Female Hair Loss After Gastric Bypass Surgery

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

I had gastric bypass surgery 2 years ago and my hair is thinning. My hairdresser recommended 1500mg biotin. I am a female 52 yrs. Can this help?

Hair loss, and change in hair color and hair quality after gastric bypass surgery are common problems and typically happen within the first year after the operation. Your body goes through a period of severe starvation and tries to divert nutrients toward more vital organs. Although carbohydrates, proteins, minerals, and vitamins (especially the family of vitamin B) have been blamed for the hair loss, the exact mechanism of this problem is not known and multiple factors might be involved. The good news is that your hair loss after gastric bypass is usually temporary and will be improved when you get out of the rapid weight loss situation. Any patient who had a gastric bypass should have frequent doctor visits following their bypass surgery as the procedure is associated with incidence of iron, vitamin B12, folate, calcium, and vitamin D deficiency. You need to be on supplements of minerals and vitamins and you should also be monitored with regular laboratory tests for these deficiencies. Please keep in mind that gastric bypass produces medically controlled malnutrition to force weight loss.

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

Permanent Make Up on the Scalp?

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

Hi Dr. Rassman. I recieved two hair transplant procedures in the late 90’s with micro/minigrafts. I just recently had them removed with lasers. It took me 11 sessions but i got there. I proceeded with 3 micropeels. I’m sad to say that I’m really not satisfied with the results. I want to know what your opinion is on permanant make up on the scalp? I really don’t want to proceed with anymore surgeries…You’re feedback would be greatly appreciated. Please note if you’ve ever seen permanant makeup on a hair transplant recipient ..thanks so much

I have seen quite a few people who had their scalp tattooed. I would suggest that this may not be the best approach for you. I will assume the the peals left you with discolored skin and the transplants that were lasered also gave you a less-than-normal looking scalp. Your situation is a complex one to solve since you have gone through all of the things (number of surgeries) you had. I would be happy to see you, but a face to face meeting is the only way I might be able to help you or anyone in a situation similar to yours. I have always said that the good and the bad news about scalp and hair surgery is that these are permanent procedures. You can try to undo what was done, but the results will never quite be 100% to where you once were. This is why researching your doctor is important and this is certainly why understanding what you are getting into is extremely important — before you ‘dive in’ and that goes for any procedure, cosmetic or otherwise.

Tags: scalp, tattoo, makeup, hairloss, hair loss, hairtransplant, hair transplant

Can the Triple-Flap Procedure Give Me a Full Head of Hair?

/by William Rassman, M.D./3 /,

Hi Dr. Rassman,

Can someone who is completely bald (everywhere, except the very back and sides) have a full head of hair like that of a teenager by the triple-flap procedure?

Is there any procedure or combined procedures to give a completely bald person that final result?

Best regards

There was an article in the news last week about this very procedure, which I am assuming is what prompted your inquiry.

The triple-flap is a corrective procedure, generally used to repair patients where slot deformities were created by scalp reduction scars (surgeries that tried to remove the bald spot). This article seems to be misleading, because it does seem to make clear enough that the triple-flap procedure should only be used to repair deformities of the scalp. If there are defects in the scalp that are not the results of multiple scalp reduction surgeries (like a burn), then many of these people need balloon expanders to shift large areas of the scalp. In any event, this is a very specialized field and something that I can not comment without examining you. Please send me photos (you may cover your face) and I will evaluate what you are talking about.

Tags: hairloss, hair loss, flap, triple-flap, triple flap, tripleflap, corrective, hairtransplant, hair transplant

Eyelash Transplants in the News

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

Dr. Rassman, It was great seeing you at the ISHRS conference. In Los Angeles last week, I demonstrated my ‘follicle-pairing’ technique for eyelash transplantation for an international group of physicians and journalists. As such, you might be receiving some questions regarding this ‘hot topic.’ Here are some of the relevant links to cosmetic and reconstructive eyelash transplantation procedures:

ABC News – Video

Reuters – Eyelash transplants set to sweep nip tuck world

Before and After photos of eyelash transplants can be found at https://www.eyelash-transplant.com

There has been great interest from recovered trichotillomania patients as well as those seeking the procedure for cosmetic enhancement. Please let me know if you would like me to provide any additional information on the procedure for your readers.

