Some of My Transplanted Hairs Never Fell Out After the Surgery

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

Hi –

Is it normal for some, but not all of the transplanted hair to remain in the transplanted area? I thought that it was an either/or kind of thing — either you were apart of the minority of s that would retain all of the transplanted hair or all of the transplanted follicles would eventually shed. I am going on 5.5 weeks now, and probably 85% of the transplanted hairs have shed, but there remains some hairs here and there that have “taken root” so to speak and begun growing. Should I expect these to fall out eventually? I have never heard of doctors talk about some but not all the transplanted hairs falling out.

Thanks!

For those that aren’t familiar, after a hair transplant surgery it’s common for the grafts to take root and the hairs to then fall out, with growth taking a few months to occur. A minority of patients (less than 5% is my unscientific guess) continue to grow the transplanted hair immediately after surgery.

I really have no way to know if you’re one of the rare patients that doesn’t go through the dormant phase following a hair transplant (it doesn’t have to be all-or-nothing in regards to immediate growth), and only time will tell if your hair will hold. In any case, keep your fingers crossed that the 15% of remaining transplanted hair continues to grow.

Tags: hair transplant, hairloss, hair loss

Propecia Before a Hair Transplant… and Does Stress Speed Up MPB?

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

Dear Dr,

Your Q and A’s are absolutely priceless in an industry where most people would not know where to start looking to gather info, so thank you for that. I have a couple of questions. I’ve read quite alot of your site now and have grasped most of what I need to know but would like to ask you about my specific case now if I may.

I am 27 and have been a Norwood 2 for 3-5 years and thought it was my mature hairline. But within the last year I had drastic life changing circumstances and alot of stress. That lasted to 4-6 months and I noticed I started losing hair around the temples(windows peak area) quite rapidly but in an even MPB fashion. I thought at the beginning it was stress induced but as it was happening evenly around both temples I thought after reading alot of your site that its just MPB getting stronger or whatever. Thus here are my questions!! :)

  1. Started Propecia and it is working amazing, from the first few days hair stopped falling out and every week it gets better. 1-2 hairs from a 4-5 day bedding wash cycle is all I get on the pillow now. I have been on it for 4 months now and obviously will continue for good, who knows what else will happen. But my Q is this, I want to get a hair transplant soon and fill up what I lost so I have all my hair back and keep the hairline I had which is windows peaks, which im fine with, suits my face and age etc.. But I was wondering. Do you think I should wait for 8 more months to see what Propecia can do before getting one or will it continue to improve wherever anyway in conjunction with the transplant?
  2. And secondly do you think in general stress really can speed up MPB evenly falling out like mine was? And if hair does fall out from stress does it ever grow back like it was before the event? Or is stress and MPB just to hard to diagnose other than on a case to case basis. Thank you so much for your time!

I’m glad you enjoy the site and find it useful. Thanks for visiting and writing.

I usually recommend to young men like yourself with male pattern baldness (MPB) that are interested in hair transplantation to get on Propecia for at least a few weeks before going for a surgery as you want the drug to bind to the hair follicle tissue to get a protective effect. In some people, waiting even longer than a few weeks may have value in seeing the benefit of the drug over time when the hair loss is still early.

Stress can certainly cause hair loss, and in men that are genetically programmed to lose hair, stress can speed up that timeframe. For those without MPB, stress-induced loss might regrow… but for those with MPB, stress-induced acceleration of hair loss is unlikely to see any regrowth even upon getting the stress under control.

Tags: propecia, finasteride, mpb, hairloss, hair loss, stress

Restoration Robotics Still Looking for Participants?

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

I just found this ad online. They are still looking for participants for Restoration Robotics’ automated transplants.

See ad

RobotYep, the ad is requesting participants for a paid research study in Colorado.

I have just had a personal viewing of the Restoration Robotics technology in my office last week and it is quite impressive. The robot only cores the grafts, then the doctor pulls them out by hand. They have not solved the placing problem for the inexperienced doctor that still plagues the industry.

