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What Factors Determine Hair Transplant Graft Count?

January 4th, 2006

Q: Is it possible to tell me roughly how many grafts would be left from donor area if one had a hair transplant of 2,500 grafts and had a density of around 2.0? G.H. – New York, NY

A: How much hair can be harvested in total depends upon a number of factors besides donor density. These include: scalp laxity, hair characteristics (such as hair shaft diameter, color and wave), and the actual dimensions of the permanent zone.

Every person is different, so all of these factors would need to be taken into account to determine the total number of grafts that would be available for the hair restoration.

Posted by Robert M. Bernstein M.D. at 2:16 pm

How Long Until One Sees Growth from Hair Transplant into Donor Scar?

December 29th, 2005

Q: I have had some grafts implanted into a donor scar. How long does it take to see the final result?

A: In normal scalps, growth is generally complete by 10-12 months.

Grafts placed in scar tissue may often take longer to grow.

Topic: Growth After Transplant

Tags: Donor Scar / Hair Transplant Before and After / Hair Transplant Surgery / Hair Transplantation / Scalp Scar / Scar Tissue

Posted by Robert M. Bernstein M.D. at 2:11 pm

What Causes Hair Transplant Graft Popping During Surgical Hair Restoration?

December 21st, 2005

Q: What causes graft popping during a hair transplant?

A: Popping, or the tendency for grafts to elevate after they have been placed into the recipient area, is caused by a number of factors including:

Packing the grafts too closely, particularly when they are placed on a very acute (sharp) angle with the skin
Rough placing techniques
Bleeding
Poor fit between the graft and recipient site
Natural characteristics of the patient’s skin, including the elasticity and stickiness of wound edges

The problem with popping is that it exposes grafts to drying (while they are elevated on the skin surface) and trauma (when they have to be re-inserted).

The judgment and experience of the surgeon performing hair transplants is extremely important in minimizing popping. It is important that the surgeon customize the site size to the different size follicular unit grafts and to test the recipient sites as they are made, to make sure that the “fit” is perfect.

Although it is important to place grafts close together to get the best cosmetic result possible, over-packing of the grafts risks popping and other factors (such as overwhelming the blood supply) that may lead to poor growth.

In the end, maximum growth of the transplanted hair should be the primary goal.

Topic: Hair Transplant

Tags: Blood Supply to Scalp / Dense Packing of Grafts / Desiccation / Graft Popping / Graft Size / Recipient Sites / Site Size / Trauma

Posted by Robert M. Bernstein M.D. at 10:03 am

Can One Vary Dosage of Propecia Hair Loss Medication in Treatment of Hair Loss?

December 14th, 2005

Q: I am not yet ready for a hair transplant but am considering Propecia. What is your opinion on the “optimal dose”? I know Merck recommends 1 mg, but could I get away with taking less? Or would I get a better result by taking more (2-3 mgs)?

A: You may get away with 0.5 mg a day. However, there are published data by Roberts et. Al. in the JAAD in 1999 showing a dose-response between 0.2 and 1 mg/day, with the lower dose showing reduced efficacy, from controlled clinical trials.

There is little evidence that a higher dose helps, but I often double the dose if a patient has been on 1mg a day for 3-5 years and then stops responding. The hope is that this can postpone the need for surgical hair restoration, but there is no scientific data to support that it will.

Topic: Drugs (Medications)

Tags: Finasteride / Hair Loss Medication / Hair Loss Medication Dosage / Merck / Propecia / Propecia Dosage / Pulse Therapy for Hair Loss

Posted by Robert M. Bernstein M.D. at 12:59 pm

Can Hair Transplant "Plugs" be Repaired by Lasers or Electrolysis?

December 8th, 2005

Q: After a bad hair transplant, can you use lasers or electrolysis to remove the transplanted hair?

A: Electrolysis does not work well, because the follicular anatomy is distorted and it is too difficult to insert the needle in the right position.

Lasers will work as well with transplanted hair as it will with normal hair but, in either case, it takes multiple treatments.

The disadvantage of both procedures is that they destroy the hair that is removed and they do nothing to improve the appearance of the underlying skin, which is often scarred and made more visible when the hair is gone.

Graft excision, on the other hand, allows the hair to be reused and can often improve the appearance of the underlying skin.

Topic: Repairs

Tags: Electrolysis / Graft Excision / Laser Hair Removal / Scalp Scar

Posted by Robert M. Bernstein M.D. at 2:08 pm