Talk to you soon,
Alan

Alan J. Bauman, MD

Eyelash transplants have risks associated with them and that has kept me from doing them without clear medical documentation of those risks. Hair direction and rotation are difficult to control with 100% precision in an eyelash transplant. My concerns are that the hair may ingrow and folliculitis of these grafts could cause various eye problems. I have seen a number of eyelash transplants and had one doctor try to build a practice doing them in my office (an ophthalmologist using my staff and facilities). I was less than impressed with the limited results I viewed, although I did supervise the actual placement of the grafts into their respective recipient sites. I would be interested in following Dr. Bauman’s results. I am sure he will keep me in the loop as time goes by. I will certainly followup any patient that has an eyelash transplant. The field is exciting and just emerging, so I am always cautious as I follow such new applications.

Tags: eyelash transplant, eyelash, hairtransplant, hair transplant, hairloss, hair loss, bauman

Body Hair Questions

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

Dr. Rassman & Dr. Pak-

I want to first thank you both for providing this blog. After looking online for some quality information and only coming across gimmicks – this is the first website I’ve found that I feel like I can trust.

Ok, here’s my question: I know you said you do not typically do body hair to scalp transplants. But bear with me here…

1) Does where the hair is growing determine the amount of pigment and texture of the hair? If body hair was moved to the scalp – does it continue to look like body hair?

2) I am a hairy guy, body hair wise. Head hair, I’m thinning. What if my body hair growth cycles are just different? Do they slow down over time? I trim my chest hair about once every 3 weeks. It would probably grow a half inch per month if I let it.

Btw, I’m a 25 caucasion male.

I read a great deal, so here are my answers based upon my understanding. Hair moved will look like the hair did at the source (donor site), but it may grow longer based upon recipient sites influences. Body hair on the scalp will continue to look like body hair on the scalp.

The length of time that body hair transplants being studied seem to be about 8 years or so. There appears to be an increasing growth rate possible when hair is moved (say from the leg to the scalp). Hair cycles may also change, but not enough to compete with scalp hair (king of hair growth length and cycle times of up to 6 years or so). If you let your body hair grow to length, I doubt that it would continue to grow longer and longer. Every body hair has its growth cycle which dictates the time the hair will be in anagen. If a body hair grows 4 months at a rate of 1/2 inch a month, it would grow out to 2 inches maximum before falling out. I am sure that if you checked your bed sheets and your body hair is dark (easiest to see with white sheets), you will see a constant shedding on your sheets if you let your body hair grow out.

Tags: bodyhair, body hair, growth cycle, hairtransplant, hair transplant

Scarring in Donor & Recipient Area, Body Hair, FUE

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

Hi Dr. Rassman,

I’m considering going in for a FUE hair transplant and I understand that there is minimal scarring involved. I was reading up on the New Hair Institute web site and noticed there are many “mini” scars. Will these scars be only in the donor area or where there is transplanted hair?

I’m also considering using body hair as a viable source for donor hair. I’ve seen a few surgeons doing this. Have you personally performed such an operation? I would love to hear your thoughts on this procedure.

Best regards.

Follicular Unit Extraction (FUE) produces very small scars in the donor area, usually less than 1mm (there are 25mm to an inch). The only way most people could see these scars is a complete shave of the head (not a short hair cut, which probably would not show any of these scars). In the recipient site, the grafts are always trimmed (in our office, anyway) to cut away the unnecessary skin so that these grafts should not produce any visible scar in the recipient area. My understanding from the recent ISHRS meeting in San Diego, is that most surgeons doing FUE do not trim the grafts and therefore may get very small recipient area scars.

