Transplant Look 1 Week Later (with Photos)

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

I am in the business world and I must go out to speaking engagements, as I make my living by lecturing. If I have a transplant, I need to be out in public in a week. I have read your newhair.com site and from that I know you need more information. My hair is black, my skin is light brown (I am Indian), my hair is straight and I am a class 3A balding pattern. Am I unreasonable to hope to get this process complete in a week and then go out into the public domain?

This patient had 2,648 grafts 8 days prior to taking these photos. He is much like you’ve described yourself: darker skin, black hair, Norwood Class 3A/4A pattern. Today’s modern technique keeps the wounds very, very small so that they heal faster. Some of the hairs already fell out so the full complement of hairs are not there and will not return until they start to grow (1-4 months). The issue with detectability has more to do with skin color and its contrast with hair color than anything else. Very white skin shows blemishes easily, so what you see here may or many not be the case in other skin colors like mine, which is olive in color and is almost as good as the man in this picture. When you actually look at him, his previous frontal balding now has a short beard in the area where he was bald and he reported that most of the people he met with socially, have not looked at his hair, suggesting that they did not notice anything worth focusing upon. Of course, you know what we are looking for, so the transplant may be evident to the viewer of this blog.

Click the images below to enlarge.




Dr Bernstein Says Transplants Won’t Keep You From Getting a Sun Burn

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

According to Dr. Bernstein, a hair transplant won’t protect you from getting sunburn. (The following is from a transcript of an open house posted on his website):

Attendee: How thick will my hair be after the hair transplant?

Dr. Bernstein: I like to describe what hair transplants do, by what they don’t do. It doesn’t keep you warm and it doesn’t keep the sun off your head. It doesn’t keep you from getting a sun burn.

I am in occasional disagreement with my very bright friend and colleague Dr. Bernstein. The statement by the patient in the post from the other day corresponds to my own experience as well. I used to get sunburns on my bald crown all of the time, but now since I have had 1600 grafts placed in the crown, I haven’t had a sunburn on my scalp. I do not believe that hair transplants should be done to prevent sunburns. The sun will still penetrate down through the transplanted area, possibly just a bit tuned down.

Transplanting the Back Hairline

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

can transplants be done in the temple areas and also in the area right above the back hairline?

Yes, transplants can be placed in the temples. As for the “back hairline”, I am assuming that you are talking about the area just behind the frontal 1 inch of hair. If that is the case, yes, I have performed such transplants on many people filling in the forelock area for a fuller appearance. If you are referring to the crown (back top of your head), then again, yes this area can be transplanted as well. Look at the photo gallery to find out what you are looking for: Hairline photos

I Don’t Want My Hair To Recede To Reveal My Transplant Scar

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

I have had 2 transplants since 2000 and have noticed that I am losing more hair at the back of the head. My concern is that the scars left from the surgery will eventually be exposed if I continue to recede. I would say that they it is 2 to 3 inches away from the first scar. Is there anything I can do to conceal the scar? Is it time for another transplant?

Thanks

As long as the scar is in the mid region of the permanent zone, I don’t think that the scar will be revealed. That is assuming that the scar width is not excessive , though most wide scars can be managed with a corrective procedure. It’s difficult for me to even try to conclude where your recession will end since I haven’t seen photos or met with you, so you may want to get a second opinion and even a third to better determine if your scar will possibly be exposed in the future and what can be done about it.

Unsatisfied With Hair Transplant, Should I Use Laser Therapy?

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

Hello Dr. Rassman,
I Recently had a Hair transplant that was performed back in July of 05. I started taking Propecia a month before surgery. I must say I am extremely dissapointed in the results of both. I feel as if the head trauma that was endured during the surgery made me lose more hair. When I inquired with the doctor he said the hairs that fell out will regrow. My hair gets thinner by the day and I dont see Propecia working from keeping the hairs I already have. My question is, there is a laser therapy used for a skin disease that also helps alopecia patients regrow full heads of hair. Is this a something I should test out? It is not covered by insurance because it would be considered cosmetic. And in the mean time, I have heard of taking daily doses of copper peptides and emu oil help the follicle and assist in regrowth of dormat hairs. Is this another route I should take? Thank you so much for your time doctor.

First I would want to know if your expectations were set correctly. You say you are disappointed, so I ask why?

There is a suggestion in your question that your hair is continuing to appear thinner. Did you experience shock hair loss (rare with a person on Propecia, but more common in young men under 30). I do not know your age and I have no idea where was your starting point and where you are now. I would suggest that you go back to your doctor. Your doctor is vested in making you happy and making sure that what he represented to you was what you got. Your best starting point is a face to face meeting with the doctor who did your surgery. I personally love talking to my patients and although few are dissatisfied, I always feel ownership. I make unusual efforts to be sure that expectations are properly fixed to what the end product will be like and that is the main value of open house events for people like you, to avoid being disappointed, because what you see is what you are going to get. I do not think that playing around with things like lasers or other regrowth formulations have value for you now, that is, until you know what happened and why the surgery failed to meet your needs.

