Category: Hair Transplantation

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Hair Loss InformationTransplanted Hairs Won’t Fall Out After Transplant – Hair Loss Information – Balding Blog

Dear Dr. Rassman,
This matter has become quite stressful to me. I went for a hair transplant a month ago, when I had a bit less than a 1000 grafts transplanted on my crown area. It was an FUE procedure. Most say that grafts should fall in 2-3 weeks following the procedure yet most of the grafts are still there on my head. They are not growing and they are not falling, period. The shaved donor area has grown but the recipient area still shows these tiny hairs with no significant change. I am becoming very worried about this matter. Is this normal ? I contacted the doctor and he said to give it more time, as hairs are supposed to fall. Any opinions/advice from your side would be very helpful.

I am starting to feel that I wasted 1000 very good grafts (as the doc said the quality was great, I had many 3-4 hairs follicles). Many thanks and best regards.

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I will say every surgery is different and the hairs will probably fall out eventually, especially when the new hairs grow in. It’s not “normal” to have them stay in your head. Even if it does (or doesn’t) fall out, the success of the surgery is still not related to the initial hairs falling out. You will only know how successful your surgery was in about 10 to 12 months.

You already spoke to the doctor who performed your surgery, so I’m not sure what kind of assurance I can provide. I don’t know you and I did not perform your surgery, so I have no way to know about your healing. It’s possible that there was a problem with the surgery, but it’s also possible that it will all turn out fine and you’ll be pleasantly surprised. I wish I was able to provide some real info, but I’m limited without knowing more about your surgery or even having an examination.

Think positively, be patient, and good luck.

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Hair Loss InformationDo Drs Rassman and Bernstein Disagree on Shock Loss? – Hair Loss Information – Balding Blog

I’ve studied a number of HT docs for hair loss info and I’d say you and Dr. Bernstein are at the top of my list as far as knowledge and being trustworthy. You say that shock loss or additional hair loss from a transplant is uncommon these day though Dr. Bernstein says that you will probably have some loss from the transplant itself. I think he said it would be unrealistic not to expect some loss. Obviously a confusing contradiction for me. Could you address this?

I also find your history with Dr. Bernstein interesting. How do you 2 originally connect? You were partners at one time?

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Dr. Robert Bernstein and I do not disagree on much. Hair loss secondary to a transplant is what is commonly called shock loss (it is a matter of degree of loss) and I think that is where your problem is. Traditional shock loss has been satisfactorily treated with finasteride in young men, but hair transplants do damage some existing native hair. Hair that is miniaturized is what is lost first, so what you see may not be a radical change even if you lose some miniaturized hairs that did not contribute to the hair bulk you have.

As for the second part of your email — Dr. Bernstein worked at New Hair Institute with me for 10 years before he opened his own practice in New York. We are good friends and colleagues. We published many groundbreaking medical articles over the years.

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Raised Scars from Hair Plugs – Hair Loss Information – Balding Blog

I was wondering if there is anything that can be done with raised scars on the top of the scalp from hair transplant plugs? I read there is a possibility of cortisone injections? What about just making the top of the head more dense with SMP?

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Everyone is different, so there’s no exact solution I can provide without seeing you and getting a better understanding of your individual case. Special cortisone injections may help, but that depends upon what we are treating. If the elevations are due to the mass displacement of the old plugs in atrophic skin, then the cortisone shots might not help.

Hair transplants around the plugs (especially in the frontal hairline) does wonders for camouflaging them, correcting the abnormal hairline — and then even Scalp MicroPigmentation (SMP), when properly used in the right places, might help further.

I would have to see you to determine what can be done appropriately. Out of curiosity, how long ago was your hair transplant that you got the old plugs done?

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Hair Loss InformationOne Side of My Hair Transplant Is Growing Faster Than The Other – Hair Loss Information – Balding Blog

Hello doctor,

Just over 4 months into my HT I’ve noticed 1 side is growing faster than the other side! Should I be worried?

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I wouldn’t be worried at this stage. The other side should catch up in the next couple of months. We frequently see different rates of growth in different areas for reasons that I can not explain. For example, when we transplant the front and the crown, often one area grows significantly ahead of the other area.

You’re only 4 months post-surgery, so give it at least 2-4 more months to give it a chance to grow in. The full results will be seen within the next 8 months (a year after your surgery).

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10 Days After FUE Surgery, I Rubbed My Transplants By Mistake! – Hair Loss Information – Balding Blog

Dear Sir,

First of all, thanks for this useful guide for those who are in this trip to recover the lost hair.

I am in my 10th day after FUE surgery and today in the shower by mistake i rub my transplanted hair once by mistake (only one gentle pass with my hand), apparently there was no bleeding or lost hairs. The problem that i see after reading this blog is that i still have many scabs so i am concerned if probably i damaged many grafts. Am I right or wrong?

Thanks a lot for your work and attention and apologies for my english because is not my native language.

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You are probably safe from losing the value of these grafts; however, there is no certainty in life. If it was just a gentle pass with no bleeding or grafts coming loose, I wouldn’t be concerned…. but if you are truly worried, you should follow up with your surgeon and have him/her examine your scalp.

