Hair Loss Articles Published on our Hair Loss Q&A website.
Hair Transplant Surgery for Young Hair Loss Sufferers: Coalition Hair Restoration Physician Dr. Mike Beehner Discusses His Philosophy - 5/24/2015.
It’s important that a hair transplant surgeon approach a 21 year old male a lot different than a 31 year old.
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How Long Does the Hair Loss Treatment Propecia (Finasteride) Work? - 5/5/2015.
The classical teaching I have heard in lectures on Propecia (finasteride) is that for most patients there is an increase in “hair mass” (determined by hair shaft diameter and length of hair, the latter factor obviously dependent on how long a patient lets the hair get before cutting it) for around 4-5 years,
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Is the Number of Grafts or the Number of Hairs More Important to the Outcome of a Hair Transplant? - 12/2/2014.
The number of hairs transplanted is a truer representation of how much “hair mass” was moved than the number of follicular unit grafts.
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The Diagnosis and Treatment of Lichen Planopilaris (LPP) Related Hair Loss - 6/19/2014.
The clinical picture and a biopsy are the usual ways to to diagnose Lichen planopilaris (LPP). It is thought to probably be of an autoimmune etiology.
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Is It Safe to Apply Antibiotic Ointment Like Polysporin to Grafts after Hair Transplant Surgery? - 6/8/2014.
Following your hair restoration surgeon’s individual advice is a good idea. There are many ways to “skin a cat” and different approaches can get equally good results.
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Can a Hair Restoration Physician Predict My Future Hair Loss? - 5/22/2014.
From the appearance of the one photo provided, it looks clear to me that a person with this pattern of hair loss through the midscalp is 99% of the time going to end up as a Norwood VI pattern later in life, which is the classic U-shaped (horseshoe shaped) zone of shiny baldness.
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Is Hair Transplant Surgery Appropriate for Young Hair Loss Sufferers? - 5/15/2014.
I think each hair restoration physician has an unofficial “cut-off” age that he or she is comfortable with. For me it is 23.
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When Should Body Hair Grafts (BHT) be Used in a Hair Transplant Procedure? - 4/15/2014.
In my opinion, beard and/or chest hair should be the last resort in looking for donor hair. The only time beard hair might be a first choice would be in the instance of transplanting a mustache in someone missing an area from burns or heredity.
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Planning a Hair Transplant for Patients with Advanced Hair Loss - 2/12/2014.
As I have said many times in the past, for Norwood VII patients with their side fringes down the side of the head, I use what I term a “forelock pattern” approach.
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Hair Loss Treatments for 22 Year Old Male with Thinning Hair and Receding Hairline? - 2/8/2014.
If you are now witnessing progressive hair loss at the very young age of 22, this most certainly means that you are headed for an extensive balding pattern, a VI on the Norwood Scale for certain and, possibly a Norwood VII.
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How Common is Shock Loss in the Hair Transplant Donor Area? - 1/17/2014.
I hadn’t noticed that many posts about that, but you could be right. However, in 24 years of transplanting, I have only had 2-3 cases of donor area shocking and, fortunately, hair growth returned in each of these patients.
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Where Do Hair Transplant Surgeons Harvest Donor Hair for Eyebrow Restoration? - 1/9/2014.
I always take the hair from the mid-occiput (back) of the head. My reasons are these:
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How Long Should Patients Wait Between Hair Transplant Surgeries? - 12/30/2013.
Like Dr. Lindsay, we also encourage patients to put 12 months between sessions. I also make one or two exceptions with shorter intervals, usually for the same reason – namely, that someone is returning to their native country and won’t be able to get back to see me a year from then.
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Does Propecia (Finasteride) Permanently Stop Hair Loss? - 11/21/2013.
I can definitely assert that Propecia (finasteride) does not halt the balding process.
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Can Physicians Predict how Hair Loss will Progress? - 11/5/2013.
Your question is one that hair transplant surgeons wrestle with constantly and are always trying to figure out in their daily practices. We have several things that help us an awful lot though.
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How Do Hair Transplant Surgeons Measure Hairline Height? - 10/8/2013.
Two different reference points are used by hair restoration physicians with regard to measuring the “height of the hairline”. One is the glabella, which corresponds roughly to the spot at the top of your nose where, if you push your finger in, you can’t go any further.
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How Common Is Shock Loss in the Hair Transplant Donor Area? - 10/2/2013.
