Hair Transplant Patient With Scarring Alopecia

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Greetings,

This is a very interesting patient of mine. This patient, whom both he and his wife happen to both be physicians, presented to me complaining of hair loss in the frontal scalp, sideburns, and eyebrows over a number of years. The patient denied any other medical conditions.

On examination I determined that the patient most likely had a form of scarring alopecia and referred the patient to a local dermatologist for confirmation. A biopsy confirmed Frontal Fibrosing Alopecia and the pathology revealed that the disease appeared inactive.

After discussion with the patient and the treating Dermatologist we agreed that I would transplant a small number of test grafts in different areas of hair loss and we would see how they grew before proceeding with a larger procedure.

The test grafts grew well and the patient returned requesting a much larger procedure to create cosmetic density in the frontal scalp, sideburns, and eyebrows.

I explained to the patient that even if we were successful with the transplant procedure, there was always the possibility that the disease could recur in the future and possibly destroy the transplanted grafts. The patient understood and wished to proceed with the procedure.

The patient received 2521 grafts via FUT to the frontal scalp, mid scalp, and sideburns, and approximately 250 grafts per eyebrow. Care was taken not to pack the grafts too densely because of possible vascular compromise of the tissue to be transplanted secondary to the scarring alopecia process.

The results are shown after 1 year.

The patient is absolutely thrilled with his results and is now requesting a second procedure to increase the density.

I hope to provide updates in the future.

All the best,

Marc Dauer, M.D.

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received a hair transplant

Patient with Scarring Alopecia who received an eyebrow transplant

Patient with Scarring Alopecia who received an eyebrow transplant

/by Los Angeles Hair Transplant Specialist

High Density Hair Transplant

Greetings,

Here is a a patient of mine who received 4322 grafts to the frontal and mid scalp is 2 sessions via FUT. The results are shown 1 year after the second hair transplant procedure.

As always, rather than create a lower hairline with a lower density of grafts, I always choose to create a more mature hairline with higher density of grafts. This case demonstrates why I use this approach with my patients.

In addition, this patient also has very fine and straight hair, which usually does not yield the best cosmetic density. However, with the proper technique and placement of the grafts we can still yield results like this.

The patient is thrilled with his results!

All the best,

Marc Dauer, M.D.

before and after hair transplant photos

before and after hair transplant photos

before and after hair transplant photos

before and after hair transplant photos

before and after hair transplant photos

before and after hair transplant photos

before and after hair transplant photos

before and after hair transplant photos

/by Los Angeles Hair Transplant Specialist

Horrible Strip Scar From Hair Transplant

Greetings,

Here is a patient who recently presented to me with these strip scars from another physician. The patient had multiple strip hair transplant procedures and on the last procedure these very wide scars formed. I do not know exactly what the physician did, or how the patient presented to the physician prior to the last procedure, but this should serve as a warning to both physicians and patients that this can happen if you are not careful. Each patient must be throughly evaluated to determine elasticity, especially after multiple procedures. Each time a strip is harvested the donor elasticity decreases, thus increasing the possibility of scar widening, or the inability to close the would. Tension on the would closure also increases the chances of shock loss of hair around the donor region. Many times the hair lost from shock loss comes back over time, but sometimes it does not.

Sometimes you don’t know you’ve gone too far, until you’ve gone too far. Patients will push the physician in some cases to go for more grafts. Physicians  will want to make the patients happy and feel confident in their abilities. No matter how good you are, you must always be cautious and prepared for the unknown. It’s always obviously better to stop before you get to a problem.

With my success performing FUE I have been encouraging my patients who have had multiple strip procedures to consider an FUE procedure which will not affect a previous strip scar. If I feel it is medically permissible to harvest another strip, I always try to educate the patient that there is always the possibility of scar widening or shock loss around the donor region.

In this case, the treating physician tried to resect the scar with no success. I opted to treat the patient by extracting FUE grafts from the beard and transplanting them into the scars. I hope to post a follow up photo in 6 months showing the results of my procedure.

All the best,

Marc Dauer, M.D.

This is a patient who had a widened strip scar following strip hair transplant.

This is a patient who had a widened strip scar following strip hair transplant.

This is a patient who had beard hair extracted via FUE transplanted into a previous strip scar.

This is a patient who had beard hair extracted via FUE transplanted into a previous strip scar.

This is one of my patients who had a strip hair transplant procedure and his strip scar.

This is one of my patients who had a strip hair transplant procedure and his strip scar.

/by Los Angeles Hair Transplant Specialist

Beard Hair FUE Extraction Transplanted to Scalp

Greetings,

Here is a patient of mine who received old hair transplants with larger grafts from another physician many years ago. He came to me requesting greater density and more irregularity in the hairline to create more naturalness. He was not a candidate for another strip procedure and he had very limited donor reserves on his scalp.

I extracted approximately 600 grafts from the sides of his scalp via FUE and just over 600 grafts from his neck via FUE as well. I used a 0.8mm punch tip for my extractions so that the extraction sites would not be visible. The neck grafts were placed in the frontal and mid scalp for greater density and the scalp grafts were placed in the hairline to create a more natural look overall.

The results are shown after 12 months.

Beard hair FUE is an excellent option for patients who do not have any scalp hair available and this case demonstrates that very well.

