Hair Loss InformationLosing Grafts After a Hair Transplant? – Hair Loss Information – Balding Blog

Hi Dr,

Thank you so much for this wonderful blog. I just recently got an HT with a very reputable clinic. My question concerns shedding of the grafts. I notice shedding began around the 9 day mark. Is this considered normal? Also, i had crusts on my head for approximately 9 days, and i noticed there were a couple of crusts that fell off with a hair in it. My question is, is it possible i lost a graft in one of these crusts. Or would there be some noticeable bleeding from the graft from being dislodged?

Thanks

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At 9 days, I would expect that the grafts will grow out nicely. In a published article where we tried to identify when the grafts would be stable to grow out normally, we determined that stability occurs usually in a week or so. When the grafts fall out with the hairs in it after a week, they leave behind the stem cells in the recipient site. Don’t worry, it sounds like you will be fine.

Can I Use Baby Shampoo On a New Hair Transplant? – Balding Blog

Doctor,

Is Johnsons baby shampoo ok to use on newly transplanted hair?

Thank you

Always check with the doctor who performed your surgery. Basic information such as this should have been explained to you when you had surgery! I sometimes wonder who is doing these surgeries and why some patients kill blindly trust doctors with their medical care.

In general, baby shampoos should be fine on a new hair transplant. But as I don’t know anything about your surgery, you should always check with your surgeon.




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Balding Forum - Hair Loss Discussion

Is There Any Hope for Norwood 6 Patients? – Hair Loss Information – Balding Blog

Hi Dr Rassman,

Had a question about hair transplantation. In your professional experience in treating thousands of patients, would you say there is any hope for norwood 6’s?? I mean I know the limitations of supply and that everyones characteristics are different, but can a norwood 6 get any kind of decent coverage to get rid of the bald look. I ask because I fear thats where I am headed.

Have many norwood 6’s on my father side and have been loosing hair. At the moment I have arrested it with the help of finasteride (stopping around a norwood 3 and have not progressed in over a year), but as you keep stating, eventually your genes win, so I was just wondering what advice you give to people high up on the norwood scale, and if transplantation can do anything for them. thanks

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We have transplanted many Norwood 6 pattern balding people. Some have excellent results, such as the one shown here (click the photos to enlarge):

 

You can read more about this patient here and here, but in case you don’t want to click, he had a single procedure of 2781 grafts. The results shown are after 9 months.

These type of results occur in people with average or above average hair density, and medium or coarser hair thickness. Don’t lose hope.

Hair Loss InformationStyling After a Hair Transplant – Hair Loss Information – Balding Blog

Hello doctor

I see a lot of HT photos, a lot of the patients seem to have their hair up and raised back like they’ve been in the wind. Is that just the way they style it? If I was to have a HT I’d want my hair down towards my eyebrows..

Is every patient different?

Regards

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Hair normally grows forward in the front (parallel to the ground when standing upright). As one moves back from the frontal edge, the angle starts to change with hair pointing a few degrees upward until it reaches the front of the crown, where the frontal pointing hairs are about 35 degrees to the ground. So you see, the hair when placed by the surgeon is never placed perpendicular to the horizon. At the crown, the hair changes direction in a circular pattern (swirl) and as you look further back, eventually the hair points down and away from the front.

What you see in our patient photos reflect each patient’s styling (or lack of it), not something we do. I always put the hair back in the direction it would have been had they never lost hair and depending where I am working on the scalp, the rules I discussed above are followed with every hair placed by me. Patients generally like to play games with their hair and although a few comb it forward, most do not. Some comb it to the side with a part on one side, others comb it back with some product that they apply to the hair. Some just let it stray, taking on the character of the hair itself. If the hair is curly, then the natural state will look less groomed than if it is straight or has a nice wave to it. If you want to comb it down to cover your forehead and point to your eyebrows, you can do that also.

Every patient is different and the results we get depend upon texture of the hair, density at the area we are looking at, thickness of the hair shafts, the degree of curliness (or lack of it with very straight hair). But the hair transplant you get will be your hair, and it will bring all of its characteristics that are present in the back of the head where the hair grafts are taken.

Hair Loss InformationWould You Try The 0.3mm FUE Punch? – Hair Loss Information – Balding Blog

Hey doc. I’m just wondering something. Since you’re willing to trial the laser hat technology would you also be willing to try out Dr Gho’s smaller 0.3m FUE punch.

I don’t really care about the supposed hair multiplication stuff that he claims but I am really interested in the size of his punch. And I am interested in the size of his punch because cosmetically speaking its really hard to see any white dot scaring on any of his patients.

Lots of people on various forums are showing really good photographic evidence of what I would simply call really really really refined FUE. The proof does seem to be out there and since I know for a fact you fight for the balding brothers would you be willing to try that out on willing patients? in the name of science and progressing FUE technology.

Cheers!!

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I assume you mean a 0.3mm punch, not 0.3m.

I am open to any innovation, but I am also a realist. Have you actually gotten out your microcaliper and measured what a 0.3mm diameter punch really looks like? It is smaller than a hair follicle, and smaller than a hypodermic 30 Gauge needle (OD). See the needle gauge comparison list here.

Hair Loss InformationWhich Association Site is Best for Finding a Hair Transplant Doctor? – Hair Loss Information – Balding Blog

I am looking into finding a doctor to discuss my plan of attack for hair loss, and i was wondering what is the ISHRS International society of Hair Restoration Surgery? Is finding a doctor off of that website reliable as finding one from the American hair loss association website?