Shock loss in the donor area is a very, very rare event. When it does occur, it is almost always caused by excessive tension in closing the wound.
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Follicular Unit Extraction (FUE) after Three Strip Hair Transplants? - 6/29/2013.
I assume you mean that the two hair transplant strip scars are “stacked” on top of each other. It is totally unrealistic to assume that they can both be cut out and the bottom edge of the lower scar and the upper edge of the upper scar can be brought together.
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Hair Transplants: Designing a Natural and Conservative Hairline - 6/26/2013.
I do think there is a point at which the hairline is too high and it isn’t worth even transplanting, because you are not truly framing the face at that height.
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Maximum Width of a Second Hair Transplant Donor Strip? - 3/22/2013.
My opinion in most cases is that the second strip should be 1mm narrower than the first strip. I take a second strip exactly above the first one. In most cases the first strip’s scar is almost undetectable, usually 1mm or less in width.
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Treating Hair Loss in Women - 1/30/2013.
Although most assume hair loss is primarily a male problem, it’s important to remember that alopecia affects a significant number of women as well. What’s more, the social stigma and psychological strain of female hair loss can be particularly devastating to women, which makes treating this condition an important task.
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What is the Hair Transplant Stick and Place Method and How is it Used? - 1/16/2013.
If one elects to perform hair transplantation using a stick-and-place method exclusively, then there are two choices both of which have drawbacks:
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Does Hair Transplant Strip Removal Rate Affect Future Hair Growth? - 12/21/2012.
First, it is important, when cutting out the underside of the strip (after the upper and lower skin incision have been made) to leave at least a thin layer of fat there, so that none of the follicle bulbs are “naked” and hanging in the breeze.
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Minimizing Native Hair Loss in and around the Hair Trasplant Recipient Area - 7/26/2012.
If you have early signs of classical patterned male pattern baldness, then many if not most of the hairs within the U-shaped area on top will be at some point of the spectrum of miniaturization.
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Hair Transplant Repair: Refining Outdated Pluggy Grafts with Follicular Unit Transplantation (FUT) - 7/18/2012.
This 47 year old hair restoration patient presented several years ago having had three previous hair transplants with large grafts commonly known as “plugs”.
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Is Hair Transplant Surgery Suitable for All Hair Loss Sufferers? - 5/24/2012.
The condition you are referring to is known by the acronym, “DUPA” It stands for “diffuse unpatterned alopecia.” It is usually easy to tell on close inspection of a consultation patient’s scalp, but we always double-check with magnification, usually around 30x power.
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Hair Transplants: Do They Stand the Test of Time? - 4/4/2012.
After 23 years of performing hair transplants and seeing many of my early patients return 15-20 years later, I can honestly say I have only spoken with two or three that wished they hadn’t had hair transplant surgery and each of these were young men in their 20′s at the time who went on to become VII’s on the Norwood Scale for Hair Loss.
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Dr. Mike Beehner is the Newest Member of the Coalition of Independent Hair Restoration Physicians - 2/14/2012.
Physician members of the Coalition of Independent Hair Restoration Physicians must meet and maintain the demanding standards set by patients like you and consistently produce excellent natural looking results.
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At What Age Should a Man Consider Hair Transplant Surgery to Restore a Balding Crown? - 1/11/2012.
I think, at the age of 29, it would be a mistake to transplant your entire crown area, especially using maximal density, which I am sure is what you probably would want.
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Why Do Hair Transplant Surgeons Rely on Assistants to Place the Grafts? - 1/7/2012.
With the size of cases we routinely do today, it is impossible for the hair restoration physician to do everything, even apart from the dissecting of the follicular unit grafts under the microscope.
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My Hair Transplant Surgeon Won’t Prescribe Proscar (5mg Finasteride) for Hair Loss - 1/4/2012.
We prescribe generic Proscar (5mg finasteride) at our practice and instruct patients to quarter the tablet. We also direct them to Wal-Mart for the cheapest price. They have a “one-price-for-all-generic-meds” policy and their wholesale source is a reliable manufacturer of generics.
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When is Hair Transplant Surgery Appropriate to Restore Temple Points? - 12/20/2011.
There are two important pieces of information that need to be known before a hair transplant surgeon can give you the best answer to your question:
How old are you?
Is there miniaturization on top to suggest you are someday going to be a typical Norwood VI bald man?
