Wound Management

Having your hair transplant is just as important as post-surgical care. The secret to getting very fine scars that are minimally visible to invisible lies in the minimizing of tension vectors at the wound margins. Consequently, all my FUSS patients get two-layer closures. The deep layer, is the workhorse, it brings the wounds margins close or nearly touching by interrupted sutures. Then the superficial layer is closed with a running baseball suture. I use all kinds of sutures; always of course an absorbable suture for the deep layer, as this will stay in place. The choice of suture in closing the superficial layer is immaterial, as this suture will be removed anyway.

A few days after your transplant you may feel well and ready for anything but it is important to remember that wound management can seriously affect your results. A question many of our patients ask is when they can get back to their work out routines. Here’s the question from the patient and the answer directly from Dr. Arocha.

Q: When can I go back to the gym?

A: Wait one week to restart your aerobic routine. Two weeks and you can go back into the gym and do light lifting as long as you do not pull on the neck area.

Skin is plastic and has tremendous elasticity. That is why we call it plastic surgery, because of the skin’s ability to stretch. The scar or wound area is even more elastic because it is a weaker structure until that wound or scar matures. The maturation of a scar takes between six and twelve months. That is why it’s critical to limit weight lifting that pulls on the margins and by that I mean squats and anything that pulls on your shoulders and neck, which can stretch an immature scar.

For more information, please see: http://www.arochahairrestoration.com/en/art/104/

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AHR Dallas website launch

We are excited to announce the recent launch of our new Arocha Hair Restoration Dallas website. The new website features patient before and after photo galleries, links to all of our social media outlets, in-set video player on the homepage, and much more. Take a look at the newest addition to the AHR online presence.

http://www.dallashairloss.com

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The Temporal Peaks

Slideshare presentation by Dr. Arocha on Temporal Peaks. Presentation covers what they are, what their function is, and what can be expected during the surgical procedure. This presentation also includes before and after visuals of patients who have undergone hair restoration on their temporal peaks. A tremendous transformation can be seen in patients just by the restoration of their temporal peak areas.

Please refer to our Glossary Terms, Part III (final) blog entry for a temporal area vocabulary review.

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Eyebrow Reconstruction

Eyebrow hair loss can be a very traumatic experience for any individual no matter their age or gender. Statistics estimate that over three million Americans experience eyebrow loss in just one year. Eyebrows play such a crucial role on our faces. They frame the eyes and help to express the emotions we are feeling. Fortunately, there is an alternative to penciling in or tattooing eyebrows to restore a more natural result. In the Slideshare Presentation below, Dr. Arocha covers the eyebrow reconstruction procedure. Presentation includes surgical and before/after photos.

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Shock Loss

Recently, we received an email from a potential patient regarding shock loss, a phenomenon where the native hair falls out after a hair transplant (temporarily in most cases). Here’s the question from the patient and the answer directly from Dr. Arocha.

Q: I have thinning and receding of my hairline and the top of my head. I’ve tried Propecia and Rogaine, neither of which have worked for the past few years. I’m afraid that my hair will shock if I get a transplant and I don’t want anyone to know I’ve had anything done. What are the chances?

A: I am very glad first of all, that you’ve had the foresight to be on Propecia. It is the most efficacious medication there is to slow or stop the progression of AGA (androgenetic alopecia).

Poor surgical hair loss is seen rarely in our practice. That is when the hair surrounding the transplant falls out after the procedure. This can be immediate, from cutting existing hair with the site marking tool, but is not true shock loss. It is temporary because the cut hair continues to grow. True shock loss is when the hair adjacent to the transplant falls out, going into a rest phase, returning in 3-4 months.

With the tiny blades we use and the very refined surgical procedures used on our patients, the chances that shock loss will occur is very slim. If it does occur, it will regrow within a few months. If you follow pre and post op instructions, it will also increase your chances of preventing shock loss or other complications.

