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This question comes from a member of our hair loss social community and discussion forums: 

I’m undergoing hair transplant surgery, and want to make sure the new hairline is created at an appropriate height. Anatomically, what is the proper distance between the eyebrows and the hairline? Are hairlines always placed at normal proportions during hair transplant surgery?

Normal hairline height is relative to the patient. Most hair restoration physicians like to refer to Leonardo da Vinci’s “rule of thirds” when determining natural hairline height. The rule of third refers to the idea that the face is split into three equal parts: the section between the chin and the bottom of the nose, the bottom of the nose to the glabella (space between the eyebrows), and the section between the glabella and hairline.

Obviously, this doesn’t always hold true in hair restoration surgery (as hairlines are sometimes not lowered to anatomic position), but it’s a good rule of thumb for “normal” hairline height. However, if you’re looking for approximate figures, most natural hairlines are around 6.5 – 7.5 cm (roughly) from the glabella.

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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

Follow our community on Twitter
Watch hair transplant videos on YouTube

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

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Kenneth Siporin:

Has anyone found scalp exercises helpful to increase donor laxity prior to hair transplant surgery?

Recently, we sought the input of our hair loss community members on the potential recommendation of Dr. John Frank, who practices high quality hair transplantation as the primary part of his practice in New York City. Today, we are pleased to announce that Dr. John Frank of New York, NY has been approved for recommendation on the Hair Transplant Network. To learn how we prescreen and recommend hair transplant surgeons, click here.

Dr. John Frank has over 15 years of experience and performs both follicular unit transplantation (FUT) and follicular unit extraction (FUE) at his clinic in New York City. He has the staff and experience to perform large sessions exceeding 2500 grafts when appropriate for the patient. Dr. Frank operates on only one patient per day and does the majority of the consultations himself.

Dr. Frank, his technique and results were carefully reviewed by our patient community. Visit the “Potential Recommendation of Dr. John Frank of New York, NY” to see what our members are saying.

After careful consideration in evaluating his technique and receiving positive feedback from patients and quality physicians, we are pleased to announce that Dr. John Frank has been approved for recommendation on the Hair Transplant Network. You are encouraged to congratulate and welcome Dr. Frank to our community by visiting his potential recommendation forum topic above.

For those considering state of the art surgical hair restoration in New York City and beyond, you are encouraged to consider Dr. Frank for your next hair transplant procedure. To view his recommendation profile, click here.

Reading though different hair restoration forums and browsing through results, it appears that follicular unit transplantation (FUT) yields better results and is more consistent in comparison to follicular unit extraction (FUE). In theory if shouldn’t be the case as FUE allows you to extract any kind of graft you want whereas strip is limited and you only got what’s in a strip of skin that’s been cut off.

FUE results vary. Some results are on par with FUT and some are not so great. Many surgeons don’t do any testing. I think the only one who does it is Dr. Rassman (not sure if he still does). Many don’t even test body hair transplants (BHT) and move to the large sessions without knowing what % of grafts will grow and we all know how unpredictable BHT can be.

Disturbing part is a lot of FUE clinics advertise 100% growth or close to it. Truth is they can’t predict that even if they are the best in the field. Also, excuses such as hair color, scalp contrast and curl is the reason why some results look better than others. Yes, these are the factors but they are often used to cover up for poor yield.

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

My understanding is that, in general, an average maximum possible hair transplant donor strip width on a virgin scalp is around 1.25-1.75 cm for a person with good laxity. What would the maximum possible average donor strip width be for this same person in their second surgery? I realize that donor strip widths are not uniform across the entire strip but I am referring to the average width along the entire strip. My guess is that it would be about 1 cm – 1.3 cm in the second surgery.

This insightful article was written by hair loss physician Dr. Carlos Wesley, who is a member of the Coalition of Independent Hair Restoration Physicians.

Patients so often, when electing for follicular unit hair transplantation (FUT) or the classic strip harvest, inquire about whether or not they should have a trichophytic closure. There are so many variables involved in this decision that even the major conference in our specialty has dedicated entire sessions to this topic.

The images below illustrate that, even within the same patient, the decision as to whether to “tricho or not tricho” can vary. All images are from my patient on his 3rd postoperative day using sterile nylon sutures for the donor closure. The first image is simply a schematic to illustrate where the magnified images were taken. The following image is a “standard” (non-trichophytic) closure used in the temporal areas where the patient had relatively low density. A trichophytic closure would not have made much sense here since little hair could’ve grown through the scar. The last two images were of the patient’s occiput (back of his head). I did use a trichophytic closure in this region (both images) because of the hair density. In the first “tricho” image, you can see that the hair is going to grow through the scar. In the second, there is little noticeable hair along the donor suture line. However, this doesn’t mean that there still won’t be hairs buried within the closure that will ultimately grow through to further camouflage the donor area.

