Category: Other Surgical Procedures

Hi Dr. Rassman & Dr. Pak,

I saw an interesting item in one of the hair loss forums about a company called ACell, which makes “extracellular matrix” (ECM) products from pig bladders for veterinary use. They are apparently in the process of getting FDA approval for use of some of their products in humans. According to the company’s website, ECM “serves as an inductive template around which around which mammalian tissues grow and differentiate.” There are pictures on this site that are pretty amazing — gaping wounds in animals with insufficient tissue for closure that heal nearly completely, including new hair growth, after application of the scaffolding material. This seems like a pretty exciting development, with obvious potential applications in the HT field. What do you think of this?

Plastic surgeons use this similar type of technology to address open wounds and reconstruct tissue. With respect to the hair transplant field, it may have certain applications in troublesome wound areas (severe scalp injuries) where the tension on the skin makes it almost impossible to close the wound. These wounds can close, but they will not develop hair on the skin and I doubt that the pig model will apply here.

Dear Dr. Rassman,
I am interested in body hair transplantation. Dr. John Cole does this procedure using special instruments he invented that have improved the results of BHT somewhat. What is your opinion of this procedure and how well do you think it works?

Body hair transplantation is still considered experimental in my opinion. Furthermore, body hair does not have the same growth cycle as scalp hair and most of the body hair is dormant (not growing). Thus, the success or growth of a body hair transplant is highly variable and rarely will more than 50% of the body hair be growing at any one time. Body hair also has a finite length of growth and a different texture than scalp hair. These factors make body hair transplants somewhat controversial. With respect to the instruments, there are many doctors who invent specialized instruments for their practice. I do not know enough of Dr. Cole’s particular instrument to comment on its efficacy other than to quote Shakespeare, “There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy.” — From Hamlet (I, v, 166-167).

Hello doctor, long time no talk. I recently found this on the internet regarding a hair transplant where the patient took hair from his leg and arm. The results look good.

Caution: Some pictures might be a bit bloody for some readers

http://hairsite.com/serendipity/authors/27-sofarsogood

Also, I notice that a lot of patients who have HT’s seem to grow their hair longer after the transplant and keep it that way. Is it because they want to cover up the other balding areas with the long hair? Can you get a HT and keep your hair short and still have that “full look?”

I am having difficulty with the first picture on the referenced site. This is not a hair transplant, but someone with a thick, natural head of hair. From a legal point of view, the inference that this representation of a transplant is fraudulent and violates consumer laws in most states. It may have just been an example of what the patient wanted, but to have it presented in the same reference with before and after photos is poor form.

Many hair transplant patients elect to comb their hair back or to the sides and keep it long. Longer hair covers better, but with good densities transplanted, short hair is not unreasonable. I tell patients that when they get a hair transplant, they create the illusion of hair, not the reality of it. Long hair with good grooming goes a long way to do this. The illusion I am talking about is basic to the math in hair demand/supply hair economics (see Patient’s Guide — How Many Grafts Will I Need?). If a person loses 60,000 hairs and gets a transplant that makes him look good with 10,000 hairs, then this is clearly an illusion, not reality. I have found that in people with good hair characteristics, low contrast hair to skin color, wavy, and coarse hair can get great results with as little as 20% of their hair returned through transplants. That, of course, requires an artistic surgeon and the budget to afford the process.

With regard to your situation with 15 hair transplant procedures, you may be running out of hair. Body hair may be a solution, but there really is not good data on it so you would have to be a guinea pig for human experimentation. This is not standard care. I would give you a one on one consultation if you are in the California area.