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Hair Transplant Surgery for a Young Male with a Naturally High Hairline? - 11/5/2011.
If your present hairline height was truly high, in the neighborhood of 9cm above a line across the top of your eyebrows, then there is an awful lot of forehead showing and I would certainly be willing to do some transplanting to make the height at which the face is framed a little lower.
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Repairing a Hair Transplant Donor Scar with Follicular Unit Extraction (FUE) - 10/13/2011.
The male patient pictured below was 39 years old when he presented to our clinic in 2002 having had two previous large hair transplant sessions at another clinic. He noted to us at that time that he thought his donor scar was wider than he liked.
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Proper Planning for Hair Transplant Surgery by Dr. Beehner - 10/2/2011.
Dr. Mike Beehner is one of the leading teachers and researchers in the field of hair transplant surgery. In 1998 he received the prestigious Platinum Follicle Award from the International Society of Hair Restoration Surgery for the best research in the science of hair transplants and was also the recipient of the 2007 ISHRS Manfred Lucas Lifetime Achievement Award.
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Is it True That 10% of Hair Transplant Patients See No New Hair Growth? - 9/14/2011.
I think you got your facts mixed up. I don’t know where you heard that 10% of surgical patients don’t have growth from their hair transplants. Rather, in many studies, roughly 10% of the hairs are not accounted for at hair counts 8-15 months out from the time of the hair transplant.
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Are Hair Transplants Permanent? - 7/27/2011.
For starters, I think the permanency of the transplanted hair varies some from one patient to another. There are patients I have seen over a 20 year period (including looking in the mirror every day at my own hair, which was transplanted 29 years ago) and it seems the transplanted hair has thinned more than the remaining donor hair has.
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How Soon Can a Patient Return for a Second Hair Transplant? - 6/22/2011.
I generally tell my patients that 10-12 months is the earliest I would recommend a second hair transplant procedure.The reasons are four:
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Is a Hair Transplant in the Crown an Option for Younger Men? - 4/2/2011.
The answer to your question about hair transplants in the crown does not have one answer for all men in their mid-30′s. There are some men with only moderate donor stores and an already fairly wide crown/vertex which you know is going to enlarge more over the next 20 years.
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Will Coloring My Hair Cause Hair Loss? - 3/12/2011.
Ammonia and peroxide are the two ingredients in hair dyes that can cause some brittleness and possible breakage of hairs. They have no effect on the follicles which are the “living” part of the hair and located under the skin.
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Graft Storage Solutions in Hair Transplantation - 2/4/2011.
Two years ago I did an extensive research study comparing grafts stored in normal saline for half of the 16 study boxes and grafts stored in HypoThermosol solution with ATP added to it in the other half of the boxes.
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Removing Plugs from an Old Hair Transplant - 1/18/2011.
One thing to bear in mind when removing “plugs” from older hair transplants is that, regardless of what size punch you use in cutting these old grafts out, with a single pass procedure there will always be some hairs that don’t get removed and still grow.
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Why Hair Transplants are Not Recommended for Very Young Men - 1/5/2011.
I will try to give a hair transplant surgeon’s point of view of this problem of “what age is too young to transplant?” For me personally, 23 is my somewhat “unofficial” cut-off age for transplanting a young man.
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Rogaine Versus Propecia: Which Is the Best Hair Loss Treatment? - 11/11/2010.
In my experience using Propecia (finasteride) the past 13 years or so and topical Rogaine (minoxidil) for the past 17 years, I feel finasteride is at least 10 times more valuable. Finasteride can take a wispy, limited-length hair and change it to a coarser and longer hair the next hair cycle. I
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What Drugs Will Be Given During a Hair Transplant? - 10/13/2010.
This varies considerably from doctor to doctor. During surgery, every doctor has to inject some local anesthetic (“Novocaine” being the generic word most commonly used) in the form of Lidocaine and in addition Marcaine (bupivacaine), which is a longer acting one.
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Can Miniaturized Hairs be Transplanted in a Hair Restoration Procedure? - 9/10/2010.
There are a couple of things that pertain to this issue: if there is more than 5% miniaturization or even a larger amount, then doing a hair transplant on that individual may not be a great idea (unless the patient understands that the gains may be only for 5-10 years).
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How Long Does It Take to Recover from a Hair Transplant? - 9/3/2010.
