Category: Hair Transplantation

Hello,

I an from India and wish to get a HT done. I approached [a doctor] but I found out that the medical trip could be quite above my spending capacity and also I cannot find enough time fo the same. There is a new surgeon in India who is a ISHRS fellow and incidentally also happened to work under [the other doctor] (according to his website). I have also seen her results and I find them better than what others in India have produced.

The only thing that stops me from going to her is that she is into practice less than a year(but i don’t have any information about her past experience). Can I trust her bald head to this new doctor or should I wait for a while and get it done abroad?

Regards

I can’t tell you who to trust. I’m not familiar with that doctor or her work, so you might want to use Google to research the doctor a bit more or ask around in various hair loss forums. Be sure to ask the doctor herself for any information about her past experiences that you wish to know. Also, ask to meet with live patient models so you can see the quality of her work in person (this is better than just seeing photos).

Don’t rush into surgery because the price is cheap. Go with whichever doctor you’re most comfortable with (and results that you like), and if it means you have to wait to save up your money, then you should do that.

I am just curious to know how many grafts would it take for a Norwood 6 to return back to a Norwood 1? I know this is not possible, but suppose hair multiplication became possible in the next decade, can you give us an estimate of how many grafts it would take for a Norwood 6 to return back to Norwood 1 ?

In general, you need about 15% of your original hair density to achieve the appearance of non-balding if you have an average hair density. Please note that this will give you a non-balding look (somewhere between a Class 2 and 3 pattern), but not the complete original density. Moreover it is NOT all about the numbers. Factors such as hair color, skin color, texture, etc are of great importance. For more, check out the Assessing Hair Loss page at the NHI site (scroll down to “How Much Hair Do I Need?”).

But if you want to know how many grafts you need to replace (hair for hair) of hairs lost, it could be in the 30 to 50 thousand hairs range. This is based on a general assumption that you are born with about 100,000 hairs. Remember, grafts are made up of 1-4 hairs.

i’m 39 yrs old. have had 4 or 5 (honestly cant remember) procedures (transplants) since age of 22. as is the norm..hair loss has progressed. was on propecia and got off it about a year ago. felt tired and down. was told propecia may contribute to these feelings.

in any event, i think my donor area is very limited (i assume) but i would love to fill in my widows peek and get some fullness back in my very thinning crown. i was never satisfied with my hairline from previous procedures..it looks very natural..but is still high in my mind. i’m wondering, in general what types of strategies you use when dealing with someone who has limited donor area like myself?

I would have to examine you to give you any information beyond generalities. There are many men who have depleted their donor areas. The FUE technique can take some hair from depleted donor areas and may be used to move beard hair or even body hair. Regular readers of this site may note that I’m not a fan of body hair transplantation (BHT), but I am willing to consider exceptions when it comes to a depleted scalp donor area.

An examination is appropriate and as you indicated that you are possibly local, we may be an easy connection for you. My office is in Los Angeles if you’d like to setup a free consultation.

Doctors,
I love the site and am a big fan but I’ve recently seen something troubling regarding a famous patient of yours. I admit to watching that Jon and Kate Plus 8 show (my wife liked it) and I saw the episode of Jon getting the hair transplant. I’ve been losing hair for years and I was intrigued, so I researched it and I came across your work and found this site.

After seeing your posts about Jon Gosselin’s great looking hair transplant I was almost considering a flight to LA but now I see this new photo of Jon and I’m quite nervous about it. So my question is, why does Jon Gosselin’s hair look like crap now after his hair transplant? Was it a problem with the transplant or just nature taking its course?

Here’s the photo

We actually addressed Jon Gosselin’s hair loss back in December, but I’ll give it another try. If you follow this site, you should be well aware that my overriding point is that hair loss is progressive with no cure, and although medication might slow the loss down, it won’t stop it forever. A hair transplant procedure is an option, but it does not bring back the hairs you lost. Hair transplants work by rearranging your small area of permanent hair (from the back of your scalp) to a big area where you are balding. With any sense of logic it is clear that you can never have full original hair density.

We rearranged Jon’s hair to the front to give him a non-balding frame to his face. He was well aware that he would continue to lose his original (non-transplanted) hair and that he may need further hair transplant surgery. He was advised at that time to take Propecia to slow this process down. Keep in mind that the hairs we transplanted are still there (even in harsh direct sun light), but the natural progression did occur. Here’s a side-by-side of the pre-surgical hairline (the area that was transplanted is circled) with the “faux-hawk” style in the photo you sent:

I have no clue if Jon took Propecia, used minoxidil, or just let nature take its course… but it appears that he’s not done much to treat his hair loss beyond the televised hair transplant. I agree that his hair doesn’t look as good as it did even last year, but in the end, Jon will continue to lose his hair in the areas where we didn’t transplant any grafts. It is not my place to critique his choice in hairstyles or force him to come in for a follow-up with me. If he elects to have another session of transplants to extend the work further back in the areas where he is clearly losing more hair, that is his choice to make.

Paid advertisements (not an endorsement):

As you’ve just stated, finasteride is not effective if a person has lost some hair due to radiation. But would a transplant be effective in that case?

The type of radiation that you got and the extent of skin damage will dictate how well the scalp will do with a hair transplant. If you or your doctor have doubts about survival of a hair transplant, we often do a test hair transplant of 20-50 grafts taken out FUE style and then wait 6-8 months and see the yield. If the yield is good, then a full transplant will do just fine. Finasteride may or may not have value in the radiated area if the radiation killed off the hair.

I saw a patient last week who had a hair transplant surgery from a local doctor. He went in for a 400 graft procedure and during the middle of the procedure (while under sedation), he was told that the doctor was able to remove about 1000 grafts more than he paid for. He was asked if he wanted to pay for the extra grafts for a special “deal”, because the alternative was to throw them away. What would you do? He was sedated, but he wasn’t crazy to let the hairs go to waste. So he reluctantly agreed to pay more for the hair.

As a surgeon, I understand that the harvested grafts cannot be an exact number that was planned. While it does happen on occasion, the actual harvested grafts are either over or under the estimate. We (NHI) do not throw away any grafts (even if the patient cannot pay) and we clearly inform all our patients well before the surgery, before they are sedated. We account for every single graft and if the actual number of grafts is short by even one, we give the appropriate refund. I have always made this point clear to my patients and for those who are on a tight budget, I try to keep the estimated harvest amount slightly under. But if the actual number of grafts is over the estimate, then it is my issue and I do not let the patient worry about the fate of those extra hairs while they are still under sedation. I transplant the extra grafts for them. The point I am trying to make is that it should never come to this, and the patient and doctor should know what to expect and the range of payment before the surgery is even considered.

Shady business practices are unfortunately a hurdle in our everyday lives. Physicians are generally held to a higher standard and are more trusted by the general public than most professionals, so it is disappointing to hear stories like that. Even hair transplant surgery is a buyer beware market.