Author: Dr. William Rassman

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Trigrowthic Suturing Technique – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I’ve asked you this question before but had not received an answer. I recently read about a so-called new “trigrowthic” suturing technique that promises to leave no visible scarring post strip op. Have you looked into this procedure before and is it to be believed? Thanks.

“What’s in a name? That which we call a rose
By any other word would smell as sweet.”

-From Romeo and Juliet (II, ii, 1-2)

The use of trichophytic closures have been around for years — in fact, that closure has been used in plastic surgery for more than two decades. The hair industry adopted it recently as a standard of wound closure. You could change its name and correctly say that you invented that name, but it would be improper to say that you invented the procedure. The doctors you have referenced here are recycling techniques under a new, original name and as such, if they are claiming inventiveness, then they might be deemed dishonest.

There is NO such technique that can provide results with no visible scarring. ALL cuts on the skin will leave a scar and the scarring is unique to individual patients. Some patients have minimal scarring, while others have more scarring — it is dependent on their genetic makeup, which no one can tell with just a physical examination. Some of our patients heal well and have very minimal scarring that is hard to detect with a regular hair style, but even these patients will have a visible scar if they shave their head bald.

We routinely use a trichophytic closure which I assume is similar to what you have read. For more information about the trichophytic closure, please see:

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Hair Loss InformationLarge 5000+ Graft Transplants – Hair Loss Information – Balding Blog

I read about megasessions of 5000 or more grafts. Particularly from a Canadian group. Yet unless the average Canadian hat size is larger, that is near impossible unless they are doing it on the graft dissection end of things. How can one doc get so much more hair then others??Larger heads, larger incisions??

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Large sessions, really large ones, were defined by me in 1993-4 timeframe when I reported first breaking 2000 grafts/session, then 3000, and finally in early 1994 I reported my first of many 4000+ graft sessions. These are not typical. First, the surgical team must be trained in doing large sessions with fast, efficient cutting and placing. The following points must be available for the surgery to be successful:

  1. The sessions should not take more than 8 hours, for beyond that time, the grafts out of the body that are awaiting placement produces reduced graft growth.
  2. The surgeon must know the nuances of prolonged anesthesia without increasing the risks to the patient.
  3. The patient’s scalp laxity must be very loose so that a wide strip can be taken safely (often these strips measure greater than 2cm in width and 10 inches in length).
  4. The patient’s density must be high (50% higher than normal densities).
  5. And as you said, the head should be a larger size to yield wider and longer strips.

Large sessions are no more risky than smaller sessions, but the above criteria must be met or the yield would not be there. My record number of grafts in any one session to date is 5800 grafts. I remember that patient well, because had his balding pattern been more advanced, I would have gotten 10,000 grafts from him with ease. His density was twice average densities, his head was larger than normal, his scalp was loose (actually, very loose), he was young and healthy and we completed the surgery in 7 hours.

Good question and thanks for asking it.

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Hair Loss InformationAre Pimples on Scalp After Transplant a Good Sign? – Hair Loss Information – Balding Blog

3.5 Weeks after a Hair Transplant, Is it normal to see pimples in the head so early on? I have maybe 3 or 4, one at the hairline and the rest in between my grafted area… I hear pimples on the head is a good sign that hair is trying to break through the surface, at almost 1 month post-op, is it possible to start hair regrowth? I do have fairly thick hair and my hair does grow fast elsewhere, just thinned in the front. I would be a 3 on the scale… Thanks!

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Pimples are never a good sign. They do happen for a number of reasons after a hair transplant:

  1. Small cysts form from sebum build-up in the sebaceous gland that remains after the hair has shed.
  2. Small bits of remaining hair shaft are below the skin and are shed. Hair is a foreign body and as such is rejected through small cysts that come to the surface. These remnants of hair follicles or sebaceous glands may get infected and require antibiotics. Generally, they can be successfully treated with warm soaks. Be sure that these do not turn into folliculitis by visiting your doctor and establishing a good dialogue with him/her.
  3. In less than a good surgeon’s hands, cysts may reflect ‘piggybacking’ of one graft placed on top of another.

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Hair Loss InformationLaserComb Versus Bigger Laser Machines – Hair Loss Information – Balding Blog

Dr. I bought the hair max laser comb, i cant tell if it is producing results or not, my hair is still pretty thick, my question is, is there a difference in the hair max laser comb compared with the machine that you sit under, is there a difference in quality or the results you can expect?

