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doctor, after my hair transplant i had shedding at the 3rd day after the operation. it comes with a hair and dark scab. is this the sign of losing graft? And on the 8th day i have a lot of scabs, more than first week. is this normal?

Grafts could come out at the 3rd day after your surgery, so if there are many then you could have a problem. I don’t know about your management of your recipient area after surgery. I generally recommend a specific washing procedure starting the next day after surgery and this keeps the eschars (scabs) down. Leave the eschars you have alone until they fall out, probably in a week or so.

Doctor, compare about eyebrow transplant and hair transplant. Which has higher success rate and why?

3-4 days after eyebrow transplant I have a very little crust and scabs. Is it a good sign? Do I have to use vaseline petroleum to my eyebrow right away after procedure?

Hair transplant results are the same for eyebrow or scalp. The eyebrows tend to crust less, but the key to keeping crusting down is to use a good washing technique daily after the transplant. I have never recommended Vaseline petroleum after a hair transplant.

Hi Doctors, great blog here! It’s an amazing cross-reference and informative place.

Just wanted to know if there are any signs of a successful FUE transplant? (other than growth of hair at 8-10 months!!).

Can the patient tell within a week, or a month, whether the surgery he had would be, say, at least 80-90% successful? Are there any signs which suggest that yes the transplant was a success, and that the roots did not dry out, and were placed correctly etc.? ( I’m guessing, that if the transplanted hair kept growing till it fell out after 3/4 weeks, that means the roots were alive and firmly in place, and the surgery was good? )

I only ask about FUE, because it seems the more delicate procedure with a higher trans-section rate.

Thank you Doctor.

I know the anxiety you have. Everyone with a hair transplant wants to accelerate the clock, but it makes no real difference if the transplant is FUE or strip. In either case, you will start seeing the results (at least some results) somewhere between 4-6 months, with good growth by the 8th month. At one month, the hair sheds in probably 19 out of 20 people. Just be patient.

Hello Dr. Rassman.

I and other readers would be thankful if you could tell us a little about some of these basic points -

1. I was told to avoid green tea because it has anti-oxidants for 2 weeks after my FUE transplant. Do antioxidants hinder with growth of new implanted grafts?
2. I was also told to avoid protein and vitamin supplements for 2 weeks for the same reason as above. Is that right?
3. I am spraying saline solution on my implanted area every hour for a week. Told to wash only after 1 week. What exactly does saline do?
4. Finally, do Soya milk/ foods really block DHT that affects male pattern baldness?

Thanks a lot, and keep up the good work!

I would add that you should not go outside during the day after your surgery due to antioxidant effects from the sun. Also not driving your car for the first year after the surgery due to the risk of car accidents, which can cause great stress. Perhaps meditating for an hour a day in a downward dog position can also promote hair growth and circulation to the scalp. I’m being sarcastic, of course.

Where do you get this information? Did your doctor tell you this? Always follow the post-operative instructions given to you by your doctor. If these are truly basic points, you should not have to worry because your discharge information should have them.

In the spirit of BaldingBlog being a source of education for general hair loss issues, I would add that green tea, protein, vitamins, and soy milk have nothing to do with a hair transplant surgery or treating genetic male pattern baldness. If you believe what you read online, it is your prerogative to not drink green tea, etc. Otherwise, in matters of personal health and YOUR surgery, it is best to ask your doctor face to face.

Hello there Doctor Rassman!

My compliments on a great blog here. I’ve just had a FUE done for my hairline today. I have 2 simple Q’s -

1. Is Ibuprofen recommended after surgery? My surgeon has prescribed it twice a day for 5 days, but I read on the internet that it promotes bleeding?

2. On reaching home, I have been spraying the recipient area with saline solution every 30 mins as prescribed. I am seeing some drops of blood oozing out of the recipient area. Is this normal? I couldn’t spot any hairs in the blood so just concerned that none of the hair roots have fallen out due to this bleeding.

Thanks for your time and help

1. Ibuprofen in general can cause bleeding, but you need to understand and takes things into context. Believe what your doctor (a real live person you trusted to perform your surgery) over what you read on the Internet.

2. A little bit of bleeding should be normal since you just had your procedure done. It was surgery, after all. Many doctors have different post operative instructions, so if you are concerned you should contact your surgeon.

Hi Doc. I’ve had 2 hair transplants. Both over 2 years ago. One in Australia and one in North Carolina.

Today my new girlfriend mentioned to me that “where my hair is it looks red and sore”…. this is very disturbing as I have often thought the skin around my recipient area had a sort of raised redness about it. But I never thought anybody else would notice.

Before you say “see my doctor” I just want to know if you’re aware of this happening and whether or not there are any skin creams that might help my skin go back to normal. If not skin creams… is there anything you can do?

