Very worried: anyone have this experience?

[doug546]

I wanted to start this in the "intro" section, but somehow it seemed to fit more into this category:

I went ahead and had a hair transplant three weeks ago, something I've thought about doing for 20 years. It wasn't cheap, and I did quite a bit of research into surgeons before I settled on one. Because I'm between a 6 and a 7 on the Norwood scale, the surgery consisted of implanting 4190 grafts into my scalp and it took about 12 hours. The entire team ended the procedure about 8 p.m. in the evening. My surgeon somewhat matter-of-factly informed me that I needed to start considering using minoxidil and propecia, gave me instructions re: shampooing my hair, etc., as well as a prescription for propecia, and they even set me up in a hotel for the night in the area (it's about an hour's drive from my home). The results looked great, and I was pretty much on top of the world, although a little uncomfortable from all the lidocaine shots I'd had (close to 50 throughout the scalp).

I returned home to San Francisco very early the next morning, and later that afternoon called in the prescription for Propecia and showered per the doc's instructions. I also remembered that a friend's husband had received a "gag" gift of Kirkland minoxidil on his 50th birthday and she had given it to me. Remembering what my doctor had said, I put a ml of it in the palm of my hand and very carefully patted it into the grafts and went about my day. If I remember correctly, I probably did that for four days in a row and I discontinued it; I've tried minoxidil before with pretty much no results but have continued on the Propecia. Due to the nerve damage from the surgery I had, I never experienced any feeling whatsoever from the minoxidil, so for all I know, thinking back, it could have been stinging like hell and I never would have known it.

I learned about a week ago after reading a posting on the web that due to the alcohol/propylene glycol content of minoxidil, it is never started that soon after surgery, but usually two weeks to a month after the procedure. My doctor never gave me any information re: waiting, and I'm assuming he never thought about it when he brought the subject up, or maybe thought it would take me awhile to finally go out and buy some. I've done more research on the web and found that some doctors, and even a study on Rogaine after hair transplants, have used it 48 hours following surgery, but it's rare. There was no mention of any complications.

Within two weeks the grafts shed, which my doctor has assured me is normal, and predicted before the surgery. My concern, however, (and his too, as I talked to him today by phone) is that in using the minoxidil I've killed a lot of the grafts. I didn't experience any loss of grafts or bleeding that I noticed, but my doctor is also agreeing that the alcohol content could easily have caused them to die out upon contact.

Right now I'm going back and forth between feeling a certain amount of panic re: losing a great deal of money and ending up with just a bald head and a very large scar, and a certain amount of anger that I wasn't informed in advance to wait on use of the minoxidil. I was very aware that the grafts were extremely delicate, but I didn't know enough about the chemical content of the drug not to use it and automatically put it in the same category as taking the Propecia.

My question: has anyone experienced this or know of anyone else who has, and what were the results? I continue to get the same response from everyone ("You're the first person I've ever heard of that happening to.") Yesterday I spoke to a doctor in Atlanta who starts his patients on minoxidil 48 hours after the procedure, and he said although he wouldn't start it at (less than?) 24, he "didn't think it would do any harm." I'm not so convinced.

I was told that the worst part of having a transplant was the long wait for it to mature and show up (usually a little over a year). Now I'd doubly anxious re: the waiting process because of this, and wondering if I'll see any growth at all.

ANY advice on this would be greatly appreciated...

[thinkingaboutit]

Hi Doug,

Although I don't have direct experience of what you've been through, I felt for your pain, and thought I should reply with my experience.

I asked the clinic where I had my FUE, and they said not to use minoxidil before 3 months. They also did NOT recommend it to me. They only said 3 month after I asked about it. In their opinion I or anyone else for that matter, should not need to take any other medication after the transplant. I had 3,400 grafts done.

They said if I wanted to use Regaine it was up to me, but not to use it before 3 months. After reading what you wrote, I probably won't use it before 6 months. I will reconsider things.

Secondly, one of London clinics I spoke (I did not have it with them) said they recommend using regaine after 10 days. I have that on email and it's a big company. So I don't know if it does any harm. I expected that it would give it a boost. But everyone is saying don't use before 10 days.

