Post Hair Loss Questions and Get Answers

This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Ricardo Mejia of Jupiter, FL who is one of our recommended hair restoration physicians. His professional answer is below.

Scarring is risk factor with any surgery even in the best hands and even when we try to minimize the risks, it happens. I can guarantee you every hair transplant surgeon has had a similar result in one patient or another. Trichophytic closures help minimize the appearance of scars, yet they can stretch. This can be a result of the genetic variation in collagen and independent of tension factors. Hair restoration surgeons have gone back and rexcised the small 3- 5 mm wide scars with hardly any tension on the wound site. This can be an option for you if you are concerned. Keep in mind, you can still get a stretched scar even after a minimal revision without any tension. These are sometimes the uncontrollable factors in medicine and surgery.

Dr. Ricardo Mejia

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Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair loss, hair loss help, hair transplant, Hair restoration

In hair transplant surgery, if one experiences “shock loss” in the donor area, will it grow back?

This question was posed by a hair loss sufferer on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

My sense is that in the majority of cases of donor hair shock loss, the hair mostly returns. I have had this happen three times in my career, none within the past 8 years, as I have gotten smarter with age, I hope.

In all three cases the hair grew back and there did not appear to be any permanent hair loss. I have personally seen four cases of extensive permanent loss above and below the donor scar in work done at other hair restoration clinics, and have heard of many others that colleagues of mine have seen come to them for repair.

One thing I have learned over the years is that, if at least one attempt has already been made by anybody to try and cut out the bare area, whether it’s from permanent shock loss or a wide scar, it is fruitless to attempt another excision procedure. Follicular unit extraction (FUE) into the scar is then the best option, even though the survival of grafts into this kind of tissue is less than the usual 90% we enjoy elsewhere.

Mike Beehner, M.D.

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Technorati Tags: hair transplant, donor hair, shock loss, hair grew, hair loss, donor scar, hair restoration, Follicular unit extraction, FUE

These questions were posed directly to Dr. Ken Siporin of Beverly Hills, CA who is one of our recommended hair restoration physicians by a hair loss sufferer seeking hair replacement surgery as a means to regrow hair.  His professional answer is below.

I too have lost half of my transplanted hair of 3 years and continue to lose hair daily.  All are from the bang area.  You mentioned that you have been down that road too Dr. Siporin.  I have 2 questions:  1) What did you do for your case? 2) What are the options to fix my balding scalp now showing through?  I am very upset to see more hair fall out around the hairline.  The rest of the scalp is fine.  I had a forehead reduction 5 years ago.  A fine line was cut and a strip of skin was removed and then stitched.  I had 2 hair transplant surgeries 2 years apart and are about half an inch to an inch from the stitch line.  The grafts too initially but slowly are falling out.  What are my options to fill in the hairline / bang area?  Please tell me your opinion on future options to regain hair in any yway.  Thank you!

Technorati Tags: hair loss, hair replacement, regrow hair, transplanted hair, lose hair, Dr. Siporin, balding, hair transplant

Is there any evidence that suggests waiting a full two weeks for suture removal, as opposed to nine or ten days after hair transplant surgery will produce a thinner donor scar? 

This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

For many years we took the sutures out at around 7 days after hair restoration surgery. Around 6 years ago we switched to taking most patients sutures out at 10 days after a first hair replacement session, 12 days after a second session, and if a patient had a third procedure, 14 days for that surgery.

The more important point is that for any hair replacement patient with a slightly tight closure or who had “hyper-elastic” scalp tissue, we have the sutures taken out at 14 days, even for the first session. On rare occasions I have gone to 16 days, but the trouble with going past 14 is that the stitch material (or staples) start to become imbedded with skin tissue creeping over it, which makes the removal more difficult and more painful.

What is actually happening when a hair loss patient goes those extra 4-6 days with the sutures in place, you give time for the hair-bearing scalp above and below the suture line to start to relax and stretch out. In this process the remaining hairs become infinitesimally further apart, which the human eye can’t detect. Keeping the sutures in keeps the wound scar from being pulled apart on from above and below during those early days when the tension is the greatest.

Technorati Tags: hair transplant, donor scar, hair loss, hair loss help, hair restoration, hair replacement

This insightful article was written by Dr. William Lindsey of Reston, VA who is one of our recommended hair restoration physicians.

This week I was reviewing my hair transplant procedure records and came across an interesting finding. We have had 9 hair loss patients who presented for consultation who on examination, were found to have skin cancer on their scalp who were treated and subsequently had hair replacement surgery at our office. I would guess that I have had twice that number who were referred out for the skin cancer treatment and didn’t proceed with hair surgery.

Recall that the 3 types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell and squamous cell are related to sun exposure and often present as a pearly white or scaly plaque-like areas that may itch, hurt or bleed. Melanomas are thought to be contributed by sun exposure although many melanomas occur in places not exposed to direct sunlight including the retina of the eye, nasal cavity, and peri-anal areas. Melanomas are often lesions that are like dark moles and patients should look for the A,B,C and D warning signs on there moles. A is for asymmetry, B is for border irregularity, C is for color change or variation within the lesion and D is for diameter larger than a pencil eraser.

Technorati Tags: hair transplant, hair loss, hair replacement, hair surgery

This insightful hair transplant article was written by Dr. Bernardino Arocha of Houston, TX who is one of our recommended hair restoration physicians.

