Is shockloss more prevalent around the trichophytic closure or within the recepient area?

Donor area

For me it was the donor area both with regular closure the first HT and with the trichophytic closure the second HT.

However, I did get recipient area shockloss both times also. Just not as extensive.

I GET SHOCKLOSS from HT's!!

Edit: The second HT is only 10 weeks old, so we have to see how that shockloss goes.

I have some nice looking blank spots in my donor as I write this!!

There are multiple variables to this answer. It can occur either place and depends on technique and closure. Usually in the donor area, it is due to tension on the wound edges.

quote:

it is due to tension on the wound edges

Thank you Dr. Mejia. That was insightful. So since there are multiple variables, is the tension at the wound edges is the main one?

I only experienced it around the donor scar with both hts. it grew back both times.

quote:

There are multiple variables to this answer. It can occur either place and depends on technique and closure. Usually in the donor area, it is due to tension on the wound edges.

dr. Mejia:

There is zero tension in my scar, yet i have some shock loss. Are there other causes for shock loss? Can dissolvable sutures be a cause?

Thanks.

There is a much higher chance of shockloss with increased tension. You can still get shockloss simply from the surgical trauma induced. Other factors include trauma to underlying vessels arteries with reduction of blood supply, infection, wound dehiscence, hematoma formation. I recently had a patient come to me from Costa Rica with a pseudomanas infection and wound dehiscense of the donor area.

Dr Mejia I know a guy who had a failed strip transplant and he says his recepient site was really never pink ,more grayish .
Have you ever seen a case like this

Dr. Mejia,

These factors that you have mentioned are somewhat worrying. I have added the definitions for the educational purposes.

I have a couple of questions:

1.What steps can a patient, as well as a surgeon, take to reduce the tendency to shockloss(with respect to all contributing factors)?

2. Is wound dehiscence and haematoma formation common or rare?


Thanks for the input Dr. Mejia!


DEFINTIONS:

Wound dehiscence is the premature "bursting" open of a wound along surgical suture. It is a surgical complication that results from poor wound healing. Risk factors are age, diabetes, obesity, poor knotting/grabbing of stitches and trauma to the wound after surgery.[1][2] Sometimes a pink (serosanguinous) fluid may leak out.


A pseudomonas infection is caused by a bacterium, Pseudomonas aeruginosa, and may affect any part of the body. In most cases, however, pseudomonas infections strike only persons who are very ill, usually hospitalized.


A hematoma, or haematoma, is a collection of blood outside the blood vessels,[1] generally the result of hemorrhage, or more specifically, internal bleeding. It is not to be confused with hemangioma which is an abnormal build up of blood vessels in the skin or internal organs.

Definitions by kind acknowledgment of the following:

http://legionella.info.ca/pseudomonas.asp

http://www.healthatoz.com/heal...monas_infections.jsp

http://en.wikipedia.org/wiki/Wound_dehiscence

http://en.wikipedia.org/wiki/Hematoma

MMHCE:

See my topic on understanding shockloss. In the right hands hematoma formation and wound dehiscence is rare. Keep in mind while some things sound worrying, we are dealing with a surgical procedure with many variables. As surgeons, we are very careful regarding all of these variables to limit any complications. I don't think there is any surgeon in the world practicing for many years who can honestly say they have never ever had a complication in any type of surgical discipline They are rare, but can occur. Hence the informed consent.

PLease grow. It is possible to get failed transplants due to too much trauma and damage in the recipient blood supply. We do monnitor the recipient area carefully to assure we do not get any dusky areas that could "potentially" comprimise the vascular blood supply. With the newer smaller instrumentations, limited depth of incisions and tumescence, this is avoided. There can be other unfortunate albeit rare cases of while failed transplants have occured which have been covered in previous topics.

I just had another HT on 11/19 to fill in the top and back towards the crown. There's a decent amount of existing hair (albeit thinning some) and the implants were placed throughout. I did not experience any noticible shock loss in the recipient area. I have however experienced some shockloss at the ends of the donor area. This was a second 2500+ HT and even though I have pretty good laxicity the tension was more noticible this time. The shockloss isn't really noticible since the hair around it covers it. I haven't worried about this too much since I've heard this is common but it's nice to hear Dr. Mejia's comments on this and I'm sure it will be growing back shortly.

Does shockloss happen to anybody who gets a HT? is it just a common thing or is it 100% bound to happen? its been a month since mine and its hard to tell but it could be thinning underneath the recipient area

Would I have a lower chance of shock loss if the surgeon is lowering my hairline without going into my existing hairs? Thanks!

quote:

Originally posted by Rachmunas4life:
Would I have a lower chance of shock loss if the surgeon is lowering my hairline without going into my existing hairs? Thanks!

From what i have seen and read, shock loss rarely occurs in the recipient area, regardless whether grafts are implanted between native hairs or not. Even when it occurs, it is even more rare that shock loss is permanent. As mentioned by dr. Mejia in another recent thread, IMO the issue of transection of native hairs is a non-issue as it is very difficult to actually kill a native follicle.

Shock loss in the donor, however, seems to be more common. It happened to me, but it is not such a big deal, as hair is covering the shock loss region. I just need to tough it out and wait for regrowth.

Thanks for the comment! I wouldn't worry too much about shock loss in the donor area for myself. I was told by each surgeon I met that I could keep my existing hair length, where my hair is rather long (bangs reach my nose). I would have my native hair cover the transplanted hair. The donor site and recipient site should be hidden immediately.

I just hope that with my existing hair being long, that it wouldn't damage the grafts in the recipient area because it would be touching the new hairs? I heard you have to be careful with the transplanted hairs the first 2 weeks on here.