Hair Transplantation – Page 136

August 21, 2007

I’m 18 and Want a Hair Transplant So Life Doesn’t Pass Me By – Hair Loss Information – Balding Blog

I live in Washington, D.C. and I have the hair loss problem, but I’m 18. I have tried Rogaine, I have tried Fo Ti, I have tried everything (except for Propecia) including going to the hair club, where they would glue a wig to my scalp. I called hair loss clinics all around my area to ask them when it would be right to have implants/ transplants done and they say that I have to wait 6 years, that is, until I have completed my transformation into Patrick Stewart. I am about a 50% on the Norwood scale and I don’t want my life to pass me by. Do you think that it would be right to get surgery done at this point in time? I don’t see any other way. Is there a minimum age for implants and if done before the minimal age will the implants fall out? Also, is there a way to keep them in (rogaine, propecia, etc.)?Thanks for your help

I hope to hear from you soon

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When a wig is applied to your scalp with glue and other similar attachments, it will pull out the hair and produce more hair loss (traction alopecia). As a result of this, you can be ‘hooked’ on the wig for the rest of your life. There is no real minimum age for a hair transplant, but generally speaking, we tend not to do these in young men under the age of 24, because the hair loss pattern is not clearly defined. Simply said, hair transplants are performed by moving the hairs from the back of the head (donor area) to the areas you need hair (front, top, crown, etc). So as long as you don’t have an underlying genetic condition such as alopecia, your hair transplants will stay in forever (independent of age). As we always want a Master Plan for each patient and their balding pattern, we need time to get there. Propecia (finasteride 1mg) works well in young men to prevent or stabilize the hair loss and that should be your first line approach.

August 20, 2007

Hair Loss InformationWhat’s the Highest Density Possible from a Hair Transplant? – Hair Loss Information – Balding Blog

Doctor,

Quick question: what is the most density one can achieve after a hair transplant? I’m a little more than 6.5 months after my first hair transplant (temple and front), and wondering if I’ll
ever be able to slick my hair back like I used to. I’m seeing growth, but the density surely isn’t near what I’ll need in order to reach my goal (at least right now it isn’t).

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The issue is fullness, not density. At 6 months, I would not expect much fullness, but each successive month I would expect to see more and more. At 8 months you should see about 80% of what will eventually be there. The fullness may not directly relate to the density, as there are many variables (hair shaft thickness, hair character, hair and skin color, degree of baldness), so any absolute number without taking these other attributes into consideration does not mean much.

August 15, 2007

Hair Loss InformationWhy Can Some Doctors Create the Illusion of Greater Density? – Hair Loss Information – Balding Blog

Dear Dr Rassman

I am inquiring why some transplant surgeons can achieve significantly greater density than other surgeons on patients with similar hair loss and hair characteristics using the same number of grafts. is this due to the way the hairs are implanted to create the illusion of higher density?

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There are many factors that distinguish one hair transplant from another with the same number of grafts. They include:

The artistic skill of the surgeon and the way the grafts are distributed (as well as the direction of the hair shafts)
Hair thickness
Hair character (curly or straight)
Color and contrast between hair and skin color
The number of hairs per follicular unit (relates to the way the harvesting is done and the density of the original hair)
Styling (layering works better on some people, particularly those with straight or slightly wavy hair

August 15, 2007

3 Weeks After Transplant, Still Experiencing Pain and Shock Loss – Hair Loss Information by Dr. William Rassman

I did a Hair Transplant about three weeks ago. Received 1727 grafts, have been taking care post op as suggested, but still experiencing numbness in the graft site and pain in the vertex area despite the fact I had not received hair in that area. I am also experiencing significant hair loss of my original hair. What is the remedy to slow the hair loss, as it defeats the purpose of getting the transplant in the first place. I am loosing the transplanted hairs as well.

