Hi there,
Im 8 weeks post op…I had 4200 grafts done…Everything went well and i seem to have had no problems at all really other than my head feels like i have sunburn…It only stings for a few second if i touch it,other than that its not sore….Just wanted to see if thats normal? Would greatly appreciate your advice on this…Thanks
At 8 weeks after your hair transplant, you should feel normal without pain. I suggest that you see your surgeon and get his opinion.
Dr Rassman,
I’m a Caucasian 27-year-old male with zero known family history of MPB. However, I’ve lost some hair on the front of my head, and crown miniaturization was detected — meaning that down the road, I could have a serious (Norwood 6?) pattern. I started taking Propecia and hope it can hold onto my hair for 5+ years.
That said, I already need a transplant. (A “conservative” well-regarded doctor recommended 1400 FUT.) I understand the need for a Master Plan and to not run out of donor hair too early. However, it’s very important to me to not be viewed as balding as a young man (I’m single and haven’t firmly established a career.)
I have fair skin and dark brown hair. Luckily, I’m blessed with wavy hair, donor density 2.3, that people commonly describe as coarse and thick. So, I’m wondering, how big of a transplant could I do now for the front of my head, and still leave enough donor hair for future loss? Could I transplant 2000-2500 grafts without worry? I imagine other patients might be in a similar situation to me.
Thanks so much.
Everyone is different. A 2.3 density suggests you have more hair in the donor area than many people, and with coarse hair you may be able to cover an extensive pattern. But for those with fine hair, it may not be enough to cover a class 6 or 7 balding pattern. I have many patients who have had more that 6500 grafts and most of them get quite depleted. A few of these patients have gone to 10,000+ grafts like this man, and although he could have passed the 10,000 graft number, he got realistically what he needed.
I’m thinking about getting a strip method hair transplant and then just filling in the scar with FUE. Is that an option thats worth pursuing? I don’t want the line scar but I want every graft transplanted. I understand FUE has problems with transection or something.
I get this question quite a bit from patients who have already had the hair transplant strip surgery and then inquire about having a follicular unit extraction (FUE) procedure to follow it up. It makes little sense for the person that already has a strip scar (no matter how wide it is) to have an FUE into the donor harvest. If it’s just about treating the linear scar, better solutions would be a scar revision or Scalp MicroPigmentation (SMP). FUE grafts used in linear scars are generally wasteful and an expensive way to treat the scar with less than ideal results.
My complaints about the way the FUE technique is used are:
As the first to publish a paper on FUE (introducing it to the medical community), I can speak with authority on these issues. The ARTAS FUE robot has not really changed the process, except for leveling the playing field for those doctors not skilled in the extraction technique. The FUE technique, as done in most doctor’s hands without the robot, is not as good as the grafts produced by a strip surgery. If there was a formal study, I would expect that each doctor would show variable comparative results when comparing their FUE results with this strip results, making such a comparison between FUE and strip surgery essentially worthless.
The presence of a fine line scar will not be seen in most patients who had a strip procedure, because they generally leave their hair just long enough to cover a strip scar. If they were to cut the donor area hair very close to the scar, at some point (depending upon hair length) the scar will show. I had two hair transplants and although I have a scar, few people can see it even when I show it to patients who visit me in the office. The public does not understand that there is scarring in FUE procedures, even though some doctors and clinics promote it as “scar-less” surgery. In some patients we have had to treat these FUE scars with SMP to allow for a close haircut or shave. The SMP process is the only one that treats FUE scars today and we are seeing more and more patients with this problem as time goes on. I suspect that the strip scar issue is more of a problem with a person who has dark hair and white skin, than the person who has medium brown hair and an olive skin. Nevertheless, both techniques do have consequences.
Here is an example of scarring from a large FUE procedure with the hair cut short. While there is no linear scar, you can clearly see the white pinpoint dot scars all over the back of the scalp. We’ve treated this with SMP (photos to come in a follow-up post later). Click the photo to enlarge.
