First of all I’m glad you took the time to write before jumping into surgery. Before I continue, I would like to make it clear that I am NOT a physician, and the information provided in this response is my...

Shock loss (or anagen effluvium), by definition , is shedding of hairs due to physical trauma of the hairs by surgical tools. There is no difference in its rate regardless the technique you are using .It concerns the recipient area. Factors...

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 withou...

Lawrence, When it comes to hair transplant,  age is very important, but the area and extent of your hair loss is also crucial.  Plus, you really must understand that hair loss is progressive and many people have more than one ha...

You can wear the hard hat after one week. The hat will not hurt the grafts but can be irritating to the donor area. The donor area should be watched closely to prevent any inflammatory response and a generous amount...

In short the answer is Very successful female hair transplantation presents its own set of distinct challenges and the surgeon needs to be aware of the specific differences in the transplantation process between men and women, but there is no...

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...

Dear Frank: The good news is that facial hair transplantation can be performed very successfully. You are at a very good age for transplantation, as men your age generally have mature expectations and a well established degree of hair loss....

It may be possible to get a hair transplant for $2 dollars a graft but you could get a bad hair transplant. Clinic’s that promote price are either hair transplant mills (more then one procedure per day) or a new do...

The first question to address is what area of the head you are transplanting. The crown area takes longer to grow in then the front.  The hair transplant will not start growing for at least three months and it takes a...

Dear Adrian, Although the side effects of Finasteride are being closely scrutinized, you may have benefited from trying it when you were 24. Now that you have the frontal loss at 29, the only way you’ll get the hairline back would be...

Dear James, Thank you for your questions. It is very common for patients to seek information about improving or revising existing “plug grafts” from the 1990s or earlier. Successful revision of obvious hair transplantation from the past can be a grea...

The crown can be a difficult area to transplant and create problems as you age. If you have a defined bald spot with distinct borders a transplant could be considered. If however, you are just thinning in the crown you...

Hair loss in women is a silent epidemic that effects the lives of far more women than is generally recognized by society or medicine. Approximately 40 percent of all hair loss sufferers are women, with a statistically significant percentage of women de...

This is an excellent question. Firstly, there have been reports of sexual side effects with Propecia, but the vast majority of people taking Propecia report no adverse side effects and the benefits of taking Propecia, especially in younger patients, are...

Thank you for your question about your daughter. I’m not an expert in the lasers used for the treatment  of port wine stains and their effect on hair. If in a discussion with the treating physician it is felt tha...

Your situation is more common than you would think. Whether or not you will be able to take off the hair piece and go without really depends on many factors. Most importantly is how much viable donor hair you have...

Dear Craig,I am sorry to learn that your experience with hair restoration surgery has not worked well for you. Your question about transplanting from one person to another is one that prospective patients frequently ask. Unfortunately this cannot be...

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 my knowledge there has never been any evidence linking the use of Propecia and the development of Prostate Cancer. There was a recent study that followed a large group of men taking Propecia for several years. The study showed...

This is a great question. I have a lot of patients between 18 – 26 that ask the same question. I really feel there is no specific age to make someone an appropriate candidate for hair transplantation. I think it depends on many di...

Dear Scott: Thank you for your letter. The good news is that it is likely that you will continue to get more hair as the transplanted grafts continue grow over the next 2-4 months. There have been sporadic reports of...

First of all Patrick, you bring up a very good case in point as to why young men (those under the age of 25 or so) should not be readily treated for their hair loss with a transplant procedure. Certainly, anyone...

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 al...

Dear RS, From your description you are suffering from traction alopecia. This condition is quite common among African American women and arises because of the fashion of tight braiding. The tight braids produce a repetitive stress on the hair follicle...

Dear Ted, Much has changed since 2003 and 2004 in respect to hairlines. Correct hairline creation is based on anatomic markers and artistry. Every head is shaped differently, however the anatomical apex and temporal points are consistent. Once consistent anatomical markers are...

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 rar...

