Hair Restoration Blog

Q:

I am 27 and have a very high laying hairline.  My hair line is the same as my mother and aunts.   High hair line resembles a male hair line with mild recession on the corners.  I know I am not balding because a few other female members of the family have an exact similar hairline patter.  Can you help me with a hair transplant procedure?

A:

There are several methods to lower a hairline both in men and women.  Hair line can be lowered by hairline lowering hairline surgery, in which a strip of skin is removed from just below the frontal hairline to bring the hairline lower.  In this method a trichophytic incision can help to blend frontal hair into the forming scar.  The result of lowering hairline surgery is instant and the surgery is less time and labor consuming in comparison with a hair transplant procedure. 

At US Hair Restoration, we recommend hair transplant using follicular unit transplant methods for lowering hairlime in men and women for the best cosmetic results.  Hair transplant cannot make such a drastic change in such a short time, but the result is completely normal with no visible scar on the frontal area.  The presence of linear scar at frontline is a major disadvantage of hairline lowering procedure.  The scar of hairline lowering surgery could be camouflaged with a hair transplant surgery with placement of minimal number of grafts on the frontal area and in front of the hairline scar.

Q:

I take Errin Tablets for a few months as a contraceptive. I have also been experiencing hair loss recently. I wanted to know if there is a correlation between losing hair and this particular contraceptive. I had a baby 4 months ago. I see thinning everywhere but it is more obvious on the front and top as diffuse thinning.

A:

Your hair loss could be related to your pregnancy and delivery of your baby. Human hair grows in cycles and goes to resting phase (telogen) between the growth cycles. About 95% of your hair is in growth phase (anagen) at anytime and about 5% of them are in resting phase. You may not see any hair growing from the follicles during resting phase. That is the reason we normally lose scalp hair on a regular basis. In fact losing up to 200 hairs every day is normal and part of the cycling of our hair. Some stimulants can put a large number of our hairs into telogen phase. This condition is called Telogen effluvium. Telogen effluvium (TE) can be seen in women after delivery of a baby. Telogen effluvium is especially seen between months one to five following delivery of a baby, when the load of estrogen is removed. It is usually seen in 40 to 50% of women after pregnancy, and like most of the changes in pregnancy, it is temporary. Wait 4 to 6 months and you should grow your hair back. Meanwhile, make sure you are taking sufficient minerals and vitamins on a daily basis.

Any other cause of imbalance in estrogen level may increase hair loss. Scalp hair loss is reported in users of oral birth control pills containing norethindrone and ethinyl esteradiol, like Errin tablets or other brands: Brevicon, Norinyl, Norethindrone. However the association of those contraceptives and hair loss has not been completely confirmed through medical literature. I women think their hair loss may be linked to the use of birth control pills, they need to stop the pill and use another birth control method after discussing that with their doctor.

Q:

I am a 40 year old man with class IV hair loss. I started taking Propecia recently with great result on the crown area only after a few months. However, it seems like I need more time to get an erection. The other problem is that I cannot maintain an erection as before. I know there is a lot of psychogenic side effect associated with this drug so I am not sure I am really experiencing a side effect or it is just in my head?

Thank you,

A:

You have been taking Propecia (finasteride) recently and have had great result from it, but you are recently experiencing erectile dysfunction. Erectile dysfunction has been reported in men who used Propecia. The comparison of its occurrence between the Propecia and placebo group showed a slight difference (1.3% in Propecia group vs. 0.7% in placebo group).

You can stop Propecia for 2 weeks to test it. If you don’t feel any improvements in 2 weeks, Propecia cannot be the cause of your problem. If your erectile dysfunction improves by stopping Propecia, then you can reduce the dose of Propecia to half and you may not experience the problem with the new dose. This method is effective in most patients who experience erectile dysfunction with Propecia.

You have to understand that erectile dysfunction may be the sign of some other medical problems and you need to discuss it with your primary physician to rule out more serious causes.

I have performed a hair transplant surgery on this 42 year old man who had another hair transplant last year with micor- and minigraft with another office last year. I would like to assume that the era of mini and micro-grafts are over, but still every now and then I see patients who are recently operated with micrograft or minigraft techniques. This 42 year old patient had small number of grafts for a large area with less than adequate coverage.

The patient’s old hair line is lower than where it should be on the corners for his age and race. He had some pluggy hair growth on the corners and on his hairline. We restored his hairline with 400 single hair FUT grafts, removed some of the pluggy hairs on the hairline using a 1mm punch biopsy device. We increased the density of hair on the front are with total of 2293 follicular unit grafts.

The frontal area was densely packed and the some of the frontal grafts with pluggy appearance were removed. I expect great result in a few months for this patient at our 10 month follow up.

Patient immediately after hair transplant surgery with 2293 FUT grafts including 400 single hair grafts on hairline.

I have announced on some TV talk shows that I will be in Dubai this summer along with my all surgical staff to present our high quality hair restoration surgeries to people who prefer having their surgeries closer to their country of residence or have difficulty traveling to the United States. As I said before, I prefer to have a full photo consultation through email and then phone conversation and then book the patients who are interested to have hair transplant surgery with us in Dubai, United Arab Emirates.

