Hair Transplantation – Page 120

February 22, 2008

Sylvester Stallone’s Hair Restoration – Hair Loss Information – Balding Blog

Dr Rassman,

As part of your occasional series discussing the hair jobs of celebrities, could you take a look at this (rather unflattering) article on Sylvester Stallone in London’s Daily Mail?

Link: Daily Mail

In short, he does look very good for his age — until you check out the closeup of his hairline. In your opinion, what technique is responsible for that restoration job?

Thanks for your time

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Yikes! What I see in the link you sent appears to be a harsh hairline. Even with the limitations of the photos, I think I am able to see some of the older type of work, some large grafts mixed with smaller grafts — so in my opinion he looks transplanted. I have no firsthand knowledge and am basing this on Mr. Stallone’s appearance in this photo. The older (and larger) grafts are relatively easy to detect and reflects more than one surgery, one of which may have been done years ago, prior to the advent of the modern Follicular Unit Transplant technique that we defined in 1997 in the published literature (see links below).

February 22, 2008

I’m Male to Female Transgender and Was Told a Hair Transplant Is Not an Option – Hair Loss Information by Dr. William Rassman

I am transgender male to female, and have male pattern thinning. I have been on hrt and antiandrogens for 2 years and Proscar and Minoxodil for 8 months. I consulted a hair transplant surgeon about transplants on the crown and top of my head, and after a video microscope evaluation he said that he cannot do transplants as there is no room for grafts. He stated that I have not really lost any hair and have great density, just that the calibre of the hair had diminished. Do you think given more time on hrt, antiandrogens, proscar, and minoxodil, that the miniaturized follicles may recover to terminal thickness and if not what other options do I have?

If your hair is miniaturizing, then the hormones and complex medications you are taking may be the cause of your problem. Hair transplants, where there are normal densities of hair, may not help solve your problem. I couldn’t tell you if more time will for sure help your hair.

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February 21, 2008

I Want My Head to Always Have a 5 O’Clock Shadow of Hair – Hair Loss Information – Balding Blog

Heres one for you: I wouldnt mind a shaved head if the shadow of existing thick hair wasnt so obvious around the donor areas. It’s like the top is your normal face color, and the donor areas white with potential hair. The shadow where hair grows is just so noticeable. My question is: is there a procedure where you can have implanted just tiny hairs as in a shadow over your balding? So it looks like you only shave your head?

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5 O'Clock Shadow I suppose you can tattoo your bald area, but that’s not the recommended route. I have seen it done in a few patients with reasonable results, but they have done this because of some deforming surgery they had from older hair transplant techniques many years earlier. Alternatively, you can air spray the balding area to develop a subtle shadow. If you’re looking to transplant a “5 o’clock shadow” look to your head (like the facial hair style that became popular in the 1980s), it’s really not going to be possible without having visible scarring to some degree (even if minor from FUE) in the donor area.

In other words, to answer your question — no.

February 21, 2008

Could Conditioner Applied 10 Days After My Hair Transplant Lead to Problems? – Hair Loss Information – Balding Blog

POST-OP CONDITIONER WASHING TECHNIQUE CAUSING GRAFT FAILURE?

Dr. Rassman,

After reading about using a gentle conditioner to aid in the removal of post-op scabbing in the recipient area after surgery on a popular hairloss forum, I applied a conditioner to my recipient area for 20 minutes on Day 10 post-surgery. (It was Haircylce Conditioner that I purchased over the Internet prior to my surgery!)

But, I foolishly applied the conditioner to my dry scalp, which made removing the conditioner nearly impossible!

Finally, after 20 minutes of constant rinsing with a cup of water, I was able to remove the conditioner by gently dabbing the area with my fingertips in between rinses. There was no bleeding or noticeable irritation afterwards. Is it possible that this constant rinsing could have damaged the grafts? Please advise because I am worried that my physician may use this information against me, if I have a poor result.

