Thank you
for
your question.
You submitted your question with a single photo and you stated in your question that
you’re 15 days after undergoing 4000 hair grafts and that you are a little bit concerned
about potentially dislodging grafts because there are a lot of scabs that seem to be attached
to hairs. And you want to know how safe it is to essentially be aggressive about shampooing
and at what point after surgery are these grafts are in a secure enough position not
to be dislodged.
I can certainly share with you how I counsel patients for many years performing hair transplant.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a
system we developed using extracellular matrix and platelet-rich plasma (PRP) to help patients
expedite healing after hair transplant. And this is actually a treatment we developed
that has evolved into a very significant non-surgical treatment for men and women with androgenetic
alopecia or genetic pattern hair loss. In addition to people who have had hair transplant
who want to further manage their hair loss beyond the time of their transplant.
So to answer the question as to when is a graft basically secure, I would say from experience
and doing every kind of hair transplant technique since the mid 90s, I would say that within
48 hours, a hair graft is pretty well secure. If a graft is above the skin and attached
by a clot, well that’s not a graft that’s going to make it anyway. A certain percentage
of grafts do not make it.
And as I said, that’s one of the reasons why we developed what ultimately became Hair
Regeneration was to help people during the time, the critical period as well as beyond
the critical period to expedite healing. The biggest challenges of transplant especially
with the strip method was to get the donor area to heal as well as possible and get the
grafts to heal as well as possible. If you think about it, you have 4000 grafts that
means you had 4000 incisions made into your scalp. That is fairly traumatic. There’s
a fair amount of bleeding and there’s a fair amount of inflammation.
We found that with extracellular matrix and platelet-rich plasma (PRP) that we got improvement
in the healing of the donor area as well as graft survival. And as an additional benefit,
we found that thinning hair became thicker. From this, we developed Hair Regeneration,
TrichoStem™ Hair Regeneration where people with male and female pattern hair loss are
also able to manage their hair loss with this treatment where injections are placed to the
scalp to reactivate hair that is not growing, to thicken thinning hair and to prolong the
lifespan of hair that is thinning. Now as far as the past 7 or 8 years of doing this,
I also developed a classification system further to optimize the dosage and delivery techniques
to maximize the outcome and coverage of every patient in addition to the use of any pharmaceuticals
such as DHT blocker like finasteride and minoxidil when appropriate.
As far as patients who have had hair transplants are concerned, again, I would say that, going
back to your question you may wash your hair aggressively. I can tell you that whenever
we would tell our patients to wash their hair aggressively, we found that they would still
be very tentative about washing their hair. And some patients, we would often ask them
to come into the office and my technicians would wash their hair and they would realize
that they were not being aggressive enough. At a certain point, you have to scrub the
scalp to get rid of the dead skin as well as the scabs so that the scalp can actually
heal well and existing hair isn't affected by your scalp hygiene as well as the grafts
themselves. But by 48 hours to 72 hours, it would actually take an instrument to remove
those grafts. So I think you can feel secure about that.
As an aside, I can tell you that a lot of patients who have come to us who have had
transplants done elsewhere and we’ve actually been able to expedite the regrowth process
as well as help the existing thinning hair when they come in somewhere between the 1
and 3 month point after undergoing a transplant and doing the injection of Hair Regeneration
and there’s a protocol for that as well. That’s not saying that you need that but
it’s just to help you understand the wound healing process.
Wound healing is still a physiological process that has a pretty stable schedule. There’s
a hemostatic phase, inflammatory phase, proliferative phase and then remodeling phase. And those
processes will take their own time and thanks to newer technologies, there are ways to help
further expedite further stages of that process and that’s something you can certainly discuss
with your transplant surgeon.
So I would encourage you to wash your hair and expect that you will see some grafts not
quite make it. You know, when you do a transplant, the bleeding can push some of these grafts
up and some of them might come up regardless. And whether or not they do come up, I’ve
had patients for example who have had mega sessions done elsewhere and have lost 90%
of their grafts. So I don't want to scare you but understand that there is a certain
amount of attrition that happens with every transplant and hopefully as long as everything
goes as planned, you’ll get the desired outcome. Certainly, you’ve already experienced
how hard it is to have hair transplant and how many hours it took to have it done. So
I know your surgeon wants the outcome for you but you should follow your surgeon’s
advice as to washing your hair to appropriately maximize from your side whatever can be done
to help your transplant heal.
So I hope that was helpful, I wish you the best of luck and thank you for your question.