Physician Answered Q & As

My Son’s Hair Transplant Has Resulted In a Tightness and Pulling Feeling – Need Advice

My son had a hair transplant done 9 yrs ago and has had a major problem ever since. He has tightness/pulling over half of his head 24/7 with no relief. His lifestyle has not been the same ever since. He cannot work full time as this condition causes much anxiety and stress. He has seen several doctors and the place that did the transplant tells him they have never heard of this before. He is pretty much handicapped with this condition and would appreciate any help or advice anyone can give. He is considering a scar revision to see if there is anything that was messed up when they did the surgery. Any advice or help would be greatly appreciated! Thank You!

What a frustrating situation!  I am so sorry to hear of your son’s plight and not at all surprised that the other doctors he has gone to have not encountered his symptoms since this sort of complication is exceedingly rare these days.  Without examining him, it is tough to fully understand what is going on – but let me try to help as best I can;

There are a few scenarios for what might have happened to your son.  He might have had a tight or inelastic scalp to begin with, or the closure on the surgery day might have been tight as well meaning the incision might have been slightly wider than average. Hair physicians can easily measure the elasticity of the donor area (using the Mayer-Pauls elasticity scale) in an office visit and this is something I would suggest initially.  If the scalp is quite tight, a scar revision might not be the best option.  It the scalp is fairly elastic, he would have more surgical options and something else might account for the pulling sensation he is experiencing.  An office visit would also allow a hair surgeon to examine the scar for signs of tension, excessive scarring, or nerve entrapment.  Thick or wide scars can enmesh the nerve and constrict it, causing tenderness or tightness.  Again, these would be rare complications of a hair surgery, but plausible scenarios given what you describe.

I would also suggest scalp stretching exercises as a means of improving the area.  To do the exercises, one needs to clasp the hands at the back of the head against the scalp (like you are leaning back in an office chair after a job well done!) and move the scalp up and down.  Patients should do this several times per day for six months – in other words, they should make it a habit.  When practiced with diligence, I have seen them give good results for several patients and the research done to date, while in small numbers of patients, consistently shows improvement in laxity.

One last possibility is that this pulling and tightness has nothing to do with hair surgery.  I have seen patients (when I was an Internist) who have the persistent sensation of a tight scalp and they are most often referred to a neurologist or anesthesiologist for treatment.  I think it is also important for him to be treated for his anxiety and stress so as not to let this condition ruin his life.  The impact of effective management of these additional issues should not be underestimated.

I sincerely hope this has helped and wish the best for your son.

  • Ramki

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