Redness can be an issue for some patients even years after surgery. I’ve seen this on occasion from old (bad) hair transplant days, but I rarely see this anymore. Maybe you have a skin problem, though it’s all a guessing game without an examination.

Hi Dr,

Thank you so much for this wonderful blog. I just recently got an HT with a very reputable clinic. My question concerns shedding of the grafts. I notice shedding began around the 9 day mark. Is this considered normal? Also, i had crusts on my head for approximately 9 days, and i noticed there were a couple of crusts that fell off with a hair in it. My question is, is it possible i lost a graft in one of these crusts. Or would there be some noticeable bleeding from the graft from being dislodged?

Thanks

At 9 days, I would expect that the grafts will grow out nicely. In a published article where we tried to identify when the grafts would be stable to grow out normally, we determined that stability occurs usually in a week or so. When the grafts fall out with the hairs in it after a week, they leave behind the stem cells in the recipient site. Don’t worry, it sounds like you will be fine.

Hello dear doctor
I did fut 21 days ago, and now i have small necrosis on my scalp, what should i do? please help me

Click the photos to enlarge:

It looks like something is going on, and it might be an infection, but I’m not sure I would call it a necrosis. I must continue to stress this point — follow up with your surgeon as soon as possible! This (and anywhere on the Internet) is not a place to receive personal medical advice or diagnosis.

Scalp necrosis (a loss of blood supply to an area of scalp) is highly unusual. In my own practice, I have never seen it (15,000 hair transplant procedures over 23 years). I have seen cases from some doctors who reported scalp necrosis in the middle of the head (where yours is) and it was caused by the use of large punches (the old days) too close together. An infection that started off locally could have extended the initial area to a large wound as you have, but good cultures of the wounds should be in your doctor’s hands by now.

The wound in the photo may be the result of tissue slough from an infection. I am limited to what I can do for you here. If you are in the area (Los Angeles), come see me. If the wound gets larger, you absolutely need cultures done to see if there is a difficult to treat infection. There are a variety of virulent ‘bugs’ that can cause it and some of these can make it worse.

Hello doctor

I see a lot of HT photos, a lot of the patients seem to have their hair up and raised back like they’ve been in the wind. Is that just the way they style it? If I was to have a HT I’d want my hair down towards my eyebrows..

Is every patient different?

Regards

Hair normally grows forward in the front (parallel to the ground when standing upright). As one moves back from the frontal edge, the angle starts to change with hair pointing a few degrees upward until it reaches the front of the crown, where the frontal pointing hairs are about 35 degrees to the ground. So you see, the hair when placed by the surgeon is never placed perpendicular to the horizon. At the crown, the hair changes direction in a circular pattern (swirl) and as you look further back, eventually the hair points down and away from the front.

What you see in our patient photos reflect each patient’s styling (or lack of it), not something we do. I always put the hair back in the direction it would have been had they never lost hair and depending where I am working on the scalp, the rules I discussed above are followed with every hair placed by me. Patients generally like to play games with their hair and although a few comb it forward, most do not. Some comb it to the side with a part on one side, others comb it back with some product that they apply to the hair. Some just let it stray, taking on the character of the hair itself. If the hair is curly, then the natural state will look less groomed than if it is straight or has a nice wave to it. If you want to comb it down to cover your forehead and point to your eyebrows, you can do that also.

Every patient is different and the results we get depend upon texture of the hair, density at the area we are looking at, thickness of the hair shafts, the degree of curliness (or lack of it with very straight hair). But the hair transplant you get will be your hair, and it will bring all of its characteristics that are present in the back of the head where the hair grafts are taken.

Does the crown stretch when closing a FUT scar?

Hi there - First off I would just like to thank you for providing this excellent resource. I just have two short questions related to FUT scars:

1) Firstly, I know you have answered this in the past with hairlines, however since the crown is within inches of the incision site above the prominent bone, does it slightly move/stretch downwards towards the incision site once the scar is closed?. For example… I have some thinning in my crown but im lucky in the fact that it doesnt dip low at the back so its not very visible unless looking from above my head. If I had a strip procedure would this thinning crown be more visible from the back because the skin has been pulled down to close the strip wound?

2) Secondly, I believe avoiding strenuous exercise is recommended for about a month after the procedure to avoid scar widening, but is general head tilting and looking downwards in the weeks after surgery ok in terms of putting stress on the scar?

I would be most grateful for any response you have for the above questions. Kind regards.

Strip scars placed in the true donor area in the back of the head should not impact the location or the size of the crown area. Strip surgery takes up laxity that is there at the time of the surgery. Bending your head should also not impact the crown area.

I have never been sure why we tell the patients not to lift heavy weights. If there is a pull from the muscles, it comes from the trapezius muscle, which inserts below the scar at the base of the skull. I still tell the patients not to lift heavy objects, but I am not certain there is any value to the advice.