About to have surgery - questions

[Mimi]

Hi,
I am a woman who will be having surgery with Dr. Epstein the third week in February and I wanted some honest opinions on the following:
1. Unfortunately I need to travel to Brazil (from the US) exactly 6 days after my surgery for my job. Do you see any problems with this? I can not reschedule this trip as a lot of people are involved. My hair transplant will involve the frontal hairline and sideburns as well as some parts of my hairlin in the back of my head. He said 1700-1800 grafts.
2. If I wear my bangs down over the transplants and cover the sides with my hair, do you think I can get away with no one noticing or will I be swollen and red?
3. I'm told Dr. E now uses dissolving stitches so it shouldn't be a problem with removing the stitches.

I did a lot of research on this Doctor but am now so nervous about somebody finding out. I would so much appreciate any feedback.

Thank you so much.

 

[s.a.f]

Will he be shaving down the recipient area? You will still have scabs at 6 days so you'll need to have plenty of hair to cover the new grafts. How long is your hair? 1700-1800 over the hairline and sides will not cover alot, I mean it must be a very small difference.

 

[DaveOne]

Can you wear one of those headbands/scarves? I've seen women wear them in offices from time to time, you could probably get away with something like that, right?

 

[Mimi]

Gosh, I'm not sure if he will be shaving the recipient area or not. I think I may send him an e-mail this evening. I have a very narrow white scar along my hairline on my forehead and that is what I want covered. It is my hope that he will be able to "feather" hair along that scar to hide it. Also, I was born with a hairline that curves in along the top sides. He is going to put some follicles there as well so I can be more comfortable wearing my hair back. Hmmm. I thought i1700 - 1800 seemed like a lot of grafts but maybe it won't take that much. I have bangs right now that come down to maybe the middle of my eyes if I pull them straight. I guess I was hoping the scabs would be hidden by my bangs but I do want to be realistic. It's going to be so disappointing if I have to reschedule this long-awaited surgery because of work. I also want to be sure he is using the dissolvable sutures. It seems like they tout this as being very easy, no big deal surgery-wise, and I just don't want to be surprised later. May I ask how long before the scabs do fall off? Also, how much time does one usually take off from work when having a hair transplant procedure? I do appreciate your replies so much. THank you. MImi.

 

[Guest]

Mimi,

First of all, I would never recommend that anyone would have their hair transplant procedure that close to a trip like you described. And most patients like yourself, do not want others to know you just had a hair transplant procedure. Dave had a good suggestion which is one I often recommend with the headband scarf.. But there are far more post-op issues to consider, then I'll comment about the graft count in your hairline.

Potentially, and as rare as it may be, you could be one to have forehead swelling that extends into one week or more. I often refer to it as the 3/3 rule. Post-op swelling in the forehead usually shows up 3 days after surgery and then lingers for another three days. It can also droop into the eye areas or make the eyes look a little puffy. Most patients take a week to ten days away from work for this reason. The scabbing/crusts take abot 8-10 days to fall off. I mean at 6 days post-op, you're just about there, but not quite.

Ask your Doctor about any post-op healing application that you can spray on the area. Many of us use a product called Graftcyte which can advance the rate of healing, It is a product specifically developed for treating the recipient area for post-op hair transplant patients. You can also apply a dilluted saline solution that again can be sprayed to the grafts post-op. Saline can also advance the rate of healing. Take additional vitamin C too post-op. Did you discuss any of this with your Doctor before you made a decision to move forward?

Now your graft count. I don't want to speak for your Doctor for two reasons. I respect him and I am not a physician. But possibly he informed you that whenever working that close to one's existing hairline OR creatinbg a new hairline, most of those grafts are single hair grafts. As we know that's how a natural hairline is established. Do you know how many of the proposed graft range will be single hair grafts?

All good questions to ask in the consultation far ahead of the actual procedure.

Lastly, I did not get the part of putiing grafts in your hairline at the back of your head? Or were you referring to where he is excising your donor strip? Best wishes to you.

