I recently performed beard and sideburn transplants on this African American man who did not have complete facial hair due to a genetic issue. I have been asked many times about this problem, so I thought I would show photos from the day after surgery. He received a total of 769 grafts (each side got about 380 grafts) to create what you see in these pictures. His natural curly hair made the results look better than if his hair was straight. Black hair on dark skin also helped.
Before SMP
This patient talks about how others were upset that he was visiting a hair transplant clinic when he had so much hair! They didn’t know he had SMP.
I am loosing hair from my crown portion of my head. I am in New Delhi (India) and one of the doctors at New Delhi advised me 1000 hair not grafts. How much area will 1000 hair cover?
There is a tendency for doctors in some geographic areas to prey on people losing hair. Your question supplies little information, but I will take liberties and assume that you’re a young man desperate over his hair loss. Based on the many, many emails I receive daily it seems that in India hair loss implies some lack of manliness and if you’re balding will not be able to find a bride. These young men will try anything offered and if they have the money, there are doctors who will offer hair transplants to anyone because they make money doing it. We see the same phenomenon in western societies.
If a balding person is ignorant, naive, has money to burn, and wants a quick fix, then the first solution for some doctors is to push for a hair transplant. That is not right, not moral, and makes the unfortunate individual into a victim, many times leaving him deformed in some way. Simply put, not everyone is a candidate for surgery.
While I have written posts like this from time to time over the years, I felt that it needed to be restated. This blog is written as our attempt to educate the public so that when anyone searches Google, low and behold, we come up. We try to make this blog easy to read and direct. I hope that we accomplish this.
To answer the question posed, yes 1000 grafts would produce detectable hair but the degree of cosmetic benefit or how much it would cover is highly variable with the type of hair loss, hair to skin contrast, hair length, etc. You need a second opinion from someone who can examine you. A one line question with a number will not address your problem.
We are announcing a summer discount program for hair transplants as follows:
· Follicular Unit Extraction (FUE), reduced from $8/graft to $6/graft (minimum 1,000 grafts)
· Strip surgery reduced from $6 to $5/graft (minimum fee $3,000)
These fees will apply for any surgery performed before August 31, 2014.
In addition, we want to invite you to visit us and see the amazing results of Scalp Micro Pigmentation(SMP) on previous hair transplant patients who wanted a fuller look or wanted to address their scars (see scalpmicropigment.com). During your free consultation, ask to observe one of our SMP procedures so you can see, for yourself, the value of this process. At our Open House Events you can meet many patients who have already had hair transplants and Scalp Micro Pigmentation – our Summer events are Thursday July 10th from 4-7 PM and Saturday August 9, 2014 from 11AM to 2PM.
Please visit us at our open house: July 10th between 4 and 7 PM.
5757 WIlshire blvd.
Prom. 2
Los Angeles, CA
Or Call us at:
(800) New-Hair
Hi,
This is the 6th month after my hair transplant was done. After 2 months my transplanted hair shed out, then after 4 months I noticed there was new hair that started growing. At the 6 month mark, the weak hair started falling out. Is this shock loss after the fact? Is this normal or there is any other issue? Can you please give me your suggestion.
Thanks
It does sound like it might be shock loss, perhaps somewhat delayed for the first round of it. The progressive hair loss that occurs in all of balding men can get accelerated by a hair transplant surgery.
I usually prescribe finasteride (Propecia) for my patients to minimize this impact. Were you on this medication? If not, you should consider going on it to slow down the acceleration of the hair loss that yet still may come. As always, if you have questions or concerns with your surgical procedure, you should follow up with your surgeon to get his/her take.
If hair cloning is a viable option in the future (perhaps in 15-20 years since I know the time line keeps moving every year) would you expect to see a large number of people elect to have a hair transplant for the sole reason of increasing overall hair density? If the amount of available donor hair was no obstacle, could someone thicken their existing hair?
Obviously, I would be satisfied just having decent hair coverage, and would elect to have a hair transplant in the future if I am a decent candidate, but I also don’t want previous hair loss remedies I’ve tried to affect any potential ‘cure’ in the future either.
I’ve always believed that hair transplant candidates should go ahead and get their hair now while they are young enough to enjoy it. To be bluntly honest, there’s no point in waiting until you are an old man for what may never come about (hair cloning).
Researchers are making great strides with hair cloning, but I have no idea how many years it’s going to be before anything reliably safe and effective is commercially available. If reliable hair cloning ever does come about to allow for unlimited donor hair, I could see possibly more people having their existing hair thickened.