Thanks in advance

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If you did not pull out the grafts in the process, I would doubt that any problems would have been produced by the conditioner you used after 10 days have passed.

February 18, 2008

Body Hair or Scalp Hair — Which Grows Faster? – Hair Loss Information by Dr. William Rassman

which grows faster body hair or scalp hair?

The cycle of hair growth is shorter with body hair than scalp hair.

If what you are actually wondering is whether or not body hair or scalp hair will grow faster after a hair transplant, that would require some experience with body hair for an answer. I frankly do not have the answer for that, other than to say that hair growth after a hair transplant ranges from immediate to about 5 months on average.

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February 18, 2008

I Had Poor Results After a Transplant 11 Months Ago — What Can I Suggest to My Doctor? – Hair Loss Information by Dr. William Rassman

Hello Dr Rassman,
i had a hair transplant surgery,(strip method of 2400grafts approx)from a well reputable doctor about 11 months ago with relatively poor results in the crown area. what can i do in my case, what can i suggest to my doctor? my doctor would make the final assets at the 12th-14th month he told me. (what usaualy happens in cases like mine?)
Thank you

Failure to grow can happen, even if everything is done right. Assuming that your doctor and his/her team did it all right and you did not grow the hair, you should sit down with your doctor for a frank discussion of the problem. His/her experience should produce a good interchange with the risks of failure amongst the possible outcomes. In the hands of an inexperienced team, failure rates might be much higher. On the rare occasions that I have seen failures of the transplants to grow, I have offered to repeat them at my cost. Sometimes it grows just fine the second time, yet sometimes it does not grow even on the second round. I generally wait a year to determine what the results will probably be.

The profession has called the failure of a hair transplant to grow, the “X” (unknown) factor. This distinguishes the cause from the “H” (human) factor, which reflects defects in either the surgeon’s control or the transplant surgeon’s team. Some of the causes of “H” factor include trauma to the grafts caused by drying (leaving the grafts exposed to air for more than 30 seconds at a time), or rough handling, or a switch of the solutions used in error from saline or Ringer’s solution to distilled water (slop in protocols and process of the team).

Failures in follicular unit extraction (FUE), in particular, reflect many elements of damage caused by the extraction process which have been defined by me and some other experts at various medical meetings. Lack of required skills in FUE is the most common cause of graft growth failures. Some of the causes of failure to grow may reflect autoimmune diseases such as diffuse alopecia areata, which has no real physical presentation for an easy diagnosis other than a series of biopsies to look at the scalp under the microscope.

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February 18, 2008

Months After My Transplant, There’s Dead Hairs In My Scalp – Hair Loss Information by Dr. William Rassman

I received a 3100 graft procedure a little over 5 months ago in the 1/3 frontal area. I see a lot of growth, but also noticed that there are areas that still have the short, blunt hairs that were originally in the follicle when it was transplanted. They never grew, nor ever fell out. If I take a tweezer to them, the hair just slips right out, and has a bent area where it’s in the scalp. Also there are black bumps at the scalp that if pulled with a tweezer, keeps getting longer and longer until it comes out of the scalp. No pain, just seems like dead hairs. Can you “shed” some light on any of this?

I am sure that when you pluck these short hairs, you will not see any bulb with them. These reflect remnants of the old hairs and they are not growth from new hair follicles. I see this in a few patients and they usually fall out with good washing.

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February 15, 2008

How Good Are The Chances that Transplanted Hair Will Grow? – Hair Loss Information by Dr. William Rassman

Hello Dr.

What are the chances that transplanted hair will grow?
What is cost/per graft?
How much area 2500 cover ?