 

[Mimi]

Gillenator,
You bring up excellent points, some of which I've never thought of. My only consultations with Dr. Epsteins have been via e-mail with pix. He never said whether they would be single hair grafts or not. From the material he sent though, it referred to grafts with three or so hairs in each. He did say I should be able to wear my hair up and/or back when he is through with me.
I am seriously worried about the Brazil trip. I maybe have to travel two or three times a year and I scheduled this surgery in October. Then last week I found the team is shooting for February 26 for Brazil. I am the main financial person so I have no alternative if this deal goes down. WHy does it have to happen like this? I can only pray it tanks.
Dr. Epstein's material does mention the graftcyte and the vitamin C. I will do everything I'm supposed to to assist my healing. Unless I'm in Brazil and can't get any privacy other than a couple hours a night. WOuld you truly think I should postpone my surgery? If so, I'll wait until I'm sure about work of course. I wonder if I'll be charged a fee for cancelling.
I still don't know though if you think my bangs will cover the scabs so I wouldn't need the headband. I'm one who will look like a dork with a headband. I'm writing to Dr. E tonight and will ask him that as well as the question on single hair grafts. I have corresponded with two other female patients of his and both are thrilled with their results. I just want to be one of those. I fly home the day after my surgery and I will bring a hat. I mean, how big can those scabs be? I just have to make sure I keep my hair all around my face and don't flick it back or I'll really scare people.

Thanks for the help. I know this is a men's forum but everyone seems knowledgeable and I couldn't get much response on the exclusively women's forums I tried.
Mimi

 

[Guest]

You're welcome Mimi and I apologize that I have not replied earlier to your last post. A couple of more things.

You and only you know yourself the best regarding your comfort zone post-op when you are around others. Chances are everything will go just fine but I have worked with countless women and can tell you first hand that there are more variations compared to men. Let me explain.

I have observed that shockloss in very unpredictable and even more so with women. I attribute that more to the diffused patterns of hairloss that seem to be more profound with females. Not to say they do not recede in loss, but that's something more prevalent with males. Women tend to diffuse in Ludwig patterns and many times it impedes their entire scalps. That does not sound like your situation though.

Still, the more recipient incisions that are made, the more trauma it instills in the scalp unless the incisions are spread out from one another. In other words, some hair transplant docs do not like doing more than 20-30 FU cm2 when there is existing natural hair in the recipient area they are grafting in. The more natural hair is existing, the more there is to shock out.

It was nice that you received those pics of multiple hair bearing grafts however I doubt that will be used on the transitioning point of your existing hairline. Only single hair grafts are used there or it does not look like the work of mother nature so to speak. If you have a wide hair to scalp color contrast, double and triple hair grafts will not look right commenicng the hairline. So single hair grafts can achieve that natural look but obviously do not provide as much coverage as two's and three's.

But keep in mind, your Doctor knows where he is putting your grafts. I know nothing about you or your case and I am not a doctor. I am only commenting on what techniques are widely accepted and practiced by the best hair transplant docs worldwide. The things I have observed in the OR and hair transplant patients over many years from many, many docs.

Back to your comfort zone. The sacbs are not big but the copper content in the GRaftcyte will make them appear black in just a couple of days from spaying. Although your bangs will hang over the crusts, ask yourself if you can still see parts of your upper forehead. If your bangs are so thick that you can't see anything, you should be fine. However if you can see some scalp through your bangs, it might be an issue. You could have some lingering redness that could potentially cause some eye drift from others. Also ask yourself how close you allow others to get to you in conversation. You can also pat some foundation over the crusts to color them, but it's all in your comfort zone.

Don't forget about forehead swelling and the 3/3 rule. Will you be uncomfortable with that, should it occur? So in conclusion, if your feel you would freak out if anyone started eyeing your forehead or would just die if anyone would know, DON"T DO IT so close to your travel. Do it when you can safely take at least a week off and away from everyone. Just have your Doctor hold your deposit until the time is right and works to your advantage, not to your disadvantage.

One last thing about women's hairloss. I have a good friend in this industry and his name is Spencer Kobren. Go to the baldtruth.com and you will see a link for hairloss treatments for women. There you will find another link which will bring you to the "women's hairloss project" where you will find a wealth of information and will also be able to chat with other women suffering from hairloss. IMHO, it is the most helpful progressive site for women and it's free.

The bottom line is that I wish the very best for you Mimi. My own mother suffered from dramatic hairloss from her mid-twenties until present time. She is 82 now but we have been through this togethor. Stay in touch. You can e-mail me too if you want.

 

[Mimi]

Thank you for the information.

I did e-mail Dr. E and he said I should be fine to go to Brazil one week after surgery. We still aren't sure of the dates though so I'm hoping and praying it will be more like two or three weeks after. At any rate, I will go back to work 6 days after my surgery. Dr. E said that should be toward the end of the period of the scabs falling off. I didn't realize they turn black. That is scary! I will for sure try concealer on them. I have blondish hair so they may very well show through. It is worrisome for me.

