Sara Wasserbauer, MD

I’m very interested in having an FUE hair transplant but I’m starting to get confused with all of the different FUE techniques being offered. Do I have a Neograft FUE  (which is extremely expensive), CIT or SAFE?  I also read something about FUE2 . Your website seems to be more straight forward then others and it seems that most FUE is very similar from what I am reading from your organization. I’d like to feel comfortable with my decision to move forward, but this is a big step for me and I keep reading conflicting information on other websites. Can you tell me the best FUE techniques and do you recommend FUE over FUT? Thank you for your time and I look forward to any answer that you can provide. ~Ross
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There are no comprehensive studies yet on any of the technologies that you mentioned, the NeoGraft, FUE2, and the SAFE Scribe System. Read the Story

Do the majority of hair transplant doctors consider it appropriate to transplant hair into thinning areas, e.g., front, mid-section, and/or crown, as opposed to transplanting hair only into bald areas? What are the risks and considerations (e.g., shock loss)? – Robert
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Robert,

Thank you for taking the time to write! I am not sure I can speak for the majority of hair transplant surgeons, but through my training and experience with many of the top surgeons out there, the short answer to your question is; it is a judgement call.

The chief concern, as you identified, is whether you will do more harm to the existing hair, than good! If the existing hair is close to complete loss, I believe many surgeons would choose to help that patient by restoring a conservative area of hair/hairline.

If the hair in the area seems to be salvageable, some surgeons would feel more comfortable trying medical therapy alone for 6-12 months, while others would simply exercise caution during the transplant. Too many grafts at once with the latter approach can exacerbate shock loss, especially if the patient has fine or miniaturized hair to begin with.

If you believe you are in this latter category, it is always best to go with the hair surgeon who levels with you about the risk of shock loss; you will be replacing the hair with permanent hair, so you will have a net benefit, but the risk of significant shedding with more limited re-growth does exist. Read the Story

I had a transplant about one year ago to hide a scar from a brow lift. Unfortunately, the scar is still very visible, but what I’m most worried about is the dramatic thinning of my hair along the donor scar line and below it. In fact, right now, I have an irritation, the second one in a month, that is about an inch wide. This one burns and appears infected. My doctor thinks it was just an ingrown hair, but I’ve never had one like this ever! Could I be having thinning hair and irritations because of my hair transplant. Will it stop? Is it likely my hair will ever regrow what I’ve lost since the hair transplant?
-Susan
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As for your donor area, it does sound like you have local infection and inflammation at the site.  This could have started, as your doctor said, with an ingrown hair and may have spread to the surrounding area.  It could also be what doctors call an “inclusion body” like a stitch that did not dissolve and is instead working it’s way towards the surface.  Read the Story

My son had a hair transplant done 9 yrs ago and has had a major problem ever since.  He has tightness/pulling over half of his head 24/7 with no relief.  His lifestyle has not been the same ever since.  He cannot work full time as this condition causes much anxiety and stress.  He has seen several doctors and the place that did the transplant tells him they have never heard of this before.

He is pretty much handicapped with this condition and would appreciate any help or advice anyone can give. He is considering a scar revision to see if there is anything that was messed up when they did the surgery. Any advice or help would be greatly appreciated! Thank You!
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What a frustrating situation!  I am so sorry to hear of your son’s plight and not at all surprised that the other doctors he has gone to have not encountered his symptoms since this sort of complication is exceedingly rare these days.  Without examining him, it is tough to fully understand what is going on – but let me try to help as best I can;

There are a few scenarios for what might have happened to your son.  He might have had a tight or inelastic scalp to begin with, or the closure on the surgery day might have been tight as well meaning the incision might have been slightly wider than average. Read the Story

As one of the few docs who does FUE routinely in my practice, I think it is interesting that all sorts of new methods for automating the process are being introduced. There have been many iterations of these machines and while none has yet panned out perfectly, I do see some hope on the horizon! For those of you who are novices to the idea here is a comparison of the two techniques;

TRADITION! The traditional FUT (Follicular Unit Transplantation) or “Strip” technique takes a thin strip of hair from the back and sides of your head. The two sides are brought back together leaving a thin line typically 1-2mm wide as the scar. Often, a “trichophytic closure” is used which allows the hair to grow through the scar, rendering the scar all but invisible. This scar is typically visible only if you buzz your hair shorter than a #2 on a pair of standard clippers (or if you shave your head with a razor.) It is typically NOT visible if you cut the hair at a #3 on clippers (or if you leave it even longer). This goes for wet and dry hair I find. Read the Story

