How Much Would a Hair Transplant Cost Me? – Hair Loss Information by Dr. William Rassman

Dear Doctor,
Im 23 and im a about 2 – 2A on the norwood scale (male pattern baldness on moms side, no balding on fathers). dark brown straight hair and my brother and cousins on my moms side all show signs of balding. I realize you are unable to make a proper evaluation of my hair characteristics with out photo’s and testing. But my question is this:

approximately what is the best, and all time worse case scenario on how much a hair transplant would cost me?

And I truly do realize it is hard for you to answer considering the circumstances so I will keep a very open mind on the subject. But there must be some rough numbers along with a brief description you could possibly throw at me to help get some idea on what a person like me should be expecting for the future. Thanks so much

Costs could range anywhere from $3000 to $10,000 on average depending on how much hair you need, but at this point you’re likely not to be a candidate. I couldn’t even begin to guess what an all time worst case scenario would be for you. If you’re worried about retaining your hair, I suppose the worst case would be that you develop alopecia universalis and lose all hair on your body, making hair transplantation impossible.

What you want to do is examine your scalp for miniaturization (here’s a handy guide to doing it yourself) and if it is present, you should try to prevent further loss by using medications. Surgery shouldn’t be the first solution you rush to, particularly as you are still young with very early hair loss. Finasteride (Propecia) is the drug of choice and requires a prescription by a doctor.

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Shock Loss for Previously Transplanted Hairs? – Hair Loss Information by Dr. William Rassman

Are previously transplanted hairs at a big risk to shock loss following a second or third transplant?

Generally, transplanted hair is “permanent” and are not at risk of shock loss. Some hair loss may occur immediately after a hair transplant, but it should not be permanent if it is transplanted hair that has fallen out. I have seen shock loss in previously transplanted hair in less than a half dozen men and the hair came back as full as it was in all of them.

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Hair Loss InformationTestim Testosterone Gel and Hair Transplants – Hair Loss Information – Balding Blog

I am on testim. Will propecia help? can transplants survive testim use?

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Propecia may help reduce the impact of testosterone, but the use of exogenous testosterone does cause hair loss in people with genetic balding. The transplants, however, will not be effected by the testosterone, as hormones do not impact donor hair (which is not prone to genetic balding in men).

Trapped Nerve After a Hair Transplant? – Hair Loss Information – Balding Blog

Your blog is incredibly insightful and useful, can’t believe its a free resource. I’ve had a strip excision, my question is that there is one area directly above the scar line, about 3 cms wide and maybe 3 cms high (where scar is probably about 20 cms long) that feels raised and different. if I run my finger from below the scarline in that area up and over you can feel how that area becomes distinctly raised even sometime after transplant. the other areas above the scar dont have that feeling. could it be a trapped nerve ? and how easy is it to treat ? my doctor (even though giving good cosmetic hair results) doesn’t have your diagnostic capabilities. thank you !

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First, with regard to the free service, I have never turned down money offers or checks in the mail. I haven’t received any, but still… :)

You raise a series of questions that pose different problems. Some people heal with elevated scars that are like mini-keloids (heaped up scar tissue on the skin edge). These scars can be difficult to control and the wider they are, the more difficult they are to treat. Steroids injected into the scar helps on those that are fresh (under 6 months old). When you don’t have feeling about the scar, if it is just the area within an inch of the scar, it may be attributable to cut nerves, which occur in everyone who has had a strip. The feeling usually returns in weeks of months after the surgery. If the area is more extensive, like a hand’s width, then you may have a cut major nerve trunk. The nerve may be cut or just squeezed in the scar tissue. You will need a skilled surgeon to make the diagnosis.

Hair Loss InformationI Had a Transplant a Month Ago and Feel New Hairs Sprouting Up – Hair Loss Information – Balding Blog

Dear Dr. I had hair transplant back in November 3, 2008. When I gently place my hand on the transplanted area I can feel the “bed of thorns” or “sprouting new hairs”. My concern is are they really new hairs or is it the grafted hair waiting to fall out. I have been taking finasteride religiously for more than two years and still continue to be on it. Does this suggest that grafted hair may not fall out and continue to grow right away, since it is over 45 days from surgery and grafted hairs should have fallen out by now. Is it compulsory for grafted hairs to fall out, if so, generally how many days from surgery they should fall out.

