Better Hair, New Problem (with Photos)

/by William Rassman, M.D./4 /,

This young man had two hair transplant procedures by yours truly (the first one was just over two years ago, the 2nd was 8 months later) to fill in his hairline and make it thicker. Now he keeps his hair short, but has a new problem. The hair in the frontal 2 inches is much thicker than the hair behind it. He does understand that cutting his hair short made this a problem that he did not have when his hair was longer, but now he wants more fullness behind the frontal 2 inches. It is a matter of supply and demand. We are now discussing his Master Plan on what to do and when to do it.

Update 6/29/2006 – I added some photos that got left out yesterday:

The photos below are before (the photo on the right is from immediately post-procedure, so you can see where the grafts were placed).




The photos below are after two procedures totalling 5,795 grafts. Click the photos to enlarge.



Tags: hairloss, hair loss, hair transplant, photos

Hair Transplant Failure?

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

Dear Doctor Rassman,

I live in Turkey.I had a hair transplant about six months a go. 2900-3000 grafts were planted on my head (mostly on middle and vertex area, some in the front). The planted hair on the front and middle area of my head has grown not so badly,and now (after six months) the front and middle areas appearance is not bad. But, my vertex area is still empty. The interesting fact is that the planted hair in the vertex area had been seen to grow satisfactorily until the fifth month after transplantation. But, between the fifth and sixth months most of the planted hair on the vertex area has fallen out. Is it normal that after six months the planted hair has fallen out? My doctor could not make me a satisfactory explanation and advised to wait more. I am depressed.

Sincerely yours

Once the hair transplants grow, they should not fall out. Are you sure that they were growing at some point and not just stubble from the original procedure?

The vertex of the head is a big area and many times the amount of hair put into the vertex is dwarfed by the size of the area. Transplants placed into the front and top will layer, such that coverage is easier to achieve. The vertex (crown) has a change in hair direction so layering is not easily accomplished. Be sure that what you are looking at is now just the effects of the swirl and the large area, but try to have the actual hairs counted.

As you are only 6 months out of the surgery, I would wait another 3 months before reacting too much to it.

Tags: hair transplants, hair transplant, hairloss, hair loss

Asian Hair Transplant Patient (with Photos)

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

I’ve been asked via email to post photos of an Asian patient, so by request, here’s a recent patient who had two surgeries with NHI. The photos below show the “before” view and two “after” views — one with his preferred spiked hair style and the other with his hair pulled back. Please note that we only put the hair in, the patient decides the way he wants to style the hair. Personally, I like his hair combed back, but then again it is his hair, not mine.

The photo on the left is before, the middle and right photos are after two procedures totalling 3,388 grafts. Click the photos to enlarge.




Tags: hairloss, hair loss, hair transplant, asian, photos

Can I Sweat After A Hair Transplant?

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

Hello Doc,
This is a wonderful service that you provide here. I applaud your commitment and dedication. I am scheduled for my first HT and am nervous after reading some web postings on a site that indicates HT’s are not the answer. Pretty scary stuff…See: home1.gte.net/dschrode/newtransplant-tales.htm

Anyway, I live in the Dominican Republic and have decided to work with Dr. Alba Reyes. Currently I am in the states and wanted to ask you a couple of questions.

Does the recipient area always have to be shaved?
Will Avodart provide the same protection as proscar for shock prevention?
How long until I can sweat as I live in a warm enviroment and go to the beach often (I wear a hat)?

Thank you again and I look forward to your reply.

Reading the horror stories are part of good research. They are the exception to the general work being done now, though. A good doctor is your assurance that these terrible things will not happen to you, but unfortunately there are still some of those doctors out there today. As I like to tell my patients, do your research! Much of this research is covered in this site in many ways (see The Truth About Cheap Hair Transplants).

