The Price of a FUE Megasession?

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

hi Dr. Rassman,
i just had a quick question for you and i would really appreciated if you could answer it. well dr. rassman i just wanted to know, i’m thinking of having a hair transplant and the only way would be with the FUE procedure. i’ve been saving money for that the past 4 years just for this, so was just wondering let say i get a mega session done with about 2,500 to 3,000 hairs how much would that cost??

and doesn’t matter when i get it even if its on a stand by procedure could you give me a rough estimate?? so i can keep on saving so what i have is not enough. once again thanks for your answer and keep up the great work!!

First, we generally use the term “grafts” which will contain 1, 2, 3, or 4 hairs. I have heard of some doctors doing 2500 to 3000 graft FUE procedures, but in my experience as the one who first published the FUE techniques in 2002 (which all doctors use), megasession FUE of that high a number may be dangerous in terms of the graft survivability and donor area scarring.

At New Hair Institute, we usually limit the FUE to 1500 maximum, but may flow over into a second day surgery in special cases where the donor density is good. The cost of FUE at NHI is now $8/graft with my associate Dr. Pak. We do not offer the FUE procedure in our standby program.

Tags: follicular unit extraction, fue, hairloss, hair loss, hair transplant

No Growth Months After My Hair Transplant — Am I a Slow Responder?

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

I had a transplant on 3.16.10. The crown and the left and right sides frontal. Went in for a 4 month check up and nothing has started to come in. I had no post operative issues. I was very careful for the 2 weeks post op with the grafts. Doctor said I am a slow responder and to come back at 7 months. I been on the internet and I see all these patients with growth at 4 months and I wondering If my procedure failed. I am getting panicky.

Don’t panic! Results from a hair transplant will usually be seen from 3 months all the way up to 7 months on average. The speed at which it grows has nothing to do with success of the surgery. The waiting is the hardest part… but you’re going to have to find the patience. If at month 7 you still see nothing, have a chat with your surgeon about that. Right now though, you have no reason to be worried about your transplant’s success or failure.

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

Scalp Massage After a Hair Transplant

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

Greetings Dr. Rassman! I just had a hair transplant about a month and a half ago. I had a full body massage today and I made the mistake of dozing off during the session. While I was asleep, the masseuse did massage my head, which probably involved some hair pulling and moderately heavy pressure on the scalp. When I woke up, there were 5 red spots on some of the areas where the transplant took place. There was minimal bleeding on each spot and I’m afraid that the grafts on those areas may have been damaged.

I was under the assumption that the grafts are permanent and would not get damaged after the first ten days following the procedure unless a really traumatic event occurs on the scalp. I’m worried that the grafts on those areas may have been damaged. Is there a chance that the grafts may have been possibly damaged on those areas where the red spots/minimal bleeding occured?

You really cannot kill the transplanted grafts from a massage after a month, and I would think it’s quite strange to have any kind of bleeding in the transplant area. Please follow up with your hair transplant doctor and have your scalp examined to see what’s going on.

Tags: scalp massage, massage, hair transplant, hairloss, hair loss

How Much Are Sideburn Transplants?

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

The problem that I have is the inability to grow sideburns due to sparcity of hair in that region. I have seen the results on your website and I am interested in obtaining information on procedures, costs, etc. If you could provide me with any details on how to initiate the process, I would greatly appreciate it. Thank You.

You’ll need to start with a consultation. You can send us photos by email along with your contact info and we can arrange for a one-on-one phone consultation with a physician. Or you can call the office at 800-NEW-HAIR (or 310-553-9113) to setup the phone consult. Photos are always helpful.

As for costs, that would depend on the number of grafts (hairs) you receive or require. Our minimum fee is $3000, and that usually ends up to be the cost of the sideburn transplants since it often comes under our minimum charge.

Tags: sideburn, hair transplant, sideburns, hairloss, hair loss

Scalp Reductions Done Today?

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

Hi Doc! I’ve just about made it through all 800+ pages on the Balding Blog and have a couple of questions about scalp reductions. I know you and most hair restoration physicians discredit them, but are there ever cases where one could be performed? Assuming good scalp laxity, how much could be removed without causing the slot deformity in the back? Some physicians still list some form of scalp reduction on their site and I’m wondering what they do these days that won’t cause more problems later.

