Day: January 1, 2023

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Taking Scabs off after transplant

I’ve been soaking and massaging twice a day per my doctor’s orders. I’m on day 5 now and quite a bit of scabbing has come off, but there’s still some left to go. I’m being gentle and no bleeding at all, so I’m just going to keep at it.

It is tricky to get scabs off at 5 days as the grafts get attached under the scabs so when the scabs come off, the grafts can be pulled out. The risk goes away at the 12th day. Read this article I wrote with Dr. Robert Bernstein: https://newhair.com/wp-content/uploads/2018/11/mp-2006-graft-anchoring.pdf


2021-10-03 09:38:48Taking Scabs off after transplant

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I had 4500 grafts last week. Was my donor area over-harvested (photo)?

Your donor area appears over-harvested especially because I see that the doctor went out of the permanent zone, into your neck hair which is not permanent and above the permanent zone on the right side. The area itself, looks like the density has been significantly depleted. Time will tell as you allow the donor hair to grow out.

donor area overharvested

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4500 FUE grafts, has see-through donor area

This patient had 4,500 FUE grafts and you can see in the photo the difference between the donor area, which is a bit too high, and the normal hair density on the neck side of the photo. The surgery depleted the donor hair significantly. This is caused by either (1) very fine hair or (2) a low original donor density (something that the doctor can measure in advance).


2020-09-15 09:04:124500 FUE grafts, has see-through donor area

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I am 45 and am worried about more hair loss if I get a hair transplant (photo)

You have a Class 3 Vertex pattern of hair loss which means that you are losing frontal hair and crown hair. At your age, I would suspect that if you lose more hair, it will not be very dramatic. You could try the drug finasteride (requires a doctor write a prescription for it) or you can transplant it. Transplants will work well for someone of your age and probably you will be stable so after a hair transplant you will just look like you never lost any hair

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Balding without miniaturization

I think that there is no miniaturization in my hair but the hair seems to be sparsely separated. Could that be true?

Hair grows in bundles called follicular units containing from 1-4 hairs each. When some people lose hair, the lose hairs within the follicular unit occurs so a three hair follicular unit might lose a hair and have only two left. Then in time, it will lose another hair and have only one hair in it. Eventually that last hair may fall out as well. This occurs all over the scalp in the balding areas in many men without miniaturization. The average human scalp has 50,000 Follicular Units of which 15,000 are in the rim around the back and sides of the head and 35,000 are subject to the patterns of balding you inherit from your family. The 15,000 follicular units around the side and back of your head are not prone to balding, keeping their hairs over your lifetime.


2021-09-05 11:25:12Balding without miniaturization

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The Ideal Hair Transplant

This man had his surgery done by Dr. Zarev (Sofia, Bulgaria) who put together an outstanding team to be able to perform up to 6,000 grafts in a single day. I have seen him working at various hair conferences with video access and therefore understand the way he organized his team. Dr. Zarev is unusual in that he built a team that can exploit graft sessions that maximize the patient’s donor area in a one or two day surgery. This patient was done in two sessions totally 11,620 grafts with spectacular results. Apparently he had still another session some 9 months later. I would warn the reader not to assume that they can get such results as explained below.
What was done: This is not the typical patient because to support 11,620 FUE grafts from the donor area, his donor density must have been substantially higher than the average man’s donor density. I have had only a few such patients, one shown here: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/. For the typical person with an average donor density with an average Hair Mass Index, they would almost certainly develop a see-through donor area as shown here if they transplanted 11,620 grafts: https://baldingblog.com/another-case-of-an-over-harvested-donor-area-from-fue-photo/. They would avoid this if their donor density and Hair Mass Index was significantly above average.
The Mathematical Analysis: Mathematically, to support this many grafts, the donor density must be at least 50% higher than the average man’s donor density [the average Caucasian man has 55,000 grafts on their head of which 25% or 13,750 grafts are found in the donor area]. Let’s say 2/3rds of the 13,750 grafts are removed from the donor area in this typical average Caucasian male. That would leave only 2,130 grafts remaining (13,750 grafts originally in the donor area -11,620 extracted = 2,130 grafts remaining). If this man only had 2,130 grafts in his donor area remaining, he would likely develop a see-through donor area which is clearly not the case as shown in the after picture here.
Working with men who have a high density and who have a better than average Hair Mass Index makes the surgeon perform ‘miracles’ as shown here. But what are we actually seeing? Let’s dissect this ‘miracle’. We are seeing the results of 11,620 grafts covering an area that would normally contain approximately three to four times that amount of grafts (34,860 – 46,480 grafts) that would have been present in the transplanted area before this man became bald. So clearly, what we see is the result of more than just hair. It is the result of the art of the surgeon who understands how to distribute these grafts and weight these grafts to look ‘full haired’ from every angle. I would expect that the leading edge of the frontal hairline was built denser than other parts of the head. As you look at the donor area, this man still has more FUE grafts that can be used for future surgeries if needed.
There is never a substitute for a great surgeon who put together a great surgical team. I have put this analysis together for those of you who really want to know the reality of the hair transplant process they often see or fail to see.
I congratulate both the patient and Dr. Zarev in the results shown here.

 


2021-02-12 10:06:48The Ideal Hair Transplant

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I Am 42 Years Old and If I Am Balding, What Should I Do? (Photo)

You have a Class 4A pattern of balding with a persistent frontal forelock. The balding is behind the forelock, and the forelock looks strong. Forelocks that persist after the age of 35 often stay, and there is a strong family history in balding families with strong forelocks. For instance, a man can lose almost all of his hair and still keep his forelock. Since you reported that you are 42 years old, I think this is the case with you, but I would need to examine your forelock to see just how permanent it is and to see if there is any miniaturization in it. Weak forelocks show miniaturization, while strong ones do not. I would transplant the area around your forelock to complete the frontal hairline if your forelock is strong in addition to the area behind the forelock.