After 6 Weeks, The Transplanted Hairs Didn’t Fall Out But Also Didn’t Grow

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

Hi Dr. Rassman,
It has been exactly 6 weeks today post off, for a FEU of 2000graphs. Now I had experienced a some shock loss after my operation for a while, still have but has been minimized a little, but with that being said most of the hairs that were transplanted have no ‘shed’. Infact they are still in tract but the only problem is that they are not growing. I was told by my doctor that all the transplanted hair would fall off within the first month. Should I be worried? Does this mean the procedure is working slower on me?

Thanks

Your doctor advised you correctly — they will shed sooner or later. I have seen some hairs remain up to a year and the hair transplants grew around them. If you pull on those short hairs, they usually come right out with no traction on them, because they are not attached to a bulb or to the underlying tissue, and have no muscle attachment on them. The shock loss you are talking about is independent of the short hairs that remain.

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

I Have Dense Body Hair — Experiment on Me!

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

This is for Dr.Rassman. You have done a great job having this blog for awareness and information but I was hoping if you could help me out or advise me regarding hair transplantation. I have already mentioned this a while ago to you that I didn’t see the 100% growth on my crown area because the Doctor i had done it from was just making money out of me. He didn’t inform me that my donor area is not sufficient to provide good follicles. Anyhow, i have seen your replies on BHT. As an east Asian (Pakistan) I have the genes of being hairy, my back,chest,abdominal areas are just hairy. And they are pretty dense. I guess this is my last chance because cloning is not even near. I am going to be married next year but i have told every one that my hairs are back because i didn’t want to be embarrassed. My only question to you is How much is BHT and please Dr. is there any way I can be your object,trial,experiment? i am student and facing the worst time of my life. Thought you may have something for me.

In my opinion, results of body hair transplants are not well documented. I appreciate your desperate cry for some solution, but sometimes the best advice a doctor can give is just by making the patient aware of limitations in medicine. Moreover, I don’t like to experiment on patients when I know the the technology and the results may well be very poor.

Tags: bht, body hair, body hair transplant, hair transplant, hair loss, hairloss

Born with a Bald Spot

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

ive had a bald spot on the side of my head since birth. hair has never grown there before. the spot is about 1.5 in. by .75 in. can a hair transplant fix this? would it look natural? and how much would a spot like that cost?

What you describe seems simple enough. A hair transplant should generally cover the area well and with natural results. It would likely involve a few hundred grafts. Our surgery fees are listed on our website, but our minimum fee is $3000 for any procedure. Sometimes if the spot is small, a reduced fee can be arranged under special circumstances.

Tags: hairtransplant, hair transplant, birth, bald spot, hairloss, hair loss

Can We Use Donor Hair from Animals?!

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

Hey Doc,

This is a bizarre question, but I was wondering if it is possible to get donor hair from animals that are similar to humans? I know it may sound curl or just flat out stupid, but I was wondering if its even possible?

Thanks

FurWe use animal hair for wigs all of the time. Let’s say hypothetically that it is possible to use animal hair for transplants — which animal did you have in mind? If you picked the animal of your choice, what do you think PETA (People for the Ethical Treatment of Animals) would say? Hair transplant isn’t life or death, like a liver or heart. If PETA supports your cause (or you don’t care about what they think anyway), what doctor will you go to? A veterinarian? If a doctor is willing to do the surgery, what do you think your friends will say? It gives a whole new meaning to “sexy beast” …

The answer to your question is — no. Your immune system will reject it in a matter of weeks. Anti-rejection medication would be far too risky to use for a cosmetic procedure.

Tags: hairtransplant, hair transplant, fur, animal, hairloss, hair loss

Sex After a Hair Transplant

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

I just had my first hair transplant and it says to not have sex for one week. Is masturbation ok the evening of or day after? or will it possibly cause some grafts to fall out?

I remember a billionaire I performed a hair transplant some years ago. He had an interpreter with him (came from Asia) and I jokingly told him not to have sex for 3 years. I remember laughing and I thought he understood it was a joking comment. Three months later, his interpreter called and told me that his boss told him ‘to hell with the transplant’, and he didn’t care if it ever grew, but could not handle the abstinence from sex for any more time. I realized how humor is very cultural and he revered my medical and surgical skills and took my joke as a directive, not as the humorous “masterpiece” that I intended. Obviously, it was a dumb joke that got lost in translation.

Anyway, I generally recommend passive sex for the first 1-2 nights, then go for it which ever way you feel up to it after. With regard to masturbation, wait a day to be safe.

Tags: hairloss, hair loss, hairtransplant, hair transplant, sex, maturbation

ISHRS Doctors that Still Do the Punch Grafts?

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

I was looking over the website of the International Society of Hair Restoration Surgeons. I was using the “Find a Doctor” feature and also looking at the sub-categories of procedures performed.

Am I missing something? Why is there even a sub-category currently listed for doctors who perform “punch graft” procedures? Furthermore, why are doctors even advertising that they perform it?

