When a Graft Comes Out, When Will it Not Grow?

Hi Dr Rassman, I have an important question for you regarding the study of hair grafts you conducted with Dr Bernstein in 2006. The study states that the Dr. Was able to tell when the growth center for the hair had been pulled out by looking at what he pulled out by eye.

My question is this:

  • how do you physically identify when the growth center has been pulled out?
  • Is there always blood?
  • Does bloody mean that the centre has been removed for certain?
  • If a hair comes out and there is a dried out “bulb” shaped skin on the end of the scalp, does that mean that the graft has been lost or the graft was a dead one?
  • did this study account for partially loose scabs?

After about 4 to 5 days, some of my scabs started to loosen…i started to gently brush some of them with my fingers and some of them were loosely stuck by a strand of skin, which I pulled gently with enough force to remove the scab. My question is this-

  • how can I identify when I have pulled out a growth centre and when I haven’t?
  • Do you think there was a good chance that I pulled a graft out?
  • Lastly, your study includes 18 gauge needles only. What is the standard size needle use or what range sized needles do you use?

Thanks so much for your time and thanks for the study!!!

Firstly, here is the article you referenced, as originally published in Dermatologic Surgery in 2006 — Graft Anchoring In Hair Transplantation — PDF file or HTML

Your email is not clearly written, but I think that you are asking about the hairs we pulled out on varying days after surgery to determine if the graft growth center was left behind. To answer that question, we asked the pathologist to identify the critical parts of the hair that determines growth (the bulge area near the sebaceous gland in particular) and this would include all parts of the hair and what is called the dermal sheath. If this was pulled out, we could safely assume the the graft would not grow. This was not done with the naked eye, but rather by the pathologist under the microscope. By having a specialist look at the grafts that were pulled out, we had an impartial expert make the judgments. I hope that this answers your questions.

With regard to your other questions, please read the article carefully, as we put it all there. Without a microscope and experience, you probably would not be able to tell the status and that is why we put the article together, to be able to guess what is really happening. When the scab is present on the surface, it is likely that the graft growth center can come out.

What’s the Difference Between Rogaines?

Hello, We’re wondering about the difference between Rogaine for men, & Rogaine for women. Also, it would seem that by now something would be developed that you wouldn’t have to use twice a day, also something less sticky…

In today’s world of hi-tech advances (Latisse is one, & what a blessing for men/women who have had surgery), that something would come along that grows hair much easier.Just wondering…
Thank you

RogaineRogaine is a brand name for a topical formulation of a generic drug named minoxidil meant for topical application to the scalp (for hair growth). It comes in 5% strength for men and 2.5% strength for women and is available without a doctor’s prescription (over the counter). I’ve written about the ingredient differences before here.

Some formulations are very sticky, as you imply, and others are not. It all depends on the preparation of how it is mixed and packaged. The brand name Rogaine also comes in a foam and it is not sticky at all, but I believe it is slightly more expensive. In summary, there is consumer choice available to each of you and some experimenting with what is available maybe a good idea. All drugs have their limitations.

What’s the Difference Between Rogaine for Men and for Women?

Hi Dr.
I have a question for you. Why does Rogaine sell a Women’s version, and a Men’s version, Why couldn’t I use the womens version if they have both have minoxodil in them?????

Thank you

Women's RogaineYes, you could use the “for women” version if you wanted to.

  • Rogaine for Men contains 5% minoxidil, less alcohol and more propylene glycol than the Women’s Rogaine.
  • Rogaine for Women contains 2% minoxidil, more alcohol and less propylene glycol than the Rogaine for Men.

Propylene glycol is found in many products, and you can learn more about that here.

What’s the Average Number of Grafts That Can Be Transplanted in a Lifetime?

Many thanks doctors for providing help to all of us!! Your blog is very interesting.

How many grafts it is possible to extract from a caucasian male with an average donor supply over the course of his life? Does it make a difference whether it is a FUE or strip? 9,000?

Generally there are around 6,000 to 10,000, but it is depending on many factors, including race, ethnicity, scalp laxity, and hair density. We have transplanted as high as 10,000 grafts in a few of our patients over several surgeries. Others we max out at 6,000. Every patient is different.

The second part of your question was answered here — Can You Get More Grafts from Strip or FUE Over a Lifetime?

what’s the average cost of a hair transplant these days and how effective is it

The costs for a hair transplant are usually priced per graft and the costs range from $4-10/graft depending upon the doctor, the location, and the reputation of the doctor for consistency and predictability. I always ask patients: Would you try to find the least expensive brain or heart surgeon? The hair you have on your head that the surgeon transplants can be seen by everyone. You MUST meet some of the doctor’s patients to see the quality of the work your surgeon does routinely. My patients have been coming to monthly Open House events months for 27 years just to help prospective patients learn about the process.


2019-03-26 18:26:21what’s the average cost of a hair transplant these days and how effective is it

What’s New In Transplants?

If you ever heard someone tell you to “get your head together’ I don’t think that they were tell you to get a new head as these researchers did here:

This is a technical challenge for the surgeons doing these head transplant, but it is a real ethical issue for me as we know monkeys are thinking, feeling beings.

