Dr. Timothy Carman

"May be used to simulate UFO's in the night sky...."

Abby- At nine weeks post op the scar may appear wider than it's "finished, mature result", as patients will experience variable amounts of temporary shock loss along the suture line in the donor area. Be patient, you are still at a very early stage. Also, as pointed out, IF you were to find (say, in one year) that you did have some scarring issues, they are usually fairly simple to correct- but again, that remains to be seen. Grow well!!

The presence of those pre-existing hairs will have no effect on newly transplanted grafts. So again, the recreation of those points is critical, in my opinion, to obtaining a natural result. Grafts for those areas are carefully chosen with respect to colour and size ("weaker" single hair grafts preferable; grey hairs in older patients). Also, the grafts must be placed at very acute angles and very specific radial directions in order to recreate a natural look.

Meta-monster- In general, in the case where there are weak "vellous"-type hairs present, the surgeon will simply place donor hair around or on top of those; they will then be lost due to permanent shock loss (in the case where the new grafts are placed close by) or injury (intentional, in the case where grafts are placed "on top" of the existing hair). As Bill points out, finasteride/rogaine may help, although in this area of the scalp (as opposed to the crown) cosmetically significant improvements in the quality of the hair aren't really common (hair LOSS may be slowed however, but that does not address the need for additional hair). And of course, this could be done in the same session as part of the overall plan. And yes, pics would be nice. By the way, are you talking about your "temporal points"? Those areas, if "faded" are crucial to assess and reconstruct when recreating a new hairline if you are to recreate a natural appearance. You can see an example of this in a patient I recently posted: http://www.hairrestorationnetwork.com/eve/showthread.php?t=145400

Thinman- "ditto" to all the above comments- I would recommend neosporin or bacitracin ointment to help keep the grafted area moist and help loosen the skin and hair shafts which are inevitably going to slough off. By two weeks all should be healed so there is no need to worry about "injuring" the grafts- Those follicles are glued in for life!!!! Grow Well!!!!

In general, and assuming you have adequate available donor- absolutely.

forgetit- Can you upload some clear photos of both the donor area as well as the transplanted area? It would help us in assessing your situation. Sincerely,

mopar- Have you had a consult with a Hair Restoration Surgeon?

exibel- The first shot (frontal), while out of focus, shows a left and right frontal flap, is that correct? Also, it appears that the left flap does have viable hair at good density, no? This may be a bit premature, and I am basing this opinion on very limited photo documentation, but, assuming you have adequate donor, it should be possible to correct this outcome with possibly one, but more than likely two procedures. Is there anyway you can get better photos taken? If so, a 1.Frontal; 2.Left/Right "3/4" view (Left /Right temporal view); 3. "birds-eye" view (straight overhead); and 4. Posterior view of donor area. I think this is a fixable situation, so again, hang in there. Sincerely,

exibel- I am very sorry to hear of your experience. Is it possible for you to upload a photo or two? It may help me determine why a flap was entertained in your case in the first place, as well as allow me to get a look at the scarring and, most importantly, your donor area supply. Even with a limited amount of donor it may be possible to create a natural looking appearance that will finally give you some peace. Please do not give up; even the most botched work can be salvaged using current standard of care techniques. Sincerely,

Guest_pavan; The photo you uploaded is a bit difficult to assess from; however, it does appear that you should not have any problem placing grafts in that area. Because of the assurance of a quality graft harvest, I would prefer to take a very small strip (2cm) to obtain the grafts necessary. FUE extraction can be employed as well, if that is your or the surgeon's preference. I would refer to the HTN resource to see if there are any recommended Hair Transplant Surgeons in your area; I am not able to refer you to anyone in those areas personally. Sincerely,

zhiangde- Welcome to the HTN. Not to worry, there are patients that "sprout" later than sooner; give your self another 3- 4 weeks; and, as per Dewayne, who performed your procedure, how many grafts were placed, and in what areas? Also, any photos you can upload would help. Sincerely,

NYC-FL-TRANSPLANT; In general, hair transplanted into the hairline should be placed at an angle that is as acute as possible with the scalp. That is, there should be a small angle between the forward projection of the hair shaft and the scalp. Exceptions to this are when you have a pre-existing "cowlick" that the surgeon may want to reproduce. That said, it would appear that the hair was placed at proper angles in your case. Were that not the case, a second procedure to address this situation can give excellent results simply by placing grafts (in that further session) in a normal (acute angle) orientation surrounding these. The newly placed surrounding hair will act as a "scaffolding", as you will, for the "old" grafts when all are the same length, so that styling to correct the original appearance will be much easier. Again, that does not appear to be an issue here. Grow well. Sincerely,

In general, the area is considered "healed", in that epithelialization is complete. I would suggest using rogaine/propecia if there are no contraindications (medical reasons) against you personally using them. In general, with all transplant procedures, that scalp redness (erythema) can last up to a year.

