Category: Post-Operative

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Hair Loss InformationAftercare Products for Eyebrow Transplantation – Hair Loss Information – Balding Blog

Once one has had their eyebrows transplanted, do you know of, recommend or sell any products such as eyebrow gel, clear mascara etc. that helps keep the eyebrows in place (ie. something with a strong, long lasting hold)? Any information or recommendations you may have would be greatly appreciated.

Please get back to me at your earliest convenience,

Thank-you

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Most eyebrow transplants come from the scalp. I am assuming that the surgeon who did your eyebrow transplants put them in the correct direction and shallow enough to lay flat. Eyebrow transplants are a real art and they must be delicate and made up largely of single hairs.

Assuming that everything was done correctly, your new eyebrows will behave like head hair. If the character of your head hair is wild, unable to control easily, then the same will be the case for your new eyebrows. Relaxers for very wild hair may work, and using a good conditioner will relax it as well. You may have to put a fine wax on it. Speak to a good hair stylist for suggestions.

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White Scabs 3 Months Post-Procedure – Hair Loss Information by Dr. William Rassman

Hello
I had a strip procedure done a little over 3 months ago and now Im starting to get a little worried. I have these white scabs in my donor and recipient area, and when these scabs come out, they carry with them 2-5 hairs. This does not seem normal…

At three months you should be completely normal. Most people have no scabs within a week or so. This may be a matter of your washing technique. I have seen men who do not wash their hair properly leaving the remnants of hair and scabs for weeks or months.

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Post-Operative Questions About Telogen – Hair Loss Information – Balding Blog

First, I would like to appreciate your online service, for freely accepting questions and comments and for your valuable answers. Thank You.

I have had my hair transplant about 12weeks ago of approx. 1,650 grafts. My donor area took quite some time to heal, approx. 9-10weeks, before the occasional swelling in a few spots which have now completely subsided. During the first 10 days I had some grafts fall out, which I was told was normal, over the next few weeks I lost more of these transplanted grafts as has been considered normal procedure after a hair transplant. I have had to deal with pimples/puss modules in the transplanted region occasionally and again I read that this is normal. I have used Neospirin ointment to treat these modules and it has helped quite a bit. I am also taking finasteride 1mg for about 17weeks (started 5weeks prior to the procedure as recommended by the Doctor). It is now 12 weeks, and my questions are:

  1. Is it possible that not all the transplanted hair has fallen out? Because when I touch the transplanted region with the palm of my hand, I still feel a few spikes here and there. Just today I noticed a couple of hairs with scab attached at the bottom fall out. Should i be concerned that even after 12 weeks not all of the transplanted hairs have fallen out?
  2. As I do not see much new hair in the transplanted area as yet after 12 weeks, should I be concerned, when I have been reading that by 2-3 months the new hair would start appearing.
  3. I am considered type VI and 35yrs of age. Even with taking Finasteride, I seem to lose at least 50-75 hair everyday after the two daily showers. Do HOT water showers have a negative impact?

Your valuable comments are much appreciated. Thank You

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I am fairly sure that you are not losing hair transplants, but what you are seeing may reflect poor cleansing of the recipient area where the scabs stayed on too long. Without seeing you, I am assuming that what you are seeing is the hair from within the old grafts that is coming out (the hair that should have fallen out earlier). The ‘root’ of the transplanted graft is secure in a couple of days after a transplant until the scabs are all off. Rarely will a transplanted graft come out after the scabs are gone (in our hands in just a few days the wounds lock the hair graft into position because of the small needles we use). We have researched this extensively, and found that they can not be pulled out the earlier of (1) after 10-12 days, even if you try to pull them out, or (2) the disappearance of the scabs (usually a couple of days in our practice). In patients who do not comply with our washing protocol, the scabs may last for weeks.

Hair roots start taking hold and growing hair in 10-20 weeks after the transplant procedure, so I would not worry at this stage in the transplant growth cycle.

Hot showers will not cause hair loss, but if you are losing hair, then there may be a shock effect from the original surgery which should be about over shortly. You need to ask your doctor to map out your remaining hair for miniaturization to determine if your class 6 pattern will progress to a more advanced pattern. That should have been in the discussion when you and your doctor made a Master Plan for what was about to happen to you with a hair transplant.

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Moser Clinic – Hair Loss Information – Balding Blog

Hello!

Here in Austria we have a hair restoration clinic named Moser Clinic. This is a quote from their website:

“Unlike scientists in America Karl Moser and Dr. Krugluger integrated the experience and know-how of organ transplantation into their research. They found out that the time when the hair is removed from the donor area until it gets placed into the recipient area is the most critical and the major reason for reduced hair growth after the transplantation. During this time the FUs need a perfect, humid environment.

