Category: Other Surgical Procedures

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Hair Loss InformationSedation and Hair Transplant Surgery – Hair Loss Information – Balding Blog

Dr. Rassman,
I enjoy your blog! One questions I had was if any hair transplant surgeons use level 2 sedation? I recently found a blog where a surgeon uses level 2 sedation instead of injection. What are the differences or risks for each one? Is one more preferred than the other?

Regards

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Nitrous oxideLevel 2 sedation scale is considered: “cooperative, tranquil, and oriented” according to the Ramsay scale. To some this can be achieved with no drugs. To some this can mean a shot of Vodka. In the doctors office this can be a shot of a sedative or a pill (like Xanax). It can also be breathing in laughing gas.

Level 2 sedation is not anesthesia.

At NHI we have evolved our sedation and anesthesia routine. We offer nitrous oxide (laughing gas) for sedation. In addition we also offer a single shot for sedation or a Xanax pill to take by mouth. Some patients choose all of the above and have a great Level 2 sedation experience. The laughing gas has the most immediate on/off response, followed by the injection. Finally the oral Xanax takes the longest for a patient to reach the Level 2 sedation.

We do monitor the breathing, oxygenation status, and cardiac status during the procedure, and if the breathing slows down, an alarm goes off. Level 2 sedation can quickly turn disastrous if the physician or the clinic is not prepared to handle the consequences of the medications.

To achieve Level 2 sedation your surgeon should be certified in ACLS (Advanced Cardiac Life Support) and the facility should be equipped to handle emergencies. Luckily Dr Pak is also Board Certified in Emergency Medicine so we are well prepared for any medical emergencies.

For Level 2 sedation we also take an additional voluntary step to be accredited by the AAAHC (Accreditation Association for Ambulatory Heath Care) as an out patient surgery center. Very few hair transplant clinics have this AAAHC rating (something to ask about when doing your research).

So that’s what we do. I can not comment on other doctor’s drugs and uses.

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Male Eyebrow Transplants (with Photos) – Hair Loss Information – Balding Blog

Hello Doctors
I am a 39 year old man and had a problem with my eyebrows since I was probably in my 20s. My eyebrows aren’t very thick. I never plucked them and do not know why they appear thin around the edges or when it exactly happened ,but I wanted to talk to you about what a transplant looks like in that area for men. My hair is otherwise great on the scalp and I have a strong hairline. Have you done any man eyebrow transplants? Thanks

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Here’s a male patient we haven’t shown before, with some beautiful eyebrow transplant results. I placed 189 grafts into his eyebrows with almost all single hair grafts taken from the scalp using follicular unit extraction (FUE).

In general, eyebrows are difficult to get control of the direction of the hair as it exits the skin, but these results turned out great! The after photo was taken about 7 months following his hair transplant.

Before photo on left // After photo on right. Click to enlarge.

 

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Hair Loss InformationHair Loss After Mammaplasty – Hair Loss Information – Balding Blog

I had a reduction mammaplasty under general anaesthesia for 6 hours in early June. In early October, my hair suddenly started to fall out more at first and only got worse till now (24th December). Could this be TE? How long is this expected to last?

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I am aware that some patients report diffuse hair loss after a major surgery. If it is telogen effluvium, then it may take 6 to 12 months to recover. However, I have often noticed that many patients do not fully recover (or regrow) all of their hair. It is my general advice that one gets a good physical examination by their physician to rule out other causes of hair loss as well.

I realize you (like many others) are looking for answers on the Internet, but I doubt you will find it… even here on BaldingBlog. This may be a good place to start, but as you explore the web you will be lost and confused, possibly ending up in a well-designed website promising you a cure for just three easy payments of only $19.95 (as an example). As I stated many times, seek out your medical issues with your doctor, one on one.

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Hair Loss InformationRemoving Brain Surgery Scars? – Hair Loss Information – Balding Blog

Hey. I’ve had brain surgery back in 2000 and an additional one in 2004. I have a scar on the front of my scalp going from my right side of my head to the top of my forehead. Its not from left to right but almost there. And I have some kind of missing spot on the back of my head. I dont know where that came from. But I was wondering if u had any suggestions on getting hair to grow inside my scars so I have no noticible scars?

