Month: August 2005

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Revising Transplant Scar – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I have had several procedures done at your San Jose NHI office over the past five or so years. The transplants are very nice and natural. However, the donor scar stretched quite badly from side to side, about 1/2 in in thickness at it’s widest behind each ear. I wear my hair cropped quite short because as my hair grows longer it does not look very good. It looks best and healthiest short. Dr. Jones performed a scar revision about 18 months ago and it reduced the scar to a fine line and it looked great for a while. However the scar has stretched back, and is even wider than before. The scar is now getting noticed fairly regularly, regardless of whether I leave my hair short or let it grow longer. If it’s possible I would still like to have more transplants as I’ve lost some of my natural hair in the past few years, but I really do not want to make this scar problem worse. And of course I really want to have the donor scar reversed and stay that way. The doctor of course was completely helpful and offered to re-revise the scar if needed, but I wanted to get your opinion. I read in your newsletter that you have new procedures that are better for the scar. I’m hoping you can help. It’s quite embarassing to have to answer the question “how did you get that strange scar?” but worse, just wondering whether people are noticing. I just want to solve the problem, and for it not to “come back” again.

Thanks for your help.

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There are no guarantees, of course. There are two causes of donor wound scars: one from your body tissue type/healing properties, and the other from surgical techniques as they interact with your healing and body tissues. You may have a collagen defect, but another attempt at scar revision is worth a try and if we were involved, we generally do these revisions at no charge for our patients. If that fails again (even with the new techniques), there are two other ways to fix scars. Each of these have a high degree of success, but they are expensive – the first is FUE and the second balloon stretching of the scalp. We subsidize the FUE repair of wound scars that were a result of a previous NHI surgery. We can talk about these alternatives and which would work best for you, once I have had a chance to examine you.

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Prescribing Propecia – Hair Loss Information – Balding Blog

I have had 1 transplant from you guys 9 years ago. I feel a need another now(I am 45 yrs old). Can you prescribe me Propecia also when I come out there or do I have to get it from a local doctor, and how do I convince them I need it?? I live in Missouri.
thanks

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Some doctors, for reasons I do not understand, have not become familiar with Propecia. These doctors don’t recognize genetic hair loss as a problem, yet for those of us who are impacted by the process, it is important. The drug Propecia is one of the wonder drugs of our time. With 50% of men eventually going bald, this drug has a place for preventing hair loss in the people like you and me.

Call my office at 1-800-NEW-HAIR and let’s talk.

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Hair Loss InformationScarring in Forelock – Hair Loss Information – Balding Blog

Dr. Rassman:
I too have some scarring in the front forelock area. I have never had a prior procedure and ample non-scarred donor areas. Can hair grow in the front forelock scarred area? If so, are you ever in the NYC or NJ office?

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Hair transplants can grow in scar. It is, in fact, a good way to hide a scar. I use hair transplants to hide neurosurgery scars, accident scars and plastic surgery scars from face lifts and brow lifts.

I no longer go to the east coast to perform surgery. Dr. Robert Bernstein is a great surgeon and I would advise seeing him for a consultation. I would have no hesitation for him to do surgery on any of my family. His phone number is 201-585-1115 and has offices in New York City and Fort Lee, New Jersey.

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Propecia Benefit – Hair Loss Information – Balding Blog

I have a question for you … on merck site it says hair mass can thicken up to two yrs… but I was told it can thicken up to three yrs… is that true??? and when is the best time to take propecia am or pm??? please let me know your answer… thanks

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I would not doubt what Merck says, but these are generalizations about the length of time the drug will give thickness- it can vary with each patient from one to three years. It is best to take Propecia in the morning, since that is the time of day that men have their highest testosterone levels. As Propecia has a half life of four hours, it theoretically gets less effective later in the day, when you take it in the morning. The reality is that the drug binds to the receptors and even if the blood levels go down, the drug may still maintain effectiveness through the day.

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Hair Loss InformationScalp Repair – Hair Loss Information – Balding Blog

Dr. Rassman…
I just finish reading one of the questions of a former transplant patient who had scarring problems and had to reveal them due to his job, where he had to keep his hair cut short. Well i’m in that same situation. I’ve several procedures and each one was worse than the last to the point that i have very little faith of any restoration and honestly not even by you. i have met you before and you did tell me just like some others that its not a guarantee!!! This is not an insult, but honestly how i feel. But i do feel that you do care and if anyone can help, you can. My situation is different, meaning i’m not interested in restoration but in skin repairing. I shave my head and use dermablend to cover as much of the scarring as possible. With so many plastic surg. in the U.S. i know someone out there can help me. I have watched Discovery Health channel at times and it gives me hope that i can get out this nightmare that has severely wounded my self esteem. Yeah,yeah,yeah i have been told it don’t look that bad but they won’t trade places with me. So i’ll start with you first. I’ve recieved a newsletter indicating surgeons on your staff specialize in this field, and by you being in this field for so long i’m pretty sure you know of others across the U.S. Sorry for the long request but its all about how you feel inside that matters right!! I’ll look forward to your reply…Thanx

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There are many doctors who claim that they can fix anything, so I agree with you that this could be a problem. I do not know what Dermablend is, but if you are talking about dermabrasion, I have always wondered about it, but I have not been willing to experiment with it. Dermabrasion (the use of a rotating file like sand paper) causes changes in the skin that produce scars and color changes (depigmentation). If you have a tan or dark skin, dermabrasion may produce a white skin. That may not look right.

Can you send me up to date photos with your head shaved and a phone number so we can speak? If you are willing, I can blank out your face and then post the photos here (to help others understand the problem), or just keep it private as I do with all of my patients. I’ll leave it up to you to decide. Also, please send me your name so I can pull up the evaluation I did on you when you came in.

