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

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I am considering hair transplant repair surgery.  What does this entail and what risks are there?  Will I be left multiple scars?

Hair transplantation has come a long way in the last few decades since it began.  Because of the vast improvements in this surgical procedure via ultra refined follicular unit grafting, many previous hair transplant patients who received plugs or mini-grafts are coming back for repair work. 

Hair tranplant repair surgery can be done a few ways.  Which one is better is debatable however, a huge determining factor depends upon the specific case of the individual hair transplant patient.

Two methods of repair using strip surgery:

Both surgical methods include removal of a strip which includes the old scar.  This will leave you with a single scar rather than two distinct scars.  With the new trichophytic closure technique, most likely, you will end up with a better looking scar than after the first surgery.

1.  Camoflauge: this is where new follicular unit grafts are transplanted around the old mini-grafts or plugs in order to camoflauge it.  Many hair transplant physicians have used this method succesfully creating a more natural look.

2.  Removal of Old grafts:  this is where a this is where the old grafts are excised from the scalp and follicular unit grafts are transplanted in it’s place which will create a more natural look.  Scarring, however, is inevitable in the locations where the old grafts were removed.

Follicular Unit Extraction  (FUE) and Follicular Isolation Technique (FIT):

Technorati Tags: hair transplant, Hair transplantation, Hair tranplant repair, hair transplant patient, follicular unit grafts, Follicular Unit Extraction, FUE, Follicular Isolation Technique, FIT

Many people ask about hair transplantation on our hair restoration discussion forum and the best way to go about it.   Before anyone can advise them, however, it’s important that they consider the answers to the following standard questions:

1. Age: How old are you? Age can be a determining factor as to whether or not you are a good candidate for a hair transplant. Typically, the younger one is, the riskier it is to jump into surgery. Hair loss is unpredictable and donor supply is limited. Young people should proceed with caution when considering a hair transplant. I recommend that the younger folks read “Am I too young for a hair transplant”.

2.  Norwood Scale and Graft Calculation: What level are you on the Norwood scale of hair loss? The Norwood scale will give a person a good idea as to how many grafts they would need in the event that they are a good candidate for an HT. Take your calculated Norwood level and multiple it by 1000 (conservative) to 1500 (liberal) grafts and that will determine approximately how many grafts are needed to achieve “decent” coverage and density of your balding regions. You might want to consider using our animated graft calculator .  Additional animations can be found here.

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I’m interested in hair transplant repair information. I’ve had over 10 hair transplant procedures over a 15 year period from 1985 to 2000. During that period, I suffered a major head trauma. Part of the trauma was the destruction of part of the transplanted area. I tried to repair the damage in 2000 with little success. Another problem has is my lack of donor hair. The donor area is pretty much a mess. I have comb over the holes to make them less visible. What can you offer?

My friend it sounds like you have really been through the hair transplant mill. Apparently your early procedures were small sessions of 100 to 200 round punch grafts (normally containing 15 to 25 hairs per round graft) removed from your donor area using round punches. As you probably know, this hair transplantation technique is very outdated and is now thankfully discontinued. The good news is that current techniques are vastly more refined, natural and non invasive.

There is now a much more refined and updated version of this punch graft technique in which a much smaller punch (approximately 1mm in diameter) is used to extract naturally occurring 1, 2, 3 and 4 hair follicular unit grafts. Due to the small size of these holes they typically contract when they heal leaving tiny scars that can be hard to detect, especially when the hair around them is not shaven. This much more refined technique is called Follicular Unit Extraction (FUE).

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I’ve seen your informative website the Hair Transplant Network and I’m currently deciding who to go with. But I don’t see Bosley as a recommended physician or clinic. They claim to be the best in their TV ads.

I live in Florida (Miami) and want to know if you recommend their
clinic in Miami or Boca Raton.

Like many hair loss sufferers, I first got interested in hair transplantation after seeing a Bosley TV infomercial. When I saw my first Bosley infomercial over ten years ago I thought I had just found the Moses who was going to deliver me from the slavery of hair loss. His infomercials, tapes and brochures became my ten commandments. I virtually slept with his video under my pillow.

But in time I came to realize that outstanding promotions do not equal outstanding hair transplants. What I did learn is that the best value (quality and price) is not to be found at the heavily advertised national chain clinics. Rather the best values are the gem in the rough hair transplant clinics that do virtually no advertising and get patients from good word of mouth on and offline. Unlike the national chain clinics, these quality independents often do just one patient a day and focus on quality rather than quantity.

Technorati Tags: hair loss, hair transplantation, Bosley, hair transplants, hair transplant clinics

I have a large bald area in the crown (top/back) with more hair in the front, but still thinning with a high hairline. I am concerned that a hair transplant in my case will show significant improvements in the front but I’ll still have a large bald spot on top/back.

Here’s an example of my concern about hair transplantation - Sen. Joe Biden. He looks like he’s had a hair transplant (if you compare now to old photos) and looks pretty good in front. But when his head is tipped forward, the top and back are quite sparse compared to the thickness of the front… that does not look natural.  I would think a U.S. senator could afford the best hair restoration procedures so this is concerning me.

This is what I’m afraid of. Thoughts…? Joey

Senator Biden in the past had a transplanted hairline that looked like it was put in by a pop rivet gun back in the 70’s -  a real diplomatic disaster and could have potentially provoked a nuclear conflict.

But clearly someone did some decent hair transplant repair work on him. So now as long as he’s facing the camera he looks ok.

Is this country ready for a transplant repair patient for President? I say yes. McCain survived a North Vietnam prison. Biden survived 70’s hair transplantation. Which one endured more suffering? Who developed more character? Perhaps the voters will soon decide.

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