Using Donor Hair from Family or Friends?

/by William Rassman, M.D./0 /,

Hi,

Great site. I am a long time reader, first time poster.

My question is this: Is it possible to use donor hair from a friend/family member with the same style hair your have if there not enough donor hair on a subject?

Hair could be donated from other people just like organ donation, but without drugs to suppress the immune response, it will be rejected. Patients who are receiving an organ transplant need to be matched before the surgery for antigen compatibility and stay on anti-rejection medication for the rest of their lives. If you have an identical twin, it will work because the hair has the same genetic code as you would have.

Here’s a clip from our NHI video about identical twins and hair transplantation:



Tags: hairtransplant, hair transplant, hairloss, hair loss, donor, organ

I Have Alopecia Areata — What Can I Do About My Eyebrows?

/by William Rassman, M.D./0 /,

Hello baldingblog staff!

My question for you, I’m a guy , 35 years old, im suffering alopecia areata (patches). I really can do nothing, Im very affected by this disease and decide to completely shave my head and i deal with it. My real problem here to resolve is the eyebrows… I’m wondering what i should do for this particular case. Im not sure about tattooing my face. I’m sure the same way you just wrote it in your article, that it will look fake on a man… Anyway, I’m asking you what’s the best avenue for my needs here?

For men tattooing the eyebrow may look “fake”, but a stippled effect with some pencil on it may be helpful. There is no real great answer. Unfortunately for patients suffering with alopecia areata there is not much hope in terms of a hair transplant procedure as long as the disease stays active for then a hair transplant will not work. When the disease burns out (become inactive) then hair transplants can work and you can get your eyebrows back. There is always a risk that the disease may return.

Tags: eyebrow, tattoo, alopecia, hairloss, hair loss, hairtransplant, hair transplant

Hair Washing After Hair Transplants

/by William Rassman, M.D./0 /,

I had hair transplants a month ago. My hair looks like it is caked with crud. When can I wash my hair?

A month following the surgery you may wash your hair as you normally would. You should have started to wash it after the surgery, but the ‘crud’ you are talking about reflects scabs from the surgery and skin that normally sheds. To wash it clean, apply shampoo and leave it on for 5-10 minutes, then gently with your fingers, rub off the built up ‘crud’. Repeat it until it is clean and then all you must do is wait for the new hair to grow in.

Tags: hairtransplant, hair transplat, washing, shampoo, wash

A Note From a US Soldier with a Hair Transplant

/by William Rassman, M.D./1 /,

This is a note I received from a GI going back to Iraq for another tour that I wanted to share. It was really nice to hear from him, and I was particularly pleased to hear about his result, of course.

Soon it will be a year from the time of my transplant and normally I would schedule my follow up shortly there after but I will be on deployment here starting next week but be back in September so will schedule then. Presently I am pretty happy with the result.

I am hoping for some additional filling in on the crown area but it is greatly improved. Especially the ones that went into my pre-existing scars. They have made it so I can wear my hair extremely short without being uptight about it anymore. The coverage on them was superb. And I have continued to see improvement throughout and I am hoping that I get a little bit more fullness on the crown area but so far like I said I am very pleased with the result.

Thanks again hope to see ya end of summer.

Tags: hairtransplant, hair transplant, hairloss, hair loss, soldier, iraq

Chances of Nerve Damage from Strip Excision?

/by William Rassman, M.D./3 /,

Haemorrhage, vascular and nerve damage is a risk of strip excision?? can we see some of these implications in patients? what are the chances of this to happen?

I can reflect on these from only experience in my practice:

  1. Bleeding after surgery — I sometimes see some wound ooze beyond a day after a surgery (I would guess 1 in 300 patients). I handle this with a simple pressure dressing over the donor wound. Bleeding is never a problem beyond a day in the recipient area.
  2. Bleeding significantly during a surgery (by “significantly”, I mean enough to impact blood pressure – more than a few ounces of blood) — Risk for this is close to zero. Every patient bleeds during the surgery as the scalp is very vascular (might lose a few ounces of blood), but it should not be meaningful bleeding that risks anything. Bleeding may be a problem if a patient is on anticoagulants, Aspirin, or if they might have a clotting/bleeding disorder that stops blood from coagulating (this last one should be known by taking a good history from a patient for hemophilia).
  3. Vascular damage — There is no risk of direct vascular damage in a normal person unless the patient has had many scalp reduction procedures or many hair transplant procedures, or the surgeon does not have experience in doing this type of surgery.
  4. Nerve damage — There are two types of nerve damage that may follow a hair transplant. The fine cutaneous nerves are cut in almost everyone both in the recipient area and the donor area. This might leave some numbness above the wound and this usually disappears in days or weeks. The second type of nerve injury occurs when and if the surgeon accidentally cut a major nerve (‘greater or lesser’ occipital nerves). This is a surgical error in technique when it occurs. In my practice, I have never seen it in a surgery I have done, but I have seen this injury in patients who came to me from other doctors who may not have been skilled surgeons in the first place.
Tags: hairtransplant, hair transplant, nerve, vascular, blood, bleeding, damage, hairloss, hair loss, surgery

No Hair Where Mole Was Removed from Scalp

/by William Rassman, M.D./0 /, ,

When I was about 16 years old I had a mole surgically removed from the back of my head because it was growing larger and the doctor said it could become cancerous. I am angry about this because I don’t know if it was necessary at the time or not. Anyway I am 22 now and no hair has grown in that spot since. I don’t under stand why but lately it has consumed me and I am extremely depressed and obsessed with it. Am I able to get a hair transplant and make the hair grow back? Also will I be loosing one bald spot and creating another one at the donor area if I can have a transplant?

