Hair Loss After Brow Lift

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

I really appreciate your informative and straight-forward approach to our hair concerns.

I have had a brow lift a little over a month ago. While the surgery was for the most part very successful, I was not prepared for the hair loss that preceeded it. I was told by the surgeon that my hairline would actually be lower afterwards. That was NOT the case.

The hair loss is along the incision line. It is more “loss” than just thinning. I was told not to worry that it would grow back.

My questions are:

1. What is the chances that the hair will return?
2. Would Propecia help?
3. About how long does the scalp normally stay numb?
4. How long should I wait to see regrowth before having hair restoration to correct it?
5. After hair restoration, how long will it be before I can do strenuous exercise and swim?

Thank you

There is a good chance that some or all of the hair will return, but brow lift scars are often detectable due to some widening of the scar when the incision was done behind the hairline and hair loss risks when the incision is done in front of the hairline to lower it. Sometimes during the type of procedure you had, the blood flow to the hair follicles can be interrupted resulting in a temporary loss. Occasionally it is permanent, but in most cases you should be able to see some regrowth within 3-6 months. Most doctors will wait up to a year before giving up on seeing some growth return, and that is about the time you can consider a hair transplant surgeon to correct it if needed.

As for your other questions, if you had a hair restoration procedure, you would need to wait a week before resuming very strenuous exercise and you’d need to wait until the wound has completely healed before swimming. Propecia is a DHT blocker which prevents male pattern/genetic hair loss and it is not proven safe for women, so it will not help. The scalp numbness does not usually last more than a year (often weeks or month and is rarely permanent). Finally, time is really the most important commodity for you to evaluate your loss/regrowth. Wait for the regrowth and follow-up frequently with your surgeon.

Of interest, this complication is the most common reason women get hair transplantation (at least in our hair restoration practice), which does not reflect its incidence (of let’s say in 100 women with brow lifts), but it does tell you that it is not an uncommon problem.

Removing a Widow’s Peak

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

Hello Dr. Rassman,

I am a 22 year old male with a widows’ peak that I would like removed. I also have bad acne if you take care of that at all. Please let me know costs, etc…

Thanks

Removing a widow’s peak is not easy and has side effects which include scarring, depigmentation, pitting, etc. That of course, depends upon the mechanism that you chose to remove the widow’s peak. FUE works, but may leave small depigmented areas, just like electrolysis might do. Laser hair removal may work but also runs the risk of depigmentation and the failure rates with laser hair removal and electrolysis is higher than 50% per hair treated.

With regard to acne, you need to see a good dermatologist. Costs are not appropriate to discuss at this time, because there is much to do to determine if you are a candidate for any of the treatments I discussed above. At 22, I am concerned about a focus to remove a widow’s peak.

Eyebrow Transplant Cost

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

just want to get a ball park figure for eyebrow transplant. I am a 38 year old male and want more thickness and shape to my brows, like had when I was younger.
thanks.

Generally, we have a $3,000 minimum fee that will cover the eyebrows easily. On occasions we can reduce the fee if the work is really minimal.

Tissue Expansion

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

Hello Dr. Rassman,

I have read in a few your blog responses about a procedure called Tissue Expansion involving the insertion and inflation of a balloon into the scalp to create new tissue allowing for a effective scar reduction. Are you familiar w/ patients w/ HT scars that have used TE and if so have they been successful?

I’m interested in learning more about this procedure and it’s viability. I live in LA – would it be possible for you to refer a Dr. who perfroms TE?

Thank you for your insight.

I would be happy to see you myself, where I would first assess your scarring problem. One must command the problem before recommending a proper treatment. I have been involved with tissue expansion for the past few years, but it is not the solution for everyone. If I can not manage the process, my ego would not get in the way; I would then refer you to an appopriate expert, that is, if you needed another opinion. First, let’s start with a visit to my Los Angeles office. Please call 800-NEW-HAIR to setup a free consultation.

Body Hair Transplants, Revisited

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

I am interested in transplants using body hair. Does it work and do you do it? Thanks

Chest hairs and pubic hairs can be harvested for hair transplantation. However, you must realize that body hairs are not ideal for transplants because they tend to be shorter than hairs from your scalp, there are not many of them despite the sense that a very hairy chest is hairy by density, and these hairs do not grow in large groupings like scalp hair does. Body hair transplants must be considered experimental at this time, until some well published sciences stand behind them. Most people who ask me questions about body hair transplantation have depleted donor supplies from the scalp. Is this what you are facing? If it is not, body hair transplants would be completely inappropriate. Since you are in Los Angeles, I want to mention that we have a local office to you, if you would like to setup a free consultation. To schedule an appointment, please call 800-NEW-HAIR or visit the Request Additional Info page at the New Hair Institute website.

Female Hairline Lowering Costs?

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

I have a high hairline that I want to fix. About how much does it cost for the procedure?

A female hairline lowering procedure in my hands, done by me, will cost you around $11,000. If hair transplants are needed for a refined frontal hairline to hide the scar (unusual), that is also included in the fee. Not everyone is a candidate for this procedure. It requires someone with a loose enough scalp to allow for the surgery and goals that are realistic.

