Hair Transplantation – Page 101

November 18, 2008

Critical Artery Was Cut During a Hair Transplant Surgery! – Hair Loss Information – Balding Blog

Dr. Rassman,

About 15 months ago, I had a transplant procedure done in another state and they severed the left posterior branch of the artery that runs up by the ear and feeds the scalp from the side of the head. To make a long story short, the artery was coterized but , the frontal hair on the left side used to be adequate and now it has thinned to the point where it is a significant social problem.

Have you had any experience in trying to transplant into this area after this artery has been severed or is it likely that the blood supply is much more spotty in the area?

Thanks for the help!

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The artery was often cut in a type of surgery called scalp lifts (a type of aggressive scalp reduction which is not done today) and these people generally did well, even with both sides cut. The nerves to the side of the head which lie close to the artery were also cut in many of these surgeries. The purpose of these now outdated procedures was to be able to remove large sections of bald scalp. In theory, the artery on the other side and the occipital arteries (which are in the back of your head) should have an increase in blood flow since the problem was created, and as such, I would think that you should have enough blood supply to support a hair transplant on the cut artery side. A Doppler study (used to study blood flow and muscle motion) of the vessels might confirm my opinion.

Generally, when a flap is built one side of a critical blood supply to the flap is severed incrementally and the flap is lifted and then put back at least once until the dependency on the blood supply switches. The body seems to be pretty smart when it comes to these things. If you see a vascular surgeon for an opinion (a vascular surgeon is probably the best one to determine adequacy of blood flow) the added information he/she might supply would be helpful.

November 18, 2008

I Have DUPA – Can I Transplant My Beard Hair to the Scalp? – Hair Loss Information – Balding Blog

i was wondering if a person like myself with DUPA had a strong beard would if be possible to transplant it to the scalp and if so how much coverage would i get?

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Such a transplant (beard to scalp) would technically work, but to what master design is the question! The character of beard hair is different than scalp hair.

You’d need to come in for a consultation and let me look at the many variables. With your goals clearly defined, we can discuss not only using beard hair, but perhaps even leg, chest, arm, and pubic hair as well. I generally do not recommend body hair transplants, but in a case of DUPA (diffuse unpatterned alopecia), things are different. Generally though, the hair of DUPA patients is so thin that you may not get what you need from other body parts.

November 18, 2008

Shock Loss in Donor Area – Hair Loss Information – Balding Blog

I was wondering if schock loss on the donor scar is common and will it grow back, I have two quarter size bald spots above each ear wher the surgeon had to take more donor hair. the rest of the scar also shows loss above and below the scar. it has me freaked out. should I be??

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A reactive telogen effluvium is what you are describing. It usually, but not always, reflects a tight closure of the donor wound. It may be permanent, but you won’t know for about 4-7 months. Wait it out and keep your hair long while you are being patient. This complication needs discussion between you and your doctor.

November 17, 2008

Could I Ruin My Hair By Sleeping On It? – Hair Loss Information by Dr. William Rassman

I had a hair transplant about 14 months ago now and the transplant was successful. I would of liked more density, however i am happy with it. My question is, when i sleep and wake up the transplanted sections-which is both temple areas are always messy and ruffled up because i lean on them on my pillow. Its hard to explain however i feel i am putting pressure on the hairs and pulling them because the hairs are getting trapped between the pillow and my head if you can understand. not terribly but my temple areas which were transplanted are always messed up as though i was lying on it and putting a certain amount of pressure as my head was lying on the hair and the pillow-its really hard to explain. Do you think this will cause damage. And if so how long will it take before i see? will it go gradually?

thank you

There’s no problem sleeping on your transplanted hair. On occasion, transplanted hair will become more curly and even wiry, so look carefully at the transplants and see if the character is the same as the non-transplanted hair.

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November 14, 2008

Hair Loss InformationHow Can I Tell If I Damaged My Transplanted Grafts? – Hair Loss Information – Balding Blog

Hi there.

14 days after hair transplant surgery i got sunburned…i saw a similar question here on the site.

my question is – is there a way to know if i damaged my hair transplant? Does in any case of sunburn the newly grafts are “killed” what are the signs ( if any ) to know whether you killed your grafts or are they alive and slowly growing….? I would appreciate if you could explain why and under what conditions the sunburn can prevent growth.

i’m quite worried and appreciate your answer. thank you

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Ultraviolet light is bad for skin and worse for new wounds, which are your healing grafts at 2 weeks. If the burn was deep enough to be a second degree burn, then you could have damaged the grafts, but superficial first degree burns should not have gone deep enough to damage the grafts from a growth perspective. Healing tissues, on the other hand, may be a problem.

Did you get the instructions to keep your head covered? My patients are indoctrinated on the things that they can and can not do. Ask your surgeon for a list of do’s and don’ts, and as long as you avoid the don’ts I’d expect that you shouldn’t experience any problems with your transplant.

