Dear Dr. Rassman:
I don’t know whether or not you’d be interested in this message. Nevertheless, I would be interested in your reaction to it …
I was a patient (age 34 at the time) of yours in August of ‘94. You transplanted about 2,000 grafts from the back of my scalp to the top of my head. My overall reaction was that the density wasn’t near enough. And there was no way I could afford a second trip through the mill.
While I thought the newly transplanted hairs themselves looked okay, I concluded that your procedure fell far short of my expectation. To be blunt, my head resembled a coconut. So I ended up going to a company that provides rather costly “hair systems” (the gentle term for wigs). They look great – full and natural. It’s an ongoing “expense” that’s become a part of my life. But I thought of you the other day.
The idea of finally just shaving my head and being done with the high cost of masking my hair loss crossed my mind again. So when I took another good look at the white scar that traverses the back of my head from ear to ear, I dropped the shaven head idea.
Maybe when head tattoos are commonplace, I’ll put one right over the scar; a picture of a “bald eagle” or something.
Your reaction to this would be appreciated.
Thank you, sir.
Thank you for contacting me. I had the opportunity to review your photographs and your medical record. Hair loss is a progressive process and it is clear that the communication between us failed. I care about my patients meeting their expectations (first being sure that these expectations are realistic) and following up with a good Master Plan to follow the hair loss over time. I did this in 1994 as well. A single hair transplant procedure of 2000 grafts may have filled in some of your thinning, but it was not enough to cover the complete hair loss pattern that probably evolved. As hair loss is a progressive process and your pictures showed that you were in the process of losing hair at the time of the transplant, clearly you were a moving target. I must have failed to explain that process to you. Drugs like Propecia (finasteride) were not around in 1994, so unfortunately, in those days, I worked with a handicap watching helplessly as people lost their valuable hair over time. As you may know by experience, hair transplants (without the protective effects of drugs like Propecia) can accelerate the hair loss and even produce shock loss, which means that the hair loss process probably accelerated.
I can suggest that you arrange a visit with me and let’s discuss your present status and your goals. There have been many advances in managing scars if that is your main focus today. Nevertheless, I do care and the best I can do is offer my advice and reconnect with you again after all of this time. My office can be reached at 800-NEW-HAIR. Please do give us a call so that my staff will be able to get your next visit arranged.
Dr. Bernstein and I wrote an article in the February 2006 issue of Dermatologic Surgery that essentially says that when the ’scabs’ come off, the grafts are anchored. That can take 3-14 days and is determined by the aggressiveness of your washing process. The abstract of the article is available here — Graft anchoring in hair transplantation.