Hair Restoration Blog

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:

is it true i can lose hair by wearing a baseball cap a lot of the time? if that’s the case, then i guess baseball players are good candidates for hair transplants! =P. but really, is there any truth to that? I read that it doesn’t have an effect on a person’s hair, but i wanted to verify with an actually hair loss doctor.

A:

We can lose hair due to environmental trauma to the hair shaft and, consequently, to the hair follicles. The name of this condition is traction alopecia; it can be seen when people braid their hair very tightly. One type of traction alopecia is called turban alopecia, for people who wear turbans on their head for long periods of time and when they wear it tightly. Baseball caps are regularly used by people, and I have not seen it in those people who wear them. However, you can guess that a tight cap of any kind may mimic the turban effect and may cause traction alopecia in which hair follicles are being pulled over time, which destroy them eventually.

Q:

I’ve been using 5% topical minoxidil in liquid form for five months and see some positive results (I think) but I have two side effects:

1) itchiness–it’s mild, I can live with it

2) a crust forms that’s dry and I can pick it off, little dry flakes–that is.

Questions are simple:

1) Can/should I still use it?

2) is the foam better to avoid these symptoms?

3) Is there an inexpensive hair conditioner or shampoo I should use? Appreciate your feedback/thoughts…thanks

A:

1) Can/should I still use it?

Minoxidil use is lifetime in most cases. If you stop using it, you may lose the hair which grew from its effect. This is called shock loss and many people experience it when they get tired of minoxidil use and stop it after using it for a few years.

2) Is the foam better to avoid these symptoms?

To avoid the itching, the foam is better based on reports I am gathering from my patients who tried them both.

3) I am not aware of any conditioner and shampoo that can be used to help the growth of hair. There are some shampoos with active ingredients such as minoxidil. However, they efficiency in comparison to minoxidil topical solution is questioned.

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:

Hiya Doc,

I’ve read in a book on hair loss that mentioned, in certain circumstances, hair loss can be caused by emotional or mental stress. I’ve started to lose a bit of hair, but I’m really hoping it’s only temporary, as I don’t think I have genetic hair loss because my two older brothers seem to be doing OK.

How common is it for hair loss to be caused by emotional distress?

Thanks,

A:

Many hair loss patients who come to me for their initial hair loss evaluation associate the beginning of their hair loss to some stressful event in their lives. Many say they notice hair loss when they moved to another city or different country, got divorced or had significant problems at work or in their personal lives. Usually, they are right as these types of evens can accelerate hair loss.

However, hair loss would not happen to these same people if they were not genetically predisposed to balding. In other words, at age 30 and after, we may have the hair loss gene which is supposed to cause balding. At age 30 or after, if we are involved in a stressful situation, an emotional traumatic event, or major surgical procedure, it can accelerate the hair loss process. So the loss expected to be seen in 10 years could come around sooner.

Stress, trauma, or major surgeries may cause hair loss in people who are not supposed to lose hair, but the condition is temporary and the lost hair will grow back after the passing of the stressful condition, or treatment of the medical condition.

In these cases, patients have a condition called telogen effluvium in which, due to stress, a significant number of hair follicles go to sleep. Remember: patients do not lose those follicles permanently and the follicles can produce new hairs in just a few weeks.

My recommendation for you is to see a hair specialist and get your hair miniaturization mapped by microscope; this way the doctor can tell you whether or not you are experiencing an early stage of patterned baldness or that you have lost your hair due to stress.

If your baldness has just begun, medication may help you. If you are experiencing telogen effluvium without being predisposed to pattern baldness, you only need to wait and your hair will grow back in a couple of weeks.

Q:

hi

I come from china ，I would like to consult your organization a few questions:

In your experience,usually Asians（chinese people) the normal growth of the number of roots Per cm² of hair? Head at the top and post-occipital whether there are different?
using FUE technology，on one operation ，After the occipital Site  get the maxinum number of FU (Asians including 2-3 days operation) at present,how much FU can be planted per square centimeter on Planting area? Between the scope of? and the percentage with normal?

Looking forward to your reply Details!

Thanks for your questions.

