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Is Hair Transplantation a Slippery Slope?

hi there . my question is why every time i have had transplant work done it has caused the hair around the transplanted hair to permantly go to sleep or fall out. i have even met doctors over the years who stopped doing tranplants for this reason.it seems like a slippery slope getting transplants done. thanks

I do not understand what your situation is, so before I dive in, let me make some general observations and pass on particular messages that I feel are relevant.

  1. I don’t like the idea that you used the term ‘every time I had transplant work’. Why is there so many times? That is not the modern approach used today and something that I would not want to hitch my wagon to. Was your work started many years ago? How many procedures did you have?
  2. Hair loss in previously transplanted hair is very, very unusual. Generally its incidence is 1 in 500 people who may temporarily lose previously transplanted hair. For men, hair loss in non-transplanted hair often does not grow back if it is well along in its miniaturization process. In women, it usually grows back when it does happen and it is present in less than 10% of women transplanted.

What you are describing in non-transplanted hair is a well known phenomenon called shock loss after a transplant. In men, it only happens once, usually after the first transplant on young men not on the drug Propecia. This can be minimized by taking Propecia and it does not happen to all patients who undergo hair transplants, particularly men over 40. Hair loss may also have occurred even without a hair transplant if there is an accelerated phase of hair loss, or the hair transplant may have just accelerated it (again, more common in young men not on Propecia). It is very troubling to me that the doctors you met have stopped doing transplants for this reason, because it signifies that they do not know the intricacies and the physiology of the hair transplantation process. Or there is possibly other factors that you’re not mentioning.


2006-03-24 09:12:33Is Hair Transplantation a Slippery Slope?

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Is Hair Normally Thinner Towards the Root?

Is it normal for a hair under an inch long to be noticably thinner towards the root? i see hairs that fall out that look kinda like an exclamation mark, thick at top and thin at the root. my hair is around 2cm long.

The exclamation point hair you’re describing usually points to a variety of conditions, such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis (see Exclamation point hair). Normally hair is uniform in width.

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Is Hair Loss from Stress Going to Be Diffuse?

Hi Mr. Rassman! Many off us now that chronic stress is bad for the overall health, one of the potential effects of stressors is an increased hairloss, maybe not such a big problem if you dont have androgenetic alopecia but if you do this temporary increased hairloss can potentially do more damage to the already weakening follicles! So my questions is:

1. In the connection to stress what is exactly happening chemically in the hair follicles that is leading to increased hairloss/premature entering of the anagen follicles to telogen?

2. And finally, hairloss that is connected to severe stress follows a diffuse pattern or am i wrong?

I do not have the answer to your question. Extreme stress (both emotional or physical) can cause hair loss and for men with genetic hair loss, it will follow a pattern of loss (not become diffuse). In women, this is often not the case as they are more likely to develop a diffuse form of thinning (without a specific pattern). I do not know the exact biochemical science behind hair loss caused by stress. As it is often said, medicine is mostly a descriptive science. Many times, we don’t know exact mechanisms.


2008-12-01 10:06:11Is Hair Loss from Stress Going to Be Diffuse?

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Is Hair Loss Due to Stress Reversible?

If the hair loss is stress induced and you have the genes for hair loss, then the answer may be no, it may not be reversible.


2020-01-20 11:20:39Is Hair Loss Due to Stress Reversible?

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Is Hair Cloning Advancing At All?

Doc

Do you think we will ever see a day when someone with complete male pattern baldness (I.e. Horse shoe shaped) will be able to get a full head of hair? It seems like hair cloning has fallen off the radar. Is anyone/company still pursuing this? Do doctors and researchers still believe that we will be able to make it work? Will we see a solution in the near future? If so how long? There must be industry discussions and gossip about where we are with it. It seems like we have been waiting for ages

There are private companies that are still working on hair cloning. It has not fallen off the radar, but the progress has been slow. I can’t put a timeline on when it’ll be a reality available to the public, but I hope it will be available within my lifetime.


2012-10-02 11:03:16Is Hair Cloning Advancing At All?

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Is FUE Worth Doing?

If you are considering putting hair back where you lost it by having a hair transplant, the big decision is to take the step of finding a caring, competent doctor working with an experienced team, followed by scheduling a hair transplant. For most men, scheduling a hair transplant is the greatest step, in other words, to fix a problem with a surgical solution.

Fortunately, the hair transplant procedure has been made absolutely undetectable today, contrary to the 1990s, when everyone could see a hair transplanted patient and know it was not normal. Today, normalcy is the rule in the hands of an excellent hair transplant surgeon who has developed an excellent surgical team that has been fine-tuned over many years.

Most cosmetic surgeries only require the skills of a single surgeon, but all hair transplant surgeries require the skills of a great surgeon who built a great team to work with. A great surgeon with a poor team will produce poor results. A bad surgeon with a great team will also produce poor results. Why am I saying this when everyone thinks that the surgeon is the key to a good hair transplant? It is because a good hair transplant requires a skilled surgical team that understands quality control systems, similar to great manufacturing operations. When the team produces 2,000 grafts, it is a team effort that works under strict quality systems rules.

Once you take the plunge in deciding if you should go for a hair transplant, the next step is to find the best doctor with the best team that knows how to work together. Then, you need to decide if you should want a strip surgery (FUT) or FUE.

The FUT procedure (Follicular Unit Transplant) harvests a batch of hair by cutting a strip from the back of the head. The strip of hair is then dissected into their natural family groups with a large team of technicians working with high powered microscopes. Both I and my wife and daughter-in-law had strip surgeries, and we have undetectable scars.

