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May 29, 2008

Reasons Why Shaving the Balding Recipient Area for Hair Transplantation May Not Be Necessary

Filed under: Uncategorized — heaven @ 11:19 pm

This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Jeffrey Epstein of Miami, FL who is an elite member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

We do not require any of our hair transplant patients to shave the hair in the balding recipient area, for a few important reasons: first, it makes it difficult to resume regular activities for the first few weeks after the hair restoration procedure, and second, during the course of the procedure, I find the presence of the existing hairs allows me to more accurately determine the relative thinness of different areas of the scalp. Yes, it may take as much as an additional 90 to 120 minutes longer to perform a procedure of 2500 plus follicular unit grafts when the hair is present, but this extra time put in is a small price for the advantages of leaving the hair alone.

Dr. Epstein

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Is it Safe For a Woman to Get a Hair Transplant with Some Hair Loss All Over the Scalp?

Filed under: Uncategorized — heaven @ 1:55 am

This question was posed by a female hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

I saw a very reputable hair transplant surgeon yesterday. I have receding hair at my temples so I went in to inquire about a hair transplant to those areas. Upon inspection, he indicated that I have about 30% or so hair miniaturization in the donor area. I’m very scared and am now thinking “am I going to go completely bald“? I have more questions. Has anyone with similiar problem had hair restoration surgery that can offer me some insight?  He says he can do the hair transplant but can offer no guarantee on how long it would last.

Also, how long to miniaturized hairs last and how fast does it progress? Is it normal for a woman at age 46 to have hair miniaturization?

30% is a fairly high percentage of hair miniaturization to be present in the occipital donor area, usually the best hair on most women’s heads who have female pattern alopecia. Most of the time I wouldn’t give a woman a hair transplant with that high of a percentage, simply because it also portends that a lot of the other hairs will probably be following in the same footsteps of miniaturization a hair growth life-cycle or two away from now. The good news is that hereditary female pattern hair loss is a very SLOW process for most women, and almost never occurs as rapidly as its counterpart in males.

The most curious part of your history is the fact that you described being thin in the temple areas only. Usually a woman with 30% miniaturization in the donor area will have an even higher percentage of hair miniaturization in the top recipient area behind the hairline, and yet you didn’t seem to complain about that at all. What degree of hair miniaturization did your hair restoration physician find in the top recipient area? Even if the hair on top was the same and no worse than the back, that degree of miniaturization would still be easy to see through and I would expect that would have been your main complaint ir at least mentioned along with the other temple problem.

Regarding the decision as to whether you should undergo hair replacement surgery, you certainly could, but your expectations would have to be lowered and realistic, especially concerning the number of years of your life you may get to enjoy this additional hair you gain by hair transplantation. For some women entering a critical period of their lives from a social or career standpoint, even 10-15 years of having increased hair density could be valuable to them and worth it. I have been fooled in a few cases in which I initially didn’t want to transplant a particular woman, she insisted on going ahead despite my low expectations for her, and she went on to do well over at least a 5-10 year period up to the present (and still doing well). In some others I can think of, it seemed like a high percentage of the donor hair, even the seemingly strong appearing ones, when they emerged in the recipient area one hair growthy cycle later (after going through the normal “shock” reaction all transplanted follicles undergo), an even higher percentage of them grew out “wispy” and the overall experience was not a forward step for the patient. Theoretically, one additional step that could be taken would be to “cherry pick” only the follicular units that contain at least one strong terminal hair and only use them, putting aside the severely miniaturized ones, as the injury to the scalp of the recipient incision is almost not worth the tradeoff for placing a hair that is unlikely to add to the cosmetic appearance and theoretically could hurt the chances for the good follicles to grow. I have transplanted hair in hundreds of women and must confess not having used this method yet. As per the other suggestions you received, Rogaine (minoxidil) will certainly slow down the hair loss process if taken faithfully. The comments about other medical diagnoses is important for completeness and can be ruled out with a couple of simple blood tests and a good history, but I must emphasize that they are very rare in most of our clinical hair practices.

The bottom line is this: if your expectations are not too high and are realistic and your hair surgeon feels that a positive result is possible, then you have a chance of being reasonably happy with your result for quite a few years.

