In the News – Man in Ireland Awarded €70,000 for Bad Hair Transplant!

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

Snippet from the article:

THE HIGH Court has awarded €70,000 damages to a sales and marketing manager over a botched hair transplant which left him disfigured.

Mr Justice John Quirke made the award to Niall Clancy (32), Scholarstown Park, Rathfarnham, Dublin, over the procedure which was carried out in the UK on January 12th, 2004.

The award included €30,000 general damages plus €40,000 for medical expenses to repair the damage.

Mr Justice Quirke also said Dr Maurice Collins, the surgeon who treated Mr Clancy after the transplant, had given him “very poor advice” not to have reconstructive surgery until after the court case was completed.

LawRead the full article at Irish Times – Man wins €70,000 damages over botched hair transplant

The online currency converter tells me that’s over $99,000 (USD)! I’ve not seen the botched work, but when the doctor told the patient to not have the repair work done until after the case was settled (which took years), it just added to the money the patient was awarded in damages. It is unfortunate that the transplant was so disfiguring, but without seeing photos I’ll have to rely on this article and the court’s decision for my source of case information.

Always remember to do your research on the clinic and physician before getting yourself into a permanent procedure like this. Perhaps this disfiguring hair transplant could’ve been avoided. See:

  1. Selecting a Hair Transplant Doctor
  2. How to Avoid Dishonest Hair Transplant Doctors
  3. Why Should You Visit Us?
Tags: hair transplant, repair, damages, hairloss, hair loss, ireland, irish, uk

I’m a Norwood 2 with Family History of Hair Loss, But I Want My Hairline Thicker

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

In the norwood scale, I beleive that I am a 2. Frontal hair line receding. I’ve done some research about hair loss, and It’s said that there’s nothing I can do to bring back my hair. Now, I can still see some thin short hairs on my hairline where its receding I was told that If I take an “ext therapy” (ext is based on shampoo,conditioners with midoxil and midoxidil pills)I will see some results. since the hairs are thin and not dead, they say that I will get results.If I can just make these little hairs thicker, I will be ok.I just dont know who to believe. And I would hate to spend $3k. Can anything make my hairline thicker? I am currently taking propecia for 3 months. I am 27yrs with history of hairloss in family. I am also considering an fue transplant, since I keep my hair really short, it’s said that that is my best option, since I am in a scale of 2, I dont really want surgery.

Without seeing you right up close and mapping out your hair for miniaturization, I really can not render an opinion. I have seem many men who are afraid of their family balding pattern, fearful that it may hit them. Some, obsess over it and want to jump into the hair transplant process way too early for me. Why are you so motivated to fill the doctor’s wallet? I make my living doing hair transplants, so I don’t make money when I turn down a patient for surgery, and yet I turn down people for surgery all of the time because it is moral to do so. Any hair transplant surgery in a typical Norwood Class 2 patient is not only unethical from the doctors perspective, but also bad for the patient both short and long term. Starting a hair transplant guarantees a long term plan with more transplants if and when the balding occurs.

What is your total hair donor supply? That is a critical question for anyone undergoing a hair transplant so that a reasonable Master Plan can be created to keep the patient looking normal for their entire life. Having some degree of balding is normal, but becoming a freak because you may have jumped the gun and used up your donor hair (especially if the donor supply is low) is the wrong thing for young men.

I would suggest that you find an ethical, competent doctor who will treat you like you were one of his sons. I am glad that you ended the post with “I don’t really want surgery,” but many doctors who chase your money will try to talk you out of that position and scare the hell out of you with visions of balding that may not even be in your future. Just be careful.

Tags: hairloss, hair loss, surgery, hair transplant

In the News – Man with HIV Denied Hair Transplant

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

Snippet from the article:

A South Florida man claims he was refused a hair transplant because he is HIV positive, and now he’s suing the doctor who denied him the new do for discrimination.

Diego Del Rio went to the Age Defying Surgical Center in Fort Lauderdale to approve his appearance, but Dr. Brett Bolton turned him down once he learned of Del Rio’s condition.

“Their medical staff told me ‘We will not do the procedure because you are HIV positive.’ I told them, ‘This is discrimination,’ and they stated ‘No it’s not,'” Del Rio said.

Read the full article — Man With HIV Denied Hair Transplant

Yes, it’s discrimination and in violation of a state law. I’m not familiar with the doctor or the clinic, but based on what I’ve read about this in various articles, it doesn’t sound good for them. I’ve said it before, but a healthy person who is HIV positive may be as good a hair transplant candidate as an HIV negative person. Here are some past related posts I’ve written:

  1. HIV and Hair Transplants
  2. HIV Positive and Hair Transplants
Tags: hiv, hair transplant, hairloss, hair loss, florida

Unethical Graft Counting, Follow-Up

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

This is in response to Unethical Graft Counting — Avoid the Scam!

