Category: Hair Transplantation

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Hair Loss InformationCase of 5000+ Grafts Immediately After Surgery (with Photo) – Hair Loss Information – Balding Blog

There have been concerns expressed that people that have had a hair transplant look like a bloody mess right after the surgery. When I recently posted a photo of a typical post-op case to another website, some forum members there expressed surprise and disbelief that a patient could not have blood on their scalp as they left our office immediately after the surgery.

To handle any concerns over whether it is actually possible to leave an operating room without having your scalp dotted with blood, I am presenting a case done just last week where the patient received 5,019 grafts in a single session. These photos are not retouched and are typical of 90+% of our patients at the time they leave our office after surgery. The technique that produces this result reflects the instrument we use for site creation. The recipient sites that are made will tighten around the graft to create a mechanical seal around the site and minimizes any post operative bleeding. With good daily washing, the wounds usually do not form any crusts (scabs). If there is any hair present, the patient can often walk around without a hat and be virtually undetectable with regard to the hair transplant visibility.

Immediately after one session of 5019 grafts. Click to enlarge:

 

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Hair Loss InformationHair Loss In Scabbed Area – Hair Loss Information – Balding Blog

About 3 weeks back i had got a bandage wrapped tightly around my head after a surgery i underwent. Since the bandage was tight, initially it hurt a bit for about 2-3 days, after which the pain subsided. The bandage eventually came off about 4 days later(it was on for 1 week in total). a week after it came off i noticed that area (about 1/2cm in diameter) had formed a kind of scab. A week after that the scab became hard and looked ready to fall off. So a few days back while gently scratching that portion of my head, the scab came off in my hand, and along with it a bunch of hairs growing through it. My worry is that, will this hair grow back? The area where the scab was now looks healed. This happened on the front crown portion of my head, just above my forehead. Will the new growth take long? Thanks.

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I don’t really understand the anatomy as you described it. Wrapping the head for a week… well, I have never heard of that excepting in World War I when soldiers had head injuries or Hollywood wanted to get audience sympathy. What I do is put a ‘tennis’ type band around the head (like a sweat band) to keep pressure on the donor wound and take it off next morning just before the hair is washed.

Generally, if the grafts have not been pulled out by the head bandage, they should start to grow in 2-5 months after the surgery and then continue at a rate of about 1/2 inch per month.

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Hair Loss InformationI Still Had Scabs for Weeks After My Hair Transplant – Is That Bad? – Hair Loss Information – Balding Blog

hi doctor,
i just had a FUE procedure last month and fine crusts had been forming on the transplanted hair since 1 week after the procedure and it had remained there and even multiply till now! The doctor’s explaination is that i didnt wash my hair properly even though i wash my hair daily. He even said that the crusts will hinder the growth of the transplanted hair which makes me worried! Can i know what is the consequences if the crusts still remain there even after 6th,7th week? Will it really affect the growth of my new hair? Thanks!

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It sounds like your washing is poor and the existence of crusts at 7 weeks reflects poor hair hygiene. I agree with your doctor on a better washing approach, but I do not agree that the crusts will stop the growth when the time comes to grow.

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Eating a Marijuana Brownie After a Hair Transplant? – Balding Blog

Doctor,

I asked you this question in a very log winded fashion the other day without a response, pls let me be more brief….as I am sure you are quite busy and I do realize you have answered somewhat similar but certianly not the same questions. If you are uncompfortable answering these questions I understand so pls let me know and I will not bother you, but i LOVE the blog!!!!

Would you think I would impact my hair transplant yield or donor scar if I eat marijuana(this is all legal) in a brownie or take it in a “marinol” pill via prescription a few times a week? Or have 1 TINY 5 second inhale of smoke daily? Pls let me know, I would love to have my hair and enjoy my life as well.

FYI I am 31 and in pretty good shape.

Thanks

I have no experience with this situation, but I would guess that there will be no impact from the marijuana (legal or otherwise *cough*) on a hair transplant growth rate.

For the record, brief emails do help (as long as the pertinent facts are there), but I wasn’t avoiding your email because it was lengthy. I just get a lot of messages and can’t get to all of them.




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Hair Transplants for Really Short Hair Style? – Hair Loss Information – Balding Blog

Hello Dr.

I have a short but interesting question for you.

Is there a way to get a hair transplant which caters to a shaved head? what I mean is, since it’s less important to have such a packed in and natural look when you shave your head; is it easier or cheaper to get some sort of thinner coverage on your head which still looks natural when you shave it really short?

