Category: Hair Transplantation

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Hair Loss InformationCould I Die During a Hair Transplant Procedure? – Hair Loss Information – Balding Blog

What’s the risk of dying from hair transplant procedure?

CNN – What really killed the beauty queen?

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DefribrillatorShort answer — the risk is extremely minimal, at nearly zero. Hair transplants are a surgical procedure and if your doctor did not know what he is doing, you could die. There is one case report of a death during a hair transplant from a couple years back, which I wrote about before.

Not only could you die from the local anesthetic that is normally safe in proper doses, but you can have an allergic reaction, an arrhythmia of the heart, a stroke or heart attack at the time of the surgery (possibly the same risk as if you were home doing regular house work), or you could die of infections, amongst other things. Then again, you can also die at the dentist for similar reasons.

In the 19 years that I have been doing this surgery, I have never had a complication that could have produced death. The risk factor is incredibly low (statistically zero), so your chances of death are essentially none. You should also read these more in-depth posts if that doesn’t set your mind at ease:

  1. Hair Transplant Surgery Risks
  2. With the Death of Kanye West’s Mom After Plastic Surgery, I Wonder How Dangerous a Hair Transplant Is?

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Hair Loss InformationCan Hair Transplant Techniques Be Refined Even Further? – Hair Loss Information – Balding Blog

hey dr i was just wondering if you feel hair transplants have peeked or will they improve some way in the future i just analyze them in terms of reaching their full potential but your opinion is greatly appreciated as always and also do you see them getting any cheaper in the near future also

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I think that the technology has been pushed as far as it can go as we mimic just what nature does. The problems in the community are mainly related to the surgical team, and a few issues with physician education. Too many doctors are doing this with inexperienced teams of assistants, so the practical problem is to get the standards up. When the transplants do not grow as expected and the surgical team is less skilled, the failures are often caused by an inexperienced team.

With regard to pricing, this is not a commodity and as such if the prices go down much from where they are, the quality of the teams just won’t be there. We pay our staff competitive wages so that they can support a family, have health insurance, etc. If you ask our patients you will find the theme they speak of is our quality patient care and great results.

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Hair Loss InformationUsing Rogaine After a Hair Transplant – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I recently had a hair transplant at your facility, everythings going well, my question to you is, can i apply rogaine on my newly transplanted hair, I read that when you apply rogaine, the hairs fall out at first, and then it grows back, is that true? I’m afraid if I apply rogaine to the transplanted area, the hair’s will fall out and not grow back. Your response will be greatly appreciated.

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I’d say to wait at least 7-10 days before using the Rogaine near the transplanted hairs. Using Rogaine Foam would likely be the best way to go about it, as it is easier to apply (requiring less rubbing on the area).

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Hair Loss InformationYou Only Want to Sell Hair Transplants to the Fruits and Nuts in California! – Hair Loss Information – Balding Blog

Sir,

I am 58 and starting to lose my hair front and top.

I have never used any product other than Nioxin, (for 20 years) but not for hair loss, I simply like the products.

I am having a very hard time, not only believing in the infomercial hair loss products like Provillus but also your negativity towards all these products. I find your foot print, disclaiming most of the infomercial hair loss products and this includes Rogaine…

Should I believe that all these products are completely bogus OR are you degrading them because you charge an insane amount of money for your hair transplants, especially in Calif where the fruits, nuts and very vain people live! I seem to feel that you are bias towards these products because you need to buy another million dollar mansion some where in the fruit and nut state? Am I correct?

By the way, I have many friends that live in Calif and I consider them to be fruits and nuts also!

Sincerely,
– Name removed
New York

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Transplanted fruitI’ll just assume you were making a very poor attempt at humor with all your “fruits and nuts” comments, so I won’t take offense. Considering our fees for hair transplants are lower than many physicians in your own state, you’re pretty narrow-sighted to think pricing is outrageous because we’re in California. But let’s get to the real meat of your oh-so-insightful email…

Most of the hair loss products you read about on the web are bogus and the makers prey on desperate people trying to retain their hair. The products that do work (and are proven to do so) are finasteride and minoxidil. And even then, I post plenty of reports from readers about side effects and concerns for those medications. I like to think I’m pretty balanced when it comes to this stuff. If you like a particular hair product then by all means continue using it. I never said these products were unhealthy or would hurt or kill you. A product like Provillus just contains minoxidil, so it works like minoxidil does. If you want to spend more on a boutique minoxidil with vitamins that I feel won’t aid in regrowth, that’s your call to make. If you want to buy a shampoo because you like the way it makes your hair feel, then please go for it.

