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The Problem of Popping

I would very much apreciate it if you could explain what “Popping” is all about. As I understand it, it limits the amount of hair that can be successfully transplanted.

Popping is a technical term referring to a problem with placing grafts into the recipient sites in the balding area in a hair transplant. The grafts are placed and then do not stay in place, ‘popping’ out of the site. In the early days when we didn’t trim the grafts as closely and the recipient sites were larger, the bulk of the graft was so large relative to the surrounding tissue, that the graft would not be held in place. When the surgeon placed another graft next to the one that was only a couple of millimeters away, the ‘mass’ from the graft into this next site, pushed the last graft that was placed out of the wound. You can imagine a cascade effect, you place one graft and then another and the first pops out. Then you finally get both the first and second secured and place a third when the first two then pop out. That was the way it used to be.

Today things have changed. When we introduced the microscope in 1994, it was evident that smaller and more accurate dissection meant better results than dissection with other less powerful magnification tools. The grafts are smaller and can be more carefully dissected, so that the bulk of today’s follicular units is less than the old minigraft. The recipient sites are much smaller today, we use needles in the 0.8 – 1.0 mm range to make the sites. The results of the smaller site is that the ‘hole’ that is made tends to ‘hug’ the graft and the ‘bulk’ of the graft is of less consequence in the hands of an expert graft placer. Today the best surgeons have staff whose skills have built over years, allowing the grafts to be placed without disturbing the last graft placed. So, popping which was a major problem when we were getting the number of grafts from 500 up to 2000 in 1993, became less of a problem as we moved into the 3000-4000 grafts per session size.

To conclude, your question of popping is more of a historical question than a problem today. What is still relevant today, however, is that surgeons who use larger sites (greater than 1.2mm in size) to manage their grafts, are still practicing older techniques and popping (which is not a problem for us) still remains one for those less skilled in the art of today’s techniques.

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Going on Holiday with No Finasteride

Im a 17y/o M and I’ve been taking fin and minoxidil from March with great results but I’m going on holiday with friends and my fin isn’t coming on time and all I have is minoxidil will it be enough to maintain my results for 2 weeks, also I expect my minoxidil usage to be inconsistent due to the nature of parties and hangovers do u guys think I’ll be ok.
Finasteride holds its value, even after you stop it for up to 10 days. Never a good idea to stop it. It is small enough to take it with you on vacation, don’t mess with it.


2020-05-04 12:44:30Going on Holiday with No Finasteride

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Graft Anchoring After a Hair Transplant

Hi,

I am confused by some of your answers in the forum relating to graft anchorage.

Specifically, in your study with Dr. Bernstein, you conclude that from the 6th day, it is not possible to dislodge a graft by pulling the hair. Similarly, this is not possible by the 9th day by pulling a scab attached to the scalp/hair.

However, on some of your answers to questions related to graft integrity, you mention that as long as the scab is present, there is risk to the graft coming out (e.g. you advocate not wearing a hat until scabs come out, etc.).

So, are you saying that from the 9th day onward, the graft will not come out even if the scabs are scrubbed off, wearing a hat, etc. and the only time to worry about losing grafts due to scabs is in the first 9 days? Or is it possible to still dislodge a graft after the 9th day?

The reason I ask, is that I have a lot of scabs and started trying to remove them on the 11th day, and am wondering if the grafts would have set permanently by then, scab or no scab.

Thank

The graft pull study (PDF file) was done to determine when the removal of the graft, really meant that the entire growth center of the graft was removed.

We found that in the first six days, although the physical graft could be pulled out, the graft growth center probably remained (reflected the sleeve of the graft itself). We generally felt better when the graft pull was done at 9 days, but that did not mean that the graft growth center could be removed at the 9th day.

We are big on post-operative correct washing to minimize the scabs present. Some doctors do not give the patient the instructions on proper washing and scabbing may remain for very long periods (as long as 3 weeks). Although pulling out the grafts (at say 20 days) would still have what appears to be graft material in the pulled samples, there is little doubt that the graft growth center did not come out with these pulled grafts at 14 or 20 days.

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Gray Hair in a 7 Year Old

Hi, My son is 7 years old and I noticed a strand of grey hair on his head. Please let me know as to how this is happening and what can I do to prevent it further.

This is a genetic process, so my initial thought was that genetics would be the likely cause. Something has probably triggered the premature graying. Some people feel that this is an errant gene, like a chimerism in your son. There are a series of vitamin deficiencies that could also cause it, including vitamin B-12, although these are found in many foods. Some disease syndromes can be associated with it as well. See DrGreene.com for more information.


2008-09-18 11:05:53Gray Hair in a 7 Year Old

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Thinned Hair From Continued Stress

I have gone through a period of very high stress and very poor nutrition, and my hair has thinned dramatically from the full head of hair I had. I am 58. My Father and Mother both had full, thick hair when they died. Will this come back as long as I have stress in my life, and is there anything I can do to help my body repair. My nutrition has improved. Thanks.

I know nothing about your sex (male or female) or if you’ve had any medical tests that may indicate disease, and on and on. See a good doctor and be sure you are completely healthy first. Then a hair expert will have value for you.

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Does All of the Hair Grow Out at the Same Time? I Am Now 4 Months from My FUE.

Hair grows at different times in the growth cycle. At four months, some will be growing out, with more in the fifth and sixth months. This is why I tell my patients that the average person has 80% of the growth in eight months to a styling length of about one and a half inches. It varies with individuals, some earlier and some later. You clearly have growth now and it will only get better, longer, and thicker.


2018-06-26 12:53:03Does All of the Hair Grow Out at the Same Time? I Am Now 4 Months from My FUE.

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4 hair transplants and now have massive hair loss, I’m worse off!

I had my fourth FUT around 11 months ago and I’ve seen zero improvement. Shock loss kicked in 3 months after the surgery and hasn’t stopped ever since. All kinds of hair (native/transplanted/vellus) are shedding. My body can’t tolerate finasteride so I bought a laser helmet which I’ve been using for 3 and a half months now. The scalp feels stiff. Will take up ketoconazole shampoo and vitamin d supplements soon. I keep cutting them shorter to get rid of the sick-ish ends with that weird wiry/coarse texture but it’s only getting worse. Visited my surgeon recently and he told me “it’s fine, you’re not bald” and dismissed me. He didn’t even examine my scalp. They rarely admit something went wrong in my experience. I am at a loss and feeling really depressed. Any help would be appreciated.

You should have, by now, developed a great relationship with your doctor after 4 hair transplant surgeries. He/she should not dismiss you. You should have developed a Personalized Master Plan for your hair loss with your surgeon when you started the hair transplants. What it happening to you now should have been anticipated as a worst case situation. Did you create a Personalized Master Plan with your surgeon? I would be happy to take a telephone consultation with you at info@newhair.com. Sounds like you need help and advice.


2020-01-31 06:29:484 hair transplants and now have massive hair loss, I’m worse off!