2019-09-06 03:44:082019-09-02 07:44:51The ideal laser helmet for hair loss
My Chin & Goatee Transplants are Red
Dear Dr. Rassman,
First of all please let me thank you upon your excellent work (as i overheard from sources). Am 25 year old and had a HT procedure of about 1600 grafts by strip method 4-5 weeks ago for increasing my facial hair density around the chin and goatee region and due to the fact that i live in the middle east i didn’t have the chance to perform it with you,otherwise things would have been different. Without any exaggeration am now having cruel restless nights with lots of suffering. I have two major problems or should i call them concerns, first is that the recipient areas are exhibiting significant redness (even after more than 4 weeks post-op). Add to this a long battle with infections, second is that after going through many forums, i’ve found that infinitely many people are depressed about their donor area linear scars as the scars tend to stretch and looks ugly which restrict them from having their heads shaved or get a simple buzzcut. Is there anything i can do about the redness of the transplanted areas? Sorry for elaboration but you are saving a man’s life Dr. Rassman
I am assuming that you had only the chin and goatee region hair transplanted. With that assumption, 1600 grafts seems a bit high. If larger than one hair grafts were used, I can imagine a great deal of reaction to them. including skin changes like puckering of the skin. If you look at typical beard hair, these hairs rarely are more than one hair per grouping so if you had more, then there are wound issues in healing which might point to problems. Without seeing you myself or knowing what you had, I can not be certain. Infections are rare indeed, but if you are having them they are most likely the results of cysts at this early stage where sebaceous glands from the transplanted hair are producing sebum below the skin and becoming reactive cysts. There are usually best treated with soaks at least twice daily and meticulous hygiene. Antibiotics may have value but good cultures should be done prior to starting antibiotics in the event that you have a bad organism causing the infections.
We have spent a great deal of time discussing scars in previous blogs.
The Pros and Cons for FUE / Strip Harvesting
I’ve put together a nice list of things to consider if you’re interested in having a hair transplant, particularly when comparing the Follicular Unit Extraction (FUE) technique and the Follicular Unit Transplant (FUT / strip) technique.
FUE pros
- There will not be a detectable scar in donor area. Of course the scar will be present after every skin incision, but since scars are very small and scattered in a larger area, they are not detectable even on a head with a close crew cut.
- There are no sutures or staples to be removed. The small pointy wounds on the back of the head will be left to be closed on their own with no sutures or bandages.
- There is minimal or no pain in donor area after the removing the grafts.
FUE cons
- Not everyone is a good candidate for this procedure. We always test our patients before doing the actual procedure with several biopsies with different methods and view the grafts under microscope to see whether we can harvest them without damaging the hair follicles. If we see a lot of transected (damaged) follicles, we can not proceed with this procedure.
- It is more expensive (almost double the cost compared to the strip procedure). Follicular Unit Extraction is very tedious and every graft should be individually extracted by the surgeon as opposed to the strip method where skin is removed first and grafts are harvested under a microscope.
- It takes more time, sometimes up to twice the time when compared to a strip procedure for the same number of grafts. A procedure to harvest one thousand grafts may take six to eight hours.
- A large area of the scalp needs to be shaved or clipped very short. This is not acceptable for many patients.
There are a few issues that are important to look at and understand. Hairs within a graft can be killed by improper harvesting (e.g. drying, cutting it at a critical point in the anatomy of the hair follicle within a follicular unit). This can happen if there is poor cutting techniques in strip harvesting, or in actual transection of hairs within a follicular unit during an FUE procedure. I personally do not believe most of the doctors who claim 95+% successful hair counts from FUE and I would love to pay a visit to some of these doctors and actually do the hair count from their FUE extracted grafts.
Thick grafts (those that are transplanted with fat around the follicular unit) can tolerate air exposure longer than a skinny graft (which can dry in seconds when exposed to the air). But tolerating air exposure for longer than 10-20 seconds suggests to me that hair follicle death may occur and the staff do not have strict quality control process implemented. What is important is not how many hairs are extracted successfully and anatomically intact. The important question to ask is, “Will they grow?”
The best part about strip harvesting is that there is a very high yield with the experienced team. The risks of scar formation that is detectable (greater than 3mm wide) is about 5% with the first procedure, 10% with a second procedure, and higher with a third procedure. Other than the scar possibilities and a slightly more painful recover period of a day or two, the strip procedure is more cost effective and more efficient from a time and yield point of view.
Good response to Miniaturized hairs from finasteride
I am on finasteride for 6 months and all of my miniaturized hairs turned in to thicker terminal hairs except temple hairs.,Why is that? Will topical finasteride or minoxidil helps in this situation?
Finasteride does not work on all miniaturized hairs. Sometimes the genes are too strong for the drug and the drug doesn’t impact it. Maybe, Topical Finasteride with minoxidil will help.
2020-09-15 03:37:272020-09-08 09:46:18Good response to Miniaturized hairs from finasteride
What theories exist for the causes of male hair loss ?
