I Want a Hair Transplant, But I Am Concerned About Keloids

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

i am seriously considering a hair transplant on the sides of my hairline. i am a african american women who have had traction alopecia for quite some time now. i have a small keloid on my ear, and my dermatologist has been giving me injections to clear this up. he also told me that if i get any plastic surgery, there is a chance that i will develop keloid scarring. i do want my hair transplant, are there things that they can do to remove the keloid from the donor site?

Keloids are very rare on the scalp. Many people have stretched (flat) or hypertrophic (raised) scars, but actual keloids (they look like tumors growing out of a wound) are so rare that they are worth reporting in medical literature. You can test the donor and recipient areas with a punch wound and/or a needle and then wait it out to see if it forms keloids. That may be the best way to know for sure.

Tags: keloid, hairtransplant, hair transplant, african, alopecia, hypertrophic

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

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

My Surgeon Didn’t Explain the Hair Loss I’d Experience After a Brow Lift

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

(female) I had a coronal brow lift 3 years ago. My forehead is wrinkle free- however, my surgeon didn’t explain I would have hair loss along the scar edges. Anyway- I am going to have a HT next month to fill in the gaps -which will acquire 250 graphs. Will this be worth the expense and more surgery? I am not being hasty, because I went to 3 different surgeons in the Boca Raton, Fl area and all told me the same thing- don’t worry- this in very common in brow lift procedures.

I agree that a hair transplant should solve the problem. I see a great number of patients with hair loss and scarring from a brow lift, but I can not say if it is common. The statistics are not clearly available.

Tags: hairtransplant, hair transplant, coronal, brow lift, browlift

Hair Loss Near Area of Brow Lift 2 Years Earlier

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

(female)
I had an endoscopic brow lift approximately 2yrs ago, and now my hair has started to fallout in the area of the endoscopic surgery. I am also experiencing extreme tightness and a burning sensation under the scalp in this area of the surgery with hairloss. What can I do to stop this from occuring? Does this mean that there is nerve damage? Is there medication that I should review with my physcian that could alleviate the painfull sensation under the scalp and hopefully stop the hair from falling out? …Help!

Scarring and hair loss from a brow lift is something I see often. I may see more of this problem, not because it is common, but because I specialize in this problem. Hair loss and detectable scars are amongst the problems I treat. Small nerves are cut with certain types of brow lifts and these small cutaneous nerves which can produce pain usually disappear in less than a year (usually weeks to some months). Minoxidil may help hold the hair that is presently falling out. You might want to see me considering that you are in San Diego and Beverly Hills is only a couple of hours away.

Tags: hairloss, hair loss, brow lift, scar, endoscopic

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

I Want a Hair Transplant, But I Don’t Want a Noticeable Scar Around My Head

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

How many years are we from a transplant without a noticeable scar (Donor Scar) around someone’s head? Im sure that a lot more people (especially people with shave fades or short hair) would get a transplant if there wasnt a large ugly permanant scar around their head.

The answer is NOW!

We have a follicular unit extraction (FUE) technique called the FOX Procedure that has been pioneered by me in the early 2000s, and was presented at the International Society of Hair Restoration Surgery (ISHRS) conference in 2002. In fact, a company in San Jose is currently working on a robotic system to accomplish this task. This technology was invented and patented by Dr. Pak and I back in 1998.

The FOX/FUE technique leaves virtually undetectable scars. It is important to understand that all surgical cuts will create a scar but the FOX/FUE technique involves extracting single hair follicles, one at a time, leaving a scar the size of a small dot. Since these dots are random and small, you would not notice the scar even if you buzz cut your hair. In other words, there will be no linear scar. If you look at this earlier posting, you will see a patient who had no detectable scar even with a shaved head.

Tags: fue, follicular unit extraction, hair transplant, hairtransplant, scar, donor, 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

Donor Area Looks Like a Golf Ball a Week After My FUE Procedure

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

Hi,
I had FUE procedure done one week ago. It was for 2000 grafts, from a reputable Doctor with many years of experience. He came recommend. I’ve seen a few of his works in person, along with numerous photos from his website.

Anyways, my concern is that the donor site has many dimpled scabs; some have fallen out but most remain. The area resembles that of a golf ball. Is this natural and will my skin go back or remain like this?

Thank you.

