Poor Growth

[giantanddwarf]

A HT candidate's greatest fear is poor growth. This rarely happens but given the stakes, it's hard not to fret over. But the reasons for it are elusive. Far as I can see, 'physiology', poor post-op care and clinic error are proposed leading causes. My (admittedly lay) opinion is that clinics pull the 'physiology' card to protect their interests, knowing they either screwed it up or speculating that the patient executed post-op care instructions poorly, with no way to prove the latter and hence opting for the less "personal" explanation of 'physiology'. No satisfactory explanation has been put forth to explain what constitutes poor HT 'physiology', in my opinion evidence that it's BS. This leaves poor post-op care and clinic error. Assuming you don't buy the 'physiology' explanation, which of these predominates? Or is there another possible cause or set of causes? My lay suspicion is that hair follicles are extraordinarily temperamental and the margin for error when handling them outside the body is low :eek:.

[JohnnyBald]

A HT candidate's greatest fear is poor growth. This rarely happens but given the stakes, it's hard not to fret over. But the reasons for it are elusive. Far as I can see, 'physiology', poor post-op care and clinic error are proposed leading causes. My (admittedly lay) opinion is that clinics pull the 'physiology' card to protect their interests, knowing they either screwed it up or speculating that the patient executed post-op care instructions poorly, with no way to prove the latter and hence opting for the less "personal" explanation of 'physiology'. No satisfactory explanation has been put forth to explain what constitutes poor HT 'physiology', in my opinion evidence that it's BS. This leaves poor post-op care and clinic error. Assuming you don't buy the 'physiology' explanation, which of these predominates? Or is there another possible cause or set of causes? My lay suspicion is that hair follicles are extraordinarily temperamental and the margin for error when handling them outside the body is low :eek:.

I don't think that post-op care is the main cause of poor growth unless you bumped your head or rubbed your scalp very hard the first few days to dislodge grafts.

[giantanddwarf]

Not properly taking care of crusting/scabbing is also a possibility. That's why I am going to go into the clinic for post-op care as many times as need be after getting my procedure. Not taking any risks.

[JohnnyBald]

Not properly taking care of crusting/scabbing is also a possibility. That's why I am going to go into the clinic for post-op care as many times as need be after getting my procedure. Not taking any risks.

actually scrubbing crusts and scabs very hard the first few days to remove them too early can dislodge grafts. Keeping scabs/ crusts for too long might slow down the growth but don't think it would kill the grafts

[ZeoRanger]

There's a huge difference between the post op guides of each clinic.

 

I assume the main reason for this is simply because there has not been done enough research on graft survival factors post op.

 

There's one clinic that doesn't allow you to fly for more than 16 hours within the first 10 days because the cabin pressure reduces oxygen supply which kills grafts. Others think grafts are secure after 5 days so ultimately you're not sure what to think really.

 

In general I wish post op guides would be more thorough and warn patients to watch out for certain skin conditions like lichen planopilaris ect. Most guides don't even mention folliculitis which is quite common apparently.

[pkipling]

There's a huge difference between the post op guides of each clinic.

 

I assume the main reason for this is simply because there has not been done enough research on graft survival factors post op.

 

There's one clinic that doesn't allow you to fly for more than 16 hours within the first 10 days because the cabin pressure reduces oxygen supply which kills grafts. Others think grafts are secure after 5 days so ultimately you're not sure what to think really.

 

In general I wish post op guides would be more thorough and warn patients to watch out for certain skin conditions like lichen planopilaris ect. Most guides don't even mention folliculitis which is quite common apparently.

 

I'm in complete agreement that there needs to be a more comprehensive, collective guide to post-op care. It's also not just that different surgeons have slightly different guidelines; the differences are sometimes huge, as you mentioned, which leads to large amounts of confusion. For this reason, there's nothing patients can do at the moment except listen to what their specific surgeon told them. I tend to believe that the surgeons who are extremely conservative with their post-care instructions are more than likely just being extra cautious so as to avoid any potential negative blowback. For example, I remember a post a while back where a guy was told that he had to wait a full 3 months before he could buzz his head, which to me sounded ludicrous.

 

As to the original post, while it's definitely possible that the "physiology" excuse can be thrown out too often, I honestly don't think that's the case with most credible doctors. First off, I'm not aware of this being an ongoing issue, but maybe I'm just not aware/up to speed on this. But I also don't think it's that unreasonable to believe that our own individual bodies each respond differently to certain amounts of stress/trauma based on our unique physiological makeup. If you see a clinic throwing this around on a consistent, regular basis, then yes - something is probably up. But I don't think it's as suspect as you make it out to be. And this isn't just with hair transplants, this is any complex medical procedure you could possibly think of.

[esrec]

Good topic. There's not much uniformity across the board. We need to protect our investment and they need to protect their artwork so the default response is usually an ultra-conservative one.

 

There's so many examples--just the other day I asked about being in the sun. I heard everything from 1 month to 9 months. Before I went into surgery I asked about re-introducing concealers and I heard everything from 7 days to 1 month, from more than 5 docs. Even take the post-op care--we all know sulfates are terrible for your hair, yet I have 3 shampoos from 3 different clinics (dont ask) and each has sulfates lol.

 

To the original question--I agree there's so many variables and oftentimes its tough to poinpoint any one particular reason, whether it be subpar post-op care or something genetic. I am curious though, in the hands of a good surgeon and a qualified candidate, how often is growth an issue? Again, we dont have stats but sure would like some.

Edited January 22, 2016 by esrec

[ZeoRanger]

Honestly this is how I feel about it:

 

Clinic before surgery: "other than Sun/UV and injury within the first days NOTHING can harm your grafts or outcome."

 

Clinic AFTER surgery: "EVERYTHING could harm your grafts from breathing the wrong air to sweating in the wrong moment. Good bye and good luck!"

[gillenator]

Several decades ago, HT surgery did not have the high success rate that it does today. Results were inconsistent including the yield.

 

IMHO, if the yield or regrowth turns out poor or substandard, it usually can be attributed to the competence of either the surgeon or just as important, the techs who dissect and handle the grafts. It can be a matter of inexperience and/or carelessness.

 

Surgeons who consistently produce good results over the long term recognize that the procedure is a team effort. They know that their techs can make or break them. Oftentimes the best doctors retain their staff over long periods of time, they train them continuously and invest in them. Good competent techs are worth their weight in gold ten times over. It's always a good idea to ask about the staff up front because if the doctor or clinic has high turnover, that's generally not a good sign.

 

Yes there are times when the individual's physiology may be a factor but it is the exception and certainly not the rule, and especially with the best docs who have long term reputations that speak for themselves...