Hair Transplantation – Page 96

February 3, 2009

Coffee After a Hair Transplant? – Balding Blog

Hello,

I was curious if you think that drinking coffee is bad after a hair transplant. I drink about 2-3 cups per day. Do you think it hurts the blood supply to the hair transplant by constricting the blood vessels? Thanks in advance. God bless.

Coffee Coffee does constrict blood vessels, but I do not believe it will harm the hair follicles. The medications that doctors use during your hair transplant surgery contain epinephrine. It is used so that bleeding can be minimized and the anesthesia can last longer. Epinephrine is a very potent blood vessel constrictor (more so than caffeine in your coffee).

In the end, use your good judgment and follow your doctors instructions. I generally tell my patients not to have coffee the day of the transplant to keep them calm more than anything else.

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February 2, 2009

Does Non-Transplanted Hair Grow Slower After a Hair Transplant? – Hair Loss Information – Balding Blog

I had a transplant over 10 months ago and my hairdresser has noticed my hair is either not growing (non transplanted hair) or is growing extremely slowly.

Do hair transplants stop hair growth in non transplanted sites?

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Miniaturized hairs will grow slower than normal hair. If you are not taking Propecia (finasteride 1mg) and had a hair transplant, the degree of miniaturization may increase and slow down the growth of the natural remaining hairs that are genetically impacted. The stress of a surgery will increase the magnitude of miniaturization in hairs that remain after a transplant, slowing down the rate of growth of those hairs. Finasteride (Propecia) can often make the slow growing hairs that are miniaturized, grow faster.

January 27, 2009

Hair Loss InformationShaving the Recipient Area Before a Hair Transplant – Hair Loss Information – Balding Blog

Dear DR. Rassman,

I notice that unlike other transplant doctors you don’t shave or buzz the donor or recipient sites. What is your feeling about this. If you’ve already answered this somewhere else, I apologize.

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I know how difficult it is for a person to undergo a buzz cut in the frontal area just to accommodate a hair transplant, so I have learned how to do this over the years without that close cut. This has, of course, helped my practice as people have built in camouflage with no forced haircut. I have been working in this field for 19 years. I know other doctors don’t do it this way, but I also know how important it is for patients to preserve the privacy and return to work rapidly after the procedure.

Over the past dozen years, we have also done other things that make the hair transplant undetectable. The swelling that was initially a major problem, now is almost completely gone and the graft hole sizes are so small, that they are nearly invisible in the first couple of days unless there is a significant pink color in a very white skinned person. The crusting which has been an annoyance for up to 2 weeks, now is washed away and most of my patients have an undetectable surgery within days of the procedure, enough to return to work in a couple of days.

January 27, 2009

Surgical Hairline Lowering + Hairline Transplant? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I recently read some posts regarding the surgical hairline lowering procedure vs. a hairline transplant. I was wondering whether it would be synergistic to do both?

If you are male (with a NW2 receded hairline due to MPB) with an inherited high hairline, wouldn’t it be better to get the surgical hairline lowering procedure done in addition to a hair transplant? Wouldn’t this conserve donor hair because you are essentially reducing the size of the forehead (less area to worry about transplanting hair follicles to…).

Thus, this would remedy the high forehead and restoration of the hairline, with enough donor hair in case of any future hair loss.

Hairline lowering procedures should only be done on women or on men who do not contain the balding genes. That means that men wanting this surgical option should be genetically tested first, perhaps using something like HairDX. For women who do not usually lose hair (as they do not have patterned baldness), the hairline lowering procedure has value since there is no significant danger of the hairline rising above the point of surgery.

The advantages of the surgical lowering procedure (like a brow lift in reverse) is that the results are basically instantaneous, a week or two after healing is complete. The hair was there prior to the surgery (just a few centimeters lower), so you do not have to wait for the hair to grow out like with a hair transplant. If you need more than one inch lowering, then the transplant option may be better. Some people with the hairline lowering procedure will develop a scar at the hairline and may require transplants to hide it.

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January 26, 2009

Hair Loss InformationIs FUE the Best Choice for Someone That Has Had a Lot of Transplant Work Already? – Hair Loss Information – Balding Blog

I have followed this site for a few years now and I am so impressed. First off, your integrity seems to be apparent in how you run this site. There is none of the cheap salsmanship common to some of the hair replacement surgeons with whom I have spoken. You provide so much disclosure that it is obvious that you truly want educated patients. It seems to me that the medical hair replacement industry was crying for someone like you.

