i have noticed that on the side of my head my hair is very thin and i notice bald spots on the side. can you please tell me why? please tell me why?
I would want to see pictures of your sides to differentiate between various forms of balding and skin/hair diseases. Please send me digital pictures to the address on the Contact page and I will give you feedback on what I see. Best if you could come to see me either in Northern or Southern California, where I have offices.
I had a number of mini and micrografts done 10 years ago behind the hairline, so they weren’t visible. Now, because I lost more hair, these grafts are now visible and they look like a transplant. What can I do to fix the situation?
There are two basic approaches to repairing visible grafts. The first directly involves the old grafts. If they are small, you can punch them out using a 1 mm punch. This will remove the bulk of the hairs, leaving a few straggler hairs which look OK and there will be a tiny round scar. If the grafts are bigger, you can remove several small areas in each graft to break it up, or you can remove the entire graft with a larger punch or a strip excision. But the latter would leave a scar that would need to be filled in with follicular units after a couple of months. The second way is to do a transplant proceedure around and in front of the old grafts to hide and camoflauge them. If the grafts are small this works well. If the grafts are large, a more radical surgery may be needed.
For an example of the procedure, please see Dean’s Story.
I had hair transplants 20 years ago. When I had them, my hair loss was just starting. Now I have an airport runway on my head and there are these plugs in the middle of my runway (rear of my bald area) like an island in the sea or an oasis in the desert. Can I take these out or do I have to get more transplants?
Your problem is a common problem which we see wherever crowds gather such as airports and sporting events. This surgery was done in the early days of hair transplantation and as the balding progresses, the plugs are ‘abandoned’ by the surrounding hair. My suggestions would be:
Your question addresses two important problems:
Here is a photo illustrating an “island of plugs” in the crown of a patient before we did his repair:
Hi im 18 years old and i have had a high receded hairline all my life. Im thinking that a hair transplant might help lower it and fill in the gaps. Am i a good candidate?
At 18 years old, that might be a problem because no one knows the status of your genetic balding. You would need to be evaluated by a hair loss specialist, to discuss your options. If you should bald as you age (a 50% chance in most men prior to the age of 45), then moving your hairline down today may be a problem for a long term normal look. Unless you make a living as a model or actor where a high hairline might compromise your earnings potential, I would suggest that you wait for 5-8 years before making a decision to have surgery.
If you are enjoying this blog, please feel free to leave a comment to say hello. If there is a particular topic you’d like to see covered, please fill out the contact form. I’m just looking for some feedback…
I looked over your newhair.com site and noticed a wide variation in the amount of fullness with the same number of grafts between patients. For example, Patient BN has almost 2100 grafts and has a thin look, while Patient DP has 2500 grafts and had a full head of hair. If I go for a hair transplant, can I buy the fuller rather than the thinner look? I’d be willing to pay more.
For reference, these are the two patients you mentioned:
I looked at the subjects you were talking about. There are many differences between the two patient’s hair characteristics that could explain the difference in the results. The finer hair of Patient BN is only 1/3rd of the thickness of the hair that Patient DP has. The distribution of the grafts and the number of grafts placed per square inch of balding area is different. DP has a stronger hair character than BN and the size of the balding area is much greater for BN, despite what these photographs show.
People with finer hair have lived their entire life with a thinner ‘see through’ look, in contrast to the ‘gorilla’ look of the coarser haired person. Your results will reflect the ‘building’ materials your hair has in your donor area (like a 2×2 as compared to a 4×4 piece of wood). The key here is to give you a look like you had before you started to bald.
To answer your question, the fees are based on the number of grafts, not your hair characteristics.
I have an autistic 17 year old female whose normally thick and healthy hair is now thinning. I know her diet is not the best secondary to autism but she gets ample amounts of protein and loves all vegetables. There are no medidcations involved and no diet changes or home stress issues that I can pinpoint. She is not verbal so questioning her is not an option. Could you lead me to a resource for information or suggestions. Thank you for your time.
I have not read any research that indicates a higher instance of hair loss in autistic teens or adults. However, I would think that autistic people have a higher level of emotional stress, which is one of the ‘big four’ causes of hair loss. You should have a good doctor examine her and look for one of the many medical causes of hair loss. The following problems are among those that should be considered: anemia, thyroid disease, connective tissue disease, and various gynecological conditions. These laboratory tests may be useful if underlying medical problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone. Many medications, including vitamins and over the counter drugs, can also contribute to hair loss.
Genetic causes of hair loss in a 17 year old female, is unusual. Look to the family and see if anyone had such a problem at that age or if there is female genetic hair loss in any of the women in your family. It is more likely that a medical condition, rather than genes, may be the cause of the hair loss.
Why can’t you just buy on price? All that a hair transplant surgeon does is puts hair follicles into holes, so what’s the big deal?
