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  1. #1
    Dr Representative Spex's Avatar
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    Nov 2008

    Default HT Info Pack

    Hi Guys - Great forum! - Hope it's ok to post here..

    Here is a variety of HT info which i have put together over the years to help inform new guys venturing into their own journey's with HT's.

    HT Info Pack:

    Here are some general tips -

    Before Tips

    1. Stay local to the HT clinic

    2. Get to the clinic early in order to not be rushed as this will allow you ample time to go through everything with the Dr.

    3. Have a list of questions for the Dr that you want answering.

    4. Take 2 loose hats with you. (one might not fit)

    5. Take a travel pillow, very handy. Especially on the journey home.

    6. Get to bed early the night before. Aided sleep is advisable.

    7. Get a massage the day before. Loads of places down in China Town(NYC)

    8. Wear a buttoned up shirt for the day of surgery. Easy to get on and off.

    9. Avoid - Alcohol, vitamins, minoxodil, MSM 7 days pre op. Can thin the blood.

    10. Wash hair the morning of the surgery and wear lots of deodorant. Its a long sweaty day you don't want to be stinking out the place

    11. Make sure you have made your story clear to various people that you are away for the next 2/3/4 weeks

    12. Make damned sure you've filled your Vicodin prescription BEFORE you get re-haired (de-balded?), as opposed to waiting until the night before because "hey, this is New York, of course I'll find an all-night pharmacy...)

    13. I would advise taking the pain killers regularly, even before the pain starts

    14. Have the clinic take lots of pre op pics in order to have a controlled
    comparison for post op

    Additional tips from other guys:

    1. My tip to anyone travelling long distances is to fly home the day after surgery! At one day post-op I had no swelling and no pain because my head was still totally numb! I flew home four days post-op and my head looked like a balloon and the aneasthetic was beginning to wear off which made for a long and uncomfortable flight home!!!!!

    2. Have the doc wash your hair the day after reduces scabing and you won't spend the next two weeks looking in the mirror waiting for them to fall off.

    3. If you are going to do zero percent credit card, sign up the month before the procedure not the month after. they don't like 10K balance transfer and won't give you a high enough limit.

    4. Sun screen on the graft for the first four months. Otherwise if you get too much exsposure you'll peel really bad and have redness for months.

    5. Read the post op instructions before you have the HT. Write down any key questions and tick them off before you leave the surgery. Its easy to forget to ask, what with the injections etc.

    6. Use a bandana - its more comfortable than the baseball hat and covers more of the head.

    7. Bring button-up shirts - easier to take off.

    8. Figure out your communications strategy. I decided to tell people on a need to know basis which meant that I told only a few.

    9. Do not watch comedy DVD's during the procedure - It can result in you laughing and moving your head at the wrong time!


    11. Take a MP3, IPOD or CD player

    Airport Security

    The best way to do it is to make sure there is nothing on you to slow down your smooth passage through security. Remove all items such as watch, keys, change, bangels, chains, ...anything that could cause a bleep..
    As you walk through remove your cap casually and calmly. They will not specifically be looking at you head at all... you will be ultra paranoid They will maybe glance and then once your through that vital 10 secs just casually pop the hat back on.
    You will never ever see the sercurity guy again so who gives if he suspects..and the people behind you will be too stressed out taking all their crap off and sticking into the machine for scanning.
    Another alternative is you can always ask for a private room........ but to be honest , just not needed!!

    Immed After Tips

    1.Never underestimate the recovery time needed. Get the absolute max amount of time off work. You will feel fine after a couple of days but you will look terrible. Its not so bad if you can wear a cap.

    2. Remove all mirrors from your house, car, office etc Seriously!

    3. Sleep upright /45degree angle to aid swelling

    4. Apply huge amounts of Aloe Vera to both donor and recipient area 5 days after. (2 x a day minimum)

    5. Distilled witch hazel helps with redness (apply 7/8 days post op)

    6. Get on MSM (makes hair grow faster)

    7. Drink lots of water / fluids

    8. Bend at the knees for first 3/4 days

    9. First 3/4 days just put shampoo in a cup and pour it over the recipient and donor area. Then build up to a shower but shield your recipient with your hand and dab on shampoo.

    10. Have a couple of beers and soak your head in a hot bath prior to Staple removal

    11. Rest as much as possible

    12. No physical activity for 10 days then build it up.
    2 weeks post op........

    1. Stop staring in the mirror all the time

    2. Start up physical exercise gradually

    3. Start Minox if you want to help speed up growth

    4. Stop inspecting scar/ donor area all the time! Its takes months to fade.

    5. Put the HT on the back burner now for at least 4/5 months

    6. Take some clear pics to compare you situation at various stages

    Post op Redness

    Post-op redness will occur both in the recipient area and the donor area. The degree and length of time in which both areas will remain pink or red, will largely depend on the individual's skin tone. Redness in the recipient area occurs due to the presence of newly formed blood vessels and inflammation from the placement of the new grafts.

