Hair Restoration Blog

We have discussed different methods to repair hair transplant donor scar in the past. There was an interesting article in Dermatologic Surgery Magazine last months on repairing the wide donor scar using body hair by Dr. Robert Jones from Oakville, Ontario, Canada.

Dr. Jones has reports revising a wide donor scar after previous hair transplant surgery by body hair transplant. He uses chest hair removed by follicular unit extraction method using a 1mm punch device. He has transplanted the grafts directly into the scar area so follicular unit grafts did not have to wait more than a few seconds.

Three months post-op follow up pictures were shown with some hair growth on transplanted donor scar with some reasonable coverage. The growth of the transplanted hair is not completed before 6-8 months after hair transplant and it is expected to see better coverage by the end of that period.

I have had a presentation on revising neurosurgical scars using hair transplant with follicular unit transplantation in the annual meeting of International Society of Hair Restoration Surgery in 2007. In that meeting, I presented four patients who underwent hair transplant surgeries to revise the widened scar of their neurosurgical scars. The results of the hair transplant on those patients were great and the appearances of the scars were completely vanished in all four of them.

Again the current article by Dr. Jones proves that hair restoration could be used effectively for improving the appearance of scalp scars. My personal preference and the method that I use in our Los Angeles hair transplant clinics is to use scalp scar rather than body hair unless patient’s donor area is completely depleted and there is not enough harvestable hair on the donor area. In those cases body hair transplant could be an alternative if patient have good quality body hair for a body hair transplant through FUE (Follicular Unit Extraction).

Q:

Dr. Mohebi,

What do you think about Nioxin for hair loss treatment? Do you offer it in your Los Angeles hair restoration offices?

A:

We currently do not sell any products in our Los Angeles hair restoration offices. Nioxin makes different products such as cleansers (shampoos), conditioners, reconstructors, and other products for hair and scalp. They are in the market and could be purchased from beauty salon. Nioxin shampoos are popular, but there appears to be nothing in them that will cure hair loss. I have had many patients who used them in the past for a while and they gave me a mixed report. If they are affordable and you are happy using them as cleansers or conditioners I have no problem with that. However, by looking at what is out there on the ingredients on Nioxin products and the reports from my patients, I cannot recommend them as a treatment for hair loss.

Many people ask me on the use of hair products such as shampoos or conditioner after a hair transplant procedure in our Los Angeles hair transplant clinic. My answer as you probably have seen in this blog is that you can go back to your routine hair wash and maintenance after the first five day after your hair transplant surgery. They practically cannot damage the transplanted hair at that time by washing or shampooing it.

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.

 

Q:

In a FUE case that you decide a larger session hair transplant, would you consider a smaller session initially (perhaps 500 - 1000 grafts) to continue with a larger session or you prefer to do it all in one day?

A:

We always evaluate patients for the required number of grafts to fill the balding area. The number of grafts required for a hair transplant has to do with hair characteristics such as hair color, shaft thickness, waviness, and contrast between the hair color and skin tone and eventually with the number of grafts that we can safely and easily remove. For FUE hair transplants, number of grafts that should be transplanted in one day is up to the patients. The best is to get as many graft as possible during the first session to minimize the risk of repeated surgery such as increased local anesthetics and other medications. Of course, I give the patients my recommendations based on the available grafts, quality of hair and hair demand (degree of baldness), but at the end patient is the one who should decide.

Central centrifugal cicatricial alopecia or CCCA is one of the less common causes of hair loss. This medical condition, which characterizes with circular balding, mainly on the top (vertex and crown) which can be expanding and only leave a rim or hair around the scalp with total baldness in the more central areas in extreme cases (see picture).

The causes of this type of balding are now quite known. This disease used to be called with different names such as hot comb alopecia, follicular degeneration syndrome, pseudopelade in African Americans and central elliptical pseudopelade in Caucasians. Microscopic evaluation of the hair loss areas shows evidences of inflammation in the area of disease activity, chronic and rapidly progressive skin changes with eventual complete baldness in some part of the scalp with its unique pattern.

This hair loss condition could be started with the evidences of skin inflammation (redness and itching), but this phase might be temporary and patient may not have any signs or symptoms other than hair loss with its specific pattern.

Treatment of this condition could be challenging. Treatment with medications is generally not successful in prevention of the hair loss and to reverse the process. Hair transplant could be an option, but it could not be done in the acute phase of the disease. Hair transplant for Central centrifugal cicatricial alopecia might be considered when the active phase is over and when the inflammation is completely subsided. I would like to do a small test hair transplant before committing to the actual hair transplant surgery to be assured of the survival of the hair grafts.

Q:

I had a hair transplant two days ago and would like to use Bromelain to aid in reducing inflammation. I have heard that bromelain interferes with fibrin which holds the grafts in place. Do you know if this is true or not?

A:

Bromelain is a combination of some enzymes that are naturally found in the pineapple juice and stalk. One of the uses of Bromelain is for its improving effects on swelling, bruising and irritation of skin after surgical procedures and injuries. You are right about the fiblinolytic (dissolving fibrin) effect of Bromelain and for the same reason you should not use it on the transplanted areas of your head. Microscopic clots that initially form around the transplanted grafts are necessary to seal the follicular grafts in place within the first few days after surgery, when grafts are still fragile and can get dislodged.

There are some medications that can improve your swelling and redness after the surgery such as steroids that are proven safe for the growth of hair grafts. You need to ask your hair transplant surgeon about what to use to decrease the swelling and redness after hair transplant surgery.

Dr. Parsa Mohebi announced this week that US Hair Restoration will soon have a branch in Dubai, UAE (United Arab Emirates) in a TV talk show in Los Angeles. This hair transplant center is going to be the first branch of the US Hair Restoration in middle east that could be utilized by hair loss patients in United Arab Emirates, Saudi Arabia, Qatar, Kuwait, Iran, Pakistan, India (good news for Bollywood actors) and even Europe that may find having a Quality hair transplant surgery in the middle east more feasible than getting a hair transplant surgery in America.

Dr. Mohebi will be in Dubai for the first time with his whole surgical team for the summer of 2008 to offer the high standard follicular unit transplant surgery to the hair loss patients in Middle East and Asia. Dr. Mohebi will be performing hair transplant surgeries on patients who had already contacted US Hair Restoration and booked their surgery in advance. Eligibility of the patients would be determined through online, phone and photo consultation before the time of their hair transplant procedure.

Q:
Does your new Irvine facility sell toppik hair fibers? Is it safe to use daily or soon after a hair transplant until the hair grows?

Hope to hear from you soon.

Thank you.

A:
We don’t sell any products in any of the offices of US Hair Restoration, but you can easily buy Toppik online through several websites.

Toppik is made of several inert substances that none of them affect the progress of the hair loss or gain.

If you are planning to have a hair transplant surgery, you need to stop using Toppik for the first four days after your hair transplant when the process of healing of the transplanted grafts is not finished. You can start using it again as early as day 5 after your hair transplant surgery when the healing process of transplanted grafts is considered to be completed.

Have a great weekend.