Category: Repair

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Hair Loss InformationHow Does Dr. Rassman Manage His Hair Loss? – Hair Loss Information – Balding Blog

hi doc, what do you use for your hairloss???? what is your regime??? do you take propecia or proscar and how long you been on it??? and has it stop your hairloss??????? please be specific on what you use… details please!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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I take Propecia, and that is all I do. Propecia may have stopped the hair loss or it may have stopped by itself (I am 63 years old, so it is not uncommon in a man of my age). I had 3 scalp reductions in 1992 (big mistake) and then 2 hair transplants in 1994 and 1999. I was lucky that the first hair transplant fixed the scarring problem and the second one added bulk to the crown.

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Scalp Reduction Slot Deformity – Hair Loss Information – Balding Blog

I had scalp reductions many years ago, about 7 such surgeries. I have this long narrow straight defect in my head that looks crazy from the back. Many people think that I had brain surgery and ask me about my brain operation. Can this be fixed?

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Thousands of men have had the bald spots of the scalp removed in a procedure called a scalp reduction. There was a naïve view by many doctors that bald areas could simply be excised surgically. When this was attempted, the surgeon might be able to remove about 1 inch per procedure and therefore some patients would have many procedures done to tackle extensive balding of the ‘Top and Crown’ that might be as much as 7 inches wide. What the patient found out, however, was that after 7 surgical procedures, they might have only reduced the bald area by 3 inches or so. The match did not add up.

That meant that the bald areas came back by stretching (“stretch-back” was the term used), and the patient was subjected to a never ending battle to remove all of the bald spot. Rarely was this ever successful for any large bald spot, but what was successful was the appearance of a slot in the back of the excision area which joined the two sides of hair that normally was on the side of the head, growing towards the ears. It was like a aprt in the middle of the head with a bald slot in the center of this slot that often measured 1/2 inch wide or so. This abnormal hair direction moved to the top of the head accentuating the slot deformity that appeared.

There have been many attempts to get this fixed, but only one surgery really works well. It is a triple flap procedure where scalp is moved around on the two sides of the slot. The hair direction is changed. The scalp reductions themselves are well exemplified in this article by Dr. Patrick Frechet, where the slot deformity as well as Dr. Frechet’s newer methods to remove the bald areas are shown.

You might want to go to France and consider having him do the surgery, as he is one of the few doctors world-wide that can achieve consistent results from this surgery with minimal risk of scalp necrosis (a common problem in inexperienced hands).

For more information, please see:

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Donor Area Repair – Hair Loss Information – Balding Blog

I would like to know if it is possible to repair the donor area. I had transplants done over 20 years ago, but they never formed well. I was able to survive on a comb over, but about ten years ago got a good hairpiece. I am satisfied with the piece and have no desire whatsoever to do a HT again (it is still painful in the back today).

The problem I have is that they took way too much hair on the back/left of my donor area. It has always been a problem and I had even resorted to using “Top Coverage” to fill it in so it wouldn’t be noticeable. If my hair gets wet or if I am laying on a pillow watching TV, when I get up, it is noticeable – VERY noticeable.

Ideally, I would love to remove the transplants form the top of my head and put them back on the side. Or, at least, reduces the thinning area in back.

Any ideas? Thank you

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Today, we can relocate transplanted hair by removing them from within the old plugs thereby thinning them. When they are taken out, we can then move these follicles into areas of need. The areas of need could be the scars from the old transplants or to fix some abnormalities that make your ‘look’ less than what you may wnat to look like. Look at the links below and see some of the wonderful ‘fixes’ we have done. Send photos of yourself (confidential of course) and then give me a call and I would be happy to evaluate you and your problem.

For more information on repairs, please check out:

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Repairing Pluggy Transplant, Part 2 – Hair Loss Information by Dr. William Rassman

Patient Update:

It is important to read the first part of this post which shows where this patient started from just 3 months ago , see last Friday, October 7th, titled Repairing Pluggy Transplant (with Photos).