You should know that Egpytians were a mix of Bantu, Arabs and even a bit of Caucasian so its not surprising that their would have hairloss. Even African Americans suffer hair-loss due to mixtures with the European gene pool even if they are not Bantu of San
The San bushmen are an isolated and relatively pure ethnic group, and they are of special interest because they share the direct lineage from the direct descendants of all humans. They give us a window to what humans might have originally looked like 60000 years ago
The history for genetic hair loss and its causes has perplexed doctors and other scientists for generations; however, one doctor did come up with a solution which I outlined in a post some years ago after reading his book. Here is the post: https://baldingblog.com/2008/01/23/evolutionary-reason-for-hair-loss/
Graft Placement, FUE, and Body Hair Transplants
first:
i need your opinion concerning the placement technique of DHI Greece group.Second:
i had a transplant with famous doctor in Australia, he is very good in FUE (body & head) but the placement is not good & transplant hair nature is changed. i think his way with washing hair not before one week of tranplantation is not good for hair, i need your opinion for that.finally:
i think you are the best doctor in this field but i have 2 problems to proceed with you:
1- getting the VISA, my application was introduced from 18 months & there is no answer. i know this is not your fault, but this is the situation
2- i am Norwood 5 to 6, i prefer to use BODY HAIR & untill now you do not proceed with this optionfinally thank you for this valuable website, i know everydetails of hair transplatation & made me have standard for quality procedure
Thank you for the faith that you expressed in my skills. To answer the first part of your email about DHI, please take a look at FUE / FIT — Minimally Invasive Hair Transplants.
It sounds like although you did your research, the “Buyer Beware” axiom still failed even after considerable research. If you are a Class 6 pattern balding patient,l the best and probably only real good source of donor hair is from the back and sides of your head and you need to exploit this first before you consider body hair transplants (most people never need them). You have clearly recognized that the art of placement is critical to the final result, which is something that many people do not differentiate from medical clinic to medical clinic. As the inventor of the Follicular Unit Extraction (FUE) technique, I know that it is not always the best procedure for those who are extensively bald. I personally think that you must focus upon the quality of the transplanted hair, and body hair does not have that same quality or quantity as head and scalp hair. Performing body hair transplants will produce a poor quality hair transplant (when compared to a good transplant with scalp hair), which may be what you are observing and blaming on your shampoo and washing technique.
Please send photographs to the address on the Contact page as a starting point of a dialogue.
Things To Do for More Hair (All in a Photo)
Great Hairline, Thin Top and Crown, Low on Donor Hair (with Photos)
This patient had 4608 grafts. As you can see from his photos below, the frontal area is great, but the top and crown are lightly covered. He lost much of the original hair in the top and crown from the balding process and as the transplant process was going on over a 10 year period in three sessions.
I am posting these photos to show that frontal hair can go a long way to making a balding man look fuller. We will still do one more surgery on him to fill in areas that need more density and then offer him Scalp Micropigmentation (SMP) to finish the creation of the fullness he wants.
Click the photos to enlarge:
Thinning All Over Scalp When Going from Adolescent to Adult?
Hi Doc,
I went to have a miniaturization study done, and the doctor noticed that I have miniaturization everywhere, even in the permanent hair zone of the scalp. He says that I am going through a thinning process as I go from an adolescent to an adult. How long can I expect this to go on?
If you are developing fine hair where it did not exist before as you go from an adolescent hair to an adult hair, then that is possibly your new norm. What did your doctor say about the cause, besides describing it to you?
Guest Post — Popular Baldness Causes and the Lack of Evidence
This post comes from Dr. Richard Shiell:
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Dr Masumi Inaba, who wrote a book on Androgenetic Alopecia (Springer 1996), was firmly convinced that the increase in Western style animal fats was causing an increase in baldness in young Japanese males. I am not sure that his statistical method would stand rigid scrutiny however.
The same lack of good statistics applies to all the popularly believed “causes” of baldness. Forty years ago when I was a young HT surgeon, the patients all blamed the wearing of hats in the Army or Police Force as the cause of their baldness, when I am sure that it was just that they entered these institutions at the precise age that severe AGA usually kicks in (19-21 years old).
I certainly believed throughout my career that “gym-jocks” lost hair more quickly than their “lay-about” brothers and cousins. The problem is that many were taking steroids and other “dietary supplements” so it was a very confusing issue to ascertain causality.
I had one of a pair of 25 year old “identical” twins who had lost significantly more hair than the other. When I spoke to the more hirsute twin about it he laughed and said it was because his brother was married with a child and mortgage, and had more stress. So there you have undeniable evidence from a large series of ONE case!!
Hair loss is the results of many complex things. For example, dietary supplements like whey and a variety of branched amino acids including creatine, push up men’s testosterone levels (and their DHT levels), which in turn accelerate hair loss. We are what we eat, I just wish I understood all of the complexities of diet as it impacts the hair loss we see.
2012-07-03 14:57:552012-07-02 11:51:43Guest Post — Popular Baldness Causes and the Lack of Evidence