Out of curiosity, is it possible to artificially create a cowlick using transplantation? Have any patients ever asked you for this?
Yes, creating a cowlick is possible. I have done a few of them, but it is rarely asked for. Many men hate their existing cowlick.
2011-05-12 08:44:432011-05-06 07:31:08Transplanting a Cowlick?
2020-08-24 02:21:492020-08-23 16:14:22Transplanted V-shaped hairline (photo)
Dear Dr. Rassman,
This matter has become quite stressful to me. I went for a hair transplant a month ago, when I had a bit less than a 1000 grafts transplanted on my crown area. It was an FUE procedure. Most say that grafts should fall in 2-3 weeks following the procedure yet most of the grafts are still there on my head. They are not growing and they are not falling, period. The shaved donor area has grown but the recipient area still shows these tiny hairs with no significant change. I am becoming very worried about this matter. Is this normal ? I contacted the doctor and he said to give it more time, as hairs are supposed to fall. Any opinions/advice from your side would be very helpful.I am starting to feel that I wasted 1000 very good grafts (as the doc said the quality was great, I had many 3-4 hairs follicles). Many thanks and best regards.
I will say every surgery is different and the hairs will probably fall out eventually, especially when the new hairs grow in. It’s not “normal” to have them stay in your head. Even if it does (or doesn’t) fall out, the success of the surgery is still not related to the initial hairs falling out. You will only know how successful your surgery was in about 10 to 12 months.
You already spoke to the doctor who performed your surgery, so I’m not sure what kind of assurance I can provide. I don’t know you and I did not perform your surgery, so I have no way to know about your healing. It’s possible that there was a problem with the surgery, but it’s also possible that it will all turn out fine and you’ll be pleasantly surprised. I wish I was able to provide some real info, but I’m limited without knowing more about your surgery or even having an examination.
Think positively, be patient, and good luck.
This is a condition called Lichen Planopilaris (LPP) which is a form of a scarring alopecia that destroys the hair follicle and then replaces it with scarring, resulting in permanent hair loss. The skin is shiny and mottled (this does not show well in the photo), and the hair ostea have some plaques around them. All this is typical of this disease. This man is 62 years old and had two hair transplants (1994 and 2006 totaling 2300 grafts in the frontal hairline). Three years ago, he had a nice frame to his face and a good hairline, but that hairline slowly disappeared. I am concerned than another hair transplant will likely fail. I recommended that he see his dermatologist and get an appropriate biopsy which will likely confirm the diagnosis. These biopsies require a skilled dermatopathologist in the microscopic evaluation of the biopsy.
If the patient has LPP, then any hair transplant would fail.
2019-11-22 03:20:372019-12-02 13:28:30Most of the Transplanted hair was lost 10 years after the hair transplant (photo)
When asked if transplanted hair will last, I always tell patients that transplanted hair will last as long as the hair in the back and sides of the head, which generally last a lifetime. However, transplanted hair can undergo senile alopecia and I have occasionally seen people’s transplanted hair thin out many years after the transplant but this is very rare. Generally, you can expect transplanted hair to last well into your senior years.
2017-10-03 07:09:182017-09-15 12:10:13How long does transplanted hair last
I had a hair transplant 8 months ago to supplement the hair transplant I had 25 years earlier. This recent hair transplant was to soften the hairline and add fullness. After about 3-5 months the hairgrafts were successful and I was quite pleased with the result. However, in late January I had major surgery (spinal fusion with titanium implants). Since that time it appears that many of the recent grafts have fallen out revealing the crude hairline from my original hair transplant and less fullness than before spinal surgery. Is this a form of “shock loss”? If so, will these grafts recovery and grow hair?
It is highly unusual for transplanted hair (taken from the correct donor area) to fall out. In the few instances I have seen it, every time I have observiced ‘permanent hair’ falling out for some reason, the hair returned. This was never in response to another surgery (e.g spinal surgery), but rather usually a response to another hair transplant. If this is truely hair taken from the permanent zone, it will almost certainly return. What I said abobe applies to men’s permanent donor hair zone.
I was told that transplanted hair is placed into a hormone sensitive area (area from hair line over the top of the head till small part at the back). What are the chances (approx. in percent if possible) of losing the transplanted hair? how many patients are satisfied with the result 5-10 years post FUE transplatation?
I have been doing hair transplants for 27 years and have seen patient I did 25+ years ago with their results as good as it was 25 years ago. A few patients will lose their transplanted hair between 5-30 years later, but that is less than 5% of patients?. I have seen many of my patients 5-20 years from their transplants and their new hair largely remained.
2019-04-15 05:10:002019-01-14 14:11:54Does transplanted hair fall out years after the surgery, if so, how frequent is this?
I had a transplant and the hair that was transplanted became kinky. Does this happen often?
No, change in hair character is not common, but it has been reported to me in about an estimated 1-2% of patients. It rarely gets very kinky, most of the time it just becomes more wavy. One patient that I do remember did get a kinky change to his hair after both transplants sessions. He loved it- his hair had never had any character before, so this was a most happy change for him.
Some women develop changes in their hairlines as they age that make them look more masculine due to receding corners. These defects are very evident in women with very dark hair and light skin (like the Asian patient below), more so than in women with blonde hair and white skin or brown hair with olive skin tones.
These changes occur with many women who undergo plastic surgery, as their hairlines are often negatively impacted by face lifts and brow lifts. The changes tend to become noticeable rapidly after their plastic surgery is done, while others who did not have any such cosmetic procedure will barely notice the changes as they occur very slowly over the years. There are many women who show miniaturization in the corners of the hairline that may eventually lead to the type of changes shown here.
We love doing these surgeries as the patients are most grateful.
The before photo is below on the left, the after photo is on the right. This was done in a single procedure of 1800 grafts, mostly in the corners with some work in the frontal hairline. The after photo was taken about 18 months after her surgery. Click to enlarge.
The blood supply to the transplanted area makes the skin darker than normal and I believe that is what you are seeing. It is not a problem and it will eventually become normal in color.