Isn’t that procedure obsolete? Who would even want it? There has to be a reason that the procedure is listed and that doctors advertise performing it – I would hope. Is the punch graft procedure indicated in any situation? If not, what gives?

Hole punchThe follicular unit extraction (FUE) procedure is in a way a mini-punch graft involving just one follicular unit. Instead of using 6mm punches, we use 0.9mm punches.

Unless there is something I am not aware of, the punch grafts are obsolete. I found the list of doctors that are listed as those still performing this archaic method — ISHRS Physicians that perform Punch graft transplantation. I must assume that this is just outdated information on the site and will inform the ISHRS to find out if my assumptions are correct. I sincerely hope I’m right and that no doctors in the ISHRS are currently doing this procedure. Fingers crossed.

Tags: doctor, punch graft, ishrs, hairtransplant, hair transplant

Transplanting Hair Between Existing Hairs

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

Dear Dr. Rassman,

How dense can hair transplant be done assuming that there are plenty of donor area with thick hair and the target area still has 50% density? Can hair transplant be done in-between existing hairs to make the hair thick again?

Tried Propecia but stopped after 2 days because of side effects. I appreciate your help on the matter.

You can transplant between existing hairs without difficulty, providing that the existing hairs are permanent and not miniaturized. I have seen patients receive very dense hair by transplanting between hairs that were previously transplanted.

Tags: hairtransplant, hair transplant, hairloss, hair loss, density, dense

7 Months After FUE Procedure, I Think My Surgery Was a Failure

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

Dr. Rassman,
I had a 3000 graft FUE procedure performed at the beginning of the year. To date, after 7 months post-surgery, I estimated based on a family member’s meticulous calculations with a magnifying glass that I have only 20-25 grafts/cm2 in my previously bare hairline area, when I supposedly grafted in my hairline area at a density of 70 to 80 grafts per square centimeter.

Should I expect further improvement in the coming months or has my surgery failed to achieve the grafted density? Of course, my doctor believes I can expect improvement in the next 5 months, but I have seen little to no improvement since the 4th month post-surgery. Should I expect my final surgery outcome to be a failure?

Thanks in advance.

Honestly, I don’t know. It can take as long as a year before all the hair grows in, although that long is unlikely. Furthermore, nothing is a 100% in life (except death and taxes). In my opinion, failure from follicular unit extraction (FUE) is common, even with doctors who promote them. The procedure is very difficult to do and 3000 grafts tells me that I might think that it was never done at those numbers, at least successfully.

I would discuss and follow up with your doctor in the next 5 months as your doctor recommends and hope that you get what you and he expect. Generally, it takes 8 months for 80% of the hair to grow and 90% in 10-12 months. I could go into this at length, but stay tuned to this site as I am going to address the subject of FUE failures in the very near future.

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

Revising a Donor Scar with a Tight Scalp?

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

I have hair transplant done 2 years ago about 2000 grafts, however I have a donor scar that runs from ear to ear and wider than 1 cm since the skin got constantly pulled. My head skin is very tight,so i am wondering what can I do to fix this ? I want to cut my hair short in the back. Should I transplant hair from other part back to the donor area or any other solutions?

thanks.

You should start doing scalp exercises (see video) and then try to get a surgeon to perform a scar revision surgery with new techniques that are available today. These do not always work, because your body has a new baseline after you have a surgery. You can also try transplanting hair to the scar using the FUE technique, which will work if a revision of the scar does not work. None of these methods are perfect, but they can minimize the look of the scarring. You need to see a doctor to discuss these options for your specific needs and expectations.

Tags: scalp, donor scar, revision, scarring, hair loss, hair transplant, hairtransplant

Facial Swelling After a Hair Transplant?

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

Hello Doctor

After a hairline transplant some people get a facial swelling for a few days and some people don’t. My question is : Is a facial swelling a good sign, a bad sign or indifferent, regarding the future success of the operation and healthy grow of the transplants

Thank you

Facial swelling is just an annoyance after a hair transplant that occurs in random individuals. It is neither good or bad. You can always minimize swelling by sleeping at a more up-right angle (so that the fluid drains downward) and in our practice, we rarely see it because of the use of short term steroids during and after the surgery.

Tags: swelling, hairtransplant, hair transplant, swollen

Norwood Class 6 Patient Just 10 Days After Surgery (with Photos)

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

Hi Doctors,
I’m schedule for surgery with Dr Pak and the last time I was there I forgot to ask to see an example of what I might look like a week or so after surgery. I’m taking a week off from work since I have a ton of vacation time saved up anyway so I’m not concerned about what my scalp will look like during that time. I just didn’t want to go back to work with a swollen head or something. Can you post some photos of a patient that Dr Pak has done? Thanks

Here’s a recent patient of Dr. Pak‘s that has agreed to show his full face (and results) to the world. He’s very excited about the future of his hair, and although these photos are only 10 days out of surgery, you can see that he’s on the right track. There’s no redness, no scabbing, no swelling (nor did he have any swelling immediately after the procedure)… things are looking great. This is typical with follicular unit transplantation surgery in the hands of an experienced doctor and team, and of course with proper aftercare washing. The patient has a Norwood Class 6 hair loss pattern and had a single procedure of 2468 grafts. I’d like to point out that the grafts were kept at a 1/4″ length at the time of transplant.

Click the photos below to enlarge.

Before:

 

10 Days After:

 

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

My Temples Are Still Red and Cobblestoned 2 Weeks After My Transplant

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

I am now two weeks post op from my forth HT. I have had great results the last three times with the same doctor. This time he did some temple work. It is now day 15 and both my temples are still red and I have a slight cobblestoning look. I know that cobblestoning in it’s true form was mainly due to large grafts, grafts too large for the incisions ect. I also understand that a this is what really sets aside a good transplant doctor from another. Is it normal for me to still have reddness and some slight elevation in the temple area after 2 weeks. I was told that while the graft area still should be red now the skin should have smoothed out to an even level by now and I should have no traces of elevation in the transplanted area. If this is true does this mean that I’m going to have a permanently detectable transplant in the temple area?

thanks

Cobblestoning, in my experience, does not occur in follicular unit transplantation. In some patients redness does last weeks or even months, but with those who have had prior transplants, the history of redness from previous transplants should tell you what you need to know. I am unwilling to give you treatment recommendations without examining you. Check with your doctor about your concerns as your recent experience seems different.

Tags: cobblestoning, cobblestonning, cobblestone, hairtransplant, hair transplant

Laser Assisted Hair Transplantation

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

Is laser assisted hair transplant better than those done without lasers. It is said that minute 0.6-0.9 mm can be evenly placed over the bald (recipient) area with the help of laser technique. The other hair transplant doctor that I met said he needs at least 2 mm space between hairs to place grafts. Since I am not completely bald but with severe thinning should I go with the laser technique. Your thoughts?

Here is the link: https://www.drbnrskinhospitals.com/html/treatments/hairtrt.asp

LaserThere was much hype about using lasers in the late 1990’s to make incision sites, but lasers are not used anymore in the United States because it burns the skin. Much about lasers is about marketing, not medicine.

Also, this might say something about the company doing the procedure — in the week or so since you wrote me about this, the site has already disappeared and is now just filled with advertisements. Did the doctor go out of business? Forget to renew his domain name? I don’t have the answer to that, but it doesn’t change the fact that the laser-assisted hair transplant does not make a better hair transplant.

Tags: laser, hairtransplant, hair transplant

The Drawn Hairline Is Different From What Was Transplanted a Week Ago!

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

Hello. I recently got a hair transplant in Canada. I am a resident of the United States. I didn’t have severe loss, but my hairline has always bothered me. It was very unsymmetrical and missing temple points on an otherwise full head of hair. I had a procedure last week and the swelling has just subsided the last couple of days. Well, what the doctor drew in for my hairline is very different than what is now on my head. My temple points are extremely unsymmetrical now, more than before. When looking at me directly, one temple point can be seen and looks great, but the other one is further back the side of my face and can’t be seen from front view. One is lower than the other… The way it is now, is not what was drawn on my head prior to the surgery. The doctor took a picture of me before the transplant, but did not take a picture of me after the hairline was drawn or after the procedure.

My question is, how do I approach this situation.. Is it the doctors responsibility to fix this for me or am I bound to this agreement even though it was not what was discussed and agreed on prior to surgery? I have seen tons of pics on forums of people who have had temple work done, even from this doctor, and none of them look as unsymmetrical as mine. Should I have this fixed asap or wait till my results grow in and go have it fixed then… I mean, it is ridiculous how much I have paid and it was a fairly easy procedure from what I understand.

The good news is that you had a photograph taken before the surgery, hopefully outlining the hairline that was proposed. If the transplant was done in the last 5 days, it would be unlikely that you could undo the problem work. The best thing is to communicate with the doctor and address your concerns.

You trusted the doctor to perform your surgery after all. It is all about communication and having a trusting relationship. My answer may sound generic, but it is really as simple as that. Your doctor should be very concerned if the work is unbalanced. You can always get a second opinion. Keep taking good photos of your hairline and growth.

Tags: hairline, hair transplant, hairtransplant, doctor, physician, hairloss, hair loss

Keloids from Hair Transplant?

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

Is it possible to get keloid or hypertrophic scarring from a hair transplant? How likely is it to occur? Or would the new hair hide it in any event?

Thanks in advance

A keloid is a possibility with any cut on the skin. If you have had a cut on the skin you will likely know if you keloid these cuts or not. Keloids are more common in people with African, Asian, and Hispanic skin types, and less common in Caucasians. That being said, scalp keloids from a hair transplant are very, very rare in all races.

Tags: keloid, hairtransplant, hair transplant, skin