Post Hair Loss Questions and Get Answers

The following thorough response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member and lead medical tech and surgical manager for the Shapiro Medical Group, “Janna”.

My first hair transplant surgery was ten years ago and I’m considering doing another one with a reputable surgeon. One issue I’ve spoken to various top hair restoration physicians about is improving my hairline which, if you look at it very closely, looks pretty pluggy due to the mini-grafts used. What I’ve discussed with some of the surgeons is the idea of removing them and planting them further back to blend with newer transplanted hair, or to place grafts around them to minimize the look. Has anyone had luck with this? Also, when mini-grafts are simply removed is there a pinhole or scarring left in their place or can they be pretty cleanly removed?

Either removing the mini-grafts or transplanting around them are both viable options when revising an older procedure. Generally, there really isn’t much of a scar remaining after a punch out session if done correctly. Which course to take depends on several factors, such as, the size of the mini-grafts, how prominent they are in the hairline and how high or low the current hairline is. If your hairline is low, the recommendation will likely be to remove as many mini-grafts as possible and replant them further back. I would imagine you’ll still need some fine single hairs to make it look natural.

The following thorough response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member “Gillenator”.

My beard line dips down a bit on one side and I’m considering hair transplant surgery to fix it. I probably only need about 100 grafts. I’m worried about scarring on my face with the transplant since I don’t always have my beard grown out. Will I see any sort of scar or mark where the follicle was transplanted? I assume that between the two methods of extraction FUT vs FUE, it will make no difference for what I’m trying to accomplish in terms of end result?

I think the method of extraction does make a difference in a small case such as yours. Since the recipient area you want filled in is relatively small, requiring the 100 grafts you mentioned, you may want to consider follicular unit extraction (FUE) versus follicular unit transplantation (FUT) to harvest the grafts you will need. Providing you have thick facial growth, you may also want to consider having the donor extracted from under your chin for several reasons.

First, the recipient area will potentially look the most natural grown out if the donor grafts also come from the face. It’s the same hair. A smaller punch (.50mm) would potentially be used so there should not be much visibility of scarring under your chin after the extractions completely heal.

This question, asked by a member of our Hair Restoration Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. Glenn Charles:

I’ve always been self-conscious about my high hairline, but I don’t think I’m ready to undergo surgical hair transplantation to lower it to a more cosmetically pleasing level. So I’m wondering, will applying Rogaine (minoxidil) 1-2 centimeters below my natural hairline create new growth and lower my hairline?

I have never really seen Rogaine lower a patients hairline. In most cases the only way to do that is with a hair transplant. In fact, even if you used Rogaine 4 times per day ( twice the recommeded dosage ) I would not expect any change in the height of your hairline.

Dr. Glenn Charles

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Blake – 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, hairline, hair transplantation, Rogaine, minoxidil, hair transplant

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 am having a small FUE procedure of around 700 grafts. If one day my balding progresses and I need a larger session, will the FUE have reduced the total amount of grafts I will be able to get from a future FUT hair transplant?

William H. Lindsey, MD, FACS
McLean, VA

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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 have mini-grafts at my hairline from a hair transplant 10 years ago. You would probably not be able to tell unless you were staring at them from a few inches away. If there was one place they were visible, it’d be right at the root which is unnaturally thick. Natural hair at the hairline is typically very soft and light. So, I’m wondering if anyone has tried lightening the root of those hair shafts right at the hairline to lessen the appearance of transplants?

Since dying or lightening your hair isn’t permanent and doesn’t typically result in significant damage to the follicle, it is worth a try and may make the hairline a little less noticeable.

You may also want to consider hair restoration surgery to remove and redistribute part of the mini grafts. Another option is placing some additional follicular unit grafts around and in between the mini grafts to help camouflage them. These techniques have been used quite successfully to enhance the appearance of older, mini-graft procedures.

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

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

I’m looking to undergo a moderately sized follicular unit extraction (FUE) procedure, but I’m having trouble finding information on the actual growth rate/yield I can expect from FUE. What kind of growth rate can I expect from a follicular unit extraction (FUE) procedure?

I think there are two things to consider with regard to follicular unit extraction (FUE) and yield/growth rate: 1. any damage to follicular unit grafts during the extraction phase (which would damage the follicle and result in a graft that didn’t grow) and 2. a graft extracted from outside the universal extraction zone, which would be susceptible to future hair loss (as the graft wouldn’t be as resistant to dihydrotestosterone – DHT).

The first variable is dependent on the skill of the hair restoration surgeon and, to a much lesser extent, the tool used. If you visit an experienced FUE surgeon, my guess is that the ’90 – 95%’ number often quoted (which is comparable to the 95% growth rate experienced with traditional follicular unit transplantation) would be accurate. If the practitioner has less experience with extracting follicular units, than issues with transection become apparent and the ‘yield rate’ will suffer as a result.

