Post Hair Loss Questions and Get Answers

If you’ve had a hair transplant, you know that the transplanted follicular unit grafts aren’t rooted in the scalp until approximately ten days after surgery.  Proper care of your transplanted hair and scalp therefore are critical during this time.  But what is the best way to care for your hair restoration surgery?  What will help facilitate healing?  What should you avoid?

Click here to see what patients have learned about what you should avoid for the first ten days after surgery.  You are encouraged to add your own thoughts and experience on proper care after your own procedure.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair transplant, follicular unit grafts, transplanted hair, hair restoration

In hair transplant surgery, if one experiences “shock loss” in the donor area, will it grow back?

This question was posed by a hair loss sufferer on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

My sense is that in the majority of cases of donor hair shock loss, the hair mostly returns. I have had this happen three times in my career, none within the past 8 years, as I have gotten smarter with age, I hope.

In all three cases the hair grew back and there did not appear to be any permanent hair loss. I have personally seen four cases of extensive permanent loss above and below the donor scar in work done at other hair restoration clinics, and have heard of many others that colleagues of mine have seen come to them for repair.

One thing I have learned over the years is that, if at least one attempt has already been made by anybody to try and cut out the bare area, whether it’s from permanent shock loss or a wide scar, it is fruitless to attempt another excision procedure. Follicular unit extraction (FUE) into the scar is then the best option, even though the survival of grafts into this kind of tissue is less than the usual 90% we enjoy elsewhere.

Mike Beehner, M.D.

—

Technorati Tags: hair transplant, donor hair, shock loss, hair grew, hair loss, donor scar, hair restoration, Follicular unit extraction, FUE

What is the difference between hair growth at 12 months and 18 months after hair transplant surgery?  How much more hair growth can I expect?

This hair loss question was posted directly to Dr. Raymond Konior of Chicago, IL, who is a member of the Coalition of Independent Hair Restoration Physicians.  See his professional answer below.

In my experience the final result for hair density following follicular unit grafting is seen around the one year mark.  This is especially true for healthy first-time hair restoration patients who have the benefit of excellent blood circulation.  Patients who have had prior procedures, especially those who have undergone minigrafting or old-fashioned hair plugs, tend to have more scar tissue and compromised circulation in the previous graft zones.  These patients may take much longer to reach their peak density, in which case the 18 month result could look better than the 12 month result. 

Another example where one may see a distinct difference between the 12 month and 18 month result is in those patients who develop a texture change in their hair during the early hair regrowth phase.  The reason that a hair shaft assumes an altered texture following hair transplantation is poorly defined, but I believe it is related to the healing dynamics between the follicle and graft insertion site.  Insertion openings for follicular unit grafts are typically less than 1 millimeter in length.  Although this very small opening appears to heal very quickly, one has to understand that scar formation still occurs between the follicle and the scalp.  After all, it is scar tissue that mends all soft tissue injuries.  Even though the graft insertion site is a very small wound, the scarring process has the capacity to alter the physical characteristics of the follicle for some patients, in which case the result is a kinky or highly textured hair shaft. 

Technorati Tags: hair growth, hair transplant, hair loss, hair density, follicular unit grafting, hair restoration, minigrafting, hair plugs, hair regrowth, hair shaft, hair transplantation, follicular unit grafts

A few days ago, I had hair replacement surgery to cover my hair loss and am having difficulty sleeping on my back.  At what point can I sleep on my stomach again?  I’m concerned about hurting the transplanted hair.

You can sleep however you are comfortable however, for the first 10 days, make sure you do not sleep with your newly transplanted hair touching or rubbing up against the pillow.  This will take some strategic planning and placement of your head.  As a stomach sleeper myself, I learned quickly how to put my head on the pillow without rubbing up against the follicular unit grafts.  I’m sure with some practice you can too.  10 days after hair transplant surgery, the hair grafts will be fully secured and you will no longer have to worry about it  :-)

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair replacement, hair loss, transplanted hair, follicular unit grafts, hair transplant, hair grafts

Is there any evidence that suggests waiting a full two weeks for suture removal, as opposed to nine or ten days after hair transplant surgery will produce a thinner donor scar? 

This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

For many years we took the sutures out at around 7 days after hair restoration surgery. Around 6 years ago we switched to taking most patients sutures out at 10 days after a first hair replacement session, 12 days after a second session, and if a patient had a third procedure, 14 days for that surgery.

The more important point is that for any hair replacement patient with a slightly tight closure or who had “hyper-elastic” scalp tissue, we have the sutures taken out at 14 days, even for the first session. On rare occasions I have gone to 16 days, but the trouble with going past 14 is that the stitch material (or staples) start to become imbedded with skin tissue creeping over it, which makes the removal more difficult and more painful.

What is actually happening when a hair loss patient goes those extra 4-6 days with the sutures in place, you give time for the hair-bearing scalp above and below the suture line to start to relax and stretch out. In this process the remaining hairs become infinitesimally further apart, which the human eye can’t detect. Keeping the sutures in keeps the wound scar from being pulled apart on from above and below during those early days when the tension is the greatest.