Please note that the image at the right is not of the Restoration Robotics hair transplantation technology, but just imagine if it were…

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

Why Might My Transplanted Hair Appear Damaged After it Grew Out?

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

Hi. I received 1500 grafts 16 months ago. The transplanted hair has grown in very well but still remains damaged. It’s very dry and frayed, is this normal for it to still be damaged? By the way my hair is slightly over two inches in length.

I do not know what to make of your description. Sometimes the transplanted hairs may look a bit different in texture, but they usually return to their natural state over time. So in other words, no… it is not normal for transplanted hair to appear or feel any different from the rest of your hair, but on rare occasions (or more often in the hands of a less experienced transplant team) the hair can be damaged during the time it is moved.

Not all hair transplants are the same, and I don’t know the exact transplant technique and methods used by your doctor. Possible damage (if that is why your transplanted hair feels different) can be caused by trauma from handling or being left open to the air for more than a few seconds when it is transplanted to the recipient site.

Tags: hair character, hairloss, hair loss, hair transplant

Styling a Partially Transplanted Hairline as Hair Loss Progresses

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

I have a styling question for you dr. rassman.

I’m thinking of transplanting some hair in the side on the front of my scalp as it is quite thin on the sides. I’m worried if my center forelock hair becomes thin one day and the sides appear thicker, it will look awkward. If such a case were to happen do you think it is plausible to individually cut some of the transplanted side hairs very short to thin it out in such a way it blends with the center? I know its a strange styling question, but let me know your thoughts if this has been done before?

thanks

Hair styleI’m just trying to figure out if I understand what you want to do and what you’re asking me. Perhaps your terminology is off. I have to assume that when you say you want hair transplanted to your “sides” you actually mean the corners of the hairline… not the sides of your head.

As for styling, I’m sure something can be done… but you could also have a second transplant procedure to strengthen the forelock area again and complete the hairline. I think most patients would opt to having another transplant to the bald area at the hairline center (assuming that is how the loss progresses), rather than just giving up after transplanting the corners. If you want to find out the options for how you can cut your hair, you should talk to a barber or hairdresser.

I’d hope that any doctor that performed such a surgery on the corners of your hairline would inform you of the possibility that your hair loss could progress, and put you on Propecia to halt that.

Tags: hair transplant, hairloss, hair loss, styling

Transplanting Neck Hair into a Strip Scar? (with Video)

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

Hi doctors. I’m a big fan of your work and this site. Thank you for what you do!!

I just saw this video by Dr Umar using beard hair taken with the FUE technique as the donor into the line scar from the strip technique. I know how you feel about body hair transplants and I agree that the results from using body hair on front/top of the scalp generally look unimpressive, but what about using body hair densely packed into the strip scar? Even if the hairs never get too long or have a different growth cycle, its just being used in the scar.

I have a scar and it doesn’t bother me, but if I have the option to essentially eliminate the appearance of the line I might consider something like this. I wanted to get your thoughts about using body hair for this and whether one could use hair from another part of the body for the same thing (why not chest hair for example). Check it out:

YouTube video

Thanks again

While I do have reservations about using body hair transplants, my biggest problem is when they’re used in the frontal hairline or top of the scalp. That being said, the use of beard hair to transplant into a linear scalp scar (from a hair transplant) is reasonable. The beard hair has a thicker hair shaft than most scalp hair and it would work well to fill in the scar.

I have used it on a limited basis, particularly when a plastic surgeon supplies me the beard skin after a facelift. The few cases I have done (one with FUE) have worked nicely.

As I mentioned in a past post, I cannot give an endorsement of Dr. Umar because I have not reviewed his work beyond what I’ve seen in YouTube videos. The video is impressive, though it is a bit long, so for those that don’t want to watch the whole thing just skip to about 2:30 to see how the linear scars disappeared.

