Category: Hair Transplantation

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My Father Started Receding at Age 50 – Hair Loss Information by Dr. William Rassman

I read your comment reccommending a 15 yo guy to wait until he’s 30 to see if he has hair loss then decide on a hairline lowering surgery. I am 31 and am considering the surgery to shorten my long forehead. I am not really sure if it is receding (must be really slow if it is), though my father’s did not until he is 50. Did you imply that hairline is not likely to recede (at least not quickly) after the age of 30?

Thanks a lot!

A receding hairline after the late 30s is unusual, but it happens. You may take after your father and recede later in life. Using Propecia is one thing that allows you to be more proactive about hair receding, rather than waiting for completion of the hair loss, but you must have a proper diagnosis so that you know what you are treating if you elect to do something about it. This way you can prevent future hair loss to some degrees, at least on the top and crown area, and take care of the frontal hairline with a hair transplant.

Taking medication before the process starts on the expectation of hair loss is certainly not something that I would recommend for my young readers who worry about what might happen to them. A long forehead (high forehead) is easy to treat with hair transplants and wonderful results are a reasonable target. You can see many, many patient results in the New Hair Institute Patient Photo Galleries.

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Hair Loss InformationUsing Minoxidil After Surgery – Hair Loss Information – Balding Blog

Hello Doctors,

Minoxidil after Surgery.

Thank you for taking our questions. I just recently had my second procedure done 1 year after my first 2700 FUS. This time we were only able to do 2005 because my scalp wasn’t very flexible. I have two questions and 1 request.

1. You mentioned in another posting that using minoxidil a few days after the surgery might help to speed up the growth process of the new hairs. How long should I wait before using minoxidil after my surgery? I had my surgery 4 days ago.

2. Should I start to do the stretching exercises after I heal to help produce better yield for my next surgery hopefully in December?

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I do not believe that minoxidil accelerates the growth process after hair transplantation. I did a study where I used minoxidil on half the head and nothing on the other half. Both sides grew at the same time and rate.

Stretching exercises to the scalp are good 6+ months after surgery if your tendency is to be tight.

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Female with DUPA, Allergic to Minoxidil – Hair Loss Information by Dr. William Rassman

Dear Dr.
I am 23 year old female who has been suffering from diffuse unpatented alopecia for the past 9 years. I have tried minoxidil, but I was and still is allergic to it. Although I am not a good candidate for surgery, I underwent transplantation and of course there were no results or improvements. It has emotionally brought me down and I keep wearing extentions to hide it.

Of course, I am disturbed that you had a surgery at all. I hope that your doctor told you that there would be no benefit from such a surgery. You are fortunate if you had no negative effects, because at times people who have surgery with Diffuse Unpatterned Alopecia (DUPA) get into real problems both in the donor site and the recipient site. Extensions will produce more alopecia (we call this traction alopecia), which means that for the short term benefit of looking fuller, you will eventually lose whatever good hair you have left. Wigs may work better for you and the use of special products like DermMatch and Toppik may have more value in that they will not cause hair loss. If you are allergic to minoxidil, there is no real benefit to other medications in a woman of your age.

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

hello,
i would like an offer for a hair transplant, i am 24 years old and have good donor hair. I would be willing to visit your clinic in california except, i had a few questions.

what would be the approxiamte price for 3000-4000 grafts if possible?
would my hair remaining hair have to be shaved off to complete the transplant? seeing that i am young and would not like “losing” half a year of my youth.

thanks in advance

You do not need to shave your hair before a hair transplant surgery. There are some doctors that request that you shave, because they want more visibility. From my clinical experience this is rarely the case. We (at NHI) routinely transplant hair without shaving the head. Shaving is more of a doctor’s preference and has nothing to do with the clinical outcome.

Before considering a trip to California for surgery, you should first send some photos and get in contact with me over the phone. You can email photos to the address on the Contact page or call (800) NEW-HAIR. Having a picture would be very helpful.

