Hair Transplantation – Page 83

July 7, 2009

My Hair Transplant Made My Skin Cobblestoned! – Hair Loss Information – Balding Blog

Ive had a transplant 6 mnths ago.The hair that has been transplanted on the front top of my head has made the skin look bumpy cobble stoned appearance. I want to shave my hair short to blade 0 and not have the bumpy look. What procedures can be carried out to solve my problem. I do not wish to have another transplant so im looking on ways to make my linear scar fade away to. Is laser treatment good for the scar.

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Cobble stone Of course, I will start by saying I want to see what your hair looks like and if you can visit California (we have two offices here) it would be best to let us examine you directly. The second option (and probably most convenient if you’re not local) is to send me good photographs of what you are referring to with good lighting. Be sure to include photos of the scar where the hair was taken from.

Cobble-stoning is usually the result of the larger grafts which have a reasonably sized skin disk with it. The skin from the graft does not align with the scalp skin around it so that it appears bumpy. If that is what you have, your doctor used an obsolete technique and these just can not be fixed by shaving down the scalp skin with dermabrasion, which only makes the visibility worse with depigmentation of the scalp skin. The only solution is to put more hair around these bumps to hide it in the ‘forest’ of normal hair (more hair transplants, but this time by a well skilled doctor using modern techniques). Laser treatments do not work either and the linear scars from the donor area can be difficult to fix, but again, I would need to see it to understand the problem.

July 7, 2009

How Many Grafts to Fill in an Area the Size of a Quarter? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I have two specific questions for you:

1) How many grafts/what would the cost be to fill in a moderately thin area about the size of a quarter?
2) Do you have any suggestions for good, reputable doctors in Rhode Island?

And I have two non-specific answers for you:

A quarter sized area might take a variable amount of hair, depending upon where in the scalp it is located. It may possibly take between 100-200 grafts. Cost per graft varies per doctor, and many have a minimum fee for surgery. Without having your age, history, or really much information at all, it’s difficult to make recommendations — but assuming your thinning area is in the crown, you should talk to your doctor about Propecia or even getting some minoxidil (Rogaine). You might be able to avoid surgery altogether.
I don’t have any physician recommendations in RI, but if you don’t mind a little drive, Dr. Robert Bernstein is in Manhattan and he’s the best doctor on the East Coast. I would recommend him if you can manage a trip to New York. He should be able to do a telephone consultation with you by looking at good digital photographs, and then you can do it in one trip all in the same day.

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July 6, 2009

Woman Experiencing Nerve Problems in Scalp After Hair Transplant – Balding Blog

(female)
I have skin cancer which required graft closures. I have had MOH’s surgery and grafts twice and once (one year ago this past March) I had hair transplantation from the nape of my neck. Approximately two months after the surgery the right side of my scalp regained feeling but the left side did not. It still hasn’t so I told my plastic surgeon and he injected a steroid thinking it was scar tissue. While he was examining my scalp (after the injection, which did not work) he touched an area of my scalp on the left side that shot pain up to the top of my head probably right on the occipital nerve (greater). He didn’t know what to do so I went to see a neurologist who told me that some of the lesser occipital nerves are not as deep and are in fact at scalp level. My scalp (at the donor site) is so tight it is difficult to move my head to the right and down. Now he says I have cervical dystonia. I don’t believe that because in my research I found nothing that even resembles what I am feeling or going through. What do you think?

Persistent pain and/or numbness is a relatively rare risk of hair transplant surgery from small nerve damage. It is always stated in our pre-surgery consent form that we go over with our patients. Tightness of the scalp is also a side effect of a hair transplant surgery. The more surgeries you have, the more risk you may have of tightness or nerve damage. As your neurologist explained to you, some of your nerves may have been cut/irritated during the surgery and this may be contributing to your problems. I really have no way of knowing, though.

