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    In the News – Robotic Surgery Costs and Effectiveness

    Apr 30, 2013/by William Rassman, M.D./0 /FUE, Hair Transplantation, Other Surgical Procedures

    Snippet from the article:

    In the dozen years since the Da Vinci robot has been approved for surgeries in the United States, it’s been embraced by health care providers and patients alike. Surgeons routinely use the multi-armed metal assistant to remove cancerous prostate glands and uteruses, repair heart valves and perform gastric bypass operations, among many other procedures.

    Read the rest at Kaiser Health News — Questions Arise About Robotic Surgery’s Cost, Effectiveness

    Although this article reflects upon robots used for abdominal, prostate, cardiac surgery, etc… some of the questions asked will apply to the ARTAS robotic hair transplant FUE system. More from the article: “At this time, health insurers generally pay for robotic surgery just as they would any other surgical procedure, and patient out-of-pocket costs are typically no different either. That could change, some say, as more comprehensive data become available that clarifies when robotic-assisted surgery helps improve patient outcomes—and when it doesn’t.”

    Robotic FUE with the ARTAS system does what appears to be an excellent job at the FUE itself; however, as the grafts that are created are removed manually, stored in traditional solutions, and placed manually, defects in process that were present before the robot was used will continue even with efficient drilling of the grafts.

    “Robot-assisted surgeries are generally more expensive than other methods, however, and don’t necessarily improve patient outcomes long-term,” says the article. Although this statement is not referring to the FUE robot, the message is clear. What is it that the public is buying and what will the long term results actually be for the FUE robots?

    Many of the ARTAS systems that have been sold to date were purchased by experienced hair restoration surgeons, so I suspect in their hands, the long term results will be good for them; however, for the novice doctor or the doctor who has not put together the system of people skills behind the robot for moving, storing, and placing the grafts, an imbalance in long term results may result. It will be years before we know, though.

    Tags: artas®, fue, hair transplant, robot surgery, kaiser, hairloss, hair loss

    Rogaine Regrew Part of My Hairline, So What Can I Do To Make The Other Side Grow?

    Apr 30, 2013/by William Rassman, M.D./0 /Drugs

    Rogaine is growing old hair line back but only on one side. Other side is still receding and thinning more. Why is this? Been on rogaine consistantly for 5 1/2 months and propecia for a year. Should I continue rogaine or stop? Do not want to lose anymore hair on that one side. Thanks

    How are you sure it was the Rogaine (minoxidil) and not the Propecia (finasteride) that caused the regrowth? If you stop either treatment, you will probably lose what you gained, even if the benefits were only visible on the one side. It’s up to you whether you’re willing to risk it.

    If you end up using both medications for at least 12 months and still don’t see a similar regrowth on the other side of your hairline, then a hair transplant may be the only solution for you.

    Tags: propecia, finasteride, minoxidil, rogaine, hairline, hairloss, hair loss

    Is Finasteride Giving Me the Urge to Masturbate More?

    Apr 30, 2013/by William Rassman, M.D./0 /Drugs

    I take proscar cut up, and I find that I’m masturbating or having the urge to masturbate more. Is this because the finasteride is not allowing me to have a proper ejaculation with enough semen and confusing my body and thinking i need to masturbate more to feel completely satisfied?

    A small percentage of men report an increased sex drive from finasteride. The reduced ejaculate is a known side effect of finasteride, though usually seen with the full 5mg dose (for treating the prostate).

    Tags: finasteride, propecia, proscar, ejaculation, semen, masturbation

    Does Mixed Race Mean More or Less Hair Loss?

    Apr 29, 2013/by William Rassman, M.D./1 /Hair Loss Causes

    Are there any trends or differences for mixed race people vs Caucasians, Black etc? I mean, do you notice any more or less cases of hair loss in mixed race guys compared to those that you see in your office that are one race? I’m just curious.

