Hair Loss Forum - Hair Loss in FUE Donor Area

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MustPunchNorwood

E-mail

29.07.2007, 17:35
 

Hair Loss in FUE Donor Area (Hair Transplant)

About 3 weeks ago I had a 1000 graft FUE precedure to help fill in an old burn scar on the back of my head and to fill in a strip scar from years ago. The grafts came from the back of my head and on my right side only. During the last few days I have been experiencing severe hair loss in the donor area. I am very concerned that it will continue and that it will be permanant. Has anyone experienced this before? If so, how did it turn out?

[image]

[image]

[image]

[image]

[image]




MustPunchNorwood is located in [NA] and he is available to meet: NO


Post reply
gac201

29.07.2007, 18:37

@ MustPunchNorwood

Hair Loss in FUE Donor Area

» About 3 weeks ago I had a 1000 graft FUE precedure to help fill in an old
» burn scar on the back of my head and to fill in a strip scar from years
» ago. The grafts came from the back of my head and on my right side only.
» During the last few days I have been experiencing severe hair loss in the
» donor area. I am very concerned that it will continue and that it
» will be permanant. Has anyone experienced this before? If so, how did it
» turn out?
»
» [image]
»
» [image]
»
» [image]
»
» [image]
»
» [image]


it's most likely shockloss and will grow back in a few months.




gac201 is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Alvi Armani 2009 - Upcoming final session
Alvi Armani 2007 -3,000 FUE
Cole 2004-2005 -3,400 FUE


Post reply
hairtech_

E-mail

Minneapolis,MN,
29.07.2007, 19:17

@ MustPunchNorwood

Hair Loss in FUE Donor Area

A few questions Norwood. First of all, I only remember one case out of thousands that produce some sort of shockloss in the donor area. However, I am guessing based on experience that this is the only thing it could be unless you have had paroxysmal hairloss in the past. Bouts of patchy hairloss with return hair growth.

1. Do you have intra-operative pictures to see the extraction sites?
2. Who performed the surgery... to see if I have cardinal knowledge of past issues concerning extractions with that doctor.
3. Have the grafts shed?
4. How do you feel in terms of your scalp? You don't "feel" sick do you?




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
MustPunchNorwood

E-mail

29.07.2007, 20:42

@ hairtech_

Hair Loss in FUE Donor Area

» 1. Do you have intra-operative pictures to see the extraction sites?
» 2. Who performed the surgery... to see if I have cardinal knowledge of
» past issues concerning extractions with that doctor.
» 3. Have the grafts shed?
» 4. How do you feel in terms of your scalp? You don't "feel" sick do you?

1. I do not have any pictures from during the surgery, but I am posting a picture below from the day after surgery that may help show the extraction locations.

2. I would prefer not to list the doctor, since naming names can sometimes cause problems. I would rather just address my problem and not do anything that would change this into a doctor bashing thread.

3. A few of the grafts may have shed. Most have not.

4. I feel completely healthy. My scalp feels pretty much like before the FUE proceedure. There is slight numbness on the back of my head, but it has been that way since my strip proceedures in the late 90's.

[image]




MustPunchNorwood is located in [NA] and he is available to meet: NO


Post reply
checkingin

29.07.2007, 21:25

@ MustPunchNorwood

Hair Loss in FUE Donor Area

» 1. I do not have any pictures from during the surgery, but I am posting a
» picture below from the day after surgery that may help show the extraction
» locations.
»
» 2. I would prefer not to list the doctor, since naming names can sometimes
» cause problems. I would rather just address my problem and not do anything
» that would change this into a doctor bashing thread.
»
» 3. A few of the grafts may have shed. Most have not.
»
» 4. I feel completely healthy. My scalp feels pretty much like before the
» FUE proceedure. There is slight numbness on the back of my head, but it
» has been that way since my strip proceedures in the late 90's.
»
» [image]

It is probably shock loss. I will say that the extraction sites themself do not look good or as good as we are accustomed to seeing. Some of the sites look like they are touching each other which will leave a noticeably larger "bald" spot. Not a good random pattern which thins all over.



checkingin has 22 Personal Journal(s). Click here to view
checkingin is located in [NA] and he is available to meet: NO

