overharvested spot?

Bmore

IHTI Staff---

I had a procedure a couple of weeks ago and have noticed that the left side of my donor area, above my ear, is growing in noticably thinner than the same location on the right side. It is also still quite pink in color, while the right side is back to it's normal coloration. Upon reviewing post-op photos, I noted that a higher percentage of grafts were taken from the left side versus the right. Why the disparity? Isn't symmetry important? Also, could the pink color on the left side, which I assume is some sort of inflammation, cause the hair to grow back more slowly than on the right side?

Let me have your thoughts. I can send photos if you think they would be helpful.

wassup

Bmore - I hope someone from IHTI responds about this because I had the same thing happen with me. I had one area on the right back side of my donor that I could have sworn a ton more grafts were taken out of than any other area. It totally felt thinner, seemed to heal a little slower than the other areas and seemed a little more pink than other side. I thought for sure that I would have had a visible square patch on my right side when grown out. But a few months later when my hair did grow out, it totally looked and felt the same all over. So in my case, I'm not sure if there really was that much more harvested from this area and or if this area patch was actually shaved down closer to the skin and the uneven hair helped contribute to this weird feeling along with the lagged healing process - note sure. hopefully in the end you'll be the same as well. I'm uploading some picts to supplement the area I thought was way too thin or irregular post-op... the shaved down pict is maybe a day or two after surgery and the grown out pict is from about 5 months.

on a side note, picts like my 5 month donor pict make me step back and think wow I can't believe I've had almost 7k of grafts harvested out of my donor... awesome job Dr Cole and staff! you all do some amazing stuff!

Bmore

Thanks, I hope someone from IHTI responds as well.

forhair

Bmore, send the word doc to me and i will post it for you...

Bmore

Here are the pics:

Bmore

Here is a close-up of the left side only: Wink

drcole

It is not uncommon for one side of the scalp to be a little thinner than the other side of the scalp. I don't have hair loss, but the right side of my scalp has less hair than the left side.

We do our best to spread the removal of hair throughout the donor area so that the areas are equal following a procedure of FIT. Sometimes there are factors that affect our capacity to do this. For instance, sometimes we might take only from one side of the scalp when we are attempting to get high numbers and expect that we will need to do more work later on. also, prior procedures and strip scarring can affect the the yield. if i see a lower density on one side compared to the other, i might take more from the side that has a higher density to begin with.

currently, i divide the donor area into 14 quadrants. i do my best to spread the extractions out over the entire area. i also measure the pre-procedure density and then record the total number of extractions. in this way i can monitor the percentaqe of hair that we remove from each quadrant. This is a newer protocol for us, but it does help us to quantify what is in the donor area and what we remove.

shock loss in the donor area is extremely rare, but it can occur. i've seen two cases. one was my patient and the other was a patient of another physician following FIT. The donor areas did grow back in.

pinkness is a sign of inflammation. usually it means the area is still healing and the increased blood flow that helps deliver healing cells is the reason for the pinkness. it can also signify infection. i have never seen a case of infection in over 9000 hair transplant procedures, however. an infected area would be warm and tender.

photos are a good thing. It cetainly helps to point out the problems. Shock loss does remain a possibility. an in person evaluaiton would be advisible in the future so that we can measure the densities on both sides. we can always add more hair back to the donor area. body hair makes a good source to replenish the donor area. of course if you need more hair, the solution is to simply take hair from the opposite side the next time so that the densities are more equal. i would give the possiblity of shock loss time to resovle itself. removal of 20 to 25% of the hair is usually a maximal extraction pattern for a single procedure. this would be very unlikely to lead to long term difficulties with density.

we appreciate the feedback. feedback helps us to refine our procedures and methods. when you are the inventor of a procedure and the worldwide leader in a procedure, you have no one to learn from except the your own experiences. in other words, we will occassionaly make mistakes in our methods. the important thing is for us to learn from our mistakes and continue to refine and improve the procedure.

Bmore

Dr. Cole---

Thank you for responding.

It isn't an infection, as it is returning to its normal color and is not really tender or hot. Shock loss is possible I suppose, as is overharvesting. It was rather thin in that area to begin with. Maybe I can meet up with you at one of your D.C. consultations this Fall and have you take a look.

As to body hair, I am reluctant to move anymore scalp hair with the possibility of Hair Multiplication around the corner. I will need some good quality scalp hair for that. Body hair transplanted directly to the scalp to provide additional density is a possibility though. I have a decent amount of chest hair, as long as scarring is not an issue.

I'll keep you posted.

Bmore

forhair

drcole

sure, we can talk about the situation, the short term, and whether anything needs to be done. often time these situations simply take care of themselves.