Query on Shedding phase

[Akash_b]

Hi,

My name is Akash, I am from India, I had a HT surgery (9weeks back).

 

I just wanted your honest, clear cut opinion about a query I have and it would be very kind if you can spare a few minutes to respond to my query.

 

During my surgery (9 weeks back) I was told by the doctor that I have a very hard skin and there is a popping effect (when they were trying to insert one graft the surrounding grafts were coming out), and after 9 weeks now I can see that most of my grafts (specially in the temporal area) have neither grown nor shed.

 

I am very worried as I read that shedding normally occurs after 1-5 weeks of the transplant, and also heard from a youtuber that if transplanted hair doesn't grow or shed within 3-4 months then they are as good as dead and new hair won't come out from them.

 

Please can you confirm this?, if it is true then my transplant most probably has failed.

 

And, is there any way to soften scalp skin, in case I go for a 2nd transplant in the future.

 

Regards,

Akash

Edited September 9, 2019 by Akash_b

[LaserCap]

Seldom do I hear "hard skin." Interesting...Perhaps doctors can jump in and give their opinion.  I don't think there is such thing.  Could it be less elastic? Perhaps that's what's causing the issue.  But....

Typically when grafts pop it's not because of the quality of the skin.  It is because you are a bleeder.  What's causing that?  Perhaps the diet.  I am very aware of the many condiments in Indian culture - as I enjoy most of them when I cook.  Tumeric is one.  If this is the case, it is important to bring it up during the initial consultation.  Leafy vegetables, fruits....that can help.  The doctor can also suggest other vitamins to minimize the issue.

But it's a bit early to question the results.  I would give it 6 months and then start taking photos.  Make sure you return to the doctor's office when scheduled to do so...and follow their instructions.

I keep looking at your photo and it might be me, but you seem tilted somehow.  Your left side is much higher than the right and it end on a point.  The right seems blunted a bit, but slopes down.  What this the hairline you and the doctor discussed prior to the procedure?  Symmetry is typically a no-no in this industry....but this is an issue.

Keep an eye on things and post at 4 and at 6 months.

[CosmoKramer]

Good advice by ⬆️.

The popping out of grafts as you say might possibly due to thin blood in the surrounding are,  as LaserCap mentioned if you are Indian/South Asian decent and consume lots of curcumen / Turmeric then that may be a possibility as they are know to be natural blood thinners and that may be why your grafts slipped out or “pooped” out....but I’m no doctor and that’s just based on what I know of supplements and diet.

As for your scalp dryness or “harness” try applying some organic coconut oil....and of course give it time and take many photos.

Good Luck!

[Dr. Glenn Charles]

There are several factors that can cause popping of the grafts during a HT procedure. Bleeding and skin characteristics are certainly two of the more common causes. However surgical technique is also important and can play a role in cases where popping has occurred. It is true that shedding of the transplanted hairs usually happen in the first month following the procedure. I have never heard of any way to soften the scalp. I have had many patients who appeared to have a tougher/ harder skin and still had positive results.

[Akash_b]

Hi,

Many many thanks for all your responses.

I must confess I have a very bad diet, I hardly get to eat home cooked food (3-4 days a week I order food from restaurant - 80% of the times chicken). It is very likely I will go for a second transplant in the future, so having a healthy diet and reducing intake of turmeric would diminish the chances of this Popping issue right?

During the procedure I also had another issue, the doctor told me that the local anesthesia effect on my scalp was fading off too quickly than normal, which he had also attributed to my hard scalp skin problem.

@LaserCap : Sir my hairline was drawn by the doctor  (free hand) just 10-15 minutes before the transplant, and honestly I was happy just by thinking that I would have that much hair and didn't pay much attention to the sides, I am attaching 4 pics of sides (L & R) taken after 12 days when I went for PRP and now i.e. after 9weeks - would love your opinion.

During the first 2-3 head washes (1st head wash was after 8 days of HT) I observed that some whole grafts were coming out, I took a photo (attached) just to keep as a reference in case I go for a 2nd transplant in the future , it would help to consult with the doctor. Is this normal ? does whole grafts come out after first head wash?

Lastly, my doctor is telling me to get a PRP  done every month for the next 6months - each costs around 50USD, but I read somewhere that PRP treatment is experimental, so would it be advisable to get one PRP every month?

Please Note :-  I don't drink or smoke and I have been taking finasteride (alternate days or sometimes every 2days) and minoxildil (once every day) for almost the last 9 years and recently after the HT I am taking Follihair (biotin) once every day.

