Dr. William Rassman – Page 1795

June 7, 2006

Doctor Using Laser to Transplant Hair? – Balding Blog

hi dr, i live in tampa and there is a dr markou over here that i really trust & appreciate, he uses a laser to do transplants, not the old laser version but some new technology, is this safe, could you please comment on it,

can a miniatuization tell you what the hair was like before?

Laser hair transplants as I know them, produce damage and are second class transplants. If there is a new technology, I would love to learn about it. Generally, I advise people looking at laser hair transplants to run hard and fast away from those suggesting it.

With regard to miniaturization, please read the many entries on this blog about the subject. A good starting point was my recent post, Miniaturization or Gimmick?

June 7, 2006

My Hair Is Thinner After Transplant – Hair Loss Information by Dr. William Rassman

I had a hair transplant in August 2005. The doctor used the slit technique and placed 900 grafts in the frontal 2.5 inches of my scalp. He told me that the “see throughness” would be corrected. I am a 33 year old female who did not notice thinning until after the birth of my son. I waited until he was 22 months old to have the surgery to rule out any acceleration in my hair loss and make sure I was done with the post-partum shed. I had previously seen one other transplant doctor before electing to have the surgery, and he had suggested two procedures in the frontal area, covering about the first 1.5 inches of my scalp. I chose the second surgeon because he said he did two female transplants a week (thus he had experience with women) and could do the whole thing in one procedure.

Immediately after my surgery I was thinner and the doctor said it was normal to lose hair during the procedure; but that it would grow back. Three months after the procedure I had lost so much surrounding hair that it totally negated any gain from the 900 grafts, 25% of which kept growing from day one on, the rest of which had begun to grow at 3-4 months. Today, 10 months later, I am about 25% THINNER than I was before the surgery. The doctor said I suffered some permanent hair loss, probably hairs that were predestined to fall out anyway. Shouldn’t he have known this when he examined me, prior to the procedure????

Now I am very upset because two transplant doctors have told me I was not a candidate in the first place; that I hadn’t lost enough hair to have the surgery. If I choose at some point in the future to have another transplant, to try to put me back where I was beforehand, what is the likelihood that the grafted hairs, and/or additional surrounding permanent hairs will be shocked out? Are there any new techniques in the works that would minimize or eliminate the irritation to existing follicles? Is a smaller procedure (100-200 grafts) in the very frontal region less likely to put my surrounding hairs at risk? Lastly, is the individual follicle removal technique okay for me, as opposed to another strip technique? To give you some idea of the condition of my donor area, the doctor noted that my density was 3.5 out of 5.0.

Thank you in advance for any insight you can offer. I am sorry I don’t live in your area, as I would definitely come in for an in-person consult. I live in the Boston area and would appreciate any sound, competent and surgically conservative referrals you could give me.

I have said many times on this blog that if any doctor tells you that he/she does many hair transplants on women, that you should run for the hills. Women generally make poor hair transplant cases, because the hair from the side and back where the hair is taken from is not normal — so why would one put not normal hair into areas of thinning, where the hair is not normal as well? You need to see a good, honest doctor with a lot of experience in this field — seriously, someone who is impeccably honest. May I suggest that you make a trip to New York and see my colleague Dr. Robert Bernstein?

June 7, 2006

Pimples in Donor Area After Transplant – Hair Loss Information by Dr. William Rassman

Doc,

I have a similar question to the person who asked “about scarring in the donor area”. I had a hair transplant on 5/16/2006, and had my sutures removed on 5/30/2006. I went to my Dr’s office on 5/25, and showed him my scar which I felt was becoming infected due to me being too agressive in cleaning the area. I felt what seemed like pimples in the area.

At that time my Dr., said it looked fine but on when I went to have my sutures removed on 5/30, the outer level (he stated he stitched below the skin as well) of sutures had become loose in some areas. He again said he had seen this before and it was nothing to worry about and would not cause the scar to be wide or hypertrophic. He popped some of these pimples in the donor area and prescribed me an antibiotic for 10 days as “a precaution”.

It has been approximately a week since I had the sutures removed and the scar is very pink and at times I feel sudden, slight, yet sharp pain the area. I think part of the problem is that this doctor excised a previous scar from a previous HT.

My question is do my symptoms sound normal to you, and have you heard of using an antibiotic as “a precaution”

PS If I ever decide to have a third HT, I think I will fly to California to meet with you in person. I regret not finding your site and this blog sooner.

What you are telling me sounds ok. Recent wounds feel different with different people. You can not really wash too vigorously on the donor wound (reasonable washing is probably what you did). Don’t blame yourself here as everything sounds OK. If there are real pimples in the donor wound, possibly suture abscesses may be occurring. A culture taken by your doctor with follow-up antibiotics are the regular approach to this type of problem. With the sutures now out, most of the pimples should be gone by the time you read this response.

