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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.

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

Will Hair Transplant Grafts Grow in Scar Tissue on Scalp?

December 6th, 2005

Q: Can hair transplants grow in scars?

A: Grafts will grow in scar tissue as long as the scar is not thickened. However, they cannot be placed as close together as in normal scalp because of decreased blood flow. When performing a hair transplant into scar tissue, it is often necessary to perform the hair restoration in multiple sessions to allow the area to gradually re-vascularize (allow the blood supply to return).

Topic: Hair Transplant into Scar

Tags: Blood Supply in Scar Tissue / Multiple Hair Transplant Sessions / Scar Tissue

Posted by Robert M. Bernstein M.D. at 10:54 am

Do You Recommend Hair Transplant for Hair Thinning Over Entire Scalp?

November 25th, 2005

Q: I am 19 years old and seem to be thinning all over, including the sides. My father has all of his hair but my grandfather is totally bald. Should I have a hair transplant now or wait until I am older?

A: Most likely you have a type of androgenetic alopecia called Diffuse Unpatterned Alopecia (DUPA).

In this hereditary condition, hair thins all over rather than just on the front, top and back as in the more common male pattern baldness.

The fact that the back and sides of your scalp are thinning (the donor area) precludes you from being a candidate for surgery. The diagnosis can be made by observing a high degree of miniaturization (fine hair) in the donor area under a magnifier. This instrument is called a densitometer.

For further information, please read the article:

Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning, published in the journal Dermatologic Surgery in 1997. Specifically, read the last part of the article.

Topic: Hair Loss

Tags: Androgenetic Alopecia / Densitometry / Diffuse Unpatterned Alopecia (DUPA) / Donor Area / Early Hair Loss / Follicular Transplantation: Patient Evaluation and Surgical Planning / Genetic Hair Loss / Hair Thinning / Male Pattern Baldness / Miniaturization

Posted by Robert M. Bernstein M.D. at 2:09 pm

After Hair Transplant, Can Donor Hair Become Frizzy and Dry?

November 18th, 2005

Q: Why can donor hair become frizzy and dry once transplanted?

A: Frizzing and kinkiness is a temporary phenomenon that is part of the normal healing process after a follicular unit hair transplant.

During the healing process, the new collagen that forms around the grafts can alter their growth. Over time, usually within a year, this collagen matures and the hair quality usually returns to normal.

If grafts have been excessively traumatized or grafts larger than follicular units have been used, these changes are more likely to be permanent.

Dry hair is felt to be caused in part by trimming follicular units too closely and thus removing the sebaceous glands which normally provide an oily film to the surface of the hair and skin. With grafts smaller than follicular units (i.e. with closely trimmed micro-grafts) the risk is even greater.

To prevent this, in the dissection phase of the hair transplant, one should isolate intact follicular units from the donor tissue and trim away excess skin, but not trim the follicular units “to the quick.”

Excess trimming, besides removing the sebaceous glands, also makes the grafts more subject to drying, warming and mechanical trauma (particularly during graft placing).

Topic: Growth After Transplant

Tags: Collagen / Dissection Phase of Hair Transplant / Donor Strip / Dry Hair / Follicular Unit Transplant / Frizzy Hair / Mechanical Trauma / Micro-grafts / Scalp Healing / Sebaceous Glands

Posted by Robert M. Bernstein M.D. at 12:25 pm

Can Hair Transplant be Harmed by Smoking Before or After Procedure?

November 10th, 2005

Q: Is it true that smoking is bad for a hair transplant and why?

A: Smoking causes constriction of blood vessels and decreased blood flow to the scalp, predominantly due to its nicotine content. Also, carbon monoxide in smoke decreases the oxygen carrying capacity of the blood.

These factors both contribute to poor wound healing after a hair transplant and can increase the chance of a wound infection and scarring. Smoking may also contribute to poor hair growth.

The harmful effects of smoking wear off slowly after one stops. In particular, chronic smokers are at risk of poor healing after smoking has stopped for weeks or even months.

Although it is not known exactly how long one should avoid smoking before and after a hair transplant, a common recommendation is to abstain from 1 week prior to surgery to 2 weeks after the hair restoration procedure.