Category: Hair Transplantation

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Staples or Sutures? What are the Pros and Cons? – Hair Loss Information by Dr. William Rassman

Dear Dr.Rassman,
I have been reading your blog for quite sometime and have a high regard for your opinions.
I’m considering a transplant and I have a question regarding the scar closure methods different doctors use. I have read they could use staples, sutures and dissolvable sutures. Could you please discuss the pros and cons of the three different methods. In your surgeries which would you prefer and why.

Thanks a lot for your time in advance.

I would have to write a textbook on the logic that distinguishes why one may be better than the others. Essentially, I use them all in different circumstances. I do prefer staples much of the time, because it is fast for the surgery and the staples allow blood to go between them, which in theory gives more blood supply to the skin edge. Sutures have a tendency to constrict the skin along the skin edge when they are use in a baseball type of way.

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Hair Loss InformationI’m Worried About this Shock Loss Talk – Hair Loss Information – Balding Blog

Dear Doctor Rassman;

Thank you for your advice and for taking our questions. I had 2700 FUs done this past February. I’m very happy with the results. I’m thinking about doing a follow up surgery to thicken the front area some more around mid December. I’m afraid about all of this talk about Shock loss. I’m 48 years old, male, and in very good health. I’ve been taking Propecia since January of this year and have noticed some improvement on the crown area. Please let me know your Opinion on this matter of Shock loss. I’m a bit confuzed and I don’t want to worsen my frontal area.

Thank you and Kind Regards.

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I would doubt that you would experience shock loss because:

  1. You recently had a transplant and had not experienced it
  2. You are on Propecia
  3. You are over 40 years old

    4. Don’t worry, be happy… and don’t be confused. Go for it!

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Patients After Hair Transplantation (with Photos) – Hair Loss Information – Balding Blog

What will I look like within a week or two after a Hair Transplant?

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Here’s a collection of recent patients. Please note that the amount of redness is different for each person, and all of these patients had these photos taken pretty soon after surgery (between 3-10 days, as noted below). Click the photos to enlarge.

This first patient is 10 days since he had 2150 grafts. He has white skin and dark hair and wants to keep his hair pulled back. He would do better to hide the transplants by combing it forward, but this is his choice, of course. What you are looking at is a new beard from the transplanted hair which is about 1/8th inches long, just below the hair that he had prior to the transplant. The transplanted hairs were placed between his longer hair.




The second patient has 1661 grafts and had no cover at all. This is his bare skin on the 7th post operative day. Good washing and small surgical wounds are the key to fast recovery of hair transplants almost immediately after surgery. Most people who are bald worry about detection of the transplant. By about two seeks, the faint pink glow will not show. If his skin color was anything but ‘very light’ not even the pink appearance would show.




The third patient had 1794 grafts and is 3 days after his hair transplant procedure. He had short hair in the front and the transplanted hairs was placed between his short hairs. He did form very small crust that did not immediately wash off in the first day, as is often the case.




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Hair Loss Information2 Weeks After Surgery and My Transplanted Hairs Haven’t Fallen Out Yet – Hair Loss Information – Balding Blog

I’m two weeks post op and I’m almost positive that I haven’t lost a single transplanted hair yet. I’m hoping that these little guys are going to stay in my head and continue to grow out with the rest of my hair. Is it possible to that the shedding stage can be avoided sometimes and the transplants grow out? If shedding is inevitable I’d like to speed up the process. Would it be beneficial to pluck the small guys so they can start their regret stage sooner? Thanks again for all your help!

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The transplanted grafts often stay in for 2-4 weeks. If they grow past 3/8 inch and keep on growing, they will most likely stay. That happens in about 5% of patients. Leave them alone, ignore them and just wait it out.

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What Should a 23 Year Old Male with Norwood 4A Pattern Do? – Hair Loss Information by Dr. William Rassman

Do you recommend that a 23 year old male with a receding hairline and visible thinning to the point of resembling a Norwood 4A should hold off on transplant options or begin preparing for treatment?

Assuming that you already started Propecia at least 8 months ago, then you need to see a good doctor to build a Master Plan. If you and the doctor hit it off and bond and he/she develop that plan, a hair transplant may be appropriate. I generally do not like to do surgery on 23 year olds, but I do violate my rule based upon the needs of my patient and the Master Plan that is built between us.

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If I Get Transplants, I Want a Perfectly Straight Hairline – Hair Loss Information – Balding Blog

So, I’m one of those losers losing his hair at 24 :(

I hear that after you get hair transplants you will always have a hairline that looks like it is receding. I do not want that- I want the hollywood straight nice hairline.

Is this possible with hair implants if I find the right surgeon?

Please advise

Thanks kindly

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DraculaGenerally, transplanted hairlines should not be perfectly straight. To be completely normal you need a transition zone between the forehead and the thicker hair with a gradual appearance of hair, not an abrupt Count Dracula hairline (see right). With that being said, I will transplant a straight “Hollywood” hairline (as you call it), but it will take some convincing that what you want is reasonable and natural. Had I transplanted Dracula’s hairline, I suspect one night when he woke up, he would realize that he was a Vampire. That’s ok for Dracula, but not for one of my patients.

