Hair Transplant for a 21 Year Old Woman Losing Hair?

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

Dear doctor

I am a 21 year old female. I’ve been losing my hair since i had my first period when i was 12. Now i have very thin hair and almost no hair on the front of my scalp. i went to many doctors here in the middle east and all of them said its genetic. Now i am using Regaine 2%. I am thinking of doing a hair transplant. what do you think? And if there is any recommendation of my case?

Thank you

I can’t tell if you’re a candidate without an exam. Many women are unfortunately not hair transplant candidates, though. I’m not sure what tests the doctors you’ve seen might have run, but if you went to many doctors and all of them say it was genetics, I won’t argue the point.

How long have you been using the Rogaine? Also, have you looked into using a topical camouflage like DermMatch or Toppik? Here are some examples:

Tags: rogaine, minoxidil, regaine, hair transplant, hairloss, hair loss, female hair loss, toppik

Should I Have a Transplant Now Even Though My Left Side Hasn’t Receded?

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

I’m 22 and have planned a hair transplant to fill in my temporal recession. One of my concerns though is that my right temple has receded further than my left temple, however, I assume over time my left temple will eventually recede as well. Right now the hairs on my left temple are definitely thinner and weaker than my other hairs.

In doing a hair transplant should I wait until these hairs recede or can I still have a transplant now? I don’t know have any notice hair loss except around my temples and thinning above my forelocks

A quick fix is never the answer, and at such a young age a hair transplant can accelerate more hair loss. You should see a hair transplant doctor to get his/her opinion. I’m certainly not suggesting you have the surgery right now, but your doctor should come up with a Master Plan for treating your loss.

Remember, genetic hair loss is progressive — so treating a minor issue now could result in those grafts not being available if you continue to thin elsewhere.

Tags: hair transplant, temple, hairloss, hair loss, age

Minimizing Bleeding During a Hair Transplant

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

Good day Doctor. Are there any ways to minimize bleeding during a hair transplant? I know there are a lot of incisions involved, so I am curious. In the two procedures I have had both at 1200 grafts several years ago, the doctor mentioned that I was a “bleeder.” Now I have never passed out in my life, but 1-2 days after both procedures I came very close before I placed my feet in an elevated position as told by the office nurses. I assumed it was from losing blood. I know you must have had similar patients and would very much appreciate it if you could provide insight. Thank you for your time and your blog!

Bleeding is almost never a problem with a hair transplant in the hands of good surgeons. For controlling bleeding throughout the scalp, the surgeon will include a solution that contains adrenaline — and it is the adrenaline that reduces the bleeding from the recipient sites and even the donor wounds.

With regard to the donor area, if a strip is the method for donor area harvesting, then bleeding will be in the hands of the surgeon. There are many blood vessels in the back of the head which must be carefully managed during the surgery. I became aware of a surgeon whose patient lost so much blood during the surgery (when a major scalp blood vessel was cut) that the patient developed a stroke from hypotension. I only heard about this situation once.

When I trained as a surgeon, I always knew to look over the head for bleeding areas when a person came into the emergency room. Sometimes a small gash in the head can bleed heavily, enough to lose a unit of blood (or more). The scalp is very vascular, so your question is quite appropriate.

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

Can’t Doctors Remove Old Hair Plugs One By One?

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

Hi Doctor. Thank you for having this great site!!

About 25years ago I had a HT using the hobby drill method. Now I have 3 rows of white plugs. I am like most of the others on this site and want to shave my head. I was wondering if you have ever considered a procedure to re-drill the plugs and suture them closed similar to the way you show it being done to patients for the top of their heads. I have spoken to other doctors and they want to cut the entire area out and suture it closed. They also state that it would take two or three procedures. Why can’t someone just re-drill and suture shut the area?

We have done what you described — taking each of the old style hair plugs out one-by-one and suturing each wound closed. We have also cut out the entire row and sutured it all closed. And we’ve even done a combination of both. Here’s a step-by-step story of the process one man took to repair his pluggy hairline. It took multiple surgeries to complete his repair, with the first procedure being a removal of a row of plugs, and the second procedure being individual removal of some of the remaining plugs.

My point is, everybody is different and every treatment plan for each individual is unique. In the end, find the doctor that you trust and ask to see some before after results of these repair procedures. You may even ask to speak to their former patients or meet them. Good luck.

