Hair Transplantation – Page 184

December 19, 2005

Would I Hate Myself If I Had a Transplant at Age 26? – Hair Loss Information – Balding Blog

I’m a 25 yr. old guy. I visited [a well known doctor] and he told me that if I had a hair transplant procedure, I’d “hate myself for the rest of my life.” Pretty harsh. I appreciate his honesty, but am disappointed that this is not an option for me. I’m confused! I would be more than pleased with the results that I have seen on various good physician web-sites. I’ll be 26 shortly, and am wondering what my options really are if the best results are so bad that I’d hate myself for the rest of my life.

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You can always get a second opinion. If the doctor is well respected, there are a number of questions I first would want to know about you, so seeing a photo/meeting with you and speaking with you would be invaluable. Things that may make the doctor have hesitatations with transplanting a man of your age would be:

Unrealistic expectations (which is why we don’t do computer imaging)
Body Dysmorphic Disorder (see BBC News: Health)
Poor donor supply (possibly from DUPA)
Too early
Unable to face the consequences of progressive balding
Psychiatric problems
Financial problems

Many times when I want to point a patient to a psychiatrist, they resist. After all, I am a hair transplant doctor and not a ‘shrink’, so it is not often that I give a special speech on this subject, and certainly not like the one the doctor you discussed gave to you. If you do not communicate with your chosen doctor, that would be one way for him to get your attention. Remember, you do have options, and if you are not comfortable with what you were told by one doctor, you are free to see another.

December 16, 2005

Hair and Love – Hair Loss Information by Dr. William Rassman

Will my wife love me the same after a hair transplant?

On first blush, this could be conceived as a funny question, but I thought hard about it and looked back on my experience with hair restoration and relationships. There is clearly a connection best exemplified by one patient story, which says it all…

A 50 year old successful, powerful bald man (Class 6 pattern with a runway on his head) had two hair transplants, each time accompanied by his caring and loving wife. I got to know them personally and his personality was the type that would stand out in a room with 100 other men. He had a dynamic character with a warm side to his powerful presence. After two transplants with me of around 5,000 grafts, he finished his restoration and appeared happy. A year after I last saw him as a patient, his wife came to my office when she was on a business trip to Los Angeles. She said, “I owe you an apology”. I could not understand the statement and probed her for clarification. “I do not know if you realized that I was against the hair transplant from the onset, but I would never challenge him in public so I kept this a secret between he and I. I loved him without hair as much as I did when I married him with hair years ago. Now that he has his hair back, I realized that the bald man I was married to had changed over the years, but with his hair back he became more like the man I married. I realized that this hair transplant was about him, his vision of himself and not about me at all. I was selfishly looking at the inside man I love, but his pain was created by the outside man he saw in the mirror. The man I married came back with the hair transplant and it made our relationship far better than I could remember in years. I never realized the pain that his balding caused, and that is why I am apologizing to you.”

This story has always stuck in my head, because it reflected the reason men have their hair transplanted in the first place. A woman who loves her man, cares about what is important to him. To conclude with an answer to your question, she will love you more if you love yourself more and are more self-confident. Men who are free to love and who are not burdened with an image of themselves that interferes with who they are, make better lovers than men with an image problem of themselves, no matter how small. Loving these men with their freedom is easier than watching them be less than they can be.

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December 15, 2005

Transplanting Eyebrows – Hair Loss Information by Dr. William Rassman

After using SELECIA 10m (homeopathy overdose), I lost all hair on body, eyebrows and scalp (also had scanty hair anyways…probably due to MPB). I developed thyroid problems after that. Now i am on altroxin 150mg per day. NOW, can i transplant some hair for EYEBROWS???? I have NO EYEBROWS and NO BODY HAIR… just some scanty beard growing…

If you lost hair everywhere, you might have a genetic condition called alopecia universalis. That would impact eyebrows, pubic and underarm hair as well. Whatever the problem, with the complexity you outline above, you need to see an expert in this field. Do not be an amateur treating yourself. The product you are referring to is a known medication that will cause hair loss. I even found a site recommending it to remove hair permanently. Does sound suspicious, yes?

Eyebrow hair transplants work well, but not in a person who might have an autoimmune problem. Please check yourself out for the various conditions that only a good doctor will identify.

December 14, 2005

Does Hair Transplantation Hurt? – Hair Loss Information by Dr. William Rassman

Hair transplanting looks like it hurts! Does it hurt is my question? I saw the video and almost threw up. So please respond to my question! Does it hurt? Especially with at least a couple of thousand grafts! Please respond! Thank you for your time.

