Hair Loss InformationHair Transplant Surgery Technician Certification? – Hair Loss Information – Balding Blog

I work for a surgeon. He wanting to provide hair transplant services- some in office. He had said something about having a technician to assist with the hair follicle grafts- Does this technician require certification and if so where do you obtain this?

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CertificateThe International Society of Hair Restoration Surgery (ISHRS) has information about fellowship programs for physicians here. It is very difficult to train a good hair transplant technician. It often requires months of daily constant practice, the initial work under close supervision. I have trained a few dozen techs and many of them want to quit within days of starting training. Errors on the part of the technician can kill the transplants from a variety of causes, including drying of a graft (usually killed in 10-20 seconds of air exposure), rough handling, killing the growth center, poor placing, and depth control. The hand-eye coordination is really difficult for placing a graft. Ask your doctor to visit an experienced hair transplant surgeon and try out some of the process. If you wanted to become a hair transplant technician, that may just change your mind. For the patient, the worst thing he can have is a technician given too much responsibility during the training process, as many grafts will die as the technician learns the process. Remember, I said it may take six months to a year to get competent and years more to get really good. As a patient, I would want an experienced technical crew. There are very few doctors that developed the skills to train a hair transplant technician so one might wonder where they got their training from.

Long story short, there is no certification for this job… just lots of training time and constant, daily practice. If your doctor expects to get growth from a hair transplant, the worst thing he/she could do is to pass on the responsibility to you (no disrespect intended).

Total Crown Renewal, Follow-Up – Hair Loss Information – Balding Blog

Dr. Mark DiStefano commented on my Total Crown Renewal post, and I’m highlighting it here:

It is truly regretful that Dr. Rassman was so scarred, both physically and emotionally by scalp reductions performed on him nearly two decades ago. I have known Dr. Rassman since I entered this field from Emergency Surgery almost 15 years ago. He has been a leader, entrepreneur, academician and teacher in the field of hair restoration.

When I entered the specialty of hair transplant surgery, Dr. Rassman had already established his practice and was experimenting with new hair transplant techniques.

With his help, the (then) modern use of the FUE (follicular unit extraction) procedure changed how we view the use of “plugs” or punches. Most hair transplant surgeons stopped using the punch 10 or more years ago . But with his invention of the FOX™ Megasession technique, he helped to lead the rest of us to today’s FUE method. When he started with this technique, many physicians were skeptical and discredited the “punch technique. But now, after continued development and refinement of technique, this has opened up an incredible area for donor hair and seemingly scarless (lack of linear scar in the donor area) surgery.

This, too, can be said for the Total Crown Renewal®. Although it may appear this procedure is based on the “old” scalp reduction, the Total Crown Renewal® utilizes different techniques to make dramatic final results.

With the old scalp reduction, the area of balding was pulled closed with from 1 or more scalp reductions. The problem with the “old” scalp reduction, was that it used mechanical stretch, (brute force), to stretch the hair bearing scalp together. This usually resulted in “stretch back, phenomena that resulted in production of excessive scar tissue in the area. Also when the number of scalp reductions was done to complete the process, there was a slot formed in the midline of the scalp and the hair was now going in the wrong direction.

[See Dr. DiStefano’s full comments here]

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I thank Dr. DiStefano for his comments. The number of surgeons capable of performing the correction surgery for the deformity created by scalp reductions are very limited I have seen many doctors attempts at this corrective procedure and it was botched. For our readership, most surgeons are cocky about their abilities to see a single surgery and then with a book in hand, do it themselves. This corrective procedure is a rare example of the failed logic of this premise.

But basic to my problems with this surgery is the logic of the scalp reduction surgery itself. When the scalp is stretched (even with the well designed Frechet Extender discussed above), the hair that comes from the sides of the head is diluted so much that the density of the donor area is significantly depleted. This means that the available hair to treat the front and top of the head is reduced substantially (robbing Peter to pay Paul). Unless a person has an unusually high donor density and a reasonably loose scalp, there may not be enough hair to properly treat frontal balding. My second problem with Dr. DiStefano’s approach is that the procedure always produces a deformity when it is successful (the famous “slot deformity”) and the only way to manage this problem is with the Triple Flap Procedure that Dr. Frechet has personally defined. That would leave me asking, “Why would anyone want to have a Total Crown Renewal and get a deformity that still needs another surgery to correct?”. Certainly not me!

