Hair Loss InformationEyebrow Transplants, Revisited – Hair Loss Information – Balding Blog

Here’s two more eyebrow transplant-related emails I’ve received…

In 2002 I cut my eye brows off. But they grew back very thin some parts did even grow back, like the ends. Only the inner part would grow but not so thick. Anyway to date they are not growing at all. My hair line has also thinned out about an inch. I do not know what is going on but I am tired of drawing it on. Please help.

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Eyebrows can be successfully transplanted, if the eyebrows you had have not returned after a couple of years. The eyebrow hair is taken from the scalp hair, and as such will have to be trimmed about three times a week and cut on an angle for hair shape. I posted a blog entry recently about this: Eyebrow Transplants. You need to be evaluated for the hairline loss. Read my responses addressing female hair loss, as they do apply to you.

I am considering eyebrow hair transplantation and I have many questions. Does having permanent makeup interfere with the procedure? Should it be removed first or will it cause scarring to the follicle? Also, does the transplant have to follow the original eyebrow hairline or will it grow in any follicle (if I wanted it slightly raised for a more youthful appearance for instance)? Do eyebrow transplants yield a high success rate? I noticed you listed some special summer prices but they were specified for the strip method. What is the cost for the FOX method. Finally, I live near Riverside Ca, zip code 92313, is there an office near me?

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Permanent makeup is cosmetic tattooing and is permanent by its nature. It will not impact an eyebrow hair transplant. You should be evaluated first, before any surgery is considered. Eyebrows can be angled for more lift, but it is difficult to angle them for less lift. The success of eyebrow transplants are high. NHI’s summer fees have been reduced by 10% but the FUE approach has not been discounted and still is priced at about twice the price per hair/graft as a traditional strip method of transplantation. Our closest office to you would be in the Beverly Hills area.

Hair Loss InformationAvodart (Dutasteride) vs Propecia – Hair Loss Information – Balding Blog

Hi.DR.RASSMAN, I would like to know if type 1 DHT causes hairloss?? or is it just type 2..?? Please let me know when you get a chance… and do you think they will becoming out with anything better then propecia in the near future???

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Propecia is a type 2 competitive inhibitor of DHT and Avodart is a competitive inhibitor of both Type 1 and Type 2 receptors. I think that is what you are asking. There is no clear evidence that blocking both Type 1 and type 2 receptors is better. What we do know is the Avodart does drop the DHT level in the blood stream more effectively than Finasteride (90% vs 75%). What this means is suggestive that it might work better in some people. But I must state clearly that safety and effectiveness is the mainstay of the FDA and until we have a handle on these two issues, I believe it is better to stick to Finasteride.

Hair Loss InformationIs a Hair Transplant The Only Answer? – Hair Loss Information – Balding Blog

im 21, but have been going bald since sixteen. i hate it cause im so young and have no confidence. i used drugs to solve it but nothing happened. is a hair transplant the only answer? sick of seeing all these ways of growing hair back, as in using tablets

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At 21, you are young to be balding, especially since this has been going on since you were 16. However, you are certainly not alone; see the Age postings in this blog for some of the other questions (and my responses) from men your age. I would suggest that first you have a complete physical to rule out any underlying medical conditions that could be causing the hair loss. Once that is done, your next step would be to see a doctor who specializes in hair loss. Be ready to discuss with them your medical history, what hair loss treatments you have tried and for how long, what effect they have had, and what is your family history of balding.

A hair transplant may be appropriate at your age if your future genetic balding pattern can be determined. A good, ethical hair transplant surgeon will be able to tell you whether surgery is an option, or if Propecia alone would be beneficial at this stage in your balding. Do not rush into surgery without a clear understanding of what your future balding pattern may be.

Hair Loss InformationItchy Scalp – Hair Loss Information – Balding Blog

I am a 27 year old African American woman. A few months ago I saw some bald spots in the middle of my head. I thought it was the wigs and hair weave I used to wear, but later on the bald spots started to spread down to the front of my hair line. When my hair itches I used to bang my head with my hand so that I could stop the iching. I don’t know what to do with this situation. I want to cut my hair off and start all over re-growing my hair. What do you think is best for me to do?

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If you have not yet seen a physician, I suggest that you get a thorough examination to rule out any underlying medical conditions, which could be causing the balding. The physician would also be able to determine how best to treat the itching.

