Hair transplant did not grow. Any advice?

[3rd time]

My 3rd HT for 1600 grafts did not grow. I am now 10 months post op and Dr has agreed to do a touch up procedure at no charge.
The issues that I had in the Previous HT.
Excessive bleeding
graft popping (13 hrs to finish)
Dried up grafts falling off after procedure.

I am now scheduled to go in for a procedure in less than a month. Some people suggested vitamin k supplementation for blood coagulation.
Are there any other suggestions on what I can do to make sure this touch up procedure is successful.

I know multi vitamins and alcohol should be stopped. Also certain foods and fish oils. Any other info would be appreciated.
I have very limited grafts left so really want to get a good yield.
Thanks.

[35YrsAfter]

My 3rd HT for 1600 grafts did not grow. I am now 10 months post op and Dr has agreed to do a touch up procedure at no charge.
The issues that I had in the Previous HT.
Excessive bleeding
graft popping (13 hrs to finish)
Dried up grafts falling off after procedure.

I am now scheduled to go in for a procedure in less than a month. Some people suggested vitamin k supplementation for blood coagulation.
Are there any other suggestions on what I can do to make sure this touch up procedure is successful.

I know multi vitamins and alcohol should be stopped. Also certain foods and fish oils. Any other info would be appreciated.
I have very limited grafts left so really want to get a good yield.
Thanks.

Any thoughts related to what might have caused issues with your third procedure? Vitamin K supplements were commonly suggested pre-op in the early days of hair transplant surgery. It's not used today because a vitamin k deficiency is considered too rare. Epinephrine is a vasoconstrictor and helps the anesthetic to last longer. If it were me and my donor was nearly exhausted, I would look at meds I'm taking that cause bleeding and consider the possibility the RN/tech/doctor used an improper or defective anesthetic.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
Atlanta

The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

[gillenator]

It seems that there are potentially two separate issues at hand. Thin blood with a corresponding loss of grafts, and possibly decrease in overall yield? And obviously the loss of grafts is related to the thin blood.

But if yield was also a problem, could PRP injections and possibly the use of ACELL help?

I also highly recommend looking into the inclusion of Liposomol ATP as a potential yield booster.

The increase vacillation to the recipient area may help you get a better or increases/gain in overall yield.

[3rd time]

3rd procedure was where we had issues. The first two procedures done overseas grew fine. This last procedure was 1500 grafts which took close to 16 hrs. Main issue being graft popping. The two tech girls kept trying to insert the grafts but as soon as one would go in another would pop out. By the end of the session it was just the Doc trying to finish everything really pushing down on my head for these grafts to stay.

Over the next few days I noticed a lot of dried up grafts falling out. Not a shed but whole grafts. I think many have been damaged due to them being out of the body for a long time and under hot lighting. But I'm not a doctor.
I was also told I'm a bleeder. I'm 18 days out so I've stopped the gym, and multivitamins. I mentioned vitamin k prescription but my Doc didn't think it would be necessary. Also mentioned prp but was told it was not yet a proven method or something like that.

All I can do is hope it goes well because my hairline looks worse than before and I really need this touch up. I'm at 10 months now and I should be enjoying my results instead I have to go through it all again and hope it works this time..
Pretty frustrating stuff.

P.S To all the young nw6s who can't take propecia just shave your heads. Will save you 10s of thousands of dollars and a lot of down time and stress for most likely a mediocre result IMO.

[3rd time]

Gillenator, very interesting stuff. Please read if interested

According to experts, the addition of ATP – in liposomal ATP form – to follicular unit grafts while they are stored outside of the body and to the recipient scalp after the grafts sites are made could allow for quicker healing and better hair transplant yields. One physician who has experimented with liposomal ATP and believes it offers a variety of benefits in hair transplantation is Coalition hair restoration surgeon Dr. Jerry Cooley.

According to Dr. Cooley:

Early on I began experimenting with ATP, but I didn’t know whether it was helping and usage was intermittent over the first 6 years. However, after reviewing my results I began to believe ATP usage was a significant factor explaining the positive difference in observed results.

Like many experienced clinics, we go to great lengths to protect our grafts from any trauma. Assuming a perfect graft is placed perfectly into the recipient site, why wouldn’t it grow? I believe the biggest reason is ischemia (lack of oxygen = lack of ATP). Doctors who do other skin grafting will tell you that blood flow (ie oxygen and ATP supply) is the major predictor in follicular unit graft survival.