To answer your questions —

  1. The recipient area where the strip is harvested does need to be shaved. Once the strip is harvested, the longer hair area above and below are brought together so that no shaved area should be seen.
  2. Avodart (dutasteride) will provide the same protection from shock loss as Propecia/Proscar (finasteride).
  3. You can sweat after the first few days and even run a marathon after 5 days if you have good post operative care and washing.
Tags: hairloss, hair loss, hair transplant, finasteride, avodart, propecia, proscar, dutasteride, sweat

Why Am I Experiencing Hair Loss Months After Surgery?

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

Hi
I’m 18 year old male. I had surgery about 4 months ago. 2 months after I noticed my long hair has been falling out in clumps of 15-20 hairs in one pull or when I brushed it. It has been going on now for 2 months and my hair got very thin very fast. I have noticed a bunch of new tiny hairs growing in front of my hair line but after reaching 1 cm in lenght they had stopped growing and some of them are falling out as well.

I would be greatful to hear your answer.

Am I to assume that your surgery 4 months ago was not a hair transplant? Hair transplantation at 18 years old is very unusual and in most situations, not appropriate. Hair transplants can accelerate hair loss in an 18 year old and that is one reason this is rarely done. If you have genetic balding and are not on the drug Propecia, I would suspect that you have an extremely high chance of acceleration of your hair loss. If your miniaturiation is high, then that makes hair loss in an 18 year old almost a sure bet. The amount of hair loss and the distribution of the hair loss will reflect your genetic pattern. This sounds like shock hair loss with the acceleration of your patterned balding and may be permanent.

If you are not on Propecia, it may not be too late to start it and try to hold on to what you still have. I would like to know who did your hair transplant (if that was the surgery you meant)?

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

Hair Transplant, 10 Days After (with Photos)

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

I am constantly asked how long it will take for a typical patient to be able to go back to work. This patient is 10 days post-surgery and went back to work in 4 days. He had 1,677 grafts transplanted and is a class 3A on the Norwood scale. He has the advantage of a blonde hair so that the beard of transplanted hair is also blonde. There is a small beard if you look carefully. The skin of the transplant is still slightly swollen with a fine pink hue (he is sandy blonde with white skin, known for showing a pink hue) and this will subside over the next week or so. The hair he has presently covers these changes so that it had not been seen in either his work or in any social setting. Click photos to enlarge.




Tags: hairloss, hair loss, hair transplant, photos

I Lose Hair Transplant Grafts in My Sleep

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

I had a hair transplant last night and this morning I found grafts on my finger nails along with blood clots. My transplant surgeon told me not to worry about them after I said that there were about a dozen grafts that I could count. He said that he did not have to see me. What would you do for me in this situation?

ReclinerI had a patient who picked his head in his sleep, just like you seemed to do. Knowing this, I had his wife make him wear ski gloves in his sleep the rest of that week. I did view the patient, but as the grafts had been already out of his body for hours, there was no point to put them back as they would not have grown. The grafts on this patient came from the crown, where he had 1500 grafts placed by me. He had about 10 grafts lost and they did not appear to be significant, considering the large number that we placed there.

I had another patient leave the office after the surgery and from the edge of the limo, he scraped the scalp removing about 150 grafts in the car’s gutter. We quickly retrieved them and washed the grafts with saline and put them right back into his head. Fortunately, the time out of the body and into the saline was only a minute or two. The grafts grew, but I think that we all had anxiety over this one.

I do not use bandages to cover the recipient site and I tell my patients the importance of keeping their hands off of the head and recipient area. I generally like a person to use a recliner chair for the first and second night, to keep the head elevated and make it more difficult to scratch the recipient area when they sleep. I have not had a problem like the ones I spoke about for over 10 years.

Tags: hair transplant, hairloss, hair loss, grafts

I Want Body Hair Transplants

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

Dr. Rassman,

I have been reading quite a bit about BHT recently, you have done a remarkable job on my hair but I have very little donor area left. Have you considered adding this procedure as it would help many who need additional donor hair, I myself could still use more hair to help fill in old plug donor areas that still bother me. It would be nice to cut my hair to a short length and not worry about the old harvested areas. I ask this because of my respect for your abilities and I frankly would prefer to only have you perform any future procedures.

