Annual Medical Hair Meeting – Summary Of FUE Findings

Since we invented the FUE (Follicular Unit Extraction’s first scientific paper written in 2002 by Rassman, et. al.), the use of this technique has become more prevalent at each and every year’s convention. What is impressive, is the inroads many physicians have made using this technology in their practice. In 2011, the Artas® Robot was introduced into the hair transplant community and as of this date, 100 robots have been purchased by doctors from around the world. The FUE procedure has become more and more popular by patients wanting a hair transplant. Although we believe that the Strip graft procedure (Follicular unit transplantation) produces better grafts, the public seems to demand more and more FUE procedures and I would’s be surprised that the FUE might reflect between 30-40% of all hair transplant procedure across the world. For the new physician learning about hair transplantation, FUE requires less staff and when it is combined with the commercial ‘hair implanters’, the skills to produce quality work throughout the world seems to be a goal more easily achieved than with the traditional FUT (strip) procedure. There are three elements of the FUE that must be mastered, (1) the actual coring of the grafts from the back of the head with enough skill not to damage or transect these grafts while coring and removing them, and (2) the implantation process itself (carried out with the commercial ‘implanters’ or manual techniques like we use at the New Hair Institute, and (3) the many nuances for quality control that allows the grafts to survive the surgical procedure (drying of the grafts or damage to the grafts on handling and implantation).

One group of Indian doctors showed long hair FUE, just like we do. The ability to do this impressed us, as few doctors I am aware of, have developed the skills for this technique.

I was very impressed with the skills developed in various Asian countries (e.g. India, Thailand, China) where considerable numbers of patients with substandard work was performed in the past. Many videos were presented that showed that the skills for #1 and #2 were comparable to what we are doing at NHI. That was a pleasant surprise. Few of those doctors from third world countries could afford the high price of the Robot (more than $250.000) so the manual skills were essential to develop. I actually viewed more videos this year from India than any previous year.

On the negative side, complications of FUE abound with significant scarring in the donor area, far worse than I have seen before. Infections of the FUE donor area seemed more common than in my experience (where it is rare), and folliculitis of both FUE donor and recipient sites were reported as not uncommon. Clearly, there is more present in these surgeries than ‘meets the eye’ through the video offerings. Doctors clearly will show their best work for the videos. Time will tell just how well these cases turn out. Despite this statement, I believe that FUE will become more and more popular world-wide. We have already seen a significant growth in the FUEs in Europe as fewer and fewer doctors entering the business adopt the Strip technique.

Some doctors are combining both FUE and Strip surgery to increase the donor yield for a hair transplant. This makes sense if the doctors and their teams are skilled in both techniques, but it does push the envelope. I welcome comments from our readership.

Finasteride Drug Dose Revisited And Rethought

First of all thank you for what you do with this site it is a tremendous resource. I am twenty and began to recede at the hairline about a year ago. I started taking one fourth of a proscar daily in April without a prescription and got a prescription for it in June after seeing a dermatologist. I have since been taking the generic version daily. The medication does not seem to be working as I have continued to lose much hair from my crown to the point where my scalp is visible in harsh lighting.

I have long hair but i have noticed in the last week that I am losing the very short (terminal?) hairs again after not noticing them for the past few months. Could this be due to the switch to the generic version? The proscar pills were individually sealed while the generic are together in a pill bottle could this air contact affect their potency? As it has been seven months and I have lost noticeably more hair should I discontinue the medication?

Thank you, my dermatologist is pretty clueless when it comes to hair loss, so I appreciate your knowledge.

Generic finasteride 5mg is the same drug as Propecia, which is just finasteride in 1mg strength, so there should be no difference in efficacy. I don’t think bottle vs individually sealed has any bearing on the potency.

Finasteride does not work that well for frontal hairline, so what you may be experiencing is just your normal course of hair loss that the drug cannot address, particular in a man of your age who might have an aggressive pattern of hair loss in the family line. Many men like you report that their father or fathers father or mothers father had an extreme balding pattern at an early age. These men will not see the same effects as men who are not heading to an advanced hair loss pattern. I would ask if any of those balding men in your family had advanced balding and at what age did they lose their hair? That may shed light on your problem. Lighting will make the hair appear thinner. Do you have comparison photos to look at from before you started? You’ll need to discuss changes to your medication with your prescribing doctor but if you have your father’s pattern (of advanced balding) nothing may help. The best way to know this is to see a doctor who offers hair bulk assessment with the HAIRCHECK system. If you are heading for advanced balding, then this test will tell you that. If it were me, I would want to know!

Thanks for the New Eyebrows!

4 years ago my brows were week from plucking in hopes of finding the best shape for my face. I had Dr Pak first perform some eyebrow restoration. Later that year Dr. Pak progressed w/ the first treatment w/ another treatment for density. The results were excellent…But being a perfectionist, I continued to pluck & reshaped the brows to being what I always wanted.

This last week I met with Dr Pak, who is a both a wonderful person & an expert Artist in this particular field of specialty for hair restoration. He performed a delicate procedure that was exactly what I was seeking and that resulted finally in a classic slanted full brow.

I could not be happier and many thanks to Dr Jae Pak as well as his assistant, who I found to be extremely kind & professional and who went the extra mile…so sweet & professional as well as fast & efficient. Dr Pak is incredible…one of a kind…understanding & extremely professional & another kiss to his assistant….love you both.

As I’ve written on this site before, we have done many of these types of procedures and the results are very good, but there is an art in the transplant process and a technical skill that is very difficult for many doctors.

I’m glad your expectations have been met (or surpassed). Knowing how pleased you are with the results and the experience is the best part of what we do. Thank you for your incredibly kind words.