Also I asked Dr. E if he did single hair transplants around the hairline and he said of course he did and will do whatever looks the most natural. The shockloss thing is new to me and also horrifying. I just looked at thebaldtruth.com site, thank you, and find that at least I am a candidate for whom transplants may make sense. I didn't notice any type of forum on that site though. My surgery is February 19. I will google the shockloss now.

Mim

 

[youngnat]

Hi there

firstly im no expert, and this forum has provided me with great information based on everyones experiences, its nice to know im not alone!

I had hair transplant surgery recently, firstly i need more, secondly it wasnt all that painful... i was really nervous but after the sedative i was on cloud 9 and 2x nearly fell asleep on the op table only to jolt myself awake haha.

Ive heard about the post op swelling (possibly 3-5 days after the op) and i just hope you dont get it, however its totally acceptable to wear a scarf or head bandanna, im a contractor doing web development and going back to work tomorrow, im going to wear a hat and let the manager know why im wearing it.... no big deal and people these days are understanding, if he does have a problem i guess he better get himself another developer in and quick smart!

whatever its gonna cost me im gonna get back a satisfactory density in my hair, its affected me mentally, i often stay home because im so self conscious, 10 grand is worth my life back.

 

[Guest]

Mimi,

Well now you are hearing more consistencies so that must be some relief. You see, he will be using single hair grafts after all.

The reason the crusts turn black is because of the copper content in Graftcyte. Don't worry though, the crusts won't be large because the coronal incisions for the single hair grafts are hardly invasive at all. They are tiny micro-incisions. And like I said ealier, a little foundation will work just fine. And yes, I agree that roughly 7-10 days post-op are when the crusts are ready to come off. Basically, they are ready to come off once the epidermis (outer) layer of scalp tissue is completely healed. The Graftcyte will help advance the healing. If you do use Graftcyte, you will end up spraying the recipient area routinely for three days following the procedure. You want to use up the entire bottle within those three days. You can ask Dr. Epstein about spraying the area with saline as well in case you won't be using Graftcyte. Either way, obviously follow his advice.

I doubt that any sense-packing will be done based on all of the information you provided so chances of you having high levels of shock are not likely, but one just cannot predict it because patients respond to trauma differently. My only point is that it is a risk and anyone needs to be aware of it upfront.

Patients also respond to medications differently and also in how they heal. If you ever get a scrape, cut, and heal normally, you'll be fine in my opinion.

I am happy to see you do your homework on this. The more facts you obtain and the questions addressed, the more informed you are before you have this done. I wish you the very best Mimi! :jump:

 

[Mimi]

Thank you Youngnat and Gillenator,
Youngnat, you sound as if you're coming along well. I hope I am so lucky. My surgery is this Tuesday and I'm getting a little nervous, having trouble sleeping, etc. It looks as if my long trip will happen first week of March so that is a huge relief that I don't have that six days later.
Dr. E said to spray the graftcyte on every half hour for the first three days. I'm going to have to go into the bathroom on the plane on Wednesday to make sure I spray!. He said he will send me to my hotel with a bandanna on. Then I have a big floppy hat for the plane ride home the next day (I believe I will rather look like Henry Fonda in On Golden Pond)!
Right now I live in a small town in Michigan and the weather doesn't look too good for my travel on Monday...I'm not usually such a worrier but this has me going....what if the planes are grounded, etc. It does happen here more than I care to say. Oh well, that I can't control.
I will let you all know how it goes.
Thanks again.
Mimi
Thank you for your help and good wishes. I appreciate it more than I can say.

 

[Guest]

It's a pleasure to be of help Mimi.

It's now Friday, you are three days post-op. How is everything going Mimi? Did everything work out okay?

 

[R U GOING BALD]

Mimi
Hope everything went well for you, let us know how you made out with the procedure. I was thinking about going to your Doctor.

 

[youngnat]

hi mimi, trust me we all know what happens and what you go through mentally!

i wore a hat, just as an update... to work, everything was all good with it. I did get a few quizzical looks at first but if i needed to i said "excuse the hat there is a reason" and people were good about it, we are all adults after all right?!?!

i know i looked worse, which is what im sure you are going through right now (did you have ur hair transplant yet?), but dont worry...

if you havent yet used a concealor, think about it, if you have hair on top (assuming you arent bald) then concealors are magic in a bottle, i use one like toppik and its called megathik, ok i know it has its limitations but far out! its like i have a full head of hair!?!?!?! i only just got some last week and it has hidden my little scabs quite nicely, good enough that 2 weeks post op and i have taken my hat off, my sister, mum dad grandma friends all dont know ive had a hair transplant at all, this stuff may not be for everyone but its given me back my confidence to go out without a hat on, and depending on where your scabs/scars. suddenly my hair looks thick again, its awesome. i dont care what others say about concealors this stuff works for me and thats all that matters... myself (not trying to sound selfish but its that self confidence we all crave right), and it looks entirely natural.

oh another thing, my head damn is it itchy! must restrain from scratching! haha, my head is itching from the healing, and now my stitches are out (all good).

