Dr. William Rassman – Page 1191

May 4, 2010

Am I Losing My Transplants After a Shower? – Balding Blog

Hi Dr Rassman,

I had two transplant done. One in aug2008 and another one in January 2010. Total about 5000 grafts altogether. Sometimes after showering I see 2 to 3 hairs in the towel with a bulb. the hair that falls out is also thick. Do you think I am loosing a root? or its normal hair cycle. Please advice. I am not sure if the hair that is lost will grow back .

thanks

Everyone goes through normal hair cycling, meaning every hair will fall out and then after a few months in the telogen phase, it will regrow. I can not comment on any particular hair loss that you are reporting, because I don’t know exactly what you’re seeing. Both transplants would’ve taken hold by now, so those 2-3 hairs on the towel are likely nothing to worry about. You should go back to your surgeon for his/her confirmation of that. Hopefully, the transplanted area will hold its overall fullness and that will be the best indicator of the permanent nature of those hairs.

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May 3, 2010

Hair Loss InformationMy Transplanted Hairs Don’t Look Like My Natural Hairs! – Hair Loss Information – Balding Blog

Hi Doc,

I am 27, and stupidly got two procedures (~800 grafts each) done about three years ago. Have been taking propecia since the age of 18 and just started on rogaine a few months ago. I guess I’m about a Norwood 3, moving towards a 4 (except no thinning on crown).

Anyway, the problem is that the transplanted hairs came in much thicker and more wiry than the natural hairs, and they were not always individual hairs, so I’m about a year into getting them removed as best I can via electrolysis. The skin is slightly scarred, but I’m unsure exactly how it will end up looking once it gets time to really heal and start to fade.

I’m trying to weigh my options for proceeding as my hairline continues to recede, and am deciding if I should continue to get the rest of the plugs removed as my natural hair goes or if it’s worth more transplantation but done with more care. The question is really do you have any knowledge about different types of hair responding differently to transplantation? My hair is dark brown and curly, would it be more susceptible to coming in thick and kinky than someone with finer straight hair? Because the last thing I want to do is get more transplants and have them be obviously fake and just compound my problem!

Thanks a lot, and I love your site.

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As I’ve said many times before, the good news about a hair transplant is that it is forever… but if you have a bad hair transplant, then you probably aren’t looking at that news as being too good. Even removing the hairs may still leave a scar and cause an unnatural hairline, as you’re noticing with the electrolysis. Something concerning me though is that you’ve had 2 procedures at 27 years old of what you describe as “plugs”. I hope you aren’t referring to the ugly, old hair plugs that you commonly see in men that had surgery decades ago. Perhaps you’re just using the wrong term and you meant “grafts”, which are made up of 1-4 hairs. Modern hair transplants will look natural and the hair shouldn’t change character or color.

There are still options even though you may have a bad transplant, but BaldingBlog is not a place for second opinions. You’ll need to have an evaluation to see what options are available to you since each repair case is unique, so you should see a hair transplant physician (just don’t go to the one you already had two surgeries with, obviously). If you want to come out to Los Angeles, our consults are free and we have plenty of experience with patients who are in your situation. We have performed corrective procedures on many sub-par hair transplants.

See Dean’s Story for an example of a repair process, and check the Repair category for even more posts about this.

May 3, 2010

Hair Loss from Alcohol Abuse? – Hair Loss Information – Balding Blog

I’m 43 years of age. I just quit drinking 6 months ago, my liver was in bad shape to the point my doctor didn’t think I was going to make it. Since then I changed my diet, abstained from using alcohol and anything else that might be hard on my liver. Blood tests that I’ve got recently show my liver to be functioning normal. My health according to my doctor is good. All symptoms like extreme bloating, sight loss due to water leakage from blood vessels, and anxiety attacks, which was the reason why I started to drink in the first place, have gone. The problem I have is that I’m losing hair in large amounts. I NEVER had any noticeable hair loss before and this started 3 months after all my symptoms of alcohol abuse were gone. I still smoke (trying to quit). I take vitamin supplements. my diet is good. what can cause this? Stress?

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Alcohol Diet and an adequate daily intake of vitamins are often a problem with alcoholics, and as you appear to have started to address these issues, it will hopefully become better in the long term. This is a complex problem in that you may have genetic factors in addition to what has impacted your general nutritional issues in the past.

A good examination by a competent hair doctor will show the degree of miniaturization and balding you may have, the status of your donor hair as compared with the areas of loss, and the presence or absence of a telogen effluvium can be evaluated. The long term impact of your past drinking history may still have ramifications for you. I can not help you more directly without examining you.

May 3, 2010

Waiting Period If Switching from Propecia to Avodart? – Hair Loss Information – Balding Blog

After reading your blog, I understand your concerns over prescibing Avodart for hairloss. However, if someone were to make an informed decision to switch from Propecia to Avodart for hopefully better results, would you advise them to switch immediately or stop taking Propecia for a while before taking Avodart? Lastly, would the switch in medication return the user to stage one i.e. they would be starting to tackle hairloss all over again, or would the Avodart immmediately “follow up” or add to the effects of the Propecia in limiting DHT etc?

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Avodart When switching from Propecia (finasteride) to Avodart (dutasteride), I wouldn’t think that any waiting period is needed. I’m not sure how informed your decision in switching medications is since dosing information hasn’t been established when taking Avodart to treat hair loss, but since both are prescription medications I’d hope these are things you and your physician have worked out. For those curious, you will not need to maintain the Propecia upon switching since Avodart is also a DHT blocker. The two medications work in similar ways, so I’d guess that it would just pick up right from where Propecia left off.

