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)

The Sun Bleached My Beard, Now I Wonder If My Facial Hair is Ruined!

i am 18 years old i have dark brown beard and i layed out in the sun for about 10 minutes and noticed when i looked in the mirror my beard lightened to a lighter brown. I Dyed my beard black a couple times using just for men beard dye and i got a very bad reaction and a burning sensation on my mustache and now every time i try to grow a mustache it looks tinted with blonde and very weak i did this in october of 2007, Do you think i have permantly damaged my roots or is there anyway i can grow a healthy mustache again or anything i can take or rub on it that would help, please i dont look right without a mustache i need any help or advice anyone can give me thank you.

Any bleaching of the beard will be short lived if you shave, as the new hair growing out should be your normal color. I don’t know if you burned your hair with chemicals as they may be one of the few ways to get what you seem to be describing. Best to see a doctor.

The Study That Was Submitted to the FDA Before Approving the LaserComb

I was looking at a site called hairlossadvances.com and on it they show a study that they claim is the actual study that Lexington submitted to the FDA for the lasercomb’s 510k SE clearance.

What I found odd was that the study was completed some 9 months before it was submitted, one of the exclusion criteria for participants was having a buzz cut, (you’d think that having shorter hair would allow more ” nourishing laser light” to penetrate the scalp and provide better results) and the person producing the study claimed that the study wasn’t required by the FDA. Have you seen this study, and if so, what are your thoughts.

I have seen the original study and I have published my opinions on the matter:

I tend to agree with your astute observations and criticism. This is a subject that I can not fight over. There seems like there is some evidence in the study that it works, but I frankly don’t believe it. It is hard for me to believe that there is almost 100% more growth after a few months. The FDA study is what it is.

The Strange Case of the Bat in the iPad Cover (from Medscape)

“Another feel-good story: An elderly man in New Hampshire was bitten by a rabid bat that was hiding in his iPad case, but he got treatment in time to save his life, as reported by WMUR. The incident was newsworthy because of its peculiar circumstances, rather than any medical novelty, and so we passed on it.

That being said, only 1 to 3 cases of rabies in humans are reported annually in the United States. Half of all lethal cases over the past decade have resulted from contact with a bat. So while we won’t go as far as recommending that you throw your iPads out, we’re glad the man in question had the insight to seek medical attention.”


2019-06-10 06:47:17The Strange Case of the Bat in the iPad Cover (from Medscape)

The story of discovering finasteride (girls became boys)

The case of the ex-girls

 

Little more than a decade ago, men afflicted with enlarged prostate glands — which can block urine’s flow and lead to dangerous infections — had essentially one treatment option: surgery. Now, drugs can often be used to reverse benign prostate enlargement. These so-called prostate pills are available thanks in no small part to a Caribbean population of pseudo-hermaphrodites.

In the early 1970s, Dr. Julianne Imperato-McGinley, an endocrinologist at Cornell Medical College, traveled to a remote mountain village in the Dominican Republic to study a group of children with a unique condition.

The sex of the children was ambiguous at birth, but to the best of the villagers’ knowledge they appeared to be girls, and so they were raised as such. But at puberty the girls’ baby fat gave way to muscle, their voices grew deep, testes descended and penises grew. The condition — which affected about 2% of the region’s children — earned the nickname guevedoces, or “penis at 12.”

The “girls” developed into adult men with all the expected physiological traits, save a few: The guevedoces men had minimal facial and body hair, unyielding hairlines and prostate glands that stayed unusually small. They also had low levels of the male sex hormone dihydrotestosterone (DHT), despite normal levels of testosterone.

Ultimately, Imperato-McGinley and colleagues traced the condition to a genetic mutation that caused low levels of the enzyme 5-alpha reductase, or 5AR.

Without 5AR, a body won’t make DHT. And without DHT, hair doesn’t sprout on the face, arms or legs, baldness stays at bay and the prostate doesn’t enlarge. (DHT levels are much higher in the prostate than they are anywhere else in the body.)

That last clinical feature of a 5AR deficiency caught the attention of scientists at pharmaceutical firm Merck & Co., shortly after Imperato-McGinley’s findings were made public. If 5AR’s absence kept the prostate small, they deduced, then perhaps getting rid of 5AR later in life could stop the prostate from becoming dangerously large, as it does in nearly 20% of men older than 55.