---
Personal Journal
http://hairsite.com/serendipity/authors/29-Checkingin


Post reply
haggis

England,
29.07.2007, 21:34

@ checkingin

Hair Loss in FUE Donor Area

Looks like a fairly large punch was used.




haggis is located in ENGLAND and he is available to meet: NO


Post reply
bverotti

E-mail

Belgium,
29.07.2007, 21:36

@ checkingin

Hair Loss in FUE Donor Area

Looks like 1 mm punches where used.
Very likely the donor area had some kind of blood flow problem caused by the surgery and caused donor shock loss. This is not permanent, the hair will regrow in 4 to 6 months.

I have not heared of donor area shock loss using sub 0.8 mm punches.

IMHO smaller instruments are important to avoid donor area shock loss.




bverotti is located in BELGIUM and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Prohairclinic Belgium
Probably most experienced FUE Team in Europe.


Post reply
hairtech_

E-mail

Minneapolis,MN,
29.07.2007, 22:19

@ bverotti

Hair Loss in FUE Donor Area

1. It looks like a punch larger than 1.0mm IMO.

2. Like the other poster said, the punch sites look close together also.

3. Shock loss could have occurred but it is so damn rare in the donor region.

4. Do you know your density before your surgery?

5. Did you use a post operative spray or topical post op?




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
MustPunchNorwood

E-mail

29.07.2007, 22:44

@ hairtech_

Hair Loss in FUE Donor Area

» 1. It looks like a punch larger than 1.0mm IMO.
»
» 2. Like the other poster said, the punch sites look close together also.
»
» 3. Shock loss could have occurred but it is so damn rare in the donor
» region.
»
» 4. Do you know your density before your surgery?
»
» 5. Did you use a post operative spray or topical post op?

1. Actually, I don't know the size.

2. They did seem close together. I was surprised then next morning to find that instead of using both sides of my head, that the grafts were mainly extracted from my right side and the back side.

3. If it is shockloss, what would you guess is the time frame to expect regrowth in the donar area? If it is not shockloss, what are the other likely possiblities?

4. I do not know the density.

5. No post-op spray. Bacitracin antibiotic ointment was applied to donor area for the first week.




MustPunchNorwood is located in [NA] and he is available to meet: NO


Post reply
hairtech_

E-mail

Minneapolis,MN,
30.07.2007, 01:58

@ MustPunchNorwood

Hair Loss in FUE Donor Area

If it is shockloss then it will start to come back in 3 or more months maybe longer.

Shockloss in the recipient area is due to the doctor transecting the resident follicles when making sites. It almost never occurs in the donor area but I suppose the same thing can happen.

Now if the extractions where randomly made and too many were side by side follicles, then a problem may arise where upon there will be noticeable areas that are devoid of hair. In FUE it is termed "the moth eaten" look.

Let us hope you are not with that problem.

Last questions:

Why did he focus on the right side and the back and not the entire donor area?

Was it easier for him to extract with you laying down on your left side?

If this was the only reason for not spreading the extractions all around the donor, which is the logical and proper way to decrease the donor density in FUE, then at the very least, send him the link to this thread so he can learn from his mistakes and perform it proper next time.

We cannot stop docs from doing shady procedures but at least some take hints.
Using respect try to tell him:
1. Tell him to use smaller tools, i.e. 0.75mm.
2. Tell him to skip follicular groups better.
3. Tell him to spread the extractions over the entire donor area if possible.




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
Jessica

E-mail

31.07.2007, 22:07

@ MustPunchNorwood

Hair Loss in FUE Donor Area

MustPunchNorwood,

I like your name!

Have you contacted your doctor? What does he/she say?

I would not advise allowing people on an internet forum to diagnose your hair loss cause. But, thank you for posting these pictures so that other people can benefit from your experience.




Jessica is located in [NA] and he is available to meet: NO

---
I am not a doctor. I am a technical writer and surgical technologist trained in hair transplant. My opinions are not necessarily those of Dr. Cole, Dr. Mwamba in Brussels, or IHTI. My advice is not medical advice.


