Hair Restoration Blog

The article “Surgeon Restores Patients’ Hair, Self-Confidence” is recently published in the popular newspaper of “The Beverly Hills Courier” based on the interview with Dr. Parsa Mohebi, medical director of US Hair Restoration.

Here is a summary of the article, which mostly focuses on the psychological impacts of hair restoration on men. Dr. Mohebi also discussed some of the new methods of hair restoration that is offered by the Beverly Hills Office of US Hair Restoration. Here is how he goes:

Nothing looks better than a full head of hair, and one of the best people to provide it is Dr. Parsa Mohebi, medical director of US Hair Restoration.

Mohebi specializes in several hair-transplant procedures:

• Follicular Unit Transplant (FUT) is the gold standard of hair-transplant surgery, Mohebi said, giving very natural results. A strip of donor scalp is removed and the follicles are prepared under microscopes and distributed in the bald area in the natural direction and orientation.
• Follicular Unit Extraction (FUE), also called non-invasive hair-restoration surgery, uses special biopsy devices to extract individual follicular units without having to remove a strip of skin; so there is no linear scar.

“Not everyone needs non-invasive surgery,” Mohebi says. “But people who want to shave their head in the future for any reason may consider FUE because there is no visible evidence of surgery on the back of their head. There’s nothing to suture, and the small dot wounds are not detectable a few days after surgery”.

• Mohebi also specializes in eyebrow transplants for both men and women.
• As testament to his skills, he also repairs bad or “pluggy” transplants, performed by other doctors. “We do several repair hair transplant surgeries a month,” he says.

Mohebi spends an hour with each new patient and does a microscopic evaluation of the scalp and a miniaturization study of the hair to predict future hair loss. “That way we’re not limited to the obviously bald areas, but we can transplant hair to where the patient may lose hair in the future. With the technology we have now, there’s no reason for anyone to experience hair loss.”

As a fellowship-trained hair-transplant surgeon, Dr. Mohebi continues research the latest high-transplant techniques and his writings have been presented and published in both national and international medical-society publications.

The article continues with discussing the published research on the psychology of hair transplant in men, which was finished last year: Dr. Mohebi’s latest article was the cover story for Hair Transplant Forum International, considered the most important journal in the field of hair restoration, on The Psychology of Hair Transplants. From research in Europe, we know that people with hair loss are prone to anxiety, depression and other psychological problems; we tried to see if we can reverse that with hair restoration surgery.

He evaluated 200 patients after surgery in eight criteria, and saw improvements with FUT in terms of happiness, youthfulness, energy levels, self-esteem and self confidence, future outlook and impact on their career and sex life. The results were amazing and improvements in all eight criteria were statistically significant. The authors, Dr. Mohebi and Dr. Rassman concluded that using the new techniques of hair restoration patient can drastically improve all of the psycho-social impacts of hair loss.

The reporter then set aside US Hair restoration from many other hair transplant clinics by several factors by referring to Dr. Mohebi’s comments on following the latest standards of hair restoration surgery and the fact that things have changed significantly recently in the field of hair restoration. What was done five years ago is not acceptable today. We have the most experienced technicians; and everything is done under a microscope to get the highest yield of hair.

Then there’s the customer service. “The day of the hair transplant procedure is a big day for patients,” Mohebi said, “often six to eight hours. Patients are usually amazed at how smooth and pleasant the day is.

Patients are given mild to moderate sedation and numbing medication for the donor and recipient area. Once the scalp is numb the strip of skin is removed and the wound is closed. The next step is to prepare hair grafts under microscope. While grafts are being made by experienced technicians of US Hair Restoration, Dr. Mohebi is designing the hair line and makes the sites according to the natural direction and distribution of hairs.

Since the newly placed follicles are so fragile, patients return the next day to get their hair washed professionally, given special shampoo and taught how to take care of their hair at home. “After five days, no special care is needed,” Mohebi said.

Ten days after the surgery, patients return to have the donor site checked and staples removed (for those who had them. Hair starts growing after three months, and is long enough to style and comb after ten to twelve months. The third follow up is at 10 months after the procedure.

