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https://clinicaltrials.gov/ct2/show/results/NCT01231607?show_locs=Y§=X430125&view=results#othr

Why is the hair from the second transplant just one year ago finer than the hair from my first hair transplant 18 years ago?

The new hair compared to your transplanted hair from 18 years ago should be the same as the hair in the back of your head. Check each area with a micrometer and see if they match.

He did 1500 grafts in just 40 minutes. I counted only 700 or so. What do you think?

The surgeon must make a surgical record of the actual graft count. Ask for that surgical record, as you are entitled to it. In 40 minutes for 1500 grafts, I would say that is ‘god’s speed’. Was the surgeon some deity? The wounds look larger than I would make them. I would need more information about the surgery such as strip or FUE? If it were a strip, the dissection would not have been very careful and in 40 minutes, I believe you may have been, as you said, ‘taken to the cleaners’.

What you are seeing is terrible post-operative care which has allowed thick crusts to form on your head and then crack. An FUE is treated just like a regular hair transplant with regard to the recipient area while the donor area has open wounds which require daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish.

The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts. IF any crust are present, use a Q-Tip and dip it into soapy water and roll it on the crusts. That will lift them off without dislodging them but never rub them, just roll the Q-Tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area are gone in 7-10 days with daily washing.

I don’t like the idea of anyone removing grafts that have scabs on them. We have published a paper in a formal medical journal (https://newhair.com/wp-content/uploads/2018/11/mp-2006-graft-anchoring.pdf) that states when a person pulls off a scab (crust) from a recipient area in less than 12 days, the risk of losing the graft is very high. Put a shampoo on your head and let it sit for 10-15 minutes, then gently work the crusts with your fingers. This will take days to get the crust off but you will not disturb the grafts.

I am also disturbed that 3000 grafts were placed in the frontal 3 inch zone of your scalp. Keep in mind that most people have only a bout 7000 grafts in their donor area and if your original donor density was low, then that number could be 4000 or even less. IF your hair is fine, things get even worse. You can contact me for more details on how to evaluate your long term planning if you wish.

Nice early results. It shows the impact of finasteride and minoxidil used in combination. The impact on the crown is clearly better than on the front, but both are better. It is unusual to see results in just 3 months but because he kept his hair short, the new hair impacted by the finasteride and the minoxidil showed better. If his hair was longer, then he may not have seen the value as quickly because only the hair close to the scalp was helped by the finasteride and the minoxidil.

I had my hair relaxed 9yrs ago and got a burn in the balding area. the burn healed but hair from that area started thinning. 3 yrs later it fell off then grew back again, thinner and on a larger area. 3yrs later same thing happened again. Last yr was another 3yrs later when it fell off again. i haven’t used hair relaxer on my head since 9yrs ago.my scalp hurts a lot on that area.what can i use to restore my scalp and get my hair back. Please please help

You seem to describe a cycle of 3 years where your hair thins and grows back. I have never heard about such cycle and I am not sure how it relates to the chemical relaxer from 9 years ago. Our hair does grow and fall out in cycles but it is not very predictable nor synchronous. Human scalp hair is constantly growing and falling asynchronously. We can lose 100-200 hairs a day but there are 100-200 new hairs growing elsewhere on the scalp at the same time. So this cycle should not be readily perceptible. On occasion some experience telogen effluvium where there is significant hair loss without any inciting cause. There is no treatment for telogen effluvium other than time, as hairs do grow back within a year.

Pain on your scalp is not normal and you should have it checked by your dermatologist.