Tags: hair plug, repair, hairloss, hair loss, hair transplant

Could the Donor Scar Become Visible from Senile Alopecia?

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

Hello Dr. R and all.

Thank you for your blog, I’m sure everyone would agree with me that it’s a venerable resource. With regard to strip surgery in a typical male who is losing hair to a NW5 pattern at 40 years of age (eg. William Hurt like) when would you anticipate the donor scar to become potentially visible due to senile alopecia?

ElderlyThe reason why hair transplants work in men is because men don’t usually bald in the donor area (back of scalp). And since men don’t bald in the back of the scalp, the scar from strip surgery isn’t shown.

Senile alopecia does NOT occur in all men. It is a rare entity where the hair thins considerably in the elderly. If you end up with senile alopecia in the donor area, I suspect the donor scar will still be well hidden, because you likely wouldn’t bald completely and the donor scar is very minimal. Of course, this depends on how this area thins out.

We must all look at the pros and cons of anything we do in life. Having a hair transplant surgery is a great option for balding men. The donor scarring, possible senile alopecia, or even balding from chemotherapy is something to think about, but in most men the benefits outweigh the risks. The other option is do nothing. It is like staying home locked up on a perfectly sunny beautiful day because you are afraid it may rain (despite a beautiful forecast).

Tags: senile alopecia, hair transplant, hairloss, hair loss

Post-Operative Hair Transplant Itching?

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

I’m planning on having hair transplant surgery this year but am concerned about post-operative itching in the scalp, which I understand it to be expected. Can betamethasone dipropionate 0.05% cream be applied to the scalp to control itching post-operatively?

Thanks.

Talk to your surgeon about how he/she best treats post-operative issues (including itching). What you are asking about is a steroid that can be used on a limited basis, but your doctor will want to know what he/she is treating.

There’s a lot of other things that could go wrong with the surgery that I’d think most patients would by concerned about before even thinking about the itching. You’re about 20 steps ahead of yourself. Many men do not have excessive itching, and the use of good conditioners can keep the scalp moist enough to avoid it.

Tags: hair transplant, itch, steroid, hairloss, hair loss

Hair Transplant for Triangular Alopecia Patient?

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

Good Evening Dr Rassman,
I have posted before and found my post from 5 yrs go!!! I have triangular alopecia and have tried to treat it using Steroids (Dermovate Scalp Application) and even stronger injectable steroid, all via a qualified dermatologist. Unfortunately, there has been no response to treatment even after 1 yr.

Will a HT work or is that area programmed to always minaturise the hair present in just that part? Also, would you be prepared to carry out such a ‘small’ HT as i not so bothered by my normal balding?
Many thanks

Triangular alopecia can be treated with a hair transplant surgery. Be warned that when you select your surgeon, they should have prior experience with this type of transplant. Hair transplantation to the side temple areas are very tricky and unforgiving, and they can look unnatural if the surgeon does not have the skills that are required.

Tags: triangular alopecia, temporal alopecia, hairloss, hair loss, hair transplant

Transplanting the Hairline First, Then the Crown Later

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

Hi,
I have a question. I am willing to do hair transplantation both back area and front area as well. I was deciding first to go front area and then back area. How many months or days gap should be given between two surgeries. Kindly help with information. Regards

First, you need to have your supply and demand understood. If your donor density is enough to address the balding problem, then starting in the front is the best way to go about the process. Will you be doing an FUE or a strip method for harvesting the grafts? That may be important in the timing.

Strip wounds will heal easily in 3-4 months and likewise, FUE wounds may heal in less time. As the areas of your focus are different (front and crown) you can have the second procedure as early as 3-4 months following the frontal surgery, provided everything is well healed.

Tags: hair transplant, hairloss, hair loss, surgery

What If There Was an Unlimited Donor Supply?

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

If an unlimited supply of donor hair were available, could transplant surgeons give a patient the 200 hairs per cm squared that the average human head has or would a new tool smaller than the .5mm tool im aware need to be created to achieve this look?

I suppose you can achieve 200+ hairs per cm squared (which is about the average for a non balding Caucasian male), but I find most people who are obsessive with hair per square centimeter don’t understand the full story and are mislead by all the discussion groups on the Internet.

