Tonsillectomy and Hair Loss

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

I am a class 3A Norwood. (I saw Dr Pak, he’s great by the way.) About 3 months after a fairly invasive surgery, my hair started to fall out and did not stop until recently. I have just been told I need to have my tonsils surgically removed, but it is not an emergency. I am currently taking Propecia and have done so for a year. Should I expect more of the same 3 months after the tonsil surgery? Would there be any benefit to waiting on the surgery or having it sooner? Thank you.

Usually shock hair loss only occurs once, but while it is unlikely, a repeat bout of hair loss is possible. Take care of your medical problem and do not focus on your hair. If you need to have this other surgery, then do it.

Tags: tonsils, tonsillectomy, hairloss, hair loss, shock loss

I Have Dense Body Hair — Experiment on Me!

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

This is for Dr.Rassman. You have done a great job having this blog for awareness and information but I was hoping if you could help me out or advise me regarding hair transplantation. I have already mentioned this a while ago to you that I didn’t see the 100% growth on my crown area because the Doctor i had done it from was just making money out of me. He didn’t inform me that my donor area is not sufficient to provide good follicles. Anyhow, i have seen your replies on BHT. As an east Asian (Pakistan) I have the genes of being hairy, my back,chest,abdominal areas are just hairy. And they are pretty dense. I guess this is my last chance because cloning is not even near. I am going to be married next year but i have told every one that my hairs are back because i didn’t want to be embarrassed. My only question to you is How much is BHT and please Dr. is there any way I can be your object,trial,experiment? i am student and facing the worst time of my life. Thought you may have something for me.

In my opinion, results of body hair transplants are not well documented. I appreciate your desperate cry for some solution, but sometimes the best advice a doctor can give is just by making the patient aware of limitations in medicine. Moreover, I don’t like to experiment on patients when I know the the technology and the results may well be very poor.

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

Galeatomy Procedure

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

Dear Dr. Rassman,

The question is in regards to the galeotomy procedure – originally pioneered by Dr. Lars Engstrand out of Sweden – I believe. The procedure was also popularized by the late prolific health writer Paavo Airola in his many writings.

I find this sunbject very interesting and have noticed an increasing interest for this procedure on the hair-loss forums, but very little information exists. I have heard that this procedure is quite effective and yet it seems to be totally ignored (or suppressed) in this country. What do you know about this procedure? Do you think it works? Do you have any first hand experience with anyone who has had it done? Do you, or can you, perform it? Does anyone in the U.S. perform it?

Please take the time to share what you know about this interesting topic.

GaleaThe galeatomy has been around for years. For those of you who do not know, above the skull lies the periosteum (the living membrane above the bone) and then the galea. Above the galea lies the scalp, which is very mobile (try to move your scalp around and you will see just how mobile it is). The scalp has a clear blood supply coming from the front, sides, and back of your head. The blood supply lies above the galea, so cutting the galea makes no sense. It is not easy to get to the galea unless you cut open the scalp. We have done galeatomies years ago with scalp reductions and today’s hairline lowering procedures, and brow lifts will frequently dissect the galea as part of the mobilization of the scalp. As working below the galea is relatively bloodless, it is a terrific surgical plane to work in. Cutting the galea will not increase the blood supply to the scalp, but will just produce morbidity if it is done in isolation of some good surgical reason to do it.

Competent doctors do not do perform this barbaric procedure for the treatment of hair loss.

Tags: galeatomy, galea, scalp, hairloss, hair loss, surgery

Can We Use Donor Hair from Animals?!

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

Hey Doc,

This is a bizarre question, but I was wondering if it is possible to get donor hair from animals that are similar to humans? I know it may sound curl or just flat out stupid, but I was wondering if its even possible?

