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Hair Loss in FUE Donor Area


#1

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?


#2

» 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?
»
»


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»

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


#3

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?

#4

» 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.


#5

» 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.
»
»

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.


#6

Looks like a fairly large punch was used.


#7

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.


#8
  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?


#9

» 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.


#10

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.

#11

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.


#12

» 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.


#13

» 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…


#14

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.


#15

» 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.


#16

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.


#17

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. :slight_smile: 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).


#18

» 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.


#19

» 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.


#20

» 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. :slight_smile: 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).
»
»

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