There’s a big difference between how a patient looks one or two days after a hair transplant versus how he looks at 7-9 days. However, there are a number of factors to consider when deciding if one week is enough time before returning to work and having every person you bump into stare at your head and start asking questions about what happened.
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Is it Possible to Have Multiple Hairs per Follicle after a Hair Transplant? - 8/19/2010.
By definition, a single hair follicle can only have one hair growing out from it. It is impossible for two hairs to come off of the same follicle. Obviously, it is hard to know the number of follicles under any given group of hairs since the follicle resides completely under the skin.
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Will My Hair Transplant Donor Scar Become Thinner over Time? - 7/27/2010.
A hair transplant scar doesn’t ordinarily get slimmer over time although, at 70 days post-op, I think it almost certainly is as wide as it’s going to be. What does happen over that first year is that the color of the donor scar goes from a pinkish hue to a white one similar to the surrounding scalp so that it is much less noticeable.
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Appropriate Waiting Time Period Between Hair Transplants - 6/2/2010.
There are basically four reasons that I advise my patients to have their next hair restoration session no sooner than 12 months (we do allow 10 months between a 1st and 2nd in some cases). 1) With today’s typically large hair transplant megasessions, it takes a little more time for the scalp’s blood supply to be restored to being normal and supportive for the next onslaught of grafts. 2) It takes time for the donor area to once again regain its laxity and...
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Wearing a Hairpiece During the Hair Transplant Post-Surgical Healing Period - 4/27/2010.
In my own hair restoration practice, and in those of several highly respected hair surgeons I have spoken with, we insist on the hairpiece staying off for a minimum of one week after a hair transplant procedure, and then, after that week is up, to wear it only as necessary for work or social engagements. This almost always means using a clip attachment for the back and sides and being able to peel back the front for cleaning purposes and then use two-sided tape to hold it to the forehead. It’s important that the clips be moved from place to place, so that the same clump of hairs is not being tugged...
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Hair Transplant Graft Survival – Do They All Grow? - 3/29/2010.
Your impression is correct, in that the great majority of the hairs that are transplanted (most of which are only 1/8th inch long) are shed during the first few months, before the “real” hairs appear 3-4 months post-operatively. They usually shed in one of two ways: some fall off with the scab at the 6-10 day point, while others just “sit in place” in the skin, even though down deep in the skin they are literally disconnected from the follicle (the living part of hair), which shrivels up and hibernates for that time period. These short stubs then can sit there for weeks or they can fall off at anytime. The best way to tell...
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Which Shampoo is Best to Use After Hair Transplant Surgery? - 3/22/2010.
My belief is that it doesn’t make any difference what shampoo you use after surgical hair restoration. All shampoos are simply soaps. Consumer Reports has done two extensive analyses of shampoos over the past ten years and published them, and their conclusion was exactly what I stated above. At our clinic we give out a “courtesy” gift tube of Nexus Therapy shampoo to each patient, but not because we believe it superior to all others, but simply as a gift. It has a slight nostalgic value to me also, since that is what the clinic gave...
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The Stick-and-Place Hair Transplant Technique Vs. Pre-made Incisions - 2/28/2010.
Summary: or myself, the one big advantage of the stick-and-place method, which I take advantage of in certain unique cases, is the fact that it allows the hair transplant surgeon to make the SMALLEST possible incision to place the graft in. This is because, at the instant you withdraw the needle or slit blade, you are immediately placing the graft into the opening before any elastic recoil or shrinkage can occur at the site. The benefits of this fact are two...
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Are Scalp Reductions Always Bad? - 12/2/2009.
I performed my last scalp reduction 10 years ago, but did many of them my first 10 years before that. The one writer is correct. You felt like a miracle man when you held that “before” Polaroid next to the “after” one and proudly gave the patient copies. But a few months later they always stretched back to some extent. Nine years ago I did a study on 11 consecutive scalp reduction patients and found that the stretchback percentage was around 40%...
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How Much Hair Density is Required to Look Natural and Thick in Hair Restoration Surgery? - 8/18/2009.
First of all, it should be noted that a very good recent research study by Coalition member Dr. Sharon Keene from Tucson, AZ showed that in “normal” men without male pattern baldness, the average follicular unit hair density at the front hairline was 51 FU/cm2 with a range of 38-78. The average density in the temple apex region (behind the recession) was around 44 FU/cm2 with a range of 25-64. The biggest factor in predicting whether or not the 35-40 FU/cm2 density you mentioned would look “dense” is the diameter of...