Thanks

FurWe use animal hair for wigs all of the time. Let’s say hypothetically that it is possible to use animal hair for transplants — which animal did you have in mind? If you picked the animal of your choice, what do you think PETA (People for the Ethical Treatment of Animals) would say? Hair transplant isn’t life or death, like a liver or heart. If PETA supports your cause (or you don’t care about what they think anyway), what doctor will you go to? A veterinarian? If a doctor is willing to do the surgery, what do you think your friends will say? It gives a whole new meaning to “sexy beast” …

The answer to your question is — no. Your immune system will reject it in a matter of weeks. Anti-rejection medication would be far too risky to use for a cosmetic procedure.

Tags: hairtransplant, hair transplant, fur, animal, hairloss, hair loss

ISHRS Doctors that Still Do the Punch Grafts?

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

I was looking over the website of the International Society of Hair Restoration Surgeons. I was using the “Find a Doctor” feature and also looking at the sub-categories of procedures performed.

Am I missing something? Why is there even a sub-category currently listed for doctors who perform “punch graft” procedures? Furthermore, why are doctors even advertising that they perform it?

Isn’t that procedure obsolete? Who would even want it? There has to be a reason that the procedure is listed and that doctors advertise performing it – I would hope. Is the punch graft procedure indicated in any situation? If not, what gives?

Hole punchThe follicular unit extraction (FUE) procedure is in a way a mini-punch graft involving just one follicular unit. Instead of using 6mm punches, we use 0.9mm punches.

Unless there is something I am not aware of, the punch grafts are obsolete. I found the list of doctors that are listed as those still performing this archaic method — ISHRS Physicians that perform Punch graft transplantation. I must assume that this is just outdated information on the site and will inform the ISHRS to find out if my assumptions are correct. I sincerely hope I’m right and that no doctors in the ISHRS are currently doing this procedure. Fingers crossed.

Tags: doctor, punch graft, ishrs, hairtransplant, hair transplant

I Remember an Advertisement for Artificial Hair Implants

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

Years back I could swear, unless I’m imagining this, that I saw an ad in a magazine about hair replacement that consisted of attaching artificial hair into the scalp. This was not a “piece” either. It was actually inserting hairs directly into the scalp. The reason I think I could be imagining this is because it was so long ago and I have never heard anything about it since. The thing is…I really do remember reading it. Have you ever heard of this? If yes, can you tell me (and your readers) what you know about it? Does it work? Do you do it? Please share whatever you know.

Thank you very much for your time.

There are many problems associated with inserting artificial hair into the scalp, including:

  1. Infection
  2. Horrible scarring
  3. Scalp irritation
  4. Accelerated hair loss
  5. Infection, infection, infection!!!

As such, this type of procedure has been banned in the United States, yet this has been done for many years in the past, particularly in some Asian countries. For more info, check out the post I wrote about this a few years back — Artificial Hair.

Tags: artificial, implant, hairloss, hair loss, biofibre, artificial hair

Thin Skin Patients

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

Hi Doc,
During hair transplant, are thin skin patients more prone to damage to dermis when incisions are made or is the thickness of epidermis layer same in everyone.

The epidermis is about the same size in everyone. Some people have large amounts of dermal and subdermal fat making their scalp appear thicker. With good surgical techniques, damage should not be a problem for those with “thinner” skin.

Tags: thin, thinner, skin, surgery, dermis

My Hairy Butt Is Perfect for Donor Hair!

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

Hello

I have little donor hair for a transplant, and not much on my body either. Except in my arse, it is very hairy there and when I shave it off it always grows back quickly. Please answer my
question seriously, would it be possible to transplant these hairs onto my head?

Thanks

This is the first time I have ever been asked that question. Yes, it could be done… but I am not sure it would be worth it.

Tags: arse, butt, hairloss, hair loss, hair transplant, hairtransplant, bht

Female Hair Loss After Gastric Bypass

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

(female) I had gastric bypass surgery. It will be 4 years in December. I was told that the hair loss was temporary. In my case, apparently not. My hair is less than half as thick as it used to be. You can see my scalp every where. I take the vitamins including extra biotin. I lost 110 lbs. and probably saved my life. I’m even at the point where if I don’t watch myself, I can gain weight. But still, my hair is very unhealthy. Is there anything I can do? Will I eventually be bald? It is not coming back at all.