A:

Here are the answers in the order they were received:

The number of hair follicles

The number of hair follicles in non-balding areas of scalp like occipital areas have been studied.  A range of 80 - 120 follicular units (FUs) per centimeter were reported. The density of follicular units vary in different locations of the scalp. Also, the number of hairs per follicular unit vary in different areas and with different races. For example, Asians usually have less number of hair follicles per cm², so even with similar number of FUs per cm², the density of their donor area is still less than Caucasians. To calculate the number of hair per cm², you have to average the number of hairs per FU and multiply it by the number of FUs per cm².

Difference of hair on top and back

The shaft of hair may or may not be different in different areas of the scalp. Obviously, if you are balding, you see more miniaturization and less terminal hair, which makes the appearance of the hair less dense on the area. However, without baldness, hair quality would be the same in back and top of the head.

FUE and number of grafts

FUE (Follicular Unit Extraction) is more labor intense and requires more time for harvesting the grafts. For that reason, FUE procedures are generally smaller in terms of the number of grafts per session. What we do at US Hair Restoration is up to 1,500 grafts per day on average, for 8 to 10 hours work in a FUE procedure. The number may occasionally go up to 2,000 grafts, too, but not everyone can expect to get that number with FUE.

Density of transplanted hair

There are many research projects on this topic. The number can be as high as normal density in some circumstances. However, practically we can make up to 35%-40% of the normal density in one session. This is a good number if you consider that the density of hair on frontal areas could be about half of the hair on the donor area in some patients, so 35%-40% is not that far from the normal density in those patients.

Q:

I had a hair transplant surgery a month ago.  As it turns out, I have a huge amount of shock loss right now.  As i’ve never taken propecia before, do you think it’s too late to combat this shock loss with propecia?  Any suggestions on how i could eliminate this shock loss from further damage?  I hope my hair will return.

A:

To prevent shock loss, it is never too late for Propecia (finasteride) if you really need it. You may not get the maximum benefit as if you started on the medications before your hair transplant, but your shock loss may not have been completed yet.

We generally start our patients on Propecia a few days prior to their hair transplant so the medication is in the system at its therapeutic level on the day of surgery.

Many people choose to continue the medication after hair restoration surgery and we encourage that. We continue the medication for 6 to 8 months after the hair transplant, depending on the degree of miniaturization for patients who do not want to be on finasteride for the rest of their lives or the ones who have minimal miniaturization. After the first few months, the chance of shock loss due to the hair restoration surgery is very minimal but it still may occur.

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:

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 prevention 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.

Q:

Dear Dr. Mohebi,

I had the hair transplant done about 5 weeks ago.  I’m very concern with the recent hair transplant.  First of all, I thought the look of my hair was fine already.  However, I did notice there are some thinning parts and it would be good to thicken the middle a bit.

I look like a mess!  My cousin saw me and she noticed that I looked different and was wondering if I had a hair transplant done.  Ahhh!  I didn’t want it to be noticeable.  If I look at myself now, I can’t help but notice the color of my scalp and how different it looks.  Pic 3 shows a clearer look on how the transplant was done.

Is there something you can do or recommend to make it look more normal to before (it kind of looks like I have thinner hair now too)?  Also, after reading your blogs, I hear that doing the procedure would cause stress to the scalp.  I’m very concern with this also b/c I’m 27 yrs old and this is actually my 2nd procedure.  I hope this does not make me more prone to losing my original hair.  I feel like it’s all my fault that I went to this particular procedure at this time and now I am completely anal about losing my hair.  Hopefully my hair loss pattern is still the same as I was before this recent procedure.

Your input would be much appreciated.

Thanks a lot,

-

A:

The hair shafts on transplanted grafts stay in place for a few weeks after the hair transplant and since they are shorter they may be detectable, but they usually fall out and you go back to where you were before. Then you have to be patient until the transplanted hair starts to grow. I usually recommend to people like you who have long hair on the back to comb their hair forward for the first few weeks after their hair transplant and also for the time that the transplanted hair might be visible because of the short hair there or the slight pinkish discoloration of the scalp.

I cannot predict what it may look like down the road, but I do not see anything unusual for this phase after a hair transplant procedure. Some thinning in your native hair for weeks to months after a hair transplant might be seen due to shock loss. I do recommend that you be on finasteride, which can prevent shock loss (losing hair due to the stress of surgery on vulnerable hair on scalp) to some degree. Try to camouflage your transplanted area and be patient for the next few months that the new hair grows and cover the balding areas.