Short Haircuts with Strip Surgery vs FUE?

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

I like to to have a buzz cut during the summer months. How short can someone cut there hair if they go with a traditional hair transplant vs a FUE?

The visibility of the linear scar from the strip surgery partially depends upon how you heal. Some people heal with a fine line scar that will allow the very short hair cut (not a buzz cut) while others will develop a wider scar that could, at worst case in a single surgery, get to 1cm in height. If the worst case happens, the haircut must be longer to cover the scar.

Tags: haircut, short hair, hair transplant, follicular unit extraction, strip surgery

My Doctor Said SMP Alone Would be a Mistake For My Norwood 6 Pattern

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

Hey Dr Rassman. I hope your doing well.

I had a consultation with my hair doctor. At which i brought up the proposition of a combined SMP and hair transplant procedure. His response was the 2 would compliment each other well but just SMP alone would be a mistake. What are your thoughts does SMP look more natural when done in conjunction with hair transplantation?

And lastly i recall reading about a young man who won the American Dream contest a few years back. You performed surgery on him as my balding pattern would be close to his (ill prolly wind up developing into a class 6)and our ages are close or were im 23 now(i have been on finasreide since 20) i am interested to see his results. Thank you.

Each person is a separate case. I can not tell you that Scalp MicroPigmentation (SMP) plus hair transplants is better than either alone. I make each judgment when I understand the patient, when I see how fast the hair loss process is, and when I can then build a Master Plan. Generally, the hair transplant is the way I start, adding SMP on only a minority of patients.

As for the winner of the American Dream Vote television show (see here if you don’t remember the single episode that aired before it was canceled), the last update photos we had to publish were from 2009 and can be found here.

Tags: pigment, smp, hair transplant, hairloss, hair loss

Am I Losing My Transplanted Hair 9 Months After the Procedure?

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

I am starting to panic a bit and wondered if you could give me some confidence for the future months. I had a ht approximately 9 months ago in October of 2010. At the end of the 5 month period I could see definite results and was excited about looking even better in the coming months. Friends and family noticed a definite difference from before I had the transplant.

Now I’m seeing a lot more hair loss of what I assume is the transplanted hair since I didn’t have very much hair before the procedure. Do you think that it’s possible that a lot of the transplanted hair could fall out and then grow back in or do you think I might be stuck with no regrowth? I have tried to do everything the doctor has told me to do but am looking worse almost daily. My doctor says that it could take 12 to 14 months for the ending results in my specific case. I sometimes feel he isn’t telling me everything. I guess I’m a bit afraid that I am going to continue to look worse as time goes on. Do you think there’s any possibility that I’m going through a shedding cycle with my ht?

I would need to see you to draw any conclusions. I generally tell patients to wait a year before questioning the survival and the results of the hair transplant procedure. I wish I could help give you a better feeling, but maybe a visit to me at the 12 month time frame would be a worth while investment.

Tags: hair transplant, hairloss, hair loss

Can I Still Have Transplants After Scalp Micropigmentation (SMP)?

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

I’m a 29 year old male who’s been dealing with hair loss since I was 19. I’m very interested in the SMP procedure because I use a ton of hair loss concealers that are costly and messy. I wear my hair pretty long (4 to 5 inches) and was wondering if SMP is a good option. If so, will I still be able to have hair transplants in the future?

Thanks for everything you guys do!

Scalp MicroPigmentation (SMP) may be a good option, but only for certain hair colors and people with specific goals that can be met with this solution. Everyone is different and the goals for some people who will accept the SMP solution may not satisfy others.

You must always consider the progressive nature of hair loss if you elect to have SMP. As you bald, you will probably have to follow the SMP process back to keep up with your balding. Hair transplantation may also be an option… and YES, you can still have a hair transplant after SMP, but you must make sure that the person doing the pigmentation process understands the balding process and develops a Master Plan for you over the years to come.

Tags: smp, scalp micro-pigmentation, micropigmentation, hair transplant, hairloss, hair loss

What Would You Do for Prince William, Specifically?