 

 

Tags: hair transplant, scarring, scar, fue, bht, body hair, neck hair

I’m 20 Years Old, Taken Propecia for 2 Years — When Can I Get a Transplant?

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

How many years of MPB does one have to go through before considering an HT considering the following facts: I started to notice hair loss at age 17 and now am 20. I have been using Propecia for 2 years now and it has maintained most of my hair (temples and crown have thinned out a bit since then but nothing cosmetically significant). My father and my grandfather are both NW6 and my uncles are mostly NW5-6. I have been losing my hair for almost 4 years now, how much longer do I have to wait before I go for an HT?

It is not about how long you should wait, but rather it’s more about building a Master Plan with your doctor to address this concern. A good doctor will always work off a Master Plan that you and the physician will create. Your questions will then be answered, because you will have a customized plan to meet your exact problem and address the rate of your hair loss. As you were already prescribed Propecia, stick with it and hope the results continue to be positive.

I don’t know enough about your current hair loss, but hair transplant surgery at 20 years old is not usually recommended. There isn’t a real minimum age for having this procedure, but we generally don’t do these in men under 24 years old, because the hair loss pattern is not clearly defined.

You can read more in these past posts about hair transplants in the young man:

Tags: hairloss, hair loss, hair transplant, age, youth, propecia, finasteride, surgery

Taking Ciprofloxacin Months After a Hair Transplant

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

Hi doc,
First off, I’d like to say thanks for all you do on here. I had a hair transplant about three months ago and am starting to finally see a little growth. I recently have been developing a lot of pain in my prostate area and have been prescribed 500 mg of Ciprofloxacin twice a day for 14 days. My doc seems to think I have developed some form of bacterial prostatitis. In your opinion, will being on these antibiotics for such a long period of time have any permanent or negative effects on my future growth? Again, thanks for putting in the extra time for all of us hopeful hair farmers. It means a lot.

CiproChronic prostatitis can be a very serious problem and must be treated with supervision from your physician. Some doctors question the use of long term antibiotics if the infection has been successfully treated, but many people with chronic prostatitis have persistent pain that may not reflect an active infection. If your doctor is going to prescribe you ciprofloxacin (an antibiotic also known as Cipro), perhaps he has more experience with possible side effects than I would.

With all that said, I do not think that Cipro will affect your transplanted hair. I’ve read reports from people online that believe Cipro and hair loss are linked, but I’ve not found anything like that in medical literature and if there is a link it would be rare.

Tags: cipro, prostatitis, hairloss, hair loss, hair transplant, ciprofloxacin

Can Hair Transplants Completely Cover Up Balding?

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

Hello doctors,

I’m a black male with very early stage thinning in a 3v pattern. I’ve been on finasteride for about two years, and am basically satisfied with the results.

I’ve talked to friends and family who might have similar patterns of thinning, and in discussing the options, several of them are skeptical about the effect transplants would have.

My question is this: what is the authoritative opinion on how well transplanting can cover up balding (specifically, can It be made to look like I have virtually no thinning?)

Your question isn’t really fair. You are asking a hair transplant surgeon who thinks about hair transplant surgery as a matter of livelihood. It’s like asking a chef if you should eat their food.

My point is you should be asking these questions to the patients who had hair transplants. You should meet them face-to-face to judge what the value has been based upon the change you see. Looking at some before and after photos has some minimum value, but face-to-face meetings like we have at our monthly Open House events in San Jose and Los Angeles give you the opportunity to see for yourself!

Hair transplants all depend on the supply of donor hair and the size of the balding area. Setting patient expectations is critical to what we do. You will never look like when you were 16 years old with regard to hair fullness. Maybe you can come close, but that depends on the number of grafts, hair color, hair texture, hair style, and skin color. For example, curly black hair on dark skin gives great coverage and fullness over thin straight black hair on while skin.