It sounds like your biggest gripe is that I’m not writing positive things about unproven treatments. I’m asked about nearly every hair treatment product under the sun, and all I can do with most of these is review the ingredients listed and give my 2 cents. Recently I was asked about a product that lists rosemary as some kind of hair growth treatment. Simon and Garfunkel might’ve had a hit with Parsley, Sage, Rosemary and Thyme, but it doesn’t mean those same ingredients will work to grow hair (otherwise I’m sure Garfunkel wouldn’t have had his infamously bad hairline). My point is that there are hundreds of products around that claim to work — and they simply don’t. There’s no proof that they are effective… and it seems people don’t tend to care if there’s proof, as long as the website looks slick and they’re offered a “guarantee” that may or may not be worth anything.

You’re free to believe what you want to believe about me, but you couldn’t be more wrong. If I was going to try to persuade people into getting surgery, I wouldn’t bother recommending any medication (which I don’t make money on). If I was trying to buy a “million dollar mansion” (actually, it would be my first), I wouldn’t offer my services, time, and support for free through this website. Why would I bother educating people about how to be a better consumer if I was trying to take advantage of them? Give me a break. As for the so-called “fruits and nuts” in California, this state has some of the most normal, driven and brightest people in the world. If you want more information on what this state has to offer, you can visit the California Tourism site. I found that site by using Google… which incidentally was founded in *surprise, surprise* California.

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Hair Loss InformationHair Length Needed to Cover a Donor Scar? – Hair Loss Information – Balding Blog

Hello Dr

I was just wondering about donor scars. How high up is the donor area on the back of the scalp? Also in your opinion how long does the remaining hair usually need to grow to get a good cover-up over the scar? I prefer to wear my hair short but i was just curious to know what the norm is for most patients that go through the HT surgery.
Thanks

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Norwood 7The donor area starts at the base of the skull (feel the prominent bone on the bottom of the skull) and go up a distance of 2.5-3 inches high. That is the donor area (see Norwood 7 art at right).

Scars from strip surgery vary in width. On average about 95% of patients will have a less than a 3mm high scar after one procedure and less than a 6mm high scar after the second procedure. Scarring varies and I see many patients who keep a very small scar (under 3 mm) for as many as 3 procedures. Likewise, some patients will stretch their scars more than others, and the scar could be 1cm high in the rare case. The wider the scar, the longer the hair has to be to cover it. Generally, the width of the scar (height) will require almost twice the hair length to cover it well, but that depends upon the hair thickness and the color / contrast between hair and skin color. On occasion, there is no significant visible scar in strip surgery and this is even more common when a trichophytic closure is used to close the donor area. In these patients, the scalp hair length can be 2-3mm long without showing anything. Having the FUE technique used will change the visible scar risk radically.

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Hair Loss InformationMy Hair Loss Is Fairly Stable but I Don’t Like My Hairline – Hair Loss Information – Balding Blog

Hi Doctor,
I have written to you before about my hairline; I was about to make my TV debut a year ago and was a little freaked out about my hair. My hairline started maturing when I was about 15 and at age 17 all recession stopped. I had some hairs along the edge and corners of the hairline that I suspected I would lose one day. About 2yrs ago I noticed some slight changes as those hairs did miniturize. I am now 38yrs old and I decided to see Dr. Bernstein in New York a couple of weeks ago. Most people laugh when I tell them I am worried about my hair. It is full and thick, and I wear it longer as I always did. Dr. Bernstein said I was on my way to a norwood 3, but I still had a great hairline. He put me on finasteride, and rogaine. He did not map my scalp for miniturization, and said he would not suggest surgery at this time. So I guess I am a norwood 2/3. My hairline looks very much like Johnny Depp’s or Robert De Niro’s. The thing is; I don’t like the way my hairline looks. My hair is almost black, and my skin is very fare which accentuates the hairline. If I decided to get a TP, I wouldn’t need alot of grafts, but it would give me more confidence. Any suggestions?

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At 38 years old with a stable hairline and no significant miniaturization, a cosmetic lowering of the hairline starts a process that could impact you as you get older and possibly lose hair. If you want a hair transplant to lower a non-balding look, then that decision will be in the hands of you and an honorable surgeon who will not do harm to you if he transplants you. I have seen some doctors go overboard in people like you, put in 3000-4000 grafts, make a lot of money off of you and do you no good in the long run.