Scalp reductionScalp reductions are not the “gold standard” in treating male pattern hair loss, because the results are sub-optimal and you end up with a scar along the top of your scalp that will be visible with continued hair loss. Although I hate to use the term “never”, I will say that I can not imagine using scalp reductions on any patient today.

Now with that said, a few of the old timers that have judgments and experience with follicular unit transplantation may find an indication for performing a scalp reduction and it might be reasonable in their hands to do a few. If the scalp reduction is limited to no more than 1-2 surgeries, then the probability of a slot deformity would be minimal and the thinning of the scalp will also be minimized. Reductions also tend to lose their value over time (a term called stretch-back) and the patient would need to understand that risk.

I had 3 scalp reductions in 1992-1993 and my scalp became very thin and easily damaged by sun. I also had a full stretch-back, resulting in a return to the original balding pattern from before the first surgery. The medical-legal risk of scalp reductions to the doctor is not insignificant in today’s litigious society, so few doctors will face the legal risk with complications that were so frequent in the early days. In the 1980s, doctors would do these frequently because the money was good ($2,000-2,500 per procedure) and the skilled doctor would be able to do it in 15-20 minutes. So the attraction to do something so profitable was irresistible for many doctors, bringing out the larcenous side of those who had that tendency. Add to that the need for 3-6 surgeries in most people and that made the money look better and better for the doctor, so much so that they lost their sense of compassion for the patients who had the many, many complications of this procedure.

For more information, including the history of scalp reductions and photos, see here.

Tags: scalp reduction, hair transplant, surgery, hairloss, hair loss

Keeping My Hair Short After FUE?

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

I have been on propecia – Generic for about 7 months. I am bald on my crown. I am 43. I have not seen any hair growth. Should I stop. I am interested in FUe and not FUT. I keep my hair really short. I am happy with not having a full head of hair, and have successfully used a hair fiber to conceal my bald spot.

Can you provide me any advice on the propecia and also what I need to get FUE. FUT is just not an option for me due to the pain, healing time and the inability to exercise for 30 days.

I don’t know your medical history, you’re not my patient, and I didn’t prescribe you Propecia. Any one of those would be reason enough to make me uncomfortable giving you personalized medical advice about your prescription drug regimen. You should discuss any changes with your medication with your doctor. That being said, Propecia might not regrow your crown, but could be preventing it from getting worse. Like I said though, I don’t know your history so I’d just be making complete guesses if I continue.

As for your interest in follicular unit extraction (FUE), short hairstyles are possible without revealing any linear scarring (because there is no line), but if you shave your head you will still be able to see some tiny pinhole scars. I don’t know how short of a haircut you’re talking about.

You are correct in that healing time is quicker with FUE compared to the traditional strip technique, but the biggest trade-offs are price (FUE is more labor intensive and thus more expensive) and with the strip, we have the ability to get more hair in a single session. Those may be non-factors though, depending on your hair requirements and finances. For more info about FUE, see here and here.

Tags: fue, hair transplant, hairloss, hair loss, propecia, finasteride

Could FUE Give Me a Hairline Like Morrissey?

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

Hello Doctors

My question is about FUE & FUE2. Would it be realistic expectation for a male patient who is a Norwood IV and benefiting from Propeciea in the crown to achieve a good density in a conservative and mature frontal hair line? I get the impression from your previous entries that it may be expecting too much . I do also understand from the all the great articles you have provided that FUE seems to best used for smaller amounts of grafts needed in patients.

If i could get a outcome to resemble something like this mans hair i would be happy: Morrissey photo

I think that’s a great look. Thanks for your time and all the great info.

MorrisseyThe density has nothing to do with the harvesting method used, just the number of hairs per square mm that the grafts are placed in. Generally, depending upon hair/skin color and hair texture, the amount of hair needed to look full will reflect somewhere between 25-50% of your original density. One reason follicular unit extraction (FUE) might be best used for smaller cases has more to do with costs involved, since it is the more expensive procedure.

Could you look like Morrissey, the musician shown in the photo you linked to? I suppose that depends on what you start with. It is a great look, and if you have similar hair type and the grafts available, I don’t see why it isn’t possible. Take a look at our photo gallery and see hundreds of patient results. Or better yet, come to an Open House and meet some of our patients in person.

Tags: hairline, hair loss, hairloss, hair transplant, fue, singer, morrissey

Did My Testosterone Injections Cause My Transplanted Hair to Fall Out?

