My Son’s Hair Transplant Has Resulted In a Tightness and Pulling Feeling - Need Advice
Written by Sara Wasserbauer, MD on April 27, 2009
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. Hair physicians can easily measure the elasticity of the donor area (using the Mayer-Pauls elasticity scale) in an office visit and this is something I would suggest initially. If the scalp is quite tight, a scar revision might not be the best option. It the scalp is fairly elastic, he would have more surgical options and something else might account for the pulling sensation he is experiencing. An office visit would also allow a hair surgeon to examine the scar for signs of tension, excessive scarring, or nerve entrapment. Thick or wide scars can enmesh the nerve and constrict it, causing tenderness or tightness. Again, these would be rare complications of a hair surgery, but plausible scenarios given what you describe.
I would also suggest scalp stretching exercises as a means of improving the area. To do the exercises, one needs to clasp the hands at the back of the head against the scalp (like you are leaning back in an office chair after a job well done!) and move the scalp up and down. Patients should do this several times per day for six months - in other words, they should make it a habit. When practiced with diligence, I have seen them give good results for several patients and the research done to date, while in small numbers of patients, consistently shows improvement in laxity.
One last possibility is that this pulling and tightness has nothing to do with hair surgery. I have seen patients (when I was an Internist) who have the persistent sensation of a tight scalp and they are most often referred to a neurologist or anesthesiologist for treatment. I think it is also important for him to be treated for his anxiety and stress so as not to let this condition ruin his life. The impact of effective management of these additional issues should not be underestimated.
I sincerely hope this has helped and wish the best for your son.
Warm Regards,
Sara Wasserbauer, MD
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association
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Hair transplant is one option or solution to your bald head. This option could cost much but it is worth it. Thanks for your great tips on how to get such transplant and no worries of baldness again.
Subj: My Experience with E. Antonio Mangubat of Seattle, Washington, USA
I am a former patient of E. Antonio Mangubat (M) of Seattle, Washington, USA and my advice is whatever you do, DO NOT go to M for any hair transplant procedures!!!! I have described below in detail my horrible experience with Mangubat (M). I’m not a doctor, but below are my recommendations (based on my experience) for treating hairloss.
I know readers of this forum are very concerned and feel down about losing your hair. I felt the same way starting at 18 when it began for me. However, you don’t have to go through my horrible experience with my hair transplant “doctor” (described below)! Not to mention forking over your hard-earned savings to him! Regarding treating hair loss, my recommendation (reasons described below also) is Avodart instead of Propecia.
Very Important: The before/after photos that many Hair Transplant surgeons show you are VERY MISLEADING because:
- Many doctors only show their best top 5% patients, and don’t show you the average result or, as in my case, the bad results.
- The photos are typically low resolution, so may not clearly show the hairline or may be in low light, thereby concealing the thin density and unnatural look of the transplants.
I was also in my mid 20s when I signed up as M’s patient. He suggested that I get 3-4 transplant sessions and 1-2 Scalp reduction surgeries (called “Brandy” procedures after Dr. Dominic Brandy http://www.brandymd.com/ ). The worst decision I ever made in my life was to follow M’s advice and have these procedures done. M left me SCARRED and DISFIGURED!!!! BTW, Dr Brandy was sued in part for performing the “Brandy” scalp reduction procedure: http://community.seattletimes.nwsource.com/archive/?date=19960915&slug=2349352
http://nl.newsbank.com/nl-search/we/Archives?p_product=PG&p_theme=pg&p_action=search&p_maxdocs=200&p_topdoc=1&p_text_direct-0=0EADFA0E15FC891D&p_field_direct-0=document_id&p_perpage=10&p_sort=YMD_date:D&s_trackval=GooglePM )
I know this sounds unreal, but anyone who has a consult with M should ask him about the “Brandy” scalp reduction procedure and ask to see before/after photos of Brandy procedures. If he dismisses your request (says you don’t need a Brandy) and refuses to show photos, ask yourself why is M refusing to show his own work? Is he hiding something? If you get to see the photos, look closely (even though he’ll show small Polaroid pics) and you’ll notice a thick straight or horseshoe-shaped scar ¼ - ½ inch from 1 temple to the crown and back to the other temple with no hair growing there. Beware that M may show you “after” photos with the surrounding hair combed over the scars. This is nothing less than totally misleading and a LIE because it doesn’t show the true result which is 1-2 scars 6-8 inches long and ¼ - ½ inch thick in the middle of your head from the temples to the crown!!!! M left me with such a horrible scar and I’ve undergone numerous reconstructive surgeries, spending over $20K, to reduce the scars.
