Category: Repair

dr.rassman, hello. as a former patient i cannot give you enough praise for the corrective work you did on my scalp. my reason for writing is to ask a couple of questions. first, can my old punch style grafts, be redistributed to create a softer look? secondly, can my donor area which is according to you less than a 2 be used to soften and thicken my hairline. i still wear a hair system behind my frontal hairline about 2 inches back. i am afraid of my donor area being bald yet i want a softer look in front to disguise my system. i would stop wearing a hair system but i now have a medium sized bald spot on top and i don’t see a way of covering it up with a very small amount of donor hair left. dr. can you help me? maybe i can fly in to california and have a procedure done to correct my first 2 questions.

People who have depleted donor areas are very difficult to treat. Yes, you can redistribute hair from the old plugs that you received years ago. What you must do is define your problems and your goals, then prioritize them, then visit me or some other competent doctor who can address your problems. Without seeing how you look today, I can not reassess your situation with the new tools and techniques that are now available.

Dr. Rassman…
I just finish reading one of the questions of a former transplant patient who had scarring problems and had to reveal them due to his job, where he had to keep his hair cut short. Well i’m in that same situation. I’ve several procedures and each one was worse than the last to the point that i have very little faith of any restoration and honestly not even by you. i have met you before and you did tell me just like some others that its not a guarantee!!! This is not an insult, but honestly how i feel. But i do feel that you do care and if anyone can help, you can. My situation is different, meaning i’m not interested in restoration but in skin repairing. I shave my head and use dermablend to cover as much of the scarring as possible. With so many plastic surg. in the U.S. i know someone out there can help me. I have watched Discovery Health channel at times and it gives me hope that i can get out this nightmare that has severely wounded my self esteem. Yeah,yeah,yeah i have been told it don’t look that bad but they won’t trade places with me. So i’ll start with you first. I’ve recieved a newsletter indicating surgeons on your staff specialize in this field, and by you being in this field for so long i’m pretty sure you know of others across the U.S. Sorry for the long request but its all about how you feel inside that matters right!! I’ll look forward to your reply…Thanx

There are many doctors who claim that they can fix anything, so I agree with you that this could be a problem. I do not know what Dermablend is, but if you are talking about dermabrasion, I have always wondered about it, but I have not been willing to experiment with it. Dermabrasion (the use of a rotating file like sand paper) causes changes in the skin that produce scars and color changes (depigmentation). If you have a tan or dark skin, dermabrasion may produce a white skin. That may not look right.

Can you send me up to date photos with your head shaved and a phone number so we can speak? If you are willing, I can blank out your face and then post the photos here (to help others understand the problem), or just keep it private as I do with all of my patients. I’ll leave it up to you to decide. Also, please send me your name so I can pull up the evaluation I did on you when you came in.

Can you point me to information about the new surgical techniques you reference? I was under the impression FUE was the primary repair technique for widened donor scars.

This is the response I wrote to another blog question…

We have developed a fascial closure of the donor wound. This has been successful in reducing the scars in the donor area. I imbricate the deep fascia holding it in place with a Vicryl suture (which lasts about 6 weeks). With the fascial closure, the tension on the skin in markedly reduced and most scars will heal with less stretching of the scar. This does not deal with the individual differences between the way we heal, but so far, the results of these repairs have been most impressive.

Hello,
I went through several procedures with a well known medical group back in the early 90’s. I was a 6 at the time.
In 2002 I was called back to military service to head to Iraq. I am an Infantryman and nedless to say our haircut is ‘extreme’. I was ridiculed and questioned constantly as to my ‘scars’. My scar from my MPR is particular noticeable and shows as ‘hole’ in the back of my head that dark hair grows out of. Since this was highlighted by the fact that everyuthing around it was shaved the jokes became of an obscene nature. Also, I was asked all of the time about my ‘smiley face’ scars on teh back of my head. My hair has continued to thin on the crown and tapers in to a long almost 1/2 ” scar that trils down to the ‘hole’. Even with my hair grown out now my ‘friends” refer to the reverse ‘mohawk’.Baghdad was hard enough without a year’s worth of snide remarks. Do you think this is ‘fixable’.I was upset at the amount of money I spent at the time only to end up being MORE self conscious then I was when I was losing my hair.
HELP!
Thanks

First I would have to see the problem as it presents. The ability to cover a scar with an almost shaved head is basically impractical/undoable. With your hair grown out and some creative work, yes, the entire donor area may be covered reasonably well. It depends upon the remaining supply and the strategy. The scars and ‘holes’ from scalp reductions have surgical solutions other than hair transplants. All the solutions, however, require that the hair remains long.

When you are teased about the scalp scars, I would use humor to deal with the uncomfortable and personal questions – tell them you had brain surgery and that’s why you are so smart! People can be insensitive and this is particularly true for young men. Be sure that you take Propecia, it is highly probable that all of the stress of Iraq is impacting your rate of hair loss. Let me know if you have trouble getting Propecia.

When you come back to the US, a visit with me would be great. Send me some photos too. My email address is on the Contact page.

I’m a former NHI patient with a bothersome donor scar. Say I came in and it was determined a certain repair treatment was indicated — would you charge full freight as if I were from another clinic?

Scars come from either the patient’s healing traits or the techniques used. For this reason, we have not charged any of ‘our’ past patients for a donor scar repair, providing that we did not have to transplant the scar. I believe that the new surgical techniques we have developed where scars can be removed, can improve scars that come about for failings of the older techniques. I believe that we should take care of our patients and that is part of our responsibility.

If we have to resort to an FUE for the repair, we have a charge between $1000-2000 per surgery (much less than our going rate) and most of these can be done in one or two sessions. In the past year, most of our patients have successfully improved their donor scars with this new technique and as a result we have not needed to do any FUE repairs in the past half year or so.

Paid advertisements (not an endorsement):

I would like to do a corrective procedure. I have way too much hair on the frontal hairline and I am receding in the back. Presntly, I can comb over much hair to create a look of fullnes; however, I fear a wind storm or having my hair wet; the result is too much long strand hair which looks awful (when wet or during a wind storm) ; I am tired of “faking: my hair style; I would like a style that is easy to care for. allows me to get my hair wet and allows me not to wear as much hair spray. I realize that means that I will be bald in the back-so be it. If I had my choice, I would be bald all over whithout transplamt scars and dolls hair look.

Is it do-able-I have some donor hair left but not a lot.

When working on the crown, there is a balance between donor supply, need and the worst case scenario for your hair loss. Often the donor supply is limited and you should have some reasonable assurance that your donor supply will not outlast your need as you continue to bald. It takes a real expert to make the most out of the least. A visit to a competent doctor with experience in corrective work will be invaluable. Be sure that the doctor will watch for your long term interests and not just transplant you today for how much money he/she can make now. When transplanting the crown, you must balance what might happen to you tomorrow. Can you send some pictures to me? It might help. My email address is on the Contact page. If you are in California or can easily come to California, please visit me.