Hair Transplantation – Page 181

February 2, 2006

Hair Loss InformationWoods Technique and FUE – Hair Loss Information – Balding Blog

Do you use the Woods style of hair transplant? Also are you in California?

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Dr. Woods (in Australia) probably is doing something like what I published in 2002 and called Follicular Unit Extraction. He kept what he was doing very secret, whereas I always publish my advances as I prove and document them for the world to see. As such, Dr. Woods promoted what he was doing on the Internet and launched a marketing campaign to sell a technique that sounds just like what we developed in California and New York. But as Woods never told anyone what ‘magic’ formula he was using, I can not claim to be using his technique. The FUE technique was defined by me (see Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation). On my site, you can see what it is (see FOX Procedure Videos) and also the type of scarring that is produced (see FUE Photos). There is no secret with what we are doing and the world of competent and honorable doctors reference my publication as the inventive breakthrough in this field. Now, almost 4 years later, there are no other published articles on the FUE ‘technique’ that I have seen.

With that said, Woods did publish one article that shed no new light on the great ‘secret’ of his technique. The article contains a case study and there is no scientific methodology defined, nor anything that meets generally accepted standards for publishing, so I was very surprised that this reputable journal took an article of this type without a good clinical scientific base. The article appears to be another type of marketing promotion. According to Woods’ site, TheWoodsTechnique.com, his technique was “Published in the British Journal of Plastic Surgery December 2004″ and “First in the world to develop and perfect single follicular unit extraction (since 1989)”. There is no reference to my published article on it a few years earlier and his claim that he perfected it in 1989 is completely unsubstantiated. It is interesting to note the gap of 16 years from the date of the unsubstantiated discovery to the date of his first publication. Woods, in my opinion, approached this process like P.T. Barnum (best known as the 19th century American Huckster). My work in the development of FUE was started in the mid-1990s and I was unwilling to publish it for grandstanding purposes (this is not a sour grapes issue), because I would not publish something for the purpose of just getting the word out to create a reputation. I know that I am very critical of Woods, but that is because all I have ever seen, even in a lecture series that he set up, was a hyped up marketing presentation with statements made that neither his commercial video nor the photos from his web-site can realistically support. The most blatant example of this is his statement about no scars, yet I have video from his office in my possession that shows more scars then I got from the technique I published and with the smaller instruments I use today, our scars are even smaller than what I have published. If you are believer in everything you read, should I have mentioned that I am the inventor of today’s modern computer chip (I don’t believe anyone would really believe me on this last unsubstantiated statement).

To answer your last question — yes, I have offices in Southern and Northern California and would love to see you. I hope that this entry on FUE entertained you. I did try to spice it up a bit.

January 31, 2006

Weak Results 6 Months After Transplant – Hair Loss Information by Dr. William Rassman

Hello. i’m 23 and had a 2000 graft procedure in new york on july 1st 2005. its been about 6 months and some weeks and i havent seen the dramatic results i thought i was suppose to see. I asked the doctor and he says its early and everyone is different, just wait and be patient. What do you think? I “feel” some hairs growing in different spots but not everywhere, and i have some slight cobblestoning, does that go away?
Thanks so much

I always tell my patients to wait a full 8 months before judging what the results look like. At 8 months, 80-90% of the transplants should have grown and much of them at styling length of 2 inches or so.

Be patient and wait it out. Significant changes will probably be evident in the next few months.

Paid advertisements (not an endorsement):

January 30, 2006

Hair Loss InformationGraft Placement, FUE, and Body Hair Transplants – Hair Loss Information – Balding Blog

first:
i need your opinion concerning the placement technique of DHI Greece group.

Second:
i had a transplant with famous doctor in Australia, he is very good in FUE (body & head) but the placement is not good & transplant hair nature is changed. i think his way with washing hair not before one week of tranplantation is not good for hair, i need your opinion for that.

finally:
i think you are the best doctor in this field but i have 2 problems to proceed with you:
1- getting the VISA, my application was introduced from 18 months & there is no answer. i know this is not your fault, but this is the situation
2- i am Norwood 5 to 6, i prefer to use BODY HAIR & untill now you do not proceed with this option

finally thank you for this valuable website, i know everydetails of hair transplatation & made me have standard for quality procedure

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Thank you for the faith that you expressed in my skills. To answer the first part of your email about DHI, please take a look at FUE / FIT — Minimally Invasive Hair Transplants.

