Older patients with very low levels of vitamin D have about a 122% increased risk for dementia compared with those with higher levels, according to a large, prospective, population-based study.
Pauline Anderson
August 06, 2014

The study provides “robust evidence” of the link between vitamin D and cognition and adds important new information to the association, said study author David J. Llewellyn, PhD, senior research fellow in clinical epidemiology, University of Exeter, United Kingdom. “

For those of you who have elderly parents, this is an important piece of information for you. Testing for Vitamin D levels in your blood is easily done in most doctor’s office and taking vitamin D is even easier.

The risks of having a complication or dying from a surgical procedure is small in some cases but clearly not insignificant. I found the following article which not only outlines the problems concerning the long-term risks of any major surgery, but also the article had some suggestions for doctors on how to go about assessing the risks. There is no easy solution.

Introduction of article: “Owing to increases in life expectancy, the patients presenting for surgery are older, and have more co-morbidities. Worldwide, 3–4% of patients die within 2 months of major surgery, with increased mortality and morbidity in high-risk surgical candidates, including the elderly and medically unwell.[1,2] In Australia and New Zealand, older patients having non-cardiac surgery have a 20% risk of serious complication and a 5% risk of dying within 30 days of surgery.[3] The cost to patients and the community is enormous. In a cohort of 806 534 Medicare beneficiaries having surgery in America, 51.5% of patients discharged after a surgical procedure had either died or been readmitted to hospital within a year, and 70.5% of re-admissions were for a medical problem.”
(*) Above quote was taken from the British Journal of Anaesthesia, 2014;112(6):955-957., “Not Fit for a Haircut … How Should We Assess Fitness and Stratify Risk for Surgery?” by M. A. Shulman, B. R. Thompson

As part of the informed consent for any surgical procedure, even a hair transplant, patients must fully understand the risks to life that confront them. I am aware of two deaths from hair transplant surgery, probably the result of doctors inexperienced with the use of medications such a Xylocaine (Lidocaine). One of those cases involved a non physician involved with surgery. That person is still out there offering discount hair transplants last time I checked. How he is still allowed to conduct business is beyond my understanding.

Many years ago, I was the guest speaker at a major medical meeting where the audience numbered about 300. At the end of my speech, a doctor came to the microphone from the audience and ask the following question (from the best of my memory) “I am seeing some of my patients complaining of numbness of their fingers and lips. Have you seen that complaint?” I asked him to see me after the meeting and found out that as his number of grafts were increasing with each surgery, he was increasing his dose of Xylocaine. Numbness of the lips is a sign of Xylocaine overdose and it may be followed by seizures and/or a drop in blood pressure. When I told him, he was shocked and relieved. He asked me why I did not get that side effect. I told him that more anesthesia was unnecessary with large hair transplant sessions. He thanked me.

Doctors must command every medication they use and the complications of that medication. Even hair transplant surgery has its risks. People have hair transplants even with known heart disease, kidney disease or liver disease. These diseases could impact the results of a hair transplant surgery and I am sure you would want to know that you doctor is prepared for all such eventualities. Both Dr. Pak and I are routinely certified for Advanced Cardiac Life Support every two years as part of our preparedness. Fortunately, in the 24 years of performing hair transplant surgery at NHI, even thought we have done hair transplants on many men over 80, some with known cardiac disease we have never had a complications from a hair transplant procedure that required our advanced (non hair transplant related) training.

For the Haircheck device what is considered a normal percentage for non-balding male 5-8% or more? what percentage would normal for a non balding male from the donor hair to the hair on front, top and the crown?if some of hairs diameters look different when I take a picture up close with my iPhone is that normal for a non balding male my dermatologist said you really can’t do that unless you have digital handheld microscope.Can you tell miniaturization by just taking a picture of your hair? My dermatologist said I had no thinning or signs of male pattern baldness and I have thick hair. Thank you again and look forward to hearing back from you! Have a great day!

Bulk measurements measures an area of hair that is gathered in a particular area of the scalp. We take several measurement on different areas of the scalp. We compare the bulk measurement from area to area. The back of the head is our baseline as this area always shows what a normal bulk will be for each person. When we compare area to area, we can tell if the bulk in one area is less than the bulk measurement from the back of the head and by how much. For example, the top of the head may have a bulk measurement equal to 50% of the back of the head and this would indicate that the person lost half of his hair volume on the top of the head. We also look at the measurements taken over a period of time (about one year) to see if there have been changes. For example, maybe last year the top of the head showed a bulk measurement of 50% of the back of the head, but today it might show a bulk measurement of 25% of the bulk measurement from the back of the head (such a finding would show progression of hair loss over the past year). This way we can put a number or a metric to the hair loss or gain. This will help the patient in developing a long term plan. It’s better than a photo.

There is a margin of error of up to 10%. You can probably measure the same location at the same location within a minute and get a small variation in the measurement. Every doctor may be different in how they go about using the bulk measurements. The number values are not important if there is no one to give you the analysis or a meaning to the numbers so that you understand the big picture.

