Hair Restoration Blog

Hair Care Beverly Hills interview with Dr. Parsa Mohebi

Below is the second interview of Hair Care Beverly Hills with Dr. Parsa Mohebi.  Dr. Mohebi is the medical director of US Hair Restoration hair transplant centers in Southern California with offices in Encino, Beverly Hills, Orange County and San Diego.  Dr. Mohebi is the author of Hair Restoration Blog.  He also responds to the questions of many other resources of hair loss and hair restoration.  Her is his recent interview of him by Hair Care Beverly Hills for BuzyMoms.com.

• If a client has already had a transplant with another hair transplant doctor and is disappointed with the hair restoration results, can the procedure be redone?

Yes, hair transplant repairs are a good portion of our hair transplant surgeries performed in our Southern California offices (located in Beverly Hills, Encino and Orange County). Many people may have unnatural results from previous hair transplants due to the older techniques such as plug surgery, but some may even have problems with recent hair restoration procedures due to technical issues or lack of proper judgment on the part of the hair transplant surgeon. In most situations, the repair is easy and can be done in one or two sessions.

• Is there a minimum age for hair transplant surgery?

It was not unusual that a Hair transplant surgeon discourage a person younger than 24 for a hair restoration surgery.  However, nowadays microscopic techniques being used to evaluate the miniaturization of susceptible hair can assist surgeons in predicting the final pattern of hair loss. By being able to predict each patient’ s final balding stages, we are able to see where the pattern of baldness is heading and based on that recommend hair transplant surgery at an earlier age.

• Won’ t my bare scalp be showing in the back of my head once the donor hair is taken?

If you do not plan on shaving your hair after your hair transplant surgery, your donor wound will never be visible. However, if you plan on shaving your head for any reason, you may choose to have a FUE or Follicular Unit Extraction procedure done rather than the general FUT procedure through removing a strip from the donor area. FUE transplant eliminates the visibility of a linear scar on the back of your head and is the best option for patients who plan on shaving their head or keeping their hair very short in the future.

• Do you provide free consultations?

Yes, the initial consultation with me (Dr. Parsa Mohebi) is always free in any of our Southern California hair transplant offices in Beverly Hills, Encino and Orange County and San Diego.

• What type of information should be brought to the consultation?

Anything related to your hair loss and hair restoration, including family history of hair loss, other medical conditions that may have been attributed to ones hair loss, medical, surgical or even cosmetic changes that you like and may help you have a better result after a hair restoration procedure.

Discount for FUE Transplant – Limited Only for Study Participants

As a leader in hair restoration, US Hair Restoration is now conducting a study on different methods of FUE (Follicular Unit Extraction) hair transplantation in its Southern California offices.  Our main goal of this study is to compare the quality of grafts harvested by the most advanced hair restoration techniques.  Study patients will be entitled to a discount from our standard rates of FUE hair restoration. The study will be going on until the end of July 2010 and the results will be submitted for publication in world-wide medical journals.

Who is a good candidate?

Hair loss patients who does not want to have linear scar on the back of their head might consider this option most probable for their needs.  Also, any candidate should know that the number of grafts available to be harvested in one FUE session might be significantly less than what could be done through a traditional strip method.  Thus, in addition to those who want to avoid scarring, patients who does not need a large number of grafts for their hair restoration may also be relatively better candidates.  FUE could be used for treatment of male patterned hair loss with class III and IV, eyebrow hair transplants, or to restore the linear scar from a previous strip procedure. Applicants can call the US Hair Restoration office at 1 (800) 302-8747 to schedule a consultation with Dr. Mohebi.  If you are still unsure whether or not FUE is the right procedure for you, please read our website and in particular the page on Follicular Unit Extraction.

Shock loss after a second hair transplant

Q:

I am considering a second procedure in a few months for additional coverage in my mid-to-crown area, will the frontal area (my first procedure) be affected with ‘shock loss’ during the healing process of the second procedure?

Thanks again for your replies.

A:

Transplanted hair from a previous surgery won’t be affected as native hair to a second hair transplant procedure, however, the surgeon should be extremely careful with transplanting into the area that has already been transplanted. We at US Hair Restoration use special devices and needles to minimize the transaction rate of preexisting hair follicles.  Some loss of the transplanted hair may be seen when we transplant to thicken up the already transplanted area, but it will be reversible as opposed to the permanence of shock loss.

Here is a new article from Wang et al from PLA Burn Institute in China that has been recently published on hair transplant for cicatricial alopecia due to burn.

The investigators evaluated one hundred and sixty six burn patients that had some balding patched on the scalp as the result of the burn injury over six years.  Hair follicles were obtained from back and side of the scalp and transplanted into the hair-less areas of the scalp.  They then made size-matched incision and implanted the grafts into the scarring area. They evaluated the patients in person and through satisfaction survey.

