Hair Transplant Scar in a Shaved Head

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

I have a question, I recently read one of your posts, and it said “In all patients, a scar will be seen if the head is shaved 100% of the time”. But is this really true, if the surgeon:

a. used a trichophytic closure
b. if there is no access tension
c. if the patient takes good care of the scar(ie-scar products..ect) and
d. if the patient has good healding capabilities.

Wouldn’t all these things make the scar almost non-detectable especially if the scar is hidden with the tricho-closure? And if you buzzed your hair, but you had it camoflauge from the special closure, than mabey it wouldn’t show as much?

My comment still stands as written. You asked, Wouldn’t all these things make the scar almost non-detectable? Using a buzz cut would be fine and probably not detectable. I was talking about shaving the head completely, which will always show at the least a fine line. The trichophytic closure puts hair into about 2 mm of wound, assuming that it stretched 2mm, but even with hair in the wound, the skin that stretches 2mm will show with shaving the head. I have some patients with buzz cuts, one who comes to my Los Angeles open house events regularly to show that yes, you can get a buzz cut. Our next Los Angeles open house is this coming Saturday, October 7th from noon to 2pm. If you’d like to RSVP for the free event, please call 800-NEW-HAIR.

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

So, What Should I Look for In a Doctor?

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

Hello, I am a 27 year old male who is seriously considering a hair transplant in the begining of next summer. My concern is to make sure I find a good surgeon. Do you have any other surgeons that would reccomend. Maybe, its just yourself and whoever works with you.

What should somone look for?
Are there any new technological breakthroughs to look for?
What can I do to make sure my scar is not very bad? I always wanted to get a fade again. Maybe Im just dreaming but in getting a fade, the side of the head is shaved and the scar would be present.

I have thinning along the middle of my head and a clear receding hair line. I now shave my head to conceal it.

My last question, is how long does it take for it to look and feel normal after and a transplant. Also, how long should my hair be when I go for a consultation?

Thanks for your time

I wrote a book on these very subjects (with Dr. Robert Bernstein), so rewriting it for this blog would just be too time consuming. You can request a copy of the book and I will send it to you or to any of my readers that want a copy. Or, even easier, the text of the book can be downloaded in PDF format here. Also, I posted a blog entry just a couple weeks ago that may be of interest to you — How to Tell if You’ve Found the Right Hair Transplant Doctor.

With regard to your other questions, thinning along the middle is an unusual presentation of genetic balding, but I have seen it. You need to get your hair mapped out for miniaturization to determine if there is genetic balding or not.

A person who has a hair transplant will feel normal (no pain in the back of the head at all) usually within 2 weeks or less. I generally like people to keep their hair long for the consultation, because I want to understand the impact of balding in a styled hairline. Sometimes thinning hair looks full when it is styled or longer.

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

Electrolysis to Make Transplanted Hairs Finer?

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

Couldn’t electrolysis be used to make transplanted hairs finer? I have mostly folicular transplants however I noticed that they are still courser and darker than my native hairs. Couldn’t electrolysis be use to make them lighter in texture and finer in contrast? Thanks for your response.

In theory, if the electrolysis damages but does not kill the hair, it would become finer. I would think that this would be a difficult or near impossible thing to achieve.

Tags: hair transplant, hairtransplant, elecrolysis

Hair Transplant for Severe Alopecia Areata Sufferer?

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

I am 52 years old, male, and since about 18 months ago I have severe alopecia areata but only in the top of my head, not on the hair line, sides or back. My dermatologist says a hair transplant will not work in my case, that it will fall shortly, etc.What is your opinion?Isn´t there any hope for me on any kind of transplant?

Alopecia areata can be transplanted if the disease has been inactive for 3 years and shows a negative biopsy for active disease during that period. For those who I have transplanted who met that criteria (very few people), the disease had not returned, but this is a real risk even when the disease is inactive for 3 years.

