Hair Restoration surgery is evolving rapidly and we are consistently refining our approach on a regular basis to improve the quality of transplanted hair while at the same time minimizing the possibility of complications. Double edged trichophytic closure is a new approach to donor wound closure that has been put into practice by Dr. Mohebi and US Hair Restoration.

Double edged or two sided trichotomy can help to minimize complications of trichophytic closure (based on the width of epithelium that is being removed and inability of some the hair follicles or oil glands to find their way out to the skin surface). This practice of double edged closure helps us to minimize the width of the top skin layer (epithelium) that is removed from each edge of the donor wound. By making these changes, double edged trichophytic closure allows hair to grow into the wound from both edges and thus minimize the contrast between a patient’s scar (with no hair) and surrounding scalp (with 100% hair density).

By employing the double edged trichophytic closure in our pratice, we constantly have results of less detectable donor scars. In addition to less detectable scarring, we are also able to minimize the risk of folliculitis or ingrown hairs in the donor area, which are the two of the most common complications of traditional trichotomy.

Q:
Several weeks have passed since my hair transplant surgery. It has come to my attention that there’s a small bald spot near my left ear. As told, I was keeping that area clean the last few weeks, but no hair has grown back, it is still the same. I do not think it is getting larger. For some reason, the bald area is more sensitive to heat or cold temperatures. I was washing my hair today, and a scab fell off, but it was about the same size as the bald spot.

Another thing, I feel numb in the surrounding area of the bald spot. For me, I’ve never seen a bald spot in my donor wound until now. I’m wondering what I can do about it. I guess trauma leads to falling out of hair in donor wound areas as well. Just to let you know, I’ve been taking doses of finasteride daily, before, during the time I had surgery, and after surgery. Comparing to times past, I think I’ve taken pretty nice care of my head vs. the other times I had hair transplant surgeries, so I’m a bit concerned.

I wonder if the hair will ever grow back, as long as there isn’t a scar over it. My bald spot is about the size of a silver dollar; it looks quite noticeable. The bald spot has been overly sensitive the whole time after the surgery, but it wasn’t infected and there was no blood oozing out of it. I’m thinking that maybe the hair surrounding the wound fell off because of shock.

Your advice would be much appreciated,

A:
I appreciate the email.  You guessed right about the hair loss probably being caused by shock around the area of your donor wound. There must have been really tight close-up of the donor area. Maybe the hard close-up caused the shock loss. The two areas, on either side of the scalp, are very vulnerable to shock loss. Usually, when shock loss occurs, it happens on both sides. Shock loss occurring around a donor wound is, most of the time, reversible. It takes about six months for hair lost because of shock loss to grow back. It’s a slow, but certain process. Stay patient.

At this time, there is not a lot that can be done. But it is important that a doctor takes a look at your shock loss. Also, the feeling of numbness in the donor area will last up from a few weeks to months. The numbness is caused by inflaming of the healing area, this has an effect on the nerves in that area. It will heal on its own time.