Is My Hair Transplant Scar Too High? – Hair Loss Information by Dr. William Rassman

I recently had 2000 FUT’s by a well respected doctor in the field (and planning to get more, but this time, FUE’s). But I notice though that my donor scar location is about an inch above the occipital protuberance (I believe that is what that small bump in the back of the head is called), that is, one inch above the ears. He evaluated my hair and also I had a small previous scar from a prior HT done with laser (600 grafts) that he cut out with the new donor location. I am 43 years of age and I believe that I am a class 4 (or maybe close to 5).
My questions are: Is my donor scar too high? Are the chances high at my age that I will progress to a class 5 or 6 pattern?
I am fearful of future hair loss progressing down to my donor location. My Father and grandfather (both from my mother’s and father’s side) had full hair and of course normal thinning hair as they reached their 70’s. Except my uncles on my mothers side are classes 5’s and 6’s.
Thank you so much for your time

One can not predict hair loss with any certainty. It is clear that you do not follow the family pattern you identified in the body of your question. Scars that are placed in the wrong position may be impacted by the hair loss pattern, but without examining you, I can not make such judgments. An FUE procedure will not address the scar adequately in one surgery and as you have already had two strip surgeries, I generally tell patients that it is too costly to go the FUE route once you had strip surgeries. Maybe with good pictures and anatomical markers on them to show the notch at the back of your head and the location of the scar relative to the ears, I can get enough information to give you further insights. If you do wish to send photos, my address is on the Contact page.

Hair Loss InformationFUE Questions – Hair Loss Information – Balding Blog

Hi,
I am seriously thinking of having a FUE procedure during the next 2-4 months. I’ll appreciate if you can please help me with the following info.
1. How do i know if i am a suitable candidate for FUE?
2. How long do i have to wait after the test to have the procedure?
3. how long do i have to wait after the surgery, before i can go about my business?
4. I see that you have a special offer going on now, what is the final per graft price after taking into account the travel reinbursement and your offfer?

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There are many things to consider before deciding on any hair restoration procedure. I’ll answer your questions on FUE (Follicular Unit Extraction) first…

  1. At NHI we use the FOX™ test to determine if you are a candidate for FUE. The FOX test lets us know how easily viable grafts can be extracted. If there is a high percentage of viable grafts, you would be ‘FOX positive’.
  2. The FOX test can be performed any time before surgery. There is no waiting period once you have had the test.
  3. Patients have different tolerances for surgery. Many patients go back to work the next day, others wait a day or two. As long as you follow the post operative instructions, you can resume your daily routine as soon as you are ready.
  4. The 2005 summer special fee applies only to traditional strip surgery. Travel expense reimbursement is up to 5% of the cost of the surgery.

Some of the other considerations to keep in mind are FUE is a good choice for patients who:

  • Need a small amount of grafts
  • Do not have an advanced balding pattern
  • Those who want to wear their hair very short
  • Those who have a very low donor supply, a scarred donor area, or very tight scalps
  • Patients who tend to heal with wide scars
  • Athletes who must resume full activity soon after the procedure

BUT, most importantly, continue to research, make sure all of your questions get answered, insist on seeing patient results in person, and make sure that you choose a doctor who has your best interests in mind.

Temple Hair Loss – Hair Loss Information – Balding Blog

Hi, I am interested in possibly obtaining your services. In particular, I am interested in the FOX procedure. My problem areas are in the temple region. I live in MD so I have included some attatchments of the temple region. The ones that look like I have less hair is what I kind of look like in the morning. The ones that look like I have more hair is after I have brushed my hair. As my hair grows longer the hair around the temple region doesnt look as thick as the rest of my hair. I am currently taking propecia which seems to have stop the hair loss but I believe I started it a little to late to help my temple region. So my primary go is to thicken the areas of the temporal region. I may also be interested in some small things such as thickening some of my facial hair. If more pictures are needed I would be happy to get them to you. I am not sure what the next step is so I’ll be looking forward to hearing back from you. Thanks.

