Greetings,
Today I will discuss donor hair quality and how it influences the results in Hair Transplant procedure. It has been said that .1mm of increased diameter of the hair follicle can create up to a 30% increase in cosmetic density. This means that an individual with coarse hair will achieve greater cosmetic density from the same number of transplanted follicles as opposed to one with thin hair. Other factors that contribute to cosmetic density achieved with hair transplants are hair to skin color contrast (dark hair on light skin shows thinning more than light hair on light skin) and curly hair versus straight hair (curly hair shows more fullness than straight hair).
These are some factors that contribute to the ultimate cosmetic density that is achieved in a hair transplant procedure.
All the best,
Marc Dauer, MD

Greetings,

Sometimes when I meet a patient for the first time in consultation, they come to me with their mind made up as to which harvest procedure for the hair transplant they wish to undergo. Other times they come to me with no idea as to which harvest method for the hair transplant that they prefer. The Internet has been an amazing tool to educate patients regarding all aspects of hair transplant procedures, however there is a huge amount of misinformation in the Internet as well. Often it is difficult for the average consumer to differentiate between the truth and the fiction. To further complicate things, some Hair Transplant surgeons have their own agendas as well. These physicians may only be proficient in either FUT or FUE, and may then try to steer patients towards the procedure that they are more comfortable with. In other instances, the physician may have purchased an expensive piece of equipment that he needs to pay for, and then will steer patients towards the procedure which helps to pay off the equipment.

When I meet with patients the first thing I do is pay close attention to the hairstyle they wear when they come into my office. How short their hair is, how it is combed, product in the hair, hair color, etc. These are all clues that help me to understand the patient as an individual. In addition, between the family history of hair loss and the patients physical exam, I do my best to estimate how severe the patient’s hair loss will progress over time. I explain in depth the pros and cons of FUT hair transplant versus FUE hair transplant and tell the patient that I have no vested interest in which procedure the patient decides to have. I truly enjoy performing both FUT and FUE. My only interest is that the patient undergoes the procedure that suits them best. Not just in the short term but in the long term as well. That is part of my duty to my patients. I encourage my patients to take their time in deciding which procedure suits them best, so that they make the right decision. Not a quick decision that could prove to be wrong in the long term.

All the best,

Marc Dauer, MD

Donor Scar After FUT- Strip Harvest Hair Transplant Procedure

Greetings,

Today I would like to discuss the closure of the hair transplant donor strip in FUT, which is the strip harvest procedure. This is where we take a strip of hair from the donor zone and dissect it into individual follicular units for transplanting. In order to have an excellent result in the donor region (a fine linear donor scar, between 1-3mm in width) it is imperative to limit the width of the donor strip. Keeping the donor strip limited to a width of 10-15mm is usually safe for a fine scar result. Performing a trichophytic closure (which I have discussed in previous blog entries) can cause the hair to grow through the scar, further camouflaging it. Some physicians prefer to close the door region using staples. This technique is much quicker and easier for the physician. It is also much more uncomfortable for the patient. Sleeping on hard staples in the back of your scalp can be very painful. Staples are also painful to remove. I prefer to use a fine nylon suture which takes longer to place, but is much more comfortable to sleep on and is painless in it’s removal. I also believe that the healing with sutures is better than with staples. I typically have my patients leave their sutures in for 12-14 days before removing them. In hair transplantation there are always many different ways that each step of the process can be performed. It is imperative that the treating physician make decisions that are best for the patient in both the short term and long term.

All the best,

Marc Dauer, MD

Greetings,

Today I want to discuss the immediate post procedure time frame and something I have found to make the healing process quicker and better. I have found over my many years of experience performing Hair Transplants that keeping the grafts moist and clean as much as possible in the immediate post Hair Transplant procedure phase has contributed greatly to better and quicker healing of the grafts. I also believe that the better and quicker healing contributes to greater growth potential of the grafts. This is also why I routinely apply a thin layer of antibiotic ointment to the grafts and the suture line immediately post hair transplant procedure. I have formulated my own compound of a copper peptide spray solution that I give to all my patients. I call my post hair transplant copper peptide solution “Heal Spray”. I dispense Heal Spray to all my patients post hair transplant procedure and instruct them to spray the grafts 3-5 times per day. I have found that this regimen loosens the crusts associated with the transplanted grafts and promotes quicker healing and return to normal appearing scalp. Patient’s also say the heal spray provides soothing to their scalp and helps to minimize the itching in the transplanted region. Patient’s who underwent previous hair transplant procedures without the heal spray and then have used it in subsequent procedures have reported significant satisfaction with the product and it’s positive effect on the entire healing process. I hope to share my heal spray with other hair transplant surgeons in the near future. Until then we look forward to sharing it with all of our patients.

All the best,

Marc Dauer, M.D.

