Hair Transplantation – Page 132

September 28, 2007

Hair Loss InformationI’m 18 and Want a Lower Hairline – Hair Loss Information – Balding Blog

I have a naturally high forehead. I want to lower it somehoe but I am only 18 and no one seems to want to deal with me. WHat can I do??

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Generally hair transplants for 18 year old males are approached with caution since they have further balding and a hair transplant may accelerate the balding process. For women, hairline lowering with a hair transplant is well proven with great results, even at the age of 18, because the worry about balding (male pattern balding) is not a factor in females. You should start with a miniaturization study of your scalp to see if you have early signs of balding. After all the risks and benefits of surgery are presented to you, it may be a consideration.

September 28, 2007

Hair Loss InformationI’m Not Hairy Enough in the Pubic Area! – Hair Loss Information – Balding Blog

i have a pretty fair amount of chest, stomach, and etc.. hair. but my pubic area is not very hairy. what can i do to increase the hair in that area? im 37, in good health, just so you know if it matters

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Hair transplant to the pubic area is a relatively common procedure that is not well publicized. Surprisingly, many Asian women have pubic hair transplants with good results. There is no reason why men cannot have the same procedure. We are an equal opportunity surgery center.

September 28, 2007

The Value of Double vs Single Follicular Unit Technique – Balding Blog

I have seen on the internet, the promotion of a double FU technique. Can you explain it to me and tell me about the value of a double follicular unit technique.

Follicular units (FUs) have one, two, three or four hairs each. When they are placed in the recipient area, they are graded in the frontal hairline (FUs with one hair each up front). There are times when the doctor wants to have more two or three hair grafts and the donor area yielded too many one hair grafts (common in Asian patients). In this situation, two single hair grafts (or one single and one double hair graft) are placed into a single recipient site and that is what is referred to as a ‘double FU technique’.

A bald man may get between 250-500 single haired FUs at the leading edge to create a soft, transitional hairline zone. All other FUs should contain more than one hair each to produce value. As each person has a different distribution of single hair FUs out of a harvested strip, the number of single hair FUs are determined by the anatomy of the patient (not the surgeon). So to get more than a single hair FU to place behind the leading edge transition zone, one might have to double up the single hair FUs to get reasonable bulk. More bulk can be obtained by putting a single hair FU with a two-hair FU to create a three-hair FU so that there is a way for the surgeon to determine and control the bulk of the hair that is transplanted.

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September 27, 2007

Hair Loss InformationI’m 19 And Losing My Hair – Taking Finasteride and Minoxidil, But I Want Faster Results – Hair Loss Information – Balding Blog

Hello

I just turned 19 and am about a III on the Norwood scale. I noticed a slight receding hairline at 17 and began using Rogaine and taking saw palmetto supplements. My father was V on the Norwood scale by the time he was 28, but his balding was not as accelerated as mine at such a young age. I have been taking finasteride (5 mg dosages cut into 4 pieces) daily for about 5 months and have continued to use Rogaine foam, and my hairline continues to rapidly recede. As I am so young this is very detrimental to my self confidence and image. I was wondering if you think that I should try dutasteride, as the finasteride seems to have had no effect (my balding wasnt progressing this fast before I went on it), or maybe even consider hair transplants to fill in what I’ve lost.

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It seems you are very proactive about your hair loss. As such, you need to start with seeing a good, qualified doctor for your hair loss options.

Saw palmetto is associated with improving prostate health and as such the natural supplement community now seems to link it to hair growth, because finasteride (Propecia / Propecia) is associated with prostate health. However, there is no ‘metric’ on the value of saw palmetto that would say just what does blocks DHT.

You need a miniaturization study before you start any medication so that you have a baseline measurement prior to taking any medical treatments. Photographs and general assessments may seem good enough, but you do not know what is going on at a microscopic level without a miniaturization study.

Avodart (dutasteride) is not FDA approved for treating androgenic alopecia (AGA). Just because it is said to be a stronger blocker of DHT does not mean it will be better than Propecia (finasteride). I always point out that the drug dosage is not documented, so every doctor that prescribes Avodart to treat hair loss should be wondering the correct dosage to prescribe. If/when it is finally FDA approved for treating hair loss, the decision to start this medication should not be frivolous.

Finally, hair transplantation in a 19 year old with Norwood Class 3 balding is not recommended. Give it at least a few more years to see where your hair loss pattern is evolving to before considering surgical options.

September 26, 2007

Hair Loss InformationSurgery vs No Surgery – Hair Loss Information – Balding Blog

Rassman I just had a patient (a 26 year old with very early class 6 thinning) who really does not look bald at all. I wish I could show you his photos, but I respect his wishes to not have his images published at this time. Anyway, he went to another hair transplant clinic (one of the chain operations) and was told that he needed 1,500 grafts. He had minimal thinning and looked good to me. I discussed it with him and he wanted to know if it would be a bad decision if he decided to just do nothing. I told him that his miniaturization was in the 30-40% range and that with his hair color and texture and considering that it really did not bother him, that just Propecia (finasteride 1mg) alone could be adequate until such a time that his situation changed. I recommended no surgery at all. He was happy to get that advice and was a bit frightened at the urgency created for a surgical procedure at the other clinic. As my consultations are free, my only satisfaction was that I saved him from unnecessary surgery or even accelerated hair loss due to shock loss after a surgery.

The reason I wrote this brief post was to point out that as a doctor, my priority is whatever is in the patient’s best interest. I’m not trying to line my pockets. I’m not trying to sell unnecessary procedures. I don’t split grafts to charge the patient more money. Unfortunately, not every physician follows this same line of thinking.