It sounds like although you did your research, the “Buyer Beware” axiom still failed even after considerable research. If you are a Class 6 pattern balding patient,l the best and probably only real good source of donor hair is from the back and sides of your head and you need to exploit this first before you consider body hair transplants (most people never need them). You have clearly recognized that the art of placement is critical to the final result, which is something that many people do not differentiate from medical clinic to medical clinic. As the inventor of the Follicular Unit Extraction (FUE) technique, I know that it is not always the best procedure for those who are extensively bald. I personally think that you must focus upon the quality of the transplanted hair, and body hair does not have that same quality or quantity as head and scalp hair. Performing body hair transplants will produce a poor quality hair transplant (when compared to a good transplant with scalp hair), which may be what you are observing and blaming on your shampoo and washing technique.

Please send photographs to the address on the Contact page as a starting point of a dialogue.

January 27, 2006

Hair Loss InformationAppropriate Amount of Grafts in Frontal Area – Hair Loss Information – Balding Blog

Dear Dr Rassman,
I am a 24 yo male who has experienced hair loss in the frontal region and am told that i am a Norwood type 4. I went to see a surgeon/dr in Australia. He told me that the best treatment was to have one large megasession and that he would use 2500 grafts on the frontal region. I am curious as to know whether this is an extreme amount in that region and your feelings on megasessions. I was also wondering that given my age how many sessions in my lifetime will i need and how frequently do people my age have to have more done. If i had a megasession would there be enough hair in my donor area if i did suffer more hair loss. Is there any way of doing a procedure, where you have existing hair, to transplant it to that area to prevent it if it was to fall out. Does one procedure in people’s liftime exist if they stay on propecia (which I am on, and doesn’t seem to be working that well).

Sorry for so many questions Dr Rassman. Thank you very much for your time.

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For a Norwood 4A balding pattern, 2500 grafts in a single session sounds like a reasonable number that might meet all of your needs, depending how large the area is. Most people have about 6,000-8,000 grafts available in their donor area, but the actual number may vary. That is why we measure everyone’s density to determine a Master Plan for the worse case scenario of hair loss. Your age is a bit young, but if the pattern of loss is relatively complete and did not reverse after taking Propecia on a trial basis for 8 months, then a transplant could be reasonably done. Hopefully with Propecia that is consistently taken, the hair loss will at least slow or stop, stalling any need for further transplants for some time. Provided that you keep the work done to the frontal area, there is little worry about running out of donor hair for most people. I would discourage work in the crown at your age.

January 26, 2006

Continued Balding After Hair Transplant – Hair Loss Information – Balding Blog

I have read a lot about mega sessions and micrografts, etc, and don’t doubt that they can produce satisfactory results if done properly. My question is: what happens as time goes on and balding continues in the untreated areas? I assume a patient would have to keep coming back every so many years to fill in the newly balding areas. How many times can someone go “back to the well” as it were. I am 43 years now, and have a receding hairline (especially at the temples). My concern is that when I am 60 or 70, I will look ridiculous with a perfect hairline but balding at the crown.
Thanks

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This is a good quesiton which I have answered in many ways before. Generally the hair loss for most people tends to plateau after the age of 35, and by the time someone reaches your age, the final pattern can be estimated by mapping out the scalp and hair for miniaturization so that you do not play ‘blind man’s bluff’ with your hair. If you will advance to a very balding pattern, then some of the hair in that pattern will be miniaturizing now, so it will be easy to see under high powered imaging.

If you take drugs like Propecia, it has several advantages, including reduction of the progressive nature of the hair loss, and probably preventing prostate cancer. Both are desirable side effects of the drug.

In most men of your age, chasing the hair loss is unusual. It is usually more of a problem with men in their 20s who get a transplant, are destined to become very bald, and who do not take Propecia. With a good Master Plan, you should never look ridiculous at any age after having a transplant, providing that you have the conversation with your surgeon and he/she is honest about his/her answers and not a salesman going for the cash that is your bank account and wanting it to be in his instead.

January 24, 2006

Transplanting with Limited Donor Area – Hair Loss Information – Balding Blog

I have had several transplants over the last 20 years. My donor area is generally depleted and cannot support any large procedures. I have 1-2 very small (quarter size) areas that if some additional transplants were done only in these strategic areas my hair would appear much fuller. Considering the small amount of donor plugs needed could these be provided by smaller more random/scattered donor sites as opposed to the larger harvesting rows that are more concentrated in one area. Thereby minimizing the thinning effect we see in a typical donor area.

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There is an art to making less hair look like more hair. I have many patients like you who have paid the price of the old antiquated procedures of the 1970s and 1980s. I have already written articles on the subject, but what I do for each patient is a one on one determination that takes the years of experience I have spent to develop the Master Plan for such person. Simply put, a good doctor, upon examination, should be able to determine the answer to your question.

