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Life after transection?


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  • Senior Member

I'm 2 years post-FUT at the hairline. I'm in consultations to get a 2nd pass for more density (FUE this time). I have curly hair.

 

In one of my recent chats with a surgeon, I was inquiring about the higher risk of transection during graft extraction on curly hair. He claims that transection does not result in a dead graft, just one that cannot be used in the current session. The root remains unharmed and will grow a new hair. How true is this?

 

Obviously, it's possible for a root to be accidentally severed, but is it likely since the root is so tiny?

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  • Senior Member

I can certainly understand the confusion. A couple of things...

 

First, curly hair can indeed be more difficult to extract without transection because it is challenging to know the exact direction of the curly hair shafts in the underlying dermis layer of scalp. And the more acute the curls are, the more difficult it can be.

 

In addition, transection is transection. Permanent damage to the graft. It is not really the damage to the root as much as the damage to the follicle which the root is attached to. If the clinic decides that a graft is not intact enough to place in the recipient site, than that's still a graft wasted anyway you look at it.

 

This is why selecting a FUE surgeon who has demonstrated skill in the end result with FUE, and especially inclusive of a high yield (regrowth), is imperative.

 

And for those individuals like yourself who have curly hair, need to require examples of that surgeons past work of other patients who have curly hair characteristics. Because if the FUE surgeon being considered does not have the proven results with curly hair individuals, the potential transection rate can be out of this world...:confused:

 

Best wishes to you in your journey of finding the right FUE surgeon...;)

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: True & Dorin Medical in New York, NY

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  • Senior Member

Thanks Gil, definitely good advice. That's why I got FUT the first time around, because I knew transection was more of a risk with FUE (for curly heads). This time I won't need as many grafts and I hope to get some scar work done.

 

This particular surgeon is very popular on this site but he uses a motorized punch which concerns me (less careful?). I'm also chatting (or trying to) with Dr. Erdogan since he uses manual and claims a better ability to feel the curvature of the follicle.

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  • Senior Member

I recommend that you have another FUT.

You can improve your scar while getting the extra grafts needed (if the skin is not too tight).

 

IMO, it is a myth that a manual punch can help extracting curly hair.

Lets imagine:

Is the surgeon with the manual punch going to penetrate the skin, hit the hair shaft, feel it and change direction without transecting it? I don't see this happening. As soon as the sharp edge of the punch touches the hair shaft it is going to cut through it instantly. If a surgeon claims that he can swerve with the manual punch without feeling the follicle, then a sharp punch user can also claim the same. I would not be able to do this. If the follicle is curly under the skin, which is not necessary in every curly haired patient, then I don't see how a transection can be avoided in FUE.

 

The fate of a totally transacted graft is not clear, however I don't think we should be very optimistic about it. A partially transected graft, that is a graft with an intact follicle and transected follicle(s) beside it however is different. I am currently on a scientific study that has currently shown me that at least half of these transected follicles beside an intact follicle can yield a fully grown hair (at the recipient area). I don't know what happens at the donor area. Further studies are of course necessary.

Edited by drkaradeniz
adding more information

Ali Emre Karadeniz, MD (Dr. K)

AEK Hair Institute

Istanbul, Turkey

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  • Senior Member

Really good advice. Unless you're done with HTs, do FUT until you no longer have the laxity to do FUT. since you already have the scar you probably won't get a worse scar and should be able to get a better scar in skilled hands.

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Thanks Dr. Karadeniz. I can see your point about "feeling" the hair shaft.

 

Unfortunately, I was told the first time around that my scalp was a bit tight. The scar stretched (or at least hair didn't grow for .5cm) and I'm sure it's only tighter now. I hope for this to be my final ht as I'm not experiencing hair loss.

 

If transection is a concern for donor extraction, is it also for the recipient incisions?

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  • Senior Member
Thanks Dr. Karadeniz. I can see your point about "feeling" the hair shaft.

 

Unfortunately, I was told the first time around that my scalp was a bit tight. The scar stretched (or at least hair didn't grow for .5cm) and I'm sure it's only tighter now. I hope for this to be my final ht as I'm not experiencing hair loss.

 

If transection is a concern for donor extraction, is it also for the recipient incisions?

 

Transection is always a concern. If you have much hair in the recipient, incisions may also transect or damage hair follicles. However that doesn't mean that you'll hair follicle in situ will always suffer at all. It really depends on how much damage is inflicted and where the damage is inflicted etc.

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  • Senior Member
Thanks Dr. Karadeniz. I can see your point about "feeling" the hair shaft.

 

Unfortunately, I was told the first time around that my scalp was a bit tight. The scar stretched (or at least hair didn't grow for .5cm) and I'm sure it's only tighter now. I hope for this to be my final ht as I'm not experiencing hair loss.

 

If transection is a concern for donor extraction, is it also for the recipient incisions?

 

While a doctor might not be able to feel the curve in a hair shaft, after a few attempts at extraction within a particular area, he should be able to predict how the shaft curves.

 

Damage to follicles in the recipient area when making incisions won't be an issue for a skilled surgeon skilled surgeon. I have African-type hair and had FUT first and FUE second to add density. No damage to existing follicles and got an excellent yield.

 

Don't do FUT if your scalp is tight. Go with a surgeon with the experience of doing FUE on curly hair - I'm sure you know who they are.

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  • Senior Member

If the hair follicle is not damaged, then yes it has the potential of survival.

 

With FUHT, the strip should be microscopically dissected and the techs are able to see the follicles and the curl of each hair shaft. This alone can greatly reduce the rate of transection.

 

If the individual must have FUE, then experience and skill is incredibly important!

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: True & Dorin Medical in New York, NY

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