Tags: alopecia, alopecia areata, hairtransplant, hair transplant, hairloss, hair loss

Shampoo and Hair Transplants

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

I seem to have this “sebum” buildup which creates dried residuals on my scalp since the transplant was done. Does that imply that I need a stronger shampoo rather? I was told that it was good to use a very mild shampoo because it did not remove the surface oils, but I would think sebum is surface oil? Thus, perhaps a “Head and Shoulders” might be better? Can ANY shampoo hurt the transplants and/or contribute to natural hair loss?

Any shampoo will work. The transplants are no different today than your original hair was, just less density than you originally had. Switch to another shampoo, be adventurous and experiment until you find something that works better for you.

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

I Have Shingles a Month After My Hair Transplant

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

Hi Dr. Rassman,

I had an all FOX procedure at your San Jose office in August and am anxiously waiting for my grafts to grow. I just found out I have a case of the shingles (2nd time — first was six years ago) and am worried that this might affect my results.

Is this something I need to be concerned about? The shingles are confined to a small area of my lower back. I’m 41 and in good health otherwise. I’d appreciate your feedback.

Shingles (otherwise known as herpes zoster) is a painful, blistering rash caused by the chickenpox (varicella) virus. You can only get shingles if you have previously had chickenpox. After having chickenpox, the virus lies dormant in the nerves, and shingles occurs when it is revitalized in one particular nerve to the skin, thus explaining the way it affects a clearly demarcated band of skin only (in your case, your lower back). Having shingles does not mean you have active chickenpox or are contagious.

With respect to shingles affecting your hair transplant, you should not be concerned. It should not affect your transplants or your hair growth.

Take care of your shingles, and I wish you well with the recovery.

Tags: hairtransplant, hair transplant, shingles

Can Trichophytic Closure Technique Remove My Scar?

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


As you can see in the picture I have had 2 HT strip scar procedures. I always liked to cut my hair short with a 1# guard but after 2nd HT scar (top one) I cut hair with 2 guard and it’s still visible. Right now I don’t know if I should get another HT but I do want repair work.

If I go and get the Trichophytic Closure Technique can my old scars be removed? How can this be possible?

How about body hair transplants into my old HT scars?

Will I ever be able to cut hair close again with a 1# guard?

Thank you

No.

All cuts will produce a scar.

The worst doctor with the worst technique can operate on one patient and have a great result with minimal scarring. Likewise, the best doctor with the best technique (using Trichophytic closure, etc) can operate on another patient and have a poor result with wide scarring. In other words, everybody heals differently and some people are more prone to scarring.

Generally a Trichophytic closure technique will benefit 1mm of the scar margin. So if you have a 5mm width scar, a Trichophytic closure technique will make it look more like a 4mm scar. It is obvious that the wider the scar is, the less benefit will be obtained by the Trichophytic closure.

At NHI, we offer free scar revision to our former patients. Sometimes we are able to achieve an improvement, but as stated earlier, there will always be a scar.

Body hair transplants are not considered a standard of care in my opinion and are still controversial because of their long dormant stage and growth cycles.

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

Using Body Hair for Eyebrow Restoration

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

(male) I have a question regarding eyebrow restoration. All of the websites I’ve been to for doctors who specialize in eyebrow restoration describe the procedure in the same way. They all talk about using donor hair from the scalp. Is there any alternative way of obtaining donor hair, i.e., from a different location on the body, so as to eliminate the issue of transplanting hair that may or may not have the same characteristics as eyebrow hair, and hair that will continue to grow unless trimmed periodically for the rest of a person’s life? What about using arm hair, leg hair, or chest hair? Also, is it possible to obtain donor hair by extracting, rather, plucking, existing eyebrow hair? Can the follicles be extracted that way?

Body hair has a long sleep cycle. For every body hair that you transplant, less than 4 out of 10 will grow at any one time because of this long cycle. Hair from different parts of the body have different sleep cycles. I’ve answered this before a few times, most recently here.

Your thinking is good, but the cycling of the hair makes this approach not practical. I would be reluctant to moving eyebrow hair around. There is a possibility that if it is move, it may not regrow, so I avoid this solution. All hair can be extracted using the FUE techniques that I have pioneered (see Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation).

