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I have had a hair transplant and I have numbness in both my front and back. How is this possible, how long will it last and will I become normal again as I love to have my scalp massaged.

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Numbness does happen frequently after a hair transplant, both in the recepient and donor areas. Everytime a person gets a cut or a bruise, the area that is cut or bruised will develop swelling and numbness. The numbness will abate with time. The cutting and/or swelling of small nerve fibers are the cause of the numbness after a surgery, but in the scalp, there is a rich supply of redundant nerves so if one small nerve is cut, another picks up the function fairly fast. There should be no long-term numbness, but I have seen an occasional patient who had their major nerve cut in the back of the head. Even when this complication happens, the alternative pathways will frequently take over and that process may take weeks, months, or on rare occasions, up to two years to correct. Most experienced surgeons should be able to avoid this problem. In conclusion, many very small cutaneous nerves are often cut, but the sensation returns with time. Having had two hair transplants, I can tell you first hand that my scalp was normal within a couple of weeks and within a month of the transplant, I was able to enjoy a scalp massage.

 

I had my hair transplant done by a cosmetic surgeon in California. This was the punch method leaving me with a doll hair look receeding on both right and left and crown. I had the procedure done in around August 2004. Now would i be a candidate for repair or would i have to wait longer? I do know my procedure was $2 a graft and I got what I paid for. Now i want to fix it before it becomes too detectable. I’m 24 and started Propecia in January 2005. Have been doing research for months and keep getting positive responses regarding NHI.

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Thanks for the many points raised in your email. The plugs may have to be excised, particularly if they are large. There is an art in doing repair work – the critical decisions are how to manage the old plugs and how to use your present donor supply and not damage any future donor supply you may need. The decision to start Propecia was good as an add-on to what you are doing.

At NHI, we use a fine needle for preparing the recepient areas- we never use punches to place grafts! The needle makes a wound that is very, very small and by using the proper angles and density, I can give you a natural look and reasonable fullness in a single session if you are not too bald. The grafts are inserted into these needle sites using fine surgical forceps. These small wounds heal in a matter of a day or two, you can even wash your hair the next day.

You are now more than 8 months from the original surgery so it would be a good time to have an assessment done. You should call and make an appointment to see me at no charge. Our phone number is 800-639-4247 and we have an offices in Northern and Southern California. Examining you will make all of the difference in what you finally end up with.

 

I am an African American female age 52. I have very long sister locks and they are beautiful. trouble is, I had a hysterectomy last summer and noticed that my hair is balding on the sides. I went to a dermatologist who said it was my locks pulling, but I clearly had to get him straight and tell him that I never had braids in that spot, only a hair line that never was long enough to incorporate into the dreads. I am a professional person and am always in the public eye. I am now wearing scarves to cover the sides. I would like to know what I can do. I did notice that before I had surgery, my scalp was itching badly on the sides and the hair at the follicle became crusty at the base, as if it was dead. Any help would be appreciated

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You should be seen by an expert. With a good history like yours, I would worry about a series of localized skin conditions that should be ruled out by a good dermatologist. As you are convinced (and have convinced me) that this is not traction alopecia, then a transplant might be a good solution provided that your dermatologist has determined that there are no skin conditions that would kill off the transplants. Transplants are undetectable in most African American hair types.

 

A former patient came to my office last week complaining that the hair from the transplant last year did not grow. He wanted to discuss his options with me. When he came in, I pulled out his before pictures to be sure that both he and I would be talking about the presence or absence or change. As he looked at his before pictures, I asked him again to repeat the complaint. He repeated it despite looking at a before picture of himself — when he was a bald man. Then I gave him a mirror and asked him to look at the pictures from one year earlier, and then look back at the man in his mirror. I asked him if there was a difference.

He looked confused. When I probed his confusion, he told me that his wife was totally convinced that the hair did not grow. She reported to him that she had watched for his hair growth very closely and never saw the growth occur. He did admit that the man in the mirror was hairy and the man in the picture was bald. To help him through whatever problem he was having, I told him to think about planting grass seed or watching a child grow. The more closely you watch, the less change you see. Clearly, his wife had that problem and complained over the past year that the transplant was a waste of money. Then I suggested that he take home pictures of himself before the surgery to show to his wife, and see if her view changed. That seemed to solve the problem and he left very happy.

We see the same thing echoed by many men who are amazed that their hair transplant was never detected, even by them. In the workplace, the change occurs so slowly, that people who see you every day never notice any change. We quickly adjust to what we see before us, not the image we stored in our memories.

I always enjoy these return visits a year or so after the initial transplants were done, to be able to compare the image stored in the before photos to the ‘hairy’ person in front of me.

 

Hi, My son, who is 23, has very thin hair on top of his head and a high forehead. He tried avacore and it’s hard to say if it helped or not. He has very thick hair on the sides-we are prone to high foreheads in our family but the thin hair on top of his head is distressing him (which I’m sure doesn’t help). Is there someone he can see to access his problem-we live in New Jersey and are a train ride from Manhattan. Thanks so much for your help.