Thank you for your letter.  It certainly is difficult to watch one of your children, no matter what the age,  have a difficult time with a condition that can be emotionally devastating. You didn’t mention how severe his hair loss...

You have a good understanding of your problem. It has the pattern of diffuse pattern alopecia, and very well could be a side effect of Accutane. My opinion is that your trial of six months of Propecia was not long...

Dear Joyce: Thank you for your letter.  Based on your explanation of the surgery and the number of grafts, I would have to agree with the answer you received from the doctor’s office. The fact that the frontal area is...

Dear Andrew, You say it was the “worst decision you made”, but I am not clear if you are happy or not with your transplanted hair. Also your email clearly shows you are unhappy with your donor scar, but you do n...

Fortunately, the risk of complications is low when surgeons perform hair transplantation using modern surgical techniques.  This has to do with the fact that techniques have been refined over the years and the scalp has such a rich vascular supply g...

Yes, eyebrow transplants are possible, and when performed properly, can provide a very close to natural appearing result. These are challenging procedures, from both an aesthetic as well as technical aspect, requiring the placement of many single hair grafts at...

Dear Janet: Thank you for your letter. Hair loss can be difficult to deal with at any age but it can be particularly hard for a young woman. Before addressing the possibility of surgery there are some other issues that...

Dear John, Thank you for taking the time to write.  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...

Todd, It is okay to color your hair.  It will not affect your ability to receive a hair transplant. I advise my patients that they are able to color their hair up to the day before their surgery.  The bigger co...

Dear Denise, It is difficult to predict how severe shock loss will be prior to surgery.  If the hairs that were lost were permanent hairs, they would typically have regrown at the same time the grafts did—within 3-6 months.  One...

Dear Leeanne: Thank you for your letter and question. The diagnosis of a scarring alopecia, such as CCCA, will require that there is evidence that the process is not active before surgical intervention may be considered. There is no correct...

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 ha...

Shedding of some of the patient’s existing hair in and around the area of a hair transplant is a relatively common occurrence and should not be a cause of concern. The mechanism appears to be a normal physiologic response of...

The challenge when repairing widened browlift scars is that many of the same conditions that were present when the original incision was made still exist-  the tightness of the scalp, the curved shape of the skull in that area, and t...

Dear Alex: Thank for your letter. You certainly have a grasp of the unique traits and “Asian hair” and you bring up some interesting questions about the implications of hair restoration in the Asian population. You are correct that in Asia...

Thank you for your question. Male pattern hair loss is a condition in which a pattern of hair is inherited, in which the hair is sensitive to DHT. Once puberty starts, testosterone production increases and it is metabolized into this...

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 n...

Avodart the brand name for dutasteride does lower the DHT by 90% whereas Propecia only lowers it by 65% so it would seem there is no argument as to which one is better for protecting the hair from DHT. I routinely prescribe...

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...

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...

Thank you for your letter. Once you’ve had a strip surgery it is often very difficult to regain the ability to wear your hair shaved close as the scar may have a slightly different shade of skin coloring than th...

Thank you for your question. Personally, I have not seen any significant post-surgical hair loss for the last 4-5 years. The reasons are many. First and foremost is the creation of precise angles of the recipient sites, while fallowing the...

There are a number of factors that can make a hair transplant obvious in the post-op period. These include the redness that you are asking about, but also crusting and swelling. Redness is easily camouflaged with ordinary make-up. At one...

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 (...

To date, all FUE is essentially the same. That is, the follicular bundle is first targeted. Then the doctor scores around it with a punch or punch like tool. Then a forcepts is used to grab and pull the graft...

Thank you for taking the time to write. You question is astute in that you are trying to take into account future hair loss – something not every patient thinks about. Let me try to answer you as best I can wi...

Thank you for your question. “Shock loss” in the recipient area may be either temporary or permanent depending on the quality and genetic predisposition of the existing hair. It is generally felt that shock loss is likely temporary, however if the...