Tags: hair transplant, hairtransplant, body, eyebrow

Doctor Charges Per Procedure, Not Per Graft

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

Thank you for taking the time to maintain this website. I met with a hair loss consultant last week for the first time. He recommended that I have 2500 grafs on my forehead area and a second transplant a year from now on the top of my head. Why not just have it all done at once? He claims that they dont charge per graf, but a flat fee regardless of how many transplants they do. Is this just a opportunity to make more money for a second procedure?

If the consultant you spoke with was not a doctor who does the surgery him/herself and is trained in hair transplantation as a specialty, then he/she is practicing medicine without a license and I would run for the hills. There are some clinics that promote consultants to recruit patients and I have seen some people get recommendations that are way out of line with their need. Doing more than 2500 grafts depends upon:

  1. The size of the bald area being treated
  2. The donor density
  3. The looseness of the donor area skin (laxity)
  4. The skill of the surgical team (only some teams are capable of performing 5000 grafts at one session)

Fees are generally priced per graft, but that is not a hard and fast rule. Whatever the basis for the charge, it should be both competitive to what a quality medical group would charge and show value for what you are going to receive (result focused of course). Selecting a doctor should follow the science I have outlined in How to Tell if You’ve Found the Right Hair Transplant Doctor.

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

Restoring the Moustache

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

MoustacheA few years ago i had some stiches places on my mustache area and it left a scar and now hair doesnt grow in the places that the stitches were placed.

I was wondering if you know of any product, surgury or any other possible solution that could allow hair to re-grow in the spots that the scar is or in other words where the stitches were placed?

Hair transplantation is an ideal procedure to address the scar on your mustache area. At NHI we have even done entire beard/chin areas and recently for a patient who wanted to grow a goatee.

[Note: photo above is of the World Beard and Moustache Championships world champion, Willi Chevalier. Photo used for display purposes only, and not to imply that Mr. Chevalier had any restoration to his facial hair.]

Tags: moustache, facial hair, hairloss, hair loss, hair transplant, hairtransplant

1 Week After Transplant, I Accidentally Hit My Head

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

i had 1200 graphs put in one week ago. after reading your blog, i wish i had done them with you. i was planning on another 1500 or so in my next procedure and i will come see you first for sure. so you will be seeing me about 12 weeks from now. unfortunately, today i was getting into my car and hit my head on inside part of my car door. ( again i am one week post op) i hit it relatively hard…when i reached to see if there was bleeding( i hit in the area of my recepient site) it was bleeding. I did not stop bleeding for about 35 minutes. Did i likely dislodge new transplanted graphs as well? The cut is about 2 inches long, not very wide not too deep. After one week am i likely to have dislodged graphs? i did not see any follicles, but you never know? your opinion?

It is difficult to answer your question without examining you in person (you’re in Los Angeles — we’re in Los Angeles). That being said, the hair grafts are generally considered permanent after the first couple of days. It is very, very difficult to dislodge a graft after they get set-up and I have seen people get lacerations of the scalp from accidents at about 1 week and when I examined them, all of the grafts were intact and in place (unless they were inside the laceration itself). If you did not see any grafts, you probably did not do any significant damage. However if you have a cut on your head, you will get an inevitable scar and hair may not grow on the scar.

If you do decide to make an appointment to have your injury looked at, please mention this blog entry to me (or to Dr. Pak, who is a contributing editor to this blog).

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

Did Jamie Fox Have a Hair Transplant?

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

I would like to know the difference between FUE and FUT and scarring between them. Also, looking at the actor Jamie Foxx, it seems like he has had a hair transplant. I see him having really short hair or shaved head, so his scar would be visible. What would you recommend to reduce the scar? Also, looking at this website, there is a difference in his hairline. It is low and perfectly lined so would you do a procedure on someone to give them that exact perfect symmetrical hairline or would you say no because it does not look natural? Is it the doctors decision or patients choice??

