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Bernstein Medical - Center for Hair Restoration
Hair Restoration Answers

If There is Some Bleeding at the Graft Site, Will it Affect Growth?

Q: I am currently 8 days post op. I started to massage my hair in the shower to get rid of the scabs. When I was done I looked in the mirror and saw two of my transplanted hairs were slightly bleeding but still intact. What does that mean? Did I lose the grafts? — B.G., Stamford, C.T.

A: If they bleed, but were not dislodged (i.e. did not come out), they should grow fine. Just be gentle for the next week. Generally, when follicular unit transplantation is performed with tiny sites (19-21 gauge needles) the grafts are permanent at 10 days. Since I did not perform your procedure and am not familiar with the technique your doctor actually used, I would give it the extra few days.

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Hair Restoration Answers

A doctor’s comment regarding the paper “Pre-making recipient sites to increase graft survival in manual and robotic FUE procedures.”

Q: While I was lying awake last night your approach of making sites the day before implantation came to mind. It takes guts to have spearheaded that! I am not aware that that precedent has been set in hair transplant surgery. I would have been timid about infection; it’s a lot like closing a wound with a foreign body in it the next day. As with most things, I am a little slow to jump on board something new so I’m glad you’ve paved the way. Do you have any hesitance about this or do you have enough experience that you no longer hesitate? I would be concerned that variations of the local flora might make a difference and that, accordingly, a large sample size would be necessary to get comfortable. Glad for all of us that you are still blazing trails. — S.S., Shanghai, China

A: Thanks for your kind words. No hesitancy whatsoever. We find no increased risk. Think of it as if you did a hair transplant and ran out of grafts. The remaining sites don’t get infected, they just close up. In the process, all those chemotactic factors involved in the healing process move toward the wounds, so if a graft is placed into them, they would be less likely to get infected than a graft placed into a fresh (non-primed) wound, not more. It is like applying the surgical dressing Duoderm to a wound that helps it auto-sterilize. Putting the speculative science aside, we have not seen one single issue with it. Give it a try with an FUE or FUT procedure. Make the sites, have the patient takes his normal shower that night and you will be pleasantly surprised how little bleeding there is the next day and how easy it is to place the grafts.

Read a summary of the article on pre-making recipient sites

Read the full article as it was published in the Hair Transplant Forum International

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Hair Restoration Answers

Is it Possible to Lose Hair Transplant Grafts Without Bleeding?

Q: Five days after my hair transplant I shampooed, rubbing the transplanted area vigorously using my finger tips and all the scabs fell off. Is it possible I have dislodged some of the grafts even though they didn’t bleed? If there was no bleeding, is it enough to assume all the new transplanted follicles stayed in place? — N.D., Redding, C.T.

A: At five days after a hair transplant the grafts are pretty secure, but still can be dislodged.

However, if there was no bleeding, it is unlikely that you lost any grafts.

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Hair Restoration Answers

Can I Have a Hair Transplant if My Scalp is Tight from Prior Surgery?

Q: What can be done if I want to have a hair transplant and my scalp is very tight from prior surgeries? — R.R., Long Island, N.Y.

A: Follicular Unit Extraction is ideal in very tight scalps, provided that there is enough hair to extract without leaving the donor area too thin and provided that the follicles are not too distorted from the scarring.

With strip harvesting, undermining techniques may be helpful to close the wound edges once the strip is removed.

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Hair Restoration Answers

How Long After Hair Transplant Can Grafts Fall Out?

Q: How do you know if you have lost any grafts after a hair transplant and how long after the hair transplant can you still lose them? — T.R. Easton, Pennsylvania

A: Each day following the hair restoration, the transplanted grafts become more fixed in the scalp and the hairs in the grafts become more dissociated (loose). At nine days post-op, the grafts are fixed firmly in the scalp – it has essentially become part of the scalp in the new area and can’t be dislodged.

The hair, however, has totally separated from the follicle by this time, so that it can easily be pulled out without dislodging the remainder of the follicle that contains the growth center. When this hair is pulled out (or is naturally shed) one often sees a tiny bulb at the end. This is the root sheath of the hair and not the growth center. This is normal and is not a lost graft.

If a graft is lost, an event that may occur within the first 3-4 days following surgery, it is almost invariably associated with a small amount of bleeding.

For details on how to care for a hair transplant, visit the Instructions After Your Hair Restoration Surgery page on the Bernstein Medical – Center for Hair Restoration website.

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