Post reply
hairtech_

E-mail

Minneapolis,MN,
31.07.2007, 22:55

@ Jessica

Hair Loss in FUE Donor Area

» I would not advise allowing people on an internet forum to diagnose your
» hair loss cause. But, thank you for posting these pictures so that other
» people can benefit from your experience.

I do advise you to read everything including posters on the internet... except those posters that say do not read other posters comments.

Of course consult with doctors... but the forums are for education which includes advice and objective comments. Folks are not dumb. They read. They go to doctors to do the work but they exchange things here. People here are pretty much seasoned in answering questions in HT.

Strange comment from you Jessica.




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
thegreek

31.07.2007, 23:30

@ hairtech_

Hair Loss in FUE Donor Area

» We cannot stop docs from doing shady procedures but at least some take
» hints.
» Using respect try to tell him:
» 1. Tell him to use smaller tools, i.e. 0.75mm.
» 2. Tell him to skip follicular groups better.
» 3. Tell him to spread the extractions over the entire donor area if
» possible.

If you have to tell him all this Hairtech... then whats the point lol you better run away.

By the way Mustpunch go to a doctor as well and get a diagnosis so that you will be relaxed knowing exactly what is wrong...



thegreek has 1 Personal Journal(s). Click here to view
thegreek is located in [NA] and he is available to meet: NO


Post reply
marco

U.K,
31.07.2007, 23:43

@ MustPunchNorwood

Hair Loss in FUE Donor Area

I might get deleted for this but it looks a lot like Ilters early work. I heard of a shock loss case resulting from this at the time. I assume it grew back. It IS a direct result of the transplant since an area in the middle of the donor area that was not touched is O.K. In my opinion, it is not likely to be transection but rather some kind of inflmitory related shockloss.

In contrast to Jessica's comment, I honestly think it is not worth asking the surgeon. I think he will be the worst person to ask as he has the most reason to be bias and could just frustrate you by dmeaning the problem. The hard truth is that you have to wait up to 6 months but hopefully 3 before you will know what is going on. Best of luck!!!!!!!!!!!!!!!!!!

As the Greeks said, go to another docter or a derm but mainly just wait.



marco has 3 Personal Journal(s). Click here to view
marco is located in U.K and he is available to meet: NO


Post reply
Jessica

E-mail

01.08.2007, 00:42

@ marco

Hair Loss in FUE Donor Area

» I might get deleted for this but it looks a lot like Ilters early work. I
» heard of a shock loss case resulting from this at the time. I assume it
» grew back. It IS a direct result of the transplant since an area in the
» middle of the donor area that was not touched is O.K. In my opinion, it is
» not likely to be transection but rather some kind of inflmitory related
» shockloss.
»
» In contrast to Jessica's comment, I honestly think it is not worth asking
» the surgeon. I think he will be the worst person to ask as he has the most
» reason to be bias and could just frustrate you by dmeaning the problem. The
» hard truth is that you have to wait up to 6 months but hopefully 3 before
» you will know what is going on. Best of luck!!!!!!!!!!!!!!!!!!
»
» As the Greeks said, go to another docter or a derm but mainly just wait.

Interesting perspective, Marco. A second opinion from another doctor is a very good suggestion.




Jessica is located in [NA] and he is available to meet: NO

---
I am not a doctor. I am a technical writer and surgical technologist trained in hair transplant. My opinions are not necessarily those of Dr. Cole, Dr. Mwamba in Brussels, or IHTI. My advice is not medical advice.


Post reply
hairtech_

E-mail

Minneapolis,MN,
01.08.2007, 01:57

@ Jessica

Hair Loss in FUE Donor Area

Norwood...

Dr. Harris was slightly concerned with seeing your pictures and he suggested MINOX in the donor area. He also agreed that this was the first time he had seen this. And this should be something to follow as it needs to be discussed at meetings to try to prevent this from occurring.

Anyway Minox might help you out to get the shockloss reversed... if that what it is.




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
MustPunchNorwood

E-mail

01.08.2007, 01:58
(edited by HairSite Admin, 27.08.2007, 12:24)

@ Jessica

Hair Loss in FUE Donor Area

I appreciate everyones opinions and questions over the last couple of days. Mostly I am in a position where I will just have to wait it out to know if it regrows. I have been lurking on this site off and on for a couple years, but I have not seen a case quite like mine. And I do plan to make arrangements to see someone else in the industry for a second opinion.