Sure enough, a drug to do just that was developed over the next 15 years. Finasteride, a 5AR-inhibitor that ties up 5AR so it can’t convert testosterone to DHT, was approved in 1992. A second 5AR inhibitor, dutasteride, was approved in 2002.

The 5AR-inhibitors are proving to have other important uses too. A study published in 2003 showed that prostate cancer prevalence was reduced by 24% in men who took finasteride compared with those who took a placebo. (For decades, scientists have known that hormones can play a role in signaling cancerous cells to grow.) Investigations are underway to determine if dutasteride (which is more active than finasteride) can reduce prostate cancer risk even further. Finasteride is also widely prescribed for halting male-pattern baldness.

The guevedoces, meanwhile — and populations like them in Turkey, New Guinea and elsewhere — continue to pique the interest of researchers. They’ve revealed dozens of mutations that can affect 5AR, but they’ve also been of interest to psychiatrists and sociologists struggling to tease out the interplay of hormones, environment and culture in gender identity.

Gender, the guevedoces appear to have proved, is not always black or white.

 


2019-10-24 10:48:17The story of discovering finasteride (girls became boys)

The Story of a 3,000 Graft FUE Procedure Failure

Story time! Although I can’t provide photos (by patient request), I’ll do my best to paint the picture…

A man in his early 20’s flew to Los Angeles from Alaska to see me last month. He already had two hair transplant procedures using the follicular unit extraction (FUE) technique — one surgery of 1,000 grafts, and another of 3,000 grafts — by two different doctors (that I won’t name) who each claim expertise in this process. The 1,000 FUE case by the patient’s estimate was about 50% successful, while the 3,000 FUE case had, according to the patient, no growth after a year. The donor area was heavily scarred from the FUE extractions and were easily seen by lifting up the hair. A strip procedure would have produced less scarring than this patient showed now. To compound the problem, those hairs that did grow from the first surgery were placed in a radial direction (like the spokes of a bicycle wheel) and the hair pointed to the sides, not the normal frontal position. So not only was he dealing with a huge failure of growth, but now he had to deal with poor placement for those grafts that did grow! Imagine a person with hair growing out of his head like the spokes of a bike?

This patient most certainly had a low donor density to start. I recommended a strip surgery to harvest the most grafts he can get and with the reduced donor density, I recommended about 1,300 grafts, which is possibly the most I can harvest. Fortunately, his hair loss was only in the first 1 1/2 inches of the hairline and by taking Propecia he might hold the rest of his hair in place, although there is miniaturization behind the frontal 2 inches, suggesting that he might bald further over time. He wanted to look normal, but I could only suggest that I would try to make him look better.

FUE is not a panacea for scars. As I have said here before, the follicular holocaust that is seen in FUE is substantial, even in the hands of those who claim success. This is a buyer beware market. You should always ask to see a number of patients who had the procedure and look carefully at the donor area. Another FUE procedure on this patient will be disastrous (even in my hands), as scarring is clearly a problem.


2009-01-12 16:34:26The Story of a 3,000 Graft FUE Procedure Failure

The Size of the Harvested Donor Area Is Critically Important

This patient had an FUE megassession surgery. When harvesting the FUE grafts, the surgeon must recognize the size of the donor area and limit the FUE extraction to the permanent zone as outlined in this FUE patient photo. The doctor who did the surgery on the patient in the photo did not understand the limits of the donor area.

The permanent donor area for a hair transplant begins at the bottom of the skull bone, known as the Occipital Notch, and extends upward two and half inches. This is the case for patients who will bald to a Class 7 pattern and sometimes to an advanced Class 6 pattern. This two and a half inch zone extends horizontally to just in front of the ear level. Hair was harvested for FUE from above and below this zone of permanent hair which in the long term will fall out by not standing the test of time. The hair below the permanent zone is neck hair and not scalp hair and this hair does not last.

QUESTION:

Why do doctors harvest hair beyond the permanent donor area as shown in the photo?

ANSWER:

(1) Because the patient wants a high number of grafts.

(2) Because the doctor makes more money by charging more for the larger FUE session.

(3) Everyone thinks it is safe and the hair will last a lifetime – Dead Wrong!

A word a of caution: some doctors will push the number of grafts within the permanent zone so much that the permanent donor area becomes a new bald area.

Buyer beware: it is your responsibility to keep the doctor honest and to make sure the doctor does what is in your best interest. This is why I shared this information with you. Good luck.

bad donor

The “Sean Connery” of Hair Restoration?

