Category: Repair

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Advice from Someone That Has Had 9 Procedures – Hair Loss Information – Balding Blog

Dr. Rassman,

I’ve had lots of procedures done; I’ll say at least 9 since 1995. I’m 41 now. I know that’s a lot. I’ve had at least 4-5 done at one center, then about another 4 done at a well know hair transplant center here in DC. I’ve even had gaps of up to 4 years between procedures because of money issues. I’ve spent at least over $20,000.00 so far. I was never given a “Master Plan”. Every person only evaluated me, then asked, “How many are you looking to get right now?.” Me being new to transplant never really realized that once you start the process, you should, in my opinion, every year get as many grafts put in as you can afford. Well, I had really bad scarring in the back going across from one side to the other which was corrected a bit. My head of hair is not nearly as full as I would want it. Actually, right now it’s still very thin in spots here and there. Sometimes I’m just so depressed about it. Don’t make the mistake like I did. If you go for transplant procedure, get another job, work part time, anything to get that head full of hair. Too many procedures, cutting, stitching, etc. spells trouble. I know.

One of the groups did a great job of reducing my scarring in the back of my head. I was also told that in a couple of years ago that lab grown hair follicles will be available. Do you agree? I’m at that point where I feel this would be my last and only alternative.

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You have a tragic story. You were not placed on this Earth to give doctors money every year to get hair moved and to manage scars on your head.

The only patients that have had over 4 procedures with me are those that were very, very bald (9,000+ grafts) or very, very obsessive (I fondly call them my ‘hair addicts’). Most people should be completed with 1-2 procedures. Informed consent requires doctors to tell you what is in store for you, what you can reasonably expect a hair transplant will do for you, and when it will be completed. That is the doctor’s moral and legal obligation and the fact that you did not have that happen, means that you must have been victimized from hopping around to different doctors. You should have held your original doctor accountable for finishing what he/she started (in a perfect world of course). I know, unfortunately, that many people who go to doctors that are not responsible or accountable are caught in a difficult position. My suggestion is that you consider going to a doctor who will give you the real scoop as to what, if anything, you can expect going forward. If you need repair work on the scar, that doctor should be able to let you know what is in store for you. As you are on the east coast, may I suggest seeing Dr. Robert Bernstein in New York. He and I literally wrote the book on repairs.

I want to also comment on your hope that soon, hair will be grown in a lab to solve the hair supply problem. I am sorry to burst your bubble, but I don’t believe that will happen in any reasonable timeframe to get you the extra hair you may need. Many doctors are promising lab grown hair in a few years, but the ignorance by these doctors seems pervasive on this subject. My opinion is that we will not see lab grown hair for more than a decade from now. So for the readers who are postponing decisions on hair transplants to wait for lab grown hair, you need to ask yourselves if you really want to wait until you are 70 years old to get the more youthful look.

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How Can I Expect a Natural Transplant Result when Donald Trump and Other Rich People Can’t? – Hair Loss Information – Balding Blog

Hi Dr.

I’ve been looking at your page for some time now and it is loaded with great information. I also consider myself to be fairly well educated regarding the various options available to balding men such as myself since I’ve spent years keeping up on these developments. I am 39 years old and my hairline began to recede when I was about 20. For the longest time, the rest of my hair was so thick that no one really noticed since I wore my hair long. Over the past few years, the top has thinned substantially and I no longer bother to try to style it. I just wear it very short. I’ve never wanted to be one of those guys that look like he’s trying to hide something. The problem is that I’m also not one of those guys who looks good bald. I wish I were, but I’m not. About 15 years ago I had consultations at two different hair replacement doctors and both, to their credit, told me I was not a candidate at that time and to come back in the future when my hair loss was more advanced. I’m sure that time is now. However, I’m not sure I want to commit to a transplant procedure. The biggest question I have is this. Is there really a chance for someone of moderate means such as myself to achieve a natural and attractive result from a hair transplant when people with unlimited resources like Donald Trump, David Lee Roth or the myriad other balding rich people can’t seem to do it? I would say that I’m probably somewhere around a 3 on the Norwood chart.

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TrumpI laughed when I read your question, for you see, I’ve been wondering the same thing. A good hair transplant today is the norm, but in the days when Donald Trump did it (allegedly *cough, cough*), it was not a procedure that produced undetectable results. Mr. Trump, I believe, had scalp reductions (the bald spot was cut out) and hair transplants of the older vintage. The issue for people like him should be to repair the process, but he can not wipe the slate clean and go back in time prior to having the surgery. We wrote and published in peer reviewed medical journals, most of the original articles on the art of repair. I have no hesitation discussing the repair process, but first please read some of the articles we wrote on the subject:

For a person having his first hair transplant, you need to find a competent doctor (when you are ready) who is artistic and has a great reputation. I stress the importance of viewing patients (one on one) as a doctor who proudly shows off his/her results by giving you the opportunity to meet many of his/her patients. This will give you a very good idea of what you would look like after a hair transplant. I always say that what you see in the patients you meet will be a reflection of the surgical results you will get. Always ask for “before” pictures when you meet these patients yourself! Not to be alarmist, but I know of one immoral doctor who used a photo in a newspaper ad of a man with no balding to promote his practice — he was legally able to call this man a hair transplant patient because he had a few grafts placed behind his thick, normal hairline.