Scars from removal of growths or just lacerations are common in the scalp. It depends upon the surgical technique and possibly more important is the general direction of the wound. Linear scars that run front to back tend to scar more than those that run side to side, but everything in the scalp can scar. With a good hair transplant surgeon, a decision can be made how best to address the scar. Some of these scars can be fixed with a simple surgical excision of the scar and proper closure techniques, while others may be fixed best with a small hair transplant (always works). See an expert.

Tags: scalp, mole, scar, hairloss, hair loss, hairtransplant, hair transplant

Touch-Up Hair Transplants

/by William Rassman, M.D./0 /

What are your thoughts on “touch up” transplants? I am currently 27 yrs old and have had thinning in my front forelock since I was 18. When I was 24 I started Propecia and although it has progressed (from the size of a dime to a quarter) It has been slow.. This makes me think that my problem could be solved with 800 or so grafts. The rest of my head has good thickness. I realize you’re going to recomend a “master plan” and “hair mapping”, but if you could include your thoughts on touch up’s. It would be appreciated. Most importantly on what criteria you would recomend them, if any.

thank you.

It is impossible for me to tell you about your hair loss and treatment plans from a simple blog posting. You seem to know about the importance of a Master Plan and miniaturization mapping and with any transplant work that you are considering, anticipating the future direction of the hair loss is critical to balance things like:

  1. Supply/demand of donor hair use
  2. The rate of hair loss for following your progressive hair loss over time
  3. Budgeting appropriately to follow-through with what you start

If you are concerned about your hair loss, your next step is to see a good, honest hair transplant doctor. If you saying that you already had a hair transplant or two or three, and this is a touch-up (meaning another small hair transplant procedure) you should ask your doctor how many more of these are needed to make sure that you know where it will all end sometime.

Sometimes patients come to me with a preconceived number of grafts they need. Often times these numbers do not match their expectations and the real needs to achieve the goals. Everyone’s needs and the criteria for choosing the numbers of grafts are different based on hair color, skin color, hair texture, head shape, etc, etc. See Patient’s Guide — How Many Grafts Will I Need?

I do not understand what you mean by a “touch up” transplant. You should either have a hair transplant to meet your goals or you should not have a transplant at all. There are some patients who may come back a year later for more fullness or address other areas and as there may be a risk of shock loss, you need to prepare a worst case scenario. You may see this as a “touch up”, but as you can see, it is related to the goals and expectations of a hair transplant program.

Tags: hairtranspant, hair transplant, hairloss, hair loss, touch-up

I Found this List of What I Can and Can’t Do After Surgery…

/by William Rassman, M.D./0 /,

Hi Dr. R!

Captain Forehead here. I’m one week post-op. Staples are good so far. Not too much discomfort.

Wow, there is SO much different info online about what you can and can’t do after surgery. I found this elsewhere on baldingblog.com, a very helpful guide.

Patients…

* Can lie flat
* Can have full aerobic exercise in 1 week (even run a marathon if they want)
* Should limit weightlifting greater than 25 lbs for 4 weeks and keep the back straight
* No sit-ups or pull-ups for 4 weeks
* May play with pets in 1 day (but no licking the transplants by your dog until the crusts are off – it had to be said)
* Smoke and dust in the environment are not a problem unless you are not clean
* Passive sex is ok for the first 2 nights, then everything after is a go

It’s just weird ’cause sometimes I feel more tension while yawning than I do after the pushup I just tried, of course while keeping my head totally back!

I guess I’m just writing to say, I wish I knew for sure how “zombie-like” I have to remain after surgery and how much of my history of widened scars is due to junky genetics.

Thoughts?

P.S. See ya at the Open House in L.A. this Saturday!

You don’t have to be a zombie after a hair transplant surgery. The precautions are so that it protects and minimized the donor area scarring and most of the rules are to protect the people who are not generally careful and do unsafe things. I am generally open to shortening all of the time lines with more careful people. To simply think about it, the more tension you put (sit-ups, etc), the more there is a risk of widened scarring when your neck muscles are pulled. You will know that if you put your hand on the back of the neck and see how much pull you get from what you are doing.

Tags: hairtransplant, hair transplant, hairloss, hair loss, surgery, aftercare

How Much Time Should There Be In Between Transplant Procedures?

/by William Rassman, M.D./1 /, ,

Dear doctor,

last week i underwent a 2500 grafts transplant to my front and sides of the head, however i still need another 2000 grafts to cover the
crown.

my question is – what is the average time gap between two transplant operations ?? when should i go in for the second tranplant?

