Posts Tagged ‘hair restoration surgery’

DHT and Hair Restoration

Friday, August 5th, 2011

Donor Hair For HAir Transplantation

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.


Transplanting Hair to a Genetically Receded Hairline

Wednesday, December 29th, 2010

I was born with a receded hairline and have always been concerned about it. Can the area that is receded still be corrected, even if there has never been any hair there in the first place?

Receded hairlineA:

Fortunately, with quality hair restoration, we are able to redesign your hairline with your final outcome in mind. Designing a hairline that was not present before is possible but each patients desires must be evaluated to determine how reasonable their expectations are. Because not all hair loss patients have the same expectations, it is not easy to say whether or not your expectations are possible. Each case is different and must be evaluated by the hair transplant surgeon to determine eligibility and possible graft numbers.

To be evaluated, we recommend attending a consultation with a good hair transplant doctor. If you are interested to schedule a consultation with US Hair Restoration California Offices, they are located in Encino, Beverly Hills, Orange County, San Diego, and San Francisco, CA.

If for any reason you are unable to attend a consultation in one of the US Hair Restoration’s offices, we recommend alternatively scheduling for a phone/internet consultation with the doctor. To fill out an online request form for a consultation with Dr. Mohebi, please see our Online Hair Loss Consultation page. Upon receipt of your information, we will follow up with you with a list questions and photos that are needed for the doctor to offer you a valid professional opinion.


After Two Weeks From Hair Transplant

Wednesday, April 14th, 2010

Q: Hello Doctor Mohebi, I hope all is well and that Orlando was a success. I am now creeping on 3 weeks post operation and just as you expected the en masse shedding commenced at right around the 2 week mark. The good news is that I still have a sizable number left, which goes to show a large number of grafts are the way to go, but I did have a couple of more questions I thought were valuable and perhaps worthy of your blog. 1) Even though I am at my 3rd week post op and many hairs have already been shed, many more seem to be sticking around — at least for now. I am wondering if there’s any kind of benchmark to assess when I can expect the shedding to stop. I would like to be able to clip all of my hair short so as to not have to keep “covering up” with hats and the alike, but I am not sure how much more shedding will take place. Should I just wait til new hairs start to grow (1-3 months post operation, as I’ve been told) or is it relatively safe to assume that most of the hair which has not been shed after approximately a month will stick around (hang in there)? 2) For a more

long-term question, what happens to the new transplants that have fallen out? Given that telogen effluvium has taken place, I am assuming that the new hair will sprout once anagen takes place. But here’s the dilemma: If the front of my head contains transplants that ALL FALL OUT (for the sake of the argument, as you have stated that 90% or so of patients experience this) then that would suggest that all of this hair would be hitting CTR+ALT+DEL (or restart!) at about the same time. If that is true, then all this hair should be hitting catagen and then telogen again at relatively about the same time, say between 2-3 years for most people. Am I then to assume that my forehead will become synchronously thin at about 3 years only to become very full again a few months later???? Thanks Doctor. Anonymously Yours, A: These are very clever questions and I will happily post them on our Hair Restoration Blog for others to see. I will try to answer your questions in the order you asked them.

Hair Shedding After Hair Transplant

Losing hair shafts of newly transplanted hair generally occurs in most transplant cases and only a small percentage of them will continue growing the transplanted hair from the day of surgery. Even if you are one of those lucky people who never loses their hair after surgery, you still may lose a significant number of hair shafts and only some of them will continue growing without going through shock loss. It is not always easy to predict the timing of hair shedding in transplanted grafts, but if you have kept them for the first month after hair restoration surgery, it is likely that they will not shed. As far as clipping your hair, you could have done it at any time after the first week following your hair transplantation. Just be careful about the length of hair on the donor area. You don’t want to expose your wound on the back and clipping your hair short tends to do this. The transplanted hairs are part of your scalp at this stage and you cannot dislodge them even if you try.

Are all transplanted hairs entering the resting phase at the same time?

When hair shafts fall out due to telogen, the follicles enter their resting (or telogen) phase. In this phase the grafts lose their shafts, the follicles shrink and become dormant for a short period of time (usually 4-6 weeks). Following telogen comes another anagen phase in which new hairs sprout from the same transplanted hair follicles. The initial hair grown is short and fine almost similar to vellus hair, but unlike vellus hair, it becomes longer and thicker over time. For some reason, the biologic timer of your hair follicles are not quite synchronized. The shedding of the transplanted hair won’t happen at the same time and therefore you won’t have to experience baldness again in the transplanted area a few years from now. You should have some of your hair growing while a small portion of them remain in resting phase the whole time.


Donor Wound Care After Hair Transplant

Tuesday, December 15th, 2009

Donor wound care after hair transplantQ:

When I do look down placing more tension or pull on the tight donor area, I noticed it is also pulling my neck muscles and there is no laxity at all (compared to the right).  There is no up or down movement possible of any subcutaneous tissue or the galea at the donor site. Is this normal? If the tightness does not subside, what solution options are there?

I also understand there are recommended scalp exercises before and after HT surgeries?



It is normal to feel tension on the side that we removed the strip.  Skin needs a few weeks to get relaxed and stretches to compensate for the removed area.  Although we generally recommend scalp exercise before hair restoration surgeries with strip technique, you should avoid scalp exercise after hair transplant for the first 3 or 4 months.

I recommend that you avoid all movements that increase the tension in the area until you feel that the tension on the skin is gone.  If you put too much stretch on the back of your head in the first few months after hair transplant, you running the risk of stretching the donor scar.

Have a good weekend.