Although M may not recommend a Brandy surgery on you, I mention this procedure for this reason: what does the Doctor care about most: your welfare and your well-being OR the money he’ll make from you?? In my case, without a doubt M only cared about the money! Otherwise he would have stopped himself from doing what he did to me, particularly the 2 Brandy procedures. He didn’t know what he was doing and he didn’t care! So in my opinion, he’s definitely NOT a doctor to be in the care of!
You should also ask M (or your hair transplant doctor) about the scar in the back of your head (the donor area) after any hair transplant procedure. M told me about all my scars that they will eventually “blend” with the surrounding skin and look much less prominent. That was a COMPLETE LIE!!! The scars will be with you for life with no hairs growing in that area ever.
I did a few quick searches and found M in his own words praising the “benefits” of scalp reduction surgery (see below). This kind of surgery (the Brandy procedure) is what left me totally scarred and disfigured!! So much for the “benefits”!!
M’s own words speak volumes on his incompetence and the fact that he’s clueless and oblivious to the harm he’s done to many like me. Here are the links:
http://www.regrowth.com/hairloss-conferences/american_society_hair_restoration_surgery/1998/ashrs_monday.cfm
The Rise and Fall of Scalp Flaps, Reductions and Lifts
[Tony Mangubat of Seattle, WA is one of the leading doctors performing scalp reductions. "I've noticed in the Seattle area over the last two years a fall in the area of scalp reductions... I was a little disappointed in it, and I was almost upset until I started looking at it in a more objective way... the answer to this question becomes very clear." Dr.Mangubat outlined his feelings on reductions and why he thinks the number of doctors performing the procedure has decreased. "We want fast results, we want a home run.. Managed care has caused an influx of newcomers. The fact is I make more income off of hair transplants than scalp lifting, so from a financial point of view maybe it's not such a bad idea..." The fall has been precipitated by an influx of newcomers due to doctors who are earning less due to managed care and HMOs. "These are all victims of our new managed care society," said Dr. Mangubat. Doctors coming in have been resistent to learning reductions, flaps, and lifts due to the steeper learning curve, greater risks, and marketing against reductions. The number of doctors performing are remaining steady, but the number of doctors coming into transplants are growing, so the overall percentage are lower.]
Please note that the following is based on my personal experience and not medical advice:
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Regarding hair loss, my advice is don’t go for hair transplants. Instead, if you still have quite a bit of hair left, make an appointment with your family physician asap and ask him/her about taking Avodart for stopping hairloss.
Apart from Avodart, the other 2 best known medications, Rogaine(minoxidol) and Propecia, are not as effective as Avodart which stops both kinds of DHT (the hormone that causes hairloss). Minoxidol is a waste of money for most people since it only works for a few people and Propecia is good (because it blocks 1 kind of DHT) but not as good as Avodart. Avodart will most likely not regrow any hair you’ve already lost but it will let you keep the hair you have now. Also, although both Propecia and Avodart have potentially harmful side effects (e.g. reduced sex drive), I have been taking Avodart for the past 2+ years with no side effects.
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If I could do it over again, I would have NEVER trusted M and NEVER let M lay a hand on me. Instead, I would have just accepted my baldness and not done any hair transplants; I would have shaved my head while we wait for a cure.
Unfortunately, M left me with huge scars on my head and so I can’t just shave my head. Instead I’m forced to wear concealers to hide the ugly scars on my head. Anyone considering M does not have to go through what I’ve been through. So I strongly recommend that YOU STAY AWAY FROM MANGUBAT!!