This patient came to NHI to repair the awful, pluggy look he had to live with for many years. These old plugs are what many people, unfortunately, think a hair transplant looks like today.

Set 5 (above) shows this patient’s results 4 days after surgery. Scabbing and redness are visible, but within a few days will be gone (see below).

Set 6 (above) shows this patient’s results 8 days after surgery. The scabbing that is visible in Set 5 is now mostly gone. The redness has reduced considerably. Although the hairline may look straight in these pictures, you must remember that what you are looking at on the 8th days is remnants of the recipient sites and the single hairs in those frontal sites. In actuality, this patient has a wide transition zone in the front with 550 single hair grafts which will not show as a line when grown, but rather a zone where the forehead goes from its non-hair forehead to the thicker hair behind the transition zone, smoothly and quietly. Look at former patients to see what I am talking about as we have over 200 patient photographs shown on newhair.com.

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Hair Loss InformationRepairing Pluggy Transplant (with Photos) – Hair Loss Information – Balding Blog

around 1989 at the age of 20 I had a hair transplant , had approx 12 grafts put into each of my temporal areas as I was beginning to notice some receding. These were the old style plugs, my hair has now receded beyond these, so now I pluck hairs from the plugs to prevent the doll hair look. The problem is that the plugs are noticeable, they are hypopigmented, they are relatively smooth and level. What do you recommend? I would prefer to avoid any more transplants. Is there any procedure to give me a more natural appearance? Would dermabrasion work? Could the Relume laser restore the pigmentation? Any and all info would be greatly appreciated. Thank you.

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I have written extensively on the issue of repairs and published these writings in a prestigious peer reviewed journal. This publication has become the standard for repair techniques in the field.

What you asked is important to people like you and others. Generally, there are many approaches to the problem. First of all, most people in your situation have lost trust, so trusting another doctor to do surgery on your is often the most difficult step. Even patients who come to me because of my reputation or due to referrals from other repair patients I have helped, come with an ingrained mistrust. There is a reason for the old cliché, “once burned, twice shy.”

With that said, the other problems that you must face are how much time it will take to fix the problem, how many procedures, and how much it will cost. A reasonable goal should be to complete the process in one to three surgical procedures, depending upon how bad the problem is. The third and most important issue that must be considered is the end result – what is the likelihood that the problem will be fixed and gone? To address your questions, I would start by giving you an example of a recent patient I did. This is his second surgery and I would expect that it will be his last with a certainty factor of nearly 100%.

You also have a special problem, with the ‘plugs’ placed in the temples. These are best treated with removal. There are many ways to remove them, but the key is to make sure that the removal process does not leave you with bad scars that are as bad as the plugs.

This patient I am about to show, is a story that is best told by pictures. His problem is similar to yours, without the temple transplants.




Set 1 (above) shows his before picture with the plugs in clear view.




Set 2 (above) shows the shaved version of set one.




Set 3 (above) shows his photographs 6 weeks after the excision surgery that removed two rows of plugs. Note a very fine line reflecting the surgical excision.




Set 4 (above) shows the pictures the day after surgery where 2800 grafts were transplanted into his frontal area. This 2nd surgery with NHI to repair his hairline should be his last. As his final result will not be in, I want to show you another similar patient, whose repair procedure was documented for our website: Dean’s Story.

I know you want to avoid more transplants, but you should think twice about that because this is a well proven technique for repairs and it will get you the normal hair that you always wanted. Any hypopigmentation is dealt with through the excision and fully camouflaged from the transplant. You can, alternatively, remove the plugs either as an excision or through our FUE technique, one hair group at a time. Repigmentation will require more surgery with less certainty in the end result, than the approach I showed above. Dermabrasion does not work because it tends to produce more hypopigmentation. Lasers leave more hypopigmentation as well.

I did note that you are from southern California, therefore a visit to us in our Los Angeles office would be relatively easy. Come to our open house and meet some of these patients yourself. It is a little last minute, but there is an open house tomorrow in LA from 12pm-2pm. That may get you the confidence you need. Keep in mind that my goal is to keep your cost and the number of surgeries down, getting you to look like a normal, hairy person. That, I believe, should be your goal as well.