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Unless you have a camera that takes pictures at the exact and repeatable spot on your scalp, it is almost impossible to tell. One researcher (see: Analyzing the Results of the HairMax Laser Comb) used a small tattooed dot on an area of interest and took serial photographs at regular intervals to see if there is a change in hair count. I reviewed that particular study, as you can see in the above unfavorable reference. To my knowledge, no comparable study has been done so far for the lasers that you sit under.

With respect to your question asking if laser comb and the ‘bigger’ laser machines differ, well, the size comparison is obvious — one is a comb and the other is a big hood that you sit under. If you are asking if one is better than the other, I have no way of telling, but based upon the study of the laser comb, which was most unimpressive, I might think that the comb has very limited value. The subjective feedback of patients who have experienced the larger system seems positive, but there are no objective criteria for me to endorse. If you are asking for the results, I have no way of telling at this time.

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Hair Loss InformationAHA Complex by Spencer Forrest – Hair Loss Information – Balding Blog

Was wondering if you have heard about a “new” product from Spencer Forrest called AHA Complex. It’s advertised by them as a “hair vitamin that helps to inhibit hair loss and encourage new growth”. It is said to include Saw Palmetto and amino acids derived from fish oil extracts, green tea extract, grape seed extract, B6, etc, etc….I have found SF to be a good company, and I use two of their products. However, I am skeptical of this new product, even though they offer a “guarantee” that the user will see “visible results in 60-90 days” and that they give a full refund after 120 days of use if you are not “thrilled with the change in your hair”.

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Good marketing appears to be their style. I would doubt that such a guarantee will materialize with hair, but if you are a gambler and believe that they will give you back all of your money if it does not perform to the promise, then you might take them up on it. Your call, of course. I remain skeptical.

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My Hair Really Stinks – Hair Loss Information – Balding Blog

I wash my hair everyday,and the next day it smells like sweat odor,stinky.If i dont wash my hair for one day it will smell more stronger,I used to have long hair and braided but cut it off because it stinks,I thought the smell will go away but it didnt.I used alot of hair products that has oil to braid my hair, I went to florida,im thinking my hair got real dry from the sun and that why it stinks,I use alots of diffrent shampoo, and no luck,can u help me

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Try different shampoos with conditioners that will put some moisture back if you think that it is too dry. I really do not have more to suggest, particularly in regard to the smell. Sorry.

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I Was Told My Grey Hair Would Be Too Difficult to Transplant Using FUE – Hair Loss Information – Balding Blog

I am a 58 year old male with grey hair and would like to have 1000 graphs using FUE but have been told with my grey hair this is too difficult. The graphs would strengthen my hair line and fill in at the crown. Was offered 1400 FUT, previously had 800 micros with good result-but an unpleasant experience. FUE not so invasive. I believe I am a Norwood grade 3-thinning at crown and an adult hairline.

Regards

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Transplanting gray hair using the FUE technique is difficult, but you can dye it the morning of surgery and then go ahead with the FUE. Problem solved!

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Hair Lice (Not Hair Loss) – Hair Loss Information – Balding Blog

Hi,
I work at a daycare and had a case of head lice a month ago. I treated it with over the counter and prescription and it came back. I then used oil treatments and homeopathy. I recently returned to the doctor to find out it is gone. HOwever; I still have itching around my ears and top of head. I also have a lot of dandruff. The doctor gave me a topical solution of cortisol but it does not seem to be helping and only making it worse? Is this normal after a case of head lice will it go away?

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LiceHead lice can be a problem and it usually requires a strong prescription medication to eliminate it. Moreover, you must remember to wash ALL your sheets and clothes in very hot water and then through a hot drying cycle to kill the lice and eggs. You may find that the dormant eggs have now hatched and that is causing your problem. I would advise you to be seen by your doctor (again) if the problem persists. For more, see:

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Chemotherapy and Female Hair Loss – Hair Loss Information – Balding Blog

At the recent ISHRS medical meeting in San Diego this past week (October 18-22), there was a suggestion that women who lose their hair from chemotherapy and do not treat the loss with medications such as minoxidil, may recover with better hair in the long term than those who are aggresssively treating their hair loss. The rationale for this appears to be interference with the normal growth cycling. If the chemotherapy causes the hair to go into its normal telogen cycle (rest) and the cycle completes itself, the hair is more likely to grow fuller than if the cycle is forced to be curtailed with these drugs. This is an interesting view of the chemotherapy hair loss problem.

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Adderall and Alopecia – Hair Loss Information – Balding Blog

Can adderall effect alopecia. Because i have alopecia, and tried Adderall a couple times, nothing consistent and i noticed that my hair growth had halted and i began getting new bald spots. I have had alopecia in the past but it always seems to grow back.

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There is a direct relationship between Adderall and alopecia in some people. The rest of your question makes no sense to me. Sorry.