You can have 100 hair per cm squared and still look like someone with 200 hairs per cm squared, as this is not a numbers game. Furthermore, hair transplant is NOT about the numbers and density. It is about the art of creating a natural looking hairline with minimal number of hairs you harvest.

With respect to graft survival, there may be some issues of the grafts surviving such close packing in ONE surgery. Now 200 hairs in a square centimeter is possible with multiple surgeries to the same area… but again, numbers do not translate to how it looks overall.

Tags: donor supply, hairloss, hair loss, hair transplant, dense packing

Plagiocephaly and Hair Transplants?

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

I have plagiocephaly and feel very uncomfortable with my head ever since I started to bald. I feel that since it has bothered me more with my balding, is hair transplantation a good solution?

Flatened headFor those that aren’t familiar with plagiocephaly, it is when the skull is misshapened and flat. This usually occurs when a baby spends too much time laying on his/her back in one position.

As you’re aware, this condition can be hidden by good hair styles… so a hair transplant is an excellent approach to your problem. Whether or not you’re a candidate, I couldn’t say without an examination. But generally speaking, transplantation should help you become more comfortable with your appearance.

Tags: plagiocephaly, hair transplant, hairloss, hair loss, misshapen skull, deformity

How Successful Are Transplants for African American Women?

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

I am an african american woman with traction alopecia. I have about an inch to inch and a half of traction above my forehead and temples. No traction any where else. I have ample donor supply. My hair is very thick and coily. I recently saw a hair transplant surgeon in San Francisco, that told me i have the donor supply but may not have a successful transplant because of the texture of my hair. The surgeon has showed me pictures of his past work but I was not impressed.

They were pics of african amer men but i saw little improvement. I see pictures and comments on the web that it is possibly for women of my hair texture to have successful transplants. I am not prone to keloids, however, I experience ingrown hairs in my pelvic region. Is there a specialist our Dr or technique that can help me?

Success of a hair transplant surgery is highly variable with each medical group. It’s not like going to a mechanic, where you can have a tire changed or your oil changed and the end result is pretty much the same. Unfortunately, I don’t have any specialist referral to provide.

Surgery in African American men and women is technically challenging, because each hair (underneath) the skin is curly. In other words, the grafts are curly. That means it is difficult for the technicians to cut and place the grafts. If threading a needle is hard enough, imagine threading a tightly coiled thread through a needle. Many doctors and medical groups for this reason shy away from performing surgery on African American hair or even curly hair. Add this to the fact African American men and women have a greater tendency to develop scarring and keloids. If you’re not prone to keloids, you’re lucky!

Another point to make is that hair transplantation surgery in women generally is not as straight forward as surgery in men, as the results may not be permanent. Men have a permanent donor area, whereas women’s hair loss is more diffuse. You should also know that to fix the balding from traction alopecia, the patient will often need more than one surgery, as the density of transplanted hair may not match the density of the natural hair behind it.

Alas, I am not your surgeon and I am not here to give you a personalize opinion. This information is generalized and you need to understand what is and is not possible. Weigh out the pros and cons of what you are trying to achieve and make an informed and educated decision.

Tags: african american, black, hair loss in women, female hair loss, hair transplant, hairloss, hair loss

How Long Will it Take from Consultation to Surgery?

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

Hey Dr.,

I’ve been a long time reader and you’ve even answered a couple of my questions on the blog in the past.

I’m 27, been on Propecia two years and am planning a trip to the LA area in the spring. I have a couple of questions, if you wouldn’t mind answering.

  1. If I set up an appointment with you and you deemed I would be a candidate for a hair transplant, how long would I have to wait before going in for surgery?
  2. In the same vein, what are the chances of being an ACell test subject? I know that it’s not fully proven, but I like the notion of it, and it seems less likely to leave a scar.
  3. If ACell is in the question, can you give a rough estimate of what the cost would be (I guess per graft).

Very much obliged for any answers.

Thank you for being a long time reader!