This is why you need a good doctor. Doing the right surgery the correct way is important, but so is the post-operative care. Things can go wrong, and although they are minimized by surgery, they still can happen and that is why you need to have a doctor you can go back to, talking through the problems. Supporting patients is part of good medical care. I would push your doctors first to help you understand what is happening to you. If that does not meet your expectations, then see another doctor.

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August 14, 2007

I Have a Shunt in My Head – Can I Have a Hair Transplant? – Hair Loss Information – Balding Blog

I have a VP shunt that drains spinal fluid from my head to my stomach due to a blockage in my spinal column. Could I still get a hair transplant ?

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Yes. In fact, we recently had a patient who had a VP shunt and had a hair transplant. Your doctor should be highly qualified and must have experience in such a matter. You would likely require a CT scan or an X-ray to confirm where the shunt traverses so that it is not damaged during the surgery.

August 14, 2007

HairStemcell Transplantation (HST) – Balding Blog

I would like to know your opinion on this procedure: Hair Science Institute

The procedure is called “HairStemcell Transplantation” and promises near complete regrowth of the donor site. It seems way too good to be true but I want to have an expert opinion on it before I jump to any conclusions.

It seems what they are doing is Follicular Unit Extraction (FUE), but they try to differentiate from FUE with what they call a Hair Stem Cell Transplantation. It is especially confusing when they show both side by side, yet they look the same. From the photograph they provide, they are using a standard dental drill head piece.

In short, stem cells are not readily identifiable even under a microscope. So to claim stem cell transplantation is likely a misnomer or sensationalism at its best to exploit the buzz word of “stem cell”.

Finally there are no doctors mentioned on this website that is associated with “research”. I find that highly suspect.

August 13, 2007

Hair Transplants, Shock Loss, and Propecia for Women? – Hair Loss Information – Balding Blog

(female) I heard of the possibility of shock and its harm to cause loss of existing hair from hair transplantaion. How frequentlly does this happen and does is the risk lower with follicular unit extracton?

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Many women can not get real benefits from a hair transplant, so that is why I want to see pictures. There is no substitute for a direct examination of your hair with miniaturization studies to determine just where your hair loss is and how good your donor area is. Most women with genetic hair loss have a poor donor supply because of the thinning and the high degree of miniaturization in the donor area so they do not qualify for a hair transplant. Too many doctors will still perform surgery on these women when there will be no benefit just for the money. You need to find a good, honest doctor who keeps your interests central to your evaluation (not your purse). I am not convinced that Propecia would work for woman’s hair loss and in fact, it is not FDA approved for treating female hair loss because there is no proven benefit of it for women.

When a transplant is done, shock loss may occur in the recipient area so the method of extracting the donor hair is what is important. The best way to reduce the risks for shock loss is the use of Propecia (for men only) to be taken orally prior to the surgery and for the subsequent 6-8 months. For women, hair loss from shock loss usually reverses if it occurs (less than 10% risk in women) and it is possible the Minoxidil may help prevent it.

August 8, 2007

I’m Advancing Toward a Norwood Class 6 or 7 – Hair Loss Information – Balding Blog

I have been balding since the age of 18 and am now 29. I have been taking propecia and then dutasteride for 5 years and although the process is still continuing I’m sure I would be completely bald by now if I hadn’t gone on the medication. I can see I am am advancing to a 6-7 norwood. I have thick blonde hair which sticks up and has lots of body, when i had a full head of hair as a child the barbers all commented on how thick it was and it was a nightmare to style. I would say presently i have about 20-30 hairs per square cm, less at the front and the coverage still looks ok. could i achieve good coverage from transplant procedures with a naturally looking but thin hairline?

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Look at the previous blog post titled, Difference Between Norwood Class 7 Patients. In that post, you will see a man (Patient BF) that became a Class 7 patient over 10 years. He started getting transplants in the front initially and then progressed to a Class 7 after the transplants were done. So yes, you can get a transplant and continue to maintain your look.

