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Celebrity Hair Transplant

Greetings,

Today I want to highlight an article I came across from the UK. A well known athlete Phil Tufnell underwent a hair transplant recently and discussed his experience with the British press. More and more celebrities are discussing their hair transplant experiences allowing people to know that hair transplants are very common amongst the celebrity crowd. In most cases the public never knows if the celebrity has underwent a hair transplant procedure as most tend to keep the information to themselves, and of course we as physicians guard the privacy of our patients extremely closely. Privacy is of the utmost concern in most of these cases. However, when the occasional celebrity decides to go public with their experience it helps to give people a feeling of confidence in the procedure. If someone who makes their living based on their looks is comfortable undergoing a hair transplant, than certainly the average person should feel comfortable that in the “right” hands they can have completely natural results with a hair transplant procedure. I have provided a link to the original article below.

All the best,

Marc Dauer, M.D.

http://www.mirror.co.uk/tv/tv-news/phil-tufnell-hair-transplant-isnt-3062284

/by Los Angeles Hair Transplant Specialist

FUE- Follicular Unit Extraction-Harvesting the Healthiest Grafts

Greetings,

Today I want to discuss the tool I use in performing Follicular Unit Extraction otherwise known as FUE. Every person’s scalp is different and therefore it is important that we do not approach what we do as Hair Transplant surgeons as a one size fits all approach. Along those lines, I recently started using a sharp tip punch with serrated edges as an option for my FUE cases. Prior this the only punch I had found that produced good results was a blunt tip punch. I will still continue to use the blunt tip as an option in some cases that do not respond well to a sharp tip punch, but I can truly say that these special sharp tip punches with serrated edges allowed me to harvest FUE grafts that are completely on par with strip harvested and dissected grafts, which continue to be the gold standard by which all hair transplant grafts are measured by. In the photo below you can see the perfectly intact FUE grafts and the large hair grouping that are present in these grafts harvested with a 1mm sharp serrated punch. In one side you can see the single hair grafts that were dissected out of the larger grafts in order to restore the patient’s hairline. In the other corner you can see the total of transected grafts which amounted to under 50 grafts. Based on this case of 1656 grafts harvested total the transection rate was approximately 3% which is incredibly low for any sort of FUE case, manual or automated. If you look closely at the grafts you can also see the amazing consistency of the grafts which you do not see with FUE grafts obtained with automated machines. I have showed this photo to a number of highly respected hair transplant surgeons and they have stated that these FUE grafts look just like dissected strip grafts which is the biggest compliment one can give to an FUE graft.

In summary, every individuals scalp and anatomy are different and it is imperative that we as Hair Transplant surgeons have many useful tools at our disposal in order to give each and every patient the best result possible.

All the best,

Marc Dauer, MD

These are FUE grafts harvested with a serrated sharp tip. The natural intact groupings are seen in the bottom right and top left corners, the single hair grafts in the top right corner, and the transected grafts in the bottom left corner.

These are FUE grafts harvested with a serrated sharp tip. The natural intact groupings are seen in the bottom right and top left corners, the single hair grafts in the top right corner, and the transected grafts in the bottom left corner.

/by Los Angeles Hair Transplant Specialist

Beard Transplants – The Latest Trend

Greetings,

After an article a few weeks ago that was picked up by multiple press publications about facial hair transplantation there has been a great deal of press focus on this topic. I have been performing facial hair transplantation for many years now. The donor hair to be transplanted on the face can be harvested either from the scalp via FUT or from the neck beard using FUE. I prefer to use the neck beard hair whenever possible as it provides the exact same character hair as opposed to scalp hair which is different from beard hair. This procedure can be very useful for cosmetic purposes to augment ones beard, goatee, or sideburns, or even reconstructive purposes in cases when one has a scar in the beard region and wishes to cover the scar with hair in order to minimize its appearance. When transplanting into scar tissue the growth rate is not the same as with healthy tissue, but there is still good growth, and it just may require more sessions to accomplish the patient’s goals.

I have attached a photo of a patient  of mine who I transplanted hair into a mustache scar with excellent results. I have also attached a link to the ABC news article on beard transplantation below.

All the best,

Marc Dauer, M.D.

http://abcnews.go.com/Health/beards-hair-raising-transplants-rise-ny-doctors/story?id=22682089

Here is a patient with a scar in his mustache who received transplanted hair grafts to cover the scar and enhance his mustache.

Here is a patient with a scar in his mustache who received transplanted hair grafts to cover the scar and enhance his mustache.

