Hair Restoration Blog

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:

Thank you for your reply to my previous e-mail Dr. Mohebi. I’m getting close to being ready for this, but I still have some concerns that I would like to address prior to booking.

I realize I won’t come out of this looking like Brad Pitt, but can I expect some decent density in the area you’re going to operate on? I’ve seen a lot of pictures of “great” results that were little more than thin whiffs of hair lying limp over shiny, conspicuous scalp. I’d like to be able to style it in the youthful way, showing off my hair line. I suppose that depends on the number of grafts?

A:

The number of transplanted grafts and extent of your balding area are two very important factors in the final thickness of your hair. However, because you have fine hair, even with using the maximum density, you may not achieve the original fullness that you once had. Some patients with the same circumstances as yourself may need more than one surgery to develop maximum density close to that of their original coverage prior to losing hair.

Using hair from other parts of the body for transplantation into scalp has been used for many years.  Unfortunately though, the change in the life cycle of body hair from different areas of the body has caused the body hair to stay as the last option for scalp hair restoration.  Body hair has long resting phase and short growth phase which means that most of the transplanted hair will stay in resting phase without having visible hair growth.

Comparison of scalp (left) vs. facial (right) hair: Note the difference in density of hair per surface area and the average number of hair in each follicular unit. Scalp hair is denser with more hair per grafts (over 2hair/graft) while beard hair is less dense with fewer hair per grafts (1-2 hair/graft)

Facial hair such as beard and mustache hair on the other hand has a longer growth phase and shorter resting phase.  That is why men can grow their facial hair to become really long.  Facial hair is also thicker than scalp hair in most people.  Thicker hair could be translated as more bulk of hair after hair transplantation.  Both longer growth phase and thicker hair shafts make beard hair a better option for scalp hair restoration in comparison to body hair transplant from other areas.

There are two problems with with beard hair restoration.  One is that they are very sparse and removing hair only needs to be done through a strip procedure.  The other problem with using facial hair for scalp transplant is that the facial follicular units are having fewer number of hair per unit that means less hair per grafts removed with FUE techniques.

Beard transplants are gaining popularity recently with newer techniques for extraction of hair (FUE) and it can be a great alternative to scalp hair for transplanting to the balding area in people who do not have good quality scalp hair.

Today, many medical specialties are using new technology that involves robots for completing procedures.  Robots can help to minimize human error or increase the speed of procedures.  In hair transplantation, one of the most meticulous procedures in the surgical field, many stages need to be done microscopically using trained and highly specialized surgical technicians for the best results.

The FUE (Follicular Unit Extraction) procedure is one of the newer techniques of harvesting hair.  FUE can help surgeons to avoid leaving a linear scar on the donor area of patients after a hair transplant.  FUE transplantation has been gaining popularity in the last few years, but it is limited in terms of the quality of grafts and the number of follicular units that are able to be harvested in one session.

The reason for these limitations are due to the fact that FUE procedures require very extended labor hours as well as the need of the surgeon and surgical team to constantly work on removing follicular units using high magnification devices.  Due to the above requirements and our standards of quality, we recognize that staying in the same position for long periods may cause fatigue in the surgical team and is a limiting factor in the number of grafts that are able to be harvested in one session.

Robotic surgery seems to be a perfect solution in which machines can do the tedious hard work in removing the follicular units in FUE sessions.  Robots can also miraculously be used for placing the removed follicular units in the recipient areas.  There have been many advanced methods of automated hair restoration procedures developed in the last few years.  There is no doubting that many of the currently available automated techniques will lead to the advanced development of a perfect robotic system to harvest and transplant hair grafts in the near future.

Restoration Robotics is one of the companies who have pioneered robotic hair restoration procedures.  The current machine used is a computer guided system that allows a surgeon to remove FUE grafts with high accuracy and a reasonable speed.  The system still needs to be equipped to a transplanter in the future but even now, it could be considered a great device in the field of hair restoration.  We will follow the advances in the field of robotic hair restoration closely and keep our viewers posted with other techniques or devices that become available in the future.

To add to our growing selection of Video Testimonials online, here is the story of one of our female patients “thrilled with the results” of her hair restoration. Her end results are instantly recognizable when compared to her before photos and the confidence restored to her was well worth more than anything else gained. With no need to hide or cover her hair loss with different hairstyles, this patient can now freely live her life without cares of wind and styling that was always needed to be accounted for before.

** To see before and after pictures of this patient, please feel free to visit her Photo Gallery. **

Q:

Dr. Mohebi,

I live outside of California and am interested in seeing you for my hair restoration. I have attached my photos to this email along with a few quick questions that I have regarding hair transplantation. Could you please check them out when you have a chance and let me know what your personal recommendations are?

- What is the approximate number of grafts required to achieve sufficient density (if not a lot) and the approximate cost of the whole process?
- How long will it take me to get back to my work and how soon I will see the results?
- Lastly, please do let me know any other important information that is relevant to the his whole procedure.

Thanks for your help!

A:

Thank you for your interest in our hair restoration services. I forwarded your information and pictures to be included in our patient system, but I also wanted to take a quick moment to review your photos and answer your questions personally. Here are the answers to your questions in the orders they are received:

Number of hair transplant grafts recommended

You are a class VI of hair loss and would require the maximum number of grafts we can get in one session to achieve the density you are striving for. The number is generally above 2500 grafts for people who have never had a surgery, but may fluctuate in the range of 2500 to 4000 grafts based on your own scalp laxity and density of hair (to be determined when you are here in our office).

What is the average hair transplant cost

The cost for hair transplants at US Hair Restoration are based on the number of grafts needed and the standard charges are as follows for Follicular Unit Transplants: $4 per graft for the first 2500 grafts and any additional grafts are charged at half price ($2 per graft).

