Category: Physician training

I understand that the transplanted hair grafts fall out a few weeks after the surgery. Could those grafts be kept and re-transplanted, or are they dead? Thanks.

I believe that you are confused. The hairs that fall out after the surgery are not hair grafts, but the hair that is caught in the scabs. Normally, all or most of the hair is shed after a hair transplant and it returns in 2-5 months after the surgery, growing to styling length by the 7-8th month. The hair that comes out after a hair transplant are not the elements of the hair organ that grow, but the hair shafts and scabs that are the aftermath of the healing process. In one out of about 20 patients who have had hair transplants, the hair growth center will generate a large number of hairs that will continue to grow. We call this instant growth and when it happens, everyone is happy.

After reading your articles and Q&A, I decided that before doing anything I should check with some dermatologist. I search for doctors for hair disorder in my area through The American Academy of Dermatology website. I am just curious about how to check if the doctor is expert in this field? or is it safe to assume that the doctors suggested on the www.aad.org are expert in this area? I am just being cautious because once I went to a dermatologist and he just gave a glance to my hair and prescribed me propecia, and that was like one minute consultation. So I just want to make sure that I dont end up doing the same. Thanks for your time.

There are many steps in the process of selecting a good hair doctor. You have done one. The ISHRS site has doctors who participate in the international hair society. These doctors do more hair work than most, but then again, that does not guarantee the best doctor. If it is a hair transplant you are looking for, go visit and interview the doctor and ask to see his/her patients. What you see is a good indication of what you are going to get.

In your situation, where the doctor didn’t provide you with a full consultation, that generally says to me that the doctor you got may not be a real expert, and although he may have done the right thing by prescribing Propecia, you still need to go through a better examination to be sure of the diagnosis. Typically, you should have a microscopic examination of your hair before the Propecia is started.

I am preparing to have another session in September for added density. The only discomfort that I had in my previous surgery was that the scar(strip harvest method) in the donor area. Is there any way to stretch that area before surgery other than massaging that area? ie an implant device to stretch the skin?

Some people have tighter scalps than other people. Also, as some people get transplanted, the tightness of the scalp may get tighter, although this is not the routine case. There are tools that expand the scalp ahead of time. These tools were invented for scalp reductions, a procedure that has fallen on hard time (for the right reasons). Many of these devices (expanders and balloons) are painful and should be preserved for those with indications for their use (burn scars, large scars from accidents and the like). Your question is difficult for me because there is an implication that either you want more donor scalp removed than is safe, or that you had unusual pain associated with your donor wound closure. It would help me to understand your question better by further clarification, call me at 1-800-NEW-HAIR so that I can grasp the direction you want me to take.

I know male pattern baldness is polygenic with multiple genes that contribute to the disease from both the mother and fathers side but i was just wondering with the news that the androgen receptor gene, is on the X chromsome given from mother to son.

Should we assume that mothers genes means “mother’s father” or generally speaking the whole maternal side of the family, which would include the mother’s brothers, uncles, and grandparents…..

I emailed regarding a similar topic and you mentioned that you could not comment on the whole androgen receptor gene article since its all new and i respect that but my main question has to do with when someone says “mothers genes”, should we assume this is exclusive to the mother’s father and that a male should look at his mother’s father to see what his hair will be similar to in the future or is it likely the other males on the mothers side have much influence also …………

Can an individual have the genetic susceptability and partly have some of the genes for MPB but for one reason or another it does not get experessed.

Thanks for your response

You have an assumption here that is confusing you. This is not an on/off gene. Gene expression can skip generations and there are variations in the way the gene is actually expressed. This makes your question moot to some degree, particularly if the X Chromosome comes from the mother’s father.

Yes, having the gene and having the gene expressed are different. We really do not understand the issue of expression or the various families that skip generations before the expression shows.

I am 32 years old and started balding about 3 years ago. My wife told me that I have about 60% hair loss located in the vertex of my head. The size is about 3″ wide and 2 1/2″ high. Here is my question: Do I need to wait until I lose more hair or all my hair in order to qualify for the transplant or can I start the transplant and make it a smooth transition so that no one will even notice a change?

