Small raised marks on the base of each grafts

[paul hewson]

Dear all,
I'm 38 years year old, writing from italy.
I had an HT 2 years ago with about 2000 graft implanted FUT.
I take 1 mg Propecia for 2 years.
This is my problem:
I have very small pimples (less than 1mm) on each graft implanted there are very visible i.e. under the sun light.
they don't hurt me and seems like the hair is pulling up the skin. I don't have any of them on non-transplanted (my natural) hair...
I searched on this site but almost all of the discussions I found are on bumps or normal pimples or pitting or scars.
the most valid explanation I found is that it is due to the graft that was implanted too deep in the scalp.If it is true, what can I do for improve the situation? Dermabrasion or laser? may I start trying some remedy for folliculitis or is completely useless?
pls give me some good hope on what I can do,I'm really desperate.
the doctor who make me the surgery (in Mumbay while I was in a long trip for job...)after the first mail, don't reply to my calls or mails...however I don't trust him anymore!
I contacted another Dr who said that the only solution maybe is to make another transplant to hide the small raised marks, but I leave this as the last solution.
pls help me if there is someone with the same problem. also do you know if is possible to take legal against this doctor? he lives and works in India, Mumbay.
Thanks in advance. sorry for my bad english.
Best Regards

[Mark]

Dear all,
I'm 38 years year old, writing from italy.
I had an HT 2 years ago with about 2000 graft implanted FUT.
I take 1 mg Propecia for 2 years.
This is my problem:
I have very small pimples (less than 1mm) on each graft implanted there are very visible i.e. under the sun light.
they don't hurt me and seems like the hair is pulling up the skin. I don't have any of them on non-transplanted (my natural) hair...
I searched on this site but almost all of the discussions I found are on bumps or normal pimples or pitting or scars.
the most valid explanation I found is that it is due to the graft that was implanted too deep in the scalp.If it is true, what can I do for improve the situation? Dermabrasion or laser? may I start trying some remedy for folliculitis or is completely useless?
pls give me some good hope on what I can do,I'm really desperate.
the doctor who make me the surgery (in Mumbay while I was in a long trip for job...)after the first mail, don't reply to my calls or mails...however I don't trust him anymore!
I contacted another Dr who said that the only solution maybe is to make another transplant to hide the small raised marks, but I leave this as the last solution.
pls help me if there is someone with the same problem. also do you know if is possible to take legal against this doctor? he lives and works in India, Mumbay.
Thanks in advance. sorry for my bad english.
Best Regards

Hi Paul,

Just to clarify, do you actually have these bumps on every transplanted follicular unit? Or just some?

Also, does it come and go, or is it always bumpy?

-Mark

[paul hewson]

Hi Mark, thx for replying me.
yes I have on the base of each transplanted grafts. no one on my natural hair... they don't come and go, they are always bumpy!

[Mark]

Hi Mark, thx for replying me.
yes I have on the base of each transplanted grafts. no one on my natural hair... they don't come and go, they are always bumpy!

Ok, that is certainly weird. Are you sure it's every transplanted hair? Your scalp must look like a cheese grater.

Can you provide some pictures? I can get them to the doctor for him to evaluate.

-Mark

[paul hewson]

hi Mark,
it is exactly how my scalp looks....like a cheese grater:(
I'm sure, I have on all transpanted grafts, some are bigger, some are smaller....
pls explain me how to send pictures. I tryed to make some shoot but it's not well visible because of the hairs....however I will try again and again.
awaiting your kind reply. thx for helping me!

[paul hewson]

Hi Mark,
it is exactly as you say, my scalp seems like a cheese grater.
I'm sure, I have in every transplanted hair..
pls let me know how to send pics to you, I'll try to make some good shoot as is difficult because of the hair.
thx for helping me!

[paul hewson]

this is what the Dr who made me the transplant replied me after sever mails and threats from myside:
> Dear ,
> the raised base is not deep placement but rather upward displacement
> of the grafts which can occur in any patient during recovery phase.
> Deep placement causes pitting at the base. My grafts are not placed
> deep. Be clear on the fact that deep placement leads to pitting and
> not raised skin on the base. This is an outcome from the procedure,
> not wrong placement. It is known to occur and you should not hold a
> grudge and label it as a mistake. If you are in India come over I can
> see what best can be done about it.
> Dr............
I don't know if I can write his name....
what do you think about this and about my last reply.
pls help me I'm going mad and depressed....
thx

>

[paul hewson]

hi Mark
can you pls reply me?
I need help on this matter.thx

[paul hewson]

Hi Dr Rassman
can you please help me with this matter?
thanks in advance.
best regards
Paul

[Mark]

Paul,

It would really help us if you could provide a photo showing the effect you're describing. I replied to your PM about how to post photos. If it's unclear in any way, please let me know and I'll try to help.