Severe baldness may require more than one surgery, usually spaced at least six months apart. “With megasession hair transplants we can do 4,000 grafts in one day. That significant number is a help to patients with a high class of baldness. We can get a higher stage of restoration with fewer sessions of transplants.”

Continuing to pioneer in the field, Dr. Mohebi is the inventor of the Laxometer, a device to measure the laxity or mobility of the scalp. Laxity of the scalp is key in determining the size of the donor strip so that enough can be removed for bigger cases, and the wound can be closed without too much tension and the scaring will be minimal.

To help people stay abreast of all that’s happening the field of hair restoration, and to answer questions (he’s heard from Europe and China) Dr. Mohebi maintains a hair restoration blog, ushairrestoration.com/blog.

Q:

I had gastric bypass about 10 years ago. Not only have I lost a lot of my hair but i have never regained it. Especially after taking a shower i notice that i loose a lot more hair then i should. I have brought this concern up with my doctor but all he tells me is to increase my vitamin intake. I have also been taking Biotin for about three months and vitamin B12 along with a multi-vitamin but have not seen a difference. In addition my eyelashes are thinner and I have lost the thickness of them. I am thinking about rogain for women but if you can please give me any advice I would really appreciate it I am only 38 and fear i will be bald byt the time i turn 40.
Thank You,

A:

gastric bypass

As we discussed in the article “Gastric Bypass Surgery and Hair Loss”, it is common to see hair loss or changes in the quality and color of hair after a gastric bypass surgery. The changes are generally seen in the first few months after the gastric bypass surgery. Similar hair loss conditions could also be seen in a variety of other medical conditions, major surgeries or trauma.

The immediate few months following a gastric bypass surgery mimics sever starvation conditions in which body may have difficulty obtaining many essential elements or nutrients through regular diet and supplement of nutrients and vitamins may become necessary.

Hair loss after a gastric bypass may be seen in the patients who don’t have any obvious vitamin or mineral deficiency. Patients need to be evaluated on a regular basis by their surgeon and with regular lab tests. The initial hair loss should return to normal if there is no other underlying condition exists.

In case patient has any other medical condition that can accelerate hair loss or in the case of genetic male patterned or female patterned baldness, patient may never gain their hair back. In those conditions the stress of the surgery acts as a stimulator forcing patient scalp hair to fall on a faster than normal pace.

My recommendation is to see a good hair transplant surgeon and undergo a miniaturization study to rule out any other treatable causes of hair loss.

Q:

I am 27 and have a very high laying hairline.  My hair line is the same as my mother and aunts.   High hair line resembles a male hair line with mild recession on the corners.  I know I am not balding because a few other female members of the family have an exact similar hairline patter.  Can you help me with a hair transplant procedure?

A:

There are several methods to lower a hairline both in men and women.  Hair line can be lowered by hairline lowering hairline surgery, in which a strip of skin is removed from just below the frontal hairline to bring the hairline lower.  In this method a trichophytic incision can help to blend frontal hair into the forming scar.  The result of lowering hairline surgery is instant and the surgery is less time and labor consuming in comparison with a hair transplant procedure. 

At US Hair Restoration, we recommend hair transplant using follicular unit transplant methods for lowering hairlime in men and women for the best cosmetic results.  Hair transplant cannot make such a drastic change in such a short time, but the result is completely normal with no visible scar on the frontal area.  The presence of linear scar at frontline is a major disadvantage of hairline lowering procedure.  The scar of hairline lowering surgery could be camouflaged with a hair transplant surgery with placement of minimal number of grafts on the frontal area and in front of the hairline scar.

Q:

I have 2 round spots of hair loss on my neck. I also have ridged fingernails with a history of thyroid disease that is now treated. The hair loss spots are shinny with no hair on them with the size of a quarter. I have read online a lot about alopecia areata, but I also heard that alopecia areata could be just general thinning of the hair. Is there any particular test that I can do to evaluate my condition and to make sure my hair loss condition is alopecia areata and nothing else?

