Hair Restoration Blog

Eyebrow hair transplant at US Hair Restoration - Top picture: Ten days after eyebrow transplantation.

I saw a patient who had an eyebrow transplant 10 days ago.  I thought it would be useful for our readers to get an idea of how a transplanted hair ought to appear about 10 days after an eyebrow hair transplantation.

For transplanting to the brow areas, scalp hair is being used. In this particular case, we have used around 600 grafts for both eyebrows (300 for each eyebrow).

After the hair transplant, transplanted hair shafts generally stay in place or may even grow for two weeks, but they almost always fall after the second week. It may take about two to three weeks for the newly transplanted hair to start growing after an eyebrow hair transplant, which is the same length of time as a scalp hair restoration.

After full growth, patients need to keep trimming their transplanted eyebrows because they have the same growth pattern of the scalp hair where they are originally from.

Q:

My son and I discussed the procedure with his Mom.  We are thinking, even though the other “FUE ?” procedure is about twice the money, it would be worth going the alternative route in order to avoid the issue of his being left with a scar (e.g., if he ever decides to shave his head, or get a very close “buzz cut”).  What is the more expensive, alternative procedure called?  And, how does that change the logistics?  By that last question, I mean, for example, what you described yesterday was a one-day procedure if we went with the “scar” procedure.  Now, however, if you do not cut a “strip” and leave a scar, how many days is required?

A:

What we discussed was Follicular Unit Extraction (FUE) procedure.  That is another version of Follicular Unit Transplant (FUT) surgery in which instead of removing a strip, we remove follicular units or the natural bundles of hair one at a time.  Removing individual follicular units allows us to keep scars small and scattered.  This prevents a linear scar on the back and donor area.

FUE is ideal for people who have a limited need for hair follicles and try to keep the option of buzzing or shaving their head open after the hair transplant surgery.  It is not for people who are destined to have large areas of baldness, due to the number of sessions they may need and the fact that their eligibility for hair transplant surgery may change over time.  In other words, they might be FOX positive to start with but after the initial surgery their candidacy may change.  Not to mention the cost of hair transplant surgery that may play a major role down the road when you are looking into filling a large area of the scalp with transplanted hair.

Strip procedure is definitely more efficient both in terms of cost of the hair transplant and the number of grafts that one can get over a certain period of time.  The donor scar of a hair transplant surgery is also getting better with the new techniques of hair restoration surgery.  However, if you want to eliminate the linear scar of strip hair transplant on the back, FUE is the only way to go about it.

Q:

When can I go back to work after my hair transplant surgery?

A:

This is one of the first questions that come to mind when people are preparing themselves for a hair transplant surgery.  The down time after a hair transplant has a lot to do with the type of work that you do, whether or not you can use a hat, how sensitive the issue of your hair transplant is and whether or not you want to keep it a secret.

Generally, we at our Los Angeles center of US Hair Restoration would like to bring patients back for a hair wash after the first day of their hair transplantation.  I like to make sure that they are given a professional hair wash with our special technique and teach the patient how to wash his or her hair for the first few days after hair transplantation.

Patients may have some swelling and redness on the transplanted and forehead area for a few days after their hair transplant surgery and the swelling after hair transplant may last up to 4 to 5 days.  Patients can use a hat for the first few days to cover the red and swollen area on forehead.

The redness and swelling may spread down to the level of the eyebrows or even eyelids in more extensive hair transplantations.  The swelling is generally completely gone by day 5 or 6 after hair restoration surgery.  The degree of swelling has to do with the size of the hair transplant surgery and the number of grafts.  Larger surgeries (over 2500 grafts) generally create more swelling, but small surgeries may not have any detectable swelling.

The other issue is the presence of hair after hair transplant.  Patients will have short hair (0.5 to 2cm) on transplanted areas for two to three weeks after their hair transplant.  They fall out in about 90% of the patients after their hair transplantation within 3 weeks after hair implantation.  Patients should be back to where they were before their hair transplant in about 3 to 4 weeks.  At that point, there should not be any swelling or redness, staples or sutures must be removed and the transplanted hair follicles will have gone into their resting phase.

Picture taken During a Hair Transplant -- when transplantation of single hair grafts for hairline are almost completed

Hello Doctor how are you?

Thanks for giving me my pics.  I cant wait to start my blog. I attached some post op pics. Dr.Mohebi just a quick question, what is that white stuff during my post op?just curious since my brother brought it up when i showed him the pics.i was looking around the net to see other post op pictures,i wanted to find out what it was,but i didnt seem to see it on other patients.

thanks Dr.Mohebi.

A:

Hi there,

The white part of the grafts that you can see is the top part of the graft that is above the skin level.  As you know, a hair transplant does not implant hair but an entire organ.  This includes the collagen band around a follicular unit, microscopic muscle, small supporting vessels and a small portion of epithelium (superficial layer of skin) within each graft.  The white portion on the picture is the skin part or epithelium.  During hair transplant surgery, the goal is NOT to bury the grafts.  Buried grafts may folliculitis, sebaceous cysts and/or dimpling of the skin.  Here at US Hair Restoration, in order to prevent those complications, we make sure to keep the grafts slightly elevated from the skin surface.  Obviously the white part that you can see will dry up and fall off after a few days after a hair transplant surgery but this little mechanism alone can certainly prevent many problems that are seen by buried grafts.

