Thank you for your question.
You submitted your question without a photo but you describe a situation in your question
where you went under 4400 grafts hair transplant but you describe is a failure because it was
a 15-20% yield and that there was a significant possibility that there was underlying scalp
fibrosis and calcification. And you want to know how you figure out that's the case
and you were about to undergo a third hair transplant. And you're asking maybe about
using magnesium oil prior to this hair transplant.
Well, I can share with you my perspectives on your situation and a little bit about my
experience in comparable situations in our practice. A little bit of background, I'm
a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years. Hair transplant
has been a big part of my practice for many years. I'm also the founder of TrichoStem™
Hair Regeneration Centers, a system we developed that non-surgically helps men and women with
genetic pattern loss. And we use regenerative medicine and technology that may be applicable
to a situation like you're currently in.
So to begin with, this unfortunately occurs more commonly in terms of the low yield of
transplanted hairs than is often presented in the transplant industry. We have had patients
who have had mega sessions and had more than 90% of their grafts not growing and these
patients were not done in our practice but they came to us. And it was practically like
they had no hair at all. So it's an entirely a possible situation.
You know, what I describe to our patients who have undergone transplant elsewhere or
have come to me for additional opinion about transplant versus Hair Regeneration which
I'll describe later, I explain to them first that understand that the process of transplantation
intrinsically is fairly traumatic. When people say I've had 1500 grafts, 3000 grafts or
in your case, 4400 grafts, well you've had 4400 stabs made into the scalp. And intrinsically,
there's going to be a vascular compromise, there's going to be inflammation and all
of those variables can play a role. Now the fact that you had a previous transplant is
significant. There is scarring that occurs with every transplant and it can have a certain
compromise in the integrity of the tissue.
Now many patients have come to us from around the world for this treatment we call Hair
Regeneration. Now Hair Regeneration was a discovery that we made based on the use of
a wound healing material when we were doing a lot of hair transplants. Basically what
we found was that thinning hairs became thicker. We were using a wound healing material to
improve the outcomes in terms of graft survival as well as the healing of the donor area.
Well, once we started using it for pattern genetic loss without surgical transplant,
it actually created now a new category to help people with thinning hair who would have
previously gone for a hair transplant.
Now as a cosmetic surgeon, I have been using this material for rehabilitation of tissue.
So for example, patients have come to me who have had multiple eyelid surgeries and they've
developed scarring and retraction and other issues. Well before doing another surgery,
I'll actually do what I refer to as tissue rehabilitation. And what I'll do is I'll
use PRP, platelet-rich plasma which is derived from your own blood which is a concentration
of the wound healing and growth factors that is necessary when you have a cut as well as
Acellular matrix. And essentially, what I believe is going on is I can see it from the
external perspective, the tissue gets healthier. It improves vascularity, improves the quality
of the tissue. And so, one of the things that I would consider in your situation would be
first tissue rehab before doing another transplant.
Another relevant example is patients who have had transplant elsewhere have come to us in
a window within the first 3 months of having surgery. And in those patients, we've actually
helped expedite their healing and we observed that the grafts actually grow sooner.
Now it is a difficult thing when you manage patients who have had transplants elsewhere.
And sometimes, I am a little bit more cautious because if they have had second or third transplant,
we want to be strategic. Sometimes I'll tell the patient, "Let's see how well
these grafts heal and then maybe after a year, when the grafts are healed, we can maybe help
you with the management of the scalp in terms of the existing hair to try to preserve and
prolong the lifespan as well as the tissue quality to help with the grafts once they've
settled in."
So there's certainly no specific right answer to your question. I think the magnesium oil
will have a limited value because just the anti-inflammatory potential benefit is not
enough to create healthier tissue. Remember, it's a hair graft. You're moving skin
bearing hair to skin and you need blood supply. You need the tissue to heal. After multiple
surgeries, the fatty cell layer under the skin, the scar tissue and other things can
actually be compromised to a level which can affect impact on the hair graft yield.
In addition of course, we also want patients to have their blood pressure checked as well
as be off of anti-inflammatories which can be blood thinners but I think that probably
already is covered. I think that it's important for you to learn about PRP, Hair Regeneration,
this emerging stem cell based technology to help with tissue rehabilitation to maybe help
improve graft yield for further surgeries. I think that this is something to discuss
with your hair transplant doctor. Remember, your donor area and probably, you might be
even going beyond the donor area and going to body hair at this point is always going
to be limited and every hair that doesn't take is a hair that's lost. So make your
decision very carefully.
So I hope that was helpful, I wish you the best of luck and thank you for your question.
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