Donor area tenderness

[Guest]

I had my transplant of 3,000 grafts nearly 8 months ago. Haven't had any problems, but the donor area (back of my head, above the scar) is still tender in places if I press it. My surgeon says it's normal, but I just wanted to get any other opinions. All the numbness has gone, what causes the tenderness to persist so long?

 

TIA,

Dom

[Guest]

I had my transplant of 3,000 grafts nearly 8 months ago. Haven't had any problems, but the donor area (back of my head, above the scar) is still tender in places if I press it. My surgeon says it's normal, but I just wanted to get any other opinions. All the numbness has gone, what causes the tenderness to persist so long?

 

TIA,

Dom

[thor]

The donor area is one of the things that would stop me from doing this again. You could have problems for the rest of your life.

[Guest]

The numbness has gone so I would have though the nerves have recovered quite nicely. Which is probably why it's a little tender.

 

Also, it's been improving month by month so I wouldn't expect it to last much longer.

 

In any case, it's really nothing - I have to massage it firmly to feel the effects.

 

Regards,

Dom

[Dr. Michael Beehner]

Dom,

Donor area pain 8 months later is distinctly uncommon in my experience. It sounds like perhaps what you had instead was simply tenderness to firm palpation (finger pressure) in some spots along the donor scar. That certainly is a reasonable thing to have. I personally last had a tiny "touch up" session around a year ago and, upon reading your note, pressed along my scar and noted like you there were two spots that were slightly sore when pressed firmly. The important thing is that patients don't walk around feeling pain there. Obviously, as anyone who has had a transplant knows, during the week after the transplant, the area that causes the most discomfort, especially when trying to find a comfortable position to sleep in, is the donor area. Thankfully, that improves dramatically simply by having the sutures (or staples) removed and gets better by leaps and bounds in just a few short days.

The only case of persistent donor pain that I have seen in my practice occurred around 5 years ago in a 65 year old man who had his first transplant with me. He had had a one-sided flap rotated into the right frontal area of his head many years earlier. For some number of weeks after his transplant with me, he complained of pain with even light touch in one spot on the donor scar. When I examined him, there was no redness or swelling, but it was somewhat sore to the touch. Thinking it was probably a neuroma, I first tried an injection of a cortisone medicine, and this did not help in the next few weeks. We then did a "en bloc" dissection in the shape of a small elipse (football shape) of the area, all the way down to the galea (the "gristle" layer that underlies the scalp), and this resulted in complete disappearance of his pain and the soreness. I have not seen it since.

The other factor in pain during the first few weeks after a hair transplant procedure is the tightness resulting from the tension in closing the wound after taking out a given amount of hair. I don't have to tell you that you had about as large a session as is possible to have, so I wouldn't be surprised that you experienced some discomfort the first few weeks - but that should not be a factor 8 months later. Good luck with your healing. I am sure you will do well.

Mike Beehner, M.D.