Post Op Questions

[EmuSteve]

So I am looking through the list of rules I have to follow pre and post op, and I was wondering if I could get the opinion of a few of the experienced people...

 

Its says in the post op instructions that for the first 4 days after surgery, I should be using graftcyte every half hour. That's going to be hard if I fly back the day after (geez, I can see myself in the airplane laboratory) . Would it be smart to stay a few days and just relax in the hotel room?

 

And if thats the case, how likely is it that I will have swelling if I ice my head every day and take the Prednisone? I read elsewhere that its smart to come back the day after because otherwise you will be traveling and your head will look like a balloon.

 

What do you guys think? Stay a few days, or fly out the day after?

[EmuSteve]

So I am looking through the list of rules I have to follow pre and post op, and I was wondering if I could get the opinion of a few of the experienced people...

 

Its says in the post op instructions that for the first 4 days after surgery, I should be using graftcyte every half hour. That's going to be hard if I fly back the day after (geez, I can see myself in the airplane laboratory) . Would it be smart to stay a few days and just relax in the hotel room?

 

And if thats the case, how likely is it that I will have swelling if I ice my head every day and take the Prednisone? I read elsewhere that its smart to come back the day after because otherwise you will be traveling and your head will look like a balloon.

 

What do you guys think? Stay a few days, or fly out the day after?

[MrJobi]

Hi Emu

 

First of all I never used graftcyte as my doctor claimed their is not solid evidence it actually works.. I have heard that often but feel free to use it .. As far as the steroid, I didn't take that either post op just anitbiotics and pain killers ( i used ice for swelling) If you wear a hat on the plane you should be ok.. My swelling didnt come until a couple days after and I only received swelling for my first HT..

 

Good luck

[Bill - Seemiller]

Graftcyte is not necessary, period!

 

It may however, help aid the healing process. At Mrjb stated, some hair restoration physicians are sold on its benefits while others are not.

 

But I think all will agree that it is only a tool to help aid healing and not required for healing.

 

Bill

[EmuSteve]

Hmm.

 

Thanks, I learned something new. =)

 

Another question... what exactly is MS and how does it help healing? I've seen a few references to it but never really understood.

 

Does anyone have any post-op routines or products that they tried that worked well?

 

Also, if I do scalp exercises regularly, will that increase the chance that I can walk away from this with a very small/almost invisible donor scar? From what I understand, More Laxity = less tension on the wound = smaller scar, especially for trico closures.

[EmuSteve]

MSM. Sorry, forgot that last M. =)

[Bill - Seemiller]

Steve,

 

MSM doesn't aid with healing. It's said to potentially increase the speed of hair and nail growth so many use it as a hope to jump start early growth. Some swear by it while others do not. I don't feel there is any harm in at least trying it. I did myself for the 2nd and 3rd HT...but I suppose I can't be sure if it did anything for me or not. My first HT started growing the fasted ironically .

 

The below is my interpretation...

 

Scalp exercises = more donor laxity = (potential for more grafts OR less tension - feelings of tightness)

 

If (scalp exercises and potential for more grafts), then risk of greater scarring is equal to doing no scalp exercises and doing a smaller session.

 

If (scalp exercises and less tension), then risk of greater scarring is even further minimized.

 

Ultimately the hair restoration physician will extract what is "safe" to ensure proper healing and minimal scarring.

 

For more information on Scalp Exercises and my observations on how skin works, click here.

 

Bill

[Jotronic]

Unfortunately, ever since the idea of using MSM post-op was introduced the original intent has morphed.

 

The first person to say anything about it on the forums was Futzyhead back in the day, I believe after his first hair transplant with Dr. Hasson in February of 2002. After he started taking it he noticed that his pre-op shaved NATIVE hairs seemed to grow back faster. While many many patients seem to think it will help kick start the newly transplanted hairs I cannot recall any that have said after the fact that they seemed to grow in ahead of the curve but it's rather difficult to say one way or the other unless the patient has previous procedures from the same clinic to judge by. So, since I believe you stated that Dr. Shapiro is going to shave your recipient area then MSM is good for at least helping this area to return to it's normal length faster than without it.

