Hair Restoration Blog

Q:

Hello Dr. Mohebi,I had a hair transplant consultation with you about a week ago regarding my hair loss type and the best method that suits my need. I am still doing some more reading and researching and I came across to the Bio-Matrix Strand by Strand (non-surgical) process.  I really would like to get your input on this particular process and if this is something that you recommend for someone like me who has lost almost 90% of his hair and might not get even 80% of it if I go through the surgical process…

I would really appreciate it if you can also advise whether you perform this method or not and if so how much it will cost approximately if I decide to do the non-surgical….

Thank you so much in advance and looking forward to hear from you…

Close up image of a Biomatrix - The mesh that keeps hair attached to the scalp. Click to see enlarged picture.

A:

Hair loss in men is a very common condition.  However, it may affect a man’s life style, career, self confidence and sex life. It seems a bit shallow, but this is the reality of how many men describe their experience.

Today, modern hair transplantation can help millions of people who have been struggling with hair loss. Many people who suffer from hair loss may hesitate to restore their hair due to hair transplant costs which seem outrageous! Should it really cost an arm and a leg to have a new and improved hair line you ask?

Hair transplantation costs can vary from $3,000 to $18,000.This is solely determined by the extent of hair loss, type of hair restoration procedure, and skill of the hair transplant surgeon. It is important for a hair loss sufferer to educate him or herself regarding the available options for hair restoration – transplant. It is also very important to learn about the procedure and find a knowledgeable hair transplant surgeon to proceed with the process of  hair restoration.

The truth of today is, despite the wide range for the cost of hair transplant surgery, you might find a doctor who offers an affordable hair transplant, who doesn’t charge an arm and a leg, and still maintians a quality standard. The surgery will be cost effective, and the results should last a lifetime!!

Check our site regarding further information on our affordable rates  for hair transplants with our “standby” list option.

There is a newly published article where the authors wrote about reconstituting skin from stem cells. This process, explained in the article, requires hair stem cells which are capable of making new skin, including hair, and other skin appendages.

The authors discuss that they have developed a simplified procedure that could modulate, or adjust, the hair formation ability of candidate stem cells. Based on their observations, the formed hair follicles could cycle and regenerate, and the reconstituted skin can heal after injury. These samples were evaluated one year after skin transplant, and they were in good condition.

Hair stem cell is a very hot topic in regenerative medicine and scientists hope they can make other tissues and organs from pluripotential cells that can develop into different cell lineages. We at US Hair Restoration have also recently published an article (Towards expansion of human hair follicle stem cells in vitro) that sheds light on another angle of hair stem cell research and can pave the way for future hair multiplication (also known as hair cloning). Hair multiplication has  great potential of being a medical treatment for hair loss in the future.

More information on this research can be found in the newly published article  in the Tissue Engineering: Part C, Methods on hair multiplication through multiplication of hair stem cells. The articles is titled “A simplified procedure to reconstitute hair-producing skin” by Lee, et al. from Division of Plastic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Q:

Hello I do mix martial arts and would like to know, how long will i be out from MMA (wrestling, jujitsu, muay thai, etc…) after strip surgery? also when can I return to regular cardio (running, rowing, sprinting,etc..) and weight lifting?  thank you. I have contacted other doctors too, but they all tell me different answers. the internet says to stay away from MMA at least for 3 months? some doctors tell me I can return to MMA after one month but in wrestling and jujitsu they are always grabbing and pulling down the back of the head in a very fast and hard manner.

A:

It has to do with the technique of hair transplantation.  If you are considering the conventional hair transplant surgery with a strip method, you should not perform any aggressive contact sports for the first month. After that first month, you can resume most of your activities, but you really need to be careful for the first 3 months and avoid some moves such as bending your head forcefully until your donor scar is fully healed, which is 3 months after  your hair transplant.