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Shock Fall-Out After Transplant – Hair Loss Information – Balding Blog

I understand that the transplanted hair grafts fall out a few weeks after the surgery. Could those grafts be kept and re-transplanted, or are they dead? Thanks.

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I believe that you are confused. The hairs that fall out after the surgery are not hair grafts, but the hair that is caught in the scabs. Normally, all or most of the hair is shed after a hair transplant and it returns in 2-5 months after the surgery, growing to styling length by the 7-8th month. The hair that comes out after a hair transplant are not the elements of the hair organ that grow, but the hair shafts and scabs that are the aftermath of the healing process. In one out of about 20 patients who have had hair transplants, the hair growth center will generate a large number of hairs that will continue to grow. We call this instant growth and when it happens, everyone is happy.

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Stimulating Human Cells to Reproduce – Hair Loss Information – Balding Blog

Is this press release true?

“Headquartered at St John’s Innovation Centre in Cambridge, Intercytex has developed a way of stimulating human cells to reproduce, not only to re-start hairgrowth, but also to accelerate wound-healing and replace skingrafts with specially grown skin replacement. ”

“The baldness treatment involves taking a small biopsy or sample hair follicles during a half-hour operation under local anaesthetic at a hair or skin clinic. The sample is then sent to Intercytex’ manufacturing plant in Manchester where the hairproducing cells are extracted and nurtured for three weeks before being returned to the clinic to be injected into the patient’s scalp. ”

“The company says a new head of hair should be evident after three months. Early trials have proved successful, with further ones planned for next year in the UK and US. “

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I believe this is old news. The challenge is not to grow a hair or two from a mixture of hundreds, but to grow a large percentage of hair reliably and safely. I heard about this group last year, but was not impressed. At the ISHRS Scientific Meeting this month in Sydney, Australia, I will inquire further about progress demanding to see real data, not hype, and I promise to post a blog entry about it at the end of the month when I return.

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Hair Loss InformationActivities After Hair Transplant – Hair Loss Information – Balding Blog

Can I go swimming after a hair transplant? Scuba? Marathon?

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I generally advise my patients differently depending upon what type of hair transplant they had. The recipient area usually heals within 4-10 days. If it is washed well, it will not scab and if there is not scabbing, then you can do any activity without losing your transplanted hair.

For those with the traditional strip method of harvesting, the donor area should not be stressed with exercises that strain the neck muscles for a period of at least 3 weeks. These people should not swim until around 2 days after their sutures come out. Prolonged soaking is not a good idea, so scuba is not something I would recommend in these people for a good 3 weeks. You can run a marathon 5-6 days after the hair transplant with this ‘strip’ approach, but not complete in Olympic weightlifting.

For those with Follicular Unit Extraction (FUE/FOX Procedure), other than the restrictions for the recipient area, you can do anything, including scuba, marathon and even Olympic weightlifting after 5 days.

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Hair Loss InformationDensity and Scalp Laxity – Hair Loss Information – Balding Blog

In an earlier entry, you were asked to talk about the ability to expand the lower donor scalp. Could you tell me more about why this is important.

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The ability to move hair from the permanent zone around the side and back of the head to areas where it may be needed are dependent upon two factors, which are:

  • the density of the hair in the donor area. The normal density measures 1250 hairs per square inch. The more the density, the more is the movable hair
  • the number of square inches of scalp that can be moved depends upon the looseness of the scalp (something we call Scalp Laxity). The more square inches we can safely move, the more hair we can transplant

The ability to move more square inches of scalp with a strip excision also depends on the ability of the surgical team to place them safely into the area of need. Of course, it is important that the need for hair reflects the size of the bald area. For small bald areas, either less hair is needed or more density is needed. The ability for an experienced and skillful surgical team to place the highest density into the recipient area safely is core to the results that one can expect after a hair transplant. This varies between doctors offices and that is why the wide offerings are promoted on the internet. Some physician teams promote 5000 grafts in a single session in a fairly bald person, while other state that a lesser number is the only safe number. The safe number varies with the skills of the surgical team and nothing else.

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Hair Loss InformationLow Laser Light Therapy for Hair Loss – Hair Loss Information – Balding Blog

I have heard reports of using unusual wave lengths of light to stimulate hair growth for MPB. Is there any documented results on this work? Is there any application in stimulating growth in newly transplanted hair?

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I have been doing the Laser Light Therapy for the past 4 months with No positive results yet, if fact it seems to have made my hair loss worse. Do you have any data on this therapy?

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I have been bombarded with questions about Low Laser Light Therapy (LLLT) for hair growth stimulation since I started writing the BaldingBlog. The above are just two recent examples which reflect the wide variations in questions, one of which was already answered in a previous entry. To address these questions, I have prepared and will continue to prepare more updated information on the laser’s mechanisms of action and benefits as understood by the medical, scientific and commercial establishment. This summary should serve to supply an overview of the subject on LLLT. Until a well controlled FDA quality study is in our hands, we will not be able to judge with any degree of certainty whether or not the laser will become an important part of today’s hair loss treatment armamentarium. The wide enthusiasm for the technology in the United States today has been preceded in Europe for many years. I expect to review the European and American literature sometime in the next month or so.

Please read the new Low Laser Light Therapy page at newhair.com for more information.

With regard to the second person’s question: the laser should not cause hair loss, so I would expect that this person is going through a rapid loss period that is coincidental to the laser treatment, or has some medical cause of hair loss that needs proper medical assessment. It is important to seek the help of a competent doctor when something like this occurs.