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Is your son balding now? I would guess from what you are describing is most probably genetic hair loss. Avacor is overpriced and has minoxidil as its active component; I would have been surprised if it would have worked. The marketers of Avacor do a hell of a job promoting the ‘benefits’ of their product and as a result, they have one of the most popular sales efforts ever and it appears to be priced over 10 times that of minoxidil. Propecia, which is made by Merck (pharmaceutical company), is under FDA and FCC regulation so Merck can not promote claims that are ill defined or vague. In a 23 year old male, genetic hair loss comes from the ‘workings’ of DHT on the growth center of the hair follicle. Propecia is the only substance that has been clearly documented to block the effects of DHT on the hair follicle. It has documented benefits on retarding, stopping or reversing hair loss. A competent doctor would make the diagnosis and appropriately manage the problem for you. To answer your request for a doctor on the east coast, I would recommend Dr. Robert Bernstein at 201-585-1115, who has offices in Fort Lee NJ and Manhattan NY. He is as good as they come and I would not hesitate to have my son treated by him.

 

I had a hair transplant in November of 2004. The doctor was a member of IAHRS and had many good patient photos, and the procedure seemed to go very well from my standpoint. But I still have seen no significant results. I was a Norwood 3 with thinning in the frontal forelock. Now, my hair is significantly thinner on the sides, and while about 20 hairs grew in very quickly (about 2 months after the procedure they began to grow) no other hairs have grown in and my front is thinner than it was at the time of the procedure. I was wondering at what point can i be sure that no new hairs will grow in, and that the procedure did not work? Soon I will be 7 months post-op, and I still have no significant growth of the 1700 grafts I had.

Thanks for your time.

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Generally I tell patients that by 8 months, fully 80+ % of the grafts should have reached styling length. That means that the growth should be well underway by now. On rare occasions, I see delayed growth, but that is not common. IF the procedure failed, speak with your doctor directly and ask him why he thinks this is happening. If he is a good person, then I would expect honesty and some reflection on his experience with this type of problem. He should be forthright and direct with you.

As a side note, many times when a patient tells me something is wrong, I make a point to focus on what the patient is saying, adding my observations to the mix. That is why a good doctor/patient relationship is important. Things can go wrong at the time of surgery that could cause this, but more often it is things that are not evident that need to be addressed. For a complete failure to occur, something bad happened at the time of surgery. But alas, doctors are not always in 100% of control of all variables. Pass me your doctor’s feedback and let me know.

 

Dr I am 26, My father is 64 with a full set of hair, how ever on my mums side they are all totaly bald (males only) im just strating to lose my hair were my crown is. I dont have alot of faith with all these product as i have tried plenty in the past. Im hoping you can regain my faith to my hair loss problem. My hair is thin and very curly i do have alot of hair exept were for the top of my crown.

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At 26, you should go on the drug Propecia as it should slow down, arrest or reverse the hair loss you are experiencing. You should be evaluated by a good doctor. Sounds like you will follow your mother’s family line, but the drug may forestall the balding or stop it from happening. After 8 months on the drug, you should be re-evaluated.

 

My husband has a bald spot which he slickly combs back his very long hair to hide. The problem is that the spot is too big to cover that way, so his long hair falls to the side. He knows this psychologically, but denies that he is constantly combing back his hair to cover the impossible. He is dead set against being ‘cut open’ with a hair transplant. What can he do about this Johnny Cochran bald spot (with respect to the departed Cochran)?

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There are many things he can do. He can wear a hair piece like the skullcap the pope or a rabbi wears, he can use spray hair from a can which he can buy for under $10 in Walmart, he can try to have the bald spot removed (a very radical surgery today with great risks) or he can consider a new minimally invasive hair transplant technique called Follicular Unit Extraction (FUE) where he gets a limited hair transplant without being cut upon like a standard hair transplant strip excision.

If he goes the FUE approach, it will not necessarily take a lot of hair to accomplish this as we can put in something I call ‘tackers’ which are a limited number of single hairs placed into the crown (his bald spot) which when grown, will act like anchors to his comb-back. It will allow him to continue the use of his styling comb-back and then with a can of hair spray applied very lightly, the comb-back hair will be held by these tacking hairs in position for the entire day. The nice part of an FUE surgery is that there is almost no pain after the surgery (few ever complain), there is relatively low recovery time, and visibility can be kept to undetectable levels in most people. People like your husband who hate the idea of surgery, may still have a stretch to look at the FUE as a non-surgery. I have called this minimally invasive surgery when I first published this in the medical journals and so have the patients who have had the procedure, but your husband may be another case all together if he is inflexible in his thinking. Maybe there is no solution for him if he can not think ‘out of the box’.

 

This was a busy day. I started early this morning – today’s surgical patient (Patient A) had a Class 6 balding pattern. He had great donor and scalp laxity- we transplanted 5069 grafts in 7 hours! Patient A’s “before” photo is just below, on the left — his “after” photo was taken immediately post-op and is below, on the right.



My clinical staff is amazing; they are so efficient and focused on the needs of the patient. I hope Patient A enjoyed his shrimp cocktail, his Thai lunch, and the movies he watched.

