Category: Other Surgical Procedures

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Hair Loss InformationCan Skin and Fat Transplants Cure Hair Loss? – Hair Loss Information – Balding Blog

I think that the hair loss is not a problem of degenerating of the hair or a genetic predisposition of the hair to fall, but it can be a degeneration of the skin where the bald area apears. May be a transplant of the hyperderm from other part of the body to the bald area may help the regeretion of the skin and the hair . Or the injection of the fat from other part of the body taken by liposuction to the hyperdermis of bald area may have an efect.

Best regards

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The skin has nothing to do with hair loss, unless it is diseased. Transplanting skin would be human experimentation with no back-up clinical trials and skin transplants might very well kill the hair. Fat transplants also will do little to help grow hair.

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My Hair Fell Out After Brow Lift Surgery and Regrew With Different Characteristics – Hair Loss Information – Balding Blog

(female)
Dr Rassman,

After having a brow lift type surgery ( no lift but same incision ) a lot of hair all over my head fell out. What grew back were strange hairs. Some are very fine only about 3 cm long, and look crimped. Others are thick coarse hairs that look like afro or pubic hairs. Together these hairs are all over the crown and have been growing this way for about 4 years now. My Dr said these hairs have nothing to do with the surgery but they all started a few months after the surgery.

I am 99 % convinced that they are related and would appreciate any information you might have. Also some of the coarse hairs have are less so closer to my scalp, that would indicate that time is possibly helping a bit. The very fine ones have not changed.

With Kind Regards

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I have not seen this type of change associated with a brow lift incision. I have seen hair loss with a finer hair appearing in front of the brow lift incision, but I have not seen someone change variable parts of the scalp hair and not other parts. I would have to examine you to make sense of the process you are discussing. The use of good conditioners after washing should minimize the kink in the hair.

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Hair Loss InformationAfter 7 Scalp Reductions, Would I Have Donor Grafts Left? – Hair Loss Information – Balding Blog

Dr. Rassman, you won’t believe this. Maybe you will. I have had I guess 7 scalp reductions. Brandy did a lateral with that Y incision, but not a scalp lift, per se. Marzola, Stough, all did a couple of procedures. I saw my scalp under bright lights (the last thing one wants as that is very unforgiving) on a big screen last night and was shocked by the 1 inch by three inch or so bald thin area in the midline. Dr. Hitzig performed two large midline graft sessions around 1999 or 2000, fixing the scar but the density leaves something to be desired. I see you mentioned Dr. Frechet of Frechet extender fame I imagine in a response to a patient. Some sort of triple flap procedure. I have some donor left but can’t get over my lack of crown density despite a large number of grafts. I know Dr. Hitzig always grafted the midline before reducing a scalp. Do grafts just not grow after reductions, especially that many reductions? I could emply better styling but I wish I had followed the late C.P. Chamber’s advice and avoided reductions altogether. He knew what he was talking about. It sounds like there is no practical fix at any price.

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Scalp reductionYour case is complex. I have no idea what densities you have or the extent of your scar and wound defect. Most people who’ve had 7 scalp reductions are left with a slot deformity. I would like to see some good pictures of your scalp from the front, top, sides, and back. I am sure that you know that scalp reduction is no longer the standard of care today, because they do not work. I have seen men who had up to 16 scalp reduction surgeries and the last ones never really accomplished anything. I wonder about your 7th procedure and what you were trying to accomplish that the prior 6 have not.

It is best to be examined carefully by an expert and then see what your needs are. Patients should make a list of priorities and then try to work down the list. Patients who have had so many procedures never really get too far down that list, so be realistic.

For more information on scalp reductions, see:

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Can I Remove My Donor Scar Using Lasers? – Hair Loss Information by Dr. William Rassman

I had three hair transplant surgeries and now I shave my head because of the results. I like the shaved head look but the scar from the donar are sticks out like a soar thumb. How can I remove the scar or make it les noticeable? Will laser scar removal help?? Is there any solutions to my problem?

Thanks

Sometimes one can address scars on the back of the head, and I have managed such scars on a few patients. The laser is not a magical instrument and I doubt it would help you with removing the linear hair transplant scar in the donor area unless it was elevated and the laser was used as a treatment to flatten it. Dermabrasion can accomplish the same thing. If the scar is heaped up (keloid like) then the use of steroid injections have value, but for a flat scar, neither the laser, dermabrasion, nor lasers will help. The treatment of acne scars with laser sare another thing altogether. There, laser resurfacing works on some people, but lasers can be used in many ways. Removing the scars from a hair transplant in the back of the head is not one of the things that lasers can offer help on.

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Skin Necrosis After Hair Transplant Infection – Hair Loss Information – Balding Blog

Hello. I’ve had my third FUT surgery about 2 months ago and due to infection the sutures incision line didn’t heal and skin necrosis happened. 16cm (6.7 inches) to 3 cm (1.2 inches) split skin graft was implemented 3 weeks ago on my donor area. Can FUE be a solution to cover up this area? And how many grafts may be sufficient?

Best regards

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FUE is not the way to go in your case. A balloon expander for a problem of this size is the right thing to do. You can learn more about tissue expansion at American Society of Plastic Surgeons.