With that, I am happy to share with you my story and ask you my questions. I am a 45 yr old male who began losing his hair at 19. I was told early on by a few surgeons that I was an excellent candidate for hair transplantation because my donor hair was so good (it was rated a 9 out of a possible 10). I believe that I am a Norwood 6 but I know that I have long lost all the hair that I was to lose. I have had 13 hair transplant procedures with Dr. X [editor’s note: name removed] and 2 scalp reductions with another doctor. The procedures were performed between 1989 and 2001. In total, I had 1679 “large” grafts, 379 “medium” grafts, and 321 “single” grafts. My hair provides decent coverage for someone who by this time would have been left with only what I call “clown fringe” (I am sure the visual will resonate with you) but I do use a concealer (Fullmore) to hide some small patches of my crown which show, and some of the scarring. My goal is to surgically get more coverage – or at least more uniformity in my existing coverage – so that I can stop using the concealer. I would like a good evaluation on what surgical options may be open to me, as I have already had so much work already performed and donor hair is not so plentiful. These are my questions:

Do you ever do any work in NYC/LI?

If the answer to #1 is no, can you recommend any good and caring surgeons in the NY/LI area?

It seems like FUE2 would be a natural choice for someone who has had so much work performed already and where so much donor hair might not be harvestable in one strip. Is this a correct assumption?

Is it possible to do many smaller strips so as to increase yield for someone who has had so much work performed already? Does it matter from where the strips are taken? I think that I may have some donor hair on the high sides.

I have not heard of too many people having as much work as I have had. Does the work I describe sound like it is so much? Are you aware of many people who have had more work?

I have been using a concealer for 15 years – just during the week and just during the day. Are there any health affects of such prolonged use?

How does the cost of the FUE2 compare with the normal strip method?

Any of these questions which you can answer would be appreciated.

Keep up the site.

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At the moment, I only have offices in California and do not plan on going to New York.
Dr. Robert Bernstein is a caring and competent doctor with a Manhattan location.
Follicular unit extraction (FUE) is less productive when donor densities are down from multiple surgeries and when there is lots of scarring.
With regard to taking high strips, it is generally not a good idea as high strip scars tend to show and they may not be in the permanent zone, so the hair may not last your lifetime.
I have seen many patients that have had more than a dozen surgeries plus scalp reductions. One patient I met had 27 procedures, of which I believe most were sham surgeries. Without seeing you, I can not comment on what you did and did not get.
Your approach with the use of concealers is well defined in my new book, Hair Loss and Replacement For Dummies, for the readers who do not know much about them.
FUE costs are high compared to the strip method, but more important, they may not be very productive. FUE costs roughly 2x the amount of strip procedures, per graft.

The problem with your situation is donor scarring and your donor area must be a mess. It’s difficult to make any real advisable points without first seeing what I’m dealing with, but you might be able to excise the highly scarred donor area (probably using a balloon expander) if that is bothersome to you. Good luck.

January 22, 2009

Why Might a Patient with 6000 Grafts Have a Thinner Appearance Than a Patient with 3000 Grafts? – Balding Blog

Dear Dr.,
First of all thank you very much for the help you have given on this forum. I have had two HT operation 1000 FUE(1.5 years ago, worked very well) and 2000 FUT (3 months ago). My question is has to do with HT results and I would appreciate if you could answer;

I saw pictures of more than 5K-6K grafts but has poor coverage/appearance compared to some 3K graft transplantation? Even, the pictures are from the same clinic. What are the reasons of this inconsistency?

Most of the pictures show hairlines and first half of the top. How about the crown? Is it a common practice to leave crown bald? Is it because the budget or a bald person does not have enough donor for front and crown so has to select one?

Does hair loss stop or decrease rate with the age? My lost started at age 26-27 with diffuse pattern now I am 31. A diffuse pattern goes till NW-7 or NW-6 or NW-6 with some diffuse hair still on top and crown?

Thank you very much.

Regards

Three months after a hair transplant should not produce enough hair to show any significant results. Wait a full 8 months to see the results of the second surgery.

