Posts Tagged ‘hair restoration surgery’

Hair loss on donor area after hair transplantation

Tuesday, December 11th, 2012

Losing hair post hair transplant surgery – “Shock Loss”


Dr. Mohebi,

I am a woman and I had a hair transplant surgery about a month ago.  I noticed a thumb size hair loss on one side around the closed wound on the donor area.  That has been doubled in size over the last few weeks.  Is my hair loss permanent in that area?


Shock loss around the donor area is not an uncommon complication after a hair transplant surgery particularly in hair transplants that require a large number of grafts or when the patient’s scalp is tight.  It is more common among women due to the overall higher strip width to head circumference ratio.

This phenomenon is a type of telogen effluvium that may last a few months, but usually resolves completely with no need to any treatment. Here is additional information on post surgical ‘Shock Loss.’ I really appreciate your question they often help other readers of this blog.

Take Care,

Parsa Mohebi, MD


How to improve a plug surgery?

Thursday, September 27th, 2012



Dr. Mohebi, I had a surgery in 1991. At the time it was better than being bald I thought. But the joke even in my house is “Doll Head.” Is there any help for guys like me; can you repair older plug-like transplants? I am anticipating your answer.

Outdated Hair Plugs have Doll Like Artificial Look That can be embarassing.


Absolutely, there is hope for you.  In fact, we perform a few repair hair transplant surgeries every month.  Mostly for people like you with plug hair transplants from the past; modern advancements and techniques have really increased your options.  Most people could use Follicular Unit Transplant (FUT) to restore the appearance of their hair significantly.  Here are some of the procedures that could help someone with an outdated plug surgery:

Creating a transitional zone consisting of refined follicular unit grafts in front of the plugs

  1. Filling in between the plugs and even out the area so they won’t be as noticeable.
  2. Thinning out the plugs by removing some of the hair units through follicular unit extraction techniques.

Unlike what some people think, plug transplant results from old hair transplant procedures are easy to repair in most cases. That means you and many people can enjoy a natural undetectable look after a hair transplant repair surgery no matter how un-natural their current hair may be.



Dr. Mohebi’s Response to Hair Transplants Question in The Dish

Thursday, July 12th, 2012

Comment on Andrew Sullivan’s website:

Andrew Sullivan, The Dish on hair restoration

… Another has a “warning to those men who are reading the posts exclaiming the positive impact of hair transplants”:

Like your reader who had a follicular transplant, one of my good friends also had this procedure when he was in his mid-20s; receiving rows and rows of transplanted hairs placed in neatly symmetrical patterns over the entire top of his head.  In the short run, this procedure, I’m sure, did much to help the self-esteem of a young man prematurely balding and panicked about his looks and the impact on his attractiveness to prospective mates.  The problem is that someone experiencing balding that severely in his early/mid-20s, is likely going to continue to bald.  Now, in his early 40s, my friend has the top of his obviously implanted head cut extremely short – making the unnatural pattern even more noticeable – because the balding has extended down creating a bare ring of head before the fringe of hair at his ear level.  The worst part of all of this: because of the horrible scarring created by the removal of the strip of hair from the back of his head to create the transplants, fully shaving  his head is no longer a reasonable option.  It’s an unfortunate example of having to live with a constant reminder of the vanity of youth.  He would have been better to just have left his hairline to nature.


Dr. Mohebi’s Response:

I read the negative comment about hair transplants of one of the readers of Andrew Sullivan’s “THE DISH” blog.  As medical director of US Hair Restoration I could not stay silent because of the erroneous information disclosed in this reader’s response on your site.

The comparison of follicular unit transplantation which is the current gold standard of hair restoration surgery with old techniques that involved transplanting plugs of hair in rows is inaccurate.  Hair transplant surgery has come a long way in only the last 20 years, from plug surgery and mini-micro grafting to natural looking hair transplant surgery through follicular unit transplants. Modern hair transplant surgical procedures are technology advanced; a skilled surgeons procedure results are natural.  Most hair stylist cannot detect that their client has had a hair transplant. This has been proven true and our practice and colleagues.