Hair Loss InformationLaser Comb, Again – Hair Loss Information – Balding Blog

I have recently began using the new lazer comb. It was given to me as a gift. I was curious if it has been effective in the hair loss fight? Any comments, advice, side effects would be greatly appreciated.

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I have not read any impartial scientific papers that verify the effectiveness of laser combs. I tend to discount any reports that claim the combs work, if they are written by those who have a vested interest in the success of the laser comb industry. On the positive side, I have not read any papers that claim that is unsafe to use the laser comb. Since the comb was a gift, and you plan on using it as recommended, I see no reason for you not to try it. However, if you see any adverse reactions or have continuing balding, you may want to have a doctor examine you and see if there are any recommended and scientifically proven methods that may help you.

I’ve previously written about this in a previous blog entry, Hair Lasers.

Hair Loss InformationLateral Slits – Hair Loss Information – Balding Blog

Thank you for answering all our questions. This site is a great help!
Can you address the below paragraph pulled of Hasson & Wong’s (Canada) website?

“Hasson & Wong have pioneered the revolutionary Lateral Slit Technique. This technique of creating recipient site incisions allows for far more accurate control of hair graft angulation and direction. In addition, the coverage of bald scalp is increased on average by two hundred percent…Hair transplant surgery utilizing the Hasson & Wong Lateral Slit Technique is the only technique that is able to duplicate the alignment and distribution of hair as it occurs in nature. The result of this amazing technique is the complete absence of plugginess seen in other techniques including standard follicular unit transplantation.”

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Hasson and Wong do very nice work. I have nothing but admiration for them both. With regard to lateral slits, I have been doing them on all my cases for three years, but I have never been convinced that they are superior to vertical slits. The written studies done by different doctors throughout the world have not proven that lateral slits are any better. Patients who have had lateral slits on one side and vertical slits on the other side, are split on which side is better. So while there may not be any scientific proof that lateral slits are superior or inferior, it becomes a matter of physician preference, and my choice is to use lateral slits.

Hair Loss InformationFUE Questions – Hair Loss Information – Balding Blog

Hi,
I am seriously thinking of having a FUE procedure during the next 2-4 months. I’ll appreciate if you can please help me with the following info.
1. How do i know if i am a suitable candidate for FUE?
2. How long do i have to wait after the test to have the procedure?
3. how long do i have to wait after the surgery, before i can go about my business?
4. I see that you have a special offer going on now, what is the final per graft price after taking into account the travel reinbursement and your offfer?

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There are many things to consider before deciding on any hair restoration procedure. I’ll answer your questions on FUE (Follicular Unit Extraction) first…

  1. At NHI we use the FOX™ test to determine if you are a candidate for FUE. The FOX test lets us know how easily viable grafts can be extracted. If there is a high percentage of viable grafts, you would be ‘FOX positive’.
  2. The FOX test can be performed any time before surgery. There is no waiting period once you have had the test.
  3. Patients have different tolerances for surgery. Many patients go back to work the next day, others wait a day or two. As long as you follow the post operative instructions, you can resume your daily routine as soon as you are ready.
  4. The 2005 summer special fee applies only to traditional strip surgery. Travel expense reimbursement is up to 5% of the cost of the surgery.

Some of the other considerations to keep in mind are FUE is a good choice for patients who:

  • Need a small amount of grafts
  • Do not have an advanced balding pattern
  • Those who want to wear their hair very short
  • Those who have a very low donor supply, a scarred donor area, or very tight scalps
  • Patients who tend to heal with wide scars
  • Athletes who must resume full activity soon after the procedure

BUT, most importantly, continue to research, make sure all of your questions get answered, insist on seeing patient results in person, and make sure that you choose a doctor who has your best interests in mind.

Hair Loss InformationDoctor Availability – Hair Loss Information – Balding Blog

I recently had a hair transplant and I hate to tell you how much I paid. What I am writing about is that after the surgery, the the instruction sheet they gave me is very poorly constructed and when I tried to call the doctor to ask questions, I got a message telling me to go to my local emergency room. Is that an acceptable way to do business or are there standards that doctors must adhere to with regard to giving patients the information they need?

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There are no standards other than the Hippocratic Oath which is: I swear by Apollo the physician, by Æsculapius, Hygeia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgement, the following Oath. “To consider dear to me as my parents him who taught me this art; to live in common with him and if necessary to share my goods with him; to look upon his children as my own brothers, to teach them this art if they so desire without fee or written promise; to impart to my sons and the sons of the master who taught me and the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone the precepts and the instruction. I will prescribe regimen for the good of my patients according to my ability and my judgement and never do harm to anyone. To please no one will I prescribe a deadly drug nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion. But I will preserve the purity of my life and my art. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.”