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

This is a follow-up to a post from last week:

Hello!

last week a question was posted about Prince William which you opened your doors to William if ever he decided to go down the hair transplant route…

my question would be – What would you do for William? we can all see where his future lies with his hairline, obviously we do not harvest an adequate amount of donor hair to cover the whole of the balding area, what would be the way forward for william in your opinion?

and also off the subject, i picked up on the comment made by the blogger, something to the tone of “feeling sorry for william on his wedding day, his looks seem to have diminished due to his balding process……” have you seen his wife? hes not doing to badly!

Prince WilliamI’m sure you’ve heard the saying, “Bald is beautiful“. With respect to Prince William, I am sure if he is bothered by his hair he would have done something for it. He looks like an excellent candidate to take finasteride and see what happens with the medication alone. One reader commented that they didn’t like Prince William’s thinning hair and wondered if he would be a candidate for hair transplant surgery. Yes, he’d likely be good candidate if that is what he wanted to do about it.

So hypothetically, assuming he has an average hair density and scalp laxity (the ideal scenario) he could cover the entire scalp with two surgeries. The first procedure would be the most dramatic, giving him a non-balding hairline with a frame to his face and some fill for the thinning top and crown. I couldn’t get too into specifics, as I’ve not met Prince William.

When and if he came to transplant, we would do almost exactly what we did for reality star Jon Gosselin. He had only one surgery and we did not address the continuing hair loss to the top crown area, which appeared to worsen. Jon has a similar hair loss pattern, but his hair is black as opposed to the royal’s blondish-brown hair. Since Jon’s hair loss gives less contrast to his skin, Prince William should attain better results.

Tags: prince william, celebrity, royal, hairloss, hair loss, gosselin

Best Post-Op Hair Transplant Shampoo?

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

what is the best shampoo to use after H.T. my head is peeling its been about 2 weeks and when can i start using rogaine again. Thanks

After 2 weeks you head should not be peeling. You need to just use your regular shampoo and make sure you are washing your scalp properly. Follow up with your doctor and make sure you are washing your hair correctly.

Usually, I’d recommend waiting 7-10 days before using Rogaine after a hair transplant. Talk to your surgeon.

Tags: hair transplant, shampoo, post-op

Hiding Old Plugs So Nobody Can See Them (with Photos)

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

This patient came to see us in March 2007 for 1004 grafts and then for a follow-up procedure in May 2009 of another 1045 grafts. All of these grafts were placed into the hairline to cover up old plugs. On his recent visit to the office, I couldn’t even find the old plugs… and when I told him that, he smiled ear to ear. Click the photos to enlarge.

AFTER (2049 GRAFTS TOTAL):

 

BEFORE:

 

Tags: hair transplant, hair restoration, repair, hairloss, hair loss, hairline

What if Prince William Had a Hair Transplant?

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

Is it possible for Prince William to have a hair transplant, and reach his father’s level of baldness ? Having a similar pattern of baldness I felt sorry for Prince William during his wedding. I believe his hair loss made him less attractive. In fact, my sister even said that Prince Harry is more attractive now. I can say the credit goes to the fullness of hair. Would a frontal coverage for that type of hair loss would be good in the long run. How would you apply a master plan toward a case like this ?

Prince WilliamBased on pictures alone, Prince William would likely be a great candidate for a hair transplant. We have treated many men with even more hair loss than he shows.

Here’s an open letter to the royal:

    Dear Prince William,

    It would be an honor if you would consider having NHI establish a Master Plan for your hair loss. If a hair transplant surgery could meet your goals, please consider us when choosing your doctors.

    Thank you and best regards!

Tags: prince william, royal, uk, hairloss, hair loss

If I Have FUE Surgery, Do I Need to Keep Using My Hair Meds?

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

I am considering surgery – FUE. I have been on propecia for 3 years now and it’s difficult to tell the effect it’s had. I mean it could be working, I haven’t seen any more hair loss really. It may have stabilised the hair loss. Or has the hair loss could have simply gone into some kind of rest bite!? If I go for FUE, would you recommend I stay on propecia – I would rather be safe than sorry! Although it does cost a lot, I currently purchase my medication for £62 per month.