Thanks

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In about 5% of people who have hair transplants, they will notice immediate growth without a ‘sleep period’ of 2-5 months, which is normally seen. If the hair falls out (95%) of patients, it will occur in the first 3-4 weeks. Propecia should be continued through the entire process without stopping it.

Hair Loss InformationCan Transplanted Hair Grow Long? – Hair Loss Information – Balding Blog

Most men who have had hair transplants show shorter hairstyles. Can transplanted hair even grown long (12 inches)? If so, what would it look like?

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Many of my patients with comb-backs, allow their transplanted hair to grow to lengths of 9+ inches routinely. From there it is up to you and the barber to decide what you want for the length of the hair. It is purely a styling decision.

Hair Loss InformationA Bargain Hair Transplant? Not Quite! (with Photos) – Hair Loss Information – Balding Blog

The following comes from Dr Paul Cotterill in Toronto, Ontario, Canada:

Here is an example of why proper training and regional workshops are a pretty good idea:

I saw this patient in my office yesterday that was referred to me for assessment. This 38 year old fellow ( Class IV-V ), had a transplant 4 weeks ago in Ludhiana, India. He felt that the procedure didn’t go very well.

On examination the crown had been transplanted with 60 – 65 punch grafts that were 2-3 mm in diameter and the distance between grafts was 1 – 1.75 cm, very irregularly, across the crown. Peri-folliculitis was evident and residual crusting on some of the grafts. There was up to 7 hairs in some of the grafts. The grafts were removed via FUE from the occipital area. The procedure took 1 hour and he was told to return next month for a second session of the same. The cost – $500.00 for both sessions.

I have swabbed for C&S what I could, cleansed the scalp, started an antibiotic and suggested Propecia, with follow up in 1 week. He would like further sessions to the crown. He needed a proper consultation as to planning and the consequences of starting the crown in a 38 year old with certainly further thinning in the future. Further sessions at this point are unwise. I will be following up with him closely.

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Dr. Cotterill has given me permission to repost these photos. It is unfortunate that people treat a hair transplant procedure as if they’re just getting a haircut. This is surgery! You want to do your research and know what you’re getting into. How could anyone recently get the old, ugly plugs of decades past? It’s disturbing on many levels. So he only spent $500 on 2 sessions to get this look. Now how much time and money will he have to spend to try to undo this foolish mistake? A bargain indeed.

Click the photos below to enlarge.

 

Hair Loss InformationMy Surgeon Said to Put Rogaine on My Newly Transplanted Grafts for 3 Months – Hair Loss Information – Balding Blog

I am 57 and had a hair transplant three weeks ago. I had a full head of hair until I was 40, and then very gradual thinning. The transplant was done to provide more thickness in the front and in the crown. The surgeon who performed the transplant said that in addition to taking finasteride (which I have done for several years), he advised using Rogaine (Regaine outside of the US) for three months on the new grafts.

However, the Rogaine website specifically says that the product should be used on the top of the head only. When I checked with their help line, they said that research had not been completed about success using rogaine at the front of the head. My guess is that this is because the success rate (both to promote new growth or even to arrest hair loss ) in the front of the head has not been good. I am looking for a second opinion and want to know whether it is best to ignore the front and just put it on the crown. If so, I wonder why one would apply six pumps to the area rather than one or two, the recommended dose, regardless of the area being covered.

The Rogaine representatives are clearly pleased that the product is being recommended by tricologists for hair transplant patients in the post operative stage but they will not endorse the use of the product on the front although they believe one should follow the advice of one s doctor. With your knowledge of transplanted follicles, what would you say about it? Many thanks

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I did a study some years ago where I used minoxidil on 1/3d of the transplants and on the other 2/3rds I did not. I maintained the treatment for the entire growth period for the hair transplants (6-8 months) and noted:

  1. That both sides grew in at the exact same rate
  2. That both sides started growing at the exact same time

I never published the study because the doctor who was doing this with me was a bit sloppy in his record keeping and I was not surprised at the outcome. I was able to conclude, however, that minoxidil has no effect on transplanted hair.

