Category: Hair Transplantation

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Sterile Spray on Scalp After a Hair Transplant? – Hair Loss Information by Dr. William Rassman

Hello Doctor

What is the use of the sterile solution that one is supposed to spray his head with for three days after a HT? Is it just to hydrate the skalp or is it vital to transplanted graft surviving ? What happens if someone , for some reason , doesnt spray his head for several hours ? And how many hours could jeopardise the survival of the grafts ?

thanks for your time

I’ve never recommend sterile spray for patients after a hair transplant, so if you miss your spray, I would doubt it will cause you any harm. I wouldn’t even know what the spray contains. Ask your doctor about it, as he/she seems to believe in it.

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When a Graft Comes Out, When Will it Not Grow? – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman, I have an important question for you regarding the study of hair grafts you conducted with Dr Bernstein in 2006. The study states that the Dr. Was able to tell when the growth center for the hair had been pulled out by looking at what he pulled out by eye.

My question is this:

  • how do you physically identify when the growth center has been pulled out?
  • Is there always blood?
  • Does bloody mean that the centre has been removed for certain?
  • If a hair comes out and there is a dried out “bulb” shaped skin on the end of the scalp, does that mean that the graft has been lost or the graft was a dead one?
  • did this study account for partially loose scabs?

After about 4 to 5 days, some of my scabs started to loosen…i started to gently brush some of them with my fingers and some of them were loosely stuck by a strand of skin, which I pulled gently with enough force to remove the scab. My question is this-

  • how can I identify when I have pulled out a growth centre and when I haven’t?
  • Do you think there was a good chance that I pulled a graft out?
  • Lastly, your study includes 18 gauge needles only. What is the standard size needle use or what range sized needles do you use?

Thanks so much for your time and thanks for the study!!!

Firstly, here is the article you referenced, as originally published in Dermatologic Surgery in 2006 — Graft Anchoring In Hair Transplantation — PDF file or HTML

Your email is not clearly written, but I think that you are asking about the hairs we pulled out on varying days after surgery to determine if the graft growth center was left behind. To answer that question, we asked the pathologist to identify the critical parts of the hair that determines growth (the bulge area near the sebaceous gland in particular) and this would include all parts of the hair and what is called the dermal sheath. If this was pulled out, we could safely assume the the graft would not grow. This was not done with the naked eye, but rather by the pathologist under the microscope. By having a specialist look at the grafts that were pulled out, we had an impartial expert make the judgments. I hope that this answers your questions.

With regard to your other questions, please read the article carefully, as we put it all there. Without a microscope and experience, you probably would not be able to tell the status and that is why we put the article together, to be able to guess what is really happening. When the scab is present on the surface, it is likely that the graft growth center can come out.

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Hair Loss InformationHair Transplants in the Frontal Hairline, Hair System Up Top – Hair Loss Information – Balding Blog

I have used a hair system for a few years. Some seem to be better than others,but I am looking for the most undetectable result. I thought of having partial hair transplants done in the front- this is the area most detectable as fake. Have you any ideas of the best possible solution for me?

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What I can tell you is that the combination of hair transplants in the front and a hair system behind it works for many people. You are correct in that the hair systems are generally easy to detect in front, so if you have a good hair transplant in front of the hair system, you will have considerably more freedom in styling your hair.

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Is Thinning on the Sides Ever Normal? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

my hair appears thinner on the sides of my head, I do not mean the temples, but the area above the ears and side burns. is this a normal part of aging or MPB? does everyones hair thin a little on the sides? or does this mean I am heading toward an extremely advances form of hairloss?

I am on proscar and I have already had a transplant (to the frontal region) with a reputable surgeon in Ontario, Canada

thank you for you input

Some men will thin out their donor area. You should be your hair mapped out for miniaturization to see if you are developing a problem in the permanent zone. One should quantify the thinning. Without a good examination of you, I really can not tell you what is going on.

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Lost Hair From Previous Transplant Due to Shock! – Hair Loss Information by Dr. William Rassman

I had four sessions done between 12 and 15 years ago. My hair looked great. About a year and a half ago I noticed that my transplanted hair started thinning out in the front making my hairline look rigid. I recently had another session (same doctor) and I experienced a shock factor – which I didn’t experience before. It has been six months since the last session and the results are not promising – the hair that I lost due to shock has not returned and I believe many of the new grafts have not started to grow.

Do you know why –
1)My transplanted hair started to thin out in the first place
2) Why the hair I lost to shock (transplanted area) has not returned and why the new hair is not as prominent as I thought and
3) Do I have hope? Help.

First, you must wait another 2-3 months for long telogen cycles to reverse. I have never seen a previous hair transplant lose hair and then not grow back. I have seen about a dozen men who have lost previously transplanted hair, and it always came back. If the new grafts did not grow, then I would worry if that ran in parallel with your previous lost grafts. Ask your hair transplant doctor and get his/her advice after another 3 months, then write again to let me know the status (reference this post when sending).

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Hair Loss InformationI Think I’m Too Young for a Hair Transplant, So I Want to Use a Hairpiece Until I’m Old Enough – Hair Loss Information – Balding Blog

Hello NHI physicians,

I’m thinking about getting a hair transplant in the future, but at the moment I think I’m a bit too young for one (under 25). I have diffuse MPB on the crown (it’s quite severe), and am thinking about shaving the top off and using a hair piece/hair system until I reach the age when the MPB is more stable.

