Category: More on Scarring

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Transplanting Hair Into Burns – Hair Loss Information – Balding Blog

Is it possible to regrow your hair through the likes of transplant surgery even though my hair was burnt in an accident? It is not a lot, its just on one side. How does one get a hold of any doctor who can help out?

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Yes, it is possible to transplant hair into the scarred area caused by burns, provided that the skin is healthy. Some badly burned patients lose skin and receive skin grafting which may not support transplanted hair if the skin graft was ‘partial thickness’. The early years of hair transplantation were for burn patients by Japanese physicians. So again, provided that the skin is healthy, hair will grow if carefully transplanted. For help finding a doctor in your area, I would use the physician search on ISHRS.org.

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My Donor Area is Depleted From Past Procedures – Balding Blog

What is your opinion on ScalpMed a product being sold via infomercial that has been getting reviews? Also, assuming someone had no more donor area from having had a few procedures, but still wanted to grow more hair, what would be the most effective way to do it? I have a full head of thinning hair, barely covering the crown, and thin in the front, but with a hairline.
Thanks.

You’ve indicated that you are located in Beverly Hills, so it would be best for you to be evaluated in person. The depleted donor area is often heavily scarred and this would have to be assessed, balancing donor supply (if available) against need (demand). If you have a full head of hair, just now thin, do you really want more transplants? Question that goal carefully. If you’d like to come in for a free consultation at our Los Angeles location, please call my office at 800-NEW-HAIR.

ScalpMed has been referenced before, here.




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Does Deep Massage on Donor Scar Have Any Benefits? – Balding Blog

Hi Dr.
Many Thanks for your efforts here. I’ve this one little enquiry. Have had a strip surgey for some 1000 grafts, Will the deep massaging of my 5 months old linear scar have any beneficial effects? like enhancing/improving it’s future appearence, Also, can now i resume my sport activites like swimming, jogging & some weight lifting without worrying that my scar could stretch, overheard that scars take up to 18 months to reach their maturity stage.

Thanks again & Best Regards

Deep massage can help loosen your scalp for future graft harvesting, however it will not improve the appearance of the scar. Sport activities such as swimming and jogging a few weeks after surgery should not widen the scar, provided that the incision was not made in the high neck area. When neck excisions are done, there is a higher incidence of widening donor scars. In the short term period after a hair transplant (first 4-6 weeks after a strip harvesting technique is use) weight lifting can potentially cause widening of the scar because straining the neck muscle may want to traction on the scar. After 5 months, I believe that everything is somewhat fixed in position. Massaging the scalp will have value if the scalp is tight.

For your information, there are three phases of wound healing:

  1. Inflammatory response — day 0 to 4 days
  2. Fibroblastic repair — day 4 to 6 weeks
  3. Maturation/remodeling — 6 weeks to 2-3 years, although most of the strength (the width of the wound) is established by the end of the 4th month




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Balding Forum - Hair Loss Discussion

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Removing the Pluggy Doll’s Hair – Hair Loss Information by Dr. William Rassman

My boyfriend has hair plugs. He got them when he was much younger (he is 35 now and has had them for at least 8-10 years).

I really don’t like them, they have a doll hair look to them that is described on your site. He is starting to bald and thin in the back now. I asked him if he can shave his head and he told me he couldn’t due to the implants.

What are his options? We are both interested in correcting or bettering the situation. It is obviously a sensitive topic for me to bring up. I love him a lot …and want to try and find a way to improve his hair situation. I know he wants to as well.

Can you help?

They say great women are behind great men and great relationships. I admire you taking the helm and trying to help your boyfriend. The pluggy look is never good, and repair procedures reflects much of what built my practice in the past 15 years. The best way to answer this is to link you to Dean’s Story, which is a step-by-step account of one patient’s repair procedure, complete with photos that might be considered too graphic for some. It’s all in there.

Other resources that will help you and your boyfriend make an informed decision:

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Ingrown Hairs at Donor Scar – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman
I’ve written this inquiry which i appreciate your priceless opinions for. I’ve had a strip surgery which normally results in a fine pencil thin linear incision (provided that healing is normal, reasonable surgery size & smart closing technique). I don’t really know how wide my scar is since I am growing my hair long in the back, but like many, i suffered shock loss in my donor region through out the linear incision. I also don’t know what closing method the surgeon used on me, but anyhow, everytime i massage my 5 month old scar, i feel those little stubbles (short ingrown hairs) that appear/feel to be growing right from the scar. Problem is that those hairs are taking forever to grow longer, normal hair grows about 0.5in/month (i think)…so why is this happening? i’ve heard of that newly used closure technique which allows hairs to grow out along the scar, so maybe it has been used with me & that could explain the existance of those hairs. Will the application of Regaine/Minoxdil do any help?
With Regards

You need to wait out a full 7-8 months for even the hair around the donor area to completely recover from a transplant. If your scar has widened, then it can be assessed now, at the 5 month time frame. New donor area closures are now the talk of the town (in doctor’s communications) because doctors seem to be admitting to seeing far too many widened scars. Hello doctors! that’s what patients have been saying for years.

We can discuss these further if you have particular questions for me.

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I Had Plugs Transplanted in the 80s – Hair Loss Information – Balding Blog

Back in 1988 I had some of the old plug transplants done.I realized I made a mistake and stopped any further transplants.( 35 in all)
I had all the transplants (Plugs) removed with some scarring.I also had the doner area removed recently by a plastic surgeon.My problem is I would like to shave my head now but have no idea how bad the scarring is and the only way to find out is to shave my head.Are there any pictures that I may view to see how the area may look like shaved.Is there any makeup I may use after I shave my head until I have the scars corrected.
The were some of the transplants still growing will they look natural when shaved, will they grow faster ( on a daily basis ) then the hair that was originally there. I am exhausted with all the effort I have had to go threw to get me back to where I was in 1988. I await your response.

