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Dr Blake Bloxham

How long do grafts grow before shedding? Dr Blake Bloxham, Great Neck, NY

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I had another patient come in for staple removal recently and noticed something I thought you guys may find interesting:

 

As usual, here is a little background information for reference:

 

I performed a 3,000 graft FUT ("strip," "FUSS," etc) procedure on this gentleman.

 

Here's how he looked during the consultation/pre-operative assessment:

 

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And here's what I did:

 

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Two weeks later, he came back for his staple removal. What struck me the most was how much his grafts had grown in the two weeks since we did the procedure:

 

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As you can see, his grafts grew a significant amount in the two weeks between the procedure and the staple removal. Normally, grafts can grow around 1-2mm a week. Depending on how long before the patient sheds, the grafts, as you can see, can grow a decent amount. And this growth often helps patients get a true "preview" of what lies ahead. This is important because it's sometimes difficult to see exactly what to expect based on the shortly trimmed grafts that are visible right after the procedure.

 

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How much do you think this guy grew? I'd say around 4-5mm? Pretty impressive, and more than we normally see! It helped him see "what lies ahead" and got him excited about the upcoming results!

 

Any post-HT guys out there who grew this much before shedding?


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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He will have exceptional yield when they resurface. Great work. My temple points grew the most post op. About half of the temple point hairs didn't shed and just grew like weeds. Maybe because they were only out of the body for such a short time.

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Mine grew, Blake. And if I shed any, I couldn't tell.


Just Sayin' What most People are Thinkin'

 

My Hair Regimen: Lather, Rinse, Repeat.

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Vox,

 

You're very lucky! We see a small percentage of patients -- maybe 2-7% -- who essentially experience no shedding.

 

The theory behind why hairs shed out and the follicles become dormant for a short period has to do with blood supply. The follicles have enough reserve supply to function and cycle somewhat normally for a short period of time after implantation. However, this is temporary and they quickly "go to sleep" without the necessary blood supply. The body naturally creates network of vascular supply to the follicles within the first 3 months and voila, new growth!

 

I have a theory within a theory that some guys don't shed because of a very diffuse vascular supply that latches on to the new grafts before they run out of their own intrinsic supply and go to sleep. It also may be that these guys have the capacity to grow vessels faster than others.

 

Receding,

 

Decreasing graft out of body time is the name of the game! I'm not sure whether or not if affects shedding, but it absolutely affects overall survival and, therefore, yield.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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I have a theory within a theory that some guys don't shed because of a very diffuse vascular supply that latches on to the new grafts before they run out of their own intrinsic supply and go to sleep. It also may be that these guys have the capacity to grow vessels faster than others.

 

 

 

I guess we will see how that theory susses out next year!

 

As you know, being on anti-platelet meds makes a HT a no-no right now. Come February 2016, it's a new day!


Just Sayin' What most People are Thinkin'

 

My Hair Regimen: Lather, Rinse, Repeat.

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Vox,

 

It will be very interesting to see if you don't shed again. Fingers crossed that you don't!

 

And it's absolutely a bummer to wait. BUT, your coronary arteries and cardiac myocardium are thankful for the nice, thin blood! Trust me! I still can't believe that happened, but relieved to see you recovering and getting back to the important stuff: hair transplants and rock n' roll!


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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If your theory is right Blake, we should perhaps consider trialing VEGF, kind of like how PRP was used a couple of year ago. Might be worth a shot.

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Vox,

 

You're very lucky! We see a small percentage of patients -- maybe 2-7% -- who essentially experience no shedding.

 

The theory behind why hairs shed out and the follicles become dormant for a short period has to do with blood supply. The follicles have enough reserve supply to function and cycle somewhat normally for a short period of time after implantation. However, this is temporary and they quickly "go to sleep" without the necessary blood supply. The body naturally creates network of vascular supply to the follicles within the first 3 months and voila, new growth!

 

Blake,

 

What are your thoughts about minoxidil post HT? I read some papers that suggested it promotes microvascularization. I believe Dr Feller used to advocate it years ago.

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Receding,

 

I actually thought about adding VEGF a number of years back. The problem, like we see with all "growth factors," is that it's a powerful, but non-specific vascular growth agent. This means injecting it may lead to good, early blood growth to the grafts. But it could also lead to fast, strong growth to ANY cells. Even an abnormal cluster of cells that shouldn't have this good blood supply. This abnormal cluster of cells could also be described as a small tumor. This is the risk with injecting almost anything with growth factors into the body. I don't think the FDA would ever let us do this. And I think they'd be right in doing so. And even if they did, I don't think I'd risk it.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Post,

 

Very interesting. I personally don't think minoxidil would create or speed up new vessel growth. However, I'd be interested in reviewing the papers if you can find them.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Decreasing graft out of body time is the name of the game! I'm not sure whether or not if affects shedding, but it absolutely affects overall survival and, therefore, yield.

 

100% agree with you on this. I think I have noticed this in my own experience.

 

Btw, Dr. Blake... your work looks great! Felleresque. :cool:

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