The second variable is really up to the hair transplant surgeon, how many grafts he/she is trying to extract, and whether or not they feel like the follicles in these extraction areas (outside of the universal safe zone) are susceptible to future loss or not.

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 recently had hair transplant surgery via follicular unit transplantation (FUT) and I am wondering how long it will be until my donor scar is fully healed. When will I no longer have to worry about complications or possible scar stretching?

One year is the usual, final end result for scars in my 16 years of practice. However, most scar problems will be evident at around 6-12 weeks and, on rare occasions, a scar can act up years later. This often occurs as the result of some incidental trauma in that area.

I ask every hair restoration patient to return at 6 weeks to look at their scar. If there is a small problem at 6 weeks, it’s usually fixable with minimal effort rather than waiting for a big problem to show at a year. Despite this educational information, most patients don’t show for a scar check.

William H. Lindsey, MD, FACS
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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Technorati Tags: hair transplant, follicular unit transplantation, FUT, hair restoration, Hair Loss

This question was asked by a member of our Hair Restoration Social Community and Discussion Forums:

After a recent hair transplant procedure, I noticed the hairline created by my hair restoration physician was slightly irregular or “jagged.” After reviewing cases on the discussion forums, I noticed that most surgeons design hairlines this way. This made me wonder, should hairlines created during hair transplant surgery be perfectly symmetrical or slightly asymmetrical and irregular?

Although each hair transplant patient‘s case is unique, surgeons generally do their best to recreate naturally occurring hairlines. Despite the fact that the “jagged” appearance seen in most post-operative pictures may look a bit odd, it actually mimics the way natural, non-balding hairlines grow. In many cases, transplanted hairlines that are perfectly symmetrical or straight create an unnatural appearance because, although it looks neat and aesthetically pleasing post-operatively, this is not the way hairlines naturally grow.  For example, here is what Coalition hair transplant surgeon Dr. Glenn Charles had to say regarding irregular versus symmetrical hairlines:

Since most hairlines in real life are not perfectly symmetrical or straight, there should be some degreee of randomness in any transplanted hairline. The term I use to describe this to patients is a regular irregularity. This means that the hairline will have a slightly staggerred/irregular pattern, but there is a method to the madness in how it was created.

Additionally,  make sure any concerns regarding the irregularity of the transplanted hairline are discussed with your hair restoration surgeon during a detailed consultation.

Look at enough hair transplant photos and it soon becomes obvious that there is a trend in the combing and styling displayed. It may best be described as the “network anchorman do.” This phenomenon leaves some patients yearning for something more youthful and trendy wondering about the possibilities and limitations of styling a hair transplant. Can you wear it long? Can you spike it? What about the ubiquitous “faux hawk”?

In most cases, hair restoration surgery cannot restore original, natural density to the balding scalp. Instead they rely on a concept known as the “illusion of density” created by skillful placement of the follicular unit grafts and enhanced by an appropriate hairstyle. But, can surgical hair replacement be designed to enhance the look of a specific hairdo?

Forum member, “Cant decide” started the discussion thread entitled, “Was your desired hairstyle discussed as part of your surgical plan?” in the search for an answer to this question. You are encouraged to add your input on this discussion.

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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

Get Proven Hair Loss Treatments at the Best Prices by visiting our new Online Hair Loss Product Store

Technorati Tags: hair transplant, hair restoration, balding, follicular unit grafts, hair replacement, Hair Loss Treatments, Hair Loss Product

It’s no secret that hair transplant surgery is a complex procedure requiring the skills of an experienced physician and the clockwork precision of a highly trained staff. Within the realm of surgical hair restoration, there lie many lingering debates regarding technique; FUE vs. FUT, sutures vs. staples, shaving the head vs. not shaving, just to name a few. But, perhaps one of the most misunderstood of these techniques is the method used to make the incisions for placing the follicular unit grafts.

The two most common slit-making techniques are parallel (sagital) and perpendicular (lateral/coronal).   By definition, sagital incisions run parallel (vertical) alongside and in-between existing hairs while the lateral incisions bisect existing hairs perpendicular (horizontal) like a T.   Learn more about parallel versus perpendicular incisions by visiting “Hair Transplant Photos – Parallel (Sagital) versus Perpendicular (Lateral/Coronal) Incisions“.

But, what does that mean to the prospective hair transplant patient? Is one technique always better than the other? Are both techniques ever used in the same procedure?

For the answers to these questions, visit the discussion topic, Does the Lateral Slit Technique Provide Better Yield than Sagital Technique?, started by Hair Loss Forum member “j1j9j85″. You are encouraged to provide your input to this important topic.

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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