-Mark

[Mark]

Dr. Rassman answered your questioin on the blog here. (http://www.baldingblog.com/2009/07/14/my-surgery-was-years-ago-and-i-have-small-pimples-with-each-transplanted-graft/)

Let me know if that's not clear.

-Mark

[paul hewson]

Hi Mark
did you showed my photos to the doctor?
from the reply seems he didn't see them as he's asking me if I have cobblestining or not?
pls let me know. maybe you can not access my album?
awaiting your reply.
thx
rgds

[Mark]

Hi Paul,

Sorry it took so long to get back with you. Dr Rassman is in europe at the moment. I got this answer from Dr. Jae Pak.

he is referring to scarring that happens after a hair transplant procedure when large grafts are used.
dermabrasion or lasers will not work and possibly make it worse.
in the end he cannot get rid of the problem
that is why choosing the right doctor and clinic is very important (over looking for a bargain)
since you cannot fix the problem only thing left is another hair transplant to hide the bad job
(but this will NOT completely solve the problem)

-Mark

[paul hewson]

ok thanks MArk....
this is the last reply from the dr who made me the surgery:

"Dear ....,

1. You cannot predict in which patient you can get the raised areas.
2. These are typically seen when the hair growth starts and the new hair begins to grow out through the skin.
3. The raised skin will subside to some extent and become less visible as time passes by but it not totally go away.
4. Dermabresion and Laser have been tried with limited benefit but not complete cure.


In order to avoid the raised skin -- and what do I prctice.

1. Use small instruments for the implantation. ---- I use a 19, 20 and 21 gauge injection needle for placement and no instruments, no cuts in the skin, only a needle puncture. Size of the needle varies with size of the graft. Same needle is not used for all the grafts.


2. Skin over hang on the graft can lead to raised skin. --- I remove the skin from all the grafts by de - epithilizing all the grafts during the dissection and preperation of the follicular units. This avoids any skin from being placed with the grafts. The grafts are extremely narrow and devoid of skin.


3. Use of saline infiltration while implanting the grafts can cause them to pushed out. -- I do not use saline infiltration while placing the grafts.


4. Use of head bands after the transplant can push the grafts out from the skin. -- I do not use tight head bands after the transplant.


5. Using Dermabresion or Laser to rub down the raised skin can still cause it to come back after the scalp heals, as it is a part of the healing process. --- I do not advise or encourage my patients to go for any procedures. --- Very rarely my patient gets these minimal raised skin even after following all precautions.


In your case --
Raise skin was not so noticeable. Then in sunlight or with good background light you made an effort at different angles o f the mirror to visualize the raised skin. This kind of out come is accepted as not severe but a part of natural healing".

so, what can I do now? can I act legally against this doctor? how?
pls let me know.
thx
rgds

[Mark]

ok thanks MArk....
this is the last reply from the dr who made me the surgery:

"Dear ....,

1. You cannot predict in which patient you can get the raised areas.
2. These are typically seen when the hair growth starts and the new hair begins to grow out through the skin.
3. The raised skin will subside to some extent and become less visible as time passes by but it not totally go away.
4. Dermabresion and Laser have been tried with limited benefit but not complete cure.


In order to avoid the raised skin -- and what do I prctice.

1. Use small instruments for the implantation. ---- I use a 19, 20 and 21 gauge injection needle for placement and no instruments, no cuts in the skin, only a needle puncture. Size of the needle varies with size of the graft. Same needle is not used for all the grafts.


2. Skin over hang on the graft can lead to raised skin. --- I remove the skin from all the grafts by de - epithilizing all the grafts during the dissection and preperation of the follicular units. This avoids any skin from being placed with the grafts. The grafts are extremely narrow and devoid of skin.


3. Use of saline infiltration while implanting the grafts can cause them to pushed out. -- I do not use saline infiltration while placing the grafts.


4. Use of head bands after the transplant can push the grafts out from the skin. -- I do not use tight head bands after the transplant.


5. Using Dermabresion or Laser to rub down the raised skin can still cause it to come back after the scalp heals, as it is a part of the healing process. --- I do not advise or encourage my patients to go for any procedures. --- Very rarely my patient gets these minimal raised skin even after following all precautions.


In your case --
Raise skin was not so noticeable. Then in sunlight or with good background light you made an effort at different angles o f the mirror to visualize the raised skin. This kind of out come is accepted as not severe but a part of natural healing".

so, what can I do now? can I act legally against this doctor? how?
pls let me know.
thx
rgds


You got this done in India, and I don't know what the laws are there. I wish I could help.

-Mark