Donor Issues


I have two questions concerning long-term hair restoration goals. Regarding medications, doesn’t Propecia lose its effectiveness over time? Also, what happens when patients’ donor hair starts to thin? I was told that hair from the “safe zone” eventually becomes susceptible to Male Pattern Baldness. If these things are true, how can anyone guarantee lasting results?

This hair loss question was answered by Dr. Cam Simmons of Toronto, Canada, who is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians.

I know some patients who have taken Propecia (finasteride) since 1997 (before they met me) who feel that they haven’t lost more hair, and some who have had a slow decline.

Some hair follicles in the donor area may be affected by DHT, but most aren’t in most men. Take a look at the seniors you meet or pass in a day. In a few, you can see through their hair on the sides, but not in most. Some men can get generalized thinning of all of their hair in advanced age, called senile alopecia.

I just did a touch-up hair transplant for a 68 year-old man who had 4 sessions from 1976 to 1980 and the transplanted hair was still there. His hair was about 2 inches long, and the rows and rows of punch graft scars did not show. The scars made up about half of his 9mm wide, 30cm long donor strip, but we still managed to get 1408 grafts.

Beard Hair for Hair TransplantFollicular unit extraction (FUE) is becoming an increasingly popular hair transplant procedure for men who don’t want a linear strip scar.  However, men with advanced hair loss are quickly learning that the available donor hair supply via FUE is typically less abundant than via follicular unit transplantation (FUT).  Thus, follicular unit extraction enthusiasts are turning to body and beard hair for alternative sources of donor hair to fill remaining balding areas.

The idea of using beard hair as a rich source of donor has enticed members of our community.  Though body hair has been notoriously inconsistent in terms of hair growth yield, beard hair is considered a viable and robust source of donor hair.  However, patients are reluctant to make use of this donor source due to risks of scarring on the face.

To learn about the benefits and risks of using beard hair for transplanting, visit “Beard Hair Transplant – Donor Scarring”.  You are encouraged to offer your input.

Bill Seemiller – aka Falceros
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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Balding men and women with advanced hair loss are often sold short due to the overwhelmingly large bald area to cover with a finite donor hair supply. Hair restoration surgeons are careful only to harvest follicles within a certain area of the sides and back of the head known as the “safe” zone. These are the areas considered to be at low risk to be impacted by DHT, thus, “permanent”.

But what if hair transplant patients were willing to take the risk to get more hair and ask their surgeons to harvest follicles outside the universal safe zone? Wouldn’t that allow patients with advanced balding a chance at thicker and fuller hair? What are the risks of losing some of this hair as male pattern baldness progresses? Does safe donor hair vary for each patient?

Recently, forum member “hairshare” started a topic on our hair loss forum to discuss the advantages and disadvantages of using hair from unsafe areas. You are encouraged to join in the discussion and offer your input on this important topic.

Bill Seemiller – aka Falceros
Managing Publisher of 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 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.

How often do patients ask hair transplant doctor to take hair from the unsafe areas of the sides and back of the head?  Could this hair be susceptible to the effects of DHT (dihydrotestosterone) and use that for the front? Is this common at all? Thanks!

Dr. CharlesIn my experience this is not very common. Most hair restoration patients trust the doctor to only take donor from an area that is most likely permanent. If a patient is already having hair loss or thinning hair and the doctor feels that it is due to male pattern baldness (mpb), it would not make sense to take donor tissue from an area that may be lost later.

Dr. Glenn Charles, D.O.

Bill Seemiller – aka Falceros
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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Watch hair transplant videos on YouTube

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Follicular Unit Extraction (FUE) has become exceedingly popular in balding men who desire to keep their hair cropped short on the sides and back of their head. Though both Follicular Unit Transplantation (FUT) via microscopic dissection and FUE cause some scarring, the main advantage of FUE is that it does not create a linear scar like FUT via strip.

However, due to the extra forces placed on the hair follicles during the extraction process, the chance of damage to fragile follicles are greater, thus potentially decreasing overall hair growth yield. Learn more about the Benefits, Limitations, and Potential Problems with FUE.

Recently, a handful of dedicated hair restoration surgeons with a realistic view of what can be accomplished with follicular unit extraction have engineered new and innovative tools designed to improve the effectiveness and speed of the procedure. To learn how each tool works and is supposed to help overcome the potential problems associated with FUE, click on the respective links below:

Recommended physician Dr. Harris’ New FUE Tool

Coalition Member Dr. Devroye’s New FUE Tool (with video)

Coalition Member Dr. Feller’s New FUE Tool

Though these hair transplant tools may help make the FUE procedure faster, easier, and more effective, the skill and experience of the surgeon performing the procedure is paramount. To discuss FUE, its benefits, limitations, and potential problems, visit our discussion forum.

This hair loss question was answered by Dr. Paul Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians

My hair transplant is booked for Dec 14th 2009. I was told not to engage in physical activity for at least 1 month post-op.  Im not sure how to do this.  I work out 4-5x/week. I take about 1 week a year off maximum.  Exercise has been and is a form of stress relief/therapy.  If there are any other exercise fanatics out there how have you dealt with this ?

