Michael Beehner, MD

I am a 54 year old man who has been  experiencing hair loss for many years. Using the Norwood scale I would say I am a five.  My question concerns how much hair I want replaced.   I do not want a full head of hair.  In other words, I do not want to  look like I am 25 or 35 again.  I just to fill in some of the places  where the hair is thinning.  Is this a reasonable request when fiances are an issue?
- – - – - – - -

Your preference for having a limited size transplant session is perfectly okay, but it is important that, whatever is done, is done in such a way that it could “stand by itself” for the rest of your life if you never had another session done. I would exclude doing the rear vertex/crown area and perhaps even some of the rear aspect of the midscalp on top, but it is important that whatever is done in the front extends across the breadth of the head and isn’t placed around some hair you happen to have still in the central areas. The problem with simply placing grafts in the “bare spots” adjacent to your native hair is that, when that native hair disappears due to the progression of male pattern baldness, the fill-in hair that was placed will look very strange and abnormal. Earlier in my career I did this a few times and always came to regret it when the patient would return a few years later with the now bare areas next to the grafts that were patched in various places. It’s important to “march through” the frontal area, even in the region of present existing hair. Read the Story

In November of 2007 I traveled to another country to have an FUE hair transplant by a supposed world renowned hair transplant surgeon. I  was impressed with his website and with his credentials and he told me on the  phone that he was the first in North American to perform this type of surgery and that no one else has perfected it to his level. He said he could guarantee  that I would have no scaring and undetectable results. Since I was told the he  was board certified in FUE, and he was the president of a couple of  organizations, I thought that I would be big good hands.

Unfortunately  for me, this was not the case. The entire experience was a disaster! I have practically zero growth and my donor area is severely scared after this  supposed surgeon removed 2000 FUE grafts from the back and side of my head. I  was told that I would be able to close crop my hair, which is now impossible,  and I look MUCH worse than when I went in to see him. I put my trust in this doctor and all I have to show for it is less hair, a scarred head and thousands of dollars less in my bank account.

I have attempted to  contact his office on several occasions but the doctor has stopped returning my calls or answering my e-mail. Read the Story

I work as a police officer in New Jersey and at times need to be outside for my job. If I were to have a major transplant procedure (5-6,000 grafts) during the winter months (such as December), how long after the last day of the procedure will it again be OK to be outside for an extended period of time (as long as 1 hour)? What I mean is, will the cold weather of December here in New Jersey have a negative effect on the newly transplanted grafts if I am outside for too long? Can I simply wear a wool head cap (after a week or two of recovery time from the procedure) to keep my head protected from the cold weather and related elements? Thanks, Jay
- – - – - – - -

I am not aware of any adverse effects of the cold air on the survival of grafts planted. They are nested well down into the warmth of your scalps warm blood supply and tissues. Just because no one knows the answer for sure and to have a little “cushion” of time, I would recommend waiting 2-3 days maybe until being outside below freezing without a hat on. Read the Story

I know that during surgery the doctor removes a strip of hair from the donor area, but lately I have found a lot of doctors and clinics offering a different technique that does not require this to be done. I believe it is called FUE, and the advantage would be avoiding a scar in the donor area. What can you tell me about these 2 different techniques? Best regards, Ezequiel
- – - – - – - – - – - – - – -
Dear Ezequiel,

For the first 30 years of hair transplantation hair was removed with large pencil-eraser size punches, with each one removing around 20 hairs. Then around 1990, the Personna company came out with a surgical blade finally sharp enough to cut narrow strips of hair-bearing scalp out, so that very small grafts could be cut under the microscope from them. Read the Story

Hi, I had a frontal procedure 9 years ago in the UK and as is very common the result is not very good, so I am looking to have another procedure.

My hair loss has progressed in 10 years to a Norwood 4, much more in the crown area so I am looking for one large procedure of approximately 4000 grafts.

Due to all the contrasting information on the internet and on forums its very difficult to decide on where to go and which doctor to choose. A lot of people have the opinion to only consider traveling to USA for a hair transplant.

I have been looking at Dr Arvind’s website and clinic in India and it looks very good, informative and very affordable compared to most, but as usual I have heard good and bad about going to India for a procedure.

Can anyone clarify that going to India especially Dr Arvind is a good decision to make because obviously I am very wary after the 1st procedure I had, and all the negativity surrounding hair surgery etc. I would love to hear about other peoples experiences with this clinic etc

It would be unthinkable if I made the wrong decision this time and was left with very little donor area and unnatural looking hair. If that was the case I would rather shave my head and wait for advancements in hair restoration which surely is inevitable some time soon.