I obviously can’t know what the future holds, but I don’t see how moving hair from the back of the head into the top/front of the head would prevent any possible future treatment.
Pakistan’s prime minister has gotten a hair transplant a few years ago. His results are amazing. However, even with the hair transplant sometimes he looks like he has no hair in the frontal zone and sometimes he looks like he has a lot of hair in the frontal zone.
Here is a picture under the sunlight where his front zone looks empty. Photo
If Nawaz went for another procedure, is there any possibility he can get a result where even if he stood under the sun, his hair transplant results would show a fuller appearance in the frontal zone? Please give your advise.
Nawaz Sharif could fill up the frontal area with another procedure and get some more hair on the top of his head, but as has a Norwood class 7 balding pattern with what appears to be fine hair, I doubt that he will ever look completely full.
In our practice, we have performed hair transplants on people with fine and average weight hair. Those with fine hair, never really look full although I have done upwards of 9000 grafts on these people; however, with an average weight hair we have succeed in getting good coverage with a good styling technique to enhance the distribution of the transplants with about 9,000+ grafts. Many Asian class 7 pattern patients will not have the density to move that high number of grafts, so even with a better hair thickness, the ability to extract and move 9000 grafts may not be possible if the density is typical of most Asians.
Of course, one other way you can give the appearance of fullness would be through the use of Scalp MicroPigmentation (SMP).
Dr. Russell Knudsen (from Australia) wrote in informative article in this months “Hair Transplant Forum International”. Clearly, the ability to harvest the donor area with FUE will be more restrictive in individuals who have more extensive balding patterns (Class 5, 6 and 7 patterns of balding). The donor area around the sides and back of the head reflect 25% of the original total hair count on the head (I call it my 25% rule). If one targets somewhere between half or 2/3rds of the follicular units found in the donor area, as the maximum safe yield for FUE over time, then for Caucasians with average hair density (100,000 hairs on their head or 50,000 follicular units in the permanent zone) might be able to safely harvest as much as between 6,250 (half) or 8,250 (2/3rds) from the 12,500 follicular units in the permanent zone (25% rule).
In those individuals with higher densities than 100,000 hairs on their head, the harvestable follicular unit numbers may safely go higher, while in the typical Asian, for example with lower hair densities (80,000 hairs on their head or 40,000 follicular units), the donor area would contain only 10,000 follicular units. With half of the Asian’s 10,000 follicular units harvested, that leaves 5,000 follicular units behind (this reflects a calculation of 25% of the birth hair follicular unit numbers which are permanent). I believe that extracting between one out of every two follicular units from the permanent zone may be pushing the limit on people with low density hair.
There may be reasonable limits for a typical Asian based upon hair density (we calculate hair density on every patient undergoing hair transplant surgery). To complicate matters, Asian follicular unit hair counts average less than two hairs per follicular unit, so to get out an average of two hair FUE grafts, it takes more follicular units to yield an average of two hair FUE grafts. Asians (or Caucasians with low hair density) who have a high number of FUEs will, in my opinion, be thin looking around the back and sides of the head. I have seen some Asians with significant track marks from the punch scars created by FUE, particularly when the harvesting numbers are high and the remaining donor hair is significantly lessened.
Many doctors are taking hair from the non-permanent area to give the patient the benefits of more hair in the transplant; however, this may spell disaster for the patient who develops more extensive balding (suggested by Dr. Knudsen). Hair taken from the non-permanent area will be lost with aging and/or advancement of the balding patterns. Over zealous FUE beyond the permanent zone, has long term consequences for some patients and they must be warned. I have seen some patients who’s balding had accelerated from multiple FUE procedures and have loss hair in areas where FUE grafts were taken while leaving visible scars.
I want to raise blood supply issues here as I have seen one patient already who had received 6700 FUE grafts in two sessions and lost more hair in the permanent zone than was removed by the surgeon during the FUE. I actually counted the grafts and the hairs on the head and had done density studies on him before another surgeon did surgery on him. When FUE numbers are pushed, this patient’s findings suggested vascular compromise may have occurred impacting the remaining hair in the donor area. I have heard, second hand, that at the last ISHRS meeting some cases of necrosis have appeared in the donor area when too many FUEs were done, possibly too close together. I don’t believe we really understanding the complications of large FUE sessions, or that doctors are not reporting their complications out of fear of professional ridicule and/or malpractice risks, all of which may become a factor in the long term future of this surgery. As we do many FUE cases in our practice, we are not anti-FUE; however, aggressive FUE megasessions in the wrong hands could be a problem.
