Category: Hair Transplantation

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Density of Hair Transplants – Hair Loss Information – Balding Blog

Hello, I just had a wonderful procedure. Their offices were clean, procedures were excellent, and the staff was very accommodating. In 2002 I had 800 grafts done by another group in San Francisco and then again I just did 3500 grafts. The follicles were transplanted throughout my scalp approximately 25 FU/CM2. I have a very nice NW2 hairline. Also, I had a very high number of 4-hair grafts. Over 400 of them! They excised a strip of 3500 grafts and got 3703!!!

Do most of your patients get about 25FU/cm2 and are happy with it? I think it will be ok but just need reassurance.

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A normal person will have 1250 hairs or 600 two-hair follicular units. When converted to cm/square, that would extrapolate to 100 follicular units per square cm. If you received 25 follicular units in 1 cm, that would suggest that in one procedure, the doctor returned 25% of your normal density on the transplanted area. This is often not really the case, as some areas will have higher densities put in and other areas lower densities. For a person with average weight hair, olive skin, and brown hair, 50% densities overall should be more than enough to produce a full appearance. If you had a high number of four-hair grafts, then that might mean that your overall densities are higher than average. I generally target 25% density return on the first session, but at times I will go higher or lower depending upon other factors.

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Hair Loss InformationWhat Percentage of People Are Happy with Hair Transplants? – Hair Loss Information – Balding Blog

Thanks for the forum Dr. Rassmun, it has been very informative. I do a lot of research on the internet and it seems that people are all for hair translplants or they are all against them with many failure and nightmare stories. I saw something you wrote saying hair grows for 99% of translpants, but gaging from other sites it seems like 50,50. I was wondering if you could give me a ballpark number in your experience of people who are happy with their transplant to people who are not.

Anyways I am 24 and have pretty accelerated hair loss, but the back and sides of my hair is pretty strong and thick. Does the regrowth of transplanted hair in the mid 20s have a better look than transplanted hair later in life? Its seems the pictures Ive seen have led me to believe this, thank you for your time and keep up the good work.

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Generally, delaying hair transplants just increases the suffering time for those individuals who are bothered by the balding process. Why delay a hair transplant when the young man needs and wants the youthful impact of a full head of hair? If you wait until you are 60 years old, then you will look older until the day you decide to be transplanted. A 25 year old may look 40, a 40 year old may look 50 or 60, and a balding 60 year old may look 80. A hairy 25 year old will look 25 and that is what most 25 year old people want. I have transplanted many 40, 50, and 60 year old men who look 10-20 years younger with hair.

Satisfaction rates in my practice are very high, not just because we are good surgeons and know what we are doing, but because we set expectations correctly, do not employ salesmen who get a commission for selling you what you may not really want or afford, and we give all of our patients access to previously transplant patients at our monthly open house events. Patient education is at the foundation of satisfied patients.

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Hair Transplant Using Single Blade or Multi-Blade? – Hair Loss Information – Balding Blog

I went to a local doctor for a consult and he mentioned that he uses a 2-3 bladed knife with the Haber spreader to insure that no transection occurs. He said that there is less transection with that than with the single bladed knife, when used properly. According to him, with the single blade, you must go down 2-3 times as deep to cut past the follicles, and if you are not right on target there will be some transection. Does this sound correct – does using a Haber spreader with a 2-3 bladed knife sound right?

Thanks…

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BladeMore than 2 blades with depth may cause hair transection. The use of spreading instruments such as the Haber spreader or a Kelly clamp will also work to minimize transection. If a two-bladed knife is used, it should have a built-in angle to minimize transection. A three (or greater)-bladed knife causes more transection and loss of hair from the donor area.

One vs two blades (with built-in knife angles for the 2-bladed instrument) are about equal to minimize hair loss from the harvest. I use a specially designed (by me) two-bladed knife that has a 30 degree angle built into the holder to minimize transection. Two-bladed knives like the one I use precisely control the width of the strip, so I prefer that to a single-bladed knife.

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Hair Loss InformationI Want to Take Propecia Temporarily Before Surgery – Hair Loss Information – Balding Blog

Dear Dr. Rassman

you mentioned before “Some of my patients do not take Propecia (finasteride 1mg) by their personal choice. It is your choice as well. The risk is that you may have increased shock hair loss without taking Propecia before surgery. Shock hair loss is common in men under 30 years old or those who are losing their hair actively when they have a hair transplant. Propecia will prevent this complication in most men” …

Well i used propecia before for 9 months and had great results. but by the 8th and 9th months it killed my libido and impotence although i was 26 years old only.. but as you said shock hair loss is really scary. so if i wanted to use finasteride just to avoid the hair shock loss post surgery, how many months you advice me to take it temporary, definitely im not willing to go on with it…

thanks doc…

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Stopping the finasteride after a hair transplant has been done with a few of my patients with success. The risk of shock loss is mostly in the first 4-6 months, and those that stopped it after the transplanted hair grew out did not have a problem with shock loss. Of course, they had the benefit of hair transplants to cover any new loss of the original hair, so they may have lost some hair without knowing. This may be a better route than not taking the drug at all, but you will still face the natural evolution of your hair loss over time without the drug on board.

