Donor Recharging with CIT

I heard the tern “Donor Recharging”, what does it means?

CIT donor recharging is a method of preparation where each extracted scalp follicular unit is replaced with a body hair follicular unit. The exchange of these grafts isn’t always one for one but the purpose of CIT donor recharging is to replete the donor area and help the donor area from being too thinned from harvesting with hair transplant. CIT donor recharging also stimulates the production of melanin, a pigment in the donor area. Donor recharging allows patients with higher degrees of hair loss to maximize their scalp hair donor supply and fill-in the absence of extracted follicular units. The results with donor recharging are subject to the same limitations as BHT and results cannot be guaranteed. CIT donor recharging results vary from patient to patient and the appearance of the results is unpredictable.

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Rechargeable donor area ?

Donor After 6,000g Harvested with donor Recharging

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Body Hair Transplant Growth

I am now 19 months post surgery from a body hair transplant with you. I noted significant improvement at the 9 month mark, but minimal since then. Can I expect more growth and more density from the body hair transplant I had with you 19 months ago. I live in Spain.

It’s always difficult to say if hair always grows. It really does not matter if it is head hair to body hair. It’s a bit easier when you place head hair on a bald scalp, however. The same is true for body hair. With body hair we’ve learned a few things. One is that lower densities can produce better yields than higher densities. What does this mean? Well, sometimes a yield of 60% to 70% is the best you will see with body hair and it could be 30 to 40%. With head hair on the other hand, the yield is always 90% or less. Usually the lowest you will see is around 70%. Again high densities seem to play a role in lower density with head hair. I’ve seen body hair results that surely look like 90% yields however. We also know that anagen hairs produce a higher yield than telogen hairs. I’m not certain why.
Body hair transplant results
You have to understand the dynamics. Head hair is 80 to 90% in anagen. Body hair is 40 to 60% in anagen. Therefore, in reality, the best you should see from a head hair transplant is 80 to 90% and the best you should ever see is 40 to 60% from body hair. That does not mean that 10% of head hair and 40 to 60% of body hair died. It means that those percentages should always be resting or in telogen. As one hair cycles out, another cycles in and begins to grow. That’s the dynamics.

I think that most body hair transplant results to date seem to follow scalp hair in terms of growth, though we did recently get a 4 year photo of a patient that certainly seemed much better than his 14 month photo. What this means is that at about 8 to 12 months, the result probably peaked with minimal improvement thereafter.
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New Hair Grow In After Hair Transplant Surgery

When and how does the new hair grow in after my hair transplant ?

Many people ask this question during and after their hair transplant; some actually think the hair will all continue to grow and they will have their “new head of hair” immediately. Unfortunately, most individuals have to accept delayed gratification as part of the transplant experience!

When the grafts are placed in the balding areas, they indeed may continue to grow for a few weeks. However, by about three weeks, the hairs begin to rapidly shed and soon most all of them are gone. The good news is that the follicle cells, the ones that make the new hair shaft that grows up and out, are still lying dormant under the skin.

At about three to four months, the first hairs begin to sprout through the scalp. At first, all new hairs will be finer, and slightly less pigmented than they will eventually be after some growth time. It is important to note that the grafted hairs do not all begin to come in simultaneously; they generally sprout in a “staggered” fashion, which means that each month some new sprouts will be noticed emerging from the scalp, until they all have grown in! Full growth will have occurred, on average, after about 10 to 12 months; full ingrowth may sometimes take a little longer on second and subsequent procedures.

Of course, the full cosmetic effect may not be apparent right away. This is because length and caliber of hair, as well as density, contribute to coverage. Once the hair has grown long enough and each shaft has become thick enough, then the full coverage will be apparent and the welcome decrease in the appearance of thinning and baldness will be noticeable.

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What Causes Shock Loss?