With all that being said, I am not denigrating FUE. It is an important technique and in certain situations it may be superior to a strip surgery. Examples of superior candidates include those without large balding areas, and athletes who want to be able to resume full exercises and swimming within a week of the surgery; however, in patients with large balding patterns, taking the required number of grafts through FUE is not efficient and is relatively more expensive. There is massive experience with strip harvesting (some good and some bad). I have seen in some patients that visit me, that many doctors are harvesting grafts with FUE from the non-permanent areas to reflect a large need for grafts in a single session. Grafts that are taken from the non-permanent zone, may not last.
Snippet from the article:
Starring in a film with Tom Cruise, can’t be good for any man’s ego. But it seems Simon Pegg gave his appearance a little helping hand by amended his receding hairline.
The Hot Fuzz star has been promoting Mission: Impossible – Ghost Protocol at various premieres this week, sporting a rather healthier head of head with a hairline that seems to have shifted a tad further forward.
Read the rest — Simon Pegg’s hairline appears to have shifted as he sports fuller head of hair
The article hints at a possible hair transplant for the actor, but I can’t find anything where Simon Pegg talks about surgery on his scalp. His hair does look thicker than before, but from the photos I’ve seen it appears he could just have some creative styling or products in use. What do you think?
Here’s a man in his early 30s that was tired of looking older than he actually is, with a Norwood 3A pattern. We restored his hairline in just one procedure of 2000 grafts, and with the hairline came the youthful appearance we’re all after. The after photos were taken at around 11 months after his hair transplant. Click the photos below to enlarge:
After (1 procedure of 2000 grafts):
Before:
This woman lost her eyebrows after multiple skin cancer surgeries. She had one procedure of 95 grafts into the eyebrow area. She told me that she cuts her new brows short every other day, and absolutely loves the results.
Click the photos below to enlarge.
Before on left / After on right:
This patient had 3 strip procedures, which yielded 7846 total grafts. His donor scar in the back of his head was revised with reasonably good results and a reduction in the width of the scar. You will find before and after photos of his hair transplant and the scar revision below.
Click the photos below to enlarge:
Scar revision (Before on left / After on right):
After (3 procedures totaling 7846 grafts):
Before:
Hi Doc..
When restoring the frontal hairline that’s thinning, by implanting hair in with existing hairs to create fullness I can’t see how the trauma to the area could not create loss to existing hairs. How off am I? Because that would be extremely frustrating.
Thanks
Existing miniaturized hairs are more fragile and we do see shock loss in young men following a hair transplant. Finasteride seems to protect the patient from this. If your question reflects the mechanical damage that can be produced by making recipient sites in the frontal hairline, this can be avoided by a surgeon who is careful as he/she does the transplant.
I had my first hair transplant in the mid 1980’s with punch grafts and over the years i have had micro grafts and more recently single grafts taken from strips. the old punch grafts were removed and then re-implanted via single grafts. My hairline looks pretty good but i am now losing a lot of hair on my crown but have very little donor hair left do i have any options?
Donor hair is finite and many people in your situation have depleted donor supplies with significant donor area scarring. More surgeries will often make the scarring worse. I see people like you all of the time and lately I have been seeing more of them. Everyone is different and an individual assessment based upon remaining donor supply, donor area scarring, the existence of old “plug grafts”, hair color (graying is good), and hair characteristics all must be considered in the equation on what to do.
I could write a book on this, but this is not the place. I would suggest that you find a hair transplant surgeon with a lot of experience in repairs.
I just had a hair transplant procedure performed on 12-06-11. I was given one of those surgical caps to wear on my head to help shield my scalp, but my scalp was still bleeding a little. I went to sleep with the cap on and woke up the next day trying to remove the cap. I could not remove the front part of the cap because the blood had dried up and become stuck to some of the areas where the grafts had been put in. I tried pulling gently on the cap that was stuck to the area where some of my grafts where placed and managed to pull it off but it came off with a good amount of scab and what I believe to be a single hair follicle.
Now I am worried that I ruined my hair line and the surgeon may not be able to do anything about it. Is it possible to have another hair follicle out in to replace the one that i accidently removed?
A surgical cap should never be worn to cover the grafts, for as you said, this could be a problem.
You should ask your doctor about the loss of grafts. If you only lost one graft, then consider yourself lucky.
