Concerns about My Recent Artas FUE

[bluegatorguy]

Hello Forum:

 

I am 2 days post op from my Artas FUE (2000 grafts). I thought doctor and their staff were very supportive during the procedure, but I think it's nice to have a forum where information can be shared between patients.

 

My post-transplant wash was yesterday, and so I've begun following the physician's instructions which are basically to pat the grafted areas for about 5 minutes with saline gauze four times a day, and then gently apply bacitracin zinc ointment to both the graft and recipient sites.

 

The doctor also gave me a prescription for Keflex to take twice a day and Predisone to take in the morning.

 

I've been following the instructions as best as I possibly can, and I don't think I'm doing anything wrong

 

My concerns so far are:

 

1. The first time I started patting the saline gauze to my grafted area there were a few (5-10 or so) small hairs that would get picked up. No bleeding that I could tell, and most of the hairs were very short although in a few of them I could see the bulb. It was just the hair, and not any other skin around the hair. Is this normal and ok?

 

2. As you can see in the pictures, some of the recipient sites look a little yellow. I know that there will be some 'crust' and I expect that, but is the yellow color normal for the recipient sites?

 

3. It looks like my donor sites look great so far. I've posted a pic of what that looks like 2 days post-op and I that looks ok to me. I guess I'm just concerned mostly about the recipient sites.

 

Am I worrying too much? I do plan on seeing the doctor as early as I possibly can, but I just wanted to get this post out there to see if anyone on the forum had some feedback!

 

Thank you in advance for your comments.

[Spanker]

It's really hard to tell from the photos but it does not look like a super dense operation, but that doesn't mean you won't get a nice result. You should keep an eye out for infection but getting some oozing is pretty normal it seems. (I did not have any.) If it looks infected contact your doctor immediately. The donor area looks good. Chances are you just could not see the tissue around the hair being implanted and it was there. Surely your doctor did not implant any capped grafts.

[bluegatorguy]

So it seems like my experience here is normal? I didn't have any oozing or anything, just didn't know whether my recipient area looked normal and expected after the procedure.

 

It's really stressful to make sure that after all of the care that's required everything is ok. It would really suck to spend all of that money and then mess something up, especially when trying so hard to follow the instructions.

 

I've posted a new picture from today. In my doctor's instructions, my first 'wash' was today, where i just poured water over my head and then gently applied hibiclens, and then my shampoo very gently to the recipient area. I could start to see some of the 'crusts' coming up, but that came with a few errant hairs as well (although again no bleeding or huge chunks of skin came up with those hairs).

 

In terms of density, I had a very narrow recipient area where I was told that my hair was 10 hairs per cm2. With the number of grafts I got, the goal was to bring that up to 50 or so. As long as I don't screw anything up, I'm praying for the best!!

[bluegatorguy]

Actually one more follow up. When you say:

 

"Chances are you just could not see the tissue around the hair being implanted and it was there. Surely your doctor did not implant any capped grafts."

 

Do you mean that the small hairs that came up as I was patting with the saline gauze were grafts but I didn't see the surrounding tissue? I was told that unless there was bleeding I didn't need to worry about losing a graft? Is that not the case?

[Spanker]

I misunderstood you, I thought that you were saying that you thought that the doc planted grafts that just hairs and you could not see the bulb before it was planted. You experience seems pretty normal to me and you are doing all that you can do now by following the doctor's instructions.

[bluegatorguy]

That's great news. In a lot of other posts, folks would say that hairs wouldn't shed until some time after the procedure, but it seems as though some hairs can start to shed almost immediately when cleaning or patting with the saline gauze. If that's not a concern, then that's awesome!

[Spanker]

Whatever is shedding now is likely your regular shedding. It is not grafts, the important part (the follicle) is still in your head. If it were, there would be bleeding. Any shedding right now (and for the next few months) is normal shedding or shock loss and will not affect your final result.

[bluegatorguy]

Thanks again for your great feedback!!!

[scar5]

Hey Blue,

 

Thanks for your post. Your concern about the washing and the bits of hair coming off would not be an issue I would think.

 

But I have a question for you. What size punch was used? At what stage were you told about the outside diameter of the punch size used on the Artas machine? Or rather, were you told, and did you ask?

Edited November 14, 2013 by scar5
autocomplete-brain malfunction

[bluegatorguy]

Hey Scar. I've uploaded two new pics of my progress. I'm on Day 6 now. One pic is of the back and the other is the top. As you can see it looks MUCH cleaner now. It's one thing to read people's journals and what not but it's another to go through the process yourself and try to understand what's going on.

