Category: More on Scarring

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I Want To Undo My Plugs From 14 Years Ago – Hair Loss Information – Balding Blog

I was looking at your photos of the blog “Alas, Bald Again”. That is what I am considering. I have had about the same amount of hair transplants and in the same area. I want to have the transplants removed and not have any more work done. I was wondering if this could be done and be able to not have a bunch of scarring and divits left on my scalp? I had the work done about 14 yrs ago and wish I just would have went bald. Thank you.

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You’re referring to: Alas, Bald Again.

Each case is different. Scars, plugs, pits, color changes in the skin of the plugs, cobbling of the skin — all of these things must be analyzed. This type of question is not an easy one to manage over the internet. I have many posts on this subject and this one shows a long cure time and an expensive process. Based upon a direct examination, I might be able to give you advice.

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Hair Loss InformationI Had 4 Scalp Reductions And My Donor Area is Depleted – Hair Loss Information – Balding Blog

Have you considered, or would you consider body hair transplants to the scalp? I was a patient of yours once, but my donor hair is depleted. And since I have had 4 scalp reductions, you could not do the FOX (I believe its called) procedure on me because the folicals were stretched or deformed from the stretching of the scalp. I have resorted to having to wear a hair “system” because even if I shaved my head, the scarring from the donor area would be quite apparent.I am hoping for cloning or multiplication, but these seem to be far in the future, and I am not getting any younger. Do you have any ideas, or have you ever planned to experimetnt with body hair?

Thank you.

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Body hair transplants have problems, including the long sleep cycles of body hair. That means that up to 80% of transplanted body hair is sleeping and not present at any one time. Body hair transplants therefore give you efficiency factors, possibly in the range of 20% — in other words, they do not provide much value. Before you go into way out treatments, come see me in Los Angeles, as Phoenix is not that far away.

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I Have a Small Scar On My Head from When I Was a Child – Hair Loss Information – Balding Blog

(female) I have a small scar from a cut I got when I was younger. Hair doesn’t seem to grow there anymore, and I was just wondering if there is any procedure I could get to fill in this scar. It’s very small, but it bothers me, because it is on my part. It’s noticible when I want to part my hair down the middle. What can I do?

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A small hair transplant into the scar should solve that problem. This is easy to do and should take under an hour (depending upon the size you call small) in a skilled specialized office.

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Plugs to Bald (with Photos) – Hair Loss Information – Balding Blog

I hate my look. I answered an ad in the newspaper when I was in my early 20s and very depressed about losing my hair. It was not bad then, just starting to thin in the front. The doctor’s sales guy came in and did a job on me, telling me that it was on special and that he would give me 50 free grafts on top of the reduced price and I would never have to deal with the balding again. I scheduled for surgery done the next morning. This was 8 years ago and have hated myself ever since. I did not see how bad they looked until the hair fell out in the front, all within a few months of the surgery. Now I just want to become bald. Can I do it?

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My astute readers will notice that this is the 3rd blog entry I’ve made in the past week relating to this very issue (see also: Alas, Bald Again and Years After Transplant, I Want To Shave My Head ), but it is very important to drive home the fact that hair transplants are forever. I know that these deforming surgeries are what most people think that a hair transplant is, but based upon what I see in these pictures, I would expect that you had this 15 or more years ago, not 8. This is malpractice today and I believe even so 8 years ago. The way the doctor unleashed the salesman on you was downright immoral and I would report that doctor, at the least, to the medical board of the state. In California, the medical board takes responsibility to protect consumers against such behavior.

I think that going backwards and becoming bald may not be your best choice, because even if each of these plugs were removed, the scalp skin would then show the individual scars from each excision and the reflection of any light in the room would show the deformity. I suspect that the situation can be improved as shown in these articles and this patient example (see Dean’s Story link below).

You need a good doctor working with you one-on-one who has the experience to address YOUR needs. This requires both a very experienced hair transplant surgeon, one with good communication skills, compassion, and understanding. Then the two of you can work out what your real options are. For those readers who are seeing this scary picture, don’t think that this is the standard of care (take a look at what is the standard of care today in our Photo Gallery).

Note: This work was NOT performed by New Hair Institute. Click the photos to enlarge.




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Years After Transplant, I Want To Shave My Head – Hair Loss Information – Balding Blog

I had a hair transplant at 22 years old in Dallas. I have to admit, it did look pretty good to begin with. But after some years, I continued to lose my hair. Fed up with the look and not wishing to continue with surgery and the additional potential scarring, I decided to shave my head.

Turns out that I have the “head” for a shaved look and got many comments on how good the look was for me, leading me to wishing I had never done the transplants to begin with. To anybody else I will always say “try the shaved look first before going with transplants – it’s permanent!” But I’m definitely not knocking transplants. It’s just no longer for me.

My dilemma now is two-fold and from looking around at the various posts, I see that you’ve answered my questions in various forms, but I guess I’m not clear as to what I should do from here.

  1. I want to reduce the donor scar as much as possible. It’s wide from left to right, starting about the middle of my head – and noticeable (of course).
  2. Next, the pitting and scarring left on the recipient site is noticeable under flourescent lighting and bright lights (not necessarily sun light). Is there any way to reduce this scarring?

Are you able to “correct” this situation? Should I send photos?

Again, I understand that I can never get back to perfect form and, granted, it doesn’t look too bad as it is now. Yet anything to reduce the scarring would be helpful.

Thanks.

