Category: Hair Transplantation

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Hair Loss InformationTransplanting Asian Hair (with Photos) – Hair Loss Information – Balding Blog

I am Asian. I lost all of the hair in the front. I understand that black hair and white skin (my situation) is more difficult to get good results. True or false?

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True. Asian hair, which is often straight and black, is contrasted with a light skin color making the hair transplant less forgiving if it is done improperly. So while it is more difficult to get great results, it is not impossible. We have transplanted hair for many Asian patients over the years.

Here’s an example of one Vietnamese patient that has a Norwood class 6 pattern of hair loss. The photo on the left is before hair transplantation, the photo on the right is after 1 procedure of 1,852 grafts. Please click to enlarge.



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Hair Loss InformationWhich is Better – FUE or Strip Harvesting of Follicular Units? – Hair Loss Information – Balding Blog

Does follicular unit extraction (individual follicles are removed from the back of the head creating a tiny round punctate scar) and FUT (follicular unit Transplant – where by a strip of hair is removed creating a line scar) produce better grafts? In your experience, what procedure out of these two causes the least amount of damage and would better serve the interest of the patient at the end of the procedure?

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Both techniques should give you real follicular units, but often the FUE in many doctor’s hands do not give real follicular units because they are transplanted as they are taken out (complete follicular units, more than one follicular unit, or parts of a follicular unit). Strip harvesting is better in most people, simply because the strip is highly efficient and very controlled in most doctors’ hands to prevent damage. FUE grafts are not always of the same quality as strip follicular units. The reason for that depends upon the particular patient and the particular method used for the extraction. In many patients, the grafts are extracted and devoid of fat and supporting infrastructure (very skinny grafts), which makes them more vulnerable to the environment and more easily damaged when transplanted.

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When Is a Good Time for a Hair Transplant? – Hair Loss Information – Balding Blog

I was just wondering when you can get a hair transplant. I’m 20 years old, male. My hair is falling and I’ve already started the propecia. I know that the propecia isn’t going to get me to where I am before so I just want to get a transplant. I don’t want to stick with where I’m at. There are no bald spots….just the scalp is visible all over when my hair is wet. My question is this…..can I get a hair transplant already or do i have to have a bald spot? Thanks a whole bunch.

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You should be on Propecia (finasteride 1mg) for at least a year. You need to get your hair mapped out for miniaturization and follow the benefits or lack of benefits of the drug. Either you will:

  1. Get better with less miniaturization after a year
  2. Slow or stop the hair loss
  3. Get worse

Based upon the response to the miniaturization mapping, you need to develop a Master Plan with your doctor which will define the various paths open to you, including the timing of things you can do. Some men of your age will slow, stop, or reverse the hair loss on Propecia, while others may continue to bald at their own accelerated rate indicative of strong genetic and hormonal influences. There is no magic about hair transplants and if you are going to get really bald, then great care in how transplants are used is critical to being sure that you will always look normal, never trading short term benefits for your long term appearance. The Master Plan will lay out the transplant option and put it into perspective with projections on your hair loss which might be easy for a doctor with a great deal of experience in doing such predictions. 20 year old men are often less objective and less able to stand back and look at the long term hair loss process when they have short term needs (girls, self confidence), but some doctors see the money in it and may be willing to take your money to allow you to focus on short term agenda issues. That is in no man’s best interest. If you are unfortunate and have a very rapid hair loss process going on that is not benefited from Propecia, hair transplants could be the worst thing you could do right now. Please remember the following philosophy: A Good Decision Today is a Good Decision Tomorrow. Get a caring doctor who works with you on that Master Plan I discussed. I have done a few hair transplants in very young men (early 20s) but I am careful that I know what is happening to them and I learn a great deal about them as fellow human being before embarking on such a path.

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I Have Very Patchy Facial Hair (with Photo) – Hair Loss Information – Balding Blog

I’ve got some horrific facial hair coverage. From the jawline up it’s just atrocious, very thin coverage of hair, and it’s very patchy. however from the jawline down, I’ve always thought I had really nice thick coverage. Not that I’m really thrilled about it, I’m not too fond of the “amish beard” look. Is there any way to fix patchyness in facial hair? And what would cause this to happen? I didn’t have any injuries to this area as a child (no scarring or burns or anything that i remember that might prevent hair from growing there). I have attached a photo which you may use on your site. I’m 25 years old. Thanks

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Some people have uneven facial hair distribution and others are delayed in their beard growth, which may develop well into their 30s with more uniformity. You should wait and see what grows out as your beard matures.

Alternatively, you may consider transplanting hair from your head to the beard area, assuming the caliber of the hair is similar (it must be close to the same texture). If it is not, then you might have two types of hair which may be obvious and another type of problem. Even though beard to beard transplants would work, I would not recommend this approach, because it would thin out the beard you have in other areas (where you are happy with it) — unless you take the hair from below the chin where it is not easy to see. This may be a bit extreme and costly, but it would work beautifully. Although the transplantation may be an option, I actually think that this may be overkill and would ask you to wait until you fully grow out your beard. If it continues into your 30s and you still want to do it, then go for it. I will take you on as a patient.

Here’s the photo that the email included (with permission to post it here):


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16 Days Post-Procedure, I Still Have Scabs – Hair Loss Information – Balding Blog

Hello,
I am a 34 year old male and it’s been 16 days since my Hair Transplant of 1200 grafts. I still have scabs. I have been very gentle with washing, but am currently allowing the full pressure of the shower head. I have not scrubbed my scalp the way I normally would prior to surgery. Today, I lightly rubbed and picked a scab with the hair attached. It came off pretty easily. Was this the graft? Did I lose the future hair?

