i had a hair transplant about 3 months ago. is it normal to feel a sensation when you had goose bumps especially on your scalp (recipient area)? as if you could feel that the hairs are erected? i didnt feel this prior to my surgery at all. thank you doctor.
I’m not sure what you may be experiencing. If you have hair in a spot you never had hair prior to surgery, maybe you’re feeling your small nerves recovering from the surgery. Ask your doctor to examine you and give you a better assessment.
I had a transplant about 10 months ago. I can feel the stubbles since back then but it doesn’t seem to grow. It’s now 10 months later and it’s still the same. I had transplants before and almost very quickly, i would notice the thickening and darkening from the previous procedures.
This last procedure was my fifth and don’t seem to see a good result at 10 months. By this time my the transplanted hair should be maturing, correct? I now have about less than 3000 grafts done. Each procedure done in the past, the doctor could never extract enough donor. Perhaps it’s my donor area. Any thoughts?
At 10 months following your hair transplant, you should definitely see growth. Unless I am misreading your question, if you had five procedures that totaled under 3000 grafts, that is not today’s standard of care… however, I can not judge what your doctor was doing.
I’m not even sure what kind of surgery you had — strip or FUE. Plus, I don’t know if he was chasing your hair loss, if you were on finasteride, what your scalp laxity was, etc.
Have you talked to your surgeon about why there’s been no growth after 10 months? If you need a second opinion, you can either schedule a visit in my office or see another good doctor if I’m not local to you.
I am 25 years old and have a receding hair line and am planning to undergo a hair transplant. I think it is class 1 or class 2 baldness currently. If I undergo a hair transplant and get my hairline fixed, is there a chance of thinning of my hair in the crown area while the hairline being intact. If so, what are the alternative procedures to prevent thinning of the crown after getting my hair line fixed with the hair transplant.
Progressive hair loss is a real problem. I am not in favor of surgery on Norwood class 1 or 2 pattern men in the early or mid-20s. I don’t know enough about your hair loss history to have any idea if you’ll eventually thin in the crown.
You have to be careful not to get into a situation where you’re using your valuable donor hair for a quick hairline fix, when you don’t know how your hair loss may progress down the line. You may need those grafts later to fill out your hair. Hopefully your surgeon will discuss this with you further.
Young men on finasteride (Propecia) can often slow down the hair loss or even stop it. That’s something else you should talk to your doctor about.
Snippet from the article:
From Wayne Rooney to James Nesbitt, the list of celebrity men who have resorted to hair transplants to revitalise their balding manes is a long one. As a result, inquiries about the treatment have shot up by 260 per cent over the last 12 months while 59 per cent of men say they would consider the treatment if they started losing their hair.
But as Michael Avola, 49, an unemployed former martial arts champion from Northampton knows only too well, the fiddly surgery doesn’t always go to plan. After he began losing his hair – and his confidence – at the age of 23, he turned to surgery in a bid to fix the problem.
‘They promised me there would be a really good result,’ he reveals. ‘They said the scarring would be invisible and that there would be full coverage at the front.’
Instead, after a bungling surgeon botched the operation, Mr Avola was left with a small amount of wiry regrowth and a front section without any hair on it at all. But six operations and £7,000 later, Mr Avola was left badly scarred and still bald.
Read the rest — Bungling surgeon leaves man scarred and hairless after botching operation SIX times
The article mentions that Dr. Bessam Farjo did a 7th surgery on this man, though it doesn’t say who did the first six botched procedures.
This patient is clearly not balding, or marginally so. He is in his mid 30’s and he did not like the corner ‘recession’. At worst, he may be a Norwood class 2 or 3. He just wanted a cosmetic improvement to lower his hairline the way it always was before it moved upward. His hair was medium coarse so only 800 grafts were needed and the probability will be that this one session might meet his orbjective because of the medium-coarse hair. The risk of shock loss was discussed and was considered minimum. He is not on Propecia (finasteride). He did not experience any shock loss anytime after the procedure.
The following results photos were taken only 5 days after follicular unit extraction (FUE) surgery of 800 grafts. What you see are small scabs with short hair stubble. These scabs and hairs will fall out within a week from the date of surgery and he will look like he never had surgery by that time. The transplanted hairs will start to grow in the coming months.
The reason I wanted to show these photos is to point out how easy it was for the patient and his recovery. You can barely notice anything in his donor or his recipient areas.
Click the photos to enlarge.
After (just 5 days post-surgery):
Before:
What exactly does hair pitting mean and how is it caused and is there any way to fix it?
I believe what you may be asking is the possible scarring that occurs after a hair transplant. It should not happen with modern day hair transplantation, but I still see it on occasion when patients come in for a consultation.
