I recently (11 days post-op today) had 1550 grafts on my fontal hairline with Dr. Alexander in Arizona. It was essentially a 'redo' of a poor hairline transplant I received from a former coalition doctor. Issues I presented with were (a) poor density of 15-30 grafts per sq cm (b) scar stretched to approx. 0.7mm to 1cm (c) squint (about 1cm higher on right side) and unnatural hairline.

I decided upon Dr. Alexander after (in contrast to first procedure) a thorough review of the coalition doctors who didn't require shaving (don't mind shaving recipient but can't shave donor with scar and not walking round with long back and shaved front). His policy of one patient per day was important for me. Despite flying from Europe, I thought the extra 4-5hrs to Arizona were worth it.

The difference between my first and second transplants were night and day.

Dr. Alexander was meticulous in his attention to every detail of the process, as were his technicians. He also spent a lot of time revising the scar. I apparently have a highly vascular scalp which Dr. Alexander explained (I think, although I was half out of it) can lead to a more rapid local decline in lidocaine/epinephrine concentrations, necessitating more frequent injections of both. It also sounded like he was cauterizing blood vessels at the back but I might have been imagining it.It was actually quite painful as the scar area became hypersensitive, but I didn't really care if this was the price to pay for a job well done.

The first transplant (and not this one) was also performed using a 'stick and place' technique, which I think might be harder for technicians to deal with if the patient is a bleeder, like I am. At least I remember the technicians saying how difficult it was in the first transplant as so many hairs were popping out again.

Now it's the waiting game, but even in my naivety I remember being very sceptical after the first transplant as there were so many things that didn't fit. I'm taking nothing for granted but I do know I've gone to a top-notch surgeon this time, so I'm quietly optimistic.

At 11 days out there's a densely packed hair line, which I expect will shed anytime soon, so I'll be a very happy man if these hairs decide to come back again. If the scar's improved it will be a home run. Will keep you updated at later dates.

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Good luck on your new procedure!

Did the new doc have any theories on why your donor scar was widened (i.e. no laxity, etc)?

__________________
Dr Arocha
3626 FU's

H1: 508
H2: 1741
H3: 1377


My Hairloss Website:
http://www.hairtransplantnetwork.com...asp?WebID=2127

Thanks!

I'm not sure if he specifically said why, but he said he didn't think a tricophytic closure was used (Dr. Alexander uses a 2 layer tricophytic closure).

For the record I never performed scalp stretching exercises for the first procedure (surgeon didn't believe in them) and started weight-training 8 days post-op (according the post-op instructions).

I've also started weight-training again (just 2 x 45mins per week), I don't believe an increase in blood pressure or 'straining' adjacent neck muscles increases scar tension, but am careful with head movements.

The stretching was only on both sides of my head, not on back, suggesting scalp tightness in that area and perhaps poor closure was the cause.

Looks good. You should have a nice result. I would be careful with the weight training because it is known to be a cause of stretching the scar. You may want to do a search on here about that. There are a couple of articles on it. I think as long as you are going light for now and avoiding anything that could cause any type of a pulling in the scar area you will be good.

Heal well and happy growing!

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Surgery - Dr. Ron Shapiro 6/14/11 - 3048 grafts

http://www.hairrestorationnetwork.com/orlhair1

Ok, thanks for your advice orlhair1!

Just on the sides... hmm. I can't see how that would be related to weight training either. I usually lift 3-4 times per week (haven't started back up yet). Doc said my closure was really easy with no tension. I created another message thread somewhere with my theory that possibly my weight training before the transplant helped with laxity.

What sucks now though is I'll have to give up a lot of my core excercises for a year. Squats, military press, situps, shrugs, rows... all out :/

What does your workout look like at this point? Btw... Arocha told me no weight training until at least two week after, which at that point needs to be very light lifting. Apparently it takes up to a year for the scar to mature.

__________________
Dr Arocha
3626 FU's

H1: 508
H2: 1741
H3: 1377


My Hairloss Website:
http://www.hairtransplantnetwork.com...asp?WebID=2127

My instructions were similar. I am almost 4 weeks out now. I decided to play it conservative and plan to start some light weights this week. Just did cardio the last couple of weeks. I agree that squats, military presses, sit ups, etc are all out for at least 6 months. But at the end of the day, it should be worth it.

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Surgery - Dr. Ron Shapiro 6/14/11 - 3048 grafts

http://www.hairrestorationnetwork.com/orlhair1

I believe there are several renowned docs who say weight training is ok 1 week post-op, Shapiro I think, and at least Dr. Alexander's technician said it was ok when she was removing the sutures.

I think doctors tend to err on the side of caution which is fine.

But there are no studies on this (as far as I know), just empirical and anecdotal evidence.

If there was a biologically plausible reason as to why weight-lifting would increase scar tension (and not just blood pressure and 'straining' of neck muscles as I often read) I'd be more inclined to believe it.

I do 2 x 45 mins sessions of core exercises, about 12 sets total per workout, with each set lasting 25-35 seconds, so it's about 12 mins total out of 168 hrs per week. I feel more tension on the wound if i simply lie on my bed and put my chin to my chest (for example to watch TV) than lifting weight above my head when it's aligned with my spine.

But I think everyone has their own ideas on this so no right answer

Agree. Dr. Shapiro told me to go light the second week and after that I would be good to go. He did caution me not to do anything that would pull on the scar for six months. With weights, he said that the main thing is to do the exercises properly so that you hold your head in a position that does not put stress on the scar. He also said that you will feel it if it starts to put tension on it and just stop what ever you are doing if that occurs. So, really just common sense and good form is the key.

__________________
Surgery - Dr. Ron Shapiro 6/14/11 - 3048 grafts

http://www.hairrestorationnetwork.com/orlhair1

Agree with this statement!

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Newhairplease!!
Dr Rahal in January 19, 2012
4808 FUT grafts- 941 singles, 2809 doubles, 1031 triples, 27 quads

My Hairloss Website