Category: Uncategorized

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Amazing transplant on a very complicated patient (photo)

This is a remarkable injury from a car accident where this woman lost most of her scalp. The initial surgery to address the loss of her scalp was with the use of split-thickness skin grafts (left photo), probably taken from her thigh or abdomen. The grafts covered the skull so that the skull didn’t die off; however, her look was clearly abnormal as you can tell in the middle photo. You can see the brusing of the split-thickness grafts. I imagine she probably used a wig to cover the deformity shown below.

Dr. Felix Popescu, from Bucharest, did approximately 3500 grafts to cover the deformity and give her back her hair. The photos below only show before and after extending 2 days, but the skin looks viable, suggesting this surgery might work. The zoomed-in view shows that a good blood supply is available to the grafts. Split-thickness skin grafts don’t have an infrastructure to support much beyond the skin grafts. I hope he will send me follow-up photos over the next few days and eventually of the final results. I greatly admire his skill and courage in tackling such a difficult case.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surgery performed by Felix Popescu, M.D.

Dr. Felix Hair Implant
Soseaua Nordului, No. 98 G
Bucharest, Romania, 14104

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Lot’s of things wrong with this transplant

I saw this photo posted and decided to comment on it. There are many things wrong with this surgery, and as I don’t know the age of the patient nor the number of grafts he received, it is hard to complete my assessment; nevertheless, it is important for those of you who are considering a hair transplant to understand the difference between good and bad hair transplant techniques.
The transplant donor area was unusually focused above the donor area, and that hair may be lost if this man develops an advanced balding pattern with age. The surgeon did not confine his surgery to the permanent zone (a 3-inch high area around the side and back of the head). The surgeon created a picket fence to the leading edge of the hairline, which will show up if the hairline finally grows in. The patient needed to be instructed in proper washing techniques, as residual crusting increases the risk of infection. ‘Cleanliness is close to godliness‘, so proper early washing is critical (see here for my golden standard: https://baldingblog.com/one-day-post-op-2150-grafts-photos/). If this man was under 25, he shouldn’t have done this because the amount of hair transplanted may have been disproportionally high when compared to his donor supply.
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Androgel and Hair Loss?

I am 52 and very athletic. I started taking Androgel about 3 or 4 years ago and usually stay on a low dose (2 to 3 pumps/day) except when training hard for a marathon or triathlon (a couple a year) and I go up to 8 pumps/day. I noticed I have lost a significant amount of hair around my crown so I’m now wanting to quit Androgel for good IF there is evidence that the hair will grow back over time. Is there any evidence that this happens or have I lost that hair for good. My hair is otherwise plentiful and my hereditary traits are for thinning hair but not baldness like I am getting so I feel sure the Androgel is causing it.

Usually, hormone induced hair loss in men is permanent. You might try minoxidil in the crown, which might grow back some of the hair. Finasteride (Propecia) may stop the progressive nature of the hair loss while you are on Androgel.

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Macular Degeneration from Propecia?

Dear Doctor,
I have a question about possible serious side effect of using Propecia. I am 23 years old male and I have started using Propecia one month ago. After already two pills I noticed some small defect in my vision which becomming worse in time (I was seeing crookedly by one eye). The diagnosis is macular degeneration. My ocularist thought it was caused by Propecia though there were no information about this side effect in the label. I was said that if macular degeneration appears by youth it is in most cases caused by using steroids and its interference to hormones. I have never taken steroids and so doctor thinks it is a result of Propecia’s hormones changes. I would like to ask you have you ever seen similar case of Propecia side effect? Could Propecia theoretically caused it (already after two pills)? And do you recommend me to continue with finasteride in the future? (I stopped after 15 pills and now I am much more worried about my vision than my hair).

Thank you very much.

This is a question you need to ask of your ophthalmologist. A short course of Propecia should not cause any problem and macular degeneration from Propecia is not defined as a known complication of the disease that I could find. I’ve certainly not had any patient mention anything like this to me over the years.

For more about macular degeneration, see Wikipedia.

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Another Hair Loss Following Pregnancy

I have experenced hair loss after each one of my pregnecies. I have three kids,while I was pregnant my hair was fine. I have seeked medical advise, I was told stop having kids. Can you tell me if hair loss after pegnancy will ever correct itself, in other words will it grow back?

Some doctor’s amaze me with ridiculous comments like, “Stop having kids”. Hair loss with pregnancy is common and most women who experience it, like you, will see the process reverse within the first year after birth of the child. Have as many kids as you want. The hair loss, unfortulately, may recur with each pregnancy on a non-permanent basis, unless you have genetic female balding.

I answered a similar question about a week ago, found here.

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One of my big questions is, can you get Male Pattern Balding without having a family history of it?

No, male pattern balding is genetic but it can skip many generations. You might not identify who you got it from if the person you inherited it from is not known to you. We often do not know our great grandparents. I recently saw my great, great grandfather’s pictures from the late 1800s and he had a full head of hair.


2017-09-16 14:41:37One of my big questions is, can you get Male Pattern Balding without having a family history of it?

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Any Adolescent Hairline Transplant Photos?

Can you post a before & after photo of someone who you’ve lowered their hairline to an “adolescent hairline”. I know you’ve said in the past you usually only do this procedure on someone who makes their living by their looks & I wanted to see how much of a difference it would make. Thanks, great blog!

These three patients had their central hairline brought down to the childhood hairline position:

Also, please take a look at the hundreds of patient before and after photos on my website in the Patient Photo Galleries.


2006-10-23 14:52:22Any Adolescent Hairline Transplant Photos?

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Anyone Taking Propecia for a Decade? (with Photos)

Hi, I just want to know: do you have many patients who have been on propecia for 8-10 years and yet still have a healthy head of hair on their heads?

Alternatively, do you have many patients who have taken propecia for a long period of time and have gone bald?

I have a number of patients who went to Mexico to get Propecia (finasteride) before it was sold in the United States (maybe 10 years or so ago). One in particular (24 years old at the time), who was balding in the crown, reversed quite nicely on Propecia and maintained that reversal without any progressive miniaturization over the 10 years. Because he was young, the drug worked beautifully. His crown was never transplanted but he did receipve alightly over 6000 grafts in the frontal area. He now has a crew cut.

I have not seen anyone who stayed on Propecia go bald, but I have seen many, many men who were taking it and decided to stop, who then went either very bald or very thin.

Before Propecia on left; After Propecia on right:



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Why do I have so manys scabs on my head after a hair transplant one week ago? (photo)

The recipient are requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts and you should be clean of crusts within a day. IF any crust are present, use a Q tip and dip it into soapy water, and roll it on the crusts and that will lift them off without dislodging them, but never rub them, just roll the Q tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area gone in 7-10 days with daily washing, You will have to leave the shampoo on for a good 15 minutes and gently rub the crusts with your fingers. Be sure not to pull them off, just let them shed with the shampoo and it will take a few days for this to happen. You can wash twice a day if you wish to accelerate the process.