FUT (Follicular Unit Transplant)


This question comes from a member of our hair loss social community and discussion forums: 

I recently underwent hair transplant surgery. Everything went well, but I’ve experienced this strange “spasm” in my forehead since the procedure. I am wondering if it was from the local anesthetic; my doctor said he performed a “supraorbital and supratrochlear nerve block.” Is this normal? Do patients experience muscle spasms after hair transplant surgery?

First, and foremost, I think you should discuss this issue with your hair transplant surgeon. The doctor may have experience with this issue and offer an explanation to help put your mind at ease. 

facial nerveMuscle twitching in your forehead would likely be related to activity of the facial nerve (cranial nerve VII). During the procedure, it sounds like your doctor performed an anesthetic “block” of the supratrochlear and supraorbital branches of the trigeminal nerve (cranial nerve V). These nerves exit the skull directly above the midline of the eyebrow. The temporal branch of the facial nerve, which controls the muscles in the forehead (and would likely cause the spasm), is a bit deeper and further lateral compared to the trigeminal injection site. This means it would be difficult to accidentally inject or damage this nerve during the anesthetic block.

The other concern could be nerve issues during the strip extraction process of a Follicular Unit Strip Surgery (FUSS) procedure. However, the facial nerve exits the skull near the bottom of the ear, and this position makes it unlikely to be damaged during the strip extraction process.

This question comes from a member of our hair loss social community and discussion forums

I recently underwent hair transplant surgery, and need to return to work. Part of my job requires me to wear a hat. I spoke with my hair restoration physician and he said I could wear a hat after the grafts were fully anchored. How long does it take for the grafts to anchor and become permanent? Can I wear a hat after hair transplant surgery?

bad hatIt takes approximately 7 to 10 days for the newly implanted follicular unit grafts to fully “anchor” and become permanent. Before this time, manipulation or compression of the grafts may cause permanent damage and affect growth. Due to this fact, most hair transplant surgeons recommend waiting 7-10 days before wearing any type of cap that could compress, move, or dislodge a graft.

After the 7 – 10 day mark, the grafts should be permanently connected; at this point, no amount of manipulation should cause any damage. Wearing a hat after this period should be perfectly safe. It is, however, important to discuss issues like this with your hair restoration physician. Many doctors have specific rules about activity post-surgery, and it is important to follow these closely.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

This common post-operative concern was recently discussed by Coalition hair transplant surgeon Dr. Carlos Wesley

post-op-pimpleA common observation among patients during the early phase of hair growth following surgical hair restoration (either Follicular Unit Strip Surgery or Follicular Unit Extraction) is ingrown hair follicles. The “pimples” that some (but not all) patients experience generally represent focal inflammation (folliculitis) where a newly-ingrowing hairs are beginning to surface.

Patients can often feel reassured knowing that these generally precede more apparent hair growth over the following weeks and months. They can be seen in both the recipient area (where transplanted hairs are coming in) or donor region (especially in FUE where any residual hair fragments may be coming in). They may be more commonly observed in zones where the angle of hair implantation is the sharpest angle (e.g. the vertex or crown).

In general, a simple cotton ball soaked in rubbing alcohol can be used to rub on each pimple. The microabrasion allows the nearly-ingrowing hair to surface and resume growth. It’s relatively rare that an antibiotic is required, but even a one-week course of antibiotic can have a positive impact. The ultimate appearance is not impacted by the presence absence of a few “pimples” and patients should simply be aware that they generally represent an early phase of growth. 

-Dr Carlos Wesley
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

This question comes from a member of our hair loss social community and discussion forums

Several years ago, I underwent a hair transplant procedure using all scalp grafts. I’m now seeking a second procedure to refine my hairline – which I think looks a bit “pluggy.” Can the surgeon refine my hairline with beard hair grafts? Are body hair grafts (body hair transplants) generally used in the hairline?

beard hair transplant fixedBody hair grafts – of any kind – are not usually placed in the anterior or temporal hairline. While the diameter of the hair shafts and duration of the hair cycling is most similar with beard grafts, the hairs themselves are still noticeably different.

I’m afraid placing beard grafts into the hairline would actually have the opposite effect: making the hairline look more “pluggy” and harsh. You likely have scalp grafts in reserve, and placing these in the hairline (via Follicular Unit Extraction or Follicular Unit Strip Surgery) would probably make the biggest difference.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

Technorati Tags: hair loss, hair transplant, , , , Follicular Unit Extraction, Follicular Unit Strip Surgery

This question comes from a member of our hair loss social community and discussion forums

Recently, I underwent a hair transplant procedure. The surgery went well, but I’m now experiencing an upset stomach from the post-operative medications. Is this normal? Can these medications cause gastric or intestinal issues?

medicationsHair restoration physicians frequently prescribe several medications after hair transplant surgery. These drugs include: pain medications, steroids, and antibiotics. Pain medications, such as hydrocodone and oxycodone, are most common. However, some physicians do prescribe anti-inflammatory steroids and antibiotics. Each of these medications can cause stomach upset and digestive issues.

Common side effects of opiate pain medications, like Vicodin (hydrocodone/acetaminophen) and Percocet (oxycodone/acetaminophen), include slowed digestion and constipation. Steroids, which may be prescribed for strip surgery (Follicular Unit Strip Surgery) scar stretching, affect the protective lining of the stomach. Steroids stop the production of the protective barrier lining and expose the sensitive stomach tissue to irritating acid. This often results in a “gnawing” stomach pain or the sensation of “acid reflux.”

