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Hair Transplant Ugly Duckling Phase – Everything you need to know

The ‘Ugly Duckling’ phase of surgical hair restoration is a euphemism for that period of the timeline of hair transplant result when it is in the healing phase of hair transplant when the crusts are present and they give an unkempt look and also when after they shed, the phase of shedding of graft hairs and later the shock loss if happens can make a patient look very different from what he was before and he shies away from this look. The phrase ‘ugly duckling ‘ phase means different things to different people. Mostly it means the period after the hair have shed and before the results start to appear and a semblance of normal appearance begins to take shape. The redness, pimples, and the dreaded shock loss do make matters worse for the initial shedding. The ugly duckling phase lasts from immediately after the hair transplant to the 3-3.5 months mark on the timeline after hair transplant.

Though most are prepared for the crusting and the shedding of planted hairs, the shock loss and the look after 2-4 weeks comes as a shock since they were counseled improperly and thought it will be life as usual and that after 2 weeks when the crusts are off they will be as presentable as before. This video is for such people to make them touch base with reality. Evidence of hair transplant though not so much visible to a person who is seeing you for the first time after 6 weeks of the hair transplant, to yourself it will be quite obvious since it is a body image issue and you shall continue to be conscious of it till the 3 month mark on the timeline.

Whereas shedding of planted hairs is an acute process and is consistent in the vast majority of patients after the hair transplant, the process of shock loss happens with only a few. This happens in the area of the plantation, when grafts are placed in high density amidst thinning hairs. Firstly the trauma of the process of slit making and secondly the inability of these thinning hairs (already devoid of blood supply due to influence of DHT) to compete for precious blood supply for survival with healthy robust anagen hairs, adds insult to injury.So this chronic shedding or shock loss is a gradual process and will continue till 6 weeks.

In 80 cases the hairs will return back, but when the implantaton has happened in thinning areas and the direction of slits were not proper (parallel to the thinning follicles) this is distressing for the patient since he had not bargained for this eventuality. Shock loss does escape the period of counseling and hence the patient is advised to do his research well before opting for a hair transplant. The doctor cannot during counseling inform the patient of all things that can happen and that cannot. It is up to the patient to go through this information on the doctor’s website and other social media channels prime amongst which is youtube.

Many clinics will advise the use of DHT blockers from 3 months before the hair transplant but this has to be with a strict caveat. If the patient’s scalp donor has miniaturisation and these drugs are started, it can make the surgeon complacent and all grafts that look thick will be harvested during the hair transplant. It is well nigh impossible to differentiate miniaturising hairs that have been rendered thick with external means like the use of DHT blockers from true good quality anagen hairs in the scalp donor.

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