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We (NHI) have been treating scars of all types on the scalp with hair transplants (especially brains surgery / craniotomy scars). The process is as simple as a hair transplant on the scar itself.

The entire process may take more than one procedure to fill in the scar, as hairs are transplanted directly on the scar and may not fully grow. Whether or not the scarring remains noticeable will remain to be seen. I wouldn’t want to make any wild promises without seeing you.

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Hair Loss InformationDr Gho’s Recently Published Partial Follicular Unit Extraction Study – Hair Loss Information – Balding Blog

What are your thoughts on Dr. Gho’s partial extraction stuff? There’s a new study in the Journal of Dermatological Treatment:

Link: Donor hair follicle preservation by partial follicular unit extraction.

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We are aware of this and I believe I’ve commented on partial unit extraction before. Similar work has been done by others with very different results, so I am a little skeptical. First of all, only five individuals were used in the study and between 100-150 grafts were harvested. The results look very promising, but I do not understand how you can achieve a success rate over 100% (104.1%) like is mentioned in the results.

It is also difficult to understand how one could keep track of where the 100 to 150 grafts were harvested from to see if they regrew hair. Think about this. Unless you make a clear mark (like a circular tattoo) around where you harvested the grafts, how can you say the hairs grew back? In the end, with all due respect to Dr Gho, I remain a bit of a skeptic.

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Hair Loss InformationDUPA and Body Hair Transplants? – Hair Loss Information – Balding Blog

Are people with DUPA candidates for a body hair transplant?

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Body hair transplants (BHT) are not considered a standard method of hair transplantation and may not give you a normal amount of bulk. I realize some doctors perform BHT with success (depending on how you define it), but the visual appearance of the hair that grows is clearly not normal. Body hair simply does not grow like scalp hair and is not the same texture.

In my opinion, even if you are desperate for hair, I would be cautious with this approach and demand to see patients who have had it done before you agree to such a radical approach to your DUPA problem. Any surgery can make the situation worse, and that risk is real.

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Hair Loss InformationExperiencing Hair Loss After Back Surgery – Hair Loss Information – Balding Blog

(female)
I recently (5 weeks ago) had back surgery. Now I find that I am losing hair. How long does this last?

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It could be a few weeks, perhaps even a few months. It may have nothing to do with the surgery, or it could be related to the stress your body experienced from the procedure. Have you talked with your physician about the hair loss?

It generally takes one year to see if you regain some hair.

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Hair Loss InformationUsing Chest and Back Hair When Scalp Density is Low? – Hair Loss Information – Balding Blog

I am Norwood 6/7. I had a nice transplant to the front 1/3 of my head, which frames my face well. Unfortunately, the density of my donor area is on the low side. I have VERY heavy body hair on my chest and back.

Would this be an acceptable situation to transplant body hair to crown area?

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Body hair is a difficult call for me. I have tried using it and have not done well with it. Aside from the physical characteristics of the body hair, the growth cycles are different from that of scalp hair.

There are a few doctors who claim to specialize in using body hair for scalp transplanting, but I am skeptical that the results are as good as claimed. The patients I’ve seen in my office with body hair transplanted to the scalp at other clinics have been less than impressive. If you’re considering body hair transplants, just be sure to meet with patients that have had it done by the doctor you’re considering so that you can see the results for yourself in person.

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Taking Finasteride After Kidney Transplant? – Hair Loss Information – Balding Blog

Hi
I had a kidney transplant 5 years ago. I use immunosupresants (Tacrolimus 2 mg/12 hr and micofenolic acid 1 g/12 hr). And im balding :(

Is it safe to use Finasteride to help regrow some hair?

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Finasteride is a safe medication, but before you start or stop any medication, check with your doctor who knows your medical history and medications. This is not a place to receive personal medication reassurance or endorsements.

You may not even have androgenic balding and finasteride may not work for you. I don’t know enough about your medical or hair loss history to make that determination. Since finasteride is a prescription medication, your prescribing doctor will be able to tell you.