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I always tell people that transplants are forever and that is why selecting a doctor and taking the time to make the right decision is something that can’t be taken lightly and shouldn’t be done when you are in such an emotional state. You need to have a long term plan and this should have been discussed with you when you started at the age of 22. As a rule, 22 year olds do not make the right decisions (there are exceptions, however), so good doctors do not do this surgery unless there are clearly indications and an excellent doctor/patient relationship is made.

You outlined the problem well. You might extract the grafts using FUE, or excise them if they are localized enough. The donor scar can be minimized, depending upon what you present with. Good photographs would help me so if you send them, please include many views with some good close-ups and mail it to me at at the address on the Contact page. Once I see your photos, I might be able to give you more information and suggestions, but now I have no way to tell exactly the extent of the problem.

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Hair Loss InformationHow Long Must Hair Be To Hide Donor Scar for 2500 Grafts? – Hair Loss Information – Balding Blog

hi dr Rassman, am considering having a megasession but am worried about the linear scar if I want to keep my hair short at the back. how long do you need to keep the hair at the back to hide the scar if I have 2500 grafts. is there anywhere on your website with pictures of the scar etc…

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I always tell people that there is always a scar present, the key is to keep the scar as small as possible. 95% of people will have a scar smaller than 1/8th of an inch wide. Assuming that there is a 1/8th of an inch scar, any reasonable length hair will cover it (even hair 1/4 inch in length). With the newer trichophytic incisions (shown here), hair can be forced to grow out of the scar so that in 95% of people, unless you shave the head, the scar will barely be visible. Using special scar reducing techniques, scars are now far smaller than they ever have been and if you are the unlucky 5%, there are ways to solve almost any scarring problem you might develop.

Today we use a deep fascia closure to reduce skin tension (the number one cause of stretching of a scar). Megasessions in the hands of experienced surgeons who practice with these techniques to control scarring is an important consideration when selecting a doctor. I have always assumed that any scarring problem in my patient is my problem and I will often fix the scar at no cost to the patient, if there is such an issue.

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I Don’t Want My Hair To Recede To Reveal My Transplant Scar – Hair Loss Information – Balding Blog

I have had 2 transplants since 2000 and have noticed that I am losing more hair at the back of the head. My concern is that the scars left from the surgery will eventually be exposed if I continue to recede. I would say that they it is 2 to 3 inches away from the first scar. Is there anything I can do to conceal the scar? Is it time for another transplant?

Thanks

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As long as the scar is in the mid region of the permanent zone, I don’t think that the scar will be revealed. That is assuming that the scar width is not excessive , though most wide scars can be managed with a corrective procedure. It’s difficult for me to even try to conclude where your recession will end since I haven’t seen photos or met with you, so you may want to get a second opinion and even a third to better determine if your scar will possibly be exposed in the future and what can be done about it.

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Haircut After Strip Procedure – Hair Loss Information by Dr. William Rassman

Scarring from a strip procedure is a big concern of mine. What method do you use to close the donor area, and how noticeable would this scar be? For example, would my barber notice it while cutting my hair if he cut it to 1/2 inch length?

The person above is talking about removing a stip of skin for donor area harvesting, the common standard surgery for today’s hair transplant. Only about 5% of the population will have a scar wider than 2-3 mm on a single surgery. With a deep fascial closure and trichophytic incisions (see Techniques to Minimize Donor Area Scarring ) these numbers should show a smaller incidence. Even with a 2-3 mm scar, you should easily be able to cut your hair to 3/8th of an inch without being observable.

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Scarless Healing from New Drug Called Juvista? – Hair Loss Information by Dr. William Rassman

Hello Again Mr.& Dr.Rassman

We’re all in here thanking you for your salvation blog as am now going thru it on a daily basis.

I’ve this Revolutionary News for you which might be the long awaited Deliverence to many of us who have had Traditional Strip HT & left with a linear thin scar(hopefully) in the back making us feel so confined. Have you ever heard of a new innovative drug being developed by ”Renovo plc.” so called ”Juvista”, as mentioned it’s now in the PhaseII clinical trial & might see the light in the few coming years. It’s basically used during the surgery by being injected to the wound edges while suturing(i think) which will later lead to an almost scareless healing (GOD I HOPE THIS GONNA HAPPEN), please comment.

Juvista consists of recombinant TGFβ3. TGFβ3 is present at high levels in developing embryonic skin and in embryonic wounds that heal with no scar, but by contrast, is present at low levels in adult wounds that scar. Since the FDA has not approved of this drug yet and it still is in clinical trials, I will not comment much until further studies have been published. To get this drug to be approved by the FDA may take many years. In the mean time, please take a look at Techniques to Minimize Donor Area Scarring, which shows the modern techniques employed today (deep fascia closure and trichophytic incisions).

You can read more about Juvista here.

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Trichophytic Closure Photos – Hair Loss Information – Balding Blog

I read your article about the Trichophytic incision. Do you have photos of what this looks like?

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The pictures shown below are of a patient who had a trichophytic incision on half of his wound and on the other side had a non-trichophytic closure. The side with the trichophytic closure has hair growing in the actual wound, making it less obvious. These pictures were taken 5 months after surgery, so the scars have not fully matured and a slight pink color still remains. The photos below are both from the same patient (right and left are exactly the same image), except the two on the left are unedited and the two on the right has a yellow highlight showing where the actual scar is, so that you can see clearly that hair is growing through it. I apologize because some of the hair from below the scar is obscuring the trichophytic set of photographs, but I believe if you look through the line of hair that is combed upward from below you will see the hair growing directly from the wound. I will replace these with better photographs from the next patient that comes in to the office. Click the images to enlarge.



The below photos show the non-trichophytic side.



For more information about Trichophytic closures, please see Techniques to Minimize Donor Area Scarring