Hair Restoration Blog

I have not been answering any questions in our hair restoration blog for a few days because I am in Florida as one of the invited faculties members in the hair restoration surgery workshop of International Society of Hair Restoration Surgery (ISHRS).  The meeting is held annually each year in the beautiful city of Orlando and prominent hair transplant surgeons from all over the world get together to share ideas and teach the future generation of hair transplant surgeons the science and art of hair transplantation.

I had one lecture yesterday on my invention of the Laxometer and the method in which we measure the laxity of donor area in large hair transplant surgeries.  We also discussed our new method of sequential strip removal that guarantees removal of the maximum number of grafts while still assuring the safety and quality of the hair transplant.  As a hair transplant surgeon that performs a majority of hair transplant procedures with large number of grafts, we have developed this method geared for hair loss patients with advanced classes of baldness.

Workshop Faculties: Dr. Parsa Mohebi, Dr. David Perez and Dr. Mark Mckenzie

These verbal lectures are usually followed by surgical workshops in the afternoon.  I will be demonstrating use of the Laxometer in the surgical workshop again tomorrow.  Dr. Mark Leavitt and Dr. David Perez, the main organizers of the hair transplant workshop, did a great job arranging the event which is a big step forward in education of hair transplant surgeons.

I will be back in Los Angeles next week and will continue answering your hair loss/hair transplant questions in the hair restoration blog upon my return.  I will also make sure to put a note on what was new in our Orlando Hair Transplant Work Shop this year. Be sure to stay tuned to the blog for this and all future updates.

Q:

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,

A:

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.

Q:

Hey there, doc,

It’s been about three weeks since my second hair transplant in Los Angeles. As of this moment, when I bend my neck, there’s a tightness and tension on the back of my head (donor area). Can you tell me if this tightness will ever go away and be back to the way it was before my operation? I really want to be back in the gym doing my jump ropes and abs.

A:

I’d say to give it about three weeks and begin more gentle activities such as jogging, brisk walking, bike riding, or push-ups. As long as you don’t stretch that donor area by looking down (this is important), you ought to be OK.

Activities to stay away from four to six weeks after a hair transplant: wrestling, flag football, basketball, boxing, abs exercises, and surfing or boogie boarding. Make sure there isn’t much strain on the donor area. It’s sensitive and requires protection and non-contact to heal.

Remember: Activities which increase tension between the edges of the healing wound in the donor area, such as lifting barbells or weights and other exercises involving intense bending of the neck are to be avoided. You should wait at least six months for this type of exercise in order to prevent reopening of the wound or stretching and widening of the donor scar.

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.

Hi Doctor,

My son has had a hair transplant years ago with old techniques and he has bad hair transplant scar now. He now wants to shave his head, but the scar of hair transplant on the back of his head may become exposed. Do you perform hair transplant scar repair or do you recommend any procedure that can help with hair transplant donor scar coverage?

Answer:

Hair transplant with strip technique can cause a linear scar that could be visible on the back of head if the patient wants to shave his/her head. A hair transplant scar is not limited to a bad hair transplant technique and it might have to do with one’s personal healing process too (some people are generally better healers compared to the others).

The good news is that we have methods to minimize the size of the scars nowadays and if you have bad hair transplant scars from bad transplants in the past, there are several new methods that can help improving the appearance of the donor scar. A hair transplant scar could be improved by repair of linear widened scars with different methods that we perform at our Los Angeles office of US Hair Restoration. Dr. Mohebi is the inventor of the axometer, a device that measure the laxity of the scalp precisely before hair transplant surgeries. Good measurement of the scalp laxity is one of the best ways to minimize development of donor wound complications and widening of donor scar and the Laxometer is the device to do these measurements.

One method is through simply excising the scar. Excision of the donor scar may be helpful for some donor scars. After removing the scar, hair transplant surgeon can close the skin with the trichophytic closure method in which a small wedge on one or both sides of the skin edge is removed and the skin is closed primarily. Trichophytic closure allows some hair follicles to grow new hair into the final scar. Presence of hair helps making the hair transplant scar become invisible.

Hair transplant donor scar coverage could also be performed by transplanting hair into the scar. Hair could be harvested from other areas using FUE or mini-strip techniques. Again, presence of the hair inside scarred area could trick the discriminating eye and the scar would become less detectable. Patients may need more than one hair transplant procedure into the donor scar for minimizing the difference between the densities of hair in scar and surrounding areas.

The last method that could be used to camouflage the linear scar is by tattooing the scar. People who plan to keep the hair very short can easily tattoo the scar with the figures of short hairs so it seems that there are some hairs present in the scar area, which can help minimizing the visibility of the scar.