There could be a variety of reasons for that. Patient A and Patient B could have different hair color, skin color, hair characteristics, degree of balding, etc. Or it could be different techniques used (many clinics have damage problems with FUE grafts, for example). There’s just a lot of variables that could be the reason.
The transplantation of hair in the crown does depend upon many factors, again including donor density, scalp laxity, thickness of the hair shafts, and the degree of balding. It may not be possible to transplant an entire head with a Norwood class 7 pattern of balding, but I have done it in patients with great hair qualities (see Patient ZU here, for example).
Only about 7% of men go as far as a class 7 pattern, about 20% a class 6/7 pattern… and most of these men with the class 7 pattern have clear signs of it before the age of 30. You need to be evaluated by a doctor like myself or Dr. Pak that specializes in this field if your doctor does not answer this question for you.

January 19, 2009

Hair Loss InformationEducate Yourself to Avoid a Hair Transplant Doctor’s Scam – Hair Loss Information – Balding Blog

I met with a patient last week who had a spectacular head of hair. On examination of the scalp there was absolutely no miniaturization anywhere, indicating that he had no genetic balding.

He was an obsessive young man who wanted to be sure that he was not going to go bald, as some of his male family members had. Because he needed the advise of a doctor to determine if he was losing his hair and what his future might be, he went to a hair transplant surgeon who determined that he might go bald and needed to do something about it. The young patient showed some maturing of his hairline only in the corners and even that assessment (by me) may be overstated, but because of the power of the doctor’s magnetic personality, the young man was convinced that he needed a transplant and got 800 grafts into the corners of his frontal hairline. The transplant clearly did damage, so he lost hair around the transplant area and many of the grafts did not grow.

Too many young men are receiving hair transplants when they are not indicated, even showing no balding. I would suggest that everyone considering a hair transplant to map out their own hair for miniaturization and if there is none, you can then confidently say that you are not balding and not fall for traps like what this young man fell for. It is unfortunate that many people are preyed upon by surgeons looking to pad their wallets, but you need to be smart about what you’re getting yourself into. Educate yourself and use the tools available online to be able to better understand things. The patient story I described above ended up leaving this young man worse off than before he ever went to see that surgeon. This site is free for anyone to use and learn from, and I am an outspoken member of my community simply because I don’t like to see people taken advantage of. I routinely turn patients down for surgery if I can see they are not candidates or a simple daily pill could be the solution they are looking for.

January 16, 2009

Hair Loss InformationWhere’s the Scar? Hair Transplant of 1807 Grafts (with Photos) – Hair Loss Information – Balding Blog

I saw this patient last week for a follow-up and he had a wonderful result from a single session of 1807 grafts in the frontal area. When I looked for the scar to see how well it had healed, I could not find it. The scar was closed with an upper and lower trichophytic closure and the results of doing this make strip surgery more than competitive to follicular unit extraction (FUE). This type of closure allows hair around the wound to grow through the scar, making it extremely difficult to see once it heals. To learn more about this, see Techniques to Minimize Donor Area Scarring. I have been routinely getting this type of healing from trichophytic closures.

The after photos were taken about 22 months post-op. Click the photos below to enlarge.

Before on the left; After 1807 grafts on the right:

Donor area – After. Can you find the scar?

January 15, 2009

Aspirin and Hair Transplantation – Hair Loss Information by Dr. William Rassman

I take baby aspirin daily as a preventive for heart and stroke, I have no history of either condition but believe it is prudent to take aspiriin daily. I am considering a hair transplant and wonder how long before a procedure should I stop the baby aspirin or is it necessary to stop taking it all? Thanks

Most doctors believe 7-10 days off of the aspirin would be adequate to have any surgery.

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January 14, 2009

Maximum Amount of Grafts That Can Safely Be Transplanted in a Single Session – Hair Loss Information – Balding Blog

My question is if this,if a person had unlimited donor hair and you had all the assistance you could use at your side.How many grafts would you be comfortable transplanting in one session without fear of the grafts not surviving?

I ask this question looking into the future,if hair cloning becomes available.Would it be possible to transplant 5,000 – 10,000 – 15,000 grafts in one session? Thanks for your time.

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Flying car My personal record at New Hair Institute has been close to 6000 grafts in a day on one patient. The patient had a very high hair density and a very lax scalp. He did not need more grafts, but I was confident that if he had the recipient area to take more grafts, his donor area could have yielded another 2000. Keep in mind the most important factor is the skill of the entire staff of the medical group. This would not be possible without a fantastic staff.

As for what the possibilities are with hair cloning — it’s all very much speculation still. Perhaps we’ll be able to hop in a flying car or maybe even teleport to the clinic where you’ll get your cloned hair implanted, then rub magic lotion on it all to get everything to grow wonderfully overnight. It’s fun to speculate on the future.