Regards,

Akash

 

 

Edited September 10, 2019 by Akash_b

[Akash_b]

1 hour ago, Dr. Glenn Charles said:

There are several factors that can cause popping of the grafts during a HT procedure. Bleeding and skin characteristics are certainly two of the more common causes. However surgical technique is also important and can play a role in cases where popping has occurred. It is true that shedding of the transplanted hairs usually happen in the first month following the procedure. I have never heard of any way to soften the scalp. I have had many patients who appeared to have a tougher/ harder skin and still had positive results.

Hi,

Thanks for replying.

Your patients who appeared to have a tougher/ harder skin - Did they had their shedding phase in 1-5 weeks after their HT or did their shedding phase took more time like mine?

[Akash_b]

On 9/11/2019 at 1:17 AM, Akash_b said:

Hi,

Thanks for replying.

Your patients who appeared to have a tougher/ harder skin - Did they had their shedding phase in 1-5 weeks after their HT or did their shedding phase took more time like mine?

Hi Dr. Glenn Charles,

It would be very kind if you can refer to my above comment and respond.

Regards,

Akash

[Akash_b]

On 9/10/2019 at 9:15 PM, CosmoKramer said:

Good advice by ⬆️.

The popping out of grafts as you say might possibly due to thin blood in the surrounding are,  as LaserCap mentioned if you are Indian/South Asian decent and consume lots of curcumen / Turmeric then that may be a possibility as they are know to be natural blood thinners and that may be why your grafts slipped out or “pooped” out....but I’m no doctor and that’s just based on what I know of supplements and diet.

As for your scalp dryness or “harness” try applying some organic coconut oil....and of course give it time and take many photos.

Good Luck!

 

Hi,

Thanks for your response.

Would you be so kind and recommend some good brands of organic coconut oil available in amazon?, also can I mix it with almond and castor oil, is that a good idea?

Regards,

Akash

[Akash_b]

On 9/11/2019 at 1:12 AM, Akash_b said:

Hi,

Many many thanks for all your responses.

I must confess I have a very bad diet, I hardly get to eat home cooked food (3-4 days a week I order food from restaurant - 80% of the times chicken). It is very likely I will go for a second transplant in the future, so having a healthy diet and reducing intake of turmeric would diminish the chances of this Popping issue right?

During the procedure I also had another issue, the doctor told me that the local anesthesia effect on my scalp was fading off too quickly than normal, which he had also attributed to my hard scalp skin problem.

@LaserCap : Sir my hairline was drawn by the doctor  (free hand) just 10-15 minutes before the transplant, and honestly I was happy just by thinking that I would have that much hair and didn't pay much attention to the sides, I am attaching 4 pics of sides (L & R) taken after 12 days when I went for PRP and now i.e. after 9weeks - would love your opinion.

During the first 2-3 head washes (1st head wash was after 8 days of HT) I observed that some whole grafts were coming out, I took a photo (attached) just to keep as a reference in case I go for a 2nd transplant in the future , it would help to consult with the doctor. Is this normal ? does whole grafts come out after first head wash?

Lastly, my doctor is telling me to get a PRP  done every month for the next 6months - each costs around 50USD, but I read somewhere that PRP treatment is experimental, so would it be advisable to get one PRP every month?

Please Note :-  I don't drink or smoke and I have been taking finasteride (alternate days or sometimes every 2days) and minoxildil (once every day) for almost the last 9 years and recently after the HT I am taking Follihair (biotin) once every day.

Regards,

Akash

 

 

 

On 9/10/2019 at 4:51 AM, LaserCap said:

Seldom do I hear "hard skin." Interesting...Perhaps doctors can jump in and give their opinion.  I don't think there is such thing.  Could it be less elastic? Perhaps that's what's causing the issue.  But....

Typically when grafts pop it's not because of the quality of the skin.  It is because you are a bleeder.  What's causing that?  Perhaps the diet.  I am very aware of the many condiments in Indian culture - as I enjoy most of them when I cook.  Tumeric is one.  If this is the case, it is important to bring it up during the initial consultation.  Leafy vegetables, fruits....that can help.  The doctor can also suggest other vitamins to minimize the issue.

But it's a bit early to question the results.  I would give it 6 months and then start taking photos.  Make sure you return to the doctor's office when scheduled to do so...and follow their instructions.

I keep looking at your photo and it might be me, but you seem tilted somehow.  Your left side is much higher than the right and it end on a point.  The right seems blunted a bit, but slopes down.  What this the hairline you and the doctor discussed prior to the procedure?  Symmetry is typically a no-no in this industry....but this is an issue.

Keep an eye on things and post at 4 and at 6 months.