That’s scary! I have a related question – do you think these Doctors “waste” grafts or do they cut thin strip containing less number of grafts to begin with? i.e., cut 3000 grafts from “donor” area and put only 1000 grafts on balding areas to save labor cost? or, Do they cut a strip with ~1000 grafts and put 1000 on head.

If it’s the later, at least the patients will have the grafts for a later surgery. If the later, the doctors are worse than Bernie Madoff!

Having been through 3 surgeries, one good way to approximately estimate how many grafts were implanted was to count (a) number of hours and (b) number of technicians putting those grafts on your head. For 1640 grafts HT — it took 2 techs@NHI about 5 hours (excl lunch break); for 1850 grafts HT — it took 3 techs about 6 hours; for 1400 grafts HT — it was about 4 hours for 2 techs. I don’t know if these are somewhat standard.

SkunkThe question is really whether or not you always get what comes out of the head. Most hair transplant doctors will be close to the graft estimate when cutting the strip, but what if the doctor got more grafts than you paid for? Does he/she throw the extras in the garbage? This is a matter of ethics and you must know that your doctor cares about your hair supply and does not waste it. Everyone has a finite amount of donor hair, and to throw those precious follicles away would be awful. If you have an ethical and honest doctor, the doctor will ALWAYS do things in your interest, even if it means giving you more than you paid for. But if he scams patients as a way to make his living, a skunk should be known by his smell.

As for speed of your procedure — all technicians are not created equal. Some are efficient and fast, while others are just the opposite.

Tags: hair transplant, hairloss, hair loss, scam, graft counting, hair restoration

Met with a Hair Transplant Surgeon — Is He Too Good to Be True?

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

Hello. I recently visited a very well known transplant surgeon. He’s all over the internet and on many of the blogs etc. I think you may have referred to his practice in some of your recent postings. The photos and testimonials on his website are almost too good to be true, I mean the results are consistently the best I have seen anywhere internet. I am a forty year old white male, with receding hairline at the temples, I’m currently a NW3. I’m mainly just concerned with filling in the temples.

Here’s the issue. This doctor recommended 2500 FUE’s to fill in the hairline, this sounds a bit high to me, but he assured me that I wouldn’t be happy with any fewer. Is it wise in your opinion to do 2500 in the frontal zone based on what I’ve stated, I’m surely bound to keep loosing hair. And, can this doctor’s results be REAL? Even if he was cherry picking his best patients, he has probably 75 patients on his website, most with unbelievable results. I’m wondering if it’s marketing hype or is it real? Maybe he’s only doing very young patients with results that look great today, but not in the future? In addition, since this clinic only offers the FUE procedure, it is extremely expensive and would require a loan for me to complete the transplant. Thanks for your time.

Getting a second opinion is a reasonable next step. Some doctors produce a terrific marketing image showing what patients they want you to see. We offer our Open House events every month where you can see patients up close, ask them about their surgery, and get comfortable with the physicians and staff. For example, in our Los Angeles open houses, we often have a dozen patients to show off, and many just show up to help educate our prospective patients. Maybe you should listen to your instincts and get another opinion.

I can not comment on the 2500 graft recommendation with FUE (in one session? hmmmm) for a frontal hairline without at least seeing a photo of your hairline. Send me a good picture or three and point out the area where the surgeon said he would move the hair to. Reference this post when sending.

Tags: hair transplant, fue, surgeon, hairloss, hair loss

Is Propecia Required To Keep Transplanted Hair?

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

If I get a hair transplant do I need to take propecia to keep that transplanted hair from falling out or it will it be permanent?

The transplanted hair should be permanent if it is taken from the permanent zone (called the donor area)… and as long as you don’t have any underlying disease that causes hair loss in that area, such as alopecia areata. Propecia (finasteride) should be used by men to halt further loss in the non-transplanted area and to prevent shock loss from the surgery. But otherwise, the transplanted hair doesn’t need Propecia to stay in there.

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

My Surgery Was Years Ago and I Have Small Pimples With Each Transplanted Graft

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

Dear Dr,
I’m a man 38 years year old, writing from italy. I had an HT 2 years ago with about 2000 graft implanted FUT. I take 1 mg Propecia for 2 years.

This is my problem:
I have very small pimples (less than 1mm) on each graft implanted there are very visible i.e. under the sun light.they don’t hurt me and seems like the hair is pulling up the skin. I don’t have any of them on non tranplanted hair… I searched on this site but almost all of the discussions I found are on bumps or normal pimples or pitting or scars. the most valid explanation I found is that it is due to the graft that was implanted too deep in the scalp.If it is true, what can I do for improve the situation? Dermabrasion or laser? may I start trying some remedy for folliculitis or is completely useless?pls give me some good hope on what I can do,I’m really desperate. the doctor who make me the surgery (in Mumbay while I was in a long trip for job…)after the first telcon, don’t reply to my calls or mails…however I don’t trust him anymore! I contacted another Dr who said that the only solution maybe is to make another transplant to hide the thin pimples, but I leave this as the last solution and I won’t make another bad transplant. pls tell me if there is something I can do for making less visible these pimples.Thanks in advance. sorry for my bad english. Best Regards

If what you’re describing is a cobblestone appearance (and not actual pimples), then please see this post. Without seeing you, it would be impossible for me to tell you what the problem is caused from.

Dermabrasion to the scalp causes visible scarring and only benefits the doctor’s pocket, not the patients who receive it. There are two types of lasers that can impact hair:

  1. Low level light laser therapy (also known as LLLT), which I feel does not work at all
  2. Higher powered lasers for hair removal, which do not work 100% on killing the hair

Neither offers much benefit to your situation. If you have bumps, some hair killed with the high powered lasers will just make what remains more visible and the laser itself can cause depigmentation (whitish areas) of the lasered skin. I would need to see you, but it is not an easy trip from Italy to my office in Los Angeles.

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

My Hair Transplant Is Already Growing in Under a Month

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

i had my second HT 25 days ago. my grafts are growing and i can see the hair. is this a good indicator of my surgery? i feel most grafts are growing. my question- does this growth indicate a successful surgery and if i lost my hair after a week or so, will it grow back after falling out depending on this growth i see now?

thank you

That is great news! Good for you. Hair growth occurs immediately in about 5% of patients. In some patients, some of it grows fast while other grafts grow slower over the 4-5 month time frame. I know when my patients grow immediately, they (and I) get excited. I only wish I knew how to make this happen more often, but it will always grow if the transplant was done correctly and if it does not grow, just be patient and it eventually will appear.

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

How Does Dr Rassman Find the Time to Blog?

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

You have a terrific website. But how do you have the time to maintain the site and actually focus on performing procedures? Given your efforts to market your business, does that take away from your practice? How many procedures do you personally perform a week? And how many blog posts do you write?

RassmanWhile I have not been successful in cloning hair, I have successfully cloned myself. One of me does surgery everyday, the other writes blogs. I myself travel the world with my beautiful girlfriend(s) to really keep me busy and happy. And when my city needs me, I’m fighting crime as a superhero in Los Angeles.

In all seriousness, I spend hours each day writing the blog (at home, between surgeries, weekends). I write the vast majority of the blog answers, but I also have Drs. Pak and Farjo helping me…. and all of the posts have my editorial oversight before publishing. Any given week could see me doing a surgery or two per day.

Tags: blog, rassman, baldingblog, hairloss, hair loss

My Hair Transplant Made My Skin Cobblestoned!

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

Ive had a transplant 6 mnths ago.The hair that has been transplanted on the front top of my head has made the skin look bumpy cobble stoned appearance. I want to shave my hair short to blade 0 and not have the bumpy look. What procedures can be carried out to solve my problem. I do not wish to have another transplant so im looking on ways to make my linear scar fade away to. Is laser treatment good for the scar.

Cobble stoneOf course, I will start by saying I want to see what your hair looks like and if you can visit California (we have two offices here) it would be best to let us examine you directly. The second option (and probably most convenient if you’re not local) is to send me good photographs of what you are referring to with good lighting. Be sure to include photos of the scar where the hair was taken from.

Cobble-stoning is usually the result of the larger grafts which have a reasonably sized skin disk with it. The skin from the graft does not align with the scalp skin around it so that it appears bumpy. If that is what you have, your doctor used an obsolete technique and these just can not be fixed by shaving down the scalp skin with dermabrasion, which only makes the visibility worse with depigmentation of the scalp skin. The only solution is to put more hair around these bumps to hide it in the ‘forest’ of normal hair (more hair transplants, but this time by a well skilled doctor using modern techniques). Laser treatments do not work either and the linear scars from the donor area can be difficult to fix, but again, I would need to see it to understand the problem.

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

How Many Grafts to Fill in an Area the Size of a Quarter?

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

Dr. Rassman,

I have two specific questions for you:

1) How many grafts/what would the cost be to fill in a moderately thin area about the size of a quarter?
2) Do you have any suggestions for good, reputable doctors in Rhode Island?

QuarterAnd I have two non-specific answers for you:

  1. A quarter sized area might take a variable amount of hair, depending upon where in the scalp it is located. It may possibly take between 100-200 grafts. Cost per graft varies per doctor, and many have a minimum fee for surgery. Without having your age, history, or really much information at all, it’s difficult to make recommendations — but assuming your thinning area is in the crown, you should talk to your doctor about Propecia or even getting some minoxidil (Rogaine). You might be able to avoid surgery altogether.
  2. I don’t have any physician recommendations in RI, but if you don’t mind a little drive, Dr. Robert Bernstein is in Manhattan and he’s the best doctor on the East Coast. I would recommend him if you can manage a trip to New York. He should be able to do a telephone consultation with you by looking at good digital photographs, and then you can do it in one trip all in the same day.
Tags: hairloss, hair loss, hair transplant

Young Daughter Lost Hair After Radiation to Brain Tumor

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

I’m hoping you can help us. When my daughter was 20 months old, she was diagnosed with a brain tumor. After numerous brain surgeries and chemo, we decided to have a bone marrow transplant just before her fourth birthday. Thankfully, this saved her life. She also had focal radiation to the tumor site – on the right side of her head – and unfortunately most of the hair on that quarter of her head did not grow back.

She has worn hair pieces since she has been five years old. We’ve talked to people about hair transplants in the past, but were told there was too much area to cover and also, that hair transplants do not work on the side of the head.

I’m wondering if this still holds true for this procedure. I could send you some photos so you could see the extent of the hair loss if you think that would help. Please let me know your thoughts.

Thank you

Most people with large defects are treated with balloon expanders, which stretch the normal scalp to cover the defective areas. There are a few doctors who are very skilled in this specialized technique and although I have assisted in this type of surgery, I would not consider myself at the lever of expertise needed. I have seen these expanders done in children, but every person and every situation is different. I would suggest that you send me photographs and I will forward them on to such a specialist. I have seen some miraculous results from this type of reconstructive surgery.

Usually, at the end of the expansion surgery, hair transplants are done to refine the work and cover remaining scars.

Tags: brain tumor, child, hair loss, hairloss, radiation, hair transplant, reconstructive surgery

Woman Experiencing Nerve Problems in Scalp After Hair Transplant

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

(female)
I have skin cancer which required graft closures. I have had MOH’s surgery and grafts twice and once (one year ago this past March) I had hair transplantation from the nape of my neck. Approximately two months after the surgery the right side of my scalp regained feeling but the left side did not. It still hasn’t so I told my plastic surgeon and he injected a steroid thinking it was scar tissue. While he was examining my scalp (after the injection, which did not work) he touched an area of my scalp on the left side that shot pain up to the top of my head probably right on the occipital nerve (greater). He didn’t know what to do so I went to see a neurologist who told me that some of the lesser occipital nerves are not as deep and are in fact at scalp level. My scalp (at the donor site) is so tight it is difficult to move my head to the right and down. Now he says I have cervical dystonia. I don’t believe that because in my research I found nothing that even resembles what I am feeling or going through. What do you think?

Persistent pain and/or numbness is a relatively rare risk of hair transplant surgery from small nerve damage. It is always stated in our pre-surgery consent form that we go over with our patients. Tightness of the scalp is also a side effect of a hair transplant surgery. The more surgeries you have, the more risk you may have of tightness or nerve damage. As your neurologist explained to you, some of your nerves may have been cut/irritated during the surgery and this may be contributing to your problems. I really have no way of knowing, though.

Tags: hair transplant, hair loss, hairloss, nerve damage, nerve, pain

Am I Under-Qualified to Be a Hair Restoration Technician?

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

I have received a job offer that seams to good to be true. I responded to and add for an administrative assistant listing and at the interview they offered me a position as a hair restoration technician. I believe that I am under- qualified with a Bachelor’s Degree in Music Business. Is it customary to only hire women technicians? How do I know if this job is legit?

Training for a hair transplant technician takes considerable time and to become proficient once the skills are learned, may take a few years. If the doctor has experience training technicians and you like the detailed work that is involved, then you can embark on this as a career move. I would hope that the doctor who offered you the position does not let you loose and expect that you will become an instant member of the surgical team, making many mistakes along the learning path. It often helps if you have some medical assistant training so you understand the sterile technique process.

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

Could Transplanted Hair Fall Out? — Follow-Up

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

I was wondering if you could expand on your entry “Could Transplanted Hair Fall Out Months After a Successful Procedure?”

Does all of the transplanted hair fall out or just some of it? How long after the HT have you seen this occur? From what you’ve seen does it happen in younger or older patients? Most importantly can you re-transplant new grafts into the area? Would the same thing happen again or could there have been a mistake made during procedure?

I am not sure about your question. The newly transplanted hair usually falls out in a month or so after the surgery and it comes back 2-5 months after in waves of hair growth. Once you’re past the 7th month, everything should be stable and your transplanted hair should be there for the rest of your life. If transplanted hair falls out, it may reflect hair that was not taken from the permanent zone and in that case it may reflect an error from the surgeon.

Tags: hair transplant, hairloss, hair loss