The author of the article reports that in half of the cases, patients have been satisfied with only one hair transplantation procedure, while in another half they needed another hair transplant into the scar within a year after initial hair transplantation surgery.  96.5% of grafts have survived and grew.  The authors concluded that the technique of perforating and transplanting follicular-unit hair synchronously is safe and effective with minimal surgical injury and negligible bleeding. Transplanted hair on cicatricial alopecia area with this technique grow well with high survival rate.

I presented the article “Hair Transplants for Neurosurgical Scars” 3 years ago in the annual meeting of the International Society of Hair Restoration Surgery in Las Vegas Nevada.  In there we presented a case study of several patients with scalp scar from brain surgery, trauma scar or other neurosurgical scars that have been successfully treated with hair transplantation. Today we see more evidences of treating scars of the scalp, face and other hair bearing areas of the body with hair transplantation.

Q:

Hello Dr Mohebi. I am about 16 days post op and had my trichophytic sutures removed about 5 days ago. The wound has healed nicely with no scabs left -but I still experience sensations in the donor area during my sleep which eventually causes me to sleep sideways or my stomach. Are these sensations unusual this many days post operation? Thanks for reading and responding.

A:

Having slight pain or tenderness following the first 2 days from hair transplant surgery is not unusual.  However, if the pain is to the point that it is affecting your life style or to the point that you have to continue to take pain medications after the first few weeks, I recommend that you go back to your hair transplant surgeon and let him/her re-evaluate you.  Development of folliculitis, especially if you had trichophytic closure, may cause pain.  Minor pain or unusual sensations (paresthesia) after any wound closure could be due to the irritation of small nerves that are in the vicinity of the healing wound and may last to a few weeks after surgery, but will eventually go away.  Having said that, it is not a bad idea for you to be evaluated by a specialist in-person to be on the safe side.

Q:

Hi doctor, I had synthetic hair transplantation last year. After a few months following the starting process, several complications started to appear such as, blistering, infection, folliculitis and a currently very red scalp. I finally had to yank out nearly all the transplanted artificial hairs, but there is still severe redness as well as a demarcated line on my scalp with some blistering and diffuse atrophy of my scalp skin. Where do I go from here? Do you have any recommendations from this point?

With thanks,

An unhappy synthetic hair recipient,

A:

Synthetic hair is known for its problems including infection, severe skin contact reaction and inflammation of scalp that may occur after their use.  We discussed artificial hair implantation in this blog before.  If you removed them, it is likely that the rest will fall off too.  Do not manipulate your scalp and your skin inflammation should improve with time.  The FDA has never approved artificial hair for their hair transplant use in the United States and hair transplantation through the use of a patients own hair is the gold standard for hair replacement surgery.  Below, you can see a summary of an article on artificial hair and its consequences from the Indian Journal of Dermatology.(1)

Implant or transplant

At the outset, it is important to distinguish between implants and transplants of hair.  In contrast to transplants that use patient’s own hairs, usually taken from the occipital area, implants indicate the implantation of prosthetic hair fibers just as artificial hair implantation does.

There are two types of prosthetic hair:

1. Synthetic fibers (such as monoacrylic, polyacrylic, and polyester)
2. Natural fibers (such as processed human hair).

They are implanted into the galea (which is the fibrotic layer underneath the skin and fat layer under that) by use of a knot through an implanter device. The advantages claimed with this technique are the relative ease of the procedure, which can be learned in a few days, relatively bloodless technique, and immediate cosmetic result. In contrast to transplants however, these fibers do not grow and hence cannot be cut or shaven. In this respect, they resemble a wig, which has been fixed permanently to the scalp.

Problems with synthetic hairs

These fibers have had a checkered history. First introduced in 1970s, they soon became the subject of much controversy because of their numerous complications including recurrent infections, rejection, periodic loss of fibers needing frequent replacement, frequent allergic reactions leading to severe contact dermatitis, irritant effects, fears about carcinogenicity, cicatricial alopecia, granulomatous hypersensitivity, and cyst formation.

In 1983, the US Federal Drug Administration banned the fibers for the following reasons:

1. The fibers presented risks of illness or injury owed to the non-biocompatibility of the fibers and non-medical performance of the implant.
2. The fibers presented fraud owing to the following:
   • Deceptive information on the efficacy.
   • Inadequate information on risks from implant.
   • They did not show any benefit for public health.

The ban on prosthetic hair fibers is established in Section 895.101 of Code 21 of Federal regulations of the FDA, title 21, vol. 8, revised as of April 1, 2004.

Reference:
1. Mysore V. Synthetic hairs: Should they be used?. Indian J Dermatol Venereol Leprol 2006;72:5-7