Author: Dr. William Rassman

Hi Doctor Rassman, how much daily hair loss is normal? some say 50-100, others say 100-150-200 is normal. From your expertise what is normal for an average male with no hairloss.

I believe we wrote about this subject many times over. The average person can loses 0.1% of their total hair count per day as these hairs go into telogen. You must also remember that the person is growing back about the same number of hairs each day. Assuming that the average telogen cycle recurs every 3 years and you have 100,000 total hair count, that calculates to about 100 hairs/day. The numbers are clearly not fixed by nature, so it may vary based upon individual circumstances, genetic patterns, your age and sex.

Scratching fresh grafts will remove them. Scratching older grafts can cause infections to develop at the point where the scratch was done.

I’ve heard it’s normal to lose over 100 hairs throughout the day, but every time I wash my hair and towel dry it’s seems I’m losing a ton of hair. I’ll shampoo and each time I run my hands through my soapy hair and look at them there’ll be close to or over 10 hairs and appears like it adds up to almost 100. No matter how many times I run my hands through my hair I’ll see a bunch of hairs. Then, if I towel dry with a white towel I’ll see even more hairs. Is it normal to lose this much hair just in the shower? I shower every day but wash my hair every two to three days.

The average hair loss per day for an average Caucasian male is 100,000 hairs, but I doubt that you would lose them all in the shower unless you are losing more than 100 hairs per day which would occur in a hair loss situation. When you rub hair that is miniaturizing, these hair easily come out with your fingers, your towel and almost anything you do to rough up your hair.

Dr.Rassman,
I heard from somebody that the average person loses 100 hairs a day. This seemed really high to me, is it true?

Yes, this is true. It is believed that the average person has about 100,000 hairs on their head and the life cycle for a hair (before going into its cycle shut down and regrowth) is 3 years. Wtih that said, that means 35,000 hairs lost per year or about 100 (rounded) hairs per day for 3 years will equal the total number of hairs on the head of an average Caucasian Male.

There has been a huge effort to get the California Board of Medicine to rule against doctor who use technicians to do their hair transplants in their surgical centers or their offices. This has been a real problem in the field, as technicians have been hired by doctor to do this surgery so that the doctor can ‘CASH IN” on the huge rise in demand for FUE hair transplants. Many of these doctors are not trained in the field of hair restoration, never did a hair transplant and don’t understand the basics of the anesthesia or the surgery but, nevertheless, driven by a desire to MAKE MONEY. These doctors hire technicians, or companies that supply technicians or even nurses to do the surgery for them. We have seen terrible complications, including one death in California from a surgery performed by someone who didn’t know what he was doing. Now it is against the law and any doctor doing this type of phantom surgery (many doctors were not even in the operating room while the surgery was being done), will be subject to California Board of Medicine legal action and could lose their license to practice medicine. Most states follow California on such policy matters so I hope that this ruling will propagate in other states and other countries as well.

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I went to Turkey so what I am going to write about here is lengthy, I wanted to have the surgery performed by Dr. ‘X’ (I don’t want to use his name for legal reasons). The doctor’s team seems very well trained but clearly they were not well organized. They failed to discuss the procedure with me, despite promises over the phone telling me what I was going to get. In the US, they have an informed consent process, this was missing in my pre-surgical meetings, They treat me like McDonald’s serves its hamburgers, not as a patient.

I has my first surgery when I was 29. A local doctors promised me between 2500-3000 grafts, started losing my hair at an early age. When I was 31 I had a FUT surgery with a local doctor who promised 2500-3000 grafts. After the surgery I had a great deal of pain and only received about 600 grafts even though I paid for many more. The experience was so bad, I started to weard a hair system.all of the time or if I took it off, I always had a hat on my head,

I first contacted Dr. X and told him of my terrible experience with my first surgery, I sent him pictures of me without the hair system system on so he could see what I looked like. He told me that I was a Class 7 patient and over the phone, he told me that I was an excellent candidate for the surgery. I thought I had an excellent donor area and told him that it might take two sessions.He told me that he should be able to get 5000 grafts in the first surgery as I have an excellent donor area. I was very skeptical about the number of grafts as many other clinics were telling me that I would get only around 3000 or so grafts. I read other patient reports about Dr. X and they were good. Dr. X was one of the more expensive doctors so I felt that paying a little more would get me a great experience. He also promised me more grafts than any other doctor had promised me.

I slowly worked out the days for the surgery. Someone told me to avoid a Sunday as the clinic often understaffed or closed on Sundays.

My wife and I were met at the airport by a driver. He was very friendly and provided some information about the area and some places to visit before the surgery. He didn’t know what time I would be picked up the next day for surgery but said the the doctor’s office would contact me at the hotel in the morning. Even though they knew that my wife was visiting with me, they only provided me with a single bed. After a few minutes, they corrected that.

Things started to get disorganized on Monday. I wasn’t contacted by anyone from the clinic qme by 11:30, still no word about my surgery. They finally called me and told me that they would pick me up at 2:30. I was already getting nervous about the surgery because of my last surgery in the US. Now I had to wait until the afternoon and I did not know ehnen they would actually come for me. They did tell me that they were very, very busy. The driver came an hour earlier than they told me to be ready. The clinic was close to the hotel.

 

When I arrived, I was asked for immediate payment, I wanted to have a consult with Dr. X first to review and make sure that everything was acceptable. I paid the fee and was then brought to see the doctor.