What you should look like in the first few days after you had a hair transplant

Many people ask me if anyone will detect that they had a hair transplant immediately after it. Of course, there will be a ‘beard’ present but if you keep your hair long, it can disappear. I have posted patient pictures to show you what you would look like immediately after a hair transplant.

https://baldingblog.com/actual-limited-frontal-hair-transplant-600-grafts-4-days-photo/

https://baldingblog.com/two-post-operative-patients-shown-one-day-hair-transplants/

https://baldingblog.com/patient-just-4-days-following-1700-grafts-with-photos/ (This patient used is hair and combed it forward because his hair was black and his skin was white)

https://baldingblog.com/class-23-patient-just-5-days-after-fue-procedure-with-photos/


2019-03-03 09:33:41What you should look like in the first few days after you had a hair transplant

What you need to know about shampoos

Web MD wrote a detailed article about shampoos, their ingredients, and how these ingredients help or harm your hair. I summarized today’s article as relevant to my readership and added some comments that I thought may shed more insights into the content. The most important takeaway here is to be careful about claims as to what any particular shampoo will do for you. If you look at the ingredients on the shampoo label, you will see the items discussed below. Educate yourself, especially if you have particular hair problems. Everyone reading this should know that the hair grown from the head is not alive once it appears from the scalp; it is dead tissue like your fingernails. We want to do things for hair to make it look and feel better, fuller, and more vibrant, but we certainly can’t give it life.

  1. Carrying agents: Shampoos contain water, which dissolves ingredients within the shampoo. Water, when used in a commercial shampoo product, should be safe.
    • Some manufacturers add alcohol, propanol, ethanol, isopropyl, and propyl alcohol, all of which can make your hair dry or brittle
  2. Thickeners are chemicals like glycol distearate that drive water into the substance of the hair shafts. The additional water absorbed within the shaft causes the hair shafts to increase their diameter or thickness. When you want a thickening agent, look at the ingredients listed below, and then you will know you are buying the right product. Common hair thickeners include Stearic acid, Gelatin, Xanthan gum, Carnauba wax, Stearyl alcohol, and Cetyl alcohol, which usually seals the water in the hair shafts.
    • People with thinning hair: I am always asked what I can do about this problem as surgery is rarely a solution for men and women with diffuse thinning, regardless of cause. The answer is here, in the use thickening agents described in this section. The commercial manufacturers have known about this for years and have produced products that address thickening the hair shafts using appropriate additives as discussed here.
  3. Surfactants are ingredients that make shampoos act like detergents. They increase suds production, and the better the surfactant, the better it cleans the hair, dirt, wax and debris from your hair. It can also address the wax buildup, which many people call clogged pores. The lather tends to make your hair dry because it washes off the protective oils that the body produces to protect your hair.
  4. Surfactants to look for include Ammonium lauryl sulfate, Sodium laureth sulfate, Ammonium laureth sulfate, Sodium trideceth sulfate
  5. Emollients balance the effects of surfactants, helping keep moisture in your hair and protecting it against brittleness. These lubricants make your hair silky and are necessary to counterbalance the surfactants discussed above. Emollients include aloe vera, vegetable oils, mineral oils, and silicone. They allow your hair to hold onto the water it acquires when you shampoo your hair. Because they are lubricants, they make your hair shiny. Dimethicone is the most common emollient.
  6. Preservatives stop mold from growing in your shampoo. The most common preservatives are sodium benzoate and potassium sorbate.
    • Another group of preservatives are called Parabens, which include Methylparaben, Isopropylparaben, Ethylparaben, Isobutylparaben, Butylparaben, Propylparaben
    • This second group has been associated with claims that they can produce cancer.
  7. Some people want only natural ingredients. These shampoos include essential oils like peppermint, lemon, and lavender, certified-organic ingredients like aloe, Coconut oil, Organic hemp, Organic honey, Chamomile, Olive, and Plant oils like geranium or jojoba oil. These products have many of the characteristics outlined above.
  8. WebMD suggested that people avoid the following ingredients for the risks outlined:
    1. Sulfates: they increase skin sensitivity and strip hair of their natural oils, causing dryness
    2. Parabens: they increase the risk of skin cancer
    3. Phthalates: they are dangerous to the environment and cause hormonal disruptions
    4. Formaldehyde: is carcinogenic and easily absorbed by the skin
    5. Dimethicone: it prevents moisture from entering the hair and clogs pores over time
    6. Retinyl palmitate: causes itching, scaling, and peeling
    7. Alcohol: makes your hair dry and brittle
    8. Toluene: can hamper the immune system and cause congenital problems
    9. Imidazolidinyl: irritates the skin and eyes

[If you have any questions, you can reach me at williamrassman33@gmail.com]

 

What would happen if i take fin at 17?

Should i just wait until i’m 18? I have a good amount of hair but i can see thin parts when i pull my hair or especially when i get out the shower. And do i take fin for the rest of my life?
I have prescribed finasteride for many 17 year old males. It is safe and contrary to fears of it impacting growth- there is no evidence that it does. Waiting, if you are losing hair now, will just make it worse.


2019-07-11 10:44:43What would happen if i take fin at 17?

What Would Happen If I Stopped Taking Fin After an Fue Hair Transplant?

Finasteride is not important for getting FUE grafts to survive. Finasteride prevents shock loss of the miniaturized hairs on your head, which is common in men in their 20s who often have a great number of miniaturized hairs.

 


2020-06-03 09:18:43What Would Happen If I Stopped Taking Fin After an Fue Hair Transplant?