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Greetings,

The question I hear very commonly is if one person’s hair can be transplanted to another. The answer unfortunately is no, unless you have an identical twin. The genetic differences between individuals do not allow transplanting hair from one individual to another. I have spoken with a colleague who has even tried to transplant hair from one individual to another , and none of the transplanted hairs grew. The good news is that extensive research is being performed on ways to clone hair in the lab and we could see hair cloning in practice in perhaps 20-30 years. This will truly revolutionize hair transplant procedures as we will no longer have limitations on a patient’s supply of donor hair, and with unlimited donor hair the options will be limitless. Let’s hope the science can lead us there soon.

All the best,

Marc Dauer, MD

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,
A question I am often asked is how soon after a hair transplant procedure can one return to work. Part of the answer to this question lies in exactly what kind of work you do. After the hair transplant procedure you are not supposed to perform heavy lifting (over 25 pounds) for about 10 days. If your job involves heavy lifting or very vigorous work you should take a little time off. If your job is an office job you should be fine to return to work the next day. I have had multiple hair transplant procedures myself and I retuned to work performing hair transplants on others the day after my procedure. If you feel a need to conceal the fact that you have had the procedure from others, there are a few options. You can wear a hat (which we give to all our patients) immediately after the procedure. If you have a large amount of pre existing native hair you can creatively style your hair to cover the areas worked on. Typically the transplanted hairs form tiny scabs that look like little grains of sand. These scabs last for 5-7 days and then they fall off. After that your scalp looks very close to normal. The small transplanted hairs usually fall off within 3-4 weeks after the procedure and then begin to grow back at around 12 weeks. In fair skinned individuals their is some redness in the scalp that may persist for weeks before it resolves.
I hope this clarifies the immediate post procedure phase in hair transplant procedures.
All the best,
Marc Dauer, M.D.

Greetings,

Today I will demonstrate a case I recently performed utilizing FUE (Follicular Unit Extraction) to harvest the individual follicles and subsequently transplanted the follicles into and eyebrow scar. Traditionally I would not usually perform FUE in an eyebrow transplant case as it only requires a small incision in order to harvest the number of follicles necessary in order to restore typical eyebrows to normal appearing density. In patients who insist on shaving their hair extremely short (#2 buzz cut or shorter) FUE is a better option in order to make sure that the scar does not show through. In a small FUE case I do not have to shave the entire donor area, and can shave a small strip of hair to harvest the donor follicles and then the patient can cover the donor region by combing the hair above over the shaved area. As you can see from these results the transplanted follicles into the scar grey very nicely and the patient was very happy with the final outcome. I have also used FUE to harvest follicles from the neck in order to transplant into mustache scars (in patients with cleft palate deformities and others) and other beard scars with excellent results. Below I have shown the before and after photos of this patient with the eyebrow scar.

All the best,

Marc Dauer, M.D.

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.

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All the best,

Marc Dauer, MD

Greetings,

Today I will discuss the usage of Rogaine and Propecia for hair loss. Rogaine is an over the counter medication that comes in a liquid form and a foam form and comes in 2% and 5% strengths. For male patients I typically recommend Rogaine foam 5% twice a day after showering and before bed. Rogaine typically works only in the crown region and is best at slowing down the rate of hair loss and in some cases taking the miniaturized hair (hair that is on it’s way out for good) and turning it back into healthy hair. The exact mechanism of Rogaine is unknown, but it is thought to promote increased blood flow to the scalp by relaxing the small blood vessels that supply the blood flow to the scalp. Rogaine 5% is approved for men, and only the 2% formulation is approved for use in women. The 5% formulation may have better efficacy in women, but it can cause hair growth on the face that is reversible when discontinued.

Propecia is an oral medication that is taken once a day. It works by blocking the conversion of testosterone into DHT which can cause hair loss. The effect of taking the medication is that it can regrow hair in some instances and can also convert miniaturized hair that is on the verge of falling out forever into healthy hair, that is cosmetically significant. Propecia is not indicated for use in women.

There have been many claims about Propecia recently, and various side effects it may cause. I typically have all my patients that are considering Propecia read a detailed explanation of all the benefits and possible side effects prior to beginning to take the propecia. I have seen excellent results with patients using propecia, and in my experience younger patients tend to respond the best to this medication.

There is also anecdotal evidence that propecia and rogaine together produce a more significant effect than either medication independent of the other. The exact cause is unknown, but there seems to be some sort of synergy between the two medications.

