Hair Restoration Blog

Q:

I have heard of FUE transplants with relatively high-quality hair coming from the neck area, and from the beard. It seems like this could dramatically increase the number of grafts available for patients, at least for the hairline and front.  Then, body-hair (chest, back…), which I think are lower quality (but very abundant on me!), could possibly be used for the crown area. I would like to take as few hair from the back of the head as possible, and as much as possible from other areas.
Doctor, what do you think of this plan? Would it be a good strategy to pull from other sources rather then the scalp for donor hairs? What would be the costs involved?

A:

Follicular Unit Extraction (FUE) can remove hair from anywhere in the body as long as you are tested positive for FOX for those areas.  Neck hair is not the best option for hair transplantation because those hairs may fall out at higher ages of some patients. We can use body hair for hairline, and front or even the crown, but you may need multiple surgeries to obtain adequate density from those areas with body hair.  As we discussed before, body hair has a long resting phase in relation to its growth phase.  So you will have more follicles in resting phase (telogen phase) that do not have any visible hair in comparison to the ones in growth phase (anagen phase) that provide you with actual hair and give you coverage. We do FUE transplants in our California hair transplant centers on a regular basis.  FUE procedures are more labor intense and more time consuming so the cost of them are almost double in comparison to regular strip hair transplant procedures.

Q:

We discussed the possibility to close the scar, which I think is a good idea, but again, I had already achieved camouflage with longer hair. While it may only be a 2-hour operation, I admit being very weary of such an operation because my skin is already so tight. I understand that the skin exercises you recommended should help a great deal, but for whatever reasons I am not comfortable with such an operation, especially considering that I would like to cover the whole head with some hair anyway. Perhaps you will convince me on the scar revision, or maybe you will advise me to pursue the FUE plan which would cover the rest of my head. Assuming I have an “average” density in the donor area, how many grafts do you think you could extract from it? How good or bad would be the mini-scars scattered all over the back of the head? I am assuming the surrounding hair will camouflage them?

A:

If you don’t want to pursue scar revision, the only option will be an FUE transplant into the scar from neighboring areas.  I recommend for you to wait until we see you in your follow up visit with a little longer hair before continuing. You also need to schedule for the FOX test to determine your eligibility for a Follicular Unit Extraction procedure.  The answer to your questions about how many grafts could be harvested in one session of your FUE procedure will be answered the day we do FOX test and confirm your eligibility.

You need to contact US Hair Restoration to schedule the FOX test as soon as you are able.  FOX test’s are done quite easily and assisted by numbing a very small area on the back of your scalp. The small scars of the FUE are going to be scattered throughout a larger area.  That can minimize the visibility of those pinpoint scars.  If you keep your hair not too short it is generally not possible to see them at all, but with a shaved head the tiny scars might be detectable from a close view.

Q:

Hi,

How soon after a FUE procedure could I expect to see some growth?
Thanks

A:

The growth after a FUE transplant would be the same as that for a strip technique.  When the telogen (resting) phase of the hair follicles is finished and the anagen (growth) phase begins, you ought to be able to see some growth after two to three months. To start with, young hair shafts are fine; it takes a few months for the hair shafts to grow to their final thickness. To see optimal results, you may need to wait up to one year (from the time of your hair transplant surgery) as that is the amount of time it takes for transplanted hair to reach its final thickness and length.

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.

Donor Scar left behind from a previous Hair Transplant Procedure

Q:

Hi,

I had an FUT procedure done a little more than 5 months ago which left a scar in the donor area at the lower left-rear of my scalp.  The FUT was meant to bring out and define my front hairline.  Can your FUE procedure cover this up as I always prefer to wear my hair short (almost military fade short)?

Also, I was wondering if it\’s possible to increase the density of my new hairline with FUE as the hairs appear to be positioned farther away than my natural hair which makes it look as if I\’m thinning at the front.  I live in San Diego, CA and am interested in your Orange County facility.
Please help.