While other clinics still use a saline solution for intermediate storage, the Moser Medical Group developed its own solution to stop hair loss after transplantations. After the FUs have been dissected, they are stored in this solution where they are treated against disturbance of growth, until they get implanted. ”

Well they claim they know how to make the hair not fall out after a hair transplant. Could such things be true or is it simply a hoax?

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The Moser Clinic is a highly respected organization and the work of Karl Moser and Dr. Krugluger has been presented to the ISHRS (International Society of Hair Restoration Surgery), where I was in the audience. They are credible scientists. Their solution appears to reduce the hair loss shedding immediately after the surgery. I would be interested in trying it, but I am prohibited from using it for many reasons including:

  1. It is not FDA approved in the United States
  2. The technique appears to have many nuances and I would want to master them before trying it on people
  3. I do not perform human experimentation

I spoke to them about the FDA and offered to cooperate with them and help them get it through the FDA process when we met this summer in Sydney, Australia.

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Hair Loss InformationPimples After Surgery Caused Skin Change – Hair Loss Information – Balding Blog

Dear dr. Rassman. Thank you for having time to answer questions concerning hair loss.

I am a black man. I had an FUE operation about 6 months ago. The donor area at the back of my head healed very well, but in the receiving area I got small pimples almost in every grafts incision (1000 grafts) in the front area of my head which looks different from the rest of the smooth skin. The hair is growing but it is not that dense to cover this area. These pimples are well seen especially from certain angles or according to the light reflection. I am really worried about if these skin changes will be permanent. What shall I do? Do you have any advice for me???

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Pimples can be caused by sebum collections below the skin edge, but should have gone away within the first few months. FUE grafts should be trimmed, for if they are not trimmed and divided into their respective follicular unit, they will contain too much skin. The added skin will produce a skin deformity at the recipient site like the cobblestonning I talk much about in my published articles. The way light is reflected is an indication that too much skin may be have been left on the FUE graft or that the FUE graft was not separated into individual follicular units. Rarely, people with dark skin will tend to cause more scarring than those with very fair skin. Changes in the recipient area with a hair transplant do occur if you had atrophic skin (skin that lost much of the supportive infrastructure from blood vessels to glands, muscles and fat) or your hair is coarser, or if the surgical instrument used was large (by large I mean greater than 1mm, as a slit graft) or combinations of any of these factors. Today’s surgeons will use very small cutting instruments to minimize the skin wounds, hence the pitting or skin changes that could occur when the wounds are made too large. Skin deformities in the recipient area are rarely detected with small cutting instruments. Without seeing you directly, it would be hard to determine if any of these factors (or other factors) are playing a role here. I would expect that most people should not have this complaint, but just the other day I met a patient who had surgery from another medical practice with a similar complaint and I barely could see what was bothering him. This man had a body dysmorphic disorder. To determine your situation, either come in to my office (if you are in California) or at the least, send photos to the address on the Contact page.

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Inducing Traction Alopecia to Unnatural Looking Grafts – Hair Loss Information – Balding Blog

2 years ago I had a transplant, but near the hairline and in the temporal zone there’s some grafts of 4 hairs that do not look natural. Beyond the excessive number of hairs per graft, the thickness of the hair shaft is greater than the neighboring hairs and therefore visible. Some of the grafts seem to have pitting, but if I pull out the hairs in the graft, the pitting is not visible. I would want to know if the transplanted hairs will become gradually finer over time. If I continue to pull out those hairs, is it probable that they will regrow finer or some not regrow at all, inducing a sort of traction alopecia? If it succeeds, I think the look one will be better.
Thank you for your kind attention and reply.

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I have seen people that have pulled their eyebrow hair out until they get traction alopecia. It sounds like your strategy may work, but I can not tell you how long it will take to get where you want to be. Every person is different. Alternatively, you can have these grafts thinned with an FUE procedure (fairly reliable) or perform electrolysis (a 30% success rate in many people’s hands). The costs for a limited number should be relatively small. The one advantage of FUE is that the grafts can be relocated with minimal effort in small numbers.

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Washing Scabs One Week After Surgery – Hair Loss Information – Balding Blog

I just had a FU mega-session 7 days ago. I have been very careful with daily washing of the 3000+ grafts that I had. I have been washing and rinsing only through a washcloth. I have been using the post-op copper peptides etc. I have been so careful that I have not really lost any of the scabs or crust associated with grafts. I even have been sleeping with moistened guaze under a surgical cap at night.

