Category: Hair Transplantation

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Hair Loss InformationHair Miniaturized on One Side – Should I Get a Transplant? – Hair Loss Information – Balding Blog

First of all, thank you for the time you put into answering questions and posting them on your blog. I have found it a truly unique resource in the often troubling search for useful information on MPB and Hair Transplants. I am 27 years old and have been very slowly losing my hair since I was 20. All the loss has been in the form of a receding hairline and I am now probabaly only a norwood class 2 – 2.5. I have kept most of my hair most likely due to my use of propecia off and on for the past 5 years (2 years on and then 1 year off (like an idiot) and now 2 years back on). The outline of my hairline is now a normal mature hairline but it has slowly gotten thinner and thinner especially on one side while the other side has stayed relatively full. My question is two parts: Is it common to see significantly more miniaturization on one side of the hairline? Are there down sides to doing a hair transplant among those thin hairs to add density? Some might call me crazy for even considering such an option but the hair has gotten very thin and I would like to enjoy a full head of hair and not have to worry about covering up a balding area. I dont mind where my hairline stands but would really like to fill in the thinning area if there are not significant negative repercussions. My two biggest concerns are shock loss and what my hair might look like years down the road (will I have a small patch of transplanted hairs while everything else has thinned out or fallen out?). Thanks again for your time and this blog in general.

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I am glad that you find my blog helpful. Thank you for your kind words.

It is not unusual for a person to show more hair loss on one side than the other. The reality is that the other side will catch up to the worse side eventually.

Transplantation may be an option, assuming that your hair loss extends beyond the class 2 pattern. If the miniaturization goes well into the existing hair, then a transplant AFTER you are on a course of Propecia, may be a reasonable option. Shock loss is rare if you are taking Propecia. Good planning with a good doctor will assure your best outcome concerning your final appearance and should prevent you from having islands of hair. This requires a master plan for your short and long term hair loss, because hair loss is a progressive process. Since you are in Los Angeles, you should call my office at 800-NEW-HAIR or visit the Request Additional Info page to setup a free consultation in our LA office, or better yet, come to one of our Open House events where you can see a patient surgery, meet many patients who had the transplants done by me and meet other patients who had surgery done by others so you can compare apples to apples.

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Risks and Pain in Transplanting a 50 Year Old – Hair Loss Information – Balding Blog

I am considering a hair transplant of 2200 grafts and am 50 years old. I am in good health and I have plenty of donor hair. I feel that this would make a tremendous difference in my hairline and appearance. What are the risks and pain involved for a man my age and with that amount of micrografts? How long would it take to heal? thank you

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2200 grafts is a moderate-sized surgery that would likely take about a week to heal in the donor area. The risks for someone of your age if you are in good health are roughly the same as those for most other ages – to be more precise, there are surprisingly few. As with any surgery you risk the possibility of scar formation, infection, and possible adverse reaction to anesthesia or other drugs are very, very rare. These are the big ones we worry about and incidences are very uncommon in a proper surgery center and with a trained and experienced doctor and team. There is also no excuse for this elective surgery to be any more painful than a mild dental visit. Good pain medicines and effective techniques are available, well known, and should be used.

To be completely honest, your biggest risk is in the choice of your surgeon and the team they use. Choose a surgeon with a good reputation whose hairlines you like, and make sure they are willing to let you meet their patients and evaluate their results for yourself. Check the facility and ask the surgeon who is on the surgery team. An experienced staff makes all the difference in the world both in your experience that day and in your final result because of the way the staff members treat the grafts. Lastly, choose someone with whom you feel comfortable. Many of my patients who come in for corrective work had a less than good feeling when they went to their doc or they chose them solely on price. Remember, you are the one who gets to live with the permanent results after all, so be a little picky.

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Cowlicks, Widow’s Peaks, and Hair Transplants – Hair Loss Information – Balding Blog

I have a question. The hair on the left side of my head, from the hairline to about 1 to 1.5 inches behind it moves in a fully forward direction instead of backwards and down. This cowlick creates a very messy look and contrasts with the normal direction of hair on my right side.

