Post Hair Loss Questions and Get Answers

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 was wondering, when a graft is extracted via follicular unit extraction (FUE), how long can it be kept outside the body before it is placed in the recipient area?  Will keeping it outside the body too long impact hair growth?

The goal for most hair restoration physicians is to have all the grafts placed back into the recipient sites within 6 hours. Grafts are very resilient, but must remain well hydrated to survive.

 It has been proven that dehydration is the the numbe rone factor than can have the most negative effect on the grafts and inhibit hair regrowth. This is why in large cases 2500 follicular unit or more it is necessary to have enough assistants to get the job done within the proper time limits.

Since follicular unit extraction (FUE) is a slower process, not as many grafts should be retrieved from donor area before time would become a factor, and the grafts would need to be placed into the recipient sites. 

Dr. Glenn Charles, D.O.

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Bill Seemiller – aka Falceros
Associate Publisher/Editor

Technorati Tags: hair loss, follicular unit extraction, FUE, hair growth, hair restoration, hair regrowth

A new surgical tool designed to make the follicular unit extraction (FUE) surgical hair restoration procedure easier and more effective has been recently released publicly by Coalition member Dr. Alan Feller.

The development of this new motorized FUE tool was designed to reduce the extra forces on the hair follicles such as torsion, traction, compression, overheating, and desiccation. It also helps to create more viable and better quality grafts more quickly.

Its design in follicular unit extraction is to reduce damage to the follicles due to torsion by oscillating instead of spinning. Once the surgeon is finished using the motorized tool to score the skin around the graft, the grafts are delivered with minimal traction by a technique known as “perforation”. Because the tool is motorized, most of the stress and strain associated with manual FUE is removed, thus seemingly making the process easier and more efficient than traditional FUE.

Coalition member Dr. Ron Shapiro reported that he’s been using this tool for a few months in his practice and believes it helps makes extracting follicles easier and less fatiguing.

Recently, Dr. Feller started the hair loss forum topic A New Surgical Instrument for FUE Procedures to garner input from patients and other hair transplant surgeons. Visit the above topic to view the input of hair restoration patients and leading surgeons such as Dr. Mohmand, Dr. Nakatsui, and Dr. Devroye who had some personal experience with this surgical tool. View also a video demonstration of how this FUE tool is used.

Recently, I read a well written summary of the follicular unit extraction (FUE) procedure, its advantages, and it’s disadvantages by Coalition member Dr. Ron Shapiro who recently started to perform FUE at his clinic. A few weeks ago, I published it on our highly popular Hair Loss Q&A Blog. In my opinion, follicular unit extraction has been overhyped online by some hair restoration clinics while underestimated by others. Reading this well balanced article was extremely refreshing. I’d encourage anyone interested in considering FUE to read “The Evolution, Advantages, and Disavantages of Follicular Unit Extraction (FUE) Hair Transplant Surgery“.

Bill Seemiller – aka Falceros
Associate Publisher/Editor

Technorati Tags: FUE, follicular unit extraction, hair restoration

Recently, we published a well written summary of the follicular unit extraction (FUE) procedure, its advantages, and its disadvantages by Coalition member Dr. Ron Shapiro who recently started to experiment with FUE at his clinic.

Follicular unit extraction (FUE) has been notoriously overhyped online by some hair restoration clinics while other clinics underestimate its potential advantages in some circumstances. Reading this well balanced article was extremely refreshing. For those of you who are interested in considering the FUE procedure as a strip alternative, you are encouraged to read ” The Evolution, Advantages, and Disadvantages of Follicular Unit Extraction (FUE) Hair Transplant Surgery“.

Feel free to offer your input on this thread.

Bill Seemiller – aka Falceros
Associate Publisher/Editor

Technorati Tags: FUE, Follicular unit extraction, hair restoration

To date, surgical hair restoration is the only proven solution to grow hair in completely bald areas. However, like any other surgical procedure, it’s important to understand the possible risks that go along with it.

In optimal candidates, those who undergo a follicular unit hair transplant procedure end up with a pencil line scar easily concealed by existing hair on the sides and back of their head. However, during the initial healing phase, almost everyone is worried about the possible risk of scar stretching.

So what if anything can be done to minimize and even eliminate this risk? How long after a hair replacement procedure do patients have to worry that scar stretching may occur? Visit this hair loss forum thread to read other’s input and join in on the discussion.

Bill Seemiller – aka Falceros
Associate Publisher/Editor

Technorati Tags: hair restoration, grow hair, bald, hair replacement

This may sound stupid, but after undergoing a hair transplant, many folks are worried about donor strip scarring due to stretching.  Why not keep your head position looking up since it’s less stressful on the scar region because the skin is not stretching?  I’ve been experimenting a little bit with this. Any thoughts? I can imagine looking up for 6 months may be outlandish, but some folks will go at great lengths to have the smallest scar possible.