Hair Transplant Pysician Dr. Paul Shapiro

Wounds heal in three stages:

The first stage is the inflammatory phase. In this phase the wound swells and the ingredients such as white blood cells, clotting factors, and fibrinogen for the adherence of the wound, prepare the wound for healing. This stage peaks at three to five days and the wound is very weak at this point. That is why it is very important to take it easy in the first week after surgical hair restoration if one wants to avoid a wide scar.

The second stage of healing is the collagen phase which starts at about one week after the hair transplant procedure. During this stage the collagen content increases and the wound strengthens. Sutures can be removed during this stage and we remove our sutures at 10 to 14 days.  The second stage of healing last 2 to 4 weeks as the collagen content increases and the wound strengthens.

Our highly popular hair restoration community consists of thousands of hair loss sufferers searching for real hair solutions and dozens of prescreened expert hair loss doctors. See how we recommend hair restoration physicians. Many of these physicians regularly contribute their expert opinions and advice on important issues related to hair loss and restoration.

Below, we’ve compiled some of the most recent and vital input we’ve received from leading physician member of our community and presented them below for your benefit.

Are Hair Transplants Detectable? (Dr. Glenn Charles)

Is FUE the Solution for Young Hair Loss Sufferers? (Dr. Cam Simmons)

Is Donor “Shock Loss” After a Hair Transplant Common? (Dr. William Lindsey)

Who are Optimal Patients for Dense Packing? (Dr. Paul Shapiro)

Bill Seemiller – aka Falceros
Managing Publisher/Editor

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Surveys confirm surgical hair restoration has gained popularity amongst balding men and women looking for real hair restoration solutions over the last several years. In fact, the number of hair transplants performed worldwide has increased 26% since 2006 alone.

State of the art hair transplant surgery has been divided into two distinct procedures, follicular unit transplantation via microscopic dissection (FUT/strip surgery) and follicular unit transplantation via follicular unit extraction (FUE). In both procedures, small ultra refined follicular units (hairs as they occur naturally) are carefully prepared and inserted into tiny recipient sites created by quality physicians using minimally invasive techniques. Where the procedures differ however, is in donor hair removal.

FUE in particular has become exceedingly popular in balding men who desire to keep their hair cropped short on the sides and back of their head. Though both procedures cause some scarring (typically minimal in the hands of a skilled physician under optimal conditions), the main advantage of FUE is that it does not create a linear scar like FUT via strip. However, due to the extra forces placed on the hair follicles during the extraction process, the chance of damage to fragile follicles are greater, thus potentially decreasing overall hair growth yield. Learn more about the Benefits, Limitations, and Potential Problems with FUE.

Recently, a handful of dedicated surgeons with a realistic view of what can be accomplished with follicular unit extraction have engineered new and innovative tools designed to improve the effectiveness and speed of the procedure. To learn how each tool works and helps to overcome the potential problems associated with FUE, click on the respective links below:

Dr. CharlesAs Follicular Unit Extraction (FUE) becomes increasingly popular amongst male hair loss sufferers, more and more hair transplant surgeons, clinics, and hair restoration companies are designing new tools and machines that allegedly work to make FUEeasier, faster, and more effective. However, with all these new “revolutionary” tools on the market, how does the hair loss sufferer know which tools will deliver the best results?

Recently, forum member “LT” saw the new automated NeoGraft FUE hair transplant machine advertised on TV as a revolutionary tool that performs faster and more effective FUE. It also claims to eliminate scarring. To discuss the new NeoGraft machine and whether or not it’s the next major advancement in hair transplant surgery, visit this discussion topic.

 

Bill Seemiller – aka Falceros
Associate Publisher/Editor

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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.

My hair transplant scar is on the wider side, 3-4mm and is pretty easy to see unless hair is combed the right way.  The scar did not stretch, and I did not feel any tension after the operation, but the scar is still wide.  When I run my finger over the scar, it feels like the scar is “thinner” that the surrounding skin – like there is a impression or ridge in the middle of the scar.  I am trying to figure out why I got such a poor scar. This was a trichophytic scar from one of the best hair restoration doctors. The only scars I have seen that are worse from a virgin scalp are stretched scars.  Mine was always wide. At first it was red, and then when redness faded, now white. No trichophytic hair growing within.

Dr. CharlesThis is one of the potential downsides of taking donor strips that contain 4500 follicular units. Bigger strips=bigger wounds= more tension=bigger scars. Some hair replacement patients have tighter scalp to begin with. Did your doctor recommend scalp exercises or was a two layer closure used in your procedure to close the donor wound? Scar revisions can be performed at a later time as well as follicular unit extraction (FUE) into scars. I admit I have had hair loss patients who really wanted to get a large number of grafts on the first procedure, and told me they really did not care about the scar in back. Probably because they intended to always keep their hair longer in back. 

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