Is this normal?

It has been about 12 days since my hair transplant. I am noticing some pieces of dead skin coming off the recipient area but also they have bunches small hair attached to them that I suspect is the transplanted hair.

Is this normal? Does it mean that the transplanted grafts are coming off with the dead skin off my scalp?

I have heard that it is normal for the transplanted hair to fall post-surgery but I am not sure if it is normal for it to happen this early.

Any doctors could comment on this? It has me kinda worried.

Is it normal for the skin in the recipient area to dry up and come off the scalp with small piece of hair attached?

I rang the doctors office and one of her staff said that the grafts are lodged by day 3 and after that they will be within the skin and the drying process and the skin and hair coming off the recipient area does not affect them. Is it true?

Dear Tenex,
My name is Jen Hoffman, and I am Dr. Robert Haber's head tech. It is completely normal for the crusts to slough off between 6-12 days post op, and very often the hair comes out with the crust. It often appears as if you are losing a graft, but I assure you, that by this time the grafts are securely in place. The hairs will all begin to grow in two to three months, and then they will continue to grow at a rate of 1/4 to 1/2 inch per month. Be Patient, I have been told it is like watching paint dry, but when the hairs come in, it will be worth the wait.

Jen Hoffman
Head Tech Haber Dermatology

Thank you Jenny. That is a relief. I knew that the transplanted hair will fall and regrow but was not sure if the drying scalp was a part of the normal process or if it could affect the transplanted grafts.

I am currently keeping my scalp as moisturized as possible.

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Originally Posted by Tenex

It has been about 12 days since my hair transplant. I am noticing some pieces of dead skin coming off the recipient area but also they have bunches small hair attached to them that I suspect is the transplanted hair.

Is this normal? Does it mean that the transplanted grafts are coming off with the dead skin off my scalp?

I have heard that it is normal for the transplanted hair to fall post-surgery but I am not sure if it is normal for it to happen this early.

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Tenex,

It simply sounds like your crusts are coming off. Yes, most of the crusts will carry the small shaft of graft hair. The hair follicle went into telogen (resting phase) and why the hair shaft falls out with the crust. Perfectly normal!

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Originally Posted by gillenator

Tenex,

It simply sounds like your crusts are coming off. Yes, most of the crusts will carry the small shaft of graft hair. The hair follicle went into telogen (resting phase) and why the hair shaft falls out with the crust. Perfectly normal!

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You guys are great in providing insight to people that are a little inexperienced such as myself.

Is it safe to slowly take the crusts and dead skin off with my nails and fingers?

I am generally fairly active but have played it carefully since the operation up until now. This afternoon I did some exercise and some lifting and immediately noticed a burning sensation on my scalp. More like a whole bunch of needles being inserted kind of feeling.

When is it safe to start exercising and how intense can the exercise be? My doctor said after 10 days and it has now been about 20 days since my operation.

It is 3 weeks and 2 days since the transplant. Almost half the density of the transplanted area (since the day of transplant) has fallen and so have all the scabs and lots of scalp dead/dried skin.

The dilemma which concerns me is why half the transplanted hair came out with the crust starting since 10th day post-op while the other half is standing nice and strong and I can tell it is even very slightly growing (I could be wrong but it certainly looks like it is).

I am really hoping that the fallen hair is going to grow back and the root of it did not fall off with dried skin and crusts.

I am going to upload some photos as well.

The first one is a couple of days after the surgery and the second one is today. As you can see half the density is gone.

The crusts coming off with pieces of hair attached to them post-op has created bald patches on my scalp and it is going to kill me before I find out whether the transplanted hair came out with their roots or it was just some crust attached to them.

Problem is the hair continues to fall even now but the difference is, now there is nothing attached to the small strands of hair that are falling off.

Tenex,

I know how this must be like an emotional roller coaster watching the bald areas redevelop but if it be of any consolation my friend, you are right at the one month post-op mark in your progress and most patients begin to shed their grafts at this point in time, just like you. Remember, you are shedding the graft hair but not the transplanted hair follicles. They are intact and they should be safe. But they are resting for 3-4 months before the new growth cycle begins. They entered the resting phase as result of the shock and trauma of being moved from one area of scalp to the other.

What I and others reading this thread you started are looking forward to is you reporting back in 6-12 months with favorable feedback regarding your regrowth. The tough part is waiting. Once we have the surgery, we have to hurry up and wait! Tenex, if you went to a reputable doctor, have no other medical condition(s) that could affect the regrowth, you'll be fine. Don't worry.

The white pieces of tissue you were seeing appear to be the crusts which as you said, are pretty much gone, along with the hair that was attached to them. That's why you are now seeing the bald patches of scalp, nothing more. And really, you don't have to do anything to your scalp other than wait it out.

Always, always follow your doctors orders and post-op instructions. They shoild be there to provide the same level of care as they did during the procedure. Obviously they will want to know how your regrowth progresses as well.

IMHO it's okay for post-op patients at this point in time to resume their normal life style excepting strenuous weightlifting and activity. That can help keep your mind on other things.

