Can I Remove the Plug-Scarred Donor Area from My Hair Transplant 25 Years Ago?

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

i got transplants in 1983 that were less than satifactory.i have been wearing a hair replacement for about 15 years.my question is this.i want to shed my hair replacement and go to the shaved head look,but the donor area in back is my problem.can plastic surgery cut outthe plug area tomake it look natural? i appreciate your advice

I see patients like you almost every day. A small portion of my practice is based on correcting bad hair transplant surgeries, like the old plugs. See Patient Photo Gallery – Repair Work for some examples.

It is very difficult to remove the scar so that you can shave your head, because the scars are going to have a white appearance. If you goal is to keep your head shaved, look at a Horror Story with a… Happy Ending?, which shows the use of tattoos to solve the problem in the donor area. It is relatively easy to disguise the unnatural scar and plugs with a follicular unit extraction (FUE) hair transplant surgery, but some hair length may be important. I would want to know how many ‘old type scars’ you had, as they may allow me to have some creative input. You must be seen in-person for a real opinion.

Further reading can be found at:

Tags: repair, hairloss, hair loss, hair transplant, hairtransplant, plugs, scar

Transplant Hair to Scar on My Cheek?

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

Dear Dr.,
I have a scar on my cheek that I have from when I was a little boy. I’ve had 2 scar revisions but the scar always spreads and I’m left with a pretty noticable scar where no hair grows.
Would it be possible to somehow fill in that area with hair from maybe my lower neck?

Scalp hair transplanted to the beard area (cheek) is a relatively common procedure. Some men who can’t grow facial hair have these type of procedures to fill in a beard, and likewise it can also be used to cover a scar. Lower neck hair would not be the best place to harvest donor hair, since neck hair is not considered permanent hair.

Tags: cheek, beard, hairtransplant, hair transplant, hairloss, hair loss, scar

My Son Scraped His Hairline on the Bottom of a Pool After Diving In

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

My son dove head-first into a swimming pool, and he grazed the bottom of the pool with his head/face. He seems to have lost some hair(about 1/2″ diameter) from his hairline just above his forehead.

I feel VERY fortunate that he didn’t break his neck, but do you think his hair will grow back after the wound heals?

DiveMaybe! It is difficult to say. A significant wound may have damaged the hair follicles and your son may have a bald spot on the area of trauma, but usually such trauma will produce only temporary hair loss. I would wait 8 months to see if hair will grow. If hair does not grow, he may be a candidate for a small hair transplant procedure.

Tags: dive, diving, swimming, pool, hairloss, hair loss, trauma, injury

No Results a Year After FUE to Fill In Dime-Sized Scar

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

Dr. Rassman,

I have a dime sized scar on the front of my head. I like to keep my hair buzzed with a number 1 or 2 and it is very visible. About a year ago I had a FUE procedure done in Detroit. Unfortunately there were no results. The scar is now pinker than before and impossible to hide. I was wonder if there are any other options? Would a scar revision reduce the amount of surface area not covered by hair? If so by how much? I am highly discouraged by the lack of success of the FUE procedure as I spent considerable money on it. Thank you very much for your advice.

FUE should have worked. Scar revisions can be a problem in the frontal area. I would have to see a picture of your scar (use a ruler next to it so I can get dimensions). Please send to the address on the Contact page and reference this post.

Tags: fue, scar, hairloss, hair loss, hair transplant, hairtransplant

Softening the Hairline (with Photos)

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

This patient came in the other day to say hello. He agreed to let me use his photographs to show his beautiful results. He had 350 grafts in one session at NHI about 8 and a half years ago to produce this hairline. Prior to seeing us, he had some older type of plugs which were neither full enough nor natural enough for his appearance. His gray hair helped me to help him.

Before:

 

After:

Tags: hairline, plug, repair, hairloss, hair loss, hairline, photo, hairtransplant, hair transplant

I Want a Scar Revision

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

I was wondering if you would do scar revision for my donor scar. I don’t think I had a very good doctor. What would the cost of a tricho closure be approximately? I have seen your photos and some look great, I can hardly tell there is a scar. Thanks!