    There are always variations in ethnicity, but the variation is also individual in nature. One ethnic hair characteristic does not always dominate over another. You can have a half black / half white baby and they can either have white skin curly hair or black skin and straight hair (or vice versa).

    We know that the donor densities are different in different races, with Caucasian the highest (100,000 hairs on the scalp) and African the lowest (60,000 hairs on the scalp). Asians are mid-way between the two.

    But to answer your question — no, I don’t necessarily see more (or less) cases of mixed race men with balding in my office.

    Tags: race, mixed race, hairloss, hair loss

    I Tried Rogaine for the Bald Spots I Saw From Extensions, Then Lost More Hair!

    Apr 29, 2013/by William Rassman, M.D./0 /Female Hair Loss, Hair Loss Causes

    I’m a 39 year old woman who started using Rogaine because I had a few bald spots from using hair extensions. I used it for about a week and have been shedding for the last six months. It’s pretty much stopped, but I’ve lost between sixty to seventy percent of my hair.

    Will I regrow any of it back? I’m MAYBE having some baby hairs returning up front but I’m not seeing that anywhere else. Is it possible that it wasn’t growing back because it was in shed mode and now that that has stopped maybe there’s hope for regrowth? Thank you for your input!

    I’m not sure what you’ve experienced with just a short history. Rogaine is used to grow hair. Some patients have reported initial hair loss in the first month, but those usually grow back within a few months. You can give it about a year to see if the hairs will grow back.

    You must also consider there might be other unrelated causes of hair loss that are coinciding with the Rogaine use. Have you seen a doctor about this loss?

    Tags: extensions, hairloss, hair loss, rogaine, minoxidil, female hair loss

    In the News – Prescription Drugs Cost More in the US Than in Other Parts of the World

    Apr 29, 2013/by William Rassman, M.D./0 /Drugs

    Snippet from the article:

    Whether you are young or old, man or woman, very healthy or quite sick, it is almost a certainty that you are going to use a prescription drug in the next year or two. These medicines are crucial for preventing diseases and treating all sorts of ailments and problems.

    They are also expensive — really expensive. For example, the best-selling drug of all time, Pfizer’s cholesterol lowering drug Lipitor, went for $3.50 per pill and up before going generic in late 2011. But these days some retail chains are giving away generic Lipitor while the rest are charging barely 50 cents a pill.

    Prescription drugs cost Americans far more than they do people living in many other parts of the world. The drug companies say it is because they have to pay back the R&D costs which is largely put on Americans. Many think that this is because drug companies spend a fortune on direct-to-consumer sales and marketing (which they don’t do in other countries) and because other nations negotiate better deals for drugs than private insurers do in the United States.

    Read the rest at CNN — How Big Pharma rips you off on drugs

    Tags: pharma, drugs, medication

    Site Stuff

    Apr 26, 2013/by William Rassman, M.D./0 /Other

    We’ve been having some problems with the contact form used on the site, so a lot of emails you’ve sent in never got to us! We changed the contact form up and added a little spam filter (simple math), and we hope that corrects the problem.

    If you’ve sent in a message in the past week or two, we might not have received it. Sorry about that! Please send it again using the new form on the Contact page.

    Does Propecia Produce Cardiac Effects?

    Apr 26, 2013/by William Rassman, M.D./0 /Drugs

    Can I ask you a medical question. I’ve been having some really fast heart beats at rest over 120bpm that were hurting, so I went to a clinic walk in today and they said it was Superventricular Tachycardia… I’m wondering if this can be caused by propecia and if maybe I should stop taking it? They said I should go see a cardiologist.

    I do not believe supraventricular tachycardia (SVT) is a side effect of Propecia. I don’t recall any cases where Propecia (finasteride) caused an irregular heartbeat. If you’re also using minoxidil, that is the more likely culprit, since minoxidil has actually been linked to cardiac issues.