P.S. I am 27 years old.

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Nice to talk to you today. You reported that you have been on Propecia for 9 months. In addition, you saw a doctor from another clinic who suggested that you visit me and get an FUE (FOX) procedure into the temples.

I have reviewed your pictures. At 27 years old, I am generally very cautious. Before I would even consider adding hair density to the temple region, I would want to assess your overall future balding possibilities, looking for miniaturization throughout the head. I would also want to see what your temple densities are. As you are on the East Coast, I would recommend that you visit Dr. Robert Bernstein in New York where he can make such an assessment. He is an excellent doctor whose opinion should have great value. No one wants you to take unnecessary risks, particularly me, so a good opinion from Dr. Bernstein will determine the best approach. His website is bernsteinmedical.com.

Hair Loss InformationFUE and Scars – Hair Loss Information – Balding Blog

I would like to get HT, but one question: how do you determine as to the donor site location? My friend had 2000 FUE’S and it seems like his donor cut was equal level with the eye brows, is this OK? He told me that he had a HT doen ten years ago and his FUE dr. told him that he would remove the old scar which was that high as well. What if he became so bald that his hair loss went lower than his current scar? Can HT doctors determine as to future loss?

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Thanks for the fine questions. Donor incisions, if placed in the middle of the permanent hair zone should be covered with the hair that is there for the life of the patient. FUE (Follicular Unit Extraction) is an alternative, but you must be sure that you will be a candidate for such a procedure. I would want to see you and test your hair to find out if you are a candidate. I suggest that you read up on FUE at newhair.com. It includes pictures and videos of the procedure as well as post-operative patient followups. Scars from traditional hair transplants can be fixed in many cases. Again, I would have to evaluate the person in order to judge repair possibilities. To answer your last question, yes doctors can determine what your most probable hair loss situation is, provided that you are over age 30.

Hair Loss InformationFriar Tuck’s Bald Spot – Hair Loss Information – Balding Blog

My husband has a bald spot which he slickly combs back his very long hair to hide. The problem is that the spot is too big to cover that way, so his long hair falls to the side. He knows this psychologically, but denies that he is constantly combing back his hair to cover the impossible. He is dead set against being ‘cut open’ with a hair transplant. What can he do about this Johnny Cochran bald spot (with respect to the departed Cochran)?

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There are many things he can do. He can wear a hair piece like the skullcap the pope or a rabbi wears, he can use spray hair from a can which he can buy for under $10 in Walmart, he can try to have the bald spot removed (a very radical surgery today with great risks) or he can consider a new minimally invasive hair transplant technique called Follicular Unit Extraction (FUE) where he gets a limited hair transplant without being cut upon like a standard hair transplant strip excision.

If he goes the FUE approach, it will not necessarily take a lot of hair to accomplish this as we can put in something I call ‘tackers’ which are a limited number of single hairs placed into the crown (his bald spot) which when grown, will act like anchors to his comb-back. It will allow him to continue the use of his styling comb-back and then with a can of hair spray applied very lightly, the comb-back hair will be held by these tacking hairs in position for the entire day. The nice part of an FUE surgery is that there is almost no pain after the surgery (few ever complain), there is relatively low recovery time, and visibility can be kept to undetectable levels in most people. People like your husband who hate the idea of surgery, may still have a stretch to look at the FUE as a non-surgery. I have called this minimally invasive surgery when I first published this in the medical journals and so have the patients who have had the procedure, but your husband may be another case all together if he is inflexible in his thinking. Maybe there is no solution for him if he can not think ‘out of the box’.