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

Over a Month After My Transplant, Grafts Came Out!

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

Hi there! I was wondering if there is a possibility for hair grafts to fall out a month and a half after the procedure. I was gently rubbing my head when I noticed one of the tiny hairs fall off. That tiny hair had a piece of the root that came off with it (not just the bulb but a piece of the root that has dried up and is normally seen with a harvested hair graft prior to the transplant). Any input would be greatly appreciated. Thank you!

I would hope you were given post-operative instructions, and that somebody at the surgical clinic explained to you what was involved and what to expect following a hair transplant.

About a month following the procedure most of the transplanted hairs fall out, at times appearing to be the full graft. This should not be the graft at 6 weeks though, as the “root” of the graft remains even if the hair and the surrounding tissue comes out with scabs. For more on this, see Graft Anchoring in Hair Transplantation (PDF file).

It takes anywhere from 3 to 8 months to start noticing significant growth, provided that your surgery was successful.

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

My Hair Looks Worse After Each Transplant!

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

Doctor,

I started noticing hair loss around the age of 26. I tried the laser for a year and did not believe it worked and took propecia, but felt that did not provide help either. In 2009 I decided to have a hair transplant surgery 2,000 hairs. 1,000 in the front and 1,000 in the back.

After the transplant I began finasteride and rogaine to maintain the amount. I was so happy after the first 6 months, until I started noticed thinning in the front again. Everytime I go to the doctor who will remain nameless they say things are fine. I went for the second procedure a year later to thicken up the front. It has been 5 months and the front looks worse and the back is starting to thin out on the sides and a little in the middle. I have a few questions.

  1. Can the initial surgery cause this shedding to occur and then stop?
  2. Could the rogaine cause an adverse affect? Every time I use the rogaine and start combing my hair at least 10-20 hairs come out. I read somewhere that if shedding does not stop after 5 months then stop.
  3. Does the finasteride not work as well as the propecia? These 2 drugs should keep the back fine, but that is not the case.
  4. Also could transplanted hair fall out?

I cannot comment too much on your particular issues, because I’ve never examined you… but I suspect there was no Master Plan associated with your hair loss issue and you were chasing after a goal that wasn’t clearly laid out. It’s possible you were never given realistic expectations. Perhaps you should see another surgeon for his/her opinion.

1. I do not know what your initial surgery was, what it was suppose to do, or even if it was successful. In general, you can have shock hair loss from the surgery itself. That’s one possibility. The shedding from shock hair loss is permanent.

2. Rogaine is a topical medication to grow hair, not lose hair. If you have an adverse reaction, then ask your doctor for an examination. Losing 10-20 hairs is normal with or without Rogaine. Finally, some patients report slightly more hair loss when starting Rogaine treatment, but as you continue to use it there should not be a problem. The initial hair loss from Rogaine is thought of as a “cycling” of the old hair falling out in preparation of new hairs to grow.

3. Propecia is finasteride in 1mg strength. There is no difference as it is the same medication. Propecia is the marketing name, like Tylenol is the marketing name for acetaminophen… or Rogaine is the name for minoxidil. I’m not sure what you mean by the “back” … is it the back of the head (donor area) or the top/crown?

4. Transplanted hairs are considered permanent as your donor hair. They do fall out as the hairs cycle, but it regrows.

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

Fungal Infection In Recipient Area a Month After My Transplant

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

Hi, I received a hair transplant FUE type, nearly two months ago. I am a male and aged 46 years. After the first month i developed bumps of dry scalp on the transplanted area only. The Doctor stated that this was a fungal infection, so i started using Nizoral shampoo after using this shampoo for 15 day’s the condition has cleared. My question is, will this effect the hair transplant and the growth of the graphs, to become a successful hair transplant.

Thanking you for you professional advice.

I’ve never seen a fungal infection following a hair transplant, so I have no experience with this type of situation as a point of reference. I would think that if the infection is gone it should not impact your hair growth, particularly since the infection occurred a month after the transplant. That being said, I would ask these questions to your surgeon and hope for the best!

