What Do Fewer Grafts Look Like If You Can’t Afford More? (with Photos) – Hair Loss Information – Balding Blog

I am what you call a Class 7 pattern with black hair. I am 55 years old and I dye my hair black. I know that if I came to see you, you would want to do thousands of grafts, but I am a bus driver and just would not be able to afford a large transplant. I might save up enough for a second surgery, but I would want to enjoy the hair while I am still young. I just got a divorce and want to start dating so my bald head really bothers me.

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I am going to show you a Class 7 patient who is about your age with just about the same problem you had. Although I would have recommended 3,000 grafts because of the large balding area, I gave this man 1677 grafts instead. Here are photos of his before and after (1 year) results. Click to enlarge.

 

He has a frame for his face and uses a ‘comb-back’ to cover the area which was not transplanted. After a year, it almost covers the entire bald area. Many doctors are reluctant to perform smaller sessions on people like you, but with a good artistic feel, the doctor should and can produce an acceptable result in one session (in most circumstances) with a thin look (as if he is losing his hair). It is important for prospective patients to be aware of these results. They can help by not dying the hair black and keeping it either salt and pepper or white, or even go sandy blonde, as it will always look fuller.

Please also note the scar on this man. We used a trichophytic closure of his wound with exceptional results, but as I have said before, the wounds are a reflection of not just the surgeon’s skills and the techniques used, but also the healing ability of the patient. Scar photo below. Click to enlarge.

Hair Length Before Hair Transplant – Hair Loss Information by Dr. William Rassman

I am 22 and am scheduled for a hair transplant surgery on July 9th this year for the frontal cortex, coming up soon obviously. My question is , How long should the donor area be in length?? I normally cut my hair short to hide the thinning, but if its crucial that my hair be a certain length, i need to know if i should get a trim instead of a full blown cutting as normal if my surgery is scheduled 5-6 weeks away from now.

This is a question that your transplant doctor should answer. Generally, I tell my patients to keep it as long as possible. Length will hide the surgical donor site best.

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Hair Loss Information20 Year Old Just Had a Hair Transplant to Cover a Scar – Hair Loss Information – Balding Blog

Hello Doctor,
Thank you for taking the time to read this. I find your site highly informative and at times humorous. I’m a 20 year old student; recently I had a hair transplant (around
1000 grafts) at the back of my head to cover an old scar. Judging by my close relatives, I will not inherit hereditary baldness.

It has been four months since the transplant and the grafts are growing quite well. However I have fairly long hair and the growth is slower than I would like. Could I use minoxidl to boost the growth rate? Also can you please explain the initial loss of hair that occurs with minoxidil usage, what causes it?

Once again thank you for reading this.

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I am pleased that you enjoy reading my blog and that your hair transplant went well. However there is not much you can do in accelerating hair growth. Rogaine / minoxidil will not boost the growth rate. As you are only 4 months from surgery, I would expect more growth over the next 3-4 months, so be patient.

With respect to the hair loss that sometimes occurs with the use of minoxidil, it is believed that the hair loss occurs from the “resetting” of the hair cycle.

Hair Loss InformationScalp Massage After Hair Transplant – Hair Loss Information – Balding Blog

Dear Doctors;

I have two questions.

  1. Can you scratch your scalp with the tips of your fingers a month after your surgery? Very gently, not using the nails.
  2. How long should I wait to massage my scalp? I had my second surgery three months ago.

thank you so much.

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You should always find this out from your doctor, but I will try to help you…

  1. Yes, you can scratch your scalp a month after surgery with your fingertips, but it is something that I would rather see you not do. Generally, hair follicles are set into the recipient area after between 3-10 days and you would have to work hard to dig them out. The hair grafted skin should always be handled carefully for a few months after the recipient areas have been placed, because the skin is more prone to damage and infection.
  2. What kind of massage do you mean? Generally, you can massage your scalp a month out from surgery. After about 3 months or so, it may be a good idea to do exercises to loosen up the scalp. Ask you doctor how to do them.

Hair Loss InformationSize of Incisions Contribute to Hair Transplant Failure? – Hair Loss Information – Balding Blog

Dr. Rassman,

For people with very fine native hair, is it important that the incisions for the recipient site be made very small to minimize shock fallout. I had a procedure about 1 year ago and lost much native hair due to shock fallout even though I was on Propecia for several years beforehand. Obviously I am very disappointed with my results (less hair now than prior to surgery) and am wondering if the size of the incisions caused this unfortunate outcome. Thanks for any insight you can provide.

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I cannot tell you why your hair transplant failed, but the size of the incisions should not have a significant impact on hair growth. The size of the incision is related to the size of the grafts (not the size of the hair). Just because your hair is fine does not necessarily mean that the size the graft will be small (needing a smaller incision). Get a second opinion. Hair transplantation works.

