I Want My Hairline Lowered an Inch

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

(female)
I’m 16 years old born with a high hairline just about 3 inches. I’ve saved about $5,000 to get the procedure to lower my hairline and was wondering about how much would it be to take off half an inch to an inch. i have a widows peak and wonder if you can fix that too. what would be an estimate and could there be any payment plans. i’d love to have this procedure done before i turn 21.

The fee for a hairline lowering procedure is $8,000 (icludes all anesthesia and facility charges). The hairline lowering procedure is like a reverse brow lift and this is often the way women get a lower hairline. The widow’s peak would have to be assessed separately.

Alternatively, hair transplants could lower the hairline as well. This is, of course, what we do regularly with men and the fees are based upon how much hair is moved (price per graft). I would be happy to review your case confidentially if you send in a picture. Please reference this post if sending.

For more about hairline lowering, see Dr. Kabaker

Tags: kabaker, hairline lowering, hairloss, hair loss

Scalp Tunnels and Attaching Wigs to the Scalp

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

Received two semi-related questions, so I’ll answer them as one —

Hello,
Several years ago I had tunnel graft surgery and I’m now in need of the clips. Can you advise me on a source where I can find them? It’s been rather difficult to locate them

Someone told me that you could sew a wig into the scalp. Is that true and does it work?

Unfortunately, I do not know who might sell these clips.

For those of you who do not know what a scalp tunnel is, it is described in PubMed as:

A new procedure for attaching a hairpiece to the scalp is described. Two skin-lined tunnels in the anterior and posterior scalp are built, using a strip of free full-thickness donor skin fron the postauricular area. Silicone-coated metal clips, suitably fashioned from .062” Kirschner’s wire, are then attached to the hairpiece. The metal clips are inserted into the skin-lined tunnels and thereby anchor the hairpiece to the scalp.

These permanent tunnels (more like bridges made of scalp skin) are created to hold a wig (also known as hairpiece or hair system) in place instead of glues or tape. It is a barbaric and deforming process, not considered anyone’s standard of care today. Note that the description on PubMed is dated October, 1976.

There have been many things that people have done that are (in hindsight) a little nutty. There are three ways that I have seen the wig attached to the skull.
Sew scars

  1. The picture on the right was of a patient who went to a company in New Jersey who hired retired doctors to actually sew wigs through the scalp skin directly (see photo at right of patient with scars from this procedure). These almost always got infected and when the patient came back to the doctor, the stitches were switched to a non-infected part of the scalp. As you can see from the pictures, the scalp was heavily scarred from the infections. At one point, I was hired by the New Jersey Medical Board to prosecute the doctor, but the doctor was replaced by another who then went through the same legal process. When the State tried to shut this company down, the company closed down and opened under another name. I do not know if they are still playing this ‘cat and mouse‘ game with the State of New Jersey.
  2. A doctor actually drilled a metal connector into the skull. The wig had a male like clips that connected with a mechanical fit to the part that was drilled and cemented in the skull. The wig could be buttoned in and out with great ease.
  3. The art below shows skin tunnels (an old procedure that required a skilled surgeon to fashion in the scalp) which are use to tie ‘shoe laces’ that were attached to the wig. The process was promoted as simple as putting on and taking off your shoes (except you just did it with your wig).
Tunnel
Tags: scalp tunnel, surgery, wig, hairpiece, hair piece, hair system

I Want a Wider Forehead

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

Hi, my forehead is small and boxed. I went to the barbers who did a shape up with a blade (straight-razor), to make my forehead wider, but it grew back. Everytime I have a haircut the barber shaves the hair connecting my forehead to my sideburns. I think thats why my forehead has become like this. I’m pretty sure it wasnt like this when i was little. Is there any natural way my hairline could be restored, or any other ways to make my forehead bigger by adjusting the forehead hairline??

yours faithfully

p.s. thank you

I am not sure what you are asking. Perhaps you can send me a picture (it will be kept confidential). Please reference this post when sending.

There is no forehead widening procedure, but there is a forehead lift (standard procedures done by plastic surgeons) which will accomplish the goal of raising your hairline, but the eyebrows would be lifted as well. I would suggest that you get an opinion from a plastic surgeon, or at the least send photographs to me as suggested above.