Greetings,

On the heels of my appearance on “The Doctors” TV show discussing Hair Transplants for female patients, I have decided to write about different causes of hair loss in women. Common causes of hair loss in women can be traction alopecia, which results from constant pulling on the hair as in braiding or tight pony tails. Alopecia Areata, which is an autoimmune disease which results in smooth round patches of hair loss. Medications such as blood thinners, seizure medication, anti inflammatory medications, Beta blockers, prednisone, mood altering drugs, chemotherapy, oral contraceptives, thyroid medications, and illicit drugs such as cocaine, can all be causes of hair loss. Anemia, which is a low blood count can also cause hair loss. Other causes include thyroid disease, connective tissue diseases such as lupus, crash diets, stress, and post general anesthesia. Major events where big hormonal changes occur, such as childbirth and menopause, can also cause hair loss in females. Scars caused by trauma or other surgical procedures can also cause hair loss in those areas. Probably the most common cause of female hair loss is a genetic form of hair loss that is an inherited trait that can come from either the mother or father’s side of the family. This typically manifests as diffuse thinning in the scalp. Often the hairline can be preserved in these cases. Some of these causes of hair loss may be treated with medications or a hair transplant procedure but it is important to have a thorough medical work up and examination to determine the exact cause, and then we can determine the treatment.

All the best,

Marc Dauer, MD

Greetings,
The hairline design is probably the most important facet of Hair Transplantation. It has the power to make a Hair Transplant look completely natural or completely unnatural. It is crucial that the transplanted hairs are oriented in the proper angle and orientation. You should not be able to tell the difference between the transplanted hair and any native hair that is present in the area. In addition, the hairline should be placed in a location that takes into account future hair loss and the patients eventual donor reserve. This means that in younger patients with more extensive hair loss, it is imperative to not place the hairline too low, as you could create the problem of running out of donor hair in the future. Every millimeter that you lower the hairline requires an exponentially large number of hairs to fill in behind it. I always tell my patients we can lower the hairline in the future if the continuing hair loss allows for more aggressive hairline advancement, but once the hairline is too low, it becomes a big problem that can be fixed, but requires a fair amount of intervention to do so. It is better not to create the problem in the first place. Also, keen attention must be paid to the patients facial symmetry, hair color to skin contrast, and hair type (curly hair versus straight hair). The new hairline must be created in an irregular pattern so that there are no straight lines at any point in the hairline. With all of these factors taken into consideration, combined with the artistry of the Hair Restoration Surgeon, a completely natural hairline may be achieved.

All the best,

Marc Dauer, MD

Greetings,

Here is a new hair transplant vedio patient testimonial discussing his experience before, during, and after his hair transplant procedure. It is very informative for anyone considering the procedure.

All the best,

Marc Dauer, M.D.

Here is a question I received from a prospective patient and my answer.

Question: My wife keeps telling me that I need a hair transplant so here I am doing some research. Here’s my situation, I am 31 years old and seem to be a 3V on that baldness scale. One of my friends is taking propecia a says it’s great stuff, but I am afraid of the side effects that I keep reading about. Is it even worth having a hair transplant if I don’t take Propecia to stop the rest of my hair from falling out?  I’ve also read that once I start this process I might have to go through several surgeries and if I don’t take Propecia I can still look bald in time. Please advise. Thank you.

Answer:

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 significant. In my practice, I have all patients read and sign a detailed Propecia consent form that discusses in depth the benefits of Propecia as well as all the possible side effects and any associated risks. I let the patients know if they start to feel any of the adverse side effects to discontinue the medication. In addition, to patients who are thinning in the crown region, which it sounds like you are, I also recommend Rogaine 5% foam twice a day. Studies have shown that patients who use Rogaine and Propecia together experience a synergy between the 2 medications which show more positive results than either medication taken independent of the other. I routinely perform a video microscopy on the scalp with my patients and if I see a large amount of miniaturization of follicles I may also recommend low light laser therapy. I have become a fan of the new LaserCap which, with it’s ease of use, provides excellent compliance among patients. I have seen great results with it low light laser therapy in patients who have a large amount of miniaturization. Finally, in order for me to determine if you are a candidate for Hair Transplant surgery I would need to see you in consultation or look at your photos, but if you are a 3V it sounds like you likely could be a candidate. I always tell my patients that you will definitely have between 2-4 procedures in your lifetime to keep up with continuing hair loss. The number of procedures is affected by the rate of your future hair loss, which Propecia, Rogaine, and Laser Therapy can markedly slow down. I hope this answers your questions.

All the best,

Marc Dauer, M.D.