Hairtech, I don't plan on advising the doctor who performed my proceedure regarding his extraction methods. I kind of agree with thegreek. Besides, the doctor is a former poster on this site, so he may be aware of your opinion already by reading this thread. I made the mistake of assuming that the grafts would be somewhat evenly extracted throughtout my donor region, instead of extracting them all from the backside and right side of may head. Hopefully this is just a mistake that I will learn from and not a mistake I will forever pay for.

Jessica, Glad you like the user name. I try to keep a sense of humor through all this. :-) I understand what you mean by not letting anyone diagnose me over the internet. I do plan to do more than just read the forum, but the additional information can sometimes help. Who knows, maybe someone will post a link to another case just like mine. (btw, non-registered readers can reach me at mustpunchnorwood at comcast.net) I did exchange emails with my doctor twice on Sunday. He said it appears to be shockloss and will grow back within 3 months and that I should keep him updated on my observations in the next few weeks.

Below I am inserting a picture from today (day 22). There is a little more hair loss from Day 20. Also, I should point out that the skin in the affected area is very smooth, like after a peeling sunburn. I don't know if it is relevent, but I thought it should be noted. There is still some slight swelling throughout. Looking back on my posts from the other day, I think I was understating the numbness in the affected area. It is more numb than before the proceedure. When I do feel in that area it tends to be a sharp, prickly feeling rather than the somewhat dull sensation it had before (ever since the strip proceedures I had in the late 90's).

[image]




MustPunchNorwood is located in [NA] and he is available to meet: NO


Post reply
MustPunchNorwood

E-mail

01.08.2007, 02:01
(edited by MustPunchNorwood, 01.08.2007, 02:54)

@ hairtech_

Hair Loss in FUE Donor Area

» Norwood...
»
» Dr. Harris was slightly concerned with seeing your pictures and he
» suggested MINOX in the donor area. He also agreed that this was the first
» time he had seen this. And this should be something to follow as it needs
» to be discussed at meetings to try to prevent this from occurring.
»
» Anyway Minox might help you out to get the shockloss reversed... if that
» what it is.


As of Sunday, I have started applying PPG-Free Minox 5% to the affected donor region.




MustPunchNorwood is located in [NA] and he is available to meet: NO


Post reply
hairtech_

E-mail

Minneapolis,MN,
01.08.2007, 04:18

@ MustPunchNorwood

Hair Loss in FUE Donor Area

» As of Sunday, I have started applying PPG-Free Minox 5% to the affected
» donor region.

Excellent... Now the hard part... Time. Keep getting photos Norwood. Keep posting them and try to get the exact angle so we and you can compare them... no matter how long it takes.




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
Jessica

E-mail

01.08.2007, 15:41

@ MustPunchNorwood

Hair Loss in FUE Donor Area

» I appreciate everyones opinions and questions over the last couple of days.
» Mostly I am in a position where I will just have to wait it out to know if
» it regrows. I have been lurking on this site off and on for a couple
» years, but I have not seen a case quite like mine. And I do plan to make
» arrangements to see someone else in the industry for a second opinion.
»
» Hairtech, I don't plan on advising the doctor who performed my proceedure
» regarding his extraction methods. I kind of agree with thegreek.
» Besides, the doctor is a former poster on this site, so he may be aware of
» your opinion already by reading this thread. I made the mistake of
» assuming that the grafts would be somewhat evenly extracted
» throughtout my donor region, instead of extracting them all from the
» backside and right side of may head. Hopefully this is just a mistake
» that I will learn from and not a mistake I will forever pay for.
»
» Jessica, Glad you like the user name. I try to keep a sense of humor
» through all this. :-) I understand what you mean by not letting anyone
» diagnose me over the internet. I do plan to do more than just read the
» forum, but the additional information can sometimes help. Who knows,
» maybe someone will post a link to another case just like mine. (btw,
» non-registered readers can reach me at mustpunchnorwood at comcast.net) I
» did exchange emails with my doctor twice on Sunday. He said it appears to
» be shockloss and will grow back within 3 months and that I should keep him
» updated on my observations in the next few weeks.
»
» Below I am inserting a picture from today (day 22). There is a little
» more hair loss from Day 20. Also, I should point out that the skin in the
» affected area is very smooth, like after a peeling sunburn. I don't know
» if it is relevent, but I thought it should be noted. There is still some
» slight swelling throughout. Looking back on my posts from the other day,
» I think I was understating the numbness in the affected area. It is more
» numb than before the proceedure. When I do feel in that area it tends to
» be a sharp, prickly feeling rather than the somewhat dull sensation it had
» before (ever since the strip proceedures I had in the late 90's).
»
» [image]