The issue of potential future hair loss is very important anytime a transplant is considered to correct a receded hairline. There is no way to do the transplant so this is “never a problem”. These are the important considerations: -age: the...

Unfortunately it is difficult to give a yes or no answer to this question since a lot depends on whether you have had a problem with “shaving bumps” which would indicate the new grafts might also curl back and cause ingr...

Thank you for your inquiry. You bring up many issues that deserve comment, however you do ask some legal questions that I am probably not completely qualified to answer. It is very unfortunate that you had an experience and an...

Psoriasis can cause thick scaly plaques in the scalp, however it does not cause hair loss. Typically itching the scalp does not cause hair loss, unless you are very, very aggressive. I have never heard of an insurance company paying...

Dear Markus, Funny you should ask! This is an excellent question so thank you for taking the time to write. For a very long time, few surgeons specialized in hair transplantation, and those surgeons worked to refine the techniques for...

There are several factors that must be considered in determining a man’s eligibility for a hair restoration procedure: 1) Age: This is not a “disqualifying” factor but one which may determine delaying the transplant in the young patient. In the early...

Hair will grow in the scar but, as you allude to, the problem is often the abnormal hair direction rather than the scar itself.  Besides adding hair to the scar, if one transplants hair adjacent to the scar, so that i...

Thank you for your question. Not only is it possible for an African American to have a successful hair transplant, often times the result will look thicker than a similar number hairs transplanted into a Caucasian. The reasons for this...

Dear Tom, Thank you for taking the time to write. Your situation is a common one and I’m pleased to hear that you have already started taking Propecia. This is one of the most significant factors for optimizing your lo...

Illnesses can cause a form of hair loss called a Telogen Effluvium. This is when the hair follicle’s cycle synchronizes and you experience excessive shedding (similar to how a cat or dog sheds). The fortunate thing about Telogen Effluvium is...

Hair transplantation is an effective way for lowering an overly high hairline, whether due to genetics or prior plastic surgery. At the same time, hair grafts can be placed to fill in patchiness and areas of thinning. With the donor...

I would LIKE to tell you that the reason you haven’t found any hair transplant doctors offering laser comb services is because such serious clinicians are averse to offering quack remedies and therefore shun “miracle machines”. I would also like t...

This is an excellent question. Whether to perform a hair transplant on a young man is a very controversial area among hair transplant specialists. My approach to this situation is based on the following considerations: 1. Hair loss when you are...

Thank you for your letter. It is unfortunate that your sister did not receive the results that she was hoping for. It sounds like there are two issues that need to be addressed, hair loss in a woman and a...

If we define success as survival of grafts, facial hair grafts do as well as hair transplant grafts placed in the balding scalp. The key determinant for survival of hair transplant grafts to the face or elsewhere is the technical...

If you bleed or bruise easily then you may potentially have more temporary bruising following the hair transplant, but it will not affect the ultimate outcome of the hair transplant.  If you scar badly or keloid this ultimately could cause a...

This is a really sensitive topic and a difficult decision to make, with very differing doctor’s opinions. The easiest and most ethical decision for the physician to make is not to treat a young patient at all. However this de...

Thank you for your inquiry. There are several issues with your sister’s transplant that need to be addressed. The first one is the issue regarding her “artificial” appearing result. Reputable, experienced physicians should be able to create a frontal hairli...

Many hair restoration surgeons would have preferred that you wait longer rather than transplanting at age 19 but I did not see you in person and your doctor did. I do not want to second guess on a patient whom I...

Unfortunately androgenetic alopecia is a disease of aging that gets worse as you get older.  Tooth decay is also a disease of aging that gets worse with aging.   Rogaine is similar to toothpaste; neither is perfect.  Tooth paste slows tooth deca...

Your questions and are commonly expressed concerns. Unfortunately you have read incorrect information. Transplanted hair is not dependent on Propecia. The donor hair follicles are genetically different from the follicles that are effected by male pattern baldness. Donor follicles are...

