kindly respond. your blog is really helpful.

Minoxidil can cause irritation and it is not necessary in your case, so stop it for a few weeks and observe if this solves the bleeding problem. You need your doctor to examine your scalp looking for things like folliculitis which can cause bleeding and itching, patchy hair loss, and shedding. If you do not have folliculitis and is treated succcessfully, then everything should work out in the next few months (assuming that you had a good doctor who did his job correctly). Speak with your doctor face to face when you get examined. Try to connect with him/her.

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February 27, 2006

Hair Loss InformationMy Doctor Told Me To Use Minoxidil After Transplant – Hair Loss Information – Balding Blog

Dear Dr.Rassman, I recently had a hair transplant the beginning of December of 2005′. I only needed a small area above my bangs,(I’m a female with blond, baby fine hair),and was given a mega’ session to my surprise!) It will be three months the start of March. My question is that post-op, I was told to start using minoxidil for 3 to 6 months. I was told that this would help in blood flow to the follicles. Will the transplants grow without minoxidil? I haven’t been using it every day like I should. Shouldn’t a transplant grow without using minoxidil? I lost alot of my hair that I already had when they were putting it the grafts. I don’t see any of the original hair coming back very fast…something about the hairs being “shocked”? Were they destroyed when the new hairs were translanted, or will they come back? I have less hair now, than when I went in for the procedure! Not to mention the “ear to ear” donor site, that is slowly coming back! Thank You.

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Minoxidil may help improve the rate of hair regrowth, however, transplanted hair does not need minoxidil for growth. It sounds to me like you may have some shock loss from the surgical procedure. More than likely, the shock hair loss will reverse (it usually does in women) and your hair would then grow back somewhere between 3-5 months following the surgery.

I am frankly surprised and dismayed by your comment that the megasession was a surprise. There should be no surprises in this process so I would think that your doctor failed you in this regard as good communication is the key to the entire hair restoration process. Your concerns are real, but I wonder if you lost faith in your doctor by my observation that you came to the internet for advice that should be part of the standard of care that one should expect from their doctor.

For the information of the readers reviewing this blog, hair transplantation in women is usually restricted to a sub-set of balding and thinning problems because female genetic hair loss does not occur in patterns like it does in men. In the fringe area around the sides and back of the head (donor area for the transplant), men usually have healthy hair (99%) while women often do not (20% have a good supply of healthy hair). That means that if a women does not have healthy hair and is transplanted, the unhealthy hair is moved along with the healthy hair (not a good use of a surgical procedure). Women with female genetic hair loss can have 4:1 unhealthy hairs:healthy hair ratios. What that means is that for every good hair transplanted, four unhealthy hairs get moved. This is the reason we do not transplant many women as the value may not be there. I have met some doctors who claim that women make up a sizeable part of their practice and generally I have the view that the value proposition here is totally favoring the unscrupulous doctors that do this and give this industry a bad name. What makes women easy victims for the unscrupulous doctor is the general hopelessness that they feel as they move from doctor to doctor looking for the magic cure for their balding so when a doctor brings the promise of a cure, they will easily spend thousands of dollars to go that route. I do transplants on women, but very few of them as women make up less than 5% of my transplant practice and of those women, half of them are treated for non-genetic balding problems such as complications of facial surgery. The old axiom remains, ‘Let the Buyer Beware’.

Good luck to you.