Category: Hair Transplantation

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Hair Loss InformationCan’t Take Finasteride, But Is a Hair Transplant Still an Option? – Hair Loss Information – Balding Blog

Dr Rassman,
If one has been evaluated by a urologist and undergone a variety of tests for problems and finasteride has been single out as the cause. Can one still undergo restoration work? Or should one simply forget it?

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You are asking for a medical opinion without my ability to find out details about you, something that I do when I perform a consultation. Things like family history, age, miniaturization (where it is and how advanced it is) will tell me much. One can have a hair transplant without taking Propecia. I do this in older men and in men who I can predict what will happen to them over time. Everyone is different. My job is to protect you from over-enthusiasm, bring you down to reality, and then try to accomplish your goals (which may or may not be a hair transplant).

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I Want Great Density Up Top and In Front — Not Too Concerned About How the Back Looks – Hair Loss Information by Dr. William Rassman

I have a hypothetical question:

I know, that in general you don’t transplant more than a certain ratio of hairs available in the donor area to the transplanted area. What i was wondering is if i wear my hair in a certain style (in this case a bald fade) it would’t be as important for me to have thicker hair in the back, but of course, i would want good density on the top and front. under these circumstances, would you transfer more than usual to the top and front?

I generally develop a Master Plan with each patient, unique to that patient. What I feel my job is, is to do what is in your best interests and that includes combining what you want and what I feel is ethical. Many patients have different priorities, so my job would be to come to some conclusion about your hair supply and then lay out a plan that is worst and best case possibilities to address your desires at this time.

Since your question is hypothetical, I will say that hypothetically what you’re asking for is possible under the right conditions. Also, if you were to want to do a fade hairstyle in the back (donor area), a linear scar could be visible with a strip procedure, but you’ll probably be alright with follicular unit extraction (FUE).

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Can I Just Let the Scabs Come Off On Their Own Over a Few Weeks After My Hair Transplant? – Hair Loss Information – Balding Blog

Dr. Rassman,

Your website has been quite helpful. I had a quick question regarding a hair transplant I got almost 3 weeks ago now. I got 1000 grafts mainly in the vertex area and I grew my hair long to cover up the area until it healed. Since I can cover it up well I have been extremely careful with washing and letting the scabs try to come off by themselves. I wash the area as if I was still in the first few days as I try not to rub the area or pull on the grafts. My question is, letting the scabs take longer to heal and fall off, even at week 3 now, is it bad for the grafts to still have the scabs, or if im comfortable how it looks, is it safe to remain careful. Anytime I do try to break up some scabs I feel like they are pulling grafts out so Id rather just wait it out if that is safe for the grafts. One last thing is that I am not sure if you would consider what I have at this point scabbing, as it is just mostly white crusts covering the grafts. Thanks so much Dr. Rassman.

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Once you allow the scabs to form after a hair transplant, they can take weeks to come off by themselves. This will not damage your grafts, just give you a cosmetic problem you would not have had had you washed them off as they formed.

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I Think My Donor Scar Is too High and Will Show Soon – Hair Loss Information by Dr. William Rassman

I’m concerned that one of my donor scars is too high and that eventually it would show as well as the grafts taken from the area will die. I’ve had three procedures. The first was in 1997. I had 800 micro/mini grafts. Then in 1998, I had another 1000. This time the doctor seemed to place the incision in the donor area high. My third procedure was in 2007. I had 2000 FU’s placed. I think I’m a class 5 or 6 (not completely sure). During my last consultation before my procedure, the doctor told me that the scar from the previous procedure looked high.

It is 2″ above the bump at the base of my skull – about the height of my eyes and the top of my ears. I’m not sure if it was higher before my last procedure. Is it possible that it now appears a little lower given that 2000 FU’s were taken below it? Does this sound too high? Would hair mapping help me to know with greater certainty? If so, where can I go to have my hair mapped?

I appreciate your time in reading and responding to my question. I’ve read several of your blog comments, etc. and I’m considering using your services in the future.

Thanks again

Perhaps your donor scar is higher than normal, but this can be a normal thing as the doctor will make subtle judgment calls during the procedure. It may bother you cosmetically, but there is not much you can do other than to grow your hair long enough to cover the scar. From a long term point of view, if the donor hair was taken too high, it may not be in the area of permanent hair, in which case you risk losing the hair that was transplanted from that area.