Hi Dr. @LaserCap

It would be very kind if you can respond to my queries in my last comment specially about PRPs and falling of whole grafts during first few head washes?

Regards,

Akash

[LonelyGraft]

21 hours ago, Akash_b said:

 

Hi Dr. @LaserCap

It would be very kind if you can respond to my queries in my last comment specially about PRPs and falling of whole grafts during first few head washes?

Regards,

Akash

Lol @ “Dr” lasercap 😂😂😂

[CosmoKramer]

22 hours ago, Akash_b said:

 

Hi,

Thanks for your response.

Would you be so kind and recommend some good brands of organic coconut oil available in amazon?, also can I mix it with almond and castor oil, is that a good idea?

Regards,

Akash

Any organic virgin coconut oil would do, you don’t need to look for the best of the best.

I suppose you can mix it with other oils but personally I wouldn’t as adding more oils might create pimples on your scalp or possibly make it irritated.

[Akash_b]

On 9/10/2019 at 4:51 AM, LaserCap said:

Seldom do I hear "hard skin." Interesting...Perhaps doctors can jump in and give their opinion.  I don't think there is such thing.  Could it be less elastic? Perhaps that's what's causing the issue.  But....

Typically when grafts pop it's not because of the quality of the skin.  It is because you are a bleeder.  What's causing that?  Perhaps the diet.  I am very aware of the many condiments in Indian culture - as I enjoy most of them when I cook.  Tumeric is one.  If this is the case, it is important to bring it up during the initial consultation.  Leafy vegetables, fruits....that can help.  The doctor can also suggest other vitamins to minimize the issue.

But it's a bit early to question the results.  I would give it 6 months and then start taking photos.  Make sure you return to the doctor's office when scheduled to do so...and follow their instructions.

I keep looking at your photo and it might be me, but you seem tilted somehow.  Your left side is much higher than the right and it end on a point.  The right seems blunted a bit, but slopes down.  What this the hairline you and the doctor discussed prior to the procedure?  Symmetry is typically a no-no in this industry....but this is an issue.

Keep an eye on things and post at 4 and at 6 months.

Hi,

As per your last message, I am posting my 4 months result.

Still there are huge number of implanted grafts that neither grew nor shed off. I think they are as good as dead. Most of my friends and colleagues are telling me that my HT has failed, and judging by the pictures it seems they are right  

Also, if I zoom in I can see on my forehead there are many tiny baby hair (I am sure these are body hair as no implantation were done on that area) and  I see many such hair are also present on my scalp so I have doubt if the scalp ones would ever grow like normal scalp hair.

Overall, I am feeling pretty bad and down.

[Shera]

Hi Akash,

I would recommend you read up on the different growth phases of a hair transplant, you could start with a few detailed patient reviews from this site.

As for your "4 month result", there is no such thing as a 4 month result, you can only really start talking in terms of results after 7-12 months.

At the 4 month stage your scalp looks exactly how it should with small baby hairs sprouting that will mature over the coming months. I'm always surprised when I come across patients panicking at 4 months, did your doctor or a rep not brief you on what you should expect over the coming months, if not then they should have.

The many baby hairs you refer to that are suddenly appearing on your scalp are good signs of early growth. Even if you lost a few that popped out during surgery your pictures do look promising, take heart from that and try to be more positive.

I can't see any reason for you feeling bad and down and lastly in my opinion if you let yourself get all stressed and deflated after only 4 months then this could affect your mental/physical well being thus detracting from your final result.

As for your friends and colleagues, don't even get me started!!!

I hope that clarifies a few things for you and puts your mind at ease.

[1978matt]

Those fine black hairs are the start of growth.  Everything is looking good and your friends are clowns to say that this has failed.  It takes 12+ months to see the final result

[Akash_b]

Thanks Shera and Matt.

Your posts gives me encouragement and hope.

By the way, in your opinion is it normal that grafts have not grown or shed off even after 4 months?, does it mean they are damaged/dead?

I have at least 600-700 grafts or maybe more (out of total 2600  implanted) that are still the same as they were implanted - neither grown nor shed off.

Have you came across anyone who had similar issue, did they get a positive result?

Regards, 

Akash

 

[Shera]

Hi Akash,

It is quite rare for hairs attached to implanted grafts to have not fallen out after 4 months but it is not unheard of. I myself had very little shedding and my result turned out fine. But looking carefully at your pics again I see little evidence of the stubbly implanted hairs still being present so personally I would put your worries to one side.

If the grafts did pop out and were not secure in the slits then this may have resulted in cobblestoning which again I cannot see any evidence in your pics.

