Hair Transplantation – Page 137

August 3, 2007

Do I Have to Shave My Dreadlocks For a Hair Transplant? – Hair Loss Information by Dr. William Rassman

I am an african american male that has a receding hairline that I would like to correct. It makes my large forehead appear even more pronounced. The problem is a have long beautiful dreadlocks that I have been growing for the past 8 years. I am worried that if i have a hair transplant I will have to shave an area from the back of my head in order to harvest hairs and then shave another area on the front of my head where i want to have the hairline filled in. My question is, can this be done without having to lose my locks? Has this type of procedure been performed on anyone with my situation? I want to get back my hairline but i don’t want to start my dreadlocks all over again.

I just had a patient with dreadlocks stop by to show his results. He did not have his dreads shaved for surgery and he had great results!

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August 3, 2007

Hair Transplants Aren’t Growing 5 Months After Procedure! – Hair Loss Information by Dr. William Rassman

Hi

I did HT surgery for about 5000 grafts in Feb. 2006. My surgeon is very well known. It is now more than 5 months and I do not see any regrowth at all. i am very disappointed. Does it mean that my HT was a failure? May the high number of transplanted grafts be the reason for no growth?

I never worry about growth at only 5 months. You should be seeing growth any day now. Wait out a full 8 months and then you can make a proper assessment. Always consult with your doctor for the type of reassurance you need.

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August 3, 2007

One Session of 4085 Grafts 8 Months Ago (with Photos) – Balding Blog

This Norwood Class 6 patient had one procedure of 4085 grafts just over 8 months ago. He went through the following routine immediately after surgery:

For the first few weeks, he let his beard grow out to a good length.
Then he shaved off his beard and left a longer mustache, which he maintained for a few more weeks.
Nobody noticed his hair transplant, but they did comment on his new facial look. The laughing ended when he finally shaved off his mustache.
Then he was his normal bald self, but slowly over the next months, the hair came in. It was so subtle that no one ever noticed it.

Before photo on the left; After photo on the right. Click the photos to enlarge.

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August 3, 2007

Wait Time In Between Hair Transplant Surgeries? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman:

I had a 4085 graft strip procedure in the front 2/3 or so of my scalp about a month ago. I want to have another procedure in the back third. I have some hair there but I want to thicken it. I was thinking of having a 500-1000 graft FUE procedure. How long after the first surgery do I have to wait?

Thanks

I don’t understand why you want to do an FUE if you already had a strip harvest. The scalp recovers in 2-3 months and then another surgery may be done if you are going to have it put into a completely separate area. I generally like to wait 6+ months between surgeries, because then you will be in a better position to determine where you want the new grafts and to find out if the goals of the earlier procedure were adequate to meet your needs.

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August 2, 2007

My Genetics Suck – I Am Losing Scalp Hair and Can’t Grow a Beard! – Hair Loss Information – Balding Blog

Dear Dr. Rassman.

I am 24 years of age and have been losing my hair since I was 17. However it has been a very slow process and I am now a NW II moving to a III but with no frontal receeding. However I can not for the life of me grow a full beard or moustache, infact my cheeks except by my jawline are pretty much bare of facial hair with a couple odd ones here and there. ( I have black hair and many of my facial hairs are red and transparent). I thought DHT was responsible for facial hair growth and thus if I was losing my hair, I would at least be able to grow a beard. I feel totally ripped off by my genetics. I can’t keep all my hair AND I can’t even grow a beard to frame my face a bit better as I deal with my rounded out hairline. What gives?

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If you have scalp hair loss with good donor hair in the back of your head, you might be a good candidate for hair transplantation (which can work on the beard as well). Look on the bright side — having less facial hair may not be such a bad thing. Personally, I would trade with you and give you my beard if I could. I’m tired of shaving every day. Ha!

August 2, 2007

How Many FUE Sessions Can Be Done Into a Scar? – Hair Loss Information by Dr. William Rassman

i recently have had some fue into a scar in my hairline. It has been 6 months and approximately 60 % of the hair has grown back. I plan on doing another fue procedure in 6 months from now. My question is how many transplants can be done into a scar? I am not sure if the density of hair in the scar will ever match the density of my surrounding hair but i will try.

There is no specific limit to an FUE (follicular unit extraction) session, other than the supply of hair you have left (and the skills of the doctor / surgical staff). As long as there is enough supply and an area (such as your scar) that require more hair, you can have the FUE procedure. As a rule of thumb after only 6 months out, you may not have all the transplanted hairs grown out (some may still be dormant). I would wait at least 10 months before having another procedure in the same area.

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August 2, 2007

Transplanting the Crown In a Young Man – Hair Loss Information by Dr. William Rassman

My crown is balding, but my frontal hair has a solid hairline. I am a 26 year old actor and a bald beany does not fit the type of actor I want to be. How can I play the role of a seducer of women, a handsome male icon who tries to get those romantic leading man roles, when the crown shines with a beacon that draws the eye like the Luxor hotel lights up the Las Vegas skyline. Many doctors frankly refused to do my balding crown. Don’t I get a say here? What do you think?

There is a general reluctance to transplant the crown of a young man by competent hair transplant surgeons who tend to think long term on the progressive nature of hair loss. I think that transplanting the crown is not a problem provided that:

You are on finasteride (my strong preference) and you give it enough time to see if the drug alone reverses the hair loss in the crown.
You are aware of the long term supply and demand issues to manage your hair loss if it becomes extensive. I would require that you work out a Master Plan with me on what you would do if your Hair loss/Hair supply issues would be a problem in the long term.