I know Dr. Bernstein and if he believes that you are not balding, you can always go back and ask him to consider this as a cosmetic approach to a hairline you don’t like and see what he says.

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Hair Loss InformationCan I Take Medication After a Hair Transplant? – Hair Loss Information – Balding Blog

Dr first this site is AWESOME and I really wish I would have read all this before I underwent my transplant 2 weeks ago…

My question is and I know you had questions simular but I’d like to add a question to it. Transplant was 2 weeks ago, and now I’m taken Terbinafine 250 MG AKA Limisil for small amount of fungus on my toes, IF, I were to see myself losing hair will taken Propecia cancel out the hair loss and bring it back to it’s normal state? Do you think it’s too soon to take Lamisal just having the surgery just 2 weeks ago? I am really trying to undertsand how Lamisil in the 1st place could cause hair loss in some!?

I am just so paranoid cause I just spent all this money on a hair transplant and dont want to LOSE any of it, and it also a catch 22 cause I don’t want yellow nails either. Thanks in Advance

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Side effects from medications (except steroids) that produce hair loss are generally rare. Those people who take anti-fungal medications do not have a problem with hair loss as a rule, but you need to discuss this with your prescribing doctor who probably has more experience with these medications than I do. I tell my patients that they can take all of their medications after a hair transplant and will frequently let them take their medications before and after the surgery.

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Hair Loss InformationWill a Hair Transplant Increase Propecia Efficacy? – Hair Loss Information – Balding Blog

Dear Dr Rassman,
You’ve said before that Propecia and Rogaine work best where there is still some hair left, not in completely bald areas of the scalp. If that’s the case, can having a hair transplant to a previously bald area actually increase the efficiency of the medicines in that area too ?

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Norwood 7I think you’re confused. It is true that Propecia and Rogaine do not work in completely bald areas, but drug impact and surgical results are independent of each other. In a person with a slick bald area, the difference will come from the hair transplant and not the medication. If the hair grafts were transplanted successfully and from the donor area, those grafts will not require medication to grow. Remember, the donor area is the back horseshoe-shaped area as seen in the diagram at right. This area is permanent in most men (unless disease is present) and that is why it is used in transplantation.

Propecia and/or Rogaine can compliment the transplant for those that still have thinning areas. Sometimes, the goal of Propecia or Rogaine is to slow down further balding in the areas that you still have some hair. So to answer your question — no.

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Hair Transplant Safety and Efficacy Standards? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,
I find your blog very informative. I am looking for answers to the following questions:

  1. How is the success measured in hair transplant?
  2. What is the life span of transplanted hair follicles? (without any minoxidil/propecia)
  3. How does hair transplant compare to just minox/prop in terms of effectiveness and durability?
  4. Is hair transplant surgery proven via large scale studies done in compliance with standards that you would like to see in any other hairloss treatment before you could accept them?

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Elvis

  1. The patient and doctor have to have specific and attainable goals before any surgery. No surgery will make you look like Elvis… in other words, no surgery will replace all the hairs you lost. So the success of the surgery is measured by the patient with realistic goals in mind.
  2. Transplanted hair has the same life span as the hair on the back of the head (the donor area), because that is where it comes from. As long as there is no disease present that would cause that area to lose hair (uncommon), the hair’s life span is until you die.
  3. Transplanted hair is genetically “strong” hair that is not affected by DHT or genetic balding. Drugs (Rogaine and Propecia) are meant for balding and thinning hair that is affected by DHT (genetic balding).
  4. Hair transplantation in one form or another has been practiced on a commercial scale since the 1950s! I have seen a number of patients who were transplanted in the 1950s and 1960s with the old hair plugs and they are still growing (for better or worse). It is in essence an autologous organ transplant, with each hair being its own organ, and it has been proven to work. Numerous studies exist that prove its success, but the cosmetic success and making it look natural is another issue that involves technique and artistry. I would argue the LARGE scale studies are right in front of you when you look at all the NHI patients in our gallery.

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Transplanting Hair from the Back of the Neck – Hair Loss Information – Balding Blog

Does the procedures available to transplant hair from along the back of your neck to where you are balding actually work as well as stay in for the duration of your life?

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Norwood 7Neck hair is not permanent like the hair of the scalp donor area (the fringe shown in the picture). Transplanting neck hair is not difficult, but if it gets lost over time, it would be a waste. Strip surgery on the neck (used for strip harvesting) tends to produce some of the worst scars seen in transplant surgery.