ConcreteLoop.com

Jamie FoxxFollicular unit transplantation means that the grafts occur in their natural unit anatomy and are transplanted that way into the recipient area. FUE is a harvesting mechanism and should be taking out the grafts as follicular units so that they are completely natural (that may not happen, however). Strip harvesting is the second harvesting mechanism and may or may not yield FUT, depending upon decisions by the surgeon and his team.

With regard to Jamie Foxx and hair transplants, the site you sent me does present some very interesting photos. There is a difference in his hairlines over time so it is possible that he did have a hair transplant. If these photos are to be believed (I am not disputing them, but I do not know the source), then it does appear that his hairline is quite a bit lower now than it previously was. Maybe there’s another explanation — his hairline could naturally be very low and he shaves it higher to achieve a different look at different times. I really don’t know, though. The perfection of his hairline may be the result of styling control that he exerts, but as a good hair transplant is undetectable, I can not tell from these photographs.

An interesting thread about this was on HairLossHelp about a year ago (found via Google) — here.

Tags: hairtransplant, hair transplant, hairloss, hair loss, hairline, jamie foxx, jamiefoxx, actor, celebrity

4 Years After Hair Transplant, I Am Still Numb

/by William Rassman, M.D./7 /,

I had a HT from another surgeon about 4 years ago. The numbness area has still not gone away after 4 years. I was told it would take 3 months to a year. Is there still hope for my nerves to reconnect on their own? If not, is this correctible by surgery or any other methods?

Thanks.

Numbness after a year reflects some nerve damage. I would want to know where you are numb. There are nerves in the back of the head than can be damaged from surgery. They are the greater and lesser occipital nerves, temporal and third occipital nerve. The following image shows the major nerve distribution and it may correspond to the area where your sensation is impacted:

As you can see from the picture, these nerves specifically cover different areas of the scalp. If any of these nerves are injured, a sensory defect will reflect the nerve’s distribution. We are fortunate that these nerves overlap in most people, and if one is damaged, the other has a distribution that covers the damaged nerve. It sounds like your back-up system did not work.

After 4 years, the nerves usually are dead, so that surgery (which is very difficult anyway) will not work. If there is pain in these nerves, then there are things that can be done to alleviate the pain, but usually after 4 years, all pain should have gone away.

(image source: eMedicine)

Tags: hair transplant, nerve damage, nerve, numb, surgery, hairtransplant, hair restoration

Doctors Refuse to Transplant Me — What Should I Do?

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

went to more than 6 institutes and all of them refuse to do the natural hair transplant because i’m not completly bald. and in new york they told me that my donor area is not strong or not enough. what should i do? would bio fiber be the solution?

Certainly you do not have to be bald to get a hair transplant, as most of our patients show clearly in the NHI Patient Photo Galleries.

There are conditions that may impact your donor supply, either a very low density or a disease called Diffuse Unpatterned Alopecia (DUPA) which may make hair transplants a poor solution for you. Without examing you, I can not tell you why the doctors turned you down, but that is a good question you should ask them. See the ‘Managing the Patient with Diffuse Androgenetic Alopecia, Definition and Types‘ section in Follicular Transplantation: Patient Evaluation and Surgical Planning? for more information.

Tags: dupa, hair loss, hairloss, alopecia, diffuse unpatterned alopecia, hair transplant, hairtransplant

Scalp Reduction After Face Lift?

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

(female) I read on your site about someone with hairloss after a face lift. I had the procedure also about a year ago and I am left with big long bald areas behind my temples. My question is can SCALP REDUCTION method be perfomed to remove the bald areas as opposed to a hair tranplant?

Thank you

I think that you are telling me that there is hair loss above your ears and behind the temple hairline. If that is the case, hair transplants are the way to treat it. I have done hundreds of women who have had this type of problem after face lifts and brow lifts and the results of this surgery has been excellent. Scalp reductions in this area, however, will be disasterous.

Tags: hairloss, hair loss, facelift, face lift, scalp reduction, hair transplant, hairtransplant