1. The time it takes from first consultation to surgery can range from the next day (rare) to one or two months. Patients who are candidates can set up surgery based on our open schedule. We have two pricing models. For those who want surgery at a specific date, they pay $6 per graft and can have surgery as soon as the next day (if the space is available). For those who are more flexible and can work with our schedule, they pay $5 per graft. If you are traveling from out of town, you can still take advantage of this by giving us a general time frame of your availability and we will give you plenty of notice to arrange travel and vacation time. We also offer a travel reimbursement program. For further info, you can read about our fees at our site or call (800) NEW-HAIR.

2. We are enrolling patients in an ACell auto-cloning study, but they need to be completely bald up top so that we can clearly document the growth. If you want to participate in the ACell scar minimizing study (where we put the ACell in the donor area) you are welcome to participate as well. If you don’t want to participate in the study but still wish to have ACell used in your surgery, you can just pay for the material cost of ACell itself ($600).

3. We do not have an official fee for ACell auto-cloning surgery, as we aren’t offering it to the general public (it is only a research study at this time). For the ACell scar minimizing surgery (NOT auto-cloning) we are charging for the material cost (see above).

Tags: acell, hairloss, hair loss, hair transplant, surgery, schedule

I Want to Pay for ACell Along with My Transplant

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

Hey Doc,

I’m wondering if I got a hair transplant within the next 2 to 4 months, after I’ve got a master plan and such, if you would use ACell if I gave my consent to use it on a normal transplant. Of course the hopeful result is that if you use it with the hair transplant alone that it helps heal faster and 50 to 400% more could potentially grow than what was transplanted. Since it’s considered harmless by the FDA, do you think it would hurt to just use it and see the results if there are any and if not, no harm done right? It wouldn’t affect the actual hair or anything if I’m not mistaken. And end result being if it doesn’t grow more hairs it would heal faster.

If this was possible could we just pay a little extra to you for the cost of using ACell and see if we get results? Not saying there would be an sort of expectations beyond the actual transplant, but would it hurt to use it just in case or do you think it would complicate the normal transplant in some way?

There are talks and unsupported reports that ACell can speed up the hair transplant healing process and help the REGULAR transplanted hair follicles to grow better/faster. This has yet to be proven satisfactorily, as far as I know.

If you want to pay the extra cost of the ACell to be incorporated in a hair transplant procedure (on the hair follicle), I do not have a problem with it. But you must also accept the fact that ACell can have the complete opposite effect of less than optimal hair growth. While I do not believe this would be the case, we really do not know at this point and must always assume the worst.

Tags: acell, hair transplant, hairloss, hair loss

Does Repairing Old Plugs Cost the Same as a Regular Transplant?

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

I had a hair transplant in Australia nineteen years ago…the hair transplant was so bad…it looks like a doll head…can I repair my hair transplant in NHI? How much it will cost? Is it the same price or different price? Thanks

RepairAt New Hair Institute (NHI), we perform corrective surgeries for patients who have had bad hair transplants (including the old doll hair looking “plugs”). You can see the before and after results of our repairs here. We’ve also created a complete step-by-step of one patient’s journey to fix his ugly hair plugs — see Dean’s Story. That’s Dean at the right before his repair procedures began.

If you would like a private consultation, please email us with detailed information (including pictures, if possible) or call us at (310) 553-9113 US.

The cost of a hair transplant and repairing old plugs generally ranges from $3000 to $10,000. As you can see with this wide range, each and every case is very different. There is usually no special fee to repair old plugs, and we charge the surgeries as in price per graft. Our fees are outlined here.

Tags: repair, hair transplant, hair plugs, hairloss, hair loss

What Hair Restoration Procedures Actually Work?

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

Assuming price is not an issue, what are the hair restoration procedures/companies that actually work? (It’s one thing to drop 20 grand and get results, it’s quite another for expensive snake oil).

What we do in hair transplants really work. The other day, I saw a man who had 2000 grafts about 14 years ago and he looked absolutely normal with no signs of balding. His pre-op pictures from oh-so-many years ago showed his Class 3A balding pattern clearly. I looked closely at this man’s hairline now and could not see any hint of surgery, even though I knew what was done.

I can only speak for my own practice and the work we do. You can and should research other clinics on the web, but always remember to meet with patients that had surgery with the doctor you choose. Photos are one thing, but seeing the hair in person is much better. We hold monthly open house events so potential patients can meet patients in person. Most doctors don’t do events like that, but you should ask to meet their patients nonetheless.

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