Enlarged Vein After Hair Transplant

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

I am a 45 years old male who has underwent over the years several HT procedure. Since my last procedure April 2010 I noticed en enlarged vein in the left temporal area which I believed is an av fistula. I have two questions. Will this resolve over time? If not what corrective procedures can be taken to fix it?

Thank you

This is a very important point: If you had surgery with a doctor, you absolutely need to discuss any concern and issues with that doctor (especially if you had the procedure just recently). It is not because I do not want to help or I am trying to pass it along, but your surgeon knows your case and your issues the best. Baldingblog is not a place to get second opinions or get medical diagnosis.

With that being said, if you really do have a AV fistula it will not resolve on its own. Complications can include bleeding, an aneurysm followed by rupture, and internal bleeding below the skin. This can be a complication of any surgical procedure. For more information, please see:

Tags: surgery, hair transplant, complications, fistula, arteriovenous fistula, hemodialysis, hairloss, hair loss

Amazing Results from Body Hair Transplants?

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

I have a question regarding hair transplants. I have come across this link on youtube.

This doctor claims to be an expert when it comes to extracting hair from the body. He even has some videos where he extracted 20,000 hair. I’ve seen the videos and the results look awesome. If I can get results like the videos maybe I might consider visiting him in the future. However, before I step forward I need your advise on whether these results are a form of deception or not ? Can this doctor really give such amazing results ? Should I consider this option for the future. Since I am from an Indian background I have a lot of hair in other areas besides my head.

I personally do not believe in performing body hair transplants and have written about the problems with this type of procedure many, many times. The body hair transplant results that I’ve seen in person were not flattering, but these do look good. I can be a skeptic at times and if it sounds too good to be true, then it probably is.

If you are looking for an endorsement of Dr. Umar, I cannot give that to you because I have not reviewed his work. If you are convinced these results are amazing then perhaps you should see him. But before you decide to go through with the surgery, I’d ask to meet patients that have already had it done so you can judge the results for yourself in person.

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

What If I’m Already Taking Anti-Rejection Medication for an Organ Transplant?

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

Dear Dr Rassman,

You’ve written before that hair transplant from another person or the dead are not possible because it’d mean the recipient needing to take anti-rejection meds and the risk being much greater than the benefit.

But what if a potential hair transplant patient has already had a previous heart/liver/lung etc transplant, and so is already committed to a lifetime of anti-rejection meds, would it then be possible (even if only theoretically) ? If so, has it ever happened, and is it something you yourself would be ethically comfortable with and technically confident of getting a natural looking result with ?

Thankfully, this is not a situation I’m in myself but presumably there must be some small percentage of your patients who this would apply to and it’d be interesting to know. Thanks!

What you are asking is theoretically possible. However, one of the many side effects of anti-rejection medication is hair loss.

In the last 15 to 20 years of my practice, I don’t recall seeing a heart/lung/kidney transplant patient nor have I met someone willing to donate their hair to someone else. I think people may be more willing to donate one of their kidneys than their hair… which says something about how important hair is to most people, eh?!

Tags: anti-rejection, organ transplant, hair transplant, hair donor, hairloss, hair loss

Can’t I Have Body Hair Transplanted to Scalp If I Don’t Intend My Hair to Be Long?

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

Hi am 30 years old with a norwood 6 level of baldness. I currently shave my hair with a razor. As i have an extremely large amount of body hair and i guess limited donour hair on my head, is body to head transplant possible? Would it be possible for the transplant to cover the crown as well as the front of the head? What is meant by resting phase for hair and how does that vary from the head and the body? I dont intend on growing my hair long and i would like to keep it at a buzz cut so it would not matter if the transplanted hair was to go frizzy or curly. But i am concerned if there will be a noticeable difference between my current head hair and the transplanted hair. Would i still be able to razor my head after i had a hair transplant? would the be any scars or signs of a hair transplant?