I decided to show you photos of patients that look perfectly natural with a transplanted mature hairline, as opposed to the straight across hairline you’re asking about. They say that pictures are worth a thousand words, so here’s 17 thousand for you…

For what it’s worth, I noted that your location was in Northern California. NHI will also start working out of Oakland next month and I expect to have a Sacramento office shortly thereafter.

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16 Year Old is Losing Hair, Wanting Transplantation – Hair Loss Information by Dr. William Rassman

I am a 16 year old male. When i turned 13 I dyed my hair about 5 times, and bleached it once. The following year I began to lose my hair. You can see my scalp on the back of my head, not greatly, but very noticablly. The hair on top of my head is very thin now, and u can almost see through to my scalp. My hair has stopped falling out since then but the damage has been done. I have been to several doctors, and dermatologists, they all say it’s hereditary, since my father is bald. My questions are, if the hair loss is hereditary why did I start losing my hair at such a young age? If my parents and I consider hair transplantation am I guaranteed to have a full head of thick(er) hair? If we decide to have the surgery should I start taking Propecia to prevent any future hair loss? I would love nothing more than to have a full head of thick hair again. This has been a very stressful situation, being in my prime teen years, and entering my junior year of high school in September. I would greatly appreciate it if you respond to my message. Thanks for your time!

You are almost certainly too young to have hair transplants. Seeing through the hair to the scalp means that you hair is probably very, very fine. This is a common look, something that my generation called a towhead. I would not be surprised to hear of balding in your family as 50% of men in their lifetime do have some form of balding. Before you start on a treatment plan, please read Miniaturization: Critical to the Master Plan for Hair Loss and develop a Master Plan for your hair.

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Hair Loss InformationRobotic Controlled Hair Transplants – Hair Loss Information – Balding Blog

There’s a doctor in the bay area that is claiming to do hair transplants with robots. What is this about? Robots??? Can you tell me more about this?

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Robot“Restoration Robotics, Inc. (Mountain View, CA) is a company using image-guided robotic technology to perform hair restoration by emulating the FUE technique. The robotic technology is in development. Currently, it is not approved by the FDA and the technology is not for sale”, said a company spokesperson when I contacted them. I also found this press release about Restoration Robotics from 2003, here.

I can imagine the scene of a movie with robots doing hair transplants, starring 3-CPO from Star Wars. I am sure that we will be hearing more about robotic-assisted hair transplants in the future and I doubt that it will be as frightening as I just made it sound. This is an exciting conceptual solution to the Follicular Unit Extraction (FUE) quality problem.

There is also the Medicamat Punch Hair Matic, first announced in late 2004 in this press release — Punch Hair Matic rescues baldies — which says: “Medicamat of France will be launching its new robot for hair transplantation”. I have been familiar with this company, which purchased the technology from a long term friend in the mid-1990s, Dr. Pascal Boudjema, one of the brightest inventors that the hair transplant community has ever had.

Their press release goes on to say: “The Punch Hair Matic (which is patent-protected) is a robot using micro-instruments to remove follicular units, which makes surgery simpler, faster, and less debilitating for the patient, with more convincing aesthetic results.” They report a very fast surgical time (2 hours to do 700 grafts) for the transplant (appears to be an FUE technique).

In many ways, Medicamat has been doing small punch grafting longer than I have, considering that they have been using smaller and smaller punches for many years. The evolution to smaller punches has been slow and methodical.

Today, the shoppers for FUE transplants pass through a mine field (a ‘buyer beware’ business for sure) where doctors from all over the world (with little or no training) are using manual techniques with varying degrees of success. Regardless of their expertise, they are telling the public that they specialize in FUE and are experts in the technique. At least, the robot approach promises to standardize the technique and the quality of the output. So we have a horse race now between two companies offering what may turn out to be competing technologies. Only the public can benefit here, so I sincerely hope that one or both of these companies succeed in making the business for automated hair transplants work.

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Will My Hair Transplant Look Natural? – Hair Loss Information by Dr. William Rassman

Dr.Rassman, I am 25/yom, with significant thinning in my frontal hairline, and temples. I was taking propecia but stopped because of the side effects, and I heard it doesn’t work for receeding hairlines. I have consulted a Hair transplant doctor here in michigan, and he says their are some miniaturized follicles, but at the same time it may be too early to get work done, because of future hair loss. I can’t stand waking up everyday and finding new balding and thinning areas, it’s killing my self esteem. They did reccomend 600 grafts if I decided, which I am seriously considering. But will it look natural? Will it cause other natural hairs to fall out? And should I be taking propecia? Please help sir, I would be so grateful. Thanks so much.

I cannot make a diagnosis or give a second medical opinion via the internet, because I am limited to your description and I have not examined you in person. When a doctor says “it may be too early to get work done”, you might want to let his words ’sink in’ and consider this as reasonable advice. If the doctor makes his living doing hair transplants, then if that doctor did not want to sell you a transplant, it should add a bit more value to the recommendation to hold off doing a transplant. As a general rule, before you consider a hair transplant, you and your doctor should review the Master Plan for your furture hair loss and your expectations with the various options. After both you and your doctor are in agreement to have drug therapy (such as Propecia) or undergo a hair transplant, then you can work from that plan. At the hands of a good hair transplant surgeon with good planning, a hair transplant should look natural and undetectable to anyone looking at it. I have many patients whose transplants looked so good that they could have even fool my trained eye.