Thanks,

A:

FUE (follicular unit extraction) can easily be used to bring more hair into the donor scar area to improve the visibility of the donor area.  However, there are other techniques that could be used to help with this condition.  First, you need to be seen by a hair transplant surgeon and be examined for the donor scar type that you have and the quality of your hair in front. In addition, you hair characteristics need to be determined as well.

Many people who need more hair in larger areas can have another strip surgery to respond to that need while removing the old scar and closing it with either one or two sided trichophytic closure. This option can minimize the appearance of the hair transplant donor scar while giving you an adequate number of hair to cover the front or balding areas.  It is also more affordable.  I have seen wonders with this technique.

People who have a stretched scar from their previous hair restoration surgeries can benefit from Botox injection around the scar of surgery after their repeat surgery.  There are reports of improvement in the size of the scar with the Botox in some patients.

If your scar is still visible after doing all those techniques, you can use an FUE transplant to fill the scar in with follicular unit grafts and improve it even further.  You have to understand that none of these techniques eliminate the scar, but they can improve its appearance significantly.

Q:

I recently had a FUE hair transplant in the front and my temples (2500 grafts) and everything was ok until 5 months after the procedure. I had to be out in the sun for a little longer and the temprature that day recorded more than a 100 degrees. Once I got back home I looked at my scalp and the skin in grafted area had turned white. I guess I got a sun burn. I did not take it seriously and I continued to use the Minoxidil with Betaderm spray that my doctor prescribed.

Over the last 1 month the top layer of the grafted area dried up and pealed off (like scabs). I also saw a few strands of the new hair come off with the dried skin but not much. Now after 2 months after that incident my scalp is clear and there are a few rashes here and there. But mostly it is clean. I am concerned if I have sabotaged the grafts by exposing it to the sun. Obviously I got a sun burn at the sixth month but is it going to be bad for the grafts if not already? I read some articles about sun burn but I am confused if this sun burn will be bad only for the skin or the grafts itself? If it is only the skin and it darkens the pigments that is ok. I am worried if I had killed my grafts. Could you please help me understand?
Thanks in advance for your response.

Regards,

A:

Sun exposure can be harmful for the native and transplanted hair.  Especially when you do not have full coverage and sun rays can reach to the scalp skin and cause sun burn. I generally advise against exposure to sun for anything more than a few minutes.  Patients can use sun block or a hat for the first 6 months after hair transplant to avoid hair loss or irreversible damage to the hair follicles.

The patients who do not have good hair coverage on their scalp should protect their scalp religiously forever, until your hair density increases to the level that your scalp is covered completely by the hair and protected from the sun.

It is hard to say if you damaged your transplanted hair or not.  You only need to be more careful from now on and wait and see what is going to happen in the future.

Hair follicles removed from neck to be used for mustache restoration

I have been looking into, the cost, scarring, technique, of the FUE method and am getting the impression that the method permanently removes the hair from the donor area.  If this is true, could the chin/sideburns be used as the donor area?   And instead of placing the hair follicle in my scalp, the extractions be disposed.
My sole objective is to permanently remove my facial hair.  And the FUE method seems to be the least invasive, least time consuming, and most effective (compared to laser and electrolysis).

Lasers works best on dark hair and fair skin, which I have not.  Electrolysis is more effective than Laser and is FDA approved to permanently remove hair. However, Electrolysis is very time consuming, I scar, and over time can be quite costly, as my hair growth is hormonal, where treatment could take years, and at 65.00 per week, get pretty expensive.

If possible I would like to have my hair follicles removed by way of FUE or any similar alternative.  Please let me know, if this is possible with this practice, or any information that would point me in the right direction.

Thank you,
A:

Hi there,

You are correct.  FUE is basically removing and replacing hair follicles permanently from one area to another.  FUE or Follicular Unit Extraction can move hair follicles or follicular units from pretty much everywhere and the extracted hair obviously could be transplanted into any part of body which is covered by skin.

