Category: Hair Transplantation

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Hair Loss InformationHair Transplant and ITP – Hair Loss Information – Balding Blog

I am considering having a hair transplant. I am have a bold spot of the right top side of my head and a similar one is gradually developing on the left. My biggest problem is that I have ITP. I had been scheduled to do a transplant a few days ago and had gone for ITP treatment- I was given IVIG but it had no impact; infact it seems the platelets dropped. So I had to put off my surgery. The problem is it is difficult to schedule an appointment for surgery without knowing for sure that I’ll have the right platelet count on the day of surgery. Do you know of any hair transplant centre whether they can handle both the haematological and transplant aspects?

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For those unfamiliar with idiopathic thrombocytopenic purpura (ITP), I’ll turn to Google Health for a good description — “a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clotting. Persons with the disease have too few platelets in the blood.” Idiopathic is just a fancy way for doctors say we really don’t know what is going on. There are some treatments as you know, but sometimes it can be difficult to treat.

Having surgery when your platelets are low can be dangerous, because your blood will not clot and any bleeding may not stop. I understand you want to have a surgery, but any surgeon in their right mind would not knowingly perform surgery on a patient with ongoing ITP with low platelets. The key point is that you need to have your ITP treated and wait until your platelets return to normal levels. Until then, I would worry more of your health than your hair.

My final thought is that you mention a bald spot on a part of your head. While I really cannot diagnose you with a description, are you sure you have male pattern baldness? Something about the way you described your hair loss makes me think you have alopecia areata (which is also a condition where your immune system attacks your hair follicle, the way it destroys your platelets in ITP). Just a hunch. Please follow up with your physician and I wish you well.

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Transplanting a Norwood 6 to a Norwood 3 or 4? – Hair Loss Information – Balding Blog

Hi Doc, Great Blog

If a patient was norwood six on the scale with normal density how many grafts do you think it would take to create a hairstyle similar to that of Tom Ford With strong density. I believe a conservative hairline with more overall density produces a better appearance that that of a lower hairline. Here is a sample of the hairstyle: Photo

I know this is difficult to estimate so even an approximate figure would be interesting. Thanks in advance doc.

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You should visit our hair transplant photo galleries, which showcases hundreds of different patients — before and after photos, their starting Norwood class, and the number of grafts it took to achieve their new look. So instead of me just giving you a number, you can see the many examples of hairlines yourself. It is not just about numbers of hairs that we transplant, as factors like hair color, style, texture, and distribution are very important in the overall cosmetic result.

With respect to lower vs higher hairline, that is more of a personal preference for each patient. Some patients choose a higher hairline. We (Drs. Rassman and Pak) do not dictate where a hairline should be. We give each patient a baseline to guide them, so we take a team approach to where the hairline should go.

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Hair Loss InformationHair Transplant After Stopping Minoxidil? – Hair Loss Information – Balding Blog

Hey Doc,

This is my second post on this Blog. I’ll repeat my initial sentiments with regards to the first-grade work you do on this site. You can’t begin to understand how useful and good this blog is.

I’m 23, and spotted some thinning a few years back. I tried Minox 5% for about 4weeks, and stopped due to skin irritation. I’m convinced that using and then stopping minox has impacted my hair terribly. I’ve been on propecia for about 9months with limited success. It has always been my intention to at some point enquire about a transplant. My question is about the affect of stopping minoxidil on a future transplant.

I understand that upon stopping minox there is a shrinking of capillaries, and consequently blood supply to the scalp. If this is the case, and I were to go ahead with a transplant, would the new grafts be affected? Would it be possible to have a successful hair transplant, after having stopped minoxidil? Have you experience of patients in similar positions?

I hope that makes sense. Your help would be greatly appreciated. Thanks for reading.

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The only problem with stopping minoxidil is from the dependencies on the hairs that have been benefited. I tell my surgical patients on minoxidil to continue using it up until the night before the hair transplant and then restart it 2 weeks after the procedure. The blood vessel impact from minoxidil on the scalp will not impact a hair transplant. I’ve had plenty of transplant patients that use minoxidil prior to surgery and have never seen any kind of issues related to using the medication.

If you stop minoxidil at the time of the transplant and decide to never restart it, the withdrawal effects of the drug I have discussed here before will become the risk. It won’t effect the transplanted hairs, but you will lose any benefits you had from the medication.

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Hair Loss InformationNo Room for Optimism for New Hair Treatments? – Hair Loss Information – Balding Blog

While I don’t disagree necessarily with the premise that doing nothing now, in hopes of treatment in the future, is a course of action that is done at an individual’s own peril — the balance of this response is quite gloomy and alarming. Of course, you are the professional, and we defer to your knowledge — but you truly believe that NO beter treament will be available to the public for decades? That hits many of us prety hard. I am a realist. However, is there no room for optimism? There is a market for this, and certainly a willingness, as evidenced by the research of the past 6 years, in finding better alernatives. Those are my thoughts. Thanks for the site — more so, when it provdies hope, as opposed to narrow courses of expensive, sometimes (not always) unflatering, options.