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I Had 3 Procedures About 16 Years Ago – I Want Them Fixed – Hair Loss Information – Balding Blog

Hello Dr. Rassman and staff.

1st – Thank you for this Q/A blog. I am sure it benefits many people and speaks well of you and your organization to take the time to help people with their situations.

I will not bore you with a long story of my situation and contempt for the HT doctors out there (not so much the procedures, rather the blatant lies as to the outcome to expect), I am sure you have heard them all. I will try to keep it short and to the questions. I did search most if not all previous posts, but none seemed to directly hit the mark on my questions. If you can, please forward your thoughts:

Desired goal:

Shaved head with as little evidence of past misguided decisions. No desire what so ever for further surgery, even if given an iron clad guarantee that it would give full coverage and a great result.

Current Situation:

  • 42 y/o male
  • 3 “procedures” in 1991 in 3 consecutive months
  • Mini and micro graphs – approx. 240-300 graphs total
  • 3 scars in donor – approx 1-1/2 to 2″ in length
  • these scars feel slightly raised, particularly on ends
  • Can not tell the width of the scars, but appear to be fairly narrow (Not pencil thin as promised)
  • Continued loss after HT, probably a NW 5/6

Recipient area:

  • Darker coarser hair in “V” shape, all alone in front of bald head
  • Some dimples, approx 5 to 10
  • No raised graphs
  • slightly pink color at many of the graph sites
  • Wear a hat all time, so no tan skin in this area, very white and greater contrast for the pink and the coarser hairs present.
  • When I shaved a test area in the recipient area, the skin surface seems to show little dark marks with the pink still present

Questions:

  1. Can the raised scars in donor area be cut out and reclosed using a more aesthetic plastic surgery type closure that would truly leave a pencil thin and flat scar. Other scars on my body heal very well, thin and flat. These other scars even take on some what of a tan.
  2. I assume that the majority of the dark marks in the recipient area is the thicker, darker hair below the skin surface showing through. I believe laser removal of this misplaced hair would remove the majority of these marks – with the hairs gone, would that eliminate the majority of the pinkness also? If not, what can be done to address the pinkness?
  3. What affect do you feel the laser hair removal, a tan and microdermabrasion, if needed, would have on these marks and the over all skin appearance.
  4. If microdermabrasion is recommended, what negative effects can this or even laser hair removal have on the recipient area? Could I end up more scarred? Could the recipient area end up not taking a tan like the rest of the head?

I realize a lot of answers are dependent on ones own body and its ability to heal. I am looking for general outcomes as I find I usually fall with in “normal” ranges of just about everything. If these are questions you can and will address, but would like to see some photos, please let me know and I will obtain some pics of the recipient area in varying lights.

Again, thanks to you and your organization. I suspect that your group is genuine and in the field of HT, that is truly rare.

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I would have to see you, or at the very least, I’d need to see some good photos as a starting point. Of course, I will keep your photos absolutely confidential (as a doctor this is not only a moral obligation, but a legal requirement under California law). If sending, please reference this post. Then we can talk over the telephone and discuss the matter. Face-to-face meeting is much more preferred though for your situation.

What you are looking for may not be possible. What you want is not standard and I would not want to represent anything that is not reasonable. The use of hair removal lasers can cause loss of pigmentation and microdermabrasion produces permanent changes on the skin quality. In other words, I don’t want to be adding to your suffering. Just from your questions, the caution I must give you is “buyer beware” and to suggest that you do your research before you start any process. There is no price for honesty and integrity and had you known what you were getting into 16 years ago, you would be in a better place. Normal balding is not freaky, as it is the norm for half of the male population to some degree.

My heart goes out for you, but it sounds like you need a personal consultation and even pictures won’t be the same as a one-on-one meeting between us. I look forward to hearing more from you and offering my assistance.

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Can I Flatten a Keloid in Donor Area? – Hair Loss Information – Balding Blog

i had hair transplantation in 2001. I had only two small patches to cover them but during the surgery i shed too many hairs and now i have a large scar at the back of my head and also have kind of wounds in some of the transplanted areas where scab is formed and i keep scratching those areas(what to do to get rid of these wounds). The scar at the back is like a small Keloid, is there a war to get it removed or flatten with some steroid injection? Also tell me if i can have hair transplanted on the area from where strip was taken so that i can keep short hair and that area remains covered. If it is possible hair from which part of the body will be taken as i dont want to donate hair from the back of my scalp. Chest hair, shoulder hair etc will do the job. Thanks

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Wow, this is pretty complicated. I really can’t give a proper response without at least pictures and I may need to even see you directly to see precisely what needs to be worked with.