Good luck.

June 7, 2006

Stretching Wounds and Scars – Hair Loss Information by Dr. William Rassman

How will these new wound closures you discussed in this blog impact people who have scars that stretch? I have scars that stretch every place I have had a surgery, including my hair transplant scar.

A trichophytic closure will not work if the wound widens more than 2-3 mm, because the hair growth from the trichotomy will only grow up to 2-3 mm from the edge of the wound where the trichotomy was done. The stretching may be helped by a sub-fascial closure below the occipitals muscle fascia. The tension reduction of such closures has value in reducing the wound size, but not necessarily in obliterating it. You might have some form of Erlos Danlos Syndrome (see here, here, and here), which comes about from defective collagen by its very nature. The story of EDS is not black and white, for I believe that some people have small amounts of this defective collagen and these people are the ones that may get stretching of the scars. In such situations, even the sub-fascial closures will not work, because eventually the body must heal the wound and as the sutures dissolve, the value of the sutures that hold the wound together will decrease over time.

Scars are at times a price one pays with surgery. For strip harvesting, this could be a price you will pay. If you have FUE harvesting (Follicular Unit Extraction), then this stretched scar problem should not become an issue with regard to your healing, as there is no large line scar to stretch.

Now with that said, putting the scar issue in perspective, the scar only exceeds 3 mm in about 5% of cases. If that happens and it bothers the patient, then I make this my problem as well and we work to solve the problem with whatever it takes.

June 7, 2006

Using Hair Oils And Protein Creams – Hair Loss Information by Dr. William Rassman

i am 19. my hair is straight and fine…

my hair was usually very full and thick when i was younger. however, i have been using hair oils like amla, almond, amla and black seed.

i shampoo my hair daily with himalaya anti-dandruff shampoo because if i dont, my scalp becomes very itchy. and then i apply the oils after shampooig and keep it for day. is it alright to use hair oils daily? and is light liquid paraffin bad for the hair (i know that mineral oil and petroleum damage the hair)? sometimes i apply a generous amount of himalaya protein hair cream on my hair and scalp… i dont know how much to apply, maybe i am apply alot. basically, my hair is a little thin on the front and middle of my scalp. however, on the back and sides they are full…

i wanna know how to get my hair back. and if using hair oils and protein creams daily and in generous quantities have good/bad effects on my hair.

note: i have seen some improvement after using hair oils…

I am not sure what you are asking. The use of oils and creams on your hair will probably not hurt but the directions on the products will tell you how to use them — hopefully they are safe. The question should be: Will it help deal with male pattern hair loss? From genetic balding, your hair will likely not come back once it is lost and treatments like those that you are using may only slow down the correct way to stop the loss. There are drugs such as finasteride (Propecia) that may prevent further hair loss or may bring some hair back. However, you need to see a medical doctor for the correct diagnosis, get your hair mapped out for miniaturization to establish the diagnosis, and have a prescription to start Propecia if the diagnosis of genetic hair loss is confirmed. It is my medical opinion that the quantity of hair oil or creams that you are using is NOT likely the cause of your hair loss.

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June 6, 2006

The Look of Hair Fullness – Hair Loss Information – Balding Blog

I would like to achieve even density on head, like I originally had before I lost it there. I dont mind my hair being short, but i would like to fill in the runways that run down the sides behind what is now an OK frontal area. How many grafts will it take and how much will it cost?

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I am not sure if you really understand your own question. The average person has 1250 hairs per square inch so if that is your target, the number of grafts (usually about half of the number of hairs or 625 grafts per square inch in your case) is easy to calculate by measuring the # of square inches you want to cover. But that number has no significance if you really just want to look full in those runways. The answer to looking full depends upon the color/contrast in your hair and skin color, the thickness of each hair shaft (coarse is better than fine and wavy is better than straight). If you are a blonde with white skin, you may only have to return 15% of the hair density, with coarse hair, you might get away with 25% of your original density in the runways, and if your hair is wavy with good body, who knows that value. Our charge per graft is lower during our Summer Special: $5.50 if you schedule an exact date and $4.50 if you take our standby rate. My personal rates are slightly higher.

June 6, 2006

Eucapil – Comments from the Inventors – Hair Loss Information by Dr. William Rassman

I received this comment to my post from last month about Eucapil from M. Sovak, M.D., University of California Medical School –

Response from the inventors of Eucapil:

We understand that a comment by Dr. Rassman was published on the site consecrated to the surgical hair loss restitution. We therefore understand that plastic surgery will remain the priority of its practitioners.

We nevertheless have to correct a number of statements which are erroneous:

1. Eucapil is not a cosmetic available only in “the Czech and Slovak countries”. Eucapil was approved as a cosmetic in the Czech and Slovak Republics and thus under the EU Law of Cosmetics can be made available in all EU countries.