Mike Beehner, M.D.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

May 27, 2008

Small “Prickly” Hairs 2 Months After Hair Transplant: When Does the Real Hair Growth Start?

Filed under: Uncategorized — heaven @ 7:02 pm

It’s gonna be 2 months on the 27th of May since my hair transplant.  When could I possibly start to see some real results?  When I slide my hand over my head I can feel prickly hairs but when I look, I can only see small thin hair growth here and there.  I also see some of my pores don’t have anything coming out of them. Any advice?. Or should I realistically be looking at the 4/5 month mark before any hair regrowth?

If you are experiencing any new hair growth at only 2 months after hair restoration surgery, you are way ahead of the game.

Transplanted hair typically start growing in thin and fine, invisible to the naked eye.  But as you are experiencing, they can be felt with your finger tips before they are seen. Transplanted hair will also “pop” through the scalp at different rates and times. Your hair transplant appears to be progressing normally. But the real fun doesn’t start for a few more months.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Is Hair Transplantation a Permanent Solution?

Filed under: Uncategorized — heaven @ 1:02 am

This insightful information was posted on our hair restoration forum by Dr. Alan Feller of Great Neck, NY who is a member of the Coalition of Independent Hair Restoration Physicians.

Hair Transplant Pysician Dr Alan FellerMake NO mistake about it. A hair loss sufferer can lose some of his transplanted hair over the years. It’s not common, but it DOES happen.

What can happen in a few hair transplant patients is that the caliber of the transplanted hairs can actually thin noticeably within 3 years of hair restoration surgery. I have no idea why this happens, but it is a definite phenomenon in few patients. The way to counter this graft thinning is simply to implant more hair in the area.

This happened to a patient of mine who used to post quite frequently. I performed two hair replacement surgeries on him that gave him a thick tuft of hair in the front and top of the head. Then, about 2.5 years later he visited the office because of noticeable hair thinning in the recipient area. We did one more transplant and that did the trick. He has no problem since. He posted a professional portrait of himself and signed off the internet to go on with his life.

Making sure your hair transplant surgery is done right is just ONE aspect contributing to the final result. YOUR personal physiology plays just as important a role. The body does many seemingly qwirky and weird things and we are FAR from having all the answers.

Fortunately, the overwhelming majority of hair restoration  patients have “average” physiologies that allow for significant cosmetic improvement after surgery.

Dr. Feller

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

May 26, 2008

Chapter 16: May 2008 (First Half)

Filed under: Uncategorized — heaven @ 11:14 am

At the end of April, I hoped that I would be off the Coney Island Cyclone. Not so lucky. The first fourteen days of May were just as bumpy, one day feeling good and the next like someone had jammed on hot iron poker in my  spine. What I wanted was control. I wanted to know that I could control my symptoms, that I could determine what, when, and how I wanted to do something and know whether or not I would hurt or my leg feel numb, or whatever. But, my body had other ideas. It would let me know what was going on when it felt like it. I felt sort of like I was sculpting jello. Working really hard at making something good happen but ending up with a whole lot of nothing. I have come to the conclusion that the body and mind have minds of their own. And, somewhere in between is me. It's like there are three beings: body, mind, self.

I finally figured out the the culprit, the engine for all of this emotional and physical upheaval was sitting. I started sitting again at the very end of April. I felt like I was being very conservative: starting with just 1 hour; 1 total hour of sitting a day. And, 1 hour seemed ok. So, the next day I went to 1.5 hours. That night, my sleep tumbled to 5 hours and I felt awful the next day.

When I tell people that the hardest thing for me to do right now is sit, I see a quizzical look crawl across their face. "Really? I would think things like bending and lifting would be really bad for your back." Well, that's true - it just depends on how you bend, how much you bend, how you lift and how much you lift. But, sitting is worse.

Why is sitting so hard on the spine? Well, two reasons. First, your spine was built for movement; not sitting. Wherever you find a joint in the body, you can assume it's there to provide motion. You have 117 joints in the spine (if you count from the head all the way to the pelvis and include the joints for the ribs that attach).  When joints don't move enough, they deteriorate. In a sense, they get weaker the more stationary you are; the less you move. Weak joints lead to symptoms like aching, stiffness, swelling, and pain in and around the joint. As far as I'm concerned, sitting is one of the worst things you can do for your back. But, you have to be able to sit - at least some. You can't go to a restaurant and eat standing up (I've tried). And, going to the movies, well, yes, technically you can stand up but who wants to do that? Sitting is a necessary function but you should move frequently if you have to sit a lot during the day.