The oath of Maimonides: Oath and Prayer of Maimonides is another iteration of this oath, possibly more comprehensive and more extensively used today. Somehow I sense that the concept of an oath is either not taken seriously today or manipulated to meet the ends of the oath taker. Let’s look as some lines in the Hippocratic Oath as it pertains to your question:
“Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain to look upon his children as my own brothers never do harm to anyone”. I take this to mean that our patients should be treated as our children, with respect and with regard to the entirity of their care. “Making a surgeon (any doctor) available to a patient he accepts as his/her responsibility” I read with interest and found no bounds to the timing of the responsibility possibly limited by reasonableness. “In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing” Here I define the house as the body of the patient, again open ended with regard to time and mechanism and the failure to adequately communicate or make oneself available can clearly do harm so ‘Ill-Doing’ can be done by not taking this responsibility seriously.

With today’s technology is is easier to be a better doctor. For example, I carry a cell phone and EVERY patient has 24/7 access to me, even on when I am on vacation, provided that I have cellular reception. I constantly am trying to improve my written instructions and learn by each phone call. Even more importantly, I prepare each patient thoroughly prior to the surgery with:

  1. a book I wrote which is possibly the most extensive book in the world on hair restoration surgery;
  2. a one hour, private consultation with most patients (sometimes longer). After the consult I put my findings and recommendations into a three to four page detailed letter customized for each patient. That frees the patient up to listen and learn and ask questions of me during the consult, at the onset of the process;
  3. open house events which are well known all over the United States. We originated the open house concept in hair transplantation and during our Los Angeles Open Houses we sometimes have a dozen patient examples of our work that you can examine for yourself.

Education and preparation make post operative follow-up easier on everyone, patient and doctor. I set my standard of care high, to better serve my patients, starting at the time of our first meeting. So while you may not have received post operative care that met your standards (or that of NHI), the physician may have felt that they provided an acceptable level of care .

Hair Loss InformationFemale Hair Thinning – Hair Loss Information – Balding Blog

Hello sir,
I am an Asian female and I am 24 years old.About 3 years ago, I noticed that my hair had started thinning. That was a period of time when I was under a lot of stress and used to hav a bad diet as well. So I thougt that was the reason for my hairloss and also thought it would come back in time. I have lost hair mostly from the front region of my head.But am not loosing much hair now.My hairloss kind of reduced on its own about few months ago and I also see few hair coming.

So does that mean that I am gonna get back my lost hair? Was the damage irreparable? Should I take treatement?

My mom had lost a lot of hair at a young age,my dad is 60 years old ,but still not bald. Could you please let me know more about my hairloss and whether it will come bacK or not.I would be extremely grateful sir.I am undergoing a lot of pain because of my hair.

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You are not alone. Since I started this blog, I have gotten quite a few questions from women about their hair loss problems. Here is a link to the similar questions and answers. The first thing you need to do is to see a physician who can examine you and order tests to make sure that there are no underlying medical reasons for your hair loss. Some of the reasons for female hair loss are: anemia, thyroid disease, connective tissue disease, and various gynecological conditions. These laboratory tests may be useful if underlying medical problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone.

If it is determined that there are no medical reasons for your hair loss, I would suggest that you visit a hair loss specialist. Since you are in New Jersey, I can highly recommend Dr. Robert Bernstein in Fort Lee- his phone number is 866-576-2400.

Hair Loss InformationMinoxidil and Retin-A – Hair Loss Information – Balding Blog

I have been taking Propecia for sime time and I recently ran across a site that talks about a combination of 2% Minoxidil and Retin-A. Should I switch?

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Propecia works at the cause of hair loss, by blocking the action of DHT on the genes that impact hair loss. Minoxidil is a drug that has a side effect: growing hair. The side effect of a noticeable growth of new hair occurs in between 3-15% of the Minoxidil taking population. Minoxidil does not block DHT, so its action is very different than Propecia. Retin-A is an acid which produces a burn to the skin. I generally look at burns negatively; why burn the skin? The burn causes increased vascularization and therefore allows a higher absorption of the Minoxidil. Retin-A also has it’s own side effects and warnings. Retin-A possibly may make the Minoxidil more effective, but at what cost to you and your skin? That is the question!