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I have undergone several transplants and scalp reductions over several years. Unfortunately the results have not been adequate and I have exhausted my donor area. I would like to consider cutting my hair short (to the scalp) or going with a shaved scalp. I am hesitant to do this because of scarring from scalp reductions and donor areas. Are there procedures to correct these imperfections or have I backed my self into a corner.

I doubt that you can shave your head without showing the obvious skin deformities that were caused by the various surgeries that you had done. Before packing it in, however, you should be seen by a good, honest, competent hair surgeon. Maybe your conclusions are not derived from knowing what can be done today.

I understand that there is something out there called artificial hair. Where can I get it and how does it work?

Artificial hair is a product sold in Asia and limited countries in the western world. It has been banned by most countries because it must be surgically implanted with a special sewing needle. This would be a procedure that would need FDA approval and it has not been approved as safe in the United States. Many patients’ bodies will actually reject the artifical hair as it would any foreign body once it is implanted into the scalp. I have seen some patients with wonderful results. It gives ‘instant hair’ and as a result it is a big selling point in countries where it is allowed, BUT I have also seen patients that have developed massive scalp infections from these ‘artificial hairs’. There is a trade off and safety is sacrificed in exchange for short term benefits. Biofibre is one of the sites for artificial hair. Reading it might give you more information, but I would strongly caution your pursuit of this as a solution for your hair loss.

Artificial hair does not need to be included in any hair cut and you can not grow your hair out with them as you could with hair transplants. Hair transplants allow you to grow your own, natural hair for as long as you live.

I heard something about a place in Las Vegas that does “head resurfacing” to get rid of scars for men who are unhappy with their hair transplants and just want to shave their heads. Have you heard of such a place? Does such a procedure exist?

Resurfacing is essentially dermabrasion where the doctor will take something like a Dremel and remove layers of skin. This clearly can change the surface of the skin, but it does produce scars and in the process of abrating the skin, it sands away the pigment cells making the skin lighter in color in the area it is resurfaced. You must be careful that the changes from resurfacing are not worse than the problem you are fixing. Any good dermatologist / plastic surgeon can do this, so you do not have to go to Las Vegas to get it done. It is not rocket science.

Is it possible to fill in a scar on my eyebrow with the hairs from my other eyebrow? If so, would it be a good idea to pluck and collect hairs from my good eyebrow to transplant them later?

Plucking and collecting the hairs for future transplant is not going to work! When we harvest the donor grafts, we are taking the full follicular unit, something that can not be accomplished with plucking. For eyebrows, we generally take the donor hair from the permanent zone in the back of your head, being careful to match the characteristics of your eyebrow hair. If they do not match, then there may be other options. You would need to trim the donated hair, unless you like the unruly look and want ever growing eyebrows with an unusual look. If you let it grow out, it might grow to pony-tail length, so cutting them is important!

There is presently no proof, contrary to claims by some doctors, that a hair that has been plucked will produce a new hair and another hair will grow from the bed of the plucked hair. That would mean that we could manufacture as many hairs as we need, giving unlimited supplies of hair. We have actually tried it based upon reports by a physician at a medical meeting. The plucked hair did not grow a new hair, but the old plucked bed did re-grow another hair.

Hi,
I have “holes” in my mustache area as a consequence of radiation treatment for cancer in that area. I would like to have my mustache restored. What donor area do you use for this procedure? I have heard that it can be done by taking beard hair from under the chin. Can you suggest someone who has been doing this?

I have done quite a few moustache repairs at NHI using donor hair from the permanent zone on the back of the head. If the hair from the head is not of the same quality, then you could FUE hair from other parts of the beard or take if from below the chin. As you are in NY, I can recommend that you schedule a consult appointment with Dr. Robert Bernstein in his Manhattan office and spend some time with him going over your options. His phone number is 866-576-2400.

Here’s two more eyebrow transplant-related emails I’ve received…

In 2002 I cut my eye brows off. But they grew back very thin some parts did even grow back, like the ends. Only the inner part would grow but not so thick. Anyway to date they are not growing at all. My hair line has also thinned out about an inch. I do not know what is going on but I am tired of drawing it on. Please help.

Eyebrows can be successfully transplanted, if the eyebrows you had have not returned after a couple of years. The eyebrow hair is taken from the scalp hair, and as such will have to be trimmed about three times a week and cut on an angle for hair shape. I posted a blog entry recently about this: Eyebrow Transplants. You need to be evaluated for the hairline loss. Read my responses addressing female hair loss, as they do apply to you.

I am considering eyebrow hair transplantation and I have many questions. Does having permanent makeup interfere with the procedure? Should it be removed first or will it cause scarring to the follicle? Also, does the transplant have to follow the original eyebrow hairline or will it grow in any follicle (if I wanted it slightly raised for a more youthful appearance for instance)? Do eyebrow transplants yield a high success rate? I noticed you listed some special summer prices but they were specified for the strip method. What is the cost for the FOX method. Finally, I live near Riverside Ca, zip code 92313, is there an office near me?

