I Want Body Hair Transplants

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

Dr. Rassman,

I have been reading quite a bit about BHT recently, you have done a remarkable job on my hair but I have very little donor area left. Have you considered adding this procedure as it would help many who need additional donor hair, I myself could still use more hair to help fill in old plug donor areas that still bother me. It would be nice to cut my hair to a short length and not worry about the old harvested areas. I ask this because of my respect for your abilities and I frankly would prefer to only have you perform any future procedures.

Thanks

I know how you feel. You just want to be normal again. The problem is that when you have had these old type of hair transplants, you may have given up the ability to be completely normal. Keeping your hair longer and use styling to augment any problems in your look may be critical to being as normal looking as possible. Body hair transplants are a general waste of money with poor results that can be anticipated.

The doctor’s site that you included in your email shows that he has very little experience in this field. Perhaps he just does not know the information that I have covered in this blog many times. I have discussed this in my piece, The Truth About Cheap Hair Transplants, and I would recommend that you read this carefully. As you are a former patient of mine, just come in and let’s take another look to see what can be done, if anything. You know that I won’t do anything just to get into your wallet.

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

Rejection for Cosmetic Surgery

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

Do you ever reject a patient for plastic surgery?

I have seen a small number of patients who seemed dissatisfied with so many of their features (inappropriately), that I’ve recommended self-evaluation and/or psychotherapy instead of cosmetic surgery. Some of these patient admit to being harshly criticized by a parent during childhood, and may have severe self-esteem issues that will not be addressed by the cosmetic surgery process. It is important for patients to be mentally sound, able to understand what cosmetic surgery will and will not do for you. I try to probe the person behind the request to understand if what I can do will truly meet the objectives of the patient. This is a difficult process for the plastic surgeon because each patient does not undergo an extensive psychological analysis, so I have to trust the instincts I have developed over the years. I do reject patients who do not have realistic expectations or those who are psychologically imbalanced.

This question was answered in conjunction with Jon Perlman, M.D.

Extreme Makeover Plastic Surgery

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

I saw you on Extreme Makeover last year. I was wondering if many patients become addicted to plastic surgery once they start doing it?

I find plastic surgical addiction to be extremely rare in my practice. Most patients are genuinely made to feel better and become happier when “flaws” are improved or fixed.
My Extreme Makeover (ABC Network) experience has shown me how for some, a “makeover” can be more effective in improving self-esteem (and be longer-lasting) than psychotherapy.

This question was answered by Jon Perlman, M.D. Dr. Perlman appeared on Extreme Makeover many, many times.

I Had 4 Scalp Reductions And My Donor Area is Depleted

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

Have you considered, or would you consider body hair transplants to the scalp? I was a patient of yours once, but my donor hair is depleted. And since I have had 4 scalp reductions, you could not do the FOX (I believe its called) procedure on me because the folicals were stretched or deformed from the stretching of the scalp. I have resorted to having to wear a hair “system” because even if I shaved my head, the scarring from the donor area would be quite apparent.I am hoping for cloning or multiplication, but these seem to be far in the future, and I am not getting any younger. Do you have any ideas, or have you ever planned to experimetnt with body hair?

Thank you.

Body hair transplants have problems, including the long sleep cycles of body hair. That means that up to 80% of transplanted body hair is sleeping and not present at any one time. Body hair transplants therefore give you efficiency factors, possibly in the range of 20% — in other words, they do not provide much value. Before you go into way out treatments, come see me in Los Angeles, as Phoenix is not that far away.

My Wife Is Pushing For Me To Get a Facelift

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

I am a 55 and my wife is 45. She wants to do a face lift and is pushing me to look into it as well. I feel that I am too young to get a face lift and that it is a better surgery for a woman than a man. Are we too young for a face lift? Is it better to undergo a surgical procedure (i.e., facelift) at a younger age when the skin elasticity is better or at an older age when everything hangs down lower?

My feeling is that one should only undergo surgery when one is excited by the prospect of change and feels that he or she will benefit maximally from the procedure (physically and emotionally). Feeling compelled to have a facelift at an earlier age is ill-advised. The key is to get a good doctor and bond with him/her to help you decide if this is the right decision for you at this time. More and more men are getting facelifts today and the results can be as dramatic as the results we get on women.

This question was answered by Jon Perlman, M.D.

Liposuction

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

Some people tell me that liposuction could leave them with an imbalanced look. Might fat “go elsewhere” if I undergo liposuction?

If you regain weight after liposuction through an imbalance between diet and exercise, the body will find remaining areas of fat cells (that were not removed with the liposuction) to enlarge to take on additional fat. This may be unnoticed if it spreads through several regions, but it could be localized, creating a new bulge or area of thickening in an undesirable area. If there are not enough fat cells in the ‘love handle area’ that was removed in a previous liposuction, for example, fat may accumulate in the under-hanging arms. Liposuction is often performed by region and with some regions untouched, it could pick up the excess fat you eat and store if your gut liposuction was successful.

