Question for Drs Beehner or Limmer

[phl]

Drs Beehner and Limmer

 

I am having a procedure next month. Re the "2nd skin" process mentioned by a poster under "Post Your Own New Topics": Sounds promising as far as lack of scabbing, etc. Any drawbacks? Dr Beehner: have you considered using it? I don't mean to open up a controversial topic among physicians - just curious about this idea.

[phl]

Drs Beehner and Limmer

 

I am having a procedure next month. Re the "2nd skin" process mentioned by a poster under "Post Your Own New Topics": Sounds promising as far as lack of scabbing, etc. Any drawbacks? Dr Beehner: have you considered using it? I don't mean to open up a controversial topic among physicians - just curious about this idea.

[Dr. Michael Beehner]

Dear Phl,

When Dr. Limmer first told us about the technique several years ago, I tried to order the Second Skin, but had difficulty doing so at the time, but went ahead and used the "grease helmet" concept using Telfa pads instead with the intent to leave it on for 3 days as he advises. The two men I chose to do this on at that time both had some bleeding under the bandages, and I personally came in and met them and removed the dressing the next day and put another one on. We have a protocol all written out with instructions for the patient, but have dropped off in our interest just because of those two experiences. In addition to helping prevent scabs, the "sealing" with the ointment over all the scabs also seems to prevent coagulation of the plasma components. We will probably try it again and do it this time with the Second Skin, to see if it holds everything in place without bleeding better.

In the same vein, we do a fair number of eyebrows, and three weeks ago we had a woman come in several hours after her eyebrow transplant. We normally had always just put Bacitracin ointment over the FU sites (around 140 per eyebrow)and not put a dressing or bandage on them. Well she rubbed her hand over her eyebrows and around 10 of the FU's came out on her hand. I put them back in at the office, as she kept them moist when she discovered what she had done. I now start the ointment in the morning, so that the coagulation around the grafts in their sites can "take hold" and not risk falling out. This is an example of something that we all learn as we go along, and eventually settle on what works best for our practice and the distance people come to see us (to minimize inconvenience or problems for them).

Mike Beehner, M.D.

[phl]

Thank you Dr Beehner for your description of your experience with the second skin process. This was the first mention of it on this forum that I had seen so I believe it is still not widely used and is still in its experimental stage. Personally I'd elect to go with the graftcyte spray and let the scabs heal in the open air. Scabbing was not a real problem for me the first time around and is only short term.

[Guest]

We have used 2nd skin dressing for about 15 years. There is no other method in my experience of 34 years that produces healing as well as occlusive dressing which is what 2nd skin is (hydrocolloid occlusive dressing). However, there is a minor drawback: since ointment is used under the dressing, this leaves ointment to remove from existing hair. For this reason, we are more likely to suggest it to those who do not have a lot of hair in the transplanted area.

 

The advantages are more rapid healing (3-4 days) versus 7-8 days for the "dry" healing method. Redness is also less because the healing rate is accelerated. The disadvantage is the need to remove the ointment from existing hair, which can take a little effort.

We have not seen bleeding as a problem because our insertion sites are so small (19-20-21-22 gauge needle).

 

The growth rate and final success rates do not seem to relate to post op care- growth and success is uniform and consistently predictable in well done Hair Transplantations seemingly regardless of type of immediate post op care used.

 

 

Bobby Limmer, MD/jal

 

Dr. Limmer

[Kourion]

I've posted elsewhere about my experience w 2nd skin. I had a HT at Dr. Limmer's office on July 29, 2003. Healing was accomplished within 3-4 days, with no scabbing, no bleeding, and no redness. I am a Norwood 6 (my wife says I was N6) with very few hairs in the frontal area. I've been reading about everyone's experience with scabbing and redness, and I was simply delighted to see how exceptionally 2nd skin worked for me.

 

My post-op period has been blissfully uneventful. No swelling has occured, probably due to prednisone that Dr. Limmer provided. I was in public as soon as I washed away 2nd skin. I will agree with Limmer that the only drawback of this method may be the fact that removing the ointment can take a couple of washes. But really, it is not a big deal, considering the immense benefits insofar as healing is concerned.

 

Although Dr. Limmers are not hands-on individuals, I think that they have trained their staff exceptionally well. Their protocols are detailed and work exceedingly well. Dr. Limmer has called me a couple of times to follow up on me.

 

I am 10 days post-op and I look and feel really well. I've cut my hair short everywhere and my new hair blends in beautifully well. I know that it will eventually fall out, but I look forward to when it starts growing again.

 

I am a scientific person myself and I am very critical of everything and everyone, and despite the hands-off approach employed my Limmer, I look forward to my second procedure probably around Christmas.

 

K