Category: Uncategorized

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Was My Transplant a Failure?

Hi Doctor,

I had my transplant on 6th july this year. I managed to go through good post-operative care for ten days but on the 12th day, I started getting rid of my scabs by gently rubbing my scalp even when it was dry. That was basically because I misunderstood my doctor who actually told me to gently press scalp at times of any itching. So everytime the scab fell off I saw a hair attached to it too and in rare cases there wasn’t a hair to it. I still have many transplanted hair left on my scalp and I am currently 20 days post-op. I have doubts that I have possibly dislodged my grafts and I am afraid my transplant may result in a failure. Incase if I have dislodged some grafts, will this affect the grafts which have not been dislodged. And is the presence of graft noticable on the scalp with a naked eye?

I am well aware that I shouldn’t have done the rubbing on dry scalp but does that mean that I have made a BIG mistake and there is no point in expecting the new hair growth at all?

I believe you are overreacting. If everything was good for the first 10 days, there is little possibility that you lost any grafts/hair. What you are doing is shedding the hair that was transplanted. It will go into a hair cycle of telogen and then ‘wake-up’ and start growing at about 3-4 months. This is normal and certainly nothing that you’ve said in your email indicates that what you did will have any negative long term impact.


2006-08-01 10:49:50Was My Transplant a Failure?

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Happy Thanksgiving!

My offices are closed Thursday and Friday this week to celebrate Thanksgiving with our families. Until we’re back on Monday, you have three options:

  1. Use the search box in the top right to find hair loss articles of interest
  2. Click here for a random blog entry
  3. Just stare intently at this picture of a turkey dinner:
Turkey
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Has Miniaturization Mapping Been Written About in Peer-Reviewed Publications?

Dr. Rassman,
First, let me thank you for the valuable resource your blog provides. I understand that it is in men’s nature to become concerned about hair loss as we age. I also understand that you have answered this question, or at least very similar questions many times. I’ll ask anyway, because you seem like a good guy.

I am a 27 year old white man. I have severe depression and OCD. I recently (past couple of months) started obsessing about my hair. I’ve always been overly concerned about the way I look, and I’ve always been severely lacking in self confidence. When I tilt my head back and look up at the front of my hair line in under direct light from a couple inches away, I can see scalp going back about two inches. When I tilt my head forward, I see no scalp and my hair looks the same as it always has. There are a few long hairs growing below my hairline. I dont notice a change in my hairline when compared with photos taken when I was in my early 20’s. If I pull hard on my hair around my hairline, nothing comes out. Same with the crown. My mom’s dad died with a full head of hair in his 90’s. My dad thinned over the course of his life, but didn’t really go “bald” until he was in his early 50’s. He’s now maybe a norwood 3v or 4. His dad had the same pattern, except it didn’t kick in until later in life. My mom’s brother went bald young. My maternal great grandfather had Homer Simpson’s hair by the time he was 30 or so. My dad’s brother still has a good head of hair in his 50’s. What do you think (and I know you can’t really tell without a miniaturization study)… which leads me to my next question.

Is a miniaturization mapping something that is common among dermatologists? Do most of them (in your experience) properly perform and understand the procedure? Is this something that has been written about in peer-reviewed publications? Will a dermatologist that does not specialize in hair loss be able to correctly diagnose what is going on with my hair (if anything)? Thank you very much for your time.

If you know you have OCD and are starting to obsess about your hair, I think you answered your own question about what my thoughts are. You’re seeing possible thinning when your head is tilted and you’re under direct light. The hair will generally appear thinner under harsh lighting.

I wrote about this when I applied for a US patent in 1992. I published it in various articles, not suggesting mapping the head, but showing the connection between balding patterns and miniaturization. The rest is not rocket science. It is not exciting to map out the scalp for miniaturization and actually if the doctor is knowledgeable, then a good sweep of the scalp will give the needed information for a well trained physician.

Many doctors now have video imaging systems in their office, like slightly more expensive versions of the USB video microscope mentioned in the Mapping Your Own Scalp series. For around $100, you can buy this microscope for yourself and get the mapping started. One of the biggest reasons that I created BaldingForum.com was because of comments like yours — that forum gives site visitors the chance to empower themselves by mapping their own hair and making their own diagnosis, following the process over time with aging, drugs, etc. You can share your results with others and get feedback from other site members, not just from me (time is always a problem for me, because I can’t just get to everyone). I believe that the real power will be in the hands of people like you — those who just want to know what is happening to them.

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What Are My Options After 2 Failed Hair Transplants?

What are my options after 2 failed procedures?

I had hair transplant surgery around 2007 using strip form back of head method, by what I thought was a credible Dr. from reviews online, experience level etc…Paid alot of money for hundreds of graft and got very little result. In fact only a few strands grew in at the hairline and temples grew in. None of the grafts in the crown area, where he said he really “packed them in” grew. He kept saying “you had beautiful grafts” and seemed dumbfounded as to why they didn’t grow.

After the salesperson tried to convince me that there was something wrong with me, the Dr. finally admitted that it was a failed procedure and agreed to do another one at no cost, This time saying he was going to try less grafts in that area hoping for better blood circulation. Well that also yielded very little growth. Although after about a year and half, filled in a little,but very little. Which shows me that there was no scalp biopsy necessary as they initially tried to say there was something wrong with me. I did get some growth. If there was a problem with my scalp, wouldn’t I have gotten 0 growth??

Overall I consider my decision to be a poor one because now i cannot even shave my head or wear a low style because of this huge scar (even wider now from 2 procedures) on the back of my head.