Many thanks.
- – - – - – - – - – -

Dear Sir,

I am sorry your first experience with hair transplantation was not up to your expectations. I assume you live in the U.K. I had heard that there were a couple of “hair mills” in your country back then that did perform sub-standard work, Read the Story

I am wondering how to care for my hair after a hair transplant, what should and shouldn’t I be doing?
- – - – - – - – -

In general, you can do pretty much everything you did before you were transplanted. Most practices, including ours, encourage the patient to shampoo and clean the hair and scalp the next day, preferably under our supervision at the office. Approximately half of our patients take us up on this service. If your shower is a fairly strong one, then I advise having a washcloth over the hair as you wash it. Or you can simply use a small pan with a handle and pour water over your head with that and not let the shower directly hit the grafts. Most fine-spray showers are not going to harm the grafts at all. The most important thing with those first few shampoos is to not let a comb or brush bristles scrape across one of the small scabs at the ends of the grafts. This could dislodge one of them. The grafts are remarkably stable in their new homes. The “blood glue” of the plasma, the factors in plasma and blood that encourage things to clot and stick together, helps stabilize that graft in the narrow recipient site. As long as the depth of the site is the same as the length of the graft, then there is sufficient room for the graft to be under the skin, with its epidermis (skin) layer at or just above that of the surrounding skin. Read the Story

I would like to know, if it is possible to have a partial eyebrow reconstruction with artificial hair or from an transplant from a different person, in those cases were there is no available donor hair from the person.
- – - – - – - – - – -

The answer in a word is “no.” Since it is almost unheard of not to have enough donor hair to do an eyebrow, I almost have to assume that your problem is one of severe alopecia areata termed “alopecia totalis,” a condition in which there is no scalp OR eyebrow hair. That is about the only condition I can think of that would prompt the need you mention. I sympathize with your situation, because I do realize how important the eyebrows are to completing the framing appearance of the normal facial structures.

The only other person you could get hair from and have it be accepted by your body would be an identical twin, which I’m assuming you don’t have. Artificial hair implants have been used in Italy, Japan, and Australia but are illegal in the U.S. I doubt they would be useful in constructing eyebrows, as they cause a lot of “fibrosis,” which is a hardening and slight swelling of the skin tissues around the hairs, and also causes a fair amount of redness and inflammation much of the time, all of which would look very unsightly in such a visible spot as the eyebrow location. A very artistic tattooing by a professional would be one way of approaching this problem, but it’s important they do it in such a way that the eyebrow looks like it has a little “texture” to it and doesn’t simply appear painted on.
Read the Story

Is it possible to take the donor hair from the beard area. I don’t have any donor hair left, and need a new side burn. -Steve

Dear Steve,
It IS in fact possible to harvest donor hair from the beard, but there is still a good chance that the wisest and best course of action may be to take it instead from the back of your scalp. There are two different ways to harvest beard hair: The older method was to cut out an eliptical strip from under the chin and then dissect this strip into individual FU grafts, but the drawback is that this method leaves a thin scar under the chin; so this method is only to be used if the man is absolutely committed to keeping a beard in that area of the face for the rest of his life, which makes the scar undetectable. Another probably better way to harvest beard hair is by “FUE,” or folliicular unit extraction, a procedure in which the surgeon uses a very small punch around 1mm in diameter and cuts into the very superficial skin surrounding the follicular unit, then follows up with a dull punch, which carries the dissection bluntly down the sides of the FU without cutting the follicles. The FU graft is then gently “plucked” out of this site, and the holes heal up beautifully in just 4-6 days and are hard to detect very soon thereafter. Read the Story

Two years ago I had a hair transplant in Washington state with very poor results. I spent over $8000 and very little of the transplanted hair has grown in. I was also left with a scar that can only be covered if I grow my hair out about 3 inches or so. The entire experience was bad. Is it possible to fix the bad hair transplant and do doctors guarantee their results?

I’m sorry you had a bad experience with your first hair transplant procedure. It’s a little hard from your letter to tell whether you really had poor growth, that is, a low survival rate of the follicles planted at your surgery – or whether the doctor or clinic led you on initially with some expectation that wasn’t lived up to in your eyes. Sometimes a clinic will promise a “full head of hair,” and that just isn’t possible in a single session by almost anybody. I’m assuming it was probably a little bit of both of the above, but the only way to be sure would be to have a graft count of what was placed, see your “before” photos, and then personally examine you. Photos would help some, but wouldn’t be as good as your possibly going to another reputable doctor in your area of the country and having him or her look at your results. Certainly, at the two year mark, you should be seeing everything you are going to get from your transplant. Read the Story