FUE (Follicular Unit Extraction) has different timelines after hair transplantation.  If receiving a FUE transplant you should be able to resume activities much quicker  because there is not a linear scar on the back of your head and you do not have to avoid bending your head for 3 months after hair transplant.  For more information, you can also read this other blog post in which I have answered another similar question from one of my patients (Physical Activity Limitations After Hair Transplant).

Q:

I was told that a spot has opened up for my hair transplant surgery. I told them to slot me in, but now that I’ve jumped into the deep end I’m a bit nervous. My nerves don’t have to do with what it will look like six months or a year from now, but for the weeks following the surgery.
I need to take the next day to really meditate on this. Although my hair loss does bother me, it’s not as if I’m noticeably bald. So I’m deciding if this is something that makes sense for me.

A:

It is completely normal to have a touch of nervousness prior to this elective surgery. Since it is an elective procedure, it is common to have questions and/or
reservations. We need to remember that it is simply hair and not some life threatening procedure! Many patients have this reluctance and there is never a clear or definitive answer aside from your intuitive feelings.

Your particular situation is for the enhancement and detailing in order to complement what you already currently have. Your hair loss is probably going to progress in the future but again, it depends on when you want to address the issue.

Having experienced seeing many other patients who had similar feelings before their hair restoration procedure, I think you will very happy you did it!! Either way, I support whatever decision you make. US Hair Restoration is always going to be a resource for you with whatever questions or concerns you have regarding hair loss and the treatment options available.

Meditate  on that assurance and clarity will present itself!

Q:

I am planning to have my hair transplantation with you soon and I have a few questions about the few days after hair transplantation.  I’ve been letting my hair grow so that I’ll be able to push it forward to cover the frontal work, but I’m concerned with how much swelling there might be, or if there’s a lot of shock loss, so that the hair I was going to use to conceal, fell out.
How many days is it again that the scabs usually persist? And how long would it be until I could get back into the gym or doing some other kind of exercise?

Also, I have been taking finasteride (1mg) and cutting the tablets into quarters. Is that correct? I haven’t kept up with the scalp massaging though. It was taking so long I was starting to wonder if was going to happen at all. But I could start doing that again now.

Thanks in advance, for your answers!

A:

These are great questions and I will be happy to answer them!

• Swelling
  Generally speaking, swelling after hair transplant surgery may occur 1-5 days following the procedure. It is usually moderate with certain exceptions which might be more noticeable and involve some area around the eyes as well. Not everyone experiences swelling, but I must always describe the worst case scenario: you may have an elevation (due to fluid) on your forehead which is alleviated by the medication we provide and elevating your head during the first few days after hair transplant.
• Bruising
  You may have some bruising or discoloration on the transplanted area, forehead, and occasionally around eyes which is even less likely, but necessary to mention. Wearing a baseball cap usually conceals your hair transplant for the following week. I’m sure your existing hair will do an adequate job as well (of course that is only for individuals who have some existing hair to cover the transplanted area).
• Shock loss
  The medication finasteride, or minoxidil in women, will help to lighten the shock loss (acceleration of the loss of native hair in balding area). Most of those shocked hairs usually go into a temporary resting phase and come back with your new transplanted hair.
• Scabbing
  The scabs are simply tiny crusts that dry up and flake off within a week.  They are hardly noticeable, and if you wear a cap no one can see anything.
• limitations in physical activities
  Exercise can be resumed two days following your surgery. Try to keep the blood pressure down (no squats, dead lifts, bent rows, etc) for the first four days after hair transplantation. If you can do some light machine work for a week, that would be best. Try to keep your head elevated/upright. You can do the treadmill or cycle, but just keep the intensity moderate. After 4 days post op, the grafts are pretty much locked in.

Rub your scalp before the hair transplantation. It helps! Your procedure size is rather small so scalp laxity will be a minor issue. However, do the scalp exercises! They are good for the delts also! And yes, you are correct in dividing the finasteride into 1/4′s!