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Dr Bernstein Said He Isn’t a Good Transplant Candidate – Hair Loss Information – Balding Blog

Dr. Rassman,

On Dr. Bernstein’s blog, he mentions that one of the reasons why he has not received a hair transplant is because he is not a good candidate. My question for you relates to that comment and is two parts. First, what would make Dr. Bernstein not a good candidate, and second, at what age can you tell whether a patient will become a bad candidate? For example, we know now that Dr. Bernstein was destined to turn into a bad candidate, but would a miniaturization study have shown evidence of that at age 25?

Thank you for a great blog!

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The good transplant candidates have enough supply to meet demand. In Dr. Bernstein’s case, my best memory of his donor density is that it is low. So from a pure numbers point of view, he is not the best hair transplant candidate.

On the other hand, he told me many years ago that hair was important to him when he was young and single, but the techniques that were available at that time were terrible and deforming. For that reason, he never offered hair transplantation service in his practice until he joined forces with me and realized that the quality of the modern hair transplant met his standard; however, his focus on hair was not one of his priorities as he got older.

For those unaware of who we’re discussing, Dr. Robert Bernstein is a world class surgeon based in New York. You can find him at BernsteinMedical.com.

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Can I Go to Work Less Than a Week After a Hair Transplant? – Hair Loss Information – Balding Blog

Really quick question. Can I go to work after a hair transplant in less than a week without it being swollen and scabby? Thanks!

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Not everyone will heal the same, but this is an example of a patient from last week who had 3,169 grafts just 3 days from the day these pictures were taken. Please note that this was a large procedure and he had no post-operative scabbing or swelling. The secret to this type of post-operative look is the washing we do during the procedure and the daily washing we do after the procedure.

Click the photos to enlarge:

Just 3 days after hair transplant of 3169 grafts:

 

Before:

 

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Hair Loss InformationBoard Certification in Hair Transplantation – Hair Loss Information – Balding Blog

Hi Doctor Rassman,

I’ve been trying to make sense of all the internet literature that states that “Board Certified” by ABHRS is not technically certification by medical standards. What would be the difference if ABMS were to include ABHRS? Would that keep incompetency to a minimum or make me safer?

Other statements made by AHLA such as, “the AHLC uses remarkably outdated information that is dangerous so avoid them etc.” It’s hard for me, to get a real confident feeling, not knowing how to determine whether I’m safe in my decision.

Thank you very much for your time and professional opinion

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Hair transplant surgery is NOT technically certified by medical standards. In the United States there are 24 approved medical specialty boards that are overseen by the American Board of Medical Specialties (ABMS), a not-for-profit organization. Certification by an ABMS Member Board has long been considered the gold standard in physician credentialing. To be ABMS board certified means that the physician has undergone formal educational and clinical training at a medical institution after earning their medical degree, and has successfully passed a level of competence via written or practical or oral examinations. I (Dr. Rassman) am ABMS Board Certified in General Surgery and my colleague Dr. Jae Pak is ABMS Board Certified in Emergency Medicine.

Hair transplant surgery is not a part of the ABMS so there can not be any physicians that are board certified as a hair transplant surgeon. This is mainly because there is no formal training or credentialing in hair transplant surgery. There is no standard curriculum. There is no oversight or direct review of the quality of the work being done. Unfortunately, there is no ABMS sanctioned facility to enroll and learn hair transplant surgery. To date, the only way to learn how to perform hair transplant surgery is to read a book, attend a seminar, or become an apprentice to a private practice hair transplant surgeon. Even ABMS board certified plastic surgeons do not receive training in hair transplant surgery as part of their formal training.

In the mid-1990s the American Board of Hair Restoration Surgery (ABHRS) was formed by a group of hair transplant surgeons to create an organization that could independently certify hair transplant surgeons. But the ABHRS does not monitor doctor’s training quality and once the testing process is complete, they do not have any authority to enforce any form of discipline. In states like California, doctors are not allowed to call themselves “Board Certified” if the only certification they have is from the ABHRS or other non-ABMS approved boards. They must qualify which board they are claiming.

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Hair Loss InformationDo Hairs Within a Trichophytic Closure Grow At the Same Rate as the Newly Transplanted Hairs? – Hair Loss Information – Balding Blog

Hello Doctor,

I had a hair transplant with the Trichophytic closure method, I was wondering, does the hairs within the scar take the same amount of time to grow through the scar as the newly transplanted ones?

My scar looks good..however, I’ve noticed some small patches where hair hasn’t grown through yet.

Thanks again for this fantastic website

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After a hair transplant surgery you may experience hair loss around the donor area with or without trichophytic closure. There can even be large patches of hair loss. The hair loss is temporary and it usually grows back after several months and it can take as long as a year. Transplanted hair takes several months to grow as well (up to one year). The hairs in the trichophytic area should grow at the same rate as the recipient area hairs.

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Hair Loss InformationHow Long Does Shock Loss Last? – Hair Loss Information – Balding Blog

I had a hair transplant done 4 weeks ago and noticed i had thinned considerably on the front side of my scalp. I hear this “shock loss” process is a temporary stage.

How long would you say that this “shock loss” process will end?

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Shock loss following a hair transplant usually occurs within 1-4 months of the surgery. The process might be temporary, but the results are likely permanent (the hair won’t regrow).

I just wrote a blog post about shock loss last week that explains more about ways to avoid it and why it occurs.