Motivation for Cosmetic Surgery

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

I feel that if I tackle what bothers me about my looks I would be shallow and superficial. I don’t like the absence of a hairline, the skin that hangs from my chin, or the rolls of fat (love handles is a poor name for it). IS there something wrong with me for wanting to look younger? What drives people to get cosmetic surgery?

Aging is not easy and not a graceful process as we might think it is. Often, some precipitating factor motivates a person to seek a return of his/her youthful look. With the many wonderful techniques that are employed for cosmetic surgery, change is easier than most people realize. It is not unusual for men and women to seek cosmetic surgery consultations as they approach a decade birthday, when they anticipate divorce or after discovering that they are being divorced, when they look in the mirror and see their body fat distribution has changed with or without weight gain, or even for women following menopause complaining that their face and neck skin has dropped. In effect, the person in the mirror is not who they think it is and they may not like what they see. You are not a freak and provided that you are not afraid of change, you can empower yourself to look further into how to get that younger look.

This piece was answered in part by Jon Perlman, M.D.

Saving Money On a Nose Job

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

Here’s a plastic surgery question I received this week. I’ve opened the blog to questions regarding cosmetic surgery, rather than limit it to strictly hair loss questions (at least on a trial basis). If you have plastic surgery questions, please write…

I have a question in regards to rhinoplasty. I feel that my nose is relatively large and has a bump on the bridge, and I am looking for a completely new nose. I have a consultation scheduled in june with a surgeon and I wanted to know would this bring the cost higher, and is this possible?

Nose jobs (rhinoplasty) are one of the more difficult and artistic plastic surgical procedures. Some plastic surgeons do not take them on, while others feel that they have the artistic skills to create the nose that the patient wants. Costs vary significantly between surgeons and locations; the well known 5th Avenue (New York docs) and the Beverly Hills plastic surgeons are probably more expensive. You have to check out your doctor by finding out his/her experience with nose jobs, see many pictures of their work, speak to a few patients if that is possible, get to see that the number of patients he/she has done, etc.. Make sure you understand the risks from his/her perspective. Fixing the bump on the bridge of your nose is more common than other types of nose jobs where missing ‘bony’ infrastructure needs to be brought in. Do you bond with your doctor? Do you like the doctor as a person? Does he/she spend enough time to answer your questions and address your concerns, dealing with your worries with compasion? I use these rules for selecting any and all doctors.

Good luck.

Moustache Restoration?

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

Moustache

i would like information on moustache restoration as mine is thin

The use of hair transplants for the moustache is relatively easy to do technically, but may be more difficult from a planning point of view. The hair usually would come from the back of the head and you therefore must be reasonably sure that the character of your hair from the back of the head will look like your existing moustache. If you have a coarse, brown haired moustache and fine, blonde hair in the back of your head, a transplant using scalp hair might not be the right decision. To get around this, one could use pubic hair which is more coarse than a fine character scalp hair transplant. Get an expert to find out what is reasonable.

African Hair and Noses

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

I am an African American man and I want my frontal hair loss fixed and a nose job. I do notice that more white people get these types of surgery than black people. Why is that?

The kinky hair of African individuals makes it slightly more difficult for hair transplants if the surgical team is not able to manage the hair grafts that are not straight below the skin. Hair transplantation is a peg in a hole skill (like fine needle work), but when the grafts are not straight, it is more difficult to put them into a straight hole. With the right skills, the team can coax the hair into the needle holes created in the recipient area.

I’ve asked Beverly Hills based plastic surgeon and UCLA Medical Center’s Clinical Assistant Professor of Plastic Surgery, Jon Perlman, MD, to answer the nose question. Here’s his response:

Black people’s noses are more difficult due to a general lack of cartilage available from the septum to build up the height of the missing bridge. Some doctors (not myself) prefer to use silicone grafts however though not unreasonable, it is associated with a much higher risk of future extrusion from within the nose. The advantage is that it comes in a package and can be relatively easily placed on the bridge of the nose to build it up.

Transplanting Chest, Leg, and Thigh Hair

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

I have read some doctors preaching the use of chest and leg hair for hair transplants. I have also read your comments and general lack of enthusiasm for this. What is behind your strong opinions against this?

Scalp hair is better understood and tested for over 50 years. Although the art form has only been reasonable for the past decade or so, the facts concerning hair growth from a scalp source as donor hair are well understood. It is always important for me to inform patients about their risks, expected growth rate, and reasonable results that they should target. We have no body of evidence that hair taken from body or leg parts will work to any reasonable degree, but there seems to be (as P.T. Barnum said) a sucker born every minute. I do not want to be part of such a process, at least until it is clarified as something real.