Yes, part of the process is painful. The first part (with anesthesia) hurts for about 1 minute. This part can be subsidized with appropriate medications to reduce the pain and possibly eliminate it if you choose this option. The more medications, the slightly more risk you may experience with side effects. Pain is also present after the surgery. If you elect to have an FUE procedure, the pain is very minimal and rarely takes any medications after surgery. If you have a strip harvesting procedure, then there is pain in the donor area, particularly more on the first night, which is easily treated with strong medications that are supplied by us. Some doctors do not like to use the word ‘pain’ because its meaning might frighten patients away, so the word discomfort is used instead. Discomfort = Pain!

On the other hand. there is also the pain of hair loss. This pain is often described by our patients as far worse than anything that they experienced in the surgery. As the old saying goes, “No Pain, No Gain” which essentially means that you need to weigh what you are willing to experience against what you are not willing to experience. A 2,000 graft procedure does not really hurt more than a 500 graft procedure. I prefer the larger procedures, because the patient has to invest less time and have less surgeries to get the final end product of their hair restoration desires.

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December 12, 2005

Hair Loss InformationTransplanting Very Bald Patients – Hair Loss Information – Balding Blog

how much “coverage and density” can a norwood 6 patient actually achieve? All your photos of men with 6 or 7 norwood, all have “comb over” type hair styles? How come u never show any pics of the back of the finished product(or crown)?

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A person with a Norwood Class 6 pattern will have lost 50-60% of his natural hair. A person with a Class 7 pattern will have lost between 70-80% of his natural hair. If you move half of the permanent zone of an average man, the most you can yield would be about 15,000-20,000 hairs (or 7,500/10,000 grafts in a series of about 3-4 surgeries). That would mean the coverage mathematics, of let’s say 60% of the total area of originally hairy scalp, can only receive maximally 20,000 hairs in an area that originally had 60,000. This is at best 1/3rd of the original density. In actuality, one rarely ge’s out that much and more likely 12,000-15,000 hairs is maximal. In the person with a Class 7 pattern and 80% hair loss by count, the maximum overall density in the recipient area is 80/12 or 15% of the total original density. We usually weight it to the front so that there is a comb-back effect, moving more density to the place where the greatest impact will occur. We could weight it to the front and sides, with a good comb-over produced (front to back or side to side). Either approach works. The crown is often sacrificed with the lowest densities placed there favoring the front or the sides, as the case may be. So you are correct, the densities in the less favored areas are ‘covered’ with some type of comb-over.

I posted these photos a few months ago here, but it is worth displaying them again to show that the results of weighting the frontal hairline can be very good, even though the crown is not as dense. Patient ZU is in his mid 60’s and had multiple procedures totalling 6,036 follicular unit grafts transplanted. “Before” is on the left, “after” is on the right. Click the photos to enlarge.

Before
After

You can see more of his before and after photos on the NHI site: Patient ZU

December 8, 2005

Lateral Slits and Transplanted Hair Direction – Hair Loss Information by Dr. William Rassman

Suppose a patient has had two non-lateral slit transplants by doctor A (who is reputable), and goes for a third operation with doctor A (who now advertises use of lateral slit)-should doctor A perform a lateral slit transplant on the same patient, or continue with the same method of the previous two surgeries? Also, does the lateral slit method deserve the positive “hype” it receives on hair transplant sites? Or, is the difference slight and subtle and even overrated? Finally, when a transplant has been completed and the required one year waiting period ends, if hairs appear to grow straight up from the scalp, would you deem this to be a poor transplant? In my case, it appears that the hairs come straight out of the scalp, but lean or lay down-perhaps because of the weight of the hairs and also because of how I comb the hairs.

Switching between lateral and vertical slits are not a problem, but the learning curve for staff is a problem and those with experience in vertical slits will not just simply become experts in lateral slits without some experience.

I like the idea of lateral slits because it forces a bend of the hair as it exits the scalp forward and downward. In addition, the concept of fencing (where hair within a follicular unit appear like a fence/wall) should enhance the value of the grafts. Now with that said and the great theory, the realities are that no one has really demonstrated the value of lateral vs vertical slits, side by side. I have massive experience transplanting with vertical slits beyond 4 years ago, however I do lateral slits because it makes sense and it is in vogue, not because I am convinced that the results are better than those of the vertical slits.

If transplanted hairs grow straight up or to the sides, it usually reflects the way the surgeon put them in. I have seen people who had radial placement of hair with straight, strong hair and the hairlines look like bicycle spokes — not a normal hairline. Last week, I saw a patient where the hair was put in pointing to the right. The patient wanted to comb his hair back but because of a strong hair character, it always pointed to the right creating an unnatural appearance. This is a problem of strong haired people, not soft haired people. Hair characteristics tend to dominate in some people, impacting the way hair can be groomed.