/by Los Angeles Hair Transplant Specialist

Precautions After Hair Transplant Procedures

Greetings,

There are many precautions that I advise my patients of post hair transplant procedures, and I give all my patients thorough instructions outlining these in detail. One precaution that is not as obvious but just as important is to watch your head getting in and out of cars and around other objects that are around your height. Because of the fact that your scalp is typically numb for a period of days to weeks after the procedure, there is some difficulty gauging the exact location of your scalp in relation to other objects. For this reason it is very common to hit your head by mistake and this can cause minor irritation to the transplanted grafts or major irritation if hit hard. It is very important to be extremely careful getting in and out of cars, in and out of the shower, and any other place that you can possibly hit your head. Keeping your head safe post hair transplant will keep your grafts safe and will lead to great growth of your new hair.

All the best,

Marc Dauer, MD

/by Los Angeles Hair Transplant Specialist

Platelet Rich Plasma (PRP) in Patients with Androgenic Alopecia

Greetings,

Today I will discuss the use of PRP in patients with genetic hair loss. Many physicians have been offering this to their patients, either alone, or in combination with a hair transplant procedure. In the most recent issue of the ISHRS Forum newsletter there is an interesting article that describes some of the different approaches that physicians are using to implement PRP into their Hair Restoration practices. What I found very interesting was some of the points of general agreement among Hair Transplant surgeons.

1) Ideal candidates for PRP are patients with thinning but not complete balding areas

2) Patient satisfaction after PRP injections may be between 70%-90% though no randomized clinical studies have been done and approximately 20% will be disappointed with their results.

3) Peak improvement after PRP would be seen at 2-6 months after injection and treatment must be continued to achieve long lasting results.

My opinion on these numbers is that I don’t feel given the very high price tag of the treatment  that there are high enough satisfaction numbers to warrant this treatment. Additionally the absence of hard data from randomized clinic trials leads me to believe that satisfaction numbers may even be lower and exact effects cannot be scientifically documented. Finally, we also don’t know about any possible long term negative side effects from the injections of PRP which may exist.

Until we have the hard scientific evidence I believe PRP injections into the scalp should not be considered not as a primary therapy for patients with genetic hair loss. It is important that we continue to research this treatment in a scientific manner and proceed cautiously before recommending this to our patients.

All the best,

Marc Dauer, M.D.

/by Los Angeles Hair Transplant Specialist

Keeping Grafts Moist Post Hair Transplant Procedure

Greetings,

Today I will discuss the importance of keeping the hair transplant grafts moist during and after the hair transplant procedure. It is imperative that the grafts are kept moist throughout the procedure as drying out of the grafts is one of the most common causes of poor growth. To that extent, my nurses are constantly spraying the grafts as they dissect them under the microscope, the grafts are submerged in saline before and after dissection, and my nurses use small “ring dishes” that have saline in them and allow the grafts to stay submerged in the saline even after they are taken out of the petri dish, but just before they are implanted.

Post hair transplant procedure, I give all my patients a specially formulated copper peptide solution that they use to spray the grafts every 4-6 hours to keep them moist, and I also cover the grafts in a generous amount of vaseline that functions to keep them moist and create an anaerobic environment which minimizes any possibility of infection.

All these steps contribute to great survival rates and thus great growth rates of the transplanted hair follicles.

I have included photos of the copper peptide solution and the graft ring dish holders below.

All the best,

Marc Dauer, M.D.

Copper Peptide Spray Graft Ring Holder

/by Los Angeles Hair Transplant Specialist

How Many Linear Donor Scars With Multiple Hair Transplant Procedures?

Greetings,

Today I want to address the question I am commonly asked, “will I have a different donor scar for each procedure?”. Every patient that has a hair transplant procedure, has more than one procedure. This is for 2 reasons. Firstly, the patient loves the results of the first procedure and at some point wants to add density to those results. Second, the hair we transplant is permanent hair and should never fall out, but the native hair that is present will erode over time, so additional procedures are usually needed to keep up with the continuing hair loss. In the strip procedure a small linear scar, usually between 1-3mm is left from the harvest of the hair from the back and sides of the scalp. When I perform additional procedures, I always make every attempt to resect the previous donor scar so that the patient does not have train track  like multiple scars in their scalp. Sometimes I see multiple stacked scars from other Doctors and it makes absolutely no sense to me that one would create an entirely new scar if the original scar was within normal limits. The instances where this is unfortunately not possible are where the previous donor scar is too wide and by resecting it we would not get any hair but just scar, or in a situation where the previous donor scar is too low or too high and taking it out would risk creating a much wider scar, or moving into an unsafe region of impermanent hair. The photos below show a patient who came to me from another physician with multiple strip scars from previous procedures and I consolidated the multiple scars into one fine scar that is much more cosmetically acceptable.