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Half fullHey, I was hoping for flying cars, public space travel, and a cure for cancer by now. I’d even settle for a cure for the common cold. I would like to think of myself as an optimist… you know, a glass-half-full kind of guy… but the cure for balding is not as easy as you may think. Being bald is like the color of your eyes, the way your ear lobes fold, or how tall you are. It is genetics! And as much as gene therapy is the new buzzword in science, it is a long ways off.

In the mean time, for those men who are bald, there are great alternatives. Hair transplant surgeries have evolved to a point where it is almost undetectable when done by the right surgeon and medical group. See my post on selecting the right surgeon. And when combined with medications such as Propecia, it definitely changes lives. So I am not sure what some of you are looking for, but hair transplants really are not unflattering nor expensive. While I agree at face value the cost of a hair transplant surgery may be in the thousands of dollars, remember that it works and it’s for life! It is often less expensive than a good quality wig, which has to be replaced or repaired ever couple of years. What other item can you purchase for a few thousand dollars to make you look younger and you get to keep for the rest of your life? As you say, you are a realist — it may not be the fountain of youth, but for the optimist, its the next best thing.

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Trichodynia After a Failed Hair Transplant – Hair Loss Information – Balding Blog

Hello Dr Rassman,
I would like to start with complicating you on your website. I think that what you are doing, in providing free information with such dedicated professionalism, which must be so time consuming is a testament to you as as a surgeon.

Doctor my question is a simple one. I had a hair transplant almost a year ago and I am living a life of hell since. I am now suffering from Trichodynia and every morning I wake up I say to myself I cannot wait for the day to end. I go to bed hoping the pain will be gone when I wake up each morning. I am emailing you as a last resort. I have been to a pain specialist who has prescribed amitriptyline and lyrica together. I am on this medication for 4 months now and as the dosage goes up there really is no difference in my condition. My transplant was also a failure along with being left with a scar of between 5 and 10mm. Please please help me doc. I did not have any pain pre surgery. Kind regards

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BurningFor those readers who does not know about trichodynia, it is a condition where the patient experiences a painful, burning sensation on their scalp. From Wikipedia — “Often there is an underlying psychosomatic cause, such as stress, depression or anxiety.” It also could be caused by trauma to a nerve(s) from the surgical wounds created during a hair transplant.

I do not know the cause of your pain and the answer you desire is not so simple. You state that the pain started after a hair transplant surgery, but I do not know if there is an actual correlation or just coincidence with the hair transplant. You need to find a physician who will listen to you and examine you. I would want to know where the pain is, if there are any sensory defects in the nerve distributions of the major and minor nerves of the scalp. Without a full history and physical, I really cannot offer much help. You are more than welcome to make an appointment to see me or Dr. Pak either in Los Angles or San Jose.

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Hair Loss InformationPicking Off Transplant Scabs a Month After Surgery – Hair Loss Information – Balding Blog

Hello, I had a hair transplant early in january, roughly two months ago, it was only a small procedure of about 700 grafts. However I have been reading about the scabbing process and I am very concerned that I may have damaged my grafts. I was very careful after surgery for about two weeks, the scabs were still strongly in place so i followed advice and scrubbed a little harder and let them soak. During weeks 3 – 4 the scabs were still there, not attached to my head but somewhere near the end of the grafts, most of them being lose. The area was very itchy and the scabs looked a mess being very flakey in my hair.

Anyway over 2 or 3 days i used my finger to rub and loosen the remaining scabs, considering it was nearly 4 weeks on i thought this would be ok. When picking the scabs off some of the grafts were still attached to the scabs. I have been told that it is natural for the grafts to come out first with the scabs and that after 2 weeks the grafts are fixed in place so its hard to damage them. However i am very worried that the result i achieve will be poor because I didn’t just let the scabs be, the rate they were going i think it could have been about 5 weeks before they would have gone. I know picking (encouraging) the scabs to come off when the hair is dry is wrong, but i didn’t at the time. Do you think any permanent damage will have been done?

kind regards.

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I do not know why your scabs would be there at a month after surgery. Just washing your hair with soap and water should’ve taken them off. I would like to know if the grafts were the large plugs, which used to produce scabs lasting 2-3 months with poor hygiene.

We did a graft anchoring study, which basically concluded that as long as the scabs are in place, the grafts might come out. Pulling scabs and grafts from the scalp just is a set-up for infection (folliculitis). Good hygiene should have started the day after surgery. Where were your post-operative instructions? The surgeon should’ve provided them to you.

