So what happens?

[glajo]

So what happens to the hair follicles that dont grow back?

[glajo]

So what happens to the hair follicles that dont grow back?

[Bill - Seemiller]

glajo,

 

Sometimes if the donor wound has been closed under high tension, there can be circulation issues that cause the surrounding tissue to become infertile for hair follicles. This may not be the case for you, but it's certainly a possibility.

 

Last we spoke privately, you were going to follow through with the free FUE. Did you have a change of heart? What did your doctor say the permanent donor shock was related to?

 

Best wishes,

 

Bill

[mmhce]

Sometimes if the donor wound has been closed under high tension, there can be circulation issues that cause the surrounding tissue to become infertile for hair follicles. This may not be the case for you, but it's certainly a possibility.

 

 

Is this (circulation issues due to high tension closure) more prevalent with staples or sutures?

 

What can cause such a high tension?

[mmhce]

anaesthetic used can absolutely cause permanent hair loss

 

If epinephrine can cause permanent hairloss:

 

1. Why is it used, and can some other anaesthetic be used in its place?

2. What is the science behind anaesthetic causing permanent hairloss?

 

I always assumed that anaesthetics were meant to disrupt the transmission of chemical signals between nerve transmitters and receptors and not deprive the hair follicles of blood or oxygen?

 

This anaesthetic epinephrine sounds toxic.

 

Which brings me to another question.

 

3. What is the toxicity of anaesthetics such as epinephrine and others on the human body?

[mmhce]

glajo,

 

I would like to refer you to this thread:

 

http://hair-restoration-info.c...&r=47810752#47810752

 

where this document:

 

http://www.bernsteinmedical.co.../Epinephrine2000.php

 

was referred to, and see if you agree with my (personal) comments at the end:

 

"Conclusion

 

The use of large amounts of epinephrine for the purpose of establishing hemostasis in large hair transplant sessions is neither necessary, nor desirable. Because intra-operative bleeding in the recipient during site creation and graft placement can be controlled by simple methods, that are easy to administer and free from adverse affects, the reliance upon epinephrine in these phases of the procedure should be reconsidered."

 

So from the conclusion it would seem that epinephrine is not indicated as a component in anaestheticizing the donor or receipient area?

 

Correct me if I am wrong.

 

Additionally if why would a coalition doctor use epinephrine if it is undesirable?

[mmhce]

glajo,

 

So did you guess this(that the doctor used epinephrine) or did he tell you he used it?

 

Why would he use epinephrine, if he knew it is undesirable (to say the least)?

 

a 50% threshold involved in donor strip that I guess was crossed

What is this 50% threshold about? Please elaborate if you can?

[Dr. Michael Beehner]

My experience over the years from seeing cases like this occur at various clinics, and a couple times at ours years ago, is that the cause of permanent hair loss above or below the donor scar is ALWAYS a closure that is too tight. I think the epinephrine plays a small if inconsequential role in this final cell death, provided it is used in the usually dilute concentrations that most hair surgeons use. I think the epinephrine CAN be a factor in the temporary telogen fallout cases, which can occur in the recipient area and rarely along the donor scar. I think it is wise to wait around 15 months before deciding that an area of hair loss near the donor scar is not going to grow back. This loss of donor border hair, if it occurs, almost always is located at the two rear corners, where the strip turns the corner in the parietal area behind and above the ears. The two most important ways to avoid this are: one, for the doctor to have excellent judgement on how wide he can go on a given patient after examining him or her, and two: the patient and the doctor not being too greedy concerning how many grafts are harvested, given the above exam. This is particularly the case for those patients the doctor does feel is "tight" but, because the patient has his heart set on a given target number of grafts, the surgeon goes ahead anyway, assuming he'll yank it together somehow. I think things are much better in recent years, as I don't see this or hear about it hardly ever.

Mike Beehner, M.D.

[Maxxy]

Hello Dr. Beehner,

 

With all respect, this is not the case with Glajo, - atleast I hope not, considering he only had 200 grafts by a coalition Dr removed and he is already 13 month post-op.

 

But thank you, its good to have a medical view on why cases like this may happen.