Density and Coverage From a Hair Transplant – Hair Loss Information – Balding Blog

This is in response to Why Don’t More Men Get Their Hair Back?

I believe that for many it is also the fact that the coverage and density you get from a hair transplant is not considered sufficient.

If you look at photos/videos of men having hair transplants, the density is at times not great – i.e. very much see through.

If density + coverage was good (cloning?!), then I believe alot more men would go and get it done even though the price would be fairly high.

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The amount of hair that is generally needed to give a man the coverage he wants/needs is upwards of 25% of his original density. As each man is different, the coverage of a single hair (one out of many) reflects:

  1. The thickness of the hair shaft (coarse hair has up to 5 times the coverage of fine hair)
  2. The color contrast between hair and skin color (white/blond hair and light skin does better than black hair and light skin)

… so the hair requirements must be tailored to the particular patient. At our Open House events held each month, there are often 2 patients who stop by with black hair/white skin and a medium hair weight, and their results are spectacular. Sports news personality Steve Hartman had it done in one session and he does not have a see-through look, probably because his hair character is very good and wavy.

Generally, I tell patients to visit an Open House event so that questions such as those that you raised can be answered by meeting patients who have already had the procedure done. You are correct, of course, that people with fine hair may not get the fullness (density) they want and need, but such issues are best raised with the transplant surgeon.

I’m in My 60s and Losing Transplanted Hair – Would Avodart Stabilize That? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,
In your opinion, would avodart as a substitute for propecia in my situation be ok to take & would the avodart dosage be more effective in stabilizing hair loss? I’m in my 60’s & the avodart sterility side effects don’t concern me. I have been taking propecia for approx. 8 years, & have been experiencing substantial hair loss in the last few years of even previously transplanted hairs from two HT’s as I was a Norwood 6-7, & had very thin, fine hair in my donor site, & quite bald on top.

I’m out of state now, but my surgeon is very well known & extremely skilled & I respect him & was enormously happy with my HT’s I had 7-8 years ago. I’m assuming my donor hair is one of the few cases where it wasn’t destined to last a lifetime. I still some have hairs on top, but quite thin & sparse.

I realize you won’t give specific suggestions concerning Avodart, but any direction would be appreciated. I don’ want to go back to wearing a hairpiece (over 30 years)! Thank you!

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Taking Avodart (dutasteride) for a man over 55 years old and not concerned about fathering more children is a reasonable approach. I have heard from the transplant physician community that when hair loss is not stopped with Propecia, the use of Avodart may help.

I am curious about the loss of your transplanted hair, however. This should not typically occur and should be discussed with your surgeon. Don’t just assume! Talk to your doctor!

I’m in My 60s and Worried About Possible Shock Loss – Hair Loss Information – Balding Blog

I’m thinking about an HT, and after reading all your topics I see my biggest concern is shock loss. I’m a 61 year old male and have a high degree of miniaturization in the proposed recipient area. In one of your responses, I believe you recommended not having an HT for thinning hair?

You often recommend Propecia for younger men and say it might prevent shock loss for possibly 90+ cases? You also recommend taking Propecia 2 weeks to a month in advance of the HT(but even the day before the HT is better than not at all?). Would this advice apply to an older guy like me? Or if I’m correct that you would not advise cases of older age onset thinning to not seek HT?

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Propecia works at any age to prevent shock loss. It is best to use this medication in advance of the surgery (at least 2-4 weeks). Older men generally have less hair transplant shock loss than younger men. I would need to know more about your miniaturization and your last 1-2 year history of hair loss. At 61 years old, few men are actively losing hair.

Using Baby Oil on Recent Hair Transplant? – Hair Loss Information – Balding Blog

Dear Sir,
I had recently done a hairtransplant surgery and starting from day one i started spraying the grafted area with johnson baby oil at night before going to bed and washing my hair with johnson baby shampoo every other morning and evening.

Do you think that gohnson baby oil might cause a problem to the grafts if the grafts are washed regularily.

your quick response will be appreciated
Best Regards

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I don’t know why you need this routine, but I can not find a problem with it, provided that the daily wash is done properly. I hope you received aftercare instructions from your doctor.

Can a Hair Transplant Cure Migraines? – Balding Blog

Does Hair Transplant cure Migraine too?

NYTimes.com – Plastic Surgery May Also Ease Migraines

Personal experience — after HT, forehead lines decreased considerably. Perhaps because of increased skin tension after a part of skin is removed?

From the article:

The double-blind study, published in the journal Plastic and Reconstructive Surgery, found that more than 80 percent of patients who underwent surgery in one of three “trigger sites” significantly reduced their number of headaches compared with more than 55 percent of the group who had sham surgery. More than half of the patients with the real surgery reported a “complete elimination” of headaches compared with about 4 percent of the placebo group.

No, a hair transplant would not cure migraines. Maybe it causes less headaches as you are not so preoccupied with balding, but a hair transplant wouldn’t be among the trigger sites the article refers to. Plus, this is all very experimental. Lots of work remains to be done, but thank you for bringing this to my attention.




