Hair Transplantation – Page 79

September 10, 2009

Do Men Have More Shock Loss Than Women? – Hair Loss Information by Dr. William Rassman

I notice most females get transplanted hairs into diffusely thin areas and seem to get better results than men in those areas. In your experience, do men tend to get more shock loss than females? And if so why? Would a male who has female pattern balding (mostly diffuse thinning down the middle front area) have a higher chance for shock loss even if they are on Propecia versus a women with the same balding pattern?

Women are not always good hair transplant candidates because they usually have diffuse thinning, including in the “donor area” (rim of hair around the back and sides). Contrary to what you may have seen, women do not necessarily have better results than men. What you may be noticing is that women tend to keep their hair longer, curl their hair, layer their hair, or style their hair that is more conducive to disguising their hair loss.

There is no difference in shock loss for men (who are on Propecia) or women. Young men that are not on Propecia are the ones that get the worst shock loss, but both sexes can get it.

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September 9, 2009

Hair Transplant Clinic Said I’m a Good Candidate Although I’ve Got Minor Early Hair Loss – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman,
I am a 30 year old male with thick curly hair but with early hairloss on my left frontal hairline. I have been on Propecia for 5 months now and I am still unsure of it’s effect. I have also been to see a HT clinic for a consultation on my options for the future. There they inspected (with the naked eye) my hair and said that most of my scalp hair was very strong and I would be a good candidate as I had thick hair with alot of double and triple follicles. They also said I could have my hairline reconstructed but that I should limit the amount of hair transplanted as I may need more to cover future loss.

My question is does the reference to double and triple follicles sound plausible or is this something that is common to most people and were they only saying it to push the idea of HT on me,especially considering they offered to reconstruct my hairline when my loss is still only at an early stage? I would greatly appreciate any advice you could give.
Regards

I think that the reference to double and triple hair follicles reflects the follicular unit count. Hair grows in groups of one, two, three, and four hairs each. Some people with terrific density have many three and four hair groups while many Asians will have mostly one and two hair groups. The more hair you have on your head (counts) the better off you will be for future hair transplants if you ever need them. I can’t really comment on whether you are a good candidate for surgery, as I haven’t seen you.

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September 9, 2009

My Transplant Wasn’t Cosmetically Adequate – Hair Loss Information by Dr. William Rassman

Hello,
I had a hair transplant in my crown area about 4 years ago. Although medically it was a success, cosmetically it did not adequately cover the bald spot and the bald spot is still obvious. I was fed up and tried shaving my head bald. This left the transplant scar clearly visible. The hair has grown back but I am now back to square one. I am not sure what to do. I think my options are to a) have more transplants in the crown, b) have hair transplants in the scar area and cut my hair short, or c) treat the scar. Are these my only options or are there other options. What would you recommend? I now feel I am in a catch-22, because I cannot cut my hair short, and I have noticeable hair loss.

Thanks

You probably didn’t get good counseling and were not given realistic expectations. Without seeing you, I can’t really give an opinion, as I do not know how “bald” you are. People have different views and I would need to see what you mean. Its all perspective. I could let you look at my (Rassman) transplanted crown and use my results as a yardstick of your expectations. If you have enough donor hair, you might be able to have more transplants to fill out the area.

Generally, it is very difficult to completely cover the bald spot on top of your head. Not because it is technically difficult, but because you might not have enough donor hair. You can transplant hair to the scar, but you will always have the scar there, although less visible. You can do a scar revision and this time the surgeon can use a trichophytic closure to hopefully make the scar even harder to detect (almost normal, but possibly not enough to shave your head). Another potential possibility is to use the FUE technique to extract hairs one-by-one and place them into the linear scar. Again, I can’t tell you what is actually possible without an exam first. For your crown, there are products like Toppik which work nicely to camouflage the area.

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September 4, 2009

Why Don’t More Men Get Their Hair Back? – Hair Loss Information – Balding Blog

I was talking to a 40 year old patient the other day who reported that he connected up with an old high school friend via Facebook who commented that he hadn’t changed in the 20 years since they last met. We started to talk about what he might’ve looked like with a Norwood Class 4 pattern hair loss had he not gotten his hairline restored, and then he wondered why any man would let himself go bald when the techniques are available to allow you to look your best.