Tags: forehead, plastic surgery, surgeon, cosmetic surgery

Hairline Lowering Questions

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

hi, i’m a female with a high forehead. I want to do a lower forehead surgery. I have some questions about the surgery.

  1. will it be local anesthesia or will i be put into sleep.
  2. how long will it take to look normal after the surgery.
  3. will the scar be obviou during the recovery period?
  4. will people notice that i did a surgery if i go out one week after the surgery?
  5. do you have any recommendation for doctors in toronto area?

Thank you very much for your time.

I will answer your questions as if you mean the hairline lowering procedure through excisional surgery, and not hair transplantation.

  1. This procedure is usually done under local anesthesia with some sedation.
  2. The effects are immediate, although there is swelling for up to a week. There is a scar at the hairline, so if you have bangs you should use them to cover the hairline scar. These scars are usually detectable for a few weeks. A small number of people will develop a white scar at the surgical site which can easily be treated with a limited hair transplant.
  3. Yes, the scar may be obvious while healing, but most patients can cover it pretty well with their existing hair.
  4. It depends on your art of styling that you use to cover the incision area and the lower hairline. As I said above, the use of bangs is a good idea because the new lower hairline should be introduced slowly so that the change will be more transparent. In a hair transplant, the change is so slow that no one usually notices it, but with this more radical surgery the final results of the new hairline is instantaneous. If you want to pull the hair back, the incision could be seen.
  5. No, unfortunately I do not have a recommendation in Toronto. Check with a good plastic surgeon in your area. Look for recommendations online, I suppose.
Tags: hairline lowering, hairloss, hair loss, hairline, surgery, hairtransplant, hair transplant

Body Hair Transplant Results

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

Hello doctor, long time no talk. I recently found this on the internet regarding a hair transplant where the patient took hair from his leg and arm. The results look good.

Caution: Some pictures might be a bit bloody for some readers

https://hairsite.com/serendipity/authors/27-sofarsogood

Also, I notice that a lot of patients who have HT’s seem to grow their hair longer after the transplant and keep it that way. Is it because they want to cover up the other balding areas with the long hair? Can you get a HT and keep your hair short and still have that “full look?”

I am having difficulty with the first picture on the referenced site. This is not a hair transplant, but someone with a thick, natural head of hair. From a legal point of view, the inference that this representation of a transplant is fraudulent and violates consumer laws in most states. It may have just been an example of what the patient wanted, but to have it presented in the same reference with before and after photos is poor form.

Many hair transplant patients elect to comb their hair back or to the sides and keep it long. Longer hair covers better, but with good densities transplanted, short hair is not unreasonable. I tell patients that when they get a hair transplant, they create the illusion of hair, not the reality of it. Long hair with good grooming goes a long way to do this. The illusion I am talking about is basic to the math in hair demand/supply hair economics (see Patient’s Guide — How Many Grafts Will I Need?). If a person loses 60,000 hairs and gets a transplant that makes him look good with 10,000 hairs, then this is clearly an illusion, not reality. I have found that in people with good hair characteristics, low contrast hair to skin color, wavy, and coarse hair can get great results with as little as 20% of their hair returned through transplants. That, of course, requires an artistic surgeon and the budget to afford the process.

With regard to your situation with 15 hair transplant procedures, you may be running out of hair. Body hair may be a solution, but there really is not good data on it so you would have to be a guinea pig for human experimentation. This is not standard care. I would give you a one on one consultation if you are in the California area.

Tags: hairtransplant, hair transplant, body hair, bht

Hairline Lowering Doctor Recommendation?

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

I am very interested in having the hairline lowering procedure. Do you know of any doctors in the OK area or anywhere close?

A hairline lowering procedure is done by plastic/cosmetic surgeons and a small number of doctors in the hair restoration business. You might check locally with those in this area of specialty. If you want to travel to California, I would be happy to consider doing this procedure, or I would recommend Dr. Sheldon Kabaker in Oakland, California.

Tags: hairline lowering, lowering, hairline, hairloss, hair loss, surgery, cosmetic, plastic surgery

What to Do About Hair Loss After Gastric Bypass Surgery?

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

(female) Hi….I’m 29 years African American and lossing hair do to the “Gastric Bypass Surgery”.What can I do to help my hair.I eat the protein like I was told too,can I buy anything…Thank You!!

This topic is also discussed in this post: Hair Loss After Gastric Surgery.