It is really unknown what causes shock loss.  Shock loss is hair loss resulting from a hair transplant procedure.  There are many theories, however.  Shock loss most likely is due to an inflammatory response as a result of physical trauma.  It is really quite uncommon in the donor area.  It is more common in the recipient area.  The density of incision sites may play a role as high density incision sites tend to produce shock loss more commshock loss Causesonly.  Shock loss will occur only in the area where the incisions are made.  It will not occur in adjacent regions.

Shock loss begins about 2 to 3 weeks after a procedure and it will continue over a period of a few weeks.  If you experience hair loss months after a procedure, it is not due to shock loss, but rather due to progression of hair loss or some other factor unrelated to the hair transplant procedure.

Some feel it is due to the injection of epinephrine, which is commonly added to the anesthetic.  This is most likely untrue as you will not see shock loss in areas where anesthesia is given, but rather only in areas where the incision sites were made.  You also more commonly see it in the recipient area while epinephrine is also given in the anesthetic given in the donor area during a hair transplant surgery.  Even though the same anesthetic with epinephrine is given in the donor area, you do not see shock loss in the donor area when it occurs in the recipient area.

The inflammation might result from physical trauma, but it also might be due to the free radicals that accumulate in tissue that continues to metabolize outside the body in an anaerobic state.  Free radical scavengers in the storage fluid along with cooling of the tissue outside the body might help reduce the amount of free radicals produced by the grafts.  One might also limit the free radical load by limiting the recipient area density during a hair transplant.

Shock loss is uncommon in the donor area with both strip harvesting and with FUE or FIT.

When shock loss occurs, the hair will generally begin to grow back after a hiatus of 3 months.  It is only the fine wispy baby like hair that seems most prone to remain dormant following shock loss.  This sort of baby fine, short, lightly pigmented hair produces the least amount of coverage, however, so it will not be missed as coarser, darker, longer terminal hairs will take their place when the hair transplantation produces new hair growth beginning three months after the hair transplant.

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Hair Transplant Hairs Are Still Growing In The Grafts…

I had hair transplant procedure a week ago and I’ve note that the hair is still growing in the grafts. Does this mean the hair has been accepted and that it will continue to grow?

Following hair transplantation hair in the grafts will continue to elongate for about 10 days. Some of this may be continued hair growth, but it also reflects a move toward anagen effluvium. In anagen effluvium the dermal sheath begins to contract and move toward the surface of the skin much like an accordion. This shortening of the dermal sheath will push the bulb of the hair shaft toward the surface of the skin. Therefore, some of the elongation of the hairs is not due to growing, but rather due to a contraction of the dermal sheath toward the skin surface.

Once the dermal sheath contracts, the hairs will either begin to shed on their own beginning in two to three weeks after the transplant. Some of the hairs will continue to rest on the surface of the skin for a prolonged period of time. Eventually the scalp skin will either begin to form a wall around the resting, non-growing hair, or the scalp will form a pustule or pimple like reaction that will eventually burst and the non-growing hair will exit the skin with the exudate from the pimple or cyst like structure.

It is probably a good idea to minimize the number of the cyst like structures that you get because they represent unnecessary inflammation. Inflammation may not always be a good thing. In theory inflammation might sometimes lead to an autoimmune response toward one’s own hair and this in turn may compromise future graft growth.

In order to minimize inflammation, we generally recommend that patients begin removing non-growing hair fragments beginning three weeks after the hair restoration procedure. The best way to manage this is to aggressively wash the scalp with soap and a wash cloth. Non-growing hair will come out easily like removing a pin from a soft stick of butter. Growing hairs on the other hand must be plucked and it takes a good bit of force to accomplish this.

Sometimes hairs do continue to grow following a hair transplant without ever going into the resting phase, but it is unlikely that you will see more than 10% go into the resting phase. It is far more likely that the hairs will shed. Occasionally hairs almost shed, but then continue to grow. We can easily recognize these hairs because they have a dark tip that is coarse followed by a narrow constriction that is of lighter color. This is followed by a gradual darkening of the hair shaft and increase in hair diameter once again. We call these hairs that exhibit signs of this trauma pol pinkus hairs and they are a sure sign of recently transplanted hairs that have continued to grow.

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