FUE donor healing: Am I healing slower?

Steve

9 days ago I had 300+ FUE procedure, and I'm concerned about the healing of those donor sites. First of all, the sites are still a little sore. It doesn't hurt, but I can clearly feel soreness in that area without even touching it.

Second, the sites don't seem to be healing impressively. The sites have healed to the point where they've sealed up (i.e. there's no blood or puss coming out), but they are slightly depressed and are still a purplish/red color. I know they are depressed because if I wipe a colored cream over the sites I can seem them clearly. This means the surface doesn't match the scalp. I've seen other healing pictures on either this site or another and my progress seems slower than what I've seen. Can anyone comment on what's going on?

I'm hoping that the soreness means that I'm still undergoing a lot of healing, and more healing means potential for better looking results. I seriously hope I'm not at that point where healing is basically done and progress will now occur at a snail's pace (like when you get a scar, it heals, then takes another 10 years for the scar to actually become unnoticable.

Also...

I've been applying various creams to my skin. I don't want the skin to ever dry out and I'm hoping that the compounds aid in healing. I've been applying some scar-removing creams and Vitamin E by breaking the geltabs and rubbing the subtance on my skin. Since my sites have healed depressed instead of raised will scar removal substances make the holes deeper?

I've also been applying desitin at night, and a retinol cream once during the day. Desitin has impressive healing characteristics that I'm hoping will occur here and I've read that the vitamin A in retinol is useful for the skin when healing.

I'm also taking oral green tea, L-Glutamine, and a multivitamin with zinc. I take them anyway but during my research on healing skin damage their names popped up too so I'm hoping they're helping.

forhair

Hi Steve,
man, you are still early in the game...there is no need get panicked in this stage.

9 days out is just the beginning of healing. It takes about 6 weeks for collagen to be laid down in the area. They are pretty much supposed to be reddish/pinkish at this stage.
You needs to let the healing take place. Also, inflammation is part of the healing process; that may explain the "soreness".
I would advise you against using the retinol cream. Just use moisturizers and realize that it is really too early for scar removal products. You do not even HAVE scars at this point in the process!...just redness that will disappear in time, every patient has a different healing time and yours is maybe slower.

FIT Club

I would concur with what Forhair has stated. Your description is well inline with 9 days out. I would not even charactarize you as a particularly slow healer, this is just common for this stage.

Regards,

FIT Club

Steve

Thanks for the replies everyone, but if you wouldn't mind I'd like to pick your brains some more Very Happy

1) The coloration of even the worst FUE scars I've seen online seems OK to me, but what really worries me is the potential for pits. Forhair, you mentioned "It takes about 6 weeks for collagen to be laid down in the area", so is this the reason why the donation point surfaces don't match the surrounding skin? Enough collagen just hasn't been laid down to fill the area? You also recommended avoiding the scar removal stuff for now. Don't scar removal creams actually attack collagen buildup? At this point would scar removal creams actually harm my body's attempt to fill in those FUE donation hole?

2) I read (on this site actually) that one of the reasons for hypocoloration of a mature scar is that during the healing process inflamation can result in the body's immune system attacking the cells that create pigment. One of the recommentations was to apply an anti-inflamatory to the sites. Should I apply hydrocortisone (or something similar) to my FUE donor sites to avoid this problem? If so, how much/often/ and for how long should I apply it? Should I also apply it to my recipiant site? (It's healing nicely but is pink)

3) What exactly is the redness anyway? Does the body lay down a network of blood vessels to supply the nurishment to build the new skin?

4) So I should avoid retinol and scar reducers for now and use moisterizers. Should I also avoid applying the oil from Vitamin E capsules ? I've heard that E is a great scar reducer so that's why I think I should stop applying it, but on the other hand I've heard Vitamin E is helpful to skin when healing. What about Desitin? As oily as it is I'm sure it's a great moisturizer but it smells and is difficult to clean off. Does it nurish the skin in any useful way or should I just stick with stuff that is more pratical to use?