Q:

I am on my day 4 after my hair transplant surgery. I’m a little concerned that I may have pulled out a few grafts accidentally. They sure look like grafts. But then, the hairs are all dry and brittle, with no moisture at the ends, and that gel-like substance is also dry. Could they have just broken off, or are these grafts that didn’t take?

Thanks again for all of your help and support. I really appreciate it.

Best wishes,

A:

The most important question is whether you lost a graft or hair with scabbing after or before day 4 from your hair transplantation.  Looking closely at the photo you submitted shows that you may have lost the entire graft and it may have happened before then and you have found it now.

Remember that follicular units (a unit of one or a few hairs and their appendages) are very fragile in the first 4 days after hair transplantation.  If you accidentally scratched or rubbed the transplanted area during the first few days you may have dislodged the grafts and lost it completely.  However, any loss of hair after day 4 might be just a telogen (resting) hair with its attached scabbing and you still will grow normal hair from the remaining follicle.

Q:

Hi Dr. Mohebi,

First off I wanted to thank you for the job you did. You and your whole staff are just wonderful and I am very excited to see what will happen in the coming months.

I was looking online and saw that spraying a saline solution on the transplanted area is supposed to promote healing and help the scabs come off easier. I was wondering what was your opinion on that?

I am having some itchiness in the transplanted area. I’m guessing that’s normal. I can keep from scratching but was wondering if there was something I should do about it or will it subside on it’s own.

Thank you,

A:

I am glad you had a good experience with your procedure and our staff at US Hair Restoration during your hair transplant surgery.  Spraying Normal Saline solution to transplanted area is not necessary after a hair transplant surgery.  You need to wash off the scabs with tap water and the shampoo we have provided after your hair transplant.  The reason you need to wash transplanted area is to get rid of the scabbing that may harm the growth of transplanted grafts.

Itchiness for a few days to weeks after hair transplantation is normal in either transplanted or donor area of scalp.  Occasionally the itching after hair transplantation may become more uncomfortable and a prescription of a mild steroid might be required.  I will be in our Los Angeles Hair Transplant office for your follow up appointment. I will examine your transplanted and donor area and will address this issue.  However, please don’t wait till then and contact us if there is any questions or concerns before your next appointment.

In the mean time, have a great week and I look forward to seeing you next time.

Dihydrotestosterone (DHT) is a byproduct of the hormone testosterone, which is formed in different areas such as the prostate gland and hair follicles.  Hair follicles which are susceptible to genetic male patterned baldness contain DHT receptors.  Over time as males produce more and more DHT the molecules affect hair follicles and cause them to become decrease in size, and eventually fall out permanently.

DHT and having the gene of male pattern baldness are the primary contributing factors for male pattern baldness. Women with female-pattern baldness, unlike men with male-pattern baldness, are usually not characterized by increased production rates of DHT due to their low levels of testosterone.  However if for any reason a woman has increased testosterone, she may develop female patterned baldness just like a man does with the same mechanism.

Hair in the areas that are prone to male patterned baldness such as corners, top and crown areas are loaded with DHT receptors in men with Androgenetic Alopecia.  However, the hair on donor areas such as back and sides do not have as much DHT receptors.  This is why hair is more permanent on the sides and back as opposed to the top and front.

The distinction in hair quality on different areas (donor vs. recipient) allows a hair transplant surgeon to remove hair from one area and transplant it to the balding portions of the scalp.  These transplanted hairs are permanent and won’t be affected by circulating DHT. Finasteride (Propecia) is a drug that blocks the conversion of testosterone to DHT by blocking the enzyme alpha reductase.  DHT levels in hair loss patients decrease when they are on Propecia and this helps maintain healthy hair, and this helps some of the miniaturized hair become stronger.

We recommend medical treatment with DHT blockers in many of our patients who undergo a hair transplant procedure to help maintaining their own hair in addition to restoring the balding areas with hair restoration surgery.