Hair Restoration Blog

The New Year has been favorable to US Hair Restoration as many have already come for hair transplantations and many more come to see if they can receive one. The first step for each individual is to receive their thorough hair loss consultation where they receive a full microscopic evaluation and determine their current state of hair loss, as well as patterns for future baldness.

Medical Director, Parsa Mohebi MD, is making the consultation process even easier by soon opening a Bakersfield Consultation office where patients in the Central California area, will receive an expert opinion with greater convenience and financial ease. This new office is scheduled to be opened in March 2012 and will utilize the newest technology in hair restoration communications.

We are excited to have the opportunity to join the Bakersfield family and more conveniently serve the residents of Bakersfield, Lancaster, Visalia, and Fresno.

US Hair Restoration sees hundreds of Hair loss patients each year. Many people find seeking treatments for hairloss to be embarrasing and prefer to keep them confidential. Every now and again there are individuals who are confident in overcoming any social taboo’s about hair replacement, and let others know about their new found joy and are excited to share how their lives changed because of new hair growth.

Recently, one such patient shared his new more youthful look with the world and was happy to let us know of his actions. We are pleased whenever we get to share our art and science of hair transplantation, but when an individual goes out of their way to do something we never asked or imagined, we take pride in knowing we changed someone’s life. We want to say “Thank You” to this individual for:

Allowing us the opportunity to make a difference in his life
AND
Letting others know there is a solution for balding!

 US Hair Restoration always appreciates when individuals spend time on their own to let others know about their satisfied results, and we are happy to share them with others. We encourage our patients not to feel ashamed about recieving a hair transplant, but rather accept the fact of baldness being a reality for many which today has natural, lifelong alternatives. People always feel better when having a solution to any common problem, and we are happy to be available as one of those solutions!

Q:

I went to a couple different hair transplant doctors for evaluations when I was 24/25 and was told I have a juvenile hairline and that i have a good donor area and scalp laxity. The doctors recommended around 2000 grafts to fill in the diffused area at the time.

One of the doctors I visited told me to give propecia another try which I did for an additional six more months, but stopped because it seemed to have no effect and from my understanding it doesn’t really help with hair in the frontal area which was my main problem. I also did not want to risk getting any more health side effects from taking propecia.

During this time I was also taking biotin supplements which I had read are good for hair but they didn’t have any noticeable effects. I decided against getting a hair transplant because of my age and I wanted to see if the hair might grow back naturally (some people who have lost hair from accutane reported regrowing their hair several years after taking the medication).

I have a history of MPB in my family but it seems to be hit or miss. My grandfathers both had full heads of hair, my dad and 1 of his brothers are completely bald but another brother has a full head of hair. My mom has 1 brother who is bald and another with very thick hair and a low hairline (which my hair most closely resembled before taking accutane). I also have a brother who is 21 and has extremely thick hair like I used to with no signs of hair loss whatsoever.

A:

Male patterned baldness (MPB) is a progressive condition and it generally won’t get better without treatment.  The medications that are being used for the treatment of hair loss are generally for maintaining your existing hair and have preventative effects rather than restoring your hair at its full thickness like what you had in previous years.

A good hair transplant surgeon can help you realize what the best options for hair restoration are; whether it is a surgery or medication.  Using Accutane could cause hair loss as one side effect, but that is reversible within a few months after stopping it.  That is the most common case for medication related hair losses.

It is important for you to develop a good relationship with a qualified hair transplant surgeon whom you can trust.  Then let him walk you through this process.  Using medications for a while is a good idea and some patients respond well to using them.  Unfortunately the results are not permanent and most hair loss sufferers continue losing hair, but at a slower rate.  

You can use medications such as Propecia or Rogaine to minimize the speed of hair loss. When it is the time for a hair transplant you can consider that as another option as well.

Q:

Hello. I am considering getting a hair transplant and had some questions for you. I am 27 years old and began losing hair around age 21 immediately after using the drug accutane. I was on a very high dose and took more than the recommended amount during those couple weeks because I thought I would get better results. Within 3-4 weeks of starting the medication I lost an incredible amount hair. After losing the hair I read online that hair loss is a possible side effect of accutane and stopped taking it immediately . My hair went from being as thick as possible (my barber would using special thinning scissors because it was so thick) to being able to see my scalp within a month. The hair loss started in a diffuse pattern about 1-2 inches above my hairline and initially the affected area was about the size of my hand. Over the next 6-12 months I lost a ton of hair and was probably shedding a couple hundred hairs a day. I also had a burning sensation on my head for several weeks after I stopped using the medication. The shedding gradually slowed down over time but the hair I lost did not regrow.