Balding Forum - Hair Loss Discussion

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My Transplanted Hair is Brown, While My Hair is Normally Blonde – Hair Loss Information by Dr. William Rassman

I had a hair transplant and the new hair is dark blonde/light brown color, but my top hair is light blonde, so every transplanted hair is much darker and is freaky. I was told this would lighten over time and would eventually grow in the same as my normal top hair color which is light blonde. Can I believe this?

When hair is transplanted, it will be thick shafted, just like the original hair in the back of the head (which usually gets less sun than hair on the top). Your blonde native hair in the recipient area will be miniaturized, so they will be blonder than the transplanted hairs, simply because miniaturized hair has less pigment and is easily bleached by the sun. You may have to dye the transplanted hair just to make it match. Assuming you are a typical summer blonde, the transplanted hair may blonde during the summer months. If you fill out the balding area eventually, then the blend will return more to a normal, where frontal hair gets sun exposure and more blonde as a result.

Balding Forum - Hair Loss Discussion

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Retained Hair Fragments 6 Months After Hair Transplant – Hair Loss Information by Dr. William Rassman

I just read a post by a doctor on one of the hair loss forums saying that retained hair fragments post op can interfere with transplant growth. I’m coming up on six months out from my procedure and haven’t seen a lot of change — still very sparse. I have noticed that I do seem to have a lot of these retained fragments where new hair should be sprouting. I had my wife tug on a few with tweezers last night and they just slid right out. Could these be interfering with my growth? Is it okay to go ahead and remove them this way?

Thanks in advance for your response.

Some people retain the hairs (beard length) for months. I generally do not remove them, particularly at this stage, as they may be the new hair growing in and you would not be able to tell the difference between new hair in its initial growth spurt and the fragments. These retained fragments that go through the skin and look like a beard have no importance and will not impact growth of the new hair. You need to wait out the full 8 months and then set up an appointment to review where you are. Patience is a virtue.

Balding Forum - Hair Loss Discussion

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Harvesting Armpit and Pubic Hair for Transplanting to Scalp? – Hair Loss Information by Dr. William Rassman

I’m 39 and I’ve a thinning crown, and there is a diffused patch on the vertex, and very thin, soft hair with not much density at the back of my head. I’m already using propecia+minoxidil But i don’t see any improvements.Given this i would like to explore my options of using armpit hair and pubic hair for hairtransplant on to my crown using FUE. At the same time i ‘m concerned about donor transection rate for armipt hair and pubic hair ( how difficult it is to harvest this hair?) and the shock loss at the receiving crown?? Can you please let me know my options. Most of the hair transplants i have seen only show frontal hair line but not crown.

ArmpitIt is good that you started using Propecia for your thinning crown hair. Although you don’t think you had improvement with medications, I think it is best for you to continue the Propecia, for you never know how your crown would look if you were not taking the medication. Propecia should be the first line of treatment of crown hair loss in most patients. The next option is to fill the crown balding area with transplants using permanent hair from back of the head. Using the hair from this area is well established for transplant to your crown area. Body hair, as we’ve discussed on this site many times before, is not a good substitute for scalp hair, because of its long sleep phase and limited length. The amount of under arm hair in available numbers is low and the hair is kinky, much different than head hair. The same is true for pubic hair.

Pubic and armpit hair in particular have different characteristics than scalp hair. They are limited in numbers and should be reserved for the cases that no other alternatives are available and when the hair can be used for ‘bulk’ rather than a frontal presentation. If the scalp donor hair is severely diminished and you opt to get a body hair transplant with the FUE technique, a FOX test must be done to evaluate your candidacy for the FUE procedure and you can anticipate the damage from such a procedure in advance. If the FOX test is positive, it means your hair transection rate is reasonably low. With that said, unless you have no donor hair available from the scalp, please think traditional transplantation.