May 3, 2010

Should I Trust This New Hair Transplant Surgeon? – Hair Loss Information – Balding Blog

Hello,

I an from India and wish to get a HT done. I approached [a doctor] but I found out that the medical trip could be quite above my spending capacity and also I cannot find enough time fo the same. There is a new surgeon in India who is a ISHRS fellow and incidentally also happened to work under [the other doctor] (according to his website). I have also seen her results and I find them better than what others in India have produced.

The only thing that stops me from going to her is that she is into practice less than a year(but i don’t have any information about her past experience). Can I trust her bald head to this new doctor or should I wait for a while and get it done abroad?

Regards

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I can’t tell you who to trust. I’m not familiar with that doctor or her work, so you might want to use Google to research the doctor a bit more or ask around in various hair loss forums. Be sure to ask the doctor herself for any information about her past experiences that you wish to know. Also, ask to meet with live patient models so you can see the quality of her work in person (this is better than just seeing photos).

Don’t rush into surgery because the price is cheap. Go with whichever doctor you’re most comfortable with (and results that you like), and if it means you have to wait to save up your money, then you should do that.

May 3, 2010

Will Hair Regrow After Cyst Removal? – Hair Loss Information – Balding Blog

I had 2 cysts on my scalp removed at Easter and one has healed quite well but the other has left a bald spot about the size of a 50 cent peice. The skin is more pink and shinny. Will the hair grow back? There doesn’t appear to be any re-growth? Should I be seeking some form of treatment? What can I do to look normal again? This is not a good look for a female. Thanks.

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You’ll have to allow more time to see if there will be regrowth. Being patient is all you can do at this point. If after a year the bald area is still the size of a half dollar, then you might have lost hair permanently… and a very limited hair transplant would likely solve the problem.

April 30, 2010

Hair Loss InformationHypothetical Graft Requirements for Norwood 6 to 1 – Hair Loss Information – Balding Blog

I am just curious to know how many grafts would it take for a Norwood 6 to return back to a Norwood 1? I know this is not possible, but suppose hair multiplication became possible in the next decade, can you give us an estimate of how many grafts it would take for a Norwood 6 to return back to Norwood 1 ?

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Hypothetical In general, you need about 15% of your original hair density to achieve the appearance of non-balding if you have an average hair density. Please note that this will give you a non-balding look (somewhere between a Class 2 and 3 pattern), but not the complete original density. Moreover it is NOT all about the numbers. Factors such as hair color, skin color, texture, etc are of great importance. For more, check out the Assessing Hair Loss page at the NHI site (scroll down to “How Much Hair Do I Need?”).

But if you want to know how many grafts you need to replace (hair for hair) of hairs lost, it could be in the 30 to 50 thousand hairs range. This is based on a general assumption that you are born with about 100,000 hairs. Remember, grafts are made up of 1-4 hairs.

April 30, 2010

Hair Loss InformationLimited Donor Hair from Previous Surgeries, But I Want a Widow’s Peak – Hair Loss Information – Balding Blog

i’m 39 yrs old. have had 4 or 5 (honestly cant remember) procedures (transplants) since age of 22. as is the norm..hair loss has progressed. was on propecia and got off it about a year ago. felt tired and down. was told propecia may contribute to these feelings.

in any event, i think my donor area is very limited (i assume) but i would love to fill in my widows peek and get some fullness back in my very thinning crown. i was never satisfied with my hairline from previous procedures..it looks very natural..but is still high in my mind. i’m wondering, in general what types of strategies you use when dealing with someone who has limited donor area like myself?

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I would have to examine you to give you any information beyond generalities. There are many men who have depleted their donor areas. The FUE technique can take some hair from depleted donor areas and may be used to move beard hair or even body hair. Regular readers of this site may note that I’m not a fan of body hair transplantation (BHT), but I am willing to consider exceptions when it comes to a depleted scalp donor area.

An examination is appropriate and as you indicated that you are possibly local, we may be an easy connection for you. My office is in Los Angeles if you’d like to setup a free consultation.

April 30, 2010

Hair Loss InformationI Was Told to Stop Finasteride 2 Weeks Before My Surgery – Hair Loss Information – Balding Blog

Hi There,
I have had 2 procedures with a clinic and have been pretty happy with the results, however I seemed to lose a number of hairs due to (what I now know to be ) shock loss. The clinic manager advised that if I was taking finasteride then I was to stop doing so 2 weeks prior to the procedure. Is this normal advice as I thought you usually advised patients to take finaseride up until surgery to help prevent against shock loss.

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You’re right to be skeptical, as this is not normal advice. I would be suspicious / curious to know why they would say that. Propecia is your best weapon against shock hair loss, the enemy of the transplant patient. There is no downside to taking the drug through the day of surgery. In fact, I encourage those that are taking Propecia to maintain their normal dosing before, during, and after the hair transplant surgery. I’d ask the doctor that prescribed you the medication, not the clinic manager, what he/she suggests.

April 30, 2010

Hair Loss InformationRogaine Causing Puffy Cheeks? – Hair Loss Information – Balding Blog

Hi,

I’ve been using Rogaine consistently for over a year now. I haven’t had any obvious side effects or reactions from it and am completely healthy. However, I’ve noticed that over time, my cheeks don’t seem to match the rest of my body. In other words, I have a very low body fat content (I’m lean and in shape) but have big “chipmunk cheeks.” I’ve looked around and found people reporting similar experiences while on Rogaine. Could this be a side effect of the Rogaine? Have you heard anything about this before? If so, would there be a way of counteracting it? The ideas I’ve read thus far have suggested that it might cause water retention in the face or redistribution of fat. I’d appreciate any insights! Thanks!

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Facial swelling is a known rare side effect possibly due to an allergic reaction of Rogaine (minoxidil), and we’ve reported on this before. Changing the dose or the formulation (like the use of foam rather than the liquid) may be helpful.