Can I start scrubbing my scalp at this point? My doctor recommended waiting 1 more week (3 weeks total) before washing and combing my hair as I did prior to surgery. What is your recommendation? And did I lose my hair graft? I am eager to get back to normal life. Thank you for any help.

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Patients may generate scabs after surgery. It is best to wash them off before they get ‘rooted’. When they are not washed off immediately, they may last for days. I have even seen patients who do not wash well and have their scabs last for weeks. Pulling off scabs during washing and styling is one of the most common causes of losing a graft after transplant, although I would doubt that it would occur 16 days out. We did a careful study to determine when the vulnerability of graft loss ends and we found out that the existence of scabs parallels that risk. Study shows that pulling grafts can remove the whole graft any time during the first 10 days, at which time the scabs usually fall off with reasonably vigorous washing.

When fully healed, the follicle becomes part of the recipient skin and will keep its ability to generate new hair. You are well beyond day 10 and it is unlikely that you will lose your graft at this point in time. Let shampoo stay on your wet hair for 10 minutes or so, then rub the scabs gently with your fingers and the scabs will fall off.

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60+ Year Old Female – Hair Transplant Possibility? – Hair Loss Information – Balding Blog

I’m a 66 year old female taking thyroid and blood pressure pills for an underactive thyroid and high blood pressure. Would having hair transplantation be successful at this age? How much would it cost? My hair has become thin and brittle, as well sparse. Please let me know what is the possibility of a successful transplant without complications.

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To answer the question, I would want to understand the quality of your donor area and the degree of miniaturization you have in the hair of that permanent zone. Then I would want to know the extent of the hair loss and the size of the area that you want to treat. I would want to map out your scalp for miniaturization as I would need to know that information in order to ascertain if you will be helped or hurt by a hair transplant. Evaluating women for hair transplants is a real art combined with science. I met a doctor at the recent annual International Society of Hair Restoration Surgeons meeting that told me that their medical group did surgery on better than 95% of women who came to them. I would suspect that the doctor has terrible results and many unhappy patients. Get a good doctor who knows about this and get yourself evaluated properly.

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Cyst Removal on Head Causing Female Hair Loss? – Hair Loss Information – Balding Blog

i have been on the depo shot for about a year now and have noticed that my hair on the top of my head is thinning. now i didnt notice this until about august i think it was after i had a cyst removed from my head. it is by the area where it was removed but all they did to remove it was make an incision and it was tough coming out so they had to pull and dig a little. my question is could that removal of that cyst have caused this and in either case, will it grow back?

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Any procedure in the scalp may trigger hair loss at the surgical site. Two main factors may cause this local hair loss:

  1. Shock loss: If you are predisposed to balding, you may have already had miniaturization to some degree and the surgery on the scalp may have only facilitated the process of hair loss. This phenomenon is called shock loss, and it may or may not be reversible. It varies per person.
  2. Undermining the edges of incision: In order to remove a mass or cyst from the scalp or sometimes to reduce the tension of the skin edges, the surgeon may cut some of the hair follicles. Dissection of hair usually results in permanent baldness in the affected area. This baldness in a scarred area is similar to the hair loss that patients get after a craniotomy or scalp trauma.

My suggestion is to wait it out for 6 months. If the bald area doesn’t grow hair during this period, the baldness may be permanent. At that point, if the location of the scar is noticeable, you may want to see a hair transplant surgeon. The treatment options for this condition will be either to primarily remove it if the scar is small enough, or to use hair transplant to fill the bald area if it is too large.

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Can the Triple-Flap Procedure Give Me a Full Head of Hair? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

Can someone who is completely bald (everywhere, except the very back and sides) have a full head of hair like that of a teenager by the triple-flap procedure?

Is there any procedure or combined procedures to give a completely bald person that final result?

Best regards

There was an article in the news last week about this very procedure, which I am assuming is what prompted your inquiry.

The triple-flap is a corrective procedure, generally used to repair patients where slot deformities were created by scalp reduction scars (surgeries that tried to remove the bald spot). This article seems to be misleading, because it does seem to make clear enough that the triple-flap procedure should only be used to repair deformities of the scalp. If there are defects in the scalp that are not the results of multiple scalp reduction surgeries (like a burn), then many of these people need balloon expanders to shift large areas of the scalp. In any event, this is a very specialized field and something that I can not comment without examining you. Please send me photos (you may cover your face) and I will evaluate what you are talking about.


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Will Propecia Only Prevent Shock Loss in Younger Men? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

You frequently mention the safeguard of taking Propecia to prevent shock loss. You also mention how shock loss is more frequent in younger men and so I’m left with the impression that Propecia will only help young men prevent shock loss. I’m 36. I seem to have stabilized my hair loss with propecia. If I’m a NW 3 and have been on propecia for 15 months, what are my chances of shock loss? Also, if I’m going for a mature hairline, how many grafts are needed for a typical NW3?

Thank you

I believe that Propecia can and does prevent shock loss in anyone having a hair transplant at any age (although nothing is 100%). The young man is most vulnerable to this complication. At your age, your chances of developing shock loss are slim.

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Hair Transplant Did Not Grow After a Year! – Hair Loss Information – Balding Blog

Dear sir,
I underwent hair restoration surgery last year in the month of Octobar. All the transplanted hair fell and i didn’t get them back.what could be wrong? doctor not skilled enough to do it or what,Is it possible to redo surgery?

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When the entire transplant fails, then it is possible that something major went wrong at the time of the surgery. This could be a disastrous mistake that killed the grafts or even an unskilled surgical team. Was the team skilled? Did you check out the doctors first? Did you see patients of theirs? If you decide to redo it, be sure that you have these questions answered… or do some more research and find a different doctor.

For more on what could go wrong during a hair transplant procedure, please see Things That Can Go Wrong in Hair Transplant Surgery.