To reduce the hair loss after a gastric bypass surgery, you need to stick to your doctor’s diet recommendations that will help you to maintain your minerals, vitamins, and proteins at an optimal level. Patients need to be tested for several factors including vitamin B12 after the surgery on a regular basis. This helps your doctor to diagnose the deficiencies and treat them promptly before they can affect your hair. Stress can also cause hair loss and these surgeries bring on some stress.

Tags: gastric bypass, gastric, hairloss, hair loss, vitamins, minerals

Burned Scalp, Missing Hair

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

about 2 months ago i had a seizure and i hit my head on the radiator in my bathroom. it looks like a long pole and it was burning hot, to the point where you cant even put your hand on it for more then 3 seconds. i became unconscious and i dont know how long the back of my head stayed on it. needless to say i didnt feel any pain when i awoke so i know i must have damaged the nerves because im also a nursing student and i learned about 1st, 2nd, and 3rd degree burns. that day the spot became very red and then it started to char and it took weeks for it to start peeling and there was some fluid in there. the size is about 2 half dollars in a circle. i dont see it growing back and i dont think it will either because its extremely smooth and like i said its been 2 months already. my question is what can i do for it and if i need surgery what kind of surgery? how much does it cost and where do i go? thank you

You burned your scalp 2 months ago and as of yet you have not grown any hair there. You have a blister on the burned area, which means you had a 2nd degree burn there. As a general rule, a 1st degree burn is superficial and does not involve hair follicles, so they usually don’t cause permanent hair loss. 3rd degree burns are deeper and usually damage the entire hair follicle and cause hair loss, and they may also damage nerve endings and cause numbness in the area.

In your case, with a 2nd degree burn they are in between and may or may not damage hair follicles permanently. You have to wait for about 6 months and by then if you are not growing hair in the bald spots you may want to consider hair transplantation. At that time you could be evaluated to see what could be done for you if the need is there. For now though, my suggestion would be to just wait it out.

Tags: scalp, burn, hairloss, hair loss, burning, radiator

Harvesting Armpit and Pubic Hair for Transplanting to Scalp?

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

I’m 39 and I’ve a thinning crown, and there is a diffused patch on the vertex, and very thin, soft hair with not much density at the back of my head. I’m already using propecia+minoxidil But i don’t see any improvements.Given this i would like to explore my options of using armpit hair and pubic hair for hairtransplant on to my crown using FUE. At the same time i ‘m concerned about donor transection rate for armipt hair and pubic hair ( how difficult it is to harvest this hair?) and the shock loss at the receiving crown?? Can you please let me know my options. Most of the hair transplants i have seen only show frontal hair line but not crown.

ArmpitIt is good that you started using Propecia for your thinning crown hair. Although you don’t think you had improvement with medications, I think it is best for you to continue the Propecia, for you never know how your crown would look if you were not taking the medication. Propecia should be the first line of treatment of crown hair loss in most patients. The next option is to fill the crown balding area with transplants using permanent hair from back of the head. Using the hair from this area is well established for transplant to your crown area. Body hair, as we’ve discussed on this site many times before, is not a good substitute for scalp hair, because of its long sleep phase and limited length. The amount of under arm hair in available numbers is low and the hair is kinky, much different than head hair. The same is true for pubic hair.

Pubic and armpit hair in particular have different characteristics than scalp hair. They are limited in numbers and should be reserved for the cases that no other alternatives are available and when the hair can be used for ‘bulk’ rather than a frontal presentation. If the scalp donor hair is severely diminished and you opt to get a body hair transplant with the FUE technique, a FOX test must be done to evaluate your candidacy for the FUE procedure and you can anticipate the damage from such a procedure in advance. If the FOX test is positive, it means your hair transection rate is reasonably low. With that said, unless you have no donor hair available from the scalp, please think traditional transplantation.

