Post Hair Loss Questions and Get Answers

This question comes from a member of our Hair Restoration Social Community and Discussion Forums:

After a recent follicular unit transplantation (FUT) procedure, I’ve decided to sleep with a pillow that elevates the back of my head and minimizes pressure or tension on the sutured donor area. I think I may investigate travel or neck pillows. Any suggestions?

Although minimizing friction and tension on the sutured donor area is a wise decision, you can probably do this with limited time and money spent shopping for a new pillow. According to hair transplantation experts, it’s ideal to keep your head elevated around 15 – 20 degrees to avoid excessive contact with the sutured region and minimize potential post-operative swelling in the forehead. Certain hair transplant patients report success using travel-like, “neck” pillows filled with air, beans (like in a bean bag), or foam. These types of pillows should be reasonably inexpensive and available just about anywhere. Additionally, other hair loss experts, such as Coalition surgeon Dr. Glenn Charles, say that simply putting a towel over a regular pillow should be sufficient if the patient doesn’t want to buy or utilize a neck pillow. Regardless, it’s probably best to ask your hair transplant surgeon for a list of post-operative instructions and follow the suggestions for sleeping post-hair transplant operation.

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Blake Bloxham – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

This question, asked by a member of the Hair Loss Discussion Forums, was answered by Coalition physician Dr. Bernardino Arocha

I am sure all hair colors are suitable for hair transplantation but would you say darker hair would get a potentially better result? This raises another question: The lighter the skin color the more noticeable the recipient area would be right after the procedure and a couple days after than for a person who has darker skin?

Hair color does have a significant impact on hair restoration outcomes. It is the amount of contrast between the skin color or complexion and the hair color that is important. That is, on a balding scalp, dark hair with pale complexion will appear thinner, while dark hair with a dark complexion will camouflage better hence appear thicker. For more information on hair characteristics and their impact on hair transplant results, please see: How Hair Characteristics Impact Hair Transplant Results | Hair Loss Q & A

Dr. Bernard Arocha, M.D., ABHRS

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David – aka TakingThePlunge
Assistant Publisher and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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Technorati Tags: hair transplantation, hair restoration, balding, hair transplant, Hair Loss

This question, from a member of the Hair Restoration Social Community and Discussion Forums, was answered by recommended hair restoration physician Dr. William Lindsey:

I went in person to several hair transplant doctors here in NYC and then I emailed three other doctors nationally and abroad with detailed descriptions and photos. Each doctor gave me a different estimate of grafts based on my degree of hair loss. The estimates ranged from 1,000 grafts to 2,700. Most of the estimates were around the 1,600 mark. So why all the different estimates?

Well, it varies from patient need to patient need, and from physician to physician. For example, a young African-American man came to my office today for a consultation. He’d been to 3 other hair transplant surgeons and had a list of questions.

First off, I thought he needed maybe 1500 grafts to the front only. That way he’d save hair for the future and limit the width of his donor scar. Plus, with that curly black hair, he needs way less hair to cover an inch of balding scalp than a thin-haired Asian or Caucasian. I told the fellow that 2200+ grafts and dense packing would be pushing it. I find that, not only do black men and curly haired Middle-Eastern men not need as much density (due to the caliber of the hair shafts and the waviness of the hair), but when we try to pack it too tight, there is just too much popping out of the grafts when placing nearby grafts.

Dr. Cam Simmons is a member of the Coalition of Independent Hair Restoration Physicians.

I am 25 years old and have been experiencing hair loss for about 4 years. Currently I am between a IV and V on the Norwood Scale. I am open to both FUE or Strip but prefer FUE.  My goals are to fill in the crown but I am not sure how many grafts are needed to cover my balding area and any info about that would really help. I am thinking about 2,500 grafts. Will this be enough?

As you are just 25 years old, you could develop a full Norwood VI pattern later and could even go on to develop a Norwood VII pattern. If you are not already using medical stabilization, you should consider using Propecia (finasteride) and Rogaine (minoxidil). Whether you choose follicular unit transplantation (FUT) or follicular unit extraction (FUE) there is a limit to how much scalp hair you will be able to transplant. You may not have enough scalp donor hair to cover your whole eventual balding area well.

If you did transplant 2,500 grafts over your whole thinning area it would probably look quite sparse. There can be a role for hair transplantation for you but you need to have a good long-term plan with clear expectations and should understand your commitment to more surgical hair restoration later.

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This question, from a member of the Hair Restoration Social Community and Discussion Forums, was answered by recommended hair restoration physician Dr. William Lindsey:

Which vitamins and supplements are the top ones to help hair growth?

There are lots of anecdotal reports of supplements, shampoos and lasers out there that claim to do wonders for hair loss and most anything else. Before you spend significant money, try to find a controlled study published in a peer reviewed medical journal in the US or Europe   showing that whatever product you are interested in actually has a clinical effect in human beings.

If you can find even one study, then I’d say it’s likely worth a try. If you can’t, ask yourself why. All doctors want to show how great their results are. If a doctor finds something that works, I guarantee you that he wants to be the first to publish it!

I can completely understand balding patients wanting to try things they hear about and avoid or augment medications like Propecia (finasteride) and Rogaine (minoxidil) or hair transplant surgery. All I’m saying is, know what you are spending your hard earned money on.