Numbness in Non-Transplanted Area 4 Months Post-Op – Hair Loss Information by Dr. William Rassman

Hello,

Im 24 years old and have been taking Propecia 6 months prior to my surgery and have been doing so ever since. In which now I am 4 months post op. I had 1500 grafts done, 500 in each temple and 500 in the crown.

I still have some mild numbness since the surgery directly on the top of my head in the non recipient sites. This area was very dense and now is very thin and I believe it is due to the numbness. Can you tell me generally when the numbness starts to subside. As well will that density come back or is it safe to say my hair will continue to be this thin?

Thank you.

It sounds like you have two different things happening. At 24 years old, if you thinned after surgery, you probably experienced ’shock loss’. Do you know if the hair you lost was miniaturized? Miniaturized hairs are the ones at risk for shock loss. Propecia has wiped out most of the hair loss caused by the surgery that we experienced prior to Propecia’s availability on the market, but there is (of course) no guarantee that it will wipe out all of the risks of shock loss.

As for the numbing you’re feeling — all numbness should be gone by now. You need to go back to your doctor and ask these questions or get a second opinion if your doctor does not give you satisfactory answers.

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What Happens When a Doctor’s Car and Mansion Payment Is More Important Than You? – Hair Loss Information – Balding Blog

Here is a man who had hair transplant surgery some years ago. He had hair then and the doctor put in about 600 grafts throughout his thinning area. After the surgery, his hair loss accelerated and when the grafts grew out, other than seeing some small plugs, he did not find any value to having had the surgery in the first place. Since his surgery, he lost all of the hair on the top and crown of his head. Now all he has left is the transplanted grafts that are now unnaturally scattered over his head. The doctor who did this was either ignorant or immoral. A properly done hair transplant should stand on its own, or the doctor should tell you otherwise. That is what is required of the doctor by law. There was NEVER a possibility that this patient had anything of value and now he has negative value that he will carry around for the rest of his life unless someone completes his hair transplant in a logical way. Even with a properly done job, he will not have enough hair to cover his crown. Still, the man he sees every day in the mirror should be much more normal looking after his ‘fix’. Unfortunately, too many doctors are quoting small and large transplant sessions where and when they are NOT NEEDED. These doctors are just out for the almighty dollar. Immorality has not been wiped out and the crooks are still out there. Don’t be fooled by slick ads and particularly watch out for doctors that use salesmen to push, push, push you into making a decision. Again I say, “Let the Buyer Beware“.

Click the photos to enlarge.

 

The Beard After a Hair Transplant – Hair Loss Information by Dr. William Rassman

Hey Dr.,

I’m coming in for about 1000 grafts next month. I do have a slight concern, however. I’ve seen pictures of this “beard” effect, in which you can noticably tell there is a dark area where there has been transplants. How long is the beard usually visible? Would it be as drastic with just about 1000 grafts in the front?

Thanks.

The beard effect you talk about is from the short transplanted hairs that are visible immediately after the hair transplant. It usually lasts one to four weeks before it sheds. It is not readily detectable if you have other hair to cover it, but if you are a class 6 (completely bald) obviously you cannot hide it. I would then suggest that you clip it short or let your facial hair grow out as this will detract from your head viewing. If you already have facial hair (a beard or mustache) shave it off for the shock value and it’ll draw less attention to the top of the head. This works very well.

Transplanting Hair in the Correct Direction – Hair Loss Information by Dr. William Rassman

doctor my question to u is regarding direction.while transplanting grafts into the balding areas of the scalp how do u determine the direction in which it will grow, the depth or angle? the hair is trimmed so short before a surgery is there a sureshot way to determine the direction of hair will grow after a transplant??

The direction the hair will grow in is determined by the surgeon as he/she puts in the recipient sites. The direction and angle of the instrument in making the ‘hole’ is the direction that the hair will grow in. Almost 100% of the hairs between the parts point forward. At the part, the hair changes angle and the surgeon’s skills here are most important. I have seen far too many patients have a ‘radial’ direction to the hair where the hair is directed more like the spokes of a bicycle wheel. For those patients with straight hair, any faulty placement of the hair direction will be magnified.

Take a look at an article I co-authored back in 2002, The Art of Repair in Surgical Hair Restoration. In the images shown in this article, you can see some of the wrong directions and how to do the work correctly. Particularly, take a look at figure 3 from the article which shows the wrong direction (below for convenience) and the right direction in a schematic form:

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Hair Loss InformationHair Washing After Hair Transplants – Hair Loss Information – Balding Blog

I had hair transplants a month ago. My hair looks like it is caked with crud. When can I wash my hair?

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A month following the surgery you may wash your hair as you normally would. You should have started to wash it after the surgery, but the ‘crud’ you are talking about reflects scabs from the surgery and skin that normally sheds. To wash it clean, apply shampoo and leave it on for 5-10 minutes, then gently with your fingers, rub off the built up ‘crud’. Repeat it until it is clean and then all you must do is wait for the new hair to grow in.