Important question for Doctors and Pat.

[Guest]

First off, just thought I'd say great job on the site, Pat! It's definitely done a good job educating me about HT procedures. Anyways, I have a question for you and the docs here.

 

I'm 22 and I'm somewhere between a late norwood 3/late 4. I have a sharp widow's peak with a growing spiot in the back. I won't be getting a HT until I start Propecia and either Rogaine or Xandrox which will be within the next month. But I do plan on getting a HT within the next year. I always hear about having enough donor area in the BACK. But i never hear about folks who had donor hair transplanted from the SIDES as this site mentions. Pat, did you have any hair transplanted from the sides, or just the back? Docs, do you all genrally discourage/not use hair from the sides? I'm guessing the side of the head would be a really tender and sketchy area to cut into and maybe riskier for donor scar recovery? How visiable is a donor scar? Does it look like a thin line or is it really wide? Thanks in advance for any info. I'm 22 and look more like 38. I need a HT badly. I'm gonna make sure I research whatever doc I go to and that he's really reputable like Shapiro.

[Guest]

First off, just thought I'd say great job on the site, Pat! It's definitely done a good job educating me about HT procedures. Anyways, I have a question for you and the docs here.

 

I'm 22 and I'm somewhere between a late norwood 3/late 4. I have a sharp widow's peak with a growing spiot in the back. I won't be getting a HT until I start Propecia and either Rogaine or Xandrox which will be within the next month. But I do plan on getting a HT within the next year. I always hear about having enough donor area in the BACK. But i never hear about folks who had donor hair transplanted from the SIDES as this site mentions. Pat, did you have any hair transplanted from the sides, or just the back? Docs, do you all genrally discourage/not use hair from the sides? I'm guessing the side of the head would be a really tender and sketchy area to cut into and maybe riskier for donor scar recovery? How visiable is a donor scar? Does it look like a thin line or is it really wide? Thanks in advance for any info. I'm 22 and look more like 38. I need a HT badly. I'm gonna make sure I research whatever doc I go to and that he's really reputable like Shapiro.

[Guest]

Donor hair can be recovered from the sides.Generally, you do not retrieve donor tissue forward of the highest point of the ear lobe. In larger cases that require longer donor strips, it is common for the donor incision to extend into the sides. The hair in the side area is often of a finer caliber, and can be used in the hairline zone to produce very natural results. Some physicians will reserve the sides for later if hairline touch ups are needed or new areas of hair loss occur. If removed properly and closed with minimal tension there should only be a fine line type scar after healing has occured.

[Guest]

Dear doc,

My biggest concern about hair transplants are the scars at the back of the head. I am one who gets big thick NASTY scars(you should see my knees from surgery). I think its called keyloid scars or something. Anyways are there ways to minimize this risk, especially for people who are prone to these type of scars? thank you.

[Guest]

There is a concern performing hair transplantation on any person who has a history of forming keloid type scars. I have had cases where the patient had several keloid scars on the body, but after testing found they did not form them on the scalp. I do keloid testing, which is like doing a mini hair transplant on any person with a history of abnormal scarring.

[GNX]

IF YOU DO NOT HEAL PROPERLY FROM SCARS THAN YOU ARE AN IDEAL CANDIDATE FOR A "SCALP JOB" BY THE STRIP EXCISION THAT WILL RESULT IN AN UNSIGHTLY TELL TALE HT SCAR ON THE REAR OF YOUR HEAD.

 

DR. WOODS IS YOUR ONLY CHANCE OF NOT EXPERIENCING THAT PROBLEM. WWW.4HAIR.COM.AU

 

GNX...

[Paul J. McAndrews, M.D.]

GNX- You either work for Dr. Woods or you have very little understanding of the "Limitations of hair transplants".

The limitation to hair transplants is that there is a fixed amount of good genetic hair you can take from the back and sides of the scalp to transfer to the balding regions.

Therefore as hair transplant surgeons we should do everything in our power to "ensure the highest percent of grafts survive and grow". The last thing you want a hair transplant surgeon to do is destroy this very limited "hair bank".

When it comes to removing hair from the donor area (i.e.- hair bank), using any device {scalpel, multi-blade knife, punch excision or by Dr. Wood's punch technique} we remove this tissue blindly (i.e.- we cannot see what we have done until after we have removed the tissue). This is a huge problem since the only time we know if we transected and destroyed these hair follicles is after the damage is done (after we have removed this donor tissue). Therefore it is best to have as little surface area as possible exposed to any device removing tissue blindly. Once we have this tissue out, then we can dissect it into smaller grafts (follicular units) with full visualization of a stereoscopic microscope (which immensely decreases the transection of these very precious and limited good genetic hair follicles).

Now let's review Dr. Wood's technique to remove the donor tissue. It's a modified version of the old, antiquated technique used in the 1960-1970's. Instead of punching out 4-5 mm plugs and letting this tissue granulate in (i.e.- heal on its own), his technique punches out 1mm plugs (or whatever fancy term he wants to give this cookie-cutting device he uses to remove the donor tissue) and lets it granulate in. This technique immensely increases the surface area of tissue being exposed to a blind excision technique. This technique permanently remove this good genetic hair from the "hair bank" and replaces it with a scar (albeit a very small scar that many times is hard to see), which ultimately decreases the density of the "hair bank".

My problem with this technique is the immensely increased amount of surface area of tissue being exposed to a device that is removing the tissue blindly. This immensely increases the risk of transection (and destruction) of the hair follicles, which is the last thing we should be doing to the fixed and very limited "hair bank".

 

As far as scarring is concern"???any time you remove tissue from the body you will get a scar, however some scars are much more unnoticeable than others are. Unfortunately, some people (taking away poor surgical technique) can form much scar tissue (i.e.-keloids or hypertrophic scars). I have seen some patient's that have developed horrendous keloids from just having their ears pierced with a needle. This is much less traumatic then having a 1mm punch removed from the scalp. So when you stated that a patient is not at risk of bad scarring following the "Wood's technique" is completely false. Both strip excision and the Wood's technique can lead to bad scarring, however with proper surgical technique this risk can be minimized (but again not removed).

 

Sincerely,

Paul J. McAndrews, M.D.

Diplomate, American Board of Dermatology

 

 

IF YOU DO NOT HEAL PROPERLY FROM SCARS THAN YOU ARE AN IDEAL CANDIDATE FOR A "SCALP JOB" BY THE STRIP EXCISION THAT WILL RESULT IN AN UNSIGHTLY TELL TALE HT SCAR ON THE REAR OF YOUR HEAD.

 

DR. WOODS IS YOUR ONLY CHANCE OF NOT EXPERIENCING THAT PROBLEM. http://WWW.4HAIR.COM.AU

 

GNX...