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Hair Loss InformationI’m 22 Years Old and Showing Norwood Class 4 Already! – Hair Loss Information – Balding Blog

hi dr. william rassman.

i am a 22 year man suffering from male baldness pattern near to stage 4. at this young age i have lost most of my front hair and from front i am almost completely bald. i want to have hair transplant surgery within next a year or two. what is your suggestion? thanks and waiting for your reply soon.

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Norwood 4Without an examination, I can’t tell you whether you are a candidate for transplantation or not. You should have your scalp mapped for miniaturization, which will help determine how advanced your hair loss pattern will get. For example, you wouldn’t want to rush into a surgery at 22 years old only to lose more hair as the years pass, leaving you with an unnatural looking pattern. At your age with class 4 hair loss, your pattern may continue to recede further. You should meet with a doctor that can help you form a Master Plan (an outline of your surgical requirements and plans for the future). The use of Propecia (finasteride) should be an absolute in slowing or stopping the hair loss in its tracks. Don’t get me wrong, even at 22 years old you still might be a candidate for a hair transplant, but you need to have a good doctor focus on building your Master Plan that will protect you for years to come.

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Hair Loss InformationGrowth After Hair Transplant – Hair Loss Information – Balding Blog

I had a hair transplant of 2010 grafts almost going on 5 months ago. My hair stylist tells me that the transplanted hair goes through a cycle and will fall out approx 3-4 months after the procedure then grows back in. Is this true? And why does it look really good in some light then in different light? When I go to work, the lights that are on there make me look like I had nothing done! I’ve been feeling very frustrated at this point.

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LightAny hair (even non-transplanted hair) looks thinner under bright light or certain lighting conditions.

In general, transplanted hair falls out within the first month or so and new hairs start growing in 3 to 4 months later. I tell every patient to wait 7-8 months before judging the results. Patience is a virtue! I can’t tell you if your surgery was a success or not. You need to go back to your doctor and ask to see your before photos to compare for yourself. Also, ask your doctor his/her professional opinion on the matter. Whatever you decide to do, you will not know the results until 7-8 months after the transplant was done.

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Search Results for “copper peptides” | WRassman,M.D. BaldingBlog

1. In my practice, I use a copper peptide shampoo for the first week as an option for hair transplant patients. My practice and thoughts on copper peptides is not new or different. 2. It does not promote hair growth nor does it provide much soothing effect on itchy scalp. I do know that minoxidil […]


2013-12-12 12:52:09Copper Peptides For My Itchy Transplant Scar?

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Temple Reconstruction Results (with Photos) – Hair Loss Information – Balding Blog

The patient elects to wear a hair system, which explains why it appears that he has a full head of hair in the After photos. The system, however, doesn’t extend to the sides of the head / temple peak area, which was the targeted transplant area. He had exploited his donor area with many transplant procedures and the available donor hair was limited. The areas which were circled were plugs that came down below the leading edge of the hair system and these were removed at the time of the transplant. These are very difficult reconstructions and your surgeon and his team must be experienced when balancing risks and rewards. Harvesting a tight donor area in particular, has wound risks. This patient has extremely fine hair and the density of his donor area was poor. These two issues (hair thickness and donor density) produce a great challenge and in this patient required two surgeries to achieve his goals. Click the photos below to enlarge.

After (two procedures totaling 2151 grafts):

 

Before:

 

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What If I Want a Hair Transplant Without Taking Propecia? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

I have been following your blog for over two years. I appreciate the work you do.

I had a question about hair transplant procedure. I understand that before or during hair transplantation, patients are prescribed propecia to help with the results. How would the results be affected if someone opts to get into hair transplantation but does not take propecia.

Your input will be greatly appreciated. Thank You.

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Some of my patients do not take Propecia (finasteride 1mg) by their personal choice. It is your choice as well. The risk is that you may have increased shock hair loss without taking Propecia before surgery. Shock hair loss is common in men under 30 years old or those who are losing their hair actively when they have a hair transplant. Propecia will prevent this complication in most men.

My personal opinion is that you are investing a lot of money in a surgery to have hair so why not try to maximize your return by taking Propecia?

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12 Days After My Hair Transplant, I Massaged the Scabs Away – Hair Loss Information – Balding Blog

I have a very important question?

After my surgery, i started getting scabs (crust- normal), which lasted about 10- 12 days. After the 12th day, i decided to massage the scabs with oil. I did that for two days and further massaged it with my hands in the shower, used shampoo to wash it up. Now, i feel like i have made a mistake. massaging the scabs away? does it mean that my hair follicles are also damages and my hair transplant is a failure? I am scared and confused. please reply ASAP

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We performed a study on grafts being secure after a hair transplant by pulling our grafts on successive days. We found that at 12 days, the grafts are secure. If you were gentle on the washing technique, usually the scabs that remain will loosen easily with soap and water. I don’t think you did anything to be concerned about.

You can read the article in PDF format here — Graft Anchoring in Hair Transplantation