August 7, 2007

Donor Scarring, Suture vs Staples, and Other Hair Transplant Questions – Hair Loss Information – Balding Blog

Hi, Dr. Rassman.
Some more issues:

Your book says the Monocryl suture can produce a fine surgical scar superior to metal staples and is less painful and more convenient to remove (since it doesn’t have to be removed…) If this is the case, why would stapling even still be used? Is it a matter of closing the wound as fast as possible?

Regarding scarring of the donor site, if scalp laxity can be measured before hand, why do people even end up with donor sites that cannot be completely closed?

Do you always remove a 1 x 15cm strip, and use all the FU’s, however much that turns out to be? Somewhere it is written that if I leave the session open-ended, more hair can be harvested. But don’t you close the donor site before proceeding with the transplants?

Tell me some more about the risks and the rates of complications. What percentage of the grafts transplanted at NHI typically grow? How much variability is there?

I am, as you would say, “doing my homework…”

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Good questions!

I have changed my mind on the use of staples. The Monocryl did produce some reaction in some patients which may have increased scarring. With regard to laxity measurements, there is presently no instrument available that will measure it (other than one we are presently testing) and laxity is often a judgment call by the experienced surgeon.
The size of the donor strip depends upon the number of grafts you need and this is a math calculation based upon the density of the hair (see Patient’s Guide — How Many Grafts Will I Need?).
I tell people to keep it open ended if possible so that a more generous strip may yield more grafts and then we can place higher densities.
With regard to the risks of any transplant surgeon, I wrote a book on this and can not replicate that book here. Our informed consent document defines those risks for our surgery patients in enough detail to manage what MIGHT happen, not what probably will happen. Most, if not all, of the grafts should grow after a transplant with a good surgeon and experienced transplant team.

August 3, 2007

Are Doctors Promising More Grafts Than Can Possibly Be Delivered? – Hair Loss Information – Balding Blog

Dr. Rassman, I’m surprised no one else has raised this issue with you given the activity on various hair transplant discussion boards during the last few months. My question concerns the quantity of grafts in the donor reserve.

On these boards, I see a new trend of very young men wanting high density transplants to restore their juvenile hairlines and being transplanted under the assumption that they have, *on average*, 10K-15K grafts available via both strip and FUE. When the blarney of the clinic(s) making these graft count claims is questioned by more critical posters, the young men in question usually get very defensive and end up expressing their confidence in their doctor(s), and say that even if such estimates are exaggerated, surely some new drug, or hair maintenance, will come along to help them by the time their balding progresses to the point of making their transplants looks unnatural.

Since you believe in documenting scientific findings and have published the pathbreaking papers in this field, do you feel that these young men are being sold a false bill of goods? Can any clinic in good conscience be promising to be able to harvest twice as many grafts as we previously believed available? Has there been some breakthrough in graft harvesting capabilities that the laymen has yet to hear about? And should hope about the availability of future technology being able to benefit patients ever be part of a Master Plan?

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You raise a very good point and concern. A typical hair transplant procedure of an average male with good scalp laxity will yield 3000 to 3500 grafts in Caucasians (who often have higher densities than Asians). The most that we were able to yield in one single surgery was about 5800 grafts from a patient with a very high donor hair density and good scalp laxity. This was the exception to the rule, of course. Some doctors split the ‘follicular units’ into smaller units and then charge the value of the ‘split’ number. So if a doctor got 3000 grafts, by dividing the grafts into smaller units, he/she may be able to charge for 5000 grafts and give the patient a feeling that he got more than he really did.

Thus, I very highly doubt that any clinic can yield 10,000 to 15,000 grafts in one procedure. They may be cutting all these grafts (which contain one, two, three, or four hairs) into single hair grafts. See my recent post titled How Do I Know I Am Getting the Number of Grafts I Am Paying For?. I feel strongly that splitting grafts to make money from patients is highly unethical and desperate patients are ultimately paying a price -– not only in financial terms, but in a lifetime of potential disfigurement from a depleted donor supply.