January 20, 2006

Female Hairline Restoration After Brow Lift (with Photos) – Hair Loss Information – Balding Blog

I have had a higher hairline since I was a teenager. I always hated it. When I had a face and brow lift at the age of 49, the high hairline became even higher. Is there a simple way of lowering it? Is transplanting the only solution?

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The photos below are of a 45 year old woman who, like you, had a high hairline compounded by a brow lift as well.

These first 3 photos are surgical pictures because they show what was missing, the deformities that were there and the problem that was tackled before (the middle and right photos were from immediately after surgery):

Before
Immediately_After_Surgery

This next set of photos were taken after this lady’s 2nd procedure had grown in. The black hair and light skin are the most challenging contrast for hair transplant surgeons, explaining why it took two procedures to get the results you see here. She had a total of 3,508 grafts (in two procedures). Note that the side hair and temples were brought forward. In normal female hairlines the temple prominences often extend closer to the eyes than in men, narrowing the amount of forehead shown. Women’s hairlines, because they are rounded, not recessed, and the temples are important for accentuating femininity, make the work more difficult from an artistic vantage point.

After
After
After

The high hairline bothered her greatly after the brow lift and became unacceptable. The brow lift produced a wide scar behind the hairline (compounding the problem). In this situation, a hair transplant is the correct decision because lowering the hairline and filling in the scar behind the hairline can be accomplished with a single procedure in a person with blonde or white hair, and two procedures with someone with dark hair and light skin. The hairline was lowered by 3/4 inch and filling in the brow lift scar was also accomplished in the same procedure. A brow lift usually takes away the possibility of a hairline lowering procedure.

January 20, 2006

Hair Loss InformationDoes a Hair Transplant Increase the Forehead? – Hair Loss Information – Balding Blog

Your site is very helpful and is a great service to the community. I applaud your selflessness. I was motivated to check your site because I saw the Procede ads – thanks for setting us straight on that one.

I am curious, however, about Regenix and wonder if anything new in the way of clinical evidence has come your way to suggest how it works vs. something like Rogaine?

Also, is it true that hair transplant surgery, by borrowing from the back of the scalp, also serves to increase the forehead space? If so, is it advisable to have the transplants along the frontal hairline to lower the hairline and reduce this space?

Thanks for your help.

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I have no information on Regenix in the way of clinical evidence (Tier 1 evidence) at the level of proven FDA approved treatments such as Minoxidil (Rogaine) or Finasteride (Propecia), nor are there any head-to-head trials comparing these sorts of treatments (who would pay for possibly proving someone else has a better treatment?). If someone tells me a certain treatment works for them, GREAT! Keep using it. However, I will not recommend treatments for which I do not have rigorous and incontrovertible scientific evidence.

As for the oft-asked question about a forehead lift from removing skin from the back of the head, I am happy to tell you that your forehead does not move, but your butt raises up two inches… I’m just kidding, you actually don’t have any change except for a little less excess skin at the back of your head because of the way the skin is attached to the skull it is loose. We have redundant tissue at the back of your head because your neck is actually a joint, like your elbow or your knee, so you need a little extra skin to allow for flexion. Thankfully for the hair surgeons, nature has provided a bit more skin there than is necessary, which is why we can take some out and not affect anything around it. Sorry for those of you who wanted a combination facelift/hair surgery!

January 17, 2006

Transplant Hair From My Back – Hair Loss Information – Balding Blog

My question is about donor sites. I have a rather extensive amount of back hair and, if possible and practical, I would like to transplant said hair (in conjunction with hair from other, more typical, donor sites) as part of a transplant to correct my scalp baldness. While I still have hair on the sides and the back of my scalp, I do have a lot of baldness all across the top of my scalp, which I assume will require lots of grafts. Can back hair be considered donor hair?

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Body hair is not a productive source for hair as traditional sources from the sides and back of your head. Unless you have significantly depleted the donor hair from the traditional source, I would not recommend hair from the body (an experimental procedure of questionable value). I have performed hair transplants on the baldest of men with great results. They have gotten hair from back and sides in each case. For example, see Class 7 Patient ZU from the NHI site.

January 17, 2006

Hair Transplant After Alopecia? – Balding Blog

I have several bald spots at the back of my head.I went to see an MD and a blood test was done all are normal and MD said that i am having alopecia. What is the approximate price of hair transplantation? i am only 26 years old / female and i don’t want to be bald this early in life. please respond. thanks

There are many types of alopecia. If you have one of the autoimmune causes of hair loss (that is what it sounds like), then hair transplantation does not work until the disease has burned out (generally you must wait for at least a couple of years and be certain that the autoimmune process has ended often requiring a biopsy). I need more information on the type of alopecia you have. See the Female Hair Loss category for the answers to your concerns that may have already been written.