The second reason sitting is so hard on spine is that the pressures produced in the spine from sitting are quite high. In fact, sitting slightly slumped creates more pressure on the spine than standing in a stooped or slightly bent over position. You can think of the pressure as squeezing the disc and discs really don't like to be squeezed for very long. A lot like the rest of the body for that matter. The sustained pressure interferes with the energy delivery and waste removal systems of the disc and this gradually erodes it.

May 1-7, 2008
The really good news this week is that my overall pain levels went through the floor averaging 1.2 out of 10. Wow. I had a few days where I felt normal; completely fine. Zero. Null set. Nada. Like I had never even been injured. That's a problem though - at least for me. Without the pain acting as a governor, I just start doing stuff. Naturally. I'm not thinking to myself, "Oh, boy, let's run the vacuum cleaner!" I just do more bending, twisting, sitting without really being aware of it. And, that leads to a system crash usually at night. I hurt and wake up hurting and am immediately ticked off and then have to focus on not being ticked off but I don't really have the energy to focus and it goes on and on until I sleep again.

My sleeping also improved overall. I had two nights of 8 hours and three nights of at least 7 hours. I also had a couple of really bad nights too but, still, five out of seven, 71%, that's at least a "C".

I also turned 52 this week (I'm not sure what 52 should feel like but whatever it is, I don't feel that way). And, my brother called me to say happy birthday. In speaking with him, I learned that he had tried a technique using meaningless sound (things like ocean waves, thunderstorms, etc.) to help him sleep and he thought that it worked really well. (Oh, and I don't mean that the sound of ocean waves is meaningless it's just that we don't immediately attach meaning to them as we do, for example, with music.) So, I created a few sound files and dropped them on my iPod to try out the night before my birthday. I wanted to be really rested and feel good the next day.

Disaster. The ear pieces were annoying and I couldn't sleep on my side because it felt as if there was a penny stuck in my ear. And, the wires kept getting caught on my pillow or something else. So, I had to sleep or try to anyway on my back. I never have liked that posture so I couldn't relax. And as far as the meaningless sounds of the ocean crashing on the beach, well, all I could think of was going to Maui and then my mind was off flip-flopping down memory lane. I slept all of 3.5 hours.

On the sixth, I started some upper body exercise and added some lower body strength training at Sports Center - all spine friendly of course. It felt really good to use some muscles again and without worrying about whether I might be injuring my spine.

May 8-14, 2008
I thought my pain was low the previous week but this week, it dropped even more to an average of  .4 out of 10. I had four days in a row with no symptoms. I started sitting more during meetings and noticed that I had very few problems if any during or after. Life was really starting to feel more normal. But, an old nuisance dropped in for a visit in the middle of the night on the 8th and hung around all week: stiff, sore, tight thoracic and lumbar spine. I had these symptoms several years ago and they come around every now and then but I was really surprised to find them now. So, sleeping wasn't as good as I would have liked but not due to my injury. I averaged right at 6.5 hours.

The weekend of the 10th and 11th, I actually ventured out into the social world. I went to a party on Saturday and on Sunday went to dinner. It was the first time I had been out to dinner since my injury. We sat at the bar, which I actually preferred for the energy and activity plus I could get up and move around and even eat standing up and no one seemed to notice or care. It's a bar. I was very tuned into time though. I set a timer on my watch, got up when it went off, moved around a little. I didn't want to end up in the hurt locker over a dinner.

I was anxious about the weekend. Would I make it through without making my self worse? And, if I felt worse, how long would it last? It felt like I was standing on the edge of a canyon knowing I was probably going to fall off and wondering just how far down it was to the bottom. I never fell off the edge. I made it through the whole weekend and felt great.

Here's what I wrote in my journal on the 13th: " What an awesome day. Did my rehab at Ross' and felt great. Like I could run; felt really, really good. Great energy. No symptoms. Felt strong again."

At the end of this period, I felt mostly normal, slept most nights fairly well, and noticed an increasing sense of optimism. That was, until I started something new; an experiment.

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