Guest_Pavan; Facial hair transplantation (including eyebrows) requires a relatively low number of grafts (when compared with the # needed for scalp hair procedures), and is routinely done in our practice, i.e., it is not an uncommon procedure. Simply inquire at the recommended hair restoration practice near you whether or not they offer the procedure. Do you have a great deal of scarring in that area? It would be good if you could upload a photo or two so that we may see the area in question. Sincerely,

Deluxe_Reverb Welcome to the HTN. As for marking the skin, those 'sharpie' markers work well, and, the marks they make can be removed with rubbing alcohol pads. Posting pictures is quite easy, and encouraged so that members may better help with your questions. On the forum page, click on "New" in the upper left side of the page, and pick "photo album" from the drop down menu. Then simply follow the directions. I would recommend uploading .jpg files from your computer that have been resized if possible to about 6 x 7 inches. If you don't have the ability to resize- no worries- just upload the photos as is, and I believe they will be resized somewhat- Looking forward to seeing your photos. And again, welcome!!

My pleasure.

mm76- I concur with the above posts, to summarize- In general, the # of grafts you can obtain in a given session depends on three things: 1) The size of your head (hence the length of the donor strip) 2) The density of your follicles (average = about 100 FU's/cm2), and, 3) The laxity (looseness) of your scalp (this determines how wide your strip can be) As Bill points out, each subsequent procedure will also remove the previous scar; depending on the size of the previous scar, this can reduce subsequent yields by no more than 10%. In general, scalp laxity increases with age, so that this is one area where being "older" has it's benefits. Overall, the number of sessions you can have depends on the size of your donor area along with the ability of your scalp to accommodate after each procedure, returning to it's pre-surgical tension (or close to it) Hope that helps. Sincerely,

madrugao- I have reviewed your photos submitted- I am sorry to see and hear of your experience. It appears that you have pitting in areas where larger graft sites were made. This could be the result of the grafts being placed deeper than is normally the case; if they are placed too deep, the epithelium will "bridge" across/up the sides in a process known as secondary intention- this will result in a pit or depression. Whether or not these grafts will "sprout" remains to be seen, as, it is early in the growth phase. Please realize though that your situation is not beyond help; with the proper assessment and surgical technique this result can be improved to the point of being a "thing of the past" for you, but you need to do your research and use this sites resources so that you CAN get the desired results which are achieved using highly refined follicular unit grafting techniques. Don't despair- it's fixable, in my opinion. Sincerely,

ThininHouston- The growth rate is constant; about 1 cm/month. And, yes, if you were to inspect the hair at 6- 9 mos, you would appreciate a difference in colour and caliber which occurs in a graduated fashion from tip to root. So again, most of that process is complete anywhere between 6 and 9 months. Does that help?

Yeah. What HT55 said.

niCe99- Yes, you need 9 months to a year to really assess how you respond to the medication. And yes, the medication only works if you take it. If you discontinue finasteride (propecia), it will take two years for your hair to "regress" to the point that it will appear the way it would have had you not been taking the medication. I try not to think in terms of "having to do it for the rest of your life"; I mean, after all, if you want to stay in good shape you have to take care of yourself (exercise, eat healthy, get plenty of rest) "for the rest of your life"; I guess it's a matter of what you are willing to do to maintain your health/appearance. I personally have been taking finasteride for about six years now, and, it's just part of my AM routine- like showering, brushing my teeth, etc.

thin- Yes, the colour and caliber of newly transplanted hair will increase as the hair comes in and matures. We have observed that, in general, 6-9 months after appearing at the scalp the newly transplanted hair will be within 90% of it's final diameter and colour.

NM76- Regarding whether your hair characteristics (Dark Hair) contribute to a successful transplant; As per Bill, the contrast between your hair and skin colour is the more important concept to appreciate when examining "dark" or "light" hair. The lower the contrast, the more "forgiving" is the appearance of hair which exists at lower densities. Hence, a gentleman with light hair and light complexion may appear to have a fuller head of hair than, say, a gentleman with light skin and jet black hair, even though the second gentleman (light skin dark hair) may in fact even have more hair density than the first. This is what we refer to as optical density. It is one of the concepts utilized by your hair restoration surgeon as you plan your hair restoration strategy. As per Dewayne, it would appear from the first photo that you are experiencing a diffuse hair loss, in all likelihood a result of androgenic alopecia. The other photos appear more dense than your hair probably is- that's one of the shortcomings about making an assessment based on photos.... It does appear that you have coarse (large caliber per shaft) hair-is that correct? If so, I don't know if you are currently attempting to manage your hair loss medically (finasteride, rogaine), but you should know that individuals with coarse (large caliber per shaft) hair respond the most favorably over other types of hair with regard to the efficacy (how well it works) of propecia. And finally, yes, better pics in general will help forum members get a better idea of your hair loss situation. Hope that helps-

hatrick- Usually by the fourth/fifth week;any hair shafts you have retained at that point in all likelihood will stay and grow from there. But as per thininhouston, don't put too much energy into this- in general, it (whether you shed the shafts or not) has little or no bearing on the final outcome. Grow well!!