    Redness in the donor area occurs where the strip was removed and is basically a wound that will eventually heal. Once the wound has fully healed, the scar should appear as a pencil thin, white line that is difficult to locate provided the surgeon skillfully applied the latest techniques when removing the donor strip and closing this area.
    For individuals with a higher degree of hair loss, the redness will be more apparent than with those who are able to partially camouflage the area with existing hairs.
    Suntan (avoid burning) a few weeks prior to surgery. After surgery and once the grafts have shed, cosmetic attempts can be made to mask the redness in the recipient area.

    The hair surrounding the donor area can be cut as low as a #2 razor guard (1/4"), and still conceal the donor wound. Depending on the thickness and density of the individual's hair. Typically 1/4" - 1/2" of existing hair, is sufficient enough to assist with covering the area.


    Pimpoles may occur on the recipient area. This is normal and should not cause any discomfort. To the touch, a pimple may be a bit sore (as with a pimple anywhere else on your body). If pimples do appear, they typically do so a month after surgery. Many patients have reported pimples appearing for months after surgery. It is thought that pimples occur due to fragments of skin or hair that may have been caught beneath the skin's surface.

    I have recommended Tea Tree oil to a couple of recent HT guys who have experienced little pimples post op and it seems to have resolved their situ's - Also a very hot flannel applied to the recipient area can help draw them out and help!

    Scabbing and Shedding Grafts

    Once the grafts are placed into the recipient area, the grafts are held in by fibrin, produced by a chemical reaction in serum when the graft sites are made. Typically, the grafts will become fully secure by the eighth day. Scabs will begin to form the day after surgery. On average, scabs will remain present for up to 10 days.

    If a scab falls out and there is a hair present in the scab, this is completely normal. As long as blood is not present and tissue does not appear around the hair, assume the graft is fine. Once the scabs have completely disappeared, you will have the appearance of a buzz cut. Within the next 2-6 weeks, these hairs will begin to shed and the recipient area will appear as it was prior to surgery. The grafts are merely in a resting phase and will begin its growth cycle in approximately 3 months.

    The next phase of post-op surgery, is the most difficult; waiting for your new hair to grow in.

    Staple/Sutures Removal

    The staples or sutures (depending on the surgeon's technique) typically remain in place for approximately 10 days post surgery. Surgeons encourage that you come back to the clinic to have them removed, but will provide you with instructions for removing them should a visit to the surgeon not be possible.

    The scar that will remain once the staples or sutures are removed will become less and less noticeable as months pass and will eventually turn into a pencil thin, white line.

    Prior to having the staples removed or sutures removed (this tip is more applicable to staples), have a long shower and soak the donor area. When scabs are dry, there tends to be a tiny pinch when the staples are removed. Soaking the donor area will moisten the scabs and minimize any discomfort.

  2. #2
    Dr Representative Spex's Avatar
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    Nov 2008

    Default Shockloss


    Shockloss is something that can be experienced when transplanting into existing hair although highly unpredictable. Shockloss occurs when the native hair is weak and isn't strong enough to resist the trauma thats going on around it. More often than not the hair that has gone into shock will grow back but after 3/4 months - after the resting phase
    Hair that goes into shock and doesn't return is hair that was inevitably on its way out anyway and wasn't strong enough to return.
    Increased trauma to a localised area will increase the chances of shockloss
    Shockloss is unpredictable and there is no hard and fast rule to avoiding it - especially if you are transplanting into existing hair.

    There are risk factors that either heighten or lessen someone's risk. Diffuse thinners seem more prone to shockloss than receders because the hair in a diffuse area is often less stable than that of a receder. Very often, a lot of the hair in a diffuse area is "on its last legs" and in the latter stages of the miniaturization process.

    Be aware that everyone is different! We ALL heal and grow at different time scales.

  3. #3
    Dr Representative Spex's Avatar
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    Default Hair Greed

    Growth and Number of sessions

    I get asked these questions all the time - "Will i only need one session?"

    The answer to this is more than likely NO - Its very rare indeed that any patient only has one session unless they have a very small amount of loss - or limited donor supply, then you potentially aren't a viable HT candidate unfortunately.

    Even if your hair loss is absolutely stable and doesn't progress any further the chances are your first session will be the foundation for a potential second session to top up/refine/add density/close angles/ work further back ..etc - regardless of technique used. Hair is like money you always want more - You will always want to make it better, we ALL do!