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Is Propecia (Finasteride) Required After Hair Transplant Surgery? - 8/4/2009.
"Attacking” is probably not the best way to think about what is happening. A better way to picture it is that the presence of DHT (which virtually every man has) PERMITS the genetic expression of each individual follicle to occur. The follicles on the sides and back of our heads have no genetic programming for miniaturization and eventual loss, whereas the follicles on the top of the head of men with hair loss do have this genetic programming. An experiment was done around 50 years ago, I believe by a Dr. Hamilton, in which he followed the paths of around a dozen pairs of identical twins, one of which was...
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Do Multi-Follicular Units Still Have a Place in Today’s Hair Transplant Procedures? - 6/29/2009.
Over the past few years Bill Seemiller (Falceros) and Pat Hennessey have asked me to share with the reading audience my rationale for using multi follicular unit grafts (MFU) grafts (multi-follicular grafts, 4-6 hairs each) in the hair transplant planning for some patients. I will try to do so here.
First of all, in order to get our terminology straight, the difference between a “minigraft” and a MFU Graft, is that the minigraft is cut with less magnification, usually with “loupes” and are “cut to size” and often have a little transection in the cutting process...
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Do Higher Hair Transplant Densities Affect Hair Growth Survival? - 4/23/2009.
There was a nice study published in the journal, Dermatologic Surgery, by Coalition members Dr. Tom Nakatsui and Dr. Jerry Wong about a year ago or so, in which they used small lateral slits and created study boxes of between 23 and 72 slits per square cm of surface area, and obtained a 95.6% survival in the 23/cm2 box and 98.6% in the 72/cm2 box. These results are outstanding, although we have to keep in mind that the study was done on only one hair transplant patient and the same results may or may not occur with another person. Also, as I recall...
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What is DUPA Hair Loss and What Signs Should I Look For? - 3/11/2009.
DUPA, which stands for “Diffuse Unpatterned Alopecia“, affects all of the potential donor hair on the back wall and on both side walls. By definition, it is the presence diffusely through these hairs of miniaturized hairs which are hairs with a limited number of life cycles left before they disappear.
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Why do Some Hair Transplant Surgeons Create Larger Incisions than Others? Aren’t Smaller Blades Better? - 1/31/2009.
I just wanted to add that a very important factor in hair transplant blade size (or needle size) selection is the coarseness of the hair (the hair shaft diameter). Very fine 1-hair follicular units can be placed into 0.6mm blade incisions, whereas coarse ones require a 0.8mm one. Same goes for 2-hair and 3-hair follicular unit. The blade width is significantly larger for these grafts when the hair is coarse.
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Removing Old Scars with Another Hair Transplant Procedure - 12/30/2008.
It’s all well and good to talk about taking out both scars and the hair in between and ending up with one scar, but in reality it’s almost never possible. When hair transplant patients have had old “stacked scars,” they are spaced apart just enough and with enough hair in the space between the two scars that that overall vertical width cannot be bridged by simply cutting everything out.
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High Level of Anxiety and Heart Racing During Hair Transplant Donor Removal - 12/7/2008.
If your pulse truly did reach 230 during hair restoration donor removal, that is not directly from the epinephrine, but almost certainly has to be a brief supra-ventricular arthythmia. There’s a good chance that the presence of some epinephrine in the numbing solution was a stimulus to help it occur though. I would recommend that you check with your personal physician, who in all likelihood may arrange for a Holter monitor (24 hour tracing of your heart rhythm) and/or a cardiac stress test. I wouldn’t just go into another hair surgery until...
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Hair Transplant Risks - A Hair Restoration Surgeon’s Point of View - 11/29/2008.
When reviewing the “negatives” regarding hair transplants, I usually touch on the following for the patient to know about: First of all, the general tone of my comments is that fortunately hair transplant surgery is a remarkably complication-free area of surgery. Much of this has to do with the rich blood supply of the scalp.
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Hair Loss: Is it Normal to Shed Vast Amounts of Hair Daily? - 11/24/2008.
As Bill (Falceros) had mentioned on our hair loss forum, it is normal to lose 50-100 hairs a day simply from the random rotation of the hairs on your head through the hair growth and resting cycles. So on any given day, you will have that many hairs falling out and that many hairs starting up growing out from the follicle again. The number you mention, assuming you’ve proved this by counting them - that’s a hard thing to “eyeball” - and you are losing that many, then one of two things is going on. Either you are really in an accelerated phase of male pattern baldness, or...