Antibiotics are designed to kill bacterial organisms. When the body is infected by a foreign bacteria, this is great! It is not ideal, however, when the targeted bacteria is a natural part of the human body. The human digestive system is lined with “good” bacteria. These organisms help us break down foods and utilize nutrients. When antibiotics unintentionally attack these organisms, two unfortunate problems occur: 1) the body cannot digest properly and essential nutrients are lost; 2) the “good,” healthy bacteria are replaced by bad bacteria. These foreign, infectious bacteria go on to cause digestive issues like “crampy” abdominal pain and diarrhea.

This below question was asked by a member of our Hair Loss Social Community and Discussion Forums and answered by recommended hair restoration surgeon Dr. Tejinder Bhatti.

How soon after a hair transplant strip removal can the scar have FUE grafts put into it? My last strip operation was in October and it’s already stretched significantly.

Also how long do you need to wait after a hair restoration surgery before doing follicular unit extraction into the previously transplanted area? I’m guessing at least 8 or 9 months to avoid planting grafts on top of previously planted ones that are still emerging.

Dr-Bhatti-photoIt takes a follicular unit strip surgery (FUSS) scar 18 months to become supple. This would be the best time to fill it with FUE grafts and disguise its straight line. If done earlier, graft take is certain to be less than optimal.

In response to your second question, 6 months is a long enough wait before we can go in again for a second harvest from the same donor area. For filling up a previously planted area, 9 months is a reasonable wait period.

Best wishes.

Dr. Tejinder Bhatti

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community.

Technorati Tags: Hair Loss, , , , , ,

This question comes from a member of our hair loss social community and discussion forum

I’m a female with a high, abnormally shaped hairline. My hairline looks more like a man’s suffering from androgenic alopecia than it does a normal female hairline. I’m not suffering from hair loss, but I do want to fix my hairline with surgery. What surgical options are available for a female with a high, abnormally shaped hairline?

hairline loweringWomen seeking surgical hairline restoration or reconstruction have two options:

The first is traditional hair transplant surgery. Hair transplantation, both via the follicular unit strip surgery (FUSS) and follicular unit extraction (FUE) method, is usually a good option for female hairline reconstruction. Female patients with high or abnormal hairlines generally do not suffer from diffuse female pattern hair loss and, therefore, possess a healthy supply of available donor grafts. These grafts can safely be used to rebuild the traditional low female hairline.

The second option is surgical hairline lowering. Female hairline lowering involves removing a strip of skin between the hairline and the forehead, physically moving the hairline to a lower position, and suturing it into place. Although this procedure is generally more invasive, the results are drastic. Those interested may want to consult with recommended hair transplant surgeon Dr. Sheldon Kabaker, who specializes in hairline lowering.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

This question, asked by a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair restoration physician Dr. Timothy Carman:

It’s been 4 weeks since my hair transplant and my donor scar is still very red. Should I be concerned?

Dr_Carman_photoIt may just be your skin type and its healing characteristics. Really, the issue is whether it feels tender or warm to the touch.

It would be unusual to have any sort of infection or reaction this far out, unless of course your hair restoration surgeon used dissolvable sutures. If that is the case, the redness should decrease as that process resolves.

Dr. Timothy Carman

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

To share ideas with other hair loss sufferers visit the hair loss forum and social community.

Technorati Tags: Hair Loss, hair transplant,

This question comes from a member of our hair loss social community and discussion forums:

I underwent a Follicular Unit Extraction (FUE) hair transplant procedure a few days ago, and I’m wondering how long it will be before the grafts are “safe” and cannot be damaged? I’m concerned about possibly damaging the grafts after I return to work (I’m an accountant).

chrisdavAccording to expert hair transplant surgeons, the newly implanted follicular unit grafts are fully anchored between post-operative day 7 and 10. This means by day 10, the grafts should be fully anchored and permanent, and no reasonable activity should damage the new follicles.

Although returning to non-physical office work should be perfectly fine, it is always best to “double check” with your clinic’s post-operative instructions. Following your doctor’s instructions after the surgery helps ensure quality results and provides useful information for any future procedures.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

Technorati Tags: hair loss, Follicular Unit Extraction, , , hair transplant surgeons

This question comes from a member of our hair loss social community and discussion forums

I’m a female hair loss sufferer. I’ve tried a variety of different medications and therapies, but nothing seems to work. I’m now considering a surgical solution and wondering if I am a candidate for hair transplantation. Can females undergo hair transplant surgery?

female hair lossYes, female patients can undergo hair transplant surgery. However, female pattern hair loss (FPHL) and androgenic alopecia (male pattern hair loss) are two very different conditions, and treating hair loss in women is often a more difficult task. Unlike male baldness, where hair sheds in patterns and leaves a viable donor region for transplantation, female hair loss is often diffuse and leaves a poor permanent donor region. This makes extraction of healthy follicular unit grafts more difficult.

Female hair loss may also be caused by a variety of complicated issues. Unlike androgenic alopecia, which is universally caused by a sensitivity to dihydrotestosterone (DHT) hormone, female hair loss can be attributed to a variety of hormonal imbalances, low blood levels, menopause, hair styling (though this is normally temporary), low iron, and other issues. Females of childbearing age are also unable to utilize finasteride (Propecia), which decreases the options for preventive medications. This means female patients must be thoroughly examined by specialized physicians (usually either endocrinologists or dermatologists) and carefully use other preventive methods before considering surgery.

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