Keloids may respond to steroids directly placed into the keloid if it is relatively fresh (past few months). Some people are keloid formers. You can always do FUE for hair transplants. Flattening them does not usually work. In your case, using body hair is a possibility.

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Plastic Surgeon Specializing in Facial Scar Repair? – Hair Loss Information – Balding Blog

I trust your opinion and was wondering if you could recommend me a Dr. that deals with scar revisions on the face or a publication that might rate plastics surgeons who do this type of work.

Kind Regards.

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All plastic surgeons can perform facial scar revision surgery. On a simple scar, it is a relatively easy surgery. I do not know of any specific ratings of doctors based on scar revision success.

You need to please keep in mind that all cuts on the skin will result in a scar to some degree. Thus, a scar revision surgery will still produce a scar. While the goal is to minimize the scar as much as possible, this is limited by the individual patient’s propensity to heal well. In other words, scar revision is not solely dependent on the surgeon’s skill or expertise.

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Can I Remove the Plug-Scarred Donor Area from My Hair Transplant 25 Years Ago? – Hair Loss Information – Balding Blog

i got transplants in 1983 that were less than satifactory.i have been wearing a hair replacement for about 15 years.my question is this.i want to shed my hair replacement and go to the shaved head look,but the donor area in back is my problem.can plastic surgery cut outthe plug area tomake it look natural? i appreciate your advice

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I see patients like you almost every day. A small portion of my practice is based on correcting bad hair transplant surgeries, like the old plugs. See Patient Photo Gallery – Repair Work for some examples.

It is very difficult to remove the scar so that you can shave your head, because the scars are going to have a white appearance. If you goal is to keep your head shaved, look at a Horror Story with a… Happy Ending?, which shows the use of tattoos to solve the problem in the donor area. It is relatively easy to disguise the unnatural scar and plugs with a follicular unit extraction (FUE) hair transplant surgery, but some hair length may be important. I would want to know how many ‘old type scars’ you had, as they may allow me to have some creative input. You must be seen in-person for a real opinion.

Further reading can be found at:

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Hair Loss InformationTransplant Hair to Scar on My Cheek? – Hair Loss Information – Balding Blog

Dear Dr.,
I have a scar on my cheek that I have from when I was a little boy. I’ve had 2 scar revisions but the scar always spreads and I’m left with a pretty noticable scar where no hair grows.
Would it be possible to somehow fill in that area with hair from maybe my lower neck?

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Scalp hair transplanted to the beard area (cheek) is a relatively common procedure. Some men who can’t grow facial hair have these type of procedures to fill in a beard, and likewise it can also be used to cover a scar. Lower neck hair would not be the best place to harvest donor hair, since neck hair is not considered permanent hair.

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Hair Loss InformationMy Son Scraped His Hairline on the Bottom of a Pool After Diving In – Hair Loss Information – Balding Blog

My son dove head-first into a swimming pool, and he grazed the bottom of the pool with his head/face. He seems to have lost some hair(about 1/2″ diameter) from his hairline just above his forehead.

I feel VERY fortunate that he didn’t break his neck, but do you think his hair will grow back after the wound heals?

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DiveMaybe! It is difficult to say. A significant wound may have damaged the hair follicles and your son may have a bald spot on the area of trauma, but usually such trauma will produce only temporary hair loss. I would wait 8 months to see if hair will grow. If hair does not grow, he may be a candidate for a small hair transplant procedure.

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Softening the Hairline (with Photos) – Hair Loss Information – Balding Blog

This patient came in the other day to say hello. He agreed to let me use his photographs to show his beautiful results. He had 350 grafts in one session at NHI about 8 and a half years ago to produce this hairline. Prior to seeing us, he had some older type of plugs which were neither full enough nor natural enough for his appearance. His gray hair helped me to help him.

Before:

 

After:

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I Want a Scar Revision – Hair Loss Information – Balding Blog

I was wondering if you would do scar revision for my donor scar. I don’t think I had a very good doctor. What would the cost of a tricho closure be approximately? I have seen your photos and some look great, I can hardly tell there is a scar. Thanks!

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We are constantly researching to come up with better methods to manage the donor area for improving the donor scars. Scar formation has to do with several factors — the surgical technique is only one of them. One important factor that patients tend to forget is their different healing potentials. Not everyone is a good healer and some patients develop widened scars regardless of the meticulous methods that are used. We usually do a scar revision for our patients with no cost to them. For those patients who are referred from other centers, we charge a minimum fee including a trichophytic closure, but we need to evaluate you with regard to the size of the scar, know how many surgeries you had, and determine the looseness of your scalp before we can tell you if we think that we can help you. You may call the office for a quote on our minimum fee — 800-NEW-HAIR. It is possible that this could be done over a telephone consultation.