I’m a dermatologist and in the past, I did a lot of skin cancer surgery which often required skin grafts to close the wounds. If we do a skin graft on to the face (where blood flow is good), it usually takes and survives. If we do a skin graft on the lower leg (where blood flow is much lower), it often sloughs off and merely acts as a biological bandage until new skin is produced to fill the wound. Years ago, I removed a large melanoma from an elderly woman’s lower shin. She had poor circulation and I had every reason to think the skin graft I placed wouldn’t survive. However, I rigged up an IV bag with ATP solution that continually dripped over the graft for several days. The graft completely took and after it healed, the only sign we had ever done a graft was a faint circular scar at the margins. The skin in the graft looked like the surrounding skin, which was a much better than expected result. This is one more piece of evidence in my mind.

Numerous top hair clinics have started trying post-op ATP spray on their patients. I have gotten feedback from many of these on how quickly their patients are healing now. It will take a couple years before these doctors are convinced it is improving survival, but that is the nature of our field. The best way for a doctor to be convinced that ATP is doing something is to use it on their toughest cases (eg. densely packed grafts into areas with low blood flow like scar tissue and areas of previous transplants) and see if their results are better than what they would predict. Some hair transplant surgeons even try to finish an area in one single surgery because they believe survival is lower in previously transplanted areas. Why? You guessed it: lower blood flow = lower oxygen = lower ATP. I believe this and have seen positive results – including less shedding, earlier regrowth, and very high yield.

Most experienced clinics get good growth. If I get less than expected growth in 10% of my cases, then for me, that is too high. I want every case to turn out perfect and every graft to survive. That is why I use post-op ATP.

[35YrsAfter]

Gillenator, very interesting stuff. Please read if interested

According to experts, the addition of ATP – in liposomal ATP form – to follicular unit grafts while they are stored outside of the body and to the recipient scalp after the grafts sites are made could allow for quicker healing and better hair transplant yields.

Yup... Liposomal ATP, PRP, ACell, and a new promising treatment for extraction sites, AmnioFix.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
Atlanta
Phone 678-566-1011
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

[3rd time]

Wish I knew about all this earlier. Especially the liposomal. I was give saline spray for the first two days post op.

[topcat]

Much better to increase cholesterol to aid in wound healing along with some raw grass fed butter which is extremely high in K2.............in a form which the body is meant to absorb.

You not going to hear too much about it from the medical community............no money to be made but sometimes passing on valuable information or having valuable information is better than money.

[Jotronic]

Wish I knew about all this earlier. Especially the liposomal. I was give saline spray for the first two days post op.

Don't be worried about these add-ons to a procedure. Not a single one would address the issue that affected your procedure. They're useless.

"Bleeders" are bleeders, regardless of using Acell, PRP, Liposomal ATP, etc, etc. The way to reduce the amount of bleeding during a procedure is to stay away from aspirin for two weeks minimum before a procedure or any medication containing "ASA". Stay away from fish oils or anything with vitamin E including multi-vitamins. Also stay away from herbs and supplements.

Another issue, that no one brought up, is your blood pressure. Be sure that your blood pressure is considered normal. You might want to get it checked before you go, that way, if it is high, you can talk to your doctor before your procedure to figure out what to do. You may also want to reconsider the vitamin K option.

I'd also stay away from using a saline mist post-op. If the grafts stay in they are being nourished by blood and they don't need saline. In fact, post-operative sprays can be harmful. For instance, if you have even one incision site that becomes infected, the use of a saline, water or copper peptide spray (any liquid for that matter) can help to spread the infection to other incision sites. Not good.

But again, none of the add-ons mentioned will make a lick of difference to a bleeder or popper like yourself. Once the grafts pop out and you are not in the clinic to have them quickly reinserted then they are dead from desiccation.

[35YrsAfter]

My 3rd HT for 1600 grafts did not grow. I am now 10 months post op and Dr has agreed to do a touch up procedure at no charge.

The issues that I had in the Previous HT.
Excessive bleeding
graft popping (13 hrs to finish)
Dried up grafts falling off after procedure.

You have two basic concerns, bleeding and growth. Because your donor supply is now limited, the first priority of course, is to see what can be done to control bleeding. Acell, PRP and liposomal ATP were not suggested to address bleeding issues although Thrombocytopenia (low blood platelet count) can in rare cases, cause dangerous internal bleeding.

We suggested ACell, PRP and liposomal ATP to help support graft health once the bleeding issue is solved.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
Atlanta
Phone 678-566-1011
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

[3rd time]

Don't be worried about these add-ons to a procedure. Not a single one would address the issue that affected your procedure. They're useless.

"Bleeders" are bleeders, regardless of using Acell, PRP, Liposomal ATP, etc, etc. The way to reduce the amount of bleeding during a procedure is to stay away from aspirin for two weeks minimum before a procedure or any medication containing "ASA". Stay away from fish oils or anything with vitamin E including multi-vitamins. Also stay away from herbs and supplements.

Another issue, that no one brought up, is your blood pressure. Be sure that your blood pressure is considered normal. You might want to get it checked before you go, that way, if it is high, you can talk to your doctor before your procedure to figure out what to do. You may also want to reconsider the vitamin K option.