In conclusion, “do FUE surgeries change donor area planning”, the answer is YES. FUE will impact long term planning and may impact strip surgery in future surgeries. Low density donor areas, resulting from FUE, make for less donor hair for a strip surgery, which will only make any scarring more visible as the hair is cut short.
Its pretty interesting to see that you are investigating this whole ACELL thing. I was kinda wondering one day if you would be one of the DOCs to have this Acell cross your mind. I just ran into this whole page doing a daily Google study on Acell and the usual Hair loss deal and saw that yeah you are thinking about it. Good to see.
Would it make sense to use Acell injections/Powder in the donor area after a strip or FUE procedure as well as Acell into the transplant area such as the frontal hairline area, etc? I have read that it helps the wounds heal faster and the scar feels better when healed With ACell then if healed naturally. IF you said that you saw that it had value in the scar area after a strip procedure. Would it then also have the same value in the transplanted area where it would cause the tiny pin holes after the hair follicle is grafted to heal faster and be less present? As well as help heal the tiny holes after a FUE procedure in the donor area where the follicle was removed. In theory In the long run, would it show almost no scaring anywhere after any type of transplant. Weather its a strip or fue?
I know all the hype is about cloning this and that and plucked hairs growing everywhere. but in the sense where it promotes rapid healing and helps the scar look/feel more natural or show almost no scarring at all. IS that not a great value to the whole hair transplant community?
There are a bunch of cases where grafts that were installed were driven into deep and look like indents after all is done and healed. Im speaking from my own experience from a procedure. Those little bastards are ugly so would that Acell bacon compound help that case as well?
So ACell alone without FRP or whatever they call it for faster healing and better cosmetic scar results seem like a very realistic and valuable thing
Things in life like this interest me. Especially When i read about things that come out like Acell and other medical devices that could potentially help people with hair loss and hair surgery
It it generally thought that ACell will help the healing process deep in the wound and possibly reduce the superficial scarring, thereby making better wounds. There is circumstantial evidence for this in our practice, but this is more conjecture than science. I have not seen that ACell has helped the graft healing or made it grow better.
In our practice we have been using ACell for donor wound for over 3 years in most of our patients on a daily basis. Subjectively, the donor wound does look better with less tactile feel of a scar, so it may have some use in reducing keloid formation. Some patients came back for repeat surgeries and the old ACell scar seem to look better, but it was not a drastic improvement. Note that this is just a subjective observation from both the patient and doctor. ACell did not really have a reduction in the overall scar width and it does not make the scar any smaller in our observation. In one or two cases, the patient (who had prior non-ACell surgeries) thought it made the scarring worse. Even I (Dr. Rassman) had ACell put in my donor wound for strip surgery, but it made no difference in scarring compared to prior surgeries. ACell does not promote faster healing in our experience.
We also used ACell in many years ago in graft growth and even possible replication in recipient area. We submitted and applied for research approval with the medical board and conducted studies with Dr. Bernstein in New York. In the end, it didn’t work. The claims were false. To date, no one was able to replicate the claims of hair regeneration. Simply put, it was a publicity hype for the hair transplant world.
hi
i have two questions. i am planning on getting a transplant done. i have read on a couple transplant sites where the doctor has posted pictures of young patients under 35 saying “patients hair loss stabilized”. How exactly does the doctor know the hair loss has stabilized and no further loss will occur in a younger patient if he is on meds? is the doctor just pretending or assuming no more loss will occur?
my second question is about my own hair. My own hair under bright lights my hair looks terrible, thin and disgusting more so in the front. In pictures and normal light my hair is thicker and nobody can tell. so if I go for a procedure can I ask my doc doing the surgery to look at my hair under the harsh light and give me grafts according to the harsh lighting and so it looks thick under those lighting conditions?
I am not sure what your doctor means by “stabilized”. In young men, the hair situation is progressive, so unfortunately stability is not the rule. After a hair transplant, some of the hair loss will increase (shock loss)… so a hair transplant is destabilizing. You should be on finasteride for a good few weeks before you get the hair transplant to help minimize this destabilization. You and your doctor should talk about the surgery that he plans on doing.
Your second question needs to be directed to your hair transplant surgeon, who should be sensitive to your desires for where the transplants will be done and in what quantity. Keep in mind that harsh lighting commonly makes hair look terrible, but your doctor should be able to create a Master Plan modified for your individual desires and your best interest.