 

To be honest, I was never 'told' about the punch size on the Artas machine by the Doctor. I think I might have done some research through this site and others that had explained that, however I chose the Artas process for 2 reasons (1) I typically wear my hair fairly short anyhow and so FUE was what I wanted, and (2) I figured that with the robotic procedure I had a good shot at a donor scar result that would be consistent regardless of the surgeon I chose.

 

In terms of my experience with Artas, I have three pieces of feedback:

 

The first is that the Artas chair is very uncomfortable. I had 2000 or so punches and I was in that chair for a while. After a few hours or so regardless of the valium or any other medication, my back needed a rest. The techs at the doctor I used had told me many people had given them that same feedback on the Artas chair as well.

 

The second is that it's literally amazing on how when the Artas punch goes in, that you literally feel absolutely nothing, even on parts of my scalp where the nerve block was wearing off.

 

The third is that, when they set the machine up to harvest from an area, they put some kind of template on your head and secure it. The template has a number of needles on it that 'grip' your scalp I suppose. Even though the punch may not hurt at all in cases where the nerve block is wearing off, if the tech repositions that template and the nerve block is wearing off, it will be very, very painfull. The lesson learned from that is that if you are having an Artas extraction with a large number of grafts, ask your surgeon for the longest acting nerve block he has.

[scar5]

That's a very informative post there Blueboy, thanks.

 

Your information will help others. If they get that chair right, and if they get decent results, I think that thing will be a boom in the states, because techs are not allowed to extract and FUE is uneconomic for most docs.

 

I had seen an amazing Artas case on the hair site - 5000 grafts - and I (rare for me on that site) commented at how big the extraction holes were. They were huge, not to mention out-of-the-safe-zone.

 

I well known FUE pioneer from Georgia launched into a massive broadside barrage aimed at both the clinic and the Artas machine in general. It was quite an attack, the like I have not seen for a while.

 

Obviously, the punch size can be adjusted and in your case, despite not being immediate post-op pics, which would enable one to compare them to this 5000 case I speak of, look much smaller. The clinic on that hair site thread, said that the case was 1mm - which is too large in my opinion for FUE and perhaps - if it is on account of transection insurance - I would suggest the ARTAS has a way to go.

 

But your donor looks absolutely beautiful from here. Encouraging to hear about the painlessness of the extractions.

 

When it comes to incisions, I wonder about the artistic side of things a bit, so i7m curious to see your result.

 

Good luck to you.

[bluegatorguy]

Hi Scar, here are a few more pics that were closer to my procedure. Im not sure if they are helpful to you or not but I thought I would post them anyway.

 

I think the pic of the back was taken the day after my extraction. The pic of the top was immediately post op.

[scar5]

Cool. Good pics. I dunno what punch size it is, and anyway it's all done. Looks clean and the hairline is fine. I wonder why the extraction area has a linear boundary at thw top? Surely it should be eliptical, with a dip in the center? Perhsps Mr. Artas is a straight-ahead kinda guy?

[bluegatorguy]

Actually, the general area that Artas extracts from is completely controlled by the Dr. (while of course the specific follicles to pluck are chosen by Artas. Here is my understanding of how it worked, and I apologize in advance to any techies out there that know more details than me, but below is my experience and my understanding.

 

The 'Template' I described earlier, to my understanding was attached to some area on the back of my head. It's almost like a metal surgical drape to speak of, and exposed a small area on the back of my head where the Artas punch would work. I think they referred to it as a 'grid' as they were working. Once Artas was done working that 'grid' they would move the template to another part of the back of my head where Artas would again extract from. Also from what I understand, the Dr., also controls things like the depth of the punch.

 

The doctor I went to did tell me quite a bit about who is a good candidate for Artas and who is not. In my case, I have fairly dark hair with only a small bit of grey that was of a certain density on the back of my head, and so according to the Dr. that made me a good candidate.

 

I read the post you were talking about with the 5000 graft mega session. From what I understand there were good points on both sides. Just like anything anything else we're told by physicians, we're relying on them to use their professional judgement. If a Dr. uses Artas on a patient that isn't a good candidate for it, it's probably not a good thing.

 

Also in my case, the number of punches from Artas were less than the number of actual grafts inserted (Artas took about 2000 punches, but the number of grafts were significantly higher because of course the technicians split some of the Artas extractions into more than one graft).

[bluegatorguy]

As a side note, things my scalp is starting to itch less, and the numbness is going away, although it's *REALLY* hard to get any idea of what my density will actually look like in a year.