All the best,

Marc Dauer, M.D.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

This is a patient who had beard hair harvested via FUE for placement in the scalp.

/by Los Angeles Hair Transplant Specialist

The 10 Commandments Of Hair Transplants

Greetings,

I recently though it would be a good idea to write down my top 10 rules regarding hair transplants.

So, in no particular order, here are my 10 Commandments Of Hair Restoration Surgery

1. You will always want more hair
2. You will never have enough hair
3. You will always consider “another” procedure
4. We can only predict so much in medicine and there will always be the 1/10 of 1% that don’t work out the way every other case does
5. There is no such thing as a “scarless” hair transplant
6. FUE is not scarless
7. This procedure comes down to “supply versus demand”. Donor area versus balding area. Expectations must be managed accordingly.
8. Always create a higher hairline with greater density than a lower hairline with lower density.
9. In all patients but in younger patients especially, imagine the end point of hair loss over time and create the complete treatment plan over many years accordingly.
10. Rarely if ever perform a hair transplant on someone under the age of 20.

 

/by Los Angeles Hair Transplant Specialist

Female Hair Transplant Patient Results

Greetings,

Here is a female patient of mine who had received 2 smaller hair transplant procedures in the past with another physician. She came to me wanting more density in the frontal scalp. I transplanted just over 1500 grafts to the frontal and mid scalp via FUT and the results are shown after 8 months. The patient is already thrilled with her results and she should see about 20-25% more cosmetic density over the next 4-5 months.

Female patients need to be evaluated and treated differently than male a patients and it is very important that your hair transplant surgeon has experience treating female patients in order to know the differences.

All the best,

Marc Dauer, M.D.

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

this is a female patient who received just over 1500 grafts with a FUT hair transplant procedure

/by Los Angeles Hair Transplant Specialist

FUE Into Previous Hair Transplant Strip Scars

Greetings,

Here is a patient of mine who had 2 strip scars from another physician. This in itself is wrong as whenever possible I always include the old strip scar in the new strip in order to only leave the patient with a single strip scar even after multiple procedures. The patient wished to conceal these strip scars so that he could cut his hair much shorter. The after photo is 1 year after I placed approximately 500 FUE grafts into the strip scars. Though they are not completely invisible they are much improved and the after photo is at a #0 hair cut so that at a #1 or #2 you should not be able to see the scars. We will place a few more FUE grafts in the future to conceal even more, but the patient is already thrilled with his results.

All the best,

Marc Dauer, M.D.

This is a patient with hair transplant strip scars who had FUE grafts placed into the scars.

This is a patient with hair transplant strip scars who had FUE grafts placed into the scars.

/by Los Angeles Hair Transplant Specialist

Amazing Eyebrow Transplant

Greetings,

Here is a patient of mine (who happens to be a physician herself) who received approximately 300 single hair grafts per eyebrow.

The results are shown after 6 months and the patient is absolutely thrilled.

The after photos are of course without any makeup.

All the best,

Marc Dauer, M.D.

before and after photos of eyebrow transplant

before and after photos of eyebrow transplant

before and after photos of eyebrow transplant

before and after photos of eyebrow transplant

/by Los Angeles Hair Transplant Specialist

FUE In A Norwood 6 Patient

Greetings,

Here is a patient of mine who is a norwood 6 (severe for of hair loss) with very fine straight hair. As I have previously discussed fine straight hair will give a completely different amount of cosmetic density in comparison to coarse curly hair (which is the best and most ideal for greatest cosmetic density).

The patient was looking to frame his hairline with hair and create as much density as possible over the frontal and mid scalp, while having FUE to preserve the option to cut the hair on the sides and back very short and avoid a linear scar.

His results are shown below after 2 procedures and a total of 2663 grafts. We are going to do an additional procedure to increase the density, but there is already a huge difference between the pre op photos and the current photos.

It can be described as turning him from someone who is perceived as bald, to someone who is perceived as having a thinning receding hairline, which is a big difference in look and perception.

All the best,

Marc Dauer, M.D.

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

FUE hair transplant photo in a norwood 6 patient

/by Los Angeles Hair Transplant Specialist

Botched Eyebrow Transplant In A Child

Greetings,

Today I will show a case I was recently sent.  A young child under the age of 10 had an accident and part of the eyebrow and face had a laceration that needed a plastic surgery repair. The plastic surgeon repaired the wound and told the parents that he could correct the defect of missing hair in the eyebrow by transplanting hair into the eyebrow. The photo below shows the results of the eyebrow transplant. Unfortunately the grafts were placed way above the skin causing what is called “cobblestoning” meaning there are bumps throughout the eyebrow because of incorrect placement. In addition, the grafts were placed sticking straight out. Finally, too few grafts were placed to  correct the defect. Bottom line, the result is unsightly and much worse than if nothing at all had been done. This is yet another unfortunate example of a plastic surgeon not respecting the art of eyebrow transplantation and performing a procedure he was not trained in and should have been doing. Unfortunately now there is a problem and the grafts probably need to be removed, the skin resurfaced, and a corrective eyebrow transplant performed.

All the best,

Marc Dauer, M.D.

Follicular Graft 12.22 through 2.24.15

/by Los Angeles Hair Transplant Specialist