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Why the Balding Crown is Sometimes Called the “Black Hole” for Hair Transplants - 11/19/2008.
can think of two good reasons to call the balding crown (vertex) a “black hole” for hair transplant surgery. Number one, it is always larger than what the patient thinks, and, most importantly, it virtually always increases in size in all young and middle-aged men with hair loss (and even in a lot of the older ones!) and the area increases almost logarithmically, not in simple direct proportion to the increase of the diameter.
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Donor Area Shock Loss Around the Hair Transplant Scar? - 11/17/2008.
Post hair restoration surgery telogen effluvium or “shock loss” above and below the donor scar should be a fairly rare occurrence. It doesn’t happen everyday - or at least shouldn’t. It is well known that the cause of telogen hair loss around the donor scar is too tight of a closure, which usually is related to taking too wide a strip in that particular section of the head.
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Concealing a Hair Transplant from Friends, Co-Workers, and Family - 11/12/2008.
I think the most important key to your problem is whether you have already existing hair down to the area you want your new transplanted hairline to be or not. If your existing hairline now is way up high and it will be brought down an inch or so, then you will have a slightly noticeable situation, although in 8 of 10 patients, it is fairly unnoticeable two weeks after hair transplantation. The redness and scabbing will most certainly be gone in two weeks. The problem sometimes are the persistent hairs that stay at the transplanted length and just sit there, or the ones that actually do take off and start growing.
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How Rogaine (Minoxidil) Really Works to Treat Hair Loss - 10/13/2008.
have been reading and going to meetings for years and have never heard Rogaine (minoxidil) described as an anti-androgen. I think you have mixed it up with Propecia (finasteride). We know that minoxidil is a vasodilator and may increase blood supply in the skin. In fact, some surgeons stop it a few days before hair transplant surgery to avoid excessive...
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Does Using Rogaine (Minoxidil) After Hair Transplant Surgery Arouse Early Hair Growth? - 9/16/2008.
One thing you have to keep in mind is that Rogaine (minoxidil) is probably the strongest blood pressure drug in the world. If put on too soon, while all these fresh open sites are present on the scalp from hair transplant surgery, the potential for the hair loss drug on the skin being absorbed into the system and dropping the blood pressure is a real risk. A person who is older or who has low blood pressure to start with would be at risk for fainting or passing out. For that reason, I wait till around the 4th day to restart it.
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Diffuse Thinning Hair, Diffuse Unpatterned Alopecia (DUPA), and Hair Transplants - 9/10/2008.
The term, “diffuse thinner,” can refer to two different types of hair loss patients. One group - and the more common one referred to this way - is the man with homogenous thinning hair throughout the typical male pattern baldness area on top (horseshoe-shaped), in whom there is some degree of miniaturization going on with some of the follicles/hairs, allowing someone to see the scalp through the hair. The second group are...
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Hair Loss Donor “Shock Loss” After a Hair Transplant - Is it Permanent? - 7/13/2008.
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.
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Does Keeping the Sutures or Staples in Longer After a Hair Transplant Help Produce a Thinner Scar? - 7/3/2008.
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...
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Is it Safe For a Woman to Get a Hair Transplant with Some Hair Loss All Over the Scalp? - 5/28/2008.
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.
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Why the Number of Transplanted Hairs is More Accurate than Graft Counts in Hair Transplant Surgery - 5/25/2008.
The total number of hair grafts planted in a hair transplant procedure simply refers to the number of “building blocks” used in that case, whatever their size or composition. In modern hair transplantation, that usually can range from a 1-hair follicular unit graft up to usually a double follicular unit graft of 4-5 hairs, both dissected under microscopes. Ordinarily the number of grafts equals the number of recipient site incisions with two exceptions.
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How Many Years is Propecia (Finasteride) Effective? - 5/21/2008.
You are still much better off staying on Propecia (finasteride). The great majority of men taking finasteride realize an increase in “hair mass” during the first 4-5 years; then there is a very gradual loss of hair, but not nearly at the steep curve and rate as if you weren’t taking this hair loss treatment. At one conference I attended a couple of years ago, the speaker said that after 5 years, 30% of men look better than...
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Does Wearing a Hat or Hair Piece Cause Hair Loss or Negatively Impact Hair Growth? - 4/27/2008.