What is the hair length needed to cover an average donor harvest scar on the back of the head? I currently keep my hair short on the sides (less than 1/2 inch) Also, where on the back of the head is hair strip collected from? Parallel to the ears? How long is the resulting scar in inches?
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Dear “Worried about Scar Camouflage,”

Thank you for taking the time to write!  An average donor harvest scar should be done with a trichophytic edge these days, so hair should be growing through it rendering it nearly invisible.  However, even without completing that extra step (which I consider essential but not all surgeons do) an average scar should be no wider than 1-2 mm.  Based on an extensive survey of my patients, a scar like this would be visible if the hair were clipped at a #2 and invisible if clipped at a #3 length.  Of course, variables like skin and hair color can impact this, but as a general rule this is what I advise my patients. Read the Story

I have a couple questions about minoxidil.  I know the common potencies are 2% and 5%.  Why not go higher?  I found a website called minoxidil.com that offers something called Xandrox with 15% minoxidil.  Is this legitimate or just a scam?  Has anything over 5% proven to make no more of a difference?  The website is run by a Doctor Richard Lee, have you ever heard of him? – John
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Dear John,

Thank you for taking the time to write.  I have not heard of Dr. Richard Lee, but it is easy to check a physician’s credentials if you know in what state they are licensed.  As for the minoxidil, all the science shows us is the efficacy for the 2% and the 5% formulations.  Going higher usually increases the risk of side effects, and it might not be more effective.  Remember that minoxidil was originally a medication for blood pressure that was taken orally (at much higher doses, incidentally).  Pfizer decided to investigate it as a hair loss drug when patients began reporting the strange side effect of unwanted hair growth!  So these drugs are not without effects on other body systems. Read the Story

I have undergone 3 hair transplant procedures and thought that they were successful.  However, recently  I have noticed further hair loss and am concerned that the hair transplants may not really be working for me, especially since reading that very, very few women are good candidates.  It is difficult to tell if I am seeing just the normal loss of my hair or if the transplants did not take.    Before I decide to have another procedure I want to be very sure that I am really a good candidate for the procedure. Thank you so much for your help.  – Lauren
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Lauren,

Thank you for taking the time to write.  Let me try to answer your question as best I can without seeing you and examining your scalp.

Hair loss, by its very nature, is relentlessly progressive.  This is why a hair restoration surgeon takes into account future hair loss when planning a transplant – they must place hair in areas that might need hair in the future in addition to the areas that have already lost hair.  In women, this problem can be worsened by the surgery itself – that is to say – if a hair is at the end of its life cycle, it may have its final “shed” at the time of surgery.  This is mitigated by the fact that the new hair you get from the surgery is permanent so you end up ahead in the long run, surgeons are just usually more cautious with their female patients.  Additionally, you do not mention what type of hair loss you have; is it androgenetic alopecia (female pattern hair loss), alopecia areata, or hair loss due to other medical problems? Read the Story

What risks,  if any should be told to a patient with a VP shunt before doing a hair transplant procedure, and should the risk of disconnection be mentioned, and/or should patient not be allowed to do a hair transplant? – John
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Dear John,

Thanks for taking the time to write!  Let me try to answer your question as best I can.  Ventriculoperitoneal shunts are rare.  Basically they channel excess fluid from around your brain to elsewhere in the body.  These shunts do not typically involve blood or the circulatory system.

For most patients, the presence of a shunt like this should not pose a problem for surgery, but I would check with the neurosurgeon who placed it or neurologist that the patient sees for specific recommendations because the location of the shunt can vary from patient to patient.  It may or may not even be in the area that the surgical plan involves. Read the Story

I have already signed up to have a hair transplant at the end of July for 3500 follicular unit grafts and I began to wonder how do I know for sure that is the amount of grafts I will receive? Is each hair counted as it is placed in my head? ~ Hector
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Dear Hector,

Thank you for taking the time to write! This is an area that causes great confusion to patients, so let me try and clarify as best I can.

Hairs grow on your head in clumps of 1, 2 or 3 hairs (and sometimes even 4 or 5 but this is more rare). These clumps are a “follicular unit” and they are what is cut into “grafts” for your hair restoration procedure. (Yes, hair surgery is the only specialty where getting more “FUs” is a good thing!) Hair surgeons often use the terms “follicular unit” and “graft” interchangeably since, ideally, they are the same thing. However, this can lead to confusion for the patient.

Here is the problem; if a two-hair graft is cut into individual hairs, it can be implanted as TWO single hair grafts – even though originally it was supposed to be one single graft with two hairs! You see how easy it is to double the number of “grafts,” you just need to cut apart each hair in the “follicular unit”, even if it existed in a clump in its natural state. Read the Story