If you are certain then there is little you can do now anyway, just be patient and see how things pan out over the coming months, and then you can re address the issue if it still exists.

[Akash_b]

Hi,

Just an update.

I went to see my doctor today.

He used a scanner (maybe called trichoscan) and showed me that in most of my non-transplanted existing grafts (with 3 or 4 hair), 1-2 hair are very thin and one is quite thick. He told me that this thick-thin hair ratio per graft should be 80:20 but in my case it is 50:50 and that is why my result could be poor.

Also, he said that in most of my transplanted grafts (multiple hair ones) only SINGLE hair are coming out and he was juite concerned about that and said that he does not know why it is happening, but said that later the other hair per graft will also come out, but then I asked him "is it possible that in later stages when other hair (per graft) comes out then the current hair that came out now will go to telogen phase?"..he said "yes, that's possible", so I guess it will be hard for me to get good density based on this current finding, but still fingers crossed and hoping for the best.

[Akash_b]

Attaching my 8 months result pictures.

Quite disappointing, I expected much better than this result, I was not expecting 100% result but would have been happy with 80% but seems the result is about 30-35% (i.e the no. of grafts that actually grew).

The doctor is telling me to wait for another 2 months at the least (then it will be 10 months) then he says he will perform another small session for 'filling in' some too bald areas and told me it would be 400-500 grafts, please suggest if I should take another chance with him?...PLEASE SUGGEST 

Note: As mentioned earlier, The doctor I have a hard skin so there was an issue with "popping" and there still many grafts attached to my scalp that didn't grow at all (they still poke when I touch them) - my doctor still says that even these grafts will grow too after some time...if though it is already 8 months!! 😲

I have attached many pictures (before HT, current_under_sunlight, current_inside_room, current_wet), so please bear with me and send your valuable feedback.

BEFORE HT

 

AFTER HT

Edited February 25, 2020 by Akash_b

[duchaine]

Let me tell my experience.
I was going to have an HT. After 200 extractions, the doctors aborted the procedure because, he said, my grafts were miniaturized and, according to his experience, when grass are miniaturized, "the hairs grow patchy".
According to your doctor, you have miniaturized hair follicle. Anyway, it is really strage he didn't see you have miniaturized hairs before or, at least, during the operation.

Do I agree you have miniaturized hair?
It is really hard to say but consider that, according to literature, miniaturization occurs at one hair per time.
That means, if you have a multiple FU, let say 4 hairs, one hair miniaturizes and disappears and you have only 3 hairs, then another miniaturizes and disappears etc.
So, you don't have a 50:50 ratio, at least you are not in the very last stage. 
In other words, if you have a lot of multiplies, it is really hard to believe you are in early phase of miniaturization.

 

[Akash_b]

16 hours ago, duchaine said:

Let me tell my experience.
I was going to have an HT. After 200 extractions, the doctors aborted the procedure because, he said, my grafts were miniaturized and, according to his experience, when grass are miniaturized, "the hairs grow patchy".
According to your doctor, you have miniaturized hair follicle. Anyway, it is really strage he didn't see you have miniaturized hairs before or, at least, during the operation.

Do I agree you have miniaturized hair?
It is really hard to say but consider that, according to literature, miniaturization occurs at one hair per time.
That means, if you have a multiple FU, let say 4 hairs, one hair miniaturizes and disappears and you have only 3 hairs, then another miniaturizes and disappears etc.
So, you don't have a 50:50 ratio, at least you are not in the very last stage. 
In other words, if you have a lot of multiplies, it is really hard to believe you are in early phase of miniaturization.

 

Thanks for replying..so is there any way of stopping/limiting this miniaturization?..by the way I have been using minoxidil and finasteride for the last 9-10 years.

So, for me going for another transplant would be just waste of time and money ?

[duchaine]

according to the doctors I consulted, fina is very helpful to stop miniaturization.
about your idea to get another HT, I suggest to consulted a very well prepared doctor on this field like Bruno Ferreira @BrunoFerreira7

[duchaine]

for the record, I "studied" your pics. It is like you got 30UF/cm2.
Maybe this the reason your hairs look patchy.

[tesla007]

12 hours ago, duchaine said:

for the record, I "studied" your pics. It is like you got 30UF/cm2.
Maybe this the reason your hairs look patchy.

What is 30UF/cm2?

[tesla007]

From where did you get the procedure done? How much is he quoting for the second procedure?

@Akash_b

[Akash_b]

7 hours ago, tesla007 said:

From where did you get the procedure done? How much is he quoting for the second procedure?

@Akash_b

I got it from Pune, India..the first transplant was 30 INR (around 40 cents) per graft, he is still charging the same.