Thank you for your question.

You submitted your question with two photos. And you stated in your question that you underwent

4200 hair grafts and that you are at day 24 and you are concerned about the lack of hair

shedding. And you’re also concerned about your head being rubbed very significantly

at day 21 and you’re concerned about damage.

Well, I can certainly share with you my perception of what you’re going through. 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. This

is a system we developed using regenerative medicine technology that evolved from application

to hair transplant surgery and I’ll discuss that even further as I discuss more details

about your question.

So to begin with, the time in which hair sheds is somewhat variable soon after surgery. There

is a certain thing called shock loss that is not uncommon where the hair from the grafts

will shed and even native hairs in an area where the grafts are placed will also shed

and that can happen in the first couple of months. And the results of a hair transplant

therefore require just waiting about a year after a transplant. It’s not unusual for

people to get concerned because of some shedding a few weeks out where things can be kind of

patchy. So for now, I think you cannot be worried that there wasn't shedding and still

be prepared that there may be some shedding in the upcoming weeks.

As far as the scalp rubbing is concerned, technically speaking, once a graft is in place

for a few days, it actually takes a lot of effort to actually get the graft to be dislodged.

In other words, wound healing occurs really in such a manner that if a hair graft is going

to survive, it will survive the hair rubbing. And a lot of times, patients are very scared

to do anything like wash their hair and they actually have to come in the office to actually

have our staff rub and clean the scalp.

Now when it comes to this type of scenario, we have a lot of experience when we were doing

a lot more transplant surgery, we wanted to achieve less shedding because, as I said,

that can be very distressing. We wanted to also have better graft outcomes, in other

words, the healing and the survivability of the grafts. We wanted to see the donor area

heal better. And so, we used this material called Acellular matrix and combined it with

platelet-rich plasma (PRP). We did find that there was somewhat less shedding after this

combination of treatment was done but we also saw that thinning hairs became thicker. And

we have been using this method that we derived after treating so many patients over the past

7-8 years who travel from around the world with thinning hair that we’ve developed

a protocol and system for different classifications of patients and that factors in age of onset

of hair loss, degree of progression, the current age, the other medical procedures such as

having a hair transplant. And we’ve been essentially able to help people in a way that’s

non-surgical using regenerative medicine technology.

Now this particular aspect of our practice has been leveraged further in helping patients

who have had hair transplant done elsewhere. Patients who have undergone hair transplants

like yourself are frequently scanning the web to learn about ways to optimize hair growth.

And a lot of times, people come across our information and they come in somewhere between

the first and third month after a transplant. And what we have been able to do is actually,

in many patients, expedite their healing. We’ve been able to get them to have regrowth

of their grafts sooner than that one year point as well as to expedite the healing process.

And further, allow the regenerative aspects of our technology to help their existing thinning

hair. And so, there seems to be a certain group of patients. I’m not saying that this

is applicable to you. But there has been a certain group of patients who have been able

to benefit from regenerative medicine technology even if it wasn't used at the time of the

surgery. And this is something to learn about and certainly not something that’s required

for you to have a successful outcome.

So I think that you can certainly and it’s very important to maintain communication with

your doctor. These are the questions that everybody does hair transplant surgery gets

asked regularly. And I think it’s very important for you to maintain this dialogue and do your

follow-up visits with your doctor so that the optimal management of your hair healing

process of your transplant is maximized.

So I hope that was helpful, I wish you the best of luck and thank you for your question.