The “pitting” you are referring to is just what it sounds like: an inward indent into the scalp – a pockmark on your head about 1/8 inch in diameter (or more). This happens when the surgeon or the staff is inexperienced. It can also happen if the patient does not heal very well. Or even a combination of both.
You really cannot fix it completely. Some have tried steroid injections, dermal fillers, or even micro-abrasion, but in my experience it never really works the way you intended and patients are left dissatisfied. The best advice is not to get yourself into a situation where you may end up with pitting. To start, you should research whichever surgeon you decide to go with. Don’t go bargain hunting for cheap surgery, because like a bad nose job, it will stand out and you’ll end up spending years and spending thousands of dollars trying to fix it.
Hi Dr. Rassman,
I’m 4.5 months post-op and noticing some issues in the past 30 days. I’ve been seeing a lot of dry skin/flaky areas all around where my transplant was completed (dandruff like). These patches of dandruff tend fall off in the shower or when my hair is brushed and have hair attached inside them. Today, I noticed a new one formed and I dabbed at it with my finger and it came off! There was three hairs inside the piece of skin and my head begin to bleed where the hair came from. I thought this flaky skin was a sign of the new hair coming through, but why is hair coming out with them and I should surely not be bleeding? I went through the shedding phase the first month; it should not be happening again.
Clearly there is something wrong, but I do not know what is going on without an examination. In general, you should not have these issues. You may have an infection, you may not be keeping your hair clean, you may have a skin condition, etc. These are all wild guesses, though.
Please go see your surgeon. What you’re describing is not normal.
I have wavy hair and would like a hair transplant but I prefer FUE so I don’t get a scar at the back of my head. I understand that the hair shaft slightly curls under the skin for wavy hair. Once my hair is extracted via FUE is it possible to implant it into my thinning area but make the hair shaft or bulb of the hair straight so I have straight hair growing out instead of wavy. I know it sounds weird but can it be done?
I had a patient once tell me that another doctor he saw for a consultation had told him he could have his hair character changed from curly to straight, but the surgeon has no such control. If a surgeon tells you he/she does have that ability, run away, because he may have other personal reasons to do your surgery ($$).
Hello Doctor,
I was just wondering, with all the advancements in technology and the rising demand for restoring ones hair do you think that hair transplants will become relatively cheaper in the near future? if so when would could someone predict a drop in price? 5, 10, 20 years?thanks
Perhaps surgery may drop in price if you adjust for inflation, but overall hair transplant surgery is an elective cosmetic surgery and as long as there is a demand, it will still likely be relatively expensive. I am sure (even now) you can find doctors who offer a very low price of around $1 per graft, but the quality and results may be questionable. I often fix many patients failed hair transplant surgeries from Tijuana and even local clinics where patients go to get bargain hair transplants for $1 to $3 per graft. In the end, the patient ends up spending a lot more to fix the bad work.
I am often amazed at how someone would go bargain hunting for cosmetic surgery that will last a lifetime. If you have a bad meal you can always go to another restaurant tomorrow, but a hair transplant is for life. You’ll be looking at the bad work on yourself each time you look in the mirror. I realize finance and fees are definitely a factor, but it should not be something to base the decision to have surgery.
I believe there will always be patients who seek out the cheapest surgery from doctors who want to compete and offer a low fee. And there will always be top surgeons who will command a very high fee for quality work and the patients who seek out top quality work. Not all hair transplant surgery or surgeons are the same, which is why many patients fly in from all over the world to see us at New Hair Institute.
I’m gonna have a hair transplant in 2 months, In the meanwhile I wear a contact skin bonding foil system applied by glue on the scalp. Can this damage my existing hair or handicap my hair transplant success? I’m removing the contact skin on a weekly basis for washing my scalp.
At the moment there’s no single sign of irritation on my scalp, everything looks fine.
The glues can cause damage to existing hair, but it shouldn’t cause problems with a hair transplant surgery as long as you don’t continue to use it after the procedure. Ask your doctor what they recommend in terms of your preparation and post-surgery concerns, as every doctor is different.
Doc, I’ve learned many years ago the difference between a top doctor and an average one. Since then if I need to see a doctor I always try to see people at the top of their field. Especially when it comes to surgery which is a true art. My concern is the reliance on technicians. I know time is a consideration when dealing with a thousand or 2 hairs. You often see patients who had bad doctors. Maybe they had bad technicians. You have stressed the importance of the placement and angle of hair, yet you leave that to technicians. Technicians turn over quite a bit in any field. So there’s a good chance some workers are learning on a patients scalp. Not a comforting thought for someone who’s gone through enough emotional concern over hair loss, not to mention spending the money their spending for top work.
