Post op Day #2 - FUE

[ThinningonTop]

Hello everyone. I am day #2 after FUE for 700 grafts to crown area. So far so good I guess. Bleeding and oozing has stopped. Scabs are forming in recipient and donor area. I washed my hair for the first time this am with Baby shampoo in a cup and rinsed 5 times w/o direct stream of water.

I am using benadryl for the itch and spraying both donor and recipient areas with Saline every 3 hours. I am also taking Keflex (2 days left) and a Medrol dose back ( 2 days left). I also restarted my oral Hair vitamins (MSM, Biotin, Fish Oil).

My question is: Is there soemthing else I can/should be doing to the donor area. My post op instructions do not mention anything. I asked the Doc and he said Aloe Vera was fine if I wanted. In other peoples experiences did Aloe Vera or Bio Oil help reducing the FUE scars/hypopigmentation from the donor area or expedite the healing process? Any other thoughts/suggestions would be greatly appreciated. I will post pics and the whole story of the Doc and process in a few days. Thanks.

J

[topcat]

You are using baby shampoo because you have been conditioned to believe the buzz work BABY means safe and gentle. If you research some of the ingredients in baby shampoo you will learn something different.

The body heals from the inside out. It’s much more important to be concerned about what you are putting into your mouth as opposed to what you are applying to your skin.

Hypopigmentation probably has more to do with punch size then applying aloe to you head. What size was the punch?

[ThinningonTop]

Punches were between 1.0 and 1.25 and a 18 gauge needle was used for rec sites. Punches appear to be healing nicely. Small scabs and already closing up. Have been over all satisfied so far. Minimal swelling and bleeding. Just trying to be careful with crown grafts. As I said I am taking a Hair skin and Nail formula, MSM, and Biotin. Just wondering if any topical solutions would help the process.

[topcat]

Wow did you do any research at all?

Why in the world would you allow a doctor to use a punch that large on your head?

Do you realize that the surface area of that 1.25 extraction is 3 times larger then the area of a .75 punch which a skilled doctor is capable of using. Does this number mean anything to you?

I'm not trying to make you feel bad but these are important points.

[ThinningonTop]

I asked a question hoping to get an answer not more questions. The general rule in skin surgery is that an incision smaller than 1.5 mm in size will heal without a visible scar to the naked eye. Therefore, in theory there should be no cosmetic advantage to a smaller incision than 1.25 mm in diameter or 1 mm in diameter and there could be disastrous results from smaller incisions in regard to hair shaft damage. Furthermore, the total number of hairs transferred by using smaller punches can be significantly less. The average scalp follicle is 0.42 mm wide from dermal sheath to dermal sheath. A two hair follicular unit averages 0.82 mm wide. This means you can use a 0.5 mm punch all you want, but the two hair follicular unit will not fit into it. In other words, you will need a little luck in your extraction process, a perfect incision, and no margin for error. You will have a lower yield and an inefficient procedure. A 0.75 mm punch will work, but the incision must be perfect. Humans are not always perfect. A 0.8 mm punch will work on the 2 hair follicular unit also, but the human must also be perfect. The 0.9 mm punch provides a larger cushion and we have used it quite often for 2 hair grafts, but it is not possible to use it on every patient or every 2 hair graft. The 1 mm punch provides a larger cushion for human error and a very high yield with most grafts and in most individuals.

Like I said mostly 1mm punches with some 1.25. The size of the punches are not my issue. I would rather have slightly larger punches then have him use 0.75 and get a 70% yield.

[ThinningonTop]

The surgeon I went to I have confidence in and trust him and he has done over 1000 manual FUEs using various size punches. He has found that this is the most efficacious and relieable size and the cosmetic result is similar with a greater yield.

Now - any suggestions on topicals?

[ThinningonTop]

I do not mean to be too blunt but I posted a question - I appreciate your concern but just looking for some advice to get some inflammation and hypopigmenation under control. I did not research - a lot of it. Yield was important to me and the fact that clinical studies have shown no cosmetic difference b/t a .75mm and 1.25mm punch - why would I go smaller and lose more grafts? In this case size, to an extent, does not matter.

[topcat]

Sorry but I disagree with you completely. A .75 - .85 punch in capable hands will yield at or near 100%. I hope you do not have white dotting but I do not believe that will be the case. The reply is not only for you but for the forum members they need to understand this.

Plenty of pictures out there of heavy white dotting from 1mm punches all one needs to do is a little research.

In my opinion topicals are of no value, when it comes to fue it's about punch size.

[Delphi]

Real nice King Topcat. A fellow hair loss sufferer comes here looking for advice after he's already gone through surgery and you give a lesson on punch sizes at this poor guy's expense. Shame on you!

One thing you neglected to tell him was that your head is a virtual road map of bad decisions. You are a bitter man who wants to make everyone else feel as bad about themselves as you clearly feel about yourself. I cannot believe that after everything that you have been through that you would be this insensitive. This is an all time low, even for you!