Hello, doctor. I do not mean any disrespect in my question, but I do believe it is an important one. I am considering surgical hair transplantation, and I’ve heard that you are one of the better surgeons in Los Angeles. My concern… my question is, how old are you? I ask this for two reasons. (1) Have you passed your surgical peak? (2) Will you be there in a couple of years when I may conisder another procedure?

Thank you. Again, no disrespect intended, but I am looking for a relationship with a physician who is not only qualified but who will be there when I need them.

What crystal ball does anyone of us have? Do you know when you cross the street that you will make it to the other side and not get hit by a car?

I am 63 years young. I have performed surgery on a couple of billionaires this past year and a number of top celebrities, one head of state, many CEOs of large companies, four patients from the TV show Extreme Makeover, construction workers, a bus driver, a grandmother and a mother of 7 kids, and many others who asked similar questions. My health is good, my maternal grandmother lived to 114, my maternal grandfather died at work when he was 102, my father’s grandmother lived to 99, and many uncles and aunts lived into their 80-90s. Like Sean Connery, I like to think that I get better with age. Mr. Connery turned 75 a few months ago, so he’s got many years on me yet.

I received the hair restoration industry’s equivalent to the Acadamy Award for Best Actor, called the Golden Follicle Award in 2004 at age 62, published the FUE technique when I was 59, and am probably one of the few doctors world-wide who does it well today. The FUE technique has to be the most taxing surgery in hair restoration that there is. I wrote chapters in text books and published scientific and other papers in the past 18 months numbering about a half dozen. I can not run the marathon (nor could I when I was 23), bench press some 500 pounds (also not able to do it when I was 23), or sprint the 100 yard dash (no comment is needed here but for that I am clearly out of shape). However, I ski regularly, scuba yearly to depths of 100 feet, ride my bike about 16 miles a day when I am not over-working and can play the piano for hours (my fingers, at least, hold up well). I can work longer hours than any of my staff and can get along on 3 hours of sleep per night if I must. If you get a younger doctor, ask to see patients of his/her which were done this year. I can show off many of my patients (which we do monthly) at our open house events and have done it for 14 years consistently. I tend to take my responsibility seriously, and have often helped my patients through many personal health crisis that were unrelated to their hair transplant. One patient of mine stands out (age 44) when he discovered that he had John Ritter‘s vascular diagnosis (actor known best for his role in “Three’s Company”). Mr. Ritter died just a few days from his 55th birthday from a rupture of his ascending aortic, so I became involved in the diagnoses and open heart surgery decisions that saved my patient’s life from Ritter’s fate. There is no doubt that had this patient not had a hair transplant, his diagnosis would probably have not been made and as his cardiac surgeon told him, he probably would have died in a year or so. If you would like, I can ask this patient for a reference that would back up this claim.

When you get to my age, you appreciate people for their value, hopefully gain wisdom, and with wisdom should come temperament that allows an artist to perform finer work, perfect his art, and refine and hone judgments that generally take years to define (just like Sean Connery has done for acting). I believe that what I bring is judgment and wisdom to my patient’s problem and potential surgery, and provided that my vision holds out and my hands remain as steady as they have for the past 35 years of doing surgery (from war torn Vietnam, to orthopedic, vascular, and general surgery), I fully expect to be doing hair transplants for some time, at least, on a selective basis.

Come meet with me and judge for yourself:

  1. if you like me
  2. if you respect me
  3. if you trust me
  4. if you think that I will be around for the duration of your needs

Your call, of course. When and if you come, please refer to this blog answer as I would love to connect with you, see the smile on your face and understand your motivation for writing this question to me. At the least, I enjoyed writing this answer, and at the most, maybe we will have things in common. I have made many friends amongst my patients, including many who did not ask traditional questions when they met with me.

The Science of Hair Loss by webMD

https://www.webmd.com/skin-problems-and-treatments/hair-loss/science-hair?ecd=wnl_day_100521&ctr=wnl-day-100521_lead_title&mb=DIjjZuHpe4pLfebJPo6kGpOenxSl%2FWb1cYT6skpYnrs%3D

https://www.webmd.com/skin-problems-and-treatments/hair-loss/hair-loss-diagnosis-women?ecd=wnl_day_100521&ctr=wnl-day-100521_support_link_1&mb=DIjjZuHpe4pLfebJPo6kGpOenxSl%2FWb1cYT6skpYnrs%3D


2021-10-05 20:58:49The Science of Hair Loss by webMD