I’ve seen the difference between a gifted surgeon and an average one.. forget a technician. I guess there’s nothing one can do about the harvesting.. that requires technicians. Are there HT docs who do all the placement themselves?
Thanks
Hair transplant surgery cannot be done with just one person. It is a team effort between doctor and technician. A great surgeon cannot produce quality work without great technicians. It is true that there is technician turnover and technicians-for-hire who jump around to different clinics, so when you interview doctors you should also ask about the turn over or if they use per diem technicians.
New Hair Institute has been open for over 22 years. Many of my staff members have been with me for close to 15 to 20 years. That is how we produce quality work.
I am a 24 year old male who has somewhat of a receding hairline like my father who has the same hairline I have, but he is 57 years old. While he has maintained his hairline, the hair on the top of his head is noticeably thinner than on the sides.
What if I had a transplant primarily to the front of the scalp and then continued to thin elsewhere on my head. Since the hair in a transplant will not thin like the rest of the scalp as one ages, my question is can the transplanted hair be thinned out or even removed to blend better with the rest of the scalp?
I wouldn’t recommend it, but I suppose what you’re asking can be done theoretically. However, if you have a good Master Plan and a good surgeon, you should be able to plan out how to address your hair needs now so that it doesn’t look bad even 50 years from now if you continue to thin.
Overall, I think you are missing the point… which is that you need to see a good surgeon (face to face) for an examination and a specific consultation for the planning of your individual needs.
I’ve had 2 procedures with a prominent surgeon for a total of around 3700 grafts. My first was at age 51, second 54. I felt I was a good candidate since the hair on the back and sides of my head was thick. My first procedure grew-in nicely but I had a lot of dry, itchy, flaking scalp issues. I began to notice thinning hair in the transplant area about 1.5 years ago. The 2nd procedure is still thickening up but I suspect it will thin as well in a year or so. I think this is partially due to my age since all my hair is getting thinner.
I’m not convinced HT’s last as long as the hype would like you to believe. I’m really concerned for guys in their 20’s going through this procedure expecting it to last a lifetime.
There are many patients who undergo hair transplant surgery in their 20’s and 30’s that still have a full head of transplanted hair in their 50’s. There is a small minority of patients who were never properly diagnosed and perhaps do not have genetic androgenic alopecia, but rather have another type of balding (such as diffuse unpatterned alopecia), that underwent hair transplant procedures that were not permanent. Or it’s possible the grafts were taken from a non-permanent zone.
When patients have transplants into thinning hair, the results are generally good for the first few years until their original non-transplanted hair starts to fall out (as they would have without the surgery) and those initial results become less impressive. This makes them think that the transplanted hair is falling out, as patients do not see (or were not properly informed) that hair loss is an ongoing dynamic process. Even with the native hairs falling out, the transplanted hair should be enough to provide a better overall look to the individual, as long as there was a proper Master Plan made.
Hello doctor
Is is possible for transplanted grafts to be rejected months or years after a successful HT? If so how often and to what extent does that happen?
For men, the hair on the back of the scalp is considered permanent. It may thin a bit with aging, but even old men in their 80s, 90s, 100s will have hair at the back of their heads. So if you harvest the hairs from this permanent area, the transplanted hairs will act like the hairs on the back of the head and will have the same life span. This concept is called “donor dominance”. This is why hair transplants work for men. For women, it may be different and there is a small risk the transplanted hairs may not be as permanent as men.
Theoretically it is not possible for successfully transplanted hairs to be “rejected” years or months after it has grown, but I have seen a handful of patients over the last 20 years who have had transplanted hairs fall out. This may be due to a diagnosed condition such as DUPA (diffuse unpatterned alopecia) or other esoteric medical conditions.
I had a hair transplant five days ago, at the frontal area and the temples. But even though the problem there is -in theory- solved for now, my vertex area is starting to thin as well, but it wasnt so bad as to need an HT yet. So Im asking you can I use minoxidil at the crown, given that the new grafts on the front & temples are still healing? Is it going to affect them at all? I don’t want to let the vertex thing turn big while Im waiting for the transplanted hairs to grow.
I don’t quite understand why you didn’t ask your surgeon when you had face-to-face access just days ago. Even after the surgery, he/she is still your doctor and will be able to provide you with a better (personalized) answer. Don’t be afraid to contact your surgeon for questions about aftercare!
In general, we advise surgical patients not to use any products, including minoxidil, for a few days or weeks (it depends on the surgery). Even if your surgery was limited to the front, you run the risk of accidentally getting the minoxidil in the transplanted area. Your surgeon might have specific directions, so I would follow-up with them to find your answer.