How does smoking post-op affect the long term results of transplants? Does it make the hair shafts thinner and eventually hair loss in the grafted region? Is this something that will reverse with exercise, and stopping smoking? — S.B.

Dear S.B., there is no evidence that smoking has any negative long-term effect on hair transplant results. As doctors, we don’t want patients to smoke for health reasons, but also, we urge patients to refrain from smoking in the short term post-operatively for an optimal healing process. Smoking reduces blood flow, and may slow the short-term healing process. Many patients who smoke simply don’t stop smoking pre-op or post-op and there is no negative impact on the results. Stopping post-operatively is a “nice-to-have” not a “must-have”.

— Jerry Wong, MD

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I’m currently using Scalpmed an it hasn’t kicked in yet. When my hair gets wet from sweating or what have you my it looks very thin and my scalp is showing in the front. The brush over doesn’t work. My question to you is how would my post transplant hair look when wet? Do you have any pictures of of clients with wet hair post transplant?—J.L.

Thanks for the question J.L. A good quality transplant will look good when wet. Ultra fine follicular units and dense packing are necessary to achieve this natural look. Of course we use all of the principles to control angle direction and orientation such as the lateral slit technique and custom cut blades. Not only is dense packing with small follicular units essential, the angle and direction of the hair must be precise. When the hair is wet, the scalp is exposed and you can see where the grafts exit the skin. If large grafts are used with big incisions, big spaces and the angles of the hair are not uniform, the transplant looks and unnatural.

In this video, the patients hair is wet:
http://www.hassonandwong.com/hair-transplant-videos.php?file=86_kdv-108-4134.flv&screenshot=86_screenshot_kdv-108-4134.jpg.

In most of our videos, you will see a comb through the hair to reveal the grafts as they exit the skin. This is where the details of a good transplant can be examined. If it looks good this close up, it’ll also look good wet.

—Jerry Wong, MD.

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I have lost hair over a period of 20 years. I want to add density to my crown by placing the grafts in between natural hair. Will this damage the existing hair? Post the scar healing period of 3 weeks, will the transplant be
obvious and visible to others? When the transplant shoots start growing after 3 months, will the difference between natural hair and transplanted hair be noticeable? Is the size of the acne big enough to give away the fact that you had a transplant? When can you take your cap off and still look the same old you?
— S.

Clinics that don’t precisely trim grafts, that do not use custom cut blades, or require shaving the recipient site, do run the risk of damaging surrounding (native) hair. There is virtually no risk at Hasson & Wong because transection of existing hair is eliminated by the use of ultra-refined follicular units and custom cut blades made to match the depth of grafts. We shave the recipient area . This allows us to read the exact angle and direction of existing hair and provides a better field of vision to make incisions without causing damage to that native hair.

As for your concerns about post-op appearance: at three weeks post-op most people will have no idea that you have had a hair transplant. Your scalp may appear somewhat red, as if you have a mild sunburn, but even with short hair, any effects of transplantation (redness, acne, flaking), will be mostly obscured by your short hair. With very fair skinned patients, the redness may linger a little longer. At three to four months, the new hair will begin to grow gradually and naturally. Because the change in your appearance is gradual, it will not draw attention to you. Acne in the recipient area, if it occurs at all, will not draw any unneeded attention; nobody will associate a few pimples with a hair transplant. By three months, you’ll look like the "same old you" and your grafts will gradually grow and improve your appearance which each passing month. At 8 months, the result is quite apparent, most growth will have occurred with further growth and maturing of hair grafts between 8 and 12 months. Please see our graft growth timeline.

— Jerry Wong, MD

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