Tags: hairtransplant, hair transplant, hairloss, hair loss, body hair, bodyhair, pubic, armpit, bht, body hair transplant, body hair transplants

Daughter Was Burned, Had 2 Expanders in Her Head

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

I have a 9 year old daughter that was burnt as a baby. She has had two expanders on her head. There has been great improvement. However, there are still few spots that are bald and there is no hair. Is there any solutions available, as the hair is quite thin and probably no more expanders will be recommended. I would greatly appreciate any guidance you can provide. regards

Excising a scarred area and using expanders to provide more flexibility with flaps, could create a drastic improvement. If there are still some bald spots in your daughter’s scalp, they might be filled through hair transplantation. A hair transplant could be used successfully in the selected thinning area to give more coverage in areas that are cosmetically more important, but you need to be evaluated by an expert. The first place to start is back at the doctors who did the expanders for her. I would be happy to see her, but you need to be in or near California for easy access to me. In this case, photos will not be adequate and a personal examination is needed.

Tags: expander, burn, repair, hairtransplant, hair transplant, hair loss, hairloss

Castration To Treat Hair Loss

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

Hello Dr. Rassman,

In one of the rare on-topic posts to the Usenet group alt.baldspot, someone cited a study from the U. of Washington investigating, among various things, a chemical called acyline:

https://groups.google.com/group/alt.baldspot/msg/d2a641313cf28285

They suggest that it can be used as an agent to induce medical castration (suppressing testosterone production?)

I imagine you’d have a rough time finding a doctor who’d prescribe any such thing, but in theory, would such treatment stop balding cold, more completely than would a 5-alpha-reductase inhibitor? If I’ve gotten the processes down properly, DHT production is not possible in the absence of testosterone.

I imagine it’d also completely eliminate one’s libido as well. Maybe I’m nuts to think it, but I doubt that’d bother me. It’s not been of much use to me anyway, but losing my hair is going to pretty quickly kill off whatever hope remains for the future.

Well, thanks for reading. The accolades on the site from your readers are well deserved.

Castration
Castration of a male will stop the balding process. What hair loss that happened prior to the castration will not reverse. So if you lost all of your frontal hair and are starting to lose the crown hair, being castrated (medically or surgically) will not reverse the frontal hair loss, but will probably halt the hair loss in the crown. Sounds like you are depressed. You might seek help.

Tags: castration, hairloss, hair loss, acyline

Hair Loss After Gastric Surgery

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

I am 65 years old and in Aug 06, I had gastric surgery due to 5 yrs of partial bowel impactions caused by scar tissue & adhesions formed from previous surgeries. Also 10″ of colon removed. Since then, I have had excessive hair loss from scalp whenever I comb or wash my hair. Also, I’m using Roux Rinse Temporary Rinse weekly. What do you think could be causing my problem? Is there a cure or medicine I can take?

A big surgery can trigger telogen effluvium and accelerate hair loss. You can also read the post, Hair Loss and Gastric Bypass. Your surgery could have caused hair loss through two mechanisms:

  1. Stress of a big surgery and compensatory mechanisms of your body to divert nutrients toward vital organs.
  2. Removing part of the intestine can cause mal-absorption. When there is rapid weight loss, hair loss is not uncommon.

In those people with the switch for genetic hair loss inherited, the switch can be turned on by either stress or weight loss. Both of these conditions can either be temporary or permanent. Make sure you have a balanced diet with adequate amount of proteins, vitamins, and minerals.

Tags: gastric, bypass, surgery, hairloss, hair loss

Hairline Lowering Procedure

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

can you lower a woman’s hairline without transplants?

Yes, the hairline can be lowered by a technique that differs from hair transplantation. In this technique, a strip of skin is removed from just below the frontal hairline and a trichophytic incision will be used to blend frontal hair into any scar that forms. The cosmetic result of a lowering hairline surgery is immediate and it is less labor and time consuming compared to hair transplantation. One disadvantage of this technique is the possible presence of a linear scar at front of the hairline. The scar could be hidden with a minimal delicate hair transplant surgery in front of it for a better cosmetic result if it is a problem. See other posts on this subject here.

Tags: hairline lowering, hairloss, hair loss, hairtransplant, hair transplant, women, woman, female

Can Eyebrow Hair Grow Through Scar?

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

I have a four inch skin lacerasion on my forehead. The skin was cut very deep and stitched back together. The scar extends right under my right eyebrow. I was wondering if my eye brow hair can still grow under the skin that was torn by the accident and stitched back together.

Hair may grow in the scar. I have performed eyebrow transplants in people who had terrible facial deformities with considerable success. Hair transplants work well at hiding scars when properly done in the hands of an expert.

Tags: eyebrow, transplant, hairtransplant, hair transplant, scar