Finally, you can’t look at miniaturization with an iPhone or a photo. We look at miniaturization with a microscope that has a 50x zoom lens. Miniaturization is also looking at comparisons between one location of the scalp to another location and seeing if there is a pattern of very thin hairs to normal thickness hairs. This suggests some early balding if the number of fine hairs is significantly larger than the number of normal hairs; however, this is hard to replicate and as it measurement only an area the size of a pea, it is far less accurate than the bulk measurement made with the Hair Check instrument.

Hi there I have scar in the back of my head very wide and I like to know if theres anything to make invisible when I shave bold I can see the big strip there, please let me know thanks!

Yes. The scar in the after picture here is still there. Can you see it? This is a typical result of our work with Scalp Micropigmentation?

SMP – Scalp MicroPigment to hair transplant scar

In addition you can check out this POST

I always find the online posts about the relationship between hair loss and weight training, most of the posts stated that weight lifting could increase the testosterone level, it will be bad for the hair follicles since more testosterone will transfer to DHT so that the follicles will be attacked more often by that. I know wight training can increase the male hormone level to build up more muscle, but I suspect that it will cause hair loss at meanwhile, do you think the statement making sense? Thank you.

Online Internet is as full of misinformation as it is with good information. Weight lifting does not cause hair loss in men (or women). The most common cause of hair loss in men is Genetic (called male patterned balding – MPB) or androgenic alopecia (AGA). It is not the testosterone (or even DHT). It is the genes that you inherited from your mother or father. If you have the genes for hair loss, then DHT (dihydrotestosterone) is one of the key hormones that seem to precipitate the male pattern balding. Propecia is a drug that impacts the way DHT works by competitively blocking the enzyme that converts testosterone to DHT at the target organ (in this case the target organ is the hair follicle). Many online and Internet sites take this information and infer that since DHT is derived from testosterone that an increase in testosterone will cause more hair loss. This logic is flawed and human biology does not work this way. You have to look at the main underlying reason for hair loss (which is genetic). If you are not confused about this thus far, you may find it interesting that testosterone is made from cholesterol (as is many other hormones). The online (bad) logic will dictate that high cholesterol will now cause hair loss but this is not the case either if you extend the logic saying that cholesterol is used to make testosterone which is needed to get DHT.

I take Propecia at breakfast time. I drink a lot of coffee and eat a lot of fiber, so in well under half an hour after I have breakfast, I have to urinate and defecate – a lot. I know you say that you can have Propecia with coffee, but if I’m using the bathroom so quickly after I take Propecia, am I really absorbing any of it? Thank you in advance.

It doesn’t matter what time of day you take Propecia. Taking medications (such as Propecia) has nothing to do with your urination and defecation schedule. It has nothing to do with your fiber or coffee intake. If you are worried enough to write about it and think about it, you can always take Propecia after your morning habit! Remember, the distance from your mouth to your rectum measures about 30 feet and whatever you take into your mouth has to transit the 30 feet and that takes time.

Hi Doc. I was just reading your recent article “Hair Transplants with Scalp Micro-Pigmentation (with Photos)” and was wondering whether or not the patient would be in the same position now if you knew the hair transplant techniques back then, that you know now.

Is it possible that with ultra refined techniques the transplanted hairs would have been transplanted more evenly around the head meaning that Scalp Micro-Pigmentation would not have been necessary.

Best

The simple answer to your question is: Yes! Many people with advanced balding patterns just don’t have enough donor hair to cover the entire balding pattern, so SMP (scalpmicropigmentation) solves this problem.

I hear ultra refined technique used sometimes but it is more of a term described in forums such as Hair Transplant Network. That terminology is just semantics. The GOLD STANDARD in hair transplant surgery is transplanting one follicular unit at a time. It doesn’t matter what you call it. AT NHI we have being doing this since we opened in the early 1990’s and have pioneered and published on this technique (HERE).

To be clear, no matter how perfect the technique (you can use ultra refined technique if you would like), you have a LIMITED and FINITE supply of donor hair. So no matter how refined, you can never have the fullness of someone who is not bald. Hair transplant is great at providing a non balding look and creating a solid non-receding frame to your face. But hair transplant is in essence moving hairs around from one place to another.

Scalp Micropigmentation (SMP) is not perfect since it is not hair. However, (like Toppik and DermMatch and other concealers) it reduces the contrast between hair and scalp providing the look of fullness that a hair transplant may not provide. It also provides an EVEN appearance when you shave your scalp. More importantly, SMP provides any hair transplant patient an option to SHAVE their scalp and disguise the donor scar. Even for people with FUE surgery, there is a scar in the form of DOTS. SMP can also blend in these FUE dots.

SMP is a great adjunct to hair transplant.

Hair Transplant Result

Shaved after Hair Transplant (no SMP)

SMP after Hair Transplant