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

Doctor,

I had a hair transplant in July 2009. The physician completely re-constructed my anterior hairline. There was no hair growing there before he transplanted some. In September of 2009 I began monthly injections of 1ml of testosterone. I noticed my hair really filling in from the transplant until about 6 months ago. Since then I have noticed a definite thinning of my hair including the reconstructed frontal hairline which was exclusively transplanted hair. Is it possible that the testosterone treatments have caused the transplanted hair to fall out? I have been taking 1mg of Propecia religiously since the transplant, but it doesn’t seem to be making a difference. Thank you.

It is possible that the testosterone impacted the transplanted hair and almost certainly may have impacted the native hair that is present. If the hair transplants are falling out due to the testosterone injections, it might even suggest that the hairs used in the transplant didn’t come from the donor area (permanent zone in the back of the scalp). You need to discuss this with your surgeon, as he has the insights into your case and I only know what you told me above.

I realize you indicated that you’re not in the Los Angeles area, but if you make it out this way I would be happy to examine you.

Tags: testosterone, hair transplant, hairloss, hair loss, shedding

Will a Hair Transplant Make Psoriasis Worse?

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

Dear Sir,

I have psoriasis and may be it has caused some hair loss. I would like to know if I conduct hair transplant on the affected area can the hair grow there or the skin become worse?

I too have psoriasis and had a hair transplant twice. The psoriasis did not impact the hair transplant or vice versa. I wrote about this very topic in one of my earliest blog posts way back 5 years ago — Scalp Psoriasis and Transplants.

It’s worth noting that I doubt the psoriasis caused your hair loss unless you picked at your scalp and developed traction alopecia.

Tags: psoriasis, hair transplant, hairloss, hair loss

At What Age Should Men Seriously Consider Hair Transplants?

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

Dr. Rassman,

Right off the bat, I have to give my deepest appreciation and gratitude for everything you do here! I have 3 seperate questions for you. I don’t believe I have seen these specific questions on your blog before, so hopefully you won’t have to be repeating yourself!

  1. For anyone willing to send you pictures to publish with your comments (I am), what are factors should we keep in mind? For example, eyebrows raised are good, correct? What about wetting your hair vs. keeping it dry? Are pictures easier to dissect and faux diagnose if it’s longer or shorter? What about including older photos of yourself? Lighting, etc.
  2. I realize every case is different, but generally speaking, at what age do you think people should start seriously considering transplants for receding hairlines? I’m 27, and I realize my mature hairline may continue to recede until at least age 30. If that’s a good rule of thumb, is it logical to wait until approximately age 30 to consider restoring your hairline? (I’m sure the last thing anyone would want is to transplant your hairline too early, only for your natural hair to recede more, leaving you with a bald gap!)
  3. While I don’t quite understand why this occurs, I often see the immediate results of transplantation, which is often scarred and scabbed looking. How long does this look last? The reason I ask is regarding those who perhaps want to try and not let EVERYONE in their office (& life) know they had a procedure. If one were to take a week off work to let their scalp heal, would it look back-to-normal after 7 days? Then can you just wait for the hair to start growing in? I haven’t seen many week-by-week photo diaries online. Most tend to be more month-by-month, IF that.

I appreciate any detailed insight you might be able to give. Thank you, sir!

Old cameraIf you want a formal consultation from me, you can call (800) NEW-HAIR or send photos to this address and make time for a phone consultation. Sending pictures to BaldingBlog and having me comment on it will be just generalizations. I recommend taking the photos outside in daylight with some close-ups that wrinkle the brow so I can estimate where the hairline belongs. I also recommend taking some photos with the hair pulled back and even some with the hair wet if you think it will help me see what you want me to focus on.

I have performed surgery on men in their early 20’s to late into the early 80’s. There is no one age I would recommend. It all depends on what you are trying to do and your expectations and your maturity and understanding of what is possible (realistic expectations).

The scabbing after a hair transplant can last as long as one or two weeks, but it all depends on how well you clean and wash your hair. It can look “normal” after one day, and patients who have considerable existing native hairs in the recipient area often have their own coverage. In other words, if you already had some hair in the transplant area, you can use that to camouflage it. If you had no hair in the area at all, that wouldn’t work for you… so we often suggest changing your face by growing a beard or mustache to give a different look overall and detract from your scalp until the healing process is done.

Tags: hair transplant, hairloss, hair loss, surgery

Recurring Rash Following a Hair Transplant?

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

I had a hair transplant 7 months ago. I have had a re-occurring rash which first appeared about 4-6 weeks after the surgery. Is this a side effect, based on hormones? I have no idea what else it could be related to.

This rash is not something that usually occurs following a hair transplant, so I don’t have a clue what it is without seeing you. You should be asking this question to your surgeon.

Tags: rash, hair transplant, hair loss, hairloss

Female Hair Loss from Chemical Relaxer?

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

I am a black (African American) woman in my mid thirties, and in the top of my head and on the right side, in the front around my ears, my hair is continuously thinning and no new hair is growing so the area is getting bald. I chemically relax my hair, and when the straightened hair grows out and the new curly hair grows from my scalp, I notice that in the area with thin hair there is no new growth.

How possible would it be for me to get a hair transplant to that area of my hairline, that extends to my right ear, and about two inches back from my forehead?

I suppose it might be possible, but this isn’t something I could agree to doing without a consultation. You might not be a candidate for surgery. I don’t know how long you’ve been waiting for the hair to regrow, but it could take a year or two.

There’s just too many variables to be able to give you a yes or no about having a hair transplant without seeing you in person. I’d meet with your doctor to find out if this is chemically related loss or if there is something else at play like a series of autoimmune diseases which can cause localized hair loss. You should try to figure out why you’re losing hair before you try to surgically correct it.

Tags: hair transplant, female hair loss, chemical relaxer, chemical damage, hairloss, hair loss

Understanding Shock Loss

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

Hi,

I had been on propecia for 5 months and after suffering from a lack of erection I talked to my doctor and told him of my fear of being on this regime. We decided best that I shall have a hair transplant once it gets really bad.

I would like to know – if after hair transplant the patient MUST take propecia ? What will happen if the person does not take that pill. Will it cause the transplant operation to fail ? Could you shed more light on taking Finasteride after a hair transplant o/p ?

Thanks

Taking Propecia either before or after a hair transplant means simply that the hair loss will slow and possibly stop. If you do not take it, then whatever is normal hair loss for you will happen on your genetic clock. Shock loss seen in young men who had a hair transplant and are not on finasteride, just means that the hair loss process accelerates from what it might have been without the drug.

Propecia isn’t a requirement following a hair transplant, but you’re running the risk of the transplant causing accelerated hair loss around the transplant area, basically leaving you with a similar thinning problem following the surgery. Talk to your doctor about possibly cutting the dose if you’re considering a transplant.

Tags: propecia, finasteride, shock loss, hair loss, hairloss, hair transplant

Major Shedding 7 Months After My Hair Transplant

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

Hello,

I had a transplant of over 3,000 follicles about 9 months ago. I have seen growth but it is still thin and not what I have expected. I have noticed major shedding about 7 months in with the hairs having white bulbs attached to the end. I am concerned that some may be transplanted hairs. What could be the cause of this? Should I be worried?

I do not know what is going on in your case, so I could just guess. Maybe you have increasing native (non-transplanted) hair loss. Maybe you have other medical problems. Maybe your hair transplant was not a success. Maybe you have diffuse unpatterned alopecia (DUPA), which would produce failures to hair transplant surgery. Maybe you are not on Propecia. Maybe you stopped Propecia. ANYTHING is possible. And I would be worried too.

You should be asking your surgeon about the problem and he should be really worried for you. Please, contact your surgeon and discuss these issues with him!

Tags: hair transplant, hair loss, hairloss, shedding

Costs to Remove Hairline Cowlick?

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

Hello. I have read in many places about how expensive it it to fix a cowlick (in the front hairline, in my case) by surgery. However, I have not yet found an estimated price range. Could you ball park what it would be to align the folicles into a more regular hairline pattern? I am a 25 year old male, and the pivot is quite pronounced about half way between the middle and the side.

I am not sure where you have tried to find the information, but here at New Hair Institute (NHI) the minimum cost of a hair transplant surgery is $3000. Otherwise, the cost of each graft ranges anywhere from $5 to $6 a graft (see fees). I don’t know that any clinic would have a flat “cowlick removal” fee.

You are more than welcome to send in some photos to me of your problem area and schedule a phone / photo consult. From those photos, I may or may not be able to quote you without seeing you.

Or…. electrolysis might be a reasonable way to accomplish what you want without surgery.

Tags: cowlick, hairloss, hair loss, hairline, hair removal