Thank you.

A:

Your description matches alopecia areata (AA), but there are some other and generally rare conditions which can resemble alopecia areata. Hair loss spots caused by alopecia areata may be found in groups or individually. The other signs such as nail pitting and ridging are not universal, but if seen with hair loss patterns typical of alopecia areata can support the diagnosis.

Thyroid disorder can also be part of an autoimmune syndrome- along with alopecia areata. A physician can confirm the diagnosis by checking the appearances of the lesions at the site of the hairloss. No other tests are needed to confirm the diagnosis of alopecia areata.

Alopecia areata usually resolves spontaneously without any treatment. In severe cases, or in alopecia universalis, medical treatment might be needed. However, hair transplant is not the proper treatment for alopecia areata; patients may lose transplanted hair or transplanted hair may never grow.

Q:

I had a burn on my upper lip with blistering 10 years ago. I lost half of my moustache that it never grows back. I want to grow moustache but it won’t be symmetrical. Is there a method that I can restore my mustache with hair transplant surgery. I don’t know anything about it so I’m unsure of where to go to for a mustache hair restoration.

Thanks,

A:

Hair transplant surgery can restore mustache hair and can be used for restoration of hair in scars such as scars of beard and mustache. You are right about mustache hair restoration that is not as popular as scalp hair transplant. We get to do mustache hair transplant every now and then. Here are the pictures of one of my patients who had a similar problem and lost his mustache hair on one side due to some skin condition.

We restored his mustache with about 200 follicular unit grafts. We generally use scalp hair for mustache and beard hair restoration, but this patient had a very fine scalp hair on the donor area that was not a perfect match with the size of his mustache so we had to harvest some hair follicles from his beard and transplant them on the upper areas of his upper lip so they could create a similar appearance and cover the other hairs while scalp hair gave the needed hair bulk below that level to his mustache.

mustache hair loss before hair transplant

Picture of mustache before hair transplant

Immediately after mustache hair transplant

Picture of mustache after hair transplant into the mustache

FUE hair follicle harvesting from beard for mustache hair transplant

FUE donor area from beard for mustache hair transplant

We used FUE or follicular unit extraction techniques for removing hair follicles from beard area from under the jaw area.

Q:

I have heard that one of the side effects of finasteride could be breast enlargement. Is it possible to develop more breast tissue because of blocking effect of finasteride on testosterone?

A:

One of the released researches from finasteride clinical studies indicates that breast enlargement (gynecomastia) rate was not higher in patients who took Propecia (finasteride) in comparison to the ones who were on placebo. One out of every 100 patients may experience breast tenderness and some degrees of enlargement, which is about the same in placebo and medication group. The similar rate of breast complications indicates that this side effect may be simply a placebo effect. Think about it, you are giving a medication to male patients, which they know has to do with their testosterone or testosterone related factors. What do you expect?

Q:

I have read an article on the active half life of finasteride, which is a few hours, but you mentioned in one of the posts that its side effects may last up to 5 days after discountinuing the drug. How do you explain that?

Finasteride (Propecia)

A:

Finasteride (Propecia) functions through blocking the enzyme, 5 alpha reductase. The enzyme five-alpha reductase is responsible for conversion of the male hormone, testosterone to dihydroxytestosterone (DHT), which is the form of the hormone affecting hair follicles and causing hair loss. That is true that finasteride gets eliminated from our body in a few hours, but its blocking effects on the enzyme 5 alpha reductase continues for a long time. If you ever experience side effects of finasteride, you can stop the medication and its effect will be gone in 5 to 6 days.

Intercytex has recently released some information on its hair multiplication experiments in a new article in the Journal of experimental dermatology. The title is “A graft model for hair development” and the article discusses what is done so far for hair multiplication experimentally. Intercytex has been involved with hair stem cell, hair culturing and hair multiplication, which is also known as hair cloning.