My Heart Pounds When I Use Minoxidil

I started using Minoxidil 5% twice a day. I didn’t experience any side effects, so a year later, I substituted the 5% Minoxidil with 12.5% at night. I still didn’t feel any side effects. I switched to Xandrox 5% (minoxidil with azaelic acid) last December since I have PCOS and it was recommended to help stop the miniaturization of my hair. Within a couple of weeks (maybe even a week), I experienced heart palpitations. Is it possible that people can become hypersensitive to Minoxidil after a period of time (for me, 2 years)? Or could it be coincidental and related to something else?

Thanks

I have never recommend 12.5% topical minoxidil, as it can have serious systemic side effects (just as you described). More importantly, heart palpitations can be a harbinger to a serious and life threatening condition. I strongly recommend that you follow up with a physician for an examination. Minoxidil can cause a drop in blood pressure in a limited number of people.

The FDA Has Been Wrong in the Past

I hear you say any Propecia side effects are gone within a few days or weeks at most. But what about other drugs that the FDA has recalled because of permanent side effects? Those drugs presumably had half lives, and the literature indicated that side effects would go away soon after stopping those drugs. Maybe the same scenario goes for Propecia.

You have an agenda in your question. God does not reside at the FDA, which means that their activities are less than perfect, and yes, they’ve made mistakes in the past. We can only tell you what we believe we know. Finasteride has been on the market for over a dozen years now. If you can’t find the research and proof to be credible by now, I don’t know what more I can do to help.

I Am On Propecia and My Hair Loss In Getting Worse

Dr. Rassman,

I have been a patient of yours for over three years now and I recently visited your office back in August. After seeing you again it was established that my hair loss had not progressed from last year and had possibly even improved. Unfortunately, over the past month, I have been experiencing non characteristic loss. When I am in the shower, I have never ending clumps of hair coming of my head and clogging the drain. Also, when brushing my hair there is even more loss. Dr. Rassman, this has never happened before and I have no idea what to do. Is it possible that the Propecia that I have been taking since November of 2005 has stopped working for me and my genes are taking over?

All of the loss has been occurring since I have been out of town on a job. I seem to even have some kind of infection on the corners of my lips. I am sure the two things are not related, but I figured I would tell you.

Anyway, is this a normal experience for someone on the drug as long as I have been? Should I take more of it? Is it possible for a person to lose all of his hair immediately? Could this be a possible hair cycle or allergy? Again, I have no idea what to do and what to expect. I appreciate you taking the time to read this and your advice/help would be greatly appreciated.

Thank you and looking forward to hearing from you soon!

Hair loss can increase from stress amongst many other things, such as the normal progression of hair loss that occurs in some men (even those on Propecia). As one of my patients, please come see me and let me see if your miniaturization has increased. We can get a baseline on the HAIRCHECK instrument by measuring your hair bulk now and then repeat it in a year to see, for future purposes, if you are continuing to lose your hair.

The Odds of Going Bald

Hi, I just turned nineteen and have become concerned about hair loss. The corners of my hairline seem high and an abundance of small hairs have sprung up around the hairline. Are these signs of recession, new hair, or can it be either? No one on either side of my family has ever been bald except my great uncle on my father’s side. What are the odds of me becoming bald?

Norwood 7There is no way to predict your hair loss completely, that is, until you are older. This site is full of information to educate you and if you are concerned, then take charge of your problem. The hairlines in men generally rise between the ages of 19-29 (see Maturation of a Hairline).

Overall, 50% of men develop some level of balding by the time that they are 50 years old and only 7% will have the most extreme form of balding, Norwood Class 7 (see image at right).

Will Vitamin D Cure My Hair Loss

Includes snippets from Wall Street Journal Article: Crucial to the hair-growth and balding process, scientists have found, vitamin D and the microscopic receptors that bind to it in skin as essential to good hair growth. These elements have become the focus for several research teams. (Supplements might offer health benefits for people lacking enough vitamin D, but they won’t bring back lost hair, researchers say.)

Some researchers, including those from the San Francisco Veterans Affairs Medical Center and Harvard Medical School, have identified molecules besides vitamin D that appear to activate the receptor and hold potential for future hair loss treatments. Japanese researchers demonstrated in animals that adding vitamin D helped the process of using stem cells to generate new follicles. Found in the Wall Street Journal — The Search for a Baldness Cure

My friend Dr. Richard Shiell commented:

“Plenty of sunlight and Vit D here in Australia (world’s highest rate of skin cancer). From my observation, our baldness rate and pattern-type is pretty much the same as elsewhere.

We are seeing Vit D deficiency in some Muslim women and children who cover-op and do not take advantage of our sunlight. I have not heard of any increase in hair loss. Kids at the beach these days are covered from head to knee as in the Victorian era so, if the author is correct, we should see more baldness in the future. I don’t believe it.”

It’s important to highlight the sentence from the article that states: “Supplements might offer health benefits for people lacking enough vitamin D, but they won’t bring back lost hair“.

In response to this news, some hair restoration doctors stated that they often recommend vitamin D as part of the treatment for women with balding or thinning hair. There does not seem to be a downside to this use, but I wouldn’t get too excited just yet about calling this a “cure”.

Tags: vitamin d, hairloss, hair loss, wsj

The surgeon pulled the FUE from the neck (photo)

The neck hair is not permanent hair so as this man gets older, he may see his neck hair disappear and so will these grafts in the recipient area that came from the neck because these hairs ‘don’t know’ that they are not in his neck.


2021-03-02 08:38:34The surgeon pulled the FUE from the neck (photo)