My question is, would the glue or bonding method from using a hair piece damage my scalp in any way that would prevent me from getting a hair transplant in the future?

I appreciate all the information you all have provided on this site.

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ToupeeGlues, tapes, and even clips are methods used to hold down the hairpiece to the scalp, which can cause even more hair loss. These will likely not prevent you from getting a hair transplant in the future, but you’re running a huge risk of causing yourself more trouble with hair loss. Weaves also cause traction alopecia. There is really no way around this. The decision to go with a hairpiece is a more common decision than those that want hair transplants, possibly because of the perceived cost difference and/or the fear of a surgical procedure. The choice may be a very expensive one, however, as the 5 year cost for a hair system can run well over $15,000. See My Hair System Cost Me Over $16,000 In 5 Years! for a breakdown, as sent in by a patient.

If you are losing your hair from MPB, be sure to also consider finasteride. This is a prescription medication and requires you to meet with a doctor.

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Hair Loss InformationPlucking Out My Old Hair Plugs – Hair Loss Information – Balding Blog

I had one procedure done around 10 years ago. I was young, and like many, I jumped without doing too much research. I’m glad that I stopped at the one procedure. Now I’m looking for a way to reverse the whole thing. The scar is hard enough to keep hidden, but the hair plugs are even harder to deal with. Is there any way to get rid of the transplanted hair besides shaving it or tweazing it? Tweazing the 600 grafts takes too long, and like a beard, they grow back a few hours later after shaving them. I thought about lazer hair removal, but I’m worried that it will permanantely damage the dormant follicles, and with just my luck, they’ll find a cure a week later!

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I really do not know your specific problem and the extent of the “pluggy” appearance to give you a personalized opinion. However, it may be almost impossible to completely undo old (or new) hair transplants, because a hair transplant is permanent. It goes to stress the importance of good research and being able to see the results of patients from the doctor as well as the medical group you are having the surgery with. Even 10 years ago, the pluggy transplants were not standard care.

You can try laser hair removal, but you may be left with scarring if the old grafts were the large plugs. Large plugs often leave a cobblestoned skin and depigmentation where the plugs were. Sometimes, these can be cored out, but an experienced hair surgeon needs to evaluate you for this option. Otherwise you can attempt another hair transplant to disguise the old plugs.

For more information on repairing old hair plugs, please see:

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Math Problem — Making a Class 7 Look Like He Has No Hair Loss – Hair Loss Information by Dr. William Rassman

This is a follow-up to last week’s How Many Grafts to Give Dick Vitale Hair Like Brad Pitt?

Doctor by saying you would need 40000 hairs to give mr Vitale the coverage mr Pitt has, do you mean that 40000 hair could produce the coverage but not the density? Cause otherwise the numbers don’t add up. A head like mr Pitt’s has at least 100.000 hairs right? Now, assuming that Vitale has kept about 10.000 hair at the back of his head : 40.000 + 10000 = 50000

What am i calculating wrong?

We at NHI have produced wonderful, full-looking heads of hair with a total of 50% of the original density. If Brad Pitt would allow me to pull out every other hair behind his hairline, I don’t believe that you would be able to tell that he lost 50% of his density. One doctor actually did this on a human volunteer and found (using good photography) that in this white male with black hair, observers and photographs could not tell the difference. The contrast of the black hair against white skin is what makes this most interesting.

This is an important observation, because if 50% is the amount of the original density a white male with black hair needs to appear full, then a white male with light brown hair may only need 20-30% of his original density, and a white male with blond hair may only need 10-20% of his original density to look full. The color contrast also extends to dark skinned people who have matching hair colors and they may behave just like the blond hair white skinned man I discussed above.

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Numbness Months After Hair Transplant – Hair Loss Information by Dr. William Rassman

I am still feeling numbness over the area of my surgery 2 months after the procedure. Is that normal?

I assume you mean numbness in the donor area (back of the head). Your doctor should check for numbness over the distribution of the major occipital nerves if the numbness is very wide. Most people who feel some numbness are experiencing the cut cutaneous nerves just above the incision. These should not extend more than an inch and they should return in time. Best to check with the doctor who performed your surgery.

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Reader Says He Discovered the Hair Transplant Miracle-Gro! – Hair Loss Information by Dr. William Rassman

Hello! I’m a 55-yr-old guy who’s had several HT procedures over the past 20 years. My last two were performed by different surgeons (both well-respected in this field), and both times I was surprised and delighted to note astounding growth of newly-grafted hair which I believe resulted from my coincidental use of a unique nutritional supplement. At six weeks following surgeries, I already had a solid half-inch crop of thick, colored new hairs which continued to grow like crazy. My current HT doc is starting a small trial with this supplement next week. Would you be interested in hearing about this? I think I accidentally discovered HT Miracle-Grow!

Sure, please keep me in the loop. I try to keep an open mind.

Update:
The person that sent me this email has told me that he’ll send me updates when he can, so I’ll post more information as it becomes available. In the meantime, take the above for what you will. Anyone want to wager a guess as to what this supplement could be?

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