Recipient area not looking great (8 days post procedure)

[zerocool]

I had my FUE 3800 8 days ago (this was my second procedure, first procedure was 6 years ago 2000 FUE).

After a wash I did on day 6 I noticed 3 places with drops of blood mixed with white substance. 

Clinic advised to resume spraying water regularly, apply antibiotic ointment (fucidin), and take oral antibiotics (latter as precautionary only).

While I'm in regular contact with the clinic I would appreciate some inputs from the community and hear if others had a similar experience.

What does this look like to you?

Do you think there's a risk of growth beyond the few grafts I probably pulled during my wash?

+6 days post op, before the wash:

6+ day post-op, immediately after the wash:

8+ day post-op, after 1.5 days of applying fucidin cream:

 

[mafpe]

that's... a big pimple.... my clinic advised me to take antibiotic as precaution, but it also act in order to prevent any infection. i can't say what's happening with your head because i'm not well educated on that, if those white yellow spots are just shed skin/scab, or something else.

go to a dermatologist to get checked, better safe than sorry.

[Gatsby]

I think you will be fine as long as you stick with the anti biotics. A lot of clinics prescribe anti biotics immediately after surgery regardless to avoid infections. All the best!

[Melvin- Admin]

It looks like you have some pimples you wanna make sure you don’t get an infection. Let me tag @DrTBarghouthi he’s our resident physician. 

[gillenator]

That almost looks like the beginning signs of an infection, so you want to follow your doctor’s instructions and stay in touch with them as you keep an eye on the area.

[DrTBarghouthi]

Thanks for tagging. 
Have you applied Fucidin on these prior to taking photos? Are there traces of it on the skin that might make it look different. If anything there might be a localized reaction or infection or even simply delayed healing giving some granulation tissue look. I would stick to their advice for now and it should be ok.

[zerocool]

35 minutes ago, DrTBarghouthi said:

Have you applied Fucidin on these prior to taking photos?

Here’s another photo taken just now. The bright white is traces of fucidin. I applied it, waited 3 hours, and then started spraying with water continuously. 

[zerocool]

Here’s another one taken just after a shower (8 days post op). It highlights that the main issue is the redness in various areas of the scalp. 
I’m going to let it dry and apply fucidin on all red areas. 

[zerocool]

@DrTBarghouthi - what are the odds that long term growth will be affected in the red area? Do you know what caused this type of bruising? 
 

9 days post op, after morning wash:

 

 

Edited June 24, 2022 by zerocool

[DrTBarghouthi]

4 hours ago, zerocool said:

@DrTBarghouthi - what are the odds that long term growth will be affected in the red area? Do you know what caused this type of bruising? 
 

9 days post op, after morning wash:

 

 

I don’t believe there will be any growth implications in the future. In some cases if an increased density is done in an area with slightly less blood supply, the healing can be delayed or the area can scab for longer giving increased crusting. Once the wash is done, that crusting reveals raw looking skin underneath so it looks more red with maturing granulation tissue. I would still cover it with antibiotics just in case as such areas with possibly delayed healing are more prone to getting infections etc. 

[zerocool]

Thank you @DrTBarghouthi!

Do you agree it’s better to keep the area moist by spraying tap water regularly? Or is it better to let it dry off? 

[DrTBarghouthi]

Keep it dry and just apply the ointment once or twice as it keeps it moist and protected that way. 

[zerocool]

Thank you! 
Updating that the clinic corrected and asked that I apply Fucicort and not Fucidin. The former has curtizone which should help with the healing. 

[mafpe]

best of luck to OP, hopefully everything heals up fine and all graft will be healthy and all grow.

[GoliGoliGoli]

 

On 6/23/2022 at 3:20 AM, Gatsby said:

I think you will be fine as long as you stick with the anti biotics. A lot of clinics prescribe anti biotics immediately after surgery regardless to avoid infections. All the best!

This is something I've been wondering about. It sounds like some but not all clinics prescribe antibiotics post HT? I would prefer to avoid having to take antibiotics if not 100% necessary, so I'm hoping it's true that not everyone takes them post HT? 

Edited June 24, 2022 by GoliGoliGoli

[DrTBarghouthi]

We only prescribe a very short prophylactic dose on the day and two days after. 

[zerocool]

Update:

12 day post op. I've been applying Fucicort (3xday) and washing (2xday). Was initially using the post op shampoo but have now switched over to the subsequent shampoo provided by the clinic to address the dandruff and dryness that has formed. Shedding has started yesterday (some hair on palm of hand during wash).

The majority of the area has healed nicely but a large scab formed on the left part of the scalp and another smaller one closer to the center. I'm worried that there will be growth issues in these areas in the future. I'm also concerned that shedding has started fairly early (11 days post op). Not sure if this will have any impact on future growth overall.

Looking for reassurance / advice to make sure I make the most out of the situation (apart from being patient). 

[zerocool]

15 day post op. Here's how it looks like now.

@DrTBarghouthi does this look like necrosis to you or is it just a scab?

[Vann]

3 minutes ago, zerocool said:

15 day post op. Here's how it looks like now.

@DrTBarghouthi does this look like necrosis to you or is it just a scab?

I think its close to it I am not medical professional but it looks like its getting infected and you could be having an auto immunity issue where it looks like necrosis. I would see a derm asap if I were in your position. Like I said I am no medical professional. 

[zerocool]

Update 16 days post op:

I'm pretty certain that this is necrosis. Kind of perplexed as I went to a forum recommended clinic, followed all pre/post op guidelines to the letter, never smoked a cigarette in my life, and I have no pre-existing conditions (apart from this being my second transplant). 

If anyone has any advice on how to make the most out of the situation, I'd really appreciate it. At this point I'm praying that the damaged area will not be visible after my hair grows out.

[gillenator]

There definitely appears to be an improvement...this IMHO, based on the photos that you have provided, was a small infection and apparently the

anti-biotics that you have been applying is working.... IMHO, this is not necrosis.... I do not see any dead tissue occurring.

[A Fue Good Men]

Can you share which clinic?

[zerocool]

I'm continuing to update as I believe this will help future patients with a similar issue. If anyone has been in a similar situation I'd really appreciate if you could provide your insight (feel free to reach out in a private message if you prefer).

20 day post op:

Went to a local derma/hair transplant surgeon who confirmed that this is necrosis (😪). He disinfected and cleaned some of the dead tissue to promote healing. I've accepted that the dead tissue is unlikely to result in any growth, but still very concerned that surrounding tissue may have also been affected. As you can see, some grafts are not growing around the dark spot. I assume it means that they are dead.

Question: if I see pre-shed hair growth (the initial growth after the transplant and before the shed), is that a sign that the grafts have proper blood supply and are expected to grow again after they shed? this will help me understand the blast radius of this wound.

 

[Yan bio]

approx. 1 week ago I asked the same question (my pics looked the same as yours) and everyone here said it's going to heal and it did heal and looks normal. I'm a bit surprised it did turn up to be necrosis in your case 😕

[Yan bio]

I seriously doubt it’s a necorsis, mine looked the same and healed completely and we’re in the same time frame