ThinninonTop, you don't have to defend your decision to this fool. I'm sure you'll be just fine. Stay positive, some of us are actually wish each other well on the board.

[topcat]

If you had any sense you would know that the response is for forum members who are researching. There is no topical that can help conceal hypopigmentation from a punch that large. You are living in dreamland, the doctor should have told him this.

Yes in the past I didn’t ask questions and only trusted the doctors, I was wrong. Others should learn from my experience along with what we see going on today.

And if you would have read my initial response I gave him solid advice. It was he who as concerned about hypopigmnentation which seemed odd because it rarely happens with small punches and is not a concern.

It is posters such as yourself Delphi which others should be leery of otherwise they could easily find themselves asking the same questions when it’s a little too late.

Delphi I like the way you use the term King Topcat just like the Roger poster. Are you both the same person and do you both work for the industry or this forum. This is a shit business and you seem to be part of it by all indications. I could be wrong here but this is how the industry operates so pay attention boys and girls.

[Delphi]

Nice attempt to deflect your shameful conduct Topcat. I know you believe that you're a master investigator, but you should recheck your "records." I've referred to you as "King Topcat" in the past because I thought it was hilarious! It cracked me up when I first read it! I didn't know your nickname was reserved for specific members here.

I do have sense Topcat, sense enough not to emotionally harass a person who came here looking for help. Not to hit someone who just had surgery, with shit like "Wow did you do any research at all" and "why in the world would you allow a doctor to use a punch that large on your head?"

I think over the years you've lost sight over what's really important, if you're willing to make your "point" at the expense of another person who is obviously at a heightened emotional state since he just had surgery and there is no way to reverse his decision. It's disgusting that you would do this!

I thought this was a support community and I have a feeling that ThinningonTop thought the same thing until he was greeted by your loveliness. Oh, but I forgot, it's all about you and your agenda. Why should you care about another person's feelings as long as you make your point? Great job, I'm sure this poor guy is going to have a wonderful weekend now!

[topcat]

I’m sorry but it is you that is misguided. It is important for those that come to these forums looking for information to know the truth regardless of it is myself or another patient. We can’t simply gloss over important issues and let others make the same mistakes we have made so that we can feel good about ourselves as if we are doing some type of good in the world.

Plain and simple the doctor gave this patient bad information and that is not the patient’s fault.

[ThinningonTop]

Do you know Dr. Cole? Respect his work and research? He gets glowing reviews all over these forums. It was his research that made the claim about punch sizes. Thanks, you are really a good guy!

[topcat]

Yes and No.

I can also direct you to a posting from 1 week ago on another forum where the patient claims he has white dotting from a 1 mm punch. I am not trying to make you feel bad but to not point this out would not rest well on my conscience. I hope you heal well.

The fact is there are very few doctors that can use a
.75 handheld punch and achieve outstanding results.

Hi Topcat611
Thanks for trying to help but I'm maxed out with FUE. There are too many scars to get most grafts out and I wouldn't want to anyway because my donor looks really thin shorter than a 4 guard.
My first 2 surgeries were manual punches. The doc was the first guy in the USA to dedicate his whole practice to FUE. He trained all these 'reputable' docs all over the world like Mwamba (who worked on me as a trainee) and Bisanga. Results? I would guess 70% yield and thousands of white dots in my donor visible up to a 2 guard. These were 1mm punches. If a FUE graft can't grow well with a 1mm manual punch then when will it ever?

My other surgeries were .75 mm electronic punches handheld by technicians - I call them home depot drills -not those robotic devices that I think you're talking about. Results: probably 60% yield. Beautiful extraction sites - no scarring visible but who cares at this point? And I went to all the guys that said FUE works in the right hands. I'm talking about 2004-2009 so maybe FUE has improved recently but that's now irrelevant to me.

So you see when I buzz my head from 0-4, white dots are visible or my donor looks very thin. The HT hairs don't look very natural either when short- something which is actually common when you have dark hair and light skin because not even expert dense packing can duplicate the density of nature.

Grown out long, it looks more natural but thin as ******* - the kind of thin that people ask "Why don't you just shave your head?"

[topcat]

Thinningontop I hope it all works out for you. I think if you would have read a thread similar to this before your procedure maybe you might have thought about these considerations. At the very least recognize that this may benefit others and it’s not meant to make you feel bad. Why on earth would that be my intent all one needs to do is look at my own experience.

If I had access to the internet 25 years ago I would have hoped to read similar types of postings with the technology that was in place at the time and I would not be here.

I think too many that work in the this industry remain quiet but they are making shitloads of money off of desperate bald guys and when harm is being done it’s wrong. Regardless of if they are actively causing harm or just sitting on the sidelines and making money. But I know in my heart that those that have enriched themselves will suffer the consequences sometime in the future. The natural law of Karma will hit them personally or someone close to them.