Your travel expenses will be reimbursed towards 10% of the cost of surgery (up to $500).

In addition to reimbursement on travel, we will book a hotel near our office for you for 2 nights with free transportation between the hotel and our office for your visits.

We also have a standby program available for people who can be flexible and go on our waiting list to await the next available surgery date (visit us at www.ushairrestoration.com for more information on that offer).

How soon will I see results after a hair transplant

The procedure for a strip hair transplant takes one whole day (from 7am to 5pm) and you are required to return the day after for your procedure for a hair wash. With these basic requirements, you can fly back home as early as the first day after your surgery. You will be fully functional the first day after surgery, but you may have some swelling for 3-4 days following.

Visible results of your hair transplantation will be seen approximately 6-10 months following the procedure itself.

How can I get more hair restoration information

You can also find great information about hair transplant methods with US Hair Restoration on our website: www.ushairrestoration.com or our blog: www.ushairrestoration.com/blog

As promised for all those waiting, we now have another patient testimonial on our Video Testimonial Page to reflect some of Dr. Mohebi’s current patient results.

Please take the time to watch the video below at your earliest convenience and do not hesitate to leave us/ the patient comments at the bottom of the page. We love having the opportunity to see life altering changes made in a people’s lives and I truly believe that these videos are the best possible reflection of their elated happiness following their hair transplant with Dr. Mohebi.  Hope you all enjoy them as much as we do  

Patient Testimonial – 3963 Total Transplanted Grafts

 ** To see before and after pictures of this patient, please feel free to visit his Photo Gallery. **

According to a recent L.A. Times article, people in our current economy are scaling back on elective cosmetic treatments, and finding ways to negotiate costs and figuring out what’s really necessary (e.g. Botox) and what’s not (e.g. massages and body scrubs).  We have posted on Recession and hair transplant cost before.

US Hair Restoration understands that people have found themselves in challenging economic circumstances. Our goal has always been, “offering quality hair transplant for everyone”. We want to relieve the pressure on people by responding to patients’ needs for more affordable hair transplant prices.

Every year, we have a summer hair transplant special, but this year, we’re going to offer it several months in advance as part of an unprecedented and huge hair transplant cost reduction. And we promise it will be the lowest price ever for our hair transplants using our standby program.

For those who are seriously considering getting a hair restoration procedure, the best time to get one is when we have this reduced-price offer. This is a limited offer and the price might not ever be this low. Now is the time to take advantage of it.

Offering hair transplant cost discounts in our standby program helps us to fill all openings in our operating room schedules. On the other hand, for those people who can be a bit more flexible with the timing of the surgery, it helps them get a US Hair Restoration-quality hair transplant done at historically low rates, at one of our Southern California offices: Beverly Hills, Encino, and Orange County.

The bright side to the recession is that retailers and companies are offering lower-than-usual prices for their products, knowing consumers have become increasingly tight-fisted about their cash. Our earlier-than-usual summer special is our way of saying we are sensitive to our patients’ financial circumstances.

Check US Hair Restoration for more info on our hair transplant promotions.

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.

Q:

Thanks Dr. Mohebi,

Your input is much appreciated.  The shock loss you had mentioned has been my concern, as a few of my frontal hair seem lighter than before.  You had mentioned that the shock loss might be visible for a few weeks to months – will it be the case that after that shock loss stage, the hair will likely return back to original form?

There’s a very important question that i would like to ask you, and was thinking the it would be great for the blog to have.  Basically, when you saw my before and after picture, i feel like i changed a bit.  The “after” picture seems like i have more redness, and i’m hoping it’s not the case where the hair transplant affects the circulation (e.g., tight donor area/scalp affecting the blood flow to my head).  My surgeon told me before the procedure that i will eventually be back to the way i was before (i.e., the “before” picture), but just have a new scar and more gafted hairs.  That’s the ultimate question: would you agree that a patient who does a hair transplant will relatively return to the condition that he was before the particular sugery (w/ of course, a new scar and more hair)?  This is what keeps me up at night, thinking perhaps my scalp has worsened, or i am now more prone to lose hair.  I hope that’s not the case, and every patient should be aware about before she or he gets a hair transplant done.

Thanks again for your help.  If I see you in person at your office, I might be interested in discussing about future scar work.

A:

What is hair transplant shock loss

Some of the hair shafts that fall off due to shock loss might come back. Especially if the shock loss happens in an area with permanent hair like back of the head. However, losing hair in the frontal area because of shock loss might not be completely reversible. But, you have to understand that falling hairs are the ones that were supposed to fall off anyway and a hair transplant just accelerates the loss.

How to prevent shock loss

Again, using finasteride can significantly reduce the extent of shock loss. After surgery, in the transplanted area, the tightness should not affect the circulation of the scalp. After a few days to weeks, on the donor area, the tightness goes back to normal.

Donor scar in strip hair transplant

And to answer to your last question, I do not agree you go back to the condition before surgery with only a new scar and some more hair. What I personally do in a repeat surgery is remove the old scar; the patient at the end has only one scar that at times may be even better than the initial scar.

How to improve the appearance of the scar

I perform trichophytic closure when I think it is the final surgery that the patient may need.  Trichophytic closure is when we close scalp skin on the back in a way that hair can grow through the scar.  Trichophytic closure reduces the contrast between donor scar and surrounding areas that eventually improve the appearance of the scar, so you are not more prone to hair loss because of your hair transplant.

In some cases and when we are looking for even less visible scar, the scar may get filled with FUE into the scar in a few months from the initial surgery.

Be patient and you should be able to see results in the coming months.