I have commented on body hair transplants before, but I’ll recap the biggest problem with them. Due to the short growth cycle, body hair will not show up very well (quantity) because for every body hair that is transplanted, less than half of them will be in growth phase at any one time. That means that less than 50% of the hairs will grow according to what you can see. At the meeting in San Diego, one doctor who does a lot of body hair transplants showed two patients who had them done. The growth in numbers was far less than 50% of what the two patients and the doctor reported was put in at the time of the surgery. The only good news about what I learned at the meeting with regard to body hair is that the length of the hair does double to what the person had in the chest or back (natural position). I would want to have a face to face meeting to understand your focus on the body hair, why you wanted it, and to see what else was available to meet your needs.

Tags: hairtransplant, hair transplant, fue, body hair, bht, bodyhair, hairloss, hair loss, scar

Restoring the Moustache

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

MoustacheA few years ago i had some stiches places on my mustache area and it left a scar and now hair doesnt grow in the places that the stitches were placed.

I was wondering if you know of any product, surgury or any other possible solution that could allow hair to re-grow in the spots that the scar is or in other words where the stitches were placed?

Hair transplantation is an ideal procedure to address the scar on your mustache area. At NHI we have even done entire beard/chin areas and recently for a patient who wanted to grow a goatee.

[Note: photo above is of the World Beard and Moustache Championships world champion, Willi Chevalier. Photo used for display purposes only, and not to imply that Mr. Chevalier had any restoration to his facial hair.]

Tags: moustache, facial hair, hairloss, hair loss, hair transplant, hairtransplant

Scalp Reduction After Face Lift?

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

(female) I read on your site about someone with hairloss after a face lift. I had the procedure also about a year ago and I am left with big long bald areas behind my temples. My question is can SCALP REDUCTION method be perfomed to remove the bald areas as opposed to a hair tranplant?

Thank you

I think that you are telling me that there is hair loss above your ears and behind the temple hairline. If that is the case, hair transplants are the way to treat it. I have done hundreds of women who have had this type of problem after face lifts and brow lifts and the results of this surgery has been excellent. Scalp reductions in this area, however, will be disasterous.

Tags: hairloss, hair loss, facelift, face lift, scalp reduction, hair transplant, hairtransplant

Eyebrow Transplant — Training the Hair

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

Hi! I was wondering about eyebrow transplants. I have researched them as a possibility to do, but I have a question. Since the hairs come from the back of the head, I gather that the hairs that get transplanted to the brow don’t lie flat. I read that they have to be trained with gel. Do they eventually lie flat or do you have to plaster them with gel forever? How long does it take to train to lie flat?
Thanks for the info.

The natural angle for an eyebrow transplant is difficult to create artificially. Sometimes the strong hair that some people have will lift up when transplanted into the eyebrow and that compounds any slight increased angle of the transplanted eyebrow to the skin. Training the eyebrow may be important if that is a problem and for many women, the eyebrow can not be trained. For these women, waxing the eyebrow or using other cosmetic adjuncts will control the way the eyebrow lies. Some women have a natural tendency for bushier eyebrows anyway and for these women, cosmetic adjuncts are familiar territory. Most men like bushy eyebrows, so some lift helps achieve a masculine look. The more extreme examples are Albert Einstein — and even me. I would hope that my similiarity to Einstein goes beyond my eyebrows, though. Einstein’s eyebrows may not work well for some women.

Tags: eyebrow, hair transplant, eyebrow transplant

Robotic Controlled Hair Transplants

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

There’s a doctor in the bay area that is claiming to do hair transplants with robots. What is this about? Robots??? Can you tell me more about this?

Robot“Restoration Robotics, Inc. (Mountain View, CA) is a company using image-guided robotic technology to perform hair restoration by emulating the FUE technique. The robotic technology is in development. Currently, it is not approved by the FDA and the technology is not for sale”, said a company spokesperson when I contacted them. I also found this press release about Restoration Robotics from 2003, here.

