Dr Cole talks about shock loss -
"When you perform hair transplant surgery, you make incisions in the scalp and place grafts. Grafts are hair taken out of the body. When you take hair out of the body, it continues to metabolize. This results in the formation of toxic by products because oxygen has been taken away from the grafts. Both the formation of toxic metabolites such as super oxide and other free radicals and the incisions are implicated in producing shock loss. Incisions in the scalp create their own inflammatory response by the body that can result in the production of toxic metabolites. These toxic metabolites are thought to cause a temporary shedding of pre-existing hair. the hair will grow back, but it may not be as thick in diameter as it was before shock loss. Therefore, we attempt to prevent shock loss. We attempt to prevent it by limiting the density of grafting we perform where there is pre-existing hair. This limits both the number of incisions and the total amount of free radicals produced by grafts. We also chill our grafts and place them in a special tissue medium that promotes a healthy environment for our grafts. It also helps to reduce the total amount of free radicals by quenching those that are made. Chilling reduces the metabolism of the cells to about 5% of their original metabolism. this reduces the amount of energy required by the cell to continue living. When cells must metabolize in an oxygen depleted environment (anaerobic environment), they will produce toxic metabolites. We minimize this by keeping the temperature between 2 and 10 degrees Celsius. We have also built a low temperature system for storing grafts, called the hypothermogod, which is a graft optimization device designed to keep the temperature of our grafts at a constant 2 degrees Celsius. Our storage solution is specially designed for these low temperatures. It is also very expensive. Most cljnics do not use this special solution and they do not have a hypothermogod. for this reason, the grafts in most clinics are either kept in a storage medium that can be harmful to hair if the temperature is lowered or they are kept at room temperature (about 20 degrees celsius). Our storage medium also quenches free radicals and reduces the total amount of free radicals prior to re-inserting them into the scalp. all these measures help to reduce the risk of shock loss and to produce a healthier graft with better survival."