Losing Grafts After Hair Transplant?

Greetings,All techniques, including handheld FUE, strip technique, and ARTAS will have some transections or grafts which were damaged during harvest.  Our numbers (which we believe translates to most other hair centers) were around 35-50% transection rate with handheld FUE, 15% transection rate with strip surgery (due to location of bevel of knife along the whole periphery of strip), and less than 5% transection rate with ARTAS.  In my own transplant procedure, I had 1000 grafts harvested and 1 transection with harvest!!!  If a patient paid for 1000 grafts, does this mean they paid for 1000 harvest attempts or 1000 legitimate grafts.Best, Dr. Anil Shah

It may be grafts or it may be scabs.  If you are concerned please follow up with your doctor for an exam.You will have hair loss after surgery. You may have graft loss after surgery. Not all the grafts will take.  You won't really know until you see results in 6 to 12 months.

Thanks for the photo.  It's tough to tell from the pic but the story sounds very familiar.  Scabs will fall off and the hair often follows.  The follicle is generally integrated into the scalp.  Thus, a hair coming out at this point doesn't mean that the follicle came out.  That's unusual.

My apologies, but it is hard to tell on my computer the details of the photo.  It looks to me like this is scab (too large to be bulb) with hair shaft only.  It is possible, though unlikely,  that that many bulbs are attached.  This should be extremely unlikely in the hands of an experienced hair transplant surgeon.

You can loose just the shaft or the whole shaft and bulb after a transplant. Loosing the bulb is rare and it would be hard to know for sure before the 1 year mark.  A lot of it depends on how good the technicians are at putting in the grafts.  Also, how much supervision was going on i.e did the doctor observe and come in the room during the graft placement?  How experienced are the technicians? Are the technicians in house or contracted/subcontractors?  At this poing the only real option is to wait and see.

This is normal, but never, never pick them off or you will lose the grafts themselves. An FUE is treated just like
a regular hair transplant with regard to the recipient area, but the donor area
has open wounds which require daily washing with soap and water. Within 3 days
of surgery, you can resume full activities, heavy exercises if you wish. The
recipient area requires daily washes as well to keep the recipient area free of
crusts. I generally recommend the use of a sponge and supply my patient with a
surgical sponge to fill with soapy water and press on the recipient area daily.
By repeating this daily, all crusts can be washed off without any fear of
losing grafts. IF any crust are present, use a Q tip and dip it into soapy
water, and roll it on the crusts and that will lift them off without dislodging
them, but never rub them, just roll the Q tip on the recipient crust. I like to
see no evidence of any crusting in the recipient area and the crusts from the
donor area gone in 7-10 days with daily washing,.

Post op care: A I
don't like the idea of anyone removing grafts that have scabs on them because
we have published a paper in a formal medical journal, that when a person pulls
off a scab (crust) from a recipient area in less than 12 days, the risk of
losing the graft is very high.

Usually after 7-8 days you can start to play with the scabs so they fall off. You do not want to remove them forcefully as you may get some follicles along with the scabs. You need to still be gentle. Usually after shower or hair wash, the scabs are looser so easier to come out. Most of the time the hair shaft is attached to the scabs but the follicles remain. The follicles will start to grow in after 3-4 months and will continue for up to 18 months after the procedure. If you have pulled the scabs with the follicles then they will not grow.