More repair before and after photos can be found here: Repair Work Photo Gallery Errors: http://baldingblog.com/photos/051007_before1.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before2.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before3.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before4.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before5.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before6.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_6wks1.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_6wks2.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_6wks3.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_post1.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_post2.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_post3.jpg is not accessible or supported filetype.

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Subsidize Wound Scar Repair? – Hair Loss Information by Dr. William Rassman

In a previous post you said:

“We subsidize the FUE repair of wound scars that were a result of a previous NHI surgery.”

What are the details of this, ie how much do you subsidize? Thanks.

I take the view that we are a full service medical practice. Because significant scarring is relatively uncommon, we will absorb the costs for scars that come about from our surgeries. If a scar came about from an NHI surgery, we will repair it at no charge to the patient with a modified scar revision surgery we recently developed. The results of this surgery has been very good in most situations.

On a few patients, the scars may reflect the person’s healing abilities, in which case a scar revision may not work. In those situations, for those who do not respond to this surgery to their satisfaction, we will perform an FUE at a cost of $2000 per surgery and put in whatever number of grafts that are available provided that this surgery can be done safely and effectively. Some patients may not qualify because they may not make good candidates for FUE surgery.

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Hair Loss InformationRecipient Area Scarring – Hair Loss Information – Balding Blog

I had two hair transplant procedures performed on me. The first was in 96 and the second in 98. I was only 21 at the time of my first procedure. I recieved a total of about 900 graphs between both sessions. I am very unhappy with the results. I’d like to know if my transplant can be reversed. What could be done about scarring in the recipient area? Any info would be greatly appreciated.

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You may be able to have the grafts removed with FUE. This may remove the grafts, but the skin may still not be normal and it would shows scars. Alternatively, you can fix it and complete the process if the hair supply is good. You first need to be examined by a first rate doctor. For more info, please see the following links:

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Hair Transplant Repair – Hair Loss Information by Dr. William Rassman

can you correct a hairline transplant already done? I have had a hair transplant done and had the hairline move down and now i don’t really like it and it does not cover the area i want it most. Can you help me?

Frontal hairlines that were transplanted in a manner that you do not like, usually can be fixed. I personally have many patients who have had old type of plugs, where I have repaired the hairline and now enjoy an undetectable, normal hairline. I have also moved hairlines up or down. We have published many articles in this area. Please see the following links for more info:

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Hair Loss InformationRemoving Growing Grafts – Hair Loss Information – Balding Blog

I just want to remove my grafts as they grow. Do you think it is reasonable to have it done with laser treatment. My scar has not healed all the way, but I guess I’ll have to live with it.

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The good news and the bad news about hair transplants, is that they are permanent. With that said, they can be removed with three types of surgical procedures. If there is no skin deformity associated with it (common in the older types of plugs), then the removal process may be easier.

Lasers have a high failure rate when used to ‘kill’ scalp hair and they will not deal with skin deformities associated with the older type of hair transplants. Be very careful about laser removal of scalp hair from hair transplants. The effective frequency used by lasers is more suited to less skin thickness found elsewhere on the body. The transplanted hairs may go too deeply into the scalp to be impacted by these lasers. If you look to our repair section in our patient photos and the articles we published in the journals on our website, you can see the various before and after pictures of the repair process and much of the details of the surgical repairs.

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Hair Loss InformationCorrecting a Scalp Reduction – Hair Loss Information – Balding Blog

I have undergone several transplants and scalp reductions over several years. Unfortunately the results have not been adequate and I have exhausted my donor area. I would like to consider cutting my hair short (to the scalp) or going with a shaved scalp. I am hesitant to do this because of scarring from scalp reductions and donor areas. Are there procedures to correct these imperfections or have I backed my self into a corner.

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I doubt that you can shave your head without showing the obvious skin deformities that were caused by the various surgeries that you had done. Before packing it in, however, you should be seen by a good, honest, competent hair surgeon. Maybe your conclusions are not derived from knowing what can be done today.