July 6, 2009

Young Daughter Lost Hair After Radiation to Brain Tumor – Hair Loss Information by Dr. William Rassman

I’m hoping you can help us. When my daughter was 20 months old, she was diagnosed with a brain tumor. After numerous brain surgeries and chemo, we decided to have a bone marrow transplant just before her fourth birthday. Thankfully, this saved her life. She also had focal radiation to the tumor site – on the right side of her head – and unfortunately most of the hair on that quarter of her head did not grow back.

She has worn hair pieces since she has been five years old. We’ve talked to people about hair transplants in the past, but were told there was too much area to cover and also, that hair transplants do not work on the side of the head.

I’m wondering if this still holds true for this procedure. I could send you some photos so you could see the extent of the hair loss if you think that would help. Please let me know your thoughts.

Thank you

Most people with large defects are treated with balloon expanders, which stretch the normal scalp to cover the defective areas. There are a few doctors who are very skilled in this specialized technique and although I have assisted in this type of surgery, I would not consider myself at the lever of expertise needed. I have seen these expanders done in children, but every person and every situation is different. I would suggest that you send me photographs and I will forward them on to such a specialist. I have seen some miraculous results from this type of reconstructive surgery.

Usually, at the end of the expansion surgery, hair transplants are done to refine the work and cover remaining scars.

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July 2, 2009

Hair Loss InformationAm I Under-Qualified to Be a Hair Restoration Technician? – Hair Loss Information – Balding Blog

I have received a job offer that seams to good to be true. I responded to and add for an administrative assistant listing and at the interview they offered me a position as a hair restoration technician. I believe that I am under- qualified with a Bachelor’s Degree in Music Business. Is it customary to only hire women technicians? How do I know if this job is legit?

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Training for a hair transplant technician takes considerable time and to become proficient once the skills are learned, may take a few years. If the doctor has experience training technicians and you like the detailed work that is involved, then you can embark on this as a career move. I would hope that the doctor who offered you the position does not let you loose and expect that you will become an instant member of the surgical team, making many mistakes along the learning path. It often helps if you have some medical assistant training so you understand the sterile technique process.

June 30, 2009

Hair Loss InformationCould Transplanted Hair Fall Out? – Follow-Up – Hair Loss Information – Balding Blog

I was wondering if you could expand on your entry “Could Transplanted Hair Fall Out Months After a Successful Procedure?”

Does all of the transplanted hair fall out or just some of it? How long after the HT have you seen this occur? From what you’ve seen does it happen in younger or older patients? Most importantly can you re-transplant new grafts into the area? Would the same thing happen again or could there have been a mistake made during procedure?

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I am not sure about your question. The newly transplanted hair usually falls out in a month or so after the surgery and it comes back 2-5 months after in waves of hair growth. Once you’re past the 7th month, everything should be stable and your transplanted hair should be there for the rest of your life. If transplanted hair falls out, it may reflect hair that was not taken from the permanent zone and in that case it may reflect an error from the surgeon.

June 29, 2009

Hair Loss InformationMy Doctor Took the Strip Out of the Wrong Place! – Hair Loss Information – Balding Blog

I got my hair transplant done in Dec of 2008. During the consultation the Doctor showed me the area that he was going to cut. After the hair transplant was done I found out that he has cut the wrong place , he has cut right under my crown area. He has cut the wrong spot and I have gone to 4 different Doctors and all of them have told me that the cut is to high and the doctor that has done the transplant didnot know what he was doing. He has taken hair from part of my head that he has told me that I will be going bald and placed it in the front. So What can I do about this. Can anyone help me with this . Oh. by the way I paid for 2500 Grafts and he told me he only did 2100. I do not think he is telling the truth about the 2100 also. Everyone of the doctors that I have seen after the Hair transplant have told me that my hair transplant is not 2100 . They all said it looks like may be from 800 to 1000 grafs. Please if anyone knows what should I do please help me out. Thank you.

