Hair Transplantation – Page 117

April 7, 2008

Does FUE Produce Higher Hair Counts? – Hair Loss Information by Dr. William Rassman

Getting confused here.

I read that the average hair per FU for strip is 2.0. On the other hand I read that average hair per graft for FUE is 2.3 or higher. Is it correct that FUE produces higher hair counts, and if so how come ?

With follicular unit extraction (FUE) you can select how many hairs per graft you want, while with strip harvesting what you get is the average density in the strip. That means that if you want a higher hair count per graft, in theory FUE will give it to you if they are present in the donor area in adequate quantities.

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April 3, 2008

Hair Loss InformationHad 3 Transplants 20 Years Ago, Now I Am Losing Temple Hair – Hair Loss Information – Balding Blog

Dr. Rassman,

Great website. I am a 50 year old man who had 3 sessions of transplantation in my early 30s. I now am in need of another procedure as my lateral hairlines have become bare, ie temple areas. I still have a good deal of donor supply in back but am not looking to use Propecia, in the past it did cause sexual side effects I was not willing to put up with. What are my chances of success and how common is it to need an additional procedure or 2 as we age? Thanks

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I can not tell you how much hair you have left to transplant in the areas that are thinning, as I do not know the following about your case:

what procedures you had done in the past
how much area of donor supply was moved
what your donor density is
what your scalp laxity is
what your Norwood classification is
what your residual donor supply looks like

It sounds like you had your surgeries prior to the advent of the megasession and follicular unit transplantation. It is not unreasonable to have more surgeries as one ages and one continues to progress in the balding process provided that you have a Master Plan which deals with change and hair loss over time. The supply of donor hair is critical in the formulae. If you want to send me some photos I would be glad to look at them and give you better advice (please reference this post when sending).

April 3, 2008

Hair Loss InformationFolliculitus Decalvans and Hair Transplantation – Hair Loss Information – Balding Blog

Doc,

I have something between reoccurring folliculitus or folliculitus decalvans, depending on which doctor (i’ve been to a few) you ask. I have had a biopsy. The problem is located on the crown of my head. Subsequently, there is bald spot on the vertex of my scalp (about the size of a dime). Assuming I can get the infection to go away, is this something that can be cosmetically repaired?

Thanks for your input

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If you have folliculitis decalvans and you can get the infection under control, any type of repair work in this area (i.e. follicular unit transplantation) could set off the disease process again and you have the potential of losing the transplanted hair and having to deal with the disease process all over again. This is your worst case scenario. I have had 3 such cases over my years in practice. Two ended up with reasonable hair growth, the third one is presently being diagnosed and treated. Good luck.

April 2, 2008

How Many Grafts to Give Dick Vitale Hair Like Brad Pitt? – Balding Blog

Hi Doc, cool blog.

I was just wondering if hair multiplication became a reality, would it be possible to give a guy like Dick Vitale hair like Brad Pitt? If so, how many grafts woud it take, and what approach would you use? I’m sure if any surgeon could duplicate nature, it’s probably you. Thank you.

I am going to assume ESPN’s Dick Vitale is a Norwood Class VII, and he has an average hair density of 2. This equals about 1250 hairs per square inch, or 625 follicular units (FU) per square inch, assuming an average of 2 hairs per FU. The front and top part of the scalp on average cover about 16 square inches, the crown another 16 square inches, for a total area of coverage of 32 square inches. If we had unlimited source of hair (cloning, multiplication, etc) we would need about 20,000 FU or 40,000 hairs to give him coverage with a density of 2 in the transplanted area (for the head of hair that Brad Pitt has). However, as the gold standard is follicular unit transplantation, this would be the method I would use, even in the make-believe world we just described.

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April 2, 2008

Retin-A and Minoxidil After Hair Transplant – Hair Loss Information by Dr. William Rassman

I am a 25 year old male. I had a HT procedure about 2.5 months ago. What is the risk to the transplanted follicles from using a minoxidil + 0.025% retin-a formula? I use 5% rogaine foam and 1/4 proscar religiously, but I was wondering if the added retin-a might help. Any advice is much appreciated.

Retin-A is an acid and is sometimes used for the treatment of acne. It causes skin irritation that some believe will help with minoxidil absorption. There is no proof this works in helping with hair growth. It is a buyer beware market. I would speak with your doctor about this use after a hair transplant, but I do not recommend that my patients take it.

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April 1, 2008

Neck Hair and DHT – Hair Loss Information – Balding Blog

Dr. Rassman,
I was told by my hair transplant surgeon that FUE can be performed effectively from extracting the hairs near my neck since he finds it unusually dense compared to other areas on my scalp.Are you in agreement of this=based on the fact that these hairs can in fact be effected by DHT?