Thank you. Regards

I’m glad to hear that the surgery helped save your life! You are right in that hair loss can be temporary, especially after things such as major surgery or childbirth. The concerning aspect is that you have continued hair loss even four years after the procedure. Many underlying, reversible, and treatable medical conditions can cause hair loss in women and in your case, it may very well be dietary. Nutritional defects or poor diets are a major cause of hair loss and with gastric bypass, this is a highly probable connection with your hair loss. Best to speak with your nutritionist for an analysis of your total daily intake of foods. Other things to look for would include hypo- or hyperthyroidism, anemia, lupus, and a miniaturization study should be done to assess what pattern of hair loss you are having and any genetic contribution you are having to cause hair loss. In your case, despite taking supplemental vitamins and minerals, a malnourished state is the most likely culprit but going through everything that you have experienced, could have precipitated an underlying genetic process as well.

Tags: gastric bypass, diet, weight loss, weight, hairloss, hair loss, stress, surgery

Using Body Hair to Transplant Into Scalp Donor Scar?

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

I know you aren’t a fan of body hair transplantation because of the different growth cycles it has compared to the hair on your head and just a general difference in the type of hair but do you think it would work when used in a donor scar from a hair transplantation? I just figure it would work pretty well when you’re just trying to cover up a smaller area like that and aren’t as concerned how the hair looks just so long as it covers.

I would agree with you on this, although Body hair Transplanation in general is not ideal for Hair Restoration surgery, it would probably work ok to give some coverage in a Donor Scar.

It may work, but as the body hair is not as thick as regular scalp hair, the coverage per hair shaft will be less than that of scalp hair. Do you have enough hair for FUE from the scalp which may be better? A stronger hair can be found in the pubic and beard areas and both of these areas can be used as donor hair sources as well.

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

Can Skin and Fat Transplants Cure Hair Loss?

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

I think that the hair loss is not a problem of degenerating of the hair or a genetic predisposition of the hair to fall, but it can be a degeneration of the skin where the bald area apears. May be a transplant of the hyperderm from other part of the body to the bald area may help the regeretion of the skin and the hair . Or the injection of the fat from other part of the body taken by liposuction to the hyperdermis of bald area may have an efect.

Best regards

The skin has nothing to do with hair loss, unless it is diseased. Transplanting skin would be human experimentation with no back-up clinical trials and skin transplants might very well kill the hair. Fat transplants also will do little to help grow hair.

Tags: hairloss, hair loss, skin, transplant, fat

In the News – Men Would Rather Remove Spider Veins Than Have Hair Transplants?

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

Snippet from the article:

Sclerotherapy has seen a 226.3% increase in males over the past five years. A drastic comparison to the 3.5% increase in females since 2002.

On the opposite end, males have strayed away from hair transplants. Cost is likely to be a cause of this decline. Over five years, the price of hair transplants increased by $1,296, while sclerotherapy decreased by $103.

Read the full article at ScienceDaily

I realize this article is a few months old, but somehow I missed it. It is, however, still interesting and worth posting about. My commentary on the article is that it is probable that the increased cost reflects the higher number of grafts being performed by today’s modern hair transplant surgeon. From what I hear amongst the transplant community, the doctors have been following the “more grafts is better” trend and is more profitable as well. More grafts means more hair in less surgeries, which drives the fees up. A fuller head of transplanted hair may not be better for the hair transplant surgeon’s wallet though, as the higher fees may drive patients away.