I got to see the patients from earlier this week, when they came in for their hair washes. They are healing really well. I wonder if I could talk the staff into doing my hair every morning.

Starting mid-afternoon, I saw a series of consultations, some new patients and a few old patients coming in for follow-ups.

 

Patient B came in today. He has had 5870 grafts with us in three sessions many years ago. He told me an interesting story today. A friend of his came over to him, looked at his hair and said, “I know that you probably don’t follow this hair transplant stuff, but I have just seen a doctor about getting one. Do you think that I am foolish?” Patient B confided in his friend, “Well that is one funny question. Didn’t you know that my entire head is transplanted?” His friend had no idea. They both laughed.

Here is Patient B’s before (on left) and after (on right). He had a procedure in 1997, 1998, and 1999. Six years later, his hair is still looking great. Please note that the quality of the “before” photo is from a scanned photo, so it is not as clear as the “after” photo, taken with a digital camera.



 

Then I saw Patient C. He had a total of two surgeries with us, the first being only about 7 months ago to repair an old hair transplant. Many years ago he had the older technique of large plugs done by another clinic, and had been wearing a hair piece to help cover them. Every morning he had faced himself in the mirror and saw this:



I removed many of the big plugs, dissected them into follicular units and then relocated the hair. I replaced his frontal hairline zone with 1501 grafts of single hair units. The entire frontal presentation is what you see here:


After his first NHI surgery he tossed away the wig once the new grafts grew out. His second and last surgery was just a couple of months ago. The photos below were taken less than two weeks after this second procedure. I was able to place 992 grafts into his frontal hairline. The hair is still very short and beard like in length. I told him that I expect this last surgery will finish his reconstruction. He now sees a normal man in the mirror every morning and he is pleased. So am I.



I love it when my previous patients come in to see me and to show me their results. Prior to surgery they are often anxious, and frequently during surgery they are so relaxed that they sleep through some of the movies they selected. These follow-up visits really give me chance to bond with them and share in their ‘hair happiness high’.

 

This is Patient D. He had three procedures with us totalling 4391 grafts and he stopped by to say “hello”. The “before” photo is on the left, the “after” is on the right.



 

Also, four new patients were on the schedule and it is the adventure in meeting new people that is most fun. Today I was able to spend at least 45 minutes with each of them. In my career I have personally consulted with tens of thousands of hair loss patients and their families. They are each unique, but they share so many of the same concerns. It is a pleasure to discuss their options, to encourage them to research, to seek out the best!

At the end of my day, I got a call (on my cell phone at about 7pm) from a very successful LA area businessman who was 4 ½ months out from his surgery. He just wanted to tell me that now his favorite activity is shaving in the morning. He said “Each and every morning there is more and more hair. It is exactly the reverse of what I saw when I was losing my hair. Back then, my nightmare started in the morning when I looked in the mirror to shave- all I could see was me getting older and older. Now, the mornings are the bright spot in my day.” His thanks and appreciation was a nice way to end my long day.
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I receive many questions each day, and because these two are both from young women with hair loss questions, I am posting both questions in this one entry.

I am 21 year old girl. Till now i didnt hav any hair problems . But for the past 4 to > 5 months i am losing my hair like anything. My hairline is gettin broader andn is gettin thin these days.Neither of my parents hav balding problems nor anyone in our whole family.Wat should i do so that i can get my lost hair back? Is this possible to get all the lost hair ?? Which shampoo shd i use?

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I would first have a good doctor see you and look for medical causes of hair loss (there are many). The following problems are amongst those that should be considered: anemia, thyroid disease, connective tissue disease, various gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone. Many other medications can also contribute to hair loss so if you are taking any drugs of any type, then that should be looked into as well. The following laboratory tests may be useful if underlying problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone.

It is possible that a medical condition may be the cause of your hair loss, so before you jump to conclusions that you have genetic hair loss, I would have you checked out for these conditions. The shampoo you choose will have no impact on the hair loss so I always tell people to use what they like, what feels good, what smells good and what makes your hair look good. Also, please read my previous blog entries on Female Hair Loss.

I am a 22-yr.-old female and am experiencing thinning hair all over my scalp, with several spots void of any hair. Possibly related elements of my history include irregular periods, dermatitis and eczema (both on-scalp and elsewhere), a family history of thyroid disease, an often-unbalanced diet due to graduate school lifestyle :-), recent emotional stress, and use of 0.1% Tacrolimus ointment (one potential side effect of which is alopecia). I know you cannot diagnose me sight unseen, but I have one question I hope you can answer:

If one’s hair loss is related to use of a medication, stress, or a dietary deficiency, is the hair loss usually only temporary if the behaviors causing it are stopped?

Thank you very much for your time.

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Sometimes the hair loss is temporary and sometimes not. The key is quick and accurate diagnosis and taking the proper action to go after the cause of the hair loss. The outline given to the first question above is appropriate for your medical work-up as well. If there is a genetic component, then the hair loss may be additive to the other contributing factors.

 

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