In today’s Follicular Unit Transplantation, hair follicles are divided into the natural groupings harvested from the patient’s donor area of scalp.  These grafts are transplanted in natural direction and distribution in the balding areas of the scalp.

Undergoing hair transplant at an early age as cited by your reader is no longer a problem.  Microscopic diagnostic methods assist a hair transplant surgeon in predicting the pattern of future hair loss in a young man.  Current state of the art diagnostic technique allows the surgeon to be able to design placement of hair grafts in a way that it looks normal at any age.  For example when I design someone’s hair line I pay less attention to where it was before and more to where it is going to be as a mature hairline in the future.  The result of a hair transplant that is done correctly should look good now and it should look good twenty years from now.

The newest methods of donor wound closure resolves the issues concerning scarring at the back of head.  One such method trichophytic closure allows hair to grow inside the scar and makes the hair transplant scar less visible.  Today, we also perform Follicular Unit Extraction (FUE) for the ones who cannot have any linear scar on the back of their head.  The FUE method is more labor intense and time consuming but it allows surgeon to remove follicular unit grafts one at a time.  After a FUE transplant the patient can keep his hair very short without being concerned about the visibility of scar of the donor area.

Finally I would like to clarify that with the knowledge we have today about balding and its adverse effects on men’s psycho-social lives, I don’t call hair transplant a vanity but a requisite that is available to us to make our lives better, just like many other advancements that are available to us in today’s world.

Parsa Mohebi, MD

Medical Director
Mohebi Medical and US Hair
Los Angeles, California


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


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,


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.


Hair Transplant: Will People Look Down On Me?

Tuesday, January 19th, 2010


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?


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.


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.


When Is a Good Time to Do a Repeat Hair Transplant Surgery?

Tuesday, December 8th, 2009


Dr. Mohebi, my next follow up appointment with you for 10 months follow up is scheduled in early January. I am very pleased with the results of my hair transplant, at the front, but, as we had thought, we may need to do some more at the back. When is a good time to do a repeat hair restoration surgery after the first one?

With all best wishes,


If you need more density on the crown, you can consider another hair transplant surgery for that area anytime after 6 months from your first hair transplant. The reason you have to wait for 6 months is because at that point you should be evaluated for the growth of the grafts from your prior hair restoration surgery and donor area. All grafts should be grown at month six after your other hair transplant. So we should be able see which areas need to be covered further. Performing another hair transplant surgery may risk putting a new graft on top of an area that is supposed to grow new hair, but the hair is not visible yet.


Peoples’ Perception of Hair Loss Sufferers

Saturday, November 28th, 2009


One time, a friend told me he was at a diversity conference and there was a man who came up to the podium to speak. He asked the audience, “what is the first thing you notice about me?” Someone yelled out, “BALDIE!” And subsequent laughter ensued (being an African American, it turned out he was hoping someone would say, “you’re black”).

Although the remark was taken as a joke, it’s unfortunate many people in our society notice physical appearances before anything else. There’s no shame whatsoever in losing one’s hair. The reality is that it’s not that person’s fault. It’s their genetic coding.

For those losing hair, there’s a socially acceptable solution: A hair transplant. Hair transplants have done wonders for all types of people, from big-name actors to prominent television sports anchors. It boosts self-confidence, makes a person feel less conspicuous in social settings, and may even increase the chance of a person landing a first date or better someone’s job prospects.

Hair transplants at US Hair Restoration are all-natural. Take a look at our hair transplant before and after photo gallery.  In a way, a hair restoration can restore your youth and help you feel at ease around people you’re meeting for the first time, making the experience of life better and more rewarding.

Much like narrowing a gap between teeth by getting braces, or correcting one’s near-sightedness by lasik eye surgery, a hair restoration can be a wonderful option for those who believe they may benefit from it.