[PLEASE GROW PLEASE]

Dont know if it was the skill of Shapiro or the graftcyte but my pinkness was gone within 5 days compared to 4-6 weeks without it.Youll be getting a free bottle so I would use it.It can only help

[EmuSteve]

Awesome. I think I understand better. And PGP, I'll def give it a shot. Can't hurt, right?

 

Thanks for the history lesson Joe. I thought MSM was something totally different. Learn something new every day!

[PLEASE GROW PLEASE]

No it cant hurt and msm did indeed help my native hair grow back alot faster ,including fingernails. Msm doesnt help everyone but when it does there is a noticable difference

[notgoing2gobald]

Emu,

You're a dedicated, diligent, determined, and meticoulous student of the fine arts of hair transplantation. Your insatiable appetite for wisdom has led your quest into depths of the abyss of knowledge which is unparalleled across the globe. Your understanding of even the most delicate and complex intricacies of hair transplantation will be studied for many, many years to come. Anyone who expects only the best results should be forced to endure such a rigirous process. The world class efforts by which you sought out such wisdom will be directly rewarded to you in your world class results. .....can I have your cliff notes?

[Time to do something]

Dr. Epstein had me use graftcyte and he is one of the top docs so I don't think it would hurt. There is no magic bullet for speedier hair growth. Hair is just dead protein so make sure you are getting a high protein diet because that is what will help hair grow and be strong. Some studies suggest that soy protein actually caused the hair to grow faster.

[Arrie]

EMU,

Congrats on the doc, I am a pt of DR. Ron Shapiro and as far as everything I have experienced so far it has been as expected and as flawless as it could be. I would highly suggest you look for a thread by Jotronic on before, during, and after suggestions on getting a HT. I believe that if everyone read this thread many if not all repetitive questions (not saying your question is a bad one) would be answered. I know Bill has asked Jo to use it so maybe you can ask Bill. If not use the find feature. I personally rated it 4/4 and I think its the most informative tread I have ever read. I wish I could remember the exact name. I hope this helps and if you ever have any questions about Dr. Shapiro from a pts perspective PM me any time. Hope this helps...

[EmuSteve]

lol NGTGB. You crack me up. =)

 

Dude, to tell the truth, even after all the research and questions and reading and looking and meeting, I still don't feel prepared. But I guess that if I don't at this point, I never will. Its time to just go take the plunge. =)

 

Arrie, thanks again for the offer. I do have one questions for you... is there anything you wish you had known before you went in for your procedure with Shapiro?

 

And this is a bit of a silly question... I guess I just assumed... but Dr. Shapiro now does Trico closures on all of his patients, correct?

[Arrie]

Emu I would be glad to help. Probably the only regret that I have prior to my procedure was not sporting a hat look prior to my procedure. No one has said anything, but the guys at work all gave me a strange look since that is pretty much the first time I have worn a hat working with them. Besides that my friend if you are traveling alone, if you are anything like me, you will be wondering the whole plane ride and prior night in the hotel about if this decision is right for you. Don't back out buddy, from the sounds of it and looks of it, you are very informed about every inch of your decision. The hotel and plane ride messed with my head a little considering it was my first surgery ever. Emu as soon as I met with Matt and Dr. Ron Shapiro, all and I mean all, anxiety, fear, and doubt flew right out the window. They really care for you as a person first then as a patient, amazing people. As far as Dr.'s closure techniques yes he does do the tricho closure, and other versions of the tricho closure (don't know names of them but all have hair growing through) pt depending. Don't quote me on that but your best bet is to try to get a hold of Janna she is very informative. I wish you all the best in your journey...