ClippersI don’t know why you’d want to just guess about the availability of your scalp donor hair. Have you been examined by a doctor? Body hair transplants (BHT) are technically possible, but they are not something I’d recommend for multiple reasons that I’ll try to explain simply. Body hair is not the same as scalp hair — it looks different, it feels different, it grows different. Even if the procedure is a technical success, it’s not going to give you natural looking results like you can achieve by using hair from the back of your head. Plus, I don’t know enough about your hair loss (donor, density, etc) to really be able to know if you’re even a candidate for any kind of hair transplant surgery.

As you seem to be aware, body hair does not grow at the same rate as scalp hair and about half of transplanted body hair is in a dormant state (see more on that here). Scarring in the recipient area depends on the skills of the surgeon and staff… but if you’re going to shave your head in the future why would you even want a hair transplant? Wouldn’t that be like getting a nose job right before you decide to take up boxing as a sport?

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

Transplanting Hair from a Donor Using Stem Cells for Anti-Rejection?

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

Again in the news this week has been the transplantation of a windpipe to a young boy from a donor. The have taken stem cells from the bone marrow of the child and coated it onto the windpipe. It is hoped that this will prevent the need for anti rejection drugs. Do you think it could be possible to try someting like this with donor hair follicle if they were coated with the recipients stem cells?

Stem cells give new windpipe to boy

We all want the future technologies to happen right now. This type of procedure is experimental (possibly the first of its kind?), and if this technology can be applied to hair, it would still be years away. This is interesting stuff though, and I do appreciate you sending the link.

I’m guessing the bone marrow stem cells were used here because if there are problems with the recovery there is still the option of using anti-rejection medications. A lifesaving procedure (windpipe transplant) is worth trying experimental technologies on, as health risks from anti-rejection medication make them not worth using in a cosmetic procedure (hair transplant).

Tags: hair transplant, hairloss, hair loss, antirejection, anti-rejection, stem cells, windpipe

AutoloGel PRP Therapy

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

I just saw this press release and wanted to know your thoughts on AutoloGel. I know you’ve been critical of PRP recently, but I’m wondering if you’ve read the doctor’s article in the Forum magazine for doctors in the industry that you’ve mentioned.

Cytomedix’s AutoloGel(TM) System Highlighted in Hair Transplant Trade Journal

I did read the article about AutoloGel in the recent Hair Transplant Forum industry newsletter, but the science behind it didn’t impress me. The findings are worth discussing further, but it is just one doctor’s review. I am not a supporter of things like this that have not had proven peer-reviewed articles written about it. The use of PRP (platlet rich plasma) is all conjectural and adds to the complexity of the surgery, possibly increasing the risk of infections with its use.

You can read the article that the press release discusses here (PDF file).

Tags: autologel, prp, hair transplant, surgery, hairloss, hair loss, cytomedix

Transplanting Hair Into a Cranial Morcellation Scar

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

I have a scar that is about the width of my pinky finger that goes from ear to ear on my head. This is a result of a surgery I had done when i was younger from cranial morcellation of my skull. I was wondering if there is anyway to get hair put into this scar.

There are ways to address such scars, including hair transplantation (in some people) or scalp surgery by those who are experts in the field. From what you described, I can not tell you which way to go, but scar repairs from brain surgery is one of the areas where what I do works very well. I need to see some good digital photos of the scarring and possibly would need to meet you to examine your head before giving any real options. Tentatively though, it does seem like you have some options.

Tags: scarring, scar, hair transplant

Orchiectomy and Hair Loss

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

Hello Dr. Rassman,

First off, thank you for your excellent blog, extremely informative!

I am a 37 year old male who has had an orchiectomy (right testicle), which occurred about 1 month ago. So far everything is working out well (aside from fatigue) and I have not had any testosterone replacement therapy at this time. I also have some hair loss, I’d say I am about an early Norwood 3, with no loss at the crown (yet).