November 13, 2008

Hair Loss InformationGoodbye Wig! A Hair Transplant Repair Case (with Photos) – Hair Loss Information – Balding Blog

This patient came in last week, a few years after having 709 grafts taken from a very depleted donor area. Half of the grafts contained just one hair. Getting those 709 grafts was a challenge, as his scalp was tight and the donor area heavily scarred. Because of the anticipated poor yield, I elected to spread the grafts over an inch from the plugs (forward) creating a loosely built thin hairline. When he allows his hair to stand up rather than pull it back as shown here, the results are even more spectacular. This patient gave up his wig and is thrilled with his result. We will try to do another procedure with up to 700 grafts in the recipient area to thicken it, but that will be even more of a challenge because the scarring is very bad and the density of the donor area is very low and he knows it.

Many of what I will call the “normal transplant patients” we perform surgery on today who have not had the old type of plugs, may look at pictures like those shown here and get very frightened. I understand the fear that gets invoked by these patients, but some of my most satisfied patients are those who walked around for years and found that people never looked into their eyes, only to their hairline. This man is an example of a patient where just a small change had a major impact on his life, allowing him freedom from a wig he despised to cover a pluggy look he hated.

Click the photos below to enlarge.

Before:

After:

November 6, 2008

Can I Shave My Head Bald After FUE? – Hair Loss Information by Dr. William Rassman

Well I am black male and currently shave bald. I want to continue to shave bald. I am thinking of FUE to give me some hair in a thinning area. I have few questions: What does the donor area look like when you shave bald after FUE, does it show scarring? I mean razor bald like MJ. Is it worth doing?

I’m confused as to why you’d want a hair transplant only to shave your head bald. All wounds to the scalp will cause some scarring. With FUE, the scars are tiny dots, instead of a straight line scar like that of the strip transplant and they may have a white color to it that would show up after healing an FUE donor area. With dark skin, that might be a problem and one way to tell that is to have a test FUE session done of just 2-4 grafts and assess the healing at 3 months. These tiny scars allow you to keep your hair very short without noticeable scarring if the whitish scar does not appear, but that being said, completely shaving your head may make these scars visible. Again, a test is worth a try.

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November 6, 2008

Hair Growth After Transplanting Hair Into Scar Tissue – Hair Loss Information by Dr. William Rassman

Dr. Rassman I want to first thank you for maintaining such a top notch site. I have a question for you regarding transplanting hair into scarred tissue. I recently (4 months ago) had hair transplanted into a 1 and 1/2 inch long scar running front to back. I am seeing very little growth…if any. What seems to be present are a few graft which never fell out and have continued to grow. I am aware that growth in scar tissue may take a little longer than if it was to be transplanted into virgin scalp, however, to put my mind at ease I was wondering in your expert opinion, what is a reasonable timeline to expect growth in the scar? Thank you very much in advance for your reply.

It’s only been 4 months, so seeing a little growth is completely normal. I tell all patients to wait for a full 8 months before judging the hair transplant results. You just have to be patient.

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November 5, 2008

Why No Photos of Hair Transplants 3-4 Years After Surgery? – Hair Loss Information – Balding Blog

hi doctor,
in most of the hair transplant sites one mostly see the after photos of 6 months or 1 year after the procedure. my question is what happens thereafter ? could you provide some 3-4 years after photos so to see the longetivity of results of transplant.

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The hair transplants are permanent. At the 1 year mark, the results will be fully visible. I’m not sure the benefits of seeing 2-3 years later, as the transplants will be the same as after 1 year. I have seen patients transplanted in the 1960s and 70’s with the terrible old plugs, and other than turning gray, they still have those same terrible old plugs. I have seen many patients 10 years out and they are happy and their hair is about the same as it was in their 1 year picture, so I just make a note on the chart saying “no change” and do not take routine photographs. If you are implying that some terrible disaster happens to the new hair and that is a concern for you, don’t worry about that one.

November 5, 2008

In the News – 10 Year Old Gets Hair Transplant – Hair Loss Information by Dr. William Rassman

From the article:

Jacob Vara, of Corona [California], loves playing baseball and wears his Yankees cap everywhere.

He has worn it ever since he was 10 months of age when he tugged on a wire attached to an electric grill and spilled searing hot cooking oil on himself. He suffered second- and third-degree burns in an accident that left him with a softball-sized bald spot on the front of his head.

Read the full story — Corona boy undergoes rare hair transplant

Although the article states that they transplanted 1500 follicles from the back of his neck, I assume that means the doctors got 1500 grafts from the donor area (above the neck). The author of the article likely doesn’t fully understand what he was writing about, so errors like that can and do occur. Obviously, transplanting a child is not a usual procedure, but this is a case of a large bald spot due to a burn. I hope this young man has an excellent result that will give him confidence that he deserves.

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