Post Hair Loss Questions and Get Answers

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeons Dr. Ron Shapiro and Dr. Glenn Charles:

During a recent hair transplantation consult, the physician told me that he will create an “irregular hairline” during my hair restoration procedure. However, I’m wondering why he would chose to do that? Wouldn’t a straight hairline look better? Why create an irregular hairline during hair transplant surgery?

The goal of any hair transplant procedure is creating natural, realistic results. A very important aspect of achieving subtle, realistic results is recreating a natural hairline. Though many individuals assume that hairlines unaffected by hair loss are straight and regularly shaped, this is not the case. In fact, in order to create a realistic hairline, hair restoration surgeons must utilize an irregular, “zig zag” design.

In fact, according to Dr. Glenn Charles:

The term we often use to describe the hairline approach is creating a “regular irregularity.” Meaning there has to be a certain degree of randomness to give a natural appearance. However, there also has to be some method to the madness. You could also call this “Zig Zag” hairline design.

Dr. Ron Shapiro agrees, and said the following:

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeon Dr. Carlos Wesley:

Does Propecia (finasteride) work better on patients in their 30′s vs. other age groups?

According to a study of 118 men (range 20 – 61 years old) with androgenic alopecia (AGA) from 2011, patients over 30 years old with higher AGA grades demonstrated more improvement than their younger counterparts with a smaller degree of hair loss.

This is currently the longest investigation of finasteride 1mg (Propecia) efficacy. I should also mention that side effects were reported in 6% of patients (decreased libido and erectile dysfunction). Persistence of hair growth was not significantly less after ten (10) years versus after five (5) years of therapy.

Dr. Carlos Wesley
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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

Technorati Tags: Propecia, finasteride, androgenic alopecia, AGA, hair loss, hair growth

This comment, from a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

I’m planning on going for a hair transplant and recently consulted two top hair restoration physicians: both highly recommended on this forum. One recommended follicular unit extraction (FUE) and the other a strip. Both recommended between 1500-2000 grafts.

I’m trying to consider worst case scenarios for both options and am wondering if the scar is poor with the strip, how well does FUE into donor scar work to cover it up if I want to keep a short hairstyle as an option in the future? Has anyone done it successfully?

Follicular unit hair transplantation via strip is much more consistent at providing good results and unless you are planning on really short hair, our office would strongly suggest strip. Plus, if you are likely to need more hair later on, strip limits the quantity of scar tissue in the donor area.

You can wind up with a bad strip scar from even the best of surgeons, but it’s not common. Just yesterday I saw another 30ish year old with Norwood Class 5 hair loss who’d had 600 FUE’s (more likely 2mm punches) to attempt to rebuild his frontal hairline.  Now he presents for repair of that plus addressing some of the “further back” loss he’s had since that procedure. Well his donor area is all full of scar and we’ll be lucky to get 2500 grafts out of him and more likely 2200 at one setting since there is so much scar tissue in his donor region.

This question comes from a member of our hair loss social community and discussion forums:

Recently, I saw an online article discussing the “vampire treatment” for hair loss. What is the vampire hair loss treatment and is it effective?

Within the last few weeks, a variety of online news sources have released stories about the “vampire treatment” for hair loss. In the articles, the authors state that the new hair loss treatment is vampire-like, because it involves the removal of a patient’s own blood followed by injection of the blood back into the scalp. While the title of the procedure is quite dramatic and mysterious, the therapy is actually something that has been used as a hair loss treatment for a number of years: Platelet Rich Plasma or PRP. So, what is Platelet Rich Plasma (PRP)?

Platelet Rich Plasma (PRP) is a procedure where a patient’s blood is extracted and spun at rapid speeds in a centrifuge device. After two sessions in the centrifuge machine, the physician is able to extract a portion of the blood serum (the non-cellular component) that is enriched with platelets (the blood components responsible for blood “clotting” in the body). Allegedly, this platelet enriched plasma contains a variety of growth proteins and growth factors that may revive hair follicles and cause some hair regrowth. After the extraction process, the physician injects the platelet and growth factor enriched plasma into the scalp and informs the patient to monitor for signs of regrowth.

From May 24th through May 26th, 2013 the International Society of Hair Restoration Surgery (ISHRS) is hosting the second annual Mediterranean Follicular Unit Extraction (FUE) Workshop in Madrid, Spain. The workshop consists of a series of lectures about important topics in Follicular Unit Extraction, FUE question and answer sessions, FUE discussions and debates, and a series of live Follicular Unit Extraction operations.