    Top Dr's will endeavour to achieve the appropriate no. / highest number of grafts possible without jeopardising you in order to create as much coverage/density as possible in one session where warranted - whilst maintaining your donor area/further supply's integrity.

    The initial session will come in so slowly and gradually that you become so used to it that it becomes the normal and YOU will not necessarily notice the change bang on month 3! - The realisation takes time!! It is only until you compare pre op pics that you actually realise how far you have come and have a glimpse at what your situation actally was.

    You will scrutinise your results constantly, inspecting it every chance you get - and feel that you will always want more hair - Even at month 5/6/7 patients are planning their 2nd session but my advice is WAIT and allow for the first session to reach its max potential

    It doesn't matter how many times i say it to people or write it they still feel that their growth has stopped at month 4/5/6...... then come month 10/11/12 they say - wow you were right.. I did get more.

    Growth doesn't stop for many many months - it can take upto 18 months to reach the max potential from your HT so why guys are convinced after 5 months their growth has stopped is just beyond me
    If you have received your HT from one of the reputable clinics around today then your growth will continue upto a year along with a great deal of maturing.

    Many Dr's have commented on time scales for growth and established posters as well who have all been through the HT process and they all agree that you need to assess your HT at at least the 1 year mark in terms of reaching full growth.

    You the HT recipient will not see the growth just occur - it takes months for the realisation to kick in. It is important to take pictures at monthly intervals to clearly see the progression.

    Its important that guys realise that HT's are a commitment long term and you must realise that you will always want to refine your hair and wish it were thicker/fuller/denser - This is the nature of hair.

    Hair greed

    Grow well everyone!!!!

  4. #4
    Dr Representative Spex's Avatar
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    Default Patience


    Patience is the toughest part of the HT procedure but one of the most important ones.

    Trust me i truly know how tough the waiting game is - I have been there many, many times before!! Looking constantly in the mirror, inspecting it every opportunity, driving along staring in the rear view mirror(how i never crashed i don't know) Wondering why at exactly 3/4 months there is still no growth!! Frustrated why the redness hasn't clamed down when forum member X was back to work at 10 days with no worries.

    The trick here is to understand that everyone is different in terms of recovery times, growth times, expectations, realisation period etc.

    Patience is an essential part of the HT journey and i think it needs more exposure - When embarking down the HT road - "Be Patient!!!"

    Just because "Joe Bloggs" had great growth at month 3/4 doesn't necessarily mean you are going to - So being aware of this prior to your HT.
    The growth will come in its own time and you will have your realisation in your own time. - Be patient!! Could be 6 could be 10 months.

    It's a fact 3/4 months post HT is the toughest time in the entire process but you are only prolonging the agony by expecting to wake up one day around month 3/4 and see it all taking place. It doesn't happen like this!!! It is soooooooooooo slow and gradual that you actually do not see it happen. You will only see the transformation when you compare your pictures along side each other at monthly intervals. A great example was Ian who i spoke with at month 9 post op and he said "well i haven't really seen much difference since month 4" - I showed him his pictures and well you do the maths.

    Be patient - I know its tough, really tough!!! By inspecting your hair though 24/7 its actually NOT going to make things happen any quicker - In fact it will make things happen slower - "A watch kettle never boils"

    Be prepared post op to really make a conscious effort to put it all on the back burner for 6 months as a bench mark as other wise you will only drive yourself MAD! - Trust me - i speak from personal experience!!

  5. #5
    Dr Representative Spex's Avatar
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    Nov 2008

    Default Hair characteristics

    Hair characteristics

    Hair characteristics play a vital role in the overall illusion and success of a HT. Some patients have more favourable hair characteristics and therefore need less grafts to gain their personal goal. Someone with fine, straight, thin hair is going to require more grafts to achieve a similar result than for example someone with coarse, wavy, thick hair.

    Remember Hair transplantation is the "art of illusion". With the appropriate placement and use of your hairs characteristic the illusion can be achieved very well - the more favourable your hair characteristic is ie; wavy, thick hair means the illusion can occur with fewer grafts if positioned correctly.

    Our hairs characteristics all vary but be aware of your own when embarking into HT's and how it can aid or not aid the illusion. In brief - Patients with very similar loss patterns may not have the same hair characteristic. Therefore they will require a different amount of grafts to achieve a similar result in terms of illusion, coverage, density.

    Hair transplants are all about the art of illusion ;-)

  6. #6
    Dr Representative Spex's Avatar
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    Default Down Time

    Down time!

    A very common question associated with getting a HT and one of the most common reasons for not getting a ht sooner in many cases. Many guys know which Doc they are going with after much research but then need to wait months, sometime years to get an appropriate window of "Down time" in order to pull the HT off unnoticed by family, friends, work colleagues etc...Down time is a pain in arse - NO DOUBT!!!