2. The definition of a cosmetic in Europe is not the same as in the US and the producer of Eucapil, Interpharma Praha, is not making any medical claims whatsoever. In the EU, a cosmetic is a product which acts on the skin and its appendages without having any systemic effects.

3. It is not clear what “good things for the appearance of hair” means. To state that there is no suggestion or proof that Eucapil can reverse hair loss is simply untrue. We refer the reviewer to the appropriate scientific presentations and articles in peer-reviewed journals on the website, www.eucapil.com (Sovak M, Seligson AL, Kucerova R, Bienova M, Hajduch M, Bucek M. 2002. Fluridil, a rationally designed topical agent for androgenetic alopecia: first clinical experience. Dermatol Surg 28:678-685, with an erratum on p.971; Bienova M, Kucerova R, Hajduch M, Fiuraskova M, Sovak M. Efficacy and Safety of Eucapil Gel in hirsutism (Pilot Study). Proceedings of 14th Congress of European Academy of Dermatology and Venereology, London, October 12-16, 2005; Kucerova R, Bienova M, Novotny R, Hajduch M, Fiuraskova M, Seligson AL, Sovak M. Eucapil in Female Androgenetic Alopecia: Efficacy and Safety after 9-month use. Proceedings of 14th Congress of European Academy of Dermatology and Venereology, London, October 12-16, 2005).

4. Everybody in hair dermatology knows that the reversal of hair loss can occur only if the follicles are still viable and this applies to systemic therapy such as one with finasteride (Propecia) or the topical material such as minoxidil (Rogaine). We agree, however, with Dr. Rassman that the ultimate and best way of dealing with hair loss which can no longer be reversed is to use implants and other plastic surgery approach which today has been developed to excellence.

5. Eucapil IND has recently been filed with the US FDA with all relevant preclinical and clinical information. We should perhaps state that the primary endpoint of the studies is arrestation of hair loss of those who suffer from continuous effluvium (hair fall out) and that as a secondary point and based on clinical observation there is a statistically significant increase in the hair diameter which may be responsible for the overall improved appearance of the hair. We wish to be sure that the readers of this response understand that Interpharma is not a “producer of natural supplements” which pushes “claims that may not be valid”. Interpharma works strictly under good manufacturing practices (GMP) and publishes its findings in recognized journals. More information for anyone who would wish to read scientific abstracts is contained at the Eucapil website, www.eucapil.com.

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June 6, 2006

I See Redness In Your After Photos – Hair Loss Information by Dr. William Rassman

i noticed that in your after photos there is still redness in the receipient area even months after the transplants.

It is very rare (almost improbable) that you would ever see redness on the transplanted area of the scalp MONTHS after surgery. Perhaps you are looking at early photos. Please email me the photos you are referring to and I would be delighted to review them and comment on them publicly.

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June 6, 2006

Pressure Burn Causing Female Hair Loss – Hair Loss Information by Dr. William Rassman

(female) I had spinal surgery april 7th of this year, and got what I was told was a pressure burn from the face pad in the front of my hairline. It was very painful and red, and it blistered then peeled, then the hair started falling out. New hair started to grow back in as stubble, but that is now falling out too. The spot is about 2 inches wide, and about 3/4 inch deep into my hairline,what new hair I have is extremely sparse (about 1/4, maybe, of what was there before) right in the middle/front. I was treated with silvadine burn cream while in the hospital. The skin there looks normal, not like a scar from a burn. Is there anything I can do to treat this and grow the hair back? I’m hoping to not have to do a transplant type of procedure. And I wouldn’t worry so much if it wasn’t smack-dab in the front of my head, I can’t hide it , even cut bangs. I’m also afraid it will get worse, as the burn was larger than the area of hair loss.

I always tell people to wait at least 8 months, even a year to get the growth to return. Hair goes through cycles and you must wait out the cycling of the hair to see the new growth. Since your surgery was in April of this year, that suggests that new growth should start between October – December and maximize at one year.

June 6, 2006

Prevail by Pfizer – Hair Loss Information by Dr. William Rassman

Hello again Dr. Rassman.

Just wanted to ask about Prevail Hair Growth Treatment by Pfizer. Is this the much talked about Minoxidil foam? Why is it so expensive, what gives?

I look forward to the last two parts of the video interview series; it was very nice to hear your voice!

Thanks.

It appears that Prevail Hair Growth Treatment contains 5% minoxidil topical solution. The rest of the treatment seems to be a shampoo, conditioner, and a volumizing mousse. A minoxidil foam may be easier to apply than traditional Rogaine, but I do not have direct experience with it. If anyone has tried it, please feel free to post a comment to let your experience be known.

Thanks for your nice words. The final 2 parts of the video interview are now up on the site in the video section, with many more videos to come.

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