I'd also stay away from using a saline mist post-op. If the grafts stay in they are being nourished by blood and they don't need saline. In fact, post-operative sprays can be harmful. For instance, if you have even one incision site that becomes infected, the use of a saline, water or copper peptide spray (any liquid for that matter) can help to spread the infection to other incision sites. Not good.

But again, none of the add-ons mentioned will make a lick of difference to a bleeder or popper like yourself. Once the grafts pop out and you are not in the clinic to have them quickly reinserted then they are dead from desiccation.

Jotronic
Makes a lot of sense because the Dr kept popping them back in over and over. Once I got home I pretty much went to bed so a lot probably popped back out.
I will begin a vitamin k supplement I think.
My blood pressure is always a little high at the start of every HT I've had due to nervousness and stress. But on a regular day to day basis it's normal.

[3rd time]

Much better to increase cholesterol to aid in wound healing along with some raw grass fed butter which is extremely high in K2.............in a form which the body is meant to absorb.

You not going to hear too much about it from the medical community............no money to be made but sometimes passing on valuable information or having valuable information is better than money.

Topcat
Funny you should mention this because I was thinking about starting a ketogenic diet high in natural fats.

[gillenator]

3rd Time,

As I mentioned earlier, you may have more issues than what appears to any of us. And don't be lead to believe when anyone blows off any application that has clinical substantiation to be simply an "add on" to be without any merit to you. These items were not mentioned to help you from grafts popping but rather to put everything on your side in all aspects of your upcoming procedure.

Some patients do bleed however in most of those cases, the reality of it comes down to pre-op period of alcohol consumption, and intake of other blood thinners such as aspirin and the like. Even high cardio activity can thin the blood and you might even have a potentially low platelet count. Could PRP which has a rich platelet count help you coagulate? Only your doctor knows, and it would not hurt to get some other opinions regarding it because the more obvious issue is that your blood is not properly coagulating as you already know.

So anything that can help with that so that your blood clots properly to hold the grafts in place is going to obviously be of benefit to you. Again, I have observed Vitamin K to work very well but the best thing for you to do is to discuss all of these options with your doctor.

One more thing. If yield is part of the problem, apart from thin blood, then Liposomol ATP can potentially increase your yield and a number of the top docs are already using it. Again, this has clinical substantiation and already showing promise so you want to discuss these issues with your doctor.

I sincerely wish you the best my good friend in your upcoming procedure...

[AfterHair]

I have read that vitamin K plays a major role in blood clotting. So it is used to reverse the effects of “blood thinning” medications when too much is given; and to treat bleeding caused by medications including salicylates, sulfonamides, quinine, quinidine, or antibiotics.

Vitamin K can be found in leafy green vegetables, broccoli, and Brussels sprouts.

[3rd time]

3rd Time,

As I mentioned earlier, you may have more issues than what appears to any of us. And don't be lead to believe when anyone blows off any application that has clinical substantiation to be simply an "add on" to be without any merit to you. These items were not mentioned to help you from grafts popping but rather to put everything on your side in all aspects of your upcoming procedure.

Some patients do bleed however in most of those cases, the reality of it comes down to pre-op period of alcohol consumption, and intake of other blood thinners such as aspirin and the like. Even high cardio activity can thin the blood and you might even have a potentially low platelet count. Could PRP which has a rich platelet count help you coagulate? Only your doctor knows, and it would not hurt to get some other opinions regarding it because the more obvious issue is that your blood is not properly coagulating as you already know.

So anything that can help with that so that your blood clots properly to hold the grafts in place is going to obviously be of benefit to you. Again, I have observed Vitamin K to work very well but the best thing for you to do is to discuss all of these options with your doctor.

One more thing. If yield is part of the problem, apart from thin blood, then Liposomol ATP can potentially increase your yield and a number of the top docs are already using it. Again, this has clinical substantiation and already showing promise so you want to discuss these issues with your doctor.

I sincerely wish you the best my good friend in your upcoming procedure...

Gillenator

I agree with you. I'm just trying to do as much possible to ensure a smooth procedure and good yield. Last time I had alcohol was 1 month ago and I never take aspirin, I also stopped fish oil and multi vitamins. The only thing I'm still doing is lifting weights and a little cardio. I'm having the procedure in two weeks so I will definitely stop the heavy lifting and cardio this coming Monday.

As for liposomal ATP I will mention it to my Doc. I asked him briefly about prp because I need something to stun any future hair loss. People are always going to have mixed opinions about certain hair loss products and procedures.
I will never discredit something unless I try it myself first. Everybody reacts differently and what works for some can be a disaster for others.
Right now I'm just hoping everything goes ok. This HT will be number 4!!!

Gillenator, thank you for all your support through this last HT. You have always been very helpful and really appreciate that.