Hair Transplantation – Page 130

October 15, 2007

Shaving the Head Before a Hair Transplant? – Hair Loss Information by Dr. William Rassman

So, when you get a transplant, MUST you shave your head? Kind of negates the whole deal. I have a very public job (actor) and the last thing I want to do is show up bald for a performance… thanks

Nope. Some doctors recommend shaving or clipping the hair close, but like you said, it would be a deal-breaker for most men who do not want their lives or their looks to change immediately after a hair transplant. The doctors who require shaving believe it is better to see the balding pattern, but I believe it is just to make it easier for them to perform the surgery. The expertise to keep everything looking the same and not call attention to the transplant is what we get paid for, though.

At NHI, we do not shave any of our patients recipient area for a hair transplant unless they really want us to. Rarely does anyone ask for this.

Paid advertisements (not an endorsement):

October 15, 2007

Transgender Male-to-Female Taking Dutasteride – Balding Blog

Hi Dr. Rassman,

I am a genetically born male, who just turned 23 years old. I am a transgendered and just recently began taking hormones 2 months ago to transition into a woman.

At age 21, as a male, I noticed my hair thinning in the temple regions. My mother father began balding pretty heavily in his 20’s. I knew I was transgendered but was unable to afford transitioning and beginning hormones at that age so I went to two dermatologists and was prescribed Propecia both times. I was on it for a little over a year. Surprisingly after a year I seemed to have less hair in the temple region and front hairline region. I can’t say it didn’t work because who would have known if I would have lost that hair anyways and Propecia helped me loose less? I’m not sure. My hair is definitely thinner and some family noticed but it’s not “socially” noticeable.

Two months ago I stopped taking Propecia I began a female hormone regimen to transition into a female begin that I am transgendered. I take 6mg of Estrace as well as Avodart daily. I also get a monthly injection of Depot Lupron 7.5mg used to treat advance prostate cancer in men and is similar to a “chemical castration”. So needless to say my testosterone levels will be taken WAY down and hopefully Avodart will absorb the leftover DHT in my system. However, at this point, now living as a female with female hairstyles I still have an issue because my hairline has started to mature in a masculine look and it’s very thin in the temples and at my hairline.

With my situation, and based on the medication’s I am taking – should I expect more hair growth than I did on Propecia? Honestly I think I need a forehead reduction but this could be particularly tricky with my thus receed hairline. What are you suggestions, or observations? Should I give it time? I CAN NOT loose ANYMORE hair and I REALLY need regrowth! I haven’t tried Rogaine because I was told in doesn’t work in the temple region on genetic men – but now that I’m on female hormones does that change that?

PLEASE HELP ME DOCTOR!!!!!!

Thank you SOOO much for this wonderful opportunity!

You have chosen non-surgical, hormonal treatments for eliminating your male hormones. Dutasteride, although not yet FDA approved for regular male pattern baldness, is studied and believed to be more potent than Propecia (finasteride) for prevention of male pattern baldness. You are right in that using other anti-androgen medications are also important to slow down the process of your male patterned hair loss. I am not sure whether Rogaine can add anything to the medication regimen that you are currently on. You have to know that it is unlikely that you can grow your receded hair completely back and medical treatment can only prevent further loss and in some cases thicken the miniaturized hair in thinning area.

For treating the receded areas that are not recovered by the maximum hormonal treatments that you are doing and to make a female hairline, the available options include hair transplantation and possible hairline lowering procedures. The latter runs a risk if you should continue to bald from your genetics, while a hair transplant has been successfully used for people like you who have male pattern hairlines and wish to migrate to a feminine hairline. Please consider coming in for a consultation so that a Master Plan will have will be clearly defined for you.

October 12, 2007

Hair Loss InformationUnfortunately, Some Hair Transplant Doctors Are Crooks – Hair Loss Information – Balding Blog

Last week, I met with two patients who came to me with thinning hair. One was 19 and the other was 22. The 19 year old had very early miniaturization, evident by the measurements that were taken of his scalp, and I built a Master Plan for him and advised him to go on Propecia. The 22 year old had clear thinning in the frontal 2 inches of his hairline with 40-50% miniaturization and a thin type hair shaft. The thin hair shaft made his miniaturization look worse than if his hair had been more coarse.