I think you are on the right track. Keep us updated. My thoughts are with you.




Jessica is located in [NA] and he is available to meet: NO

---
I am not a doctor. I am a technical writer and surgical technologist trained in hair transplant. My opinions are not necessarily those of Dr. Cole, Dr. Mwamba in Brussels, or IHTI. My advice is not medical advice.


Post reply
hairtech_

E-mail

Minneapolis,MN,
01.08.2007, 15:57

@ Jessica

Hair Loss in FUE Donor Area

One thing that is noticeable though... the time at which you shocked out. There was a rapid loss from day 12 to day 20... so this might be another indicator that it is shockloss and not something else. Shockloss occurs a couple of weeks post op in the recipient area. The loss in your donor falls within this time frame. Let's keep our fingers crossed.




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
haggis

England,
01.08.2007, 18:44

@ hairtech_

Hair Loss in FUE Donor Area

sorry to be negative but if my head looked like that i would be very worried :-( i hope it works out ok for you.




haggis is located in ENGLAND and he is available to meet: NO


Post reply
hairtech_

E-mail

Minneapolis,MN,
01.08.2007, 19:51

@ haggis

Hair Loss in FUE Donor Area

» sorry to be negative but if my head looked like that i would be very
» worried :-( i hope it works out ok for you.

Just looking at this from a technicians (not doctor) point of view... One can see that the punch size was larger than what most clinics use today... 0.75mm-0.9mm. It looks over 1.0mm. (dangerous IMO and unnecessary)

This can easily be confirmed by his 1-2day post op picture that is still crusty /bloody. You just never see that sort of thing when you use smaller tools...

I want ghost readers and clinicians alike to start looking at post op photos of different clinics with FUE. You will be able to tell punch size by shear comparison of post op donor areas even in the same day.




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
MustPunchNorwood

E-mail

02.08.2007, 03:27

@ Jessica

Hair Loss in FUE Donor Area

» I think you are on the right track. Keep us updated. My thoughts are
» with you.

Thanks Jessica! I appreciate your advice and support. I will definitely update all developments. I have an appointment tomorrow to see another HT doctor to get a second opinion. I'm curious to see what he thinks.




MustPunchNorwood is located in [NA] and he is available to meet: NO

---
mustpunchnorwood at comcast.net


Post reply
MustPunchNorwood

E-mail

02.08.2007, 03:39

@ haggis

Hair Loss in FUE Donor Area

» sorry to be negative but if my head looked like that i would be very
» worried :-( i hope it works out ok for you.

I don't think you are negative at all. Anyone would be very worried it this happened to them. Friday and Saturday night it did affect my sleep a bit, but now that the shock has gone it is much easier. I am getting a second opinion tomorrow and hopefully I will end up with a better understanding of the situation.

Also, I am lucky that I have enough going on in my life that I don't have too much time to dwell on it. My girlfriend is more supportive than you could imagine, I have a job that I really enjoy and I've got a couple of comfortable ballcaps, so it could be a lot worse.:ok:




MustPunchNorwood is located in [NA] and he is available to meet: NO

---
mustpunchnorwood at comcast.net


Post reply
hairtech_

E-mail

Minneapolis,MN,
02.08.2007, 04:55

@ MustPunchNorwood

Hair Loss in FUE Donor Area

this is great news norwood... Let us knows how it goes...