    Downtime is definitely an element of the whole HT procedure you need to consider when embarking on your HT journey.

    Depending on the size of the session obviously some patients down time is less than others: ie smaller sessions can get away with a shorter down time period compared to larger session sizes.

    Healing is only half the battle - Many guys heal up with no real evidence of surgery in as little as 10 days and some can still have lingering redness for quite a prolonged periods of time - especially fair skinned patients. There is also the factor of having to have the recipient areas shaved down in order to achieve the best result possible and provide the doc great flexibility etc -Shaving down is essential!...(thats a whole other topic )

    The answer to the question of "how much down time do i need?" is an impossible one to answer but i recommend that you give yourself as much time as possible - a MINIMUM of 2-3 weeks ideally 4-5 (especially larger strip sessions.) If you can wear a hat to work then you are laughing and could literally be back to work within days if you wanted to but for the vast majority wearing a hat at work is not an option and the appropriate amount of downtime post op needs to be considered!

    I have received a number of sessions over the years and never once have i been able to back at work within 2 weeks and i know all the tricks - Some are below, please feel free to add any handy minimising "down time" hints.

    1. Apply Aloe Vera gel, Emu oil, distilled witch hazel etc.. to the healing areas to help soothe and speed up healing process.
    2. Take MSM (3000mg) to speed up the existing hairs growth since the buzz to get some length back to help disguise.
    3. Use concealers in areas once hair is long enough to help bulk up and disguise lingering redness.
    4. Wearing a hat to buy you valuable days.
    5. Growing hair long pre op to help disguise areas worked on.
    6. Buzz hair short pre op in advance so people you see on a day to day basis don't notice the new buzz cut post op.(Especially FUE guys)
    7. Take a holiday post op and take yourself out the loop for 3-4 weeks
    8. Take sick leave right before your holiday comes to a close - buy you valuable days

    The list will hopefully be added to with experiences that guys have been through in order to help minimise their own personal downtime.

    Hope all this info helps guys out - especially newbies who find research a complete mind field.


  7. #7
    Administrator SpencerKobren's Avatar
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    Oct 2008
    Los Angeles, CA

    Thumbs up

    Thanks for contributing Spex! Great information.
    Spencer Kobren
    Founder, American Hair Loss Association
    Host, The Bald Truth Radio Show

    I am not a physician. My opinions and knowledge concerning hair loss and its treatment are based on extensive research and reporting on the subject as a consumer advocate and hair loss educator. My views and comments on the subject should not be taken as medical advice. Always seek the advice of a medical professional when considering medical and surgical treatment.

  8. #8
    Dr Representative Spex's Avatar
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    Nov 2008


    Thanks Spencer. Nice to talk to you via IM last night

  9. #9
    Dr Representative Spex's Avatar
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    Default Expectations

    Hair Transplants and Expectations:

    I think its very important that guys venturing into HT's have a very good understanding of THEIR "expectations". Its important that perspective patients understand that essentially THEIR hair's characteristic, donor supply, donor density, laxity, physiology play the most vital role in the short/long term success of their HT. (Along with appropriate planning with a competent Doc) ie. Understanding that Patient X's hair characteristic may provide them with a completely different cosmetic result compared to Patient Y's - even though they had similar graft counts.

    Obviously we all try to compare our own situations to various posters with similar loss patterns and we all obviously hope for results like, Jotronic, Hairroot,Bushy, PB, Garageland, etc.. BUT although the perspective patient feels they are very similar doesn't necessarily mean they are going to end up with the same result - especially not first time round - and this is where "Expectations" need to be kept realistic.

    The most appropriate surgery possible will be performed on the patient (doc dependant) applying their supply to their demand - off the back of the patients goal, requirements, hair characteristic, donor supply etc. - to enable the patient to reach the max potential from 1 surgery but more surgery potentially will be required in order to reach the finally goal.

    Everyone wants to have their situations resolved first time round via HT's but this is very rare. No one gets just one HT - Even guys with minimal loss will obtain hair greed and want even more. Nature of the beast - hair and money..., we always want more.

    Point i am trying to get across here is have a "realistic expectation" first time round of what you are setting out to achieve - and be aware that YOU the patient need to be aware of the variables that you bring to the table so to speak - Its at this point the experience of the Doc is applied in order to enable YOU to reach the max potential from YOUR session - - again taking into account YOUR characteristics, donor supply, loss pattern, personal goal, donor density, laxity, physiology, previous surgery..... etc

  10. #10

    Default Great information Spex

    Thank you for being so forth-coming in your post spex.You gave all the information Ive been searching for wrapped up in a nut shell.I just finished my very first session and am litterally at home trying to rest, with still many questions on my mind.
    Your words were comforting.Thank you so much.

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