I can imagine the scene of a movie with robots doing hair transplants, starring 3-CPO from Star Wars. I am sure that we will be hearing more about robotic-assisted hair transplants in the future and I doubt that it will be as frightening as I just made it sound. This is an exciting conceptual solution to the Follicular Unit Extraction (FUE) quality problem.

There is also the Medicamat Punch Hair Matic, first announced in late 2004 in this press release — Punch Hair Matic rescues baldies — which says: “Medicamat of France will be launching its new robot for hair transplantation”. I have been familiar with this company, which purchased the technology from a long term friend in the mid-1990s, Dr. Pascal Boudjema, one of the brightest inventors that the hair transplant community has ever had.

Their press release goes on to say: “The Punch Hair Matic (which is patent-protected) is a robot using micro-instruments to remove follicular units, which makes surgery simpler, faster, and less debilitating for the patient, with more convincing aesthetic results.” They report a very fast surgical time (2 hours to do 700 grafts) for the transplant (appears to be an FUE technique).

In many ways, Medicamat has been doing small punch grafting longer than I have, considering that they have been using smaller and smaller punches for many years. The evolution to smaller punches has been slow and methodical.

Today, the shoppers for FUE transplants pass through a mine field (a ‘buyer beware’ business for sure) where doctors from all over the world (with little or no training) are using manual techniques with varying degrees of success. Regardless of their expertise, they are telling the public that they specialize in FUE and are experts in the technique. At least, the robot approach promises to standardize the technique and the quality of the output. So we have a horse race now between two companies offering what may turn out to be competing technologies. Only the public can benefit here, so I sincerely hope that one or both of these companies succeed in making the business for automated hair transplants work.

Tags: hair transplant, robot, robotics, hair restoration

Cosmetic Surgery Questions

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

I have a couple questions regarding cosmetic surgery.

  1. I had upper jaw surgery in February and ever since my nose has no long matched my face. It is noticeably off center, and it stands out from my face much less than it did before. I know the surgery did not cause it to become off center, as it made the rest of my face more symmetrical, but in order to make my nose match my now symmetrical face the results will have me looking much more youthful and slightly feminine. (Which occurred once already from the jaw surgery) I do not mind this, but then again, I am only 19. People guess my age as between 15 and 16, and I take it as a compliment. If I do go through with the procedure, will my face continue to mature? I have heard that once your nose has been surgically altered it will no longer grow. I worry about being 40 and having the same face I do now… plus a few wrinkles. Boy would THAT look unnatural…
  2. I also was wondering about jaw contouring. My mandible is very straight on one side but for some reason has a rounded area on one side near my chin which does nothing except make my face slightly more off balance. My jaw line is quite prominent and therefore it has been pointed out more times than I care for. I have never heard of anyone actually having their jawline shaved down to create symmetry and I was wondering if it is an actual procedure… and how much something like that might cost financially and in healing time.

Thank you for your time

  1. By the age of fifteen or sixteen your nose has effectively stopped growing. It sounds like you have likely lost projection of your tip and or bridge area. These areas can be improved or corrected using reconstructive techniques including the possibilities of bone and/or cartilage grafts. I do not expect your nose to grow any further at the age of nineteen.
  2. It may be possible for a maxillofacial surgeon to refine your jaw contour. This would depend upon the thickness of your jaw bone in the area to be recontoured, and the possible proximity of sensory nerves responsible for sensation in the area of your lower lip and chin. The surgical team that worked on your previous jaw surgery would probably be best equipped to advise you.

Answers supplied by cosmetic surgeon Jon A. Perlman MD, FACS

Tags: cosmetic surgery, plastic surgery, perlman

Hairline Lowering Procedure for Men?