Another question: Is hair plugs still used in hair transplants? or is this an old procedure? I do not like the look of hair plugs and it is obvious when someone has them.

Thanks.

You should be evaluated first to see if you are a potential candidate for hair transplantation. You should also consider the use of medications that will slow or stop the hair loss, possibly even return some of the lost hair.

The hair transplant methods have advanced light years since ‘plugs’ were the norm. Although there may be physicians who still use the ‘plugs’ you are talking about, they would be practicing outside the standard of care and as such, it could be considered malpractice.

As i am concerened by hairloss, I have looked at your site and read some useful information. The one question I had was, while going through the Horror Stories link [note: on our sister site, TheBaldMan.com], are there any horror stories which have occured after about the year 2000, and the development of FUE and FUT. I can understand that an operation which cuts a large chunk of skin out of a persons head is going to run the risk of causing a large scar and other related complications, but has the development of new techniques like those above which allow the removal of single hairs got away from these problem or has got other ones? Also why do so many people choose to keep the name of a bad doctor to themselves?

Thank you

You are correct that fewer and fewer horror stories are appearing because today’s techniques are much better than those of the 80s and early 90s. Certainly, the quality of the work of the top notch surgeons has improved to produce virtually undetectable transplants. The focus of those surgeons is now on improving the growth of transplanted hair. There are still some failures with these modern techniques because today’s FUE and FUT techniques require exacting methods which, if not followed, will cause the transplant not to grow.

Well trained doctors using modern techniques should produce not only undetectable transplants, but a very high survival rate. Still, there are some doctors who do not know what they are doing, and I still see some terrible complications which reflect a doctor’s lack of training, skills or ethics. I am also seeing more and more patients who are being transplanted that should not have been transplanted and those who being sold more grafts which are put in beyond the balding area and into the permanent hair zone, just to increase the fees. Find yourself an ethical doctor who uses modern techniques and be sure to meet with some of his patients before you take him/her on.

I often ask the same question that you did in this email: “Why are the names of bad doctors kept secret?” The answer here is that men are generally not confrontational, and they do not like to be reminded that they made a mistake. They do not want to relive a bad experience over and over again. Just sharing their stories to prevent others from making their same mistakes is not a pleasant experience for these victims.

I am 20 years old and very nervous about losing my hair. Since about my senior year in highschool ive seen the front of my hair line recide. This is a very stressfull and private thing for me so I only talk to my family members about it. When I ask if it looks like im going bald the answer is always no. But my hair line from my senior pictures to now has deffinately changed. Its seems to be going back on the sides, right above the eyebrow.(im sure you know what im talking about. So I do have a couple of questions.

1. Am I to young to get a hair transplant?
2. How much hair do I have to lose to actually be able to get one. Im always reading different sites and all kids my ages ask almost hte same questions but everyone always says wait till you go more bald… Well I dont want to wait, I want to prevent it before it starts. I dont want any sign of thining hair or a reciding hairline. Its like my petpeve.
3. Do hair transplants look like real hair, or can you tell the difference? Ive seen about 2 people in person that got them done..and one person It was pathetic he had like 3 strands of hair growing out of one section. Then about a 1/4 inch space and then more hair. If I get a transplant I want it to look so real that even I cant tell it was doen.

Also I was reading a question that someone posted on your site. And I read an answer by some John Doe. He said that there were scars from his transplant. This is the first time that ive ever heard anyhting about scars. Can you tell me more about that?

You have many questions, all good ones, but not easy to answer without writing a book. I actually wrote a book, The Patient’s Guide to Hair Restoration, which you can get by clicking here. The entire book is available in PDF format, but you can also order a complimentary print copy complete with photos at the Request Additional Info page. Many of these questions will be answered by the book or even in the previous blog questions from other young men about your age. No matter what I tell you, you must have a visit with a competent, caring doctor. Although I have performed hair transplants on patients as young as 18 years old, it is not my usual case, but before I would do this, I would want to know what is happening to you. Make an appointment with a good doctor who specializes in hair loss treatments. Dr. Robert Bernstein in New York is such a doctor, if you can handle the 5 hour drive to visit him. He is at (201) 585-1115.