Thanks

I know how you feel. You just want to be normal again. The problem is that when you have had these old type of hair transplants, you may have given up the ability to be completely normal. Keeping your hair longer and use styling to augment any problems in your look may be critical to being as normal looking as possible. Body hair transplants are a general waste of money with poor results that can be anticipated.

The doctor’s site that you included in your email shows that he has very little experience in this field. Perhaps he just does not know the information that I have covered in this blog many times. I have discussed this in my piece, The Truth About Cheap Hair Transplants, and I would recommend that you read this carefully. As you are a former patient of mine, just come in and let’s take another look to see what can be done, if anything. You know that I won’t do anything just to get into your wallet.

Tags: body hair transplants, bht, hairloss, hair loss

Shock Loss in Donor Area After Transplant?

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

I had a transplant procedure 2.5 months ago—I am experiencing very little if any growth of the hair located below the donor scar area—my doctor assures me that this is related to some type of shock caused by the procedure and that in time it will regrow—-Is this normal??

This is not normal, but not a reason to worry. Wait it out and the hair around the donor wound should return about the same time that the transplanted hair will start growing.

Tags: hairloss, hair loss, hair transplant, shock, donor, scar

I’ve Had 7 Strip Surgeries

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

ive had about 6 or 7 full strip procedures over the past seven years and have developed a scar that runs almost ear to ear and is an inch wide!

My surgeon has tried twice unsuccessfully to cut out the scar. There feels like very little excess tissue when i try and pinch. Im a dentist and am sure the tension from looking downwards post surgery was a factor although my surgeon says no. He is now talking about FUE from my chest. Would i be better suited seeing a plastic surgeon. He doesnt think anyone could achieve a better scar result. Ive had 2 colleagues get similar scars from the same doctor. Any advice would be greatly appreciated.

You must be careful here. Do you want to continue on a never ending process from surgery to surgery? There are creative options including:

  1. FUE — but not from the body, rather from the scalp where hair is active 85% of the time, rather than 20% of the time as with body hair
  2. Balloon expanders which can reduce scars very nicely if there is reasonable donor hair

Send me pictures (which I will keep confidential) and then I can offer you general advice about what is possible and what is not. You might consider coming to California after I get your photos for a one-on-one consultation if the photos lead me to believe that there may be a good solution for you.

Tags: density, hair transplant, surgery, fue

I Take Aspirin Therapy and Plavix — Can I Get a Hair Transplant?

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

I am a previous patient of yours. Since my procedure several years ago I suffered a heart attack. As a result, I am on aspirin therapy (325 mg/day) and Plavix (75 mg/day), indefinitely. Does this preclude me from ever having another transplant?

I would like to have a conversation with your doctor prior to going forward and then meeting with you as well. Please send me your doctor’s name and phone number.

I have transplanted people on both of these medications. The bleeding time will be longer, but the bleeding that is prolongs will not be life threatening and the clotting mechanism that is made to stop you from bleeding will stop the bleeding (it just might take longer). Fortunately, all of the bleeding areas from a strip harvesting technique of hair transplantation will be seen at the time of the surgery and the surgeon can use basic techniques to address these bleeding areas safely.

For your general information, aspirin and Plavix medications prolong bleeding times, making it more difficult for a clot to occur in the short term. Heart attacks and strokes often come about when a clot forms inside a blood vessel that has considerable plaque build-up. The point of taking these medication is to slow down the clotting mechanism for heart attacks and strokes in these areas of plaque so that the heart attack and stroke does not develop. But the clotting process is a necessary part of daily life and is not disabled. We constantly have small bleeding episodes when we ‘grunt’ or stress during a bowel movement (for example). Many people will note that they develop small clots on the legs or if they bump themselves, they depend upon the clotting mechanism to prevent any excessive bleeding. So, in effect, the clotting mechanism still works and in a safely controlled surgery like a hair transplant in the hands of a skilled surgeon, bleeding should not be a problem.

Tags: heart attack, blood, aspirin, plavix, hair transplant

Did Johnny Depp Have Hair Transplants?

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

Hi doc, I have a few questions.

