HOLES in my head?????????????

[Guest]

Hey,

I'm about 4 weeks post HT and I'm starting to worry about incision marks which appear as "large pores" on my scalp. I found a post from 2003 that had experienced this, but I'm surprised I don't see more comments if it's a typical issue. Any experiences to share on how long this takes to disappear? Can I put something on my scalp to help things along? I'm guessing this is an issue that occurs more with needles rather than blades.

 

Trying not to panic, but it sure looks like !@#$

 

-tbt

[TheHairLossCure]

I don't know that we can say that needles are the culprits here. Also, we don't need to jump the gun and starting thinking that this issue is permanent.

 

First, I absolutely believe you need to call your physician and explain your situation. Second, it would be interesting to check out any photos you might have.

 

What, if anything, have you been applying to the scalp post surgery?

[the B spot]

One of the drawbacks of using needles improperly IMO.

Depth control, Depth control, depth control!!

 

I would have to actually see what your talking about, but if your still seeing these incision marks 4 months post-op, they probably are not going away.

 

You need to wait and see how well your transplants come in and then decide your next move.

 

I would caution you to get some additional opinions in light of your situation.

 

Relax and do not stress about it right now-- there is nothing to actually do about it at this time but wait.

 

Take Care,

Jason

[Bill - Seemiller]

turnbacktime,

 

Welcome to our forum community.

 

Who was your physician? Without pictures, one can't make assumptions, but the first thought that came to mind when I read your post was that the physician created larger than necessary incisions for the grafts.

 

As a point in reference, I did not experience anything like that in all 3 of my surgeries starting back in 2004 to my last surgery in 2007.

 

This is not a call to panic however, as all you can really do is wait. But this could be an indication of the use of an outdated technique and tools and as B Spot pointed out, depending on your situation, they may heal completely or they may not go away.

 

If you have any pictures of your head that you can post for us, this would give us a better indication.

 

Best wishes,

 

Bill

[Guest]

Thanks for the quick responses.

 

Bill - my doctor is Dr. Quatela...seems like he has the credentials, so I doubt he is using an outdated technique. Let me know if you've heard anything to the contrary.

 

THLC - I've tried emu oil and aloe which both seem to cause irritation. I've backed off right now to using nothing.

 

B-spot - I'm actually at 4 weeks (not months).

 

I'll try to get some pix that capture it. I'm having trouble getting a closeup that's not blurry. I do plan to call Dr. Quatela first thing on Monday, so I'll let you know what he says.

[Bill - Seemiller]

turnbacktime,

 

Dr. Quatela does do standard follicular unit hair transplantation however, I am not exactly sure what size needles he uses. Typically, very large instrumentation is used only for mini and micrografts. I imagine this is not the case.

 

However, pictures will help us better understand what is going on. Contacting your physician is also a great idea.

 

Thanks,

 

Bill

[the B spot]

Standard follicular grafts are on average larger than the refined grafts we see on a regular basis.

 

How large?

 

I cannot say, but if memory serves me correctly, .9-1mm are used for 1 hair grafts (on average) then the sizes go up from there.

 

Take Care,

jason

[Guest]

I've tried a bunch of angles...can't seem to get the picture in focus (not to mention the glare off my dome!). You can see from the attached pix that my scalp is still pretty red and uneven at 26 days. Not sure what's causing the inflammation/redness but I suppose it could be slowing the healing process.

 

I'm going to call the doctor tomorrow. I'll keep you guys posted. Thanks again for the feedback.

[wylie]

I'd try a few more angles with your camera, if you can post some clearer pictures you are surrounded by a wealth of knowledge on this forum, including some premier docs. How many grafts?

 

Personally, I cant offer any advice other than everyone heals at a different pace. It's possible you had some kind of allergic reaction to the emu oil/aloe and that it actually slowed your healing time. Good luck and heal well.

[Guest]

I will try some more pix tonight.

 

To answer the question, I had 1800 grafts in the frontal area.

 

I had an email exchange with the person that performed the procedure (I must say that the office has been VERY repsonsive). She explained that I was probably experiencing folliculatitis and that warm compresses were my best option. From the pix I sent, and the description, my condition didn't seem unusual to her at 4 weeks. I also tried some Neosporin last night which seemed to help a bit.

 

I inquired as to the size of the needles used...she indicated that it was mostly 20 gauge (which I think is about .8mm) and some 19 gauge.

 

I want to understand more regarding Jasons comment on the differences between "refined grafts" and "follicular grafts". I missed that fine point in my research on the topic.

 

Thanks again for all the help. This really is an amazing resource!

 

-tbt

[Bill - Seemiller]

Use of 19 and 20 gauge needles are pretty common although a bit larger than those physicians who perform ultra refined follicular unit hair transplantation.

 

Being that your physician isn't too concerned and has given you some instruction on how to handle it, I'd give it some time to heal properly.

 

By the way...for those who are interested:

 

I found this chart that might be helpful when talking about converting needle gauges to diameter in inches and milimeters.

 

Gauge Size - Inch Equivalent - mm Equivalent

 

13 - 0.095 - 2.413

14 - 0.083 - 2.108

15 - 0.072 - 1.829

16 - 0.065 - 1.651

17 - 0.058 - 1.473

18 - 0.049 - 1.245

19 - 0.042 - 1.067

20 - 0.035 - 0.889

21 - 0.032 - 0.813

22 - 0.028 - 0.711

23 - 0.025 - 0.635

24 - 0.022 - 0.559

25 - 0.020 - 0.508

26 - 0.018 - 0.457

27 - 0.016 - 0.406

 

Best wishes,

 

Bill

[the B spot]

That is a GREAT chart Bill-- I think that should be a sticky for those who want to know the difference or blade equivalent.

 

All

Needles are a "closest-fit" option, mostly slightly larger incisions when measured against the size of a patients grafts.

 

Custom-cut blades are exactly that--"custom" for the docs that use them they are the size of the patients grafts--

 

As far as the difference between refined and standard follicular unit grafts--- there is more tissue left on standard grafts whereas refined grafts are trimmed of almost all excess tissue.

 

One of the trademarks of standard follicular grafting is a propensity to leave larger follicular units together --ala 4-5-6 hair grafts as opposed to refined follicular units where every possible attempt to trim the units into 1-2-3-4 hair grafts is made. (basically ANY space between follicles gets trimmed out)

 

Take Care,

Jason