Month: January 2023

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After Hair Transplants, many doctors ignore patients’ questions – why?

Almost every day I get emails (because of my internet presence) from patients who had surgery and find their doctors don’t seem to answer their concerns and questions. Many of these men see an abrupt change in the doctor when compared to before their surgery. I guess it is like being sold a used car and the salesman is all over you, attentive to your every need, until…. that is, you purchase the car and have problems. As they already got your money they don’t to have to be responsive anymore.

Being a good doctor means taking care of the patient and all of his/her needs before, during and AFTER the hair transplant. I find, however, that I am stepping up to help those whose doctors just don’t seem to care about them after their surgery. This may be more of a problem as Medical Tourism is becoming very common (I get both types of post-surgery emails). If for example, you go to Turkey and have a surgical procedure, then go back to your home country, local doctors will have no interest in you and the doctors in Turkey (assuming that they were doctors – which is often not the case) certainly have no structure put together to help you in your home country.

My advice for anyone reading this post is to meet and speak with patients who had surgery with that ‘doctor’ you are considering before you make the decision to go with that doctor or that clinic. Their patients will always share with you what their experience was, so this way you hear it first hand and will avoid the problems if you listen to what you are told.


2019-12-12 11:51:46After Hair Transplants, many doctors ignore patients’ questions – why?

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After Chemo, My Yearly Shedding Has Stopped

(female)
I have always had yearly autumn hair shedding but since I had chemo 2 years ago this has stopped, do you have any ideas why this might be? Thanks.

Sorry, I’m not familiar with a possible reason for what you’re experiencing.

Just so I’m clear, you’re saying that your hair grew back after chemotherapy, but the seasonal shedding you normally experienced in the past has stopped, right? Have you talked with your oncologist about this?


2010-10-29 15:47:20After Chemo, My Yearly Shedding Has Stopped

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After Care for Scar Revision

Everything seems very promising at this stage, two weeks after a scar revision procedure. I am wondering whether there is anything proactive that I can do to help minimize the presence of the new scar. (Besides avoiding exercise involving unexpected head-turning.) Such as:
– applying onion-based anti-scarring ointment; or
– not applying onion-based anti-scarring ointment;
– or using or not using some other topical thing.

Thanks for everything!

I think that patience is a virtue and if the surgery was done well, that should suffice. Applications of any topical ointment may be pointless at this time. If hypertrophic scarring should occur, then you may need to take a look at it as it forms. Stretching of the scar will take time, as stretching usually starts to become evident at about 6 weeks. Keep in touch with your doctor if anything worries you.

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After a Year on Propecia (with Photos)

This patient came to our office a year ago showing a Norwood Class 3 pattern of hair loss. Dr Pak prescribed Propecia to this young man and after a year of taking it every day, the patient returned to our office to show off his results. He had no hair transplant surgery. The results shown (in the photo on the right) are strictly from a daily Propecia pill.

Before on the left, after on the right. Click the photos below to enlarge.

 

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After a Stressful Situation, My Hairline Has Receded

Dear Balding Blog,
I recently went through a very stressful experience and now 1 month later, I noticed that my hairline has matured or possibly receded around the temple areas. There are many factors I have considered (stress, wearing my hair in a side part, maturation of the hairline), do you think I should begin to take action and see a doctor?

Without knowing how old you are or any of your medical or family history, it would be impossible for me to say what you might be experiencing. So yes, if you’re concerned you should see a doctor for an in-person examination to help determine what is causing you recent loss. At the very least, you should get your stress under control.


2011-08-01 08:17:14After a Stressful Situation, My Hairline Has Receded

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After a Hair Transplant, When Can I Stop Being Careful with My Hair?

Is it possible say after 4 months of the procedure to damage the hair grafts if you are kinda compulsive and don’t really like to even show that you are losing hair as in my case i didn’t have to much hair loss in the first place but don’t like to show that i am losing any at all by styling the hair downwards. spending like 10-20 minutes doing so basically what I am saying is that if the hairs are inplanted after the immediate post op 1-3 months is ok to be less careful after this period and is there any adverse way to affect the growth. Also when is ok to buzz ones head after the FUE technique is performed.

thank you very much

Your hair transplant doctor should have told you this. Hair that was transplanted is considered permanent after a week or two.