So my question is a two part question. Is a future transplant out of the question for me or could it be that this Dr and staff blew it twice? It should be noted that I am of mixed race(black and white) 38 years old,(34 at time of procedures), with more of wave than a curl to my hair, not real kinky but thick and puffy and coarse when it grows long on back and sides. The Dr did say they had experience in afro american hair types and seemed very confident during consultation with my donor area and being able to handle my hair type

Any insight as to what might of went wrong? The balding area was pretty much completely bald so I am not seeing native area that has thinned out after surgery, but the area that never fully grew in after 2 procedures.

Also is it possible that 4-5 year later that some of those graft may still have ability to grow?? With the aid of a product like Nioxin??

Thanks in advance for your answers

That is one hell of a story! If that happened to one of my patients, I would want to get a biopsy of his scalp, looking for a disease like alopecia areata that would cause rejection of the hair grafts. Unfortunately, your story is far more common than our profession would care to admit. Doctors who lack competence often use salesmen to push hair transplants beyond their abilities to perform it well.

One of the reasons that I started BaldingBlog is to have a place to let people share their stories. Your situation is quite unfortunate. For those that are shopping around for a doctor, remember that it is critically important to have thorough research. I’ve written a “how to” guide of sorts for selecting your hair transplant doctor.

As for your options, I think you should see a doctor who specializes in fixing screw-ups. The grafts should be growing, and if there’s nothing there after 4 or 5 years, I wouldn’t expect them to suddenly appear. I would be happy to give you my opinion, but I would have to see you. I’m in Los Angeles… but as you are in the Northeastern United States, consider a visit to Dr. Robert Bernstein for an opinion. Best of luck to you.

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Have You Heard About AAPE For Hair Transplantation Use?

Does anyone have experience with AAPE from Prostemics? A patient asked if I do this.

Dr. Brande Wolfe described AAPE as an abbreviation for “Advanced Adipose-derived stem cells Protein Extracts”, is a mixture of refined growth factor proteins that is extracted from human adipose-derived stem cells conditioned media. With its unique protein formula. AAPE is supposed to maximize the revitalizing effects of skin and hair follicles and consists of human proteins created by stem cells, natural composition with multi-function such as anti-wrinkle, antioxidant, whitening, hair re-growth and even wound healing effect. It is interesting that this AAPE product is approved by the US FDA.”

This is not mainstream clinical hair transplant technology.

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What Can I Do for Smelly, Oily Hair?

Hi Dr. Rassman,

I’m a 18 year old male and my hair is really oily and I mean REALLY OILY I take a shower every night but once I wake up in the morning its already really greasy and it smells, this started 4 years ago when I started High School I went to a regular doctor about 2 years ago so he could check out my scalp but he said it was fine. I have used Paul Mitchell Tea Tree Oil Shampoo, Head & Shoulders Hair Endurance for Men, Selsun Blue and Suave Clarifying Shampoo in the past couple of years and have have little to no success, so I was wondering if you can help me with my “smelly hair syndrome” as they call it I will really appreciate the help.

Thank You for your time

It’s possible there’s some shampoo out there that might help, but I couldn’t specify which one help for your particular case. A good dermatologist might be able to help you.

There is a pretty good article on this “Smelly Hair Syndrome” available here.

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Headaches and Stomach Pain from Propecia?

Hello Dr Rassman,

Thank you for your amazing blog. I would like some advice from you.

I started Propecia months ago. I am often tired, have headaches or stomach pain. My doctor said to me that I should take some Magnesium chloride daily. He said that it removes “bad material” of your body. Does this treatment represents a danger for my Propecia treatment?

Thank you for your answer

I have not heard about these side effects from Propecia from any of my patients (though I’ve received some emails about this over the years). If you believe that these pains are from the medication you can always stop the drug for a week and see what happens. Perhaps you have an allergy to finasteride or a filler ingredient that is causing the problem.

As for magnesium chloride, I have no experience on the use of this.


2010-07-02 13:56:57Headaches and Stomach Pain from Propecia?

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What do you think of Graft Calculators to compute how many grafts a bald area needs?

A graft calculator (there are many) doesn’t take into account such things as hair mass index, a critical element for determining how many grafts one needs for a given bald area. To make my point clearer, image a fine hair (equal of a 1 by 1 piece of wood) or a 4 by 4 piece of wood). The 4 by 4 would have four times the mass of the 1 by 1. Then assume that the analogy is that a 1 by 1 is equal of a fine hair, but a 4 by 4 is equal to a coarse hair. The number of hairs (or grafts which contain hair) required will be significantly different so it is not just a number calculation as these Graft Calculators show. Then there is the ‘ART’ that allows an experienced surgeon to blend the numbers and the hair mass of the hairs and grafts into a plan. At the time this plan is built, the surgeon must take into account the donor supply (is it high or low). High density people with coarse her can do more to cover their balding area than fine hair low density people. To make maters even more complicated, imagine that you continue to bald even after the hair transplant. Most people are somewhere in-between low and high densities and that is why an experienced hair transplant surgeon is critical to the entire process. I am not easily replaced by a calculator.

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I Am a Heavy Smoker and Will Not Stop Even When I Have a Hair Transplant

If a heavy smoker has a hair transplant, there is potentially decreased growth because cigarette smoking reduces the blood supply to the scalp. No one can predict your results other than seeing what happens 8 months after the transplant. We are all in control of what we do.


2018-06-22 09:49:13I Am a Heavy Smoker and Will Not Stop Even When I Have a Hair Transplant