Hurting the Growth Rate of Hair Grafts – Hair Loss Information – Balding Blog

I recently had a hair transplant procedure done a clinic in Las Vegas. I keep worrying that something I do will hurt the growth of my grafts. It’s not an OCD but I’m always thinking about it when something happens.

Recently, my doctor put me on Ibuprofen 400 mg 3 times per day for a week to see if it calms this pain I’ve been having in my Gall Bladder area. This was in case I have some kind of inflammation. I’m having an Ultrasound next week. I’m wondering if we have to surgically remove my gall bladder, will that hurt the growth because of stress on the body? If we don’t find anything with the ultrasound, we might result to antibiotics for a week. Is that something that might hurt the transplant?

You see where I’m going with this? What is the threshold for something hurting the growth rate of the grafts. If they’re in there, are they pretty much in there and going to grow at 90% no matter what? What would one have to do to hurt that growth rate?

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Hair transplants are robust when they grow and very little can be done to damage a grown out hair from a transplant. In a couple weeks, everything is set… so depending on how recent your hair transplant was, I wouldn’t say there’s any cause for concern. Don’t worry, be happy!

Hair Loss InformationWays to be Ripped-Off by Your Hair Transplant Surgeon – Hair Loss Information – Balding Blog

This week I saw a man who claimed that he had 3000 grafts (he said his doctors told him that his grafts had about 9,000 hairs) placed on his head about a year ago. I could not see much hair from the hair transplant and because of his dark skin and diffuse hair loss, it was difficult to see detail well without a good light. The patient was not sure what benefit he had and came in for another 3000 grafts, this time from me.

I did my usual analysis. His family came from India so I was immediately alerted that he probably had a density in the 1.6 hairs/square mm range (average for an Indian from India). When I measured it, his average density was 1.5 hairs hairs/square mm. To have received 3000 grafts containing 9000 hairs, his density would have to be at least double what I measured. People who can get 3000 grafts averaging 3 hairs per graft, are very, very rare and it was clear that his 3 hair count per graft was not possible based upon my assessment of his donor area density. Putting aside this way of analysis, I would take it a step further. The size of the strip for 9000 hairs would have been huge. I would doubt that he had a strip of that size. My conclusion was that what he thought he received a year ago almost certainly did not happen. I believe that he had to have been duped by his surgeon.

I asked him about his doctor. He liked his doctor’s personality and his prices, but did not want to go back to him because he did not see much in terms of the results he expected. When I asked him what he paid, he told me that he paid $3/graft and selected the doctor after extensive shopping. This was the one doctor he felt that he could afford. When he looked into this doctor’s reputation, he did not find anything bad about the doctor (I did not probe what he meant by looking into the doctor’s reputation). When I suggested that he might not have received 9,000 hairs in 3,000 grafts, he said that he wouldn’t know, since he trusted that the doctor sold him what he paid for.

So here’s my analysis and the reason for writing this…

This patient was fleeced by his doctor. He was robbed. Not only did he not pay $3/graft (because the graft count was highly inflated), but he did not get what he wanted or needed and his results reflected that. What transplants he did get, seemed to be very few by my estimate (less than 500 grafts had grown). Assuming the 500 graft figure, one could calculate that he paid far more than the $3/graft. It angers me when patients get screwed over like this and I’ve been very open about my feelings in the past (see here, here, here, and here for examples).

I personally believe that his experience, although extreme, unfortunately does reflect some doctors’ practices where the doctors manage their way out of the recession in the US economy by taking advantage of the patient who believes in and trusts them. Doctors are like many professionals on Wall Street, where the bottom line is money and not the welfare of their clients. Scummy doctors unfortunately give the honest doctors out there a bad name and the good doctors really can’t compete with price claims of $3/graft (that actually reflect higher fees). My analysis was reached by my knowledge of the field and the science of hair density calculations which I have defined in the literature. I’m not trying to scare you away from having surgery if you are a candidate thinking about doing it, but I’m hoping this serves as a warning to do some extensive research and learn about what you’re buying… and above all be careful about your research. Some of the references here give more specific advice.