I came to the following conclusions:

Fear. Men are fearful of change of any type, particularly when it comes to their looks. Or perhaps it is the fear of surgery itself. What if something goes wrong? What if I’m worse off than before? What if the surgery hurts? These are huge concern and researching the doctor will likely alleviate some of that. It’s completely natural to have these fears, as you’re putting a lot of trust in someone you barely know. Build a relationship with the doctor beforehand, meet patients, know what you’re getting into and what to expect.
Finances. Money is a problem, particularly in these trying economic times, but if you consider that this is a once-in-a-lifetime investment, it really is quite minimal. And you need to consider how much your confidence is worth. Some men are fine with their hair loss, and others simply don’t feel complete without their hair. And that takes me to point #3…
Control. Having surgery is an admission that their vanity is in control, not them. That’s one way to look at it, anyway. I look at it as someone taking charge of their life and wanting to be the best they can. Confidence goes a long way in life, and if you’re not feeling 100% confident some people will pick up on that.

Considering the changes in what a patient looks like, the naturalness of the results today, and the need to cling on to our youth, everyone should be lining up to get surgery, right? Interestingly, the ISHRS has just released some statistics about hair transplant surgeries and it turns out that there was a 26% increase since 2006, so maybe the fear factor is shrinking and more men are actually addressing their physical appearance.

Come visit us at one of the Open House events that we hold every month and meet men who have had hair transplants. If they hadn’t told you, you’d likely never know that they had hair restoration. Most important, they are normal, youthful focused men, even those in their 70s who come to these events.

September 4, 2009

Female Hair Transplant Without a Line Scar? – Hair Loss Information – Balding Blog

Hi I am a 20 yr old female wondering about a hairline transplant. A previous question on your site about evening out a widows peak was the most similar to my request. I have had a high hairline on the sides for several years and a recent year on medications has now thinned out the hair on either side near the temple. I have always hated my hairline which is ill suited to my face shape and want to at least fill in the hairline around my temples. I am assuming hair grafts would be the correct procedure and want to know more about them.

HAving watched documentation of several female hairline transplants I wonder : Is the donor area for the grafts always left with a long scar? (example had one across the back of her head) CAn this be done without any scarring or difference to the doner area? and (of course) what would be the cost for this procedure?

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There are 2 techniques for hair transplantation — the strip method (with the linear scar) and FUE (where you are left with small punctuate scars in the donor area). There’s no surgical procedure without some level of scarring, though trying to minimize the scarring is the best we can do. Everyone scars differently, and closure techniques for the strip method have resulted in extremely thin linear scars, and the length of the scar depends on the amount of grafts required. Costs also depend on how many grafts are needed, with FUE fees being higher due to the more time-intensive nature of the procedure. You can learn more about FUE at the following pages:

September 3, 2009

Hair Loss InformationTechnique Development and Badmouthing of Doctors – Hair Loss Information – Balding Blog

Hello doctor Rassman,

with all the shady HT docs out there you seem to have a very good record of ethics; but recently I came across the first negative “report” that i’ve ever seen about you.

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“Bobby Limmer presented FU style grafting in 1989. It took 10 years to gain a foothold even though it was clearly better. During this time there was an active movement by the practitioners in the industry to badmouth and prevent the adoption of this new technique. That’s right they were actively stopping the evolution of technique. If a patient asked about these techniques they’d be told false and baseless statistics about transection, etc. if they were lucky. If they were unlucky the doctors wouldn’t even present the option to them. Documented examples of this exist online.

“FUE grafting encountered the same resistance from the industry. Every trailblazing FUE practitioner has had false claims and allegations made against their results. Leading this badmouth charge was William Rassman from NHI. Dr. Woods has recorded evidence of this.

In fact FUE was known by the industry for several years and you couldn’t get any of the top clinics to admit its existence.”

Care to comment?

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I originated many of the techniques done today (see medical publications) including the follicular unit extraction (FUE). Dr. Woods and I seem to have evolved it simultaneously, but I published the technique in 2001 and he kept his technique secret. In fact, I am still not sure just what he does, technique wise. I have taken lumps on my head as other doctors badmouthed me in the early 1990s, but after my patients got out to the market, the great results seemed to quiet down the accusations made against me. In 1994, I presented 23 patients with completed results to a group of about 500 hair transplant surgeons at an ISHRS meeting in Las Vegas. I would say that 95% of the doctors at that meeting were doing the old plug technique at the time. I did my presentation with live patients and compared what I did with the poor photography shown at the meeting by other doctors. My patient models spoke reams about the techniques I used, and that meeting seemed to be the actual end of the plugs as the standard of care.

I have been an outspoken critic of misrepresentations by doctors about their skills and techniques. After I announced FUE to the world, one doctor called me to ask how it is done. He had never done anything like it before. Within the week, he announced (over the internet) about the FUE technique he invented and his wonderful results from it. Now, when I meet that doctor I want to puke.

Nobody is without criticism and I am sure that some patients may not have reached their expectations with me as their surgeon, but setting up expectations is what I do and then the surgery is just a fulfillment of meeting those expectations. I show patients off every month at my office in Los Angeles and the experience of sharing has been central to my entire practice strategy.