On another note, about a year ago I started minoxidil to improve the density of my hair. I think it’s had some kind of small positive effect, not much though. But here’s the issue I have. If I decide on a FUE, do I have to continue on minoxidil – because I cannot afford to both this and propecia.

You need to continue Propecia and minoxidil to see their benefits. As soon as you stop one or the other (or both), the benefits from that medication will be gone. In other words, you’ll see hair loss. The transplanted hair won’t be the issue, as it is permanent if taken from the donor area, but it is the remaining hair around the transplant area that will be unprotected. Propecia also helps protect from shock loss following transplant surgery.

Some patients choose to use generic finasteride in 5mg (prostate medication) and cut it to smaller pieces. Propecia is 1mg finasteride and not available (at least in the US) as a generic. The 5mg generic will be a lot cheaper than the 1mg name brand. You just need to find a doctor to prescribe this to you. Or if the 1mg generic is available in your country, that might be a way to save money. Also, your doctor should be able to show you some analysis from before you started Propecia and compare it to today to find out if there are real results. Hopefully your doctor has such information for you.

Tags: minoxidil, propecia, finasteride, rogaine, hair transplant, hairloss, hair loss

BHT for African Americans

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

Dr. Rassman,

In many of your posts regarding body hair transplant, I see that you tend to discourage the use of body hair for transplants. Some of the reasons include the fact that body hair is curly and does not grow long enough. I am a black person who grows a short Afro. I have a bald spot of the right front side of my scalp which I have managed to concealed with my own pubic hair. It just so happens that my pubic hair is just as curly and has the same texture as my scalp hair. So what I do from time to time, is cut my public hair, wash it thoroughly and then get it entangled with my scalp hair in the balding area. The entangling is due to the curliness of the hair and it holds even in the wind.

So far no one seems to notice. In fact, when I first saw a hair loss doctor, he was amazed at how well I concealed my hair loss.

In any case, I think transplanting hair from the pubic area for African Americans may be a viable option since both the pubic and scalp hair in African Americans is curly and perhaps has the same texture in most African American(as is my case). In any, what is your take on this issue.

I have done a few pubic hair to scalp transplants and they work very well. I recall one African American fellow in particular and a few Caucasian patients that had this done over the past many years. The FUE technique may have a good role here.

I have also seen another person who used pubic hair to entangle with their afro to add bulk with the same observations you demonstrate. It’s certainly not for everybody, and I still say scalp hair works best.

Tags: body hair transplant, bht, pubic hair, hairloss, hair loss

Are Sideburn Transplants Done?

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

I have lived my whole life without sideburns as I have never been able to grow them. Are sideburn transplants an option? Are they at all common where a doctor would be comfortable doing one? I would also be interested to know if you’ve done any and if there were any problems.

Thanks.

Also, any photos you have of clients before and after a sideburn transplant would be appreciated.

ElvisYes, sideburn transplants are commonly done by experienced hair transplant surgeons. We actually do this procedure on more women than men, because many women who have facelifts lose their sideburns and often have scars that need to be hidden with the transplants.

You can see some excellent photos in our hair restoration gallery.

(It should go without saying, but the photo at right of Elvis Presley is meant to show sideburns, not to suggest that he had transplants.)

Tags: sideburn, sideburns, hair transplant

Could SMP Cause Shock Loss?

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

Hello, I was hoping you could answer these two questions:

1. With the advent of the Scalp Micro-Pigmentation, have you had any patients experience “shock loss” following the procedure?
I’m seriously considering the procedure but am a bit wary that the trauma to the scalp caused by the needle will cause shock loss.

2. Drawing on your years of experience, have you noticed a certain threshold (or range) for transplanted grafts where a patient is more prone to experience shock loss?

i.e. Is a patient who receives 1500+ grafts in one session more susceptible to shock loss than a patient who has two transplant surgerys of 750 grafts each session, say, three or four months apart?