Permanent makeup is cosmetic tattooing and is permanent by its nature. It will not impact an eyebrow hair transplant. You should be evaluated first, before any surgery is considered. Eyebrows can be angled for more lift, but it is difficult to angle them for less lift. The success of eyebrow transplants are high. NHI’s summer fees have been reduced by 10% but the FUE approach has not been discounted and still is priced at about twice the price per hair/graft as a traditional strip method of transplantation. Our closest office to you would be in the Beverly Hills area.

Is it not possible to transplant hair from other body parts to the head. I do realize the texture etc is different, but it might be usefull as filler to make the transplant of people with finer hair like myself have a fuller look. I have had 2 procedures with you with over 3000 grafts but i still really am not 100% happy with the density. And i do not think i have enough hair in my donor area to do another procedure. So i thought it would be great if other hair could be used in order to give my already transplanted area a fuller look. What do you think?

Body hair is being transplanted by a few doctors, but there has not been any real follow-up on the results. The few that I have seen did not meet my standards on density or quality so I have not jumped on board to do body hair transplants. FUE is possible from your remaining donor area, however I would need to assess your supply to judge what kind of density and coverage you could expect. Generally most people have well over 3000 grafts in the donor area, so I would suggest that you make a re-check appointment at my office. While I do keep an open mind on new and creative solutions, I would need to be convinced that body hair transplants will give good results before recommending them over standard solutions.

Can you transplant an eyebrow?

Yes, eyebrow transplants work nicely. There are a series of problems that hair taken from the back of the head causes when it is moved to the eyebrow:

1. It will grow long, so it must be cut on an angle a few times a week.
2. It may take on the thickness of the hair behind the head. If the eyebrow has finer hair, than this might be a problem.
3. There is always a risk of a change in character of the hair itself (unusual).

I love doing eyebrows on men, as most men want bushy or wider eyebrows. For women, we must be selective and sensitive to hair type. The photos below are of one of our male eyebrow patients who just came back a little over a year after his transplant. On the left is the “before” photo, on the right is the “after” photo.

I met with a doctor last week who suggested that I take out the bald area. I am very bald so the bald area is very big. Is this a good idea?

Removing the bald area (scalp reductions) were very popular surgeries 10+ years ago. Thousands of men have had it done. You might even see them at airports, where they have a scar down the middle of their head, like they had brain surgery. Starting with that as my answer, I think that you will see (from everything else I am about to write here) that I am not open minded about this surgery. First, I should state that I am a victim of this surgery, having had three such surgical procedures to remove my bald spot (much smaller than yours, I suspect). I was scarred, but I got lucky in that I did not pursue more than the three surgeries, for had I done so, I would have been really deformed.

These surgeries have many, many problems associated with them and they have been largely abandoned over the past 10 years, largely because of the efforts of myself and a small handful of other doctors who have brought the complication of this surgery to the public. The most important issue to remember here is that when you are considering a hair restoration procedure, you want low risk and high certainty in the outcome. These scalp reductions produced many, many risks and the outcome was only occasionally successful. This is not a good procedure to do. For more information, please see Scalp Reductions on the NHI website.

In reply to my post titled Hirsute Men and Head Hair Loss, Duke writes…

That is fascinating but it prompts a few thoughts. Why not use body hair for transplant processes?

More research into the Red Indian genetic heritage us surely required.

And why does the balding gene only impact on the top of the head and not the sides.

This is a fun question. First, why the top of the head. Leonard Shlain’s book, “Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution,” had an interesting insight into the cause of balding. He postulates that our tribal heritage arose when man lived amongst his peers constituting 100-150 people. When looking at that the hunters (the healthy and fit men) in the light of certain qualities, there was a distribution of 4 traits that would pencil out to an 8% rule. He believed as animals learned to be afraid of man, the 8% of the hunters who were bald did not frighten the animals because they did not have the typical framed face of a hairy man, so animals would not run from them. They fulfilled the role of the spotter in the hunting party. Likewise, 8% of men were color blind and could see the animals in the bush missed by normal color visioned men, 8% were left handed and they threw the spear from the left side of the hunting group and 8% were gay so that they would stay home with the women and become more involved in their activities yet retain the strength to protect them. Fathering of children, while the heterosexual man were away hunting, was therefore not a concern.

If you take the 100-150 tribe hypothesis into the Red Indian, it would be relatively easy to see that with a small band of Indians that moved over from the Alaskan Bridge and down the Canadian countryside (they initially migrated to what would become the western American territory) it is possible that selective extermination of a sub-set (based upon the balding trait for example) of Indians over some generations during hard times, might have wiped out that genetic characteristic. This hypothesis for the Red Indian has been made by some, but without the presence of a written language or other documentation of their history, such assumptions might be a dangerous precedence to be proposed by a hair transplant surgeon.

Now, regarding body hair transplantation:

Experimentation is presently occurring on the use of body hair in some transplant centers (they just do not call it experimentation). As body hair grows in singular numbers (not follicular units of more than 1 hair each as in scalp hair) and length is not as long, and the hair cycle is possibly much shorter and the sleep cycle much longer, the use of body hair for transplantation might leave much to be desired.