A:

Many medications like Accutane may have hair loss as one of their side effects.  If your hair loss was only because of the use of this medication, it should have been improved after stopping it.  You  started losing your hair at the time that most people show early signs of Male Patterned Baldness (MPB).  Being on Accutane may have accelerated the pattern that you were supposed to develop, but probably was not the only reason for your hair loss.

Alopecia areata (AA) is a type of local hair loss due to autoimmune reaction of the patient’s body against hair follicles.  Alopecia Areata generally presents as circular coin shape hair loss lesions, but it can progress to involve larger areas of the scalp (Alopecia Capitis) or even the entire body (Alopecia Universalis).

Several treatment options are recommended for inducing hair growth for treatment of alopecia areata. Some patients may recover spontaneously over a period of time; because of this patients should be evaluated and selected carefully.  It is important that the options to forgo treatment are reviewed with the patients, as well as discussing the high failure rate of all the various options available.

Most people who have hair loss on the hair line prefer to treat this condition more aggressively with a variety of medications.  The chance of spontaneous recovery appears to be more in patients who have smaller and fewer hair loss paths.

• Topical Steroids

Topical steroids for treatment of AA has been widely used with little evidence of success.  They are easy to use and more affordable to many patients. However, the current lack of evidentiary success does not make this a valuable recommendation for patients.

• Local Injection of Steroids

Infiltration of long acting corticosteroids into the AA lesions has been studied with some degree of success.  Patients with smaller lesions of alopecia areata may respond better to local steroid injections.

This type of local injections of steroids is most desirable for limited lesions of cosmetically sensitive areas like hair lines and eyebrows.  The most common used medication is Triamcinolone acetonide (5-10 mg/mL).

• Systemic Steroids

Systemic treatment with steroids may stimulate hair regrowth in a limited number of patients.   Continued use of steroids is generally needed in most of these patients to maintain the level of hair growth.  Pros and cons of long term use of steroids should be discussed with these patients before initiating systemic steroid therapy.

• Topical immunotherapy

Topical immunotherapy utilizing allergens has been studied and proven to have some success in patients. The protocol for contact immunotherapy using DPCP has been recommended. Continued use of DPCP is needed to keep the skin irritated for a long time.  The inflammation seems to be able to change the progress of immune reaction that causes hair loss in alopecia areata.

Treatment should be discontinued only after full regrowth is apparent.  This can take an indeterminate length of time, and during this period patients may have to tolerate inflammation of the skin.  A high rate of relapse after discontinuation of treatment makes this option less desirable for most hair specialists.

• Other treatments of alopecia areata

Other medical treatments such as phototherapy, photochemotherapy, minoxidil and dithranol  have shown limited improvements.  Finally patients with extensive stages of hair loss with no response to treatment options may use wigs or hair systems.  That is more desirable for many women with extensive hair loss due to alopecia areata that are having zero to minimal response from any other treatments.

Q:

Hi Dr Mohebi,

Can you tell me your opinion on products like iGrow (low level laser therapy).

Thanks so much,

A:

Hello,

Unfortunately, there has been very little research done on different types of laser treatments for hair restoration and most studies are done in small numbers, lacking significant results.  As you already know there are a variety of devices such as laser combs, hoods, or brushes, yet most of these do not show significant improvement like I continue hearing from my patients who used them before. In spite of all this, I have heard a growing number of hair specialists talk about how they are seeing good results from the Laser Cap.

It seems like the best candidates are people with generalized hair thinning, as in typical female patterned hair loss.  Laser cap treats entire scalp with 224 individual red 5mw – 650 laser diodes.  This is much more coverage than the comb or other hand held laser devices offers.

I reviewed your file and based on your microscopic evaluation from 3 years ago you might be a good candidate.  However, I would like to evaluate your current condition with another microscopic evaluation.

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:

Hello,

I wanted to get more information like FUE vs FUSS…I have been doing a lot of reading..How do you know if one is best and using a FOX test??..I like the idea of the FUE but hear manny claims that it is not good..However, I am not a big fan of getting a piece of my sking taken off. There is so much differnet information.. also all the normal questions that come with the procedure….I hope to hear from you.