We are constantly researching to come up with better methods to manage the donor area for improving the donor scars. Scar formation has to do with several factors — the surgical technique is only one of them. One important factor that patients tend to forget is their different healing potentials. Not everyone is a good healer and some patients develop widened scars regardless of the meticulous methods that are used. We usually do a scar revision for our patients with no cost to them. For those patients who are referred from other centers, we charge a minimum fee including a trichophytic closure, but we need to evaluate you with regard to the size of the scar, know how many surgeries you had, and determine the looseness of your scalp before we can tell you if we think that we can help you. You may call the office for a quote on our minimum fee — 800-NEW-HAIR. It is possible that this could be done over a telephone consultation.

Tags: scarring, scar, hairtransplant, hair transplant, donor scar

Transplanting Into a Neurosurgical Scar (with Photos)

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

This patient had an extensive neurosurgical procedure with a corresponding scar. Even when his hair was longer, the scar showed because he had frontal recession from genetic balding. We performed a hair transplant (one session of 1433 follicular units) and successfully treated both the scar and the frontal genetic recession. The “after” photos were taken just over 4 months after his procedure.

I have done this type of corrective surgery on many people. It is a life changing experience for these people, not having to face their deformities every day. Unfortunately, few neurosurgeons understand what modern hair transplants can do, not only for their patients, but for their own balding sons.

Click the photos to enlarge.

Before:

 

After (only 4.5 months):

Tags: hairtransplant, hair transplant, photos, results, hairloss, hair loss, neurosurgical

Repairing Micro and Mini Grafts

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

i’m 40 yrs old. in 96 & 98 i had two transplants,not a lot of them because at that time i wasn’t making enough money. the work was done in the temple areas,(micro& mini)are what i selected. today, the work has become noticable to me because the remaining hair in the temples have continued thier departure from my head, most of my hair is salt & pepper(more salt) now, the transplanted hair in the tempel are as black as ever. is the fue the way to go?

FUE (Follicular Unit Extraction) works well for these, as well as building a good normal hairline to create enough camouflage to cover the old type of work. I would need to see how bad the old plugs are and exactly where they are located to answer your question properly. You can call my office at 800-NEW-HAIR to schedule a free consultation, if you are interested. My offices are in Los Angeles and San Jose, California.

Tags: fue, repair, mini-graft, micro-graft, hairloss, hair loss, hairtransplant, hair transplant, plug

Tissue Expansion to Repair Alopecia After Ringworm Resulted in Infection

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

My 13 year old son underwent tissue expansion in 2003 for an area of alopecia following an attack of ringworm. He developed an infection an underwent scalp reconstruction. The scar stretched and he underwent scar reconstruction again. Yet again the scar stretched. He has refused any further expansion. The scar is very wide 1inch wide running from ear to ear across his head. Please can u help

I have seen similar patients who have had scalp reconstruction and were left with bad scars. It is not really possible for me to assess what was done from you brief narrative, but when scars become stable, hair transplantation works well to cover many of these scars. Bad scarring occurs in accident, in neurosurgery cases, and associated with different types of scalp surgery. We are presently writing a paper on the treatment of such scars.

As much as you would like to help your son, your son is also the main participant in the matter. While I sympathize with your need to address your son’s scar, it seems your son does not want any more intervention. Nevertheless if you are exploring all the options, you should seek second opinions on flap surgery and see doctors that are also experts in hair transplantation. A next step might be to send your son’s picture or make an appointment to see me if you would like your son to have a formal consultation. Remember, he is 13 years old, and at 13 he has other priorities which may interfere with sound logic.

Tags: tissue expansion, alopecia, ringworm, infection, scarring, scar, hairloss, hair loss, reconstruction

I Was Told Hair Transplants Wouldn’t Grow in Scars from Severe Burns

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

Doctor:
I am a 17 year old male. At the age of 2, a boiling pot of water fell all over my body and left significant scars in my arms and head. About 1/3 of my hair is missing on my scalp; hair fails to grow in the maturing scars of my burn. Consultations with different doctors have concluded that it is not possible to get hair transplants in scars caused by severe burns because the hair will fail to grow. The only option I have is tissue expansions, but this seems like a lengthy and discomforting process. I would like to verify if it is true that hair transplants will not continue to grow overtime on scars caused by burns. Is this true? Does it depend on the scar? Are there other factors? Thank you.

Hair transplants will grow in some scars better than other scars. It depends how much infrastructure is in the skin (fat, blood vessels, stem cells, etc..) I have seen remarkable results from tissue expansion for large areas of scalp burns. The results are better with tissue expansion and as such has no comparison. Also, the course for tissue expansion is much shorter than transplants. Be open minded.