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Legal As you indicated you are in the area, a visit to my Los Angeles office will allow me to really understand the damage you have. The hair that was transplanted is not permanent hair if it was taken from too high on the back of the scalp. I would want to examine that area today and measure the degree of miniaturization, which will tell me how long that hair may last. Donor strips taken from the crown tend to scar badly — is that the case with you also? If it is, it will need to be transplanted as well. You have legal recourse against the doctor for not only the costs of the surgery, but the damage that he did which may have a long term consequence to you. These options also should be explored. I look forward to meeting with you.

Doctor selection is doing your research, knowing the experience of the doctor, his patient results, his skill and artistry, and his overall integrity. Hair transplantation is a lifetime process and often can not be reversed.

June 29, 2009

Hair Loss InformationWas I Misdiagnosed with Alopecia Areata If My Hair Grew Back? – Hair Loss Information – Balding Blog

Hi Dr Rassman – In my late teens I had a bald patch appear in the back of my head that was diagnosed as alopecia areata, but it all subsequently grew back within a few months and has been normal since then. I’m now 30 and I’m thinking about a transplant to my hairline, I’m wondering if the previous alopecia areata puts me at additional risk for shock loss or any other complications (I’m already on Propecia). Thanks in advance.

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Alopecia areata will often disappear months after it first appears. There is always a risk of it reappearing at any time, but considering how many years it is since its last appearance, it seems unlikely.

Alopecia areata (AA) is often regional so if you are genetically balding (more patterned loss) and the diseased area is outside the area of your need, it can be transplanted knowing that there is a remote risk of AA appearing in the recipient area. If the desire is to transplant a bald spot created by AA, then there are two conditions that I feel must be met:

The AA has not been active for at least 3 years
A biopsy should be performed to rule out it being active at this time

June 26, 2009

Hair Loss InformationDid Retired Pro Hockey Player Eric Lindros Have a Hair Transplant? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

If you watch the attached videos of Eric Lindros (former professional hockey player), would you assume that he has had a hair transplant or is that a hair piece? I would estimate that the videos are 5-8 years apart. If it is a transplant, the results are exceptional. In the first video, he clearly has signs of a receeding/thinning hairline. Conversely, in the second video (interview after his retirement) he has a full head of hair. What are your thoughts?

– Youtube – Eric Lindros in 1997
– Youtube – Eric Lindros in 2007

Thank you in advance for your time. Best Regards.

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Here are side by side still shots from the videos you linked to:

The comparison with the 1997 pictures show Eric Lindros is a Class 3 Vertex balding pattern (front and crown). From the pictures, I can not tell if it is a hair piece or a hair transplant, but he is doing something to give himself hair. When the hair is combed forward, a lot can be hidden. Perhaps he started on medication like Propecia or Rogaine. Propecia was FDA approved in late 1997, so he could’ve started it soon after. I really am just speculating, of course. For all I know, it could’ve been witchcraft (though I’m 99% convinced it wasn’t).

June 25, 2009

Hair Loss InformationHair Transplants for 20 Year Olds? – Hair Loss Information – Balding Blog

do you do procedures under the age of 25 im 20, because for some reasons other surgions like bernstein wouldnt……also is there another alternative other than propecia that doesnt have side effects to prevent further hair loss?

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At 20 years old, you’re likely not a candidate for surgery unless there is obvious recession and you are realistic in your expectations. When Dr. Bernstein turns down a 20 year old, I generally follow his lead as we both are very concerned about your long term prognosis. Hair loss is progressive, so transplanting you now without planning for future hair loss is a bad idea, particularly if your future pattern is uncertain. You have a finite amount of hair that can be transplanted, so you don’t want to use it all up now and then continue to bald years down the line without enough reserves to follow the hair loss. There are many doctors eager to get your money, so you can find other doctors willing to transplant a young man of any age.

As for Propecia’s (finasteride) side effects — they are overblown. Propecia is easily the best medication for those men with early hair loss. The only alternative I recommend is minoxidil (Rogaine), as it is also FDA approved to treat hair loss. Minoxidil will not prevent hair loss in the same way that Propecia will, and has it’s own issues with side effects. Remember, each and every medication has the potential for side effects (look at Tylenol, for example), as each person is different and will respond differently to it.