Removing hair for the purpose of getting rid of hair permanently is doable, but you need to be evaluated through a FOX text first.  FOX test is a minor procedure that we perform in the offices of US Hair Restoration to determine the candidacy of the patients for FUE hair transplant procedure.  FOX is a small FUE procedure in which we attempt to remove hair under local anesthesia from the donor area (could be scalp or body).  The reason that we perform a FOX test is to make sure the the hair grafts can be removed from the patient with minimum transection.

If you want to remove body or facial hair through FUE technique instead of laser hair removal, you need to be FOX tested prior.  If we cannot remove hair follicles intact from your donor area, follicles or part of them remain in the skin and can grow into new hair.  Even if you do not want to use harvested hair for transplant purposes, you still need to have a FOX test to make sure that hair follicles can come out completely.

Q:

I read on the website that scar revisions are case by case in terms of pricing. On an average how much do you charge? I had a hair transplant done in Newport Beach a couple of years ago, and I’d like to revise the scar to a hopefully smaller one. One side is fairly good, about 2-3 mm, the other side is more like 6mm. Is it better to do only half and not touch the good side so to speak? How long would the wait before such a procedure. I’m looking into doing it in May.
Please get back to me,
I’d appreciate it.
Thank you,

A:

Hair transplant scar revision could be done in part or the entire scar and it might require many different techniques:

1.    Simple excision and closure of the scar may reduce scar width.

2.    People who tend to stretch their scars can be treated by injection of BOTOX around the scar after wound closure to prevent future stretching.  Some people require tricophytic closure which allows hair to grow into the scar.
3.    Ultimate elimination of the scar visibility may require an FUE (Follicular Unit Extraction) to fill the scar of a strip hair transplant with hair.

Wound healing and scar maturation is a timely phenomenon.  Most scars continue to evolve for six months from the time of wound closure.  The process of scar maturation may even continue after that but it will be at a much slower pace.  In most cases I generally don’t want to touch scars before 6 months in our California office of US Hair Restoration.

The article “Surgeon Restores Patients’ Hair, Self-Confidence” was recently published in the popular newspaper of “The Beverly Hills Courier” based on the interview with Dr. Parsa Mohebi, medical director of US Hair Restoration.

Here is a summary of the article, which mostly focuses on the psychological impacts of hair restoration on men. Dr. Mohebi also discussed some of the new methods of hair restoration that is offered by the Beverly Hills Office of US Hair Restoration. Here is how he goes:

Nothing looks better than a full head of hair, and one of the best people to provide it is Dr. Parsa Mohebi, medical director of US Hair Restoration.

Mohebi specializes in several hair-transplant procedures:

• Follicular Unit Transplant (FUT) is the gold standard of hair-transplant surgery, Mohebi said, giving very natural results. A strip of donor scalp is removed and the follicles are prepared under microscopes and distributed in the bald area in the natural direction and orientation.
• Follicular Unit Extraction (FUE), also called non-invasive hair-restoration surgery, uses special biopsy devices to extract individual follicular units without having to remove a strip of skin; so there is no linear scar.

“Not everyone needs non-invasive surgery,” Mohebi says. “But people who want to shave their head in the future for any reason may consider FUE because there is no visible evidence of surgery on the back of their head. There’s nothing to suture, and the small dot wounds are not detectable a few days after surgery”.

• Mohebi also specializes in eyebrow transplants for both men and women.
• As testament to his skills, he also repairs bad or “pluggy” transplants, performed by other doctors. “We do several repair hair transplant surgeries a month,” he says.

Mohebi spends an hour with each new patient and does a microscopic evaluation of the scalp and a miniaturization study of the hair to predict future hair loss. “That way we’re not limited to the obviously bald areas, but we can transplant hair to where the patient may lose hair in the future. With the technology we have now, there’s no reason for anyone to experience hair loss.”

As a fellowship-trained hair-transplant surgeon, Dr. Mohebi continues research the latest high-transplant techniques and his writings have been presented and published in both national and international medical-society publications.