Have a great weekend,

Best,
Parsa Mohebi, MD

Q:

I am wondering if it is possible to place a more curved hairline on the corner areas.  I believe — but I am not sure — you have already commented on this, saying something to the effect that:  since the original hairline did not go down toward the temples (which, I believe you said is pretty typical — that the hairline does NOT go down to the temples), any new hair transplanted in that new area would either not grow or would not look natural (right).

A:

Before adulthood we have curved hair on the temple corners.  That is called a Kiddy Hairline or childhood hairline.  Our hairline matures as we grow up.  This is called maturation of hairline.  The male hairline generally converts from the kiddy hairline to a mature one at around 16 to 24.  When we transplant in the corners, we try to imitate a mature hairline and not the child hairline.  We can be a little flexible when it comes to designing the hairline, but remember that transplanted hairs are permanent and although a curved and lower hairline may look normal at an early age, it might seem unnatural and inappropriate in a fifty year old man.

Q:

I am a male to female transgender.  I have some hair thinning on top with receded corners as a male hairline.  I am already taking Propecia and Spironolactone to block my testosterone effect. I would like to change my hairline from a male hairline with corner recessions to a female one. I have some thinning on the top too.  I have fine and curly hair to start with.  How can a male hairline be converted to a female pattern?  Do you recommend hair transplant for transsexuals or is there any other options to restore receded corners to a perfect feminine hair line?  I’m interested to know my options and what you recommend.

A:

Male to female transgender patients may experience two personal problems.  The first is having receded frontal corners in mature male patterned hairline which is what makes the frame of the face “masculine”. Receded corners can be easily restored with hair restoration through follicular unit transplantation.  The second issue is when there is also miniaturization or balding of the rest of their hair in a male patterned baldness that may require further hair restoration.  Taking anti-testosterone medications can help to slow down your hair loss, but it does not stop the balding process completely.  Removing the testicles surgically as part of a transgender procedure can eliminate testosterone and, in turn, stop the process of male pattern hair loss in people who are genetically susceptible to it.
If you are only changing your male mature hairline to a feminine one or if you have male patterned balding, a hair transplant can help you.  Obviously, you need to continue with your anti-testosterone medications and get a hair transplant to reshape the frame of your face.  You may need more than one hair transplant procedure for maximum fullness of the hairline in a perfect female pattern.

Transsexual hair transplantation is a meticulous procedure and the hair transplant surgeon needs to understand your facial proportions.  Your Hair transplant doctor needs to be experienced with shaping the hairline in women.  Women hairline is different from male in many aspects such as: the location of the hairline from eyebrow level at mid frontal and laterals; temples need to be restored in a complete female shape; direction and orientation of hair shafts are also different between men and women.  All these features and details need to be dealt with meticulously.  We at US Hair Restoraiton offer quality hiar restoration to change a male to female hairline for transgenders.

Q:

I was diagnosed with Alopecia and lost pretty much all of my hair during pregnancy. My son is now 5 months old and my hair has grown back. All but one spot. I can hide it but I would love for one day not to have to hide it.

A:

Dear Mo,

You have experienced extensive alopecia (I am assuming that you mean alopecia areata) and now only after a few months got your hair back except for a small patch. This is a pretty good recovery for a condition that could have had a much worse outcome. My suggestion to you is to hang in there. It is very likely that you can grow the rest of your hair back without any treatment. If your hair loss is due to alopecia areata, a hair transplant can not help your condition.  You need to be seen and examined by a hair specialist or a dermatologist to best confirm the diagnosis.

Best of luck to you.

Looking at the trend of search on our website, I noticed hair transplant cost, hair transplant costs, cost of hair transplant are among the most popular phrases that are used by the visitors who are trying to educate themselves on hair restoration and what is involved including the cost of hair transplant or hair restoration cost or costs in a hair restoration procedure.  There are many people who try to get the best value their money can buy and some people are cheap shopping.  I don’t mind finding a chip product when I am shopping for the same brand that I usually buy at a discounted rate.  However, when it comes to the cost of hair restoration, I don’t recommend finding a hair transplant surgeon merely based on the price of hair restorations.

Affordable hair transplant surgeries or other promotional phrases such as discounted hair transplants, $1 per hair, low cost hair transplants could be found everywhere, however when it comes to hair transplant with its permanent effect on your face, it should be more of a value shopping rather than price shopping.  Remember that you are buying something that is going to stay with you for the rest of your life.

I perform quite a few hair transplant repair procedures every months.  Some of the patients who go through repaire surgery are the ones who had their hair transplantation years ago, before the era of follicular unit transplants, but unfortunately a large number of those patients had their hair restoration surgeries in the last few years.  They either never received the number of grafts that they were promised and end up with less than optimal coverage due to technical problems or got problem with the artistic design of the hairline or issues with distribution of the hair on the balding area.

