Hair Transplantation – Page 69

March 1, 2010

Trichophytic Closure, Hair Transplant Scars, and Scalp Tattoos – Balding Blog

Hey Dr. Rassman,

I must tell you that your blog has become an important part of my daily routine and can not thank you enough for your continual work on it. I know you probably have your reserves about this head tattoo procedure, but how about getting it done just on the scars from a HT procedure, it seems like a great way to cover up scars for people who want to shave their heads, especially on the sides and back, where you do not have to worry about losing hair. I am thinning on the top and receding and I am hesitant to get the procedure done on the top of my head in case i ever want to grow my hair out again and continue receding, but at least on my HT scar it makes sense? What are your thoughts? Thanks.

Tattoos can work if they are stippled so that they look like hair, but changes in color of the tattoo can be a real problem (imagine a green tattoo over time). As I understand it, most inks won’t change color, but from the few patients I’ve seen with a tattooed scalp that hasn’t been the case. Be sure to research the tattoo issue, as I’m not that informed about the various inks and methods.

I am not sure if you had a hair transplant and have a scar or if you’re considering a hair transplant and are worried about the scar. In either case, scars can be largely prevented most of the time, but if you have one, a revision of the scar (at least one attempt) should be made. Each case is different, so a good doctor is what you want to have. Ask your doctor about the frequency of scars and the sizes that he/she sees. Consider sending me a photo of your scar if you have one.

The photo below is a 4 year old scar after a single procedure of 2090 grafts done here with a trichophytic closure. There is a scar, but it is barely noticeable, typical of trichophytic closures in my hands. Click to enlarge.

February 25, 2010

Flu After a Hair Transplant – Hair Loss Information by Dr. William Rassman

Dear Sir,

First of all, congratulations for this site and all the usefull info that comes with it.

Im in my 15 day after my mega FUE sesion and i got flu with some fever. Is there any chance that this will interfere with my process due to the high temperature or the use of medication like antibiotics and ibuprofene?.

Thanks in advance for your attention and work.

You’re safe. Neither the flu nor those medications will interfere with the growth of hair transplant grafts. There’s no impact on future growth from getting sick.

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February 24, 2010

Hair Loss InformationIf There’s No Growth a Year After My Hair Transplant, Should I Just Get Another One? – Hair Loss Information – Balding Blog

sir,

i would like to know that if hair don’t grow as expected after 1 year of transplantation then what should we do? can we go for 2nd surgery? what could be reason for that?some white marks are still there. how can i get rid of them? is it possible that after transplantaion some hair root was not fixed properly? i removed some of them on 4th day. could it be reason? plz help me.

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Fail Hair transplantation that failed is a subject you should discuss with the doctor who performed it. This doctor should give you a reasonable opinion as to why the failure occurred. When a hair transplant is unsuccessful, it is almost always caused by technical failures of the surgeon and his team. On rare occasions, the patient can have some disease like alopecia areata, but that should be evident to any educated doctor (which means the surgery is unnecessary and should not be done). As for removing grafts, perhaps you just got rid of scabs. I don’t know.

If your doctor does not give you a logical explanation, go get a second opinion and certainly do not go back to the doctor whose failed transplant was not a good experience. Why would you consider going back to the surgeon that has wronged you? You have a limited amount of donor hair, not to mention the value of your time, money, and confidence.

Here are some recent posts we’ve made about hair transplant failures that you might find interesting:

February 24, 2010

Hair Loss InformationTransplanting Just the Temples? – Hair Loss Information – Balding Blog

First of all i would say that i appreciate your website and the information you give.

Im am 33 years old and still have a fair amount of hair. Lately I am bother by my temples, its not bald but it’s not what it used to be.

Last year (september) I started to take propecia to keep the hairs I have. I am now thinking of taking a hairtransplant to insert some hairs in the temples to make it full again. I don’t think I will need a lot of hairs or grafts. What is your opinion about a hairtransplant for the temples? I am afraid that if I do it now maybe later on the hairs ‘behind’ the temples will fall out. Of course I dont want a hairtransplant to make me look like 20 again but just some hairs added to the temples. Do you think its wise to do that considering im now 33 years old?

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First, I want to make sure you’re talking about the temple peaks on the sides of the head, and not the corners of the hairline (many people refer to the corners of the hairline as the “temples,” but that isn’t right). So assuming you’re talking about the temple peaks (the prominences above your ears), then I’d have no problem transplanting those if you didn’t show miniaturization on the top of the scalp. If you meant the corners of the hairline, I’d need to see what your loss pattern is looking like.

Your question is a good one, because sooner or later you will bald behind the hair transplants if your hair loss pattern is still progressing, which is why the Master Plan is created by you and your doctor with the primary focus of keeping you always looking good. Really, the best way to answer this question is to be seen by a good hair transplant doctor who doesn’t just want to take your money.

February 22, 2010

Was My Hair Transplant Scar Too High? – Hair Loss Information – Balding Blog

Dr. Rassman,

Thank you for your informative blog. I wanted to ask two questions. I had a hair transplant recently with a well-recommended surgeon. Two things concern me. First, the scar feels awfully high. It’s right above the ridge at the back of the skull. Second, one side has grown in much faster than the other. The surgeon said asymmetrical growth was normal, but I’m not sure.

Thanks for your feedback.