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December 8, 2005

Transplanted Hair Characteristics – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman,
Does hair from the neck change structure when it gets on the top of the head? And how long will that take if it does ? I mean does hair fit in properly with your original hair in the front of your head or is there a permanent difference ? The micro “scars” you will get in recipient area will they ever heal 100 % ? If you later in life choose to shave your head can one notice something on the skin in recipient area ? Best regards

Scars are scars and they always show. Depending upon what type of scars and where they are placed, the scars may be less obvious. Scars in the neck always widen and are always visible. The neck hairs used for transplants are often lost with time as these hairs are not permanent like the hair above, in the back and sides of the head. Transplanted hairs usually follow what they looked like from where they were taken. On rare occasions, the hair becomes wavy or curly. I remember one case where a patient’s transplanted hair became kinky, and he loved it. It was what he wanted and that made me happy because I always want to please the patient (but I personally did not like the look). Clearly, the grown characteristics are not in the control of the doctor when a hair transplant is done. The good news is that changes beyond what the original characteristics of the hair are rare.

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December 7, 2005

Natural Looking Hairlines – Hair Loss Information – Balding Blog

Dr. William Rassman,
is it possible to restore the original hairline through hair transplant since my hairline had receded so much but not completely bald & its really affecting my self confidence. is it too early for me to undergo this procedure or should i go ahead? whats the best hair transplant method that gives a more natural looking hairline? thanks

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You did not state your age and without a photo it is impossible to go into detail about whether a procedure is right for you or not. Hair transplantation today can be and should be undetectable and able to produce a completely natural hairline. The appropriateness of the surgery depends on the individual assessment of each person. There are hundreds of patient hairlines on our website, and you are invited to come to one of our open house events in Los Angeles and San Jose to meet patients directly, so you can see for yourself what can be achieved.

For a great example of what is possible in hair transplantation, please see the Steve Hartman feature on the NHI site. There are larger photos available on the previous blog entry, Where Are the Celebrity Transplant Photos?.

December 5, 2005

I’m 21 and Balding – What To Do? – Hair Loss Information – Balding Blog

Dear Sir:
I’m 21 years old , i’m suffering from hair loss , its not that much till now but i have a feeling that if i just ignored it , it will be very bad later , & i realy care sooooooooooo much about my Look. So please tell me what can i do , Do you prefer surgery for me , or Drugs ( if yes mention one ) i used to use REGAIN EXTRA STRAINGTH . but i stopped. because i wanted a faster solution . please reply as soon as possible . thanks so much

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It is very difficult to evaluate hair loss without at least pictures, and an in personal consultation is better. I don’t recommend hair transplantation as the first option to solve your balding problem. First, you would have to be evaluated to map out your hair loss as it progresses by determining the degree of miniaturization that is in every part of your scalp. Then, providing you are a male, I would likely have you on Propecia for a year or so, then reassess the miniaturization and your observable pattern of hair loss (if any) or reversal of hair loss. From there, transplantation might be right for you, but only an in-person evaluation will be able to determine this. If you’d like to email photos to me, please use the email address on the contact page.

December 1, 2005

No Improvement After Two Hair Transplant Procedures – Hair Loss Information – Balding Blog

I am a 42 going into 43 years old. I have been losing my hair slowly but steady for a good 12 years now. Only about 5 years ago clear spots started to become more and more evident. I had 2 transplants. Both of them about 1300 grafs. The count of insertions was about 270 so I figure it must be in groups of 3 and 4 grafts. In the areas where I had the transplants done I dont see any improvement.IF any I see it getting more and more bald. I don’t know if is that I am just not holding the transplanted graffs. Is there such a possibility. My operating physician said that that was imposssible. That they will never come out. The first procedure was in October 2001 and 2 and 3 weeks after I had a lot of dry roots and hairs come off. I asked the Doctor that operated and he said that was normal. I was doubtful specially because of the roots being dry and out. Then last year I had another procedure. And I dont see any improvement from that either.I dont smoke , dont drink. I exercise, and I tried to eat healthy. I am contemplating a 3rd procedure but I am concern that I may not be holding it.

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It sounds to me like you are having confidence problems with your present doctor and certainly have not adequately communicated on the problem as you’ve presented it to me. Before you go at it a third time, get a second opinion. This is not something I can do over the internet, and since you indicated that you are on the east coast, I can recommend Dr. Robert Bernstein in New York and New Jersey at 866-576-2400 to get that second opinion from. If you are willing to make a trip out to California, I have offices in Los Angeles and San Jose and can be reached at 800-NEW-HAIR if you’d like to set up a free consultation.

Some of the things you are saying do not leave me comfortable. Clearly, that is your view as well. I would advise you to not rush into a third procedure if the other two did not work out. I find that we always get results and rarely have I heard of one of my patients have the issues that you’ve mentioned.