Because we recommend a number of FUE innovators and experts, several of our recommended and Coalition hair transplant surgeons are participating in the FUE workshop. According to the official program, our hair restoration physicians are participating in the following activities:

During the first day of the workshop, Dr. Jean Devroye, Dr. James Harris, and Dr. Bijan Feriduni are participating in a debate about the anatomy of FUE grafts. Dr. James Harris is also lecturing about motorized FUE procedures and performing a live, 1,000 graft FUE case on the first day of the conference (and hosting a “Q&A” session after the procedure). On the second day of the workshop, Dr. Devroye is presenting a lecture about motorized FUE and Dr. Feriduni is lecturing about manual Follicular Unit Extraction procedures; both physicians are also performing live, 1,000 graft FUE operations at the end of the day. On the third and final day of the workshop, Dr. James Harris is giving a presentation on automated FUE procedures and the ARTAS Hair Restoration System for automating FUE hair transplant surgery.

This comment, from a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

I know that this will sound funny, and it is not a complaint, but it seems like the hair on top is much thicker than my hair on the side. I have been told I have good hair transplant donor hair, but the area that I see scalp when I part my donor region is much larger than, say, if I were to part my hair down the middle. Does this make sense?

My donor part may look like it is a half an inch wide or more, and my hair parted down the center may only be a quarter on an inch. I will see my hair restoration physician sometime this summer and talk to him about it but, until then, I was wondering if this is normal at all. It just seems like my donor is thinner than my non donor, or I could be OCD and over analyzing things? Any thoughts?

I’d guess that in 40% of the follicular unit transplant (FUT) strip cases we do that the hair is noticeably thinner on one or both of the sides than in the middle or up higher on the head. Then throw in a guy with salt and pepper hair and it can really get dicey as to how many grafts you’ll get from a typical strip.

Due to its less invasive nature and modern approach, Follicular Unit Extraction (FUE) hair transplant surgery continues increasing in popularity. As patients continue requesting FUE procedures in large numbers, hair restoration physicians have begun explaining their FUE philosophy and describing how they practice the procedure.

Recently, Coalition hair transplant surgeon Dr. James Vogel decided to take part in this ongoing trend and shared his Follicular Unit Extraction philosophy with our hair restoration community. According to Dr. Vogel:

I have been  performing FUE donor harvest technique for the past three and a half years.  My  philosophy has been never to be the first on the block to try new techniques on my patients; however when a new technique or procedure is proven safe and effective I embrace all new technology in a comprehensive manner.  The development and refinement of FUE is a perfect example. 

My  approach to FUE donor harvest is identical to the way I  manage all aspects of the transplant.  I am  extremely “hands on” and  intimately involved with every aspect of the procedure.  I have  tried numerous methods for FUE harvesting over the past several years. The current FUE device I  prefers to use is the Alpha Graft Unit. This is a simple FUE device that offers easy angulation and  adjustment to enable alignment with the  plane of the follicular unit as they exit the scalp.  Tumescent saline is used in the donor scalp to “straighten” the follicular units to maximize extraction and minimize transection of grafts.  Click here to see a video of my FUE extraction. 

This comment, from a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

Before you start shouting Nizoral and Selsun Blue, hear me out. Since I started Propecia (finasteride), my scalp has been itchy. I soon went for the Zinc Pyrithione, Selenium Sulfide, etc., but that seemed to make things much itchier.  I then reverted to regular shampoo and things got a bit better.

My hairdresser mentioned that my scalp looked dry rather than it being dandruff.  I then started using hydrating conditioner which has helped a lot, but my scalp still itches intermittently. I’ve Googled for scalp moisturizer but haven’t found much. Do you guys have any suggestions?

I think a trial of Neutrogena T/Gel shampoo, available at most grocery stores in our area for about $9.00, is worthwhile. I find that it solves most dry problems. If it doesn’t help in a few weeks I’d see a dermatologist.

T/Gel shampoo has tar in it so it’s not the best smelling. Not a problem for old married guys but if you are single you may want to pick up a better smelling shampoo or conditioner to use after the T/Gel.

Dr. William Lindsey – McLean, VA

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

This question, from a member of our hair loss forum and social community, was answered by Coalition hair transplant surgeon Dr. Vladimir Panine:

It’s about two days after my hair transplant surgery of 3000 grafts. I knew there would be some swelling, but this is insane. I have probably 10% visibility right now at best. Both eyes are almost completely swollen shut. Question is, is this normal? I was assured swelling is normal but these black eyes are starting to scare me. Any help would be appreciated.

Swelling sometimes happens after hair restoration surgery and is usually resolved by end of the week. We recommend keeping your head above your heart when you sleep, finish taking Medrol doze pack, warm compresses (warm teabags work well).

Swelling is somewhat dependent on how your body mobilizes fluid and can be more or less pronounced but it is transient and will be gone and forgotten by the time we take sutures out.

Dr. Vladimir Panine

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

Technorati Tags: hair loss, hair transplant, swelling, hair restoration