  1. Do you think Johnny Depp has had hair transplants?
  2. I’ve been on propecia for 5 months now and so far the right portion of my hairline has actually filled in while the left has gotten worse. I’m 19 right now and I dont expect my right side to get as bad as the left side. Is it possible to get a hair transplant on just one side of my head? Would there be a particular reason why its like that?
  3. I’ve found this very interesting article on the aging process. (Hankooki.com) What would its implications have on the advancement in hair restoration?

Thanks.

Johnny Depp

  1. I am guessing that Johnny Depp did not have them either as I have no direct experience with him. I haven’t read anything where he has said he’s had hair transplants, so I couldn’t say. If he did and I did it, I would not be able to say that I did him because it would expose his confidential personal information.
  2. It is not uncommon to bald faster on one side than the other. The two sides will eventually even out. If Propecia worked on one side and not the other, then I suspect sooner or later the side it worked on will start to bald as well. Maintaining the Propecia may keep the imbalance present. I have transplanted one side in certain unusual cases. I judge each one on their own merits.
  3. I read with interest the article you referenced. I only know what I read. There are parts of our genetic material called telomeres which shorten as we age. This is an aging clock in our system and when the telomeres drop off to a certain level, cell death occurs. A great deal of research has been done to increase these telomeres so that our biological clock is extended. The science of anti-aging is developing rapidly, and hopefully we will live long enough to see the fruits of such developing science. Genetic hair loss may or may not be helped by this research. Your guess is as good as mine.
Tags: johnny depp, actor, hollywood, propecia, proscar, hair transplants, hairloss, hair loss, telomeres, aging, finasteride

Accutane and Hair Transplants

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

Hello Doc.

Thanks for your continued efforts to answer most hairloss related questions. Am 26 healthy male & I have had a hair transplant for frontal & side burns some 8 months ago. Growth is great. I do have some problem with ACNE & actually planning to take ACCUTANE, my question is, will the treatment with this drug have any side-effects on my transplants?

Accutane can cause hair loss in some patients, even in hair transplanted follicles. It is a known side effect of that drug. Are you sure that alternatives are not available that would work to address your acne? Talk with your doctor.

Tags: accutane, hair loss, hairloss, hair transplant

Free Hair Transplants from Trainees?

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

my question is, do medical students do hair transplants for free. For experience, like a dentist in trainning would give free cavity fillings if the patient let them work on them. i ask this because i dont make alot of money and is hard for me to save up due to bill. also i dont want to go bald, so im trying to find out other ways to not go bald. thanks for reading my question.

Surgery is not something that is legally allowed in any ordinary hospital or clinic for a non-physician to do and that includes medical students. Teaching hospitals have special waivers for medical students (who are not licensed medical doctors), so it is possible that medical school hospitals can offer this, but I am not familiar with this service being offered at any medical school in the United States. We do not have a medical school affiliated with New Hair Institute.

Tags: free, hair transplant

Is My Son Too Young For Transplant at 19?

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

Dr. Rassman,

My son is 19 and has always had a lot of forehead. He seems to have been experiencing a receeding hair line, and I would like to know if he is to young to consider hair transplants? If not is there a concern about having a procedure, and then the hair line receeding even potentially leaving a bare spot between the hair that was transplanted and the natural hair line now receeded?

The problem with a 19 year old is that if genetic balding is the correct diagnosis, the pattern is not predictable. In a 26 year old it will probably be predictable based upon the miniaturization patterns that develop by 26. That addresses your question directly, because if he is transplanted, the new hair will be in front of what is lost in the near term future so that a bare spot will develop and could progress. Worse, the balding pattern could develop to be very advanced so that a very bald person may emerge with a transplanted frontal hairline. These is our worst case problem, better to avoid until all of the information is at hand. A good doctor should map out his hair from miniaturization and then with knowing what is actually happening (assuming he has genetic balding), prescribe the use of Propecia with yearly monitoring of the miniaturization process. This will let you know how well it is being managed. The same applies to the maturing hairline, which must be differentiated from genetic balding.

Tags: teen, hair transplant, hairloss, hair loss