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The International Society of Hair Restoration Surgery (ISHRS) website lists doctors who are members of a learning society. The American Hair Loss Association (AHLA) is a similar site. You must understand that any doctor can be a member of these associations and societies as long as they pay a yearly membership fee. These societies do not have the power to enforce or regulate a doctor’s practice and skills, and the hair restoration/hair transplant field does not fall under the American Board of Medical Specialties (ABMS).

In the United States, there are 24 approved medical specialty boards that are overseen by ABMS, a not-for-profit organization. Certification by an ABMS member board has long been considered the gold standard in physician credentialing. To be ABMS board certified means that the physician has undergone formal educational and clinical training at a medical institution after earning their medical degree, and has successfully passed a level of competence via written or practical or oral examinations.

Since hair transplant surgery is not a part of the ABMS, there can not be any physician that is board certified as a hair transplant surgeon. This is mainly because there is no formal training or credentialing in hair transplant surgery. You read that correctly — there is no board certification in hair transplant surgery! There is no standard curriculum. There is no oversight or direct review of the quality of the work being done. Unfortunately, there is no ABMS sanctioned facility to enroll and learn hair transplant surgery. To date, the only way to learn how to perform hair transplant surgery is to read a book, attend a seminar, or become an apprentice to a private practice hair transplant surgeon. Even ABMS board certified plastic surgeons do not receive training in hair transplant surgery as part of their formal training.

In the mid-1990s the American Board of Hair Restoration Surgery (ABHRS) was formed by a group of hair transplant surgeons to create an organization that could independently certify hair transplant surgeons. But still, the ABHRS does not monitor a doctor’s training quality and once the testing process is complete, they do not have any authority to enforce any form of discipline. In states like California, doctors are not allowed call themselves “board certified” if the only certification they have is from the ABHRS or other non-ABMS approved boards. They must qualify which board they are claiming.

So to answer your question about which site is best, well, I don’t have an answer to that. They’re all pretty good resources for finding doctors in your area, but you need to do your own research to find the doctor that can provide the results you want. The real test for finding a good surgeon is outlined here on our Selecting a Hair Transplant Doctor section.

Does Closing a Strip Scar Cause the Crown to Be More Visible? – Hair Loss Information – Balding Blog

Does the crown stretch when closing a FUT scar?

Hi there – First off I would just like to thank you for providing this excellent resource. I just have two short questions related to FUT scars:

1) Firstly, I know you have answered this in the past with hairlines, however since the crown is within inches of the incision site above the prominent bone, does it slightly move/stretch downwards towards the incision site once the scar is closed?. For example… I have some thinning in my crown but im lucky in the fact that it doesnt dip low at the back so its not very visible unless looking from above my head. If I had a strip procedure would this thinning crown be more visible from the back because the skin has been pulled down to close the strip wound?

2) Secondly, I believe avoiding strenuous exercise is recommended for about a month after the procedure to avoid scar widening, but is general head tilting and looking downwards in the weeks after surgery ok in terms of putting stress on the scar?

I would be most grateful for any response you have for the above questions. Kind regards.

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Strip scars placed in the true donor area in the back of the head should not impact the location or the size of the crown area. Strip surgery takes up laxity that is there at the time of the surgery. Bending your head should also not impact the crown area.

I have never been sure why we tell the patients not to lift heavy weights. If there is a pull from the muscles, it comes from the trapezius muscle, which inserts below the scar at the base of the skull. I still tell the patients not to lift heavy objects, but I am not certain there is any value to the advice.

I Think Some of My Grafts Were Dropped on the Floor During Surgery! – Hair Loss Information – Balding Blog

I recently received a hair transplant and while I was in surgery I believe some of my transplant hairs were dropped. The doc had pulled a lot of hair out and another worker was doing something with them for a long time in another room and then when coming back she dropped a glass containing the hair. I could tell something bad had happened but nobody said anything because it was behind me and I couldn’t actually see it. I overheard someone saying she was cleaning them but the doc ended up pulling more hair out of my head. I figured by asking it wasn’t going to affect my outcome so I didn’t say anything. Do you think these hairs were lost or could they have been saved and used?

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You can suffer from infection or hair death if the grafts remained on the the floor for a period of time without being hydrated and kept wet. There no absolute cut off time limit but I am just giving a generality here. It probabaly also depends on how dirty the floor was. Mistakes can happen but there are appropriate steps to take if there was contamination (such as thoroughly rinsing / washing the grafts). Ask your doctor! Trust should be the foremost foundation between the patient and surgeon.

If You Transplanted Hair from a Balding Area, Could It Save Those Follicles? – Hair Loss Information – Balding Blog

It’s always confused me how putting hairs from non-balding areas into areas which are prone to male pattern baldness, works. Surely it’s due to the area of the head, and not the individual follicles? I was just wondering, is there evidence to prove that transplanting follicles from areas prone to balding, into other parts of the head would mean that these hairs would still bald eventually?

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For men, the area on the back of the head is considered a “permanent zone” (that will never go bald). So when we harvest the hairs from that area, the hair follicles will always behave as it was from the permanent zone. This concept is called “donor dominance”.

If we harvest the hairs from other parts of the scalp (for example, the front) they will continue to behave like the hairs from the harvested area. If the hairs in the front are genetically programmed to die and go bald over the years, the hairs harvested from that area will also die and fall out (never to regrow). This concept is the basis of modern day hair transplantation and has been proven since the 1940s.

So just to summarize — if you have hair harvested from a balding area, those harvested hairs will eventually fall out just as they are genetically programmed to do.