Both of these young men went to these doctors before they came to see me (and no, I won’t name names). In my opinion, both patients should not have hair transplants at this time; certainly the 19 year old is not a candidate at all and probably will not be for years, and the 22 year old may become a candidate if the Propecia does not stop or reverse his hair loss to meet his goals. However, the 22 year old might be able to avoid a hair transplant if the Propecia works well for him. The lack of ethics of the two doctors who viewed both men and gave them both recommendations of 3000 grafts each reflect the ‘scum’ of the hair transplant industry. I know I’ve written on this topic a few times before, but it truly outrages me and demands this repetition. Performing surgery when it could be avoided with a simple daily medication shows that the doctors were chasing their patient’s pocketbooks, not pursuing their patients best interests. Fortunately, both patients liked my advice and will see me for a follow-up in a year or so. I am sure that they will get calls from these two doctors and/or their sales staffs and I strongly advised them to resist sales pressures to sell them what they do not need.

To make matters worse, in my normal examination I measured the hair density of the donor hair on these patients and found them both to be lower than average. That means that they might be limited as to what they can expect from a hair transplant when and if they balded. Both of the doctors that they met with just ran their hands over the patients’ scalp in the back of their heads and magically reported that they were unusually blessed with “lots of donor hair”. Neither of these doctors made a measurement of the donor density on either of these patients and as if by magic — *poof* — they had enough hair to meet the doctor’s income requirement. These scams are unfortunately common in this industry and I always warn patients that if the doctor does not precisely measure the donor density, they should run for the hills when told that their donor supply is good. Worst of all is the fact that if these men had undergone hair transplantation, their donor hair (which was limited in the first place) would be depleted, wasted, and worse yet, put in the wrong place. Over and over again I warn patients to do their diligence on the doctors they see and choose. This again, is a Buyer Beware market.

October 10, 2007

Dr. Rassman’s Hair Surgeries – Hair Loss Information by Dr. William Rassman

Dr. Rassman, I was wondering about your own hair and treatment. I found the past blog entry where you provided a photo showing your donor scar. I was just curious to know how many procedures you have had done and was it one of the other doctors at NHI that did the procedure? Also, how long have you been taking Propecia and have you ever experienced any side effects, mild or otherwise? If these questions are too personal, feel free to not answer! Thanks as always for such a well informed blog.

I had two hair transplant surgeries done by a doctor at New Hair Institute with our experienced team. He fixed my scars which came about from a series of mistakes where I had three scalp reductions in 1992. The hair transplants solved my balding crown and scars in the crown. I take Propecia, and did develop some mild reduced sexual performance which was transient.

October 10, 2007

Haircut After Hair Transplant – Hair Loss Information by Dr. William Rassman

When is it OK to have a haircut after a transplant, especially for the transplant area? Thanks.

After a couple of weeks you should be able to get a regular haircut. Don’t expect that the transplanted hair will grow out in less than 5 months.

Paid advertisements (not an endorsement):

October 10, 2007

I Had Mini-Micrografts Transplanted 2 Years Ago in the Crown and Now My Sides Are Thinning! – Hair Loss Information by Dr. William Rassman

I am 24 years old. My hair loss was started when i was 20 years old. I had full head of hairs before I shaved em off for summer and surprisingly they never grew back My areas were crown and front. 2 years ago, I went under the surgery for my crown area but there is nothing worse if you runs out of luck. The surgery was mini-micrografts which according to you should not be recommended. Now my crown has just few hairs and front is totally gone but i dont know why my sides are going thinner too. I am definitely not a candidate for strip surgery anymore but for FUE I am very confident that I can be a good candidate. All I desperately wanna ask you that does propecia can do any good for my sides and back? I am a poor guy who believes in miracles because I cant afford another surgery, I did but got disappointment. PLZ reply me on my email address and plz plz tell me if there is anything I can still do from becoming completely bald..

Your scenario shows what happens to a person who does not have a Master Plan and starts getting hair transplants in the wrong place and at the wrong time. Based on what you’re telling me, I question if your doctor even had your real interest at heart. Propecia (finasteride 1mg) may slow down fringe loss, but I suspect that you are going to have a very advanced hair loss pattern. For your own sake, please get to a caring, competent doctor to build a Master Plan for you with your present situation as the baseline.