Yes folks, honesty is absolutely the best policy. Please remember this when choosing your hair transplant doctor. If you feel pressured, take a step back and remember that you aren’t buying a car, you’re having a consultation about cosmetic surgery.

September 25, 2007

Can Shock Loss Be Permanent? – Balding Blog

Hello Doctor

I have a question for shock loss after an HT procedure. You always say that healthy hair (not miniaturized hair that MPB did not so far affect and neither will in the future ) lost due to shock loss should come back after a few months ( even without the use of propecia ? ) Why do you use the word ’should’ and not the word ‘will’? Is there a chance that shock loss could make healthy hair permanently die , and if so what is that chance ? Let’s of course exclude the case that the transplant doctor makes mistakes and accidently scars the healthy follicles.

The use of the word “should” rather than “will” is a way of predicting the future. Let’s not play language games here. Shock loss, when it occurs in men with genetic hair loss, can (not “will”) accelerate the hair loss process by a few years and this can (again, not “will”) be prevented with the use of Propecia (finasteride 1mg). Each person is different, and as such, each person reacts differently to various drugs, procedures, stresses, etc.

September 24, 2007

Half My Moustache Stopped Growing – Hair Loss Information – Balding Blog

One side of my mustache does not grow. I shave it everyday and still nothing. I was able to grow a mustache before, but all of a sudden my left side stopped growing. What can i do or use to make it grow back. Thanks.

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It is very strange that only one side of your moustache grows. There is nothing that will make the other side grow. Please send me a picture (reference this blog post) and it will be kept confidential. If indeed one side of your moustache is not growing, hair transplantation may be an option. If your moustache hair is not of the same character as your head hair, then mixing head hair along with using the right side of your moustache (the side with the hair) as a donor, is a real option if transplants are done.

September 24, 2007

Pimple in Recipient Area After Hair Transplant – Hair Loss Information – Balding Blog

Hi Dr. Rassman:

I had a pimple in my recipient area (I am 5.5 weeks post op) that I accidentally popped while washing and it drew a little blood. Am I in danger at this stage of losing a graft and will this affect the growth in that area?

Thanks as always

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Pimples (follicular cysts) do occur after a hair transplant. They most often reflect remnants of hair that is left behind at that site. The body tries to expel those remnants and these are what people call ‘pimples’. Warm soaks are generally the best treatment. Be careful that you do not have a ‘folliculitis’ (an infection of many hair follicles) that may require medical attention.

September 24, 2007

Hair Loss from Testosterone Replacement Therapy? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I have been under the care of an anti-aging doctor for two years. I have been taking testosterone (TRT). I have had hair transplants 10 years ago. I have been recently experiencing
more hair in my comb. Can Testosterone replacement cause transplanted hair to be lost?

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Testosterone replacement may cause androgenic alopecia, but it should not cause hair loss in the permanent hair that was transplanted from the back and sides of your head (these hairs are not affected by DHT). You may be experiencing hair loss from your native non-transplanted hair.

September 24, 2007

I Had a Procedure with You in 1994, But Wasn’t Satisfied – Balding Blog

Dear Dr. Rassman:

I don’t know whether or not you’d be interested in this message. Nevertheless, I would be interested in your reaction to it …

I was a patient (age 34 at the time) of yours in August of ‘94. You transplanted about 2,000 grafts from the back of my scalp to the top of my head. My overall reaction was that the density wasn’t near enough. And there was no way I could afford a second trip through the mill.

While I thought the newly transplanted hairs themselves looked okay, I concluded that your procedure fell far short of my expectation. To be blunt, my head resembled a coconut. So I ended up going to a company that provides rather costly “hair systems” (the gentle term for wigs). They look great – full and natural. It’s an ongoing “expense” that’s become a part of my life. But I thought of you the other day.

The idea of finally just shaving my head and being done with the high cost of masking my hair loss crossed my mind again. So when I took another good look at the white scar that traverses the back of my head from ear to ear, I dropped the shaven head idea.

Maybe when head tattoos are commonplace, I’ll put one right over the scar; a picture of a “bald eagle” or something.

Your reaction to this would be appreciated.
Thank you, sir.

Thank you for contacting me. I had the opportunity to review your photographs and your medical record. Hair loss is a progressive process and it is clear that the communication between us failed. I care about my patients meeting their expectations (first being sure that these expectations are realistic) and following up with a good Master Plan to follow the hair loss over time. I did this in 1994 as well. A single hair transplant procedure of 2000 grafts may have filled in some of your thinning, but it was not enough to cover the complete hair loss pattern that probably evolved. As hair loss is a progressive process and your pictures showed that you were in the process of losing hair at the time of the transplant, clearly you were a moving target. I must have failed to explain that process to you. Drugs like Propecia (finasteride) were not around in 1994, so unfortunately, in those days, I worked with a handicap watching helplessly as people lost their valuable hair over time. As you may know by experience, hair transplants (without the protective effects of drugs like Propecia) can accelerate the hair loss and even produce shock loss, which means that the hair loss process probably accelerated.

I can suggest that you arrange a visit with me and let’s discuss your present status and your goals. There have been many advances in managing scars if that is your main focus today. Nevertheless, I do care and the best I can do is offer my advice and reconnect with you again after all of this time. My office can be reached at 800-NEW-HAIR. Please do give us a call so that my staff will be able to get your next visit arranged.