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Financing a Hair Transplant? – Hair Loss Information – Balding Blog

What is the best way to finance a hair transplant? I will be graduating in May and will turn 24 in July. I have done the research and about 2,000 grafts are needed in my frontal hairline. My receded hair line itches at me daily. What is the best way to plan for about 2,000 grafts? Obviously every office is different on pricing, but I want to fix my hairline before I get started in my profession (public speaking and sales) – what is the best way to go about this for a broke college graduate?

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MoneyDifferent physicians/clinics will likely have financing available, though some patients opt to pay cash or put it on a credit card. We do offer financing if you elect to have your surgery at New Hair Institute, and that info is available here.

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Forehead Muscles and Hairlines – Hair Loss Information – Balding Blog

This is in reference to this response.

You mentioned needing to see the eyebrows and forehead lifted by an individual to see where exactly to construct a hairline. I read a lot of doctors ask the patient to lift their forehead to help construct a hairline as well. My understanding was it showed the extent to where the muscles of the forehead ended which would basically indicate the lowest possible position of one’s hairline. Anyhow, regardless if I was correct or wrong in my understanding, what about individuals such as myself who cannot move or lift their forehead through use of the muscles located there? I was told by my doctor that these muscles were “underdeveloped” or weak and I have never been one either to voluntarily or involuntarily move my forehead in which to show creases or wrinkles. How would a doctor determine where a proper hairline should be located in my case and others? Thank you!

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We do not base a hairline on forehead muscle per se, but it does give a generalized reference point. It does not matter if you cannot lift your forehead to delineate a muscle. An anatomically correct hairline is made with the general proportions of a person’s face using the rule of thirds the way artists draw a face. Alternatives that we use are in equalizing the chin to nose distance with the distance from the glabella (groove between the eyes above the nose) and a similar distance upward.

Hairline position is not an exact science — it is an artistic design based on proportions and knowledge of human anatomy and form, and takes into account what the patient believes fits his facial proportions. We often find that this process becomes a negotiation to arrive at the ideal location.

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I’m 20 Years Old and Losing Confidence Because of My Hair Loss! – Hair Loss Information – Balding Blog

i am 20 years old and live in Mi. I started losing my hair since when i was 17 years old and after 3 years that now i am 20 years old i have lost enough hairs that i look 10 times older than my age. I have lost a lot of hairs from and middle and day by day it is increasing due to this reason i am losing confidence and every time try to cover my head with something so people don’t see my baldness and right now i have short hairs which make it more obvious and make me look a 30 year old like man.

Please advice me should i get done hair transplant from your surgical institution or is there any other way to get my hairs back. Because i told you i have almost lost a lot of confidence in myself. Please doctor your advice is required. Thank you

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At 20 years old, you’re more than likely not a candidate for hair transplantation. I understand that you’re losing confidence and covering your head — this is common among many men that are seeing hair loss. I don’t know how bad your loss is, but my suggestion is:

  1. Get your hair mapped out for miniaturization to make a diagnosis on the presence and degree of pending hair loss
  2. Talk to your doctor about a prescription of Propecia. I’ve seen this medication work well in younger men with early hair loss like you describe.

There are many doctors that would be more than willing to take your money, but realize that you’re just going to cause problems for yourself in the future if you rush to surgically treat your hair loss today.

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Hair Loss InformationI’m Holding Out for Future Technology Instead of Getting a Hair Transplant Today! – Hair Loss Information – Balding Blog

Hi, thank you so much for all your help and knowledge. We greatly appreciate it!

Can you please tell me your thoughts as to when if ever we will see a more progressive approach to fixing hair loss? Such as through stem cells or tissue engineering. i am holding out getting a Hair Transplant in hopes one day this will come. Do you think holding out will be worth any wait?

Thank you for your help!

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Imagine that your father and grandfather had prostate cancer and that you run a very high risk of developing the same disease. Rather than get tested to get a diagnosis for you in advance of getting this terrible disease, you decide to just wait until a cure is available. Then you die because the cure never came in time to save you. I realize this logic may be a stretch to bring up the point I am trying to make, but stick with me…

Waiting just means paying the piper of the process as time, whether it is cancer or hair loss, just works against you. Hair cloning or a hair loss cure are still not even close to being available to the public. In fact, I believe it will take decades before some more solid solution to hair loss comes along. People still think that hair transplants can be socially detected on any person who had it done, will always cause terrible scarring, are extremely painful, etc. Well, it may be the perfect solution today. I would challenge you to pick out a hair transplant amongst my patient population (assuming I started the transplant process on the patient being examined myself).

Drugs like Propecia are great at stopping or slowing hair loss with minimal side effects for 99% of men. Why hold out? You could be enjoying your hair now instead of waiting on something that isn’t guaranteed to come in your lifetime. The decision ultimately is up to you.