He told me that because some of his patients missed flight in, they were working hard to keep up with the surgery load that day. I was worried that the people performing the surgeries working for that many hours on so many patients in one day, might be too tired. Would I get their undivided attention? Should I move the surgery to another day when the staff was not so overworked? The doctor told me that his staff would be fine and that they do this many surgeries every day. He told that some patients were only getting smaller, 2000 graft procedures, and as mine would be a larger procedure, they would have more time to work on me. He then told me that my surgery would be for only 3000 grafts and would be very fast. When I reminded him that he said he should be able to do 5000 he said that my donor area wasn’t that good and that I had limits on the number of grafts. This is an exact opposite of what he said in emails to me. I pushed the point and he said he would have to see what he could do as I had short hair and it was hard to tell. “Don’t worry”, he said. most people require 2 surgeries anyway. He traced his standard hairline on my head and I did not like it. I wanted it narrower. I asked if it would not make more sense to narrow the hairline coming forward so we could provide thicker density and more coverage in the rear. He reassured me again that I would be ok, ignoring my ideas on my hairline. Dr. X seemed very rushed and didn’t seem interested in answering any more of my questions other than to say this is what he does. They put me into a gown that was too small for me (I take a large size) and I asked if they had something larger and was told that they didn’t. I was then instructed empty all my pockets into a bag that they gave me and that made me uncomfortable as it included my credit cards and Passport. They also focused in on my cell phone insisting that it must be given over. I said no as my wife was was there and I needed to keep in touch with her. Once I spoke to Dr. X he agreed to let me keep it as long as I didn’t use it during the donor extraction period. They next provided some drugs for me to take. I asked what they were for and they did not understand my question. A lady had to be called in to explain what the drugs were for. They then shaved my head and we moved to another room to see Dr. X. He looked atthe scar from my pervious surgery. When I asked what the story was or if there was any concerns, Dr. X said he was just consulting with his staff. I asked what about and I was told nothing to worry about. As the patient I felt very much like I was in a meat market just being moved from one room to another. I had no feedback to my questions and I felt like it was just going along for the ride.

The Surgery went well. The injections weren’t painful and the gentleman he who preforming them was very good at his job. The extraction team and the implant team (two different teams) were good at their job. Dr. X came near the end of the extractions he told me he was leaving my surgery room and that there wasn’t any issues I was in good hands.

I also had a cocern that there was a complete lack of privacy during the surgery. Even my driver came into the room looking over the results. I was bored through the entire procedure as the only thing I had was Turkish TV and even the position of my chair was such that I could barely see the TV

I didn’t sleep much that night because of the position I was told to stay in. I wasn’t in pain or any discomfort.

The next day at breakfast I ran into several other patients. At 9:30am I was called to say the driver was there for me. I came down and there was 5 of us there. The driver brought us to a midsize car and wanted us all to get in. The driver noticed that it was going to be very tight and said he would be right back for me. I went back into the hotel and ran into another patient who was late getting down. Not sure how the driver planned to fit 6 grown men into a 5 seat midsize car. The driver was back and we were taken back to the clinic. All six of us were gathered in the reception area and this is where they took the dressings of us. We were then all huddled up to Dr. Maral’s office as a group and he provided instructions for post care. Several questions were asked of him and he quickly dismissed them with the statement “he hasn’t seen any need for it and that it was a waste of time”. Again it felt like we were just meat being processed instead of patients.

I asked about the timing for the transfer to the airport and I was told to speak with the driver as he would arrange everything. I spoke with him and he said I would be going with another gentleman as our flights were an hour apart. He was also traveling with his wife and I raised a concern about fitting 4 people plus driver and all their luggage into a midsize vehicle. I was told not to worry about it that it would all fit. I tried to explain that my wife and I had larger size baggage as we were going on to another destination from there. The other gentleman said his wife and him were in the same situation. We were told not to worry about it that it would all be taken care of. I did call the clinic back at the hotel and was told that I needed to send an email. I sent an email explaining my concern. Dr. Maral responded and told me he would arrange separate transfers for us and then went on to say “but please do me a favor and prefer another clinic if you go more sessions? or your price will be 1000000 euro”.

That night I spoke with several of the other patients and they all were promised more grafts then they received and were very unhappy with the communication. One of the gentleman said he was supposed to have his surgery on Saturday but they rescheduled it to Monday and they need to give their staff some time off. Of the 4 other patients I spoke with, all were promised above the 4000 and all received around 3000.

I’m not sure of the end results yet but I’m hoping for the best. I will be looking at a second session in the fall but I can guarantee I will be going with another clinic.

Maybe this was the perfect storm for the clinic and they were overwhelmed but I suspect this was not the case.

Happy 2015! David (Van Halen) Lee Roth performed this past Saturday with the Foo Fighters in LA.

I was watching the clip online and when he took off his cap, he had a shaved head. What I noticed was what looked like a strip scar on the back of his head. Does this appear to be a scar from a HT? Would it be less obvious if he had SMP to help conceal it?

Just curious. I enjoy your site and have been pleased that you have answered my questions over the years.

Many celebrities have had hair transplant strip surgeries hidden under their long hair and from the photos I’ve seen circulating around the Internet it does seem like a hair transplant scar.

I wonder if he knows it can be camouflaged with SMP? If not, someone should show him this post.