I would agree that hats do not have a negative effect on hair growth, either your natural hair or follicular unit grafts that have been transplanted. The only thing that goes on the head that I do know can have a negative impact on some patients is wearing a hairpiece. Over the years, I would say that approximately 15-20% of my alopecia wig wearing hair restoration patients have had slight to moderate diminishment of growth compared to my normal non-hairpiece-wearing patients.
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Early Signs of Hair Loss or a Cowlick? - 4/8/2008.
I had an 18 year old young man in my hair restoration clinic yesterday with that exact same complaint. The best way to be certain it is not an early sign of male pattern baldness is simply to have your nearby hair loss doctor (medical or surgical) examine the area under high magnification for any signs of hair miniaturization. If there is...
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Is Propecia a Requirement for a Hair Transplant? - 4/4/2008.
Imagine that you and I have a brief consultation visit in approximately four years to see how your hair is doing. If you have both the hair transplants AND go on Propecia (finasteride), we will see the ADDITION of two things: the transplanted hair PLUS the increase in hair mass that occurs in a majority of finasteride treated hair loss patients.
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Side Effects with Propecia for Hair Loss: What Should I Do Now? - 3/27/2008.
If you are experiencing side effects with Propecia, you might want to try a much smaller dose regimen, which is likely to still help you prevent hair loss, and at the same time possibly reduce or remove the side effects. I have had many male hair transplant patients of mine, especially those over 45, use a half tablet of Propecia (finasteride) every other day. This averages out to 0.25mg/day. Merck’s own research showed a 62% reduction of dihydrotestosterone (DHT) with only 0.2mg/day.
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The Difference Between Male and Female Pattern Hair Loss and Approaches to Hair Transplantation - 2/21/2008.
Female Hair loss is a little different than in men, and the approach for transplanting hair is often different for most hair restoration physicians. In our practice, women make up about 15-20% of our hair transplant patients. I find that around 70% of the women who present for consultation are able to be offered hair transplantation. The two key requirements are sufficiently dense, high-quality donor hair AND realistic expecations.
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Is a Blood Test Required Before Undergoing Hair Transplantation? - 2/5/2008.
This debate as to whether or not a hair transplant surgeon should do hair transplant preoperative blood testing has been going on for years and is probably pretty evenly divided in numbers as to supporters for the two opposite opinions.
First of all, the main two conditions that are being checked for by the doctors who do test are HIV and Hepatitis C. Others will check a blood count, clotting studies, chemistry studies (liver, kidney function, etc). One advantage of having this information on the hair transplant patient’s chart before hair restoration surgery is that, should the hair transplant doctor or one of his assistants be stuck by a bloody sharp during the surgery, immediate measures can be taken to minimize the chance of later serious infection for that person.
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Does Propecia and Rogaine Treat Hair Loss in the Front of the Balding Scalp? - 1/27/2008.
The whole issue of hair loss drugs such as Propecia / Proscar (finasteride) or Rogaine (minoxodil) only working in the crown/vertex region of the scalp for hair loss is totally false. The reason these two companies have to say that in their advertising is that the studies they conducted on these hair loss medications were done in those areas, and, because of the strict rules of the FDA, one can only say hair loss drugs work in the area in which you studied it. I have had many, many hair restoration patients given either or both hair loss treatments who have benefited in all other areas of the scalp, including the midscalp on top, the frontal region, and even rarely in the balding recessions in front.
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Will Hair Loss Ever Stop By Itself? - 1/14/2008.
If one of the various well-known patterns of male pattern baldness expresses itself in its early stages, it is virtually unheard of for it not to progress gradually to a more severe degree of baldness. About the only exception to this might be the man who only has a minimal fronto-temporal recession (level II on the Norwood scale). Occasionally one of these will “lock in” and stay there. It is true that many men have periods of their life during which it seems the hair loss progression accelerates and other periods in which it seems to stabilize, but in my 19 years of following balding men, when you see any man 5 years later who was not on hair loss medication such as Propecia (finasteride) or Rogaine (minoxidil) or who received a hair transplant, there is a progression of hair loss. The two age plateaus where I see most men start this process is first in the early 20’s when many, including myself, start to recede in the front corners and at the same time thin in the crown. The second is in the 40’s, when a fair number of men, who previously thought they were immune to hair loss, also start to thin in front and in back.