You should start off with a good examination and consultation for a second opinion. That will address your concerns above. You must have a worst case scenario managed with a Master Plan for future hair loss, as you are suggesting in your questions. I don’t have a list of every doctor that will map your scalp, but you can find a transplant doctor in your area by using the physician search at ISHRS.org.

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Facial Hair Transplants – Hair Loss Information by Dr. William Rassman

Please send me more information about transplants, hair to face. tell me how the process works and if that really works and in how much time it takes. i need to know the average price. send me back an email as soon possible thank you.

You can transplant scalp hair to your face, but you must have similarity in the hair, because it will come with its characteristics. If your hair is fine and your beard it coarse, there may not be a match. Meet with a good hair transplant surgeon and discuss the issues, including his/her fee schedule.

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I’m Scared and Nervous About My Upcoming Hair Transplant Surgery! – Hair Loss Information by Dr. William Rassman

Dr Rassman . i’m really confused going in for a hair transplant. i have booked a session but am not sure yet. they say “when in doubt- wait” should i wait or just close my eyes and jump? do we really get whats promised? why am i so so so damn scared? is it natural? are HT really worth for common man or only for celebs? should i wait for technology to get better or few more people to get it done?

going through this site i have become a big fan of your work. i’m 27 yr old going for a transplant. i dont look as bald as people who normally go in for a hair transplant. i read about your take on ’shock loss’ post hair transplant. i dont want to take any propecia or finasteride as my wife and i are planning to start a family. is this a big risk i’m taking going for a HT now because of ’shock loss’ possibility? is it worth the risk?

Fear of the unknown is natural, but one of the things that your doctor should be doing is educating you enough to manage this decision. A good decision today will be a good decision tomorrow. You should get another opinion if your doctor isn’t providing you with all of the information you’re seeking. Absolutely do not rush into something that you think you’ll regret down the line. Make an informed choice.

I posted this list of links a few months ago, but they’re important to read. For more information on doctors — what to avoid, how to find a good one, what some don’t want you to know — see:

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I’m Taking Propecia – Can I Still Have Shock Loss After a Hair Transplant? – Hair Loss Information – Balding Blog

Its been 8 months since my 2nd HT and I got 2100 grafts. of those 2100, i got 400 grafts in the temple area with left side getting 250 grafts and the right side 150 grafts. My recipient temple area was fairly dense but the doctor suggested that I should get 400 grafts in the temple region. Can the newly placed grafts in the temple area destroy my existing hair follicles?

I had this HT in september 2007 and I have been on propecia since september 2005. can this HT still damage the existing surrounding hairs?

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Whatever damage you had from the hair transplant (shock loss) should be over by now. Ask your doctor these questions. What you are seeing with your eyes is real, so he should be able to comment on what he sees when he examines you. Although the use of Propecia has shown good value at preventing shock loss, it is not 100% the case. When it comes to hair loss, there is no sure thing.

For more information about shock loss, please see:

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How Do I Know If I’ll Have Enough Donor Hair for Another Transplant Later? – Hair Loss Information – Balding Blog

Dr. Rassman, i have had a hair transplant using the strip method. I have a long scar across my head. You can not see it however as it is unnoticable. My question is, i only had a transplant in the temple area for a receding hair line and the areas are very small. I had good density however the length of the scar looks massive in relation to how many hairs have been transplanted. If i need another transplant later in life will there still be enough donor hair. Obviously you havent seen me so you couldnt tell me , but with strip methods is there any left over hair as they can determine how many hairs there will be. Im worried that they have used all my donor supply. I am happy with the transplant.

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Most people will be able to get about 5,000 grafts from their donor area. Clearly, that depends upon the donor density and the scalp laxity you have. I have seen some people exploit their donor density after 3,000 grafts, but that is unusual. I have taken as many as 10,000 grafts in others. The efficiency of the harvest is critically important. Discuss this with your doctor and he/she should give you good answers to this question, as it relates to your donor supply and scalp laxity.