August 31, 2009

Hair Loss InformationCan I Even Out My Widow’s Peak? – Hair Loss Information – Balding Blog

Ok, I’m a 20 year old male, and I was born with a widows peek. Is there anything that can be done, to like, normal that out. I have never had hair on that part of my head and it’s beyond embaressing.

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Norwood Class 4A It is generally not a great idea to transplant hair into a non-balding 20 year old, because you must take into account the possibility that you might bald as you get older. Imagine that you got the right side evened out and then began balding to a Class 4A pattern. You would have a wing of hair where the transplant was done and then be bald to the Class 4A pattern.

You need to accept the premise that if you bald and have the frontal line fixed to your liking and desires, that you will be committed to transplanting behind it if you should lose the hair behind it so you will not look freakish.

August 28, 2009

Hair Loss InformationCould a Fraxel Laser Damage My Hair Transplants? – Hair Loss Information – Balding Blog

i had an HT-surgery in the late 90ies with a 20 centimeter linear scar. a year ago i made a scar repair (FUE-technique) and i can cut my hair now from 1.8cm down to 0.9cm which is a great improvement.

now, i am considering to do a fraxel treatment on the scar and wanted to ask if the FUE-transplants (~250 follicles) would be damaged with the laser

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Fraxel For those that aren’t familiar with the Fraxel laser treatment, it is an outpatient procedure that renews the look of your skin. The depth of these lasers do go into the dermis and therefore create a partial 3rd degree burn, but apparently the damage is limited to a narrow column which is claimed to heal quickly. If the laser took the burn into the depth claimed, any hair could be killed… and in theory, there could be an infection risk, as 3rd degree burns open that possibility, even if it is an a narrow column.

Check with the doctor offering this treatment, as he/she has practical experience. You might also wish to research a little about safety issues on your own. For more info on how the Fraxel laser works, see here.

August 26, 2009

Hair Loss InformationWhy Is Surgery So Expensive? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I really like this blog, and all the help you’ve given us, but I have a question (not a good one for you, I suppose). Why there are such exorbitant prices for hair transplants, making them available only for those rich guys?! Another question, which probably will make you think before answering the first: Do you think those diagnosted with leukemia, who need a marrow transplant, don’t have the right to live on because they don’t have 150.000 $ for the surgery?! Medicine shall not be business, but as we all see it is. Anyway, thank you for your time and I really hope in the future medicine will be as it should be, available for everyone! (just a teenager view)

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Hair transplants are not just available to “rich guys”, but as you are a teenager with an interesting view on things, perhaps you consider anyone with a better-than-minimum wage job to be “rich”. Remember that hair transplantation is a completely elective procedure and not for everyone. If you buy a hair system and do the ordinary wig replacements and wig repairs, the cost will average $15,000/5 year time frame. Every 5 years the cycle continues. If you have a hair transplant, most people can get it for between $5,000 and $10,000. For me to do a hair transplant, I use a certified facility that is accredited (a process that is very expensive, but guarantees quality processes and sterility), I have a team of people working almost all day with the patient having the hair transplant, and I pay support staff, buy surgical supplies, and have rent, which is expensive. All of my staff are paid a decent living wage so that I can retain the best staff and they get medical coverage included in their employment. My overall costs are a fraction of what you would pay to have a surgical procedure performed on an outpatient basis in any hospital in the US (normally between $1000-2500 per hour) and our typical surgery runs 5-7 hours in length. And you’re always open to save a buck by using doctors who do not have my experience, many of them producing inferior results (or even worse).

By comparison, if you bring your dog into the veterinarian, the office visit often runs about $80, and blood work and any X-rays could run $1,000 or more. Your dog may not be cured in one visit, so repeat visits and repeat tests will drive up the costs further. He/she will probably get sick again another time. Another example: my son just had his timing belt replaced along with miscellaneous other things on his 11 year old Toyota car and it cost him around $2,500. I doubt it took a team of people 7 hours to do it. A good hair transplant, compared to a wig or a vet visit, is most often a one time cost that will probably not be repeated (if you take finasteride) in the lifetime of many people. Compare the value: a wig at $15,000 over 5 years or a hair transplant that will last your lifetime and will be less than the cost of a wig for 5 years. I think that comparing a bone marrow transplant is not appropriate here and your question about that is pretty ridiculous.

August 25, 2009

Transplanting Pubic Hair to the Temples? – Hair Loss Information by Dr. William Rassman

Can I use my pubic hairs as donor hair for my temple?

If you want curly hair in the temples, it can be done… and done successfully. I would question your motives, but upon examining you I can answer questions about the character of your head hair that will allow me to judge the appropriateness of such a request.

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