For more on shock loss, visit our friends at the Hair Loss Q & A Blog: shock loss article.

Another article on shock loss from Dr. Arocha.

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Glossary Terms, Part III (final)

Final installment of some common hair transplant/hair restoration terms (taken from the International Society of Hair Restoration Surgery). Unless written in italics, all content was taken from the ISHRS website.

Recipient Area: Area where hair loss has occurred and hair follicles will be implanted during a hair transplant procedure.

Slit Graft: Hair obtained from a donor site directly or sectioned from a larger round graft is inserted into a slit made in the scalp by the tip of a scalpel blade.

Temples/Temporal Area: The two upper outer corners where the forehead meets the hairline. This is usually the first area where male pattern baldness is observed, causing the hairline to recede.

temporal-peaks

Temporal Point: The two triangular shaped areas of hair located in the lower outer corners of the forehead, where the temporal hairline meets the sideburns.

Vertex Area: The area in the top/back portion of the head which contains a swirl or spiral pattern of hair growth. Also called the ‘crown,’ it may be the first area where male pattern baldness is noticed.
Vertex

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Glossary of Terms, Part II

Glossary of Hair Restoration Terms (taken from the International Society of Hair Restoration Surgery). Unless written in italics, all content was taken from the ISHRS website. To see a list of previous terms, visit this blog post.

Grafting: A variety of procedures where hair-bearing skin is removed from the lower scalp at the back of the head-the “donor area”-and transferred to thinning or balding areas.

Hair Economics: A theory that states only a limited or decreasing supply of hair exists, but the demand for hair increases as balding patterns develop.

Hair Flaps: Techniques to rotate large portions of hair from the sides and back of the scalp to the front and central areas of the head. Most effective when used with a tissue expander. See also “Scalp Rotation Flaps.”

Hair Follicle: A strand of hair and its root which is extracted from the donor area and transplanted to the recipient area during hair restoration surgery.

HairFollicle

Hair Grafts: Hair follicles that have been harvested from the donor area and are ready for transplantation into the recipient area of the scalp. The numbers of hair follicles per graft vary widely depending upon the transplantation technique used. A graft may contain a single hair follicle, a single follicular unit, multiple follicular units, or even 20 or more follicles (as in a large round graft).

Hair “plugs”: A slang term typically used to describe the large round grafts that were used more commonly years ago.

Hair Transplant: A surgical technique that transfers hair follicles from the donor area to the recipient area.

Hairline Refinement: or “Hairline Correction” refers to the use of a variety of newer, more delicate grafting techniques to alter, camouflage or soften the “pluggy” looking results of older hair transplant techniques.

Example of one of Dr. Arocha's patients with a transplanted hairline that looks undetectable.

Example of one of Dr. Arocha's patients with a transplanted hairline that looks undetectable.

Male Pattern Baldness: An inherited condition in men which is triggered by the hormone Dihydrotestosterone which causes gradual miniaturization (and eventual loss) of hair follicles. Starting anytime after puberty with a recession of the hairline and thinning of the crown areas, it can eventually lead to complete baldness at the top of the scalp. The areas around the sides and back of the scalp are not typically affected by male pattern baldness.

Micrograft: A graft containing 1 or 2 hairs, obtained from the donor area with a micropunch or sliced off from a round graft (see below). A micrograft is typically placed into holes made in the scalp with a microneedle or punch.

Minigraft: A graft containing 3 or 4 hairs (small minigraft) or 5 or 6 hairs (large minigraft). There are many variations of minigrafts derived from round grafts.

Multi-unit grafts (MUG): Grafts that contain two or more follicular units in a single graft. This term replaces the older “minigraft”. In practice today, MUGs contain 2-6 follicular units per graft.

Multi-unit grafting: Hair transplantation using multi-unit grafts. In practice, these grafts may be placed into small round holes, slots, or slits. This would always be in combination with the use of FUT in the same procedure.

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