On the other hand, the FUE procedure (Follicular Unit Excision) is a hair transplant procedure that harvests the hair follicles in singular hair groupings. FUE is a great procedure that I pioneered. But contrary to most young men’s belief that FUE is better than a strip procedure (FUT) because it does not scar, this is not the case. Many doctors would like you to believe that FUE is a scarless surgery, but take a look at the type of scars a large FUE session can create. Scars are a complication when FUE is performed on a person with low donor density and is unable to support a large number of FUE grafts. Many patients found out the hard way by getting 3,000-6,000 FUE grafts without having an assessment of their donor density performed prior to their surgery. As a result, over-harvesting has become far more common than you might expect. I love doing FUE and half of all of the surgeries we do today are FUE hair transplants, but for those of you who are reading this post, please note that anything done well in moderation may be good/ . Likewise, FUE done in moderations is a great surgical hair transplant procedure. However, when done in excess, the patient pays the price with ugly scarring that may never have been anticipated. Certainly, the unfortunate man in the photo below had no idea that his FUE was a massively scar-producing surgery because his doctor over-harvested grafts.


2018-06-22 11:39:06Is FUE Worth Doing?

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Is FUE the Best Choice for Someone That Has Had a Lot of Transplant Work Already?

I have followed this site for a few years now and I am so impressed. First off, your integrity seems to be apparent in how you run this site. There is none of the cheap salsmanship common to some of the hair replacement surgeons with whom I have spoken. You provide so much disclosure that it is obvious that you truly want educated patients. It seems to me that the medical hair replacement industry was crying for someone like you.

With that, I am happy to share with you my story and ask you my questions. I am a 45 yr old male who began losing his hair at 19. I was told early on by a few surgeons that I was an excellent candidate for hair transplantation because my donor hair was so good (it was rated a 9 out of a possible 10). I believe that I am a Norwood 6 but I know that I have long lost all the hair that I was to lose. I have had 13 hair transplant procedures with Dr. X [editor’s note: name removed] and 2 scalp reductions with another doctor. The procedures were performed between 1989 and 2001. In total, I had 1679 “large” grafts, 379 “medium” grafts, and 321 “single” grafts. My hair provides decent coverage for someone who by this time would have been left with only what I call “clown fringe” (I am sure the visual will resonate with you) but I do use a concealer (Fullmore) to hide some small patches of my crown which show, and some of the scarring. My goal is to surgically get more coverage – or at least more uniformity in my existing coverage – so that I can stop using the concealer. I would like a good evaluation on what surgical options may be open to me, as I have already had so much work already performed and donor hair is not so plentiful. These are my questions:

  1. Do you ever do any work in NYC/LI?
  2. If the answer to #1 is no, can you recommend any good and caring surgeons in the NY/LI area?
  3. It seems like FUE2 would be a natural choice for someone who has had so much work performed already and where so much donor hair might not be harvestable in one strip. Is this a correct assumption?
  4. Is it possible to do many smaller strips so as to increase yield for someone who has had so much work performed already? Does it matter from where the strips are taken? I think that I may have some donor hair on the high sides.
  5. I have not heard of too many people having as much work as I have had. Does the work I describe sound like it is so much? Are you aware of many people who have had more work?
  6. I have been using a concealer for 15 years – just during the week and just during the day. Are there any health affects of such prolonged use?
  7. How does the cost of the FUE2 compare with the normal strip method?

Any of these questions which you can answer would be appreciated.

Keep up the site.

  1. At the moment, I only have offices in California and do not plan on going to New York.
  2. Dr. Robert Bernstein is a caring and competent doctor with a Manhattan location.
  3. Follicular unit extraction (FUE) is less productive when donor densities are down from multiple surgeries and when there is lots of scarring.
  4. With regard to taking high strips, it is generally not a good idea as high strip scars tend to show and they may not be in the permanent zone, so the hair may not last your lifetime.
  5. I have seen many patients that have had more than a dozen surgeries plus scalp reductions. One patient I met had 27 procedures, of which I believe most were sham surgeries. Without seeing you, I can not comment on what you did and did not get.
  6. Your approach with the use of concealers is well defined in my new book, Hair Loss and Replacement For Dummies, for the readers who do not know much about them.
  7. FUE costs are high compared to the strip method, but more important, they may not be very productive. FUE costs roughly 2x the amount of strip procedures, per graft.

The problem with your situation is donor scarring and your donor area must be a mess. It’s difficult to make any real advisable points without first seeing what I’m dealing with, but you might be able to excise the highly scarred donor area (probably using a balloon expander) if that is bothersome to you. Good luck.

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Is Follica the Breakthrough?

Hello Doctor,
I came across this article regarding Follica – Hairloss Cure: Could Follica Be A New Breakthrough In Baldness Prevention Products?

What are your thoughts about this? Is it something you are looking forward to?

Would you peel your scalp skin back? As the article states: …“sounds mildly terrifying: they start with a process called ‘skin-peturbation’ where the top layers of the scalp are peeled back.”

There’s a long way to go before Follica would be able to be taken to market, so I’m not going to get excited about it yet. I’ve seen a lot of promising “cures” go nowhere over the years. We shall see.

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Is Finasteride Working?

You may slightly notice if hair loss has stopped or slowed down. The drug will be having an impact. The only way to find out what is happening is to stop the drug, and if you do, you may shed a great deal of hair that may not return. Therefore, stopping Finasteride may not be a good idea. This is a difficult place to be, but you almost always must stay on the drug, and in up to two years, you will almost certainly get value from it.

9 months of fin.. from tressless