Is it safe to transplant hair into thinning areas, or do you risk damaging existing hair in these regions?
This is an excellent question and the answer ultimately depends on your doctor’s judgment and your personal hair and hair loss characteristics. The major concern, of course, is whether a transplant will damage the existing hair in the thinning area. If the existing hair is very limited, and likely to fall out eventually anyway, most surgeons would feel comfortable performing a transplant and implanting grafts into this region to restore some density. Even if the existing hair is lost, the net benefit of having it replaced with permanent hair will be worth it.
On the other hand, if the existing hair is relatively dense and/or in good condition, most surgeons would prefer that you first try medical therapy for 6 to 12 months, to see if you can slow your hair loss or even restore some hair. Some surgeons, however, may feel comfortable proceeding with a hair transplant. In this case, your doctor must be careful not to place an excessive number of grafts in this delicate region because this could lead to increased shock loss. Make sure your surgeon speaks honestly with you about the risk of shock loss and limited re-growth if you choose to go this route.
Don’t forget that everyone has only a limited supply of donor hair on their scalp. You do not want to jump into anything, particularly if you are not sure how your hair loss will progress in the future. Top hair transplant doctors will discourage you from rushing into anything and will help you create a long-term plan for combating your hair loss.
I am appealing to any experienced FUT professional (doctor or patient) for a favor. I did my surgery on last week and I cannot tell if my doctor (who is highly reputable) did as many grafts as he said. Could you kindly look at the attached photo and give me your opinion as to how many incisions/grafts this appears to you (we focused just on the frontal area)?
Many thanks to any one who gives me some guidance.
If you really want to improve your capacity to know exactly how many recipient sites were made, you should insist that your physician use the Counting Incision Device from Device For Hair. You can see this at Counting Incision Device (C-ID) . This device will cost your physician only 22.00 to use and he can give it to you at the end of the case. This device allows you to know precisely the number of incision sites filled with grafts and it is the only way you can know for certain how many incision sites were made. Of course, if you have a site that is not filled with a graft, then you should not be charged for the graft.
We have found that most physicians are not willing to spend the extra 22.00 to be accurate with their incision site count. While the Physician is making thousands of dollars on your procedure, he appears to be less concerned with accuracy and more concerned with the extra expense. Therefore, you might want to purchase one for your physician and insist that he use it and then give it to you at the end of the case. This way you can be certain what was done.
Don’t rely on the surgery staff to count your grafts or your incision sites. They have no real interest in being accurate and they are often more concerned with what they are going to have for dinner than an accurate graft count. Try sitting at a counter and cutting grafts day in and day out. It becomes routine and monotonous. Over time, the surgery tech’s mind begins to wander and they next thing you know, they have lost count.
Insist that your physician use the Counting Incision Device (CID) so that you can be certain what the exact graft count is.
One important point to consider with the CID is that it is disposable. There is no way to properly sterilize it once it has been used. Insist that the physician use a new one on you and not one that he used on someone else the day before. It really is up to you to insure that you get what you pay for and that your physician use properly sterilized single use CID instruments on your case.
Getting back on the subject of your grafts, there is some elongation noted and many of the hairs appear to be falling over to the side suggestive that they are about to be expelled from the skin and lost in your shower drain. This would not happen one day after a procedure.
I have been recommended 600 to 1000 grafts to the front. I would like to know what is the highest density and graft count with more aggressive density on the front hairline. I would like to have the front hairline to be suitable for a 36yo that is not on meds.
You can go with the maximal density, but I’ve seen many patients from physicians who claim to place 70 to 100 grafts per sq cm that are growing 20 grafts per sq cm. One of two things occurred. One is that the patients received 20 grafts per sq cm, which is not likely. The other is that they received 60 to 70 grafts per sq cm and they lost 50 grafts per sq cm because the placed density was much higher than their scalp could tolerate. There are studies out there showing that densities of 40 per sq cm grow only 73%. I like to keep my maximal density between 40 and 50 per sq cm because I have seen consistent growth rates above 90% in my hands. The other problem with poor growth from an attempt to achieve maximal density is that it may poison the scalp for future surgery and nothing may grow subsequently. It is best to stick with a safe density of 45 per sq cm on the hair line and in the rest of the scalp. This seems to work best for my patients. It’s not as if 70 per sq cm will not grow in some patients. The problem is that you cannot tell which patients it will grow in and which patients it will not grow in. The only way to tell is to try it and if it does not work, the patient is in real trouble.
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When can I resume exercise after a hair transplant?
After a strip surgery, it is recommended that you refrain from exercise for several weeks after the procedure to limit the widening of the strip scar. One advantage to CIT or FUE is that you can resume exercise the same day as the procedure. The reason is that you do not need to worry about increasing the width of a strip scar. You should avoid any exercise that might rub on the grafts, however such as standing on your head or martial arts.
With any hair transplant procedure, however, you must be careful with the grafted area. Anything that disturbs this area may result in the potential for a lost graft. Therefore, we recommend that you do not scrub the top of your scalp or pick at the grafts for the first 6 days after a procedure. I let my patients resume washing their scalp the following morning after the day of their procedure, but I recommend they use Hair Cycle shampoo, which has less lather and is easier to get out. I tell them to avoid letting the shower water hit directly on the scalp. I encourage them to use a 
cup of water on the scalp to remove the shampoo.
It is quite common, for some reason, for patients to hit the top of their scalp on the car, while getting into the car. For some reason they tend to do this right after a procedure only because they are being so careful not to do it.
Of course after 6 days the grafts are in place and you will not disturb them so you can resume normal shampooing and all physical activities.
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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