It doesn’t sound stupid at all – in fact, it’s very logical. Yet, I don’t know anyone who could really keep their head position in the “up” position for 3 to 6 months straight after surgical hair restoration. Instead, the idea is not to do anything to strain the donor area which will help minimize the risks of scarring.  Thus, holding your head in a downward position so that your chin touches your chest would not be a good idea because it adds tension to the wound.  Also, avoid any exercises in the gym that might put a strain on the area.   Some of these exercises may include crunches with your hands behind your head, flat bench press, and shoulder shrugs.

In the meantime, don’t strain your neck by looking upwards too long :-)

Bill Seemiller – aka Falceros
Associate Publisher/Editor

Technorati Tags: hair transplant, hair restoration

I  feel I have suffered hair transplant “shock loss” from the actual area where the strip was taken despite it being stitched up after the op. I am not talking about the top part of the recipient or frontal area. Has anybody heard of this before?

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

Shock loss in the donor area definitely can occur after surgical hair restoration. We don’t see it too often mainly because of hair covering the scar. But I have a marine we worked with about 2 months ago who, like all marines, didn’t take his valium as he is tough. This guy was a character!  When I started giving him a hard time about 90% of my military patients not taking valium and then I gave him the first shot, he said “thank you sir may I have another!”. Indeed he was tough.

Given the number of impressive hair transplant results presented in the “Results Posted by Leading Hair Transplant Clinics” forum, Coalition member Dr. Jean Devroye has quickly become recognized as a leading hair transplant surgeon in Europe.

In an attempt to improve the quality of results patients can achieve with follicular unit extraction (FUE), Dr. Devroye designed and has been using for 6 months a unique powered instrument (prototype) for FUE hair replacement procedures. This prototype was designed to improve the speed of the follicular unit extraction procedure while maintaining the same effectiveness as when performed manually by a skilled surgeon.

This new powered FUE device works by spinning alternatively with a low angular motion.  This allows for fast and effective penetration of the scalp and extraction of the follicle while keeping the risks of damage to the follicles virtually nonexistant.  It’s speed is controlled by a foot treadle allowing for better hand control of the device.

While Dr. Devroye believes his FUE tool prototype helps to increase the speed of the hair restoration procedure, he admits it doesn’t reduce the already very low transection rates he achieves while performing follicular unit extraction with a manual tool. Dr. Devroye’s powered FUE instrument has allowed him to increase the number of follicular unit grafts he can transplant daily via FUE from approximately 1200 to 1500 per day.

A hair restoration physician told me that he invented a procedure a year and a half ago for removing scars that he invented and he expects it will be the wave of the future for how scars will be done from now on.   Does this sound right?

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

Be cautious of folks who have “invented” some new technique that will revolutionize hair transplant scars. There are literally thousands of general and facial plastic surgeons who daily want to avoid significant scarring at almost any cost. Do you really think if someone invented something a year and a half ago that solved all scar problems that it wouldn’t make headlines and we’d all be doing it?

The best prevention is selecting a hair transplant surgeon who has a track record of creating good scars. Note that I am not saying “guarantees” or “no scars”.  Even the best suturer will have some scars that just aren’t so good. Remember people are like chemistry or cooking recipes, not exact math.  Meaning that 2 plus 2 is always 4, but if you do chemistry or cooking in one location and replicate it elsewhere, you should get similar results but there will be variations in outcome even with the same ingredients.

William Lindsey, M.D.

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Bill Seemiller – aka Falceros
Associate Publisher/Editor

Technorati Tags: hair restoration, hair transplant, hair transplant surgeon

This hair loss article was written by Dr. Ron Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians. 

What is Follicular Unit Extraction (FUE)?

Follicular Unit Extraction (FUE) is a method of obtaining donor hair for Follicular Unit Transplantation (FUT), where individual follicular units are harvested directly from the donor area, without the need for a linear incision. With the FUE technique, a .8mm to 1 mm punch is used to make a small circular incision in the skin around the upper part of the follicular unit, which is then extracted directly from the scalp.

Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) are sometimes mistakenly viewed as being two totally different hair transplant procedures. FUE, in fact, is a sub-type FUT where the follicular units are extracted directly from the scalp, rather than being microscopically dissected from a strip that has already been removed. To say it another way, in Follicular Unit Transplantation, individual follicular units can be obtained in one of two ways; either through single strip harvesting and stereomicroscopic dissection, or through FUE. Therefore, when comparisons are made between FUT and FUE, what is really being compared is the way the follicular grafts are obtained (i.e. strip harvesting and dissection vs. direct extraction). The process in the recipient area is the same.

The main advantage of FUE is that it does not cause a linear scar. Therefore it is useful in patients who for one reason or another may in the future want to have their donor area very short. (<1cm in length). This advantage was the main reason for the development of the technique.