For more, see:

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Hair Loss InformationReader Profile – What Is My Degree of Hair Loss? (with Photos) – Hair Loss Information – Balding Blog

Hello, I am turning 26 in a few months, I would like to know what transplant procedure would best suit my current hair loss pattern. I have researched the strip method, also the individual extraction method, I like the individual method better, it seems to be less evasive and less surgical, however, the cost appears to be higher, why is that? Would I qualify for the single extraction? What degree of a transplant do I require to restore my hairline to a even more full appearance? Any estimates in cost? Thank you for viewing my questions and looking over my pictures, you have my permission to use them on your site if they help in any way. If you require photos from any other angles please let me know. I am not on Propecia, I have been reading about Provilus, is that a good alternative? I am more interested in the natural ingredients if they have similar results.

Thank you again, I hope to hear back from you with some positive ideas!

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Reader

 

Norwood 4AFirst, thank you for permission to post your photos! If I was able to map out your scalp for miniaturization, I’d be able to tell if the top and crown of your head, which appears normal now, has any early signs of balding there. The pattern you present with is between and Norwood 3A and 4A pattern and I suspect that there is miniaturization in the 4A pattern area where part of the forelock still persists. If you took Propecia (necessary to prevent further loss and the possibility of shock loss after transplantation), then transplanting the frontal area with about 2000 grafts would suffice in most men with your pattern. I would have to know more about your hair characteristics (straight vs curly, coarse vs fine) as this will tell me the value of your hair, part of the essential formula for estimating hair replacement.

Provillus will not give you the same protection against shock hair loss that Propecia (finasteride 1mg) would, so if you get a hair transplant, you need to be aware of this. For your information, the main ingredient in Provillus that does work is saw palmetto, which as I’ve stated many times before, is a weak DHT blocker at best.

The follicular unit extraction (FUE) technique is very labor intensive and the time it takes to do it is much more than a standard strip procedure. That is why the cost is higher. Also, the results from FUE are variable while the strip procedure is predictable nearly 100% of the time. For more info on FUE, please see:

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Hair Loss InformationI Don’t Want to Take Propecia Until After I’m Married – Hair Loss Information – Balding Blog

i am a 24 yr old sikh male living in the uk. up until the age of 18 i had long uncut hair but then in 2003 i cut my hair. my hair has always been thin in texture from a young age. at first when i cut my hair it seemed to be quite thick on top and didnt seem to concern me too much. however after a few months of getting it cut i began to realise that a lot more of my scalp was visible, particularly in well lit areas.

so in following summer of 2004 i shaved my hair off completely in hope that it would grow back thicker which was really a waste of time. by summer 2005 i had realised that my scalp was a bit more visible than before so then i made the decision to start using rogaine. this seemed to work at good effect and by jan 2006 i had grown my hair a bit longer and had a new style cut. my hair appeared to be a lot better than before and a lot of people did notice. this however may have been due to the new style as well. but by summer 2007 i began to realise that my hair was appearing to be thinner again and i also noticed that at my crown the balding area had increased. the fact i have got a double crown does not help appearance either. so in late december 2007 i decided to switch rogaine for a private minoxidil 5% containing MPG. this too at first appeared to have made a slight improvement, and is a lot easier to apply than the rogaine. however by now in may 2008, i am still not to happy with the density of my hair. i went to a trichologist late last year, he advised me that i should not consider a hair transplant until i am least 25 and that i still have a bit too much hair for a HT. he advised me to take propecia, however i am scared of using the drug due to all the reported side effects. i would be willing to use the propecia, preferbly in a few years and after marriage! both my mother and fathers family have cases of hair loss, my father is bald apart from the hair on his back and sides. both my sisters have fine hair aswel, but they have a full head of hair.

i have seen pictures of hair transplants on patients who have diffused thinning and this would be my preferred method of sorting my hair out, however i am aware that i need to consider the long term instead of the short term. can you please give me some advice on what to do? thanks.

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I don’t know what I can say that hasn’t already been said on this site —

I’m not sure I quite follow the logic about waiting until after marriage to start Propecia (finasteride 1mg). The side effects from Propecia occur in less than 2% of men and most claims you read about on the Internet are unsubstantiated. Without seeing your hair, I couldn’t tell you if you’re a transplant candidate, but if you’ve already seen a doctor and were told that surgery was not recommended, I’d listen to him. You could’ve very easily gone to someone that would’ve taken your money and performed a surgery on you just to appease you. I don’t know which doctor you went to, but by not doing surgery on you, he likely did you a favor. You are, of course, entitled to go to another doctor and I’m sure eventually you will find a surgeon that is more than willing to take your money.

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