The article continues with discussing the published research on the psychology of hair transplant in men, which was finished last year: Dr. Mohebi’s latest article was the cover story for Hair Transplant Forum International, considered the most important journal in the field of hair restoration, on The Psychology of Hair Transplants. From research in Europe, we know that people with hair loss are prone to anxiety, depression and other psychological problems; we tried to see if we can reverse that with hair restoration surgery.

He evaluated 200 patients after surgery in eight criteria, and saw improvements with FUT in terms of happiness, youthfulness, energy levels, self-esteem and self confidence, future outlook and impact on their career and sex life. The results were amazing and improvements in all eight criteria were statistically significant. The authors, Dr. Mohebi and Dr. Rassman concluded that using the new techniques of hair restoration patient can drastically improve all of the psycho-social impacts of hair loss.

The reporter then set aside US Hair restoration from many other hair transplant clinics by several factors by referring to Dr. Mohebi’s comments on following the latest standards of hair restoration surgery and the fact that things have changed significantly recently in the field of hair restoration. What was done five years ago is not acceptable today. We have the most experienced technicians; and everything is done under a microscope to get the highest yield of hair.

Then there’s the customer service. “The day of the hair transplant procedure is a big day for patients,” Mohebi said, “often six to eight hours. Patients are usually amazed at how smooth and pleasant the day is.

Patients are given mild to moderate sedation and numbing medication for the donor and recipient area. Once the scalp is numb the strip of skin is removed and the wound is closed. The next step is to prepare hair grafts under microscope. While grafts are being made by experienced technicians of US Hair Restoration, Dr. Mohebi is designing the hair line and makes the sites according to the natural direction and distribution of hairs.

Since the newly placed follicles are so fragile, patients return the next day to get their hair washed professionally, given special shampoo and taught how to take care of their hair at home. “After five days, no special care is needed,” Mohebi said.

Ten days after the surgery, patients return to have the donor site checked and staples removed for those who had them. Hair starts growing after three months, and is long enough to style and comb after ten to twelve months. The third follow up is at 10 months after the procedure.

Severe baldness may require more than one surgery, usually spaced at least six months apart. “With megasession hair transplants we can do 4,000 grafts in one day. That significant number is a help to patients with a high class of baldness. We can get a higher stage of restoration with fewer sessions of transplants.”

Continuing to pioneer in the field, Dr. Mohebi is the inventor of the Laxometer, a device to measure the laxity or mobility of the scalp. Laxity of the scalp is key in determining the size of the donor strip so that enough can be removed for bigger cases, and the wound can be closed without too much tension and the scaring will be minimal.

To help people stay abreast of all that’s happening the field of hair restoration, and to answer questions (he’s heard from Europe and China) Dr. Mohebi maintains a hair restoration blog, ushairrestoration.com/blog.

Q:

I had a burn on my upper lip with blistering 10 years ago. I lost half of my moustache that it never grows back. I want to grow moustache but it won’t be symmetrical. Is there a method that I can restore my mustache with hair transplant surgery. I don’t know anything about it so I’m unsure of where to go to for a mustache hair restoration.

Thanks,

A:

Hair transplant surgery can restore mustache hair and can be used for restoration of hair in scars such as scars of beard and mustache. You are right about mustache hair restoration that is not as popular as scalp hair transplant. We get to do mustache hair transplant every now and then. Here are the pictures of one of my patients who had a similar problem and lost his mustache hair on one side due to some skin condition.

We restored his mustache with about 200 follicular unit grafts. We generally use scalp hair for mustache and beard hair restoration, but this patient had a very fine scalp hair on the donor area that was not a perfect match with the size of his mustache so we had to harvest some hair follicles from his beard and transplant them on the upper areas of his upper lip so they could create a similar appearance and cover the other hairs while scalp hair gave the needed hair bulk below that level to his mustache.

mustache hair loss before hair transplant

Picture of mustache before hair transplant

Immediately after mustache hair transplant

Picture of mustache after hair transplant into the mustache

FUE hair follicle harvesting from beard for mustache hair transplant

FUE donor area from beard for mustache hair transplant

We used FUE or follicular unit extraction techniques for removing hair follicles from beard area from under the jaw area.