Doctors on Hair Loss & Hair Transplant surgery.

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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Can beard hair be removed through hair transplantation?

There are two ways to remove hair from the donor area. One is by strip method. The other is by removal of individual follicular units. The strip method is not acceptable because it will leave a permanent linear scar. Individual follicular unit removal is acceptable and does work. In fact we often employ this for transplant of beard hair to the scalp. We also use this method to remove unwanted facial hair. This can occur with some forms of face lifting where the hair from the beard is relocated behind the ear. This can be a very difficult and unnatural place to get a razor to shave the beard. We have also used this method to relocate eyebrow hair from a location well above the eyebrow and re-implant the hair into the thinner medial aspect of the eyebrow to create a natural eyebrow transplant.

You should first consider laser hair removal for unwanted facial hair. This may require more than one procedure to remove all the hair. Laser hair removal is only indicated when you have pigmented hair. If there is no pigment in the hair or the hair has turned “grey”, you laser hair removal will not work. Removal of facial hair by CIT or FIT may require more than one pass, as well, to remove all the hair.

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I’m told by various strip physicians that the strip scar is a thin as a pencil mark. Is this true?

This is completely dishonest. The average strip scar is 2 to 3 mm wide and it can stretch from ear to ear. If you plan to cut your hair short, this can be a problem for you as it is obviously a man made scar. It is an obvious sign that you had a hair transplant. No one wants anyone to know they’ve had a hair transplant, however. No one wants anyone to know they had hair loss or that they ever considered hair restoration surgery. Even shorter hair styles can expose the strip hair transplant scar. Frequently we are told that a hair cut of a number 3 or shorter exposes the strip scar form a strip hair transplant.

There is a new fallacy you are hearing from strip surgeons, as well. They claim that their new trichophytic closure technique produces pencil thin scars that are invisible. We’ve seen 5mm wide scars produced by this technique. Five millimeters is ¼ inch wide. It is a huge gap with no hair in it. When the trichophytic closure works, it rarely works in the rear of the scalp. You will not see an advantage along the sides of the scalp usually. Furthermore, the tighter you make the scalp by performing successive strip procedures, the more likely it is that your scar will widen and stretch out. Furthermore, these strip scars can turn whiter than the surrounding skin or bright pink. This produces further contrast to the scars should they be exposed by a short hair cut or by a medical illness that causes thinning or loss of your hair.

One other problem you will never hear about from your strip surgeon is that strip procedure causes irreversible changes in your donor area hair growth angles. A strip is nothing more than a scalp reduction in the donor area. It alters hair growth angles for the rest of your life.

There is no reason to have a strip procedure. It really is up to the patient to demand the alternative, which is far better. Patients should begin to demand CIT, which is an advancement over our older FIT procedure. There is CIT and no quite CIT. Many physicians will tell you they perform FUE. This FUE procedure does not meet the quality of CIT. CIT is a proprietary procedure with quality instrumentation. Only CIT has proven results day in and day out with all types of hair including wiry, kinky hair seen in men of African decent.

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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 commonly.  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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What are the ways to camouflage strip hair restoration scars?

Camouflaging Strip Scars

Scars in the donor area from strip harvests may be problematic for many men. They may be short or run from ear to ear. Sometimes they widen over time, occasionally to more than two centimeters, which is deforming. This is usually due to an overly tight scalp, too low a placement, or poor surgical technique. They also change the direction of hair growth below the scar, relative to above the scar, which may cause a “shadow” of the linear scar to be evident even with the hair grown out somewhat.

IN order to minimize the appearance of scars, several strategies are available. There are cosmetics such as Dermatch, which may help disguise the scar. The hair may also be grown out fairly long to attempt coverage. This, of course, may not be an option for those with an over harvested donor region.

Surgical scar revision may be attempted, often without success. This consists of excising the scar and them suturing up the wound, hoping that the resultant scar will look better than the original one. This can work in some instances; however, if the condition that led to the scarring is not remedied, then even the best revision may fail.

Grafting into the scar is another option. Because yields tend to be lower in scars, this may take more than one surgical procedure over many months to have a significant cosmetic effect. Either body or scalp hair may be used; scalp hair is generally a better choice if it is available.

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