Tags: scar, burn, hairtransplant, tissue expander, expansion, hairloss, hair loss

6 Months After Repair Procedure (with Photos)

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

This patient had some of the old hair plugs in his hairline, which we removed with a FUE procedure (2,200 grafts) and then created camouflage to rebuild a new frontal hairline. In just 6 months (see after photos), the early results are very impressive indeed and I would expect that the fullness will double in the next 2-3 months. Click photos to enlarge.

Before:

 

After (6 months later):

 

Tags: hairtransplant, hair transplant, trichophytic, closure, donor, scar, repair, hairloss, hair loss

Transplanting Into Burn Tissue

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

does hair transpalnt work if you had a 3rd degree burn on the back of your scalp the size of a silver dollar?

Yes. However, there may be a blood supply issue and the growth to a scarred or burned tissue may not be as optimal as normal skin. Alternatively, if the scar is small enough, you may explore the option of a scar reduction or other creative type of surgery in the hands of an expert who knows about scalp scars.

Tags: scar, hairloss, hair loss, burn, burned, tissue

My Old Plugs Are Going to Be Visible Soon!

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

I’m 47 years old and had several “plug” transplant sessions and a few single hair sessions. My first session was in 1990. I was on Lexapro for 4 months (Feb 06 – May 06) and I lost a lot of hair. That hair has not grown back and I’m losing additional hair (sides and back)! Soon my “plugs” will be very noticeable and I’m very upset! I’m currently using Nizoral, Avodart, laser comb and 2% Rogaine for the last 6 months.

Will the hair I lost from the Lexapro grow back?

There is no way to tell if the hair will grow back. I suspect you have a component of genetic male pattern hair loss and at your age, you will lose more hair despite all your preventative measures. You many need further hair transplant surgery to disguise the plugs (granted that you enough donor supply left), or you can have an FUE procedure to core out and thin the plugs. You need a real expert to give you an opinion. For more information on repairing old hair plugs, please see:

Tags: hairtransplant, hair transplant, fue, plugs, hair plugs, avodart, rogaine, lexapro

What Happens When a Doctor’s Car and Mansion Payment Is More Important Than You?

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

Here is a man who had hair transplant surgery some years ago. He had hair then and the doctor put in about 600 grafts throughout his thinning area. After the surgery, his hair loss accelerated and when the grafts grew out, other than seeing some small plugs, he did not find any value to having had the surgery in the first place. Since his surgery, he lost all of the hair on the top and crown of his head. Now all he has left is the transplanted grafts that are now unnaturally scattered over his head. The doctor who did this was either ignorant or immoral. A properly done hair transplant should stand on its own, or the doctor should tell you otherwise. That is what is required of the doctor by law. There was NEVER a possibility that this patient had anything of value and now he has negative value that he will carry around for the rest of his life unless someone completes his hair transplant in a logical way. Even with a properly done job, he will not have enough hair to cover his crown. Still, the man he sees every day in the mirror should be much more normal looking after his ‘fix’. Unfortunately, too many doctors are quoting small and large transplant sessions where and when they are NOT NEEDED. These doctors are just out for the almighty dollar. Immorality has not been wiped out and the crooks are still out there. Don’t be fooled by slick ads and particularly watch out for doctors that use salesmen to push, push, push you into making a decision. Again I say, “Let the Buyer Beware“.

Click the photos to enlarge.

 

Tags: hairtransplant, hair transplant, photo, hairloss, hair loss, doctor

No Hair Where Mole Was Removed from Scalp

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

When I was about 16 years old I had a mole surgically removed from the back of my head because it was growing larger and the doctor said it could become cancerous. I am angry about this because I don’t know if it was necessary at the time or not. Anyway I am 22 now and no hair has grown in that spot since. I don’t under stand why but lately it has consumed me and I am extremely depressed and obsessed with it. Am I able to get a hair transplant and make the hair grow back? Also will I be loosing one bald spot and creating another one at the donor area if I can have a transplant?

Scars from removal of growths or just lacerations are common in the scalp. It depends upon the surgical technique and possibly more important is the general direction of the wound. Linear scars that run front to back tend to scar more than those that run side to side, but everything in the scalp can scar. With a good hair transplant surgeon, a decision can be made how best to address the scar. Some of these scars can be fixed with a simple surgical excision of the scar and proper closure techniques, while others may be fixed best with a small hair transplant (always works). See an expert.

Tags: scalp, mole, scar, hairloss, hair loss, hairtransplant, hair transplant