Is there any procedure that can be done to just change the angle of direction of those hairs? If so, who performs this?
Thanks very much

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Cowlicks are hairs that grow in a different direction than adjacent hairs. They can be very sexy or they can be annoying, much like your complaint about them. Grooming can be a problem if you are a perfectionist, your hair character is strong, and the direction abnormality is in an obvious place, like the very frontal hair line. This is most often seen in the central area of the frontal hair line, frequently in association with a ‘widow’s peak’ or as in your case, it can be off center. There is little to do about them without damaging the frontal hair line. When we transplant near them and they are strong, there are many artistic judgments that the surgeon must make on how to deal with them. I love and hate them, depending upon what I am asked to do with them and the patient’s opinion of what he wants and what he can reasonably achieve.

My suggestion is for you to accept the cowlick, learn to style around it and not to aggressively go after it unless it is very limited to a small area, in which case, FUE might be possible. You need an expert to evaluate this in person and to protect your interests.

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Advice for Balding Actor – Hair Loss Information – Balding Blog

Dear Dr Rassman,
I’ve got to a point now where i need to address my Hair loss!! I started losing my hair in my early 20’s but it was never that noticeable -this was probably due to the fact that it was a gradual thing and that my hair was densly thick! I’m now 29 and my hair seems to be falling out rapidly and it’s becoming harder and harder to cover it up. I’ve started using Propecia with the hope that it will stop the Hair loss. I’m an actor and am worried that my eventual lack of hair will effect my work! Any advice?
Yours Faithfully

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I understand the need to maintain your appearance as an actor. Some character actors can establish a balding persona, so you can accept a balding fate and still make it in the movies or theater. As actors reflect the male population, half of all men will be balding by the time they are 45 years old.

Now that does not mean that I am advocating balding. If your desire is to maintain your hairy appearance and Propecia does not hold it, then hair transplantation is a reasonable option that can produce wonderful, normal, and undetectable results. First, get your hair loss pattern established with a map of your miniaturization. Then, work out your supply versus demand possibilities for hair over time based upon the mapping I just outlined. With that in hand, you can establish a Master Plan, from which you can then make plans. Hair restoration surgery does not mean that you must go bald to get hair back. It means that you plan out everything that is happening to you, short and long term, with the best tools and doctors available today. We are there, just look for us.

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Hair Transplant Without Surgery? – Hair Loss Information – Balding Blog

Are any of the topical ointments being sold on TV effective? I have heard (in Jacksonville, FL) of a new transplanting system without surgery – any such thing??

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Effective? That depends on what you want them to do. I’m not even sure what hair regrowth products are being marketed on TV these days.

There is nothing new on the face of this earth that can give you a hair transplant without surgery. Someone is dishonest or plainly a crook. Maybe you misunderstood, so giving the benefit of the doubt, please send me a phone number, website, or at least the name of this procedure the next time you hear about it, and I will check it out for you.

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Lateral Slit Method – Hair Loss Information – Balding Blog

What exactly is the “lateral slit method”? Do you use it? How does it improve results?

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The lateral slit method for placing grafts in a hair transplant recipient area constitutes the use of slits which are oriented from ear to ear, rather than slits that are oriented front to back. Proper slit making is best done with very small slits, measuring between 0.8-1.1 mm in length. Clearly for people with coarse hair the wider hair shaft may require the longer slits, while those people with fine hair will require smaller slits.

The skills in placing lateral slits is different than the more conventional slits oriented front to back. It is slightly more difficult for those not accustomed to the technical issues involved in the process. The claimed advantage of lateral slits are many, including:

  1. As the grafts heal, there is a fence like orientation of the hairs within the grafts which may increase a sense of fullness from a frontal view.
  2. There is a possibility that the hairs may angle forward from the point where they exit the skin. This may accentuate the layering effect from the transplant and some people believe that this will create more fullness.

The problem with these ideas is that there is no proof. But despite the absence of proof, I perform lateral slits in almost all of our transplants because there is no down side to doing it this way. I wrote about the lateral slit method earlier this month: Lateral Slits and Transplanted Hair Direction.

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9 Months After Hair Transplant (with Photos) – Hair Loss Information – Balding Blog

This patient is a Norwood Class 6 and had one hair transplant procedure of 3,206 grafts just 9 months ago at the New Hair Institute.

This is what he had to say…

No one ever knew that I had a hair transplant or that it was even me until I told them! I had to let the secret out of the bag, because people couldn’t recognize me.

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Even after only one procedure, the change in his appearance is so remarkable, that I wanted to show off his results (with permission, of course). The photo on the left was taken just before hair transplantation, and the photo on the right was taken 9 months after. Click each image to see the full size photo. Forgive the quality of the “After” photo — there was a problem with the camera that wasn’t noticed right away.