All the best,

Marc Dauer, M.D.

This is a photo of multiple strip scars created by another Hair Transplant surgeon.

This is a photo of multiple strip scars created by another Hair Transplant surgeon.

This is a photo after the multiple scars were removed and consolidated into a single fine line strip scar.

This is a photo after the multiple scars were removed and consolidated into a single fine line strip scar.

/by Los Angeles Hair Transplant Specialist

Eyebrow Transplant In African American Patient

Greetings,

Today I want to demonstrate the results of an eyebrow transplant I performed on an African American female patient. I always let patients know that since I am taking the donor hair from the scalp, the eyebrow hair that grows in after the eyebrow transplant will resemble the character of the scalp hair. For this reason patients with straight hair on their scalp have the closest resemblance to typical eyebrow hair. In patients with very curly hair I do advise them that they will probably want to trim their eyebrow hair on the shorter side in order to maintain the most natural look to the eyebrows post eyebrow transplant. However, as you can see from the photos below, this patient who has very curly scalp hair still has a very nice cosmetic result after only a single eyebrow transplant procedure. I transplanted approximately 300 grafts per eyebrow on this initial procedure.

All the best,

Marc Dauer, M.D.

Eyebrow Transplant In African American Female patient

Eyebrow Transplant

/by Los Angeles Hair Transplant Specialist

Hair Loss That Is Not Genetic In Origin

Greetings,

Today I want to discuss a patient who recently presented to me for a consultation for his hair loss. He stated that he had been gradually losing his hair over the past 10-15 years and now it had reached a point where all the hair in the frontal and mid scalp had fallen out. He was seeking a hair transplant.

Most of the cases of male hair loss I see in my practice are typical genetic hair loss which responds amazingly well to the hair transplant procedure. In this case, a close examination of the scalp revealed that the skin in the frontal and mid scalp was completely smooth and devoid of sweat glands that you normally see in healthy skin, including balding regions of the scalp. In addition the hair follicles on the periphery of the balding regions showed tiny red dots of inflammation surrounding them and they were easy to pull out. The patient also showed hair loss on his sideburns and eyebrows. I suspected a scarring form of alopecia and referred the patient to a dermatologist for a scalp biopsy and confirmation of my diagnosis.

On biopsy the diagnosis of Lichen Ploanopilaris was confirmed. This is an inflammatory scarring alopecia of the scalp that presents clinically in this exact manner. The biopsy also showed that the LPP appeared to be inactive. The patient came back to me and I explained that we could do a very small hair transplant procedure of test grafts in 3-4 different locations of the scalp to see if the transplanted grafts grew well. If they grew well, we could then proceed to a larger procedure to create some degree of cosmetic density in the areas of hair loss. I also explained to the patient that even if the transplanted hair grew well, there was still a chance that the LPP could reactivate in the future and destroy the transplanted grafts.

The patient decided to move forward with the hair transplant test grafts and we should know in 3-4 months if the growth is successful. I will continue to update you on the progress of this interesting case.

All the best,

Marc Dauer, M.D.

Lichen Planopilaris of the scalp.

Lichen Planopilaris of the scalp.

/by Los Angeles Hair Transplant Specialist

What Is The Best Age For A Hair Transplant?

Greetings,

I am often asked what is the best age for a hair transplant? The answer is that this is different for everyone.

In the past 2 days my patient’s ages were 28 and 83. Mt 28 year old patient was just beginning to thin in his hairline region and was requesting increased density to keep up with his recent hair loss.

My 83 year old patient had undergone multiple hair transplant procedures in the past and was requesting additional density in his frontal and mid scalp. He is a very healthy 83 year old taking no medications and with no major medical conditions. He still had good donor supply and was deemed an excellent candidate for an additional hair transplant procedure. I harvested 1000 grafts via the strip method and the hair transplant procedure went very smoothly.

My 28 year old patient had undergone a small hair transplant procedure with another doctor a few years ago and was requesting additional density in the hairline and frontal scalp. He had robust donor supply and his previous hair transplant procedure was performed using the strip harvest procedure. I harvested a new strip, including the old scar (so the patient still has only one scar), and transplanted just over 1500 grafts into the frontal and mid scalp.

So to answer the original question, the best age for a hair transplant can be anywhere from 25-85. It is the time when there is enough thinning in any particular region of the scalp that transplanting hair in between the native hair will lead to an increase in hair density. This is something that must be evaluated by an experienced hair transplant surgeon, but when done properly in the “right” time, this procedure can lead to excellent results.

All the best,

Marc Dauer, M.D.

/by Los Angeles Hair Transplant Specialist

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