In this article follicular cell implantation (FCI) is discussed as an experimental cell therapy for the treatment of hair loss that uses cultured hair follicle cells to induce new hair formation. The process of culturing hair cells is based on the demonstration that adult dermal papilla cells (DPC) retain the hair inductive potential that they acquired during hair morphogenesis before birth. To obtain FCI, the investigators isolated hair inductive cells from scalp biopsies and then propagated them in culture media in order to provide adequate cells to generate several new follicles from a few hair follicles.

Following expansion of cells in culture, they implanted those cells into the scalp where they induce the formation of new follicles below the level of skin. They describe a consistent, reliable method in which they can test hair induction. Since the process relies on the ability to retain the potential for hair induction during the expansion of DPC in culture.

They go over a simple graft model that supports hair morphogenesis. In this experiment, they combine dermal cells with embryonic mouse epidermis that provides the keratinocyte (one of the skin cells) component of induced follicles. The grafts are placed under a protective skin flap in the host athymic mouse (a special mouse without capability to reject the transplanted grafts from human) where the cells will form a skin graft with hair if the dermal cells are hair inductive DPC.

Using the assay freshly isolated and cultured mouse embryo dermal cells as well as cultured dermal papilla cells from other species all induced hair formation. They also showed that induced hairs were aesthetically indistinguishable from those of the epidermal donor in length, thickness, and pigmentation. The investigators stated that the newly formed hairs were histologically normal and could resemble a complete natural hair.

We at Los Angeles hair transplant surgery centers of US Hair Restoration will closely follow up with the progress of hair multiplication and cloning techniques. Although the result of the cultured hair on animals has been released before, the current released article is interesting and elucidates more on the characteristics of cultured hair during the process of hair multiplication so called hair cloning. It seems like we still have a long way to go till we can practically use hair multiplication techniques in restoring human hair.

A Los Angeles Hair Restoration patient asked me today about Kevis products for medical hair loss treatment in men the other day. His father used to use those hair loss products when he was in Europe and He recommended that he can use them as well. I had to do some research on the website of the company to find out what are the ingredients of this presumed hair loss medication.

Kevis products are claimed to be natural and chemical drug-free. They work through the biological compound, hyaluronic acid, which is found in eyes and joints in its highest concentration.

Kevis uses a high-molecular-weight product called HUCP, to address hair loss and follicular mal-nutrition. HUCP is claimed that it directly impacts hair follicles, cuticles, and shafts in a positive way, bringing about stronger, thicker, and healthier hair. HUCP also hydrates and balances the moisture levels in hair and the skin of the scalp.

Kevis hair loss prevention and hair care products gently clean hair and selectively remove residue from the scalp, encouraging follicular health and greater natural hair production.

It is all nice to have a product to help cleaning the scalp and the root of our hair and also to keep the moisture to the hair shaft, but neither dryness nor dirtiness of hair is the cause of hair loss. I could not find a significant research on the effect of any of those ingredients on the health and growth of hair. We at our Los Angeles hair transplant clinics of US Hair Restoration recommend products with solid medical research showing their effectiveness and safety.

Q:

I am a 35 year old woman with history of scalp dermatitis. My doctor gave me steroid solutions for my dermatitis that helped the condition, but I have been suffering from hair loss now. Could steroid solution be the cause of my hair loss or could the scalp dermatitis be the cause of my hair loss?

Although hair loss is reported as a rate side effect of many medications, losing hair is not a common condition that could be seen after topical steroid use. Dermatitis or inflammation of skin could be seen as part of many other skin conditions. I think you have to see a good dermatologist and get an accurate diagnosis for your hair loss condition. Microscopic evaluation of the scalp or miniaturization study is a great tool to diagnose the condition of your hair loss and to see whether your hair loss is still active or not. I perform a miniaturization study on almost all my patients to determine the activity of their hair loss condition and also to predict their future hair loss. The type of your hair loss and its association with other medical conditions could be assessed by a hair specialist after taking a history and examination of your hair and scalp including performing a miniaturization study. We do perform

miniaturization study on all patients while evaluating them for hair transplant. If you are diagnosed with a treatable condition that has caused or accelerated your hair loss, proper treatment may cure your balding and give you your full head of hair back.