Tags: hair transplant, hairtransplant, surgery, news, hairloss, hair loss

My Hair Fell Out After Brow Lift Surgery and Regrew With Different Characteristics

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

(female)
Dr Rassman,

After having a brow lift type surgery ( no lift but same incision ) a lot of hair all over my head fell out. What grew back were strange hairs. Some are very fine only about 3 cm long, and look crimped. Others are thick coarse hairs that look like afro or pubic hairs. Together these hairs are all over the crown and have been growing this way for about 4 years now. My Dr said these hairs have nothing to do with the surgery but they all started a few months after the surgery.

I am 99 % convinced that they are related and would appreciate any information you might have. Also some of the coarse hairs have are less so closer to my scalp, that would indicate that time is possibly helping a bit. The very fine ones have not changed.

With Kind Regards

I have not seen this type of change associated with a brow lift incision. I have seen hair loss with a finer hair appearing in front of the brow lift incision, but I have not seen someone change variable parts of the scalp hair and not other parts. I would have to examine you to make sense of the process you are discussing. The use of good conditioners after washing should minimize the kink in the hair.

Tags: hairloss, hair loss, brow lift, surgery, regrowth, kink

After 7 Scalp Reductions, Would I Have Donor Grafts Left?

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

Dr. Rassman, you won’t believe this. Maybe you will. I have had I guess 7 scalp reductions. Brandy did a lateral with that Y incision, but not a scalp lift, per se. Marzola, Stough, all did a couple of procedures. I saw my scalp under bright lights (the last thing one wants as that is very unforgiving) on a big screen last night and was shocked by the 1 inch by three inch or so bald thin area in the midline. Dr. Hitzig performed two large midline graft sessions around 1999 or 2000, fixing the scar but the density leaves something to be desired. I see you mentioned Dr. Frechet of Frechet extender fame I imagine in a response to a patient. Some sort of triple flap procedure. I have some donor left but can’t get over my lack of crown density despite a large number of grafts. I know Dr. Hitzig always grafted the midline before reducing a scalp. Do grafts just not grow after reductions, especially that many reductions? I could emply better styling but I wish I had followed the late C.P. Chamber’s advice and avoided reductions altogether. He knew what he was talking about. It sounds like there is no practical fix at any price.

Scalp reductionYour case is complex. I have no idea what densities you have or the extent of your scar and wound defect. Most people who’ve had 7 scalp reductions are left with a slot deformity. I would like to see some good pictures of your scalp from the front, top, sides, and back. I am sure that you know that scalp reduction is no longer the standard of care today, because they do not work. I have seen men who had up to 16 scalp reduction surgeries and the last ones never really accomplished anything. I wonder about your 7th procedure and what you were trying to accomplish that the prior 6 have not.

It is best to be examined carefully by an expert and then see what your needs are. Patients should make a list of priorities and then try to work down the list. Patients who have had so many procedures never really get too far down that list, so be realistic.

For more information on scalp reductions, see:

Tags: scalp reduction, scarring, slot deformity, hairloss, hair loss, scalp

Can I Remove My Donor Scar Using Lasers?

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

I had three hair transplant surgeries and now I shave my head because of the results. I like the shaved head look but the scar from the donar are sticks out like a soar thumb. How can I remove the scar or make it les noticeable? Will laser scar removal help?? Is there any solutions to my problem?

Thanks

Sometimes one can address scars on the back of the head, and I have managed such scars on a few patients. The laser is not a magical instrument and I doubt it would help you with removing the linear hair transplant scar in the donor area unless it was elevated and the laser was used as a treatment to flatten it. Dermabrasion can accomplish the same thing. If the scar is heaped up (keloid like) then the use of steroid injections have value, but for a flat scar, neither the laser, dermabrasion, nor lasers will help. The treatment of acne scars with laser sare another thing altogether. There, laser resurfacing works on some people, but lasers can be used in many ways. Removing the scars from a hair transplant in the back of the head is not one of the things that lasers can offer help on.

Tags: laser, hairloss, hair loss, hairtransplant, hair transplant, laser removal, scarring, scar