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I really don’t know what your expectations are, but I think that the answer is a hair transplant will not add value to your bald areas in the front, top, or crown in very low densities and wide distributions. If you want the easiest and cheapest way to have a shaved head look, use a razor and just take off whatever hair you have left.

Otherwise, the follicular unit extraction (FUE) technique doesn’t leave any linear scar in the back of the head, but there are tiny pinhole size scars that could be visible upon close examination. I’m not sure how short “really short” is for hairstyles.

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How Long Should I Wait Between Hair Transplants? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I recently had a hair transplant in February and have a few questions:

  1. How long do you recommened waiting before having another procedure? I’m thinking a year (to see results), but would any sooner hurt the transplanted hair?
  2. If you have additional procedures, can the newly transplanted hair be affected by shock loss?
  3. How often do your patients stop using Finasteride after having hair transplants?

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  1. I generally recommend waiting between 8-12 months between hair transplants as 80% of the hair will be at styling length by the 8th month.
  2. Shock loss is rare in a second hair transplant within 2 years of the first.
  3. I generally think of Propecia/finasteride as a lifetime decision, because stopping it would allow the progressive nature of hair loss to show and evolve. So I don’t recommend stopping Propecia once it is started. I don’t have statistics on how many patients stop using the medication after a transplant, though.

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Hair Loss InformationHair Transplant at Early Stage of Hair Loss? – Hair Loss Information – Balding Blog

hi doctor,
in your earlier blog you said that best time to do a hair transplant is when the hair loss becomes unbearable and you(doctor) has something to work upon.however in your recent blog you said that it is better to have hair transplant in early stage. what exactly in your view is the better option?

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For starters, you need a Master Plan to understand what is going to happen to you.

Hair transplants work well early in some men if there is obvious balding, but just having miniaturized hair and some thinning may be better treated with medications like Propecia (finasteride) before considering a surgical approach. Frontal areas, as they bald, work well with hair transplants, while crown areas may take huge amounts of hair that will not meet your needs in the supply/demand ratios of your hair density and scalp laxity.

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Does an Area of Scalp Need to Be Completely Bald Before It Can Be Transplanted? – Hair Loss Information – Balding Blog

I’m curious – in your response you state “Transplants should never, ever be used to build up what you may lose in the future.” Why is this?

Also, does this mean that an area that’s thinning but not totally hairless (in my case, the frontal scalp, or “forelock”) can’t be thickened up until it’s gone completely bald, or nearly bald? I’m confused.

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Just to clarify for readers, the above email was received in response to My Crown Is Starting to Thin and I Want to Thicken It Up With a Hair Transplant. Now that we’re all on the same page, I may not have been clear in that posting so I’ll attempt to fix that now.

Some unethical doctors use hair transplants in areas which are not balding and show no miniaturization on the anticipation that it may happen. I do not approve of that practice, nor do I approve of transplanting an area that has minimal cosmetic balding without first using a course of Propecia (finasteride 1mg).

Assuming that you have lost 50% or more of the frontal hair and are obviously thinning, transplants can be done. In this case, Propecia is good to prevent shock loss to the existing hairs. You do not have to go bald before having a hair transplant.

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When Can the Grafts Come out? – Balding Blog

Hi there Doctor Rassman, I’ve got a question for you about graft safety/anchoring. It has been roughly 13 days (12 days, 14 hours) since my procedure – I had a temporal/hairline restoration of about 2200 grafts.

My question is simple, at 12-13 days post-op is there any single circumstance that can dislodge a graft? My crusts started flaking off about 9 days post-op. I have been washing using the fingertips to gently massage and soak the crusts, and they seem to be flaking off no problem. Sometimes throughout the day, i will gently massage the scabs with my fingertips (without washing my hair, just dry) and the crusts will continue to flake off. I am noticing hairs in many of the scabs, but I know this is normal.

However, I noticed a few particularly persistent scabs. I did not peel or pull on the scab, but rubbed it much more vigorously with my finger tips until it came off, however, I noticed a slight bit of bleeding in the area where the scab was.

I have two questions.
1) If you do not see any bleeding, but see a hair/bulb in your crusts as they flake off, is it 100% certain that the growth center has not been dislodged?
2) If you DO see bleeding, is that generally a guarantee that the growth center has been dislodged with the scab?

There are no 100% guarantees, but it is probable if there is no crusting and you did not pull out the graft (and it shed on its own), a hair with a bulb after 12 days will leave behind the growth center. See the medical paper I co-authored, Graft Anchoring in Hair Transplantation (PDF file).

Bleeding should not change what I said above, but why are you bleeding 12 days after a surgery?




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