My question is this: What can I expect in the way of hair loss at this point? I realize my testosterone levels are lower (503ng/dl), and I’ve taken 1.25 mg of Proscar daily for about 6 months and it seems to have worked quite nicely, but I am still wondering what impact the orchiectomy might have for my hair loss. Will my hair loss advance as rapidly as it would have had the orchiectomy not occurred, or will it possibly stop?

Thanks Doc!

A loss of one testicle will be compensated by the other testicle as it may “rise” to meet the needs of your body. Usually, the remaining testicle will increase testosterone production and this is something you can follow with your doctor through appropriate blood tests. There should be no impact on your hair loss other than what you were destined to lose based upon your genetics.

Tags: testicle, orchiectomy, hairloss, hair loss, testosterone

My Boyfriend’s Hair Transplant Didn’t Grow Back After Shaving His Head!

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

Dear Dr. Rassman,
My boyfriend had a FUE operation using hair both from the back of his head and his chest (all together about 1200 follicular) to cover the toothbrush look of his previous punch graft operations on the frontal part of his head. After less than six months the result was so great that everybody was under the impression that with another operation or two on the crown part of his head he would have a 70 to 80 percent of his previous normal hair days look back.

Approximately eight months after the operation he completely shaved his head with a Gillette Fusion razor with the hope that his new and old hair may look thicker and more ready for the next operation, but to everybody’s surprise (not to mention his horror) only 40 to 50 percent of his newly transplanted hair has grown back (after two and half months now) and the look of his frontal head now can be described as balding with previous plugs being visible again. I would really appreciate your comment and/or advice on the matter.

RazorFUE is not a perfect technique and it has a higher failure rate than the standard strip surgery, as the follicular units are often stripped of fat at the bottom of the grafts. Also, body hair transplants do not work to my satisfaction, because body hair does not grow the way scalp hair does. Body hairs do not grow continuously like scalp hair, as it is in its resting phase much longer. That is why most doctors do not perform body hair transplants; it’s not because body hair transplant is difficult.

Aside from these generalizations, I would only be guessing as to what caused the hair to not regrow after shaving it. And providing a guess would not be fair to you, your boyfriend, and even the surgeon. He needs to go back to his surgeon and follow up with this issue.

Tags: fue, body hair, bht, hair transplant, hairloss, hair loss

Hair Loss After Partial Hysterectomy and Stresses of Life

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

In 2006 I had a partial hysterectomy (uterus only). This past July my doctor put me on 1 mg. of Divigel. I’ve noticed the past couple of months that my hair is falling out. I don’t know if it is the hormone replacement therapy or not. I should note that when I’ve had surgery or a stressful time in my life, I tend to shed, but the hair comes back. I’m wondering if my “empty nest” this fall or the Divigel is causing the hair loss. Any ideas?

DivigelStresses (emotional, surgical, medical, etc) can all cause some degree of hair loss. It usually takes about one year or so before you notice the hairs regrow once the stress is under control. Or, it could be the medication you’re on. Divigel (estradiol gel) does list mild hair loss as a common side effect.

It is best to discuss your concerns with your doctor that is treating you. On top of the stress and medication, there may be other medical issues that you are not aware of as well. In the end, hair loss for women is very frustrating for doctors and patients alike. There is no one magic bullet or a defining cause. And worse yet, there is no definitive treatment (let alone, a cure). Good luck.

Tags: divigel, estradiol, gel, hairloss, hair loss, stress, hysterectomy, female hair loss

Transplanting Hair Into a Cleft Lip Scar

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

Hi I have a keloid scar from a failed surgery in the past. My keloid scar is located from my left nostril to the bottom of my upper lip. (cleft lip) Is it possible to transplant hairs on the keloid scar? has such a procedure ever been done before? I know you transplant hairs on lips not sure about on top of a keloid scar.

If this is a cleft lip scar, it is rarely a keloid. These scars make good transplant recipient sites and many people have grown transplanted mustaches to cover the cleft lip scar.

Tags: scar, cleft lip, cleft lip and palate, hair transplant, mustache, moustache, facial hair

Male Hairline Lowering Photos?

