A few questions about Post-Operation

[Tenex]

I had a few questions regarding post-op would be great if I could get some expert advise or just experience. FYI I have done 2600 grafts.


1) I currently experience some pain in the "recipient" area, this is more of a sharp pain that comes for a few seconds and goes and is just specific to certain areas but my concern is that prior to operation, I experienced a similar type of pain on my scalp in the areas that I later lost the hair in. Is this normal?

2) How much physical activity is too much in the first few days post operation? I still went for a walk, did some shopping etc.... Could this change anything and when can I see myself fully exercising (ie: weight lifting)?

3) If for any reason, I accidentally dislodge a graft, will I notice it?

4) I am in tele-sales which means I sit a lot infront of the computer and make a lot of phone calls, How many days should I wait before I go back to work?

5) How long can I wear the baseball cap at a time? The post-op notes I have says use it only if it is absolutely essential. I do need it every time I go out....

[Tenex]

Any doctors are able to answer those questions?

[mattj]

If the pain in the recipient area existed prior to surgery, then it sounds like the sort of sensation many hairloss sufferers experience as part of the process of losing hair. I get the impression that you might be worried that your hairloss is continuing with the grafted hairs being effected. Was the recipient area completely devoid of hair before surgery? It is, of course, possible that remaining native hair will continue to be lost, but I wouldn't be concerned about losing the grafts. Those scalp sensations might very well continue even in areas where male pattern baldness has already done it's worst.

Dr Rahal tells his patients they should hold off from lifting weights or any other more strenuous forms of exercise for three months. Lighter exercise can be resumed at one month, but the sort of thing you have already done is essentially fine right from the beginning. Walking and going out and about can't be avoided.

Bleeding usually occurs when grafts are dislodged.

It is generally advised to wait a week before going back to work, but after that it's up to you and what you feel comfortable with.

Loose-fitting hats/caps can be worn two days after surgery when necessary.

You didn't mention exactly how many days post-op you are. If you've reached the ten day mark then your grafts will be secure, so actually losing them due to the actions you take won't be an issue.

[gillenator]

In all of the years of listening to hairloss sufferers, I rarely hear of scalp pain associated with the progression of MPB. My guess is that momentary sharp pain is more related to the nerves that were severed while the recipient incisions were made. In fact the healing process can involve what seems like sharp stings in various areas. This is also true with the transplanted hair that begins to break through the scalp surface. Those individuals with a high degree of coarseness can experience the stinging sensations even more.

[gillenator]

I had also meant to mention to not allow the band on your ball cap to be tight on the suture line.

[mattj]

I would've assumed he meant pain as a result of the procedure had he not mentioned that he experienced it before his transplant. I took it to mean the tingling/itching sensation. Perhaps Tenex will come back and explain.

[Tenex]

Well prior to the surgery and ever since my hair loss began I experienced discomfort and some mild (at times sharp pain) in areas that I later lost hair in. It wasn't the entire scalp just designated areas. I experienced the pain weeks or months before I lost hair in that area.

Post-surgery I experienced what I could describe as a similar kind of pain (but the cause of it could be different). I was wondering if it is normal to experience mild pain or sharp pain in the recipient area.

[gillenator]

Tenex,

Sorry my friend, I see that I did not address your concern of scalp pain in random areas of your scalp "prior to your procedure", and the question regarding the potential of a lost graft.

Your prior experience is a rare phenomenon IMHO, and something I have indeed heard of before. In most cases, those patients who have got back to me were referred by their respective physicians (PCP) to other specialists involving neurological evaluation, testing, and the like. In other words, that type of pre-procedure scalp pain was more often related to a medical condition unrelated to MPB.

And regarding post-op discomfort in the recipient area, it is not uncommon in larger sessions although most who do experience it state that it is not at acute levels and certainly not anything that a mild over-the-counter pain med would not relieve.

We can know when we lose/pop a graft post-op when there is a steady stream/trickle of blood down the scalp. You can literally trace the trickle right back to the incision site. Fortunately, the grafts are pretty well attached to the soft tissue in the scalp after 72 hours "providing" we all follow the post-op instructions after surgery.

Out of concern and curiosity, has your pain improved? Have you presented these concerns to your doctor? That would be the best place to start.

Wish you well including the regrowth.

[Tenex]

Tenex,

Sorry my friend, I see that I did not address your concern of scalp pain in random areas of your scalp "prior to your procedure", and the question regarding the potential of a lost graft.

Your prior experience is a rare phenomenon IMHO, and something I have indeed heard of before. In most cases, those patients who have got back to me were referred by their respective physicians (PCP) to other specialists involving neurological evaluation, testing, and the like. In other words, that type of pre-procedure scalp pain was more often related to a medical condition unrelated to MPB.

And regarding post-op discomfort in the recipient area, it is not uncommon in larger sessions although most who do experience it state that it is not at acute levels and certainly not anything that a mild over-the-counter pain med would not relieve.

We can know when we lose/pop a graft post-op when there is a steady stream/trickle of blood down the scalp. You can literally trace the trickle right back to the incision site. Fortunately, the grafts are pretty well attached to the soft tissue in the scalp after 72 hours "providing" we all follow the post-op instructions after surgery.

Out of concern and curiosity, has your pain improved? Have you presented these concerns to your doctor? That would be the best place to start.

Wish you well including the regrowth.

Thanks for your comments

Yes the pain has improved but even when I experience the paid it is not steady. More of a subtle background noise that comes and goes.

I have emailed the doctor and she says it is normal although I am not overly satisfied with her answer.

What I am experiencing right now however is that they had instructed me to wash my hair with a certain soap-free chemical which dried my scalp significantly. This resulted in a lot of dead-skin and peeling in my scalp especially in the recipient area which is coming off with bunches of small hair attached and at present I am just hoping that this is not the actual grafts coming out.

[gillenator]

Tenex,

Was your doctor based in Arizona? Dr. Sharon Keene?

Anyway, I highly doubt you lost any grafts because they are well seated after 72 hours post-op and difficult to lose.

[Tenex]

The doctor is Jennifer Martinick : http://www.martinick.com/

I am hoping that I have not lost any grafts.

I believe three things accelerated the process of the small transplanted hair and attached skin to come off quickly.

I was instructed to start washing my hair with a soap-free liquid from the third day. This is the first thing that makes the skin in the area dry.

I was also instructed to use 5% minoxidil from the third day 1 ml applied once daily to the transplanted area.

I was instructed to use aquas cream from the third day applying it on the recipient area which is a water-based cream and it's purpose was to not only moisturize but also accelerate the scabbing process.

The small transplanted hair and the skin attached to them started coming off around a week to 10 days post op.

Fingers crossed.

[gillenator]

Tenex my friend, I am not a doctor however I am in shock that they instructed you to start applying minoxidil just three days post-op?!

Anyone can read the ingredients on any minoxidil topical product and see that there are multiple forms of alchohol included which can dry out one's scalp.

Further, anyone can clearly see that the recipient sites are not fully healed at three days post-op. IMHO, that's why most docs will want their patients to wait until two weeks post-op before applying minoxidil to the recipient area.

I cannot remember if I asked if you had seen a dermatologist for your dry scalp? IMHO, that probably would be the best specialist for you to see at this point.