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18 Year Old Man Wants Options for a Lower Hairline – Hair Loss Information by Dr. William Rassman

Hey doc, I’m an 18 year old male with a big forehead for someone my size, and it’s really bugging me. What option would be the best to remedy this for a guy who is my age, who is not balding or has ever had any form of hair loss, whose father did not start balding until his 50s, and who only needs to lower his hairline by 1-2cm?

I know that my two choices are forehead reduction surgery (but I’m kinda wary about the possible visible scar if I start balding), and hair transplantation. Which would the costs generally be for each option for a hairline 1-2cm lower?

At 18 years old, you really won’t know if you will bald, so if you move your hairline down with transplant and should start to recede in the future, you will have a vacant space behind the newly lowered hairline. If you move down your hairline with a hairline lowering procedure and should bald, then the scar from the procedure may show as you continue to recede. Many surgeons will not tackle lowering the hairline on an 18 year old male. For women though, it is generally no problem!

The cost of either procedure (hairline lowering or hair transplants to the hairline) may run about the same.

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Hair Loss InformationImplanting Artificial Hair for Alopecia Areata Patient? – Hair Loss Information – Balding Blog

HELLO Dr. Rassman

I am a 24 year old male and suffer from Alopecia Areata. Is it possible too have false hair transplants as i have no hair on my scalp, i only want eyebrow hair is this a possibility and what are the procedures!!

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Implanting artificial hair is dangerous and leads to massive infection. This is not a solution. Usually, alopecia areata does not cause complete loss of the scalp hair, and you may have alopecia totalis or alopecia universalis.

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Hair Loss from Z-Plasty Incision in Scalp – Hair Loss Information by Dr. William Rassman

Doctor, I recently have had a spot removed from the top of my head. It was necessary to do a z plasty, which is roughly 4 inches in the longest part. I have no natural hair loss, but have been on Propecia for roughly 14 months. Since the surgery, (6 weeks ago) I have significantly thinned in a z pattern on my head, where the incision was made. It actually looks worse than it did 1 week after the surgery. I am very concerned and would like your opinion if I am experiencing what some might classify as shock loss, and if my being on propecia for a year prior would lend itself to me getting my hair back. Thank you

Having any scalp surgery in an area where you are genetically balding will accelerate the hair loss, and it quite possibly may be permanent. Even a scalp surgery like what you described can cause hair loss in non-balding people. Shock loss is usually best prevented by Propecia (finasteride 1mg) in men with genetic hair loss. You will know what will happen in 6-8 months. You may need transplants there if it does not self correct.

For those curious about a Z-plasty, Wikipedia has a nice explanation here.

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Removing a Cowlick in the Hairline? – Hair Loss Information – Balding Blog

I am 19 years old and am interested in the surgery your company offers for hairlines. My father recently had a follicle hair transplant done and he was greatly satisfied with the results. He chose to have this transplant done due to balding. My case is different however.

I have a cowlick in the center of my hairline which is wierd and I hate it. I am interested in a transplant that could fix this hairline issue and possibly get rid of my cowlick structure. Is this possible? I must also add that I am only 18 years of age. What would be the average cost for such a procedure that I am requesting? Is there another type of surgery that could fix this issue? (such as brow lift, or etc)?

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These cowlicks are interesting and I have always personally liked their look, but many of the men who have it might not agree with me. If you want to remove it, there are some options including laser hair removal and follicular unit extraction (FUE). I would be reluctant to do this surgically on a 19 year old without your parents involved in this decision.

As a side issue, transplanting into a cowlick to restore it, does present interesting challenges.

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Hair Loss InformationFemale Hair Loss Continuing After Serious Surgery a Year Ago – My Doctor Dismissed My Concerns – Hair Loss Information – Balding Blog

(female)
Hello,

I’m having a hard time with hair loss since a serious surgery in May of 2007 (it lasted approximately 6 hours). It is now April of 2008 and I’ve noticed a steady and very noticeable loss in hair (I can see my scalp from the back- very little coverage of hair).

I have no known genetic hair loss in my family (that I’m aware of) my grandparents and parents have full, very thick, heads of hair and I had a full head of healthy hair prior to my surgery. My Dr. dismissed my concerns as attached to the surgery in May, however, I have not seen any return of hair since then, but rather a continuing loss.

When should I expect the hair to regrow? Is it unusual for hair loss to continue 10 months after surgery (note: the loss didn’t start until a few months after surgery and it was dramatic loss all of a sudden rather than slow shedding). Sometimes I find that my scalp hurts- it’s a hard feeling to explain. It is not severe pain, but rather a dull sort of sensation all over my scalp. I’m very concerned and have tried one treatment (oil and shampoo system -the oil treatment was twice a week for three months-that was supposed to stimulate growth). It did not seem to help at all.

What do you recommend I do? Is this normal or the sign of something irreversible? Thank you for your help. I do hope you can answer my question. I’m desperate to find some solution.

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Hair loss after a surgery or from a severe stress is called telogen effluvium. If it lasts less than a year as it normally does, it will reverse after the stress abates. Some people go on to a chronic telogen effluvium. Both forms may be treated with minoxidil while you are waiting for it to reverse. More information about telogen effluvium can be found at eMedicine.