Best Regards

If everything goes as planned, you should expect 95+% of the transplanted follicular units (grafts) to grow. I am not sure if you are asking me what the cost per graft is for us at NHI or what the average rate is. Prices do vary per doctor or clinic. There are many variables to consider when evaluating a facility to perform your surgery, and cost should not be the most important factor. There are many places that will charge you per hair, and not per graft. Some clinics cut up follicular units to milk the patient for more money, yet no more hair. The quality of work will also suffer if you choose a disreputable hair transplant surgeon, just because you are attracted to their price for the procedure.

The number of grafts you require is relative and depends on the color of your hair contrasting with your skin tone, the character of hair you have (curly vs straight), and your hair density. In general you should get about 4 sq. inches of coverage with 2500 follicular units. Shear numbers are not the answer — all the other aspects are just as important.

For more, please see:

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February 14, 2008

Hair Loss InformationHair Transplant Tools – Choi Implanter vs Carousel – Hair Loss Information – Balding Blog

I have sent this question to this blog several times, however have had no response. I understand you have extremely high volumes of email, but i feel i might of had no reply due to the question its self as it may be considered that i am being purposely insulting. My question is as follows. The carousel i think is an extremely well designed implanter. And i imagine its results are alo very good, however i have seen in one of your replies to a question about the choi implanter were you said, ‘The Choi implanter is just a surgical tool. It makes some aspects of the transplant easier to perform, especially for those people who did not develop the difficult placing skills with the more traditional transplant tools used throughout the world.”

This to me seems a contradiction when the carousel is also an automated surgical tool, which also makes some of the transplant easier to do. I admit that the carousel could be considered to be better in the sense that it may harvest the hairs better, however its still like the choi implanter. One could say the carousel is a better evolved version of the choi implanter. The carousel and the choi implanter do the same job in almost exactly the same way. Please will you reply as i would find an explanation really interesting. Thanks.

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Caousel Practically speaking, the Carousel and Choi implanter are similar in that both make a recipient site directly into intact skin and then place a follicular unit into such sites. Mechanically speaking, the way they place the follicular unit in the site is different. The main limitation of the Choi implanter is that you have to load one follicular unit at a time, make the site with the implanter, place the FU in the site and load it back again before you can continue. For the Choi, a single hair graft is pulled into the instrument by a hair (being backed in). The advantage of the Carousel implanter is that it holds 100 follicular units, making the process smoother. The discussion is moot, however, because the Carousel is not currently on the market and can not therefore be used by any surgeon.

Note: The image to the right is of the Carousel implanter.

February 13, 2008

Hair Loss InformationDo You Have An Opinion on Individual Doctors? – Hair Loss Information – Balding Blog

Do you have any insight on Dr. [name removed]? As in do you think hes skilled and ethical? Please would like your advice

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Over and over again I am asked such questions. I just can not answer them, because I could be at legal risk if I thought badly about a particular doctor and voice my opinion over the internet… and there are many doctors in this field who I might not speak highly about.

There are some websites that claim to be consumer advocates and give such information to potential shoppers. Some of them provide a service and some do not. It is important for the readers to understand that many of these websites charge doctors a fair amount of money for an endorsement. That may not mean that if a doctor is not endorsed on the website, he/she is not a good doctor; it means that they do not want to pay thousands of dollars a year for such endorsements.

This is a buyer beware market, a theme I proclaim over and over again. In this blog, I tell consumers how to find a good doctor and I do not charge for any of that advice. So why do I add content to this blog day and after day addressing such questions as how to select a hair transplant doctor? The answer is that this is part of an overall philosophy I have to educate the public and to let the public know that there are many good doctors out there who perform quality hair transplants. Today’s modern hair transplant creates results which are indistinguishable from a person who never had a hair transplant and is blessed with a good head of hair. At our Open House events every month, many of our patients come in to help me illustrate that very point. I stress ethics in the field, tell the consumer how to hold a doctor responsible for their work and warn the consumer that this is a buyer beware market and the burden is on them, as a buyer, to do his/her research to get a quality job done.

For more information on doctors — what to avoid, how to find a good one, what some don’t want you to know — see: