Burned Area on My Face Doesn’t Grow Facial Hair

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

Hey Doc,

My question is not to complex. I have a facial scar from a burn on my right cheek. When i grow facial hair it grows everywhere but the burn on my cheek. Looks kinda dumb! My question to you is can i have hair transplanted into the burn so that hair will grow and cover the scar? Have yo done this before with sucess? Thanks for your time in answering my question…. Happy New Year!

My answer is simple — yes. Hair transplantation to burned areas work and can disguise the burn on prior hair-bearing skin. The texture and the growth rate may be slightly different than the facial hair, but it should be better than a bald spot.

Tags: burn, skin, facial, beard, hairloss, hair loss, hairtransplant, hair transplant

I’m 8 Days After Surgery — Can I Do Kung-Fu?

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

Hi there,

This will be my 8th day of post-op HT and I have read several blogs regarding what kind of physical activity is ‘allowed’ and which ones are not recommended.

Any movement involving the trapazieus muscle was not recommended, anything with weights heavier than 25lbs was not recommended either. Can I assume that doing something along the lines of push-ups, dips, and squats with no weights other than your own body weight and perhaps yoga is fine?

How about something like Kung-Fu with no contact to either the graft or donor area?

Thank-you v. much

For recovery from a follicular unit extraction (FUE) procedure, everything can be done. For recovery from a strip harvesting procedure, always test your trapezius muscle for contraction. The more the tightness created at the neck, the more of a problem that could be created from such activities as sit-ups and push ups. Squats are probably alright.

Tags: hairtransplant, hair transplant, hairloss, hair loss, kung fu, kungfu, exercise

Number of Hair Transplant Procedures Done in the US Annually?

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

How many hair transplants is done every year in the U.S? How many of these are fue operations?

MoneyFor the numbers of hair transplants done in the United States, the answers vary depending upon the source. I have read that the estimates are now around 100,000+ procedures annually. The dollar value for surgery runs somewhere between $500 million and $1 billion annually. You can find some stats at this article from the NY Sun — The $1.2B Growth of Scalp Restoration Surgery.

More complete statistics can be found at the International Society of Hair Restoration Surgery 2007 Census Report (PDF file).

There are no figures on Follicular Unit Extraction (FUE) procedures that I know of. I suspect that the numbers are very low (less than 1,000 patients per year), as most doctors do not want to do this type of procedure due to the required skills and patience that are not most of the doctors’ forte.

Tags: hairtransplant, hair transplant, fue, hair loss, hairloss, surgery, statistics, stats

I Think I’d Be a Good Candidate for Hair Transplantation at Age 19!

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

Hi Dr. Rassman, Im a 19 year old male who has been losing his hair quite quickly since the age of 18. I honestly had VERY thick curly hair all through my life honestly had a huge curly afro like the guy from american idol when i was about 16. And now my hair on the top of my head and my crown has thinned and a bald spot is coming in. my question is, even at 19, could you get a successful hair transplant? You honestly can plainly see the balding pattern that im getting by visual and its the same pattern as my grandpas who im almost positive had more hair than me still at 30 but he is now completely bald. I was just wondering if at 19, it is virtually impossible to rethicken the hair. My hair loss is not insane but you can see the Horseshoe balding pattern and easily notice my thin crown spot. Please any positive advice, this is really really depressing me in such a horrible way. i would think since you can so easily see my balding pattern id be a good candidate for HT. always my back and side hair is still extremely thick and in good condition

If you have genetic male pattern balding as you describe, you may be a great candidate for Propecia (finasteride 1mg), but hair transplantation would likely accelerate further balding. I realize that in your urgency to regrow your hair, you’re wanting to do whatever it takes. But unless you are completely bald already, I would generally advise against a hair transplant for someone your age. This is a decision that will stick with you for the rest of your life, and is not something you should be rushing into. You need to see a doctor and have a good physical exam and educate yourself on hair loss options and then develop a good Master Plan for your hair loss management. Hair transplants can be part of a Master Plan if indicated and done at the appropriate time.

Tags: hairloss, hair loss, propecia, finasteride, hairtransplant, hair transplant, teen

Transplanting Hair Into a Bald Spot from Birth Mark

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

I was hoping someone could shed some light on hair transplatation for life-long bald spots. I have a bald spot (birth mark) about the size of a quarter over my right temple. I have a full thick head of hair otherwise… I can obviously hide such a small spot but prefer to have my hair cut short. Would this type of bald spot be a candidate for hair transplantation or because hair has never grown in this spot,it would be unlikely to grow via a transplant. Thanks in advance for your insight.

I would have to see the bald spot (send a photo and reference this blog post), but a hair transplant would probably work. If you want to keep it short, it would require a high density hair transplant.

Tags: birthmark, birth mark, hairloss, hair loss, hair transplant, hairtransplant

Juvista for Healing Hair Transplant Scarring?

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

I know this is years down the line, but when Juvista comes out, do you think that Juvista combined with tricho closure on HT scars (either after the process or in a revision) will allow men to cut their hair down to a 1 grade or even to the skin without the scar being too obvious? I know your response would be conjecture at this point, but it would be interesting to get your thoughts.

RenovoThe scarring may be reduced, giving it a better ability to blend in (without being hyper- or hypo-pigmented or raised), but the hair will not grow on the scar. Scarring is very individualized. Even under the worst case scenario without a trichophytic closure, some people heal great and are able to cut their hair really short without visible scarring in the donor area. How well you scar is also a genetic factor (much like hair loss) and there is only so much you can do.

If Juvista does as it sets out to (eliminate scarring with a simple injection at incision site), it could be great for a percentage of those that it works for, but the drug just failed in its most recent clinical trial. Read Renovo, Shire Developing Anti-Scar Drug and Bad news on drug rocks Renovo for more.

So, the short answer to your question is… probably not.

Tags: juvista, renovo, shire, scarring, hairtransplant, hair transplant, scar, healing, trichophytic, closurep

Side Effects Prevent Me From Taking Finasteride or Dutasteride — I Want a Transplant Without Shock Loss

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

I’m a 23 year old male with thinning hair to what has been diagnosed is a 5A pattern. Unfortunately, i’m one of those few who cannot use propecia. I’ve tried it at the 1mg and .5mg doses, but experienced libido/ejaculation side effects both times after a few months. However, i use rogaine 5% 2x daily. I wonder if you would ever consider operating on a young male who IS NOT on propecia. I know there is a risk of shock loss, but how big is this risk? What if you transplant hair in a pattern that will still look ok if the future hair loss occurs? Although i’m not going to get a transplant tomorrow, I am curious as to what you have to say on the matter. Thanks.

It is true that finasteride may be causing the decreased libido, as it occurs in 1 to 2% of the males who take the medication. A decreased volume of ejaculate is also a known side effect reported in over 10% of men. However, there is also a possibility that your sexual problems may be related to other problems, such as other medications (antidepressants) or uncovered medical issues. At face value, if finasteride is the cause of your sexual issues, hair transplant surgery is still an option. You do have a higher risk of shock loss, but the risk versus the benefits must be discussed in depth with your treating physician. It is not a perfect world! The best way to find out if finasteride (or dutasteride) is causing your reduced libido is to stop it for 2 weeks and see if the side effect disappears — but as I am not your doctor, this is not me telling you what to do! Discuss this with your physician, please.

Tags: propecia, finasteride, dutasteride, avodart, shock loss, hairloss, hair loss, hairtransplant, hair transplant

Increasing Density of Pubic Hair with Transplants

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

can i get an idea what the price would be to increase hair density in pubic area? male 50 yrs, good health. donor area good.

We charge per hair graft — a hair graft contains one, two, or three hairs. Generally, a hair graft is approximately equal to two hairs. Our complete fees are available on the Fees and Financing page, but in short it is $6 per graft (or $5 per graft on stand-by basis).

The pubic area requires anywhere from 500 to 1000 grafts. This is an over-generalization and depending on the patient you may need more or less.

Tags: pubic, hairtransplant, hair transplant, surgery, procedure, fees

5 Months After Transplant, There’s a Tiny Lump in the Transplanted Area

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

i had a hair transplant about 5 months ago and everything seems to be fine and the hairs are growing fine, however recently i have had a tiny small raised lump on the transplanted area which looks slighlty red and hurts to touch. It doesnt look at all infected. What might this be and will it go its self.

It is probably an inclusion cyst (ingrown hair or a pimple). Warm compresses or a simple incision and drainage (squeeze out the cyst) should do the trick. This should have been a part of your normal post-operative care instructions. You should speak with your surgeon.

Tags: hairtransplant, hair transplant, cyst, pimple, bump, hairloss, hair loss

Is There a Recommended Hairstyle After a Hair Transplant? (with Photos)

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

Hi Dr. Rassman,
I am 33 years old former patient. I was wondering what kind of hair style you recommend for patients who have had a procedure done? I have great coverage in the front but it gets a little thinner towards the back which however, is a huge improvement from my balder self. I would love another procedure, but I have had two so far and I think I will have to wait financially to afford the third one. Until then…is longer on top better or is shorter better? I sometimes feel a little more “exposed” on top when I cut my hair short revealing thinner hair. I was also wondering about highlighting my hair for a thicker look? I have dark blonde hair currently.

Thanks and happy holidays

If what you’re asking is for hair style decisions after the new hair growth is starting, look to the photo galleries on NewHair.com to see all types of hair styles used by transplant patients. There isn’t one best way to style your hair. Some opt to keep the hair a little longer to cover thinner areas, but that is really a patient decision, not a doctor decision. In other words, I don’t really have any styling advice.

Since you have had previous procedures, you’re intimately familiar with how the recipient area looks immediately post-op, but I’ll use this opportunity to answer one of the most frequent requests I get from people — to see what a hair transplant looks like just days after it is done. Many are concerned that they will be a walking billboard for surgery, and understandably so. I tell these patients that if they had any hair in front, they could cover the hair transplants. Of course, each person is different and your redness level may differ from the patient below, but here are photos taken just 12 days after a procedure of 1,959 grafts, showing a patient who used his existing hair to cover the transplanted area (only one side is shown in these photos which reflect half of the total number of transplanted grafts he received). Note that when you zoom in on the photo, most of the hair has already fallen out (and will return sometime between 2-5 months).

Click photos to enlarge.

 

Tags: hairloss, hair loss, hairtransplant, hair transplant, photo, styling

Late Onset of MPB? (with Photos)

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

Hi Dr. Rassman,

Consider this permission to use the photos if you use my question.

51 years old, full, thick head of hair until recently. I have been thinning for about 2 years I guess, it has been a few hairs here and a few there. Didn’t think too much of it until this last 6-8 months when it really seemed to accelerate. My brother is 59 and has no balding in the crown/vertex. I started on Propecia in December of this year and have been tolerating it well. So far no side effects. Have a very stressful life ( I’m in Healthcare ! ) and this Year has been the worse.

My question is ? I would like to try the propecia for a full year to see if it can help. Given my age and late onset of what I think is MPB do you think this is a good course of action ? At what point would I be a candidate for a hair transplant ?

Thanking you in advance, maybe one day we will meet !

 

It is unusual for a man of your age to start genetic hair loss, but I have seen it before. You want to make sure that you do not have a medical illness that is causing it. Propecia is most effective with recent hair loss of 2-3 years duration. Thank you for giving me permission to post your photos (click them to enlarge).

You have some options. You can try taking Propecia for 8-12 months. As a general rule, the older you are, the less likely will be the response, but with your gray hair, any response will add value and with the 2-3 year history of hair loss, you may break the ‘rules’. If you still have no response after that period of time and wish something done about it, then a hair transplant may have value. Alternatively, you can have a transplant and take Propecia. There is no doubt that the hair restoration will be good with the transplants alone, and any gain you have from the Propecia is a bonus. The more the grafts, the better the fullness if you go forward to transplants. I’d estimate between 1000-1500 grafts might give you reasonable coverage.

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

I’m Worried That When Cleaning My Transplant Scabs a Week After Surgery, I Injured Grafts

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

I had my first transplant recently and the washing of my scabs did not go as smoothly as planned. In other words on day 6 or 7 my scabs were such that they felt soft enough to gently scrap, which I did. The stress for me was that many, many hairs accompanied those scabs for which made me think, did I lose the entire transplanted graft? Some scabs had a fatty white tissue attached. Am I okay? A tech stated not to worry as the hairs are their permanently after the first couple of days, is that true? I was very gentle during the washing process but am concerned that I may have lost the entire graft?

Generally, when the scabs are off, there is no risk of graft loss. When there are scabs present, you can pull out the grafts if you are rough with it, but at a week, it would be unlikely. Most people see scabs and hair and something that looks like a graft to the untrained eye, but it is generally not grafts at a week. For more info, please see:

Tags: hairtransplant, hair transplant, healing, heal, scab, scabbing, hairloss, hair loss, graft

I’m 18 Years Old with Norwood Class 2 and I Want a Hair Transplant

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

Dr.Rassman, I am an 18 Y/O male Suffering from MPB which started at 15 and I Am wondering if there are any Hair transplant options For me, I Realize the problems that can arise when getting a HT at this age which is why a surgeon like you who maps out future progression hair loss plans Is a must, I understand you prefer not to Perform HT on people below the age of 25 And 18 is clearly well below that margin, however I have been on propecia for over a year now And have been using rogaine for the past 7 months, alas Neither have stopped the progression of my MPB Although propecia has slowed it down and Rogaine has improved my temples. I have moderate expectations And do not expect the hairline I had at 13 but any improvement would be a blessing.

I’m a nw2.5 and my hairloss is very zig zaggy along the frontal hairline with the classic M shape above the temples then another M shape at the widows peak, I can send pics If that could assist you. I have bad miniturization along the frontal hairline, Moderate behind that and then healthy hair behind that giving me a less then acceptable hairline to say the least but overall decent coverage.

My father is a nw5 at 50 as well as all his brothers so I believe that is the direction I am heading in currently(although none of them ever tried propecia or rogaine so I do not know how mine will develop on my current regimen.

Thank you for your time any help and advice would be greatly appreciated.

Norwood Class 2While the real rule might be “never say never”, I need to know about my patients before undertaking any surgery on them. One might ask, with being a Norwood Class 2 and wanting a hair transplant, could you possibly be body dysmorphic? That is something I will understand when we meet. A Norwood Class 2 patient having a hair transplant may be doing more damage to the patient than they suspect. I’ve posted similar commentary in the past on this subject:

Tags: hairtransplant, hair transplant, norwood, class, hairloss, hair loss

Won’t I Have to Keep Having Hair Transplants Year After Year to Keep Up With the Loss?

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

First of all, thank you so much for taking the time and trouble to maintain such a wonderful resource that this website is.

My question is about getting a hair transplant procedure. A recent question posted in this forum concerned a patient that had nine transplant procedures. You advised him that you see no reason that a person should not be completed within 1-2 sessions.

My specific question is this: I have a receding hairline and loss at the crown (typical MPB). Since I will, in all likelihood, continue to bald further what is the point of getting a hair transplant? The transplanted hair, as I understand it, will not be prone to balding, but all the hair around the newly transplanted hair will. I will have to play catch up for the rest of my life, or at least until I run out of donor hair, right? For example: If I have a transplant procedure to fill in my receding hairline, what happens in a few years when it recedes even further and away from the newly transplanted hair? Won’t I have to continue playing catch up and chasing the recession?

Yes, you are right. Please keep in mind that not everyone balds completely. The patterns of hair loss (see below) are end stage patterns in many men. So if you are a Norwood Class 3 balding pattern and that is your genetics, that is where you will end up and once you put the hair back through transplants, you need never worry about ‘catch up’ hair loss. If you are going to be a Norwood Class 6 and you’re transplanted while still in the early stages of your hair loss, you will continue to lose hair (taking drugs like Propecia will slow this down).

Of course, we do not have a crystal ball to tell us what our long term worst case pattern will be, so that is why you need a Master Plan and a great doctor to work out the best and worst case scenario for you as you grow older.

Norwood Chart

 

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

My Hair Transplant Is Growing At an Unnatural Angle (with Photo)

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


Hello Dr. Rassman,

Thank you so much for the service you provide the public with this site. It must be alot of extra uncompensated work for you, I appreciate it.

I got a 1300 hair graft about 9 months ago to the area that I roughly outlined in red (on both sides of my head of course, I am only showing one side). As you can see it is growing at nearly a 90 degree angle on my head whereas my natural hair falls forward. Even though I cut my hair at the same length, the transplanted area looks twice as long because it is growing directly ‘up’. My two questions are this: 1. Is this a lack of skill on the doctors part that it is growing at an unnatural angle? and 2) if I keep trying to comb it forward can you gradually adjust the natural angle of the hair so that it matches with the rest of my hair as to the angle that it grows (or will the transplanted area permanently be at odds with my natural hair growth angle)?

My doctor recommends a second procedure because as you can see the transplanted area looks quite thin. I am 26, do you see any concerns with having a second procedure done with this doctor, or do you sense a lack of skill and I should look elsewhere? I have minor thinning in the crown area as well, but I do not plan on transplanting anything to that area. I have been on propecia for 9 months, and while it has not totally regrown the crown area, I am hoping that it will prevent further loss in that area.

Many thanks, and feel free to post the picture.

 

Thank you for permission to post your photo. Please click the photo to enlarge.

You are correct. It seems your hair was transplanted at different angle than your native hair. The surgeon planning for the correct angle and direction of hair is a very important factor in a hair transplant procedure. Unfortunately, this is very difficult to correct and relatively impossible to reverse. Your transplanted hair will always grow in that unnatural direction. One of your options is to have another transplant procedure and make sure that the new transplants are in the correct direction to “blend” in with your hair.

With respect to a second surgery with the same doctor, you need to be able to trust the doctor before having any procedure. Doctors are human beings and they can make mistakes or misjudge the many decisions that are before them in a treatment plan. If you and your doctor have a good trusting relationship, I am sure he/she will see the difference in angle and your concerns and will be more than happy to accommodate accordingly. The key here is to directly discuss this with your doctor first, and then make decisions on the value of the doctor/patient relationship.

Tags: hairtransplant, hair transplant, photo, angle, surgery, procedure, unnatural, hairloss, hair loss