Author: Dr. William Rassman

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10 Months After My 5th Transplant, I’m Not Seeing Any New Growth

I had a transplant about 10 months ago. I can feel the stubbles since back then but it doesn’t seem to grow. It’s now 10 months later and it’s still the same. I had transplants before and almost very quickly, i would notice the thickening and darkening from the previous procedures.

This last procedure was my fifth and don’t seem to see a good result at 10 months. By this time my the transplanted hair should be maturing, correct? I now have about less than 3000 grafts done. Each procedure done in the past, the doctor could never extract enough donor. Perhaps it’s my donor area. Any thoughts?

At 10 months following your hair transplant, you should definitely see growth. Unless I am misreading your question, if you had five procedures that totaled under 3000 grafts, that is not today’s standard of care… however, I can not judge what your doctor was doing.

I’m not even sure what kind of surgery you had — strip or FUE. Plus, I don’t know if he was chasing your hair loss, if you were on finasteride, what your scalp laxity was, etc.

Have you talked to your surgeon about why there’s been no growth after 10 months? If you need a second opinion, you can either schedule a visit in my office or see another good doctor if I’m not local to you.


2014-02-05 11:25:1510 Months After My 5th Transplant, I’m Not Seeing Any New Growth

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1 year on finasteride (photo)

This is a predictable response for finasteride. This drug works best on the crown and it is more predictable with response in the crown when compared to the frontal area. The older you are, the less responsive the frontal reversal will be.

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1 year finasteride question

Have you seen first sign of improvement on Finasteride after one year?

This is not uncommon. Sometimes just slowing the hair loss is hard to notice, but if, while taking finasteride, your biological hair loss activity slows down, then the finasteride may become more effective. This might explain why you see improvement appearing at one year after starting the drug. This drug, in sensitive men, can give reversal of hair loss especially in the young men under 25 or even 30. It works better in the crown than on the frontal areas.

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10 Days After FUE Surgery, I Rubbed My Transplants By Mistake!

Dear Sir,

First of all, thanks for this useful guide for those who are in this trip to recover the lost hair.

I am in my 10th day after FUE surgery and today in the shower by mistake i rub my transplanted hair once by mistake (only one gentle pass with my hand), apparently there was no bleeding or lost hairs. The problem that i see after reading this blog is that i still have many scabs so i am concerned if probably i damaged many grafts. Am I right or wrong?

Thanks a lot for your work and attention and apologies for my english because is not my native language.

You are probably safe from losing the value of these grafts; however, there is no certainty in life. If it was just a gentle pass with no bleeding or grafts coming loose, I wouldn’t be concerned…. but if you are truly worried, you should follow up with your surgeon and have him/her examine your scalp.

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1 year after a hair transplant and it looks spotty

At one year after a hair transplant, I would expect to see at least 95% of the growth to styling length on your head. Go back and meet with your doctor and see what your doctor has to say. If you were my patient, I would want to know for sure that you don’t have some autoimmune disease and if you don’t then your doctor should make it right financially for you

poor result

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10 year study of finasteride use

This 10 year study of finasteride in Japanese men is very significant. (1) it revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years, (2) younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.

https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

We evaluated the long-term (10-year) efficacy and safety of AGA treatment with 1 mg/day finasteride in a large study population (532 patients), as the first study of this kind in Japan, to our knowledge. A high objective efficacy was demonstrated by the MGPA, which revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years. Furthermore, the outcome was similar to or better than that reported by other studies in Japan [8-10,13,17]. Differences have been known to occur in the progression of AGA symptoms between Japanese and Caucasian men [8,18]. This efficacy of the investigated treatment in Japanese men exceeded that reported in other studies in Caucasians. The superior response of Japanese men with AGA was reported to likely be attributable to their hair characteristics (greater diameter, black color, and lower density), which facilitated the detection of slight changes [10,19-23]. A novel finding observed in this study was the significant difference in the improvement of AGA following finasteride treatment between the N-H: I/II/III and N-H: IV/V/VI/VII groups at the first visit. The ROC analysis revealed a similar difference, that was performed to classify patients with improvement (MGPA?5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III (AUC: 0.746). Furthermore, the MGPA of the total study population and the N-H: I/II/III group at the first visit significantly improved from treatment year 5 to 10 (P<0.001). This efficacy was different from that of a 5-year study in Japanese men, which reported that the efficacy began to plateau after 4 years of treatment [10]. Several studies have reported that AGA progresses in N-H classification with age, [7,11,12,18] and that younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.


2020-05-06 18:24:3310 year study of finasteride use

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100% Donor Scar Elimination?

Dr. Rassman,

Do you think that 100% elimination of donor scars will be possible in the future? Technology is always improving and it seems like scars could be emliminated. Are there any other possibilities other than Juvista and Acell that are being researched? Thank you for all the helpful information.

Scarring happens as a result of all surgeries. There is no such thing as 100% elimination of a scar and treatments like Juvista and Acell will not dispose of scars entirely. The key to dealing with scars is to keep them very, very small. In the case of a donor scar, it can be as small as 1mm wide naturally in good healers, or reduced to that level on occasion. For bad healers, there really is no solution. By “bad healers” I mean those people who stretch their scars after the wound has healed.

Techniques such as the trichophytic closure repair of a wound in the donor area works well in many, but not all patients. For more info on the trichophytic closure technique, see here and here.