Technorati Tags: hair transplant, donor scar, hair loss, hair loss help, hair restoration, hair replacement

I had my hair transplant surgery for my hair loss five days ago. I would like to know if I massage my hair with oil if my new transplanted hair roots will be affected or not?

The first two weeks after hair restoration surgery are extremely critical as the scalp is still healing.  By day 9 or 10, the grafts should be tightly secured and you can apply anything that you would normally apply to your scalp.  Some hair transplant patients however, do apply oil to their scalp to help loosen the scabs during the first 2 weeks.  If you are going to do this, apply the oil with a dropper and don’t touch the transplanted area for the first 9 days.

Bill Seemiller - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair transplant, hair loss, transplanted hair, hair restoration, hair transplant patient

After hair transplant surgery, are there any drugs that the hair loss doctors recommend or prescribe to get a good amount of hair growth or is it just surgery that causes the new hairs to grow?

The good news is, transplanted hair will grow on it’s own and does not require any use of hair loss or any other kind of medication.  Some physicians believe however, that using Rogaine 5% (minoxidil) for the first 3 months after hair replacement surgery might help “jump start” early growth however, it is not required for the hair implants to grow. 

Hair loss drugs such as Propecia (finasteride) and Rogaine with minoxidil however, are typically used to help maintain any “native” or natural hair you might have left.  Remember that hair transplant surgery does nothing to stop the progressive and unpredictable nature of male pattern baldness.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair transplant, hair loss, hair growth, transplanted, hair replacement, Hair loss drugs, Propecia, finasteride, Rogaine, minoxidil, male pattern baldness

As a hair loss sufferer visiting this hair restoration blog I’d like to inform you that Dr. Alvi Armani has filed a lawsuit against the Hair Transplant Network community for comments made on our forum that were critical of him and his clinic.

Yet another hair transplant surgeon does not feel that me or certain other members of this hair restoration community have the right to express our opinions or share our experiences.

I invite you to exercise your right to free expression by visiting our forum topic, Dr. Armani Lawsuit Against the Hair Transplant Network, and reply to demonstrate that you are prepared to exercise your right to free speech.

Fortunately our forefathers had the good sense to make the first amendment protecting free speech the very first amendment. Many people, including me, have expressed numerous reservations online about Dr. Armani and his questionable ethics, deceptive marketing practices, as well as issues with his hair transplant technique.

Two posters, one of whom claimed to be a patient of Dr. Armani, were banned on Hair Loss Help when they expressed reservations about Dr. Armani,his practice and his results. They then came to this forum and exercised their right to share their experiences and concerns. One of Dr. Armani’s online representatives then contacted us. We encouraged them to exercise their right to reply and refute any claims that they felt were not accurate. However, instead of replying they chose to sue the Hair Transplant Network.

I was wondering if someone can briefly explain what donor closure technique is the best and can produce the finest scar in hair transplant surgery?  Based on the discussions that I read on this hair loss forum, it seems like the trichophytic closure is by far the best technique to cover the donor area and reduce the scar but this is only true if you don’t need to have additional hair transplants.  Also, what is the difference between a single and double layer closure technique?  What about staples verses sutures?  Is this a personal preference or is there a specific reason to perform such techniques?

Excellent Question.

Having observed surgery at dozens of leading hair restoration clinics, it is surprising that there is not one predominant school of thought on the optimal donor closure technique.

Some physicians argue that using internal sutures below the surface of the skin in the subcutaneous tissue will reduce the tension on the skin that is sutured by an external skin layer suture. This technique is typically referred to as a “double layer closure” and can be used with or without the trichophytic closure.

Typically the internal sutures are dissolvable, while the external skin layer sutures need to be removed.

Other physicians argue that internal sutures should only be used when the donor area is particularly tight due to either low scalp laxity and/or a wide strip being removed. They claim that internal sutures, which can take over a month to dissolve, can potentially create reactions or irritations, although very rare, under the scalp.

Technorati Tags: hair transplant, hair loss, trichophytic closure, hair transplants, hair restoration, double layer closure

This insightful hair transplant article was written by Dr. Bernardino Arocha of Houston, TX who is one of our recommended hair restoration physicians.

A survey of this hair transplant patient’s bald head, shows that the lateral fringes and crown have completely been eroded. The lateral humps have been obliterated, and the hair on the temporal areas (sides) is quite low. This isa level 7 on the norwood scale of hair loss country, it is a follicular unit barren real estate , where there is more hair loss, then there is remaining hair!

As if, that is not enough, study of the permanent donor area reveals that the hair density is decreased and the total occipital hair remaining is very diminished by baldness on two advancing fronts. From above, Androgenic Alopecia is eroding the crown, while from below a Retrograde Alopecia is raising the neck hair line.

After careful study, it is determined that a minimum of 2000 follicular unit grafts will be needed to commence the hair restoration process. That is, 500 follicular units to raise the lateral humps. Into which, we can anchored the hair line , which is estimated to need at least 1500 follicular units. We do not know at this juncture, whether, we can achieve the full 2000 hair grafts, much less, any extra to transplant into the area beyond the hair line.

Technorati Tags: hair transplant, norwood scale, hair loss, hair density, baldness, Androgenic Alopecia, Alopecia, follicular unit grafts, hair restoration, follicular units, hair grafts