    Some causes of SVT can be from anything with caffein (coffee, energy drinks), certain cold medications that have pseudoephedrine (Sudafed), or stimulants (cocaine). Sometimes there may be no direct cause from any extraneous source, but rather an inherent issue with your heart’s electrical system.

    In any case, SVT can be serious or lead to something more serious, so you should see a cardiologist for this.

    Tags: cardiologist, heartbeat, propecia, finasteride

    Using Oral Minoxidil to Regrow Hair?

    Apr 26, 2013/by William Rassman, M.D./1 /Drugs

    Hi Dr.Rassman,

    What is your opinion on oral minoxidil (Loniten) regarding hair-regrowth and are you able to provide any information from your practice or any other doctor’s experience?

    The original use of this drug in the 1960s was for hypertension (high blood pressure) and some patients may still take it for treating that. The side effect was the growth of hair on the body (everywhere and anywhere). For women, mustaches and chest hair would appear.

    There may be dangerous side effects of dropping of blood pressure when taken in a non-clinically controlled or indicated circumstance. This is not a good drug for oral use to regrow hair. Stick to the topical.

    Tags: minoxidil, loniten, hairloss, hair loss

    Press Release – RepliCel Receives Issue Notification from USPTO

    Apr 26, 2013/by William Rassman, M.D./0 /Hair Cloning

    Snippet from the press release:

    RepliCel Life Sciences Inc. is pleased to announce that it has received issue notification from the United States Patent and Trademark Office with respect to RepliCel’s technology for preparing populations of dermal sheath cup cells for its hair regeneration procedure. These cells are used to treat patients suffering from androgenetic alopecia, also known as pattern hair loss. With the issuance of this patent, RepliCel will now have patents issued in the United States, Australia and the European Union. Additional patent applications, further protecting and expanding on our technology, are pending in the European Union, Canada, Japan, the United States, as well as other countries.

    Read the rest — RepliCel Receives Issue Notification from the United States Patent and Trademark Office Protecting Methods of Preparing Dermal Sheath Cup Cells for Its Hair Regeneration Technology

    I don’t know what it means for the viability of hair regeneration, but they are proud to announce they’re getting patents on their technology.

    Tags: replicel, patent, hair regeneration

    What Can I Do at 16 Years Old If I’ve Been Receding for 2-3 Years Already?

    Apr 25, 2013/by William Rassman, M.D./2 /Age, Hair Loss Causes

    I’m 16 years old and I’ve been receding for about 2-3 years now. But last year I started thinning and it got worse over time. I’ve been currently using Kevis 8 for about 2 months and was wondering if this doesn’t work for me then what are my options at such a young age? And I also have carry the genetic hair loss gene as well.

    Genetic hair loss for men can start with puberty. If you started losing hair at 13 or 14 years old, that is rather young, but it isn’t impossible (as you can attest). If what you’re seeing is male pattern baldness, then unfortunately, it is the genetic hand you were dealt. But are you sure it is actual genetic loss and not some other factors?

    There are medications such as Rogaine and Propecia that treat hair loss, but you would need to be seen by a doctor with the permission of your parent/guardian for a diagnosis and a possible treatment plan. At 16 years old, you are likely not a candidate for Propecia yet, as it is theoretically possible that it could stunt growth for those young men still going through puberty.

    In general, herbal products, magic lotions, and special shampoos do not work. It is a buyer beware market.

    Tags: teen hair loss, hairloss, hair loss

    My Tight Eyeglasses Caused Thinning on the Right Side of My Scalp

    Apr 25, 2013/by William Rassman, M.D./0 /Hair Loss Causes

    Hello,

    from 2010 until September 2011 I was wearing eyeglasses that were too tight, and I suppose the tightly fitted frames lead to a pressure-induced alopecia at both lateral scalp sides, decreasing the blood flow passing through the external carotid artery. The right side of my scalp shows reduced hair density. Is this due to an ischemic process? How do I know if the alopecia is scarring and if this process is reversible? Up until now the hair hasn’t regrown. Thanks a lot

    EyeglassesI suppose anything is possible. Perhaps you have traction alopecia, but I wouldn’t say it is from an ischemic process. If the problem has been ongoing, the hairs may not grow back. Only time will tell (about 1 year), but I suppose if it has been since late 2011, you would know by now.