Thank you for taking the time to read this,

_

A:

Thank you for your question. It is a very good one.

Follicular Unit Extraction (FUE) is a method by which we remove hair follicular units individually as opposed to taking a strip of scalp and dissecting it, extracting the follicular units.

You are absolutely right in the fact that there is a lot of different information online, for and against FUE procedures. The truth is that many hair restoration surgeons and facilities promote one method versus another due to their specific surgical capabilities. FUE, if done right, might be a great solution for some hair loss sufferers – primarily those with minimal hair loss, those who (for any reason) cannot have any type of scarring on their scalp, those who have had problems associated with previous strip procedures, and those with a compromised donor area wherein a strip procedure just isn’t possible.

Having said that, most hair transplant surgeries are still performed utilizing the strip method, for a number of reasons:

Strip hair transplantation allows the surgeon to maximize the quality and viability of the hair follicles. We anticipate a maximum hair follicle transection rate (“transaction rate” referring to hair follicle ‘grafts’ that are cut during surgery, resulting in follicles no longer capable of growing healthy hair) of 1-5%, since the grafts are harvested under 3-D magnification with stereotactic microscopes.

In FUE cases, patients may experience significantly higher hair follicle transection rates of up to 10% or more. A FOX test is performed, primarily, on patients with curly hair to determine whether or not they are candidates for an FUE procedure. (It is basically a small FUE procedure.)

Although mega and giga session hair transplant procedures of 4,000 grafts or more can be performed using the strip method, individual FUE procedures cannot harvest more than 1500 to 2000 grafts. Sessions larger than this will keep hair grafts outside of the body for an extended period of time, potentially jeopardizing their survival.

Today, we have several methods to minimize the visibility of any scarring resulting from a strip procedure.

An FUE procedure is labor intensive, and as such the cost for performing an FUE procedure is significantly greater.

I think it’s best that you be evaluated by a hair transplant surgeon, skilled in both FUE and strip techniques before deciding which procedure is right for you.

Please don’t hesitate contacting us if you have any additional questions.

Thanks,

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.

Q:

I have read some good things about your practice and I am willing to travel. I am in need of 1500 to 2000 graphs placed using FUE. Please let me know the price/graft you have available. I have been quoted 4/graph but was not comfortable with the doctor.

PS. A representative at Bosley is saying FUE is not possible at 1500 to 2000 graphs. Is this true? I am not trusting this notion. Thank you

A:

Thank you for your interest in our quality hair restoration services and for taking the necessary time to contact our office regarding your inquiries. Although I cannot personally evaluate your options or offer you recommended graft numbers without reviewing your past and current medical history, I have taken the time to address your questions below.

- You stated that you are in need of 1500-2000 FUE grafts.
Here at US Hair Restoration, the regular cost for FUE hair transplant services is $8.00 per graft.

*If you have a flexible schedule and willingness to book for your procedure within 7-10 days of the hair transplant then you are eligible to take advantage of our standby option which offers a discount on the total cost of your procedure. The current discount percentage fluctuates, so please call our office for more information on the current seasonal rate.

- You stated that you were not comfortable with the previous clinic you consulted. If you are feeling uncomfortable with the last clinic you consulted for a hair transplant, we urge you to continue consulting doctors until you find the perfect fit. Finding the perfect physician for you will likely not happen over night, but the research to achieve your best possible results is well worth the wait.

- As for a Bosley representative saying that 1500-2000 FUE grafts is not possible, I would not necessarily agree. To be sure, you would need to be evaluated in a consultation for other restricting conditions. Because FUE procedures are so meticulous and time consuming, many doctors do not want to plan for over 1500 FUE grafts to be transplanted in one day. This is not to say that it is impossible to transplant more than 1500 FUE grafts in one day, but 1500 transplanted grafts of FUE will typically take about 8 -12 hours of work for the doctor and technicians. We do not like to push our patients, or surgical team to the limit, so if any patient is wanting more than 1500 FUE grafts we elect to break up the surgery between two or more days of work (up to 1500 FUE grafts per surgery day).

If you would like to schedule a free consultation so that we can discuss your options and graft number recommendations, submit an online consultation form through the main US Hair Restoration website and one of our patient coordinators will respond when they have a free moment. Thank you for your inquiries.