In the book by Elise A. Olsen, Disorders of Hair Growth, the rest cycles of hair are stated. Although I can not attest for the science of these figures, let’s take them at face value for a moment and see what it means if correct. All hair cycles go through various growth phases, so the length of these growth phases are critically important to understand. For head hair, growth cycles range from 2-7 years, with a sleep period of 3-6 months. Generally it is believed that head/scalp hair is in its resting phase for about 10% of the hair population, which means that of all hairs growing on the head, another 10% is lying dorment awaiting its growth phase.

  • Leg hair has a cycle between 7-12 months, but between 62-88% of these hairs are in their dormant phase.
  • Thigh hair has a cycle of 3-5 months, but between 64-83% of these hairs are in their dormant phase.
  • Arm hair have a cycle of 3-7 months, but between 72-86% of these hairs are in their dormant phase.

With chest, arm, and body hair, the above numbers suggest that there is a large number of sleeping follicles at any one time. If this is true, then there will be questionable value from a hair transplant using these body parts from fullness or coverage point of view. Add to that the pain of hundreds or thousands of small wounds created all over your body might produce. I wonder about the doctors who are routinely performing this type of surgery and ask about their motives. I have concluded that any doctor who offers this must let his patient know that this is not a tested procedure, falling in the experimental rather than the clinical hair transplant offerings. I’d also hope they reveal the figures related to sleep cycle of the hairs from the various body parts as discussed above so that their patients are well informed.

15 Year Old Male Wants a Lower Hairline

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

I read the article regarding the 15 year old with a high hairline. I have the same problem (I am male) but when I read your response, there was nothing saying what there is out there to fix the problem. Would you please let me if there is hope for myself. I comb my hair forward too, to cover it up but I am tired of having to do that. Please let me know. Thanks for your time, I will be looking forward to your response.

At 15 years old, you are too young for hair transplants or hairline lowering procedures, because you do not know what will happen with regard to balding in your future. Such surgery, although it might work well today, may make you look abnormal if you should join the balding men out there (almost half of the male population in adulthood). Are you sure that you have a high hairline and not a maturing hairline which normally develops between the ages of 17-29? You must be seen in person to map out your hairline and entire head to determine if you truly have hair loss, a congenital hair hairline, or just part of the maturing hairline process.

Transplanting Animal Fur to Human Heads?

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

Bear

You mentioned joking about transplanting animal fur to human heads.

Why isn’t this possible? Only because of an immune response to the hairs as a foreign body?

What animal did you have in mind? As if fur coats aren’t bad enough, what would PETA say?

You answered your own question — the body’s response to the hairs would prevent transplanting animals to humans (or humans to other humans, unless they are identical twins).

Removing a Sebaceous Cyst from the Eyebrow

/by William Rassman, M.D./6 /

Hi. My 9-year-old daughter has what the plastic surgeon called a ‘sebaceous cyst’ on her left eyebrow (actually sort of in her eyebrow). It started out very small about six months ago and has become so large it distorts her eyebrow hair. He is supposed to remove it on April 5. My question is that she is terribly afraid of scarring: the doc said it won’t happen bc he’ll excise it directly in the eyebrow line. Do all of these cysts HAVE to be removed surgically? Is there any other way to remove them?
Thanks!

When I was in residency training I saw a middle aged bus driver who had a sebaceous cyst on her buttock. It bothered her while she worked, sitting on her bus driver seat. I apologize if this is too graphic, but she finally came to see me when it was the size of a big orange with a foul smelling infection on top of it. When I asked her why she waited so long, she said she didn’t want surgery so she prayed for it to go away.

My point is, sebaceous cysts have the tendency to become infected and when they do, it does create a minor surgical problem, so the issue is: should they be removed? It might be in your daugther’s interest because the alternative will be, as you put it, a “distorted eyebrow” which could become a focus issues for her in her teenage years. All surgical procedures have risks. All surgical procedures will leave a scar and the eyebrow in particular may lose eyebrow hair that will not grow back. But as you have been informed by the plastic surgeon, he/she should take great care to leave a minimal scar in the most inconscpicuous place (along the eyebrow line to hide the scar).

Female Hair Loss After Face Lift

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

I had a facelift last Sept and in Feb I noticed my hair has thinned to the balding stage. Is this permanent, caused by the facelift, or just temporary? What can I do to stimulate hair growth?

Hair loss around the scar after a face lift surgery is a common problem. Fortunately, it is one of the indications where a hair transplant procedure will help very nicely. You should first followup with your plastic surgeon for his opinion on the permanence of the hair loss, but as this has been a year already, I suspect that it may be permanent. If you are on the west coast, please consider paying me a visit in Los Angeles or San Jose, or if you can not easily drop by, send me good photographs and I will give you an opinion. Your privacy will be protected and I will not show them here on the web without your consent.