Finasteride, is a 5-alpha reductase inhibitor that prevents the conversion of testosterone to dihydrotestosterone (DHT). In the 5-mg dose, it has been used for the treatment of non-cancerous prostate tumors and in the 1-mg dose has been prescribed both as...

I feel the perfect start in looking for a qualified surgeon is through the IAHRS.  This is also what I would look for in a surgeon when considering a hair transplant, or any surgery for that matter. 1. Look for a p...

FUE is a new and exciting technique of hair transplantation, but it is not for everyone. FUE should be thought of as an adjunct to strip surgery, and not its replacement. And lets be clear about this, FUE is most...

First of all, studies on Propecia showed that approximately 2% of patients who take the medication will experience a decrease in libido, or sex drive. Interestingly, in half of the patients who experienced this side effect, it resolved despite continuing to...

This is a good question. We believe that the scarring from FUE is under reported as we have seen numerous cases where the scarring from FUE is quite evident even with less than a shaved donor area. While the scarring...

It is generally speaking possible to wear a hair piece shortly after a hair transplant surgery. However it is very important in which manner the hair piece is fixed on the scalp. High quality hair pieces are mostly manufactured in...

You are correct that if you have diffuse thinning by age 25, you would not be a candidate for a hair transplant. I would use both Finasteride and Rogaine and begin these medications as soon as possible. With diffuse thinning, it...

Thank you for your letter. You are absolutely correct that you may ask the surgeon any question that you would like and you have to feel comfortable with the way the surgeon answers your questions as well as the answers...

The use of new polymers purported to be “biocompatible” certainly sparks the imagination. I applaud ANY student who can think out of the box by looking for real-world applications for a new material. Such thinking is rare indeed and should be e...

Thank you for your letter. I would first like to say that qualified hair restoration surgeons can provide a result that appears perfectly natural; this should not be major area of concern if you pick the right surgeon. Examine the...

There are internationally renown physicians around the world. If you are looking at Latin America you will find Dr Carl Bazan and Dr. Hector D. Sandoval both in Mexico, Drs Carlos O. Uebel and Marcelo Gandelman of Brazil are greatly...

Dear Linda, Your question is an excellent one. I wrote a short paper on this topic way back in 1997 called “What is Delayed Growth?” The following section addresses your question. "Generally, following a transplant, all of the transplanted hair is shed...

I would recommend that you see a specialist in hair loss such as a hair restoration specialist or a dermatologist with a special interest in hair loss to examine your scalp and give you a likely reason for your hair...

The cause of the hair loss is what we call ‘anagen effluvium’ assuming that there is no severe scar tissue in the area of hair loss.  This means that the trauma caused an acute lack of blood supply (oxygen) to the h...

Yes, there are people on the internet claiming to perform body hair transplants, but the sad truth is that to date not a single clinic has posted cosmetically consistent results. Not one. I have challenged every high profile body hair...

Although there are no scientific studies to assess graft survival with “ultra” mega sessions consisting of 5000 or more grafts, a few clinics seem to have the capability to achieve these large sessions with apparently, good results. Without question, as the numb...

Hair loss is progressive. The fact that you have just started noticing your hair loss in your early 50s is a good sign that you are likely not going to lose all your hair, therefore a more “aggressive” approach can be t...

The mechanics of the eyelash transplant is similar to a normal transplant, which entails- 1) Removing the donor tissue (usually the back of the scalp), 2) dissecting the hairs into single hair micrografts under the microscope, 3) making the incisions in the eyelash...

The answer to that depends on how large the bald spot is to be filled and how large and dense the donor area is. Usually the person who has the greatest need has the least amount of donor. The number...

Finasteride, which is the generic name for Propecia, has been approved for the treatment of Male Pattern Hair Loss since 1998. Finasteride works by inhibiting the enzyme ,5 alpha reductase type II, that forms DHT. There has been a lot of interest...

First and most importantly, I make sure my patients understand the greatest limit to any hair transplantation is that there is a fixed and limited amount of good genetic hair that we can transfer to the balding areas. With that...