Thank you in advance for your help.

Best

We haven’t experienced “shock loss” per se in patients that had Scalp MicroPigmentation (SMP). One or two patients did report some hair loss initially, but it was not significant to be noticed. The risk is probably in the use of the anesthesia, rather than the SMP.

Dr. Pak’s mother had SMP done and did report hair loss the first few days, but it was insignificant. She had her procedure six months ago and other than the initial few days of hair loss, everything else stabilized.

Patients experience shock hair loss when their hair loss is ACTIVE and dramatic to begin with. In general, shock hair loss is more of a factor in men in their early 20’s (actively losing hair) and those who are not on Propecia. Your doctor should be able to better assess your risks of shock loss to the benefits of a procedure. The number of grafts you receive in a session is probably not related to the degree of shock loss.

Tags: smp, shock loss, hair transplant, hairloss, hair loss, scalp micro-pigmentation, micropigmentation

I Bumped My Head 2 Weeks After My Transplant

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

Hi Dr Rassman, big fan of your blog, lots of info very helpful!

I had an fue transplant with a good clinic about 3.5 weeks ago. On day 14 I bumped my head on my left temple, not very hard. I wouldn’t of even paid attention to it if I hadn’t undergone an HT 14 days prior. Anyway no blood or visible damage to the skin occured although it may of been slightly pink (it was pink anyway because of the op). Could this of caused any damage to the new grafts at all? My patient advisor says its unlikely, but I wanted an opinion from somebody else like yourself.

Although there wasn’t any bleeding or even a scratch, could this damage what the grafts are doing under the skin?

Many thanks

I would doubt that you did any damage. Two weeks after your procedure, I wouldn’t be concerned about a slight bump to the head.

Tags: hair transplant, injury, trauma

If I Don’t Take Propecia, Will My Transplanted Hair Fall Out?

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

Hello Dr. Rassman,
I have done a hair transplant surgery about 6 months ago and I am using Rogaine twice a day along with Hairman comb for maintaining my hair. I am not using Propecia as it is having sexual side effects. My question is that since I am not using propecia which stops DHT which causes hairloss, are my new hair follicles in danger of falling out? I am 26 years old.

Another question that I have came across a clinic in London and they are offering Minoxidil 12.5% which stronger then the normal 5% Minoxidil. Minoxidil 12.5% have to be used only once a day. Switching to Minoxidil is a safe idea, please advise.

Your prompt response will be appreciated. Regards

Transplanted hair is from the donor area (back of the head), so it should not fall out from genetic causes. If you didn’t experience shock loss after your surgery, particularly since you’re a young man, you are quite lucky. There is a chance your loss could still progress, but there is no laser or topical treatment that will prevent that. Actually, there’s nothing that will 100% prevent all future hair loss (that would be called a “cure”, which doesn’t exist).

Propecia helps slow the progression of genetic male pattern baldness (MPB), but if that isn’t an option for you, I’m not sure what to tell you. Did you experience side effects yourself or are just frightened by what you’ve read on the internet?

Minoxidil has been proven safe and effective at 5%. If clinics are offering stronger medication, that doesn’t necessarily mean it will work better. You do run a higher risk of irritation and other side effects from minoxidil as the concentration is increased. Have you tried the 5% without success? I’m confused as to why you’d want to try a very high strength right off the bat.

Tags: minoxidil, propecia, hairloss, hair loss, hair transplant

24 Hours After My Transplant, I Found a Loose Graft

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

After shampooing gently using the cup method 24 hours later, I noticed a hair graft with skin still attached laying on top of my hair just as I was starting to comb my hair. I didn’t see any blood anywhere when I checked. Could this be a lost graft or could the follicle still be intact under the skin?

-Thanks.

It’s probably a lost graft. Have your doctor examine the area. At 24 hours after surgery, the grafts haven’t taken root yet. If the loose grafts are caught early enough and in the right circumstance, your doctor can usually push it back in and save it. Otherwise, it is expected you will lose a few grafts no matter how careful you are.

Tags: hair transplant, grafts