How many days after your surgery did you use minoxidil?

[doug546]

If I remember correctly, it was the next day, but it could have been the day after that. If you read through post-surgery info from different hair transplant clinics on the web, some are recommending using it within 48 hours. I spoke to a doctor in Atlanta who informed me that his patients use it that early, but he hadn't heard of 24 hours, but that it "would probably be okay." His surgical tech told me he had a 98% success rate. I also spoke with a Dr. Vera Price, who actually did a research study in 1999 re: putting propylene glycol on hair transplants right after surgery, and there was no effect in their growth (however, she did not elaborate on whether or not alcohol was combined, which I'm more concerned about). My doctor is now telling me he tells his patients not to use it for a month (which he said NOTHING about to me about after surgery). I have no idea what to expect, but I can tell you that the waiting period for the grafts to take effect within 3-4 months is bad enough as it is, without having to go through this. One of the frustrating things I'm finding re: doing research on the web is how so many doctors contradict each other in what they recommend to their patients. Last night I read post-op instructions re: FUE surgery that said if there was any crusting right after the surgery, use alcohol to wipe it off... (???). The advice I AM getting from everyone is 1.) "I've never heard of anyone doing this before"; and 2.) "All we can do is wait and see what happens at this point. It's doubtful that if you killed grafts, you killed them all." It's hard for me to believe that out of (tens? hundreds? of) thousands of hair transplants throughout the last couple of decades, I'm the only person who's ever done this. LOL, one thing is for sure: the physiology of the hair cycle in re: to the waiting process of this procedure is excruciating. My doctor talked about a possible second restoration at the end of the surgery, telling me there weren't enough grafts to cover the crown of my head the way he wanted to; this experience (as well as still waiting for my hair to grow over the scars - they're still noticeable, and I'm really sick of wearing baseball caps!) has convinced me not to do it again. I may feel differently if everything turns out okay and it grows out the way it looked when I left his office and for the next couple of weeks before it shed, but having to wait like this after using the minoxidil is the worst suspense I've ever been in.

[doug546]

Thinkingaboutit: did some editing on my posting after I realized I'd repeated some info, as well as thanked you for your input... somehow the editing didn't go through, and it posted what I;d written originally. Sorry about the re-iterations of the Atlanta doc...

[inspects]

Doug,

I don't know the answer either if harm was done, I was told to wait 30 days.

If the incisions were crusted over, hopefully no harm was done, or the minox doesn't cause harm.

Many of my follicles didn't loss the hair after surgery, but a significant amount did, I had the surgery in August, the TP hairs are about 1/4 inch long now. Hopefully you will begin to notice some regrowth in the next few weeks.

I hope a doctor steps up to the plate here and answers your questions specifically.

Good Luck...!!

[Artista]

Doug, Hopefully 'Inspects' thoughts proves to be correct.
(thanks inspects) I'm rooting for you Doug!!
This part of your experience is very concerning-

" My surgeon somewhat matter-of-factly informed me that I needed to start considering using minoxidil and propecia..."

He wasn't specific as to when you would be able to use these products?
I'm sorry if I have missed something in what you've said Doug.

[doug546]

Thanks for your suport, guys... Artista, no, he never said anything about when to start it, so I assumed it meant immediately along with the propecia. Was very careful to sleep upright, not trouch or scratch, etc., for the first three-four days to protect the grafts, so definitely wouldn't have done this had he told me to wait. I'm curious if it stung like hell... my head was completely numb, so I never would have known it if it did. I'm hoping what I DO have on my side is I knew enough not to disturb the grafts so I just gently patted it onto the top of my hair rather than massaging it in. Maybe it never made it to the lesions?

[waitforanagen]

Wow... hard to believe a surgeon doing this would recommend putting minoxidil on immediately post op.

Grafts are pretty resilient so hopefully no harm was done. Out of curiosity did he/she give you graftocyte to spray on the area?