/by William Rassman, M.D./3 /

I have always had a high forehead which combined witha ralativly narrow face spoils an otherwise very attractive face. wearing a fringe or hat – simulating a lower hairline dramatically increases the balance in my face and makes my face look much more attractive. I have other striking features and work hard on my phsyique, being attractive is important to me and I would like to model in the future. I have been told with a few slight alterations this ambition could be a success!

My hairline starts above the point where my forehead begins to curve back to join my scalp and recedes a lot above my temples.

I am relativly young, 23 and male – with no history of balding anywhere within my family, and feel that even if I were older hair transplants would be unsuitable as I wish to wear my hair short and the thin/unpredictable growth patterns I have seen from transplants is not the look I am looking for.. I am wishing to improve my asthetic not correct a baldness problem, thus the overall result would have to look good and be virtually undetectable.

My question is, have hair line lowering operations (forehead reduction?) being carried out on men, and with what degree of success? How dramatic is the scarring – can it be made undetectable even with short spikey hair? Does this kind of procedure alter the direction of growth of the individual folicles – causing a somewhat ‘wild’ appearence of the hairline?

Most of the information I have been able to gather reagarding this surgery has related to older females, although I have seen that such surgery has been popular with transexuals, and the results here – in younger people – seem to be very positive.

Id appreciate if you could email me any help you can give me!

Thanks

My question is, have hair line lowering operations (forehead reduction?) being carried out on men, and with what degree of success? How dramatic is the scarring – can it be made undetectable even with short spikey hair? Does this kind of procedure alter the direction of growth of the individual folicles – causing a somewhat ‘wild’ appearence of the hairline?

Hairline lowering procedures work as well for men as they do for women. The problem is that 50% of men will experience some form of balding, most in the front of their heads. With a successful hairline lowering procedure, what do you think will happen when the hairline recedes from male patterned genetic hair loss? The answer to this question is that you would bald from the incision (scar is minimal usually) backwards, losing all of the benefits of the hairline lowering procedure. This is especially worrisome for the young man, because the ability to predict hair loss in a 23 year old is difficult, near impossible. You would be taking a risk if you have your hairline lowered now. If, however, you go the transplant route, the look is impressive and totally normal and can be followed with more transplants if balding should occur. One of the reasons that hairline lowering procedures works well in gender changing situations is that the testicles are taken off, so the risks of male genetic hair loss is obviated.

See this previous blog entry for photos of a hairline lowering procedure with transplants in a woman with coarse hair.

Tags: hairline lowering, hair transplants, hairloss, hair loss

Why Not Transplant Hair From the Arm to the Eyebrow?

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

Hello
I had a question about hair transplantation for eyebrows. Ive read through the blog and many articles about this kind of procedure. What am wondering about is, why take hair from the scalp when we know it will act like the hair from the scalp, growing 3 feet or so when using hair from the arm won`t grow any longer than an avergae eyebrow hair.

Would that be a possibility, to actally take hair from the arm insead of the scalp, and not needing to trim the eyebrows after the procedure?

Arm hair will grow like arm hair so you are correct that for delicate eyebrows in a coarse haired person, head hair may be too thick and arm hair in theory might be better. Now with that said, the problem with arm hair is that the telogen (sleep) cycle for the hair is longer than the growth cycle. If you place 10 arm hairs in the eyebrow, only 2-4 of them will be growing at any one time while the rest is in telogen. To address this problem, you would have to transplant at least twice the number of hairs to achieve the targeted densities. Great idea, just not the right hair sleep cycle.

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

Can a Hair Flap Be Removed?

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

i had the hair flap surgery, done back in 1989, when i was around 25, my question is , can the flap be removed from the head??. to be honest i look kind of silly, with this thick hair in the front that grows in the wrong direction…thank you for your time…

To learn what this person is asking about, read more about the flap.

The flap can be reversed, but the scarring is high and it may not answer your needs. There are many ways to manage such a flap. See an expert and be careful that you do not make another mistake. You don’t want to go down a one way street the wrong way.

Tags: hairloss, hair loss, flap, repair, hair transplant