I Don’t Want Hormone Changing Drugs, But I Want to Stop Hair Loss – Hair Loss Information by Dr. William Rassman

Hi,

What if we do not want to take propecia (too many side effects). Can we still do a hair transplant? I am not happy taking hormome changing drugs for life, but want to stop hairloss.

Thanks

I can’t offer you more advice than I have already posted. See these posts:

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I Didn’t See Shedding, But My Hair Is Thinner After Starting Minoxidil – Hair Loss Information by Dr. William Rassman

I have read through this blog but cannot find a question that is very similar to mine. Much appreciate an answer.

I’m 40, been balding slowly for many years now, and when the middle part of the scalp started showing up, decided to do something about it. The dermatologist prescribed fin-minoxidil combo. But I have been only on minoxidil for over 6 weeks now. For the first five, I’ve been applying about 1.5ml twice daily; then I realized I was reading the meter on the injector wrong, and have been doing 1 ml twice a day since.

My hair has thinned at a much faster rate after starting the treatment. I know that some people experience minoxidil-induced shedding initially, but here is what perplexes me: I did not notice any visible shedding. By ‘visible shedding’, I mean that I did not see hairs falling off, but the appearance on the scalp is one of heavy loss. In fact, visible shedding has come down quite a bit. My hairs are thick, and prior to beginning the treatment, I would see a lot of hairs on the floor at workplace, or on the pillow, or in the bathroom sink. I see far fewer hairs now after minoxidil. Yet, overall, my hair definitely has thinned at a much, much faster rate.

I am not sure what to attribute this to. Should I assume that minoxidil is working, and that thinning has happened because I shed miniaturized hair that naked eye couldn’t quite spot well? Or am I experiencing a rare adverse reaction due to first 5 weeks of overdose?

Is it possible that minoxidil can cause permanent hair loss that wouldn’t otherwise have occurred without the drug? Thank you very much.

First, you should meet with the doctor that recommended the treatment. I would have mapped out your scalp for miniaturization so without those baseline measurements, I would not know what is going on with you.

Is the finasteride/minoxidil combo a 2 step approach (oral finasteride, topical minoxidil)? Either way, two months is a short time for these medications to give you an effect, but your doctor should check you out to be sure you are not harming yourself (doubtful).

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Folliculitis 2 Years Ago Caused Crown Hair Loss? – Balding Blog

I was diagnosed with folliculitis 2 years ago that caused hairloss at the crown. I noticed it got much worse everytime I took a haircut. After a rigorous course of antibiotics and avoiding the barber I am seeing improvement and regrowth of hair. This regrowth, however is exceedingly slow. The doctor recommended hair force to help but its still quite slow. Given such a lengthy time frame of 2 yrs. do you think my hair will fully recover?

Without examining you, I can not give you an answer to your question. What you need to know is whether you have genetic balding. This can be answered with a genetic test to see if you have the balding genes (HairDX) or a miniaturization mapping of your scalp which will show if the hair is in the process of balding. With the history of folliculitis, I would suspect that you precipitated a genetic balding process, but without examining you, I can not tell.




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DHT and Estrogen? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman!

I have a question regarding DHT and its effect on estrogen.

Isnt it true that DHT is essential to keep estrogen levels at bay? And by removing up to 70% of DHT with a drug like finasteride youre exposed to amounts of estrogen not normal to a male body. That could make for ex building muscles harder, cause you to develop gyno (male breasts) and or other feminine atttributes? What can be done to keep the estrogen levels normal when youre on a drug like finasteride.. or does it matter much if estrogen is roaming freely? whats your opinion Dr. Rassman.

This is a huge concern of mine. Thank you

Your questions are all over the map and many of your facts just don’t fit together. You do not wipe out 70% of DHT, you just block 70% at the hair follicle level. There is no feminizing effects of taking a DHT blocker and if by rare chance you got breast enlargement, it is thought of as an idiosyncratic reaction, not a feminizing process.


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Woman’s Hair Loss Worsens Even With 2 Years of Laser Comb Use – Hair Loss Information by Dr. William Rassman

i am using laser comb for about 2 yrs now and my hair loss continues to worsen. am wondering if you have heard of any negatives about its use in women? i cant help but wonder how much worse it would get if i quit using the comb. any comments please????