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

So far I’m at 68 days (give or take a day) post-op and I’ve experienced some limited hair growth in the recipient area (I had hair transplanted into a childhood scar) as well as shock loss around my donor scar. Since my procedure, I’ve been experiencing mild sensitivity around my donor scar. It’s difficult to explain. It isn’t painful but it isn’t comfortable either and, on occasion if I turn my head in a certain angle, it can still hurt my donor scar or make it feel uncomfortable. I’ve always attributed this to tightness, etc., of the donor scar. It feels like pulling or something.

Anyway, I’ve been surfing around trying to see if anybody else has been experiencing any odd pain such as weird stinging pain above the actual donor scar and I think I found a post where one hair transplant patient mentioned he had a staple or stitch left over in his donor area. I’m thinking the same may apply to me, which has me worried, and I noticed when I feel my scar there’s a slight thread-like substance felt above the very edge of my donor scar. What is it? I have no idea as I’ve never noticed it until now and nobody has ever mentioned it despite the number of people I’ve had inspected my scar to assure it wasn’t stretching during the initial first month or so.

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

Five months ago, I underwent a large Follicular Unit Transplantation (FUT) procedure. The surgery was successful, but one area of the strip scar remains raised and hard. I visited the surgeon who performed the procedure, and he said this part of the closure was now considered a hypertrophic scar. He said at this point I can undergo some steroid injections (with cortisone) to treat the area. Should I get the injections done? The operating surgeon is now in a different country, so should I travel to have him do the injections?

Dr. Charles: 

I generally wait at least 6-8 months before recommending any cortisone (steroid) injections. This is because hypertrophic scarring can continue to raise and thicken for up to 6 months after the operation.

The steroid injections can help flatten and sometimes shrink hypertrophic/keloid type scars. Additionally, because this procedure is routinely performed by primary care physicians and dermatologists, there is no need to travel to another country to get this done. Simply follow up with your hair transplant surgeon and make sure he knows about the procedure and how it affected the scar. 

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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

Several months ago, we started a new feature at our hair loss community: the Hair Transplant Patient of the Week.

Each week, we review hair transplant cases posted by patients on our Hair Restoration Discussion Forums and select one particularly excellent result as our Hair Transplant Patient of the Week.

In February, we selected four community members as our patients of the week:

First was AllAboutHair, who received 2,989 grafts via Follicular Unit Transplantation (FUT) with recommended hair transplant surgeon Dr. Radha. AllAboutHair recently shared a 9 month post-operative update with our hair restoration community, and the results are impressive. To see AllAboutHair’s 9 month results, please view the following: Hair Transplant with Dr. Radha – 2,989 Grafts.

Next was JohnnieBravo1, who received 2,592 grafts via FUT with Coalition hair restoration surgeon Dr. Pathomvanich. JohnnieBravo1 recently shared a 6 month update with the community, and the results are great. To review JohnnieBravo1′s results, please see the following: 2,592 Grafts with Dr. Pathomvanich.

Next was Oceanchild, who received 3,091 grafts via Follicular Unit Transplantation with Dr. Feriduni. In December of 2011, Dr. Feriduni used 3,091 follicular unit grafts to rebuild Oceanchild’s temples, hairline, and partial vertex. Several weeks ago, Oceanchild shared a 14 month post-operative update, and the results are excellent. To see Oceanchild’s 14 month results, please review the following: Dr. Feriduni 3,091 Grafts FUT – 14 Month Update. 

This common question was asked by a member of our hair loss social community and discussion forums: 

I’m in my early twenties and considering hair transplant surgery. However, I’ve been told by a few clinics that I’m too young for the procedure. Is this true? What is the minimum age for hair transplantation?

Altogether, it’s difficult to define the minimum age requirement for hair transplant surgery.

Patients are unique, and it’s nearly impossible to create a minimum “cut off” age and not allow any patient below this date to undergo surgical hair restoration. Some hair transplant surgeons feel comfortable operating on younger patients, especially those dedicated to adjunct preventive therapies like Propecia (finasteride) and Rogaine (minoxidil). Others think this is dangerous, and believe operating on young patients does not take the progressive nature of hair loss into account.

However, I believe the consensus on minimum age for hair transplant surgery is likely around age 25-26. This will definitely vary and should be evaluated on a case-by-case basis, but 25-26 is a decent rough average.

___________
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

Follow our community on Twitter
Watch hair transplant videos on YouTube

Technorati Tags: hair loss, hair transplant surgery, hair transplantation, surgical hair restoration, hair transplant surgeons, Propecia, finasteride, Rogaine, minoxidil