About     Contact     Archives     Videos     Events     Hair Transplant

Snippet from the article:

Medical device company Restoration Robotics Inc. said Thursday the Food & Drug Administration approved its system for treating hair loss.

Mountain View-based Restoration Robotics, which is privately held, said the system harvests hair follicles from the scalp in men diagnosed with male pattern hair loss with black or brown straight hair.

Read the full story — FDA approves Restoration Robotics system for treating hair loss

This product has limited use, as it only performs the FUE (follicular unit extraction) harvesting, not the implantation of the grafts, which is by far the most challenging technical aspect of the hair transplant process. The learning curve for manual FUE takes a few months, but the learning curve for placing the grafts easily approaches one year. For the novice surgeon who never learned the manual FUE technique, it allows that person (with minimal training) to produce a high quality FUE process.

In our original article which introduced FUE to the hair transplant community a decade ago, we categorized patients in 5 categories to determine which were the best and the worst patients for FUE (Fox class 1 was the best and Fox class 5 was the worst). In that article, we reported the worst Fox class 5 patients reflected about 20% of the population. It remains to be seen whether the robot can produce the high quality grafts with minimal damage in the Fox class 5 patient. Today, I believe that only about 10% of patients would be classed by me as a Fox class 5.

The cost of the robot, I believe, will be very high (significantly more than $100,000)… so the market will be small. There are many alternative approaches to the FUE technology, as there must be more than a dozen extraction devices produced. Some work, but many do not. Despite the automation of the extraction process, I doubt that this robot will become today’s ‘Standard of Care’. There is no doubt that the FUE technique has been well defined and proven today with the various techniques, but there are still a number of doctors who perform the technique very poorly. I have unfortunately seen too many of their failures in my office. At least with the robot, I would expect that the patient will be confident that what he is paying for and what he is going to get is what he expects he will get, and that alone should help the patient make a decision about their surgeon (if there are any doubts as to their chosen surgeon’s competency).

I must reveal here that we have a vested interest in the success of this particular robot, as we licensed the core optical technology for the robotic FUE technique many years ago. Seeing that the product finally has come to the market is very satisfying to us. We have also developed comparable hardware technology for placing grafts and obtained US patents in this arena, so when and if Restoration Robotics moves into graft placing, we can finally say that the automation process is complete.

Is there any truth in the statement on the Hasson and Wong website about not shaving the recipient site. They say that by not shaving you risk causing permanent shock loss to certain hairs?

If this is not true then is it still fair to say that you can do a more artistic job and get better looking end results that achieve greater density IF you shave the recipient area. Based on that what is your perfect scenario when performing HTs.

There is no doubt that shaving the recipient area makes the job for the surgeon much easier, but I rarely do it because my patients do not want to deal with the social disruptions in their life that would occur with shaving the head. It takes considerable experience working with the hair on the head and often this can slow down the work on the recipient site.

Concerning shock hair loss, shaving the recipient site can not (in my wildest imagination) reduce the risk of shock loss. The use of finasteride is the best preventive measure a man can take to prevent shock loss.

Does having hair loss affect the rate at which it grows? So in other words, if your experiencing hair loss, would that cause your hair to grow slower?

Hair growth does change as we get older and it changes if we have genetic balding (the impacted hair in the hair loss pattern slows). There are other causes of slower hair growth, including various diseases and malnutrition that impact the metabolic state of the body.

Dr. Rassman -
An anecdotal, first-hand report on my experience with finasteride and saw palmetto/beta-sitosterol for your readers: taking the latter for about 10 months, my frontal area continued to thin and my libido was crushed. Taking the former for now about 13 months, my frontal area has maintained and my libido is totally normal.

In other words, you’re saying saw palmetto and beta-sitosterol caused libido issues. I don’t know what dosage you were taking or if you were strictly taking it for treating hair loss, but thank you for the reporting your experience.

Im a 58 year male who is seriously considering transplant surgery to restore my frontal hairline area. Im interested in the FUE procedure. My question is if Im not satisfied with the results can I still undergo strip harvesting in the future

I realize your question is very limited and I don’t know anything about your hair loss, but based on what you are asking I think you are going about this completely wrong. First, you need a Master Plan for your hair loss.

Follicular unit extraction (FUE) is a great surgery, but it has limitations. One of the main reasons you should have an FUE procedure is because you want to cut your hair short in the back without seeing a linear scar. If you don’t mind the linear scar (which I assume to be the case if you’re considering the strip procedure), I’m not sure why you’d want to go with FUE to start with. There’s a list you might find to be an interesting read — The Pros and Cons for FUE / Strip Harvesting.