Is the Flap a “Cure for Baldness”?

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

There is a post out of the UK that says there is a cure for Baldness called the Fleming-Mayer Flap. Please see the link and give me back your comments. See “An end to baldness – for those who can stomach it“

The original procedure was actually ‘invented’ by Dr. Jose Juri in South America. It was widely performed around the world with, at times, terrible consequences. Dr. Juri has been quoted by doctors I know as believing that this invention was a terrible mistake and I believe he apologized for the damage his procedure did to the many victims that the radical surgery produced.

As there is no cure for baldness, certainly a radical scalp moving procedure has many opportunities for problems. Worse, it can not cover all of the balding area, for that would take God’s hands, and not this technique.

  • A banana-shaped piece of hair-bearing skin is marked out on the side of the head
  • Incisions are made and the flap is loosened, always remaining attached to the head in order to maintain the blood supply
  • The bald area is cut out of the patient’s scalp and removed
  • The flap is twisted, flipped over the top of the head and sewn into place where the bald patch was. Surrounding skin is stretched lower down to compensate

I would not recommend this procedure for many people with ordinary male pattern balding. Even if their balding pattern does not look too bad at the time they have the procedure, as they get older, the flap will make them look freakish and I have treated many patients for deformities resulting from this type of surgery as they continued with an advancing balding pattern. The article you sent is very misleading; the flap is not a cure for baldness.

For more information about the flap procedure, please visit:

Cole’s FIT and BHT Procedures

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

What are your opinions on the techniques and procedures of Dr. John Cole, such as his FIT procedures which he acknowledges was developed from your FUE. However, the FIT is allegedly an improvement. Also, what do think about his claims regarding Body Hair Transplants. I know you have made previous comments regarding BHT’s. However, I am asking specifically about Dr. Coles procedures regarding BHT.

FUE and FIT is exactly the same procedure, with some technique variations. There are a number of technical ways to do it and FIT is a proprietary brand name developed by Dr. Cole to show some unique identification for him. Body hair transplants are new with not much validation from other doctors. There are only a few patients with any history to the process and we do not know much about success rates in, let’s say, 100 patients overall. I am not surprised that they may work, but body hair is limited in numbers, usually growing as a single hair unit although there are some two-hair groups. The hair has a different character than scalp hair, but Dr. Cole’s claims have no real science with them, although I am not saying that it is not true, just not proven scientifically. I would not jump into it just yet. It is, in my opinion, still an experimental procedure.

Sideburn Transplants

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

How many sideburn transplants have you performed and what is the success rate? How much do you charge per follicular unit? Where are you located?

Although I couldn’t guess the exact number, we have done many sideburn transplants, more in women who had plastic surgery problems following a face lift, rather than men. However, they work wonderfully for both sexes (see Other Hair Restoration Photos).

The fee is $6/graft, or for those with more flexible schedules we have a Standby fee at $5/graft. We have a minimum surgical fee of $3000 (this includes everything except a basic blood test. Our fee includes anesthesia fees, medications after surgery, etc). My personal charge is higher per graft; the minimum fee is $3,500 with me at $10/graft, whichever is greater. We have locations in Los Angeles and San Jose, California.

For more info on pricing and locations, please see:

Hair Transplant Before Face Lift?

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

I have a question about possible future hairloss. I have a list of procedures I want to have done and thought I knew the best ordering of them. I plan on having a hair transplant first, this so my hair has time to regrow. About 6 to 7 months later I would have a SMAS Facelift. However, I have been reading about the hairloss common to post face lifting and now I am perplexed. Bear in mind, my eyebrows are to be lifted with a method that doesn’t go near my hairline on top, however, it is the sides of my hairline, the temple region that has me stressed. A facelift will deal in that area and quite truthfully, I can’t afford to lose hair there. It is already thinned out considerably as it is. But, I need to have the facelift. So, is it possible to have a “temple” hair transplant? I don’t see any way around this. Help me by imparting your knowledge so I make an educated choice. I think I can proceed with the transplant on top, to be scheduled in early december, but what about the temples and future facelift?

Thanks so much for taking the time to answer my question and solve this.

Generally, I like to do hair transplants after face lifts, because if there are any problems to the hair caused by the face lift or brow lift, they can be addressed at the time of the hair transplant. A good deal of my practice is this type of surgery. Clearly, the newer face lift procedures spare some, but not all of the problems. You can follow your facelift with a hair transplant after a few weeks to a few months. If there are hair problems following the facelift, they will be evident by month three.

European Office? BHT? FUE?

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

Do you do Body Hair Transplants (BHT), FUE, and do you have an office in Europe?

New Hair Institute has offices in Northern and Southern California. Sorry, we do not have a location in Europe.

We do perform Follicular Unit Extraction (FUE), and in fact, we invented it. See our site for information about FUE.