Also is it necessary that i take medication after these transplants.

The spacing of hair transplant procedures should be at least 8 months apart to allow the grafts to grow from the first session. I always tell my patients that when they see the growth, they will know:

  1. If another hair transplant is needed, and…
  2. Where these grafts are needed in the second session

The only medication I recommend after a transplant is Propecia to arrest or slow the progressive nature of genetic hair loss. I suggest taking the medication before the transplant as well.

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

Avodart vs Hair Transplant

/by William Rassman, M.D./0 /, ,

I was wondering if you give prescriptions for avodart. I had some frontal transplants in early 90’s but continued to lose behind transplant..i now wear a hair system and Have learned to live with it…i need to keep what hair i have in the back and on the crown so my systems do not have to be made any larger..I have been doing alot of research about avaodart..i was able to get a sample pack (2 weeks) from a dr friend..but need prescription to get more…

Avodart (dutasteride) should not be the first line for you unless you are sure that Propecia (finasteride) is not working. I would be happy to evaluate you, but the few times I have prescribed Avodart, I had good reason to do it. The side effects on Avodart are more than the side effects of Propecia. If you have a void now developing behind the old transplants, have you considered fixing this (it is relatively easy)? It may allow you to get rid of your hair system. In any event, you need to have miniaturization analysis before any treatment to know what is happening to you.

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

Regrowing Hair on a Scar

/by William Rassman, M.D./1 /, ,

I have this bump on my scalp for years so i decided it to get it removed. so now i got a scar and hair doesnt grow on it. can you regrow hair on a scar and if it can be done when u cut your hair will hair grow back again? please help

Scars can be effectively transplanted. The hair that grows is the hair that was moved, not the original hair that was there before.

Tags: hairloss, hair loss, scar, hairtransplant, hair transplant

I Want My Hairline Lowered an Inch

/by William Rassman, M.D./1 /, , ,

(female)
I’m 16 years old born with a high hairline just about 3 inches. I’ve saved about $5,000 to get the procedure to lower my hairline and was wondering about how much would it be to take off half an inch to an inch. i have a widows peak and wonder if you can fix that too. what would be an estimate and could there be any payment plans. i’d love to have this procedure done before i turn 21.

The fee for a hairline lowering procedure is $8,000 (icludes all anesthesia and facility charges). The hairline lowering procedure is like a reverse brow lift and this is often the way women get a lower hairline. The widow’s peak would have to be assessed separately.

Alternatively, hair transplants could lower the hairline as well. This is, of course, what we do regularly with men and the fees are based upon how much hair is moved (price per graft). I would be happy to review your case confidentially if you send in a picture. Please reference this post if sending.

For more about hairline lowering, see Dr. Kabaker

Tags: kabaker, hairline lowering, hairloss, hair loss

Best Sutures for Donor Area After Transplant?

/by William Rassman, M.D./0 /

What form of sutures do you recommend for the donor area after surgery? My first transplant was a 1900 graft procedure, and my doctor used absorbable sutures which took more than two months to absorb. I would prefer the non-absorbable that would be removed after two weeks. What are the pros and cons of each? Does either one promote better healing? I live a few hours from my surgeon, so I understand that is why he probably used the absorble suture. I am a 39 year old male. Thanks for your advice.

Speak with your doctor. Absorbable sutures vary (some get absorbed quickly and some slowly), while removable sutures or staples are usually out in less than 2 weeks. The decision is between you and your surgeon as there is no ‘correct’ answer for everyone.

Tags: suture, absorbable, hairloss, hair loss, hairtransplant, hair transplant

Why Would Propecia Prevent Shock Loss After a Hair Transplant?

/by William Rassman, M.D./0 /, ,

Is there any data to suggest that if your a young male taking propecia prior to a hair transplant that you will have less shock loss? I only ask because I read your comments about this subject. What would be the mechanism behind this, other than the usuall effects of finesteride on 5-alpha-reductase enzyme?

The information I have is based upon my observations from a large number of surgeries I have done both prior to Propecia (finasteride 1mg) being available and then after it came on the market. Prior to using Propecia, almost every young man (under 30) who underwent a hair transplant had some shock loss. Since I have placed almost all of my patients on Propecia, I have rarely seen shock loss. As to why it works, I do believe it is because of the protective effect of finasteride on the 5-alpha-reductase enzyme in the miniaturized hair covers the ‘stress’ of the surgery.

Tags: finasteride, propecia, hairloss, hair loss, hairtransplant, hair transplant, shockloss, shock loss

Do You Think Hair Transplantation will Become a Defunct Practice?

/by William Rassman, M.D./0 /,

Doctor Rassman,

Do you believe that hair transplantation will ever become a defunct practice (due to a cure or a commercially viable alternative)? Do you believe this will happen in YOUR lifetime?

If there is a medical cure for balding (medicine, cloning, etc), I think I would become a very rich man. After all, who else is better equipped to treat balding than the doctors who are already in the practice? I should hope that there will be a cure in my lifetime!

Tags: hairtransplant, hair transplant, hairloss, hair loss, cure, cloning