So while the short answer to your question is “yes”, I think you should seek a good hair transplant surgeon to discuss your overall goals and expectations.

Hello, thank you for your informative blog, it has been a way for me to maintain hope as I have lost my hair at a relatively young age.

My question is not in regards to myself, but a general question. Have you noticed in your personal practice that there are more young men coming to you with male pattern hair loss? As in, are more young people losing their hair at younger ages than in the past?

From your responses, it seems you do not like idle speculation, but if the above is in fact true, would you have any guesses as to why?

thank you again.

No, I do not believe that there are more men balding at an earlier age. Because of the internet, we are more informed. We have more information available to us than ever before. We also have more opportunities to be targeted by advertisers that pray on insecurities. The result of this is a heavy bombardment of ads from hair transplant doctors, drug companies, and snake oil salesmen that transmit the balding message.

The reality suggests that there is no real increase in the number of young men who are balding today compared to young men that were balding in past years.

Snippet from the non-hair-loss-related article:

The death of Elena Caro, which police say came at the hands of Colombians who flew into Southern Nevada posing as medical practitioners, has left Las Vegas plastic surgeon Dr. Julio Garcia wondering who set her up for what turned out to be a fatal buttocks enhancement.

“Who is marketing Las Vegans to these people?” he said. “You know they didn’t come all the way here if they weren’t assured patients. And they’re sure not advertising any normal way. I feel whoever is telling people they can get cheap plastic surgery from these people is as guilty as the guy who did it. They’re taking advantage of people in their community. More has to be done to fight this medical fraud.”

At a news conference Monday, Homicide Lt. Lew Roberts said Caro’s death was not an isolated case of a “makeshift doctor” illegally treating patients, although this was the first fatality he could recall.

Read the full story — Backroom surgery death raises questions about ‘makeshift’ doctors

This is an unfortunate result that could’ve been avoided. Safety was ignored in favor of a low cost, but the ultimate price was paid.

The article even mentions other ways in which people have been horribly scarred by surgeries done by fake doctors, including butt enhancement by using floor wax and industrial strength silicone injections.

Good Day Dr. Rassman,

I am 21 this year. I have been using excessive amount of hair spray and wax for a period of 4 to 5 years, on top of poor washing of the head. As a result, my scalp has a shiny layer, what I think is product build-up, over it. After 2 years away from the products, the shiny layer has cleared considerably. I want to seek your opinion on this shampoo, Menscience Daily Shampoo (with AHA and BHA), on its ability to clear product build up and sebum from my oily scalp. Would such product build up actually cause temporary hair loss?

On addition, as I reside in a hot and humid country. Is it okay to shampoo twice a day, once in the day and once at night? If not, my scalp would feel very oily and uncomfortable.

Thank you so much! I really appreciate your effort!

Styling products like hair spray or hair wax will not cause balding, even if you leave it on. If the product is not a known safe product, you could damage the hair, but it would be doubtful that the damage would extend below the skin surface. Shampooing twice a day is not a problem either.

My now 2 year old daughter was presented at birth with a large bald spot on her scalp (from the frontal part to the vertex part) its about 2-3 in long and 1.5 in wide. plz help I dont know what treatment to decide since I dont even know exactly what kind of congenital defect/disorder of the scalp/hair it is

There are multiple possible causes for this, but there is little information supplied. Most bald spots are acquired, unlike your daughter’s situation. Bald spots in children can be treated with a variety of modalities, including hair transplantation and balloon expanders. These expanders work best when the bald spots are large (like what you described with your daughter).

The best age to treat the child needs to be discussed with the surgeons that have the experience. Generally, that will be a special type of plastic surgeon who can do expanders if the bald area is very large. I don’t have any personally recommendations on the east coast (where you indicated you’re from), but if you’d like I can ask some of my colleagues in that area if they can recommend someone.

Hi,

We recently published an article entitled “15 Disturbing Facts About the FDA“. If you find that this resource would be of interest to your audience, please feel free to share it with them at your discretion.

Either way, I’m glad to have come across your blog. If there’s anything else on our site that interests you, please feel free to let me know. Thanks again for the great content!

The US Food and Drug Administration (FDA) is a government regulator and as such, has its problems. Nobody here is suggesting the FDA is perfect, but they do serve a very important purpose. Without the FDA, things would get out of hand in a hurry.

The article is a round-up of links to actual articles about red tape issues, mistakes, and budget cuts. Thanks for letting us know about your site.