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
JonnyE

02.08.2007, 19:45

@ MustPunchNorwood

Hair Loss in FUE Donor Area

» » I think you are on the right track. Keep us updated. My thoughts are
» » with you.
»
» Thanks Jessica! I appreciate your advice and support. I will definitely
» update all developments. I have an appointment tomorrow to see another HT
» doctor to get a second opinion. I'm curious to see what he thinks.

Ive never seen hair loss like that, i would definiltey get a second opinion from another doc.




JonnyE is located in [NA] and he is available to meet: NO

---
3083 Grafts Transplanted by Dr. Armani in April 2004
Minoxidil 1 times daily
1.25 Proscar 1 times daily


Post reply
vic

03.08.2007, 09:24

@ JonnyE

Hair Loss in FUE Donor Area

» » » I think you are on the right track. Keep us updated. My thoughts are
» » » with you.
» »
» » Thanks Jessica! I appreciate your advice and support. I will
» definitely
» » update all developments. I have an appointment tomorrow to see another
» HT
» » doctor to get a second opinion. I'm curious to see what he thinks.
»
» Ive never seen hair loss like that, i would definiltey get a second
» opinion from another doc.

I think maybe a visit to a dermatologist wouldn't hurt, maybe a biopsy to see if there is any internal infection. Good luck.




vic is located in [NA] and he is available to meet: NO


Post reply
MustPunchNorwood

E-mail

04.08.2007, 05:47

@ vic

Had 2nd Opinion Yesterday

I visited with an FUE HT doctor yesterday and I had a great visit. His diagnosis was basically that the hair in my donor area is experiencing temporary shock loss from an unusual cause that he had never seen before.

Unfortunatly it is late, so I will have to fill in all the details of my visit and his diagnosis sometime tomorrow (Saturday).




MustPunchNorwood is located in [NA] and he is available to meet: NO

---
mustpunchnorwood at comcast.net


Post reply
Sofarsogood

Los Angeles area,
04.08.2007, 06:11

@ MustPunchNorwood

Had 2nd Opinion Yesterday

Congrats!
I've been following this thread and hoping for the best for you.

That news had gotta feel great.
Hope you are partying hardily or sleeping heavily.

Peace.



Sofarsogood has 7 Personal Journal(s). Click here to view
Sofarsogood is located in LOS ANGELES AREA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
BHT was used to "soften" my former HT hairline that was made up of larger grafts.
At the ISHRS 2007convention, 12 docs from 10 countries, many techs and one famous forum moderator
acknowledged the BHT growth. Click the link for more about my case.
http://hairsite.com/serendipity/authors/27-sofarsogood
Video of my BHT result:
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Post reply
vic

04.08.2007, 06:40

@ MustPunchNorwood

Had 2nd Opinion Yesterday

» I visited with an FUE HT doctor yesterday and I had a great visit. His
» diagnosis was basically that the hair in my donor area is experiencing
» temporary shock loss from an unusual cause that he had
» never seen before.
»
» Unfortunatly it is late, so I will have to fill in all the details of my
» visit and his diagnosis sometime tomorrow (Saturday).

Fingers crossed all will be well...Good luck




vic is located in [NA] and he is available to meet: NO


Post reply
hairtech_

E-mail

Minneapolis,MN,
04.08.2007, 09:22

@ MustPunchNorwood

Hair Loss in FUE Donor Area

this is good news my bro...




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


Post reply
MustPunchNorwood

E-mail

05.08.2007, 15:19

@ hairtech_

Finally some answers

A little background on my situation. In the late 90’s I had a series of 3 strip procedures with a now-retired SoCal ht doc, which left a nasty scar and left the backside of my head somewhat numb from nerve damage from the strip extraction. The numbness seems to be permanent.

On Thursday, I went to see Dr Harris in Denver. During the examination, he noticed that the hair fallout only occurred in the region where the grafts were extracted and there was numbness. The exact line of where the numbness ended is also where the hair fallout stopped. He explained there is a strong relationship between the nerves and the vascular system and that the numb area would have impaired blood flow. So when the grafts were extracted there may have been enough blood flow to support healing the wound or to support hair growth, but not both. So the hair went into a resting phase while the scalp heals. Dr Harris said I should expect to see regrowth beginning in about another 6 weeks.