Rain, Wind, and Sun on a Bald Head

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

Will hair transplants protect me from getting a sum burn on my bald head?

Burning HeadA patient recently wrote to me about this very point. His answer defines the impact of the elements on balding heads and the benefits of hair transplants, and he has given me permission to repost this part of his email:

“I wanted to thank you for the wonderful, life changing experience you gave me. I used to be conscious about weather and that bothered me more than any single issue I can point to. When it rained, my comb-over fell apart, the wind would also destroy my morning efforts to keep my hair orderly and in the hot Florida sun, my head would burn badly. It seemed like any weather made me aware of my balding head. Now with hair on my head, styling is something I do not focus upon and the freedom it allows me is most responsible for the change in my individual confidence. Although my wife supported me in the hair transplant decision, my balding never bothered her as it did me. “

Transplanted Hair From Leg To Forehead

/by William Rassman, M.D./2 /,

Female – Hi, I had a body hair transplant (300 grafts)four days ago. I had leg hair moved from my legs to the the top of my forehead to get my forehead to look smaller. I don’t have a hairloss problem, I have a naturally high hairline and am trying to lower it. After the procedure I had lots of numbness, even 3 inches away from the recipient area. Today I have numbness around the recipient area only. Up to an inch away. I am very concerned about shock loss. Does the numbness indicate trauma and that the existing hairs in the numb area will fall out? I’m very worried about this. If there’s something you can tell me that I can do to prevent this, I’d greatly appreciate the help. Please let me know.

First, you should go back to the doctor who did your transplant and ask him/her if there were any issues the time of surgery that may have caused problems. Some sensory defects are often present and usually go away within a few days after the surgery. At times some small nerve endings are severed with the needles used and this can last (rarely) a long time until other nerves take over. There is little to do but to wait it out.

I am curious why you elected to do a leg to forehead hair transplant? This is unusual and probably experimental and you should have been informed of this by your doctor. There is no real data for leg to forehead hair transplants, so predictable results are not something that you can depend upon. I would hope that your doctor told you this.

Why Are Some Transplant Doctors Bald?

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

I see that some hair transplant doctors (like Dr.Bernstein) are actually balding and still don’t have a hair transplant.Do they not trust in this procedure or are there other reasons behind?
Thanks for your time

First, it is important to understand that the decisions to reverse balding reflects a very personal decision for each person. Being bald does not reflect any freakish state, but rather a NORMAL appearance that is the decision of each person to maintain or reverse. Some men do not find being bald as anything wrong, while on the other extreme, some people are obsessed over getting their hair back. I personally find it more extreme to wear wigs, but that is my personal view, and I chose to have hair transplants instead. Doctors who are bald have exactly the same choices. It would be wrong for a bald hair transplant surgeon to have a hair transplant just to prove that it has value to his patients. Many other hair transplant surgeons have made this election for their own personal reasons. I have not declared war on balding, not in the slightest. Bald is beautiful for some people.

2 Weeks After a Hair Transplant (with Photos)

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

I have some hair in the frontal area but it is thin. I want to know how would I look after a transplant? I must be in the public view within 2 weeks. Is that possible and still be undetectable?

The pictures below are from 13 days after this patient’s hair transplant of 2,710 grafts in the frontal area. He also had some hair present, just as you asked. This photos below show typical healing with small wounds, good post operative care, washing any scabs off within the first day or two and good overall planning. Your doctor should tell you what to expect, as each doctor’s work differs on the post operative course.



Propecia and Body Hair (with Photos of Hair Transplant)

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

This patient had a very nice result from one hair transplant procedure. An interesting item to me was that he reported that when he started to take Propecia, the hair from his chest and back (which was very heavy) returned to his barely hairy 18 year old body’s hairless appearance. In addition, he also reported a reduction of nose and ear hair. So this patient shows not only the benefits of a good hair transplant, but also a rare but good side effect of Propecia (I have rarely seen been made aware of this loss of body hair). I only have photos of his head, as I didn’t think people needed to see photos of the inside of his nose or ears (and so I didn’t take any).

The first set shows his before photos. Click the images to enlarge.




And this set shows his results after one hair transplant procedure of 2,073 grafts.




How Many Donor Grafts Does an Average Person Have?

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

Dear Dr. Rassman,

I have been researching Male Pattern Baldness and Hairloss for about 7 years.I am 28 and a Norwood 4. My question concerns how much donor supply the average person has over their lifetime to transplant to balding areas.

I know that currently some clinics have performed, 6,000 and 7,000 strip/graft procedures in a session and that even more has been transplanted over several sessions. How much donor hair does the average person have ? It would seem that the average would have to be well over 10,000 and close to 12,000.

Thanks for taking the time to answer my question.