We will be in Dubai from August 14, 2008 to August 21, 2008. We have already done some consultations with patients from Dubai, UAE, Iran and. If you are interested in having a hair transplant surgery with US Hair Restoration, please don’t purchase a ticket or arrange for your travel before completing your hair transplant consultation and booked your hair restoration surgery with us. We do not accept walk in patients while we are in Dubai.

The process of online consultation is very simple. You need to visit US hair Restoration online hair transplant consultation page in US Hair Restoration web site and fill the questionnaire. In the comment section, mention that you are interested in having your hair transplant surgery in Dubai, UAE. When we receive your email, we will send you another email asking some more questions and pictures that could be sent through email. At the end, we will have a phone conversation with you to answer all your questions and if you are a good candidate for hair transplantation book you for your hair restoration surgery in our Dubai office.

I hope this service can provide US Hair Restoration quality hair transplant surgery including follicular unit transplant (FUT) and follicular unit extraction (FUE) for people of Middle East, such as UAE, Qatar, Saudi Arabia, Iran, Iraq and Kuwait and other countries of the region. Our Dubai hair transplant clinic may also be easily accessible from India, Pakistan, and European countries. If you have more questions on your hair loss treatment with US Hair Restoration, please email us at info@ushairrestoration.com or call our Los Angeles Hair Transplant center at 1-818-788-8363.

Dr. Parsa Mohebi

Medical Director

US Hair Restoration

Los Angeles, California

Hi Dr. Mohebi,

A couple of questions for you and the blog perhaps.

Just wondering - I’ve noted that one LA area hair transplant doctor has used Vaseline on patient’s heads after surgery to prevent graft scabbing - what’s your opinion on this?

By the way I’m mentioning this as I feel I may have a greater tendency to scab as despite the twice daily washings my three grafts that you so kindly placed scabbed up and still are scabbed on this 6th day out, Sunday, but seeming to loosen up a bit now (patient had a FOX test with us to check his candidacy for FUE procedure and we implanted the three intact grafts that we biopsied to his crown). I’ve had prolonged scabbing before despite the washings and frequent wetting that I was advised with prior procedures. Also, I don’t necessarily mind the scabs other than I’d prefer not to have to return to work with them if they could be minimized with the Vaseline possibly or something similar.

Otherwise I’m wondering if Neutragena shampoo is okay post op vs. baby shampoo? Here’s a Neutragena link for reference.

http://www.drugstore.com/qxp14485_333181_sespider/
neutrogena_shampoo/shampoo_anti_residue_formula.htm

Thanks much,

Patient’s name

A:

Scabbing after hair transplant is very important and if not treated properly may affect the growth of the transplanted hair grafts. We are very meticulous on the care after hair transplant especially hair wash after hair transplant.

Many shampoo s are recommended and used by different hair transplant doctors, but we really don’t have a strong researched based proof for many of those. The only thing that I can tell you is to increase the number of washing in every day to minimize the chance of scabbing. In terms of using shampoos, I prefer using baby shampoo for the first 4 days that skin incisions area still healing, but after that you can use whatever you were using before. We know that there are some solutions and shampoos that can minimize the scabbing and crusting that is seen in the process of wound healing, but since we don’t know how they affect the growth of transplanted grafts we really cannot recommend them in our Los Angeles hair transplant centers. Not until we can have the evidence of their safety on the grafts from a medical study.

Using Vaseline falls in the same category. I prefer not using it in the first two days when the tiny incisions on the recipient area might not be quite sealed.

 

Different types of body hair and the indication for the procedure is a question that I have been asked many times in last week. So that is why I thought I should write a post to answer it for everyone. Body hair transplant has been discussed in Hair Restoration Blog in the past in several posts. Patients ask which one is a better source for body hair transplant to the scalp: chest hair, abdominal hair, pubic hair or armpit hair.

Hairs of the body have different characteristics, than hair from the scalp Pubic hair is generally thicker and curlier than other areas of the body. Chest hair may be thick in some patients, but may be finer than scalp hair. Armpit (Axillary) hair is also generally curlier than scalp hair, but may not be as thick as the other types of body hair.

Before deciding to use body hair, a hair transplant surgeon has to examine the scalp donor hair carefully and then only consider body hair if the scalp hair is severely depleted. Depending on the area that you want to use body hair, you may choose different types of body hair. If you want to choose body hair only to fill in the crown area in patients who already have good coverage on top and front, pubic hair could be a good option.

Research has shown that body hair characteristics may change and become longer when transplanted to the scalp. It also shows the anagen phase of body hair may become longer after transplanting it to the scalp. Which is why this is one more advantage for body hair transplant, but still body hair transplantation needs to be done selectively.

The office of US Hair Restoration in Los Angeles was visited by Patrick Hennessey - President of Media Visions, Inc. and publisher of the Hair Transplant Network.com, the popular and highly respected online community that guides hair loss patients to find the best hair transplant center for their hair restoration procedure.