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NW7 The location of the incision should be within 1/2 cm above the notch on the back of the skull in the midline and then if it needs to be longer, taken to about 1 inch above the ears. The permanent fringe area is seen in the Norwood class 7 patient (see diagram) and measures 2 1/2 inches high. If the surgeon takes the strip above this 2 1/2 inch point in the midline, it would not reflect the permanent hair.

As for the asymmetrical growth, I don’t know how long it has been since your transplant, but give it some time and it should even out.

February 19, 2010

Optimal Age for a Single Hair Transplant? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

Thank you very much for your helpful book and web site. I am a 29 year old male planning to get a hair transplant. You have recommended waiting until the thirties before getting a transplant due to the risk of shock loss before hair loss has slowed.

One question I have is does using Propecia push back the age in which shock loss is still a risk? Since Propecia generally slows the hair loss process I would think that the age in which hair loss stabilizes would be later. Can a hair transplant surgeon figure out whether shock loss is a possibility just by examing your hair?

A second question, if I were interested in getting just one transplant in my life, what would be the optimal age? Or, if I were willing to get two, what would be the best times? Again, is this something that a surgeon needs to address on an individual basis?

Thanks so much for your help!

Propecia will certainly slow down the timeline for your hair loss. Shock loss does not happen following surgery in most men who are taking this drug. There’s no guarantee though, and determining the risk isn’t something that can be done by an exam.

I generally tell patients to wait until at least the age of 25 before considering a hair transplant, but questions about the ideal age reflect where you are in the balding process and if it bothers you. There is no ideal age for a transplant and only your needs should be a consideration. Be sure that you are on Propecia first and for everyone else reading this, if by chance you are under 25 years old, then trying the drug for a year is very important in building a Master Plan for you.

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February 18, 2010

Scarring Amongst Different Races? – Hair Loss Information – Balding Blog

I am a 40 year old asian male with slowly thinning hair. I’ve been using minoxidil for 4 years and propecia for 2 years now. They seem to help maintain what I have. Eventually I would like to consider surgery, but I am not bald enough according to the doctor I have seen. My question is:

1. is it better to wait until I am more bald, and, if so, why?
2. Is it true that FUT generally causes more scar in asian men? While I prefer FUE, I was told that the result is much better with FUT than FUE.

I would much appreciate your professional opinion. Thank you.

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Without seeing you, I can not address your concerns about when the best time is for your hair transplant. I generally tell patients that when it bothers them a lot, the surgery may be appropriate provided that the doctor agrees that you are a good candidate for it.

FUT (strip) and FUE are both good harvesting mechanisms. There may be better growth with FUT, but in good hands the FUE should be a fine alternative provided that you have a biopsy and are what we call “FOX positive” (see this article for more about the FOX Test). Scarring is not a racial thing except in keloid formation, which is more common in dark skinned people. If you have a scar on your body and it did not heal well, discuss this with your doctor.

February 18, 2010

Wearing a Hat After FUE Surgery – Hair Loss Information – Balding Blog

Hi there,
I am wanting to go for the FUE procedure in Thailand to have 1500 grafts in my crown and two temples. I only have one week of work and have 5 or 6 days to recover before returning to work. I don’t want anyone to notice so i would like to wear a hat or beanie and for health and safety i must wear a safety hat at work. Will this effect the result of the outcome of the procedure or how long must i wait until i can wear a hat. Thank you.

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Hard hat You should ask this question to the doctor who is going to do the surgery. Don’t be afraid to ask questions to the person that will be performing a permanent cosmetic procedure on your scalp. Have an open dialog!

Generally, after the transplants have passed the 3-14 day period and there is no scabbing, then wearing a hat should not be a problem provided that it does not rub on the recipient area.

February 16, 2010

Guaranteed Graft Growth? – Hair Loss Information – Balding Blog

How can clinics like Bosley and M.H.R. guarranty that every graft will grow or they will replace it and you and Dr. Berstein make you sign a disclaimer stating that a hair transplane is not guaranteed to grow at all. Thanks for a great blog.

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There are no guarantees on workmanship. You could imagine that someone with cancer wants the doctor to guarantee that he can cure them. Ridiculous, yes? So the most that a doctor can guarantee (under the law) is to replace what did not work at no charge to you.

The signing of a legal document on the day of surgery is a legal requirement that says both you and your doctor agree that you’ve been fully informed of all of the risks, including the possibility of death from an anesthetic agent. It also forces the doctor to reveal everything that is risky to you. That is why it is called an informed consent document.

February 16, 2010

Scabbing 20 Days After a Hair Transplant – Hair Loss Information – Balding Blog

I underwent a mega session of 2884 grafts and was worried on the 20th day as my scabs didnt fall off. So I contacted my doctor who told me to do a gentle massage. I did it but during this massage what I noticed was that there were some scabs that had hair attached to it. Does it mean I have pulled the graft even after 20 days!?

I would like to clear that i massaged with my fingers ( not nails ) in a slow circular motion.

Waiting anxiously for a quick response.

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I’m confused. You called your doctor who performed your surgery to ask about scabs, but you’re asking me if the grafts were pulled out? The problem is that you should not have waited until 3 weeks after surgery to do a proper washing of your recipient sites!

Some of the hairs should be falling out on their own with or without scabs, but the roots of the grafts will still be in place, as seen in the article we published in 2006 — Graft Anchoring in Hair Transplantation [PDF file].