Body Hair Transplants (BHT) are still experimental. I do not do them because I want 100% predictability and I am not sure that this will be achieved with BHT. Some past BHT posts include:

Body Hair Transplantation

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

Two different BaldingBlog readers had two similar questions…

Dr. Rassman,
recently some hair transplant surgeons reported very good results from body hair transplants. Other doctors remain more cautious and say it may yield good results in some, but not all patients. What’s your view on this?

Dr. Rassman,
Would you ever consider using bodyhair for some of the grafts in the scalp? I was wondering because it would seem a good way to increase density results. I am a bit paranoid about using only scalp hair to graft because I would not want to run out before getting decent density. I would think that you could mix in some sideburn or beard hair with regular scalp hair in the crown. What is your take on this. Thanks for your time.

Body hair has generally low densities (contrary to what it looks like on some men) so they do not make for a good donor supply in terms of quantity. A focus upon head hair should be primary. Then if you run out, moving to other body parts may be reasonable, especially as some studies are now appearing that indicate that this type of transplant works (leg and body to head or neck). What is still missing is the yield rates from the leg or body and the growth success from these areas.

As far as using sideburn or beard hair, this is an option in certain circumstances. They should only be considered as a last resort, when all usuable scalp donor hair is used. The other time that sideburn or temple hair can be used is when a patient is going to have a face lift and the sideburn/brow area is going to be excised as the brow is raised up.

Until the research information about body hair transplants is in our hands, it must be looked at as if it were human experimentation. A number of our patients have volunteered for this, so I am clearly interested in following the experience of others who I trust and then possibly get involved myself. I just do not want to sell hype and disappoint anyone.

I have performed one body hair transplant. The transplant was done from the abdomen to the eyebrows and it failed to yield hair in 10 months. I lost contact with the patient so I do not know if the transplant showed delayed growth or reflected some mechanism that caused it to fail. What I believe is that we need better scientific evidence on the following questions:

  1. Does it works reliably 100% of the time?
  2. If #1 is true, is that for all donor sites?
  3. What is the yield of viable grafts?
  4. What are the risks of body scarring / complications?
  5. Is it cost effective?

I would want to see many successful patients before I recommend it routinely for my patients.

While I can perform body hair transplants, I choose not to until they have been proven as a reliable procedure. If I make representations to my patients, I must be able to support what I say. If I embark on body hair transplants now (even on a limited basis), my patients must know the many uncertainties associated with the procedure. Until my comfort level is higher, I will not be doing body hair transplants.

Body Hair Transplants

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

Can you use body hair (like from my back to graft into my head??) All I have left is straight black hair. The brown reddish wavey hair is elsewhere on my body. What about if I want my once wavy hair back?

Does one consider using grafts from the other body areas such as pubic area hair?? As a former Physiology major and Chemist, this in theory seems possible considering the technology being used at the moment yes? Thanks — I’ve many questions, appreciate your bearing with me.

Hair can be transplanted from most parts of the body to other parts of the body. Some of the best work in this area was done by a Dr. Kim from Korea, who transplanted head hair to his leg as part of his PhD project where he tried to get more than one hair from one hair. He succeeded to transplant these hairs to his leg but failed to get more than an one for one yield.

Today, there is much human experimentation in moving hair from legs, abdomen, back, chest and beard to the scalp. It appears to work, but the question is one of value. Is the hair valuable enough to achieve the goals of the patient. How long will it last? How long will it take to grow? What are the growth cycles of these hairs when moved to the scalp or eyebrows? There are many unanswered questions and some answers are appearing to show that these types of transplants work.

All of these body hair transplants are done with the FUE technique. There is not a mystery as to how to do this, but the problems I see are more in the many unknowns for routine clinical use.

Correcting a Scalp Reduction

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

I have undergone several transplants and scalp reductions over several years. Unfortunately the results have not been adequate and I have exhausted my donor area. I would like to consider cutting my hair short (to the scalp) or going with a shaved scalp. I am hesitant to do this because of scarring from scalp reductions and donor areas. Are there procedures to correct these imperfections or have I backed my self into a corner.

I doubt that you can shave your head without showing the obvious skin deformities that were caused by the various surgeries that you had done. Before packing it in, however, you should be seen by a good, honest, competent hair surgeon. Maybe your conclusions are not derived from knowing what can be done today.

Artificial Hair

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

I understand that there is something out there called artificial hair. Where can I get it and how does it work?

Artificial hair is a product sold in Asia and limited countries in the western world. It has been banned by most countries because it must be surgically implanted with a special sewing needle. This would be a procedure that would need FDA approval and it has not been approved as safe in the United States. Many patients’ bodies will actually reject the artifical hair as it would any foreign body once it is implanted into the scalp. I have seen some patients with wonderful results. It gives ‘instant hair’ and as a result it is a big selling point in countries where it is allowed, BUT I have also seen patients that have developed massive scalp infections from these ‘artificial hairs’. There is a trade off and safety is sacrificed in exchange for short term benefits. Biofibre is one of the sites for artificial hair. Reading it might give you more information, but I would strongly caution your pursuit of this as a solution for your hair loss.

Artificial hair does not need to be included in any hair cut and you can not grow your hair out with them as you could with hair transplants. Hair transplants allow you to grow your own, natural hair for as long as you live.