I do not charge for a consultation and at the least you will get an honest assessment of your situation. You indicated that you are not near my offices in California, but you can still send me good pictures and we can try to do this by phone. Reference this post when sending the photos, please.

October 9, 2007

HIV and Hair Transplants – Hair Loss Information by Dr. William Rassman

I just got a call from a young man who is HIV positive. He has been turned down for a hair transplant by a number of doctors. He said he felt like he was some leper.

I have performed hair transplants on many HIV positive patients. Just like poor or rich patients, I do not discriminate. I have transplanted men with known heart disease, diabetes, women with active cancer, men and women with sexual identity problems and even people with a variety of mental illnesses. Each person is first a human being and I swore an oath to help people in need. That applies as much to cosmetic surgery as to people who are sick and in need of help.

Paid advertisements (not an endorsement):

October 9, 2007

I Tend to Form Keloids — Will FUE Give Me Problems? – Hair Loss Information by Dr. William Rassman

hello doctor,
my skin has a tendency to form keloids. i’m considering of having FUE on my frontal hairline. I know that keloid will probably grow on the donating area, but is there any possibility at all that it will form on the recepient area? Your answer is very important to whether I’ll have the procedure or not.

Thank you.

Keloids in the frontal area are extremely rare. In fact, I do not recall ever seeing a case or even hearing from the medical community about this complication. Although an unscientific study, hundreds of doctors were polled some years ago in an audience setting and the results were that not one hand was raised asking about keloids in the frontal hairline. With that said, I would do a few test grafts and wait 6 months or so before undergoing a hair transplant. Better to be safe than sorry.

Paid advertisements (not an endorsement):

October 8, 2007

Can I Flatten a Keloid in Donor Area? – Hair Loss Information – Balding Blog

i had hair transplantation in 2001. I had only two small patches to cover them but during the surgery i shed too many hairs and now i have a large scar at the back of my head and also have kind of wounds in some of the transplanted areas where scab is formed and i keep scratching those areas(what to do to get rid of these wounds). The scar at the back is like a small Keloid, is there a war to get it removed or flatten with some steroid injection? Also tell me if i can have hair transplanted on the area from where strip was taken so that i can keep short hair and that area remains covered. If it is possible hair from which part of the body will be taken as i dont want to donate hair from the back of my scalp. Chest hair, shoulder hair etc will do the job. Thanks

Block Quote

Wow, this is pretty complicated. I really can’t give a proper response without at least pictures and I may need to even see you directly to see precisely what needs to be worked with.

Keloids may respond to steroids directly placed into the keloid if it is relatively fresh (past few months). Some people are keloid formers. You can always do FUE for hair transplants. Flattening them does not usually work. In your case, using body hair is a possibility.

October 8, 2007

Experiencing Shock Loss Months After My Hair Transplant – Hair Loss Information by Dr. William Rassman

Ok here’s my situation, about 7 months ago I got about 1400 grafts performed. The standard strip style surgery. I’ve healed up well and I would say less than 2 months after surgery the hairs immediately started to grow. I also started propecia right before the surgery. I experienced shock loss immediately after the surgery and it ceased about 2 months after. I shaved my head completely and my hair grew in like crazy very thick and flowing. About 4 months after the surgery my hair started to fall out again and has since been falling out and progressively getting worse. I apply rogaine and copper peptide solution daily and am not doing anything any different. What can you suggest as a course of action?

Because of the protective effect against shock hair loss, you should’ve been taking Propecia (finasteride 1mg) prior to the hair transplant surgery — so the question now is whether you started it early enough (best a few weeks before the procedure). Accelerated hair loss associated with a hair transplant is most probably caused by shock loss. One must use the history and the association to point to the cause. You might be going through a hair loss cycle unrelated to what you are doing and there may not be anything you can do except to wait for your hair cycle to take its course. If there was a considerable amount of miniaturized hairs, then you would be a ’set-up’ for shock loss. Studying your hair miniaturization and distribution may point to more information in helping to make a diagnosis, but as I am not your doctor, I have no access to your patient records and can’t provide much more help than suggesting you post these questions to your doctor.