One way to look at it is, yes it has alcohol in it but minoxidil is a vasodilator (if memory serves) so perhaps it helped the grafts revascularize and get their blood supply reestablished quicker?????? (not a doctor).

I was reading one guy was instructed to rub triple antibiotic ointment (the gooey stuff) on his receiptent area the day after surgery. It is kind of amazing the range of post op instructions out there.

As a general rule, I take "orders" from my doctors as suggestions... I research what they tell me to do/take and if there are no red flags I do it. I hate to be skeptical but there are plenty of idiots out there with "MD" after their name.

[doug546]

I don't think he did it on purpose, I just think he hadn't thought about what he was saying. It had been a 12-hour surgery, we were all worn out, and it was eight o'clock at night... I think he said it somehow thinking I would know to wait ("You need to think about starting on minoxodil and propecia now."). When I mentioned it to him a couple of weeks ago, he's now only stating, "I usually tell my patients to wait about a month before they start minoxidil." He never told me that. There would be absolutely no way to prove the grafts didn't grow as a result of using minoxidil... any physician could come back and say that it could be the result of poor implantation, etc. From what I'm reading on the web and in other hair loss forums, some grafts just don't grow for some patients... how can you go back and prove what caused it?

[inspects]

I don't think he did it on purpose, I just think he hadn't thought about what he was saying. It had been a 12-hour surgery, we were all worn out, and it was eight o'clock at night... I think he said it somehow thinking I would know to wait ("You need to think about starting on minoxodil and propecia now."). When I mentioned it to him a couple of weeks ago, he's now only stating, "I usually tell my patients to wait about a month before they start minoxidil." He never told me that. There would be absolutely no way to prove the grafts didn't grow as a result of using minoxidil... any physician could come back and say that it could be the result of poor implantation, etc. From what I'm reading on the web and in other hair loss forums, some grafts just don't grow for some patients... how can you go back and prove what caused it?

Doug,

Now that I think about it....when I went back to get the sutures removed I asked if I should start using Minox, I specifically remember him saying it would be fine, but I might have a burning sensation, it would be best to wait a couple more weeks, but the doctor never mentioned anything about possibly causing damage, just the burning sensation, and he emphasized that waiting a couple more weeks for everything to heal wouldn't make any difference as far as hair growth.

I was basically like you, waited 15 years before I actually had the FUT done.

I distinctly remember him explaining to wait for 30 days on the Minox during my initial consultation prior to the surgery, and the instructions were on the post-op papers I received to wait the 30 days, but I do remember asking if I should-could begin the Minox at 10 days, when I had the stitches removed, probably because I was anxious like you.

I remembered the conversation with my doctor after thinking about your initial post here, regardless, I do hope all is well.

What didn't shed showed some growth in 30 days for me, now its been three months and I have 1/4 inch stubs everywhere.

By the way, how long ago did you have the TP?

I bet you will see some growth real soon....!!!

[doug546]

Hey, inspects, thanks for the encouragement. I had the transplant on October
7th... so I have at least a couple of months to go, I guess, before I know anything. I originally had a quite a few fuzzy hairs on the top of my head, which have grown back, and a couple of weeks ago I was sure it was already the grafts growing, lol! Now that I'm looking at it, it's pretty much the same growth I always had up there, not any denser. The doc told me I would probably lose those as a result of the transplant, but they obviously stayed, so hopefully if the grafts work they'll add to the density. I am noticing this morning I have what looks feels like a pimple that's a little sore on the top of my head, and I've never had a pimple on my scalp before in my life. Maybe it's a hair trying to grow in? :-) Great you're having success with yours right now, hope I get to that stage. How long did you have the sutures before they were removed? I haven't used minoxidil in the scarred area, as since there are no follicles there anymore, obviously I didn't think hair would grow...