The answer to this question relates to a few things:

  1. Your donor density (average is 2 hairs/mm2)
  2. The laxity of your scalp (looser scalps should supply more donor hair)
  3. The balding pattern (Class 7 patients lose up to 70% of all of their hair so if this is a possible balding pattern then 1/3rd of the remaining hair number may be the maximum donor supply available to you over your lifetime)

The degree of scarring and how your body handles the movement of large amounts of donor hair may be the determining factor on your overall supply. Generally, a person may easily get 5-7,000 grafts (10,000-14,000 hairs) and that number can be pushed upward with good healing, minimal scarring, return of scalp laxity and good donor densities. On the high end, I have transplanted up to 25,000 hairs in some people (10,000+ grafts) with unusually good healing and a good scalp laxity.

Patient ZU is in his mid 60’s and had multiple procedures totalling 6,036 follicular unit grafts transplanted. The “after” photo on the right shows the results after only 6,036 grafts, but he actually had another procedure after this, bringing the total up to 8,300. Once I have photos of the results of his last procedure, I’ll post them. In the meantime, please see the photos below and click them to see full size.



My Hair Doctor Told Me To Wait For Transplant

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

Hi Dr. Rassman,

I’m a 22 year old male. In the last two years I’ve noticed more hair falling out in the shower and if I run my hands through my hair, as well as a decrease in volume and more visible scalp. Although others haven’t said the same, I feel like I know my hair pretty well. I have mild temporal and frontal recession, a widow’s peak that was never there before, but most worryingly I noticed that individual hairs falling out are much thinner.

I saw a transplant/hair loss doctor and he took global photographs, but told me I have to wait. He said my small recession is just called ‘sculpting’ and that looking at my head you can’t see any pattern of loss.

My question: Why do I have to wait until its clear I’m losing my hair visibly to take action? My father has lost some of his hair (class III?), my mother has pretty severe hair loss, and one of my uncles as well (father’s side).

You always refer to miniturization, and I understand this process, but the doctor made no mention of mapping it in my case. Does every good hair doctor map for miniaturization? Is it right to pursue in my case?

What should I do?

Please respond, my hair is my confidence!

Thanks and all the best

Good measurements are the heart and soul of good science. That is why I map out the scalp in all of my patients. I generally do not like to transplant a 22 year old, but if you are in the early balding process you do need your scalp mapped out for miniaturization to understand what is happening to you. The science of measurement (metrics) is the back bone to diagnosis in your case. Where are you now with regard to miniaturization and where will you be in a year? If your hair is miniaturizing, why are not not taking Propecia? You need to have some good solid measurements to define where you are and where you are going. Then, with those good measurements over time, it will be easy to answer your questions. Please remember that what you do now will impact you for the rest of your life, so timing is critical.

I Had a Hair Transplant, But I Want the Corners Lower Than “Normal”

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

Hello, I had 1200 grafts last year, and they have done well, but the hairline is too far back in the corners. It is probably just fine for most men, but I wanted a more rounded hairline. I think that I got the male “template.” I have a widows peak, it does not, nor the area of about 1 inch to either side, need to be lowered, just the area in the corners. I have heard of hair line advancement, could this help? Most literature says that all men should look the same, as it comes to hairlines, its just not what I want. I travel to Sacramento and San Jose frequently. Hope to hear from you.

Picking a hairline is a negotiation between you and your surgeon. I have restored the original hairline in men and if this is part of your Master Plan, then it can be done. Be sure to get a great doctor, because these rounded corners can be a difficult part of the art of hair restoration.

Here’s Patient NU, whom I have featured on this site previously. The corners of his hairline were lowered dramatically and the patient wanted his central frontal hairline to look like actor Andy Garcia. Each of us has a different look and different taste, thank God. If we did not, then the world would be farily dull. The patient shown below had let his hair grow out to shoulder length for a number of years, and then recently cut it to crew cut length. He clearly enjoys the freedom of having his hair just the way he wants. Also, it is worth noting that he had temple transplants many years ago, and his results are available here and here.




Other examples include patients EO, KB, and IU.

Am I Too Young For Hair Transplants at Age 28?

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

I am a 28 year old man. I have been losing hair since my late teens. It has been mentioned to me as male pattern baldness by doctors I visited. Over the years, the baldness has become more visible and I now comb my hair staight down. I am getting increasing uncomfortable with my baldness. I am wondering what the best option for me would be. I recently visited HairClub and they said that I should not consider hair transplantation at such an early age as I might exhaust the donor area supply and would have permanent bald spots down the line when male pattern baldness takes full effect. Also, I am scared at the idea of having an incision on my head. What advantages does your organization have over a place like others (honestly I don’t even more of any other reputed transplantation shops)? Please provide advice as to the best course of action for me. Thanks

It does not sound like good advice you got. You need a diagnosis and a good doctor who will map out your scalp for miniaturization. With this done, at age 28 you may be able to predict much of your future hair loss. Then you and a good doctor will be able to develop a Master Plan, which will incorporate medications and transplants (if needed). I suspect that the person you visited wanted to sell you a hair system (also known as a wig), so the financial interests were driven by the salesman’s agenda. If you saw a doctor and he did not evaluate you as I said above, then he/she would be no more value to you than a used car salesman. If you are in California, come visit me. Otherwise, send me photographs and lets talk. I do offer telephone consultations as well.