I am needing these (scabs etc.) to be gone so that I can return to work. In a previous posting you mentioned advocating “aggressive washing”. How should I be washing the grafts at 7 days post-op, in order to expedite the scab removal. I haven’t been picking at them but maybe I have been too careful…….Please help.

Your sight and advice are very valuable and I thank you for them……

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Washing is something that must be started at the time of the surgery so that when the patient leaves the surgical suite, the recipient area should be clot and blood free. A good thorough washing the morning following the transplant is critical as it will impact the appearance on all subsequent days. Good washing protects most people against folliculitis and infections of the donor wounds so daily or twice daily washes are critical. There is a washing art form, one which we teach our patients at the time of the surgery and on the day after, when most patients return for a hair wash administered by us. After 5-7 days, the scabs should be gone. If they are present to a significant degree, then you must be gentle with them for if you pull one out, the graft may come off with it. Mostly, if the wounds are small and the scabs are already shedding, you can wet your hair, cover it with a good conditioner when wet, leave it on for 10-15 minutes to allow the scabs to soak up the moisture, and then wash your hair using your finger tips to gently try to get the scabs off. Dr. Robert Bernstein and I just wrote a scientific paper on this to show that when the scabs are off, the grafts are safely anchored. The scabs anchor to the grafts, so if you pull on a scab the graft can come out with it. If you follow the washing technique I just outlined the scabs should come off in a day or two, providing that they are not anchored too tightly to the scalp.

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Hair Loss InformationFollow-Up From an NHI Patient, ProCede Question – Hair Loss Information – Balding Blog

Dr. Rassman,
I had undergone a surgery at NHI, San Jose in 2003. I must say the transplant has been one of the best decisions I’ve taken in life. Thank you and your awesome staff! I could see my photograph is now featured in the NHI website. Wow!

After the holiday season, I am going to seek an appointment to evaluate the present state of scalp. However, I just came across a “cosmetic” hair-product called Procede that claims to “increase diameter of hair shaft”. However, they also say it’s “not going to work for persons who already had undergone Hair Transplantation”. That, frankly, sounds a bit weird to me.

Do you have any idea what this is?

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I am happy to hear about your nice results. Your photos are very impressive and the change must make you quite happy. It certainly made my day reading your email. For those interested, this patient’s photos can be seen on the NHI site as Patient NO.

I’ve written previously about Procede here. As to why they say the product is not suitable for people who have had hair transplantation, I can not imagine why it would be harmful. However, if that is their warning it suggests to me that there may be something toxic about the product. I have no inside knowledge about this product or its potential toxicity.

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Hair Loss InformationPost-Transplant Shampoo Recommendation? – Hair Loss Information – Balding Blog

I had my HT one month ago and have been searching for a good shampoo and conditioner. On the blog I’vee seen entries talking about Regenix and Nioxin, which you seem to think have had anecdotal evidence of working. Would you recommend one over the other, or do you think its a waste of money. I just feel like I spent a lot of money and want to protect my investment as well as possible.
Thanks.

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Use whatever shampoo you like, as none will be better than the rest in getting you to where you finally want to be after a hair transplant. What is most important is to get the ‘scabs’ off with good washing and then keep clean. Do not scratch your recipient area.

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Can My Grafts Be Dislodged 4 Years After Transplantation? – Hair Loss Information – Balding Blog

Hi there
I’ve had three graft procedures – the first of these 6 years ago and the last 4 years ago. The results were not that great (I still look balding) though there is quite a bit of new hair overall.

This past year I’ve been considering having another procedure done. However, just lately i’ve been waking up once or twice a month to find very tiny-pin pricks of blood behind my hairline in the area where the grafts are – sometimes just one, sometimes two or more. Despite all the time that has passed since the procedures, I am concerned I am managing to somehow dislodge some of the (still vulnerable?) tiny grafts while I’m sleeping (I’m told I’ve been thrashing around a lot in my sleep the last few months due to various stress going on). Have looked on my pillow and cannot establish whether this is the case or not. However, it seems the only logical explanation I can think of …

Grateful for your comment.

Thanks

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Transplanted grafts are permanent, except for those that may have been taken from areas of the scalp where the hair may not be the permanent hair. These areas include grafts taken too high on the back of the head (where the donor area balds like it normally would) or from the neck (where the hair is not always permanent). But in your case, something else is going on and you need to see an expert to let you know what is happening. Could you be picking on it at night and not knowing that you are doing this?