Balding Forum - Hair Loss Discussion

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Can I Really Trust My Surgeon? – Balding Blog

I recently had a hair transplant and I can tell that the grafted skin is clearly visible in only one particular area (I keep the hair extremely short). All other grafted areas are perfect. The difference is night and day. Can the surgeon tell if there will be a mark in one spot by inspecting the grafted areas during surgery? What causes one grafted area of skin to be visible and not all others? Could it be that the incision wasn’t deep enough…making the grafts not go in far enough and stand out a bit resulting in bumpy grafts? I hope you can answer because I am concerned about returning. I need to know if I can really trust the surgeon. Maybe I made him angry?

It is difficult to understand why you would have surgery without being able to trust him/her. Afterall, they are cutting you open. You really do need that trust. Furthermore, I cannot stress the importance that the relationship between a doctor and yourself should be a partnership and one of mutual respect. Your surgeon should be able to address any and all of your concerns before and after surgery without any reservations. I understand that it may not be a perfect world, but I would recommend that you speak with your surgeon first.

With respect to your particular situation, it is virtually impossible to know what was done and what the plan in your surgery was without examining you or asking your surgeon/and yourself the pre-operative plans and expectations. The ability to see the transplanted skin in the graft could be caused by many factors, including the deployment of minigrafts rather than follicular units, placing the grafts too deep or too superficial, angular placement that is inconsistent, inadequate trimming of the grafts when they were harvested, etc…


Balding Forum - Hair Loss Discussion

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Hair Loss InformationDisappointed with My Hair Transplant from 8 Months Ago – Hair Loss Information – Balding Blog

Hello. I had an FUT procedure done at [name removed] about 8 months ago. I see visible, what look like holes on my recipient area from overhead lighting, almost like scarring. Obviously, I wasn’t expecting this as I had heard that new techniques show no visible recipient scarring or mini holes. Will this EVER heal in time, because now i am freaking out about it. If so, how long does this take to go away?

In addition, my hair is darker on the sides than the top so the recipient hair does not match in color. Will this change in time? My doctor tells me the sun will change it and it will eventually grow in lighter at the roots but I don’t know if I trust anything they say anymore.

I wish I had never done this and don’t know where to go from here. Any answers and direction would be very helpful because I am freaked out now.

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Generally by 8 to 12 months most of your hair transplants should have grown and you should not have the visible holes or scarring that you are describing. As you do, then this is probably permanent. Sometimes certain patients are more prone to scarring than others, but that is not what you seem to be describing and it is very, very, very rare in the recipient area. With respect to hair color, your hair color should generally match the hair on the back and sides of your head.

Obviously it is very difficult and practically impossible to give personalized advice this way. If I viewed the recipient site ‘holes’ you are talking about, what you call ‘holes’, I may call something else. If you like to have a formal consult, I would be happy to review your case. Please call my office at 800-NEW-HAIR to arrange this or send photos to the address on the contact page (reference this posting, please). You pictures and your correspondence with us will be maintained confidential (it is also the law that protects privacy).

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Hair Loss InformationBody is Very Hairy, Head is Very Bald – Hair Loss Information – Balding Blog

Most of my hair on the top is gone except for some baby fuzz, and very thin on the sides and back. Will I see benefit from the use of minoxidil or propecia?

PS: my body is very hairy (face, chest, back, etc) will taking any of these medications increase body hair?

Since I hardly have any donor hair on my head, is body hair transplant a possibility? Where can I get good information on this subject?

Thanks for your assistance.

Best regards

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MonkeyThe medications of topical minoxidil or systemic Propecia (finasteride 1mg) should not cause more hair to appear on your already hairy body. If you have a full Norwood Class 6 or 7 balding pattern, then chances are that these medications may not help. The marginal edges are where such patterns may see benefit, but you need to get a good doctor to help. Body hair transplants are not the solution (see Body Hair Transplantation for more). To see a Class 7 patient who had enough donor hair to cover his balding head, see Is Hair Transplantation too Risky for Older Men? Each person has different hair characteristics and densities, so you need to be evaluated to find out where you stand.