Sorry, but recent articles and studies show the various laser combs and laser treatments for hair loss are not as good as once thought. The science I have seen is flawed. In other words, lasers do not work as promised. For those of you who spend hundreds or thousands of dollars on this and many other illusive cures for hair loss, remember one thing — “let the buyer beware!”

I’ve written about laser treatments many times before, so please search for LLLT to read more.

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My Hair Thickened and My Depression Disappeared – Hair Loss Information by Dr. William Rassman

Hi I have a question about medications. I have been with a hair company called Ashley and Martin and I have been using their hair products. These being saw palmetto, proscar, and their special hair solution which has minoxidil in it. Also before I had been using these products I had depression, anxiety and my sexual libido(appetite) was not around. Since taking these medications for hair loss I feel great, my hair has thickened, my depression has disappeared, and my sex appetite is very high. I’m just a bit scared of getting off the medication in case I start losing my hair and also go into depression again. Also are these medications ruining my health? I need your help and would be very thankful for a reply

First off, you said that you’re taking Proscar (finasteride). I hope you’re cutting the pill if you’re taking it to treat your hair loss. Proscar is 5mg of finasteride — you only need 1mg daily to treat hair loss (marketed as Propecia).

You’re seeing good results from the combination of treatments, but if you stop them you will lose the hair you gained from the medication. Minoxidil and finasteride are proven hair loss treatments (and the only FDA approved medications for that), and stopping them will cause any benefits you saw to disappear and your hair loss to resume. Could losing your hair lead to depression? It’s possible. If you’re not seeing negative side effects, I don’t see how the medications could be ruining your health. Like I said, the minoxidil and finasteride are FDA approved to treat hair loss, and they are proven both safe and effective.

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I Want a Teenage Hairline Permanently! – Hair Loss Information by Dr. William Rassman

Hello,
I am 20 years old and my hairline seems to be receding. There is miniaturization in a clear line, and then thick normal hair also in a clear line. I am wondering If this is a sign of my hairline settling into a mature widows peak sort of line(I went to talk with a specialist at at a clinic in New York and they said I wasn’t even the first part of the Norwood in the receding section, though I notice a lot receding at the temples.

Could this be the end if the miniatrization is that clear or would taking finasteride(probably finpecia since I am currently unemployed) be a smart option. I am opting for a teenage hairline permanantly seeing as I plan on doing sort of gender bending performance art and want a hairline that can he feminine as well.

I am willig to do anything to get ride of the receding hairline, I never want a mature hairline. This might sound naive or childish, but I do not feel comfortable looking manly at all, and never will, so I am DESPERATE. I know my options, would I have luck with finasteride?

At 20 years old, you might be a good responder to finasteride… but as for expecting it to regrow a maturing hairline and go back to your 10 year old line, it won’t do that. What you’re asking for is likely going to require surgery (as drugs will not reverse frontal balding), and at 20 years old it doesn’t sound like you made up your mind wanting your 10 year old hairline back. Hair transplants can be done to give you that, but do you really know where you mind is when you are 30 or 40. You get the picture? I never say never, but you need to bond with a good doctor, not one that just wants to take your money in these difficult financial times and become realistic with regard to what may happen to you over time.


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I Felt Testicle Pain Within 2 Days of Taking Propecia – Hair Loss Information by Dr. William Rassman

Dear Doctor,
First I would love to thank you for your informative website which is really helpful.

Two month ago I started Finastride 1 mg as my doctor told me to do. I felt a testicular pain within two days of using the medicine. It got worse everyday till the 6th day that I got annoyed so, I stopped taking the pill and the pain disappeared within a week. now I started again with 0.25 mg of the medicine as my doctor said to lower the dosage. Again the second day I felt the pain. I was wondering if it is harmful to wait for a while? and how long is the time that I can wait without being harmed by the drug, assuming that the pain is bearable?

There are reports of testicular pain with finasteride, although rare. Your history suggests a one to one relationship between the two. If half the dose (0.5mg Propecia) does not work and your doctor examined your testicles and they are normal, then you may not be able to tolerate the drug. Speak with your doctor before making that decision.

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