I think the reason I am worried is that I saw this guy:
http://www.forhair.com/hairtransplant/topic1131.html?highlight=healing

And his photos at day 4 and his donor sites look smooth to his surrounding skin and overall look more healed than mine at 9 days. I know "your mileage may vary" but it still makes me nervous! Confused

Thanks everyone[/url]

FIT2Btied

Frankly, I think you're thinking too much, Steve
I don't say that in a negative way, because I also am subject to this kind of overthinking. Sign of an active brain.
It's WAY too early in the healing stage to really make ANY kind of meaningful evaluation about the process.
Inflammation is part of the healing process. It is characterized by: redness, edema (swelling), heat and pain. Now don't go looking for all those, because they may not all be manifesting. Redness is histamine early on, plus growth factors and, yes, neovascularization (ingrowth of new, tiny blood vessels).

I've NEVER seen these pits you're talking about. The healing results in smooth areas on plane with the surrounding tissue. Period. It is healing by secondary intention, ie, filling the hole up with granulation tissue. You gotta wait.

The questions about the scar removal preparations are tough to answer, because I don't think any one's done research on this. My feeling is this: wait on the scar removers until you HAVE some scars, if indeed you ever do. At his point you are not even close to scar formation.

Certainly you can try some hydrocort. It may diminish the potential for hypopigmentation. Keep it off the recipient area.

Frankly, I'd just let the donor area heal by itself. You can use any ointment (although I'm not sure what the Desitin is about). Probably any old triple antibiotic oint or even the carrier without the antibiotics will do just fine for keeping the area moist (which is what helps the area heal). Use the practical stuff.

As far as the other guy, it's very hard to evaluate anything from a picture. Apples and oranges.

FIThair

Sometimes patients could heal slower than the others but you can try post surgical products to acelerate the healing like HairCycle products or you can use aloe vera to speed up the healing process in the donor area.

Regards,

willifos

I had an FUE procedure performed exactly two weeks ago, April 15, 2007.

My donor site looks awful. I only recieved 400 grafts, however, the technicians removed over 1000 grafts from my donor area because the transection rate was so high. I did not realize this until after the procedure was completed. It was my first session.

The main problem I am having however is with the appearance of the donor area. The entire area is still bight pink. Worse, the donor sites are still very noticeable even from a distance and after two weeks of hair growth. The entire area is covered with crater-like scars (pitting). The punch used to extract the grafts may have been placed too far, (i.e. breached the dermis layer of skin).

I am not currenly using anything other than a topical lotion on this area.

I have heard the vitamin E can actually slow down the healing process (Univ. of Michigan study).

I am holding out, hoping that the donor sites will heal without leaving the depressions which are still so noticeable right now.

FIT2Btied

willifos,

You don't have scars yet, it takes a while for scar tissue to form, and it doesn't happen in 2 weeks.
Generally speaking, there is pinkness in the donor area for a variable length of time. It should resolve in time.
I'm not sure what you mean about breaching the dermis; of course, with any FUE type procedure, the punch or tool goes well into the dermis (maybe around 3 mm).
In our experience, the depressions in the donor sites are temporary; the healing occurs and the tissue is then "on plane" with the surrounding tissue. This is characteristic of healing by secondary intention, especially with such small circular incisions.
Good luck.

Steve

Yesterday was my 8th day after I decided to write my original post and I am seeing improvements.

Like last time I shaved off the donor sites and then rubbed a heavy cream onto the area to make the spots stand out. That last time I would clearly see the spots as I wiped the cream across the skin (reminded me of placing a piece of paper on a tombstone and rubbing it with a crayon), but last night it was difficult getting the cream to show any noticable depressions. Looking at the sites closely in the mirror I can tell they still haven't filled in completely, but I'm only on day 17 of a process that some have said can take 6 weeks. As long as I can see progress I'm happy.

The sites themselves have lost most of their tenderness, but I can still detect some soreness if I try to find it. The spots are still pinkish-purple but I imagine that won't change until after the site fills in completely and another step in the healing process begins.

Question: How come when I see a scar from someone who had staples (or possibly stitches) in their skin the spot is extremely noticable yet with FUE/FIT donor sites the sites appear to heal almost invisibly? The FUE/FIT hole had to have been bigger than the diameter of a staple. Is it because the staple wound begins its healing with a staple stuck inside of it? I know someone who had staples in his arm as a kid and it's over 10 years later and you can still see them clearly.

FIT2Btied

The staples may have been left in too long, or that particular person heals that way, which is usually some degree of hypopigmentation. There is also, as you alluded to, the issue of foreign body reaction (to staple or suture).
Glad you're seeing progress, as I thought would be the case.