Mega session hair transplant surgery has been around for almost a decade since Dr. Rassman and others started doing bigger and bigger sessions. Before 1993 all could be done was less than 1000 and occasionally 1500 grafts per each session. Using newer techniques and larger team of experienced technicians, we at US Hair Restoration are currently performing large sessions on a regular basis.

Not all physician teams are equal. If a doctor routinely performs sessions in over 2500 graft size, then it would be safe to assume that this doctor has mastered the skills required for large session. Unfortunately, not all doctors have either the teams or the skills to accomplish the feat on a routine basis. Limiting the size of the session to under 2000 grafts, it may take more surgical sessions to accomplish the same goal as when twice the number is transplanted.

Many factors should come together for a megasession hair transplant surgery. First, the surgical team must be trained in doing large sessions with fast, efficient cutting and placing. The following points must be available for the surgery to be successful. The sessions should not take more than eight to ten hours, for more than that, the grafts that are out of the body awaiting placement produces reduced graft growth. Hair transplant surgeon should keep a larger team of technicians to help reducing the time of surgery.

The surgeon must know the nuances of prolonged anesthesia without increasing the risks to the patient. The patient’s scalp laxity must be very loose so that a wide strip can be taken safely (often these strips measure greater than 2cm in width and 22cm in length). The patient’s density must be high (50% higher than normal densities). Large sessions might carry increased risk of swelling and redness after surgery, but overall are not more risky than smaller sessions, but the above criteria must be bet or the yield would not be there. At US Hair Restoration, we offer megasessions to patients with extensive baldness with good donor quality with excellent results.

Question:
Hi Dr.Mohebi,

I am wondering if the chest hair be transfer to the head?

Yours,

Name

Answer:
Good question and the answer is yes. Some people with limited scalp hair can be good candidates for body hair transplants. This is how it works:

Body hair can be harvested and used for hair transplants in people who have both good course body hair and are severely depleted of scalp donor hair (hair on the sides and back of the head). Body hair should not regularly be used as an alternative to scalp hair for hair transplants. This is because body hair has a short growth cycle in comparison to scalp hair, which makes body hair less desirable than scalp hair for a hair transplant.

Each scalp hair grows between 1 to 6 years and then goes to its resting phase for 4 to 6 weeks in which the hair follicle falls out before the start of another growth cycle. Body hair on the other hand has a different growth cycle, which consists of much shorter growth phase and a longer resting phase. In other words, many body hair follicles that you transplant stay in resting phase most of their lives and only a fraction of them grow and are visible at any given period of time. So you are transplanting hair follicles knowing that not many of them could be seen at any given period of time.

Having said that body hair transplants are OK for people who have no alternative ie. bad donor hair density or quality.

I visited a woman today who was suffering from female patterned baldness. She said she heard about the great work we do and she was interested in having a hair transplant procedure done at US Hair Restoration. Since her hair thinning pattern was typical of hair loss in women with female patterned baldness (also called female patterned alopecia) I decided to post this article on women’s hair loss and hair transplant to answer some of the questions many women have pertaining to female hair loss.Our hair loss patient was around 50 years old with a history of hair loss for over 6 years with more accelerated hair loss in the last 2 years. This woman has dark hair and white skin. As you can see in the picture, the thinning in the front and top was giving her the appearance of balding in front that she could not hide this with regular styling techniques.

Patients with female pattern baldness usually have significant miniaturization of hair follicles and significant widening of the spacing between hair shafts. Miniaturization occurs when hair follicles start to get smaller and smaller and they look like baby hairs that do not grow past a certain length. This miniaturization and space widening occurs in a large area of skin including their donor area. The donor area is the hair on the sides and back of the head, which remains intact in men with male patterned baldness due to male genetics.

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We discussed different medical problems that could cause hair loss in women and the importance of discussing those with her family doctor, internist or endocrinologist. The most common causes of accelerating genetic hair loss in women are:

• Iron deficiency

• Thyroid disorders
• Female hormonal imbalance or the use of OCP ‚Äúthe contraceptive pill‚Äù
• Excess levels of male hormones
• Auto-immune disorder
• Some medications

My recommendations to this patient and other patients with this similar condition are:

1. No hair transplant as of yet
2. Visit her family doctor with our letter in hand to look for any treatable causes of hair loss
3. Rogaine 2% lotion, twice a day
4. Visit us in a year to be evaluated with another miniaturization study for the progress of her hair loss or gain
5. Coloring hair lighter to decrease the sharp contrast between hair color and skin tone to create the appearance of fullness
6. Toppik, which is a topical hair product that can give more body to hair shafts

For more information on women’s hair loss you can also visit US Hair Restoration.