Category: Hair Transplantation

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Hair Loss InformationCan Hair Transplants Completely Cover Up Balding? – Hair Loss Information – Balding Blog

Hello doctors,

I’m a black male with very early stage thinning in a 3v pattern. I’ve been on finasteride for about two years, and am basically satisfied with the results.

I’ve talked to friends and family who might have similar patterns of thinning, and in discussing the options, several of them are skeptical about the effect transplants would have.

My question is this: what is the authoritative opinion on how well transplanting can cover up balding (specifically, can It be made to look like I have virtually no thinning?)

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Your question isn’t really fair. You are asking a hair transplant surgeon who thinks about hair transplant surgery as a matter of livelihood. It’s like asking a chef if you should eat their food.

My point is you should be asking these questions to the patients who had hair transplants. You should meet them face-to-face to judge what the value has been based upon the change you see. Looking at some before and after photos has some minimum value, but face-to-face meetings like we have at our monthly Open House events in San Jose and Los Angeles give you the opportunity to see for yourself!

Hair transplants all depend on the supply of donor hair and the size of the balding area. Setting patient expectations is critical to what we do. You will never look like when you were 16 years old with regard to hair fullness. Maybe you can come close, but that depends on the number of grafts, hair color, hair texture, hair style, and skin color. For example, curly black hair on dark skin gives great coverage and fullness over thin straight black hair on while skin.

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Over a Month After My Transplant, Grafts Came Out! – Balding Blog

Hi there! I was wondering if there is a possibility for hair grafts to fall out a month and a half after the procedure. I was gently rubbing my head when I noticed one of the tiny hairs fall off. That tiny hair had a piece of the root that came off with it (not just the bulb but a piece of the root that has dried up and is normally seen with a harvested hair graft prior to the transplant). Any input would be greatly appreciated. Thank you!

I would hope you were given post-operative instructions, and that somebody at the surgical clinic explained to you what was involved and what to expect following a hair transplant.

About a month following the procedure most of the transplanted hairs fall out, at times appearing to be the full graft. This should not be the graft at 6 weeks though, as the “root” of the graft remains even if the hair and the surrounding tissue comes out with scabs. For more on this, see Graft Anchoring in Hair Transplantation (PDF file).

It takes anywhere from 3 to 8 months to start noticing significant growth, provided that your surgery was successful.




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Hair Loss InformationMy Hair Looks Worse After Each Transplant! – Hair Loss Information – Balding Blog

Doctor,

I started noticing hair loss around the age of 26. I tried the laser for a year and did not believe it worked and took propecia, but felt that did not provide help either. In 2009 I decided to have a hair transplant surgery 2,000 hairs. 1,000 in the front and 1,000 in the back.

After the transplant I began finasteride and rogaine to maintain the amount. I was so happy after the first 6 months, until I started noticed thinning in the front again. Everytime I go to the doctor who will remain nameless they say things are fine. I went for the second procedure a year later to thicken up the front. It has been 5 months and the front looks worse and the back is starting to thin out on the sides and a little in the middle. I have a few questions.

  1. Can the initial surgery cause this shedding to occur and then stop?
  2. Could the rogaine cause an adverse affect? Every time I use the rogaine and start combing my hair at least 10-20 hairs come out. I read somewhere that if shedding does not stop after 5 months then stop.
  3. Does the finasteride not work as well as the propecia? These 2 drugs should keep the back fine, but that is not the case.
  4. Also could transplanted hair fall out?

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I cannot comment too much on your particular issues, because I’ve never examined you… but I suspect there was no Master Plan associated with your hair loss issue and you were chasing after a goal that wasn’t clearly laid out. It’s possible you were never given realistic expectations. Perhaps you should see another surgeon for his/her opinion.

1. I do not know what your initial surgery was, what it was suppose to do, or even if it was successful. In general, you can have shock hair loss from the surgery itself. That’s one possibility. The shedding from shock hair loss is permanent.

2. Rogaine is a topical medication to grow hair, not lose hair. If you have an adverse reaction, then ask your doctor for an examination. Losing 10-20 hairs is normal with or without Rogaine. Finally, some patients report slightly more hair loss when starting Rogaine treatment, but as you continue to use it there should not be a problem. The initial hair loss from Rogaine is thought of as a “cycling” of the old hair falling out in preparation of new hairs to grow.

3. Propecia is finasteride in 1mg strength. There is no difference as it is the same medication. Propecia is the marketing name, like Tylenol is the marketing name for acetaminophen… or Rogaine is the name for minoxidil. I’m not sure what you mean by the “back” … is it the back of the head (donor area) or the top/crown?

4. Transplanted hairs are considered permanent as your donor hair. They do fall out as the hairs cycle, but it regrows.

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Hair Loss InformationFungal Infection In Recipient Area a Month After My Transplant – Hair Loss Information – Balding Blog

Hi, I received a hair transplant FUE type, nearly two months ago. I am a male and aged 46 years. After the first month i developed bumps of dry scalp on the transplanted area only. The Doctor stated that this was a fungal infection, so i started using Nizoral shampoo after using this shampoo for 15 day’s the condition has cleared. My question is, will this effect the hair transplant and the growth of the graphs, to become a successful hair transplant.

Thanking you for you professional advice.

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I’ve never seen a fungal infection following a hair transplant, so I have no experience with this type of situation as a point of reference. I would think that if the infection is gone it should not impact your hair growth, particularly since the infection occurred a month after the transplant. That being said, I would ask these questions to your surgeon and hope for the best!

If one of my patients had a fungal infection, I would get the opinion of an expert who works with fungal infections (perhaps a dermatologist). Good luck.

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Donor Scarring from Hair Plugs Done About 30 Years Ago – Hair Loss Information – Balding Blog

Thirty years ago I had 4 or 5 sessions hair transplant sessions done using the old punch graph method. For most of those years I was fairly satisfied. Lately that has not been the case. The appearance of corn rows is starting to show in the front and it is getting harder to cover up the donor area in the back. Twenty years ago I spoke to a specialist in Philadelphia who disappointed in the methods used in my procedures and he implied that I was not a good candidate for future transplants. If this is the case I would prefer to shave my head instead of continuing trying to cover up, which can only become more problematic in future years.

The scarring at the donor site is a concern. Are there any procedures to reduce this scarring? Thank you in advance for any information and/or advice you can give me based on this limited description.

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We have routinely performed surgeries for men who are in your situation. You can read about one patient’s journey here and see some of my repair patients here.

As you undoubtedly know, everyone is different and unique so I really cannot comment on your particular case without examining you. Many patients who had 4-5 sessions of the old hair plugs have heavily depleted donor areas, and a skilled surgeon with experience in this field can often soften the plugs by harvesting the recipient plugs as well as redistribute some of the remaining donor area. If you want to explore options, please send me photos and set up at the least a phone consultation with me.

There is no simple answer to your problems, and each person must be evaluated one on one before recommendations can be made. This goes for both repairing/removing the “corn rows” and seeing what can be done about fixing the donor scars.

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Hair Loss InformationDoes a Hairline Shift When Closing a Strip Procedure? – Hair Loss Information – Balding Blog

Hi, doc. I’ve been researching hair-transplantation, and I have a question concerning F.U.T. (strip-harvesting): I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) — when, totally, a reasonably wide portion of the scalp has been removed, will not a patient’s hairline, in accordance, also be shifted?

That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me.

I understand a physician will take into consideration laxity of the scalp, so what I’m talking about might not be immediately noticed — I also hear doctors will try to cut out strips that are longer rather than wider, to reduce tension — but, ultimately (again, especially when a large number of grafts must be harvested), will not the hairlines (front and certainly rear) be affected? If not, why not? If so, is this effect permanent? The piece of scalp taken out can’t “regenerate,” can it (and, if it could, would it regenerate hair follicles, too)?

Sorry for this long question, but certainly I’d appreciate your taking the time to answer. Thank you very much.

P.S. Just one other question (a brief one): Can hair that’s already been transplanted to a new location be removed and successfully retransplanted in another area (e.g., back to front, then, later, if need be, north of that region)?

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The hairline never shifts, but the scalp itself does stretch a little with each procedure so that the donor density reduces a bit. I’ve answered a similar question before.

Neither the front hairline nor the neck hair moves as a result of these excised areas. The only part of the scalp that is impacted is either the posterior scalp (which would be stretched) or in a small group of these patients, the redundancy of the scalp (scalp laxity) reduces. The scalp is attached to the galea and then to the skull. This keeps the movement from one area to another minimal, if at all. Scalp and follicles can’t regenerate.

As for your P.S. — Yes, we often move previously transplanted hair when the work is not good, but there are limitations to moving a great deal of transplanted hair. This is commonly done in repair procedures.

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The Price of a FUE Megasession? – Hair Loss Information – Balding Blog

hi Dr. Rassman,
i just had a quick question for you and i would really appreciated if you could answer it. well dr. rassman i just wanted to know, i’m thinking of having a hair transplant and the only way would be with the FUE procedure. i’ve been saving money for that the past 4 years just for this, so was just wondering let say i get a mega session done with about 2,500 to 3,000 hairs how much would that cost??

and doesn’t matter when i get it even if its on a stand by procedure could you give me a rough estimate?? so i can keep on saving so what i have is not enough. once again thanks for your answer and keep up the great work!!

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First, we generally use the term “grafts” which will contain 1, 2, 3, or 4 hairs. I have heard of some doctors doing 2500 to 3000 graft FUE procedures, but in my experience as the one who first published the FUE techniques in 2002 (which all doctors use), megasession FUE of that high a number may be dangerous in terms of the graft survivability and donor area scarring.

At New Hair Institute, we usually limit the FUE to 1500 maximum, but may flow over into a second day surgery in special cases where the donor density is good. The cost of FUE at NHI is now $8/graft with my associate Dr. Pak. We do not offer the FUE procedure in our standby program.

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Hair Loss InformationNo Growth Months After My Hair Transplant – Am I a Slow Responder? – Hair Loss Information – Balding Blog

I had a transplant on 3.16.10. The crown and the left and right sides frontal. Went in for a 4 month check up and nothing has started to come in. I had no post operative issues. I was very careful for the 2 weeks post op with the grafts. Doctor said I am a slow responder and to come back at 7 months. I been on the internet and I see all these patients with growth at 4 months and I wondering If my procedure failed. I am getting panicky.

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Don’t panic! Results from a hair transplant will usually be seen from 3 months all the way up to 7 months on average. The speed at which it grows has nothing to do with success of the surgery. The waiting is the hardest part… but you’re going to have to find the patience. If at month 7 you still see nothing, have a chat with your surgeon about that. Right now though, you have no reason to be worried about your transplant’s success or failure.

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Scalp Massage After a Hair Transplant – Hair Loss Information – Balding Blog

Greetings Dr. Rassman! I just had a hair transplant about a month and a half ago. I had a full body massage today and I made the mistake of dozing off during the session. While I was asleep, the masseuse did massage my head, which probably involved some hair pulling and moderately heavy pressure on the scalp. When I woke up, there were 5 red spots on some of the areas where the transplant took place. There was minimal bleeding on each spot and I’m afraid that the grafts on those areas may have been damaged.

I was under the assumption that the grafts are permanent and would not get damaged after the first ten days following the procedure unless a really traumatic event occurs on the scalp. I’m worried that the grafts on those areas may have been damaged. Is there a chance that the grafts may have been possibly damaged on those areas where the red spots/minimal bleeding occured?

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You really cannot kill the transplanted grafts from a massage after a month, and I would think it’s quite strange to have any kind of bleeding in the transplant area. Please follow up with your hair transplant doctor and have your scalp examined to see what’s going on.