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

Can you post a picture of a male who received a hairline lowering procedure? I can’t find any only females. Thank you!

I have never done a hairline lowering procedure on a man because of the risk of further balding, but there would be no difference in the technique between this procedure on a male or on a female.

On Dr. Sheldon Kabaker’s site, he’s got just 2 male patients out of 32 patients shown, likely because it isn’t as common of a procedure in men. The male hairline lowering patients he’s posted can be found here and here.

Tags: hairline lowering, hair loss, hairloss, hairline

Are There Any PRP Studies Underway?

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

You recently stated that you would need to see a well-controlled scientific study to be convinced that PRP would be worth the cost. I was wondering if you were aware of any such study. I’m sure doctors and patients alike would be eager to see the results if in fact a study is currently underway.

The popularity of PRP treatment seems to be increasing and I get the impression (just from what I read online) that more and more doctors are adopting the practice.

Platelet-rich plasma (PRP) is a great marketing gimmick, but there is no good scientific evidence that it has any value. Most of the studies that I do know of don’t provide the quality of data I demand before I’d consider using it. Also, we have not heard from the FDA, which may be interested in the claims made by those who promote it.

I am not aware of a well designed scientific study going on with good double blind controls, but maybe there is such a study being conducted. If so, when it is published, I will certainly know about it. As a surgeon quoted in this recent article about PRP says, “there currently is minimal evidence of this clinically and more research must be performed“.

Tags: prp, platelet rich plasma, surgery, hair transplant, study, fda

How Common is Hair Loss Following Gastric Bypass?

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

Hello Doctors,

I just read an article from a writer for the local paper about her 100 pound weight loss following gastric bypass, which is something I’ve considered doing for myself. One thing that stuck out to me was that she says, “One common post-surgery side effect is hair loss. And I have been losing my hair. I knew about this before surgery, so I am dealing with it. I don’t like it, but it will grow back, and I have also lost most of my eyebrows, but that too will grow back.” See article here.

So my question is, how common is this loss? Scalp hair loss is a problem in itself, but to lose my eyebrows too would be devastating. How long could something like this take to regrow (or will it not regrow)? My husband visits this site quite frequently and when I mentioned the story, he suggested I write to you. Thanks for your help.

A gastric bypass surgery causes weight loss and in many cases can produce signs of malnutrition. Weight loss is often associated with hair loss, particularly in men who have genetic hair loss. For women who do not have genetic hair loss, the hair loss may reverse as nutrition gets better and the weight stabilizes, but for men with genetic hair loss, it often accelerates the genetic process. For men in this situation, it’s best to take finasteride prior to having the gastric bypass, and maintaining this drug for life. Even with the DHT block offered by the drug finasteride, hair loss may still occur.

The good news is that hair transplantation can be used to replace the lost hair in the same way as in a person with hair loss that didn’t have the gastric bypass. As far as eyebrow loss, it would be unusual, but again, hair transplants into the eyebrow easily can solve that problem as well.

Tags: gastric bypass, malnutrition, hairloss, hair loss, eyebrow loss, weight loss

Swelling the Scalp Before Inserting Grafts?

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

  1. I have heard that another hair transplant firm injects something into your scalp that swells your scalp before inserting the grafts?
  2. I also want to get eyelid surgery. Should the eyes or hair come first? How much time should elapse before the second surgery? It would be nice to heal from both at the same time.

  1. I do not inject anything into the recipient area to swell the scalp. The doctors who do these injections think that by stretching the scalp with saline, the grafts can be put closer together. I do not believe that this is the case.
  2. It might be better to do the hair transplant before the eye surgery, because if swelling occurs after a hair transplant and the eyes were freshly done, that could cause more discomfort. I’d give it about 2 weeks after your hair transplant before you undergo the eyelid procedure.
Tags: hair transplant, saline, swelling, scalp, hairloss, hair loss, hair restoration, eyelid