Dr. William Lindsey – Mclean, VA

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David – aka TakingThePlunge
Assistant Publisher and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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This question, from a member of our Hair Restoration Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. Glenn Charles:

I’ve recently become worried about my hair loss and I’m wondering if there is a way to measure dihydrotestosterone (DHT) levels in the blood? I know these types of tests are possible for measuring regular testosterone, but I didn’t know if it would work for DHT?

Yes, you can measure a hair loss patient‘s DHT (the hormone directly responsible for genetic balding)  levels. The two most common methods of measuring DHT , as well as many other hormone levels, is through a blood draw or a saliva panal. In my experience, saliva panals are more accurate in determining a patient’s available hormone levels (including DHT and Testosterone).

Glenn M. Charles, D.O.

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Blake Bloxham – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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Technorati Tags: Hair Restoration, hair transplant surgeon, hair loss, dihydrotestosterone, DHT, hair loss patient, balding

This question comes from a member of our Hair Restoration Discussion Forums and Social Community:

I recently underwent two separate consultations with different, recommended hair transplant surgeons and each one provided me with unique and differing assessments. Each hair restoration physician said I was a different level on the Norwood balding scale, and then suggested an unrelated number of grafts (one doctor suggested more and the other suggested less). Is one surgeon right and the other wrong? What should I do?

Differing hair transplantation assessments is most likely a fairly common occurrence, and it’s difficult to state that one surgeon is “right” while the other is “wrong.” There are several variables which could cause this issue and lead to a bit of post-consultation confusion:

First, remember that hair transplant surgery, and medicine in general, is comprised of 50% science and 50% art. Knowing this, it’s easy to understand how two, highly trained surgeons can evaluate your scalp scientifically and still devise two separate restoration plans based on their own experience and preference. It doesn’t mean one is valid or invalid, simply that these two practitioners understand the data, but view the “plan of attack” differently.

Second, the Norwood scale is not necessarily the final decider of your balding pattern and future progression. The scale, while very helpful, is simply a set of guidelines, created to help physicians diagnose and explain the hair loss process to their patients. It’s a generalization, and there is no guarantee that you will perfectly fit a pre-determined mold (especially when it comes to different physician’s interpretations and something as unpredictable as hair loss).

This question, from a member of the Hair Restoration Social Community and Discussion Forums, was answered by recommended hair restoration physician Dr. William Lindsey:

Do you find that a lot of people have same concerns about hair transplant surgery? If you have a difference of opinion with your doctor, should you bring that up? At what point do we have to trust them?

You should absolutely bring up a discrepancy in planning to your hair restoration doctor pre-op! To not discuss this may result in you being less satisfied, feeling swindled (even if no swindling occurred) and possibly with the wrong treatment plan to deal with your hair loss. On occasion, patients ask for something that is not right for them but most can be educated (not brainwashed) with a fairly simple conversation.

If something doesn’t make sense to you that the doctor is telling you pre-op, consider an opinion from a different doctor. Note that I am saying, if you don’t get it explained well, see someone else. I sometimes tell prospective patients something they don’t like or what I won’t do, but I try to make it very clear as to why. For example, if someone wants to sprinkle hair into a mildly balding area or a young fellow wants a low hairline which may look goofy when he’s 50 years old, I’ll refuse as I don’t think it’s in their best   interest.

Dr. William Lindsey – McLean, VA

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Within the last several months, injectable, cell-based hair loss treatments seem to be the most discussed topic in medical hair restoration. Whether it’s a hair stimulating complex, stem cell based therapy, or even clandestine, miracle “compounds,” injectable hair loss therapies are being hailed as baldness cures by patients, rushed to clinical trials by biomedical corporations, and cautiously analyzed by practitioners and dedicated researchers.

Although excellent, detailed analysis has been written on the subject, hair loss sufferers still yearn for two crucial details: 1. Will these products work, and 2. When will they be available for use?

Unfortunately, we simple do not know (yet).

The efficacy of these products is something every individual involved with the field of hair restoration eagerly awaits. Although it’s difficult to generalize, many of these therapies have fallen prey to common research fallacies, such as initial promising data that does not continue during later phases, funding issues, a lack of adherence to scientific research techniques, and conducting insufficient rounds of clinical trials. However, several products have continued demonstrating noticeable results and are conducting advanced research trials as we speak. This type of progress will demonstrate the true initial efficacy (maintenance over a long period of time could become another issue) of these therapies, but unfortunately is not available yet. Additionally, until these products are proven safe and effective, they probably will not be available for commercial usage.

This hair loss question was answered by Dr. Glenn Charles of Florida who is a member of the Coalition of Independent Hair Restoration Physicians. His professional answer is below.

I understand that current lasers used for hair growth have not been proven to work but I have known several people to undergo laser hair removal and, instead of a reduction, they experienced growth of thicker, fuller hair in the treated area. I doubt any new hairs grew; I think that the extremely fine hairs just became much thicker and more noticeable. Does this mean that if lasers are perfected or used properly, they can potentially induce hair growth?

I have heard that a few new companies are coming out with stronger lasers for treating hair loss. We will have to wait to see if this really happens. I still tell patients that lasers probably help more patients with quality of hair rather than quantity of hair. However, I have had many patients over the years who are very happy and feel they have more healthy hair than before the treatments. I have also had patients who did not see any real, noticeable improvement in the appearance of their balding areas. Like many other medical treatments the success varies from patient to patient.

Dr. Glenn Charles

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David – aka TakingThePlunge
Assistant Publisher and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
Follow our community on Twitter
Watch hair transplant videos on YouTube