Hair Loss InformationFUE Information Request – Hair Loss Information – Balding Blog

Dr,
I recently saw you on channel 4 news describing a new procedure of hair transplantation where there is no incision done.I have had procedures done going back 15yrs.Approximately 5500 of the old grafting technique.my frontal hairline and down the middle needs to be enhanced.I still have gaps and have lost more hair since my last procedure 8 yrs ago.Could you please tell me a little bit about the new procedure or where I can read up about it. I should also set up a consultation appt.
Thanks

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You are referring to the news item from April on the FOX Procedure, also known as Follicular Unit Extraction or FUE. This is a technique that I introduced in the medical literature in the summer of 2001, and published in 2002 in an article titled Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation. The procedure essentially removes the follicular unit one by one without a traditional incision. More information can be found on newhair.com: FOX Procedure, FOX Megasession, and Medical Publications. Newhair.com is probably the most comprehensive hair restoration-related site in the world, with the greatest amount of original content and patient photographs, so please poke around the site to see exactly what we offer.

The FOX Procedure is an exciting new technique for minimally invasive hair transplant surgery, but it is not for everyone because:

  1. the costs are higher
  2. it is better for less bald people
  3. it is very difficult to perform and very few doctors are willing to step up and build the expertise
  4. not all patients are good candidates for this procedure because of the type of collagen that they have in their connective tissue (10% of people are in the category).

The procedure has the advantage of having almost no post-operative pain, and very fast healing with full activities within days of the surgery.

As you are local, I would recommend that you visit me in my Los Angeles office, which is only about 8 miles away.

Hair Loss InformationTransplantation From Body Hair – Hair Loss Information – Balding Blog

Does body hair work for hair transplantation?

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There are no survival reports or good data on the subject so there is little to report that is reliable. There is one published case with scant data from an unreliable source so I can not feel comfortable about recommending it.

This is an issue that particularly bothers me. Body hair generally grows one at a time, rarely are there two or three “body hair groups” as it is in donor from the head where groupings of one, two, three and even four hair is not uncommon. For those doctors who are offering it, I wonder if the offering is accompanied by “informed consent” documents that reflect the experimental nature of the process. It would seem to me that for those who are considering it, they should first be sure to consult a competent, ethical doctor capable of doing all of the types of follicular unit transplants including FUE / FOX techniques before going any further.

Hair Loss InformationFUE in Stress-Related Hair Loss – Hair Loss Information – Balding Blog

Rick asked…

Unlike the 62 year old man, I’ll soon be 48 & my loss started about the age of 25, gradually. Now, I am about a VI hair loss on this website’s Norwood Scale & will this new minimal hair transplant I saw on Ch. 4, Bruce Hensel, work for me ? I think the root cause(no pun intended !) is primarily stress. Many thanks in advance.

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Stress is one of the four causes of hair loss in the genetically prone individual. Yes, the minimally invasive surgery, the FOX™ Procedure (Follicular Unit Extraction) can work, but before embarking upon that route, plan on a visit to a competent doctor’s office. If you are in California or the New York area, we have easy access. I assume that since you referenced NBC Channel 4 News, you are local to the Los Angeles area. If you would like more information from me directed at you and your condition, please call for a free consultation or at the very least, send me a photo of your hair loss from a series of views. A good digital camera will work, or call my office at 800-NEW-HAIR or fill out the form on my website and we will send you a disposable camera.

Hair Loss InformationOn NBC in Philadelphia – Hair Loss Information – Balding Blog

I just got word that the news item about the FOX™ Procedure that aired this past Monday on NBC in Los Angeles is now going to air tonight (April 13) on the 11pm news on NBC 10 in Philadelphia.

For those outside of the Philadelphia area, if you missed the airing in LA, or you just want to see it again — the video is posted on my earlier blog entry, found here.

More information on the FOX Procedure:

Update: Found the article on the NBC 10 website

Hair Loss InformationApril 11 on NBC in Los Angeles – Hair Loss Information – Balding Blog

I just got word that the local NBC affiliate in Los Angeles are going to air a piece about the FOX™ Procedure tonight (April 11) on the Channel 4 News at 11pm. Readers from the LA area should try to watch (or set your TiVo).

Update (April 13, 2005):
Found an article on Los Angeles NBC News

Update (April 12, 2005):
Here’s the video from NBC News in LA.

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