 

[Mimi]

Hi Everybody,
Thank you for your concern. I had my procedure on Tuesday in Florida and it was quite amazing to me. Dr. Epstein had me take a prozac (although there was also a stronger option if I wanted it). Before I knew it, he said he had already removed the donor strip and was in the last stages of stitching it up! I couldn't believe it as it didn't hurt. He had told me my procedure would last about five hours. They started about 9:00 AM and it really lasted until about 4:00 PM with about a half hour or so out for lunch, so it was longer than expected. I had lost hair along my hairline in front and had some minor scarring due primarily to an accident I was in many years ago and the resulting surgery. IN addition, my natural hairline had always sort of receded along the temples in a sort of "M" hape. So I wanted my temples filled in and some along my front hairline to hide scarring and previous hair loss.
Dr. E first drew the new hairline and had me look in the mirror. Then after he removed the donor strip, about five or six people worked at microscopes separating the follicles (I'm not sure how technically correct I am with this stuff). THen he had two of his staff (one on each side of me) putting in the new grafts. I was surprised at this as I had thought he did this all himself. They were wonderful, caring, compassionate and singing away to the radio the entire time.
After lunch, my head really hurt in the back when I was lying on the table. I told them so and they said it was normal. HOwever, when they were cleaning me up toward the end they discovered that I had not been fully stitched up. Dr. E came in and did that. Then again, they called him in as once again it appeared there were problems with the stitches in back. This time he took a while longer and did it again. He said that my hair was the exact same color as his sutures so I'm not sure if that contributed to the problem or if it is because my hair is maybe four or five inches long back there and he was having trouble seeing. ANyway, that part didn't make me happy at all and sort of frightened me. Also I didn't realize the donor site would be as long as it was. It sort of curves in the back actually from right about mid ear level then down in a semi arc and back up on the other side. He said most of the time the scar is very inconspicuous and heals to be about 2 mm. I hope he's right.
The next morning I went back to have my hair washed and he again examined me and said all looked fine. I then went directly to the airport and arrived home about 12 hours later. During the end of the trip, my head bled a little in back right through my floppy hat (I looked like a real idiot in the hat).
My biggest problem now is that I am afraid to scrub my scalp in the back and I still have a fairly large patch of dried blood on one side of my head. Also, I'm not aware that any scabs are falling off yet and I have to go back to work tomorrow.

If any of you can help me with these questions, I'd really appreciate it:
I plan to vigorously rub my scalp in the back with shampoo today and stay in the shower until the blood is gone. I have washed my hair each day with a large plastic measuring cup, slowly pouring the water over and I haven't been able to get the blood off, although it is better than when I started. Today is day five for me but his instructions say on day six I should be able to begin lightly rubbing the graft area to help remove crusts and shower normally letting the water hit my scalp. Do you think this should hurt anything?
Secondly, I plan to use a hair dryer today to style my hair. Do you think the heat will hurt? I will try my best to keep it away from the graft areas but I have to go back to work tomorrow and so I must somehow hide the grafts. I'm sure I can do it with my existing hair and bangs as long as I can use a hair dryer. If I can't use a hair dryer I'm toast. I am going to try to start researching that immediately.

I do want to mention that I have no complaints about the whole process other than the stitches. Dr. E called me the first evening to make sure everything was okay which was nice. The entire process was very organized, they gave me the graftcyte, the toppik powder, tylenol with codeine, antibiotics, anti swelling meds and probably one or two more. So I didn't have to get anything. They also sent me out with a bandanna on my head.
Sorry for the length of this thing but I thought if anybody hasn't gone through the process yet, it might help.
Mimi
The next day I went back and they washed my hair.

 

[s.a.f]

Glad it went well for you, You're luck as a woman you have long hair to cover the strip scar. Dont be too rough with the scabs though. Cant you hide them behind a loose hairband?

 

[Guest]

Wow. Startled to hear of the mishap with the sutures. That is not something that happens very often. The color of your hair, etc has nothing to do with why the area was not completely closed. But it was corrected so at this point, you no doubt are doing better, the crusts are gone, etc.

Did you have any post-op swelling in the forehead area? Hope you are doing well Mimi.