He said that he had not seen or heard of this happening before and that he would have to start keeping this possibility in mind when dealing with patients with nerve damage from previous strip surgeries. Also, if my FUE extractions had been spread all throughout my donor region instead of being concentrated on just my right side and the back, it may have reduced or eliminated the shock loss.

If I have misstated anything above, I hope Hairtech_ or Dr Harris will let me know, so I can edit any errors.




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hairtech_

E-mail

Minneapolis,MN,
05.08.2007, 16:28

@ MustPunchNorwood

Finally some answers

[image]

Your description is correct... If you have a more right side picture(cropping out your face of course) we can show where the line exactly stops from the previous strip and where this shows the exact line of demarcation where you have shockloss as well as feeling and/or numbing. It is compelling. This picture might show this already.

The red line is where the strip was cut. Everything below it and on the right side where the purple line is, has feeling and no shockloss. Everything above the red line and to the left of the purple line is shocked out and completely numb.




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marco

U.K,
05.08.2007, 16:44

@ MustPunchNorwood

Finally some answers

Hi Mustpunch,

You told Dr. Harris that the numbness ends with the old scar line and that it can be seen that the shedding ends at that point. Dr. Harris's instinct and experience makes him feel that there will soon be regrowth. I am sure you can trust that. The rest is just voodoo.



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hairtech_

E-mail

Minneapolis,MN,
05.08.2007, 17:02
(edited by hairtech_, 05.08.2007, 17:48)

@ marco

Finally some answers

Think about this Marco... Mustpunch probably received tons of epi for hours on end to control bleeding. That is based on the fact the case for the 1000 FUE grafts went on until 1AM. And judging from the post op pictures the day after and showing massive blood and crust, one can guess that the guy bled a lot during the procedure... (punch size was a factor) Given this scenario, and from my experience with several doctors extractions are impossible without a clean field of vision... epi was used for probably 12-14 hours along with more marcaine/lido-epi mixtures to keep his head numb for the entire case.... combining that fact with the already nerve/vascular damage... the scalp in that area could not support resident growth and/or healing or both. He the went into effluvuim and shocked.

Remember Zayden's case? His flap re-attachment was improperly sutured back together and he got the worst case scenario from Zero blood profusing the flap...

Sort of the same premise here, but at least he will have more than likely a fast re-profusion(should have occurred after a day or so after the epi burned off.)But it was too late at that point.

I saw this one particular case(years ago) where a guy got too much of a concentration of epi in one area and his skin where the epi was injected, right in front of our eyes began to necrose and slough. Epinephrine is a powerful drug




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marco

U.K,
05.08.2007, 18:13

@ hairtech_

Finally some answers

I don't have any difficulty accepting the conclusion and that is the most important thing for the patient, that his hair will almost certainly grow back. It is very common and understandable that a medic feels the need to explain the underlying causes to the patient in order to put the patients mind at rest.

The reality is that there are many explanations for why this kind of thing happens (drug or surgically induced shedding) and an acceptable answer has never been given.

The idea that there was enough circulation to either heal or grow is, lets face it, just a justification for something that is not understood. The idea that nerve damage and vascular damage are closely tied is not strictly true. There are parallel paths of the occipital nerves and vasculature but they heal very differently.


Another explanation is that the occipital protuberance almost exactly defines the scar and the circulation and dermis are much better supplied bellow this area. BUT THIS IS JUST A HYPOTHESIS as was Dr. Harris's thoughts.

One thing of importance about Zydan's case that you bought up; In fact there was no necrotic event and the scalp healed perfectly. The aberrant appearance is just the result of the design of the flap such that the bald scalp was bought down into the donor area and on the other side the flap was not taken from the safe zone and as a result continued hair loss left a scar in the forehead as the donor hair receded.

All the best,
Marco.



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hairtech_

E-mail

Minneapolis,MN,
05.08.2007, 18:48
(edited by HairSite Admin, 27.08.2007, 12:22)

@ marco

Finally some answers

I don't have a problem with accepting other possible causes but lets try to see what hypothesis more closely relates to what is going here. That's all. And what was compelling Marco was the exact place that he shocked was directly in the exact place that was numb and where extractions were performed. There were extractions outside the numb area that were outside from the scarline that healed perfectly and had no shockloss.