People who are body dysmorphic can be treated with transplantation if there is enough education, maturity, and money available in following the course of the progression of the hair loss. With luck, you might just be a pure vertex balder (like me, who had just a crown hair loss and crown transplants) or have great success with finasteride with reversal of the hair loss. Behind every balding head is a balding ‘human being’ whose vote is important in determining what trade-offs the person is willing to accept in his future. Knowing who you are is important to me, so our relationship then becomes a mutual decision (a partnership) and although I agree that for many patients transplanting just the crown of a young man is not a good idea, I would put the doctor/patient relationship to the center of this discussion. Although I understand the general reluctance for good, honorable, and competent doctors to transplant a crown in a young man, rules are just rules and they do not dictate every decision before me.

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July 31, 2007

Hair Loss InformationTransplant Hair to Scar on My Cheek? – Hair Loss Information – Balding Blog

Dear Dr.,
I have a scar on my cheek that I have from when I was a little boy. I’ve had 2 scar revisions but the scar always spreads and I’m left with a pretty noticable scar where no hair grows.
Would it be possible to somehow fill in that area with hair from maybe my lower neck?

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Scalp hair transplanted to the beard area (cheek) is a relatively common procedure. Some men who can’t grow facial hair have these type of procedures to fill in a beard, and likewise it can also be used to cover a scar. Lower neck hair would not be the best place to harvest donor hair, since neck hair is not considered permanent hair.

July 31, 2007

Keeping Up with Hair Transplants Once Finasteride Loses Effectiveness – Balding Blog

Doc,

It appears that most of the hair transplant examples I’ve seen have tended to be transplants around the hairline (and hair combed back in most cases too) versus crown transplants. If one suffering from MPB were to undergo a hairline transplant and be on Propecia (for the crown) indefinitely, there will inevitably come a time (5+ years) when even the finasteride will wear out in terms of its effectiveness in keeping the crown hair. Does that mean that a series of hair transplants are required to “keep up” with the rate of hair loss overtime?

To give this question the respect it deserves, one needs to understand the natural progression of genetic male patterned balding. This is a progressive process that will eventually lead to a final pattern consistent with your genetically predetermined pattern. Look at the Norwood classification chart for hair loss and you will see a series of patterns. These can be the ‘end stage’ of the hair loss or they may be intermediate stages leading to a more advanced stage along the progression indicated in the Norwood scale. The problem is that you really do not know (for sure) where you will end up, but there are many ways to estimate where you might be by looking at:

Your miniaturization map of your scalp. The final pattern may very well show some degree of miniaturization, even if you are not frankly balding yet.
Your family pattern and see if you can identify (a) the worst case in the family or (b) the person whose pattern you believe you are following. Then you might be able to ascertain your final pattern (an educated guess).

If your final pattern is not the more advanced patterns (demand for hair) and if your hair density is adequate (supply), then you might be able to keep up with the progression of your balding as it is happening. If, however, the final pattern will be a Class 5, 6 or 7 pattern, you might not be able to keep up with the balding process with additional transplants because you may run out of donor hair (supply). The one clear point I wish to make is that you need to have a Master Plan to take in your worst case scenario and you must have a doctor who you can trust to work with you on that plan. The Master Plan has one objective and that is that no matter what happens, your hair restoration surgeries should always leave you with a natural appearance. Too many patients and doctors think in the short term, and think that the hair transplant will solve the problems of balding. That may not be realistic, so the relationship between the patient and the doctor is all important.

If you are having your first surgery when you are 24 years old and you are supposed to become a class 6 or 7 in the future, even though you are only a class 3 now, it is likely to assume that you need more than one surgery. On the other hand, if you are 35 and have almost reached the end of your hair loss process, you may be done with just one procedure and may never need another surgery. You have to understand that Propecia is not a permanent solution, but it does slow down the loss process in most men. Sooner or later, your hair loss will catch up until that final hair loss pattern is reached. Taking Propecia (Finasteride) may prolong the outcome, but the final pattern is probably inevitable.

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July 26, 2007

Hair Loss InformationHow Do I Know I Am Getting the Number of Grafts I Am Paying For? – Hair Loss Information – Balding Blog

Thank you for your time in answering these questions. It is hard to find anything on-line about hair transplants that isn’t a biased sales pitch.

How does a person know he is getting all the grafts that he is paying for? I am going in to get 900 grafts. This alone concerns me because I was originally going to get 800 but they are “throwing in” another 100 grafts because I was made to wait two hours to meet the doctor. So how do I know if I am getting 900, or 850, or for that matter 600. I have a hair-line like Bill Murray and I am trying to take some of the edge off of it.

Thank you in advance.

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Honestly, you really don’t have anyway to know! Aside from having a good rapport with your doctor and being comfortable with the reputation of the medical group, the accounting process of dissecting grafts is highly variable. You may start by asking the medical group or your doctor on how the counting of the grafts are done and if you can see the sheets of paper which has the numbers of grafts cut by each technician.

Also, be aware of “graft splitting”. Sometimes a doctor may require making single hair grafts by splitting a two hair graft so that he/she can transplant it to the frontal hairline. But there should be no need to split a 4-hair graft into two 2-hair grafts or a 2-hair graft into 1-hair graft just to push up the total number of grafts. That would be like double charging you and I do believe that this is sadly quite a common practice! It may seem a bit complicated, however, your doctor should be able to produce and explain the exact number of cut grafts and how the numbers were totaled.

Bottom line, you need to have an honest doctor who you trust.

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