A survey of this hair transplant patient’s bald head, shows that the lateral fringes and crown have completely been eroded. The lateral humps have been obliterated, and the hair on the temporal areas (sides) is quite low. This isa level 7 on the norwood scale of hair loss country, it is a follicular unit barren real estate , where there is more hair loss, then there is remaining hair!

As if, that is not enough, study of the permanent donor area reveals that the hair density is decreased and the total occipital hair remaining is very diminished by baldness on two advancing fronts. From above, Androgenic Alopecia is eroding the crown, while from below a Retrograde Alopecia is raising the neck hair line.

After careful study, it is determined that a minimum of 2000 follicular unit grafts will be needed to commence the hair restoration process. That is, 500 follicular units to raise the lateral humps. Into which, we can anchored the hair line , which is estimated to need at least 1500 follicular units. We do not know at this juncture, whether, we can achieve the full 2000 hair grafts, much less, any extra to transplant into the area beyond the hair line.

Technorati Tags: hair transplant, norwood scale, hair loss, hair density, baldness, Androgenic Alopecia, Alopecia, follicular unit grafts, hair restoration, follicular units, hair grafts

This question was posed by a female hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

I saw a very reputable hair transplant surgeon yesterday. I have receding hair at my temples so I went in to inquire about a hair transplant to those areas. Upon inspection, he indicated that I have about 30% or so hair miniaturization in the donor area. I’m very scared and am now thinking “am I going to go completely bald“? I have more questions. Has anyone with similiar problem had hair restoration surgery that can offer me some insight?  He says he can do the hair transplant but can offer no guarantee on how long it would last.

Also, how long to miniaturized hairs last and how fast does it progress? Is it normal for a woman at age 46 to have hair miniaturization?

30% is a fairly high percentage of hair miniaturization to be present in the occipital donor area, usually the best hair on most women’s heads who have female pattern alopecia. Most of the time I wouldn’t give a woman a hair transplant with that high of a percentage, simply because it also portends that a lot of the other hairs will probably be following in the same footsteps of miniaturization a hair growth life-cycle or two away from now. The good news is that hereditary female pattern hair loss is a very SLOW process for most women, and almost never occurs as rapidly as its counterpart in males.

Technorati Tags: hair loss, hair loss help, hair transplant surgeon, hair transplant, hair miniaturization, bald, hair restoration, female pattern alopecia, hair growth, female pattern hair loss

This insightful information was posted on our hair restoration forum by Dr. Alan Feller of Great Neck, NY who is a member of the Coalition of Independent Hair Restoration Physicians.

Make NO mistake about it. A hair loss sufferer can lose some of his transplanted hair over the years. It’s not common, but it DOES happen.

What can happen in a few hair transplant patients is that the caliber of the transplanted hairs can actually thin noticeably within 3 years of hair restoration surgery. I have no idea why this happens, but it is a definite phenomenon in few patients. The way to counter this graft thinning is simply to implant more hair in the area.

This happened to a patient of mine who used to post quite frequently. I performed two hair replacement surgeries on him that gave him a thick tuft of hair in the front and top of the head. Then, about 2.5 years later he visited the office because of noticeable hair thinning in the recipient area. We did one more transplant and that did the trick. He has no problem since. He posted a professional portrait of himself and signed off the internet to go on with his life.

Making sure your hair transplant surgery is done right is just ONE aspect contributing to the final result. YOUR personal physiology plays just as important a role. The body does many seemingly qwirky and weird things and we are FAR from having all the answers.

Technorati Tags: hair loss, transplanted hair, hair transplant patient, hair restoration, hair replacement, hair thinning

I am 10 days after my hair transplant and went to get my sutures taken out, and the ends behind each ear seem to be difficult to remove. I’m not sure if the doctor I visited to have them removed (not my hair restoration physician) was new to this, but he said that I had scabs surrounding the knots on each end.

I soaked my head for 15 minutes before I went in, but this didn’t help much. Any ideas guys? He removed the middle section of the sutures along the back of my donor scar, but I still have to remove both ends behind my ears.

This hair loss question was answered by Dr. William Lindsey of Reston, VA who is one of our recommended hair restoration physicians.

In our hair replacement clinic, we usually remove all of the sutures by day ten.

However, we occasionally use coetaneous (skin) sutures which will dissolve in two weeks or so. More commonly, patients think that there are sutures still in place and its actually just dry skin/scabs along the suture line that needs more vigorous cleaning.

Finally, with our 2 layer donor closure technique, about one person in thirty has a deep suture extrude, usually around 3 months out. Thus, we often ask patients to come in for a checkup around that time and particularly to call if they are having any issues like this. You were smart to call your doctor and ask her thoughts.

William Lindsey, M.D.

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

I had a hair transplant (2800 follicular unit grafts) 5 months ago mostly in the crown and some in the hairline.  So far, I see no hair growth of the transplanted hair.  Should I be worried?  I have heard that growth in the crown tends to be slower.

At just only 5 months after hair restoration surgery, I don’t feel that you have any reason to be concerned.  Remember that the transplanted hair only starts to grow between 3-5 months after surgery.  They will typically start to grow as thin, fine, and colorless, not visible to the naked eye however, often times if you gently touch your scalp with your finger tips, you can feel some signs of new growth.  Over time, your replaced hair will grow, thicken, and darken until it comes to full maturity.  This process can take up to 12 to 18 months.

If you don’t see any visible signs of hair growth in the next 3 months or you are still extremely concerned, be sure to contact your hair loss doctor to get their input.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair transplant, follicular unit grafts, hair growth, transplanted hair, hair restoration, hair loss doctor