Great question and an important one as well. We are all sensitive to price and there is no doubt that if you can buy the ‘car’ cheaper from one dealer, why pay the higher price from another dealer. The higher price dealers try to sell service, but the reality is that a Lexus is a Lexus and you can get maintenance from any authorized dealer so you could buy the car over the internet and save thousands of dollars. A better question to ask: Why is a hair transplant (or any cosmetic procedure) different from buying a Lexus at the lowest price you can get?
I think that you now might understand where I am going with this question. How does one value cosmetic surgery services by particular doctors in a comparative shopping viewpoint? When you are buying the services of a surgeon for cosmetic surgery, you are buying:
In a major cosmetic procedure (like a face lift for example), it often takes years to get the experience ‘under your belt’ to make a great cosmetic surgeon. Doctors just starting off are taking their skills from training and finely honing them, often ‘practicing’ the techniques that they accumulated in training. For a hair transplant surgeon, the same is true. I see hairlines that are not quite right, that are not well placed, that are not balanced, not distributed properly or placed in the proper alignment and/or are not delicate or subtle. So putting hairs into holes without skills and artistic judgments may give you an Edsel rather than a Lexus and everyone (unfortunately) knows what an Edsel looks like.
In a hair transplant, there are issues of ethics and judgments on the extent of surgery, the indications when to do it and when not to do it, how much to do, how often to do it, what is the particular variables of each patient when it comes to planning, and what risks should be taken for what gain, etc… Doctors who cut corners in recruiting patients have to employ people who sell for them and substitute their expensive time to the more cost effective time of a salesmen. As long as you have the money, a salesman will tell you that you need the surgery in order to take your money. In my practice, I turn down more work than I perform because I know when to do surgery and do not value the almighty dollar over what is best for my patient. This is not a plug for me, but a statement that a doctor’s value is in his knowledge and honesty in placing his patient’s interests above his financial interests.
In modern hair transplant surgery, the team is as important as the surgeon. Experienced team members are critical to producing a successful hair transplant. Novice doctors get hair transplant failures on a significant scale, but unfortunately, the consumer only learns of these failures 6-8 months after the surgery was done because it takes that amount of time for the hair to grow no matter who does the surgery. By the time a patient may find out that the transplant was a failure, his check has cleared the doctor’s bank and the doctor may not be in business anymore.
Take a look at newhair.com, read our history, our publications, and request a free copy of the book we wrote on transplantation. Look at the pictures of our patients and their results (over 200 on our site). We have written the authoritative articles for the repair of hair transplant problems. Be sure to thoroughly check out your doctor. With our medical group, you can meet a dozen or more patients at our monthly open house events and judge for yourself the value of what your dollar buys. There is no need to overpay, just to get real value and that is the power you, as a consumer, hold.
I have had a hair transplant and I have numbness in both my front and back. How is this possible, how long will it last and will I become normal again as I love to have my scalp massaged.
Numbness does happen frequently after a hair transplant, both in the recepient and donor areas. Everytime a person gets a cut or a bruise, the area that is cut or bruised will develop swelling and numbness. The numbness will abate with time. The cutting and/or swelling of small nerve fibers are the cause of the numbness after a surgery, but in the scalp, there is a rich supply of redundant nerves so if one small nerve is cut, another picks up the function fairly fast. There should be no long-term numbness, but I have seen an occasional patient who had their major nerve cut in the back of the head. Even when this complication happens, the alternative pathways will frequently take over and that process may take weeks, months, or on rare occasions, up to two years to correct. Most experienced surgeons should be able to avoid this problem. In conclusion, many very small cutaneous nerves are often cut, but the sensation returns with time. Having had two hair transplants, I can tell you first hand that my scalp was normal within a couple of weeks and within a month of the transplant, I was able to enjoy a scalp massage.
I had my hair transplant done by a cosmetic surgeon in California. This was the punch method leaving me with a doll hair look receeding on both right and left and crown. I had the procedure done in around August 2004. Now would i be a candidate for repair or would i have to wait longer? I do know my procedure was $2 a graft and I got what I paid for. Now i want to fix it before it becomes too detectable. I’m 24 and started Propecia in January 2005. Have been doing research for months and keep getting positive responses regarding NHI.
Thanks for the many points raised in your email. The plugs may have to be excised, particularly if they are large. There is an art in doing repair work – the critical decisions are how to manage the old plugs and how to use your present donor supply and not damage any future donor supply you may need. The decision to start Propecia was good as an add-on to what you are doing.
At NHI, we use a fine needle for preparing the recepient areas- we never use punches to place grafts! The needle makes a wound that is very, very small and by using the proper angles and density, I can give you a natural look and reasonable fullness in a single session if you are not too bald. The grafts are inserted into these needle sites using fine surgical forceps. These small wounds heal in a matter of a day or two, you can even wash your hair the next day.
You are now more than 8 months from the original surgery so it would be a good time to have an assessment done. You should call and make an appointment to see me at no charge. Our phone number is 800-639-4247 and we have an offices in Northern and Southern California. Examining you will make all of the difference in what you finally end up with.