Here is a summary of what he observed during his one day visit of US Hair Restoration:

• I expect Dr. Mohebi will become well known in the coming months and years online for his quality follicular unit grafting.

  

Mr. Hennessey spent one day in the Los Angeles office of US Hair Restoration. He observed a hair transplant surgery too. He commented on the dedication and skill of Dr. Mohebi and his surgical staff:

• Dr. Mohebi impressed me as being passionate about his work and dedicated. He has succeeded in attracting a skilled and experienced staff. On the day I observed surgery in his office two of the medical technicians on duty had 13 years experience and a third had nine years experience in hair transplantation. He and his experienced staff have the capability to do sessions exceeding 3,000 grafts.In addition to performing state of the art follicular unit hair transplantation, he also performs FUE (follicular unit extraction) with sessions up to 1,500 grafts a day. During my visit they performed a 1,948 follicular unit graft session to restore the patient‚Äôs hairline. The 1,948 grafts consisted of 319 ones, 1,541 twos and 85 threes and 3 four hair grafts for a total of 3,678 hairs.‚ÄùIn the past Dr. Mohebi has had a strong interest in researching hair growth, hair multiplication and wound healing. He currently collaborates with academic centers on studies on hair growth, gene therapy techniques and hair multiplications.Dr. Mohebi uses 20 gauge needles to make tiny graft incisions as small as 0.7mm. He told me that he intentionally zig zags his donor excision slightly so that the thin donor scar is harder to detect even under close examination. He uses a double layer closure when he feels it is needed to minimize any potential scaring. He uses staples of the external suture.
  

To see the pictures and read more on Pat Hennessey’s trip to Los Angeles Hair Transplant Center of US Hair Restoration you can see the page on visit Dr. Parsa Mohebi in Los Angeles in Hair Transplant Network.

Q:

I am a 45 year old woman. My dermatologist told me that I have male patterned baldness. I am also diagnosed with Iron deficiency anemia. Can Iron deficiency in women cause hair loss in male patterned baldness and if so, can treatment of iron deficiency help reversing balding process?

A:

Iron deficiency with or without overt anemia can intensify the rate of hair loss in women with either male or female patterned hair loss. If Iron deficiency is the only cause of your hair loss and you are not genetically prone to anemia, hair loss can be reversible. However in many situations, patients are genetically predisposed to patterned hair loss and Iron deficiency has only accelerated the hair loss process. Accelerated hair loss in women who are genetically predisposed to patterned hair loss may not be reversible by just correcting the Iron deficiency. You need to see a good hair specialist to confirm the type of your hair loss and plan the proper treatment method including hair transplant surgery.

Hair transplant cost is one of the questions that we have answered many times in this blog and we still receive it from our patients. The quality of hair transplant surgery have been improving within the last few decades with the use of stereotactic microscopes and advanced methods of handling and maintaining the hair grafts. However, not every hair transplant clinic could have kept up and adopted the new technology.

Cost of hair transplant surgery varies from clinic to clinic and from surgeon to surgeon. You may find a wide variety in hair transplant costs. Many clinics that offer cheap hair transplants are not committed to the quality of service. They hire inexperienced hair transplant staff. Some of the hair restoration surgery clinics do not use microscope and are not scientifically in line with the advanced techniques that are available today. Some clinics are run by technicians and doctor is only involved in a small portion of the procedure.

Hair transplant costs are generally calculated as per hair graft basis. Hair transplantation with exclusive follicular unit transplant could cost $3 to $10 per each graft (average for exclusive follicular unit transplantation). That is the cost of hair transplants with strip techniques of FUT or follicular unit transplant and the price of the FUE (follicular unit extraction) hair transplant is higher. Affordable hair transplant could be found in high-quality hair restoration clinics too. They may not be able to lower the cost of surgeries to $2 per graft (as you may see in some hair transplant offices) because of the fact that having an experienced surgical team and skillful surgeon cost more than that.

As I said, you can find low cost hair transplant centers that still offer quality hair restoration surgeries. Some of them are very skillful and offer individual services unlike the big chain hair transplant centers. The big chain hair transplant centers have a variation in their services due to different surgeons and staff. I have seen a diversity of results from some of those clinics. The variation is generally seen due to difficulty keeping the same standard in different offices. Most patients with a previous surgery in the chain clinics who have a repeat surgery at Los Angeles Hair Transplant center of US Hair Restoration are critical of the lack of personal attention and individual care in those clinics.

In conclusion, although the cost of hair transplant surgery is an important factor, it should not be the sole factor in choosing a hair transplant clinic. I always encourage my patients to educate themselves on the most advanced techniques of hair restoration surgery. Internet is a great source of information. We have a useful collection of hair loss and hair restoration articles in our web site. I also answer the patient’s hair restoration questions in hair restoration blog on a daily basis.

My recommendation is to shop around for the best value hair restoration surgery and not for the cheapest one. Think about it as a lifetime investment. Good or bad you will see your hair every day for the rest of your life.