Greetings,

I have recently begun to experiment using PRP, which is platelet rich plasma, in certain hair transplant procedures. PRP has been used in wound healing for a number of years. Recently some have begun to use it in conjunction with Hair Transplant procedures. The PRP is obtained from the patient prior to the procedure via a blood draw. The blood is then spun down to separate the red blood cells from the PRP. The PRP contains growth factors that aid in healing. We have been experimenting injecting the PRP into the donor region, bathing the grafts to be transplanted in the PRP, and then spraying the PRP onto the scalp for better post operative healing. So far the initial results have been promising. I still cannot definitively state that I see a superior result using the PRP compared with procedures performed without it, but I will continue to investigate and look forward to having more information moving forward. I also plan to offer it to my patients who are interested, though letting them know that we are still in the experimental phase. I look forward to discussing this further in the future.

All the best,

Marc Dauer, MD

Greetings,

Recently there has been a lot of discussion in regards to an article in CBS news (see below) that discusses researchers growing hair on mice. My thoughts on this are that this is one of the first in a series of studies that hopefully down the line will lead us to the ability to clone our own hair in a laboratory setting. I still believe we are at least 20 years away from being able to do this in a practical and economical way, but this is definitely the future of Hair Transplantation. The ability to clone one’s own hair will negate the need to harvest the hair from the individual either via FUE or FUT and will also give us unlimited supply for any demand. Again I believe we are at least 20 years away from this, but this is definitely the future of Hair Transplantation and I look forward to being a part of this exciting future. Here is a link to the article.

http://www.cbsnews.com/8301-504763_162-57416401-10391704/researchers-successfully-grow-hair-on-bald-mouse-humans-next/

All the best,

Marc Dauer, MD

Greetings,

Here is a patient of mine who I performed an eyebrow transplant on 7 months ago. She is extremely happy and we will be performing a secondary “touch up” procedure to increase the density slightly and fill in a few spots. These results are typical with my special technique for eyebrow transplantation.

All the best,

Marc Dauer, MD

Greetings,

In this blog I will demonstrate a patient who came to me after he underwent the strip harvest procedure from another physician and his donor scar was wider than he expected and he could no longer wear his hair at the short length he wanted. In some cases these wide scars can be revised by excising them and closing them again under less tension than they were previously closed. In this case, the physician who performed the original procedure had already attempted to revise the donor scar and was unsuccessful in reducing it’s size. I recommended to the patient that I perform Follicular Unit Extraction (FUE) by harvesting follicles ones by one  with a special tool and then placing these harvested follicles into the strip scar to cover it with hair. Here are the results after 9 months. It made a significant difference to the donor scar and the patient is very happy as he can now wear his hair shorter and not be conscious of his wide donor scar. I have treated a large number of patients like this and it remains a good option for those with wide donor scars who wish to wear their hair shorter.

P1070449-274x300 P1050483-255x300

All the best,

Marc Dauer, MD

Greetings,

Today I will discuss a very interesting case I just performed. This patient presented with a skin graft in his mustache region from a previous accident that required extensive Plastic Surgery. He was left with a large scar  and no ability to cover the scar as it would only grow a scant amount of hair. The patient prefers to wear a goatee but it is very unnatural with only one side growing hair. In this case I performed follicular unit extraction otherwise know as FUE by harvesting the hairs from his beard on the neck individually with a .8mm punch. I harvested the neck hairs as these will most closely resemble the beard hairs we are meant to recreate. After I harvested all the beard hairs via FUE we placed the grafts individually to recreate a mustache.The angles and orientation of the grafts placed in the mustache were made to mimic the angles of the hairs on the unaffected part of the mustache. Typically there is a slightly lower growth rate of grafts transplanted into scar tissue, but these patients usually have excellent cosmetic results. Below you can see the pre operative photo and the post operative photo and the immediate difference that is seen with the transplanted grafts present over the scar.

All the best,

Marc Dauer, M.D.

Greetings,

Today I would like to discuss lowering the hairline in a female patient. This is a procedure that has become more common recently with advances in Hair Restoration techniques and the ability to create density that was previously unattainable. In these cases patients report having a high hairline that has been present for their entire lives. In some cases there is thinning behind the hairline, but more often than not, the high hairline is the only issue. With the ability to transplant single hairs into recipient sites that measure .6mm-.8mm we can create cosmetic density in the hairline that rivals a completely normal hairline. Care is also taken to angle the hairs in the exact angle and orientation of the pre existing hairs so that one should not be able to identify any difference between pre existing native hair and the new transplanted hairs. In the case I am highlighting today, this patient has some thinning in her frontal scalp, which I addressed by transplanting hairs into the thinned out region. However her primary concern was her high hairline that had been present for her entire life. I lowered her hairline by just over a centimeter and kept the same design as her original hairline with the peak in the middle. Notice this patient had a very specific angle to her hair growth in the hairline which I maintained with the new transplanted hair grafts. Below you can see the pre operative photo and the immediate post operative photo that show the grafts placed in the new hairline. I hope this discussion provides some insight into this concept.

All the best,

Marc Dauer, M.D.