Hair Restoration Blog

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:

Dr. Mohebi, this may seem like an unusual question, but I’ve been hearing a lot about Prince William’s hair loss and wondered if you wouldn’t mind letting me know what treatment option(s) you’d recommend. Rogaine? Propecia? Hair transplant surgery, and if so, how many grafts?

Thanks so much!

A:

Prince William is a class IV hair loss in Norwood classification with significant thinning on the top area that indicate he will be heading toward class VI if he does not use any treatment for his hair loss.  Looking at Prince William pictures, you can see that he has had the initial signs of hair loss in his early twenties that is typical for Caucasian hair loss.

Although you may argue that wearing the crown will eventually cover the balding areas on the top, he may still have a few more viable options.  Prince William needs to be on some sort of medical treatment, either Propecia or Rogaine, to minimize his hair loss or at least to prevent or slow further thinning.  He should also consider a hair transplant surgery to reinforce his hairline and add density to his corners.  Restoring his crown balding spot will be the next priority and I think if his donor quality is good all of those goals could be achieved in one session.

I think with one hair transplant he can eliminate the appearance of balding while he might need another procedures to thicken up the frontal density and add more to the volume of top and the crown area.

Trichotillomania is a type of patchy hair loss which results from the compulsive pulling out or scratching of hair shafts.   The cause of this compulsive behavior is not completely understood.  Trichotillomania is not an uncommon condition and it can be seen in both sexes as well as different ethnic backgrounds.  Its lifetime incidence is about 0.6% and may be as high as 1.5% in men or 3.4% in women.

People with trichotillomania may initially be seen by a dermatologists or hair transplant surgeons without its sufferer being aware of their pulling hair habits.  Trichotillomania generally shows its first signs before the age of seventeen.  Circular balding patches are the initial signs that are typically seen almost anywhere that hair grows.  The balding patches are uneven and incomplete, unlike other patchy baldness conditions such as Alopecia Areata in which hair loss is almost complete in the balding patch.

Trichotillomania: Microscopic evaluation of lesions. Left: Hair shafts in different length and growth phases. Right: Hair loss and scalp skin inflammation due to scratching the skin by patient. (Parsa Mohebi, MD)

Microscopic examination of the balding patchs show broken hair and fine hair in different stages of growth.  Balding patchs of trichotillomania can most-likely be found on the scalp, eyebrows and eyelashes, but almost any area of skin has the possiblity of being involved.

Denying hair pulling is very common and in most patients, the doctor or one of the family members notices their habits first. Other self injury behaviors may be accompanied in patients with trichotillomania. These self inflicting habits should be addressed by a psychiatrist for the best possible outcomes.

Diagnosis of trichotillomania is clinical and and more often than not, no labwork is required to confirm its diagnosis.  Occasionally a skin biopsy may be necessary to rule out other causes of patchy hair loss, such as alopecia areata, cicatricial alopecia or fungal infections.

Most patients suffering from trichotillomania need behavioral therapy, but some may require medications such as selective serotonin reuptake inhibitors (SSRIs) to assist in breaking the habit.  Medical or behavioral treatments for stress reduction is also recommended for many patients.  Hair transplants are not recommended for patients suffering from trichotillomania due to the high likelihood of its sufferes pulling out the newly transplanted hair just as they had initially with their natural hair.  In most patients, trichotillomania hair loss can be reversible as long as the compulsive disorder is sucessfully treated.  A hair transplant can be used to restore balding or thinning patches that never completely recovered, but a hair transplant for trichotillomania is only recommended after months or years following the complete resolution of its sufferer’s compulsive hair pulling episodes.

As promised before, the Hair Restoration Blog will now bring on board more hair loss related videos for its viewers.  While typically educational, we don’t want to miss the opportunity to relax and enjoy a fun hair loss related music video when the opportunity is presented.

Check out the video below whenever you have a free moment and feel free to leave us any comments if you have any 

Brought to you by a very talented musician.

You don’t have to be a billionare to have a great head of hair. Feel free to contact us any time for a free consultation with Dr. Mohebi and get back on your track to a full head of hair today.

Q:

Hey Doctor Mohebi,

I was wondering, I’m thinking about getting a hair transplant, but I’m afraid of telling my future wife and female friends that I’ve had a hair restoration. I know men may not care that much, but if I’m dating someone and eventually I tell them I’ve gotten a hair transplant, I fear that they may get turned off.

I kind of look at it like plastic surgery. I know when I meet women who has undergone a nose job, I kind of feel strange about it and think maybe that person was not happy with their looks.
To be honest, it  turns me off.

So, my question is: from your experience with patients, do they keep it a secret from others or do they not mind telling people?

A:

Today, we have capabilities we did not have 50 years ago. As a young soccer lover, I used to have the disadvantage of wearing glasses.  It was very difficult for me to stay competitive in succer team without wearing my glasses.  Every now and then, I use contact lenses to be able to put aside my glasses. I am planning to get a LASIK procedure for that as well.

If I undergo a LASIK procedure, does it make me an insecure person. Not at all. I call it using all your resources to look your best.

We do have technology that we did not have 10 years ago. I say: why not use it? A lot of people are doing it, and nobody cares if these peoples’ hair is native hair or transplanted. The point: they are not bald any more and they can be as competitive as their non bald rivals in life.

One time, I met a very beautiful woman at a party and I ended up having a conversation with her.  When I told her I do hair transplants, she told me a story about someone who proposed to her and she rejected him. She said the man was bald. But I’m not saying because he was bald that he got rejected, but because he did not do anything about it. I know the argument can be made that what the woman did is sad and superficial but, hey, looks do play a part in initial courtship, whether we would like to admit it or not. And it was her prerogative to make that decision.

My point is: Be yourself and do whatever makes your heart happy. No matter what you do with your life, there are going to be people who may not like it. It should not influence your decisions.