In other words if the hairs are in fact efected by DHT why would I go through this expense/discomfort if they will eventually fall out? please advise

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Neck hair is not scalp hair and as such it is NOT considered permanent hair. I have seen plenty of patients who had lost their neck hair as they age. If you transplant neck hair it may NOT be permanent. In your particular case, you mention hairs “near” your neck — and I simply don’t know precisely the area you’re talking about.

April 1, 2008

4 Months After Hair Transplant, Seeing Dead Skin and Hair Coming Out – Hair Loss Information – Balding Blog

Hi,
Im 4 months post op and noticed some dead skin peeling off fro the recepient area while combing my hair after shower.

There was no blood behind. Just Dead skin with some attached hair to it. is there anything to worry about? Will the hair grow again in place of the dead skin?

thanks

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This is probably crusting that you haven’t washed off. I have seen this on people who were too gentle with their post operative washing. See your hair transplant doctor to ask about your post-op care.

March 28, 2008

Thanks, My Stylist Doesn’t Believe That I Had a Hair Transplant! – Hair Loss Information by Dr. William Rassman

I had two transplants at NHI over the past 5 years (last one was 3 years ago) and the results are fantastic. Whenever I get a haircut I will tell the stylist that I had the transplant procedure done just so they are aware of the line scar in the back and don’t cut my hair too short back there. I find that as long as I tell them before they get started, its no big deal and the scar is never visible, even with a $15 Supercuts haircut that I get. BUT, I usually end up spending the 10 minutes I’m getting my haircut explaining to them that yes, this is a hair transplant and no, I’m not just joking around. Nobody believes me! Outside of getting a haircut, I never mention it anyway… but the one time I tell someone, they don’t believe it. So that just goes to show that you did a damn fine job. Really incredible work and as you can probably tell I am thrilled with the end result. I’ve included a couple photos that you can use for your blog.

Thanks, doc. I’m very, very, very pleased.

I’m glad to hear that nobody believes you — that means we were successful! In all seriousness, this is how any good hair transplant should be. We never want patients to be easily spotted as having had a hair transplant. The end result should always look natural.

This patient had 1,737 grafts transplanted over two procedures.

Update Dec 2008: [Photos removed by request]

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March 27, 2008

Hair Loss InformationAfter 4 Years, I Still Feel Pain in the Donor Area – Hair Loss Information – Balding Blog

After almost four years, I feel pain around the donor area. I doubt the doctor has cut too deep and damage my nerve or muscle. What is the way to identify the source of the pain?

Thanks!

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Possible nerve damage or irritation is a potential risk of hair transplant surgery as well as other surgeries which involve a deep cut in to the skin. Rarely, I have seen cases where a patient may experience pain in focused areas around the donor scar. With time this should resolve. However, after four years you may want to go back to your surgeon and discuss what this source of pain may be. Without a direct examination, I do not believe I can advise you on a possible source of your pain. An examination of your scalp will show if the major nerves are intact, and if you have a trigger point from which the pain can be elicited. This should be part of a doctor’s examination of you, something I would do if I were your doctor.

March 25, 2008

Hair Loss InformationTransplanting Hair While Still In the Early Hair Loss Stages – Hair Loss Information – Balding Blog

Hi,

Why do you say it is such a bad idea to thicken up an area that you may lose in the future? Say if you had hair that was 50% of it’s original density and thinning continually, could you not get 50% of the original transplanted into the thinning so that as the remainder eventually thins out and has gone your still left with what was transplanted earlier?

Thanks!

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Shocked! If your hair loss is in its early stage and a hair transplant procedure was in that early stage there are problems with that approach. I have little doubt that in the young man with early hair transplants, the hair that is destined to fall out, may fall out at a faster rate than they would have had a transplant not been done. I am not talking about hair transplant shock alone (which is short term by months), but rather mid and long term by years from a time frame point of view.

Even though Propecia (finasteride 1mg) works in most men to prevent hair transplant shock, there is no better treatment for hair transplant shock than not having a transplant into areas of early thinning. So if you transplant hair that causes native hair in the vicinity to fall out, you could possibly wind up just replacing miniaturized hairs with a lesser number of transplanted hairs. The net effect may be zero and the preventive hair transplant would have been unnecessary and wasteful. Hair transplantation is a permanent process and it must fit the Master Plan of your hair loss process.

I do not believe surgery is in their best interest for younger men thinking about getting hair transplantation when the hair loss is just starting. All hair taken from the donor site is ‘finite’ which means that transplanting donor hair depletes the donor supply. If a person had 6000 grafts in his lifetime and he uses 2000 of them in an attempt to anticipate what might happen, the reserves for treating what will happen will be less than had the person had no surgery. The young patient can always delay the decision to have a hair transplant. Perhaps meeting again 8-12 months after your initial consultation will allow your physician to reassess the Master Plan to see where your hair loss is going.