I see what you are saying though about the nerve/vasculature coinciding as the cause for the shockloss. The numbed ares are IMO would be indicative of damaged nerves... and then one can assume that since there was already evidence for damaged via numb specific areas, then one can also assume there had to be a vascular damage that while not significant enough to cause an initial shockloss post op the strip surgery, it did have an event of shockloss after 14 hours of epi marcaine or whatever. Again there were extractions on both numb and non numbed areas


[image]




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marco

U.K,
05.08.2007, 18:59

@ hairtech_

Finally some answers

I guess it's not really worth battling this one out but one thing that we both agree on and I know this is an area of interest to you is that the environment of the graft durring the holding phase as well as the environment of the graft at and shortly after insertion (chemical and biochemical and general vascular) are greatly understudied and its importance is probably greatly under-estimated.



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hairtech_

E-mail

Minneapolis,MN,
05.08.2007, 19:05

@ marco

Finally some answers

True True..




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Shapiro Medical Group


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Jessica

E-mail

06.08.2007, 17:03

@ MustPunchNorwood

Finally some answers

I'm glad Dr. Harris was able to give you a second opinion to set your mind at ease. I bet that takes some weight off your shoulders. It can be difficult to deal with when you don't know the probable causes.

Let us know when it starts growing back! ;-)




Jessica is located in [NA] and he is available to meet: NO

---
I am not a doctor. I am a technical writer and surgical technologist trained in hair transplant. My opinions are not necessarily those of Dr. Cole, Dr. Mwamba in Brussels, or IHTI. My advice is not medical advice.


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hairtech_

E-mail

Minneapolis,MN,
06.08.2007, 19:13

@ MustPunchNorwood

Hair Loss in FUE Donor Area

... sorry I was posting on a different thread.




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checkingin

08.08.2007, 13:29

@ MustPunchNorwood

Another possibility ..

Not sure, so maybe someone can help here. I saw on another site where someone lost big patches of hair on his face. He went to a doctor and they gave him some cortisone injections and the hair grew back very quickly.

It sounds like this will happen with time anyway, but would this help to speed the process??



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hairtech_

E-mail

Minneapolis,MN,
08.08.2007, 14:07

@ checkingin

Another possibility ..

» It sounds like this will happen with time anyway, but would this help to
» speed the process??

IMO I would have to say no... Corticosteroids are used for inflammatory processes. I would have to check more with Dr. H but this process that he thinks created the shock does not have anything to do with inflammation so we think at this point. However good thinking. ;-)




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hairtech_

E-mail

Minneapolis,MN,
08.08.2007, 18:09

@ hairtech_

Another possibility ..

Mustpunch,

How are you?




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MustPunchNorwood

E-mail

09.08.2007, 00:40

@ hairtech_

Quick Update

» Mustpunch,
»
» How are you?

Hi Thomas, I have been doing well. Since coming to Denver to see Dr Harris last Thursday, my life has been busy. I've been so preoccupied with being out of state training for a new position with my company, that I really have not been been able to provide updates here.
There has been a little bit more shedding since the last pictures, but not in the last few days. It seems to be done shedding. Also, I have trimmed my hair a little bit shorter so the difference between the normal areas and the shed area have a little less drastic contrast (if that is possible). I cover it up with a ball cap and will just have to be patient.
Thanks to everyone who who has given advice or their thoughts on my bizarre little situation. I will try to post every week or so until the problem resolves itself.
If anyone has any questions, let me know.




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mustpunchnorwood at comcast.net


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hairtech_

E-mail

Minneapolis,MN,
09.08.2007, 04:11

@ MustPunchNorwood

Quick Update

Ok so no questions about your growth... We all have to wait for that. I know your down in Texas somewhere... training for five weeks. That's cool... so when your not so serious... what music do u listen too? I think it is cool to see, in my mind images of folks... What music do you like? Alternative? Rap? Classical? Don't be Mr. Cool... Give it to us real... I don't care if you listen to liberachi, ludacris... what up dude?




hairtech_ is located in MINNEAPOLIS,MN and he is available to meet: NO

---
Hairtech
Shapiro Medical Group


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