Author: Dr. William Rassman

I was wondering how long can you have a hair follicle outside the body before it dies? I had surgery that lasted 10 hours and I am worried because I saw my grafts sitting in a clear solution for over three hours. Is this normal?

A freshly extracted hair follicle or hair graft can survive outside the body for as long as 6 plus hours. It is very fragile and if mishandled it may desiccate and “die” in as little as a minute. A harvested graft must be hydrated, kept moist, and cooled as soon as it leaves the body. Cooling slows down the metabolism process. If your grafts were not cooled, it may be an issue!

It all comes down to the experience and expertise of the surgeon and staff. With poor coordination, and standardization the surgery may be failure even before it has a chance to be implanted.

Some doctors use special solutions and precise temperatures to keep the grafts alive longer. However, this DOES NOT guarantee that the grafts will go on to survive the implantation process! More importantly there have been recent concerns that these new “solutions” to maximize the graft survivability may actually do harm than good. Often times doctors may advocate PRP but these solutions also have not been proven by randomized controlled scientific studies.

The implantation process can also dry up the grafts and harm the grafts if mismanaged by an inexperienced staff. In other words, cooling or preserving the harvested grafts would all be for nothing, if the team cannot transfer it from the petri dish back to the recipient site with care and expertise.

This is one of the many reasons that hair transplant surgery is not a standard or a guaranteed process. In other words, shopping for “cheap” surgeries may sacrifice these critical quality control issues.

Source: NY Post: “Teenagers are fighting the “recession.”
The battle against baldness is sprouting to new heights as boys as young as 16 flock to surgeons for hair transplants, doctors and patients told The Post.

These young men have a high return rate for their hair when put on Propecia. Propecia is an elective medication and like all drugs, it has it’s side effects. The side effects are well publicized in the Internet balding forums and hotly debated. The reality is that Propecia works and the side effect only affects 1 to 2 % of men.

Doing a hair transplant commits a young man for a life time of hair transplants without giving him the opportunity to reverse or stabilize the hair loss. Doing surgery at an early stage can often accelerate the genetic balding in young men. The overall profession does not look kindly on hair transplant surgeries on teenagers. The only exception may be if the teenager is completely bald (Norwood 6/7) and understand the full implication and limitation of a hair transplant surgery.

I had a hair transplant surgery three months ago by a reputable doctor, but I am not seeing any results. I think it may be a failure. What can I do?

Transplanted hair grafts usually shed and fall out within the first few weeks after surgery. Transplanted hair grafts usually go into a dormant state and will not produce new hairs or continue to grow. The first few months after surgery you may look worse as you may continue to lose your native non-transplanted hairs. Not much happens in the first three months as the grafts are mostly in the dormant state. Be patient, you will start seeing results in 6 to 12 months (sometimes longer). At this point (at 3 months) think of the grafts is if they are “hibernating”.

I currently wear hairpiece that I’ve had for about 25 years (I’m 50 now). it’s a bonding tape/glue kind. my shop in phila is closing and I’m wondering if it’s time to consider transplantation. however, how would i transition to that w/o everyone knowing? do you have anyone that is/was in this situation

We’ve transitioned many patients from a wig/ hair piece to hair transplant and SMP.
If you choose the SMP method, you can still have the hair piece during the process and when complete, have a “coming out” party and show the world you decided to shave it all off.
If you choose the hair transplant method, you can have the FUE surgery and still wear the hair piece (without the glue) and over the course of several weeks to months, have the hair piece made with thinner looking hair.

This a of course a very simple way of explaining a delicate process. You would need to sit down and discuss the plan with a doctor in detail.

A young 20 some year old who lost most of his hair realized that no matter how many grafts with hair transplant surgery, he will never have a full head of hair (especially if he kept his hair short). So he just accepted the fact and kept his hair shaved. He still didn’t like the horseshoe balding pattern despite the daily shaving. He decided on the Scalp MicroPigmentation – SMP – approach.

The one on the left had SMP, the one on the right did NOT have SMP (it is just his normal hair line)

How many grafts can you harvest with surgery?

Maximum number of grafts in one session is dependent on the exam. Doctor needs to determine your hair density and scalp elasticity for maximum harvest. Every person is different and with each surgery the maximum number changes.

The maximum number can be a high as 6000 grafts but this is not typical.

i am 30,having male pattern baldness(loosing hair for last 5-6 years),using minokem n 5% and finpecia 1mg(using last 3-4 years).no impressive result,can i switch to Regaine 5% /Hair 4u 5% /Mintop 5% /Morr Forte 5%.or any other?
please suggest.

If you have genetic male pattern balding (MPB) or androgenic alopecia (AGA), there is no definite medical or surgical “cure”. There are medications to help slow the process or even regrow some hairs but in the long run you will continue to lose hair. Hair transplant surgery helps but it does not stop the inherent balding process. It is a good idea to see a doctor for such treatment options and explore what is possible.

Does low lever laser therapy work for hair growth. I see lots of positive reviews and videos. It’s expensive and I’m not sure if I should try that before Propecia

Lasers in my opinion do not grow hair. I’ve offered it at my practice for FREE. I even gave it away as a study. I have not seen results. Maybe you can claim the patients didn’t use it right.

The studies or papers that are out there do not show clear results. If they work, it is so minimal it’s not worth the effort or cost to justify a result that can not be seen with a naked eye for someone to say “that was worth it”.

Scientifically, these lasers such as Revage 670 are just low power red lasers that emit at a 670 nm wavelength. (thus the designation 670)

670nm is not a magic number wavelength for hair growth.
670nm is the RED wavelength in almost ALL lasers.
The makers of the hair growing lasers didn’t pick 670nm for its hair growing potential
It’s the only one commercially available.
The $1 WallMart laser pointer is ALSO a low power (low level) laser that emits at 670nm

These hair lasers are just a dome or a hat that incorporates 30 of these.
You can make one for yourself for probably under $50.

This is a GREAT marketing and business plan.

Had a FUE about 3 years ago and was very happy with the results. Now, it seems like I have half the hair after the FUE and my hair gets very greasy – like one day after shampooing, it feels oily.

Could the transplant have transplanted extra sweat glands in addition to the hair which is causing this? Or is it because there is less hair now which causes more grease to be absorbed by the remaining fewer hairs?

Also, is it normal to have hair loss after FUE – I am thinking of going again, but if I have to do this every 3 years, not sure if its worth it. I am a norwood 6 so I’m assuming that whatever hair has shed in the last 3 years since the transplant is the actual hair (not the transplanted hair).

Oily or “greasy” scalp / hair is not necessarily related to a hair transplant surgery. You may want to see a dermatologist or follow up with your hair transplant surgeon for an exam.

Transplanted hairs may come with oil glands but it does not mean you would have “extra” glands. You can try using different shampoos.

Finally, it is not normal to lose transplanted hairs after surgery. As long as you have good donor hair (and not losing donor hair) your transplanted hairs will behave the same.