I am a female age 64 and had an 800 graft hair replacement done about 5 years ago. Since the thinning on the front and crown has become very noticeable, I wonder if there is any way to tell if these grafts actually worked? I really don’t see any difference. I have received HRT since I was 26 and it had both male and female hormones in the pill. I wrote and asked the drug maker if their pill could cause hair loss and they assured me that it could not. I now find out that it can and does along with facial hair. Would minoxidil work for me or not? And if so, what is the difference between the generic and the brand name if any. Thank you for any information that you can give me.
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Thank you for your question and I will do my best to give you the best information that I can to assist you. I am going to assume that the 800 grafts you had done five years ago were placed in the front and the crown as these are the areas that you are concerned about. Read the Story

Surgeon: Jeffrey S. Epstein, MD
This girl was 9 months old when she suffered the burn caused by hot oil. Her first procedure was when she was 7 years old, involving the placement of the balloon expanders. 7 weeks later she had the balloons removed and half of the burned area was recovered with the stretched out normal scalp. A year later, she had three more balloons inserted which were then inflated over the next 7 weeks- then these balloons were removed and the remainder of her scalp was resurfaced with the stretched portion of scalp. Read the Story

Trichophytic Closure on Scar Revision

I am really struggling with the idea of having a hair transplant and being left with a long scar on the back of my head. I recently read an article about a new technique called trichophytic closure. The article stated that this technique promotes the growth of hair through scar tissue, is this really possible? Have I understood this correctly and does this mean that I will be left with no scar after a hair transplant? Please explain. Thanks! -Ben
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Thank you for your question. The trichophytic closure is a method of preparing one side of the surgical wound to allow the hair follicles on the margin of the incision to produce hair that will grow through the scar. There are several methods of preparing the incision to allow this but there is no clear “correct” way to do this. If done properly, and the outcome successful, the hair growing through the scar will camouflage the typical straight linear appearance of the scar. Read the Story

Ten years ago I had 300 round circular plugs taken from the donor area and placed on the middle and crown area. I have 100 round “white” circles on the crown, but what is worse are the indentations. They appear to be “crater like” scars on the middle of the scalp. Is there any method(s) to correct the craters and smooth out the skin? The donor area is too thin for future use and I would like to just correct the scalp issue and be able to live without wearing a baseball hat in public. I tried a hairpiece but the thinning hair on sides could not hold it in place. Your insight is appreciated! Thank you for your time and consideration. ~Dante
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Dante

Unfortunately large plugs become very detectable when they are located in the middle of a large balding area. Indentations suggest that the grafts were placed too low in the scalp. Improper graft placement results in a cobblestone appearance when positioned too high and in a crater or pit-like appearance when positioned too low. The “white” circles you describe suggest that there is little or no hair growing out of the grafts. The combination of a white plug and no hair means that the graft did not survive the original transplant procedure. What you are now seeing is the residual scar tissue that has replaced the once healthy plug tissue. Read the Story

I am a 24 year old male with a light moustache and a full thick beard except along the sides of my mouth. If I decide to undergo a hair transplant procedure to thicken these areas how soon will it be till I can I see results and how long will the procedure take? Also, how much would the hair transplant cost me approximately? I also heard that applying Rogaine to the bald spots can work also, is this true? – Rafael
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The first thing that is required is a good, clear photo so that your situation can be evaluated. The cost is generally related to the size of the procedure, but it would probably cost several thousand dollars. The size of the procedure would determine the length of time to do it. It normally takes at least 6 -9 months to evaluate the results. The donor hair may have to come from under the chin to match the other beard hair, especially if you have coarse beard hair on the rest of your face. Read the Story

Do surgeons ever perform hair transplants from non-autologous donors? I am a 56 year old female with considerable thinning all over, and it does not seem to make sense to just shuffle the hairs to different places on my own head. Thanks. – Michelle
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Dear Michelle:

Thank you for your question. If you were to have a hair transplant utilizing follicles from a genetically dissimilar person your body would reject this tissue just as it would with any other transplanted organ. For example, if you were to have a heart transplant, you would need to be on lifelong medication such that your body would not reject the transplanted heart. In similar fashion, a “non-autologous” follicle would be rejected by your body without lifelong anti-rejection medication. It would make good medical sense to utilize these medications for something like a heart, or lung, or kidney, or pancreas, but not for a hair transplant. Therefore, the only acceptable tissue for a hair transplant would come directly from the patient, and/or a genetically identical person, i.e. an identical twin. Read the Story

I recently had a hair transplant consultation and I was told that 800 grafts placed into my crown area would be all that I need to cover my baldness. After doing research, it doesn’t seem like this amount of grafts would be sufficient to cover the hair loss in my crown which is about the size of a grapefruit. Can 800 grafts really make a difference?
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Your question is a little difficult to answer without knowing specifics. For example, your age, hair color, caliber (diameter of your hair shafts), curl pattern (straight or kinky) and color of your skin. Your age is important because if you are 25 you can expect continued expansion of your bald spot and the necessity for additional procedures, as long as you have sufficient donor area. If you use all your donor area in the back you would have none left for the front. In my practice, I would rarely perform an isolated crown procedure in a young man, before giving him an adequate trial of Propecia/Minoxidil(at least 1 year) and if there was no response I still probably wouldn’t do it because the potential for future hair loss is too great. Read the Story

I had a hair transplant seven years ago and have never been happy with it. It is constantly on my mind and has destroyed my social life. The main concern I have with my hair transplant is the resulting cobblestone appearance, it looks shocking when exposed to light ie sunlight. I would like to have another procedure to improve the density, but I am still concerned with the pitting. Nobody ever discusses treatments for scarring/pitting to the donor area, is this because there are none? I’ve often thought creams or laser treatments similar to that used in acne scarring could be used or would these treatments damage or kill the hair follicles. Surely with all the skin treatments available there must be something to rid or improve the pitted appearance. ~Tony
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Tony, I am very sorry to hear about the position that you are in. Cobble-stoning in the recipient area could be due to particular healing characteristics of your skin but could also be due the grafts placed too shallow in the slit i.e. the slits being not deep enough. Read the Story

I have been on Propecia in an effort to stop my hair loss for the past 7 months but have been experiencing some sexual side effects. I would like to have a hair transplant, but I am concerned that undergoing the procedure without being on Propecia might not be a good idea. Do you recommend having a hair transplant if the patient can not tolerate Propecia?
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Propecia is a medical treatment designed to slow down male pattern hair loss and promote growth of new hair. It does not work for everyone and some can experience sexual side effects. In addition, there are some patients who do not want to take a medication for their hair loss and propecia is expensive. Read the Story

I’m interested in knowing where doctors receive their hair transplant training and can any doctor of any medical specialty such as a podiatrist perform hair transplant surgery?
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Any licensed MD or DO can perform hair transplant surgery. Doctors who have had training in surgery and diseases of the scalp as well as doctors who have had no training in surgery or diseases of the scalp can perform this surgery. For example, psychiatrists, allergists and family practice doctors can legally operate. However a podiatrist cannot because they are neither an MD nor a DO. Since the procedure can be done in the office and not in a hospital, there is no regulatory system that monitors the quality of the new doctor’s work.

Doctors can learn how to perform hair transplant surgery through formal training or by on-the-job experience. Hair transplantation may be taught as part of an accredited residency program in dermatology or plastic surgery. Read the Story