P.s The post you should read is by Spex Spex and I pasted it below he is the artist of this master piece....

 

 

Posted March 23, 2007 07:47 AM

Please feel free to add.....

 

Here are some general tips - Please note they are from a variety of experienced guys! Smile

 

Before Tips

 

1. Stay local to the HT clinic

 

2. Get to the clinic early in order to not be rushed as this will allow you ample time to go through everything with the Dr.

 

3. Have a list of questions for the Dr that you want answering.

 

4. Take 2 loose hats with you. (one might not fit)

 

5. Take a travel pillow, very handy. Especially on the journey home.

 

6. Get to bed early the night before. Aided sleep is advisable.

 

7. Get a massage the day before. Loads of places down in China Town(NYC)

 

8. Wear a buttoned up shirt for the day of surgery. Easy to get on and off.

 

9. Avoid - Alcohol, vitamins, minoxodil, MSM 7 days pre op. Can thin the blood.

 

10. Wash hair the morning of the surgery and wear lots of deodorant. Its a long sweaty day you don't want to be stinking out the place

 

11. Make sure you have made your story clear to various people that you are away for the next 2/3/4 weeks

 

12. Make damned sure you've filled your Vicodin prescription BEFORE you get re-haired (de-balded?), as opposed to waiting until the night before because "hey, this is New York, of course I'll find an all-night pharmacy...)

 

13. I would advise taking the pain killers regularly, even before the pain starts

 

14. Have the clinic take lots of pre op pics in order to have a controlled

comparison for post op

 

 

Additional tips from other guys:

 

1. My tip to anyone travelling long distances is to fly home the day after surgery! At one day post-op I had no swelling and no pain because my head was still totally numb! I flew home four days post-op and my head looked like a balloon and the aneasthetic was beginning to wear off which made for a long and uncomfortable flight home!!!!!

 

2. Have the doc wash your hair the day after surgery...it reduces scabing and you won't spend the next two weeks looking in the mirror waiting for them to fall off.

 

3. If you are going to do zero percent credit card, sign up the month before the procedure not the month after. they don't like 10K balance transfer and won't give you a high enough limit.

 

4. Sun screen on the graft for the first four months. Otherwise if you get too much exsposure you'll peel really bad and have redness for months.

 

5. Read the post op instructions before you have the HT. Write down any key questions and tick them off before you leave the surgery. Its easy to forget to ask, what with the injections etc.

 

6. Use a bandana - its more comfortable than the baseball hat and covers more of the head.

 

7. Bring button-up shirts - easier to take off.

 

8. Figure out your communications strategy. I decided to tell people on a need to know basis which meant that I told only a few.

 

9. Do not watch comedy DVD's during the procedure - It can result in you laughing and moving your head at the wrong time!

 

10.

 

11. Take a MP3, IPOD or CD player

 

 

Airport Security

 

The best way to do it is to make sure there is nothing on you to slow down your smooth passage through security. Remove all items such as watch, keys, change, bangels, chains, ...anything that could cause a bleep..

As you walk through remove your cap casually and calmly. They will not specifically be looking at you head at all... you will be ultra paranoid They will maybe glance and then once your through that vital 10 secs just casually pop the hat back on.

You will never ever see the sercurity guy again so who gives if he suspects..and the people behind you will be too stressed out taking all their crap off and sticking into the machine for scanning.

Another alternative is you can always ask for a private room........ but to be honest , just not needed!!

 

 

Immed After Tips

 

1.Never underestimate the recovery time needed. Get the absolute max amount of time off work. You will feel fine after a couple of days but you will look terrible. Its not so bad if you can wear a cap.