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Why Is My Hair Transplant Doctor Waiting to Transplant Hair in the Crown? - 1/6/2008.
This is a common problem for young men, who want to have all of their hair restored. I think your hair transplant doctor was very wise in telling you what he did. You have no idea (nor does anyone else, including the hair transplant doctor) how bald you may become some day. And if you start filling in the crown/vertex as part of the initial plan on a man in his 20’s, and male pattern baldness (MPB) progresses and logarithmically enlarges, as it almost always does, and the project in that area can’t be completed, you will have a huge bald halo around a patch of transplanted hair and will look very abnormal, and there won’t be any donor hair left to fill in the halo.
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How is Shock Loss Minimized During A Hair Transplant Procedure? - 1/6/2008.
Most of the factors that we think have to do with “shock loss” of native hair following a hair transplant procedure all take place at the time of hair restoration surgery. The two most important things are: one, the VULNERABILITY of the hairs that exist on top, and two, the AGGRESSIVENESS with which the recipient sites are made. If a large percentage of those remaining native hairs are “miniaturized” (limited length and decreased diameter; ie: “wispy”) they are much more likely to be shocked than a strong terminal hair is. When recipient sites are aggressively made, whether it is the closeness with which they are made or the width, depth, or length of the individual sites, native hairs can be lost either by taking a “direct hit” by the instrument used or simply as a “shock” reaction to having all these cumulative injuries occurring so close to them.
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“Chubby” Verses “Skinny” Hair Transplant Grafts - 1/6/2008.
It was interesting reading Dr. Rose’s and my comments on this subject from several years ago. I thought I would try to update the readers on my thoughts concerning chubby grafts vs skinny grafts and also make a few additional comments regarding follicular unit graft survival.
There is no question that a greater yield, sometimes beyond 100%, is possible with “chubby” grafts. Most small studies of reasonably trimmed follicular units shows that survival around 90% can be expected. The survival rates over the years on follicular units have varied tremendously, all the way from 80% up to over 100%.
I believe the biggest factor in high survival of follicular unit grafts is that the hair transplant doctor or hair transplant technician placing the grafts have years of experience and are conscientious about their work. Four years ago at the ISHRS (International Society of Hair Restoration Surgery) meeting in New York City, Dr. Kim from Korea and myself both presented studies in which we looked at follicular unit survival rates and interestingly we both came up with an identical 90% survival in our two studies.
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Where is the Best Place on the Scalp to Remove the Donor Hair Strip for a Hair Transplant? - 1/6/2008.
Nine out of ten times, it turns out that the best place to mark the lower border of the donor strip to be taken does in fact lie just over the level of the occipital tubercle (”bump”) on the back of the head. This level corresponds to a point, below which lies around 1/3 of the dense donor hair and above which lies around 2/3 of the same. Assuming at least a couple of sessions are done and that the hair transplant surgeon takes the second strip just above the first scar (removing the initial scar at the same time), this is usually a good point to mark this lower strip level. But there are exceptions.
Some men show evidence of hair thinning up from the nape of the neck. In these sometimes the strip is taken slightly higher up if there is a sufficient height of “safe” donor hair there. In each hair transplant patient an experienced hair surgeon uses a great deal of judgement in choosing at which level the best hair to take is located.
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After a Hair Transplant, What Happens to the Transplanted Hairs? - 1/4/2008.
You have to understand what is happening at the microscopic level under the skin after a hair transplant. After hair transplant surgery, approximately 95% of the hair follicles that have been moved to the recipient area are “shocked” into a 3-4 month telogen phase, during which the follicle structure “shrivels” up, shrinks, and takes a nap for a few months. While it does this, it totally disconnects from the little stub of hair above it, leaving it sitting in its little superficial hole. Often times, a shower, brushing, or rubbing your scalp will cause these to fall out of their tenuous hold in your scalp and cause panic. Don’t worry.
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Dr. Mike Beehner is one of the leading teachers and researchers in the field of hair transplant surgery and has been performing world-class hair restoration surgery to patients worldwide since 1989 in Saratoga Springs, New York. Dr. Beehner provides a full range of hair transplant services for men and women including follicular unit strip surgery (FUSS), follicular unit exxtraction (FUE), eyebrow restoration, repair surgery and trans-gender hair restoration. Dr. Beehner is very hands on and personalizes each hair transplant procedure based on the individual needs of the patient.