[inspects]

Hey, inspects, thanks for the encouragement. I had the transplant on October
7th... so I have at least a couple of months to go, I guess, before I know anything. I originally had a quite a few fuzzy hairs on the top of my head, which have grown back, and a couple of weeks ago I was sure it was already the grafts growing, lol! Now that I'm looking at it, it's pretty much the same growth I always had up there, not any denser. The doc told me I would probably lose those as a result of the transplant, but they obviously stayed, so hopefully if the grafts work they'll add to the density. I am noticing this morning I have what looks feels like a pimple that's a little sore on the top of my head, and I've never had a pimple on my scalp before in my life. Maybe it's a hair trying to grow in? :-) Great you're having success with yours right now, hope I get to that stage. How long did you have the sutures before they were removed? I haven't used minoxidil in the scarred area, as since there are no follicles there anymore, obviously I didn't think hair would grow...

Hi Doug,

I had the sutured removed at the 10 day period. Like I said many of the hairs shed, I'd say 50%+ shed. The doctor said I should expect all the TP hairs to shed but the ones which do not shed just chalk it up as a bonus, but don't expect them to grow for a while even if the follicle doesn't lose the hair.

Now that the grafts are growing nicely after three months post-op the hairs which didn't fall out are about 1/8th inch longer then the new hairs. I have a very even pattern of new hair over my entire head, rubbing my head the new hairs feel very healthy, stiff, standing straight upward, the ones at the temples are growing at different angles, I believe the doctor and his team did one hell of a good job. It took about 2.5 months for me to see any real noticeable growth.

The doctor said all patients are different, some see growth in as little as a month, others may not experience growth for four of six months. Multi-Vitamins, Fin, and Minox all play a role in the development process.

My brother had the same procedure from the same doctor performed eight years ago, he is the person who told me about this forum so I could learn more about FUT's and other new evolving technology, his hair looks like he never lost any in the first place, when in fact he was in worse shape then me regarding thinning hair from his temples to crown. So I have high expectations of similar results which I'm seeing now.

My brother has been on Fin and Minox for the last eight years with no side-effects, just positive results not losing anymore hair and keeping what he has healthy after his TP.

I expect you will have the same results, you have to think positive, no point in losing sleep over the premature Minox application.

I'll call my doctor when I get home from the office and explain to him a friend applied Minox the day after surgery, what if any issues could arise. My doctor has been performing HT for fifteen years. He should know the answer, like you said, you certainly cannot be the first person to prematurely apply Minox.

Hard to believe not a single doctor or affiliate of a HT physician has not added any incite to your original question.

Keep your spirits up, Doug...!!

[thinkingaboutit]

Hi Doug, I think you know you are in one of those wait and see situations. I personally don't think you've done much damage. I think if you are like me, you would do more damage stressing over it.

I was asking my doctors questions after question to the point that I felt I was becoming irritating. After reading your story, I feel I did the right thing by asking all those questions. I asked my clinic if I should use Regaine etc. They said they feel that I (or most people) should not need any products post HT. And as a general rule they don't recommend any products post HT. The said if I did want to use Regaine, that I should wait at least 3 months.

I am surprised how varied the post HT advice is. We are all going through some level of anxiety post HT, but it's nice to have you guys here to bounce off.

[rev3]

hey doug

i read one doctor's concern about using minoxidil too early is due to:

POSSIBLE SKIN IRRITATION
and
POSSIBLE DROP IN BLOOD PRESSURE (due to the vasodilator medication properties)

nothing about destruction of grafts

others suggest to use
Rogaine immediately after the surgery, especially is grafts have been placed in and around existing hair to prevent shock loss

this said, you have nothing to worry about

best

[doug546]

Rev3, I think I read that doctor's response in a question-and-answer site. He does, state, however, that there are some "potential" dangers (which connotates, again, nobody seems to know for sure). In any case, have stopped overly stressing about it. Inspects, I'd really like to know what your doctor says if you mention it to him. I have to admit, I've read a lot of questions on this forum that have been answered by docs, and I'm a little disappointed and curious why none of them have put in an opinion on my situation... I even wrote individually to a doctor on another forum and he didn't even bother to answer back. Maybe - again - no one knows the answer or what to expect?

Thanks again for all the support, anyway, to all you guys. I'm staying as positive as I can, but it's still pretty early in the game (five weeks today). Will keep you posted, really glad this forum exists...