Either you are an obsessive compulsive or have not been told the right information. You do not have to be so careful 4 months out from surgery. The point of the surgery is to have your own natural hair. Treat it as such.

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After 8 Years on Propecia, I Think Stress is Causing Noticeable Thinning

Dr. Rassman,
Thank you for providing this informative blog.

I have a question, I have been taking Propecia for 8 years now. But in just the last 3 months I lost hair noticeably in the entire area from the mid section to the front hairline. I think this is the result of stress, lack of proper sleep and not using Minoxidil since the beginning of the year. Can I “hope” that if I start Minoxidil 5% (I had used 2% for over 12 years), reduce stress and get more sleep, I may see some of that hair back? My experience so far is that once I lose hair, it’s gone, I just try to keep what is there.

I’m 48, male, and have had 5 transplant procedures over the last 14 years.

Thank you!

There’s no clear cause for the rapid hair loss you’ve seen in the last 3 months. Since you have had multiple hair transplant surgeries, perhaps you should follow up with your transplant doctor and get a good examination.

The hair loss could be stress related, but it can be anything. You can try getting your stress under control to see if that helps slow the loss down, but I cannot provide more input from such limited description.


2010-09-30 12:09:35After 8 Years on Propecia, I Think Stress is Causing Noticeable Thinning

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After 7 Scalp Reductions, Would I Have Donor Grafts Left?

Dr. Rassman, you won’t believe this. Maybe you will. I have had I guess 7 scalp reductions. Brandy did a lateral with that Y incision, but not a scalp lift, per se. Marzola, Stough, all did a couple of procedures. I saw my scalp under bright lights (the last thing one wants as that is very unforgiving) on a big screen last night and was shocked by the 1 inch by three inch or so bald thin area in the midline. Dr. Hitzig performed two large midline graft sessions around 1999 or 2000, fixing the scar but the density leaves something to be desired. I see you mentioned Dr. Frechet of Frechet extender fame I imagine in a response to a patient. Some sort of triple flap procedure. I have some donor left but can’t get over my lack of crown density despite a large number of grafts. I know Dr. Hitzig always grafted the midline before reducing a scalp. Do grafts just not grow after reductions, especially that many reductions? I could emply better styling but I wish I had followed the late C.P. Chamber’s advice and avoided reductions altogether. He knew what he was talking about. It sounds like there is no practical fix at any price.

Your case is complex. I have no idea what densities you have or the extent of your scar and wound defect. Most people who’ve had 7 scalp reductions are left with a slot deformity. I would like to see some good pictures of your scalp from the front, top, sides, and back. I am sure that you know that scalp reduction is no longer the standard of care today, because they do not work. I have seen men who had up to 16 scalp reduction surgeries and the last ones never really accomplished anything. I wonder about your 7th procedure and what you were trying to accomplish that the prior 6 have not.

It is best to be examined carefully by an expert and then see what your needs are. Patients should make a list of priorities and then try to work down the list. Patients who have had so many procedures never really get too far down that list, so be realistic.

For more information on scalp reductions, see:

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After 6 Months, I See No Change from Propecia

Hello,

I am 24 and have been taking Propecia for nearly 6 months now, but I have noticed little to no change in my hair loss. I have spoken to a doctor about getting a hair transplant but was told that I need to continue taking Propecia after the transplant in order to keep my existing hair, or else I will only have the transplanted hair on my head in the future. If the Propecia is not responding to me are there any options for the future in terms of keeping my hair?

Thank you!

I often write here about the importance of speaking with your doctor for a treatment plan, but I suppose even after talking to a doctor there are things that go missing. Your doctor should have explained to you (and maybe he/she did) that Propecia is not a cure for hair loss, but it should help hold onto the hair you currently have. Some patients respond better than others to Propecia, but that does not mean it isn’t working. It just means your hair loss predisposition is outweighing the limits of the drug.

Hair transplants may help, but you deal with your existing hair problem. This is the main reason you need to have a Master Plan. Hair transplantation is not a simple decision to take lightly. You need to plan for what your hair will look like in the future. With or without Propecia if you are destined to go completely bald (Norwood class 6 or 7) you need to plan for your surgery accordingly.