    Transplants work well if it does not grow back, and in fact, you would never know that they are transplants.

    Tags: hair transplant, hairloss, hair loss, eyeglasses

    My Head Was Shaved at a Year Old, So Is That Why I Don’t Have Thick Temple Peaks?

    Apr 25, 2013/by William Rassman, M.D./0 /Hair Loss Causes

    does shaving at an age of 1 to 2 years damage the follicles? I ask this because I had my head shaved when I was 1 year old and i’ve noticed like my friends, i dont have thick temple peaks. but my mother has that and my close relatives also have that

    Head shaving at any age should not damage hair follicles. We all have variations in hair lines and temple peaks. This is more about genetic variations.

    Tags: hairloss, hair loss, temples, shaved head

    Wouldn’t Delaying the Final Balding Pattern by Taking Finasteride Cause a Delay in Having a Transplant?

    Apr 24, 2013/by William Rassman, M.D./0 /Drugs, Hair Transplantation

    Dear doctors, love the website. I come here as much as i can and its helpful in learning and coping with hair loss, which is the worst thing a man can go thru.

    I understand that a lot of transplant doctors tell their patients its better to wait to get a final hair loss pattern rather than going for a hair transplant when the hair is still falling out. So wouldn’t finasteride be a bad thing to take then because if it merely slows down the hair fall out rate and doesn’t stop it, then a patient wouldn’t really reach his final pattern at a proper age where he can have a full HT?

    The drug would just keep on delaying the patient from reaching the final balding pattern but he would still be losing hairs, albeit not as many as he would have if he were not on the drug, but he would still be losing hairs and can not get a hair transplant.

    NW2Delaying the need for surgery is sort of the point.

    The goal for finasteride in many patients is just what you said. Why rush into surgery that may not be necessary? If you are lucky, the drug may delay the final pattern for many decades. Surgery is more of a last step unless the pattern impacts your appearance and you want it restored.

    Many young men find themselves in the situation you are talking about and may never develop a pattern beyond a Norwood class 2 and could keep the hair throughout the scalp.

    Tags: hairloss, hair loss, finasteride, propecia, hair transplant

    Finasteride Benefits Were Slow to See, But I Stuck With It and The Difference is Significant!

    Apr 24, 2013/by William Rassman, M.D./0 /Drugs

    Great blog! I frequent it periodically and have been following some useful advice you’ve given to your readers. It has helped me, so I thought I’d share my success story (thus far).

    I’m 25, and began to notice thinning according to a Norwood 4 pattern around the age 22. No doubt it would progress further seeing my father and brother are a Norwood 6 – 7. I was in denial initially, but after reading your blog I came to terms with my fate and recognized treating the issue sooner would allow me to keep my current hair longer.

    After talking with my doctor, I began finasteride 1mg. I didn’t notice any significant changes for quite some time. In fact, I continued to lose hair… for a while too. After about 9 months my hair began to look healthier but I never grew new hairs. Nevertheless, my hair appeared to improve according to my girlfriend and close friends.

    I can confidently say my balding had drastically reduced, if not stopped for the time being. After 1.5 years on finasteride, I decided to throw Rogaine in the mix. I’ve been using Rogaine at my hairline now for 4 months (in conjunction with finasteride). Although not perfect, my hairline is much improved. Even with wet hair, you can only detect traces of my balding. I only hope the results continue to improve.

    Good luck to everyone with the fight!

    This is not an atypical story. The full value of finasteride may take up to two years to see… and adding minoxidil does work in some men, as you have clearly stated here.

    Thanks for sending in your story and I hope you have continued success!

    Tags: finasteride, propecia, hairloss, hair loss
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