If one of my patients had a fungal infection, I would get the opinion of an expert who works with fungal infections (perhaps a dermatologist). Good luck.

Tags: fungus, fungal infection, hair transplant, hairloss, hair loss

How Fast Does an Eyebrow Transplant Grow?

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

Hello Dr. In How many month I can see the final results for an eyebrow transplant?

As with hair transplant surgery on the scalp, you should see some results from an eyebrow transplant anywhere between 3 months up to 12 months after the procedure. Some grow faster, some grow slower. Everybody is different.

Tags: hair transplant, eyebrow transplant, hair growth

Donor Scarring from Hair Plugs Done About 30 Years Ago

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

Thirty years ago I had 4 or 5 sessions hair transplant sessions done using the old punch graph method. For most of those years I was fairly satisfied. Lately that has not been the case. The appearance of corn rows is starting to show in the front and it is getting harder to cover up the donor area in the back. Twenty years ago I spoke to a specialist in Philadelphia who disappointed in the methods used in my procedures and he implied that I was not a good candidate for future transplants. If this is the case I would prefer to shave my head instead of continuing trying to cover up, which can only become more problematic in future years.

The scarring at the donor site is a concern. Are there any procedures to reduce this scarring? Thank you in advance for any information and/or advice you can give me based on this limited description.

We have routinely performed surgeries for men who are in your situation. You can read about one patient’s journey here and see some of my repair patients here.

As you undoubtedly know, everyone is different and unique so I really cannot comment on your particular case without examining you. Many patients who had 4-5 sessions of the old hair plugs have heavily depleted donor areas, and a skilled surgeon with experience in this field can often soften the plugs by harvesting the recipient plugs as well as redistribute some of the remaining donor area. If you want to explore options, please send me photos and set up at the least a phone consultation with me.

There is no simple answer to your problems, and each person must be evaluated one on one before recommendations can be made. This goes for both repairing/removing the “corn rows” and seeing what can be done about fixing the donor scars.

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

Does a Hairline Shift When Closing a Strip Procedure?

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

Hi, doc. I’ve been researching hair-transplantation, and I have a question concerning F.U.T. (strip-harvesting): I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) — when, totally, a reasonably wide portion of the scalp has been removed, will not a patient’s hairline, in accordance, also be shifted?

That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me.

I understand a physician will take into consideration laxity of the scalp, so what I’m talking about might not be immediately noticed — I also hear doctors will try to cut out strips that are longer rather than wider, to reduce tension — but, ultimately (again, especially when a large number of grafts must be harvested), will not the hairlines (front and certainly rear) be affected? If not, why not? If so, is this effect permanent? The piece of scalp taken out can’t “regenerate,” can it (and, if it could, would it regenerate hair follicles, too)?

Sorry for this long question, but certainly I’d appreciate your taking the time to answer. Thank you very much.

P.S. Just one other question (a brief one): Can hair that’s already been transplanted to a new location be removed and successfully retransplanted in another area (e.g., back to front, then, later, if need be, north of that region)?

The hairline never shifts, but the scalp itself does stretch a little with each procedure so that the donor density reduces a bit. I’ve answered a similar question before.

Neither the front hairline nor the neck hair moves as a result of these excised areas. The only part of the scalp that is impacted is either the posterior scalp (which would be stretched) or in a small group of these patients, the redundancy of the scalp (scalp laxity) reduces. The scalp is attached to the galea and then to the skull. This keeps the movement from one area to another minimal, if at all. Scalp and follicles can’t regenerate.

As for your P.S. — Yes, we often move previously transplanted hair when the work is not good, but there are limitations to moving a great deal of transplanted hair. This is commonly done in repair procedures.

Tags: hair transplant, scalp laxity, hairline, hair loss, hairloss, repair, surgery