*PHOTOS* What a difference 3 months makes- Feller and Bloxham, PC Great Neck, NY

[Dr. Alan Feller]

After a transplant the hair doesn't automatically grow, nor grow normally. If only it did. Rather, the follicles go into a sleeping phase and then wake up slowly. As the follicle wakes up, not all of the hair producing cells come "online" at once, so the hair that is produced is incomplete. This "incompleteness" is seen in the form of a kinky hair, even if the patient's hair had always been very straight.

 

By month 8 their may be new hair on top of a bald area, but it can look frizzy and hard to style. Rest assured this is completely NORMAL. The follicle and hair have to go through a "normalization" period wherein the follicle wakes up completely and starts producing a complete hair.

 

The photos below show a patient of ours in whom we implanted about 3000 grafts. Look at how frizzy the hair looked by 11 months. One might think that was going to be it. But in reality, the normalization process kicked in and the hair became much more straight, flat, and silky. Look at the ends of the hair in the 14 month photo. You can see the last of the frizz is growing out.

 

We got the 14 month photos today as we are now lowering his hairline and filling in the crown.

[Dr Blake Bloxham]

Posting the hosted images:

 

 

 

[humble1]

Thank you for the post Dr. Feller. We need more "what to expect" pre-op and most certainly post op informational posts such as yours, from surgeons such as yourself. I think a lot of post-op "panic calls" may be eliminated.

 

I believe Spex's posts have calmed quite a few, who may have otherwise been on the phone or at the surgeons office expressing concern over "no growth/results". (I know his posts have helped me.)

[esrec]

Well explained. There's such variability from patient to patient it nice to hear this reiterated. It really is challenging to set expectations.

[Dr Blake Bloxham]

Humble and Esrec,

 

Thanks for the kind words. I do hope this presentation helps patients out in the future. Patients do occasionally come in during the "kinky" hair phase concerned and unaware that it will mature and naturalize with time. In the future, I think I'll show them this case for reassurance!

 

Like Dr Feller said, we performed some hairline lowering and crown finishing work on him yesterday. We'll keep you guys updated on the results.

[bunsenburner]

Another interesting presentation. The explanation of how and why the "frizz" normalizes as the results mature makes sense. It is worth mentioning that the patient has undergone a substantial transformation as well. I suspect it will look even more impressive after the most recent surgery matures too. Updates would be appreciated. Great work.

[Dr Blake Bloxham]

Thanks, Bunsen. We will do our best to keep you guys updated!

[mrkellymac10]

This is nothing short of astonishing doctor. This is why I want to visit with you and have you evaluate me. I had one transplant ten years ago in the midwest and the results were not good. I have an unnatural hairline and I need to get that addressed. If you can give this man a new hairline I'm sure you can fix the one I have.

 

I have a question please, I do not think I have as much donor as this gentleman does. Do you honestly believe my hairline can be thickened anyway. I'm coming in for a consultation soon but like a kid before Christmas I find it hard to wait !

 

Thanks in advance.

[thisguy1]

Thank you for the post Dr. Feller. We need more "what to expect" pre-op and most certainly post op informational posts such as yours, from surgeons such as yourself. I think a lot of post-op "panic calls" may be eliminated.

 

 

Agreed.

 

See many people complain about texture of hair in month 5-6 on here but it really does appear you have to wait until a few months past the year mark to get the real "feel" of what the hair will be.

 

I will freely admit if that was the texture of mine at month 11 I'd be a bit frustrated. Amazing what 90 days can do.

 

Good educational stuff.

[Sethticles]

A bit of a catch 22 here, 11 months frizzy but looks thicker, 14 months his hairs look natural but clearly has less density. is the patient planning on a 2nd HT to fill in the crown, he wears his hair nice a long to cover any scarring makes sense to have another 3000 or more.

[Wwiizzkkiidd24]

I thought you only get the 'frizzy' or 'wirey' phase with FUE? I'm sure you said a couple months back that this only happens with FUE due to how you extract the grafts.

[Dr Blake Bloxham]

Yes, he recently returned for a second procedure to address the crown.

 

Wwizz,

 

No, you get the "frizzy" or "wiry" phase with both. The key difference is temporary kink/wiry versus permanent texture changes.

 

Allow me to explain:

 

The internal portion of the follicle -- specifically the internal root sheath -- determines the texture of the hair. Thick, fine, wiry, or straight, a lot of this comes down to the internal root sheath. This internal portion of the follicle can be disrupted as a normal part of a transplant procedure. This is why the new hairs grow differently up until around the 9 month mark. The internal portion of the follicle is jumbled around, and it takes some time to right itself and start producing normal hairs. This results in temporary wiry/kinky hair that normalizes over time. This is what is normally seen.

 

If the internal portion of the follicle is permanently disrupted, however, this can result in permanent texture changes in the type of hair produced. Specifically, a permanent wiry or kinky appearance. This happens most often in FUE procedures because the stress and strain of the extraction creates permanent distortion of the internal root sheath. Does it happen every time? No, but it can happen because of the FUE process.

 

Hope this clarifies!

[Wwiizzkkiidd24]

Yeah thanks. so what about nerve damage to the sheath can this have an affect on how it comes out. if you cut away or force through them(nerves attached to sheath) surely it would have the same affect on the sheath or am I wrong..

[Hoster1492]

Great results.

 

Great photos too. Honest by showing the top down angle as well as the front. We need to see more of this.

 

The difference in frizziness between the three months is undeniable. (Unless he switched shampoos.)

 

Congratulations Doctor.

[esrec]

Agree with above. We rarely get an overhead view and not sure why. Hairlines close-ups really don't tell the entire story. Good work.

[Dr Blake Bloxham]

Thanks for the comments about the photography. We have put a lot of time and effort into thoroughly documenting with both photos and video, and it's nice to know it's paying off!

[Wwiizzkkiidd24]

I see my post was nicely swerved ha

[Dr Blake Bloxham]

Hi Wwizz,

 

Sorry! I didn't see your question before.

 

Are you referring to nerve damage to the internal rooth sheath? The big nerves involved with the hair follicle are usually near the bulb (bottom of the follicle) and the arrector pili muscle next to the follicle -- but still usually considered part of the pilosebaceous unit. While there are likely some type of nerves that extend deeper into the follicle, I don't think you could really differentiate damage to a nervous structure this deep versus damage to the general structure of the sheath. If there was a specific nerve to this structure that played a vital role in hair growth and it was damaged at any point during a hair transplant, I do think it would have the type of consequences you described above.

 

Hope this helps.