Cause of Poor Growth

[Upshall]

What do you think is the most responsible for poor growth, is it mostly poor post op care (so down to the patient) or is it mostly poor graft handling (so physician fault)??

I am going through the growth phase right now, am 1 week short of 4 months, I went to an elite doctor, but no mater how many times I tell myself I"m crazy I keep doubting all the grafts will take.

[Gasthoerer]

If you have chosen an elite clinic: non of your choices. Genetics is the right answer. 

[delancey]

1 hour ago, Gasthoerer said:

If you have chosen an elite clinic: non of your choices. Genetics is the right answer. 

There is no reason why hair shouldn't take if the donor is healthy and underlying medical conditions have been reviewed to ensure a successful transplant. 

[txtransplant]

Tons of reasons. But as others have said, if you truly went to a very respected and experienced HT surgeon then it is unlikely he/she was at fault.  HT's can fail for many reasons. 

   Procedure. This can take any form. Even the best surgeons will transect a few hairs and damage them. But the best practitioners maybe do this to less than 5% of the grafts. They can dry out. I read a study that in well under 10 min of just being in the dry air, grafts die. And even in storage solution they become less viable past 6 hours. The good docs will label the grafts and the first ones out are the first to go back in your head. So really, skill of the surgeon, and any breakdowns in the process can cause poor growth. Fortunately most reputable practices get over 85% regrowth and I believe some are getting well into the 90's of average. So many things can go wrong...only use a well oiled machine when picking a Dr. 

  

   Patient. Patents are responsible for some failures too. Smoking reduces the success and healing, not following the doctors orders. Stress. My doc says he sees a correlation between major life stresses and less than great results. So try and be in a good place mentally after your procedure. Stress does cause hair loss and effects the body.  I also read extreme cold or heat can run grafts in the first few days when they don't have great blood flow yet.  Most of all though, everyone is different. Some people heal better and have stronger grafts. Occasionally even the best doctors have a failure. So our body rejecting the grafts even when everything is done right is possible, though unlikely.   The reality is we are all different and it is surgery. No 100% guarantees. But in the real world if you do your part and go to a respected surgeon...the typical patient will have between 80 and 97 percent regrowth. Most seem to do around 90 from what I can tell.  I see very few failures. But we do see plenty of mediocre results.  It is all averages. Most patients are pleased, but not truly blown away by their results. especially in the first procedure. But a few have amazing results and a few have below average results.  That's life. 

 

Simply put. A healthy patent going to a top doctor can be about 95% sure they will get 80% growth. That same patient probably has a about a 75% chance of getting 90% growth and so on.  It is a very safe and effective procedure with rather  predictable results. But like all surgery....not completely predictable

 

At 4 months. Assuming you are average. If you were a big shedder then the typical non smoker can expect the resting phase to last 3-4 months. So you could be completely bald of any grafts you received and  still be right on track.  By 5 months if nothing is even beginning to sprout..then you have some legitimate concerns.  On the human side, you can intellectually know all this and still be worried because waiting is hard and some people are way ahead of you.  I completely get this...it's just human nature. But just because you don't see much growth at 4 months isn't a sign it failed.  I have seem some early growth patients here who then just never really had a great growth stage after and some patients who were looking pretty weak at 4months and then it went great.  The real home run cases usually are strong early and finish strong too. But we are all different and too early to tell in your case. But if you used a great doc, I wouldn't be too concerned. You paid a premium not to gamble...enjoy the peace of mind you paid for.

 

[Upshall]

Really appreciate the answers, I do have some growth right now, tiny wispy hairs all over, they are hard to notice since a lot were place in between existing hairs, this is a picture of my surgery, let me know what you guys think,

 

[delancey]

Hi Upshall,

How many days after surgery was that photo taken? Do you have any photos of what the area looks like now? 

[Upshall]

This was 1 day post op. I will wait for 4 months to show a pic of now. This has been extremely stressful for me and I have seen people be very harsh in this site. I am worried I will not he able to take additional stress

whar do you think of my post op pics? 

[Spaceman]

4 hours ago, txtransplant said:

Simply put. A healthy patent going to a top doctor can be about 95% sure they will get 80% growth. That same patient probably has a about a 75% chance of getting 90% growth and so on.  

Where do you get these numbers from?

[txtransplant]

37 minutes ago, Spaceman said:

Where do you get these numbers from?

Check online in the actual medical journals that are published. They state what proficient surgeons have been observing as far as graft survival. The rest comes from observing the hundreds of results found here and other sites. 

[Spaceman]

Great, maybe you can provide a link?

[Upshall]

You guys mind arguing over this on a different thread. I really appreciate anyone’s input. What do you guys think of my post op pics? 

[Spaceman]

Upshall, sorry, didn’t mean to redirect your thread.

Most causes of poor growth have been mentioned. Poor growth is caused by poor surgical protocol or execution, post-op care issues (particularly in the first week post-op), and other unknown “x factor” issues that Gas refers to as genetics. 

If you see tiny wispy hairs now, then you are probably on track. That’s what most people would see at 3+ months. 

Edited February 24, 2019 by Spaceman

[txtransplant]

1 hour ago, Spaceman said:

Great, maybe you can provide a link?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764754/  Probably the most directly relatable article to the OP's question and a good read for him.   But since you seem curious...here is more reading.  To the OP, this will answer most of your questions. Nothing looks out of the ordinary and good choice going conservative. How many grafts did you receive? It looks clean and professional, but like only a few hundred were implanted. If you went too conservative you may not get the density you were expecting. That is not related to graft survival though. But at under 4 months and some wispy growth...you sound right on track. 

 

 

• Beehner M (2004) Beehner’s study of Fu vs 1.3mm minigrafts after one to three sessions; graft survival, growth, and healing studies. Hair Transplantation (4thetdn) New York: Marcel Dekker Pp: 268.
• Limmer R (2004) Hair growth studies in follicular units/micrografts. Hair Transplantation, 4th edn. New York: Marcel Dekker Pp. 268.
• https://www.oatext.com/How-to-improve-graft-survival-in-hair-transplantation.php
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[Upshall]

Actually 1200. My main concern with my last transplant was that it didn’t look natural due to the thickness of the grafts which is why this time the surgeon was very careful to use only thin grafts. Which is why they are harder to see. 

[txtransplant]

8 minutes ago, Upshall said:

Actually 1200. My main concern with my last transplant was that it didn’t look natural due to the thickness of the grafts which is why this time the surgeon was very careful to use only thin grafts. Which is why they are harder to see. 

Okay, Well I am going completely on faith here. It already looked pretty good in the pic. So I can only image it will be even better if you went to a good Dr. Hard to loose when you already look good.   They do this every day and know what they are doing. Hair mills....maybe not so much as that is sometimes quantity over quality, but you didn't go to one of those places. 

[Gasthoerer]

22 hours ago, Upshall said:

This was 1 day post op. I will wait for 4 months to show a pic of now. This has been extremely stressful for me and I have seen people be very harsh in this site. I am worried I will not he able to take additional stress

whar do you think of my post op pics? 

I think it does not look like 1 day post op. Also, if you want out help you need to show more and honest pics.