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Developed Scabs 13 Days After My Hair Transplant – Balding Blog

After 13 days post transplant, I developed lots of scabs on my head. I used a brush to help remove these scabs as it is said the scabs can damage the regrowth process. But using the brush removed much of the transplanted hair in one go along with the scabs. Was using a brush a mistake? Or would the hair roots not have been affected by the brush as it was on the 13th day?

Great work on the site, a real help.

Cheers

I do thank you for reading the site and I am more than happy to give you general information, but shouldn’t you be asking your post-surgical questions to the doctor who performed your surgery? Answering such specific and personal post-operative questions (simple as they may be) could be potentially misleading just by the fact that I do not know what was done in your particular case. I mean, developing scabs on 13th day (with no scabs prior) is very strange if I am reading your question literally!

Small scabbing (1 to 2mm size) on the transplanted recipient sides after a normal follicular unit hair transplant surgery is common, but very minimal. With daily hair washing it should resolve in a week or two. I am not sure how you brush your scabs away, but if the hair grafts are not locked in by that time, you run some risk of pulling them out with the scabs. I would ask your doctor and have it checked out to make sure it is healing properly. See our published article on the subject — Graft Anchoring in Hair Transplantation (PDF file).




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Reactive Hair Loss? – Balding Blog

Please explain to me what reactive hair loss is…..

This is usually another name for shock hair loss (or shock loss), which can occur in association with a hair transplant. We used to see this often in the days before Propecia (finasteride 1mg) was available, but the use of this drug in men before the hair transplant has prevented most surgical induced hair loss.




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Does Body Hair Transplantation Cost More? – Balding Blog

Dear Doc,

I have a burning question regarding hair transplant if hairs can be harvasted from areas of the head that are deemed to be sufficent can the same be done from other areas of the body i.e arms, legs etc. I understand the hairs are gentially different, growth rate etc but in principle could it be done and retrospectifcally will it cost more then harvesting hair from the head?

Have you ever undertaken or known dr to undertake this procedure? outcomes?

Thanks doc

Body hair transplants are not generally considered accepted treatment for balding. It is considered more on the experimental side. As for costs, it really depends on the doctor. As body hair transplantation is done with follicular unit extraction (FUE), costs are likely higher than a traditional strip surgery using scalp hair anyway. That is moot though, as I don’t believe anyone should have this done if your scalp donor hair is usable. So while technically, body hair transplantation is possible (and is done), I personally do not believe it is viable for the reasons you are familiar with. I’ve written about it before.

As for outcomes…. I’ve seen some complete failures of body hair transplantation and even more poor, unnatural looking results from using body hair to transplant to the scalp. One particular patient I recall spent about $11,000 with a doctor who claimed to be an expert. The surgery was a failure and the patient was none too pleased, as one might expect (see story here). I’ve yet to see a natural looking body hair transplant that appeared anywhere near the quality of using scalp hair from the donor area.




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Insurance Company Pay for Hair Transplant? – Balding Blog

In your experience as a medical professional have you ever seen an insurance company pay for a hair restoration as a preventive measure to certain skin cancers & not view it as simply cosmetic? Im very fair skinned & had a small piece of skin removed from my face today & am now waiting for the biopsy results. Thank you for your time & have a great day.

Insurance companies do not pay for cosmetic hair transplants that treat genetic balding, but insurance companies have paid for hair transplants for men and women with hair loss from accidents (burns/scarring).




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Hair Loss InformationPossible to Change the Angle of Hair Grafts? – Hair Loss Information – Balding Blog

Hey Dr. Rassman,

Appreciate all you do on the blog as well as answering my questions in the past. I had a less than desirable result from a HT procedure to say the least. Make a long story short, if I ever need to get one again, which I will since I have small gaps on my head still, I will be visiting your office before.

The grafts that did grow, which was on the low side, are coming in at all different angles and growing in different directions than both the other grafts and of my current hair. When I mentioned this to my doctor and the dissatisfaction of my results, he mentioned that it might be possible to change the angle of the grafts with a new tool? Is this possible to your knowledge? If not, is there anything I can do or this is just the way my grafts will grow forever? Also, do you ever have any open houses in the New York area?

Thanks so much.

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It is unfortunate that your grafts were placed at poor angles and your results are questionable. Your story of a bad procedure result illustrates the fact that hair transplant is for LIFE and you should do your research of the doctors and see their work first hand before going ahead with the surgery.

There is no tool or technique that will change the direction of your hair. I suppose you can individually excise them one by one and try to re-implant them, but that could potentially cause more damage, trauma, scarring, and failure to grow. Plus why would you place more trust and risk a poor outcome from the same doctor who already put the hairs in the wrong angle? You are a brave man!

I don’t have offices on the east coast any more, but Dr. Bernstein does have open houses in his NY office.