 

2. Remove all mirrors from your house, car, office etc Seriously!

 

3. Sleep upright /45degree angle to aid swelling

 

4. Apply huge amounts of Aloe Vera to both donor and recipient area 5 days after. (2 x a day minimum)

 

5. Distilled witch hazel helps with redness (apply 7/8 days post op)

 

6. Get on MSM (makes hair grow faster)

 

7. Drink lots of water / fluids

 

8. Bend at the knees for first 3/4 days

 

9. First 3/4 days just put shampoo in a cup and pour it over the recipient and donor area. Then build up to a shower but shield your recipient with your hand and dab on shampoo.

 

10. Have a couple of beers and soak your head in a hot bath prior to Staple removal

 

11. Rest as much as possible

 

12. No physical activity for 10 days then build it up.

2 weeks post op........

 

1. Stop staring in the mirror all the time

 

2. Start up physical exercise gradually

 

3. Start Minox if you want to help speed up growth

 

4. Stop inspecting scar/ donor area all the time! Its takes months to fade.

 

5. Put the HT on the back burner now for at least 4/5 months

 

6. Take some clear pics to compare you situation at various stages

 

Post op Redness

 

Post-op redness will occur both in the recipient area and the donor area. The degree and length of time in which both areas will remain pink or red, will largely depend on the individual's skin tone. Redness in the recipient area occurs due to the presence of newly formed blood vessels and inflammation from the placement of the new grafts.

 

Redness in the donor area occurs where the strip was removed and is basically a wound that will eventually heal. Once the wound has fully healed, the scar should appear as a pencil thin, white line that is difficult to locate provided the surgeon skillfully applied the latest techniques when removing the donor strip and closing this area.

For individuals with a higher degree of hair loss, the redness will be more apparent than with those who are able to partially camouflage the area with existing hairs.

Suntan (avoid burning) a few weeks prior to surgery. After surgery and once the grafts have shed, cosmetic attempts can be made to mask the redness in the recipient area.

 

The hair surrounding the donor area can be cut as low as a #2 razor guard (1/4"), and still conceal the donor wound. Depending on the thickness and density of the individual's hair. Typically 1/4" - 1/2" of existing hair, is sufficient enough to assist with covering the area.

 

Pimples

 

Pimpoles may occur on the recipient area. This is normal and should not cause any discomfort. To the touch, a pimple may be a bit sore (as with a pimple anywhere else on your body). If pimples do appear, they typically do so a month after surgery. Many patients have reported pimples appearing for months after surgery. It is thought that pimples occur due to fragments of skin or hair that may have been caught beneath the skin's surface.

 

I have recommended Tea Tree oil to a couple of recent HT guys who have experienced little pimples post op and it seems to have resolved their situ's - Also a very hot flannel applied to the recipient area can help draw them out and help!

 

Scabbing and Shedding Grafts

 

Once the grafts are placed into the recipient area, the grafts are held in by fibrin, produced by a chemical reaction in serum when the graft sites are made. Typically, the grafts will become fully secure by the eighth day. Scabs will begin to form the day after surgery. On average, scabs will remain present for up to 10 days.

 

If a scab falls out and there is a hair present in the scab, this is completely normal. As long as blood is not present and tissue does not appear around the hair, assume the graft is fine. Once the scabs have completely disappeared, you will have the appearance of a buzz cut. Within the next 2-6 weeks, these hairs will begin to shed and the recipient area will appear as it was prior to surgery. The grafts are merely in a resting phase and will begin its growth cycle in approximately 3 months.

 

The next phase of post-op surgery, is the most difficult; waiting for your new hair to grow in.

 

Staple/Sutures Removal

 

The staples or sutures (depending on the surgeon's technique) typically remain in place for approximately 10 days post surgery. Surgeons encourage that you come back to the clinic to have them removed, but will provide you with instructions for removing them should a visit to the surgeon not be possible.

 

The scar that will remain once the staples or sutures are removed will become less and less noticeable as months pass and will eventually turn into a pencil thin, white line.

 

TIP:

Prior to having the staples removed or sutures removed (this tip is more applicable to staples), have a long shower and soak the donor area. When scabs are dry, there tends to be a tiny pinch when the staples are removed. Soaking the donor area will moisten the scabs and minimize any discomfort.

