Category: Post-Operative

Hello! I had a transplant at NHI with Dr. Mcclellan in February 2005 (2000 grafts). After the growth, and then fall out, I am starting to sprout What I have developed the past 3-4 weeks is a horribly itchy scalp that feels slightly greasy and is covered with a layer of sebum.

I have tried Nizoral and Head & Shoulders, but am afraid they will make my hair fall out, and dry/damage it. Is this a normal occurence after a transplant? I am itching so badly, that I am starting to shed.

You will have to experiment with different shampoos and conditioners, to find out what works for you. Remember, a hair transplant is a series of organ transplants and each and every one of the follicular units are full organ. It appears from your question that the glands of the new hair are producing excess sebum. Possibly twice daily shampoos during this period might help. You are nearing the 8 month post operative period, so please make an appointment with me so that I can see where you are, and maybe give you a more personalized suggestion.

I have had a hair transplant and I have numbness in both my front and back. How is this possible, how long will it last and will I become normal again as I love to have my scalp massaged.

Numbness does happen frequently after a hair transplant, both in the recepient and donor areas. Everytime a person gets a cut or a bruise, the area that is cut or bruised will develop swelling and numbness. The numbness will abate with time. The cutting and/or swelling of small nerve fibers are the cause of the numbness after a surgery, but in the scalp, there is a rich supply of redundant nerves so if one small nerve is cut, another picks up the function fairly fast. There should be no long-term numbness, but I have seen an occasional patient who had their major nerve cut in the back of the head. Even when this complication happens, the alternative pathways will frequently take over and that process may take weeks, months, or on rare occasions, up to two years to correct. Most experienced surgeons should be able to avoid this problem. In conclusion, many very small cutaneous nerves are often cut, but the sensation returns with time. Having had two hair transplants, I can tell you first hand that my scalp was normal within a couple of weeks and within a month of the transplant, I was able to enjoy a scalp massage.

I had a hair transplant in November of 2004. The doctor was a member of IAHRS and had many good patient photos, and the procedure seemed to go very well from my standpoint. But I still have seen no significant results. I was a Norwood 3 with thinning in the frontal forelock. Now, my hair is significantly thinner on the sides, and while about 20 hairs grew in very quickly (about 2 months after the procedure they began to grow) no other hairs have grown in and my front is thinner than it was at the time of the procedure. I was wondering at what point can i be sure that no new hairs will grow in, and that the procedure did not work? Soon I will be 7 months post-op, and I still have no significant growth of the 1700 grafts I had.

Thanks for your time.

Generally I tell patients that by 8 months, fully 80+ % of the grafts should have reached styling length. That means that the growth should be well underway by now. On rare occasions, I see delayed growth, but that is not common. IF the procedure failed, speak with your doctor directly and ask him why he thinks this is happening. If he is a good person, then I would expect honesty and some reflection on his experience with this type of problem. He should be forthright and direct with you.

As a side note, many times when a patient tells me something is wrong, I make a point to focus on what the patient is saying, adding my observations to the mix. That is why a good doctor/patient relationship is important. Things can go wrong at the time of surgery that could cause this, but more often it is things that are not evident that need to be addressed. For a complete failure to occur, something bad happened at the time of surgery. But alas, doctors are not always in 100% of control of all variables. Pass me your doctor’s feedback and let me know.

I had a transplant and the hair that was transplanted became kinky. Does this happen often?

No, change in hair character is not common, but it has been reported to me in about an estimated 1-2% of patients. It rarely gets very kinky, most of the time it just becomes more wavy. One patient that I do remember did get a kinky change to his hair after both transplants sessions. He loved it- his hair had never had any character before, so this was a most happy change for him.

I don’t like pain so I have stayed away from hair transplants. If I take the plunge, how much will it really hurt?

Pain is relative. When I discuss pain, I always discuss safety at the same time, for it is not worth putting someone’s health at risk to wipe out pain. Some people handle pain better than others so there are no absolute rules here. Most people tell me that it is like having your dentist making an injection in your gums, but the pain comes in two flavors:

1. The pain from the administration of the anesthesia itself (like what the dentist does to numb your gums and nerves)
2. The post operative pain. There is no pain once the local anesthesia takes effect, most patients either fall asleep or just relax and watch a movie during the procedure.

If the hair transplant is performed completely under local anesthesia, the risks to your health are almost non-existent. You almost never hear of a person dying from filling a cavity in a dental office, but many die crossing the street. Laughing gas, prior to the local injections of Xylocaine, helps with reducing the pain from the injections but doesn’t eliminate it. In some cases, the doctor will administer stronger medications that will block even more pain and will allow the patient to more fully relax. The risks to health of being “put out” completely are slightly higher than putting up with subdued pain with laughing gas. The choice is made between you and the doctor. I have found varying reactions to the injection pain, from “no big deal” to the other extreme. The pain from the injection rarely lasts more than a minute. During the surgery we make sure that you are kept pain free, and the medications given last for about a four hour period after you leave the office.

If there is pain following the transplant, it occurs the first night. To deal with that pain, we do give you medications to take with you that will block the pain. These medications are strong and I recommend that they be used for night use only. A sleeping aid is also given for you to use. The use of simple over-the-counter pain medications will work during the daytime. Rarely are there many complaints of pain after the first night.

Getting hair is far less painful than the emotional pain of going bald- at least, that is what my patients tell me. I feel that pain is a non-issue since we have effective ways to deal with it, most of them pleasantly.

I have thin hair in front. I am in the public eye and can not take off more than a day or two. What will I look like after a hair transplant?

To answer your question, I took some pictures of a person who is 50, who had a hair transplant (1,046 grafts) and came in for a hair wash by us the next day. He has enough hair to cover the transplants. Good washing will guarantee, as much as possible, that any scabbing is removed. With the use of medications, we can keep swelling on most people to undetectable levels. He can go out in public the day after surgery without any real detection.

The photo on the left was taken before his procedure — the photo in the middle and the photo on the right are 1 day after.

Update: Oops, I originally posted the wrong patient photos with this entry. I apologize for the confusion. The correct photos are what you see above.