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This is not an uncommon question, but unfortunately the answer is not what you want to hear. The scar from excision of your open donor area will show very well, like any scar on the body, even if it healed perfectly. People who have had any excision (even today’s modern hair transplant) will have a large ‘smile like’ line on the back of their head if they shave their head. The shaved head will bring attention to every defect on your scalp from where each of the grafts were removed and it will be made worse in bright light. Normally, a shaved scalp is smooth, but I suspect that yours is puck-marked and shaving it will only draw attention to the defects.

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Using FUE for Scar Repair – Hair Loss Information by Dr. William Rassman

Trying to do scar repair on strip scar from 800 graft surgery. I was told the 500 FUE’s into scar would conceal it enough to shave my head or am I better off doing a Trichophytic Donor Closure. Scar is about 5 1/2 inches long and a 1/4 inch to slighlty smaller wide. Tryin to do this just once. Doctor told me he has about 80% growth with FUE (can that be true?). I would like to shave my head completely bald with a razor. please advise. Thank You

There is no guarantee that 500 grafts would cover the donor scar in a single surgery. Based upon that measurement, I would think that 250-300 grafts in two sessions might do the job. The problem is density per hair/graft and that they can not be placed too close in a single session, as that may be unrealistic in a scar (which is often not compliant as it does not stretch well). Packing the grafts too closely in the scar may produce a failure of some of the grafts to grow.

Growth in a scar varies between people. Most people will get 80-90+% growth if the spacing is properly placed. The FUE procedure itself is a reflection of the particular doctor’s skills in doing them (harvesting, graft preparation, placement). I cannot comment on the skill of a doctor I do not know and have not personally observed.

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Hair Loss InformationWhat If I Shave My Head After a Transplant? – Hair Loss Information – Balding Blog

What is the average total cost of a hair transplant and what if I decide to shave my head, will there be noticible scars?

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I’m sorry to tell you this, but there is no “average total cost” of a hair transplant. It varies from patient to patient and from doctor to doctor. However, you can usually count on a good hair transplant costing several thousand dollars because it is (or should be) a very detailed and labor intensive process with a highly trained staff.

As for shaving your head, any time the skin is cut, you will have a scar. The degree of your scar will depend both on the skill of your surgeon and how your body heals, but scars can be minimized through multiple techniques. If you plan to “go Marine” you might consider the FUE/FOX Procedure if you are a candidate (see FUE category ). This, too, will leave scars but they will be little white dots versus a thin line which will draw the eye and be more obvious with a shaved head.

For more information about Follicular Unit Extraction (FUE), please take a look at:

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Transplanting with Limited Donor Area – Hair Loss Information – Balding Blog

I have had several transplants over the last 20 years. My donor area is generally depleted and cannot support any large procedures. I have 1-2 very small (quarter size) areas that if some additional transplants were done only in these strategic areas my hair would appear much fuller. Considering the small amount of donor plugs needed could these be provided by smaller more random/scattered donor sites as opposed to the larger harvesting rows that are more concentrated in one area. Thereby minimizing the thinning effect we see in a typical donor area.

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There is an art to making less hair look like more hair. I have many patients like you who have paid the price of the old antiquated procedures of the 1970s and 1980s. I have already written articles on the subject, but what I do for each patient is a one on one determination that takes the years of experience I have spent to develop the Master Plan for such person. Simply put, a good doctor, upon examination, should be able to determine the answer to your question.

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Hair Loss InformationPimples After Surgery Caused Skin Change – Hair Loss Information – Balding Blog

Dear dr. Rassman. Thank you for having time to answer questions concerning hair loss.

I am a black man. I had an FUE operation about 6 months ago. The donor area at the back of my head healed very well, but in the receiving area I got small pimples almost in every grafts incision (1000 grafts) in the front area of my head which looks different from the rest of the smooth skin. The hair is growing but it is not that dense to cover this area. These pimples are well seen especially from certain angles or according to the light reflection. I am really worried about if these skin changes will be permanent. What shall I do? Do you have any advice for me???

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Pimples can be caused by sebum collections below the skin edge, but should have gone away within the first few months. FUE grafts should be trimmed, for if they are not trimmed and divided into their respective follicular unit, they will contain too much skin. The added skin will produce a skin deformity at the recipient site like the cobblestonning I talk much about in my published articles. The way light is reflected is an indication that too much skin may be have been left on the FUE graft or that the FUE graft was not separated into individual follicular units. Rarely, people with dark skin will tend to cause more scarring than those with very fair skin. Changes in the recipient area with a hair transplant do occur if you had atrophic skin (skin that lost much of the supportive infrastructure from blood vessels to glands, muscles and fat) or your hair is coarser, or if the surgical instrument used was large (by large I mean greater than 1mm, as a slit graft) or combinations of any of these factors. Today’s surgeons will use very small cutting instruments to minimize the skin wounds, hence the pitting or skin changes that could occur when the wounds are made too large. Skin deformities in the recipient area are rarely detected with small cutting instruments. Without seeing you directly, it would be hard to determine if any of these factors (or other factors) are playing a role here. I would expect that most people should not have this complaint, but just the other day I met a patient who had surgery from another medical practice with a similar complaint and I barely could see what was bothering him. This man had a body dysmorphic disorder. To determine your situation, either come in to my office (if you are in California) or at the least, send photos to the address on the Contact page.