 

 

Shockloss

 

Shockloss is something that can be experienced when transplanting into existing hair although highly unpredictable. Shockloss occurs when the native hair is weak and isn't strong enough to resist the trauma thats going on around it. More often than not the hair that has gone into shock will grow back but after 3/4 months - after the resting phase

Hair that goes into shock and doesn't return is hair that was inevitably on its way out anyway and wasn't strong enough to return.

Increased trauma to a localised area will increase the chances of shockloss

Shockloss is unpredictable and there is no hard and fast rule to avoiding it - especially if you are transplanting into existing hair.

 

There are risk factors that either heighten or lessen someone's risk. Diffuse thinners seem more prone to shockloss than receders because the hair in a diffuse area is often less stable than that of a receder. Very often, a lot of the hair in a diffuse area is "on its last legs" and in the latter stages of the miniaturization process.

 

 

NOTE:

Be aware that everyone is different! We ALL heal and grow at different time scales.

 

Be very patient and take pictures to enable you to see the results a little clearer. The realisation of the results will be hard for you to actually see as is so gradual.

 

Pictures at 6-8-10-12-14 months are important to give you the visual realisation of the developments occuring to keep you in a positive frame of mind!

 

All the best and heal and grow well all!!!

 

Spex

 

This message has been edited. Last edited by: spex, March 24, 2007 01:38 AM

 

 

As of August 21, 2006 I am a paid UK showcase and consultant for Feller Medical, PC.

My Weblog

 

"Research - Research - Research"

[the B spot]

Emu--- Yes, Dr. Shapiro uses the Trico closure.

 

Also, it is very normal to get cold feet before your surgery....just relax!!!!!!

 

Take Care,

Jason

[philip_go76]

Hey Steve, I was the fellow you met in the operating room when you visited Dr. Ron Shapiro's office on Tuesday, October 9. (I couldn't remember my password or what email addy I used, so I just created a new handle.)

 

I just wanted to say that I think you made a great choice with Dr. Shapiro. I'm going to post some pictures and a comparison between my latest procedure and my previous two procedures at a different clinic. I'll do that in the next few days.

 

If you have any questions for me, please don't hesitate to ask. Since I had my operation on Tuesday, I've got post-op fresh on the mind and I have no problem offering kind words and any other form of encouragement you need.

 

One last thing... if you haven't made a reservation with a hotel yet, I highly recommend Country Inn & Suites. I stayed there and they were very accommodating. They have a free shuttle that will pick you up and drive you to the airport (though I gave a nice tip) and they'll take you to Dr. Shapiro's office. However, I actually just walked since it was only about 3 blocks.

 

Anyway, I'll send you a note once I've posted pictures and related my recent HT procedure.

 

Best of luck to you!

 

Phil

[Guest]

file:///C:/Documents%20and%20Settings/Administrator/My%20Documents/My%20Pictures/bibarz%20post%20ht.bmp

[Time to do something]

bibarz,

 

I can't seem to access what you sent.

[Bill - Seemiller]

Bibarz,

 

If you are trying to upload a photo, you are going to have to attach it as a file in your post rather than linking to a file on your desktop that the internet can't access.

 

Bill

[EmuSteve]

Philip,

 

It was great meeting you too man. =) We were probably staying in the same hotel on the same night actually. Should have thought to ask, maybe we could have met in the lobby and talked a little more. Ha ha.

 

Anyway, thanks for the encouragement. It was great to meet you. I'll be looking forward to seeing your pictures in the weeks to come.

 

Are you planning on going back to Dr. Shapiro to get the staples removed? I am seriously considering flying out of Tampa again to visit Doc Shapiro after the surgery for staple removal. Call me nuts, but I'd really like to have the same doc doing everything from start to finish.

 

Anyway, thanks again. Looking forward to hearing from you.