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Matthew McConaughey and Hair Transplants – Hair Loss Information – Balding Blog

Dr. Rassman, I am concerned that your post about Matthew McConaughey is misleading. Do you honestly believe he had transplants? Here are two reasons why I think it is unreasonable to think so. First, he had a full head of hair in movies before and directly after the picture (showing hairloss) was taken. The only way he could have had transplants is if his hairloss was sudden and his regrowth was extremely quick. Second, the results are be too good to be transplants even if used in conjuction with drugs or anything topical. I’m sure transplants can make make a big difference, but not that big of one. If he did have transplants then the pictures of your work appear to pale in comparison to the kind of work that can be done. I don’t think your work is substandard to anyone. I think he uses a hairpiece. Are you worried at all that passing his improvement off as a transplant will give people unrealistic expectations as to what hair transplants can do and perhaps unduly persuade people to get hair transplants. Also, do you think hair transplant doctors may be attributing Matthew’s results to hair tranplants in fear of losing people to the hairpiece business?
Sincerely,
Concerned

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Just to be clear for the readers of this blog, your question is in reference to the post I made back in May regarding Regenix and the role it may have played in the hairline restoration of this actor.

I have no first hand knowledge of Matthew McConaughey. From photos I have seen of him, there is obviously a big change in his hairline between the older pictures and his current presentation. If the change reflected a hair system, then it is a good one. In the movies, this is done quite often for balding actors, and there are people primping and grooming the hair piece just before they are on film to achieve the best possible look. If the change reflected a hair transplant, then he had a good hair transplant surgeon. Photographs show us what the photographer wants us to see. A hair piece (a wig) would be instantaneous, while a hair transplant would take 8 months to grow out.

As far as expectations, look at the change a hair transplant made in broadcaster Steve Hartman, as featured on the NHI website. The results were at least as good as a great wig, but since it is his real hair growing from his head, he doesn’t have to worry about the costly maintenance or smell issues associated with hair pieces.

I’ve posted links to these photos before, but they are worth reposting to show the dramatic change in Mr. McConaughey’s hairline.

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Shaving the Head Before Transplantation – Hair Loss Information – Balding Blog

I had 1600 grafts transplanted at the hairline area about 4 months ago. When the procedure was done the doctor shaved that part of my head. My hair loss up until that point was somewhat concealable when the hair that I had was grown out and some of the hair further back was combed forward. After the procedure I had to cut the rest of my hair to make it look even with the area that had been shaved. This made my hair loss much more noticeable. I was not aware until seconds before the shaving that this would be happening and I was told that this was necessary to gauge the proper growth direction of the follicle. Was this necessary? Had I known it would take about 3 months of growth just to get my hair back to a place where I wasn’t obviously balding I may have reconsidered. At 4 months my hair looks very similar to my pre-operation density and I do not notice any significant new growth. Should I be concerned?

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Sounds like some failure of communication occurred. You should have been told that your head would be shaved. I know that many doctors do this, but I do not recommend it. I tend to just work around the problem of long hair. I take the view that everything should be as natural as it was prior to the surgery. At 4 months, I would expect that the hair should be starting to grow out. Look for 80% of the benefits by the 7th month. Good luck.

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Redness, Hair Growth, and Differences Between Doctors – Hair Loss Information – Balding Blog

My boy friend is considering hair transplant surgery. How long will the redness last? How long does it take for hair to re-grow? Are there different procedures use by different doctors?

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If there is redness at all, it will be gone in 19 out of 20 patients within a week. It generally starts to regrow (like seeds of grass that get placed and take time to grow) in 2-5 months. I tell most people that they can see the impact of the hair nicely by the 7th month, where 80% of the hair will grow to styling length. In one out of 20 patients, the growth will be immediate. Most patients experience some early growth, but I generally tell them to wait patiently for the hair to grow.

There are many different procedures that doctors do. To get a complete scoop, you can call 800-NEW-HAIR or fill out the form on the Request Additional Info page and I will send you a free copy of The Patient’s Guide to Hair Restoration, the book I wrote with Dr. Robert Bernstein that defines the differences. As price is also an issue for the cost conscious buyer, please also take a look at the past blog entry, The Truth About Cheap Hair Transplants.