The healing process of a wound goes into different phases. The length of the time it takes to heal reflects the size of the instruments used. Doctors use instruments that range in size from 1.5mm to 0.8mm. The best and fastest healing is in those with smaller wounds and the final appearance will reflect the size of the instrument used. See 1 Year Post-Op Photo of FUE Donor Area for an example.

The initial scabs should have come off in a week from the donor area. Full healing usually takes months and within 4-6 months the wound is probably close to its final stage. Healing of the FUE wounds is not an exception to this rule. Give it more time and the scabbing will go away in a week or two. The area may continue to be red for a while, but eventually will get back to its normal color.

If you are telling me that you have a golf ball size swelling in the donor area, you probably have an infected ingrown hair, which happens in FUEs when a graft is buried in the wound and did not come out after an attempt to extract it. Buried grafts can reflect your tissue type, your surgeons skills, the instrument used, etc… In this case, you may need your surgeon’s attention.

Tags: fue, follicular unit extraction, donor, scarring, scar, hairloss, hair loss, hairtransplant, hair transplant

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

Regrowing Hair on a Scar

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

I have this bump on my scalp for years so i decided it to get it removed. so now i got a scar and hair doesnt grow on it. can you regrow hair on a scar and if it can be done when u cut your hair will hair grow back again? please help

Scars can be effectively transplanted. The hair that grows is the hair that was moved, not the original hair that was there before.

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

Scar on Top of Head Isn’t Taking Hair Transplants

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

I have roughly been losing my hair slowly for nine years, all in the frontal hairline area. I have had a couple procedures to thicken up the frontal hairline, and the doctors upon examining always comment on how thick the rest of my hair is. However, on the vertex of my head I have a twenty year old scar (dent) the size of a quarter which has been grafted into, but does not retain much of the hair (I am aware scars have a lower success rate). It is very thin compared to the surrounding areas, and makes it look as if I am losing the hair on the top of my head. I was curious if a revision of the scar (to make it smaller and more linear) would be possible. Thankyou.

Scar revisions are possible depending on the location and the size. Without a physical exam, it is difficult to give you a specific answer. You may consider sending me your picture and I would be happy to give you a private consultation. Please reference this blog post when sending.

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

Big Scar After 3rd Hair Transplant Procedure — I Want to Hide This!

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

I’ve had a 3rd FUT HT procedure almost 4 months ago. A gross infection followed and split skin graft was needed to close the donor area which was about a 6 1/2 inches long and 1 1/2 inches wide. The skin graft is 2 months old and has contracted to 3/4 of an inch. Once the skin graft is healed can FUE help to hide the scar. Scar is also depressed about 3 mm.

I’m very demoralized and looking for help.

Thank you.

You should discuss this with your doctor and/or seek another opinion. Unfortunately, I do not have the luxury of a formal physical exam with you via the internet. Generally, there are options available to you which may include hair transplants around the area or scar reduction (often best used with balloon expanders if the scar is as wide as you claim), etc. Balding Blog is not a good avenue to seek a second opinion.

My offices are in California, but as you are on the east coast, I can recommend Dr. Robert Bernstein in NY. If you can make it out to California, I’d be glad to provide you with a private consultation.

Tags: hairtransplant, hair transplant, fue, infection, scar

Scar Revision with Trichophytic Closure (with Photo)

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

This is a patient who had a scar from a strip procedure. The scar was unusually low from a previous surgery at another clinic, and while low donor scars like these generally give poor results on repair, we did a scar revision with a trichophytic closure. The results are outstanding in a single session from 8 months ago.

Click the photo to enlarge.

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

I Want to Remove My Transplanted Hairline Altogether

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

I had single hair and multi-hair transplants on my hairline but I am not pleased with the results. I’ve had multiple procedures over the years expecting frontal hairline to one day be as thick as before. I suppose I held wrong assumptions. I’d rather remove the 1/4 to 1/2 inch length hairline of transplants than “fill in” the area with more hair. I followed that advice over and over but it never fully filled so it does not look natural. Is there a method to remove them without obvious scaring? I shave and even pluck them out of frustration but I end up regreting because it looks awful. I wish I never had gotten the transplants. Can I be helped? Thank you.

I have removed hairlines, but that requires surgery in most instances either by excising individual grafts or the entire line with a brow lift type of incision. Scars are generally barely detectable. Alternatively, you can do laser hair removal, which may take up to 6 treatment sessions. There could be depigmentation present, where the skin will become very light as its pigment cells are killed off.

Tags: hairtransplant, hair transplant, repair, pigment, removal