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Originally Posted by gillenator

Tenex,

I know how this must be like an emotional roller coaster watching the bald areas redevelop but if it be of any consolation my friend, you are right at the one month post-op mark in your progress and most patients begin to shed their grafts at this point in time, just like you. Remember, you are shedding the graft hair but not the transplanted hair follicles. They are intact and they should be safe. But they are resting for 3-4 months before the new growth cycle begins. They entered the resting phase as result of the shock and trauma of being moved from one area of scalp to the other.

What I and others reading this thread you started are looking forward to is you reporting back in 6-12 months with favorable feedback regarding your regrowth. The tough part is waiting. Once we have the surgery, we have to hurry up and wait! Tenex, if you went to a reputable doctor, have no other medical condition(s) that could affect the regrowth, you'll be fine. Don't worry.

The white pieces of tissue you were seeing appear to be the crusts which as you said, are pretty much gone, along with the hair that was attached to them. That's why you are now seeing the bald patches of scalp, nothing more. And really, you don't have to do anything to your scalp other than wait it out.

Always, always follow your doctors orders and post-op instructions. They shoild be there to provide the same level of care as they did during the procedure. Obviously they will want to know how your regrowth progresses as well.

IMHO it's okay for post-op patients at this point in time to resume their normal life style excepting strenuous weightlifting and activity. That can help keep your mind on other things.

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Thanks for your advise. what you say makes sense.

Being in my position and having thought about doing a HT for years, the money, the hair they take which creates a patch at the back of my head that I need to cover from now on and the trouble of doing it can only be justified when you know that over 90% of the transplanted hair is going to grow back.

I have actually asked the doctor and her consultants (and to my knowledge she is a good doctor and also a researcher in the field) but the problem is the answers have been vague and mixed and usually not directly answering my questions. I suppose they may go through a fair share of complaints and try to be careful with how they answer people....

I have followed the doctors advise as much as I could.

The advise was to wash my hair after 3 days with a soap-free liquid hand wash, apply minoxidil and then aqueous cream which is a again a soap-free water-based cleanser and moisturizer. I started this process from the morning of the 4th day.

My concern is not that the hair is falling now. I believe it is normal. My concern is that few days after surgery the combination of the hand-wash which I used to wash my hair and minoxidil may have dried my skin and the moisturizer may have just facilitated the process of the scabs and hair starting to come off at around 8th to 10th day post op. At the time the hair that did come off pretty much came off with the skin and scabs but now it is just the small hair.

I am refocusing on being positive, have started my exercise routine and hoping that as you said the hair that came off early on was just the scabs and the root is in fact deep inside the tissue and did not come out due to dry skin.

You guys are great, I should have discovered these boards before the HT.

Well to be perfectly honest, I have never heard of that type of post-op routine, especially applying minoxidil within several days of the surgery before the epidermis completely heals. Very high alchohol content in the inactive ingredients of minoxidil and yes that can dry out one's scalp.

But again, the follicles are not the root, but are imbeded into the sub layer and very difficult to lose at this point. Keep us in the loop once you see the new growth start in 3-4 months.

Best wishes to you Tenex...

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Originally Posted by gillenator

Well to be perfectly honest, I have never heard of that type of post-op routine, especially applying minoxidil within several days of the surgery before the epidermis completely heals. Very high alchohol content in the inactive ingredients of minoxidil and yes that can dry out one's scalp.

But again, the follicles are not the root, but are imbeded into the sub layer and very difficult to lose at this point. Keep us in the loop once you see the new growth start in 3-4 months.

Best wishes to you Tenex...

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Well they were quite insistent that I use minoxidil and the water-base cream both of which accelerated the scabbing and skin/hair coming off fairly rapidly.

It is now at about a month and 10 days, I can see that about 10% of the transplanted hair is growing back. I'm still having my fingers crossed the rest will grow too.

What is the verdict on getting head massages and doing heavy exercises at this stage?

I can still feel the pain in my scalp and also my scalp is still partially numb since they cut the nerves in the process of doing the HT.

Sure, I understand. Wait on the head massages and heavy lifting activity. Those type of activities can potentially stretch your linear scar, and you do not want to deal with that.

It is now exactly two months since the surgery. Only about 10% of the transplanted hair is coming out of the scalp and there is no visible density of hair.

Not sure where this is going from here but it's frustrating.

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Originally Posted by Tenex

It is now exactly two months since the surgery. Only about 10% of the transplanted hair is coming out of the scalp and there is no visible density of hair.

Not sure where this is going from here but it's frustrating.

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Hang in there Tenex. It is perfectly normal to have very little growth at this stage. It typically takes up to a full year to see the complete results for your hair transplant, though using minoxidil may speed that up some, as you will be putting more of your hair in the growth phase early on than would occur if you just late it takes its natural course.

I agree. At two months post-op most of your grafts are still resting. Yet we all look in the mirror every day looking, looking. The toughest part is waiting for the results.:cool: