Category: Hair Transplantation

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Hair Loss InformationMajor Shedding 7 Months After My Hair Transplant – Hair Loss Information – Balding Blog

Hello,

I had a transplant of over 3,000 follicles about 9 months ago. I have seen growth but it is still thin and not what I have expected. I have noticed major shedding about 7 months in with the hairs having white bulbs attached to the end. I am concerned that some may be transplanted hairs. What could be the cause of this? Should I be worried?

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I do not know what is going on in your case, so I could just guess. Maybe you have increasing native (non-transplanted) hair loss. Maybe you have other medical problems. Maybe your hair transplant was not a success. Maybe you have diffuse unpatterned alopecia (DUPA), which would produce failures to hair transplant surgery. Maybe you are not on Propecia. Maybe you stopped Propecia. ANYTHING is possible. And I would be worried too.

You should be asking your surgeon about the problem and he should be really worried for you. Please, contact your surgeon and discuss these issues with him!

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Hair Loss InformationCosts to Remove Hairline Cowlick? – Hair Loss Information – Balding Blog

Hello. I have read in many places about how expensive it it to fix a cowlick (in the front hairline, in my case) by surgery. However, I have not yet found an estimated price range. Could you ball park what it would be to align the folicles into a more regular hairline pattern? I am a 25 year old male, and the pivot is quite pronounced about half way between the middle and the side.

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I am not sure where you have tried to find the information, but here at New Hair Institute (NHI) the minimum cost of a hair transplant surgery is $3000. Otherwise, the cost of each graft ranges anywhere from $5 to $6 a graft (see fees). I don’t know that any clinic would have a flat “cowlick removal” fee.

You are more than welcome to send in some photos to me of your problem area and schedule a phone / photo consult. From those photos, I may or may not be able to quote you without seeing you.

Or…. electrolysis might be a reasonable way to accomplish what you want without surgery.

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Hair Loss InformationWould Getting a Hair Transplant Give Me Cloning Priority at NHI? – Hair Loss Information – Balding Blog

Dr. Rassman I have an odd question for you. I plan to have a hair transplant with you in the near future. Playing devils advocate here, let’s say that hair cloning is a viable option in five years and the demand would be great.

Would having a prior surgery with you give me an advantage of getting this procedure done sooner? (i.e. cutting in line)

Thank you for your time.

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First and foremost, having posted over 8000 questions on this site and answering some real doozies, I don’t think yours is all that odd.

Hair cloning just means there will be more hairs available for transplantation and you will not be limited to the donor hair. With respect to priority, our surgeries are scheduled on a first-come, first-served basis… but when it comes to procedures done with hair cloning, it’s all hypothetical at this point. I’d like to hope that in 5 years from now we’ll be transplanting with cloned hair, but that remains to be seen.

We look forward to seeing you!

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Hair Loss InformationTransplanting from My Hairy Neck – Hair Loss Information – Balding Blog

I have quite a lot of hair in my neckline. The hair is thick and straight, which makes me wonder whether it could be transplanted to my head. I have already had 1000 grafts via FUE, and I see the diffuse pattern from the FUE transplant whenever I trim my hair very close to the scalp. Using neck hair seems like a way to augment the donor pool, but I don’t know how receptive the scalp is to that type of hair and whether FUE performed on the neck would leave visible scarring. What do you think?

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Neck hairNeck hair is not considered “permanent” like the hair on the back of your scalp. There is a chance that as you get older your neck hair will fall out, so if neck hairs were used for a hair transplant it would also fall out. This is what makes neck hair not ideal for transplantation.

In addition, as you clearly have found out, follicular unit extraction (FUE) still produces small round punctate scars. So if you have a FUE procedure to the hairs on your neck you will definitely see the same type of scarring, which would be more difficult to hide.

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Hair Loss InformationUsing Body Hair With Scalp Hair for Transplanting? – Hair Loss Information – Balding Blog

Hi
I have read about Body Hair Transplants and I do see that it is not recommended. I was wondering though, would it be a feasible thing to have it used in conjunction with scalp transplants, kind of a topping it up for density?

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As you’re familiar with my issues with body hair transplants (BHT) due to differences in growth cycle, length, and character, I won’t get into it again here. For those unfamiliar with my stance, you can read about it here, here, and here.

It is technically possible to do what you’re asking, but whether it adds real value is another story. For the patient who had a depleted donor supply in their scalp from many hair transplant procedures, body hair may have value.

First, you need to be evaluated by a GOOD doctor who cares about you and your results, not just the money he would make. I realize finding a “good” doctor is easier said than done, but do your due diligence. Research this procedure and the surgeons who perform it to form a short list of doctors you want to meet with to hopefully find someone you trust with the patient results you’re looking for. Then get an assessment of your need, and your donor supply will be matched to your goals by that doctor. Only after you have a good education on the matter, should you make decisions like what you are asking me here.

You might detect that I am neutral on the value of body hair transplants when mixed with donor hair, but I would be open to do them if I felt that it had value to you and you were well informed.

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Hair Loss InformationMy Hair Was Transplanted with Micrografts Lower than My Juvenile Hairline! – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

I had a couple of HT procedures in the late 90’s that placed several hundred “micrografts” and “minigrafts” into my hairline. While the result is not as bad as some of the super-pluggy transplants I’ve seen, I now know that an FUE procedure could produce much better results. The issue is that the surgeon placed my hairline too low – it was lower than my juvenile hairline, but still along the forehead muscle. Due to this, I have no room to have a “transition zone” transplanted in front of it.

Would it be possible to have my hairline taken back a centimeter or so over a few sessions by individual graft excision and then have some refinement with FUE? I have spoken to one doctor who wants to bring my hairline down further, but I am completely opposed to this (I would like it to be a little higher at the end of any repairs).

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Without examining you, I wouldn’t be able to define your options (particularly based on your unique case, which might be very difficult to correct). Generally, a brow lift may essentially bring the hairline up to a level that can be worked with, but it’s really not a sure thing. There will always be some risk of scarring when you take out old grafts in the front, but with a brow lift and a surgery to bring up the hairline you might be able to have follicular unit extraction (FUE) to thin it out some. People have entertained using laser hair removal which may expose the micrograft scarring (I personally have not seen a successful one yet) and even with FUE there are issues of scarring and a risk of an unnatural appearance.

You need to find a surgeon that will work with you, and assess the risks and benefits. You have limited options, but you need an expert to analyze your problem.

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Hair Loss from Combat Stress, Heavy Equipment, and Wearing a Helmet for 5 Years? – Hair Loss Information – Balding Blog

Dear Doc Rassman

How are you doing doc rassman? i have an interesting question for you. and from reading your bio im sure you already have seen and know the answer for this. im 23 years old and have been in the army 5 years as an airborne infantryman, deployed to baghdad iraq for 15 months and am current back in iraq. been here a year. ive always had great hair, my buddies nicknamed me Jewfro hah. its thick, and slighty wavy. i did notice tho during my last deployment the hair on my temples was going, quick.

i was injured, put in combat stress and have worn heavy equipment and a helmet for 5 years straight, it seemed like when i came home the areas regrew. now that im back its happening again, worse, almost into a widows peak. again i am under constant combat fatigue and stress. its got me worried. im young, about to be a civilian and in college and id like to…well not look like an old beat up war horse. ive wondered if this was common or am i just balding? i know my current situation is almost more stress inducing and extreme than others who are and im sure its got alot to do with it.. just wanted to double tap. and see what i have to look forward to.. hoping to have a full head of healthy hair in my near future

Thank you

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HelmetAny stress could potentially cause hair loss (called telogen effluvium), and certainly the emotional and physical toll of war is among those stressors. I couldn’t say with any degree of certainty that your hair will regrow again, but if you saw regrowth the last time you were home, I’d hope you’d see the same regrowth the next time you’re home.

When you get back to the US, you should see someone who specializes in hair loss and can judge what has happened to you. In the examination will be a process I call mapping the degree of miniaturization of the hair in different parts of the scalp (learn more about that here). This will show if the hair loss is in a pattern consistent with genetic hair loss or not. If you have miniaturization present, the use of finasteride (Propecia) may be warranted. Helmets should not cause hair loss unless the helmet is tugging on the hair, creating traction alopecia.

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I’ve Taken Propecia for Years, But Now I’m Afraid – Hair Loss Information – Balding Blog

I have been on propecia for 4 years prior to a procedure. The medication was working very well and I was holding on to most of my miniaturized hair until the procedure shocked all of it out and basically voided any benefit and progress that the medication provided me.

Since my terrible experience with this surgery, I have been doing so much research and have come across horrible side effects of propecia that I previously was not aware of…ED, breast enlargement, etc…. This has scared me so bad and is adding to my stress level which I am trying to control. I have not experienced ED up to this point, but not sure about the other…..have you seen these side effects in others and how often?

My question is that do you think (in your general experience) since most of my hair has been lost because of surgery that the propecia is not really necessary now? I just want to get off it and not take any more risks….

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PropeciaSo you took Propecia for years (including follow-up visits and prescription renewals) and somehow were never informed of any side effect potential, nor did you even read the insert that comes with the medication? If you have not had any side effects after 4 years, it would be unlikely that you will experience them now or at any time. I believe erectile dysfunction risks are about 1%, libido decrease 1%, breast enlargement much less than 1%. You should be in discussion with your prescribing doctor, not me over the internet.

Just because you had the surgery doesn’t mean Propecia is unnecessary. I don’t know where your surgery was on your scalp, but let’s assume it was done in the hairline and Propecia has kept the crown. Stopping the Propecia would just create a need for further procedures, as the hair that Propecia kept would soon be gone. Obviously this is just an example as I have no idea about your case or history, but if you stop the medication all the benefits disappear within a year.

With regard to the shock loss you experienced following your procedure, this is highly unusual in patients that are taking Propecia. I would have to know more about you, examine you, and understand just what happened and when.

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In the News – Other Doctors Starting to Warn About NeoGraft – Hair Loss Information – Balding Blog

Snippet from the article:

Hair transplant experts are excited about a new technology called NeoGraft that restores lost hair.

But they warn that a never-ending series of bad hair days could be the outcome for patients who turn to NeoGraft clinics run by poorly trained doctors and technicians.

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NeograftRead the full text — Bad hair forever? Experts: It’s possible

A little over 3 months ago, I posted my concerns about the NeoGraft hair transplantation tool and the fact that it was being marketed to surgeons that had no experience doing hair transplants. Well, now it seems others are finally speaking out.

I have personally tried to get to the company to observe the system in action, but my requests have been ignored by them. Considering that I hold many patents in this field and am a real expert on automation, their disinterest tells me that they don’t want to be observed in action. I would, of course, remain objective and if it is all that it is hyped to be, I would probably want to buy one… but that does not seem to be happening any time soon.

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Small Bumps on Scalp After Hair Transplant? – Hair Loss Information – Balding Blog

Dear Dr.,
I had a HT about a year ago utilizing the strip to micro graft method and I noticed that I have small bumps resembling chicken skin from where the hair is anchored. When this occurs from the old hair plug method it’s referred to as cobble-stones and surgery and/or camoflouging tends to help but what about when the hairs are single grafts? Do these bumps go away over time? Is laser surgery or some other cosmetic method suitable? I like the hair I have just not the rough scalp.

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I have heard complaints about bumps around the grafts after a hair transplant surgery, but frankly I have not seen them in my practice. The classic cobblestone appearance of the large, older “hair plugs” did form many skin abnormalities, and even the types of transplants done today could produce bumps if the instrument used is too large.

Bumps like you describe likely can not be repaired, but they can be camouflaged with a good hair transplant around them. Have you talked to your surgeon to find out why your result came with these bumps?