Among hair transplant surgeons some charge more due the name, brand and the location.  You have probably seen the signs like: “Beverly Hills Hair Transplant Surgeon.  Some of the older hair transplant doctors have been unable to keep up with the new techniques of hair restoration, I don’t see then participating in hair restoration scientific meetings thus are simply are not aware of what is the gold standard in hair transplantation.  Having said that, I do now some of the the pioneers in hair restoration that are always ahead of their time and are involved in hair transplant research and development.  One good example is Dr. William Rassman whom I had privilege of working with closely in the past.  He is one of the few hair transplant surgeons capable of providing quality hair restorations utilizing the new techniques while using his years of experience in the field of hair restoration.

In conclusion, it all comes bacn to the patient who need to realize what he is getting is a procedure that produces permanent changes and they better off doing it right the first time and don’t risk getting a less than optimal hair restoration that might need a repair hair transplant in the future.  Whether you are in Los angeles or elsewhere, you need to do your homework to find a good hair transplant surgeon and even after that know what kind of questions to ask from your hair transplant doctor.

Hair transplant cost is important and is a determining factor for some people, but you should not make your decision solely based on the cost and affordability in your hair transplant surgeon search.  That is why I deliberately avoided explaining about hair transplant cost in Southern California hair transplant centers of US Hair Restoration in this article, which is titled “hair transplant cost in Los Angeles”.

Please call Los Angeles Offices of US Hair Restoraiton for our current rates and promotions on hair transplants:  Telephone: 888-302-8747
Or visit: Hair Transplant Cost

There is just another study on a potential new medication that could be used for treatment of hair loss. Currently, there are only two FDA approved medications for male patterned baldness or typical men hair loss in United States. The two medications that we have extensively discussed on this web site are finasteride (Propecia) and minoxidil (Rogaine).

The article “Effect of Cuscuta reflexa Roxb on androgen-induced alopecia” was published in the Journal of cosmetic dermatology September 2008. The research is done in India and the authors discuss the significance of hair loss in men and the effect of androgenetic alopecia on millions of men and women. They classify typical men hair loss as androgen-driven disorder. They used Cuscuta feflexa Roxb for hair growth activity in androgen-induced alopecia.

The authors of the article used petroleum ether extract of C. reflexa for its hair growth-promoting activity on albino mice. They induced male patterned alopecia in mice by testosterone administration for 20 days. The inhibition of baldness by simultaneous administration of the extract was evaluated using follicular density, anagen/telogen ratio, and microscopic observation of skin sections. To investigate the mechanism of observed activity, in vitro experiments were performed to study the effect of extract and its major component on activity of 5alpha-reductase enzyme.

The researchers announced that petroleum ether extract of C. reflexa exhibited promising hair growth-promoting activity as reflected from follicular density, anagen-telogen ratio, and skin sections. Inhibition of 5alpha-reductase activity by extract and isolate suggest that the extract reversed androgen-induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone. They concluded that the petroleum ether extract of C. reflexa and its isolate is useful in treatment of androgen-induced alopecia by inhibiting the enzyme 5alpha-reductase.

This hair loss research needs more research on human volunteers on a long period of time before it can be considered as a balding treatment. There must also be more research done on the application of the product on human in terms of medication side effects and its comparison with currently available medications for treatment of hair loss.

We at US Hair Restoration continue to follow on the most advanced investigations and researches on hair loss treatment. We keep our patients and the readers of hair restoration blog updated with the new information and medical technology to improve the quality of our hair restoration treatments at our Los Angeles hair restoration clinics.

This article was just published last month in Dermatologic Surgery Journal.  I thought the results should be interesting for the readers of this blog.  The article title is Survival of densely packed follicular unit hair grafts using the lateral slit technique.

The authors, Nakatsui, Wong and Groot, describe their experiment on densely packed follicular hair units and follow up on the rate of survival of the transplanted hair.  They use a density of 75 hairs per square centimeter which is even higher than the regular hair transplantation methods currently in use. The authors explain that the use of densely packed follicular unit grafts (>30 grafts/sq cm) is a highly debated issue with some claiming decreased survival rates.

Those who perform dense packing routinely do not believe they have seen any impaired survival. However, no prior study has rigorously analyzed densely packed areas to assess survival rates.

This is true and some hair transplant surgeons still advocate the use of lower densities which make the patient commit to multiple surgeries. These hair transplant surgeons convince their patients that dense packing can negatively affect the circulation of the skin and jeopardize the rate of growth for implanted hair follicles.

The study was only done on one patient and needs to be experimented on a larger number of patients but this at least clarifies the mechanism of hair restoration with new methods of highly dense packing. The authors concluded that 98.6% of transplanted hair follicles survived and were able to re-grow a normal hair.  Obviously, this is the first study that demonstrates high growth rates in densely packed follicular units using the lateral slit technique, even at densities of 72 grafts/sq cm.

We do perform densepacking hair transplant surgery at the US Hair Restoration clinics in Los Angeles, Beverly Hills and Orange County in California on a regular basis.